Patent ductus arteriosus (PDA) is a persistent opening between the two major blood vessels leading from the heart. The opening (ductus arteriosus) is a normal part of a baby's circulatory system in the womb that usually closes shortly after birth. If it remains open, it's called a patent ductus arteriosus.
A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications.
Treatment options for a patent ductus arteriosus include monitoring, medications, and closure by cardiac catheterization or surgery.
commonly used for medical students, and helpful to use this ppt to study for them, and also a common man can understand very easily what is coarctation of aorta.
commonly used for medical students, and helpful to use this ppt to study for them, and also a common man can understand very easily what is coarctation of aorta.
Patent ductus arteriosus (PDA) is a congenital disorder in the heart wherein a neonate's ductus arteriosus fails to close after birth. Early symptoms are uncommon, but in the first year of life include increased work of breathing and poor weight gain. With age, the PDA may lead to congestive heart failure if left uncorrected. The ductus arteriosus is a normal fetal blood vessel that closes soon after birth. In a patent ductus arteriosus (PDA) the vessel does not close and remains "patent" (open) resulting in irregular transmission of blood between two of the most important arteries close to the heart, the aorta and the pulmonary artery. PDA is common in neonates with persistent respiratory problems such as hypoxia, and has a high occurrence in premature children. In hypoxic newborns, too little oxygen reaches the lungs to produce sufficient levels of bradykinin and subsequent closing of the DA. Premature children are more likely to be hypoxic and thus have PDA because of their underdeveloped heart and lungs.
A patent ductus arteriosus allows a portion of the oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta (which has higher pressure) to the pulmonary artery. If this shunt is substantial, the neonate becomes short of breath: the additional fluid returning to the lungs increases lung pressure to the point that the neonate has greater difficulty inflating the lungs. This uses more calories than normal and often interferes with feeding in infancy. This condition, as a constellation of findings, is called congestive heart failure.
In some cases, such as in transposition of the great vessels (the pulmonary artery and the aorta), a PDA may need to remain open. In this cardiovascular condition, the PDA is the only way that oxygenated blood can mix with deoxygenated blood. In these cases, prostaglandins are used to keep the patent ductus arteriosus open
Patent Ductus Arteroisus, PDA, Cardiology, Paediatrics, Pedicatrics, Critical Care, Emergency medicine, Medicine, Internal Medicine, MBBD, MD, India, CMC Vellore, Christian Medical College
most common congenital cyanotic heart disease.one of the conotruncal family of heart lesions.. It accounts for 7 to 10% of all congenital heart abnormalities.
A cyanotic heart defect is a group-type of congenital heart defects (CHDs). The patient appears blue (cyanotic), due to deoxygenated blood bypassing the lungs and entering the systemic circulation. This can be caused by right-to-left or bidirectional shunting, or malposition of the great arteries.
Cyanotic heart defects, which account for approximately 25% of all CHDs, include:
Tetralogy of Fallot (ToF)
Total anomalous pulmonary venous connection
Hypoplastic left heart syndrome (HLHS)
Transposition of the great arteries (d-TGA)
Truncus arteriosus (Persistent)
Tricuspid atresia
Interrupted aortic arch
Pulmonary atresia (PA)
Pulmonary stenosis (critical)
Eisenmenger syndrome(Reversal of Shunt due to Pulmonary Hypertension) .
Patent ductus arteriosus may cause cyanosis in late stage.
Patent ductus arteriosus (PDA) is a congenital disorder in the heart wherein a neonate's ductus arteriosus fails to close after birth. Early symptoms are uncommon, but in the first year of life include increased work of breathing and poor weight gain. With age, the PDA may lead to congestive heart failure if left uncorrected. The ductus arteriosus is a normal fetal blood vessel that closes soon after birth. In a patent ductus arteriosus (PDA) the vessel does not close and remains "patent" (open) resulting in irregular transmission of blood between two of the most important arteries close to the heart, the aorta and the pulmonary artery. PDA is common in neonates with persistent respiratory problems such as hypoxia, and has a high occurrence in premature children. In hypoxic newborns, too little oxygen reaches the lungs to produce sufficient levels of bradykinin and subsequent closing of the DA. Premature children are more likely to be hypoxic and thus have PDA because of their underdeveloped heart and lungs.
A patent ductus arteriosus allows a portion of the oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta (which has higher pressure) to the pulmonary artery. If this shunt is substantial, the neonate becomes short of breath: the additional fluid returning to the lungs increases lung pressure to the point that the neonate has greater difficulty inflating the lungs. This uses more calories than normal and often interferes with feeding in infancy. This condition, as a constellation of findings, is called congestive heart failure.
In some cases, such as in transposition of the great vessels (the pulmonary artery and the aorta), a PDA may need to remain open. In this cardiovascular condition, the PDA is the only way that oxygenated blood can mix with deoxygenated blood. In these cases, prostaglandins are used to keep the patent ductus arteriosus open
Patent Ductus Arteroisus, PDA, Cardiology, Paediatrics, Pedicatrics, Critical Care, Emergency medicine, Medicine, Internal Medicine, MBBD, MD, India, CMC Vellore, Christian Medical College
most common congenital cyanotic heart disease.one of the conotruncal family of heart lesions.. It accounts for 7 to 10% of all congenital heart abnormalities.
A cyanotic heart defect is a group-type of congenital heart defects (CHDs). The patient appears blue (cyanotic), due to deoxygenated blood bypassing the lungs and entering the systemic circulation. This can be caused by right-to-left or bidirectional shunting, or malposition of the great arteries.
Cyanotic heart defects, which account for approximately 25% of all CHDs, include:
Tetralogy of Fallot (ToF)
Total anomalous pulmonary venous connection
Hypoplastic left heart syndrome (HLHS)
Transposition of the great arteries (d-TGA)
Truncus arteriosus (Persistent)
Tricuspid atresia
Interrupted aortic arch
Pulmonary atresia (PA)
Pulmonary stenosis (critical)
Eisenmenger syndrome(Reversal of Shunt due to Pulmonary Hypertension) .
Patent ductus arteriosus may cause cyanosis in late stage.
Intracranial hemorrhage (ICH) refers to acute bleeding inside skull or brain. It’s a life-threatening emergency.
An intracranial hematoma is a collection of blood within the skull, most commonly caused by rupture of a blood vessel within the brain or from trauma such as a car accident or fall. The blood collection can be within the brain tissue or underneath the skull, pressing on the brain.
Intracranial hemorrhage refers to any bleeding within the intracranial vault, including the brain parenchyma and surrounding meningeal spaces.
Congenital heart disease (congenital heart defect) is one or more abnormalities in your heart's structure that you're born with. This most common of birth defects can alter the way blood flows through your heart.
Congenital heart disease is one or more problems with the heart's structure that exist since birth. Congenital means that you're born with the defect. Congenital heart disease, also called congenital heart defect, can change the way blood flows through your heart. IF YOU LIKE GIVE YOUR LIKES AND FOLLOW THIS LINK
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Postpartum Hemorrhage (PPH) is a significant and potentially life-threatening medical condition that occurs after childbirth. It is characterised by excessive loss of blood, typically defined as blood loss exceeding 500 millilitres for a vaginal delivery or 1000 millilitres for a cesarean section. PPH is a critical concern due to its capacity to lead to severe maternal morbidity and even mortality.
Keratitis is an inflammatory condition that affects the cornea of your eye.
The cornea is the clear part that covers both the iris and the pupil.
Keratitis can be caused by an infection or injury to the eye.
Keratitis is a common condition.
People who wear contact lenses may experience keratitis more frequently than people who don’t wear contacts. In either case, you can take steps to help prevent this condition.
If you do develop keratitis, see your doctor right away.
Central and Peripheral Vision & their DiseasesHuzaifa Zahoor
The act or power of seeing
The special sense by which the qualities of an object (such as color, luminosity, shape, and size) constituting its appearance are perceived through a process in which light rays entering the eye are transformed by the retina into electrical signals that are transmitted to the brain via the optic nerve.
Types of Vision
Central Vision
Peripheral Vision
Disease of Vision
Central Vision Loss
Peripheral Vision Loss
Quality sexual health education (SHE) provides students with the knowledge and skills to help them be healthy and avoid human immunodeficiency virus (HIV), sexually transmitted diseases (STD), and unintended pregnancy.
A SHE curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development.
The curriculum is age-appropriate and planned across grade levels to provide information about health risk behaviors and experiences.
Sexual health education should be consistent with scientific research and best practices; reflect the diversity of student experiences and identities; and align with school, family, and community priorities.
The diaphragm is a dome-shaped muscular barrier between the chest and abdominal cavities. It separates your heart and lungs from your abdominal organs (stomach, intestines, spleen, and liver).
A diaphragmatic hernia occurs when one or more of your abdominal organs move upward into your chest through a defect (opening) in the diaphragm. This kind of defect can be present at birth or acquired later in life. It’s always a medical emergency and requires prompt surgery to correct.
Cryotherapy is the use of extreme cold to freeze and remove abnormal tissue.
Doctors use it to treat many skin conditions (including warts and skin tags) and some cancers, including prostate, cervical, and liver cancer.
This treatment is also called cryoablation.
Surgery is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment.
Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, "To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature.“
Diet therapy is a broad term for the alteration or adoption of a diet to prevent or treat a disease or to simply promote optimum health.
In some cases, an alternative dietary lifestyle plan may be developed to eliminate certain foods to reclaim health.
An incorrect diet can cause not only weight gain and skin conditions but may promote exhaustion and fatigue.
Depending on the disease, if you do not follow the diet advised to you by a specialist it may have serious consequences on your health.
A good diet can prevent various diseases.
Traditional medicine (also known as indigenous or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies before the era of modern medicine.
Rheumatic fever (acute rheumatic fever) is a disease that can affect the heart, joints, brain, and skin.
Rheumatic fever can develop if strep throat and scarlet fever infections are not treated properly.
Early diagnosis of these infections and treatment with antibiotics is key to preventing rheumatic fever.
Cushing syndrome occurs when your body has too much of the hormone cortisol over time. This can result from taking oral corticosteroid medication. Or your body might produce too much cortisol.
Too much cortisol can cause some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.
Treatments for Cushing syndrome can return your body's cortisol levels to normal and improve your symptoms. The earlier treatment begins, the better your chances for recovery.
Avicenna, an Iranian philosopher and physician of the tenth and eleventh centuries (4th and 5th century A.H.) is without doubt one of the eminent scientists and talented scholars of his own age.
His scientific fame and influence was not only spread in Iran and the Islamic world, but also extended to the whole world.
He is still known as a universal scientist in particular in medicine in the views of the researchers and historians of science history.
Greece the territory of beginning of practice of healingHuzaifa Zahoor
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The history & development of traditional chinese medicineHuzaifa Zahoor
Traditional Chinese medicine is system of medicine at least 23 centuries old that aims to prevent or heal disease by maintaining or restoring yinyang balance.
China has one of the world’s oldest medical systems.
Acupuncture and Chinese herbal remedies date back at least 2,200 years, although the earliest known written record of Chinese medicine is the Huangdi neijing (The Yellow Emperor’s Inner Classic) from the 3rd century BCE.
MODY is the name given to a collection of different types of inherited forms of diabetes that usually develop in adolescence or early adulthood.
MODY stands for “Maturity-onset diabetes of the young” and was given that name in the past because it acted more like the adult type of diabetes (Type 2 Diabetes) but was found in young people.
MODY limits the body’s ability to produce insulin, but is different than the juvenile type of diabetes (Type 1 Diabetes).
When our bodies don’t produce enough insulin, it can increase blood glucose levels. High blood glucose levels lead to diabetes.
Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in the liver.
Mere deposition of fat in the liver is termed steatosis, and together these constitute fatty liver changes.
The word is from steato-, meaning "fat“ and hepatitis, meaning "inflammation of the liver".
Ultrasonography of Heart or Cardiac ultrasonography or Echocardiogram or ultrasound of the heart is the production of two-dimensional cross-sectional images of intracardiac anatomy by stop-action compound scan pulse-echo ultrasound.
The images show the size and shape of the cardiac chambers in systole and diastole, the appearance of heart valves, and the orientation of the great vessels.
The stop-action display is created by repetitively activating the recording oscilloscope for a selected short segment of each cardiac cycle.
The activating signal is timed by the patient's electrocardiogram.
The asynchronous motion of the scanner accumulates additional echoes with each cycle.
As a non-invasive technique, it is without risk or morbidity.
The right equipment is essential for a clinic that provides physical therapy, and choosing the right medical gear for your business is rarely simple.
High-quality systems often command high prices, and ensuring you have the tools you need to help patients with both occupational health development and recovery is essential.
You don’t have to break the bank to acquire the best physical therapy equipment, but you do need to be sure that your equipment is made of sturdy material that can withstand regular use by patients with a variety of different needs and body types.
The ability to understand the routes of infection, conduct epidemiology studies and to implement effective infection control procedures are crucial to hospital hygiene management.
Prolonged patient stays lead to increased morbidity and mortality rates in many cases.
Therefore, Healthcare-Associated Infections (HAI) represent a significant cost to hospitals and hinder patient care.
Advanced microbial strain typing, hospital hygiene and infection control solutions are improving the way hospitals deal with HAI.
The vas deferens, also called ductus deferens, is part of the male reproductive system of many vertebrates; these ducts transport sperm from the epididymis to the ejaculatory ducts in anticipation of ejaculation. It is a partially coiled tube that exits the abdominal cavity through the inguinal canal.
Palestine last event orientationfvgnh .pptxRaedMohamed3
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Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. Overview
▪ Patent ductus arteriosus (PDA) is a persistent opening between the
two major blood vessels leading from the heart.The opening (ductus
arteriosus) is a normal part of a baby's circulatory system in the
womb that usually closes shortly after birth. If it remains open, it's
called a patent ductus arteriosus.
▪ A small patent ductus arteriosus often doesn't cause problems and
might never need treatment. However, a large patent ductus
arteriosus left untreated can allow poorly oxygenated blood to flow
in the wrong direction, weakening the heart muscle and causing
heart failure and other complications.
▪ Treatment options for a patent ductus arteriosus include monitoring,
medications, and closure by cardiac catheterization or surgery
3. Patent Ductus Arteriosus
▪ Patent ductus arterious, shown
in the heart on the right, is an
abnormal opening between the
aorta and the pulmonary
artery.
▪ A normal heart is shown on the
left.
4. Path physiology
▪ The ductus arteriosus is a normal
connection between the
pulmonary artery and aorta; it is
necessary for proper fetal
circulation.
▪ At birth, the rise in PaO2 and
decline in prostaglandin
concentration cause closure of the
ductus arteriosus, typically
beginning within the first 10 to 15
hours of life.
▪ f this normal process does not
occur, the ductus arteriosus will
remain patent.
Pulmonary blood flow, LA and LV volumes, and
ascending AO volume are increased.
AO = aorta; LA = left atrium; LV = left ventricle;
PA = pulmonary artery.
5. Path physiology (Contd..)
▪ Physiologic consequences depend on ductal size.
▪ A small ductus rarely causes symptoms.
▪ A large ductus causes a large left-to-right shunt.
▪ Over time, a large shunt results in left heart enlargement, pulmonary
artery hypertension, and elevated pulmonary vascular resistance,
ultimately leading to Eisenmenger syndrome.
6. Specific Inspection Findings
▪ A patent ductus arteriosus (PDA) is variable in its presentation. It
may vary in size from small to large and may not be picked up based
on physical examination at birth.
▪ Patients usually appear well and have normal respirations and heart
rates. A widened pulse pressure may be noted when the blood
pressure is obtained. Suprasternal or carotid pulsations may be
prominent.
▪ As many as one third of children with patent ductus arteriosus (PDA)
is small for their age. In the presence of significant pulmonary
overcirculation, tachypnea, tachycardia, and a widened pulse
pressure may be found.
▪ Cardiac Assessment is used to diagnose the PDA.
7. Specific Inspection Findings(Contd..)
▪ CardiacAssessment
– In neonates, a heart murmur is
discovered within the first few days or
weeks of life.The murmur is usually
recognized as systolic rather than
continuous in the first weeks of life
and can mimic a benign systolic
murmur.
8. Specific Inspection Findings(Contd..)
▪ Findings upon cardiac examination include the following:
– If the left-to-right shunt is large, precordial activity is increased, with the
magnitude of increased activity related to the magnitude of left-to-right shunt
– The apical impulse is laterally displaced; a thrill may be present in the
suprasternal notch or in the left infraclavicular region
– The first heart sound (S1) is typically normal, and the second heart sound (S2) is
often obscured by the murmur; phonocardiographic data from the past
suggested the occurrence of paradoxical splitting of S2 related to premature
closure of the pulmonary valve and a prolonged ejection period across the aortic
valve
– The murmur may be only a systolic ejection murmur, or it may be a
crescendo/decrescendo systolic murmur that extends into diastole
– Occasionally, auscultation of the patent ductus arteriosus (PDA) reveals
numerous clicks or noises resembling shaking dice or a bag of rocks
9. Palpation, Auscultation, Percurssion
▪ Palpation
– We studied the Cardiac Assessment, that how we can perform palpation on the patient of
PDA.
▪ Auscultation
– The murmur may be only a systolic ejection murmur, or it may be a
crescendo/decrescendo systolic murmur that extends into diastole.
– Occasionally, auscultation of the patent ductus arteriosus (PDA) reveals numerous clicks
or noises resembling shaking dice or a bag of rocks.
▪ Percussion
– Using the percussion technique, we can identify the patent ductus arteriosus sound.
– The murmur of a PDA is described as a medium pitched high-grade continuous murmur
heard best at the pulmonic position, with a harsh machinelike quality that often radiates
to the left clavicle.
10. Complaints
▪ Clinical presentation depends on patent ductus arteriosus size and
gestational age at delivery.
▪ Infants and children with a small PDA are generally asymptomatic; infants
with a large PDA present with signs of heart failure (eg, failure to thrive,
poor feeding, tachypnea, dyspnea with feeding, tachycardia).
▪ Premature infants may present with respiratory distress, apnea, worsening
mechanical ventilation requirements, or other serious complications (eg,
necrotizing enterocolitis).
▪ Signs of heart failure occur earlier in premature infants than in full-term
infants and may be more severe.
▪ A large ductal shunt in a premature infant often is a major contributor to
the severity of the lung disease of prematurity.
11. Lab Tests
▪ If a PDA is suspected, the doctor will use a stethoscope to listen for a
heart murmur, which is often heard in babies with PDAs.
▪ Follow-up tests might include:
– a chest X-ray
– an EKG, a test that measures the heart's electrical activity and can show if the
heart is enlarged
– an echocardiogram (ultrasound of the heart). In babies with PDA, an echo shows
how big the opening is and how well the heart is handling it.
– blood tests
12. EKG Changes
The EKG may demonstrate
sinus tachycardia or atrial
fibrillation, left ventricular
hypertrophy, and left atrial
enlargement in patients with
moderate or large ductus
shunts.
In patients with smaller ductal
shunts, the EKG is often
completely normal.
In the patient with a large
ductus arteriosus and
elevated pulmonary artery
pressure, signs of right atrial
enlargement and biventricular
hypertrophy are frequently
present.
13. Treatment
– Supportive medical therapy
– In symptomatic premature infants, cyclo-oxygenase (COX) inhibitor therapy
(eg, indomethacin, ibuprofen lysine)
– Sometimes transcatheter closure or surgical repair
▪ Typical medical management of patent ductus arteriosus includes
fluid restriction, a diuretic (usually a thiazide), maintenance of
hematocrit ≥ 35 %, providing a neutral thermal environment, and, for
ventilated patients, use of positive end-expiratory pressure (PEEP) to
improve gas exchange.
▪ Treatment differs depending on whether the infant is premature or
full term.
14. Treatment in premature infants
▪ Fluid restriction may facilitate ductal closure.
▪ In premature infants without respiratory or other compromise, a patent
ductus arteriosus is typically not treated.
▪ In premature infants with a hemodynamically significant PDA and
compromised respiratory status, the PDA can sometimes be closed by
using a COX inhibitor (either ibuprofen lysine or indomethacin). COX
inhibitors work by blocking the production of prostaglandins.Three doses
of indomethacin are given IV every 12 to 24 hours based on urine output;
doses are withheld if urine output is < 0.6 mL/kg/hour.
▪ An alternative is ibuprofen lysine 10 mg/kg orally followed by 2 doses of 5
mg/kg at 24-hour intervals.
15. Indomethacin Dosing Guidelines*
Age at Dose 1 Dose 1 Dose 3 Dose 3
< 48 hours 0.2 mg/kg IV 0.1 mg/kg IV 0.1 mg/kg IV
2–7 days 0.2 mg/kg IV 0.2 mg/kg IV 0.2 mg/kg IV
> 7 days 0.2 mg/kg IV 0.25 mg/kg IV 0.25 mg/kg IV
* Dose intervals are based on urine output.
16. Treatment in full-term infants
▪ In full-term infants, COX inhibitors are usually ineffective.
▪ Transcatheter closure has become the treatment of choice for PDA in children > 1 year, and some
authors consider transcatheter closure to be the preferred route in term neonates and young infants as
well.
▪ A variety of catheter-delivered occlusion devices are available (eg, coils, septal duct occluder).
▪ In infants < 1 year who have ductal anatomy unfavorable for transcatheter closure, surgical division and
ligation may be preferred over the transcatheter approach.
▪ For a patent ductus arteriosus with a shunt large enough to cause symptoms of heart failure or
pulmonary hypertension, closure should be done after medical stabilization.
▪ For a persistent PDA without heart failure or pulmonary hypertension, closure can be done electively
any time after 1 year.
▪ Delaying the procedure minimizes the risk of a vascular complication and allows time for spontaneous
closure.
17. Treatment in full-term infants(Contd..)
Outcomes after PDA closure
are excellent.
Endocarditis prophylaxis is not
needed preoperatively and is
required only for the first 6
months after closure or if
there is a residual defect
adjacent to a transcatheter-
placed device or surgical
material.