(1) Indonesia has the 4th largest population in the world with over 265 million people spread across its archipelago of over 17,000 islands.
(2) There is a shortage of OBGY specialists in Indonesia, with only about 7,000 serving the population, far below the ideal ratio. Most specialists are concentrated in big cities.
(3) Programs aimed at reducing maternal mortality in Indonesia include the "Pink Book" given to mothers for medical records, "Puji Rochjati Score Cards" to identify high-risk pregnancies, and delivery planning stickers.
PRECONCEPTIONAL COUNSELLING A NEED OF THE HOUR in India DR. SHARDA JAIN Dr. ...Lifecare Centre
PRECONCEPTIONAL COUNSELLING DEFINITION
Pre-counselling is a meeting with health care professional (generally a doctor or nurse) by the couple before attempting to become pregnant.
PRECONCEPTIONAL COUNSELLING A NEED OF THE HOUR in India DR. SHARDA JAIN Dr. ...Lifecare Centre
PRECONCEPTIONAL COUNSELLING DEFINITION
Pre-counselling is a meeting with health care professional (generally a doctor or nurse) by the couple before attempting to become pregnant.
School of Health and Social Development, Deakin University
Presentation given at "Health Literacy Network: Crossing Disciplines, Bridging Gaps", November 26, 2013. The University of Sydney.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Better Care for clients and families experiencing or at risk for stroke or transient ischemic attacks (TIA's) using telehealth and multidisciplinary and inter-regional resources was realized in Sunrise Health Region over the course of a two year pilot.
Better Care
Jacquie Holzmann, Sunrise Health Region, Shannon Schmidt, Sunrise Health Region
Guidelines for antenatal care and skilled attendance at birth by ANMs/LHVs/SNsAnil Mishra
Abstract:
Prepared by the MOHFW in 2010 to strengthen and operationalise the 24X7 PHCs and designated FRUs in handling Basic and Comprehensive Obstetric Care including Care at Birth, this guideline reorients the service providers particularly the Auxiliary Nurse Midwives (ANMs), Staff Nurses (SNs), and Lady Health Visitors (LHVs) for providing skilled care during pregnancy and childbirth.
Keywords: Maternal Health, Newborn Child Health, Quality of Care, Health workers, ANC, Obstetric care, Guidelines, Government
Year of Publication: 2010
Source: MoHFW
School of Health and Social Development, Deakin University
Presentation given at "Health Literacy Network: Crossing Disciplines, Bridging Gaps", November 26, 2013. The University of Sydney.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Better Care for clients and families experiencing or at risk for stroke or transient ischemic attacks (TIA's) using telehealth and multidisciplinary and inter-regional resources was realized in Sunrise Health Region over the course of a two year pilot.
Better Care
Jacquie Holzmann, Sunrise Health Region, Shannon Schmidt, Sunrise Health Region
Guidelines for antenatal care and skilled attendance at birth by ANMs/LHVs/SNsAnil Mishra
Abstract:
Prepared by the MOHFW in 2010 to strengthen and operationalise the 24X7 PHCs and designated FRUs in handling Basic and Comprehensive Obstetric Care including Care at Birth, this guideline reorients the service providers particularly the Auxiliary Nurse Midwives (ANMs), Staff Nurses (SNs), and Lady Health Visitors (LHVs) for providing skilled care during pregnancy and childbirth.
Keywords: Maternal Health, Newborn Child Health, Quality of Care, Health workers, ANC, Obstetric care, Guidelines, Government
Year of Publication: 2010
Source: MoHFW
it is coming under the National ruler health mission. every year various guidelines are published by CENTRAL GOVERNMENT to improve the condition of children.
MOTHER AND CHILD HEALTH CARE is an important topic in community. They are two vulnerable group who need special care that's why government provides special care to them for preventing mortality rate of both. Mother is pillar of the family and child is future of nation.
Improving Access to Healthcare for Impoverished Communities Rotary International
Interested in global public health? Bridge to Health Medical and Dental has worked in partnership with local grassroots organizations in rural communities in southwestern Uganda and Ethiopia to provide education and training, clinical services, and build innovative solutions to complex problems. Come learn about these initiatives, connect with Rotarians who build sustainable collaborations to improve health and education, and be inspired to take action.
This slide contains information regarding Maternal and Child Health Program. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
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
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.
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
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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!
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
2. Indonesia (インドネシア)
• Population: estimated around 265.555.7241 as of 22 January 2018 -
4th country with the most population
• Area: 1.910.931 km2 = 5x Japan.
• Archipelago - The largest archipelagic state and island state in the
world by area and population. Ranked 14 in the world2
• Religion: 87.2% Islam, 7% Protestant,
Catholic 2.9%, Hinduism 1.6%, Buddhism 0.72% 11
3. OBGY specialist in Indonesia (SpOG)
• Total number = 71263 (2017)
• Ratio = about 1/76.000 while ideal ratio 6/100.000 based on
Indonesia Sehat Indicator 2010
• POGI = Indonesian Obstetric and Gynecologist Association
• Available consultants = oncology, fertility, fetomaternal,
urogynecology-reconstruction, social obstetrics.
• More concentrated in big city4 (ex: in Jakarta there are about 740
SpOG 2015)
4. OBGY education
• About more or less 18 public universities offer the education
• Finish more or less 4.5-6 years ( depends on the university)
• There are selections (written test, interview test, some OSCE) and
requirements ( ex: minimum GPA 2.75, age maximum 35, TOEFL score
>500 etc)5
• We don’t get paid, but pay for our education.
• In the end there is national board test
• After finish education, we must practice in small city/area for 1 year
(compulsory as of 2017)6,7,8
5. Epidemiology
• Fertility rate = 2.49,10
• Average marriage age = men 25.7, women 22.39
• About 80% of delivery in Indonesia is helped by medical service
provider and in health care facility. ( Indonesia Health Profile 2015)
• About 90% of the pregnant mother in Indonesia have at least 4 times
check up in their pregnancy ( Indonesia Health Profile 2015)
6. Maternal Mortality Rate • WHY?
• 3 Late
• to make decision
• to reach destination
• for treatment because
of resource
• 4 Too
• Young
• Old
• Many
• Close
Indonesia Health Profile 2015
Some area have very low number of birth
rate in the health facilities as low as 26%
7. Cause
• Postpartum Hemorrhage
• Hipertensive Disease in
Pregnancy
• Infection
• Long labor
• Abortion
• Emboli?
Indonesia Health Profile 2015
8. Health Care System
• Health care system in Indonesia is referral system
Modified from : https://www.slideshare.net/deniiskandar/indonesia-health-delivery-and-financing-sys
Primary Health
Care/ Puskesmas
Midwives/Kader /
people from PHC
ObsGyn Specialist
ObsGyn Subspecialist
General Practitioner
(sometimes with maternal
USG Training)
“Smart People”
9. Primary Health Care
• Polindes – ANC basic & counseling
• Poli KIA – Mother and child outpatient
• ANC advanced - 10T (height, blood pressure, fundal height, upper arm
circumference, tetanus toxoid status, iron tablets) + dental screening + blood
test (HIV rapid + Hb) – some PHC
• K1 and K4 – 1st visit and total 4 visits minimally (1 x T1, 1 xT2 and 2 xT3)
• Sometimes maternal USG is available in the PHC
• Contraception (Depo Progestin every month, Implant or IUD copper-T)
• Given the PINK book and evaluation of the high-risk pregnancy in first visit
Picture taken from : http://beranisehat.com/archives/puskesmas-fasilitas-kesehatan-yang-masih-banyak-dikeluhkan/
10.
11. Instruments used to help reduce MMR in
Indonesia
• Mother and Children Book / Pink Book
• Puji Rochjati Score Card
• Sticker delivery planning
• AMP ( Audit maternal – perinatal )
12. Pink Book
• This book is given to the mother at the
first visit in the primary health care
• This book is integrated with the children
growth chart can be used up to 5 years
• Used for education (pregnancy, labor,
pueperium and contraception) , medical
records
13. Poedji Rochjati Score Card • Score 4
• Young age <16
• Old age >35
• Pregnant after 4 year married
• Secondary primigravida
• Pregnant again in less than 2 year
• Short stature <145
• Abortion history
• Maternal disease (TB, DM,
cardiac, anemia, malaria, STD)
• Gemelli / twins / more
• Grande multi ( >P3)
• IUFD
• Postdate
• Polyhydramnion
• Previous assisted delivery
• Score 8
• Previous CS
• Breech or transverse
• Bleeding
• Preeclampsia/Seizure
Image taken from : http://khazanahdokter.blogspot.jp/2008/07/kartu-skor-poedji-rochyati.html
Start with score of 2, if >= 10 = high risk pregnancy go to
hospital for delivery
14. • This sticker is the planning during labor including the
dates, location of delivery, transportation, the person
who will donate blood if needed, and is sticked in front
of the house.
15. Interesting facts about Indonesia
• Marriage in early age = sometimes arranged marriage
• Sometimes people practice taaruf and it occurs not only in rural
areas, but also in cities.
• Some people in Indonesia, especially in the rural areas, sometimes
believe in alternative therapy (herbal/spiritual) first, rather than
medical professional and in the end the come in the late condition.
And they are very disclosed in giving this information.
• Sometimes autonomy is overridden with family decision.
16. Dukun Beranak / “Smart people”
• Some Indonesian in the rural area still
believe in the “smart people”
• These people have the knowledge from
their predecessor, but didn’t have any
medical education/training.
• They provide delivery service
• In other field we have also “ sangkal
putung” the people who deals with
fracture and sometimes Indonesian
believes these people with herbal
therapy/ alternatives then come up late
in the hospital, already in bad condition.
https://www.motherandbaby.co.id/article/2014/12/6/2929/Indonesia-Masih-Percaya-Dukun-Beranak