The document discusses various topics related to preterm and post-term infants. It defines preterm babies as those born before 37 weeks of gestation and notes that preterm births account for 2/3 of low birth weight babies. Potential causes of preterm birth are discussed. The document also summarizes the characteristics, assessment findings, and care needs of preterm infants. Risk factors and screening for intrauterine growth restriction are outlined. Post-term infants are defined as those born after 42 weeks gestation and their characteristics are summarized. Methods for screening and monitoring post-term pregnancies are also mentioned.
neonatal hypothermia is a very emergency condition. if we identify this in early stage we can save the life of neonate. all should know about the maintaining the temperature if the neonate is in our home.
neonatal hypothermia is a very emergency condition. if we identify this in early stage we can save the life of neonate. all should know about the maintaining the temperature if the neonate is in our home.
baby born before 37 weeks of gestation calculating from the first day of last menstural period is defined as preterm baby/ premature baby.
These babies are known as preemies
baby born before 37 weeks of gestation calculating from the first day of last menstural period is defined as preterm baby/ premature baby.
These babies are known as preemies
Management of Preterm And Low Birth Weight
Dr. Raheel Ahmed FCPS Pediatrics
Children Hospital, Chandka Medical College Larkana
Definitions
Prevalent
Etiology
Assessment of gestational age
Problems of prematurity
Management
Antenatal (Prevention)
Natal (Delivery room care)
Post natal (after birth care)
Prognosis
Discharge criteria
Definitions
Term?
Preterm?
Immature?
LBW? VLBW?ELBW? ILBW?
SGA?
IUGR?
Gestational Age
Full-term
infant born after 37 completed menstrual weeks of pregnancy
Preterm (or premature) infant
infant born before 37 completed weeks of gestation
Late preterm infant (a recently identified category)
infant born between 34 and 36 weeks gestation
Moderately preterm infant
infant born between 32 and 34 completed weeks of gestation
Very preterm infant/ Early preterm
infant born before 32 completed weeks of gestation
Immature < 28 weeks
ELGAN: Extremely Low Gestational Age Newborn < 26 weeks
Weight
Low birth weight (LBW)
infant who weighs less than 2,500 grams at delivery
Very low birth weight (VLBW)
infant who weighs less than 1,500 grams at delivery
Extremely low birth weight (ELBW)
infant who weighs less than 1,000 grams at delivery
Incredible Low birth weight
infant who weighs less than 750 grams at delivery
Pre-term, Small for gestational age and Post-term InfantLipi Mondal
Due to high risk of pregnancy there are several adverse outcome or poor perinatal outcome we can see.... So most commonly adverse out come should be known by health care providers.
The high risk neonate is defined as one who has a greater than average chance of morbidity or mortality during the prenatal ,peri natal and postnatal periods..
Lactation management is the science and art of assisting women and infants with breastfeeding, because the mother-infant pair is dynamically interrelated for breastfeeding, it is imperative to consider both individuals when attempting to assess and “manage” breastfeeding.
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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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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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.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. DEFINITION:
A baby born before 37
completed weeks of gestation
calculating from the first day of last
menstrual period is arbitrarily
defined as preterm baby
Babies born before 37
completed weeks usually weighing
2500gms or less.
3. Preterm baby constitutes 2/3
rd of low birth weight
babies. The incidence of low
birth weight baby is about
30-40% in the developing
countries as such the
incidence of preterm baby is
about 20-25%.
5. Health status of the mother
Multiple pregnancy
Advanced parental age
Placental problems
Preterm labour and premature rupture of membrane
Low maternal weight
Chronic and acute systemic maternal disease
Ante partum haemorrhage
Cervical incompetence
Maternal genital colonization and infections
Cigarette smoking during pregnancy
Acute emotional stress
Physical exertion
Sexual activity
Trauma
Bicornuate uterus
Congenital malformations
6. Maternal diabetes mellitus
Placental dysfunction as indicated
by
unsatisfactory fetal growth
Eclampsia
Fetal hypoxia
Ante partum haemorrhage
Severe rhesus iso immunization
7. Measurements:
Size is small with relatively large
head
Crown- heel length is less than 47cm
Head circumference is less than 33
cm
But exceeds the chest
circumference by more than 33 cm
8. Activity and posture:
General activity is poor
Automatic reflex response such as
Moro response, sucking and
swallowing are sluggish or
incomplete
Baby assumes an extended posture
due to poor tone
9. Face and head:
Face appears small
large head size
Sutures are widely separated
Fontanels are large
Small chin
Protruding eyes
Optic nerve is usually unmyelinated
Ear cartilage is deficient or absent with poor
recoil
Hair appears woolly, and fuzzy and individual
hair fibres can be seen separately
10. Skin and subcutaneous tissues:
Skin is thin, gelatinous, Shiny and
excessively pink
Abundant lanugo
Very little vernix caseosa
Edema may be present
Subcutaneous fat is deficient
Breast nodule is small or absent
12. Skin
Bright pink, often translucent,
depending on the degree of maturity
Smooth and shiny ( may be
oedematous)
Small blood vessels clearly visible
underneath the thin epidermis
Fine lanugo hair is abundant
13. Ear cartilage
Soft and pliable
Soles and palms
Minimal creases
Smooth appearance
Scarf sign
Elbow may be easily brought
across the chest with little or
no resistance
14. Male genitalia
Male infant’s scrotum is undeveloped and
not pendulous
Minimal rugae are present
Testes may be in the inguinal canal or in
the abdominal wall
Female genitalia
Clitoris is prominent
Labia majora are poorly developed and
gaping
15. Central nervous system:
o Immaturity of central nervous
system
o Poor cough reflex
o In coordinated sucking and
swallowing
o Retrolental fibroplasias
o Intra ventricular and
periventricular haemorrhage
16. Respiratory system
Resuscitation difficulties at birth
Hyaline membrane disease
Breathing is periodic and associated with
intercostal recessions due to soft rib
Pulmonary aspiration
Atelectasis
Broncho pulmonary dysplasia
17. Cardio vascular system
The closure of ductus arteriosus is delayed
among preterm infants
G I system
Regurgitations and aspirations
Abdominal distension and functional
intestinal obstruction
Enter colitis
Hyperbilirubinemia
Hypoglycaemia
18. Thermo-regulation
Excess heat loss
Infections
Renal immaturity
The blood urea nitrogen is high
Acidosis
Edema
Toxicity of drug
Nutritional problems
anemia
Deficiencies of folic acid and Vit E
osteopenia and rickets
Biochemical disturbance
hypoglycaemia, hypocalcemia, hypoxia
20. Cushioned bed
Avoid excessive light, excessive sound, rough handling and painful procedures.
Use effective analgesia and sedation for procedures
Provide warmth
Ensure asepsis
Cover the baby appropriately
Provide effective and safe oxygenation
Nutrition
Tactile and kinaesthetic stimulation
Prone position
Photo therapy
Prevention of nosocomial infection
Weight record
Immunizations
Family support
Discharge policy
Follow up
Home care of preterm babies
31. MAJOR RISK FACTORS
Maternal age >40 years
Smoker > 11 cigarettes per day
Cocaine
Daily vigorous exercise
Previous SGA baby
Previous stillbirth
Maternal SGA
C/c HTN
Diabetes & vascular diseases
Renal impairment
Antiphospholipid syndrome
Echogenic bowel
preeclampsia
Severe pregnancy induced HTN
Low maternal weight
32. MINOR RISK FACTORS
Maternal age > 35 years
Nulliparity
BMI <20
BMI 25-29.9
Smoker 1-10 per day
Low fruit intake per day
Preeclampsia
Pregnancy interval < 6 months
34. 1. SCREENING:
Accurate knowledge of gestational age
Past history of IUGR & any maternal
complication
On obstetric palpation, height of uterus <4
weeks or more for the gestational age.
Uterine fundal height: serial fundal height
measurements throughout pregnancy.
35. Ultrasound measurements:
Fetal biometry: fetal parietal
diameter(BPD),femur length (FL) &abdominal
circumference(AC) are measured.
Body proportions: HC/AC ratio, FL/AC ratio &
ponderal index for asymmetric IUGR.
HC/AC ratio: size of liver is disproportionately
smaller than head circumference or length of
femur
Amniotic fluid volume: Oligohydraminos d/t ↓
fetal urine production.
Doppler velocimetry: abnormal umbilical artery
Doppler velocimetry increased systolic-diastolic
ratio, absent or reverse end-diastolic flow.
36.
37. Infants born of a
gestation age that
extends beyond 42
weeks as calculated
from the mothers last
menstrual period
38. Pregnancy between the age of
15-19yrs
Elderly women
Wrong dates
Multiple pregnancy
Fetal anomalies
hereditary
39. Absence of vernix caseosa
Loose skin and little subcutaneous
fat
Absence of lanugo
Abundant hair on the head and long
nails
Skin is wrinkles, cracked and peeling
Umbilical cord is thin
41. Clear the airway
Maintain thermoregulation
Prevention of infection
APGAR scoring
Early beast feeding
Card care
Eye care
Preventing hypoglycemia
Administer vitamin K injection
Assess the weight