Can we give loperamide in first trimester of pregnancy

FETAL ALCOHOL SYNDROME. FETAL ALCOHOL SYNDROME(FAS)/FETAL ALCOHOL SPECTRUM DISORDER(FASD). is a birth defect caused by exposure to alcohol during pregnancy. *There is no cure for FASD. *A person with FASD can get help with their learning and behavior to maximize their independence and achievements. *WHO recommends that pregnant woman should avoid alcohol. *Drinking during pregnancy can cause brain damage , leading to a range of developmental,cognitve and behavioral problems which can appear at any time during childhood. *In the united states,FAS is one of the leading cause of birth defects and most common cause of preventable mental retardation. SYMPTOMS. *CHARACTERISTIC FACIAL FEATURES. Microcephaly. Small palpebral fissures. Epicanthic folds. Depressed nose. Flattened philtrum. Thin upper lip. Micrognathia. *CENTRAL NERVOUS SYSTEM PROBLEMS. Mental retardation. Hyperactivity. Delayed development of gross motor skills such as rolling over,sitting up,crawling and walking. Delayed development of fine motor skills such as grasping objects with thumb and index finger,and transferring objects from one hand to the other. Impaired language development. Memory problems,poor judgement,distractibility,impulsiveness Problems with learning. Seizures. *Decreased birth weight. Hearing disorders. CAUSE OF FAS. FAS is caused by a women's use of alcohol during pregnancy.the alcohol that a pregnant women drinks travels through her blood stream across the placenta to the fetus.A fetus breaks down alcohol much more slowly than an adult.this exposure of the fetus to alcohol causes FAS. TREATMENT. As the child has mental and behavioral problems,they need special education classes,supplemental classroom aids. PREVENTION. PREGNANT WOMAN MUST ABSTAIN FROM ALCOHOL. *

This is an anomalous baby terminated. though there are no gross external anomalies, you can derive at the diagnosis if you keenly observe the baby.

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Identify the structure and the pathology in Abd USG.

A 70 year-old woman has been admitted with shortness of breath. On further questioning she says she has been unwell for about 8 weeks. She has decreased appetite and nausea when she eats. She has lost weight but her abdomen feels swollen. She has generalized dull abdominal pain and constipation, which is unusual for her. There are no urinary symptoms. She has always been healthy with no previous hospital admissions. She is a widow and did not have any children. Her periods stopped at 52 years and she has had no post- menopausal bleeding. She has never taken hormone-replacement therapy. Examination She appears pale and breathless on talking. Chest expansion is reduced on the right side, with dullness to percussion and decreased air entry at the right base. The abdomen is gen- erally distended with shifting dullness. There is a mass arising from the pelvis. Speculum examination is normal, but on bimanual palpation there is a fixed left iliac fossa mass of about 10 cm diameter. Haemoglobin 9.2 g/dL, Mean cell volume 82 fL, White cell count 4100, Platelets 197, Sodium 135, Potassium 4, Urea 5.1, Urea Creatinine 89, Alanine transaminase 18, Aspartate transaminase 17, Alkaline phosphatase 78, Bilirubin 12, Albumin 30, CA-125 118. 1. What is the likely diagnosis? 2. How should this woman be further investigated? 3. If the diagnosis is confirmed how should she be managed?