second trimester medical termination of pregnancy in very crucial in terms of place where it is done, person who conducts it and method followed to conduct it. the PPT deals with only second trimester of MTP based on a case scenario
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
Obstetric instruments power point presentaion jagan _jaggi
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Image result for obstetric instrumentswww.slideshare.net
Our gynaecology instruments include: Forceps & Clamps - For uterine and caesarian birthing, hysterectomy and other obstetrics and gynae surgery. Cervical Dilators - For stretching the cervical wall and dilating the cervical muscles. Vaginal Speculums - Used in procedures such as the pap smear.
Dilatation and curettage (D & C) is a procedure to remove tissue from inside the uterus. Doctors perform D & C to diagnose and treat certain uterine conditions — such as a heavy bleeding — or to clear the uterine lining after an abortion or miscarriage.
Presentation on this topic is available on link 👇
https://youtu.be/d_JgNiYv7eU
This topic contains detail about genital prolapse in pregnancy, It's definition, incidence, types, stages, causes, risk factors, clinical features, effect of prolapse, effect on pregnancy, effect during labour and puerperium, prevention, treatment and nursing management during pregnancy, labour and puerperium.
Obstetric instruments power point presentaion jagan _jaggi
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Image result for obstetric instrumentswww.slideshare.net
Our gynaecology instruments include: Forceps & Clamps - For uterine and caesarian birthing, hysterectomy and other obstetrics and gynae surgery. Cervical Dilators - For stretching the cervical wall and dilating the cervical muscles. Vaginal Speculums - Used in procedures such as the pap smear.
Dilatation and curettage (D & C) is a procedure to remove tissue from inside the uterus. Doctors perform D & C to diagnose and treat certain uterine conditions — such as a heavy bleeding — or to clear the uterine lining after an abortion or miscarriage.
Presentation on this topic is available on link 👇
https://youtu.be/d_JgNiYv7eU
This topic contains detail about genital prolapse in pregnancy, It's definition, incidence, types, stages, causes, risk factors, clinical features, effect of prolapse, effect on pregnancy, effect during labour and puerperium, prevention, treatment and nursing management during pregnancy, labour and puerperium.
Optimising Delivery Of 1kg Fetus - Special Considerations.pptxNiranjan Chavan
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After an uncomplicated vaginal birth in a health facility, healthy mothers and newborns should receive care in the facility for at least 24 hours after birth.
The clinical management of eclampsia has gone through many changes and achieved a good result with introduction of different regime. One of the most significant developments has been the recognition of the need for a multidisciplinary approach in the management of eclampsia and its complication.
Abortions and Maternal Termination of Pregnancy pptMichael Kino
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Abortion means spontaneous or induced expulsion of products of conception before the period of viability( 28 weeks).
In medical practice, the abortion occurs in 1st trimester, miscarriage in the 2nd trimester and premature labor in the 3rd trimester.
legally all the above terms are synonymous.
recent updates Anaphylaxis and anaphylaxis shock.pptxSurjeet Acharya
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anaphylaxis is an antibody antigen reaction and commonly seen in the ER and ICU setup. in this presentation, there are updates regarding anaphylaxis (& shock) treatement.
this ppt is for the general public who do not know anything regarding Basic Life support (BLS). this ppt is made entirely in keeping in mind the knowledge of a layman in providing BLS.
Thyrotoxicosis- complete review of anatomy, physiology, types and clinical fe...Surjeet Acharya
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this presentation covers extensive pictures for clear explanation. this includes the anatomy & physiology of thyroid gland, a case review, types, clinical features and treatment of thyrotoxicosis. and the most intersting part it, it also includes Recent Advances in field of thyrotoxicosis
cataract surgery is the most common surgery which every elderly person undergoes atleast once in the lifetime. unless medical therapies arise, surgery is the mainstay for cataract correction, and all surgeries are related with some complications (major or minor)
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
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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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
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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 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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
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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.
New Drug Discovery and Development .....NEHA GUPTA
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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.
Medical termination of pregnancy in second trimester
1. A 18 year old girl was brought to the opd by her
mother with h/o amenorrhea for last 2 weeks.
Girl was dull and silent.
UPT was done by nurse and the results were
positive.
Later, the girl gave h/o 14 weeks amenorrhea. And
want to terminate the pregnancy.
YOUR APPROACH??!!!!
5. WHO?
• PG degree or diploma holder in OBG
• Completed 6 months of house surgeon in OBG
• Atleast 1 year of experience in OBG in any
hospital having all the facilities
7. Points for approval of a place by DLC
• Gynaecological examination or labor table
• Resuscitation and sterilization equipment
• Drugs and parenteral fluids
• Backup facilities (to treat shock etc.)
• Operation table and instruments for
performing abd. & gynac surgeries
• Anesthetic equipments
8. How to approach in this case??
• History
• Examination
• Diagnosis
• Investigations
• OPNION BY FELLOW OG doctor
• CONSENT
• Management
10. PG & analogs
MISOPROSTOL= 400-800microg, vaginally at 3-
4hrs (or)
600microg vaginally then
200microg oral, every 3 hrs (or)
400microg, sublingual every 3
hrs (max 5 doses)
Mean induction-abortion interval is 11-12 hrs
11.  MIFEPRISTONE & PG= 200mg oral,
misoprostol 800microg vaginal
after 36-48 hrs; then misoprostol 400microg oral every
3hrs (4 dose)
Mean induction abortion time 6.5hrs
 GEMEPROST= 1mg vaginal, every 3-6 hrs (5 dose) in 24
hrs
Mean induction-abortion time is 14-18 hrs
12. DINOPROSTONE= 20mg vaginal 3-4hrs (4-
6 dose)
PGE2 analog
Expensive
Needs refrigeration
Mean induction-abortion time is 16-17 hrs
PROSTAGLANDIN F2alpha= carboprost
tromethaine 250
microg IM 3 hrs (ten doses)
More A/E, C/I in Bronchial asthma
13. OXYTOCIN= used with IV NS alongwith other
intra-amniotic or extra-amniotic space
300units in 500mL dextrose saline is used
14. SURGICAL
D&E= less commonly done
cervical preparation (laminaria osmotic
dilator, mifepristone, misoprostol) are used
generally USG guided
oxytocin infusion can be done
15. INTRAUTERINE INSTILLATION OF
HYPERTONIC SOLUTION
EXTRA-AMNIOTIC= 0.1% ethacridine lactate,
trancervically, No.16 Foley’s catheter
Liberation of PGs (due to stripping of membrane)
from decidua & dilatation of cervix
INTRA-AMNIOTIC= abdominal route
amniocentesis is done (15 cm
18-guage needle), amount of saline to be filled is
number of weeks of gestation X 10ml
PGs are liberated (due to necrosis of amniotic
epithelium and decidua) excites uterus causing
contraction
16. C/I= in cases of cardiovascular, renal diseases
PRECAUTIONS= needle position
instillation rate (10mL/min)
vitals are to be checked and
maintained
A/E like abd pain, headache,
tingling of fingers
ampicillin 500mg thrice X 3-5d
A/E= Headache, fever, abd pain, cervical tear or
laceration, hypernatremia, renal failure, death
(0-5 in 1000 cases)
17. Intra amniotic instillation of hyperosmotic urea
40% urea sol. (80g in 200ml distilled water)
can be mixed with PGF2alpha
less complicated
induction-abortion time is 13-15 hrs
18. HYSTEROTOMY
INDICATIONS- failed in all previous attempts
fibroid in lower segment
uterine anomalies
placental abnormalities
A/E- hemorrhage, shock, anesthetic
complication, intestinal
obstruction, hernia, scar
endometriosis, menstrual abn.,
Always combined with sterilization operation
20. SUMMARY
Midtrimester termination of pregnancy is done
13-20 weeks
Medical management with PGE analogs are best
and most effective
Surgical approach is less commonly advised
