This document discusses galactorrhea, which is the spontaneous flow of milk from the breasts in non-lactating women. It defines galactorrhea and outlines its causes, which can include inhibition of prolactin-inhibiting factor, stimulation of prolactin-releasing factor, increased prolactin production, drugs, hypothyroidism, and idiopathic factors. The document provides details on diagnostic evaluation, treatment options, medications used to treat hyperprolactinemia like bromocriptine, quinagolide, and cabergoline, and considerations for pregnancy and breastfeeding.
Presentation on the description of normal and abnormal uterine bleeding, menstrual cycle, FIGO classification with PALM-COEIN, common differentials of AUB, assessment, diagnosis, and management.
Presentation on the description of normal and abnormal uterine bleeding, menstrual cycle, FIGO classification with PALM-COEIN, common differentials of AUB, assessment, diagnosis, and management.
Recurrent pregnancy loss is a significant redroductive medical problem, influencing 2%–5% of couples. ... Throughout the years, proof based medications, for example, surgical correction of uterine abnormalities or asprin and heparin for antiphospholipid syndrome have improved the results for couples with repetitive pregnancy loss.
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)
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.
Recurrent pregnancy loss is a significant redroductive medical problem, influencing 2%–5% of couples. ... Throughout the years, proof based medications, for example, surgical correction of uterine abnormalities or asprin and heparin for antiphospholipid syndrome have improved the results for couples with repetitive pregnancy loss.
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)
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.
This slide is for educational purpose prepared by medical student at Nepal. This slide include introduction, Investigation and Management of Hirsutism.
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
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.
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
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
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.
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.
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
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!
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
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
2. Define
Nonpuerperal watery or milky breast secretion that
contain neither pus nor blood.
Color Amount
Side Spontaneous or not
Incidence
Unk Recently increased
How to elicit?
Aboubakr Elnashar
4. Causes
I. Inhibition of PIF
1. Stress . Prolonged suckling . Jug & run
2. Thoracotomy scars . Cervical spine lesions . Herpes zoster
3. Drugs 4. Chronic renal failure
5. CNS disease 6. Pituitary stalk lesions
II. Stimulation of PRF
Hypothyroidism
III.Increased prolactin production
1. Pituitary tumor 2. Non pituitary tumor
IV. Idiopathic
Aboubakr Elnashar
5. Drugs
The most common cause of galactorhea.
The commonest are metaclorpromide & phenothiazines
I. Estrogens & drugs that increase estrogen
1. OCP 2. Digitalis
3. Marijuana 4. Heroin
II. Dopamine receptor blockers
1.Phenothiazines 2.Haloperidol
3. Metaclorpromide 4. Isoniazide
III. CNS dopamine depleters
1. Psychoactive:Tricyclic antidepressant,phenothiazines,
Benzodiazepins
2. Antihypertensive: Reserpin, Methyl dopa, verapamil
3. Cimetidine
When galactorrhea disappear ?: 3-6 moAboubakr Elnashar
6. When to investigate ?
1. Nulliparous
2. 12 mo after last pregnancy or weaning
Aboubakr Elnashar
7. Galactorrhea without hyperprolactinamia:
50%
1. Episodic fluctuation & sleep increments
2. Bioactive PRL which is not detectable
3. An earlier episode of hyperprolactinaemia which
triggered persistent galactorrhea.
Aboubakr Elnashar
8. Hyperprolactinaemia without galactorrhea
66%
1. Inadequate detection
2. Hypoestrogenic state.
3. Inadequate estrogenic or progetational priming of the
breast
4. High PRL does not interact with the breast receptors
Aboubakr Elnashar
9. Diagnostic evaluation
History & Examination: Exclude: Recent pregnancy, breast stimulation
Drugs, Breast or chest lesion
Prolactin
>20 ng/ml <20 ng/ml
TSH
Normal High (hypothyroidism)
MRI (Normal or hyperplasia, Microadenoma or Macroadenoma)Aboubakr Elnashar
10. PRL
Basal conditions
Late morning
Fasting
after 60 min rest
not in late follicular phase
2nd blood sample if the first is raised
Level
> 100 ng/ml: 60% pituitary tumor.
> 300 ng/ml: 100% pituitary tumor
Modest elevation can be associated with pituitary tumor
Aboubakr Elnashar
12. Treatment
I. Idiopathic (normal PRL)
. Observation
. Dopamine agonist (anxiety, pregnancy). Stop during pregnancy
II. Hypothyroidism
. Eltroxin
III. Microadenoma
. Observation: annual PRL
. Dopamine agonist (anxiety, pregnancy). Stop after 2-3 yr.
. Surgery (rapid growth).
Transsphenoidal microsurgery is very safe, but recurrence is high (Sperof,1999)
IV. Macroadenoma
. Dopamine agonist: long term
. Surgery (No response, suprasellar extension, pregnancy).
Preoperative bromocriptine may result in fibrosis
Aboubakr Elnashar
13. I. Microadenoma:
usually do not enlarge significantly during pregnancy
II. Macroadenoma:
may grow rapidly & cause visual disturbance during
pregnancy.
Surgery before pregnancy should be considered.
An alternative method is continuation of dopamine
agonist during pregnancy: & visual field/ 3 mo: No
detrimental effects on the fetus, Nearly all delivered at
term without complications
Pregnancy, Breast feeding, COC s, ERT
not contraindicated Aboubakr Elnashar
14. Bromocriptine
(Parlodel, lactodel, Dopagon , 2.5 mg)
Dose:1 t bid
Side effects: n & v. , postural hypotension, headache,
nasal stiffness, constipation.
Can be minimized: give t at bed time, avoid large dose
increament, vaginal adminstration
Monitoring: mid normal values, titrate the dose
accoringly
Galactorhea stops after: 6 w & 11 w if there is adenoma
Vaginal: Absorption is almost complete & slow, the first
pass through the liver is avoided: 1 t /d & less side
effects. During menstruation: tampon at night.No effect
on sperms
Aboubakr Elnashar
15. Quinagolide
(Norplac, 75 ug)
Dose: 1 t/ d
It has higher affinity for dopamine receptors: tumors resistant to
bromocriptine have responded to this drug (Speroff,1999)
Aboubakr Elnashar