This document provides an outline on normal labor and the mechanism of labor. It defines labor as the physiological process of expelling the fetus, placenta, and membranes through the birth canal after 24 weeks of pregnancy. Normal labor fulfills criteria of spontaneous onset at term, vertex presentation, no prolongation, and natural termination with minimal aids. The document describes the three stages of labor as well as the cervical changes, fetal positioning, and mechanisms involved in labor including engagement, descent, flexion, rotations, and expulsion of the fetus through the birth canal. It emphasizes the importance of classifying pregnancies as high or low risk and addressing any medical issues to ensure a safe delivery.
Induction of labour and prolonged pregnancyHashem Yaseen
Lecture under the tittle (Induction of labour and prolonged pregnancy) presented for the fifth year medical students in faculty if medicine in Mutah University
Labour induction
Induction of labour
Guidelines on induction of labour
Guidelines on labour induction
induction of labour is not risk free
prostaglandins for induction of labour
Bishop score
Cervical ripening techniques
mechanical and pharmacological induction of labour
Post dates induction
options for cervical ripening
oral vs. vaginal misoprostol
advantages diadvantages and techniques for induction of labour
gynecology & obstetrics
Labour induction methods
review of guidelines for labour induction
Induction of labour and prolonged pregnancyHashem Yaseen
Lecture under the tittle (Induction of labour and prolonged pregnancy) presented for the fifth year medical students in faculty if medicine in Mutah University
Labour induction
Induction of labour
Guidelines on induction of labour
Guidelines on labour induction
induction of labour is not risk free
prostaglandins for induction of labour
Bishop score
Cervical ripening techniques
mechanical and pharmacological induction of labour
Post dates induction
options for cervical ripening
oral vs. vaginal misoprostol
advantages diadvantages and techniques for induction of labour
gynecology & obstetrics
Labour induction methods
review of guidelines for labour induction
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.
what is labor and what is the normal?
what are the signs of labor?
what are the stages of labor?
what are the mechanism of labor?
what are the factors that affect the labor?
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.
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
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.
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
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
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
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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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. OUTLINE
• Definition of Labor
• Mechanism of Labor
• Stages of Labor
• Management of Normal
Labor
3. Labour
• It is a physiological process by which the
fetus, placenta and membrane are expelled
out through the birth canal after twenty four
week of pregnancy
• Parturition isthe process of givingbirth
4. Normal labour
• Normal labour is physiological process by
which the fetus ,placenta and membrane are
expelled through the birth canal after full
term pregnancy (37-42 weeks ofgestation)
5. • Labour is called normal when it fulfills
the following criteria :
Spontaneous onset at term
With vertex presentation
Without prolongation
Natural termination with minimal
aids
6. Clinical course of labour
Onset of labour: not definitely known
Mechanical factors:
- uterine distension
Hormonal factors:
1. Maternal :
o progesterone withdrawal
o oxytocin stimulation
o prostaglandins
o serotonin
2. fetal:
o fetal cortisol
o fetal membranes
3. Neuronal:
o sympathetic- alpha receptor stimulation
8. NORMAL LABOUR
FIRST STAGE
SECOND STAGE
THIRD STAGE
LATENT PHASE: 0-6cm
ACTIVE PHASE: 6-10cm
FULL DILATION TO EXPULSION OF FETUS
BIRTH TO EXPULSION OF PLACENTA
Expectant (physiological) vs Active (CCT + OT)
9. 1. True labour pains – colicky pain in the abdomen and back
are characterized by:
A Character True l.pains False l.pains
Irregular
Short duration, not
progressive
contractions
Interval between
contractions and
intensity
Changes in the cervix
Membranes
Response to analgesia
Labour
regular
Progressive (increase in
frequency and
intensity)
Associated with
effacement and dilation
of the cervix
Associated with bulging of
membranes
Not relieved by sedation
Followed by labour
Not associated with
effacement and dilation
of the cervix
Not associated with
bulging of membranes
Relieved by sedation
Not followed by labour
10. • Cervicaldilatation:
• Thecervix begins dilating and stretching
beyond the normal dimensions and is
measured in centimeters. (0-10cm).
• Cervicaleffacement:
• softening, thinning and shortening of the
cervix. It is expressedin percentage (0 –
100%)
12. Factors affecting Labor (5 P’s)
In every labor; there are five essential factors affect the
process. 5 P’s:
1. Passenger: the fetus
2. Passageway: the pelvis and birth canal
3. Powers: the uterine contractions
physical
4. Position: maternal postures and
positions
5. Psyche: the response of the mother
7
13. 1.Passenger (The Fetus):
The fetus relationship to the passageway is the major
factor in the birthing process. The relationship includes:
• Fetal skull and size
• Number of fetuses
• Position of feus
– Fetal lie: relationship of fetal spine to maternal spine;
longitudinal (vertical) or transverse (horizontal)
– Fetal presentation: part of fetus that enters pelvis first
– Fetal attitude: relationship of fetal body parts to each other;
flexion (normal) or extension (abnormal)
– Fetal position: fetal direction in the pelvis
– Fetal station: position of the baby's head relative to the lower
bone of pelvis called the ischial spines 8
19. 2. Passageway (The pelvis):
• Includes bony pelvis, soft tissues of the cervix,
and vagina.
• The maternal pelvis is the greatest determinant
in the vaginal delivery of the fetus.
• During the first stage of labor, the cervix dilates
and thins out (effaces).
• The cervix must be 100 percent effaced and 10
centimeters dilated before a vaginal delivery.
22. ST
AGESOFLABOUR:
First stage:
stageof cervical effacement and dilatation
Definition:
refers to the period from the onset of true
uterine contractions to full dilation of cervix,
when it measures 10cm.
25. Secondstage of labour:
stage of delivery of the fetus.
Definition:
the second stage refers to the period from complete
cervical dilatation to the birth of thefetus.
Duration:
primigravida =2h
multigravida =1h
However the duration of second stage is
controversial
30. Stageof
labour
Definition Duration
StageI latent
phase
(affacment)
•Beginsfrom the onset of regularcontractions.
•Endswith acceleration of cervicaldilatation
•Prepares cervix for dilatation.
<20hours in PG
<14hours MG
Stage1 active
phase
(dilatation)
•Beginswith acceleration of cervicaldilatation.
•Endsat 10 cmdilatation
•Rapid cervical dilatation
<2/hours in PG
<1.5/ hrs inMG
Stage2
(descent)
•Beginsfrom 10cmdilatation
•Endswith delivery of thebaby
•Descent of the fetus
<2hours in PG
<1hours in MG
Add 1 hour inepi
Stage3
(expulsion)
•Beginswith delivery of thebaby.
•Endswith delivery of theplacenta
•Delivery of the placenta
<30min.
31. Mechanism of Labor
19
In the normal labor; there are series of changes in position
and attitude of the fetus to accommodate himself to the
pelvic to pass easily through the birth canal:
1. Engagement
2. Descent
3. Flexion
4. Internal rotation
5. Extension
6. External rotation
7. Expulsion
32. 1. Engagement
20
of the fetal head passes
The greatest diameter
through the pelvic inlet.
2. Descent
Movement of the fetus through the birth canal
during the first and second stages of labor
3. Flexion
The chin of the fetus moves toward the fetal chest
which reduce the fetal head diameter from nearly 12
to 9.5 cm.
34. 4. Internal rotation
The rotation of the fetal head until the longest
diameter of the fetal head match the longest
diameter of the maternal pelvic.
22
35. 5. Extension
The fetal head passes beneath the symphysis
pubis and passes out of the birth canal making the
crowning.
23
36. 6. External rotation (Restitution)
After the head has delivered, the shoulders
rotate internally to fit the pelvis.
24
38. During antenatal period, the women should be
classified as high or low risk pregnancy.
The medical or surgical problems should be corrected
(anaemia, hypertension, urinary tract infection),
Vaccination
Investigations
(HIV, HCV, Hbs Ag, blood grouping).
Advise her to attend atenatal classes and hospital
delivery.