Uterine cancer is one of the most common female reproductive cancers. It occurs in the endometrial lining of the uterus. The main risk factors are prolonged, unopposed estrogen exposure from conditions like obesity, diabetes, nulliparity, or prolonged estrogen therapy without progesterone. Endometrial hyperplasia, which is often estrogen-dependent, can progress to cancer if left untreated. Uterine cancers are surgically staged and treated depending on the stage, with surgery being the main treatment for early stage disease and chemoradiation often added for more advanced stages. Prognosis depends on stage, grade, and histological subtype.
Presentation at Chittaranjan Seva Sadan, Kolkata where Dr Dasgupta was invited as faculty in the CME organized by Medical Education and research Committee, Bengal Obstetrics and Gynaecological Society
Presentation at Chittaranjan Seva Sadan, Kolkata where Dr Dasgupta was invited as faculty in the CME organized by Medical Education and research Committee, Bengal Obstetrics and Gynaecological Society
endometrial cancer
endometrial carcinoma
gynaecological oncology
uterine cancer
uterus
post menopausal bleeding
endometrial neoplasms
gynaecology
cancer
endometrial cancer
endometrial carcinoma
gynaecological oncology
uterine cancer
uterus
post menopausal bleeding
endometrial neoplasms
gynaecology
cancer
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. General Description
• Uterine cancer is one of the most
common malignancy of female genital
tract.
• The incidence is increasing worldwide in
recent years.
• Overall,2%-3% of women develop uterine
cancer during their lifetime.
3. General Description
• A malignant epithelial
disease that occurs in
endometrial gland of
uterus
• Also called endometrial
cancer
4. Classification
(pathogenetic,biologic behavior )
• Estrogen dependent type
- have a history of exposure to unopposed estrogen
(either endogenous or exogenous).
- Hyperplastic endometrium
- Better differentiafed
- ER(+),PR(+)
- Mere favorable prognesis
5. Estrogen independent type
-- Have no source of estrogen stimulation of
endometrium.
--Arising in background of atrophic
endemetrium
--Less differentiated
--ER(-)PR(-)
--Poor prognosis
6. Risk Factors
1. Medical conditions
a. Diabetes mellitus, hypertension.
b. Overweight---obesity (excess
estrogen as a result of peripheral
conversion of adrenally derived
androstenedione by aromatization in
fat).
c. Late menopause.
8. Risk Factors
3. Prolonged Use of estrogen
a. Prolonged menopausal estrogen
replacement therapy without
progestogen.
b. Prolonged use of the antiestrogen
tamoxifen for breast cancer.
9. Risk Factors
4. Genetic factors and other factors
a. Endometrial and ovarian cancer are the
simultaneously occurring with other
genital malignancy ,reported incidence
(1.4~3.8%).
b. Family history of tumor is higher.(12-
28%)
12. How endometrial hyperplasia is associated
with endometrial cancer
Endometrial hyperplasia is a continuum…
Simple hyperplasiacomplex hyperplasia
without atypiacomplex hyperplasia w/
atypia endometrial cancer (well
differentiated adenocarcinoma)
13. How endometrial hyperplasia is associated
with endometrial cancer
Simple hyperplasia– 1% progress to
endometrial cancer
Complex hyperplasia– 3%
Simple hyperplasia with atypia—8%
Complex hyperplasia with atypia—28-30%
30-40% of endometrial cancers are found in
a background of atypical hyperplasia.
Overall, these tend to be lower grade
14. Hyperplasia: Progression to Cancer
• NO ATYPIA
Simple – 1.3%
Complex – 3%
• ATYPIA
Simple – 8%
Complex – 29%
Significant percentage (43%) of complex
hyperplasia with atypia will have
coexisting adenocarcinoma
15. Management: Hyperplasia
NO ATYPIA
–No Treatment (only for
simple)
–Continuous Progestins
–Re-examination if
bleeding
PROGESTIN OPTIONS
Medroxyprogesterone 10mg/d
(10-30mg/d) Norethindrone
2.5mg/d (2.5-10mg/d)
Megestrol 160mg/d*
Oral contraceptive pills
19. Five histological subtypes
--Mucinous carcinoma
Rare (about 5%)
a. Most of them is a well differentiated.
b. Behavior is similar to that of
common endometrial carcinoma.
20. Five histological subtypes
--Serous adenocarcinoma
a. Architecture is identical with
complex papillary.
b. More aggressively with deep
myometrial and lymphatic invasion.
c. Simulating the behavior of ovarian
carcinoma.
21. Five histological subtypes
--Clear cell carcinoma
a. A rare subtype
b. Is high grade and aggressive
c. Prognosis is similar to or worse than that
of papillary serous carcinoma
d. Survival rate is lower 33%~64%
23. Important Histology Points
• Papillary serous carcinomas are aggressive
– Even when mixed with other types, if there is >
25% serous they will retain aggressive behavior
• Clear cell carcinomas act similar to high
grade endometrioid type carcinoma
• Mucinous carcinomas act similar to well
differentiated endometrioid type carcinoma
• Squamous carcinomas have a poor
prognosis
24. Endometrial Cancer Grade
• The grade is based on the
percentage of the solid component.
– Well Differentiated (Grade 1): <5%
– Moderately Differentiated (Grade 2): 5-50%
– Poorly Differentiated (Grade 3): > 50%
25. Clinical Features--Symptoms
• Asymptomaic (about less than 5% )
• Abnormal vaginal bleeding (premenopausal or
postmenopausal, minimal or nonpersistant)
• Abnormal vaginal discharge(25% infection of uterine
contents)
• Pelvic pressure or discomfort (uterine enlargement or
extrauterine disease spread)
26. Clinical Features--Signs
• No evidence in early stage on
physical examination
• Slight enlargement of uterine size
and soft
• Uterus fixed, immobile, adenexal
mess in advanced stage
27. Special Examination
Dilation and fractional curettage ( D. C)
– Most effective ,definitive procedure and
commonly used
– Significance
-Established correct diagnosis, clinical
stage
-differentiated from cervical cancer or
cervical involvement
28. • Ultrasonography
– Useful adjuvant method
– Significances
• Size of lesion
• Invasion of endometrium or cervix
• Resistant index of new vessels
29. Endometrial carcinoma in a 58-year-old woman with substantial
postmenopausal bleeding. (A) Sagittal transvaginal US scan shows the
endometrium with a thickness of 44 mm and a large area of mixed
echogenicity suggestive of a mass. (B) Transverse sonohysterogram shows
a 50-mm-diameter polypoid mass protruding into the endometrial cavity
(calipers indicate the stalk of the mass). Histopathologic findings indicated
poorly differentiated endometrial carcinoma.
A B
33. Differential Diagnosis
• Senile endometritis / vaginitis
• Dysfunctional uterine bleeding
• Submucous myoma / Endometrial
polyps
• Cervix cancer / Sarcoma of uterus/
Primary carcinoma of fallopian tube
34. Metastasis Route
• Direct extension
• Lymphatic metastasis: important route
• Hematogenous metastasis
35. Clinical Stage
(FIGO 1971)
• Stage I
Ia The carcinoma is confined to the corpus and
the length of the uterine cavity is ≤ 8 cm
Ib The carcinoma is confined to the corpus and
the length of the uterine cavity is > 8 cm
• Stage II The carcinoma has involved the corpus and the
cervix, but has not extended outside the uterus
36. Clinical Stage
(FIGO 1971)
• Stage III The carcinoma has extended outside the
uterus, but not outside the true pelvis
• Stage IV
IVa The carcinoma has extended outside the
uterus and involves the mucosa of the bladder or rectum
(a bullous oedema as
such does not permit the case to be allotted to Stage IV)
IVb The carcinoma has extended outside the true
pelvis and spread to distant organs
37. Surgical pathologic staging
(FIGO 1988)
• Stage I
Ia* Tumour limited to the endometrium
Ib* Invasion to less than half of the myometrium
Ic* Invasion equal to or more than half of the
myometrium
• Stage II
IIa* Endocervical glandular involvement only
IIb* Cervical stromal invasion
38. Surgical pathologic staging
(FIGO 2000)
• Stage III
IIIa* Tumour invades the serosa of the corpus
uteri and/or adnexae and/or positive cytological findings
IIIb* Vaginal metastases
IIIc* Metastases to pelvic and/or para-aortic lymph
nodes
• Stage IV
IVa* Tumour invasion of bladder and/or bowel
mucosa
IVb* Distant metastases, including intra-
abdominal metastasis and/or inguinal lymph nodes
39. Stage Ia*
Tumor limited to the endometrium
Stage Ib*
Invasion to less than half of the myometrium
Stage Ic*
Invasion equal to or more than half of the myometrium
43. Treatment
• Surgery Radiation
• Chemotherapy Hormone therapy
Early stage
--- surge+ postoperative adjuvant therapy
Advanced stage
--- radiation+ surge+ medicine
44. Principle of choice
• General condition (Age, complication)
• Clinical stage
• Tumour pathologic type
45. Surgery
• Object
– Operative pathologic stage, finding prognosis risk
factors
– Remove uterus and metastasis tumour
• Stage I :
– Abdorminal hysterectomy + bilateral salpingoophorectomy
+ selective lymphadenectomy
– clear cell or papillary carcinoma–
omentectomy+appenditectomy
46. • Stage II
–Radical hysterectomy + pelvic
lymphadenectomy + paraortic
lymphadenectomy
• Stage III,IV
–Cytoreductive surgery
47. Indications of pelvic lymphadenectomy
• Special pathogenetic pattern
• Endometrial cancer, grade 3 or no differentiation
• Myo-invasion more than ½
• Size of lesion more than 50% of uterine cavity
• Involvement in isthmus of uterus
50. Indications for radiation alone
• Elderly or obesity
• Multiple chronic or acute medical
illness
(hypertension, cardial disease, diabetes,
pulmonary, renal)
• Advanced stage unsuitable for
surgery
51. Hormone Therapy
• mechenism
– Most endometrial cancers have both ER &
PR.(Estrogen dependent subtype)
Indications:
– Advanced or recurrent stage
– Early stage and desire for fertility
• Used drugs
– MPA
52. Chemotherapy
• Advanced stage or recurrent carcinoma
• Postoperative adjunctive treatment for
high risk factor
• Used drugs:
– DDP (cisplatin), CTX (cyclophosphamide),
ADM (doxorubicin ), 5-Fu,Taxal
MMC, VP16.
53. Prognostic Factors
• Tumour bilologic bihavior
– Cell type
– Histological grade
– Depth of myometrium infiltration
– lymph-node metastasis
– Presence of lymph vascular space
involvement
– Positive peritoneal cytology
• General condition
– Old age
– Acute or chronic medical illness
• Choice of treatment
54. 5-Year Survival Rate
• Stage I b: 94%
• Stage I c: 87%
• Stage II : 84%
• Stage III : 40-60%
55. Follow-up
• 75-95% disease will recur within 2-3 years after
operation.
• Items
– Main complaints
– Pelvic examination
– Vaginal discharge smear
– Chest X ray
– Serum CA125
– Blood routine test
– Blood biochemistry examination
– CT/MRI
56. Questions
• How to make diagnosis of uterine cancer?
• What’s the principle of treatment on
patients with uterine cancer?
• What’re associated with prognosis of
uterine cancer?