This document provides information on operative vaginal delivery and Caesarean section. It discusses the indications, techniques, risks and complications of forceps delivery, vacuum extraction and Caesarean section. Forceps delivery risks maternal and fetal trauma while vacuum extraction carries lower risks of trauma but higher risks of failure. Caesarean section has a higher mortality rate than vaginal delivery but may be necessary when risks to the mother and baby outweigh vaginal delivery risks.
Brief overview of operative vaginal delivery as a method of expediting the second stage of labor. The presentation covers both forceps and vacuum delivery including their indications, applications and complications.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
Brief overview of operative vaginal delivery as a method of expediting the second stage of labor. The presentation covers both forceps and vacuum delivery including their indications, applications and complications.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
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.
under and post graduate best presentation ever about the assisted vaginal delivery,operative vaginal delivery, or instrumental vaginal delivery.
done by waill salan al.timeemi/stager 2014-2015/ Iraq-al.qadisiyyah college of medicine.
VACUUM DELIVERY - OBSTETRICS AND GYNAECOLOGY-
DEALS WITH THE DELIVERY OF HUMAN BABY BY VACUUM IN SPECIAL OBSTETRIC CONDITIONS.
VACUUM is an instrumental device designed to assist delivery by creating a vacuum between it and the fetal scalp.
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
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.
under and post graduate best presentation ever about the assisted vaginal delivery,operative vaginal delivery, or instrumental vaginal delivery.
done by waill salan al.timeemi/stager 2014-2015/ Iraq-al.qadisiyyah college of medicine.
Functional Anatomy and Innervation of Urinary TractSiewhong Ho
Dr Ho Siew Hong lectured on the anatomy and innervation of the urinary tract with special emphasis on clinical relevance during the 3rd Japan ASEAN Conference 08
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
A review of clinical pelvimetry and its usefulness in determining if a operative vaginally delivery may be performed. Multiple types of forceps are reviewed. This is a must read for all obstetric providers.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
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.
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
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!
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
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
3. Indications for assisted vaginal delivery
FETAL INDICATIONS:
◦ Malposition, (occipito-transverse and occipito-
posterior).
◦ Fetal distress
4. Maternal indications:
1. Maternal distress & exhaustion.
2. Prolonged second stage of labour:
• Nullipara: 3hours with and 2hours without regional
anaesthesia
• Multipara: 2 hours with and 1 hour without regional
anaesthesia
3. Medical conditions:
cardiac disease III/IV, hypertensive crises, aortic valve disease
with significant outflow obstruction, spinal cord injury,
proliferative retinopathy or myasthenia gravis.
5. Contraindications
◦ Forceps and vacuum extractor deliveries before full
dilatation of the cervix are contraindicated.
◦ Ventouse should not be used in:
1. gestations of less than 34 completed weeks
because of the risk of cephalohaematoma and
intracranial haemorrhage.
2. face or breech presentation.
6. Prerequisites for any instrumental delivery
◦ F: full dilatation
◦ O: OA, OP or occipito transverse
◦ R: ruptured membranes
◦ C: contractions are adequate, consent
◦ E: empty bladder, experienced staff
◦ P: pelvis of adequate size
◦ S: station (below ischial spines), less than 1/5
palpable per abdomin
8. ◦ The basic premise of such instruments is that a
suction cup, of a silastic or rigid construction, is
connected, via tubing, to a vacuum source.
◦ Recent developments have removed the need for
cumbersome external suction generators and have
incorporated the vacuum mechanism into ‘hand-
held’ pumps.
9. Technique
◦ soft cups: for straightforward deliveries with an
occipitoanterior position
◦ metal cups: suitable for occipitoposterior and
transverse.
◦ centre of the cup should be positioned directly
over flexion point . This is located at the vertex, on
the saggital suture 3 cm anterior to the posterior
fontanelle and thus 6 cm posterior to the anterior
fontanelle.
10.
11. ◦ vacuum pressure (0.6 and 0.8 kg/cm2) is
built
◦ the traction plane is at 90º to the cup.
◦ no more than two episodes of breaking
suction in any vacuum delivery are safe.
◦ Maximum time from application to delivery
should ideally be less than 15 minutes.
15. The basic forceps design
• two blades with shanks,
• joined together at a lock,
• handles to provide a point for traction.
16. Technique
◦ the left blade is inserted before the right
with the accoucheur’s hand protecting the
vaginal wall from direct trauma.
◦ The axis of traction changes during the
delivery and is guided along the ‘J’-shaped
curve of the pelvis.
◦ It has been recommended that an
episiotomy be cut whenever an
instrumental vaginal delivery is performed.
20. Comparison
The ventouse, when compared to the
forceps is significantly more likely to:
◦ fail to achieve a vaginal delivery.
◦ be associated with maternal worries about
the Baby.
21. The ventouse, when compared to the forceps
is significantly less likely to:
◦ use of maternal regional/general anaesthesia.
◦ significant maternal perineal and vaginal
Trauma.
◦ severe perineal pain at 24 hours.
22. The ventouse, when compared to the forceps
is equally likely to:
◦ delivery by Caesarean section;
◦ low 5 minute Apgar scores.
23. factors contribute to delivery failure:
◦ inadequate initial case assessment – high head,
misdiagnosis of the position and attitude of the
head.
◦ failure due to traction in the wrong plane.
◦ poor maternal effort with inadequate use of
Syntocinon to aid expulsive efforts in the second
stage.
◦ failure to select the correct ventouse cup type
and/or incorrect cup position.
24. Strategies to lower the rates of assisted delivery
◦ Provision of a caregiver during labour.
◦ Active management of the second stage
with syntocinon in women with epidural
analgesia.
◦ Delayed pushing(1-2hours) in women with
epidural analgesia.
26. Definition
A Caesarean section, also known as C-section
or Caesar, is a surgical procedure in which
incisions are made through a mother’s
abdomen (laparotomy) and uterus
(hysterotomy) to deliver one or more babies.
27. Prevalence
In the UK, more than 21 per cent of all babies are now
delivered by Caesarean section.
Factors that increase in the rates of C- section:
◦ Inaccurate dating of the pregnancy.
◦ Fetal monitoring.
◦ Macrosomia.
◦ Maternal request.
28. Indications
There are many different reasons for
performing a delivery by Caesarean section.
The four major indications accounting for
greater than 70 per cent of operations are:
1) previous Caesarean sections
2) dystocia
3) malpresentation
4) suspected acute fetal compromise.
29. Other indications, such as multifetal
pregnancy, abruptio placenta, placenta
praevia, fetal disease and maternal disease
are less common.
No list can be truly comprehensive and
whatever the indication, the overriding
principle is that whenever the risk to the
mother and/or the fetus from vaginal
delivery exceeds that from operative
intervention, a Caesarean section should be
undertaken.
30. Morbidity and mortality
◦ case fatality rate for all Caesarean sections is
five times that for vaginal delivery.
◦ Some maternal deaths following Caesarean
section are not attributable to the procedure
itself, but to medical or obstetric disorders
that lead to the decision to deliver using this
approach.
31. Procedure
Informed consent:
◦ Full informed consent must always be
obtained prior to operation.
◦ It is important to remember that no other
adult may give consent for another, Where
there is incapacity to consent the doctor is
expected to act in the patient’s best interests.
32. ◦ Surgical basics
The bladder should be emptied before the
procedure.
A left lateral tilt minimizes compression of the
maternal inferior vena cava and reduces the
incidence of hypotension syndrome.
33. Skin incisions
1)The Pfannenstiel incision (low transverse) :
The skin and subcutaneous tissues are incised
using a transverse incision two fingerbreadths
above the symphysis pubis extending from and
to points lateral to the lateral margins of the
abdominal rectus muscles.
2) The infra-umbilical incision(vertical):
from the lower border of the umbilicus to the
symphysis pubis, and may be extended caudally
toward the xiphisternum.
34.
35. Uterine incisions
1)A lower uterine segment incision:
is used in over 95 per cent of Caesarean
deliveries.
2)classical section (upper uterine segment):
Used when:
A) lower uterine segment containing fibroids or
dense adhesions.
B) placenta praevia.
C) presence of a carcinoma of the cervix.
36.
37. Complications of C/S
1) Haemorrhage
2) Caesarean hysterectomy
3) Bowel damage
4) Urinary tract damage
5) Infection and endometritis
6) Thromboembolism and deep vein thrombosis
7) prolonged recovery.
8) long-term bladder dysfunction.
9) increased risks of placenta praevia and scar
rupture in subsequent pregnancies.
10) transient tachypnea of new born syndrome.