This document provides tips on how to give effective presentations. It discusses that public speaking can be scary but is possible to overcome. It recommends focusing on the audience, keeping messages concise with 3 key points, speaking precisely and quickly while also being emotional, and rehearsing. Effective presentations are prepared through grooming skills like debates and involve using body language appropriately along with clear slides and messages.
22. Diagnosis of AUB : NEVER ENDING TEXT
22
Etiology Polyp Adenomyosis Leiomyoma Malignancy and Hyperplasia
History
Prolonged
uncontrolled Bleeding
Inter-menstrual bleeding
Pallor may be there
May have infertility
Heavy Menstrual Bleeding (HMB)
Marked dysmenorrhea
Submucous-more prolonged
un-controlled bleeding
Intra-mural variable amount of
HMB Subserous. May be
asymptomatic
Postmenopausal Bleeding
Varied type of bleeding at Peri-
menopause.
Signs
Uterus is usually normal
in size
If big cervical os may be
patulous
Polyp extruding outside
Uterus enlarged up to 18 wks.
Uniformly enlarged, globular
May or may not be tender
Enlarged variable size, variable
shapes, firm.
Normal to mildly enlarged uterus
Mobility may be restricted
Imaging
Endometrium looks
thickened
SIS echogenic smooth
intra-cavitary mass
outlined by fluid
Globular uterine enlargement up to
18 weeks (not due to leiomyoma)
Thickening of uterine wall, which
may be asymmetrical in focal
disease
Obscuring of endomyometrial
junction
Multiple hypo-echoic halo zones-
heterogeneous myometrium.
Well-defined, solid masses
with a whorled appearance;
similar echogenicity to the
myometrium, occasionally
hypoechoic
Alteration of the normal uterine
contour of uterus
3D USG- In unmarried girls
Exact location of fibroids- MRI
USG: Endometrial Hyperplasia-
Thickened Endometrium > 12mm
at premenopausal age
USG: Endometrial carcinoma-
Thickened endometrium, irregular
endometrial lining, loss of
endomyometrial junction
23. Reduction of Bleeding & Dysmenorrhoea with LNG IUS
» LNG IUS significantly reduces menstrual blood loss and alleviates dysmenorrhoea from as
early as 3 months after placement
Yoo HJ, et al. Arch Gynecol Obstet 2012; 285: 161–6.
Pictorialbloodlossscore
200
150
0
50
Baseline 3 6 12
Duration of LNG IUS use (months)
100
24
Subjectiveassessmentscore
ofdysmenorrhea
3.0
2.5
0
0.5
Baseline 3 6 12
Duration of LNG IUS use (months)
1.5
24
-59%
* * * *
*p<0.01 vs baseline
1.0
-79% -87% -87% -95%
-47% -54% -63%
* * * *
*p<0.01 vs baseline
2.0
CROWDED
24. LNG IUS vs other medical therapies for HMB
LNG IUS is more effective than tranexamic acid, mefenamic acid, combined oestrogen-progestogen,
or progesterone alone in reducing the effect of HMB on women’s daily life
80
60
20
0
40
LNG IUS
(n=225)
Practical
difficulties
Social
life
Psychological
health
Physical
health
Work/daily
routine
Family life/
relationships
Other medical
treatments**
(n=208)
*p<0.001 vs LNG IUS®
* * * * * *
Proportionofwomen
freeofHMBsymptoms
(MenorrhagiaMulti-AttributeScale)(%)
More women using LNG IUS are free of HMB symptoms at 24 months
Gupta J, et al. N Engl J Med 2013; 368: 128–37.
25. What will be PUBLIC PERCEPTION /
EVEN YOURS PERCEPTION
30. 30
Clear
Message
Short, informative
talks designed to be
inspirational,
dynamic, and
engaging
Relevant to
clinical
practice
Move away from the
standard lecture to a
style based on KOL and
customer feedback
Less Data
Intensive
Slides
98%
O
R
D
I
N
A
R
Y
DOCTORS
2%
T
E
A
C
H
E
R
type
34. The Efficacy and Safety of GARDASIL (1st HPV Vaccine) is
Supported by Over 20 Years of Clinical Development and
Experience1
Proof-of-concept studies for GARDASIL
1997 2000 2006 2008 2016 2018
Clinical trials for GARDASIL
Gardasil 2 dose
approved in India
for 9-14 yrs
GARDASIL
Approved
GARDASIL
Approved in
India
GARDASIL
10 year
RWE data
GARDASIL
14 year long
term data
DataonFile, MSDINDIA
35. Data on File, MSD India. Presented at EUROGIN 2018
QHPV
36. All available long term
data with QHPV
Young women
(15-26 yrs)
14 years
FUTURE II follow-up
(NORDIC)1
Adult women
(24-45 yrs)
10 years
FUTURE III follow-up
(Columbia)2
Pre/Adolescents
(9-15 yrs)
10 years
Ferris etal
(9 countries)3
1. Data on File, MSD India. Presented at EUROGIN 2018
2. R. Das. LONG-TERM EFFECTIVENESS OF GARDASIL™ AMONG ADULT WOMEN IN COLOMBIA
3. Ferris et al 4-Valent Human Papillomavirus (4vHPV) Vaccine in Preadolescents and Adolescents After 10 Years Pediatrics. 2017 Dec;140(6)
37. Conclusions
» No breakthrough cases of HPV16/18 related
CIN2 or worse in the QHPV study, vaccine
effectiveness was 100% in the PV population through
14 years post dose
» Persistent and sustained immunogenicity after
14 year of follow-up.
» QHPV continues to be generally safe and well
tolerated up to 14 years post vaccination.
Conclusions: