Domiciliary Care It’s the care given to a pregnant woman by a midwife at her home environment, embracing prenatal, Intranatal and postpartum management.

Definition: This describes the Impaction of the anterior shoulder against the symphysis pubis after delivery of the fetal head. Shoulder dystocia is said to have occurred when there is: • Failure of the shoulders to rotate spontaneously into anterior, posterior diameter of the pelvis outlet after delivery of the head • The anterior shoulder becomes trapped behind or on the symphysis pubis while the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory

Gastric or stomach cancer is a disease in which malignant (cancer) cells form in the lining of the stomach. Gastric cancer is the fifth most frequently diagnosed cancer and the third leading cause of cancer deaths worldwide. (Globocan 2018,Babiker,2021)

Disorders of the digestive system have serious consequences for the activity of the organism as a whole congenital malformations traumatic processes inflammatory processes neoplastic processes infectious processes Digestive system communicates with the external environment through the intake of fluids and food. Common git disorders • Motor dysfunction of smooth muscle of the individual parts of the digestive system • Indigestion of food and absorption of nutrients - malabsorption syndrome • Bleeding into the individual parts of the digestive tract • Perforation of the wall of the digestive system with subsequent leakage of the contents to the peritoneal cavity • Obstruction in moving of the contents of one part of the digestive system to the next section • Circulation disorders in the wall of the individual parts of the digestive system

The Digestive System Consists of ; a) Long hollow muscular tube or canal or tract called gastrointestinal tract or (GIT): • it is about 5 meters long b) Accessory glands: include: • Salivary glands • Liver and gall bladder • Pancreas

Tumors of the heart are rare; most (75% to 88%) are benign (Braunwald et al., 2001; Kamiya et al., 2001). • Primary tumors occur in less than 1% of the population; metastatic tumors have been • reported in 1.5% to 35% of oncology patients (Braunwald et al., 2001; Reynan, 1996; Shapiro, 2001). • Tumors may be sites for thrombus formation and therefore create a risk of embolism. • Dysrhythmias may occur as the myocardium or conduction system is affected. PRIMARY CARDIAC TUMOURS BENIGN 1. Myxoma 2. Papillary fibroelastoma 3. Fibroma 4. Lipoma 5. Rhabdomyomas 1. MYXOMA • Myxoma is a noncancerous tumor that arises from connective tissue, which is tissue that connects and supports other tissues all over the body. • Show familial pattern of tumor development based on autosomal dominant inheritance. • Mostly occur after trauma or even surgery i.e atrial septal defects, valve repairs. • Present with signs of right ventricle failure

altered level of consciousness is defined as a condition of being less responsive to and aware of environmental stimuli. • LOC is gauged on a continuum with a normal state of alertness and full cognition(consciousness) on one end and coma on the other end.

Anatomic and Physiologic Overview • The nervous system consists of two divisions: Central nervous system (CNS), including the brain and spinal cord Peripheral nervous system (PNS), made up of the cranial and spinal nerves. • The peripheral nervous system can be further divided into: Somatic, or voluntary, nervous system Autonomic, or involuntary, nervous system

Cardiac surgery -performed on the heart to correct life- threatening conditions. Types of heart surgeries The surgery can be either; OPEN HEART SURGERY CLOSED HEART SURGERY MINIMALLY INVASIVE SURGERY depending on the conditions to be corrected.

The heart’s primary function is to pump blood to all parts of the body. The circulating blood not only brings oxygen and nutrients to the body’s tissues but also helps to take away the body’s waste products. Its essential to understand the structure and function of the heart in health and in disease in order to understand the assessment skills.

Consists of two divisions: • The central nervous system (CNS), including the brain and spinal cord, and • The peripheral nervous system, made up of the cranial and spinal nerves. • The peripheral nervous system can be further divided into • The somatic, or voluntary, nervous system, and • The autonomic, or involuntary, nervous system.

Blood transfusion is the transfusion of whole blood or its components such as blood cells or plasma from one person to another person. Blood transfusion involves two procedures; • Collection of blood from a donor • Administration of blood to the recipient.

In fracture management, the objectives of the treatment are as follows: • To regain and maintain the normal alignment of the injured part. • To regain normal function of the injured part. • To achieve the above objectives for the patient in the shortest time possible.

It is an abnormally increased concentration of haemoglobin in the blood, either through reduction of plasma volume or increase in red cell numbers. People with polycythemia have an increase in hematocrit, hemoglobin or red blood cell count above the normal limits.

Anatomy and physiology • There are 206 bones in the human body, divided into four categories: • Long bones (eg, femur) • Short bones (eg, metacarpals) • Flat bones (eg, sternum) • Irregular bones (eg, vertebrae) • The shape and construction of a specific bone are determined by its function and the forces exerted on it

Hematologic system consists of ; blood and sites where blood is produced, (bone marrow and the reticuloendothelial system (RES). • Blood is composed of plasma and various types of cells. • Plasma is the fluid portion of blood; it contains various proteins, such as albumin, globulin, fibrinogen, and other factors necessary for clotting, as well as electrolytes, waste products, and nutrients. • About 55% of blood volume is plasma.

Hypertensive disorders complicating pregnancy are common and are among the three (with hemorrhage and infection) leading causes of death. Pregnancy can induce hypertension (HTN) or aggravate pre-existing hypertension.

Acute Pharyngitis is an inflammation or infection in the throat usually characterized by sore throat

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019 .Over 80% of these deaths occurred in low- and middle-income countries (LMIC).COPD causes persistent and progressive respiratory symptoms, including difficulty in breathing, cough and/or phlegm production. COPD results from long-term exposure to harmful gases and particles combined with individual factors, including events which influence lung growth in childhood and genetics. Environmental exposure to tobacco smoke, indoor air pollution, and occupational dusts, fumes, and chemicals are important risk factors for COPD. Early diagnosis and treatment, including smoking cessation support, is needed to slow the progression of symptoms and reduce flare ups.(WHO,2019)

Parathyroid gland is located on the neck, embedded in the posterior aspect of the thyroid gland. • They are four in number • Parathormone, a protein hormone, regulates calcium and phosphate metabolism. • Increased production results in increased calcium absorption from the kidney, the intestines and the bones.