This document discusses pediatric healthcare systems in India. It describes initiatives like Physicians for Peace that provide medical training in developing countries. The author shares their experience participating in programs in India, including treating over 2,700 patients during an expedition to Dharamsala. Key differences between healthcare in India and the US are outlined, such as lower physician ratios and higher rates of infectious diseases as top causes of child mortality. Cultural factors that impact care, like family involvement and home births, are also examined.
1) ART pregnancies have some differences from natural pregnancies that require special care and monitoring, such as progesterone and estrogen supplementation due to the absence of a corpus luteum in some cases.
2) Multiple pregnancies are a major risk factor for ART pregnancies and require close monitoring due to higher risks of preterm birth and low birth weight.
3) While antenatal care is largely the same for ART and natural pregnancies, ART pregnancies have slightly higher risks of complications like preterm birth and birth defects, so careful screening and management is important.
This document summarizes the results of a 2005 survey of neonatal births in urban China. Some key findings include:
- 8.1% of births were preterm and 0.7% were very low birth weight. Caesarean delivery rate was 49.2%, higher than rates in the US and Asia.
- Factors associated with higher risk of preterm birth included maternal age over 35, assisted reproduction, pregnancy complications like hypertension, and multiple gestations.
- Overall infant outcomes were good, with 4.8% having low Apgar scores at birth, 7.14% requiring neonatal unit admission, and 0.74% mortality.
Immunization for INDIAN Adolescents Dr. Jyoti Agarwal Dr. Sharda Jain Dr. J...Lifecare Centre
Vaccinations are among the greatest public health achievements of the 20th century
First recorded in 1890-95
Imminization is the action of making a person immune to infection, typically by inoculation
Immunization prevents disability & death from infectious diseases
It also helps control the spread of infections within communities
1) The document discusses H1N1 virus infection in pregnancy, including its clinical presentation, diagnosis, complications, treatment, and prevention.
2) It notes that pregnant women are a high risk group for H1N1 and that infection during pregnancy can lead to maternal deaths and adverse pregnancy outcomes like spontaneous abortion.
3) Treatment involves early antiviral therapy with oseltamivir as the drug of choice, along with general supportive care, infection control, and encouraging breastfeeding while taking precautions to prevent transmission to the infant. Vaccination is also recommended for pregnant women.
HIV and Pregnancy : Dr Ruby Bansal (1st Session of DGF HIV Committee on 10th ...Lifecare Centre
This document discusses HIV and pregnancy in India. Some key points:
- Over 21 million people live with HIV in India, including 880,000 women. 60% of pregnant women with HIV access antiretroviral therapy (ART).
- ART and other interventions can reduce the risk of parent-to-child HIV transmission to under 2%. Without treatment, transmission rates range from 15-45%.
- Timely diagnosis and treatment of HIV-positive pregnant women is important to prevent transmission to infants. Options include different ART regimens starting during pregnancy, delivery, or breastfeeding depending on when the woman is diagnosed.
- Close coordination between HIV physicians, gynecologists, and other care providers is
This document discusses the epidemiology of pediatric cardiac diseases in India. It notes that congenital heart disease (CHD) accounts for 28% of all birth defects in India, with a birth prevalence of 8-10 per 1000 live births. Risk factors for CHD include maternal infections like rubella, diabetes, family history of CHD, and exposure to certain drugs. The incidence and prevalence of CHD in India is reviewed based on several studies. Prevention strategies discussed include rubella vaccination, folic acid supplementation, controlling chronic conditions, and avoiding harmful medications during pregnancy. The current status of CHD care in India is outlined, noting limitations in resources and access. Strategies for improving care are proposed.
1. Emergency contraception, also known as the "morning after pill", can prevent pregnancy up to 5 days after unprotected sex but is most effective the sooner it is taken.
2. The document discusses various case presentations involving patients seeking emergency contraception and provides guidance on appropriate contraceptive options and counseling points.
3. Key recommendations include no need for physical exam prior to emergency contraception, offering advance prescriptions, and providing the most effective option of copper IUD insertion for emergency contraception when possible.
This document discusses emergency contraception (EC), including its history, methods, mechanisms of action, indications, and recommendations. EC aims to prevent pregnancy after unprotected intercourse by disrupting ovulation or fertilization. The two main methods are hormonal EC using combined or progestin-only pills, and mechanical EC using a copper IUD. Hormonal EC is most effective when used as soon as possible within 5 days of intercourse. The document recommends making EC widely available without a prescription to help prevent unwanted pregnancies and unsafe abortions.
1) ART pregnancies have some differences from natural pregnancies that require special care and monitoring, such as progesterone and estrogen supplementation due to the absence of a corpus luteum in some cases.
2) Multiple pregnancies are a major risk factor for ART pregnancies and require close monitoring due to higher risks of preterm birth and low birth weight.
3) While antenatal care is largely the same for ART and natural pregnancies, ART pregnancies have slightly higher risks of complications like preterm birth and birth defects, so careful screening and management is important.
This document summarizes the results of a 2005 survey of neonatal births in urban China. Some key findings include:
- 8.1% of births were preterm and 0.7% were very low birth weight. Caesarean delivery rate was 49.2%, higher than rates in the US and Asia.
- Factors associated with higher risk of preterm birth included maternal age over 35, assisted reproduction, pregnancy complications like hypertension, and multiple gestations.
- Overall infant outcomes were good, with 4.8% having low Apgar scores at birth, 7.14% requiring neonatal unit admission, and 0.74% mortality.
Immunization for INDIAN Adolescents Dr. Jyoti Agarwal Dr. Sharda Jain Dr. J...Lifecare Centre
Vaccinations are among the greatest public health achievements of the 20th century
First recorded in 1890-95
Imminization is the action of making a person immune to infection, typically by inoculation
Immunization prevents disability & death from infectious diseases
It also helps control the spread of infections within communities
1) The document discusses H1N1 virus infection in pregnancy, including its clinical presentation, diagnosis, complications, treatment, and prevention.
2) It notes that pregnant women are a high risk group for H1N1 and that infection during pregnancy can lead to maternal deaths and adverse pregnancy outcomes like spontaneous abortion.
3) Treatment involves early antiviral therapy with oseltamivir as the drug of choice, along with general supportive care, infection control, and encouraging breastfeeding while taking precautions to prevent transmission to the infant. Vaccination is also recommended for pregnant women.
HIV and Pregnancy : Dr Ruby Bansal (1st Session of DGF HIV Committee on 10th ...Lifecare Centre
This document discusses HIV and pregnancy in India. Some key points:
- Over 21 million people live with HIV in India, including 880,000 women. 60% of pregnant women with HIV access antiretroviral therapy (ART).
- ART and other interventions can reduce the risk of parent-to-child HIV transmission to under 2%. Without treatment, transmission rates range from 15-45%.
- Timely diagnosis and treatment of HIV-positive pregnant women is important to prevent transmission to infants. Options include different ART regimens starting during pregnancy, delivery, or breastfeeding depending on when the woman is diagnosed.
- Close coordination between HIV physicians, gynecologists, and other care providers is
This document discusses the epidemiology of pediatric cardiac diseases in India. It notes that congenital heart disease (CHD) accounts for 28% of all birth defects in India, with a birth prevalence of 8-10 per 1000 live births. Risk factors for CHD include maternal infections like rubella, diabetes, family history of CHD, and exposure to certain drugs. The incidence and prevalence of CHD in India is reviewed based on several studies. Prevention strategies discussed include rubella vaccination, folic acid supplementation, controlling chronic conditions, and avoiding harmful medications during pregnancy. The current status of CHD care in India is outlined, noting limitations in resources and access. Strategies for improving care are proposed.
1. Emergency contraception, also known as the "morning after pill", can prevent pregnancy up to 5 days after unprotected sex but is most effective the sooner it is taken.
2. The document discusses various case presentations involving patients seeking emergency contraception and provides guidance on appropriate contraceptive options and counseling points.
3. Key recommendations include no need for physical exam prior to emergency contraception, offering advance prescriptions, and providing the most effective option of copper IUD insertion for emergency contraception when possible.
This document discusses emergency contraception (EC), including its history, methods, mechanisms of action, indications, and recommendations. EC aims to prevent pregnancy after unprotected intercourse by disrupting ovulation or fertilization. The two main methods are hormonal EC using combined or progestin-only pills, and mechanical EC using a copper IUD. Hormonal EC is most effective when used as soon as possible within 5 days of intercourse. The document recommends making EC widely available without a prescription to help prevent unwanted pregnancies and unsafe abortions.
Born too soon the global action report on preterm birthPaul Mark Pilar
The report Born Too Soon analyzes the global problem of preterm birth. It features the first estimates of preterm birth rates by country and is authored by over 45 international experts. The report finds that about 15 million babies are born prematurely each year, which is more than 1 in 10 babies worldwide. Prematurity is the leading cause of newborn death and the second leading cause of death in children under 5 years of age. Many preterm babies who survive face lifelong disabilities. The report highlights proven solutions to save lives of preterm babies and reduce rates of death and disability.
Under Five Child Mortality Experience from Bangladeshijtsrd
Under five mortality rates is a key indicator for several development policies, targets and programs. However, relevant source of data on causes of death are not available in developing countries, including Bangladesh. Because sometimes the information is hidden with the various causes of risk. The main purpose of this study is to find out some different cases of child mortality with the various causes. The paper reveals that several characteristics socioeconomic, demographic, health related disease and non disease are affecting child mortality. Juliet Reberio "Under Five Child Mortality: Experience from Bangladesh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42601.pdf Paper URL: https://www.ijtsrd.combiological-science/other/42601/under-five-child-mortality-experience-from-bangladesh/juliet-reberio
Neonatal Outcome In Pregnancy Induced Hypertensive Mothers – A Tertiary Care ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Problems in late preterm babies, iap bps,bangalore,webinar, 20-5-20 - Dr Kart...karthiknagesh
This document discusses problems faced by late preterm newborns, including respiratory issues, thermoregulation difficulties, and hypoglycemia. It provides epidemiological data on the increasing rates of late preterm births and their associated higher morbidity and mortality compared to full-term infants. Specific problems faced by late preterm infants are outlined, such as transient tachypnea of the newborn, respiratory distress syndrome, and feeding difficulties. Strategies for prevention and management of complications are discussed, including use of kangaroo mother care and dextrose gel to treat hypoglycemia.
This document provides guidance for breastfeeding mothers during the COVID-19 pandemic. It recommends that mothers continue breastfeeding and take precautions like wearing a mask, washing hands, and cleaning surfaces. If a mother has COVID-19, she can express milk and have another caregiver feed the infant. The document provides tips for proper hygiene during formula feeding as well. It emphasizes the importance of breastfeeding for infant health and immunity.
The document provides an overview of emergency contraception (EC), including its history, methods, efficacy, side effects, and guidelines for use. It discusses the Yuzpe method (combined pill), Plan B (progestin-only pill), high-dose estrogen, and copper IUD. Key points are that EC prevents pregnancy by delaying or inhibiting ovulation and works best the sooner it is taken after unprotected sex. Advance provision of EC has been shown to reduce unintended pregnancies.
Delhi gynaecologist forum Guidelines on Immunization for Indian Adolescent...Lifecare Centre
The document provides guidelines on immunizing Indian adolescents. It recommends that all 11-12 year olds receive the Tdap, meningococcal, HPV, and influenza vaccines. HPV vaccination is especially important for adolescent girls to protect against cancers later in life. Barriers to adolescent immunization include lack of education, costs, and provider challenges. Improving rates requires taking advantage of all healthcare visits, improving communication, using reminder systems, and adopting standardized immunization processes. Physicians play a key role in educating, recommending vaccines, and changing attitudes.
Diarrhea, Maternal attitude, skill, knowledge a prospective studyAjay Agade
1) The study assessed the knowledge, attitudes, and practices of mothers in Bhilai, Chhattisgarh regarding diarrhea prevention and oral rehydration solution (ORS) use.
2) While knowledge of diarrhea definition and ORS was high, knowledge of specific causes and proper ORS preparation was low. Many mothers had poor hygiene and feeding practices during diarrhea.
3) Targeted efforts are needed to address the gaps identified, including demonstrations on danger signs, ORS preparation, and emphasizing exclusive breastfeeding and hygiene. Improving maternal education can help reduce diarrhea mortality in children under five.
This document provides guidance on the management of HIV in pregnancy. It discusses preconception counseling, antenatal screening and care, interventions to prevent mother-to-child transmission including antiretroviral therapy and mode of delivery, management of delivery, postpartum care, breastfeeding recommendations, and management of the neonate. The overall goal is to educate patients, monitor the health of the mother and fetus, and utilize antiretroviral regimens and delivery methods to minimize the risk of transmitting HIV from mother to child.
Acceptability of HIV Counselling and Testing among Healthcare Workers and Pre...Helen Madamba
The document reports on a study that assessed the acceptability of HIV counseling and testing among healthcare professionals and pregnant women at an urban hospital in the Philippines. A total of 865 participants completed questionnaires on their demographics, HIV knowledge, attitudes towards people with HIV, and views on HIV testing. While both groups showed generally good knowledge of HIV transmission, pregnant women displayed more stigma towards those with HIV. Overall attitudes towards HIV testing were more positive among healthcare professionals. The study concludes that while HIV knowledge is high, stigma reduction programs are still needed to address issues related to HIV prevention and care.
Mission Down’s Syndrome
we are running
Mission Down Syndrome and
congenital heart defetcts detecion Program
in pregnant mothers in antenatal period.
Now we wish more Gynaecologists to join hands and extend this noble facility to larger section of INDIAN society .
1) Maternal mortality in India remains a significant problem, with 212 deaths per 100,000 live births according to 2009 data.
2) The main medical causes of maternal death are postpartum hemorrhage (24%), hypertension/eclampsia (12%), and infection (15%).
3) Addressing the "three delays" - delay in deciding to seek care, reaching a facility, and receiving care at the facility - is critical to reducing maternal mortality through strategies like community education, improving transportation and emergency services, and upgrading health facilities.
This document discusses the role of counselling in the management of infertility. It begins by outlining the psychological and social impacts of infertility, including depression, anxiety, and damaged self-esteem. It then defines counselling and explains that the main purposes of infertility counselling are to support patients, help them make decisions regarding treatment, and address any psychological distress. There are four main types of infertility counselling: information counselling, implications counselling, support counselling, and post-therapeutic counselling. The document concludes that infertility counselling addresses both the medical and psychological aspects of infertility treatment.
CME presentation on birth defect and Zika virus in pregnancy on 24 Feb 24, 2016 at Paropakar Maternity and Women's Hospital, Kathmandu: Way forward to Celebrating World Birth Defects Day on 3rd March 2016.
Shereen Hamadneh power point presentation International Congress of Paediatri...Dr. Shereen Hamadneh
Sudden Infant Death Syndrome (SIDS) Risks and Future direction for SIDS prevention in Jordan: Using Particepatory Action Research (PAR) to Create a Ripple of Change.
Speaker: Shereen Hamadneh
RN, PhD. ECU, WA
Msc Maternal-Child Health,
JUST Jordan
Sex dimorphic effects of prenatal treatment withHiya Boro
1) The study assessed the long-term cognitive functions and scholastic performance of 34 children aged 7-17 years who were treated with dexamethasone in the first trimester of pregnancy for risk of congenital adrenal hyperplasia, compared to 66 healthy controls.
2) Neuropsychological tests assessed intelligence, executive functions, processing speed, memory, and scholastic competence. No significant differences were found between the dexamethasone-treated and control groups on any measures.
3) This study suggests that short-term prenatal dexamethasone treatment in the first trimester does not adversely impact long-term cognitive functions or scholastic performance during childhood and adolescence.
Family planning class for MBBS students based on Park textbook including details on MTP, abortion, Family planning infrastructure and delivery systems in India and National Family Welfare Programme.
Lisa Bohmer worked as the HIV/AIDS Director for UNICEF in Ethiopia and presented on challenges and opportunities for preventing mother-to-child transmission of HIV/AIDS in Africa. Key points included: HIV transmission can occur during pregnancy, labor, delivery or breastfeeding; Ethiopia faces high infection rates particularly among young people and women; and challenges include stigma, improving safer birthing practices, counseling on infant feeding options, and ensuring a steady supply of drugs and testing kits. Opportunities lie in increased funding, integrating PMTCT into other health programs, and engaging communities to promote testing and reduce stigma.
This document discusses obstetric emergencies and the role of nurses. It begins by defining obstetric emergencies as life-threatening conditions that occur during pregnancy, labor, delivery or postpartum. It then lists some common causes like postpartum hemorrhage, eclampsia, obstructed labor and discusses their management. It emphasizes the importance of recognizing early signs, performing life-saving interventions and timely referral. It outlines essential life-saving skills for nurses including managing hemorrhage, infection prevention and using a partograph. It concludes by stressing the need for nurses to anticipate problems, communicate well with doctors and be prepared for emergencies.
The Baby-Friendly Hospital Initiative was launched globally in 1992 to promote breastfeeding. It originated from the Innocenti Declaration and Ten Steps to Successful Breastfeeding. Over 152 countries have implemented the initiative. India launched its program in 1993, with over 1,372 designated baby-friendly hospitals. Key policies include exclusive breastfeeding within 1 hour of birth, rooming-in, and not providing pacifiers or bottles. The initiative has increased exclusive breastfeeding rates for the first 6 months. Hypothermia is a risk for newborns and can be life-threatening if body temperature drops below 36.5°C. Risk factors include prematurity, low birthweight, and improper warming procedures. The "warm chain
Born too soon the global action report on preterm birthPaul Mark Pilar
The report Born Too Soon analyzes the global problem of preterm birth. It features the first estimates of preterm birth rates by country and is authored by over 45 international experts. The report finds that about 15 million babies are born prematurely each year, which is more than 1 in 10 babies worldwide. Prematurity is the leading cause of newborn death and the second leading cause of death in children under 5 years of age. Many preterm babies who survive face lifelong disabilities. The report highlights proven solutions to save lives of preterm babies and reduce rates of death and disability.
Under Five Child Mortality Experience from Bangladeshijtsrd
Under five mortality rates is a key indicator for several development policies, targets and programs. However, relevant source of data on causes of death are not available in developing countries, including Bangladesh. Because sometimes the information is hidden with the various causes of risk. The main purpose of this study is to find out some different cases of child mortality with the various causes. The paper reveals that several characteristics socioeconomic, demographic, health related disease and non disease are affecting child mortality. Juliet Reberio "Under Five Child Mortality: Experience from Bangladesh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42601.pdf Paper URL: https://www.ijtsrd.combiological-science/other/42601/under-five-child-mortality-experience-from-bangladesh/juliet-reberio
Neonatal Outcome In Pregnancy Induced Hypertensive Mothers – A Tertiary Care ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Problems in late preterm babies, iap bps,bangalore,webinar, 20-5-20 - Dr Kart...karthiknagesh
This document discusses problems faced by late preterm newborns, including respiratory issues, thermoregulation difficulties, and hypoglycemia. It provides epidemiological data on the increasing rates of late preterm births and their associated higher morbidity and mortality compared to full-term infants. Specific problems faced by late preterm infants are outlined, such as transient tachypnea of the newborn, respiratory distress syndrome, and feeding difficulties. Strategies for prevention and management of complications are discussed, including use of kangaroo mother care and dextrose gel to treat hypoglycemia.
This document provides guidance for breastfeeding mothers during the COVID-19 pandemic. It recommends that mothers continue breastfeeding and take precautions like wearing a mask, washing hands, and cleaning surfaces. If a mother has COVID-19, she can express milk and have another caregiver feed the infant. The document provides tips for proper hygiene during formula feeding as well. It emphasizes the importance of breastfeeding for infant health and immunity.
The document provides an overview of emergency contraception (EC), including its history, methods, efficacy, side effects, and guidelines for use. It discusses the Yuzpe method (combined pill), Plan B (progestin-only pill), high-dose estrogen, and copper IUD. Key points are that EC prevents pregnancy by delaying or inhibiting ovulation and works best the sooner it is taken after unprotected sex. Advance provision of EC has been shown to reduce unintended pregnancies.
Delhi gynaecologist forum Guidelines on Immunization for Indian Adolescent...Lifecare Centre
The document provides guidelines on immunizing Indian adolescents. It recommends that all 11-12 year olds receive the Tdap, meningococcal, HPV, and influenza vaccines. HPV vaccination is especially important for adolescent girls to protect against cancers later in life. Barriers to adolescent immunization include lack of education, costs, and provider challenges. Improving rates requires taking advantage of all healthcare visits, improving communication, using reminder systems, and adopting standardized immunization processes. Physicians play a key role in educating, recommending vaccines, and changing attitudes.
Diarrhea, Maternal attitude, skill, knowledge a prospective studyAjay Agade
1) The study assessed the knowledge, attitudes, and practices of mothers in Bhilai, Chhattisgarh regarding diarrhea prevention and oral rehydration solution (ORS) use.
2) While knowledge of diarrhea definition and ORS was high, knowledge of specific causes and proper ORS preparation was low. Many mothers had poor hygiene and feeding practices during diarrhea.
3) Targeted efforts are needed to address the gaps identified, including demonstrations on danger signs, ORS preparation, and emphasizing exclusive breastfeeding and hygiene. Improving maternal education can help reduce diarrhea mortality in children under five.
This document provides guidance on the management of HIV in pregnancy. It discusses preconception counseling, antenatal screening and care, interventions to prevent mother-to-child transmission including antiretroviral therapy and mode of delivery, management of delivery, postpartum care, breastfeeding recommendations, and management of the neonate. The overall goal is to educate patients, monitor the health of the mother and fetus, and utilize antiretroviral regimens and delivery methods to minimize the risk of transmitting HIV from mother to child.
Acceptability of HIV Counselling and Testing among Healthcare Workers and Pre...Helen Madamba
The document reports on a study that assessed the acceptability of HIV counseling and testing among healthcare professionals and pregnant women at an urban hospital in the Philippines. A total of 865 participants completed questionnaires on their demographics, HIV knowledge, attitudes towards people with HIV, and views on HIV testing. While both groups showed generally good knowledge of HIV transmission, pregnant women displayed more stigma towards those with HIV. Overall attitudes towards HIV testing were more positive among healthcare professionals. The study concludes that while HIV knowledge is high, stigma reduction programs are still needed to address issues related to HIV prevention and care.
Mission Down’s Syndrome
we are running
Mission Down Syndrome and
congenital heart defetcts detecion Program
in pregnant mothers in antenatal period.
Now we wish more Gynaecologists to join hands and extend this noble facility to larger section of INDIAN society .
1) Maternal mortality in India remains a significant problem, with 212 deaths per 100,000 live births according to 2009 data.
2) The main medical causes of maternal death are postpartum hemorrhage (24%), hypertension/eclampsia (12%), and infection (15%).
3) Addressing the "three delays" - delay in deciding to seek care, reaching a facility, and receiving care at the facility - is critical to reducing maternal mortality through strategies like community education, improving transportation and emergency services, and upgrading health facilities.
This document discusses the role of counselling in the management of infertility. It begins by outlining the psychological and social impacts of infertility, including depression, anxiety, and damaged self-esteem. It then defines counselling and explains that the main purposes of infertility counselling are to support patients, help them make decisions regarding treatment, and address any psychological distress. There are four main types of infertility counselling: information counselling, implications counselling, support counselling, and post-therapeutic counselling. The document concludes that infertility counselling addresses both the medical and psychological aspects of infertility treatment.
CME presentation on birth defect and Zika virus in pregnancy on 24 Feb 24, 2016 at Paropakar Maternity and Women's Hospital, Kathmandu: Way forward to Celebrating World Birth Defects Day on 3rd March 2016.
Shereen Hamadneh power point presentation International Congress of Paediatri...Dr. Shereen Hamadneh
Sudden Infant Death Syndrome (SIDS) Risks and Future direction for SIDS prevention in Jordan: Using Particepatory Action Research (PAR) to Create a Ripple of Change.
Speaker: Shereen Hamadneh
RN, PhD. ECU, WA
Msc Maternal-Child Health,
JUST Jordan
Sex dimorphic effects of prenatal treatment withHiya Boro
1) The study assessed the long-term cognitive functions and scholastic performance of 34 children aged 7-17 years who were treated with dexamethasone in the first trimester of pregnancy for risk of congenital adrenal hyperplasia, compared to 66 healthy controls.
2) Neuropsychological tests assessed intelligence, executive functions, processing speed, memory, and scholastic competence. No significant differences were found between the dexamethasone-treated and control groups on any measures.
3) This study suggests that short-term prenatal dexamethasone treatment in the first trimester does not adversely impact long-term cognitive functions or scholastic performance during childhood and adolescence.
Family planning class for MBBS students based on Park textbook including details on MTP, abortion, Family planning infrastructure and delivery systems in India and National Family Welfare Programme.
Lisa Bohmer worked as the HIV/AIDS Director for UNICEF in Ethiopia and presented on challenges and opportunities for preventing mother-to-child transmission of HIV/AIDS in Africa. Key points included: HIV transmission can occur during pregnancy, labor, delivery or breastfeeding; Ethiopia faces high infection rates particularly among young people and women; and challenges include stigma, improving safer birthing practices, counseling on infant feeding options, and ensuring a steady supply of drugs and testing kits. Opportunities lie in increased funding, integrating PMTCT into other health programs, and engaging communities to promote testing and reduce stigma.
This document discusses obstetric emergencies and the role of nurses. It begins by defining obstetric emergencies as life-threatening conditions that occur during pregnancy, labor, delivery or postpartum. It then lists some common causes like postpartum hemorrhage, eclampsia, obstructed labor and discusses their management. It emphasizes the importance of recognizing early signs, performing life-saving interventions and timely referral. It outlines essential life-saving skills for nurses including managing hemorrhage, infection prevention and using a partograph. It concludes by stressing the need for nurses to anticipate problems, communicate well with doctors and be prepared for emergencies.
The Baby-Friendly Hospital Initiative was launched globally in 1992 to promote breastfeeding. It originated from the Innocenti Declaration and Ten Steps to Successful Breastfeeding. Over 152 countries have implemented the initiative. India launched its program in 1993, with over 1,372 designated baby-friendly hospitals. Key policies include exclusive breastfeeding within 1 hour of birth, rooming-in, and not providing pacifiers or bottles. The initiative has increased exclusive breastfeeding rates for the first 6 months. Hypothermia is a risk for newborns and can be life-threatening if body temperature drops below 36.5°C. Risk factors include prematurity, low birthweight, and improper warming procedures. The "warm chain
The document summarizes health programs and progress in Bangladesh. It notes that Bangladesh has achieved significant reductions in under-5 and maternal mortality rates through effective interventions. Key interventions include oral rehydration therapy for diarrhea, immunizations, integrated management of childhood illness, and newborn health programs. Bangladesh has also seen major declines in malnutrition and fertility rates. Overall, Bangladesh has made major improvements in health indicators through the efforts of the government and development partners.
Bangladesh has made significant progress in health outcomes for women and children through effective interventions. The under-5 mortality rate fell from 151 per 1000 live births in 1990 to 38 per 1000 in 2017, exceeding Millennium Development Goal 4. This was achieved through programs promoting oral rehydration therapy, immunizations, integrated management of childhood illness, and newborn health interventions. Bangladesh also reduced the maternal mortality ratio by 75% and exceeded Millennium Development Goal 5. Current challenges include further reducing child injuries such as drownings, improving nutrition, and addressing emerging issues like non-communicable diseases and environmental health hazards.
1. The document discusses prevention of parent-to-child transmission (PPTCT) of HIV, including that transmission can occur during pregnancy, labor, delivery and breastfeeding. It also discusses the importance of PPTCT for preventing pediatric HIV infections.
2. PPTCT services in India aim to detect positive pregnant women and provide them comprehensive services including antiretroviral treatment (ART). The objectives are to detect over 80% of positive women, provide services to over 90%, and ensure over 95% ART compliance for positive women.
3. Care for HIV exposed infants includes care at birth, infant feeding support, antiretroviral prophylaxis, vaccines, cotrimoxazole
This document provides guidance for Lady Health Workers in Pakistan on maternal and child health. It outlines key goals such as reducing childhood mortality and improving family practices. It discusses important issues like breastfeeding, immunizations, hygiene and neonatal care. Traditional practices that can increase infection risks like applying unclean substances to umbilical cords are identified. Clean cord cutting and care is emphasized to avoid neonatal deaths from common infections.
Aradhya Agrawal completed an investigatory project on reproductive health under the supervision of Mrs. Majinder Kaur. The project covered topics like population explosion, contraceptive methods, medical termination of pregnancy, sexually transmitted diseases, infertility, and assisted reproductive technologies. Mrs. Kaur certified that the project met expectations and guidelines. Aradhya thanked Mrs. Kaur for her support and guidance during the project.
This document provides guidelines for the care of normal newborns, including establishing respiration and preventing hypothermia at birth. It outlines the personnel, equipment, and facilities needed for delivery and newborn resuscitation. Key steps for care include cleaning the baby, delayed cord clamping, vitamin K administration, and exclusive breastfeeding. Guidelines are provided for monitoring the newborn's temperature, weight, measurements, and reflexes during the initial examination and beyond the first few hours after birth.
The document discusses Integrated Management of Neonatal and Childhood Illness (IMNCI), an integrated approach to child health focused on reducing mortality and improving growth and development for children under 5. It describes the three main components of IMNCI as improving case management skills, health systems, and family/community health practices. The case management process involves assessing, classifying, identifying treatments, counseling, and follow up care for sick young infants and children.
The document discusses antenatal, intranatal, and postnatal care. It defines key terms like maternal mortality ratio and rate. Antenatal care includes regular checkups, tests, supplements, immunizations, and identifying high-risk pregnancies. Intranatal care aims to ensure clean delivery, monitor for complications, and care for the newborn. Key aspects of care discussed include frequency of antenatal visits, identifying danger signs, use of a partograph during delivery, and rooming-in after birth.
Cancer is uncontrolled growth of abnormal cells that can be caused by chemicals, radiation, genetics, or pathogens. In India, childhood cancer incidence is lower than other populations but survival rates are also lower due to lack of awareness and treatment. CanKids aims to increase childhood cancer survival rates in India to 70-90% by providing treatment, social support, and reintegration services. Specifically for retinoblastoma, a rare eye cancer affecting young children, CanKids works to improve early detection and advocacy to deliver higher quality care through programs like the Sajeev CanKids RB Fund.
This presentation is part of and education series to pediatric healthcare providers in Syria and it may be useful to all practitioners working in low resource settings.
Burden of leprosy in India
Multi-drug therapy
MDT
WHO Diagnostic guidelines
Drug resistance
Stigma
Serological tests
Social stigma of leprosy
Dapsone resistance
Rifampicin resistance
Mycobacterium leprae
surveillance of AMR in leprosy
Adherence to MDT is important
Global leprosy strategy
Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life.
The document discusses the Reproductive and Child Health (RCH) Programme in India. Some key points:
- The RCH Programme was launched in 1997 with the objectives of reducing maternal, infant, and under-5 mortality as well as promoting adolescent health.
- The programme aimed to achieve targets such as an infant mortality rate below 60 per 1000 live births and a maternal mortality rate below 400 per 100,000 live births.
- RCH Phase 2 was launched in 2005 with a focus on achieving the Millennium Development Goals and expanding access to essential obstetric and newborn care services.
- The strategies under RCH include improving antenatal, delivery and postnatal services; increasing
This document provides an overview of Integrated Management of Neonatal and Childhood Illness (IMNCI). Some key points:
- IMNCI is an integrated approach that aims to reduce death, illness and disability among children under five by improving case management skills, health systems, and family/community health practices.
- It focuses on preventing and treating the major causes of childhood mortality like pneumonia, diarrhea, malaria, measles and malnutrition.
- The case management process involves assessing, classifying, identifying appropriate treatment, counseling the mother, and follow up care for sick young infants and children. Classification is done using a color-coded triage system.
- For young infants, signs like
Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.
VISION 2020 is a global initiative to eliminate avoidable blindness by the year 2020. It focuses on disease control, human resource development, and infrastructure/technology development. It establishes various centers - Centers of Excellence, Training Centers, Service Centers, and Vision Centers - to coordinate efforts and provide different levels of eye care, serving populations from 50,000 to 5,00,00,000 people.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Objectives
To recognize the importance of global health
initiatives in pediatrics
To understand the universality of infant and child
health and safety issues
To recognize some of the important differences
and similarities in healthcare systems in a
developing country
To develop increased cultural competence –
increasing numbers of international travel,
adoptions, and medical tourism
3. Physicians for Peace
Founded by Dr. Charles Horton in 1989
Mission: To develop sustainable programs in the
developing world based on the belief that health care
can best be improved by training health professionals
in that country, who then can continue to heal
hundreds to thousands of people there
Programs designed by communicating with
physicians indigent to the area with regards to
educational activities they feel will most benefit their
community
4. Physicians for Peace
NALS/PALS/nursing education
Nagpur, Maharashtra, India
In collaboration with Dr. Satish
Deopujari, pediatrician and co-
founder of Child’s Hospital of
Central India
Our mission consisted of:
Dr. Ed Karotkin,
Neonatologist
Ms. Karen Horton, Neonatal
Nurse Educator
Dr. Sheetal Ajmani, PGY-3
5. Physicians for Peace
Specific Programs Completed:
Nursing education to 125
nurses in Nagpur, India and
60 nurses at Sawangee
Medical College
NALS reviewed with 15
pediatric residents at
Sawangee Medical College
PALS workshop with 40
practicing pediatricians in
Nagpur
Neonatology topic-specific
updates given to 20
practicing pediatricians in
Nagpur, as well as to 15
pediatric residents at
Sawangee Medical College
14. Healthcare System in India
Subcenter: staffed by 1
female worker and 1
male worker and covers
a population of
3000-5000
Primary Health Center:
staffed by 1-2 physicians,
and 2 or more ancillary
healthcare workers and
serves a population of
30,000
Each PHC oversees
6-8 SCs
Each CHC serves 3-4
PHC’s
15. Healthcare System in India
Hospitals
Government vs. Private (Nursing Homes)
No good public medical transportation system
At private hospitals, families must be actively involved
in all decision-making, since they must be able to
directly pay for care (including all lab tests, radiology,
and treatment plans)
1 relative must stay at bedside at all times
If a new medication is needed, the family is given the
prescription to be filled at the pharmacy and bring it
back to be administered
No family members allowed in ICU’s
16. Healthcare System in India
Infection control in ICU’s (hats, gowns, shoe covers)
No incubators in NICU; only radiant warmers (and
use plastic wrap if needed)
No consistent temperature control on the warmers in
the NICU
Role of nurses is minimal
Blood bank
PALS
No manometers on BVM
Broselow tape
Workshops – airway opening maneuvers
17. Antenatal Care in India
Family planning education is lacking
Contraception: sterilization accounts for 75%
of all contraceptive use
60% of women child-bearing age never heard
of AIDS (2003)
30,000 HIV+ infants born/year (by conservative
estimates)
In 2007, 159 cases of HIV were diagnosed in
children under 13yo in the U.S.
18. Antenatal Care in India
Since pregnancy is ‘natural,’ use of prenatal
services is considered unnecessary by many
Government hospitals provide financial
incentive to mothers to deliver in hospital,
including transportation
65% of deliveries are at-home
2% of families sought medical care for mother
or child within the first 2 days
17% sought medical care within 2 months of
delivery
19. Child and Infant Mortality
India contributes to 25% of the 10 million
deaths under 5 years of age in the world
Neonatal mortality rates (per 1000 live births)
U.S. 4:1000
India 39:1000
20. Child and Infant Mortality:
Distribution of Causes of Death <5yo
(2000)
India U.S.
Neonatal 45.2 56.9
HIV/AIDS 0.7 0.1
Diarrhea 20.3 0.1
Measles 3.7 0
Malaria 0.9 0
Pneumonia 18.5 1.3
Injuries 2.2 10.3
Other 8.5 31.3
22. Healthcare System Comparison
Physician to 10,000 population ratios
U.S. 26:10,000
India 6:10,000
In India, 74% of physicians live in urban
areas, where only 28% of population resides
23. Himalayan Health
Exchange
Mission: To provide medical and
dental care to the underserved
people living in remote regions
of the Indian and Nepal
Himalayas
NGO based out of Atlanta, GA
Founded by Ravi Singh in 1996
Eight expeditions/year
comprised of physicians,
dentists, nurses, pharmacists,
and medical students
24. Dharamsala Expedition
April 2008
37 Health professionals: 7
physicians, 29 medical students, 1
RN
Also, 1 local pharmacist, 1-2 local
physicians/each clinic site, staff of
cooks, drivers, and translators
Provided care at 7 rural villages, and
2 monasteries
About 2700 patients seen; ¼ of
which were pediatric
My role: Providing medical care at
the attending level in the Pediatric
medical tent. Supervision of 5-7
medical students/day in the
Pediatrics tent
30. Scabies
Species: Mite Sarcoptes scabiei; females are fertilized at skin
surface, then burrow into the epidermis, traveling 2mm each day
while laying a total of 10-12 eggs, female dies in 1-2months
Epidemiology: crowded areas, in colder and more humid
conditions (long survival on fomites)
Transmission: person to person; direct contact; very contagious
Clinical features: itching due to type IV delayed hypersensitivity
reaction, worse at night and out of proportion to visible
dermatologic manifestations; secondary staph infections
common
31. Scabies
Diagnosis: History and
physical exam; family
members typically affected;
can microscopically
visualize mites from skin
scraping, but not necessary
for diagnosis
32. Scabies
Treatment:
-First line: Permethrin 5% cream (safe in
infants; cotton mittens to prevent toxicity);
Oral Ivermectin
-Alternative Topicals: Benzyl Benzoate,
Lindane, Malathion, Sulfur in Petrolatum
-Treat all household and close contacts
-Treat secondary reactions: anti-pruritics;
secondary staph infections
34. Tinea capitis
Gray patch tinea capitis: Microsporum Canis (bright green
flourescence under Wood’s lamp); erythematous patches with
scale; may develop into kerion (boggy, tender nodules with
exudate) and/or secondary staph infection
Black dot tinea capitis: seen more in the U.S.; Trichophyton
tonsurans; erythematous patches with “black dots” from hairs
breaking off in affected areas
Treatment: Griseofulvin is the primary treatment choice
(20-25mg/kg/day for 6 weeks); Other treatment options include
terbinafine, itraconazole, fluconazole
35. Tinea corporis
Circular patch with central
clearing and raised,
erythematous border
Treatment:
-Local – topicals including
miconazole, ketoconazole,
clotrimazole
-Systemic – for widespread
infection; griseofulvin,
terbinafine, itraconazole,
fluconazole
37. Pinworms
Enterobius vermicularis
Humans are the only host
Most commonly affects school-age children
Present with itchy butt, worse at night
Female pinworms crawl out of the anus to deposit eggs
at night
Spread by contact/fomites
Scotch tape test – eggs will be visualized on a single
specimen 50% of the time; 90% if have 3 samples
Treatment
Albendazole as single dose; or, mebendazole once
and again 2 weeks later
42. Summary
Participation in international health electives is an
invaluable experience:
PFP: Develop academic and professional networks
with international community of healthcare
professionals
HHE: Gain experience practicing medicine with
limited resources, and gain insight to different
perspectives and opportunities for healthcare
Welcome Shruti Deapujari to CHKD