The document provides guidance on evaluating pelvic masses in women. It discusses that pelvic masses can have benign or malignant causes, with risk of malignancy increasing with age. Evaluation includes assessing symptoms, performing physical exam including inspection and palpation of the abdomen, and utilizing ultrasound imaging as the initial test. Key investigations involve determining probability of malignancy, impact on fertility for premenopausal women, and considering further imaging or laparoscopy if needed. The goal is to diagnose non-malignancy or detect cancer at early stages.
The Primary Care Physician's guide to management of Pregnancy DiabetesHanifullah Khan
A guide on the screening, diagnosis and management of diabetes in pregnancy aimed at facilitating the handling of this condition in a primary care setting. Includes details on medications and dosages
An outline on how to approach the problem of pregnancy anaemia from a clinical standpoint. Specially presented for the benefit of students and primary care physicians.
An alternative way at looking at pregnancy complicated by diabetes. A guide for the student in understanding this problem and the important points to be included in a clinical assessment.
The Primary Care Physician's guide to management of Pregnancy DiabetesHanifullah Khan
A guide on the screening, diagnosis and management of diabetes in pregnancy aimed at facilitating the handling of this condition in a primary care setting. Includes details on medications and dosages
An outline on how to approach the problem of pregnancy anaemia from a clinical standpoint. Specially presented for the benefit of students and primary care physicians.
An alternative way at looking at pregnancy complicated by diabetes. A guide for the student in understanding this problem and the important points to be included in a clinical assessment.
Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours. The cells that form gestational trophoblastic tumours are called trophoblasts and come from tissue that grows to form the placenta during pregnancy.
review the evidence (RCT & meta-analyses) concerning the best practices in contemporary Recurrent Pregnancy Loss and Thrombophilia depending on Eshre guideline 2017 and other EBM sources.
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor.
4 cases of pelvic mass are discussed .Adnexal mass invilves masses arisinf from ovary,fallopian tube,uterus,bowel and some miscellenious masses.USG is used to detect its size and the origin.Histopathological findings are diagnostic.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours. The cells that form gestational trophoblastic tumours are called trophoblasts and come from tissue that grows to form the placenta during pregnancy.
review the evidence (RCT & meta-analyses) concerning the best practices in contemporary Recurrent Pregnancy Loss and Thrombophilia depending on Eshre guideline 2017 and other EBM sources.
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor.
4 cases of pelvic mass are discussed .Adnexal mass invilves masses arisinf from ovary,fallopian tube,uterus,bowel and some miscellenious masses.USG is used to detect its size and the origin.Histopathological findings are diagnostic.
For difficult vaginal delivery,forceps delivery,vacuum application are done to assist the vaginal delivery.Many types of forceps are there divided in 3 categories.
A comprehensive guide to the management of hyperglycaemia in pregnancy aimed at the primary care physician and based on latest evidenced based criteria. Includes information from latest studies such as HAPO study and ACHOIS, and involves guidelines from the IADPSG, ADA, WHO and Malaysia.
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
Reproductive cancer ( A Common geriatric problem)Binuka Dahal
Reproductive cancers are cancers that occur in the reproductive organs. These are cancers in the breast, cervix, uterus, vulva, endometrium or ovaries.
Brief overview of Breast anatomy and clinical assessment of benign as well as malignant breast disease. This information is perfect for the level of Final Year medical students.
Polycystic ovary syndrome (PCOS) is of clinical and public health importance as it is very common in today’s era affecting women of reproductive age group. It has significant and diverse clinical implications including reproductive (infertility, hyperandrogenism, hirsutism), metabolic (insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, adverse cardiovascular risk profiles) and psychological features (increased anxiety, depression and worsened quality of life).
Another commonest ovarian disorder is ovarian cyst. The treatment of an ovarian cyst relies on its nature, and accurate preoperative discrimination of benign and malignant cysts is therefore of crucial importance.
In a regular Homoeopathic OPD the physician today encounter these two cases frequently. Most of the patients visiting with these disorders opt for Homoeopathy as an alternative treatment option to revert surgical procedures, or after failed hormonal therapies.
Homoeopathic management should focus on education, addressing psychological factors and strongly emphasizing healthy lifestyle with targeted medical therapy as required.
The present article discusses on various aspects of these ovarian disorders. Cases of Ovarian disorders which were successfully treated with homoeopathic medicines by the author are reported here.
Dr. Smita Brahmachari
M.O., Dept. of AYUSH, Govt. of NCT Delhi.
Breast biopsy is a medical test involving the removal of cells or tissues that has formed a lump, or a cyst, or is not normal.
http://docturs.com/dd/pg/groups/11280/breast-biopsy/
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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
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.
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!
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Learning objectives
! to formulate a list of
differentials for a patient with
a pelvic mass
! identify the risk factors for
malignancy
! to establish a system of
evaluation for such tumours
2
3. These are growths that are
associated with the reproductive
What are they?
tract
They include tumours arising from
the female reproductive organs
Although pertinent, breast
tumours will not be discussed
here
3
4. Why the fuss?
! We all worry about
cancer
! As such, all growths
should be suspected
cancerous
! It is our duty to confirm
non-malignancy
4
6. The objectives when a growth is
discovered
! Most importantly,
assess the
probability of
malignancy
! If malignancy is
less likely, then
assess the
association with
fertility
! Plan for
management, most
likely surgery
6
8. Concepts on aetiology
! most premenopausal tumours are benign in origin
! malignancy can occur at all ages
! this risk increases with age
! postmenopausal women require aggressive evaluation
! cancer until proven otherwise
8
9. General Causes
! Uterine fibroids ! Ovarian cysts
! Adenomyosis (older pt) • Epithelial (arising from ovarian
epithelium)
! Functional cysts -
- Serous & mucinous
occasionally grow large &
symptomatic - most common
! Pregnancy • Germ cell (from egg-producing
cells)
- In younger women
• Stromal ( from hormone
producing cells)
9
10. In the reproductive age group
! functional cysts (follicular or luteal) are most common
! usually small but may become larger - 10 cm
! frequently asymptomatic but can have dull, non-
specific pain
! mostly due to intracystic haemorrhage
! tumours are rare - most common dermoid cysts &
benign teratomas
! never forget pregnancy!
10
11. nongynae causes
Don t forget there s other stuff in the pelvis!
Brown G. A gynecologic approach to evaluation of pelvic masses in women JAAPA 2012
11
13. The asymptomatic patient
! during a routine medical
check up – physical
exam, U/S scan etc
! from Pap smear results
13
14. Abnormal Vaginal Bleeding
! usually occurs with tumours of lower tract
! endometrial, myometrial cervical etc..
! fibroids are prone to heavy cyclical bleeding
! irregular, non-menstrual bleeding is more sinister
! postcoital bleed suggests intravaginal location
! polyps and cancers can occur, but infection is the most
common cause
! ovarian tumours mostly bleed if cancerous, & only when advanced
14
15. Abdominal pain
! ascertain if cyclical/dysmenorrhoea - more likely
endometriosis or PID
! how long has it been there?
! If it has been there for a long time, is it progressively
worsening?
! remember abdominal quadrants,
! usually, the pain will be overlying the offending
organ
15
16. Nonspecific symptoms
! bowel or urinary, these usually are sinister
associations with the tumour
! endometriosis and/or adhesions may mimic these
! other symptoms that should be questioned include
appetite & weight loss
16
17. Infertility
! women in the reproductive age group must be
questioned on this
! endometriosis & adenomyosis are among the most
common causes of the pelvic mass
! the association of this symptom with a mass in most
cases is due these conditions
17
18. Ovarian cancer
! often manifests late
! abdominal or pelvic pain
! bloating
! abdominal distension
! other nonspecific symptoms
18
19. Postmenopausal patient
! any tumour here warrants
extensive investigation
! postmenopausal bleeding
must be taken seriously
! commonest tumours at this
age are ovarian
! may present only with
nonspecific symptoms
! the pelvis should be
looked at carefully
19
20. SUMMARY OF !
TUMOUR!
CLINICAL FEATURES!
heavy cyclical menstruation,
fibroids ! irregularly enlarged, mobile smooth
uterus, usually non-tender
nonspecific pelvic or abd pain,
bloating, constitutional symptoms,
ovarian cancer!
fixed mass, may be irregular, firm,
hard or soft, ascites may be present
cyclical pain, dyspareunia, infertility,
abnormal menstruation,soft-to-firm
endometrioma!
mass, usually fixed, lateral or
central
20
22. Inspection
! overall, the patient
may look unwell
! she may be in
extreme pain
! the abdomen may be
distended, generally
or asymmetrically
! the umbilicus may be
deviated
! if acute, the abdomen
may not move with
respiration
22
23. Palpation
! is the surface smooth or nodular?
! nodularity is not good
! is the mass fixed or mobile
! consistency - hard, firm or soft
23
24. Can you go below the
mass?
! important to feel if you can go
below the mass
if not, then it is most likely arising
from the pelvis
24
25. Ascites
! this is never
a good sign
! you must
know how to
evaluate for
shifting
dullness
25
36. Role of ultrasound
! an essential tool for diagnosis - first Ix to be
considered
! any mass must initially be scanned
! abdominal or transvaginal
! features to look for include composition of tumour,
size, uni- or bilateral and presence of ascites
36
38. Blood tests
! General - assess cell lines for health & mx issues
! Tumour markers - limited diagnostic capability
• May be used as surveillance when increased
! Other tests depend on type of tumour
38
39. Other imaging
! MRI & CT
! Laparoscopy - can be diagnostic, but better to be
therapeutic
39
41. Key points
! pelvic masses may have a benign or malignant
aetiology
! the risk of malignancy is increased in
postmenopausal women
! premenopausal masses are usually benign
! evaluation of premenopausal masses must include
relationship with fertility
! U/S is an important evaluation tool for possibility of
malignancy
41
42. References
! Brown G. A gynecologic approach to evaluation of pelvic masses in women JAAPA
2012
! Johnson BA. Evaluation of pelvic masses 2001
http://www.eric.vcu.edu/home/resources/whh/
VIIIeEVALUATION_PELVIC_MASSES.pdf
42