How science is advancing

Health & Medicine

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GnRH Agonist in Endometriosis- An Old Good Friend

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Niranjan Chavan

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*EXPERINCE SHARING By EXPERTS* Dr Uma Rai(DGF *E*) Dr Sangeetaa Gupta(DGF *E*) Dr Neerja Varshney(DGF *E*) Dr Surjeet Kapoor(DGF *E*) Dr Rupam arora(DGF *E*) Dr Meenakshi Ahuja(DGF *S* ) Dr.Harsha khullar(DGF *C* ) Dr Mamta mittal(DGF *N*) Dr Leena Sreedhar(DGF *D*) Dr.Dipti Nabh(DGF *E*) Dr. Shama Batra(DGF *E*) Dr Poonam Paul(DGF *SW*) PAN DGF ( DELHI GYNAECOLOGIST FORUM) CME ON DYDROGESTERONE ON 3/2 /22

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Peter Ram

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Miscarriage is the commonest complication in pregnancy. One in four pregnancies ends this way. The physical experience can be awful in itself, but in the words of a patient, "the grief of miscarriage can last forever." The commonest question for women who have experienced miscarriage is simple--why did it happen? The answer is rarely apparent. Many so-called "treatments" to prevent miscarriage are unproven. But recent research suggests some miscarriages may be prevented with progesterone. In this talk for clinicians, I explored the most recent evidence.

Is there a place for progesterone in the management of miscarriage?

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What's hot (20)

GnRH Agonist in Endometriosis- An Old Good Friend

Boosting Endogenous Progesterone

Role of Progesterone in Preterm Labour

Estradiol Valerate in Fertility Care: New Vistas

Role of Dydrogesterone in repeated pregnancy loss

Progestogens in miscarriages | Progestogens in Early Pregnancy | Seeds of In...

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The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).

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Management of locally advanced ovarian, fallopian tube, and peritoneal tumors requires a comprehensive and multidisciplinary approach. Locally advanced tumors are those that have spread beyond the ovaries or fallopian tubes and may involve nearby structures, such as the peritoneum or adjacent organs. Here's a brief overview of the management strategies: Surgery: Debulking Surgery: The primary treatment for locally advanced tumors involves cytoreductive or debulking surgery. This aims to remove as much of the tumor as possible. Surgeons may perform a total hysterectomy, bilateral salpingo-oophorectomy, and removal of involved peritoneal tissues. Lymphadenectomy: Lymph node dissection is often done to assess the extent of the disease spread and to remove involved lymph nodes. Chemotherapy: Neoadjuvant Chemotherapy: In some cases, chemotherapy may be administered before surgery to shrink the tumor, making surgery more effective. Adjuvant Chemotherapy: Following surgery, chemotherapy is typically recommended to target any remaining cancer cells. Platinum-based chemotherapy regimens are commonly used. Targeted Therapies: PARP Inhibitors: Poly (ADP-ribose) polymerase inhibitors, such as olaparib and niraparib, have shown efficacy in treating ovarian and related cancers with specific genetic mutations, like BRCA mutations. Immunotherapy: Checkpoints Inhibitors: Immune checkpoint inhibitors, like pembrolizumab and nivolumab, may be considered in cases with specific molecular profiles. Radiation Therapy: External Beam Radiation: In some situations, radiation therapy may be used to target specific areas affected by the tumor. Clinical Trials: Participation in clinical trials may be an option for patients with locally advanced disease, offering access to innovative treatments and therapies. Follow-up Care: Regular monitoring and follow-up care are crucial to assess treatment effectiveness and detect any signs of recurrence. Palliative Care: Palliative care should be integrated into the management plan to address symptom control, improve quality of life, and provide support for both the patient and their family. A personalized treatment plan should be developed based on the specific characteristics of the tumor, the patient's overall health, and individual factors. Regular communication among a multidisciplinary team, including surgeons, medical oncologists, radiation oncologists, and other specialists, is essential for optimizing the management of locally advanced ovarian, fallopian tube, and peritoneal tumors.

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Abstract— Cervical ripening is an essential factor for initiation of normal labour for vaginal delivery. Prior to onset of spontaneous labour the cervix undergoes a gradual process of ripening. But in certain cases it does not occur spontaneously at term and sometimes induction of labour is required. Then cervical ripening means high bishop score in essential for successful induction of labour. This comparative study was conducted at Bikaner to compare induction of labour by vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and Intra cervical Dinoprostone gel 0.5 mg. For this purpose 100 clients were given vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and 100 clients were given Intra cervical Dinoprostone gel 0.5 mg. It was observed in this study that Dinoprostone gel is more efficacious for cervical ripening and labour induction in cases of nulliparous & primiparous at term with unfavourable cervix with intact membranes, as compared to misoprostol in terms of shorter total duration of labour, shorter mean induction delivery interval, more spontaneous vaginal deliveries, and reduced incidence of LSCS as well as instrumental deliveries.

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The thin endometrium refers to the lining of the uterus, known as the endometrium, being insufficiently thick. This condition is typically characterized by a reduced thickness of the endometrial layer, which plays a crucial role in supporting the implantation and development of a fertilized egg during the menstrual cycle. A thin endometrium is commonly associated with hormonal imbalances, such as low estrogen levels, which are vital for the growth and maintenance of the endometrial tissue. Inadequate blood flow to the uterus, chronic inflammation, or certain medical conditions can also contribute to this condition. Women with a thin endometrium may experience difficulties in achieving and maintaining pregnancy, as the thin lining may not provide an optimal environment for the embryo to implant and thrive. Addressing the underlying causes of a thin endometrium often involves hormonal therapies to regulate estrogen levels, lifestyle modifications, and sometimes surgical interventions. Fertility treatments, such as in vitro fertilization (IVF), may be considered to overcome the challenges associated with a thin endometrium. In conclusion, a thin endometrium can pose challenges to fertility and reproductive health, requiring a comprehensive approach to address the underlying factors and improve the chances of successful conception.

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Introduction: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn, research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1 rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl.

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In this lecture on circulatory shock, Dr. Faiza, an Assistant Professor of Physiology, delves into the profound implications of inadequate blood flow throughout the body, leading to tissue damage. The session begins by defining circulatory shock and elucidating its physiological causes, including decreased cardiac output, diminished blood volume, decreased vascular tone, obstruction to blood flow, excess metabolic rate, and abnormal perfusion patterns. Dr. Faiza categorizes shock into various types, such as cardiogenic shock, hypovolemic shock, neurogenic shock, obstructive shock, anaphylactic shock, and septic shock, and explores the pathophysiological basis of each. Furthermore, the lecture examines the stages of shock, from the non-progressive phase where compensatory mechanisms aim for full recovery to the progressive phase where shock worsens steadily without intervention, potentially leading to irreversible damage. Dr. Faiza discusses therapeutic interventions for shock, including replacement therapy, blood and plasma transfusion, sympathomimetic drugs, and other adjunctive treatments like head-down positioning, oxygen therapy, and glucocorticoids.

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