This document discusses techniques for fetal age estimation using obstetric ultrasound. It begins with an introduction to obstetric ultrasound, describing its history and uses. It then covers ultrasound technology and transducer principles. The main uses of obstetric ultrasound are established as determining fetal number, position, growth and detecting abnormalities. Examination types like transabdominal and transvaginal ultrasound are described. The document outlines fetal assessment and measurements used in each trimester to estimate gestational age, including crown-rump length in the first trimester and biometric parameters like biparietal diameter in later stages. Fetal age estimation is emphasized as fundamental to obstetric care, with ultrasound providing a reliable method.
Cervical ripening is the preparation of the cervix for labour and delivery. The Bishop score is the commonest used methodology to assess it. For more like this visit my page on YouTube https://www.youtube.com/@mudiagaakpoghene2243
Nuchal translucency
It is a sonographic pre natal screening scan to detect cardiovascular abnormality in a fetus.
NT can also detect altered extra cellular matrix composition and limited lymphatic drainage
Obstetrical Ultrasound• Introduced in the late 1950’s ultrasonography is a safe, non- invasive, accurate and cost-effective means to investigate the fetus• Computer generated system that uses sound waves integrated through real time scanners placed in contact with a gel medium to the maternal abdomen• The information from different reflections are reconstructed to provide a continuous picture of the moving fetus on the monitor screen
Cervical ripening is the preparation of the cervix for labour and delivery. The Bishop score is the commonest used methodology to assess it. For more like this visit my page on YouTube https://www.youtube.com/@mudiagaakpoghene2243
Nuchal translucency
It is a sonographic pre natal screening scan to detect cardiovascular abnormality in a fetus.
NT can also detect altered extra cellular matrix composition and limited lymphatic drainage
Obstetrical Ultrasound• Introduced in the late 1950’s ultrasonography is a safe, non- invasive, accurate and cost-effective means to investigate the fetus• Computer generated system that uses sound waves integrated through real time scanners placed in contact with a gel medium to the maternal abdomen• The information from different reflections are reconstructed to provide a continuous picture of the moving fetus on the monitor screen
In this presentation we will discuss
First trimester US especially TVS is an integral part for confirmation of intrauterine pregnancy and to rule out ectopic pregnancy.
First trimester US helps us in suggesting conceptus viability.
First trimester US especially TVS is very efficient in approaching and evaluating the cause of vaginal bleeding.
Obstetric ultrasound uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother's uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies.
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Prenatal Assessment of Gestational Age - Case Presentation Nawras AlHalabi
Prenatal Assessment of Gestational Age - Case Presentation
تقدير عمل الحمل، حالة سريرية.
Faculty of Medicine of Syrian Private University
كليّة الطّبّ البشريّ في الجامعة السّوريّة الخاصّة
20-12-2015
Smart sonography is an ultrasound Diagnostic Centre in Accra. We provide ultrasound services and basic ultrasound training for health practitioners. If you wish to train with us visit our website at www.smartsonography-gh.com.
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
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
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.
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.
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.
- 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
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
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
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.
3. Sequence
• Introduction to Obstetric Ultrasound
• Technology
• Common Uses
• Types of USG
• Indications of Ultrasound Examination
• Application of Ultrasound in Trimesters
• Fetal Age Estimation
• Conclusion
• Q & A session
3
5. Introduction to Obstetric Ultrasound
• Use of ultrasound scans in pregnancy
• Introduced in late 1950s
• Provision of good information about the fetus
and its environment
• Determining early intervention or conservative
management
• Safe, non-invasive, accurate, and cost-effective
investigation in fetus
• Important role in care of pregnant women
5
6. Ultrasound Technology
• Principle of SONAR, used by bats and ships
• Generation of high-frequency sound waves
through a transducer
• Pulsed sound waves penetrate till structures of
different tissues densities is reached
• Reflected energy to the transducer is amplified
and displayed on a screen
• Detection of breathing, cardiac actions and vessel
pulsations through real-time ultrasonography 6
8. Common Uses of Obstetric USG
• Obstetrical ultrasound is a useful clinical test to:
– Establish the presence of a living embryo/fetus
– Estimate the age of the pregnancy
– Diagnose congenital abnormalities of the fetus
– Evaluate the position of the fetus
– Evaluate the position of the placenta
8
9. Common Uses of Obstetric USG
cont
– Determine if there are multiple pregnancies
– Determine the amount of amniotic fluid around the
baby
– Check for opening or shortening of the cervix or
mouth of the womb
– Assess fetal growth
– Assess fetal well-being
– Suspected hydatidiform mole
9
10. Common Uses of Obstetric USG
–
–
–
–
–
–
–
–
–
cont
Suspected fetal death
Suspected uterine abnormality
UCD localization
Ovarian follicle development surveillance
Biophysical profile after 28 weeks of gestation
Observation of intra-partum events
Suspected poly- or oligohydramnios
Suspected abruptio placenta
Adjunct to external version from breech to vertex
presentation
10
11. Types of Ultrasonography
• Trans Abdominal Ultrasonography (TAS)
• Trans Vaginal Ultrasonography (TVS)
• Doppler Ultrasound
• Tissue Harmonic Imaging (THI)
• Three-dimensional Ultrasound (3-D USG)
11
12. Trans Abdominal Ultrasound (TAS)
• Major technique for imaging in 2nd and 3rd trimester
• Patient to have full bladder because
– Pushes the uterus out of the pelvis
– Provides an acoustic window
– Displaces pelvic bowel loop superiorly
• Real-time ultrasound equipment includes:
– Sector transducers, when access is limited
– Linear curved array transducers, for less distortion
and greater field of view
12
14. Trans Vaginal Ultrasound (TVS)
• Method of choice for
– Monitoring infertility disorders
– Diagnosis of ectopic pregnancy
– Differentiation of normal and abnormal 1st
trimester pregnancy
– Diagnosis of congenital anomalies in 2nd trimester
• Patient to have empty bladder because
– Uterus will be pushed posteriorly out of the field
of view of the transducer
14
15. Trans Vaginal Ultrasound (TVS)
cont
• Specially designed high frequency transducers
• Higher resolution images
• Favorable for obese patients or in early stage of
pregnancy
• Limitations include
– Reduced beam penetration
– More invasive nature of the technique
15
17. Doppler Ultrasonography
• Most widely employed for detection of:
– Fetal cardiac pulsation
– Pulsation in various fetal blood vessels
• Doppler waveform for useful information about
intra-uterine growth retardation
• Use remains controversial due to increased power
17
19. Tissue Harmonic Imaging (THI)
• Processing of lower amplitude, higher frequency
waveforms accompanying fundamental frequency
• Lesser clutter and scatter
• Better visualization of fetal structure
19
23. Application of Ultrasound in Trimesters
• First Trimester
– Commonly performed at 9-12 weeks
• 2nd and 3rd Trimester
– Commonly performed at 18-20 weeks
23
24. Obstetric USG in 1st Trimester
• Identification of Gestational sac and Embryo
First trimester fetus and yolk sac
24
25. Obstetric USG in 1st Trimester
cont
• Recording the presence or absence of fetal life
Embryo 4 weeks
25
26. Obstetric USG in 1st Trimester
cont
• Identification and documenting the fetal number
Two gestational sacs,
each containing a yolk sac
26
27. Obstetric USG in 1st Trimester
cont
• Evaluation of Uterus and Adnexal structures
Uterus and cervical plug
27
28. Obstetric USG in 1st Trimester
cont
• Measurement of Nuchal Translucency
Nuchal
Translucency
28
32. Obstetric USG in 2nd and 3rd Trimester
• Fetal life, number and presentation
• Amount of amniotic fluid
32
33. Obstetric USG in 2nd and 3rd Trimester cont
• Record Placental localization
• Establishment of fetal age and growth by fetal
biometry including
–
–
–
–
Bi-parietal Diameter
Head Circumference
Femur Length
Abdominal Circumference
33
34. Obstetric USG in 2nd and 3rd Trimester cont
• Evaluation of the uterus and adnexal structures
• Evaluation of fetal anatomic structures :
– Cerebellum and Cerebral ventricles
– Spine
– Stomach-bowel, abdominal wall at the area of the
umbilical cord insertion
– Bladder and kidney
– All four Limbs
– Four chamber view of the heart
34
36. Fetal Age Estimation
• Assessment of gestational age is fundamental to
obstetric care
• Ultrasound is a reliable method for establishing
the length of pregnancy
36
37. Fetal Age Estimation in 1st Trimester
• Identification of Gestational sac
– Correlation of MSD and CRL with menstrual age
• Visualizing of Embryo by TVS and TAS
– Estimation of gestational age by crown-rump length
• Nuchal Translucency assessment in 1st trimester
37
39. Fetal Age Estimation in 2nd & 3rd Trimester
• Bi-parietal diameter measurement
– Around 09 weeks until end of pregnancy
• Head Circumference measurement
– Gestational age prediction when abnormal skull shape
– Measured on same plane as Bi-parietal diameter
• Abdominal Circumference measurement
– Measurement similar to head circumference
– Less accurate for establishing gestational age
– Perpendicular plane to the long axis of fetus
39
40. Fetal Age Estimation in 2nd & 3rd Trimester
Bi-parietal diameter and head circumference measurements
40
42. Fetal Age Estimation in 2nd & 3rd Trimester
• Femur measurement
– Only long bone measured routinely
– Fetal age assessment when head cannot be utilized
for Bi-parietal diameter
• Multiple Fetal growth parameters
– Single parameter increases variability in predicting
fetal age in 3rd trimester
– Variability reduction through parameter combination
42
44. Conclusion
• Fetal age estimation is fundamental to obstetric
care
• Ultrasound is a reliable method for establishing
the length of pregnancy and in this way can
improve obstetric care
44