The document discusses lactation physiology and breastfeeding recommendations. It recommends exclusive breastfeeding for six months, and continued breastfeeding for at least one year. The benefits of breastfeeding for both mother and baby are outlined. Proper breastfeeding techniques and managing common issues like sore nipples and engorgement are also covered.
Health education on Antenatal care include definition,aim, objectives, registration, antenatal check up, immunization, iron & folic acid, diet, bowel care, cleanliness, clothing, shoes, dental care, care of breast, sleep, exercise, coitus, travel, smoking & alcohol, family support & dangers signs during pregnancy.
Health education on Antenatal care include definition,aim, objectives, registration, antenatal check up, immunization, iron & folic acid, diet, bowel care, cleanliness, clothing, shoes, dental care, care of breast, sleep, exercise, coitus, travel, smoking & alcohol, family support & dangers signs during pregnancy.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Hyperemesis Gravidarum - Disorder of PregnancyJaice Mary Joy
Hyperemesis gravidarum is characterized by severe nausea and intractable vomiting sufficient to interfere with maternal nutrition causing deleterious effect on her health. It has got deleterious effect on health of the patient and incapacitates her day-to-day activities. According to the national health portal 0.3%-3% pregnant women suffer from hyperemesis gravidarum – commonest indication for hospitalization in the first trimester of pregnancy.
This document covers following topics -
• Introduction
• Definition
• Prevalence
• Etiology
• Risk factors
• Theories behind hyperemesis gravidarum
• Symptoms:
• Signs
• Investigation
• Diagnosis
• Complications
• Prevention
• Management principles
• Nursing management
This presentation is related with the contents regarding breast feeding. It includes complete information about breast feeding including different pictures and beautifully designed.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Hyperemesis Gravidarum - Disorder of PregnancyJaice Mary Joy
Hyperemesis gravidarum is characterized by severe nausea and intractable vomiting sufficient to interfere with maternal nutrition causing deleterious effect on her health. It has got deleterious effect on health of the patient and incapacitates her day-to-day activities. According to the national health portal 0.3%-3% pregnant women suffer from hyperemesis gravidarum – commonest indication for hospitalization in the first trimester of pregnancy.
This document covers following topics -
• Introduction
• Definition
• Prevalence
• Etiology
• Risk factors
• Theories behind hyperemesis gravidarum
• Symptoms:
• Signs
• Investigation
• Diagnosis
• Complications
• Prevention
• Management principles
• Nursing management
This presentation is related with the contents regarding breast feeding. It includes complete information about breast feeding including different pictures and beautifully designed.
Lactation management is the science and art of assisting women and infants with breastfeeding, because the mother-infant pair is dynamically interrelated for breastfeeding, it is imperative to consider both individuals when attempting to assess and “manage” breastfeeding.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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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
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.
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
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Introduction
”The more we know
about human breast
milk the more we
discover about its
value in human
nutrition and
development”.
3. American Academy of
Pediatrics Recommendations
Exclusive breastfeeding for the first six months of
life
Continued breastfeeding for at least one year,
As long as is mutually desired by mother and child
4. Exclusive breast feeding
Exclusive breast feeding
means feeding the baby with
breast milk soon after birth
and continuing it until 6 month
of age without giving baby
any other food .The baby is
given only breast milk and
nothing else whenever the
baby is hungry.
5. Components and benefits of Breast milk
1. Carbohydrates:-
2. Proteins
3. Fats
4. Vitamins & Minerals
5. Water & Electrolytes
6. Immunological Superiority
7. Protection against other illness
8. Growth & Development
9. Easily digestible
6. Cont…
Benefits to mother
Helps uterine involution
Reducing chances of postpartum
hemorrhage.
Lactational amenorrhea
Helps in birth spacing.
Convenient & time saving.
Reduces the risk of cancer
Improves the figure of the mother
9. Physiology of Lactation
The physiological basis of lactation
is divided into four phases :-
1. Preparation of breasts
(Mammogenesis).
2. Synthesis and secretion from the
breast alveoli (lactogenesis).
3. Ejection of milk (galactokinesis).
4. Maintenance of lactation
(galactopoiesis).
12. Lactogenesis:-
1. Begins when estrogen and progesterone
are withdrawn following delivery,
2. Prolactin begins its milk secretary activity
3. The secretary activity is enhanced growth
hormone, thyroxine, glucocorticoids and
insulin.
4. Milk secretion actually starts on 3rd or 4th
postpartum day
13. Galactokinesis/Milk let down reflex
Discharge of milk from the
mammary glands depends
not only on the suction
exerted by the baby during
sucking but also on the
contractive mechanism which
expresses the milk from the
alveoli into the ducts.
14.
15.
16. Galactopoiesis
Prolactin appears to be the
single most important
galactopoietics hormone. For
maintenance of effective and
continuous lactation, suckling
is essential.
17. Milk production
A healthy mother may
produce about 500-800 ml
of milk a day to feed her
infant with about 500 kcal
/day
18. Reflexes in the baby
The rooting
reflex
The suckling
reflex
The
swallowing
reflex
19. Factor Which Lessen Milk
Production:-
Bottles feeds -even one or two feeds.
Making the baby wait for feeds.
Giving feeds like sugar water, honey, formula feeds
or at anytime.
Certain medications for mothers like oral
contraceptives or methargine.
Painful breast conditions like sore or cracked nipples,
congested breast & breast engorgement.
20. Drugs to improve milk
production:-
Metclopramide (10 mg thrice
daily) increases the blood volume
by increasing prolactin level.
Intranasal oxytocin contracts
myoepithelial cells and causes
milk let down
21. The Varying Composition of
Breastmilk
Colostrum
Transitional milk
Mature milk
Preterm milk.
Fore milk
Hind milk
22. Colostrum
Colostrum is the milk secreted during the first three
days after delivery. It is yellow & thick & contains
more antibodies & cells & high amounts of vitamins
A, D, E & K.
23. Initiation of breastfeeding
Breast feeding should be started within half an hour
of birth as soon as possible after normal delivery
where as in case of caesarian section
delivery,within 4 hours. Rooming in and bedding
should be done with mother and baby to prevent
separation and promote breast feeding.
24. Technique of
Breastfeeding:-
Positioning:-
Baby’s head & body straight.
Baby’s body turned towards the mother, nose opposite
the nipple.
Baby’s body touching mother’s abdomen.
Baby’s whole body well supported not just neck or
shoulders.
Mother should than support her breast with her finger
flat against her chest wall under her breast.
25.
26.
27.
28.
29.
30.
31. Good Attachment
Baby’s mouth wide open.
Baby’s lower lip averted.
Upper areola more visible than the lower.
Baby’s chin touching the breast.
32.
33. Effective suckling
Baby’s cheeks are full & not
hollow.
Baby suckles pauses & suckles
in regular deep sucks.
34.
35. Principles of breast feeding:-
Breast feeding should be done in as clean and
safe as manner as possible.
The mother and baby should be comfortable
and relaxed at feeding time.
Breast feeding should be initiated within the
first half hour after birth.
Colostrum is most suitable food for the baby
during the first few days after birth because it
contains a high concentration of nutrients and
anti-infective substances
36. The intervals between feeds vary between 1-4
hours.
Starting from the initial 5 mins of feeding, the
time can be gradually increased to 15 to 20
minutes in the subsequent days
Burping should be done after the feeding in order
to kick out the swallowed air.
The baby should be allowed to suckle from both
the breasts during each feeding.
It is desirable to feed the baby on demand it
helps baby to gain weight.
The mother should be instructed to feed the child
even when the child is ill.
37. Contraindication of breast
feeding:-
In Mother
1. Chronic disease such as active TB,
leprosy, AIDS etc.
2. Mothers addicted to alcohol or heavy
doses of some drugs.
3. Psychosis
4. Local condition like breast abscess,
cracked nipples
The mother should give adequate attention
to her diet, personal hygiene and health and
should have sufficient rest.
38. Contraindication…….
In infant:-
Gross prematurity of baby or other
conditions in which the newborn
cannot suckle.
Inborn errors such as
phenylketonuria, lactose intolerance.
39. Problems in breastfeeding
Treatment is started after
birth of the baby.
The nipple is manually
stretched & rolled out
several times a day.
A pump or a plastic syringe
is used to draw out the
nipple & the baby is then
put to the breast.
40. Sore nipple
Correct positioning & latching of the
baby to the breast.
Hind milk should be applied to the
nipple after a feed.
The nipple should be aired & allowed
to heal in between feeds
If the baby has oral thrush, treat it and
apply the same medicine on mother’s
nipple.
If sucking is impossible for a day or
two express the milk and feed the
baby from cup.
41. Breast engorgement
Treatment:-consists of local warm
water packs, & analgesics to the
mother to relieve the pain.
Allow the baby to suckle as far as
possible. If the baby cannot get hold
of an engorged breast, help the mother
to express milk. Milk should be gently
expressed to soften the breast to make
the mother comfortable& then the
mother must be helped to correctly
latch the baby to the breast. Hand
expression is preferable.
42. Breast abscess, Blocked duct,
Mastitis
Treatment:-
Mother must be treated with milk expression, analgesics and
antibiotics.
The abscess may have to be incised and drained.
Breastfeeding must be continued from the other breast.
If sucking is painful, help her to express her milk every 3 hours.
Warm compression help to relieve pain.
If mother develops fever, chills, body ache, she may need a full
course of antibiotics
43. Others
Menstruation and pregnancy:-
Mother can feed during menstruation and half way
through pregnancy. If she is eating well, breast
feeding can continue throughout the pregnancy.
Maternal illness:-
Most maternal illness does not require
discontinuation of breastfeeding. It is recommended
with mastitis, Breast abscess, UTI, TB, hepatitis,
typhoid, leprosy.
44. Human milk bank
A human milk bank is
a service which
collects, screens,
processes, and
dispenses by
prescription human
milk donated by
nursing mothers who
are not biologically
related to the recipient
infant.
Donor’s requirement:-
1. Be healthy
2. Be in the process of
lactation
3. Undertake a chest x-ray
4. Have a negative VDRL
5. No evidence of Hepatitis
45. Storage of milk
Milk can be stored at in the freezer at 20o C at home.
Milk is stored at room temperature upto 10 hours.
Milk can be stored at -40C upto 8 days.
46. Research study
According to some authorities, increasing evidence
suggests that early skin-to-skin contact (also
called kangaroo care) between mother and baby
stimulates breastfeeding behaviour in the
baby. Newborns who are immediately placed on their
mother’s skin have a natural instinct to latch on to the
breast and start nursing.According to studies cited
by UNICEF, babies naturally follow a process which
leads to a first breastfeed.
47. Cont..
Initially after birth the baby cries with its first
breaths. Shortly after, it relaxes and makes small
movements of the arms, shoulders and head. The
baby crawls towards the breast and begins to feed.
After feeding, it is normal for a baby to remain
latched to the breast while resting. This is sometimes
mistaken for lack of appetite.