Polyhydramnios, or excessive amniotic fluid, is defined as amniotic fluid volume greater than 2000ml or an amniotic fluid index over 25cm. It can be caused by fetal issues like congenital anomalies that prevent swallowing of amniotic fluid, or placental problems. Maternal causes include diabetes. Clinically, it presents as abdominal discomfort and pressure symptoms in the mother. Management depends on the severity and gestational age, ranging from expectant monitoring to induction of labor or amniocentesis. Complications for both mother and baby can include preterm birth.
Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children.
Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children.
Placental abruption is premature separation of placenta from the uterus/ in other words separates before childbirth.
It occurs most commonly around 25 weeks of pregnancy characterized by vaginal bleeding, lower abdominal pain, and dangerously low blood pressure
this is the first part of my FACE PRESENTATION.this ppt contains all the required content for a face presentation and mechanism of labour in face presntation and also for diagnosis i uploaded another ppt. the main objective of my ppt is the viewers shouldn't get bored of what we say this is simplified yet professional .. have a look at it and enjoy, thank you.
complcations of third stage of labour, includes PPH, Inversion of uterus, retained placenta, placenta accreta, increta, percreta, amniotic fluid embolism
A serious pregnancy complication in which the placenta detaches from the womb (uterus).
Placental abruption occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
Symptoms include vaginal bleeding, stomach pain and back pain in the last 12 weeks of pregnancy.
Depending on the degree of placental separation and how close the baby is to full-term, treatment may include bed rest or a Caesarean (C-section).
Placental abruption is premature separation of placenta from the uterus/ in other words separates before childbirth.
It occurs most commonly around 25 weeks of pregnancy characterized by vaginal bleeding, lower abdominal pain, and dangerously low blood pressure
this is the first part of my FACE PRESENTATION.this ppt contains all the required content for a face presentation and mechanism of labour in face presntation and also for diagnosis i uploaded another ppt. the main objective of my ppt is the viewers shouldn't get bored of what we say this is simplified yet professional .. have a look at it and enjoy, thank you.
complcations of third stage of labour, includes PPH, Inversion of uterus, retained placenta, placenta accreta, increta, percreta, amniotic fluid embolism
A serious pregnancy complication in which the placenta detaches from the womb (uterus).
Placental abruption occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
Symptoms include vaginal bleeding, stomach pain and back pain in the last 12 weeks of pregnancy.
Depending on the degree of placental separation and how close the baby is to full-term, treatment may include bed rest or a Caesarean (C-section).
To perform his experiments, how did Mendel prevent pea flowers from self-pollinating and control their cross-pollination?
He cut away the pollen-bearing male parts of a flower and dusted that flower with pollen from another plant.
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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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
4. • Physical characteristics ; -
• It is a clear pale yellow fluid.
- pH is around 7.2.
- Specific gravity of 1.0069 – 1.008.
• Volume depends on gestation , 400ml at mid
pregnancy and reaches about 1000ml at 36-38 weeks
• High volume of amniotic fluid i.e. more than 2000 ml
is called Polyhydramnios.
• Low volume of amniotic fluid i.e. less than 400 ml is
called Oligohydramnios.
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5. Amniotic Fluid
• Chemical composition:
The composition of the amniotic fluid changes with gestation in early
pregnancy it is similar to maternal and fetal serum.
• 98-99% of the amniotic fluid is water.
• A large number of dissolved substances such as creatinine, urea,
bile pigments ,renin, glucose ,fructose, proteins(albumin and
globulin) ,lipids, hormones(estrogen and progesterone ),enzymes
minerals (Na+ ,K+ Cl- ) .
• suspended in it are some undissolved material such as some fetal
epithelial cells .
• during the second half of gestation its osmolarity decreases and is
close to dilute fetal urine with added phospholipids and other
substances from fetal lung and other metabolites .
-
6. - Amniotic fluid production;
• At very early stages the amniotic fluid is secreted by the amniotic
cells .
• Later most of it is derived from the maternal tissue fluid by
diffusion,
across the amniochorionic membrane and from the placenta.
A little is contributed by fetal respiratory secretions through
the skin which becomes less later in progressed pregnancy
since the fetal skin becomes less permeable .
-By 11th week, fetus contributes to amniotic fluid by
urinating into the amniotic cavity; in late pregnancy about
half a liter of urine is added daily.
-After about 20 weeks, fetal urine makes up most of the
fluid.
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9. Etiology
• Increased production or decreased
consumption of amniotic fluid will result in
polyhydramnios.
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10. Etiology>POLYHYDRAMNIOS
Fetal causes:
a. Congenital anomalies:
b. Uniovular twins:
c. Increased placental mass:
Maternal causes:
a. Diabetes mellitus
b. Pregnancy induced hypertension
c. Severe generalized edema
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11. Fetal causes>Congenital anomalies:
a. Anencephaly:
1.transudation of the cerebro-spinal fluid
from the exposed meninges.
2. absence of swallowing of the liquor.
3. foetal polyuria resulting from lack of
antidiuretic hormone or irritation of the
exposed centers.
b. Atresia of the esophagus or duodenum
enables the foetus to swallow the liquor.
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12. Fetal causes>Uniovular twins:
• Due to interconnecting vascularity in the
placenta, one foetus obtains more circulation
so that its heart and kidneys hypertrophy
leading to increased urine production. So one
amniotic sac only is affected.
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13. Foetal causes> Increased placental mass
a. Oedema of the placenta due to:
1.hydrops foetalis resulting from Rh-
incompatibility, severe anaemia,
haemoglobinopathies particularly a-thalassaemia
major and cytomegalovirus infection.
2.true knot of the cord causes obstruction of
venous return with placental congestion.
3. foetal liver cirrhosis as in syphilis.
b. Chorio-angioma and large placenta.
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14. Maternal causes>Diabetes mellitus
Diabetes mellitus due to:
a. increased osmotic pressure of the liquor
amnii due to its high sugar content,
b. foetal polyuria resulting from hyperglycemia.
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21. Clinical Varieties
• Acute hydramnios:
a.Very rare,
b. rapid accumulation of liquor,
c. occurs before 20 weeks,
d.the commonest cause is uniovular twins but foetal
anomalies
• Chronic hydramnios
a.More common,
b. accumulation of liquor is gradual,
c.it occurs in late pregnancy,
d.the condition may end by preterm labour.
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22. Clinical Picture
Symptoms
a. Abdominal discomfort and pain in acute
hydramnios.
b.Pressure symptoms: dyspnoea, palpitation,
indigestion, haemorrhoids, oedema and
varicosities of the lower limbs.
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23. Clinical Picture
Signs
a.General examination: may reveal pregnancy-induced
hypertension.
b.Abdominal examination:
Inspection: overdistended abdomen.
Palpation:
1.The fundal level is higher than gestational age.
2.The uterus is tense cystic.
3.The foetal parts are felt with difficulty by dipping.
4.Fluid thrill can be elicited.
5.Malpresentation and nonegagement are common.
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25. Management>Acute hydramnios
• Termination of pregnancy by high artificial rupture of
membranes. This allows gradual escape of liquor thus
shock and separation of the placenta are avoided.
• Shock results from rapid accumulation of blood in the
splanchnic area after sudden drop of intrauterine
pressure.
• Separation of the placenta occurs due to sudden drop
of intrauterine pressure and shrinkage of the placental
site following this. Drew Smythe catheter is used for
rupture of hind water in such conditions.
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26. Management>Chronic hydramnios
• During pregnancy:
a.Termination of pregnancy by high artificial rupture of
membranes if the foetus is dead or malformed.
b. Expectant treatment if the foetus is healthy.
> rest,
>sedative,
>salt restriction,
> treatment of the underlying cause as diabetes and
toxoplasmosis.
> Termination of pregnancy if the condition is not
improved or get worse.
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27. Management>Chronic hydramnios
• During pregnancy:
Repeated amniocentesis may be indicated in
premature foetus with marked pressure
symptoms. 1.5-2 liters can be aspirated in a
rate not exceeding 500 ml/hour under
sonographic control. However, the amniotic
fluid is rapidly reaccumulating and there is risk
of premature labour, injury to the foetus or
umbilical cord vessels.
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28. Management>Chronic hydramnios
• During labour:
• a. Malpresentation, cord presentation and / or
cord prolapse should be detected and the labour
is managed according to the condition.
• b. When the cervix is half dilated Drew Smythe
catheter is passed to rupture the hind water. This
will initiate uterine contractions which can be
enhanced by oxytocins.
• c. Active management of third stage is carried
out to guard against postpartum haemorrhage.
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