If the buttocks are delivered first it is called as breech delivery. only 3 to 4% pregnancies are with breech presentation at birth. Breech position is an abnormal position and vertex presentation is normal birth presentation.

Most breech birth or breech presentation occur at the 32 week of gestation and at this time head of fetus is not turned down.  The main causes of breech presentation or birth are

* Prematurity is the main cause of breech presentation. Increased amniotic fluid or polyhydraminos,
* Fetal abnormalities such as hydrocephaly, anencephaly, and congenital abnormalities of fetus,
* Maternal abnormalities such as Uterine abnormalities.
* Placental abnormalities, Uterine fibroid and
* Multiple pregnancy.

Types of breech presentation are:-

* Frank breech presentation : baby’s buttocks comes first, and breech baby’s legs are flexed at the hip and extended at the knees (with feet near the ears). Nearly 65 to 70% of breech  delivery are in the frank breech position.

* Complete breech delivery: the baby’s hips and knees are flexed so that the baby is sitting cross legged, with feet beside the bottom. This is not common as frank breech position.

* Footling breech delivery : one or both feet come first, with the bottom at a higher position. This is footling breech position is rare at term but relatively common with premature fetuses.

* Kneeling breech delivery :  The breech baby is in a kneeling position, with one or both legs of breech baby are extended at the hips and flexed at the knees. This Kneeling breech delivery position is not common type of breech delivery.

Common injuries to breech babies during breech delivery:-

Umbilical cord prolapse : Is the common abnormality of breech delivery. As soon as the amniotic sac ruptures, the umbilical cord expels out. Due to umbilical cord prolapse the breech babies  receives less oxygen and becomes oxygen deprived.

Head injury : Injury to fetal skull or brain occurs as the late coming head of baby struggles to come out of maternal pelvis. Cranial lacerations, and intracranial hemorrhage may occur. Squeezing of abdomen causes damage to internal organs of breech baby.

Severe hemorrhage is the main complication to mother. Breech birth or breech delivery is one of the causes of maternal mortality. Hysterectomy is indicated in some mothers when uterine rapture occurs. External cephalic version is done in some mothers before labor starts.

Even most of the experienced doctors have stopped conducting birth canal breech delivery and they will plan for cesarean section to prevent injury to new born baby and to avoid maternal complications. It is confirmed that elective cesarean section is done by concerning fetal and maternal well being.

Heart disease:-

Heart is the cone shaped blood pumping organ situated between lungs in chest cavity and has a very very vital function in the body. The diseases or abnormalities are called as heart disease and number of symptoms or clinical features which indicates heart disease are called as heart disease symptoms or heart symptoms.

Impaired heart structure and function is called as heart disease and the heart symptoms are very clear and can be identified by the heart disease individual and a doctor.
Causes of heart disease symptoms:-

Diseases such as hypertensive diseases, congenital heart disease, rheumatic heart disease, and other disorders causes heart disease symptoms. The heart is the main organ of circulatory system and  heart disease directly affects the circulatory changes of body.

Coronary artery disease, the condition in which narrowing of the heart wall supplying blood vessels with accumulation of  fats and plaque is the main cause of heart disease symptoms.

Heart disease is the number one cause of death in united states, and heart disease symptoms should be known to heart patients to prevent complications. Most of heart disease develops gradually and heart attack is an acute heart disease, if not treated leads to death of affected individual.

Heart disease symptoms:-

Common heart disease symptoms include chest discomfort, Chest pain and left shoulder pain, shortness of breath, nausea, coldness, vomiting, unexplained severe headache, sweating, anxiety, heart burning sensation, swelling of ankles, etc

Heart symptoms vary according to heart disease. Heart symptom or heart disease symptoms in case of heart attack  are

* feeling of nausea,
* dizziness,  headache or pain the jaw,
* pain the shoulder or in the left arm,
* chest pain of  squeezing nature

Most of heart attack occurs without heart symptoms, and these heart attack should need kind attention to save the life.

Heart disease  symptoms in the case of arrhythmia are, the person realizes that his or her heart is occasionally missing a beat in between. Palpitation is also one of heart symptoms. No personal decision should be made about heart disease symptoms and one should get checked for heart symptoms by the cardiologist or doctor.

Arrhythmia is the clear heart symptom which indicates inability of heart to pump enough blood because of heart disease such as heart valve problems, which may  be indication of damage to heart valve.

Chest pain with radiating nature, increased with work is the clear heart disease symptom which indicates heart is in problem. The common cause of chest pain are atherosclerosis, moving clots in coronary arteries, etc.

Fatigue and swelling of the extremities are heart disease symptoms in case of heart failure. Feeling of lungs filled with fluid by the patient and difficulty breathing are heart symptoms of disease.

The signs and symptoms of atrial fibrillation  are fainting, feeling of heaviness inside the chest, dizziness and  heart palpitations are heart disease symptoms.

Thyroid nodule are lumps which commonly grow within thyroid gland. These lumps are the abnormal growths of thyroid tissue which are situated at the edges of thyroid gland and are felt as lump on throat by feeling external palpation. Sometimes thyroid nodule can be seen as a lump in the front of the neck in thin individuals who have less subcutaneous fat deposition.

Causes,  Facts related to thyroid nodule and thyroid biopsy:-

* Women are more prone to have thyroid nodule .  1 woman out of 15 has risk of getting thyroid nodule.
* 1 out of  40 young men has risk of developing thyroid nodule.
*  discomfort
* Thyroid nodule are benign tumors and non cancerous cells. Only five percent may develop carcinomas.
* More than 95 percent of all thyroid nodules are benign (non-cancerous growths)
* Some  thyroid nodule  are cysts  filled with fluid rather than thyroid tissue
* People aged over 50 years have chance of developing thyroid nodule.
* Thyroid biopsy is done to diagnose the nature of thyroid nodule, as a benign or malignant. Thyroid biopsy is the important diagnostic test for confirmation of thyroid nodule.
* complete family physical examination, measurement of serum TSH level and FNAB of the nodule are the diagnostic tests done before treatment of thyroid nodule.
* Ultrasound thyroid scan is done to notify the nature and extent of thyroid nodule.
* Thyroid biopsy is the procedure done to get the sample tissue for diagnostic studies. Thyroid biopsy is done in the minor OT with aseptic techniques. Care should be taken to avoid damage to blood vessels or thyroid gland while conducting thyroid biopsy. Needle biopsy is the common thyroid biopsy type. Biopsy specimen is tested in the laboratory and nodule nature is identified as benign or malignant.

Treatment of thyroid nodule:-

Experienced physicians need to treat the thyroid nodule. Treatment based on the nodule is benign or carcinogenic, metastatic. Hormone replacement may done after removal of affected thyroid lobe or thyroid part. Surgery is done to correct or remove thyroid nodule,  concerns about cosmesis should be taken by the surgeon. Patient need  some days of hospitalization and she can lead normal life. Regular medications should be taken as per doctor’s advice. Follow the medical care and have a healthy soft diet. Liquid diet is given for some days after thyroid nodule surgery.

Pituitary gland:-

Pituitary gland is an important endocrine gland in the body. Pituitary gland is very small in size measures the size of Pea nut. Pituitary gland is an external protrusion from the hypothalamus, situated in the bony cavity called sella turcica. The pituitary gland locates in the pituitary fossa, situated in the sphenoid bone in middle cranial fossa. Pituitary gland is the master gland among endocrine glands because pituitary controls the functions of the other endocrine glands

The pituitary gland secretes several hormones and maintains homeostasis of the body,  and produces tropical hormones which stimulate other endocrine glands to release certain hormones. Pituitary gland  is functionally connected to the hypothalamus. Adenohypophysis and neurohypophysis are the two lobes of the pituitary gland. Adenohypophysis is also called as anterior pituitary gland and neurohypophysis is called as posterior pituitary gland. Each lobes have different functions and secretes different hormones.

The  anterior pituitary gland synthesizes and secretes important endocrine hormones, which includes ACTH, TSH, PRL, GH (growth hormone), FSH (follicle stimulating hormone) , and LH (luteinizing hormone). These hormones are released from the anterior pituitary regulated by hypothalamus. Hypothalamic hormones are secreted to the anterior lobe by a special capillary system.

Oxytocin and Antidiuretic hormone are the hormones secreted by posterior pituitary.  ADH helps in maintaining water balance in the body and Oxytocin helps in contraction of uterus during labor or child birth and maintains lactation in mother.

Intermediate lobe is the lobe of thin layer between anterior and posterior pituitary gland. This gland is related to melanocytes and controls skin pigmentation.

Hormones  plays a major role in maintaining various bio chemical changes in the body. Some hormones are released when an individual grown up or attains puberty. It has been proved that love, affairs and some emotional changes occurs because of hormones produced by pituitary gland. Hormones produced during young age regulates the desire to love, affection, etc. Steroids or steroid hormone leads to  puberty and physiological changes in the body.

Functions of pituitary gland:-

* Growth regulation,
* Controls Blood pressure,
* Uterine contraction with release of oxytocin during labor,
* Maintains pregnancy with some hormones,
* Production of milk from mammary glands,
* Regulates thyroid function,
* Helps in metabolism of food,
* Osmolarity regulation, etc are main functions of pituitary gland.

So the pituitary gland is the important gland has various functions in the body.

Kidney infection:-

Infection of the kidney with microorganism is called as kidney infection. Kidney infection is also called as pyelonephritis, is special type of upper urinary tract infection. The infection to kidney is passed to kidney through urethra, urinary bladder and ureter.

The main function of kidney is to purify the blood, Water absorption, maintains biochemical levels in the body and also regulates blood pressure through renin angiotensin system.

Urine is formed after filtration of blood and renal tubules helps in the absorption of different electrolytes and water.  The urine formed in the kidney is passed through ureters to the urinary bladder. From urinary bladder to urine is passed out with voluntary effort through urethra.

The infected bladder provides an opportunity for micro organisms to ascend into upper urinary tract and causes kidney infection. The infected kidney leads to kidney pain. Bacteria are the common micro organisms causes kidney infection. Sever kidney infection causes pus formation and kidney pain.

Diagnosis of Kidney infection:-

Diagnosis of kidney infection is made by urine test. The protein urea, passing pus cells or epithelial cells in the urine, confirms the kidney infection or urinary tract infection. Antibiotics are used to treat  kidney infection and analgesics to relieve kidney pain. Ultrasound scan shows any enlargement of kidney due to severe kidney infection.

Causes of kidney infection and kidney pain:-

The untreated lower urinary tract infection is the main cause of kidney infection. The untreated kidney infection leads to improper kidney function and even leads to kidney failure also.

* Causes of kidney pain may of different origin.
* abdominal surgeries,
* urinary cauterization,
* kidney biopsy,
* Untreated kidney infection may cause kidney pain,
* An external injury to kidney also causes kidney pain,
* Presence of kidney stones leads to kidney pain. The kidney pain may be radiating and felt in the lower back region.

Symptoms of kidney infection:-

# continued urge to urinate
# Burning sensation or pain while passing urine,
# lower abdominal pain
# urine is Cloudy in nature with  strong odour
# Pus or red blood cells in your urine (hematuria)
# urinary retention
# nocturia, passing urine during night
# low Back pain, (kidney pain) or groin pain
# fatigue, nausea and vomiting etc..

Treatment of kidney infection and kidney pain:-

Treatment of kidney infection is given with antibiotics. Give plenty of water to kidney infection person. To relieve kidney pain, analgesics are administered. The kidney pain is very complicated  and immediate diagnosis and treatment is needed with hospitalization.

Hypertension pregnancy or pregnancy induced hypertension is the hypertension or increased arterial pressure developed during pregnancy. The changed hormonal levels in the body and physiological changes causes hypertension during pregnancy. The hypertension pregnancy or high blood pressure pregnancy develops after the gestational age of 20 weeks.

Symptoms of hypertension in pregnancy:-

Swelling over ankles, hands and puffiness of face are main symptoms of high blood pressure in pregnant mother. Mother may complaint headache as soon as she wake up from the bed. Dizziness is also present with some discomfort.

Causes of hypertension in pregnancy:-

Persistent elevated hypertension with systolic blood pressure of more than 160 mm of Hg and diastolic blood pressure of more than 110 mm of Hg in pregnant mother is called as pregnancy hypertension or pregnancy induced hypertension.

Hypertension in pregnancy occurs only in some women but not in all pregnant mothers. Mother develops high blood pressure because of increased blood volume during pregnancy. High blood pressure pregnancy is developed into pre eclampsia.

The untreated high blood pressure pregnancy becomes complicated with HELLP syndrome and Eclampsia. Eclampsia is the high blood pressure pregnancy with convulsions. Pre eclampsia and eclampsia affects the health of both mother and growing fetus. only 2 to 3 % of pregnancies becomes complicated with eclampsia.

Treatment of hypertension pregnancy:-

* Immediate control of hypertension pregnancy is needed to protect the fetus and to promote  intrauterine fetal growth and development. Untreated high blood pressure pregnancy may become fatal and Labor or child birth becomes very difficult. Hypertension pregnancy is the cause of higher maternal, prenatal mortality and morbidity rate in India.
* Close monitoring of mother with high blood pressure pregnancy is needed to prevent complication for both pregnant mother and baby. No specific treatment is needed if hypertension stays in mild elevated level.
* Hospitalization is needed for health care and to avoid emergency at the time of child birth or labor.
* Now a days stem cell therapy is used to treat pregnancy hypertension.
* Anti hypertensives and anti convulsant are required to treat Eclampsia.

Brain lesions:

An abnormal area of brain tissue anatomically or physiologically is called as brain lesion. The MRI scan shows the shadow area or abnormal image, which confirms, the brain lesions. The brain lesions may be formed as a blood clot, cerebral hemorrhage, etc.

MRI scan doesn’t confirms clear diagnosis of brain lesions and careful assessment is needed to diagnose brain lesions. Familial history of brain lesions is one of the risk factor for development of brain lesions. Mechanical or internal brain damage is also considered as brain lesion.

Researchers have confirmed that nearly 5 % of individuals who have brain lesions are prone to have heart holes, i.e. impaired closure of foreman ovale.

Causes of brain lesions:

* Unstable blood pressure also causes white matter brain lesions.
* Previous head injury,
* Genetic mutation also causes brain lesions.
* Accumulation of death nerve cells also causes micro lesions in old age people.
* Head trauma with incomplete healing,
* Cerebral Stroke
* Brain tumors (benign or malignant)
* Internal cerebral hemorrhage,
* Multiple sclerosis
* Brain injury
* Congenital brain anomalies, such as hydrocephalus

Severe migraine headaches  are caused because brain lesions. MRI scan of individuals with migraine headaches shows presence of brain lesions. The early detection and treatment should be given to prevent further complications. Presence of small brain lesions may not cause any trouble to individuals and large lesions should be treated immediately ; otherwise brain function may be altered. Some lesions are formed after strokes and brain function is disturbed as the paralysis occurs.

Symptoms of large brain lesions:-

* Sense of smell impaired,
* Unable to taste properly,
* Unable to balance the body,
* Hand tremors,
* Mental confusion
* some lesions causes dementia and cerebral stroke… are the some symptoms of brain lesions, which affects different functional centers in the body.
Multiple brain lesions are found in some individuals, and these brain lesions causes sever symptoms such as mental confusion, etc.. Some mental disorders are such as organic disorders of brain may be caused by untreated brain lesions. Parenchymal brain lesions causes Cerebral sinovenous thrombosis  in neonates and children.The neonates will have smaller brain lesion and elders children will have large lesions.

People who eat fish high with omega 3 fatty acids more than three times a day are at lower risk of developing silent brain lesions. Brain aging can be slow down by taking certain food stuffs in the diet. Brain damage of different origins should be avoided to prevent mental abnormalities. ..

Mouth sore:-

Number of factors causes bacterial, viral or fungal infections of mouth. The mouth sore are the painful infections or rupture of the mucus membrane of mouth is called as mouth sore. A loose orthodontic wire, improper implantation of denture, sharp edge of broken teeth causes mouth sore.  Mouth sore are the common mouth problem that makes an individual very difficult to eat and even to drink hot or cold drinks.   Mouth sore may occur as  symptoms of a particular disease or disorder. Examination of mouth by  a dentist is needed to visualize  mouth sore that lasts a week or longer.

Common mouth sores and treatment:-

Canker ulcers : these are small ulcers which have red border and white or grey base. These mouth sore appear on the mucus membrane of the mouth and are not contagious. Number of ulcers may vary from one or more mouth sore. No exact cause of canker ulcer is known. it is believed that stress, fatigue, allergy to certain substances causes mouth ulcer. No specific treatment is needed to treat mouth sore or Canker ulcers. Topical anesthetics and antimicrobial mouth rinses  are used to treat mouth sore of this type. Avoid hot and spicy food until the healing of mouth sore.

Cold sore : These  sore are called as herpes simplex or fever blisters. Usually occurs on the soft membrane of lips, or under the nose. Cold or flu infection of mouth is the common cause of cold sore of mouth. Mouth pain is common with cold sore and is the recurring mouth problem in some individuals. The sore heals normally and in some recurring cases antivirals are prescribed.

Leukoplakia : these are white, thick patches appears inside the cheeks, mouth gums and tongue. Tobacco users are more prone to have such mouth sore and excess cell growth occurs on the sores. Biopsy of mouth sore is done for further diagnosis and treatment. Advice the patients to avoid tobacco and cause of lesion is found and treated.

Candidiasis : Is the fungal infection of mouth because of infection of candida albicans, which reproduce in the mucus wall of mouth. Denture wearers are more prone to have candidiasis mouth infection is the common problem of mouth. Antibiotic treatment is needed to reduce the symptoms and to treat the mouth sore. Provide oral hygiene to prevent the further complications.

Childhood diabetes:-

Diabetes can affect individuals irrespective of age, sex, or race. Type 1 Diabetes is the  common type of childhood diabetes. Statistics shows that 90 percent of the children (under the age 16) are affected with Type 1 Diabetes. Type 1 Diabetes in children or childhood diabetes is caused because of pancreatic  inability to produce insulin.

The  rate of beta cell ( Pancreatic cells) destruction in type 1 diabetes is rapid in  infants and children and slow in  older adolescents and adults. ketoacidosis as the first indication of type 1 diabetes is present in both children and adolescents. signs of diabetes in children are  post-meal hyperglycemia, fasting hyperglycemia that rapidly develops to severe hyperglycemia. Main signs of diabetes in children includes  ketoacidosis in the presence of any infection in body.

Causes of childhood Diabetes:-

cause of type-1 diabetes:

Type 1 diabetes in children is caused by immune destruction of the insulin-producing beta cells of pancreas.Production of antibodies against proteins in the islets cells of pancreas is found in children. But in  adolescents, antibodies are produced before some months of onset of diabetes.

The presence of antibodies against proteins of islets such as GAD-65, ICA, IAA and IA-2, have formed the basis for trials and easy to predict who will develop type 1 diabetes. Children with high titer auto immune antibodies and those with more than one antibody are more prone to develop type 1 diabetes.

In addition, young age and being a first degree relative of someone with type 1 diabetes place children at high risk. In general, 70 percent of people with new-onset diabetes will have a positive antibody if only one antibody is tested, whereas 90 percent will have at least one antibody when all four are measured.

cause of type-2 diabetes:

Cause of  type 2 diabetes in children and adolescents is because of  obesity or overweight, insulin resistance, and  a family history of type 2 diabetes, are important causes of type 2 children diabetes. Diabetes blood sugar  balance is important to prevent hyperglycemia or increased glucose level.

Childhood diabetes effects normal life of growing children. Some children becomes dull and looks depressed. Dullness and in activeness in children are important signs of diabetes in children.

Cause of diabetes in children are different. Cause of Type 1 diabetes in children  is because of pancreatic abnormality to produce insulin. Cause of type 2 diabetes in children are obesity, family history of diabetes, etc.

Children diabetes diagnosis is very important to start treatment to prevent complications. childhood diabetes onset is not found exactly as the symptoms seen later. Childhood diabetes risk is high to child as the childhood is the growing period. Improper health care and failure to maintain diabetes blood sugar leads to worsened symptoms and complications.

Symptoms of diabetes:-

More or less symptoms of children diabetes are similar to that of symptoms of diabetes in adults. Most of children are asymptomatic to some years and diagnosing diabetes in children is very critical and important.

The symptoms of childhood diabetes include

* frequent urination and Increased thirst
* extreme hunger
* unusual weight loss
* irritability
* repeated infections
* slow healing of wounds
* bruises under skin
* numbness in hand’s and feet
* tiredness
* behavioral problems
* headache increases with mild work also,
* tummy pains etc

Facts about childhood diabetes:-

* Avoid children to become obese as it helps in prevention of type 2 diabetes.
* Type 1 diabetes in children is common and appropriate insulin administration to maintain diabetes blood glucose in normal range is important.
* Insulin administration to treat type diabetes should be taught to parents and to grown up children also.
* Diabetes children may oppose to get injected regularly. Motivation by the parents and health education by the health care member should be given to child.
* Presence of HLA genes is found in nearly 70 % of type 1 diabetes affected children.
* Childhood diabetes should be well treated for the better health of child.
* Follow up medical care and administer medications regularly.

Urinary tract infection:-

The urinary tract is one of the important system of body and  purifies the blood removes liquid wastes. Women have more chance to get  bacterial urinary tract infection because of easy entering of bacteria through the short urethra.

Urinary tract infection symptoms:-

Urinary tract infection symptoms include a strong urge to urinate,  sharp pain follows soon after urination or men or women will feel burning sensation in the urethra after urine is released from urinary bladder.  Urinary tract infection men passes urine frequently and in small quantity.

Urinary tract infection men always feels like urine is coming through urethra and pain is more common in men compared to urinary tract infection in women. Bladder infection is the commonly occurring urinary tract infection. The Urinary tract infection men will pass urine more than six times a day with feeling of discomfort and have urinary tract infection symptom.

Urinary bladder is commonly infected urinary tract and the bladder infection spreads to kidney through ureters as the  bacteria enters the ureters and transmits infection.

symptoms of a urinary tract infection with bladder and kidney infection are as follows.  lower tract infection may be mild but upper urinary tract infections are complicated.

List of Symptoms of a urinary tract infection:-

* Frequent urination : An urge to pass urine often and often,
* Nocturia : urge to urinate during  night.
* Urethritis :  Discomfort or pain because of inflammation of urethral meatus, or a burning sensation throughout the urethra while passing urine.
* pain in  supra pubic region
* pyuria : presence of Pus cells in urine
* Hematuria : presence of red blood cells in urine.
* Cloudy and foul-smelling urine on observation after storing for some minutes.
* Proteinuria : presence of albumin and proteins in urine,
* The symptoms of kidney Urinary tract infection are
* low  back pain,
* recurring chills,
* fever with mild to moderate temperature,
* nausea, and vomiting may occur,

The symptoms of upper urinary tract infection are always associated with lower  urinary tract infection symptoms.

Proper diagnosis is needed to identify the cause of infection and to distinguish various symptoms, as some symptoms can also caused by other problems like infections of the vulva. The physician can make the distinction and make a correct diagnosis of disease.

urinary tract infection symptom are different from person to person as the severity of infection and the extent of inflammation or disease.

Cephalosporin is the important urinary tract infection antibiotic, and success rate of treating urinary tract infection  is high with use of antibiotics. Antipyretics and analgesics are also administered to treat fever and pain.

Urinary tract infection prevention is important to prevent damage to urinary structures and to prevent symptoms.

male urinary tract infection is less as compared to women. Women are more prone to have urinary tract infection.