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.
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.
This topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
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.
Cord prolapse is a frightening and life-threatening event that occurs in labor. Rapid identification and immediate appropriate response may well save the life of a neonate. Therefore, clinicians should be knowledgeable in its recognition and management.
Cephalopelvic disproportion (CPD) is a pregnancy complication that may interferes with vaginal delivery; making it dangerous or impossible and requires caeserean section.
Obstetrics and Gynecological Nursing
The PPT contains detailed information about Abnormal uterine action, its classifications, causes, sign and symptoms and management.
This topic contains detailed description about labour, its definition, date of onset of labour, calculations of date of delivery, causes of onset of labour, physiology of normal labour, and events, clinical course and management of each stages of labour.
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.
Cord prolapse is a frightening and life-threatening event that occurs in labor. Rapid identification and immediate appropriate response may well save the life of a neonate. Therefore, clinicians should be knowledgeable in its recognition and management.
Cephalopelvic disproportion (CPD) is a pregnancy complication that may interferes with vaginal delivery; making it dangerous or impossible and requires caeserean section.
Obstetrics and Gynecological Nursing
The PPT contains detailed information about Abnormal uterine action, its classifications, causes, sign and symptoms and management.
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.
This topic contains Gametogenesis- oogenesis and spermatogenesis, ovulation, fertilization, development of fertilized ovum/ zygote, implantation, development of decidua, chorion and chorionic villi, development of inner cell mass.
This topic includes menstruation:- its definition, anatomical aspects- follicular growth and atresia, germ cells, premodial follicle; menstrual cycle/ ovarian cycle:- definition, phases- recruitment of groups of follicles (premature phase), selection of dominant follicle and its maturation, ovulation, follicular atresia; Endometrial cycle:- division of endometrium- basal zone, functional zone and its phases- stage of regeneration, stage of proliferation, secretory phase, menstrual phase, mechanism of menstrual bleeding, role of prostaglandins, hormones in relation to ovarian and menstrual cycle, ovulation, luteal-follicular shift, menstrual symptoms, menstrual hygiene, anovular menstruation, artificial postponement; cervical cycle, vaginal cycle and general changes in follicular and luteal phase.
This topic includes difference between female and male pelvis, various pelvis types, general description of pelvis bones, division of pelvis, landmarks of pelvis, plane, axis, sacral angle, diameters of inlet, cavity and outlet.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
This topic includes Introduction, common side effects from maternal medications on infants, guidelines for medication during lactation, effects of various medications on lactation and neonates
This topic contains anticonvulsants used in obstetrics such as magnasium sulphate, diazepam, phenytoin and anticoagulants such as heparin and warfarin.
It is from biochemistry subject and continuation of previous topic from organization of matter. This topic contains definition of Chemistry, Matter, Mass, Weight. Description of physical state of matter and chemical structure of matter.
link for previous topic: organization of matter- important terms
https://www.slideshare.net/priyankagohil10/organization-of-matter-important-terms-237314150
Vital statistics related to maternal health in indiaPriyanka Gohil
This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
Presentation on this topic is available on link 👇
https://youtu.be/d_JgNiYv7eU
This topic contains detail about genital prolapse in pregnancy, It's definition, incidence, types, stages, causes, risk factors, clinical features, effect of prolapse, effect on pregnancy, effect during labour and puerperium, prevention, treatment and nursing management during pregnancy, labour and puerperium.
This topic contains definition, incidence, varieties, causes, risk factors, dangers, diagnosis, prognosis, prevention and management of inversion of uterus.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
This topic contains definition, meaning, classification, pathophysiology, clinical menifestations, metabolic and general changes, management of obstetrical shock
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.
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.
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
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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
4. The prolongation may be due to
protracted cervical dilatation in the first
stage and/or inadequate descent of the
presenting part during the first or
second stage of labor.
Labour is considered prolonged when
the cervical dilatation rate is less than 1
cm/hr and descent of the presenting
part is < 1 cm/hr for a period of
minimum 4 hours observation (WHO-
1994)
5. Prolonged labour is not synonymous
with inefficient uterine contraction can
be a prolonged labour but labour may
also be prolonged due to pelvic or fetal
factor.
6. Latent phase is the preparatory phase
of the uterus and the cervix before the
actual onset of labour.
Mean duration of latent phase is about
8 hours in a primi and 4 hours in a
multi.
Whether prolonged latent phase has
got any adverse effect on the mother or
on the fetus, it is not clearly known.
7. A latent phase that exceeds 20 hours in
primigravidae or 14 hours in multiparae is
abnormal.
The causes include:-
1) Unriped Cervix
2) Malposition and Malpresentation
3) Cephalopelvic Disproportion
4) Premature Rupture of the Membranes
Prolonged latent phase may be worrisome
to the patient but does not endanger the
mother or fetus.
8. Expectant management is usually done
unless there is any indication (for the
fetus or mother) for expediting the
delivery.
Rest and Analgesic are usually given
When augmentation is decided,
medical methods ( oxytocin or
prostaglandin) are preferred.
9. Amniotomy is usually avoided.
Prolonged latent phase is not an
indication for cesarean section
delivery.
11. Failure to dilate the cervix is due to:-
FAULT IN POWER
Abnormal Uterine Contraction such as uterine
inertia or incoordinate uterine contraction
FAULT IN PASSAGE
Contracted pelvis, cervical Dystocia,
Pelvic Tumor, or even full bladder
FAULT IN PASSENGER
Malposition (OP) and Malpresentation
(face, brow), congenital anomalies of the
fetus (hydrocephalus)
12. Too often deflexed head, minor
degrees of pelvic contraction and
disordered uterine action have got
sinister (threatening) effect in causing
non-dilatation of cervix.
OTHERS
Injudicious (early) administration of
sedatives and analgesics before the
active labour begins.
16. Prolonged labour is not a diagnosis but
it is the manifestation of an
abnormality, the cause of which should
be detected by a thorough abdominal
and vaginal examination
During vaginal examination if the
finger is accomodated in between the
cervix and the head during uterine
contraction pelvic adequecy can be
reasonably established.
17. • Intranatal imaging ( radiography, CT or
MRI) is of help in determining the fetal
station and position as well as pelvic
shape and size.
FIRST STAGE
Duration is > 12 hours
Cervical dilatation rate < 1 cm/hr in
primi and < 1.5 cm/hr
Rate of descent of presenting part is <
1 cm/hr in primi and < 2 cm/hr in multi
18. A) Protracted (prolongated) active phase
It may be due to:-
Inadequate uterine contraction
Cephalopelvic disproportion
Malposition
Malpresentation
Epidural anaesthesia
DISORDERS OF ACTIVE PHASE
19. B) Arrest Disorder
When no dilatation occurs after 2 hours
in active phase of labour
Commonly due to:-
Inefficient uterine contraction
No descent for a period of > 1hour is
called arrest of descent.
It is commonly due to CPD
20. Secondary Arrest
When Active stage of labour
commences normally but stops or slows
significantly for 2 hours or more prior to
full dilatation of the cervix
Commonly due to malposition or CPD
21. SECOND STAGE
Mean duration of second stage is 50
minutes for nullipara and 20 minutes
for multipara
Prolonged stage is diagnosed if the
duration exceeds 2 hours in nullipara
and 1 hour in a multipara when no
regional anesthesia used.
1 hour or more is usually permitted in
both the groups when regional
anesthesia is used during labour.
22. A) Protraction Descent
When:-
Descent of presenting part is < 1 cm/hr
in nullipara and < 2 cm/hr in multipara
May be due to one or combination of
several underlying abnormalities like
CPD, Malposition, Malpresentation,
Inadequet uterine contraction
DISORDERS OF SECOND STAGE
25. PREVENTION:-
Antenatal or early intranatal detection
Use of partograph
Selective and injudicious augmentation
Change of posture in labour
26. ACTUAL MANAGEMENT
Careful evaluation is to be done to find
out:-
Cause of prolonged labour
Effect on the mother
Effect on the fetus
In nulliparous women: Inadequete
uterine activity, primary dysfunctional
labour
In multiparous women: CPD,
28. DEFINITIVE TREATMENT
FIRST STAGE DELAY
IF only uterine activity is suboptimal,
Amniotomy/ oxytocin infusion
Effective pain relief
SECONDARY ARREST
Careful use of oxytocin
Cesarean section delivery
29. SECOND STAGE DELAY
Short period of expectant management
is reasonable provided the FHR is
reassuaring and vaginal delivery is
emminent
Otherwise, appropriate assisted
delivery , vaginal or abdominal should be
done.
Difficult instrumental delivery should
be avoided.