The first stage of normal labour begins with the onset of true labour pains and ends with full dilatation of the cervix. For primi-gravida women this stage typically takes 12 hours, and for multi-gravida women it takes around 6 hours. Nursing care during this stage includes admission assessment, perineal care, monitoring contractions and vital signs, allowing rest and ambulation as tolerated, and shifting the patient to the delivery table once full dilatation is reached. Evidence shows that practices like ambulation during labour, support from a companion, and restricted vaginal exams and enemas can help make the first stage of labour safer and more comfortable.
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
Normal labor usually begins within 2 weeks (before or after) the estimated delivery date. In a first pregnancy, labor usually lasts 12 to 18 hours on average; subsequent labors are often shorter, averaging 6 to 8 hours.
Pathophysiology of Normal Labor:
A series of events that take place in female genital organs to expel the product of conception that are fetus, placenta, membranes) out of womb through the vagina into the outer world. We further describe pathogenesis and features of different stages of labor
Management of the complications of second and third stages of labour - DUUM.pptxduumnwachukwu
This presentation covers
effective strategies for managing second and third-stage labour complications. We will discuss a clinical approach for providing optimal care to patients during these critical stages of childbirth
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. NORMAL LABOUR
Series of events that
takes place in the
genital organs, in an
effort to expel the
viable products of
conception out of the
womb through the
vagina into the outer
world.
4. STAGES OF LABOUR
Ist STAGE:-
From onset of true
labour pains till the
full dilatation of
cervix. Its 12 hrs in
primigravida and
6 hrs in
multiparae.
7. 4TH STAGE
It is the stage of observation for at
least 1 hour after expulsion of the
after birth. During this period,
general condition of the patient and
the behavior of uterus are to be care
fully watched
8. First stage of labour
The first stage of labour starts with
the onset of labour pains to the full
dilatation of the cervix. This stage
takes about 12 hours in primi-
gravida and half that time for
subsequent deliveries.
9. EVENTS IN 1ST STAGE OF
LABOUR
FACTORS
Predisposing Actual
factors factors
10. Pre-disposing factors
Softening of the cervix
Fibro-musculo-glandular hypertrophy
Increase vascularity
Accumulation of fluid in between collagen fibres
Breaking down of collagen fibrils by enzymes
collagenase and elastase.
12. Actual factors
1)Uterine contractions and retractions
The longitudnal muscle fibres of upper segment are attached
with circular muscle fibres of lower segment and upper part
of cervix in a bucket holding fashion .
13. 2)Bag of memberanes
The memberanes are
attached loosely to the
decidua lining the uterine
cavity expect over the
internal os . In vertex
presentation girdle of head
fit in to lower uterine
segment and divides amnotic
cavity in to two parts that
are forewater and
hindwater. This generates
hydrostatic pressure and
dilates the cervical canal
14. Fetal axis pressure:
in longitudnal lie there is tendency of
straightening out of the fetal vertebral column
due to contractions of circular muscles of the
body of uterus, this exerts pressure on cervix
and dilates cervical canal.
15. Vis-a-tergo: it is the downward thrust of
the presenting part of fetus and upward
pull of cervix over lower uterine
segment.
16. Effacement
It is the process by which the muscular
fibres of the cervix are upward and
merges with fibres of the lower uterine
segment.
17. Lower uterine segment
As the labour
progresses wall of upper
segment becomes
thickened and there is
thining of lower
segment. A distinct ring
is produced at the
junction of two, called
physiological retraction
ring.
19. NURSING CARE DURING THE FIRST
STAGE OF LABOR:
A. Hospital Admission. After a physician or
nurse has evaluated the patient, an admission
order is written. At this point duties of nurse
are:
(1) Establish a rapport with the patient and
significant others.
(2) Remove nail paint from hands, feet, jewelry
and handover all belongings to significant
relatives
(3) Change the clothes of the women according to
policy
20. (4)Taking history
- Present labour – name
- Case number
- When labour started
- Membranes ruptured or intact
- Frequency or strength of contractions
21. - Past history
- Parity
- Character of previous labour
- Weight and condition of previous babies
- Evidence of cephalopelvic disproportion
- Maternal disease
- Rh- isoimmunization
22. (5) Perineal Preparation
Shaving of pubic hair to prevent
infection of perineal
episiotomy/lacerations.
(6) Enema
The purposes of enema are:
To stimulate uterine contractions
To assure a clean field without fecal
contamination at the time of delivery
23. (7) Rest and ambulation
Intact membranes- allowed to walk
Ruptured membranes- bed rest in left
lateral position.
(8) Diet-
Food is withheld during active labour
Fluids in the form of plain water, fruit
juice may be given in early labour
In DMC & H
Semi solid diet and liquids are allowed
during first stage
24. (9) Bladder care –
Patient is encouraged to pass urine by herself
as full bladder often inhibits uterine
contractions.
(10) Explain all procedures or routines, which
will be carried out prior to performing them.
These include:
(a)Explain activities allowed and disallowed
according to ward policies (i.e. bathroom
privileges).
(b) Use of fetal monitors to
know the fetal well being
25. 11) Initiate the patient's labor chart.
12) Orient the patient to the
surroundings.
13) Explain visiting hours or policies to
patient and relatives:
IN DMC&H
One female attendant is allowed for 24
hours
No male attendant is allowed.
26. 14) Use of partograph to assess progress of
labor as well as fetal status and well being.
NOTE: In Partograph nurse has to assess:
i) Fetal heart rate
ii) Status of liquor
C- clear
MS -meconium stained
Amniotic fluid should be carefully
examined for meconium if the fetus is in
the vertex presentation, (that is, head
first).
27.
28. VAGINAL EXAMINATION.
Only the physician or a trained
nurse performs this exam.
It is done to evaluate cervical
effacement, cervical dilatation,
status of membranes, &
station of presenting part.
Care must be taken to
perform good perineal
cleansing before and after the
procedure (vaginal
examination).
Once membranes rupture, the
exam should be limited even
further to prevent the risk of
infection.
29. CONTRACTIONS
When palpating for
contractions, place
hand over the fundal
area of the patient's
uterus.
Contractions can be
felt by fingers before
the patient actually
becomes aware of
them.
30. Contractions
The purpose of this evaluation is to assess the
ability of the uterus to dilate the cervix, help in
determining the progress of labor
1.FREQUENCY(how often in minutes
contraction occurs
2. INTENSITY: (Strength of Contractions as:-)
MILD- <20 seconds
MODERATE- 20-40 seconds
SEVERE- 40-60 seconds
3. DURATION:(How long the contraction lasts
in Seconds)
31. Vital Signs
Monitor the patient's vital signs.
(1) On admission.
(2) Every hour during early labor.
(3)Blood pressure (BP), pulse (P), and
respiratory rate (R) every 30 minutes
during active, to include the
temperature every hour.
(4) More frequently if complications arise.
32. General measures
Rest and ambulation
Vaseline may be applied to her lips to
prevent chapping.
Assist the patient in turning side to side
Elevate the bed at 30 to enhance
breathing
Avoid supine position
Prefer left lateral position
33. Criteria for shifting the patient
to delivery table
After full dilatation ( 10 cm dilatation )
shift the patient to delivery table.
35. Use of birthing ball for comfort in
pregnancy & labour
This will help to keep the deep
muscles of the spine in good
working conditions. The ball has
many uses in late pregnancy
when sitting can become so
uncomfortable. The ball support
perineal muscles without a lot of
pressure and keep the fetus
aligned in the pelvis.
36. Ambulation during labour
Ambulation in women
during labour is very
necessary during the
labour. It should be free to
adopt any position unless
there is any medical or
obstetrical contraindication.
It helps to reduce the time
period means shorter the
labour with less labour
pain.
37. Vaginal examination
It should be performed by
trained personnel only. It
should be done every
4 hourly not more
frequently and should
be carried out under
strict asepsis during labour.
38. Support during labour
According to evidenced
based practices the
presence of second
person of the women
own choice during the
labour. The second
Should be an
experienced women who
has some understanding
of the birthing process.
39. Use of enemas
There is no evidence that enemas will
shorter the length of labour and also
reduce in infection rate in post delivery.
It should be given when there is clear
indication and women has to wish to
take it.