External Cephalic Version

by dr.Ay

Just want to add some pictures about external cephalic version...

External cephalic version is a way to try to turn a baby from breech position to vertex (head-down) position while it's still in the mother's uterus. In other words, external cephalic version means turning the baby from outside of the abdomen so that it's in the head-down position. Your doctor will use his or her hands on the outside of your abdomen to try to turn the baby (see the pictures below).

First step is:

"Beginning the forward roll. The doctor places his or her hands on the abdomen, moving the baby up out of the pelvic bone"

Second step is:

"The baby is turned either forward or backward...."

Third step is:

... until the baby is in the vertex (head-down) position.

This procedures are usually done before the head of the baby engage in the upper pelvic gate. We also have to check the baby's heart rate before and after doing the procedures to make sure that the baby is fine. If there is deterioration of baby's heart rate, we must repositioning the baby to the previous position. Always ask your doctor for further information.

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A Gene Map of the Human Genome

taken from GeneMap'99

The Human Genome Project is expected to produce a sequence of DNA representing the functional blueprint and evolutionary history of the human species. However, only about 3% of this sequence is thought to specify the portions of our 50,000 to 100,000 genes that encode proteins. Thus an important part of basic and applied genomics is to identify and localize these genes in a process known as transcript mapping. When genes are expressed, their sequences are first converted into messenger RNA transcripts, which can be isolated in the form of complementary DNAs (cDNAs). Approximately half of all human genes had been sampled as of 15 June, 1996.

A small portion of each cDNA sequence is all that is needed to develop unique gene markers, known as sequence tagged sites or STSs, which can be detected in chromosomal DNA by assays based on the polymerase chain reaction (PCR). To construct a transcript map, cDNA sequences from a master catalog of human genes were distributed to mapping laboratories in North America, Europe, and Japan. These cDNAs were converted to STSs and their physical locations on chromosomes determined on one of two radiation hybrid (RH) panels or a yeast artificial chromosome (YAC) library containing human genomic DNA. This mapping data was integrated relative to the human genetic map and then cross-referenced to cytogenetic band maps of the chromosomes. (Further details are available in the accompanying article in the 25 October issue of SCIENCE).

The histograms reflect the distributions and densities of genes along the chromosomes. Because the individual genes (>16,000) are too numerous to represent, images have been chosen to illustrate the myriad aspects of human biology, pathology, and relationships with other organisms that can be revealed by analysis of genes and their protein products.

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Cesarean Section for a Breech Baby

What is a cesarean section?

A cesarean section is an operation that delivers a baby through a cut in your abdomen and uterus. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

This procedure is also called a C-section.

When is it used?

A baby in a breech position is one reason a C-section may be done. The breech position means that the baby is in a position where the bottom, knees, or feet will come out before the head in a delivery through the vagina. Such a delivery may be hazardous. For example, the baby's head may become trapped in your cervix or the birth canal.

In some cases safe vaginal delivery is possible. In other cases a C-section is recommended to prevent the possible dangers of a breech delivery.

If your baby is in a breech position near your due date, there are a couple of other choices. One choice is to wait and see if the baby will turn to a position that allows the head to come out first (the vertex position). Another option is to try to turn the baby to a vertex position before labor. This is a procedure called external version. You should ask your health care provider about these choices.

You and your health care provider should discuss C-section delivery during the early part of your pregnancy. This will help you prepare for it if it suddenly becomes necessary.

How do I prepare for a cesarean section?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your health care provider. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

If you go into labor, call your health care provider.

What happens during the procedure?

You are given a regional or general anesthetic. A regional anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, puts you to sleep, and prevents you from feeling pain.

Your health care provider makes a cut below your bellybutton and into the lower part of the uterus to remove the baby. Your provider removes the baby, placenta, and birth sac. Your provider then sews the uterus and abdomen closed.

What happens after the procedure?

Your abdomen will be sore. You may need help with positioning your baby comfortably for feeding. Walking and standing will be painful for the first few days. Since you will probably be in the hospital for just 2 to 4 days, try to have some help at home for the first week or two.

Avoid heavy lifting for 6 weeks. After 6 weeks you may begin an exercise program to regain abdominal muscle tone. Ask your health care provider what other steps you should take and when you should come back for a checkup.

The cuts made in the abdomen to deliver the baby are usually horizontal, or across the womb. This allows the muscles in the womb to safely stretch for future childbirth. Many women are able to deliver the next baby through the birth canal.

What are the benefits of this procedure?

Delivering a breech baby by C-section may be safer for you and the baby. You may be able to schedule the time of delivery.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your health care provider.
• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. In most cases regional anesthesia is considered safer than general anesthesia.
• A blood vessel may rupture or be cut and bleed inside the body.
• A piece of blood clot may break off, enter the bloodstream, and damage the lungs.
• The cut in the wall of the uterus may leave a weak part in the wall.
• Any future children may need to be delivered by C-section, depending on how this C-section was done.
• You may develop an infection or bleeding.
• The baby might be injured during the surgery.

You should ask your health care provider how these risks apply to you.

When should I call my health care provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You have drainage from your incision, or the incision separates.
• You have heavy bleeding from the vagina.
• You become dizzy or faint.
• You have leg pain, especially if your leg is also swollen and red.
• You have nausea and vomiting.
• You have chest pain.
• You become short of breath.

Call your provider during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.
  

Developed by McKesson Provider Technologies.

Published by McKesson Provider Technologies.
Last modified: 2005-07-07
Last reviewed: 2005-03-25

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Breech Babies: What Can I Do if My Baby is Breech?

taken from familydoctor.org

What is a breech birth?

Right before birth, most babies are in a head-down position in the mother's uterus, which is why most babies are born head-first. Sometimes the baby is in a bottom-first (or feet-first) position. When a baby is in that position before birth, it's called a breech birth or breech baby. Many babies are breech early in pregnancy, but most of them turn to the headfirst position near the end of the pregnancy. Babies that are born early are more likely to be breech. If more than one baby is in the uterus at a time, one or more of the babies may be breech. Abnormal levels of amniotic fluid around the baby may result in a breech birth. As you get closer to your due date, your doctor will be able to tell (by physical exam, ultrasound or both) if your baby is breech.

Can a breech baby be delivered without a cesarean?

Some breech babies may be safely delivered from the vagina. However, more complications can occur if the baby is breech. A baby who is breech may be very small, or it may have birth defects that are caused by a breech delivery. When breech babies are delivered vaginally, they are more likely to be injured during or after delivery than babies that are delivered head-first. Babies delivered vaginally in a breech position are also more likely to develop a birth defect where the baby’s hip socket and the thighbone become separated. Complications with the umbilical cord are also more likely in babies who are delivered vaginally in a breech position (for example, the umbilical cord is more likely to be compressed during delivery, which can cause nerve and brain damage due to lack of oxygen).

Although breech babies can be delivered vaginally, it's generally safer and easier to deliver babies head-first from the vagina. Doctors usually deliver breech babies by cesarean delivery (also called a C-section). Risks are also involved with cesarean delivery (such as bleeding, infection and longer hospital stays for both the mother and her baby).

Can I do anything to help if my baby is breech?

It's very important to see your doctor regularly throughout your pregnancy. Your doctor can tell if your baby is breech and help plan what to do. Some doctors will plan to deliver the baby by cesarean section. Others may give their patients exercises to do at home that may help turn the baby to the head-first position. Some doctors try to turn the baby in the mother's uterus using a procedure called external cephalic version. If this procedure is successful and the baby stays head down, a normal vaginal delivery is more likely.

What is external cephalic version?

External cephalic version is a way to try to turn a baby from breech position to vertex (head-down) position while it's still in the mother's uterus. In other words, external cephalic version means turning the baby from outside of the abdomen so that it's in the head-down position. Your doctor will use his or her hands on the outside of your abdomen to try to turn the baby (see the pictures below).

When is external cephalic version done?

External cephalic version is done at the end of pregnancy, after about 37 weeks of gestation.

Who can have external cephalic version?

Many women who have normal pregnancies may have external cephalic version. Women who cannot have it are women who have one of the following:

• Vaginal bleeding
• A placenta that is near or covering the opening of the uterus
• A nonreactive nonstress test
• An abnormally small baby
• A low level of fluid in the sac that surrounds and protects the baby
• An abnormal fetal heart rate
• Premature rupture of the membranes
• Twins or other multiple pregnancy

What are the risks of external cephalic version?

External cephalic version has some risks, including the following:

• Premature labor
• Premature rupture of the membranes
• A small blood loss for either the baby or the mother
• Fetal distress leading to an emergency cesarean delivery
• The baby might turn back to the breech position after the external cephalic version is done

Although the risk of having these complications is small, some doctors prefer not to try an external cephalic version.

What can I expect if my doctor and I decide to try external cephalic version?

External cephalic version is usually done in the hospital. Before the procedure, you will have an ultrasound to confirm that the baby is breech. Your doctor will also do a nonstress test to make sure that the baby's heart rate is normal. A tube of blood will be drawn and an anesthesiologist will be notified (just in case you need to have an emergency cesarean delivery). You'll be given medicine through a vein in your arm to relax the muscles in your uterus. This medicine is very safe, with no risk to your baby. While you're lying down, the doctor will place his or her hands on the outside of your abdomen. After locating the baby's head, the doctor will gently try to turn the baby to the head-first position.

What happens after the procedure?

When the procedure is completed, your doctor will perform another nonstress test. If everything is normal, you won't have to stay in the hospital. If the procedure is not successful, your doctor will talk to you about the possibility of having a vaginal delivery or a cesarean section right away. Your doctor may also suggest repeating the external cephalic version.

What is the success rate of external cephalic version?

The success rate of external cephalic version depends on several factors, including the following:

• How close you are to your due date
• How much fluid is around the baby
• How many pregnancies you've had
• How much your baby weighs
• How the placenta is positioned
• How your baby is positioned

The average success rate is about 65%. Even if the procedure works at first, there's still a chance that the baby will turn back around to the breech position. This also depends on the factors listed above.

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8 Types of Baldness

by dr.Ay

Baldness, or in medical terms known as alopesia, is consist of various types and causes. The common type of alopesia is alopesia areata and alopesia androgenika. The causes of alopesia areata are mostly genetic or imunologicc factors, while alopesia androgenika which usually occured in men attain the age of late twenty or early thirty is caused by genetic factors and high level of androgen hormones in the skin of head. The other causes that comes from outside the body (external causes) such as dandruff, inflammation, fungus, thyroid hormones disorder, syphilis, drugs, stress, or something which holds the hair too much by squeezing oftenly becomes the factors that can cause alopesia.

The mechanism of baldness in alopesia androgenika occured in several stage that begin from lateral and front side. The front line hair contour decline backward and we might see wider forehead. This type of baldness is divided into 8 types:

1. Type I : fully haired head
2. Type II : decreased amount of hair on both side of lateral head
3. Type III : border line
4. Type IV : decreased amount of hair on front & lateral area accompanied by the decline of middle frontline hair
5. Type V : more severe form of type IV
6. Type VI : the alopesia become one
7. Type VII : severe form of type VI with invasion to the lateral side
8. Type VIII : complete baldness

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Detecting the Early Symptoms of Autism is Important

by Gust Lenglet (the founder of Autism Resources and has written several articles on what to look for to see if your child has autism)

If you ask the vast majority of parents what gender they would like their child to be before they are informed of the sex, they would happily answer that they do not mind as long as the baby is healthy. Although those parents will worry that their child will have some disorder, most do not have cause to worry, but those that do may not always notice the symptoms. The early symptoms of autism, for example, are not blindingly obvious and can easily be mistaken for something else. However, if you know a little about this disorder, then you will be able to recognize them.

Autism is effectively a brain development disorder that can be present at birth but can also manifest itself a little later into childhood. In most children, the symptoms are evident by the age of two but the vast majority of those cases are only diagnosed between the age of two and three years old. However, the sooner you notice the early symptoms of autism, the quicker you can get a diagnosis and a treatment plan to ensure that the disorder is as stable as possible. It is not unheard of for a six month old baby to be diagnosed!

Although the early symptoms of autism will vary from child to child, there are some common symptoms that are present in autistic children to varying degrees. Some are physical symptoms while others are mental. For example, facial expressions tend to be common physical symptoms. A high number of autistic children do not smile before the age of six months, unlike children that are developing normally. They also tend to avoid eye contact. In fact, many autistic children only display blank expressions.

Many early symptoms of autism are behavioral. For example, a baby can either appear to be hyperactive or destructive. In some cases a child may be both. Similarly, a child with autism may also self-harm by throwing a tantrum for no apparent reason at all. This could include biting him or herself, banging limbs and the head against the floor or their bed, and may even try to scratch or bite you. As autistic children often have less sensitivity to pain, this is more painful for the parent than the child. Finally, another of the early symptoms of autism is that the child cannot interact with others. That may include other children, in which case they often play on their own.

The early symptoms of autism outlined above are not exhaustive by any means, and it may be that not all of them apply to your child. However, it is worth reviewing a checklist to see just how many of the symptoms your child displays. If there are any, you should consult with a qualified physician as soon as possible.

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LASIK Eye Surgery (getting rid of glasses)

taken from youtube.com

Want to see the real LASIK surgery procedure...? Here is one of the example. This video is taken from youtube.com that had been made by TontonZen. This video shows how his operation had been done well for about 20 minutes for two eyes operation (in this video, there is only one eye operation). Now, he doesn't wear glasses anymore. So....Do you wanna try...?^_^

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Top 5 Fears Associated with LASIK Surgery

Free article by Danielle Briones

"… I lay in the bed at the LASIK surgical facility, eyes pried open with what appeared to be some medieval torture device, the wild-eyed surgeon coming at me with a scalpel. His accomplice, the nurse, stood ready behind him, aiming the high-tech laser system that was to obliterate my entire ocular cavity."

Clearly, I had a number of fears associated with LASIK surgery before undergoing the procedure in 2006. My paranoid visions of a crazy surgeon doing irreversible damage to my eyesight caused me to put off the procedure for five years. After undergoing surgery, I found that most of my fears were exaggerated and that 20/20 vision was definitely worth all the apprehension I had felt about LASIK.

Although millions of Americans are candidates for LASIK surgery, a significant portion elect not to undergo treatment due to fears associated with the procedure. It's not surprising, considering how heavily we rely on our vision. Remember the frustration that came from being blindfolded when playing games at birthday parties as children? Fumbling around to pin-the-tail-on-the-donkey or wildly bashing a candy-filled piñata while engulfed in utter darkness? Experiences such as these have helped us to understand the importance of our vision and have led some people to avoid vision correction surgery altogether. Here are the reasons why:

1. Going blind as a result of the procedure

Many potential LASIK candidates fear that they will go blind as a result of the procedure. But according to the FDA, there has not been one case of a patient going blind as a result of LASIK surgery.

2. Pain

Fear of pain is one of the main reasons people avoid undergoing medical procedures. Fortunately, LASIK is one of the least invasive forms of surgery performed today. Patients are typically offered a sedative prior to treatment, and numbing drops are applied to the eyes to alleviate pain.

3. Having the eye cut with a scalpel

Aside from those who are addicted to plastic surgery, no one really wants to have their bodies sliced up with a scalpel. LASIK patients don't have to worry about "undergoing the knife" if they don't want to. A scalpel is not used during the LASIK procedure; rather, the corneal flap that allows the surgeon access to the tissue underneath is created with use of the Intralase® laser or a blade known as a microkeratome.

4. Laser contact with the eye

Yes, an excimer laser is used to shape the cornea. No, the excimer laser is not a lightsaber-esque instrument used to battle evil forces. While many potential LASIK patients fear the part of the procedure in which the laser comes into contact with the eye, it lasts for only about 10 seconds per eye. And the majority of patients say they did not experience pain, just slight pressure, when the laser shaped their corneas.

5. Being awake during the procedure

LASIK surgery is an outpatient procedure during which patients are awake. Fear of seeing the microkeratome or laser come into contact with the eye is enough to convince some prospective patients to stick with their eyeglasses or contact lenses. However, contrary to popular belief, LASIK patients can't see the microkeratome or excimer laser during surgery. LASIK surgeons apply eye drops that cause the eyes to black out during treatment.

I myself experienced each of these fears prior to LASIK surgery. In the end, I found the procedure itself to be a minor inconvenience that is certainly worth the benefits. I did experience some pain in my eyes a couple hours after the procedure. My LASIK surgeon had recommended that I go to sleep as soon as I got home - but I didn't take his advice. When the numbing drops wore off and I began to feel some pain, I decided to sleep it off. I fell asleep and woke up about five hours later, around midnight, feeling no pain. When I opened my eyes and saw that the illuminated numbers on my clock were clear, not fuzzy, I realized the treatment had worked – and that my fears regarding LASIK were unfounded.

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The Principle of LASIK Surgery

taken from youtube.com

Well...In order to have better description about the principle of LASIK surgery, let me show you the ilustration. Hope it helps

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New risks in Lasik procedure?

free article from Pamela Ellermann

Study finds that certain traits, like dry eyes, make surgery complications more likely

Although Lasik eye surgery has relieved 8 million Americans of the need to wear glasses or contact lenses, new concerns about surgical risks are being raised on the eve of its 10-year anniversary.

New findings show that people who are not suitable candidates for the procedure for a variety of reasons are at greater risk for a problem during the surgery. With up to 700,000 Americans going under the knife each year, that leaves substantial room for mishap.

General eligibility requires patients to have a consistent glasses or contact lens prescription for at least two years and limits candidates to those over 18 years old.

Qualities that make candidates less ideal include dry eyes or scarring of the cornea, according to the Eye Surgery Education Council.

In response to recent media attention about complications that arise from the surgery, the Food and Drug Administration plans to provide new graphics and text to make the risks of this surgical procedure more explicit to candidates.

Measures include providing photographs of what halo vision - a possible side effect that makes a person see rings of light around bright light sources - might look like.

The FDA cites dry eyes, loss of vision, glare, halos and double vision as possible risks of the procedure, acknowledging that it is relatively new and that studies on the long-term effects are not available yet.

Although complications from the surgery might be debilitating, the odds of problems are low.

Up to 92.6 percent of patients leave the operating room with 20/40 vision or better, and up to half enjoy 20/20 or better, according to a study by the American Association of Professional Eyecare Specialists.

The Eye Surgery Education Council puts the risk of severe complications at less than 1 percent.

College junior David Weinreb, who after 12 years of nearsightedness got the procedure this January, said he would recommend Lasik surgery to most people, as long as they consider the potential risks.

"You have to have a certain medical capacity to say I'm going to have surgery" with real risks, he said.

Improving from 80/20 vision to 20/15, Weinreb described the transition as "unbelievable," once the short term side effects of halo vision and light sensitivity subsided.

Among the most important things Lasik candidates can do to ensure their own safety is ask questions, Weinreb said.

During the time in which he experienced halo vision at night, Weinreb wasn't worried about the side effects being permanent because he was in regular communication with his doctor, who explained what to expect in detail.

For those concerned about complications, surgery can be performed one eye at a time, using contact lenses to maintain consistent vision in both eyes between operations.

And for success stories like Weinreb, the procedure has huge benefits, like being able to see at those "strange times" he couldn't wear glasses, like in the shower or the swimming pool.

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