Face presentation occurs when the fetal chin presents at the pelvic inlet. The mentum engages in either a right or left oblique diameter. While mentoanterior positions often rotate anteriorly and deliver vaginally, mentoposterior positions have a 25% chance of persisting or rotating posteriorly, requiring cesarean section. Brow presentation involves the fetal forehead presenting and is not suitable for vaginal delivery due to the large engaging diameter. It usually converts to vertex or face but if persistent requires cesarean section.
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
this is the first part of my FACE PRESENTATION.this ppt contains all the required content for a face presentation and mechanism of labour in face presntation and also for diagnosis i uploaded another ppt. the main objective of my ppt is the viewers shouldn't get bored of what we say this is simplified yet professional .. have a look at it and enjoy, thank you.
This topic contains definition, incidence, types, causes, diagnosis, mechanism, management of occipito posterior position and deep transverse arrest and manual rotation of occipito posterior position
this is the first part of my FACE PRESENTATION.this ppt contains all the required content for a face presentation and mechanism of labour in face presntation and also for diagnosis i uploaded another ppt. the main objective of my ppt is the viewers shouldn't get bored of what we say this is simplified yet professional .. have a look at it and enjoy, thank you.
This topic contains definition, incidence, types, causes, diagnosis, mechanism, management of occipito posterior position and deep transverse arrest and manual rotation of occipito posterior position
This is the relationship of the longitudinal axis of the fetus to longitudina...ssuser0d3989
Breech Presentation: This is one of the most well-known anomalies in fetal positioning. In a breech presentation, the baby's buttocks or feet are positioned to emerge first during childbirth, rather than the head. Breech presentations occur in approximately 3-4% of full-term pregnancies. There are different types of breech presentations, including frank breech, complete breech, and footling breech.
Transverse Lie: In this position, the fetus is lying horizontally across the uterus, with its head on one side and its feet on the other. This positioning can obstruct the birth canal and make vaginal delivery difficult or impossible.
Face Presentation: This occurs when the fetus presents with its face rather than the top of its head toward the birth canal. Face presentations are relatively rare and may result in prolonged labor or the need for cesarean delivery.
Occiput Posterior Position: In this position, the fetus is facing the mother's abdomen rather than her spine, with the back of the baby's head (occiput) against her spine. This position can lead to back labor and increased discomfort during childbirth.
Compound Presentation: In a compound presentation, one of the baby's limbs (such as an arm or hand) presents alongside the head during delivery. This can complicate the delivery process and increase the risk of injury to both the baby and the mother.
Asynclitic Presentation: This occurs when the baby's head is tilted to one side, making it difficult to descend through the birth canal. Asynclitic presentations can prolong labor and increase the likelihood of instrumental delivery (e.g., forceps or vacuum extraction).
Anomalies in fetal position can be diagnosed through physical examination, fetal ultrasound, or other imaging techniques. Management of these anomalies may involve techniques to try to manually correct the position of the fetus, such as external cephalic version for breech presentations, or interventions during labor and delivery, such as cesarean section.Breech Presentation: This is one of the most well-known anomalies in fetal positioning. In a breech presentation, the baby's buttocks or feet are positioned to emerge first during childbirth, rather than the head. Breech presentations occur in approximately 3-4% of full-term pregnancies. There are different types of breech presentations, including frank breech, complete breech, and footling breech.
Transverse Lie: In this position, the fetus is lying horizontally across the uterus, with its head on one side and its feet on the other. This positioning can obstruct the birth canal and make vaginal delivery difficult or impossible.
Face Presentation: This occurs when the fetus presents with its face rather than the top of its head toward the birth canal. Face presentations are relatively rare and may result in prolonged labor or the need for cesarean delivery.
Occiput Posterior Position: In this position, the fetus is facing the mother's abdomen rather than her spine, with the
Cephalopelvic disproportion, contracted pelvis, Etiology, risk factors, management, assessment methods of cpd,clinical features,Munro Kerr muller method,imaging pelvimetry,trial of labour in CPD,conduct of Trial of labour,complications of CPD
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
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
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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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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.
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.
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Malpresentation (face, brow)
1.
2. Face: chin to glabella
Results when the head is hyperextended
with the occiput touching the fetal neck
All parts of the face from the chin to the
glabella present in the pelvis
Incidence is about 1/200-1/500 deliveries
5. Denominator The mentum (chin)
Attitude Complete extension
Engaging diameter Submentobregmatic
Possible positions Right mentoanterior (RMA)
Left mentoanterior (LMA)
Right mentoposterior (RMP)
Left mentoposterior (LMP)
6.
7. Face presentation can be primary or
secondary Primary face presentation Secondary face presentation
Multiparity Abnormal pelvic
configuration
Fetal anomalies-
Anencephaly
Meningocele
Dolichocephaly
Tumors in the neck-thyroid
enlargement, other tumors
Spasm of extensor muscles
of neck
Loops of cord around neck
Large baby
Polyhydraminos
Prematurity
8. ENGAGEMENT
Submentobregmatic diameter engages in left or right
oblique diameter
Vertical diameter between face and the biparietal
diameter > the vertical distance between the pelvic
brim and ischial spines
So the face is well below ischial spines when the bp
diameter crosses the brim
And the head is palpable per abdomen even after the
face has descended below the level of ischial spines
9. DESCENT
INCREASING EXTENSION- as the fetal
trunk descends, extension of head
increases
10. INTERNAL ROTATION- the mentum rotates
anteriorly toward the pubic symphsis through
45 degrees in mentoanterior, and 135 degrees
in mentoposterior. Rotation takes place at a
lower level than in vertex presentation
11. FLEXION
The chin hitches under the pubic symphysis
and the mouth, nose, glabella, forehead,
and occiput are born, in that order
12. RESTITUTION
Neck untwists toward the opposite side
EXTERNAL ROTATION
Shoulders rotate toward the pubic
symphysis
14. Palpation Auscutation
Umblical grip
Back anterior in
mentoanterior positions
Back posterior at the flank in
mentoposterior positions
Fetal heart heard clearly in
mentoanterior position
Toward the flank in
mentoposterior position
Second pelvic grip
Sinciput at higher level than
occiput
Groove felt between occiput
and back
Cephalic prominence on same
side as back
15.
16. chin, mouth, malar eminences, nose,
glabella felt
Mentum in anterior or posterior quadrant
17. Labor progresses normally in
mentoanterior positions since the engaging
diameter is similar to that in vertex
presentation
Majority of the mentoposterior position
also rotate anteriorly and deliver normally
25% may remain as mentoposterior or
rotate to direct posterior
19. Estimate weight of baby
Perform internal pelvimetry
Monitor
Uterine contractions
Descent of presenting part
Fetal heart rate
Cervical dilatation
Station of presenting part
rotation
Mentoanterior
If rotation is complete- normal or forceps
If no rotation- caesarean section
Mentoposterior
If rotates anterior- normal
If no rotation- caesarean section
Oxytocin augmentation
Only if baby weight average, pelvic configuration normal
20.
21. Caesarean section is required if
Fetus is large
Mentum does not rotate anteriourly 1 hour
after full dilatation
Fetal heart rate abnormalities occur
22. Brow- anterior fontanelles to supraorbital
ridges
In brow presentation all the structures
from the orbital ridges to the anterior
fontanelle are present at the pelvis
23. Most common
Prematurity
Multiparity
Cephalopelvic disproportion (CPD)
Others
Tumour of neck
Spasm of neck
Polyhyrdoamnios
24. Denominator – Frontum
Attitude – Partial extension
Engaging diameter –Vertico-mental(13.5)
Positions
LFA
LFP
RFA
RFP
VAGINAL DELIVERY NOT POSSIBLE (unless
the fetus is very small or premature or the
pelvis is very roomy)
25. Usually found early in labor
With good contractions, flexes to vertex or
extends to face presentation
If it persists in established labor, there is no
mechanism of labor or delivery
If undiagnosed, can lead to rupture of
uterus in multigravida
26. Maternal complications- premature rupture
of membranes, prolapse of cord, if
undiagnosed can lead to uterine rupture
Fetal complications- related to associated
anomalies, operative delivery and
obstructed labor
27. On abdominal examination, head feels
broader
Sinciput is higher than the occiput but not
so high as in face presentation
Diagnosis with certainty only on vaginal
examination
Anterior fontanelle, forehead, and orbital
ridges are felt
28. If diagnosed in early labor, the mother is
monitored closely and vaginal exam
repeated every 4-6 hours to see conversion
If diagnosed in active labor, cesarean is
indicated
Oxytocin augmentation not recommended