Abdominal pain in pregnancy is a very common problem encountered in day to day practice. Although is can be benign at times great care should be exercised to dismiss as nothing significant.
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor.
Obstetric fistula is an abnormal opening between the reproductive tract (usually the vagina) and the urinary tract (frequently the bladder) or alimentary tract (usually the rectum) or both. Obstetric fistula typically develops after several days of prolonged or obstructed labour.
Bartholin’s Gland
Function :
The production of mucoid secretion that lubricates the
distal end of the vagina during intercourse.
The glands become active after menarche and are non
palpable.
Bartholinitis
Causative agent:
Gonococcus
Streptococcus
Staphylococcus
E. coli
End result :
Complete resolution
Recurrence
Abscess
Cyst formation
Clinical features :
Local pain discomfort.
Difficulty in walking / sitting.
Examination :
Tenderness
Induration of post half of vagina.
Secretion coming out from the duct when pressed.
Treatment
Local :
Systemic:
Ampicillin 500 mg TDS
Bartholin’s Abscess
End result of acute Bartholinitis.
Clinical features:
Severe local pain and discomfort.
Difficult / painful walking and sitting.
On examination:
Unilateral tender swelling.
Oedomatous red overlying skin.
Treatment:
Rest.
Sitz bath.
Systemic antibiotic Ampicillin 500 mg.
Drainage of abscess.
Bartholin’s cyst
The content is colourless glairy liquid.
C/f :
Small cyst : usually unnoticed.
Larger cyst : Local discomfort and dyspareunia.
Examination:
Unilateral swelling on post half of labia majora.
Projection on vulval cleft into S-shape.
Overlying skin is shiny and thin.
Cyst remains non tender and fluctuant.
Treatment:
Marsupilisation.
This presentation contains details on normal anatomy on female pelvis and fetal head, process of normal labour, abnormal labour, induction of labour and malpresentations.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor.
Obstetric fistula is an abnormal opening between the reproductive tract (usually the vagina) and the urinary tract (frequently the bladder) or alimentary tract (usually the rectum) or both. Obstetric fistula typically develops after several days of prolonged or obstructed labour.
Bartholin’s Gland
Function :
The production of mucoid secretion that lubricates the
distal end of the vagina during intercourse.
The glands become active after menarche and are non
palpable.
Bartholinitis
Causative agent:
Gonococcus
Streptococcus
Staphylococcus
E. coli
End result :
Complete resolution
Recurrence
Abscess
Cyst formation
Clinical features :
Local pain discomfort.
Difficulty in walking / sitting.
Examination :
Tenderness
Induration of post half of vagina.
Secretion coming out from the duct when pressed.
Treatment
Local :
Systemic:
Ampicillin 500 mg TDS
Bartholin’s Abscess
End result of acute Bartholinitis.
Clinical features:
Severe local pain and discomfort.
Difficult / painful walking and sitting.
On examination:
Unilateral tender swelling.
Oedomatous red overlying skin.
Treatment:
Rest.
Sitz bath.
Systemic antibiotic Ampicillin 500 mg.
Drainage of abscess.
Bartholin’s cyst
The content is colourless glairy liquid.
C/f :
Small cyst : usually unnoticed.
Larger cyst : Local discomfort and dyspareunia.
Examination:
Unilateral swelling on post half of labia majora.
Projection on vulval cleft into S-shape.
Overlying skin is shiny and thin.
Cyst remains non tender and fluctuant.
Treatment:
Marsupilisation.
This presentation contains details on normal anatomy on female pelvis and fetal head, process of normal labour, abnormal labour, induction of labour and malpresentations.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
this is a lecture to undergraduates and healthcare professionals in the Obstetrics and Gynecology field about an important topic which is ectopic pregnancy. in this lecture, I simply described ectopic pregnancy for beginners in the medical field of Obstetrics and Gynecology with a focus on tubal ectopic pregnancy as it is the most common type of ectopic pregnancy.
I discussed the topic about its definition, important tips about normal pregnancy at its early stages, differential diagnosis, how to reach the correct diagnosis, different lines of management, and what is the situation of Anti D in Rh-negative women
Cervical incompetence is the inability for the cervix to retain an intra-uterine pregnancy till term as a result of structural and functional defects of the cervix
Post-operative apnoea fortunately rare can catch the anaesthetist off guard. A through knowledge is needed to make a quick differential diagnosis to correct the problem leading to prolonged apnoea
Tubing misconnections in critical set up is often a grave error which needs to be addressed well with policies and standard operating procedures. A good understanding of the problem by the team will go a long way in preventing this mishap to ever happen in your team.
Trauma management is a team approach. A careful planned policy & dissemination of information is necessary for good outcome in managing trauma patietns
Presentation describes the pathophysiology of Acute pancreatitis & its management in detail. Information is useful in practice although acute pancreatitis is quite rare
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
India Diagnostic Labs Market: Dynamics, Key Players, and Industry Projections...Kumar Satyam
According to the TechSci Research report titled “India Diagnostic Labs Market Industry Size, Share, Trends, Competition, Opportunity, and Forecast, 2019-2029,” the India Diagnostic Labs Market was valued at USD 16,471.21 million in 2023 and is projected to grow at an impressive compound annual growth rate (CAGR) of 11.55% through 2029. This significant growth can be attributed to various factors, including collaborations and partnerships among leading companies, the expansion of diagnostic chains, and increasing accessibility to diagnostic services across the country. This comprehensive report delves into the market dynamics, recent trends, drivers, competitive landscape, and benefits of the research report, providing a detailed analysis of the India Diagnostic Labs Market.
Collaborations and Partnerships
Collaborations and partnerships among leading companies play a pivotal role in driving the growth of the India Diagnostic Labs Market. These strategic alliances allow companies to merge their expertise, strengthen their market positions, and offer innovative solutions. By combining resources, companies can enhance their research and development capabilities, expand their product portfolios, and improve their distribution networks. These collaborations also facilitate the sharing of technological advancements and best practices, contributing to the overall growth of the market.
Expansion of Diagnostic Chains
The expansion of diagnostic chains is a driving force behind the growing demand for diagnostic lab services. Diagnostic chains often establish multiple laboratories and diagnostic centers in various cities and regions, including urban and rural areas. This expanded network makes diagnostic services more accessible to a larger portion of the population, addressing healthcare disparities and reaching underserved populations. The presence of diagnostic chain facilities in multiple locations within a city or region provides convenience for patients, reducing travel time and effort. A broader network of labs often leads to reduced waiting times for appointments and sample collection, ensuring that patients receive timely and efficient diagnostic services.
Rising Prevalence of Chronic Diseases
The increasing prevalence of chronic diseases is a significant driver for the demand for diagnostic lab services. Chronic conditions such as diabetes, cardiovascular diseases, and cancer require regular monitoring and diagnostic testing for effective management. The rise in chronic diseases necessitates the use of advanced diagnostic tools and technologies, driving the growth of the diagnostic labs market. Additionally, early diagnosis and timely intervention are crucial for managing chronic diseases, further boosting the demand for diagnostic lab services.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
For those battling kidney disease and exploring treatment options, understanding when to consider a kidney transplant is crucial. This guide aims to provide valuable insights into the circumstances under which a kidney transplant at the renowned Hiranandani Hospital may be the most appropriate course of action. By addressing the key indicators and factors involved, we hope to empower patients and their families to make informed decisions about their kidney care journey.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
1. Abdominal pain in pregnancy
Dr.Rupa Rajshekar MBBS, MD
Specialist in Obs & Gyne
2. Introduction
• Abdominal pain is a very common symptom in
pregnant women
• It is of varying degree, may be acute with
rapid onset or chronic that recurs or persists
for long time
• It is convenient to divide the cause of pain due
to pregnancy into those most commonly
encountered in each of the three trimesters
3. • A 22 year old Para-1 with 6-8 weeks gestation
presents with abdominal pain
What are you thinking of???
4. History
• Localized one sided pain, no radiation,
spasmodic to start with – now constant
• Mild p/v bleeding
• Some chest pain & shoulder tip pain
• Has been feeling faint
• Pregnancy test positive
6. Ectopic pregnancy
Pitfalls in diagnosis
• Wide variations in clinical presentation
• Pregnancy test can be negative
• Trans vaginal ultrasound even in best hands is
only 50% accurate in early ectopics
• B-HCG can double in very early ectopics
7. Treatment of ectopic pregnancy
• Medical with Methotrexate
• Surgical – Laparotomy/Laparoscopy
» salphingostomy / salphingectomy
8. Is it Ovarian?
• Corpus luteum cysts:
– Mild aching pain
– Usually asymptomatic
– Maternal pulse in not raised
– Hemorrhage inside cyst can cause severe pain
9. Adnexal torsion
• More common in pregnancy (28%)
• Pain is sudden in onset in lateral lower quadrant
• Fever, leucocytosis, nausea, vomiting
• USS – shows cyst with no flow on color mapping
• At times difficult to differentiate from ectopics
and appendicitis
• Miscarriage & preterm are common
consequences
• Surgery should not be delayed
10. First trimester pain
• Abortion
• Pregnancy in rudimentary horn
• Acute salpingitis
• Acute retention of urine
• Hydatidiform mole
11. A 22 yr old para 1 with 6-8 weeks
amenorrhea presents with
abdominal pain
• The history changes:
– Crampy lower abdominal pain
– Heavy bleeding p/v
– Speculum examination
• Cx os closed
• Cx os open
12. Diagnosis - ? Miscarriage
• Assess hemodynamic stability
• Arrange pelvic ultrasound
• Management depends on ultrasonographic
findings
• No role of B-HCG
• Blood group, Rhesus and anti D if needed
13. Some USS findings
• An intrauterine gestational sac seen 25x30
mm in diameters. No fetus visible
• An IU gestational sac seen 20x20mm in
diameter, Fetal pole seen 6 mm CRL. No FH
• An IU gestational sac seen 35 x35 mm in
diameters low down in the cavity. Fetal pole
seen. FH seen but appears slow
14. The management of miscarriage
• Conservative
• Reassurance and TLC
• No role of bed rest
• ERPOC
15. Miscarriage
• Always confirm a possible complete
miscarriage by serial BHCGs
• This is specially true if there has been no scans
to prove an intrauterine gestational sac
• Pitfall: You might miss an ectopic
16. First trimester pain
• Pregnancy in rudimentary horn
• Pain resemble that of ectopic & usually the
condition discovered during laparotomy
• If rupture occurs it usually in the mid-
trimester & of sudden onset with collapse
17. First trimester pain
• Acute Salpingitis:
• May develop up to 10 wks after conception,
due to gonococcal infection or infection due to
attempted abortion
• Pain felt in both iliac fossae & is continous
• Associated tenderness, tachycardia & elevated
temperature, culture of discharge may reveal
pathogen
18. First trimester pain
• Acute retention of urine
• Due to enlargement of fibroid in response to
pregnancy
• Severe lower abdominal pain, large tender
bladder which may be mistaken for ovarian
cyst
• Catheterisation causes immediate pain relief
19. First trimester pain
• Hydatidiform mole
• Pain in lower abdomen due to
– Overdistention of uterus
– Concealed haemorrhage
– Perforation
– Infection
20. Mid trimester pain
• Red degeneration of fibromyoma
• Stretching of round ligament
• Acute polyhydromnios
• Rupture of rudimentary horn containing
pregnancy
• Acute retention of urine due to incarcerated
RVF gravid uterus
21. Mid trimester pain
• Red degeneration of fibromyoma
• Causes mild to severe pain. Tenderness
present over fibroid
• USS detects fibroid
• Conservative treatment with analgesics
22. Mid trimester pain
• Stretching of round ligament
• 10-30% of pregnancies
• More in multipara
• Cramp like or stabbing continuous pain, some
tenderness in the groin
• Reassurance & mild analgesics required
23. Mid trimester pain
• Acute polyhydrominos
• Pain due to over distention
• Diagnosed clinically & by USS