Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL following vaginal birth or 1000 mL following c-section. It can occur within 24 hours (primary PPH) or 24 hours to 12 weeks (secondary PPH) postpartum and is a leading cause of maternal mortality. The 4 T's of PPH include tonicity (uterine atony), tissue (retained placental fragments), trauma, and thrombin abnormalities. A case is presented of a woman with risk factors of preeclampsia and prolonged labor who develops PPH. Her management involves IV fluids, uterotonics, uterine massage, and monitoring for signs of deterioration requiring additional interventions like embolization
complcations of third stage of labour, includes PPH, Inversion of uterus, retained placenta, placenta accreta, increta, percreta, amniotic fluid embolism
Postpartum haemorrhage is defined as blood loss greater than 500ml following vaginal delivery or 1000ml following c-section. The leading cause is uterine atony which can be caused by factors like overdistension of the uterus or uterine fatigue. Prevention focuses on active management of the third stage of labor with uterotonics. Initial management of PPH involves ABCs, IV fluids, uterine massage, additional uterotonics like oxytocin, ergometrine, or misoprostol. If bleeding persists, further interventions may include bimanual compression, arterial embolization, compression sutures, or hysterectomy. Secondary PPH occurs after 24 hours and is usually due to retained placental
This document discusses the diagnosis and management of two obstetric emergency cases. The first case involves a 26-year-old pregnant woman at 8 months gestation presenting with vaginal bleeding. This is diagnosed as antepartum haemorrhage, which can be caused by placental abruption or placenta previa. Ultrasound is used to differentiate between the two. The second case involves a woman who just gave birth with continuous bleeding. This is diagnosed as postpartum haemorrhage, which is most commonly caused by uterine atony. Management of both cases involves initial resuscitation, identifying the cause, controlling bleeding through medical or surgical methods such as uterotonic drugs, compression sutures,
This document summarizes causes, risk factors, diagnosis, and management of postpartum hemorrhage (PPH). PPH is defined as blood loss of 500 ml or more within 24 hours of delivery. Common causes include uterine atony (70%), retained placenta, genital tract trauma, and bleeding disorders. Risk factors include previous uterine surgery, uterine abnormalities, and operative delivery. Diagnosis involves estimating blood loss and identifying the cause. Management involves resuscitation, arresting the bleeding through uterotonic drugs, manual removal of retained placenta, repairing lacerations, and in severe cases, surgical procedures like hysterectomy.
This document summarizes causes, risk factors, diagnosis, and management of postpartum hemorrhage (PPH). PPH is defined as blood loss of 500 ml or more within 24 hours of delivery. Common causes include uterine atony (70%), retained placenta, genital tract trauma, and bleeding disorders. Risk factors include previous uterine surgery, operative delivery, and bleeding abnormalities. Diagnosis involves estimating blood loss and identifying the cause. Management involves resuscitation, arresting the bleeding through uterotonic drugs, manual removal of retained placenta, repairing lacerations, and in severe cases, surgical procedures like hysterectomy.
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL following vaginal birth or 1000 mL following c-section. It can occur within 24 hours (primary PPH) or 24 hours to 12 weeks (secondary PPH) postpartum and is a leading cause of maternal mortality. The 4 T's of PPH include tonicity (uterine atony), tissue (retained placental fragments), trauma, and thrombin abnormalities. A case is presented of a woman with risk factors of preeclampsia and prolonged labor who develops PPH. Her management involves IV fluids, uterotonics, uterine massage, and monitoring for signs of deterioration requiring additional interventions like embolization
complcations of third stage of labour, includes PPH, Inversion of uterus, retained placenta, placenta accreta, increta, percreta, amniotic fluid embolism
Postpartum haemorrhage is defined as blood loss greater than 500ml following vaginal delivery or 1000ml following c-section. The leading cause is uterine atony which can be caused by factors like overdistension of the uterus or uterine fatigue. Prevention focuses on active management of the third stage of labor with uterotonics. Initial management of PPH involves ABCs, IV fluids, uterine massage, additional uterotonics like oxytocin, ergometrine, or misoprostol. If bleeding persists, further interventions may include bimanual compression, arterial embolization, compression sutures, or hysterectomy. Secondary PPH occurs after 24 hours and is usually due to retained placental
This document discusses the diagnosis and management of two obstetric emergency cases. The first case involves a 26-year-old pregnant woman at 8 months gestation presenting with vaginal bleeding. This is diagnosed as antepartum haemorrhage, which can be caused by placental abruption or placenta previa. Ultrasound is used to differentiate between the two. The second case involves a woman who just gave birth with continuous bleeding. This is diagnosed as postpartum haemorrhage, which is most commonly caused by uterine atony. Management of both cases involves initial resuscitation, identifying the cause, controlling bleeding through medical or surgical methods such as uterotonic drugs, compression sutures,
This document summarizes causes, risk factors, diagnosis, and management of postpartum hemorrhage (PPH). PPH is defined as blood loss of 500 ml or more within 24 hours of delivery. Common causes include uterine atony (70%), retained placenta, genital tract trauma, and bleeding disorders. Risk factors include previous uterine surgery, uterine abnormalities, and operative delivery. Diagnosis involves estimating blood loss and identifying the cause. Management involves resuscitation, arresting the bleeding through uterotonic drugs, manual removal of retained placenta, repairing lacerations, and in severe cases, surgical procedures like hysterectomy.
This document summarizes causes, risk factors, diagnosis, and management of postpartum hemorrhage (PPH). PPH is defined as blood loss of 500 ml or more within 24 hours of delivery. Common causes include uterine atony (70%), retained placenta, genital tract trauma, and bleeding disorders. Risk factors include previous uterine surgery, operative delivery, and bleeding abnormalities. Diagnosis involves estimating blood loss and identifying the cause. Management involves resuscitation, arresting the bleeding through uterotonic drugs, manual removal of retained placenta, repairing lacerations, and in severe cases, surgical procedures like hysterectomy.
This document discusses postpartum hemorrhage, including definition, risk factors, diagnosis, and treatment. It begins with two case examples of women experiencing heavy bleeding after delivery. The main causes of postpartum hemorrhage - uterine atony, retained placenta, lacerations, and coagulation disorders - are reviewed. Treatment focuses on the "four Ts": addressing tone with uterotonic drugs, checking for retained tissue, repairing any trauma, and evaluating for thrombin abnormalities. Early diagnosis and treatment are important to prevent severe bleeding and potential mortality from postpartum hemorrhage.
This document discusses complications of the third stage of labor, specifically postpartum hemorrhage. It defines postpartum hemorrhage, classifies it by severity and timing, and identifies the main causes as being an atonic uterus, trauma, retained placental tissues, and coagulation disorders. The management of postpartum hemorrhage is described in stages from immediate resuscitation through bimanual compression, uterine tamponade, surgery such as ligation of arteries, and hysterectomy if needed. Specific approaches are provided for addressing atonic, traumatic, or coagulation-related causes of bleeding.
3rd stage of labour by dr shazia a khan 4 mar 19mahmoodayub2
The third stage of labor involves delivery of the placenta and ends with delivery of the membranes, normally lasting 5-15 minutes. Complications during this stage can include postpartum hemorrhage (PPH), the leading cause of maternal mortality worldwide. PPH is primarily caused by uterine atony, genital tract trauma, retained placental tissue, or uterine inversion. Management involves resuscitation, uterotonics to contract the uterus, examination under anesthesia, and potentially surgical interventions like uterine artery ligation.
Dr. Monika Madaan discusses postpartum hemorrhage (PPH), a leading cause of maternal mortality. PPH is defined as blood loss over 500ml after delivery. Risk factors include placenta previa/accreta, coagulopathy, overdistended uterus, grand multiparity, abnormal labor, and previous PPH history. Active management of the third stage of labor can help prevent PPH. Treatment involves resuscitation, fluid replacement, administering uterotonics and other drugs, uterine tamponade, compression sutures, devascularization, and hysterectomy if needed. New developments include tranexamic acid and recombinant factor VII. Proper documentation and debriefing are also
BLEEDING IN LATE PREGANCY MAL PRESENTATIONS.pptxKwizeravirgile1
The document provides information on abnormal midwifery, including assessing and managing complications like bleeding in late pregnancy, malpresentations, and malpositions. It discusses placenta previa and placental abruption, their risk factors, signs and symptoms, investigations, and management. Uterine rupture is also defined and its causes, signs, investigations, and surgical management are outlined. Finally, different malpresentations like brow, face, breech, and transverse positions are defined along with their diagnosis and management.
Postpartum hemorrhage (PPH) is defined as blood loss exceeding 500 ml after vaginal delivery within 24 hours. It is a leading cause of maternal mortality, especially in resource-poor settings. Risk factors include polyhydramnios, macrosomia, prolonged labor, and previous surgery. Management involves resuscitation, assessing uterine contraction, exploring the uterus, and administering oxytocics for atony or performing manual removal of placental tissue. Prevention strategies include active management of the third stage of labor with oxytocics immediately after delivery and risk assessment during antenatal care.
This document discusses post-partum hemorrhage (PPH), including its definition, causes, risk factors, prevention, and management. It describes:
1) PPH is defined as blood loss over 500ml within 24 hours of delivery. The main cause is uterine atony but can also be due to retained placenta or trauma.
2) Risk factors include previous c-section, large babies, and medical conditions like placenta previa. Prevention focuses on identifying risks antenatally and using oxytocics to manage the third stage of labor.
3) Initial management of PPH involves resuscitation, oxytocics, and identifying the cause. Further steps may include balloon
This document discusses various risk conditions and complications related to pregnancy. It covers topics such as maternal mortality rates, high risk factors, gestational conditions like hyperemesis gravidarum and polyhydramnios/oligohydramnios. It also discusses hemorrhagic disorders like placenta previa and abruptio placentae. Other topics covered include hypertensive states of pregnancy including preeclampsia, Rh sensitization, and blood group incompatibilities.
Postpartum haemorrhage (PPH) is a major cause of maternal mortality. It can be primary (within 24 hours of delivery) or secondary (24 hours to 6 weeks postpartum). Primary PPH is usually due to uterine atony or trauma during delivery. Management involves emptying the uterus, replacing blood loss, and ensuring haemostasis. Secondary PPH is often caused by infection or retained placental fragments. Treatment focuses on identifying and addressing the underlying cause while providing supportive care.
This document provides information on assessing and managing common obstetric and gynecologic emergencies that EMTs may encounter including ectopic pregnancy, pelvic inflammatory disease, spontaneous abortion, preeclampsia, eclampsia, abruptio placentae, placenta previa, uterine rupture, emergency childbirth, breech presentation, limb presentation, prolapsed cord, meconium, and multiple births. Key steps are providing high-flow oxygen, rapid transport, addressing any hemorrhage or shock, and preparing for potential neonatal resuscitation.
The classic sign of a postpartum infection is a temperature increase of 100.4 degrees F or higher on any two consecutive days of the first 10 days postpartum, not including the first 24 hours.
Some other signs and symptoms of postpartum infection include:
- Foul smelling lochia or discharge
- Malaise, anorexia, tachycardia, chills
- Pelvic pain
- Elevated white blood cell count
Treatment would include administering broad spectrum antibiotics, providing warm sitz baths, promoting drainage by having the patient lie in a high Fowler's position, forcing fluids and hydrating with IVs, keeping the uterus contracted by giving methergine,
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Obstetric emergency which can kill instantly !! - PPH presenting to ED, so what is the role of Emergency Dept ? The most basic presentation of Obstetric emergency and how to tackle it? Being an emergency physician, obstetrics is always challenging! Keep yourself updated with Obstetric emergency.
This document discusses causes and management of antepartum haemorrhage (APH). The main causes are placenta praevia (20%), abruptio placentae (30%), and indeterminate (45%). Management involves resuscitation, identifying the cause using ultrasound, and managing the specific cause. Placenta praevia risks include prematurity and PPH. Abruptio placentae risks include fetal death from inadequate oxygen. Women with prior c-sections are at increased risk of morbidly adherent placenta. Indeterminate APH requires delivery by 40 weeks due to possible minor abruptio.
Postpartum haemorrhage (PPH) is defined as blood loss greater than 500 mL following vaginal delivery or 1000 mL following cesarean delivery. The main causes of PPH are uterine atony, retained placental fragments or blood clots, genital tract trauma, and coagulation disorders. Risk factors include uterine fibroids, multiple pregnancy, and polyhydramnios. Clinical signs include lightheadedness, fatigue, and dropping blood pressure and pulse as blood loss exceeds 1500 mL. Treatment involves uterine massage, IV fluids and oxytocics, emptying the bladder, repairing lacerations, and blood transfusions. Prevention strategies include active management of the third stage of labor and careful examination of the
Abruptio placenta, or premature separation of the placenta from the uterine wall, can occur anytime after 20 weeks of pregnancy. It poses risks to both the mother and fetus, such as bleeding, shock, and restricted blood flow between the placenta and fetus. Risk factors include advanced maternal age, smoking, and prior abruption. Management may involve bed rest, monitoring of the fetus and mother, and sometimes surgical delivery of the baby via cesarean section.
1. Post-partum haemorrhage (PPH) remains a major cause of maternal mortality worldwide, accounting for approximately 100,000 deaths annually.
2. PPH can be primary (within 24 hours of delivery) or secondary (after 24 hours) and is usually caused by uterine atony (80%) or trauma (20%). Prevention focuses on risk identification, active management of the third stage of labour, and prompt treatment.
3. Initial management of PPH involves uterotonic drugs, uterine massage, IV fluids, and bimanual compression. If bleeding continues, additional measures may include condom catheter tamponade, uterine or internal iliac artery ligation, or hysterectomy.
1) Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality, complicating between 1 in 20 and 1 in 100 deliveries.
2) PPH can be classified as primary (occurring within 24 hours of delivery) or secondary (occurring 24 hours to 12 weeks after delivery). The most common causes of primary PPH are uterine atony, retained placental tissue, and genital tract trauma.
3) Prevention through active management of the third stage of labor and use of uterotonics can reduce the risk of PPH by 40%. Treatment involves bimanual uterine compression, uterotonics, uterine tamponade, and in severe cases, procedures like
Third stage complications of labour- post partum hemorrhage in obstetrics and...sreya paul
management of postpartum hemorrhage in obstetrics and gynecology,bleeding can lead to death of mother after delivery. it is a very serious problem that need immediate interventions
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
This document discusses postpartum hemorrhage, including definition, risk factors, diagnosis, and treatment. It begins with two case examples of women experiencing heavy bleeding after delivery. The main causes of postpartum hemorrhage - uterine atony, retained placenta, lacerations, and coagulation disorders - are reviewed. Treatment focuses on the "four Ts": addressing tone with uterotonic drugs, checking for retained tissue, repairing any trauma, and evaluating for thrombin abnormalities. Early diagnosis and treatment are important to prevent severe bleeding and potential mortality from postpartum hemorrhage.
This document discusses complications of the third stage of labor, specifically postpartum hemorrhage. It defines postpartum hemorrhage, classifies it by severity and timing, and identifies the main causes as being an atonic uterus, trauma, retained placental tissues, and coagulation disorders. The management of postpartum hemorrhage is described in stages from immediate resuscitation through bimanual compression, uterine tamponade, surgery such as ligation of arteries, and hysterectomy if needed. Specific approaches are provided for addressing atonic, traumatic, or coagulation-related causes of bleeding.
3rd stage of labour by dr shazia a khan 4 mar 19mahmoodayub2
The third stage of labor involves delivery of the placenta and ends with delivery of the membranes, normally lasting 5-15 minutes. Complications during this stage can include postpartum hemorrhage (PPH), the leading cause of maternal mortality worldwide. PPH is primarily caused by uterine atony, genital tract trauma, retained placental tissue, or uterine inversion. Management involves resuscitation, uterotonics to contract the uterus, examination under anesthesia, and potentially surgical interventions like uterine artery ligation.
Dr. Monika Madaan discusses postpartum hemorrhage (PPH), a leading cause of maternal mortality. PPH is defined as blood loss over 500ml after delivery. Risk factors include placenta previa/accreta, coagulopathy, overdistended uterus, grand multiparity, abnormal labor, and previous PPH history. Active management of the third stage of labor can help prevent PPH. Treatment involves resuscitation, fluid replacement, administering uterotonics and other drugs, uterine tamponade, compression sutures, devascularization, and hysterectomy if needed. New developments include tranexamic acid and recombinant factor VII. Proper documentation and debriefing are also
BLEEDING IN LATE PREGANCY MAL PRESENTATIONS.pptxKwizeravirgile1
The document provides information on abnormal midwifery, including assessing and managing complications like bleeding in late pregnancy, malpresentations, and malpositions. It discusses placenta previa and placental abruption, their risk factors, signs and symptoms, investigations, and management. Uterine rupture is also defined and its causes, signs, investigations, and surgical management are outlined. Finally, different malpresentations like brow, face, breech, and transverse positions are defined along with their diagnosis and management.
Postpartum hemorrhage (PPH) is defined as blood loss exceeding 500 ml after vaginal delivery within 24 hours. It is a leading cause of maternal mortality, especially in resource-poor settings. Risk factors include polyhydramnios, macrosomia, prolonged labor, and previous surgery. Management involves resuscitation, assessing uterine contraction, exploring the uterus, and administering oxytocics for atony or performing manual removal of placental tissue. Prevention strategies include active management of the third stage of labor with oxytocics immediately after delivery and risk assessment during antenatal care.
This document discusses post-partum hemorrhage (PPH), including its definition, causes, risk factors, prevention, and management. It describes:
1) PPH is defined as blood loss over 500ml within 24 hours of delivery. The main cause is uterine atony but can also be due to retained placenta or trauma.
2) Risk factors include previous c-section, large babies, and medical conditions like placenta previa. Prevention focuses on identifying risks antenatally and using oxytocics to manage the third stage of labor.
3) Initial management of PPH involves resuscitation, oxytocics, and identifying the cause. Further steps may include balloon
This document discusses various risk conditions and complications related to pregnancy. It covers topics such as maternal mortality rates, high risk factors, gestational conditions like hyperemesis gravidarum and polyhydramnios/oligohydramnios. It also discusses hemorrhagic disorders like placenta previa and abruptio placentae. Other topics covered include hypertensive states of pregnancy including preeclampsia, Rh sensitization, and blood group incompatibilities.
Postpartum haemorrhage (PPH) is a major cause of maternal mortality. It can be primary (within 24 hours of delivery) or secondary (24 hours to 6 weeks postpartum). Primary PPH is usually due to uterine atony or trauma during delivery. Management involves emptying the uterus, replacing blood loss, and ensuring haemostasis. Secondary PPH is often caused by infection or retained placental fragments. Treatment focuses on identifying and addressing the underlying cause while providing supportive care.
This document provides information on assessing and managing common obstetric and gynecologic emergencies that EMTs may encounter including ectopic pregnancy, pelvic inflammatory disease, spontaneous abortion, preeclampsia, eclampsia, abruptio placentae, placenta previa, uterine rupture, emergency childbirth, breech presentation, limb presentation, prolapsed cord, meconium, and multiple births. Key steps are providing high-flow oxygen, rapid transport, addressing any hemorrhage or shock, and preparing for potential neonatal resuscitation.
The classic sign of a postpartum infection is a temperature increase of 100.4 degrees F or higher on any two consecutive days of the first 10 days postpartum, not including the first 24 hours.
Some other signs and symptoms of postpartum infection include:
- Foul smelling lochia or discharge
- Malaise, anorexia, tachycardia, chills
- Pelvic pain
- Elevated white blood cell count
Treatment would include administering broad spectrum antibiotics, providing warm sitz baths, promoting drainage by having the patient lie in a high Fowler's position, forcing fluids and hydrating with IVs, keeping the uterus contracted by giving methergine,
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Obstetric emergency which can kill instantly !! - PPH presenting to ED, so what is the role of Emergency Dept ? The most basic presentation of Obstetric emergency and how to tackle it? Being an emergency physician, obstetrics is always challenging! Keep yourself updated with Obstetric emergency.
This document discusses causes and management of antepartum haemorrhage (APH). The main causes are placenta praevia (20%), abruptio placentae (30%), and indeterminate (45%). Management involves resuscitation, identifying the cause using ultrasound, and managing the specific cause. Placenta praevia risks include prematurity and PPH. Abruptio placentae risks include fetal death from inadequate oxygen. Women with prior c-sections are at increased risk of morbidly adherent placenta. Indeterminate APH requires delivery by 40 weeks due to possible minor abruptio.
Postpartum haemorrhage (PPH) is defined as blood loss greater than 500 mL following vaginal delivery or 1000 mL following cesarean delivery. The main causes of PPH are uterine atony, retained placental fragments or blood clots, genital tract trauma, and coagulation disorders. Risk factors include uterine fibroids, multiple pregnancy, and polyhydramnios. Clinical signs include lightheadedness, fatigue, and dropping blood pressure and pulse as blood loss exceeds 1500 mL. Treatment involves uterine massage, IV fluids and oxytocics, emptying the bladder, repairing lacerations, and blood transfusions. Prevention strategies include active management of the third stage of labor and careful examination of the
Abruptio placenta, or premature separation of the placenta from the uterine wall, can occur anytime after 20 weeks of pregnancy. It poses risks to both the mother and fetus, such as bleeding, shock, and restricted blood flow between the placenta and fetus. Risk factors include advanced maternal age, smoking, and prior abruption. Management may involve bed rest, monitoring of the fetus and mother, and sometimes surgical delivery of the baby via cesarean section.
1. Post-partum haemorrhage (PPH) remains a major cause of maternal mortality worldwide, accounting for approximately 100,000 deaths annually.
2. PPH can be primary (within 24 hours of delivery) or secondary (after 24 hours) and is usually caused by uterine atony (80%) or trauma (20%). Prevention focuses on risk identification, active management of the third stage of labour, and prompt treatment.
3. Initial management of PPH involves uterotonic drugs, uterine massage, IV fluids, and bimanual compression. If bleeding continues, additional measures may include condom catheter tamponade, uterine or internal iliac artery ligation, or hysterectomy.
1) Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality, complicating between 1 in 20 and 1 in 100 deliveries.
2) PPH can be classified as primary (occurring within 24 hours of delivery) or secondary (occurring 24 hours to 12 weeks after delivery). The most common causes of primary PPH are uterine atony, retained placental tissue, and genital tract trauma.
3) Prevention through active management of the third stage of labor and use of uterotonics can reduce the risk of PPH by 40%. Treatment involves bimanual uterine compression, uterotonics, uterine tamponade, and in severe cases, procedures like
Third stage complications of labour- post partum hemorrhage in obstetrics and...sreya paul
management of postpartum hemorrhage in obstetrics and gynecology,bleeding can lead to death of mother after delivery. it is a very serious problem that need immediate interventions
Similar to post patum hemorrage presentation that elaborte the clinical features of PPH (20)
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
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.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
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
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
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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.
6. Management
1. Prevention
Assessment of risk
Sytometern with anterior shoulder vaginal delivery (beware of 2nd twin
PGF 2alpha. IM or intrauterine & C.S ( beware of bronchospasm)
Do not manipulate uterine fundus
7. 2. Diagnosis
Estimation of blood loss (visual)
Vital signs Pulse, BP
Look for sweating palor, drowsiness
Feel uterine fundus
Ask midwife to check placenta
Assess perineum
5 ml of blood in test tube
If bleeding is not heavy- think unexplained shock Rupture Uterus, Uterine
inversion, Amniotic Fluid Embolism
8. 3. Treatment
A. immediate
Positioning, O2, Morphine
Correct hypovolemia: large IV cannula
fluid: saline, haemacele or plasma
Send blood of HB, coagulation, grouping &crossmatch 5 units, U&E
Rub for contraction and massage
If placenta retained controlled cord traction
Drugs: Iv Oxytocin, Ergometrin, PGF2 alpha
9. Operative
Transfer to theatre. Position, good Light, Anaesthesia
1. If placenta retained> 30minutes
Manual removal if whole
Retained cotyledon- Polyp forceps
Placenta Accreta
Conservative : primigravida , cut cord short, antibiotics, mesotrexate..
Radical: Multigrada, consent & S.T.A.H
2. If atonic uterus
Bimanual compression
Hot uterine douche/ no packing
If bleeding persists: Laparotomy
bilateral internal iliac artery ligation
if fails: S.T.A.H
10. 3. Traumatic (laceration)
Valva, vagina or cx
need suturing
Rupture uterus - Laparotomy
or laparoscopy for suturing the rent or S.T.A.H