1) The use of tocolytic drugs is associated with prolonging pregnancy up to 7 days but does not significantly impact preterm birth rates or neonatal outcomes.
2) Tocolysis should only be considered if delaying birth will allow for completing a course of corticosteroids or in utero transfer to another hospital.
3) Nifedipine and atosiban are effective tocolytic options, with fewer maternal side effects than beta-agonists, though long-term neonatal outcomes remain unclear for all tocolytic drugs.
Ovarian Hyperstimulation Syndrome(OHSS), is a Rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy where a patient's ovaries become swollen and fluid builds up around her abdomen
In cases of Nulliparous prolapse or even patients deserving child bearing uterus preserving surgeries are done.
Recently even for prolapse if women want to preserve uterus for variety of reasons ,with newer minimally invasive methods it is now gaining popularity.Larger studies and longer followup is required.
Ovarian Hyperstimulation Syndrome(OHSS), is a Rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy where a patient's ovaries become swollen and fluid builds up around her abdomen
In cases of Nulliparous prolapse or even patients deserving child bearing uterus preserving surgeries are done.
Recently even for prolapse if women want to preserve uterus for variety of reasons ,with newer minimally invasive methods it is now gaining popularity.Larger studies and longer followup is required.
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
Fetal growth restriction (FGR), formerly called intrauterine growth restriction (IUGR), refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb.
Mild FGR usually doesn't cause long-term problems. In fact, most babies who have it catch up in height and weight by age 2. But severe FGR can seriously harm a baby before and after birth. The extent of the problems depends on the cause and how severe the growth restriction is. It also depends on what point in the pregnancy it starts.
Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer
Antenatal care is the routine health control of presumed healthy pregnant women without symptoms (screening), in order to diagnose diseases or complicating obstetric conditions without symptoms and to provide information about lifestyle, pregnancy and delivery.
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
Fetal growth restriction (FGR), formerly called intrauterine growth restriction (IUGR), refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb.
Mild FGR usually doesn't cause long-term problems. In fact, most babies who have it catch up in height and weight by age 2. But severe FGR can seriously harm a baby before and after birth. The extent of the problems depends on the cause and how severe the growth restriction is. It also depends on what point in the pregnancy it starts.
Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer
Antenatal care is the routine health control of presumed healthy pregnant women without symptoms (screening), in order to diagnose diseases or complicating obstetric conditions without symptoms and to provide information about lifestyle, pregnancy and delivery.
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
A brief introduction regarding oxytocics & tocolytics which are the indispensable drugs in obstetrics. It consists of illustrative images, classification of drugs with their dosage, uses & side-effects along with contraindications
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Role of Atosiban In ART,Dr Jyoti Agarwal, Dr. Sharda Jain Lifecare Centre
Exponential increase in IVF Procedures in India
India performs approx 1 Lac IVF cycles annually &
55% of the IVF cycles performed across the top eight metro cities
The clinical approach to ovulation induction requires an
understanding of the causes of anovulation. Check my detailed presentation to get detailed understanding.
“Clinicians should proactively talk to their patients of reproductive age about ECPs and offer advance prescriptions for ECPs during routine gynecologic office visits….”
IUI is a basic but effective form of fertiltiy treatment and can be a viable alternative to the expensive IVF / test tube baby treatment that is normally advised.
This presentation will be very useful for the practising gynecologists, IVF specialists and General practitioners who perform IUI.
Even patients on going through this presentation will be more educated about iui.
Please reach out to me on 9833032120 by whatsapp / Telegram or phone call or email on dalalsj@gmail.com for further details / treatment options.
Get Treatment By IVF experts India, ICSI and Surrogacy Specialist, Get Detail of male Ivf treatment, Couses, Diagnosis , Consult with IVF issues and get Solutions By top IVF Doctors
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
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
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
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.
Evaluation of antidepressant activity of clitoris ternatea in animals
Tocolysis for preterm labour: RCOG Guidelines
1. Tocolysis for Women
in Preterm Labour
Green-top Guideline
RCOG, 2011
Prof Aboubakr Elnashar
Aboubakr Elnashar
2. Use of a tocolytic drug is associated with a
prolongation of pregnancy for up to 7 days but with
no significant effect on preterm birth and no clear
effect on perinatal or neonatal morbidity.
There is no clear evidence that tocolytic drugs
improve outcome and therefore it is reasonable not
to use them.
However, tocolysis should be considered if the few
days gained would be put to good use, such as
completing a course of corticosteroids or in utero
transfer.
Aboubakr Elnashar
3. Use of a tocolytic drug is not associated with a
clear reduction in perinatal or neonatal mortality, or
neonatal morbidity.
Aboubakr Elnashar
4. Tocolysis may be considered for women with
suspected preterm labour who have had an
otherwise uncomplicated pregnancy.
It is reasonable not to use any tocolytic drug.
Women most likely to benefit from use of a
tocolytic drug are those who are in
very preterm labour,
those needing transfer to a hospital which can
provide neonatal intensive care and
those who have not yet completed a full course of
corticosteroids.
Tocolysis should not be used where there is a
contraindication to prolonging pregnancy.
Aboubakr Elnashar
5. Nifedipine and atosiban have comparable
effectiveness in delaying birth for up to 7 days.
Compared with beta-agonists, nifedipine is
associated with improvement in neonatal outcome,
although there are no long-term data.
Aboubakr Elnashar
6. Beta-agonists have a high frequency of adverse
effects.
Nifedipine, atosiban and the COX inhibitors have
fewer types of adverse effects, and they occur less
frequently than for beta-agonists but how they
compare with each other is unclear.
Using multiple tocolytic drugs appears to be
associated with a higher risk of adverse effects and
so should be avoided.
Aboubakr Elnashar
7. The comparative effects for the baby of
alternative drugs are unclear. Most drugs have
been compared with beta-agonists.
There are insufficient data on long-term follow-up
for reliable conclusions about the effects on the
baby for any of these tocolytic drugs.
Aboubakr Elnashar
8. Dose of nifedipine:
an initial oral dose of 20 mg followed by 10–20 mg
three to four times daily, adjusted according to
uterine activity for up to 48 hours.
A total dose above 60 mg appears to be
associated with a three- to four-fold increase in
adverse events.
Dose of atosiban
an initial bolus dose of 6.75 mg over 1 minute,
followed by an infusion of 18 mg/hour for 3 hours,
then 6 mg/hour for up to 45 hours (to a maximum
of 330 mg).
Aboubakr Elnashar
9. Cost effectiveness has not been reported but the
purchase price of atosiban is nearly ten times that
of nifedipine.
Aboubakr Elnashar
10. There is insufficient evidence for any firm
conclusions about whether or not tocolysis leads
to any benefit in preterm labour in multiple
pregnancy.
Aboubakr Elnashar
11. There is insufficient evidence for any firm
conclusions about whether or not maintenance
tocolytic therapy following threatened preterm
labour is worthwhile. Thus, maintenance therapy is
not recommended.
Aboubakr Elnashar
12. Summary
Use of a tocolytic drug is not associated with a
clear reduction in perinatal or neonatal mortality or
neonatal morbidity.
The main effect of tocolytic drugs when used for
women in preterm labour is to reduce the numbers
who deliver within 48 hours or within 7 days of
commencing the drug.
Aboubakr Elnashar
13. Data on long-term outcome are sparse. It
remains plausible that, for selected women, such
as those who require transfer for neonatal care or
time to complete a course of corticosteroids, there
may be benefit associated with tocolysis. However,
this benefit has not been formally evaluated in
randomised trials.
Aboubakr Elnashar
14. If reliable prediction of which women in suspected
preterm labour are likely to have a preterm birth
were possible, the use of tocolysis could be
reserved for these women. Unfortunately, few tests
offer useful predictive value. Fetal fibronectin has
been advocated as a promising predictive test but it
may have limited accuracy in predicting preterm
birth within 7 days for women with symptoms of
preterm labour.
Aboubakr Elnashar
15. Ultrasound assessment of cervical length is also
a promising predictive test for symptomatic women.
It remains unclear whether any predictive test, or
combination of tests, is sufficiently accurate to be
cost effective.
Aboubakr Elnashar
16. If the decision is made to use a tocolytic drug,
nifedipine and atosiban appear to have comparable
effectiveness in delaying delivery, with fewer
maternal adverse effects and less risk of rare
serious adverse events than alternatives such as
ritodrine or indomethacin.
There is limited evidence that use of nifedipine,
rather than a beta-agonist, is associated with
improved short-term neonatal outcome. There is
little information about the long-term growth and
development of the child for any of the drugs.
Aboubakr Elnashar
17. Ritodrine and atosiban are licensed in the UK for
the treatment of threatened preterm labour.
Although the use of nifedipine for preterm labour is
an unlicensed indication, it has the advantages of
oral administration and a low purchase price.
Aboubakr Elnashar