hsg.pptx
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Hysterosalpingography (HSG) Hystero + Salpingo + Graphy HSG is a radiological procedure done to assess the interior anatomy of the uterine cavity and the shape and patency of the fallopian tubes. It is a radiographic study using fluorescent dye to visualise the anatomy of uterus and fallopian tubes. Indications: Assessment of tubal patency. Detection of uterine malformation. Diagnosis of cervical incompetence. Detection of translocated IUD. Diagnosis of uterine synechiae. Diagnosis of uterine fibroid , uterine polyp. Diagnosis of abdominal pregnancy. Uterine Malformation Steps of operation The patient is asked to remain empty bladder. Operation is done under general anaesthesia. The patient is placed in lithotomy position. Local antiseptic cleaning is done. Posterior vaginal speculum is introduced. Anterior lip of cervix is grasped with Allis tissue forcep. HSG cannula is fitted with a syringe containing radio opaque dye. About 5- 10 ml of dye is slowly introduced. The passage of the dye is observed by using X-ray intensifier and a video display unit. Two radiographic X-rays are taken. First one to show the filling of uterine cavity and other one 10-15 mins after the completion of procedure. Timing of procedure : HSG is done between D6 and D10 of cycle. Antibiotics are given one day prior the procedure up to 5 days. Contrast media Complications Peritoneal irritation. Pelvic pain. Vasovagal attack. Intravasation of dye into the venous or lymphatic channels. Flaring up of pelvic infections.
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procedure allows the direct visual examination of intraabdominal organs including large surface areas of the
liver, gallbladder, spleen, peritoneum, pelvic organs, and
retroperitoneum. Biopsies, aspiration, and cultures can be
obtained, and laparoscopic ultrasound (US) may be used.
Diagnostic laparoscopy is safe and well tolerated and
can be performed in an outpatient or inpatient setting
under general anesthesia (Fig. 1A). There may also be
unique circumstances where office based diagnostic
laparoscopy may be considered under local anesthesia.
These circumstances should include only procedures where
complications and the need for therapeutic procedures
through the same access are extremely unlikely. Manipulation
and biopsy of the viscera is possible through additional ports.
Diagnostic laparoscopy is the most commonly performed
gynecological procedure today. Its greatest advantage is that
it has replaced exploratory laparotomy.
Diagnostic laparoscopy was first introduced in 1901,
when Kelling, performed a peritoneoscopy in a dog and was
called ‘‘celioscopy’’. A Swedish internist named Jacobaeus is
credited with performing the first diagnostic laparoscopy on
human in 1910. He described its application in patients with
ascites and for the early diagnosis of malignant lesions.
In last 10 years, laparoscopy has made a great difference
to the diagnosis of abdominal acute and chronic pain. It
has evolved as an informative and important method of
diagnosing a wide spectrum of both benign and malignant
diseases. Exploratory laparoscopy also allows tissue
biopsy, culture acquisition, and a variety of therapeutic
interventions. Elective diagnostic laparoscopy refers to the
use of the procedure in chronic intra-abdominal disorders.
Emergency diagnostic laparoscopy is performed in patients
presenting with acute abdomen
Laparoscopy in gynecology
An introduction to laparoscopy in gynecological practice: the instrument, procedures, indications and recent advances.
Female reproductive pathology
The document describes the female reproductive system, including both external structures like the vulva and internal structures like the uterus and ovaries. It then discusses common diagnostic tests for reproductive disorders, such as laboratory tests, radiologic tests, surgical biopsies, and examinations. Specific conditions like pelvic inflammatory disease and endometriosis are also summarized, along with their symptoms, causes, treatments, and nursing considerations.
Principles and diagnostic use of Endoscopy in canines
Endoscopy refers to examining the interior of hollow organs or body cavities using an endoscope, an instrument with a camera, light, and channels. The document discusses the history and development of endoscopy from the early 19th century to modern techniques. It also provides details on the various types of endoscopy used to examine different parts of the gastrointestinal tract, respiratory tract, urinary tract, and other body cavities in both human and veterinary medicine for diagnostic and therapeutic purposes.
Renal biopsy
This document discusses renal biopsy procedures and indications. It provides details on the history and technique of renal biopsy. Key points include that renal biopsy can provide a diagnosis in over 95% of patients with a complication rate of less than 0.1%. An adequate biopsy sample contains 10-15 glomeruli. Tissue is divided for light microscopy, immunofluorescence, and electron microscopy. Complications include hematuria and pain in 3-4% of patients. Indications for biopsy include nephrotic syndrome, acute kidney injury, systemic diseases affecting the kidneys, and unexplained chronic kidney disease.
Renal biopsy
This document discusses renal biopsy procedures and indications. It provides details on the history and technique of renal biopsy. Key points include that renal biopsy can provide a diagnosis in over 95% of patients with a complication rate of less than 0.1%. An adequate biopsy sample contains 10-15 glomeruli. Tissue is divided for light microscopy, immunofluorescence, and electron microscopy. Complications include hematuria and pain in 3-4% of patients. Indications for biopsy include nephrotic syndrome, acute kidney injury, systemic diseases affecting the kidneys, and unexplained chronic kidney disease.
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database.pptx
1) The document discusses various databases related to Ayurveda including literature databases containing Samhitas and other Ayurvedic texts, manuscript databases, herbal databases containing information on medicinal plants from sources like the Flora of India and the Wealth of India series, the Traditional Knowledge Digital Library, clinical trials registry, Cochrane library, and dissertation repository Shodhganga.
2) It also mentions databases containing information on Ayurvedic pharmaceutical companies and their products, the national pharmacovigilance program and database, patent databases, gemological and minerals databases, and mobile apps databases.
3) Several national organizations that maintain important Ayurveda databases are discussed, including the National Institute of
uterine fibroid.pptx
Uterine fibroids are benign tumors that develop in the uterus. They are composed of smooth muscle and connective tissue and are the most common tumors found in females. The highest prevalence occurs in women between ages 35-45. While the exact cause is unclear, genetic and hormonal factors likely play a role. Fibroids can be asymptomatic but may cause heavy periods, pelvic pain, infertility, or pregnancy complications. Diagnosis involves ultrasound, MRI, or other imaging. Treatment options include medication, myomectomy (surgical removal of fibroids), hysterectomy (removal of the uterus), or embolization (blocking the blood supply).
Trichomonas vaginitis.pptx
Introduction
Causative agent : Trichomonas vaginalis
Transmission : Sexual contact
Incubation period : 3 – 28 days.
Clinical features
Sudden profuse and offensive vaginal discharge.
Severe irritation and itching around introitus.
Dysuria and increased frequency of urine.
Examination:
Thin, greenish yellow frothy offensive vaginal discharge.
Inflammed vulva
Vaginal examination may be painful.
Diagnosis:
Culture of discharge :
Diamonds TYM or Feinberg
Whittington medium.
Treatment:
DOC : Metronidazole
200mg TDS x 1 week.
Tinidazole
syphilis.pptx
Introduction
Causative agent : Treponema pallidium
Transmission : Abraded skin / mucosal surface.
Spreads through direct contact.
Incubation period : 9 -90 days.
Clinical features
Phases of syphilis :
Primary syphilis
Lesion / Chancre : Single/ Multiple
Site : Labia, fourchette, anus, cervix or
nipples.
Small papule gets eroded into an ulcer. The margins of ulcer are raised and floor is smooth and shiny.
Healing of primary chancre takes place in 1-8 weeks.
Secondary Syphilis
Secondary syphilis is evident in form of Condyloma lata in vulva.
Condyloma lata : coarse, flat topped, moist, necrotic lesions.
Maculopapular rashes : Palms and soles.
Alopecia, lymphadenopathy, mucosal ulcers.
Latent Syphilis
Quiescence phase.
Duration : 2 -20 years.
Tertiary Syphilis
Progression of tertiary syphilis occurs only in condition of untreated syphilis.
Damages CNS, CVS, Musculoskeletal system.
Cranial nerve palsies III, VI, VII and VIII.
Gummatous ulcer : deep punched ulcer with rolled out margins. Painless with moist leather base.
Diagnosis
History of exposure.
Identification of organism.
Serological test
VDRL (Venereal disease research laboratory)
TPHA (Treponoma pallidum haemagglutination)
EIA (Enzyme immunoassay)
FTA (Fluorescent treponomal Antibody)
TPI (Treponoma pallidum immobilisation)
Treatment
Benzathine penicillin IM
Tetracycline 500 mg
Doxycycline 100 mg
Serological test should be performed 1, 3, 6 and 12
month after treatment of syphilis.
pruritis vulvae.pptx
Pruritis vulvae
Etiology:
1. Vaginal discharge : Trichomonas vaginalis, Candida albicans
2. Local skin lesion: Psoriasis, Dermatitis
3. Vulvar infection: Fungal, Viral, Parasitic, STD
4. Medical disorders: Glycosuria
5. Deficiency: Fe, Folic acid, Vit B12 Vit A
6. Psychosomatic causes
Investigations
Age of onset
Intensity of itching
Duration
Vaginal discharge
Contraceptive practice
Allergy- nylon, soap, detergent.
DM
Liver disorder
Thyroid
Hematological disorder
Special Investigations
Microscopic examination: Vaginal discharge / vulval scarping
Urine examination: Sugar, Protein and pus cells.
Blood examination: CBC, Thyroid profile, Glucose, LFT, RFT
Stool examination: Ova, Parasite, Cyst.
Treatment
Maintain local hygiene.
Loose fitting clothing
Local topical application: antibiotics/ clobetasol propionate
Treat specific disease
Surgery: Neoplasia invasion
POP.pptx
Pelvic organ prolapse
Pelvic Organ Prolapse
Most common gynaecological problem.
Amongst parous women.
A form of hernia.
Anatomy of Uterus
Anteversion and anteflexion position.
Lies between rectum and bladder.
Cervix pierces the vagina at the right angle to the axis of vagina.
Supports of Uterus
Uterus is held in position by 3 tier support system.
Upper tier
Middle tier
Inferior tier.
Upper tier
Primarily, maintains the uterus in anteverted position.
The structures responsible are:
Endopelvic fascia.
Round ligaments.
Broad ligaments.
Middle tier
Constitutes the strongest support of uterus.
Responsible structures are:
Pericervical ring.
Pelvic cellular tissues.
Inferior tier
Indirect support of uterus.
Responsible structures are pelvic floor muscles including:
Levator ani
Endopelvic fascia
Levator plate
Perineal body
Urogenital diaphragm
Anatomical Factors
Gravitational stress.
Parturition stress.
Pelvic floor weakness.
Inherent weakness of supporting structures.
Acquired Predisposing Factors
Trauma of vaginal delivery causing injury :
Ligaments
Endopelvic fascia
Levator muscle
Perineal body
Pudendal nerve and muscle damage due to
repeated child birth.
Congenital Predisposing Factors
Inborn weakness of supporting structure.
Aggravating factors
Post menopausal atrophy
Poor collagen tissue repair with age.
Increased intra abdominal pressure.
Occupational hazards
Asthenia
Obesity
Fibroid/Polyp
Clinical Degrees Of Uterine Prolapse
Symptoms
Feeling of something coming out per vaginum.
Backache or dragging pain in pelvis
Dyspareunia
Urinary symptoms
Bowel symptoms
Clinical examination
Inspection and palpation.
General examination.
Pelvic examination
Uterine prolapse
Management of Prolapse
Preventive
Conservative
Surgery
Preventive Measures
Pelvic floor exercise during puerperium.
Avoid strenuous activities.
Avoiding prolonged cough.
Avoiding constipation.
Avoiding heavy weight lifting.
Avoiding future pregnancy too early.
Conservative Management
Indications :
Asymptomatic women
Mild degree prolapse
POP in early pregnancy
Treatment :
Oestrogen replacement therapy.
Kegel exercise
Pessary treatment
Surgical Management of Prolapse
Restorative
Extirpative
Obliterative
pid.pptx
Definition
PID is a disease of the upper genital tract.
It is a spectrum of infection and inflammation of the upper genital tract organs typically involving the uterus (endometrium), fallopian tubes, ovaries, pelvic peritoneum and surrounding structures.
Epidemiology
Occurs both in the developed and developing
countries.
85 per cent are spontaneous infection in sexually active females of reproductive age.
The remaining 15 per cent follow procedures, which favors the organisms to ascend up.
Two-thirds are restricted to young women of less than 25 years and the remaining one-third limited among 30 years or older.
Risk factors
Menstruating teenagers.
Multiple sexual partners.
Absence of contraceptive pill use.
Previous history of acute PID.
IUD users.
Area with high prevalence of sexually transmitted diseases.
Protective factors
Contraceptive practice
Barrier methods
Oral steroidal contraceptives
Monogamy / Vasectomy
Others
Pregnancy
Menopause
Vaccines
CLINICAL FEATURES
Bilateral lower abdominal and pelvic pain dull in nature.
Fever, lassitude and headache.
Irregular and excessive vaginal bleeding .
Abnormal vaginal discharge (purulent or copious)
Nausea and vomiting.
Dyspareunia.
Pain and discomfort in the right hypochondrium.
Signs
Temperature >38.3°C.
Abdominal palpation
(1) Tenderness on both the quadrants of lower abdomen.
(2) The liver may be enlarged and tender.
Vaginal examination
(1) Abnormal vaginal discharge (purulent).
(2) Congested external urethral meatus or openings of Bartholin’s ducts through which pus may be seen escaping out on pressure.
(3) Speculum examination shows congested cervix with purulent discharge from the canal.
Clinical diagnostic criteria of PID (CDC-2006)
Minimum Criteria
Lower abdominal tenderness.
Adnexal tenderness.
Cervical motion tenderness.
Additional Criteria
Oral temperature > 38.3°C.
Mucopurulent cervical or vaginal discharge.
Raised C-reactive protein and/or ESR.
Definitive Criteria
Histopathologic evidence of endometritis on biopsy.
Imaging study (TVS/MRI) evidence of tubo-ovarian complex.
Laparoscopic evidence of PID
Investigations
Identification of organisms
Blood: Leucocyte count shows leucocytosis to more than 10,000 per cu mm and an elevated ESR value of more than 15 mm per hour.
Laparoscopy
Complications Of Pid
Immediate
Pelvic peritonitis or even generalized
Septicemia
Late
Dyspareunia
Infertility
Chronic pelvic inflammation
Formation of adhesions or hydrosalpinx or pyosalpinx and tubo-ovarian abscess.
Chronic pelvic pain and ill health.
Ambulatory Management Of Acute PID (CDC-2006)
Patient should have oral therapy for 14 days
Regimen A
Levofloxacin 500 mg (or, ofloxacin 400 mg) PO
Metronidazole 500 PO bid
Regimen B
Ceftriaxone 250 mg IM single dose
Doxycycline 100 mg PO BID with or without
Metronidazole 500 mg PO BID for 14
endo.pptx
Definition
Presence of functioning endometrium (glands and stroma) in sites other than uterine mucosa is called endometriosis.
It is a benign but it is locally invasive.
Prevalence
The real one is due to delayed marriage, postponement of first conception and adoption of small family norm.
The apparent one is due to increased use of diagnostic laparoscopy as well as hightened awareness of this disease complex amongst the gynecologists
Sites
Abdominal: Usually confined to the abdominal structures below the level of umbilicus.
Extra-abdominal: Common sites are abdominal scar of hysterotomy, cesarean section, tubectomy and myomectomy, umbilicus, episiotomy scar, vagina and cervix.
Remote
Pathology
Naked Eye Appearance: The appearance of the lesion depends on the organs involved, extent of lesion and reaction of the surrounding tissues.
Pelvic endometriosis: Small black dots, called ‘powder burns’ seen on the uterosacral ligaments and pouch of Douglas.
Fibrosis and scarring
Symptoms
Dysmenorrhea (70%)
Abnormal menstruation (20%)
Infertility (40–60%)
Dyspareunia (20–40%)
Chronic Pelvic Pain
Abdominal Pain
Urinary— frequency, dysuria, back pain or even hematuria.
Sigmoid colon and rectum—painful defecation (dyschezia), diarrhea, constipation, rectal bleeding or even melena.
Chronic fatigue, perimenstrual symptoms (bowel, bladder).
Hemoptysis (rarely), chest pain.
Surgical scars—cyclical pain and bleeding.
Examination
Abdominal palpation
A mass may be felt in the lower abdomen arising from the enlarged tubo-ovarian mass due to endometriotic adhesions. The mass is tender with restricted mobility.
Pelvic Examination
Pelvic tenderness, nodules in the pouch of Douglas, nodular feel of the uterosacral ligaments, fixed uterus or unilateral or bilateral adnexal mass of varying sizes
Diagnosis
Bichemical parameters:
Serum CA 125
Monocyte Chemotactic Protein (MCP-1)
Imaging:
TVS - ovarian endometriomas
Endorectal USG - Rectosigmoid endometriosis
MRI - deep infiltrating endometriosis.
Colonoscopy, rectosigmoidoscopy and cystoscopy
Differential Diagnosis
Chronic pelvic infection / symptomatic endometriosis. Laparoscopy is helpful in actual diagnosis.
Ovarian endometrioma / benign ovarian tumor / malignant ovarian.
Ultrasonography or Laparoscopy
Rupture of the chocolate cyst / torsion or rupture of the ovarian tumour, disturbed ectopic pregnancy, appendicitis or diverticulitis.
Complications
Endocrinopathy
Rupture of chocolate cyst
Infection of chocolate cyst
Obstructive features:
Intestinal obstruction
Ureteral obstruction → hydroureter
hydronephrosis → renal infection
Endocrinopathy in Endometriosis
Corpus luteum insufficiency
Luteolysis due to ↑ PGF.
Luteinized unruptured follicle (LUF)
Anovulation
Elevated prolactin level
Double LH peak.
Staging
Endometrios is should be staged appropriately.
To predict prognosis.
To choose therapy.
To evaluate the treatment protocol.
The stage is determined by adding specific points given to each.
contraception.pptx
Contraception
Contraception is defined as the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs or surgical procedures.
The preventive methods to help women avoid unwanted pregnancies are called contraceptive methods.
Need for contraception
• To avoid unwanted pregnancies.
• To regulate the timing of pregnancy.
• To regulate the interval between pregnancy.
Ideal Contraceptive
• Safe
• Effective
• Acceptable
• Reversible
• Inexpensive
• Long lasting
• Requires little or no medical supervision
Contraceptive methods
Spacing methods
Natural
Barrier
IUDs
Emergency contraception
Terminal methods
Male fertilisation
Female fertilisation
Natural Methods
Coitus inteyrruptus / withdrawal
Rhythm Method
Lactational Amenorrhoea
Barrier Methods
Mechanical
Male : Condom
Female : Condom, Diaphragm, Cervical cap
Chemical
Creams - Deleen
Jelly – Koromex, Volpar paste
Foam tablets – Aerosol foams, Chlorimin T or Contab
Combination
Combined use of Chemical and Mechanical methods.
Male condom
• Most commonly known and used contraceptive.
• Better known in India as NIRODH.
Female condom
Femidom
Diaphragm
Spermicides
Spermicides are surface active agents which attach
themselves to spermatozoa and kill them.
Available in various forms like
Intrauterine Contraceptive Devices
Cu T200
T shaped device Polyethylene frame.
215 mm2 surface area of Cu wire.
Contains 124 mg of copper
Cu is lost at the rate of 50 µg/day.
Polyethylene monofilament tied at vertical stem.
Cu is radio opaque so additionally barium is
incorporated in the device.
Supplied in a sterilised sealed packet.
Lifetime 4 years.
Cu T 380A
380 mm square surface area of copper wire.
Replacement 10 years.
Multiload Cu 250
60-100 ug/day
Replacement 3 years
Multiload - 375
Mode of action
Biochemical and histological changes in endometrium.
Increased tubal motility.
Endometrial inflammatory response.
Prevents implantation.
Contraindication for insertion of IUCD
Presence of pelvic infection
Genital tract bleeding (undiagnosed)
Suspected pregnancy
Uterine fibroid
Severe dysmenorrhoea
Ectopic pregnancy history
Caesarean section
Cu allergy
Time of insertion
Interval
2-3 days after menstrual phase.
During lactational amenorrhoea.
Postabortal
Done immediately following termination of pregnancy.
Postpartum
After 6 weeks of delivery.
Postplacental delivery
Post delivery of placenta.
Method of Insertion
Preliminary steps:
History taking and examination
Patient is informed and consent is obtained.
Insertion is done in OPD aseptic conditions.
Placement of device in inserter.
Steps of operation
The patient is asked to remain empty bladder.
The patient is placed in lithotomy position.
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forcep.
The device is placed in the inserter and introduced through cervical
BARTHOLINS.pptx
Bartholin's glands are paired oval-shaped glands located on each side of the vaginal opening that produce lubricating secretions. Bartholin's gland infection, or Bartholinitis, can be caused by various bacteria and may result in complete resolution, recurrence, abscess formation, or cyst formation. A Bartholin's abscess is an infection of one of the glands that causes severe pain and swelling. Treatment involves antibiotics, sitz baths, and draining the abscess. A Bartholin's cyst is a fluid-filled sac that can cause discomfort and dyspareunia, and treatment is marsupialization to remove the cyst.
Moniliasis(Candida vaginitis)
Candida vaginitis is caused by the fungus Candida albicans. It presents with intense vulvovaginal discharge, dyspareunia, and a thick, curdy white discharge on examination that resembles cottage cheese and adheres to the vaginal walls. Diagnosis is made via wet smear, and treatment involves removing predisposing factors as well as using local and oral antifungal creams, ointments, pessaries, or single dose therapies like fluconazole or itraconazole.
Lgv (Lymphogranuloma Venereum)
Lymphogranuloma Venereum
Dr. Yashika
Causative agent : Chlamydia trachomatis
Incubation period: 3-30 days
Clinical features :
Initial phase:
Painless papule, pustule or ulcer in vulva, urethra,
rectum or cervix.
Involved inguinal nodes feels rubbery.
Acute lumphangitis and lymphadenitis.
Necrosed glands and abscess formation.
Rupture of abscess occurs within 7-15 days.
Sinus and fistula formation.
Intense fibrosis with lymphatic drainage.
Secondary phase : Painful adenopathy.
Classical clinical sign:
Groove sign
A depression between the groups of inflammed nodes.
Complication:
Vulval elephantiasis
Perineal scarring
Rectal stricture
Sinus and fistula formation.
Diagnosis
Culture and isolation
Detection of LGV
Treatment:
Doxycycline 100 mg BID x 21days.
Azithromycin 1 gm PO weekly x 3 weeks
Abscess aspiration
Leucorrhoea
Leucorrhoea
Dr. Yashika
Abnormal Vaginal Discharge
Frequent complaint.
Discharge may vary from excess to normal.
Discharge may be blood-stained / contaminated with urine or stool.
Characteristics of normal vaginal fluid
Nature - watery
Colour - white
Odour - Odourless
pH - 4.0
Microscopically - Squamous epithelial cells,
Leucorrhoea
Leucorrhoea is defined as excessive normal vaginal discharge.
Features of vaginal discharge in leucorrhoea :
Excess secretion.
Non purulent
Non offensive
Non irritant
Never causes pruritis.
Etiology :
Physiological excess
Cervical causes
Vaginal causes
Physiologic excess
Puberty
Menstrual Cycle
Pregnancy
Sexual excitement
Cervical causes:
Cervicitis
Cervical ectopy
Cervical polyp
Treatment
General health improvement
Surgical treatment of cervical factors
Pill users are asked to stop pill immediately
Local hygiene
Hysterectomy
HYSTERECTOMY
Hysterectomy
Hysterectomy
Term origin:
hyster + ectomy
uterus surgical removal
Definition:
Hysterectomy is defined as the surgical removal of uterus.
Routes for Hysterectomy
Abdominal Hysterectomy
Vaginal Hysterectomy
Laparoscopic Hysterectomy
Caesarean Hysterectomy
Types of Hysterectomy
Total Hysterectomy
Removal of entire uterus.
Subtotal Hysterectomy
Removal of body or corpus leaves behind the cervix.
Panhysterectomy / Hysterectomy with bilateral salpingo oophorectomy
Removal of uterus along with tubes and ovaries of
both sides.
Indications
Hsv Herpes Genitalis
Herpes Genitalis
Dr. Yashika
Introduction
Causative organism : Herpes Simplex virus type 1 and 2
Transmission : Orogenital contact
Incubation period : 2 – 14 days.
Clinical features:
First attack with 7 days of sexual contact.
Red painful inflammatory area around clitoris, labia, vestibule, vagina, cervix and perineum.
Appearance of multiple vesicles which progress into ulcers then heals up by crusting
Lymphadenopathy
Fever, malaise and headache.
Diagnosis:
Virus tissue culture and isolation
ELISA
Fluorescent method
PCR test
Treatment
Specific treatment is yet to b explored.
Acyclovir 200 mg 5 times x 5days.
Saline water bath.
Hsg
Hysterosalpingography
Dr. Yashika
Hysterosalpingography (HSG)
Hystero + Salpingo + Graphy
HSG is a radiological procedure done to assess the interior anatomy of the uterine cavity and the shape and patency of the fallopian tubes.
It is a radiographic study using fluorescent dye to visualise the anatomy of uterus and fallopian tubes.
Indications:
Assessment of tubal patency.
Detection of uterine malformation.
Diagnosis of cervical incompetence.
Detection of translocated IUD.
Diagnosis of uterine synechiae.
Diagnosis of uterine fibroid , uterine polyp.
Diagnosis of abdominal pregnancy.
Uterine Malformation
Steps of operation
The patient is asked to remain empty bladder.
Operation is done under general anaesthesia.
The patient is placed in lithotomy position.
Local antiseptic cleaning is done.
Posterior vaginal speculum is introduced.
Anterior lip of cervix is grasped with Allis tissue forcep.
HSG cannula is fitted with a syringe containing radio opaque dye. About 5- 10 ml of dye is slowly introduced.
The passage of the dye is observed by using X-ray intensifier and a video display unit.
Two radiographic X-rays are taken. First one to show the filling of uterine cavity and other one 10-15 mins after the completion of procedure.
Timing of procedure :
HSG is done between D6 and D10 of cycle.
Antibiotics are given one day prior the procedure up to 5 days.
Contrast media
Complications
Peritoneal irritation.
Pelvic pain.
Vasovagal attack.
Intravasation of dye into the venous or lymphatic channels.
Flaring up of pelvic infections.
Human Immunodeficiency Virus - Acquired Immuno Deficiency Disease
AIDS
Dr. Yashika
Introduction
Causative agent : Human Immunodeficiency Viruses (HIV)
HIV belongs to retrovirus family (double stranded RNA).
Mode of transmission
Sexual intercourse
IV drug abusers
Blood transfusion
Use of contaminated needles
Breastfeeding
Perinatal transmission
Immunopathogenesis
Immunological Markers
CD4 T lymphocyte count
RT-PCR
Raised P-24 antigen titre
Raised serum β2 microglobulin
Clinical Presentation
Development of Ab marks the stage of seroconversion aka flu-like syndrome.
Acute infection syndrome characterized by fever, skin rash, arthralgia, lymphadenopathy and diarrhoea. This is called seroconversion illness lasts upto 2-3 weeks and gets resolved itself spontaneously.
Gynaecological Symptoms
Infections of genital tract.
Neoplasm of genital tract.
Menstrual abnormalities.
Fertility and pregnancy are not affected.
Diagnosis
Detection of IgG antibody.
ELISA
Western blot
PCR
Treatment
Gonorrhoea
GONORRHOEA
Dr. Yashika
Introduction
Causative agent : Neisseria gonorrhoea (gram negative diplococcus).
Incubation period : 3-7 days.
Site of invasion : columnar and transitional epithelium of the genitourinary tract.
Primary sites of infection : endocervix, urethra and Bartholins gland.
Other sites of infection : Oropharynx, anorectal and conjuctiva.
Clinical features :
Local:
Excessive irritant vaginal discharge
Dysuria
Acute unilateral pain
Swelling over labia.
Pharyngeal infection
Intermenstrual bleeding.
Rectal discomfort.
Signs :
Swollen labia and inflammed.
Mucopurulent vaginal discharge.
Speculum examination reveals congested endocervix.
Distant symptoms :
Perihepatitis
Septicaemia
Complications:
PID
Infertility
Ectopic pregnancy
Chronic pelvic pain
Tubo ovarian mass
Bartholins gland abscess.
Diagnosis
Nucleic acid amplification test (NAAT)
urine culture
Drug sensitivity test.
Treatment
Adequate therapy for gonococcal infection.
To treat both the partner simultaneously.
To avoid multiple sex partner.
To use condom till free from disease.
Cervical biopsy
Cervix Anatomy
Lowermost part of uterus
Cylindrical shape
Diameter and length are 2.5 cm.
Parts Supravaginal
Infravaginal
Extends from histological internal os to anatomical external os.
Nulliparous - Pin hole cervix
Parous - Bilateral slit
Cervical Biopsy
Punch Biopsy
Wedge Biopsy
Ring Biopsy
Whole of squamo-columnar junction area of the cervix is excised with a special knife.
The tissue is subjected to serial section to detect cervical intraepithelial neoplasia (CIN) or early invasive carcinoma.
Cone Biopsy - Conization
Complications
Thank you
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We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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STIs may cause PID. For the both disease, herbal medicine Fuyan Pill can be a solution.
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Light House Retreats: Plant Medicine Retreat Europe
Our aim is to organise conscious gatherings and retreats for open and inquisitive minds and souls, with and without the assistance of sacred plants.
The Best Ayurvedic Antacid Tablets in India
Treat the symptoms of indigestion, heartburn and stomach reflux with the 10 Best Ayurvedic Antacid Tablets in India.
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Identification and nursing management of congenital malformations .pptxMGM SCHOOL/COLLEGE OF NURSING
Identification and nursing management of congenital malformations Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
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hsg.pptx
- 2. Hysterosalpingography (HSG) Hystero+Salpingo+Graphy • HSG is a radiological procedure done to assess the interior anatomy of the uterine cavity and the shape and patencyofthefallopiantubes. • It is a radiographic study using fluorescent dye to visualisetheanatomyofuterusandfallopiantubes.
- 3. Indications: • Assessmentoftubalpatency. • Detectionofuterinemalformation. • Diagnosisofcervicalincompetence. • DetectionoftranslocatedIUD. • Diagnosisofuterinesynechiae. • Diagnosisofuterinefibroid,uterinepolyp. • Diagnosisofabdominalpregnancy.
- 5. Steps of operation 1. The patient is asked to remain empty bladder. 2. Operation is done under general anaesthesia. 3. The patient is placed in lithotomy position. 4. Local antiseptic cleaning is done. 5. Posterior vaginal speculum is introduced. 6. Anterior lip of cervix is grasped with Allis tissue forcep.
- 6. 7. HSG cannula is fitted with a syringe containing radio opaque dye. About 5- 10 ml of dye is slowly introduced. 8. The passage of the dye is observed by using X-ray intensifier and a video display unit. 9. Two radiographic X-rays are taken. First one to show the filling of uterine cavity and other one 10-15 mins after the completion of procedure. Timing of procedure : HSG is done between D6 and D10 of cycle. Antibiotics are given one day prior the procedure up to 5 days.
- 8. Complications • Peritonealirritation. • Pelvicpain. • Vasovagalattack. • Intravasationofdyeintothevenousorlymphatic channels. • Flaringupofpelvicinfections.