This document provides information on endometriosis including:
- Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus, most commonly on the ovaries, fallopian tubes, and pelvic peritoneum.
- Stages of endometriosis range from minimal to severe based on the extent of growth and severity of symptoms. Symptoms include pelvic pain and infertility.
- Risk factors include family history, early menarche, and nulliparity. Evaluation involves obtaining a detailed health history and performing a pelvic examination.
This power point describes in nut shell hte definition, etiopathogenesis, clinical features, gross , histological and MRI findings in adenomyosis and its management
This power point describes in nut shell hte definition, etiopathogenesis, clinical features, gross , histological and MRI findings in adenomyosis and its management
This module explores the ups and downs of within the mobile catering industry, the obstacles that may occur and how to maximise your start ups effectiveness and efficient.
Module 7, "Making Profit from Imagination" examines the keys concepts of the business sector in relation to finance. It gives a brief overview of business finance, including turnover, business costs, cash flow, financial planning, and other routes to finance.
Millones y millones de personas se han bautizado sin realmente entender el significado de esta practica. Descubre los orígenes y el significado del "bautismo" (TEVILAH).
Que significa ser bautizado en agua?
Que significa ser bautizado en Espiritu Santo y Fuego?
El deseo de mi corazón es que mediante esta meditación en la palabra del Eterno puedas comprender el llamado que hay detrás de este acto simbólico de purificarse mediante el agua que Jesus (Yeshua) y los apóstoles profesaron. Shalom.
“Señor, ayúdame a agradecerte y a contar más mis bendiciones y no poner los ojos en las cosas del mundo que pronto perecen, sino poner los ojos en Ti, que vives para siempre.”
En Tu nombre Jesús; ¡Amén!
El uso de portafolios en la Educación Superior: El ejemplo de la Educación Médica.
Conexiones: Plataforma de Ciencias del Aprendizaje se enfoca en:
- Asesoría y acompañamiento “in situ”
- Formación continua
- Investigación
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Alun Roberts presentation to Offshore Renewables - Wind conference in London December 6 about new offshore wind projects in the pipeline and the consequential demands for the supply chain.
Endometriosis: an invisible and neglected disease that affects 180 million women. Celebrities and famous women over the years have been known to be affected by this Queen Victoria to Marilyn Monroe to Katrina Kaif who had surgery for endometriosis.
Endometriosis: an invisible and neglected disease that affects 180 million women. Celebrities and famous women over the years have been known to be affected by this Queen Victoria to Marilyn Monroe to Katrina Kaif who had surgery for endometriosis. The old theories of Endometriosis such as Sampsons Theory Angiogenesis, Lymphogenesis theory are no longer acceptable. The Epigenetic/ Genetic theorey has been postulated. ROle of biomarkers in diagnosis Risk factrs affecting Endometriosis and Risk of Cancer is discussed
endometriosis is a common, benign, and chronic disease in women of reproductive age that is characterized by the occurrence of endometrial tissue ourside the uterus.
for more informations you can read this file.
An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus.
Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus.
It is the benign kind of Gestational Trophoblastic Disease (GTD) while the cancerous kind is Invasive mole, Epithelioid trophoblastic tumor, Choriocarcinoma and Placental Site Tumor. H. Mole could lead to Invasive moles or Choriocarcinoma if not treated immediately with prophylactic chemotherapy.
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
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.
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
4. Clinical Evaluation of patient with endometriosis
History
Examination
Diagnosis
Treatment
Complication
Differential diagnosis
Prevention
Prognosis
Follow-up
Conclusion
5.
6. Functional human uterus are receiving the
embryo, to give shelter to the foetus during
pregnancy and delivering the newborn at
term. The uterus is a pear-shaped, muscular,
hallow organ with a triple-layered wall:
i. Myometrium (middle tunica mucosa)
ii. Perimetrium ( outer tunica serosa)
iii. Endometrium (inner most layer)
7. Endometriosis is originated from the word
endometrium.
The endometrium is the layer in which the
implantation takes place. It experiences
morphologic and functional changes that are
closely associated with the cyclic release of
sexual hormones.
In the light of the above, if implantation
doesn't occur the layer of the endometrium
shed and expulsed, leading to menstruation.
8. Endometriosis is a benign gynaecological disease
characterized by the presence of functional
endometrial glands and stroma outside the uterus
(ectopic).
In a typical patient, the ectopic implants are
located
in the dependant portions of the female pelvis:
9.
10. Because is a chronic oestrogenic-
dependant inflammatory disease, it
therefore affects approximately 10%
of women of reproductive age.
11. The public health burden of endometriosis
remain elusive because of the mode of
diagnosis of the disease, giving us a lack of
reliable data annually.
Moreover many women are asymptomatic
and endometriosis lesions heal
spontaneously in them without a diagnosis
been previously made.
13. There is a 10-folds increase incidence in women
with an affected first degree relative(family
history). And as well as monozygotic twins are
markedly concordant for endometriosis.
Rate of endometriosis was found to increase
with age from 12% in females ages 11-13 years
to 45% in females aged 20-21years and peak
incidence between ages of 25 and 35 years.
14. Endometriosis is classified into one of four
stages depending on the following;
Size, location
Type
Extent
Depth of endometriosis implants
Presence and severity of adhesions
Presence and size of ovarian endometriomas
18. 1. Superficial peritoneal lesions is typically
located on the pelvic organs /pelvic
peritoneum
subtypes:
I. Classic bluish or blue-black lesion
(powder-burn)
II. Non-classic lesions or clear and red or
white lesions (flame-like)
2. Endometrioma /Endometriotic Cyst
3. Deep endometriosis
19.
20. Stage I
Stage II
Stage III
Stage IV
minimal 1-5
mild 6-15
moderate 16-40
severe >40
21. Minimal (stage I) or mild(stage II)
endometriosis, is characterized by superficial
implants and mild adhesions. And majority of
women have these stage of endometriosis.
While moderate(stage III) and severe(stage IV)
endometriosis is characterized by chocolate
cysts and more sever adhesions. The stages of
endometriosis is not a criteria for the presence
of severity of symptoms, in the same vain
infertility is likely with stage IV endometriosis.
22.
23.
24. 1.Retrograde Menstruation
Retrograde menstruation theory is one of the
oldest principle that explains the
aetiopathogenisis of endometriosis, this occur
due to the retrograde flow of sloughed
endometrial cells/debris via the fallopian
tubes into the pelvic cavity during
menstruation.
However, retrograde menstruation occurs in
76%-90% of women with patent fallopian
tubes and not all of these women have
endometriosis.
25. Factors obstructing menstruation are,
congenital abnormalities, including
imperforate hymen and iatrogenic
cervical stenosis etc.
The location of superficial
endometriotic lesions in the posterior
aspect and left side of the pelvis may be
due to the effects of gravity on
regurgitated menstruation product and
the anatomical position of the sigmoid
colon.
26. 2.Coelomic Metaplasia
These theory postulates the origin of
endometriosis from metaplasia of specialised
cells that are present in the mesothelial lining
of the visceral and abdominal peritoneum
Hormonal or immunological factors
stimulates the transformation of normal
peritoneal tissue/cells into endometrium-like
tissue.
27. These theory clearly explains the occurrence of
endometriosis in pre-pubertal girls even thou
oestrogen which is the driving force of endometrial
growth is not present in them and therefore this
condition may be different from endometriosis that
is found in women of reproductive age.
According to this theory, residual embryonic cells of
the wolffian or mullerian ducts persist and develop
into endometriotic lesions that respond to oestrogen.
these describes the hormon-dedpendent
transformation of peritoneal cells into mullerian-
type cells in adolescent.
28. 3. Oxidative stress and
inflammation
Reactive oxygen species (ROS) causes lipid
per-oxidation which leads to DNA damage in
endometrial cells, resulting to increase
water and electrolyte in the peritoneal fluid
which harbours the source of ROS.
Iron overload occur in the peritoneal
cavities from the breakdown of
haemoglobin, which in turn causes redox
reaction.
29. The release of the pro-inflammatory
heam products and the oxidative stress
signals generated from the ROS causes
inflammation which leads to the
recruitment of lymphocytes and
activated macrophages producing
cytokines that induce oxidizing of
enzymes and promotes endothelial
growth.
30. excess proliferation of ROS is accomplished
by a decreased level of antioxidants which
usually eliminates these molecules.
The resulting accumulation of ROS may
contributes to the propagation and
maintenance of endometriosis and
associated symptoms.
31. 4. Immune Dysfunction
Autoimmune disease is more
common in women with
endometriosis. This is due to
regurgitation of endometrial cells
into the peritoneum which triggers an
inflammatory response causing the
recruiting of activated macrophages
and leukocytes.
32. This inflammatory response leads to a
defective immune-surveillance that prevents
elimination of the menstrual debris and
promotes the implantation and growth of
endometrial cells in the ectopic sites.
These theory explains better why women
with endometriosis have higher
concentration of activated macrophages,
decreased cellular immunity as well as a
repressed NK cell function.
33. 5.Stem Cells
stem cells are undifferentiated cells,
characterized by their ability to self-renew
and differentiate into one or several types of
specialized cells.
Due to the natural ability of the stem cells to
regenerate, the stem cells then give rise to new
Endometriotic deposits, these pathogenesis
supports the possibility of retrograde
menstruation which provides an access for the
endometrial stem cell to extra uterine
structure.
34. Monthly, there is regeneration of the
endometrium after menstrual shedding and re-
epithelisation of the endometrium after
parturition or surgical curettage, these all
support the existence of a stem cell pool and
resides in the basalis layer of the endometrium.
Resulting in the formation of ectopic
endometrial lesions.
However these stem cells may be transported
via the lymphatic or vascular pathways to
ectopic sites. Some of the endometrial stem
cells have bone marrow origin and further
supports the haematogenous dissemination
theory of these cells.
35. 6. Apoptosis Suppression and
Alteration of Endometrial Cell Fate
Alteration of the endometrial cell fate to favour
antiapoptotic and pro-proliferation phenotype is
paramount for the survival of the endometrial cells in
the peritoneal cavity to initiate ectopic deposits and for
the maintenance of the established lesions.
The inhibition of the apoptosis of endometrial cells
may also be mediated by the transcription activation of
genes that normally promotes inflammation,
angiogenesis, and cell proliferation.
36. Red lesions /early endometriosis
Black lesions /advanced
endometriosis
White lesions / healed endometriosis
37. Genetics (positive family history)
Nulliparity
Early menarche
Hormones
Obesity
Uterine retroversion
Miscarriage.
38. Although a significant number of women with
endometriosis remain asymptomatic, but
symptomatic patients can be variable and
reflects the depth and area of involvement.
Signs and symptoms includes:
1.Pelvic pain
2.Dysmenorrhoea
3.Dsyparinuria
39. 4.Dysuria
5.Dyschesia (pain on defecation) often with cycles of
diarrhoea and constipation
6.Lower abdominal pain or back pain (worsen during
menstrual period)
7.Inguinal pain
8.Pain during exercise
9. Heavy or irregular bleeding
10. Bloating, nausea and vomiting
42. History taking is an essential aspect in the
evaluation of a patient with endometriosis, the
following guidelines must be observed.
Having completed your bio data, the necessary
important history based on the chief
complaints of the patient with endometriosis
must be asked.
Infertility/ pain is usually the chief
complains of patients with
endometriosis.
44. 2. Menstrual History
Menarche and menopause
1st
day of last menstrual period
Length of bleeding
Frequency
Regularity
Bleeding between periods
Bleeding after intercourse
Post menopausal bleeding
Nature of periods
Heavy?
Clots?
Flooding?
45. 3. Past Gynaecological History
Gynaecological symptoms
Gynaecological diagnosis
Gynaecological surgery
Date & result of cervical smears
Conception
46. 4. Past Obstetrics History
Gravity & Parity
Dates of deliveries
Length of pregnancy
Mode of delivery
Weight of babies
Sex of babies
Complication before, during & after delivery
Days spent before discharged.
47. 5. Past Medical History
Current or past illnesses
Hospital admission
Past surgeries
48. 6. Drug History
Current medication
Prescribed/ over the counter medication
Herbal Remedies
Recreational drugs
Any known drug allergies.
49. 7. Contraception
Types of contraception
Side effects of contraception
Any history of unprotected intercourse
50. 8. Family History
History of endometriosis (occurs 10 times in
someone with positive family history)
Gynaecological condition
Malignancies
Consanguinity
History of demise, causes and age at demise.
51. 9. Social History
Occupation
Alcohol, how often and quantity
Smoking, how often.
52. 10. Other history
Sleep pattern
Change in bowel movement
Micturation
Defecation
Weight loss/gain
Addiction
53. Majority of patient with endometriosis do not
frequently present with physical findings beyond
tenderness related to the site of involvement. The
hallmark of finding on examination of a patient
with endometriosis is pelvic examination. Major
finding:
On pelvic examination
Tender nodular masses
Adenexia mass
Bluish nodule is seen as a result of infiltration
from the posterior vagina wall.
Cervicities
Foul smelling vaginal discharge
54.
55. Methods of diagnosis
1. Invasive diagnosis
a. Laparoscopy
b. Microlaparoscopy
2. Non invasive diagnosis
a. Therapeutic trials
b. Imaging: USS,CT, MRI
c. Endometrial nerve fibers
d. Serum markers
v. Other.
56. Invasive Diagnosis
Laparoscopy: is the gold standard diagnostic
test.
Advantages
1. Excludes other condition e.g. ovarian cancer
2. Treatment of endometriosis
Disadvantages
1. requirement for surgery and anaesthesia
2. risk of major complications (bowel perforation)
3. visible inspection doesn't detect deep
endometriosis.
57. Technique
It has two approaches which includes;
Inspection of D pouch, US lig, Pelvic side
walls, Anterior surface of the ovary
(adhesion). It endure complete evaluation,
inspection of the pelvic is in a clockwise
fashion.
Biopsy in case there is a doubt.
58. Findings:
A. Peritoneal
i. Typical endometriosis : Black-blue, powder-burn
appearance, and doesn't require any biopsy.
ii. Atypical endometriosis: Lesion that lacks the
typical black-blue, powder-burn appearance but
however diagnosis may be difficult with standard
laparoscopy so biopsy is necessary for confirmation
of diagnosis.
B. Endometrioma
59. 1. Near-contact: it magnifies the peritoneal area
2. Peritoneal blood painting: flowing erythrocytes
outline surface irregularities.
3. Examined from different angles and at
different degrees of illumination: it shows
vesicles or whitish lesions.
4. Direct vision
5. Laparoscopic visualization of peritoneal lesions
is of limited accuracy, and biopsy confirmatory.
6. Bubble test: posterior cul de sac is irrigated with
short bursts of saline under controlled pressure. It
increases the level of triglycerides in the
peritoneal fluid.
61. Non Invasive Diagnosis
Therapeutic trials
i. Pain suggestive of endometriosis
ii. Women not trying to conceive
iii. No pelvic mass
Chronic pelvic pain
i. Unrelated to menstruation
ii. Unrelieved by NSAID & antibiotics
iii. Is clinically suspected.
62. Imaging
1. Transvaginal ultrasound
First line investigational tool for the suspecting
endometriosis
Visualization of deep nodules (retrovaginal
septum)
Results :
Anechoic to echogenic cysts
Masses containing multiple septations & solid
tissue
Cysts with low-level echoes ( this is the
commonest finding 0f about 95%).
63. 2. Transrectal ultrasound: it detect
Rectal involvement
Depth of infiltration
Lesions on the posterior bladder wall.
3. CT : it has an important role in detecting an
unrelated involvement and possible renal
insufficiency.
It has been replaced by MRI due to,
poor specificity
High radiation
64. 4. MRI: it helps to detect pigmented hgic lesion and
inadequately localized lesions.
Posses greater sensitivity which detects about
75% of mild disease
Evaluation of deep lesions
Is also superior to ultrasound in diagnosis
rectosigmoid lesions and bladder of the
endometriosis
Disadvantages
It is expensive
And not readily available
65. 5. Endometrial nerve fibers: they are
reported to be small unmyelinated
sensory C fibers in the functional layer
of endometrium which are identified by
their staining with PGP9.5, VIP, and
substance P, but not with neurofilament
66. 6. Serum makers: is a useful marker for
monitoring treatment.
Others:
Cystoscopy : for bladder endometriosis
Sigmoidoscopy or colonoscopy: for transmural
bowel lesions
Ultrasound-guided fine needle aspirate: for
endometriosis in the rectosigmoid ,
rectovaginal septum, or in abdominal scars.
IVP, barium study.
67.
68. Treatment for endometriosis can be
expectant, medical, or surgical depending on
location, depth, severity of symptoms and as
well as the desire of the patient to maintain or
restore fertility.
Medical treatment:
Is used in patients with pelvic pain or
dyspareunia and the aim of treatment is to
focus on hormonal manipulation of the
menstrual cycle to create the state of
pseudopregnancy, pseudomenopause, or
chronic anovulation..
69. Medication includes
1. Danazol
2. Gonadotropin-releasing hormone agonists
3. Oral contraceptive pills and other
4. Progestational agents
70. Surgical treatment can be :
A. Conservative
B. Definitive
A. Conservative Surgery
These can be performed with laparoscopy or
laparotomy
And the success rate is however high, but
implant recurrence occurs in 28% of patient
at 18 months after surgery and 40% by 9
years.
Adhesion recur in 40-50% of patients
71. B. Definitive surgery
These include
Hysterectomy and oophorectomy
Is usually reserved for women with
intractable pain. And in one severe cases, one
ovary may be retained.
Endometriosis may recur with exogenous
estrogens replacement therapy, even in
patient who has undergone oophorectomy.
72.
73. Complications of endometriosis includes the
following:
1. Bleeding : forming bands of scar tissue leading to
adhesion which then attaches to the organs in the
pelvis and abdomen.
2. Infertility : usually of unknown origin, and may be
caused by adhesions forming on or close to the
ovaries and fallopian tubes.
3. Miscarriage or premature birth
4. Cancer (most esp. Ovarian cancer)
5. Blocked or twisted bowel : due to endometriosis
of the intestine
6. Adhesion
76. Prevention of endometriosis includes a wide
range of activities known as interventions
Its aim is to reduce risks of threats to health.
These leads us to the three categories of
prevention of endometriosis;
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
77. Primary prevention:
Its aim at preventing disease or injury of
endometriosis before it ever occurs.
This is done by;
i. Preventing exposures to hazards that can cause
disease or injury which alters unhealthy
behaviours that can lead to endometriosis.
ii. Enforcement to ban or control the use of
hazardous substances.
iii. Education about healthy and safe habits.
78. 2. Secondary prevention:
Aims to reduce the impact of endometriosis or
injury that has already occur. This is done by;
i. Regular examination and screening to detect
endometriosis in its earliest stage.
ii. To treat endometriosis as soon as possible to slow
its progression.
ii. Encouraging personal strategies to prevent re-
injury or recurrence, and implementing programs
to return people to their original health.
iv. To prevent long-time complications of
endometriosis.
79. 3. Tertiary prevention:
Aim to reduce the impact of an ongoing illness or
injury that has lasting effects, and is done by;
i. Helping people to manage long-term, often-
complex health problems and injuries, in order to
improve as much as possible their ability to
function, their quality of life and life expectancy.
ii. Support groups that allow people to share
strategies for living well
iii. Vocational rehabilitation programs to recover as
early as possible.
80.
81. The recurrence rate five years following surgery
is between 20% and 40%, providing menopause
has not been reached and hysterectomy has not
been performed
Women who have undergone treatment for
endometriosis needs to attend periodic
examinations so they can be monitored using
sonography
Note that endometriosis may recur after surgery
or medical intervention if the underlying p causes
is not probably treated.
82. Endometriosis is often a chronic disease, and
thorough discussions to ensure a good level of
patient understanding is essential.
It’s important to assess your level of symptoms,
your desire to have children in the future, as well as
your social and occupational needs for better health.
Comprehensive follow-up will aid in the assistance
of total rehabilitation.
83. Majority of patients with endometriosis will
have increasing fertility problems.
Fortunately, the results of assisted
reproduction (such as IVF) after treatment
for endometriosis are very good.
While some of these patients , even if they
have an initial problem with their fertility,
end up becoming pregnant after adequate
and carefully monitored treatment.
84. In the same vain, some patients will require
a higher level of technology to achieve a
pregnancy, such as IVF or GIFT.
Note that, pregnancy is not a complete and
definitive cure for endometriosis, the
combination of pregnancy and breastfeeding
significantly slows down the course of the
disease and may even get rid of it entirely.