Abnormal vaginal dischage is the most common presentation to Gynae opd so this presentation is helpful in diagnosing abnormal vaginal dischage and treating its different causes.
Secretions produced by the glands of vaginal wall and cervix that drain from the vaginal opening.
Vaginal discharge is a common presentation of women to the STI clinic
Can be physiological or pathological
Related with some common STIs
Secretions produced by the glands of vaginal wall and cervix that drain from the vaginal opening.
Vaginal discharge is a common presentation of women to the STI clinic
Can be physiological or pathological
Related with some common STIs
Pelvic inflammatory disease is ascending infection from the endocervix. There are two main groups of organisms involved. These are STIs and commensals of the female genital tract
Chronic pelvic pain can be defined as intermittent or constant pain in the lower abdomen or pelvis of a woman of at least 6 months in duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy.
Pelvic inflammatory disease is ascending infection from the endocervix. There are two main groups of organisms involved. These are STIs and commensals of the female genital tract
Chronic pelvic pain can be defined as intermittent or constant pain in the lower abdomen or pelvis of a woman of at least 6 months in duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy.
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 Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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.
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!
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
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.
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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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
6. Vaginal discharge – infective causes
Non STI
BV
Candida
STI
• Chlamydia trachomatis
• N gonorrhoeae
• Trichomonas vaginalis
• Herpes Simplex
7. Non Infective Causes of Vaginal
Discharge
• Foreign Body
• Cervical polyp/ectopy
• Fistulae
• Allergic reactions
• Personal Hygiene
8. Bacterial Vaginosis
• Commonest cause of abnormal discharge in
women of reproductive age
• Can occur & remit spontaneously
• Not an STI but link with sexual behaviour
14. Vulvo-Vaginal Candidiasis
• Only treat if symptomatic
• Often precipitated by use of antibiotics
• Diabetes
• Immunocompromise
• NOT associated with tampons/sanitary towels
20. Management of a lady with vaginal
discharge
• Clinical & Sexual History ( Vaginal Discharge is
a poor predictor of STI)
21. Management of a lady with vaginal
discharge
• Assessment of Symptoms • Characteristics of the
discharge
• What has changed
• Onset
• Duration
• Odour
• Cyclical changes
• Colour
• Consistency
• Exacerbating factors
23. Vaginal Discharge
• Dermatological conditions ( Lichen Planus) –
superficial dyspareunia & itch (RCOG
Guidance on Vulval Disease)
• Enquire re OTC Rx of VVC ( Women are not
good at self diagnosis)
• Examination & Swabs
25. Bacterial Vaginosis
• 1st Line Rx – oral Metronidazole ( less
expensive than vaginal preparations)
• Metronidazole safer than oral Clindamycin
(pseudo-membranous colitis)
• Acidifying gels may prevent recurrence
• Rx of male partners ineffective in recurrence
prevention
• Consider Rx female partners
26. Vulvo-Vaginal Candidiasis
• Rx with oral or vaginal antifungals (cure rate –
80%)
• No data to support Rx or screening of partners
• Vaginal & oral Rx – equally effective
• Vulval symptoms – topical antifungals
29. Recurrent Bacterial Vaginosis
• Median recurrence rate – 58 % after
treatment
• Risk Factors : New/multiple partners, oral
sex, Cu – IUCD
• COCs & condoms reduce the risk of BV
30. Recurrent Bacterial Vaginosis
• Optimal Rx of recurrence has not been
established
• Twice weekly Metrondiazole gel ( only 33%
remained recurrence-free 12 months after
stopping)
• Acidifying gels – 2 lactic acid vaginal products
available in the UK
37. PCOS
• 20 % of self selected normal women had PCOS
on scan
• 5 % of the general population is hirsute
• 75% of women with secondary amenorrhoea
fulfil diagnostic criteria for PCOS
38. PCOS – Clinical Features
• Onset between 15-25 years of age
• Infrequent cycles
• Hirsutism
• Acne
• Acanthosis Nigricans
• Obesity
• Frank virilisation does NOT appear in PCOS
39. Described in medical literature in the 1800s
John Sampson(1927) introduced the term endometriosis – retrograde
flow of endometrial tissue through the fallopian tubes & into the
abdominal cavity as the primary cause of the disease
40.
41.
42.
43.
44. Treatment of PCOS
• Laparoscopic cauterisation of ovaries
• Ovulation Induction ( for Infertility)
• Oestrogen + Cyproterone acetate (for
acne/hirsuitism)
• Metformin ( helps weight loss & ovulation)
• Spironolactone (50-100mg/day) – anti androgen
• Diet & lifestyle
• Cosmetic measures
45.
46.
47. Endometriosis
• Prevalence – widely varying figures
• 10 % of women in the reproductive age group
• 25-35% of infertile women
• 4 per 1000 women aged 15-64 hospitalised
each year
• Does not occur before menarche
• Not confined to nulliparous women
48. Endometriosis – Symptoms & Signs
• Dysmenorrhoea
• Dyspareunia
• Diffuse pelvic pain
• Symptoms from rectal/urethral/bladder
involvement
• Low back pain
• Infertility associated with above symptoms
• Menstrual dysfunction not increased
50. Pelvic Pain – different presentations
• 15-16 year old with severe dysmenorrhoea
• 35 year old post laparoscopic sterilisation –
pain since she stopped the COC
• Pain associated with menstruation or may be
non cyclic
• Endometriosis may co exist with other
conditions
• In women < 25 years think of STIs
52. Chocolate cyst of left ovary (Dr Malpani’s blog)
Chocolate cysts tend to be complex & have a ground glass appearance
53. Relationship between pain & endometriosis unclear
Classic blue or black powder burn appearance
Lesions can be red, black, blue or white & non pigmented
Tan, creamy, fresh appearing endometrium can also be observed
54. Ovary – most common site for implants & adhesions
Distribution of endometriosis may be widespread – anteriorly &
posteriorly over the broad ligament & cul-de-sac