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Mechanism of Normal Labor

  Mechanism of normal labor Definition: The series of movements that occur on the head in the process of adaptation during its journey through the pelvis is called mechanism of labor. Mechanism:   In normal labor, the head enters the brim more commonly through the available transverse diameter (70%) and to the lesser extent through one of the oblique diameters. The position is either occipitolateral or oblique occipitoanterior. Left occipitoanterior is more common than right occipitoanterior as the left oblique diameter is encroached by the rectum. The engaging anteroposterior diameter of the head is either suboccipitobregmatic 9.5 cm or in slight deflexion-the suboccipitofrontal 10 cm. The engaging transverse diameter is biparietal 9.5 cm. As the occipitolateral position is most common, the mechanism of the labor in such position will be described. The principal movements are: Engagement Descent Flexion Internal rotation  Crowning Extension Restitution External rotation Expulsion of
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Alopecia (Baldness)

 Alopecia: causes, diagnose, and treatment Alopecia : Alopecia means loss of hair. There are two types of alopecia. Non-cicatricial alopecia Cicatricial alopecia Difference between cicatricial and noncicatricial alopecia Alopecia Areata (AA) Etiology The pathogenesis of AA is uncertain and following factors are incriminated: Immunological factors: AA is considered an immunological disease because of: Association of AA with other auto-immune diseases (auto-immune thyroid disease, pernicious anemia, vitiligo, and atopy) Cytokines produced by dermal papillae in lesions not only attract lymphocytes to perifollicular region but also stimulate them to multiply. As opposed to normal hairs, strong major histocompatibility complex (class 1 and class 2) immunoreactivity found in affected follicles. 2. Genetic factors: AA may be present in some families, so it may have a genetic basis. 3. Emotional factors: In some patients, AA is precipitated by emotional stress. Epidemiology     Prevalence:   A
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Hereditory spherocytosis

• This is the abnormality of red blood cells. • This is usually inherited as an AUTOSOMAL DOMINANT condition. • The most common abnormalities are deficiencies of BETA SPECTRIN or ANKYRIN. • Most cases are associated with an asymptomatic compensated chronic haemolytic state with spherocutes present on the blood film, a reticulocytosis and mild hyperbilirubinaemia. • Pigment GALLSTONES are present in up to 50% of patients and may cause chlolecystitis. The clinical course may be complicated by crisis : • A HAEMOLYTIC CRISIS occurs when the severity of haemolysis increases. • A MEGALOBLASTIC CRISIS follows the development of folate deficiency. • An APLASTIC CRISIS occurs in association with PARVOVIRUS B19 infection. Investigations • The blood film will show spherocytes but the direct Coombs test is negative, excluding immune haemolysis. • An OSMOTIC FRAGILITY TEST may show increased sensitivity to lysis in hypotonic saline solutions but is limited by lack of sensitivity and specificity. •
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