This document discusses several types of benign cervical lesions:
- Cervical polyps are benign tumors arising from the endocervical epithelium that appear as smooth reddish protrusions. They are usually asymptomatic but can cause bleeding. Treatment involves removal by forceps.
- Cervical ectropion (erosion) is the replacement of stratified squamous epithelium with columnar epithelium around the external cervical os. It has various causes and may cause discharge or bleeding.
- Cervical stenosis is pathological narrowing of the endocervical canal, often due to prior surgical or medical treatments for premalignant cervical conditions. It can cause issues like hematometra or infertility. Treatment involves physically dil
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
Cervical Erosion
Dr. Yashika
Definition
Cervical erosion is a condition where the squamous epithelium of the ectocervix is replaced by columnar epithelium which is continuous with endocervix.
Aetiology
Congenital
Acquired
Clinical features
Symptoms :
Vaginal discharge
Contact bleeding
Associated cervicitis
SIGNS :
Diagnosis
Ectropion
Early carcinoma
Primary Lesion (Chancre)
Tubercular ulcer
Management
Pregnancy
Pill user
Persistent ectopy
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
Cervical Erosion
Dr. Yashika
Definition
Cervical erosion is a condition where the squamous epithelium of the ectocervix is replaced by columnar epithelium which is continuous with endocervix.
Aetiology
Congenital
Acquired
Clinical features
Symptoms :
Vaginal discharge
Contact bleeding
Associated cervicitis
SIGNS :
Diagnosis
Ectropion
Early carcinoma
Primary Lesion (Chancre)
Tubercular ulcer
Management
Pregnancy
Pill user
Persistent ectopy
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
A cervical biopsy is a procedure to remove tissue from the cervix to test for abnormal or precancerous conditions, or cervical cancer. The cervix is the lower, narrow part of the uterus. It forms a canal that opens into the vagina. Cervical biopsies can be done in several ways.
cervical cancer is the most common type of cancer in females and death by its meglancy, there are many female who are unaware of this cancer and its treatment, early detection and its treatment can help females in good prognosis and speedly recovery and can be refer by all nursing student for their knowledge, study, improving skills and application in their clinical practices
Subject: Midwifery and Obstetrical Nursing. Topic: Ectopic pregnancy, Its types, various Implantation sites, Pathophysiology, Risk factors, Diagnosis, Various Managements and Recent Advancements.
It is the expulsion or extraction from its mother of an embryo or fetus weighing 500 gm or less when it is not capable of independent survival (WHO).
The 500gm of fetal development is attained approximately at 22 weeks of gestation.
Expelled fetus- Abortus
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
4. Definition:
Benign cervical Lesions:
Are non cancerous cervical tumors that don’t
metastasize or invade the surrounding tissues
& not a life threatening Conditions.
The following are examples of the BCL:
Cervical polyps, Cervical ectropion.
Cervical fibroids, Cervical stenosis & Nabothian follicles.
5.
6. They are benign tumors arising
from the endocervical epithelium
& maybe seen as smooth reddish
protrusion in the cervix.
Cervical
Polyps
Definition
8. Types:
Ectocervical & endocervical.
Signs & Symptoms: asymptomatic.
Investigations: It’s usually
diagnosed when performing
routine pelvic examination but
other investigations can be done
to exclude other causes like:
Cervical smear, Biopsy, &
Colposcopy.
9. TREATMENT:
Removal of the polyps by ring forceps.
If the polyps is infected antibiotics may be prescribed.
12. Cervical Erosion (Ectopy):
A bright red area around the external OS due to
replacement of the stratified squamous epithelium
of the ectocervix with the endocervical columnar
epithelium, which is thin
& shows the underlining
blood vessels .
13. Chronic cervicitis:
- Infection discharge produces denuded area
around external os.
- Columnar epithelium grows from the cervical
canal to cover the denuded area.
Congenital erosion:
- Persistence of the intra-uterine condition where the
columnar epithelium covers an area on the ectocervix.
Hormonal erosion:
- Excess estrogen causes the columnar epithelium to
grow & replace the stratified squamous epithelium.
14. Clinical features:
most patients have no complaint ( see during speculum
examination ).or it can be associated with:
1- Excessive Mucoid vaginal discharge.
2- Brown intermenstrual discharge.
3- Slight postcoital bleeding ( should investigated ).
4- During pregnancy slight bleeding
( could be a cause of early pregnancy bleeding or APH ).
5- Sometimes cause pain during or after cervical screening.
17. cervical stenosis refers
to pathological narrowing
of endocervical canal, &
its usually an iatrogenic
phenomena.
18. Causes:
1. Surgical event
2. Treatment of premalignant
diseases of the cervix using cone
biopsy or loup diathermy
3. Endometrial ablation affecting the OS
4. Trauma to the cervix
5. Repeated vaginal infections
6. Radiation
7. Atrophy to the cervix after the
menopause
19. Symptoms:
my be associated with:
1- Irregular menstrual cycle.
2- Dysmenorrhea.
3- Chronic pelvic pain.
After menopause: cervical stenosis my
be present but not cause symptoms.
20. Complications due to cervical
stenosis include:
1- Hematometra ( collection or
retention of blood in the uterus ).
2- Pyometra ( defined as an
infection in the uterus ).
3- Infertility ( because sperm can’t pass through
the cervix to fertilize the egg ).
21. Diagnosis:
Clinical Evaluation:
1- May be suspect based on symptoms & signs.
2- Inability to obtain sample of tissue from the
cervix for diagnostic test ( pap or HPV test ).
3- Confirm the diagnosis by trying to pass a
probe through the cervix into the uterus.
If cervical stenosis cause symptoms or uterine
abnormality ( Hematometra ) cervical cytology
& endometrial biopsy should be done to exclude cancer.
22. Treatment:
1- physically widening the cervix with
instruments called dilators ( inserted one
by one until the appropriate dilation has
been reached). Under ultrasound or
hystroscopic guidance.
2- In some cases, the doctor will then insert a cervical stent,
which is a tube that can keep the cervix from re-closing.
The stent may remain in the cervix for 4-6 weeks.
23.
24.
25. What is the Nabothian cyst?
Nabothian cysts are tiny cysts filled with
mucus (that is secreted by the cervical
glands), form on the surface of cervix.
Sometimes these tiny bumps (النتوءات) are called
cervical cysts, mucinous retention cysts, or epithelial cysts.
Nabothian cysts are common. But they aren’t a threat
to health, & they aren’t a sign of cervical cancer.
26.
27. • SO Nabothian cysts are mucus filled cysts in the surface of the uterus.
• Most often caused when Stratified Squamous Epithelium of the
Ectocervix ( towards the vagina ) grows over the Simple Columnar
Epithelium of the Endocervx ( towards the uterus ).
28. Symptoms of Nabothian cysts:
Nabothian cysts range in size from a few
millimeters to 4 centimeters in diameter.
They’re smooth & appear white or yellow
in color.
These cysts don’t cause pain, discomfort, or other
symptoms. But they maybe a cause for bleeding
between periods, unusual discharge, or pelvic pain.
29. Diagnosing of Nabothian cysts:
o Nabothian cysts can be screened &
diagnosed during a pelvic examination.
They can sometimes be seen on a pelvic
ultrasound, MRI, or CT scan.
o After discovering these small white bumps on cervix, the
doctor may break a cyst to confirm the diagnosis or may
use a colposcopy ( المهبل تنظير ) to make an accurate
diagnosis.
31. doctor may take a
biopsy of a cyst if
they suspect that
the patient might
have a type of
neoplasia affecting
mucus production.
This condition, called
adenoma malignum, is
very rare and is not a
cause for concern.
This involves magnifying the
area to distinguish Nabothian
cysts from other types of bumps
32. Management & Treatment
Of Nabothian Cysts:
Nabothian cysts are benign & usually don’t require
treatment, In rare cases the cysts may become large
& distort in the shape & size of the cervix.
If it’s severe, it can make a routine cervical
examination difficult or impossible!
33. In this case doctor may recommend removal of the
cyst in order to examine the cervix, These examinations
can ensure reproductive health & help the doctor identify
problems with cervix early.
Surgeries & procedures for Nabothian cysts:
Nabothian cysts that need treatment can be
removed through:
1-Excision.
2-Electrocautery ablation.
3-cryotherapy.
34. 1- Excision: In excision method uses scalpel
or blade to remove the excessive growth.
2- Electrocautery ablation: In electrocautery ablation uses
electric current to remove the cyst, The heat generated
by the electric current is flowing over the cyst for
removing purpose of the cyst.
3- Cryotherapy: To remove the cyst also In cryotherapy
uses liquid nitrogen for freezes & shrinkage the cyst.
This procedure is less invasive than excision or ablation.
35. THE END .. THANK YOU
Designed By Esraa Alnabilsy