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Update in anesthesia for non obstetric surgery in pregnency
1) Non-obstetric surgery during pregnancy presents challenges as the anesthetist must care for both the pregnant woman and fetus. Regional anesthesia is preferred when possible to minimize fetal drug exposure.
2) The goals of anesthesia management are to optimize maternal physiology and uteroplacental blood flow, avoid unwanted drug effects on the fetus, and prevent preterm labor. General principles include fluid management, thromboprophylaxis, and fetal monitoring.
3) Laparoscopy can be performed safely during any trimester with low pneumoperitoneum pressures and fetal monitoring. Cardiac and neurosurgery also require careful management of hemodynamics and oxygen delivery to maintain uteroplacental perfusion.
drugseffectonthepregnancy-170219000730.pdf
This document discusses the effects of drugs on pregnancy. It notes that many pregnant women are exposed to medications, some without medical advice. Most drugs should be avoided during pregnancy as they can harm the fetus. About 2-3% of birth defects result from drug use other than alcohol. Some drugs are essential for serious medical conditions. Pregnant women may not comply fully with drug regimens due to pregnancy concerns. The FDA categorizes drugs based on risk to the fetus, with Category A posing the lowest risk and Category X the highest. Common antibiotics and acetaminophen are generally considered low risk. Narcotics, benzodiazepines, and radiation can pose higher risks and should be used cautiously or avoided when possible
Drugs effect on the pregnancy
what is the drugs which are effect on the pregnancy and how to avoid these drugs and which drugs are safety for pregnancy
Cancer in pregnancy
Cancer during pregnancy can present challenges for balancing treatment of the mother's cancer while protecting the fetus. Key points include:
- Treatment should not differ between pregnant and non-pregnant women when feasible, and aim to benefit the mother's life while protecting the fetus from harmful effects.
- The most common cancers in pregnant women are melanoma, breast cancer, thyroid cancer, and gynecological or blood cancers.
- For imaging, ultrasound and MRI are preferred over X-rays, CT scans, and PET scans to minimize radiation exposure to the fetus.
- For breast cancer, surgery is usually the initial treatment. Chemotherapy can be used in the 2nd and 3rd trimesters for
Surgical Risk Assessment is an Important Factor in any Surgical Treatment
Surgical risk is a form of assessing the clinical conditions and health conditions of a person who will undergo surgery, so that the risks of complications are identified throughout the period before, during and after surgery. It is calculated through a physician’s clinical assessment and the requirement for some tests, but to facilitate the assessment, there are also some protocols which have better directing in medical thinking. Any doctor can make this assessment, but most often it is done by a general practitioner, a cardiologist and an anesthesiologist. In this way, it is possible for each person to receive some attention before the surgery, such as seeking more appropriate tests or performing treatments to reduce the risk.
Surgical Risk Assessment is an Important Factor in any Surgical Treatment
Surgical risk is a form of assessing the clinical conditions and health conditions of a person who will undergo surgery, so that the risks of complications are identified throughout the period before, during and after surgery. It is calculated through a physician’s clinical assessment and the requirement for some tests, but to facilitate the assessment, there are also some protocols which have better directing in medical thinking. Any doctor can make this assessment, but most often it is done by a general practitioner, a cardiologist and an anesthesiologist. In this way, it is possible for each person to receive some attention before the surgery, such as seeking more appropriate tests or performing treatments to reduce the risk.
Critical Care in Pregnancy
This document discusses critical care for obstetric patients. It begins with an introduction and epidemiology section noting that while the proportion of obstetric patients in ICUs is low, the most common reasons for admission are postpartum hemorrhage and hypertensive disorders. It then covers obstetric critical care, basic principles for obstetric emergencies, transfer to critical care settings, the role of obstetricians, resuscitative hysterotomy, and supportive care. It provides recommendations including prioritizing maternal stabilization, consulting obstetricians, and not withholding necessary treatments due to fetal concerns. The document aims to guide management of critically ill obstetric patients.
Novel Management Strategies in the Treatment of Infections with MDROs (RP Ber...
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A lecture on Novel Management Strategies in the Treatment of Infections with MDROs delivered during the 2019 Annual PHICS ConventionRecommended
Update in anesthesia for non obstetric surgery in pregnency
1) Non-obstetric surgery during pregnancy presents challenges as the anesthetist must care for both the pregnant woman and fetus. Regional anesthesia is preferred when possible to minimize fetal drug exposure.
2) The goals of anesthesia management are to optimize maternal physiology and uteroplacental blood flow, avoid unwanted drug effects on the fetus, and prevent preterm labor. General principles include fluid management, thromboprophylaxis, and fetal monitoring.
3) Laparoscopy can be performed safely during any trimester with low pneumoperitoneum pressures and fetal monitoring. Cardiac and neurosurgery also require careful management of hemodynamics and oxygen delivery to maintain uteroplacental perfusion.
drugseffectonthepregnancy-170219000730.pdf
This document discusses the effects of drugs on pregnancy. It notes that many pregnant women are exposed to medications, some without medical advice. Most drugs should be avoided during pregnancy as they can harm the fetus. About 2-3% of birth defects result from drug use other than alcohol. Some drugs are essential for serious medical conditions. Pregnant women may not comply fully with drug regimens due to pregnancy concerns. The FDA categorizes drugs based on risk to the fetus, with Category A posing the lowest risk and Category X the highest. Common antibiotics and acetaminophen are generally considered low risk. Narcotics, benzodiazepines, and radiation can pose higher risks and should be used cautiously or avoided when possible
Drugs effect on the pregnancy
what is the drugs which are effect on the pregnancy and how to avoid these drugs and which drugs are safety for pregnancy
Cancer in pregnancy
Cancer during pregnancy can present challenges for balancing treatment of the mother's cancer while protecting the fetus. Key points include:
- Treatment should not differ between pregnant and non-pregnant women when feasible, and aim to benefit the mother's life while protecting the fetus from harmful effects.
- The most common cancers in pregnant women are melanoma, breast cancer, thyroid cancer, and gynecological or blood cancers.
- For imaging, ultrasound and MRI are preferred over X-rays, CT scans, and PET scans to minimize radiation exposure to the fetus.
- For breast cancer, surgery is usually the initial treatment. Chemotherapy can be used in the 2nd and 3rd trimesters for
Surgical Risk Assessment is an Important Factor in any Surgical Treatment
Surgical risk is a form of assessing the clinical conditions and health conditions of a person who will undergo surgery, so that the risks of complications are identified throughout the period before, during and after surgery. It is calculated through a physician’s clinical assessment and the requirement for some tests, but to facilitate the assessment, there are also some protocols which have better directing in medical thinking. Any doctor can make this assessment, but most often it is done by a general practitioner, a cardiologist and an anesthesiologist. In this way, it is possible for each person to receive some attention before the surgery, such as seeking more appropriate tests or performing treatments to reduce the risk.
Surgical Risk Assessment is an Important Factor in any Surgical Treatment
Surgical risk is a form of assessing the clinical conditions and health conditions of a person who will undergo surgery, so that the risks of complications are identified throughout the period before, during and after surgery. It is calculated through a physician’s clinical assessment and the requirement for some tests, but to facilitate the assessment, there are also some protocols which have better directing in medical thinking. Any doctor can make this assessment, but most often it is done by a general practitioner, a cardiologist and an anesthesiologist. In this way, it is possible for each person to receive some attention before the surgery, such as seeking more appropriate tests or performing treatments to reduce the risk.
Critical Care in Pregnancy
This document discusses critical care for obstetric patients. It begins with an introduction and epidemiology section noting that while the proportion of obstetric patients in ICUs is low, the most common reasons for admission are postpartum hemorrhage and hypertensive disorders. It then covers obstetric critical care, basic principles for obstetric emergencies, transfer to critical care settings, the role of obstetricians, resuscitative hysterotomy, and supportive care. It provides recommendations including prioritizing maternal stabilization, consulting obstetricians, and not withholding necessary treatments due to fetal concerns. The document aims to guide management of critically ill obstetric patients.
Novel Management Strategies in the Treatment of Infections with MDROs (RP Ber...
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1) GSK produces vaccines for diseases like pneumonia, polio, rotavirus, cervical cancer and others. Their vaccines have helped prevent up to 3 million deaths and disability in 750,000 children annually.
2) GSK's cervical cancer vaccine, Cervarix, is dedicated to preventing cervical cancer. Clinical trials showed it has nearly 100% efficacy against HPV types 16 and 18, which cause over 50% of cervical cancer cases. It also has efficacy against other high-risk HPV types and has a good safety profile.
3) GSK provides holistic support for vaccination programs including cold chain management, training, advocacy, and monitoring to help ensure vaccines are effectively delivered and utilized. They aim
Renal transplantation in pregnancy
Pregnancy is possible after renal transplantation, though rates have declined in recent decades. Hypothalamic-gonadal dysfunction resolves within 6 months post-transplant, allowing fertility. It is recommended to wait at least 1 year post-transplant for conception to ensure graft stability. Pregnancy outcomes include increased risks of preeclampsia, preterm birth, and low birthweight. Women with simultaneous kidney-pancreas transplants have poorer outcomes than kidney transplant alone but better than diabetes with kidney transplant alone. Kidney donors also have higher rates of pregnancy complications like preeclampsia compared to non-donors.
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The document discusses intrauterine contraceptive devices (IUDs). It notes that two copper IUDs and one levonorgestrel-releasing IUD are currently available. IUDs are highly effective forms of reversible birth control, with failure rates of 1.26 and 0.09 per 100 women-years respectively for copper and levonorgestrel IUDs. Common side effects include irregular bleeding and cramping, which usually decrease over time. Risks include perforation, infection and expulsion.
Long Acting Reversible Contraception
This document discusses long-acting reversible contraception (LARC) as the recommended first-line contraceptive option for adolescents. It describes the various LARC methods including intrauterine devices (IUDs) and implants, and their effectiveness rates of over 99%. Common misconceptions about LARC risks are dispelled, noting that LARC does not increase risks of infertility or pelvic inflammatory disease. Barriers to LARC use among teens are identified as lack of provider training and misinformation. Resources for provider training and patient referral are provided.
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The document provides instructions for using the CoronaVac vaccine under an emergency use authorization in Indonesia. Key points include:
- CoronaVac is approved to induce immunity against SARS-CoV-2 and prevent COVID-19 for people aged 18 and older.
- The recommended administration is two 0.5 mL doses given intramuscularly in the deltoid muscle, with doses spaced 2 weeks or 4 weeks apart depending on the situation.
- Common adverse reactions reported in clinical trials were mild to moderate, including pain at the injection site and fatigue.
Acs0903 The Pregnant Surgical Patient
1) The document discusses the management of pregnant patients requiring surgery or experiencing trauma. It notes special considerations for pregnant patients, including physiological changes and the need to care for both mother and fetus.
2) In trauma situations, the initial focus is stabilizing the mother to benefit both patients. Penetrating injuries often directly threaten the fetus while blunt trauma poses less direct risk, usually resulting in placental abruption or preterm labor.
3) Surgical decisions must weigh fetal viability against maternal stability, with non-urgent cases delayed if possible. Monitoring includes fetal heart monitoring and ultrasound to detect issues like abruption.
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1) Major causes of maternal death are severe bleeding, infections, high blood pressure during pregnancy, and complications during delivery. Preventing these is key to reducing mortality.
2) 20-30% of pregnancies in India are considered high risk and account for 75% of perinatal morbidity and mortality.
3) High risk pregnancies require close monitoring and care at facilities equipped to handle potential complications, such as those providing specialty or subspecialty care (Levels 2-4).
JPDS
This document summarizes a talk on adverse reactions to oral contraceptives (birth control pills). It discusses how third generation oral contraceptives with modern progesterone types have a higher risk of venous thromboembolism than second generation pills. It also notes that the new progesterone drospirenone seems to increase the risk compared to older pills. While risks exist, the overall benefits of oral contraceptives in preventing pregnancy and some cancers outweigh the risks. The talk aims to examine the evidence behind controversies on health risks and discuss implications for the growing number of potential oral contraceptive users in India.
Dental procedures during pregnancy(abirami vetriselvan)
The document discusses dental considerations during pregnancy. It notes that hormonal changes during pregnancy can affect the oral cavity. Treatment should focus on maintaining oral health while avoiding risks to the developing fetus. Non-essential procedures are best delayed until after delivery, but emergency treatments may be done in the second trimester while taking precautions like short procedures and protective gear. The goal is providing care safely while educating women on important oral health issues during this critical life stage.
HIV/AIDS in Pregnancy
This document summarizes HIV/AIDS during pregnancy. It discusses how HIV causes AIDS by depleting CD4 cells. Around 25-30% of people with HIV worldwide are women aged 20-49. The document outlines how HIV is transmitted from mother to child, mainly during labor and delivery. It recommends offering HIV testing to all pregnant women and treating HIV-positive mothers with antiretroviral therapy to reduce the risk of transmission to less than 2%. Safety measures during pregnancy, delivery and postpartum are also discussed.
Pregnancy Outcome in Cancer Patients
Pregnancy does not negatively impact cancer prognosis. Cancer can be diagnosed or treated during pregnancy with careful management. A multidisciplinary team is needed to determine the safest diagnostic methods and treatment options while minimizing risk to the fetus. Ultrasound and MRI are generally considered safe imaging techniques in pregnancy. Chemotherapy may be given during pregnancy for some cancers but is typically avoided in the first trimester and near delivery. Fertility can decrease after cancer treatment but pregnancy after treatment usually has a normal outcome.
A global challenge to reduce harm and save lives
Apresentação de Itziar Larizgoitia Jauregui durante o
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Imaging in prgnancy
The document discusses the balance between risks and benefits of medical imaging during pregnancy. It describes various imaging modalities like X-ray, CT, MRI, and nuclear medicine. While ionizing radiation carries risks like childhood cancer, the risks are very low from typical medical exposures. MRI is generally safe in pregnancy without radiation. The risks of any diagnostic imaging must be weighed against the potential benefits for both mother and baby.
HIV & TB IN PREGNANCY
HIV & TB are serious pandemics affecting millions worldwide. Both can severely weaken the immune system and lead to opportunistic infections. When contracted during pregnancy, they pose risks like preterm birth, low birthweight, growth restriction, and mother-to-child transmission. Treatment involves comprehensive care and antiretroviral therapy to suppress the virus and prevent transmission. Close monitoring of the mother's viral load and CD4 count along with delivery planning and neonatal prophylaxis are important to reduce transmission risk.
Sudip presentation
Non Obstetric Surgery in Pregnant Patients discusses considerations for anesthesia when performing non-obstetric surgery on pregnant patients. Anesthesiologists must provide safe anesthesia for both the mother and fetus by considering the physiological changes of pregnancy and avoiding fetal asphyxia, teratogenic drugs, and preterm labor. Regional anesthesia techniques like spinal or epidural blocks are preferred when possible due to advantages like limited drug exposure to the fetus. Surgery should generally be performed in the second trimester to balance maternal and fetal risks. Fetal monitoring is recommended during procedures to assess fetal well-being.
Special patient for local anesthesia
This document discusses managing dental care for patients with special needs. It notes that children with conditions like autism often experience extensive dental decay due to lack of preventative care. Sedation dentistry and general anesthesia allow comprehensive dental treatment for patients who cannot cooperate. The document provides guidance on psychological preparation, local anesthetics that are safest for children, and techniques for patients with conditions like bleeding disorders, pregnancy, liver disease, or those taking multiple medications. Sedation dentistry is recommended for patients with special needs, fear/anxiety, cancer treatments, or other challenges.
Family planning...BEST-1.pptx
This document provides information about family planning and contraceptive methods. It discusses that family planning refers to limiting the number of children through contraception, and half of pregnancies in the US are unintended. Contraceptive methods are classified as modern or traditional. Modern methods have lower failure rates and include IUDs, implants, injections, pills, condoms, etc. The document then discusses various contraceptive methods in detail, including their mechanisms of action, effectiveness tiers, and contraindications. Top-tier highly effective methods include IUDs, implants and sterilization. Second-tier include hormonal methods like pills, injections, patch and ring.
Why HPV Vaccination for Preventing Cervical Cancer in India Should Become a P...
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Conservative treatment of ovarian cancer
- The study evaluated 39 patients in Saudi Arabia who underwent conservative surgery for ovarian cancer between 2000-2010 to preserve ovarian function and fertility.
- Most patients (80%) had stage I cancer, with germ cell tumors being the most common (52% of cases).
- After treatment, 98% of patients returned to regular menstruation, and 20% went on to have a normal pregnancy and delivery.
- The study found conservative surgery for ovarian cancer to be safe and allow for ovarian preservation and fertility in most selected cases.
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This document discusses HIV treatment and treatment coverage. It provides information on different classes of drugs used to treat HIV, including non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, protease inhibitors, and others. It also discusses factors considered when choosing a drug regimen, such as other health conditions, side effects, potential drug interactions, and cost. Guidelines for first-line and second-line treatment in children, adolescents, and adults are also presented. The document then covers topics like drug resistance, global treatment coverage levels, and targets to increase treatment coverage, linkage to care, and viral suppression.
How to Control Your Asthma Tips by gokuldas hospital.
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
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New Value of Vaccines
1) GSK produces vaccines for diseases like pneumonia, polio, rotavirus, cervical cancer and others. Their vaccines have helped prevent up to 3 million deaths and disability in 750,000 children annually.
2) GSK's cervical cancer vaccine, Cervarix, is dedicated to preventing cervical cancer. Clinical trials showed it has nearly 100% efficacy against HPV types 16 and 18, which cause over 50% of cervical cancer cases. It also has efficacy against other high-risk HPV types and has a good safety profile.
3) GSK provides holistic support for vaccination programs including cold chain management, training, advocacy, and monitoring to help ensure vaccines are effectively delivered and utilized. They aim
Renal transplantation in pregnancy
Pregnancy is possible after renal transplantation, though rates have declined in recent decades. Hypothalamic-gonadal dysfunction resolves within 6 months post-transplant, allowing fertility. It is recommended to wait at least 1 year post-transplant for conception to ensure graft stability. Pregnancy outcomes include increased risks of preeclampsia, preterm birth, and low birthweight. Women with simultaneous kidney-pancreas transplants have poorer outcomes than kidney transplant alone but better than diabetes with kidney transplant alone. Kidney donors also have higher rates of pregnancy complications like preeclampsia compared to non-donors.
Iucd
The document discusses intrauterine contraceptive devices (IUDs). It notes that two copper IUDs and one levonorgestrel-releasing IUD are currently available. IUDs are highly effective forms of reversible birth control, with failure rates of 1.26 and 0.09 per 100 women-years respectively for copper and levonorgestrel IUDs. Common side effects include irregular bleeding and cramping, which usually decrease over time. Risks include perforation, infection and expulsion.
Long Acting Reversible Contraception
This document discusses long-acting reversible contraception (LARC) as the recommended first-line contraceptive option for adolescents. It describes the various LARC methods including intrauterine devices (IUDs) and implants, and their effectiveness rates of over 99%. Common misconceptions about LARC risks are dispelled, noting that LARC does not increase risks of infertility or pelvic inflammatory disease. Barriers to LARC use among teens are identified as lack of provider training and misinformation. Resources for provider training and patient referral are provided.
Fact Sheet Sinovac untuk Lansia
The document provides instructions for using the CoronaVac vaccine under an emergency use authorization in Indonesia. Key points include:
- CoronaVac is approved to induce immunity against SARS-CoV-2 and prevent COVID-19 for people aged 18 and older.
- The recommended administration is two 0.5 mL doses given intramuscularly in the deltoid muscle, with doses spaced 2 weeks or 4 weeks apart depending on the situation.
- Common adverse reactions reported in clinical trials were mild to moderate, including pain at the injection site and fatigue.
Acs0903 The Pregnant Surgical Patient
1) The document discusses the management of pregnant patients requiring surgery or experiencing trauma. It notes special considerations for pregnant patients, including physiological changes and the need to care for both mother and fetus.
2) In trauma situations, the initial focus is stabilizing the mother to benefit both patients. Penetrating injuries often directly threaten the fetus while blunt trauma poses less direct risk, usually resulting in placental abruption or preterm labor.
3) Surgical decisions must weigh fetal viability against maternal stability, with non-urgent cases delayed if possible. Monitoring includes fetal heart monitoring and ultrasound to detect issues like abruption.
HIGH RISK PREGNANCY (PART 1) Dr Meenakshi Sharma
1) Major causes of maternal death are severe bleeding, infections, high blood pressure during pregnancy, and complications during delivery. Preventing these is key to reducing mortality.
2) 20-30% of pregnancies in India are considered high risk and account for 75% of perinatal morbidity and mortality.
3) High risk pregnancies require close monitoring and care at facilities equipped to handle potential complications, such as those providing specialty or subspecialty care (Levels 2-4).
JPDS
This document summarizes a talk on adverse reactions to oral contraceptives (birth control pills). It discusses how third generation oral contraceptives with modern progesterone types have a higher risk of venous thromboembolism than second generation pills. It also notes that the new progesterone drospirenone seems to increase the risk compared to older pills. While risks exist, the overall benefits of oral contraceptives in preventing pregnancy and some cancers outweigh the risks. The talk aims to examine the evidence behind controversies on health risks and discuss implications for the growing number of potential oral contraceptive users in India.
Dental procedures during pregnancy(abirami vetriselvan)
The document discusses dental considerations during pregnancy. It notes that hormonal changes during pregnancy can affect the oral cavity. Treatment should focus on maintaining oral health while avoiding risks to the developing fetus. Non-essential procedures are best delayed until after delivery, but emergency treatments may be done in the second trimester while taking precautions like short procedures and protective gear. The goal is providing care safely while educating women on important oral health issues during this critical life stage.
HIV/AIDS in Pregnancy
This document summarizes HIV/AIDS during pregnancy. It discusses how HIV causes AIDS by depleting CD4 cells. Around 25-30% of people with HIV worldwide are women aged 20-49. The document outlines how HIV is transmitted from mother to child, mainly during labor and delivery. It recommends offering HIV testing to all pregnant women and treating HIV-positive mothers with antiretroviral therapy to reduce the risk of transmission to less than 2%. Safety measures during pregnancy, delivery and postpartum are also discussed.
Pregnancy Outcome in Cancer Patients
Pregnancy does not negatively impact cancer prognosis. Cancer can be diagnosed or treated during pregnancy with careful management. A multidisciplinary team is needed to determine the safest diagnostic methods and treatment options while minimizing risk to the fetus. Ultrasound and MRI are generally considered safe imaging techniques in pregnancy. Chemotherapy may be given during pregnancy for some cancers but is typically avoided in the first trimester and near delivery. Fertility can decrease after cancer treatment but pregnancy after treatment usually has a normal outcome.
A global challenge to reduce harm and save lives
Apresentação de Itziar Larizgoitia Jauregui durante o
Itziar Larizgoitia Jauregui é médica, nascida na Espanha, com atuação em Saúde Pública, com mestrado nessa área e Doutorado em Políticas e Gestão da Saúde. Nos últimos 13 anos, tem atuado como membro da Organização Mundial da Saúde (OMS) em Genebra, Suíça. No total, são mais de 20 anos de experiência nas áreas de Qualidade e Segurança do Paciente, Organização e Reforma de sistemas de saúde.
Imaging in prgnancy
The document discusses the balance between risks and benefits of medical imaging during pregnancy. It describes various imaging modalities like X-ray, CT, MRI, and nuclear medicine. While ionizing radiation carries risks like childhood cancer, the risks are very low from typical medical exposures. MRI is generally safe in pregnancy without radiation. The risks of any diagnostic imaging must be weighed against the potential benefits for both mother and baby.
HIV & TB IN PREGNANCY
HIV & TB are serious pandemics affecting millions worldwide. Both can severely weaken the immune system and lead to opportunistic infections. When contracted during pregnancy, they pose risks like preterm birth, low birthweight, growth restriction, and mother-to-child transmission. Treatment involves comprehensive care and antiretroviral therapy to suppress the virus and prevent transmission. Close monitoring of the mother's viral load and CD4 count along with delivery planning and neonatal prophylaxis are important to reduce transmission risk.
Sudip presentation
Non Obstetric Surgery in Pregnant Patients discusses considerations for anesthesia when performing non-obstetric surgery on pregnant patients. Anesthesiologists must provide safe anesthesia for both the mother and fetus by considering the physiological changes of pregnancy and avoiding fetal asphyxia, teratogenic drugs, and preterm labor. Regional anesthesia techniques like spinal or epidural blocks are preferred when possible due to advantages like limited drug exposure to the fetus. Surgery should generally be performed in the second trimester to balance maternal and fetal risks. Fetal monitoring is recommended during procedures to assess fetal well-being.
Special patient for local anesthesia
This document discusses managing dental care for patients with special needs. It notes that children with conditions like autism often experience extensive dental decay due to lack of preventative care. Sedation dentistry and general anesthesia allow comprehensive dental treatment for patients who cannot cooperate. The document provides guidance on psychological preparation, local anesthetics that are safest for children, and techniques for patients with conditions like bleeding disorders, pregnancy, liver disease, or those taking multiple medications. Sedation dentistry is recommended for patients with special needs, fear/anxiety, cancer treatments, or other challenges.
Family planning...BEST-1.pptx
This document provides information about family planning and contraceptive methods. It discusses that family planning refers to limiting the number of children through contraception, and half of pregnancies in the US are unintended. Contraceptive methods are classified as modern or traditional. Modern methods have lower failure rates and include IUDs, implants, injections, pills, condoms, etc. The document then discusses various contraceptive methods in detail, including their mechanisms of action, effectiveness tiers, and contraindications. Top-tier highly effective methods include IUDs, implants and sterilization. Second-tier include hormonal methods like pills, injections, patch and ring.
Why HPV Vaccination for Preventing Cervical Cancer in India Should Become a P...
Why HPV Vaccination for Preventing Cervical Cancer in India Should Become a Part of Immunization Programme
Conservative treatment of ovarian cancer
- The study evaluated 39 patients in Saudi Arabia who underwent conservative surgery for ovarian cancer between 2000-2010 to preserve ovarian function and fertility.
- Most patients (80%) had stage I cancer, with germ cell tumors being the most common (52% of cases).
- After treatment, 98% of patients returned to regular menstruation, and 20% went on to have a normal pregnancy and delivery.
- The study found conservative surgery for ovarian cancer to be safe and allow for ovarian preservation and fertility in most selected cases.
Hiv.
This document discusses HIV treatment and treatment coverage. It provides information on different classes of drugs used to treat HIV, including non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, protease inhibitors, and others. It also discusses factors considered when choosing a drug regimen, such as other health conditions, side effects, potential drug interactions, and cost. Guidelines for first-line and second-line treatment in children, adolescents, and adults are also presented. The document then covers topics like drug resistance, global treatment coverage levels, and targets to increase treatment coverage, linkage to care, and viral suppression.
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Sensation is the neurological process by which we become aware of surrounding environment.
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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solid organT,CONTRACETIVE.pptx
- 1. CONTRACEPTION IN SOLID ORGAN TRANSPLANT Dr.parichehr pooransari. Fellowship of perinatology,shahid Beheshti university of medical science
- 2. After a transplant ■ woman’s risks from an unintended pregnancy are always greater than the risks from any contraceptive, and this is important to reinforce in counseling.
- 3. Pregnancy should be avoided ■ while transplant patients are taking FDA category D immunosuppressant drugs ■ during the first year after transplant. Unintended pregnancy can have serious health consequences for the mother and the fetus, as well as poor pregnancy outcomes.
- 4. ■ The CDC categorizes a patient’s medical condition after transplant as either complicated or uncomplicated. ■ Complicated conditions include acute or chronic graft failure, graft rejection, and cardiac allograft vasculopathy.
- 5. Effectiveness of contraceptive methods the pregnancy rate with “typical use” of that particular method in 1 year ■ Very effective (0%–0.9%) ■ Effective (1%–9%) ■ Moderately effective (10%–25%) ■ Less effective (26%–32%).
- 6. CDC criteria and categories for contraceptive use ■ Category 1: A condition for which thereis no restriction for the use of the contraceptive method ■ Category 2: A condition for which the advantages of using the method generally outweigh the theoretical or proven risks ■ • Category 3: A condition for which the theoretical or proven risks usually outweigh the advantages of using the method • ■ Category 4: A condition that represents an unacceptable health risk if the contraceptive method is used.
- 7. ■ VERY EFFECTIVE CONTRACEPTIVES (UNINTENDED PREGNANCY RATE 0%–0.9%) TL,Vasectomy,Implant,Iud The main disadvantage of the subdermal implant and IUDs is unscheduled bleeding. An important benefit is prolonged amenorea
- 8. IUD The CDC: lists copper and levonorgestrel IUDs in MEC category 3 (the risks generally outweigh the advantages) for initiation in patients with complicated transplants and in category 2 (advantages generally outweigh the risks) in patients with uncomplicated organ transplants. The devices are in category 2 for both complicated and uncomplicated cases if the IUD is already in place.
- 9. The implants ■ classified as US MEC category 2 in uncomplicated cases; ■ initiation in complicated cases is considered category 3 but continuation is considered category 2.
- 10. EFFECTIVE CONTRACEPTIVE METHODS (UNINTENDED PREGNANCY RATE 1%–9%) ■ include injectable contraceptives, ■ combined hormonal contraceptives ■ and progestin-only contraceptives (. are classified as category 2 for patients after both complicated and uncomplicated transplants).
- 11. ■ The combined hormonal oral contraceptive pills, patch, and ring are in ( cat 4:unacceptable health risk),. in complicated cases category 4 In uncomplicaed cases Category 2
- 12. MODERATELY EFFECTIVE METHODS (PREGNANCY RATE 10%–25%) ■ all barrier methods, ie, male and female condoms, vaginal diaphragms, cervical caps, and sponges ■ These methods are considered category 1 according to the US MEC.