By J. Bufford. Cornell University.

The spinal cord carries all the nerve messages to and from the brain 10 mg loratadine mastercard allergy virus, and runs through the centre of the 24 vertebrae that form the backbone order loratadine 10mg mastercard allergy symptoms home remedies. A small amount of anaesthetic is injected into the spinal canal, so that the nerves below the level of injection no longer work and pain from the operation cannot be felt. The patient is often tilted slightly to prevent the anaesthetic from flowing further up the spine and affecting nerves above the level required for adequate anaesthesia. The side effects of a spinal anaesthetic include low blood pressure, a headache for several days, and a slow heart rate. This type of anaesthetic is usually given when the patient is not well enough to stand a general anaesthetic, for Caesarean sections, and in other circumstances when it is desirable for the patient to be awake. They are caused by a break down and stretching of the elastic fibres in the skin by changes in the body’s hormone levels as well as direct stretching of the skin. Once they form they usually remain permanently unless removed by plastic surgery or reduced by creams containing retinoic acids. Cushing syndrome is caused by an over production of steroids such as cortisone in the body, or taking large doses of cortisone. Headache, obesity, thirst, easy bruising, impotence, menstrual period irregularities, stretch marks, acne, high blood pressure, bone pain and muscle weakness are common symptoms of this syndrome. In many patients, the symptoms are so mild that they are ignored, but in severe cases the patient complains of a low-grade fever, tiredness, muscle aches, joint pains, headache, sore throat, a mild rash and enlarged glands. The disease can be detected by a specific immunoglobulin blood test, and this test is often routinely performed during antenatal blood examinations. Unfortunately, because the disease has already occurred, there may still be some damage to the foetus. During the first trimester (the first three months) the structure and form of the foetus are developed. The second trimester is involved with the growth of the foetus while the third trimester is the maturity of the foetus. This allows a woman to attempt a natural vaginal delivery while a medical team is readily available to intervene with forceps or surgery if necessary for the health of the mother or baby. It is located in the pelvis and is loosely tethered to the pelvic walls by two ligaments on each side, the round and broad ligaments, giving it a high degree of mobility. The upper part of the uterus is called the body, and is attached to the two egg-conducting Fallopian tubes. It narrows at the lower end to form the cervix, or neck, which protrudes into the vagina and provides a passage for sperm to enter and menstrual blood to flow out. In the middle is a thick layer of muscle called the myometrium, while the inner lining consists of a blood enriched mucous membrane called the endometrium. If this does not eventuate, all but the deepest part of the endometrium is discarded, leading to the monthly menstrual period. The menstrual flow consists of the liquefied dead endometrium together with some blood lost in the process. They expand to accommodate the growing foetus, and when the time comes for the baby to be born they engage in a series of contractions, helping the hitherto tightly closed cervix to open and propelling the baby into the vagina during labour. About six weeks after pregnancy, the muscles have shrunk again and the uterus has returned to its normal size. Sperm ejaculated during intercourse travel through the cervix and into the uterus and Fallopian tubes to fertilise an egg if one has been released. The lining of the vaginal wall is made up of a moist mucous membrane arranged in folds, which enable its muscular tissue to expand for the purposes of sexual intercourse and childbirth. The muscles in the wall of the vagina will also contract in spasms when a woman has an orgasm during intercourse. In children the external opening to the vagina is partly covered by a thin mucous membrane called the hymen. This will be broken at the time of first sexual intercourse, or it may break spontaneously earlier than this. The tube leads to a suction device, which can create a vacuum, and the chain is attached to a handle that is held by the doctor. The rubber suction cap is placed on the baby’s head as it emerges from the dilated cervix of the mother, and the vacuum pump is turned on to firmly attach the cup to the baby’s scalp. The doctor can then pull on the chain and therefore the baby to assist the mother who is pushing the baby out. The vacuum pressure is adjusted so that if the doctor pulls too hard on the chain the suction cap detaches from the baby’s head.

Promotion of Breastfeeding Key messages • Timely initiation of breastfeeding (1 hour of birth) • Exclusive breastfeeding until six months • Breastfeed day and night at least 10 times • Correct positioning & attachment • Empty one breast before switching to the other Estimated decrease of child mortality is 13% if the child is optimally breastfed 2 buy generic loratadine 10 mg on line allergy forecast cedar rapids iowa. Appropriate Complementary Feeding Key messages: • Introduce appropriate complementary foods at 6 months • Continue breastfeeding until 24 months & more 84 Nutrition • Increase the number of feeding with age • Increase density buy loratadine 10mg without prescription allergy forecast gainesville fl, quantity and variety with age • Responsive feeding • Ensure good hygiene (use clean water, food and utensils) 3. Feeding of the sick child Key messages: • Increase breastfeeding and complementary feeding during and after illness • Appropriate Therapeutic Feeding. Control of Vitamin A Deficiency: Estimated decrease of child mortality is 2% Key messages: • Promote breastfeeding: source of vitamin A • Vitamin A rich foods 85 Nutrition • Maternal supplementation • Child supplementation • Food fortification 6. Control of Iodine Deficiency Disorders: Key messages Access and consumption by all families of iodized salt How the Essential Nutrition Actions expands coverage of nutrition support in the health sector: There are six critical contact points in the lifecycle 1. Worldwide, fewer than 20% of deaths associated with childhood malnutrition involve severe malnutrition; more than 80% involve only mild or moderate malnutrition. The Management of Severe Malnutrition a Suggested Manual for Ethiopia, July 2002 6. Retain palmitate supplementation by inhalation of an aerosol improves vitamin A status of preschool children in Gondar Region, Ethiopia. The prevalence of low birth weight and factors associated with low birth weight in Gondar region, northwest Ethiopia. Together, we are producing 13 Modules to upgrade the theoretical knowledge of the country’s 33,000 rural Health Extension Workers to that of Health Extension Practitioners, and to train new entrants to the service. Every student learning from these Modules is supported by a Tutor and a series of Practical Training Mentors who deliver the parallel Practical Skills Training Programme. This blended approach to workplace learning ensures that students achieve all the required theoretical and practical competencies while they continue to provide health services for their communities. These Blended Learning Modules cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities in Ethiopia. A strong focus is on enabling Ethiopia to meet the Millennium Development Goals to reduce maternal mortality by three-quarters and under-5 child mortality by two-thirds by the year 2015. In time, all the Modules will be accessible from the Ethiopian Federal Ministry of Health website at www. Dr Kesetebirhan Admasu State Minister of Health Ethiopian Federal Ministry of Health i Acknowledgements Nutrition is one of the 13 Blended Learning Modules for the Ethiopian Health Extension Programme. Some of the illustrations in this Module were produced by Terefe Wondimagegnehu from the Federal Ministry of Health. The opinions expressed in this Module are those of the authors and do not necessarily refect the views of any of the donor organisations whose generous support made the production of Nutrition possible. The Nutrition Module is studied in parallel with a Practical Skills Training Programme at health facilities in your locality. This blended approach to learning will ensure that you achieve all the theoretical and practical competencies required to give effective nutritional care and support in your community. The Nutrition Module has 13 study sessions, starting with the basics of nutrition and fnishing with a session on the Nutrition Information System in Ethiopia. The frst three Study Sessions cover food, diet and nutrition; nutrients and their food sources (in Ethiopia); and nutritional requirements throughout the human lifecycle. Study Session 4 deals with infant and young child feeding in the context of our country. Following this, you will learn different methods of nutritional assessment (Study Session 5) both at individual and community level. In Study Sessions 6 and 7, the nutritional problems that are of public health importance in Ethiopia are elaborated; followed by household food security (Study Session 8). Study Sessions 9 and 10 cover the treatment and control of the main nutritional problems of Ethiopia, including severe micronutrient malnutrition. In Study Session 11 you will learn about education and how to counsel people in your community to prevent or address nutrition problems. Finally, in Study Session 13 you look at the Nutrition Information System in Ethiopia and your role in collecting data that helps to inform decision- making in relation to nutrition programmes and other interventions in Ethiopia. You will learn what is meant by food and diet as well as the meaning of nutrition and nutrients in general.

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