Adenomyosis, is a defined mass of cells within the uterine wall, is characterized as ectopic endometrial tissue within the myometrium in the uterus.
In adenomyosis, a series of immune responses is activated, including changes in both cellular and humoral immunity.
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Adenomyosis is a benign disease of the uterus characterized by ectopic endometrial glands and stroma within the myometrium.
It is associated with myometrial hypertrophy and may be either diffuse or focal.
Adenomyosis & Infertility - A Webseries TalkDr Aditya Keya
Adenomyosis has a negative impact on reproductive outcome, there is a correlation between extent of the disease and reproductive outcome .Strict diagnostic criteria and classification of disease are needed for an image diagnosis of adenomyosis.
Adenomyosis is a benign disease of the uterus characterized by ectopic endometrial glands and stroma within the myometrium.
It is associated with myometrial hypertrophy and may be either diffuse or focal.
Adenomyosis & Infertility - A Webseries TalkDr Aditya Keya
Adenomyosis has a negative impact on reproductive outcome, there is a correlation between extent of the disease and reproductive outcome .Strict diagnostic criteria and classification of disease are needed for an image diagnosis of adenomyosis.
Understand the history and pathophysiology of endometriosis
Understand the critical need for timely diagnosis and effective intervention
Understand the considerable effects and cost burdens of this chronic disease and employ best-practice techniques to mitigate them
Understand the history and pathophysiology of endometriosis
Understand the critical need for timely diagnosis and effective intervention
Understand the considerable effects and cost burdens of this chronic disease and employ best-practice techniques to mitigate them
Evidence linked treatment for endometriosis-associated infertilityApollo Hospitals
Endometriosis is conventionally defined as the presence of
tissue lesions or nodules that are histologically similar to
the endometrium, but are present at sites outside the uterus.It is a chronic, often recurring disease of complex and unclear aetiology. Endometriosis is a highly variable condition in terms of age and mode of presentation, range of symptoms, anatomical sites, response to treatment and likelihood of recurrence.
Endometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failurecare women scentre
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Endometriosis is a disease restricted usually to the female genital tract. Involvement of the bowel by this disease can lead to a diagnostic dilemma due to the great variation in the symptomatology. Awareness of the pathophysiology, clinical features and diagnostic modalities is of utmost importance to decide the modality of treatment. Hormonal manipulation and surgical resection are the two modalities of treatment. The choice depends upon critical analysis of clinical and radiological findings and the desire to have pregnancy in cases associated with infertility.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Paget's disease of the breast is an extremely challenging problem. It not only poses a diagnostic dilemma but a therapeutic as well. The paper describes the diagnostic and therapeutic challenges.
Primary Endometrial Stromal Sarcoma arising from Cervixiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
...Understand the Definition and the underlying pathology of endometriosis
...sites of endometriosis
....Theories of development of endometriosis
...the Clinical presentations and investigations
...Management options for endometriosis in patients presenting by pain and those presenting by infertility
....Understand the Definition of and the underlying pathology of adenomyosis.
.......the clinical presentation, diagnosis of adenomyosis.
....... management options (medical and surgical) for adenomyosis
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
1. 387
Adenomyosis and Reproduction
C N Purandare
J Obstet Gynecol India Vol. 56, No. 5 : September/October 2006 Pg 387-389
EDITORIAL The Journal of
Obstetrics and Gynecology
of India
Introduction
Adenomyosis, very precisely described as internal
endometriosis, is characterized as ectopic endometrial
tissue within the myometrium in the uterus. It is the
most inaccessible disease for preoperative
histopathological diagnosis. Its diagnosis is always
accomplished retrospectively after hysterectomy.
Interestingly hysterectomy is usually done in
multiparas and infrequently in infertile patients. Older
literature supports the view that adenomyosis is a
disease of multiparas. However increasing number of
hysterectomies done for endometriosis show the
presence of adenomyosis in the uterus. Hence the
effect on reproduction is possible. Due to lack of high
resolution imaging technics in earlier era, the
preoperative diagnosis was impossible. But today we
can have early diagnosis and offer treatment.
Effect of adenomyosis on reproduction
It is well known that endometriosis is frequently associated
with various autoimmune phenomena. In adenomyosis, a
series of immune responses is activated, including changes
in both cellular and humoral immunity, i.e. a strong
expression of cell surface antigens or adhesion molecules,
an increased number of macrophages or immune cells,
and deposition of immunoglobulins and complement
components.The disease exhibits high frequency of
autoantibodies in peripheral blood. Thus, an immunological
vicious circle is formed in the endometrium in
adenomyosis. Endometrial cells seem to be under
immunological stress, protecting themselves by exposing
health shock proteins. The endometrial environment in
adenomyosis differs widely from that in normal fertile
women. These abnormal immune responses might be
involved in poor reproductive performance in
adenomyosis 1
.
Hormone response of the endomyometrial
junctional zone differs in adenomyosis. Evidence has
been provided that pelvic endometriosis is significantly
associated with uterine adenomyosis and adenomysosis
may be the major cause of infertility in such
conditions. Mild peritoneal endometriosis of the fertile
woman, premenopausal adenomyosis of the parous and
nonparous women, and adenomyosis in association
with endometriosis of the infertile woman constitute a
pathophysiological continuum that is characterized by
the dislocation of basal endometrium 2
. Due to the
postponement of childbearing late into the period of
reproduction, premenopausal adenomyosis might
increasingly become a factor for infertility in addition
to adenomyosis associated with endometriosis of
younger women. In any event, the presence or
absence of uterine adenomyosis should be examined in
a sterility work-up.
A study of 160 patients with endomtriosis and 67 without
endomtriosis showed a prevalence of adenomyosis of up
to 90% on MRI. Uterine adenomyosis is significantly
associated with pelvic endometriosis and constitutes an
important factor for sterility in endometriosis presumably
by impairing uterine sperm transport 3
.
Adenomyosis may also affect fertility by altered
contractility of the myometrium, possible effects on
implantation, and poor placentation. These factors may
be responsible for poor reproduction in patients with
endometriosis.
Peristaltic activity of the nonpregnant uterus serves
fundamental functions in the early process of reproduction,
such as directing transport of spermatozoa into the tube
ipsilateral to the dominant follicle, high fundal implantation
of the embryo, and possibly retrograde menstruation.
Hyperperistalsis of the uterus is significantly associated
with the development of endometriosis and adenomyosis.
In women with hyperperistalsis, fragments of basal
endometrium are detached during menstruation and
transported into the peritoneal cavity. Hyperperistalsis
induces the proliferation of basal endometrium into
myometrial dehiscencies. This results in endometriosis
2. 388
associated adenomyosis with a prevalence of
approximately 90%. Adenomyosis results in impaired
directed sperm transport and thus constitutes an important
cause of sterility in women with endometriosis. The
principal mechanism of endometriosis/adenomyosis is the
paracrine interference of endometrial estrogen with the
cyclical endocrine control of archimyometrial peristalsis
exerted by the ovary, thus resulting in hyperperistalsis 4
.
Effect of reproduction on adenomyosis
It is not very well described as yet but histopathologically
proven adenomyosis is seen more often in muliparas.
Hence the possibility of pregnancy promoting the
invagination of basal endomtrium and producing
endometrial nests in the myometrum is considered. These
cellnests are having high hCG/LH receptors. But majority
of these cells are devoid of progesterone receptors and
hence do not respond to endogenous or exogenous
progesterone, where as pregnancy is known to arrest the
progress of external endometriosis
Clinical features of adenomyosis
The typical symptoms include pelvic pain,
dysmenorrhea, and menorrhagia. However, these
symptoms are nonspecific and can be encountered in
disorders such as dysfunctional uterine bleeding,
leiomyoma, and endometriosis.
Examination reveals an uniformly enlarged tender uterus
or rarely a nodular uterus or a thickened nodular
rectovaginal septum. This is felt when there is external
adenomyosis i.e. endometrial glands, stroma, and
fibromuscular hyperplasia in the septum. This may present
as dysparunia as well.
Diagnosis
The current preoperative diagnosis of adenomyosis is
based on the clinical methods, and does not include
authentic and specific laboratory markers.
Advanced imaging technics like sonography and MRI have
enabled a better diagnosis. The typical gross appearance
of adenomyosis is due to accompanying smooth muscle
hyperplasia and corresponds to areas of decreased
echogenicity at endovaginal ultrasonography and areas of
decreased signal intensity at MRI. Endovaginal sonography
also shows heterogeneity of the myometrial echotexture,
which corresponds to small echogenic islands of
heterotopic endometrial tissue surrounded by the
hypoechoic smooth muscle. On T2-weighted MR images,
bright fociare seen in areas of abnormal low signal intensity
within the myometrium in approximately 50% of patients.
Various signs include myometrial cysts, myometrial
nodules, linear striations, pseudowidening of the
endometrium, and poor definition of the endomyometrial
junction. Pitfalls in diagnosis of uterine adenomyosis
include leiomyoma, endometrial carcinoma, myometrial
contractions, and muscular hypertrophy.
Serum levels of VEGF-A in patients with adenomyosis
are significantly higher and could be used as a biochemical
marker. However this is still under research.There seems
to be a dysregulation of angiogenic activity in the eutopic
endometrium of women with endometriosis 5
.
Importance of imaging in adenomyosis
Imaging helps not only diagnosis but also can be used to
guide the treatment. The correct diagnosis is established
with imaging. Uterus conserving therapy is possible in
cases of leiomyoma, whereas hysterectomyis the definitive
treatment for debilitating adenomyosis. Imaging is
performed to determine the extent and depth of myometrial
penetration. Symptoms have been shown to correlate with
theextent of disease. Determining the depth of myometrial
penetration is important for treatment planning because
superficial adenomyosis responds significantly better to
endometrial ablation than deep adenomyosis. Imaging is
also used to monitor the evolutionof the disease in patients
receiving conservative therapy.
Postoperative diagnosis
Histopathology forms the gold standard for the final
diagnosis.Uterine adenomyosis is a common gynecologic
condition that is characterized by the presence of
heterotopic endometrial glands and stroma in the
myometrium with adjacent smooth muscle hyperplasia.
Treatment modalities
Uterine artery embolization, laparoscopic or surgical
adenomyoma resection, hysteroscopic endomyometrial
resection, assisted reproductive technics, and therapy with
Gn Rh agonist and antagonists have been found useful
with variable responses.
Conclusion
Adenomyosis has adverse impact on reproduction and may
be the factor responsible for infertility in cases of
endometriosis. There is increasing evidence to support
this concept. Because of improved and high resolution
imaging technics, it is possible to diagnose the condition
today and we can offer a ray of hope to these women
who are infertile and want to preserve the fertility.
Editorial
3. 389
References
1. Ota1 H, Igarashi S, Hatazawa1 J et al. Is adenomyosis an immune
disease? Human Reproduction Update 1998;4:360-7.
2. Leyendecker G, Kunz G, Kissler S et al.Adenomyosis and reproduction.
Best Pract Res Clin Obstet Gynaecol. 2006;20:523-46.
3. Kunz G, Beil D, Huppert P et al. Adenomyosis in endometriosis—
prevalence and impact on fertility. Evidence from magnetic
resonance imaging. Human Reproduction 2005;20:2309-16.
4. Leyendecker G, Kunz G, Herbertz M et al. Uterine peristaltic
activity and the development of endometriosis. Ann NY Acad Sci
2004;1034:338–55.
5. Bourlev V, Volkov N, Pavlovitch S. The relationship between
microvessel density, proliferative activity and expression of
vascular endothelial growth factor-A and its receptors in
eutopic endometrium and endometriotic lesions. Reproduction
2006;132 :501-9.
CN Purandare
Visiting Consultant St. Elizabeth Nursing
Home & Breach Candy Hospital, Mumbai.
Secretary General, FOGSI.
Purandare Griha, Dr. N A Purandare Marg,
Mumbai - 400 007. Cell 98200 88183
Email : dr.c.n.purandare@gmailcom
Editorial