Preconception care involves counseling women before pregnancy about nutrition, lifestyle factors, medical conditions, and other issues that could impact a future pregnancy. Components of preconception care include risk assessment, health promotion, medical intervention, and psychosocial intervention. The goals are to improve pregnancy outcomes, have a healthy baby, and support the mother's well-being.
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Maternal and Neonatal morbidity and MortalityBPKIHS
It deals with:
Introduction
International Perspectives
National Status
Complication during Pregnancy, Childbirth, Postpartum period including Neonatal Problems
Causes of Maternal and neonatal mortality
Framework of determinants of maternal mortality
Three delay model
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
It explains the mechanism of normal labour to medical and para-medical staff.It also puts light on principle movements underlying mechanism of normal labour with pictures.Thank You Like an share it to the maximum.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Maternal and Neonatal morbidity and MortalityBPKIHS
It deals with:
Introduction
International Perspectives
National Status
Complication during Pregnancy, Childbirth, Postpartum period including Neonatal Problems
Causes of Maternal and neonatal mortality
Framework of determinants of maternal mortality
Three delay model
Every woman should be thinking about her health whether or not she is planning pregnancy. One reason is that about half of all pregnancies are not planned. Unplanned pregnancies are at greater risk of preterm birth and low birth weight babies. Another reason is that, despite important advances in medicine and prenatal care, about 1 in 8 babies is born too early. Researchers are trying to find out why and how to prevent preterm birth. But experts agree that women need to be healthier before becoming pregnant. By taking action on health issues and risks before pregnancy, you can prevent problems that might affect you or your baby later.
Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ensure a positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases.
In any community, mothers and children constitute a priority group. In sheer numbers, they comprise approximately 71.14 per cent of the population of the developing countries. In India, women of the child bearing age(15-44 years) constitute 52.4 per cent of total female population, and children under 15 years of age about 26.5 per cent of the total population. Together they constitute nearly 57.5 per cent of the total population. By virtue of their numbers, mothers and children are the major consumers of health services, of whatever form.
Mothers and children not only constitute a large group, but they are also a "vulnerable" or special-risk group. The risk is connected with child-bearing in the case of women; and growth, development and survival in the case of infants and children. Whereas 50 per cent of all deaths in the developed world are occurring among people over 70, the same proportion of deaths are occurring among children during the first five years of life in the developing world. Global observations show that in developed regions maternal mortality ratio averages at 12 per 100,000 live births; in developing regions the figure is 232 for the same number of live births (1). From commonly accepted indices, it is evident that infant, child and maternal mortality rates are high in many developing countries. Further, much of the sickness and deaths among mothers and children is largely preventable. By improving the health of mothers and children, we contribute to the health of the general population. These considerations have led to the formulation of special health services for mothers and children all over the world.
The problems affecting the health of mother and child are multifactorial. Despite current efforts, the health of mother and child still constitutes one of the most serious health problems affecting the community, particularly in the developing countries. The present strategy is to provide mother and child health services as an integrated package of "essential health care", also known as primary health care which is based on the principles of equity, intersectoral coordination and community participation. The primary health care approach combines all elements in the local community necessary to make a positive impact on the health status of the population, including the health of mothers and children.
Mother and child - one unit
Mother and child must be considered as one unit. It is because:
(1) During the antenatal period, the foetus is part of the mother. The period of development of foetus in mother is about 280 days. During this period, the foetus obtains all the
(2) Child health is closely related to maternal health. A healthy mother brings forth a healthy baby; there is less chance for a premature birth, stillbirth or abortion.
(3) Certain diseases and conditions of the mother during pregnancy (e.g., syphilis, german measles, drug intake) are likely to have their effects upon the foetus.
(4) After birth, the child is
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
3. INTRODUCTION
There were about 4million birth in the U.S
in 2003,with almost all born healthy but, the
infant mortality rate in the U.S ranked 28th
that year.
Preconception care has been advocated as a
measure to improve pregnancy outcomes i.e
healthy child/children and mother with
happy family
4. TIMING
The appropriate time for preconception care
include:
Routine health maintenance visits
Pre-appointment examination
Pre-marital or family planning visit
After negative pregnancy test
Pre-school examination
5. COMPONENTS
Components of preconception care
parallels that of prenatal care i.e :
Risk assessment
Health promotion
Medical intervention
Psychosocial intervention
6. NUTRITION
A woman’s nutritional status may have a profound effect on
reproductive outcome
The two forms of malnutrition are : over nutrition (obesity) and
under nutrition
Obesity
poses the following risks:
hypertensive disorders
gestational diabetes
UTI
LGA babies
Intrapartum complications
Obese patients should be advised to loose weight before
pregnancy
8. NUTRITION CONT’D
At preconception visit patient’s weight and
height should be measured and inquiries
should be made about Bulimia, Anorexia ,
Pica, Vegetarian eating habits ,
Megavitamins supplements e.g. vitamin A is
a known teratogen at high doses(>5000
iu/d).However , it should be noted that
retinol not B-carotene which is found in
fruits and vegetables is the teratogenic form.
9. Folic acid supplementation
4000 pregnancies are affected in the U.S. by
neural tube defects(NTDs);spinal
bifida,anencephaly and encephalocele.Spinal
bifida is usually complicated with disabilities
like paraplegia, bowel incontinence,bladder
incontinence,hydrocephalus,and intellectual
impairment.
Studies have shown a 72% reduction in
recurence of NTDs with 4mg daily dose of folic
acid.
10. Folic acid contd
CDC recomends that all women of
childbearing age who are capable of
becoming pregnant take 0.4mg of folic acid
daily starting 1-3 month prior to planned
conception and through the 1st trimester.
11. EXERCISE
Available data suggest that moderate
exercise is safe for pregnant women who
have no medical or obstetric complication
Advantages of exercise include:
decrease pregnancy related discomfort
improve maternal fitness
improve maternal self-esteem
12. MEDICAL CONDITIONS
Diabetes mellitus
congenital anomalies is 2-6 times
commoner in pregnant diabetic patients
compared with non-diabetic pregnant
women.
RBS goal in pregnant diabetic is 110mg/dl
while 2hpp should not exceed 115mg/dl
13. Medical condition contd
Hypertention
preconception hypertention should be
adequately managed
Epilepsy
Epilepsy is the commonest neurological
problems in pregnancy. It leads to
menstrual irregularity ,ovulatory
dysfunction and infertility.
14. Phenylketonuria
Most common in-born error of
metabolism that leads to mental
retardation, seizures, microcephaly,
delayed speech, eczema and autistic-
like behavior.
15. Genetic counseling
The ideal time for genetic counseling is before a
couple attempt to conceive especially in advanced
maternal age, consanguinity or family history of
genetic diseases. e.g. Ashkenazi Jews have 1/25
chance of carrying gene for Tay sach ‘s disease
The U.S whites have 1/22 chance of caring gene for
Cystic fibrosis.
Africans ----------------Sickle cell diseases
Mediterranean -----------β- thalasemia
S/E Asia----------------------&-thalasemia
16. IMMUNIZATIONS.
The following vaccine are recommended in pre-
conception period:
• T.T
• Rubella
• Varicella
• Chicken Pox
• Hepatitis B among others.
-
17. LIFE STYLE CHANGES
CAFFEINE
Caffeine is present in most beverages, in chocolates and in
over -the - counter, medications such as cold and headache
medicine. 1 cup of coffee contains only 120mg, a cup of tea
has 40mg and coke has 45mg per 12-02. consumption of
caffeine during pregnancy is quite common, but its
metabolism is slow. Cigarette smoking increases caffeine
metabolism leading to high intake.
EFFECTS.
• Decreased fertility
• Increased spontaneous abortion
• Decreased birth rate.
18. TOBACCO
12 -20% of woman smoke during pregnancy,
subjecting themselves and their infants to a
number of adverse effect. Woman
contemplating pregnancy should be advised
to quit smoking.
19. LIFE STYLE CHANGES CONTD.
ALCOHOL
The most severe consequence of exposure to
alcohol during pregnancy is Fetal Alcoholic
Syndrome (FAS) consisting of a trial of
prenatal or postnatal growth retardation,
Neuro-developmental abnormalities and
facial abnormalities. It is the largest
preventable cause of birth defect and
mortality rate in western world. Intending
mothers should be counseled that there is
no safe level of alcohol consumption during
pregnancy. Effects include: Infertility,
spontaneous abortion, hypertension, stroke,
20. ILLICIT DRUGS
At preconception visits, inquiry should be made
about drugs used and counseling, referred and
access to recovery program me should be offered as
the case may be. Examples of drugs are: Marijuana,
Heroine, Cocaine. Their effects are: Hyperactivity,
Inattention syndrome in older years, LBW, IUGR,
Preeclampsia, Abruptio Placenta, Fetal distress,
sudden infant death syndrome, GI dysfunction.
21. STI
The preconception visit is a good opportunity to
screen for genital infections such as: Chlamydia,
Gonorrhea, Syphilis, HIV.
EFFECTS
Chlamydia – Inclusion Conjunctivitis,
Pneumonia
Syphilis – Spontaneous abortion, non-immune
hydrops, still birth, neonatal death
Gonorrhea – Ophthalmia Neonatorium.
HIV
22. LIFESTYLE CHANGES CONT’D
• MEDICATION
Antihypertensive - ACEI (Renal impairment),
Diuretics (decreases maternal plasma volume).
Anticoagulants ---warfarin is a teratogen and it crosses
placenta.Heparin is better sustitute because it does not
cross placenta.–
Antithyroid drugs
Hypoglycaemics – oral hypoglycaemics should be
switched to Insulin.
23. LIFE STYLE CHANGES CONTD
OCCUPATIONAL EXPOSURES
Increasing no of women are entering the workforce world-
wide and most in their reproductive years. The
preconception visit is the best time to identify and control
exposure that may affect parental health and pregnancy
outcome.
The 3 most common occupation exposure reported to
affect pregnancy are:
.Organic
solventse.g.painting,printing,varnishing,plastic etc
.Lead e.g.smelting,printing,battery.
.Video display terminals
24. DOMESTIC VIOLENCE
Domestic violence is increasingly recognized
as a major public health issue. Findings from
the 1998 National Violence Against Women
Survey showed that in the United States 1.5
million women are raped or physically
assaulted by an intimate partner every year.
Domestic violence crosses all socioeconomic,
racial, religious, and educational boundaries.
:
25. Domestic violence cont’d
Even physicians are not immune. In a survey, 17%
of female medical students and faculty had
experienced abuse by a partner in their adult life,
an estimate comparable to that of the general
population. Victims of domestic violence should
be identified preconceptionally, because the
pattern of violence may escalate during
pregnancy. The prevalence of domestic violence
during pregnancy ranges from 0.9% to 20.1%, with
most studies identifying rates between 3.9% and
8.3%.
26. DOMESTIC VIOLENCE CONT’DS
Whereas violence in nonpregnant women is
directed at the head, neck, and chest, the
breasts and the abdomen are frequent
targets during pregnancy. Physical abuse
during pregnancy is a significant risk factor
for low birth weight and maternal
complications of low weight gain,
infections, anemia, smoking, and alcohol or
drug usage.
27. If it is identified that a patient is the victim
of domestic violence, the physician should
assess her immediate safety and make
timely referrals to local community
resources and shelters.
28. CONCLUSION
Preconception care has been
advocated and is being practiced in
some developed countries,the
situation however is different in
this part of the world.Therefore
awareness and education should be
encouraged.