Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
The aspire of the journal is to present a platform for scientists and academicians all over the world to encourage, distribute, and discuss various new issues and developments in different areas of Pediatrics and to promote responsible and balanced debate on controversial issues that influence child health, including non-clinical areas such as ethics, law, surroundings and economics.
Austin Pediatrics accepts innovative research articles, review articles, case reports and rapid communication on all the aspects of Pediatrics.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
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.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
The aspire of the journal is to present a platform for scientists and academicians all over the world to encourage, distribute, and discuss various new issues and developments in different areas of Pediatrics and to promote responsible and balanced debate on controversial issues that influence child health, including non-clinical areas such as ethics, law, surroundings and economics.
Austin Pediatrics accepts innovative research articles, review articles, case reports and rapid communication on all the aspects of Pediatrics.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
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.
a case study on burn injury / case presentation on burn injury martinshaji
Damage to the skin or deeper tissues caused by sun, hot liquids, fire, electricity or chemicals.
The degree of severity of most burns is based on the size and depth of the burn. Electrical burns, however, are more difficult to diagnose because they're capable of causing significant injury beneath the skin without showing any signs of damage on the surface.
Symptoms range from a feeling of minor discomfort to a life-threatening emergency, depending on the size and depth (degree) of the burn.
Sunburn and small scalds can often be treated at home. Deep or widespread burns and chemical or electrical burns need immediate medical care, often at specialised burn units.
A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. While rates are similar for males and females the underlying causes often differ.
this is a case study on burn injury , this details about the diagnosis, management, treatment, patient counselling & pharmacist interventions , regarding medication etc , and also describes in detail about all aspects of burn injury .
please comment
thank u
Nonsyndromic orofacial clefts (NSOFCs) are the most common craniofacial malformations observed
across the globe. They are classified into three types: (a) cleft palate, (b) cleft lip, and (c) cleft lip and
palate.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Pediatrics new born resuscitation dr.gangadhar rao g m+91 949 3864 912
1. NEW BORN RESUSCITATION &
MECONIUM ASPIRATION
Dr. G GANGADHAR RAO
GUNTUR MEDICAL COLLEGE
FORMER PAEDIATRICIAN YASHODA HOSPITAL SEC.
Department of Pediatrics
COMPOSITE HOSPITAL CRPF HYDERABAD
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3. MECONIUM ASPIRATION
SYNDROME
Mortality and morbidity is 28% to 40% of MAS.
INCIDENCE IS 8.8%, USUALLY POSTMATURE INFANTS,
APGAR SCORE 1- 5 Min. IS LESS THAN 6
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4. What is Meconium?
• In Greek - means "Poppy juice".
• Black Green, Thick sticky odorless and acidic
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5. Contents
• Water 72%-80% • Proteins
• Intestinal secretions • Lipids 8% dry wt.
• Epithelial cells • Bile acids and salts
• Swallowed Amniotic fluid • Enzymes
• Mucopolysacchrides 80% • Blood substances
of dry wt. • Squamous cells and
• Cholesterol and Sterol Vernix caseosa.
precursors
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7. Pathogenesis
• Bile salts are blamed for. Exact cause unknown.
• Inflammatory response by lung tissue.
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8. Introduction
• Cause of Respiratory failure in newborn.
• Inhalation of Meconium causes respiratory distress.
• Degree of severity vary.
• Meconium in Amniotic fluid 10%-20% of total deliveries.
• Mortality and morbidity in 28% to 40%
of MAS.
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9. Incidence
• Amniotic fluid stained in 16.5% (India)
• MAS develop in 18.7%
• MAS 1.44% in all births
• No seasonal variation
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10. Definition
• Meconium below the vocal cords.
• Mild MAS < 40% Oxygen needed for < 48 hrs.
• Moderate MAS > 40% Oxygen needed for > 48 hrs.
• Severe MAS Ventilation > 48 hrs often with
persistent pulmonary hypertension.
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11. Working definition
• Staining of Liquor Umbilical cord. Skin and nail.
• Respiratory distress after 1 hr of birth.
• Radiological features of Aspiration pneumonitis.
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12. Causes in-utero
• Meconium staining rarely
before 38wt
• Levels of motilin
• Maturity of myelination of
• Foetal distress – hypoxia
gut
• Diving reflex
• Lack of strong peristalsis
of gut • Umbilical cord
compression
• Good sphincter tone
• Gut maturation
• „Cap‟ viscous meconium in
rectum • Breech presentation
• Listeriosis in foetus –
foetal diarrhoea
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13. Risk factor
• Maternal hypertension and diabetes mellitus
• Maternal heavy smoking.
• Chronic Respiratory and CVS disease.
• Post term pregnancy.
• Pre eclampsia / Eclampsia.
• Oligohydramnios.
• Poor biophysical profile.
• Foetal distress (Abnormal
Heart Rate)
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14. Mechanism of injury
1. Mechanical Obstruction.
2. Pneumothorax – “Ball Valve”.
3. Pneumonitis
1. Bile salts
2. Bile acids
3. Release of cytokines
4. Pulmonary Vasoconstriction.
5. Surfactant Inactivation.
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16. Clinical Features
• Usually full term and post term
• Signs of post maturity.
• Green Yellow staining of nails, skin and umbilical cord.
• Afebrile, Fever or hypothermia if infected.
• Resp. rate > 120/min.
• Subcostal, Intercostal and sternal retraction.
• Use of accessory muscles
• Flaring of nostrils
• Grunt
• Increased Ant. Post diameter
• Apnoea
• Rhonchi and crepitations.
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17. Clinical Features - Contd..
CVS 1. Hypoxic myocardial damage.
2. Hypotension
3. CCF
4. S2 may be single
5. Murmur of tricuspid regurgitation
Abd 1. Distended (Aerophagia)
2. Liver and Spleen displaced.
3. Constipation.
4. Absent bowel sounds in severe cases.
5. Urinary retention.
CNS: 1. Hypoxic ischemic Encephalopathy.
2. Signs of birth asphyxia. RAO G
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21. Diagnosis
• Meconium stained amniotic
fluid (MSAF)
• Presence of meconium in trachea.
• Radiological features.
Always suspect MAS in MSAF.
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22. Investigations
• Hb % normal
• White cell count R
• Thrombocytopenia with PPH
• Disseminated Intravascular coagulation
• PaCO2 Low – Normal - Raised
• Metabolic acidemia
• Culture for sepsis
• Parameters of renal failure
• Urine analysis – Normal except in renal failure
• Color is Greenish brown due to Meconium pigment
• ECG -Normal
• ECHO – Reduced cardiac contractility
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24. Radiology
Use: Determine the extent of intrathoracic
pathology
• Identify areas of atelectasis and air block
syndromes.
• Assure appropriate positioning of endotracheal tube
and umbilical artery catheter.
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25. Radiology - Contd..
• Patchy infiltrates.
• Increased anterioposterior diameter.
• Atelectasis.
• Flattening of diaphragm.
• Retrosternal lucency.
• Small pleural effusions in about 33% cases.
• Pneumothorax and/or pneomediastinum in 25% cases.
• Diffuse chemical pneumonitis
• Cardiomegaly to be detected due to underlying perinatal
asphyxia
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29. Prevention
• Optimum Antenatal care
• Risk factors for MAS
• Monitoring of foetal heart for
foetal distress
• Foetal scalp blood pH where possible
• Expediate delivery if foetal distress
• Avoid post maturity (more than 42 wt.)
• Presence of two skilled persons in resuscitation for every
delivery in labour room
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31. Prevention contd.
Intrapartum MSAF present:
• Aspirate oropharynx first then nasopharynx after
the birth of head.
• Assess the newborn after birth.
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32. Classification
Vigorous Newborn: Non Vigorous Newborn:
• Strong spontaneous Resp. Airway suction
Effort Direct laryngoscopy and
• Good muscle tone suction
• Heart rate > 100/min
• Monitor for MAS
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40. NEW BORN RESUSCITATION
Intubate
• Suction through Intubation tube.
• Continue tracheal aspiration with meconium
aspiration till “little or no meconium is aspirated or
heart rate indicates resuscitation”.
• Aspirate Gastric meconium
sev asthma.MP G
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50. Do’s
1. Oropharyngeal suction at perineum in all MSAF babies.
2. Intrapartum fetal heart rate monitoring in all MSAF
babies.
3. Anticipate passage of meconium or MAS during birth of
all IUGR babies in the labor room.
4. Skillful resuscitation and assistance are key points in
management.
5. Do intubate neonates born through MSAF who are
depressed (non vigorous babies) at birth irrespective of
consistency of meconium.
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52. Dont’s
• Do not go by the consistency of
meconium in management for intubation.
• Do not apply cricoid pressure,
chest compression or occlude
airway by fingers to prevent initiation
of respiration in MSAF babies.
• Do not ignore the general condition of baby during
intubation.
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Thank you 52
53. CH CRPF PHOTOES – (SEE FILE)
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64. Thank you
Dr. G GANGADHAR RAO
STUDENT OF GUNTUR MEDICAL COLLEGE
FORMER PAEDIATRICIAN YASHODA HOSPITAL SEC.
Department of Pediatrics
COMPOSITE HOSPITAL CRPF HYDERABAD
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65. Thank you
Dr. G GANGADHAR RAO
STUDENT OF GUNTUR MEDICAL COLLEGE
FORMER PAEDIATRICIAN YASHODA HOSPITAL SEC.
Department of Pediatrics
COMPOSITE HOSPITAL CRPF HYDERABAD
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