The document discusses various gynecological procedures including:
1. Dilatation and curettage which is used to dilate the cervix for procedures like hysteroscopy or IUD insertion and to curette the uterine cavity to diagnose or treat conditions.
2. Anterior and posterior colporrhaphy which are used to repair cystocele and rectocele by incising and suturing the anterior and posterior vaginal walls.
3. Fothergill's operation which is used to treat combined vaginal and uterine prolapse and involves cervical amputation and shortening of ligaments.
4. Various myomectomy and hysterectomy techniques for removing fibroids and
Urinary Tract Fistulas -(VVF) Etiology, Diagnosis, ManagementVikas V
Urinary Tract Fistulas - Etiology, Diagnosis, Management
Surgical and Relevant Anatomy, Classification, eitiology, VVF in Detail, Examination and Diagnosis, Management of VVF - Both Conservative And Surgical Management - Steps of Surgical Management, Post operative Management.
Urinary Tract Fistulas -(VVF) Etiology, Diagnosis, ManagementVikas V
Urinary Tract Fistulas - Etiology, Diagnosis, Management
Surgical and Relevant Anatomy, Classification, eitiology, VVF in Detail, Examination and Diagnosis, Management of VVF - Both Conservative And Surgical Management - Steps of Surgical Management, Post operative Management.
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.
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.
Cervical incompetence is the inability for the cervix to retain an intra-uterine pregnancy till term as a result of structural and functional defects of the cervix.
Genital prolapse is the descent of one or more of the genital organ (urethra, bladder, uterus, rectum or Douglas pouch or rectouterine pouch”) through the fasciomuscular pelvic floor below their normal level.
Pelvic organ prolapse
Etiology of pelvic organ prolapse
Vaginal vault prolapse
Etiological factors of vault prolapse
Signs and symptoms of vaginal vault prolapse
Diagnosis of vaginal vault prolapse
Treatment measures
Uterine prolapse occurs when weakened or damaged muscles and connective tissues such as ligaments allow the uterus to drop into the vagina. Common causes include pregnancy, childbirth, hormonal changes after menopause, obesity, severe coughing and straining on the toilet.
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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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
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
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
2. DILATATION & CURETTAGE
Indications
A. Dilatation of the cervix
1.A preliminary to curettage
2.Prior to hysteroscopy
3.As a step of other operations e.g. cervical
amputation or Fothergill repair
ABOUBAKR ELNASHAR
3. 4. Insertion of IUD in stenotic cervix
5. Introduction of intracervical or intrauterine radium
6. Cervical stenosis
7. Spasmodic dysmenorrhea
8. Drainage of pyometra or haematometra
ABOUBAKR ELNASHAR
4. B. Curettage of the uterine cavity
1.Diagnosis & treatment of abnormal uterine
bleeding
2.Diagnosis of endometrial cancer
3.Diagnosis & treatment of endometrial hyperplasia,
endometrial polypi & submucous myoma
4.To detect ovulation & its defects in infertility
5.Removal of IUCD
ABOUBAKR ELNASHAR
11. Perforation of the uterus
Diagnosis: Sound, dilator or curette is passed beyond
the pre-determined length of the uterus.
Management:
1.Avoid the part where perforation occurred (no
necessarily to stop)
2.Observation: hemorrhage, peritonitis
3.Laparotomy: intestine is exposed for possible injury,
uterine wound is sutured, peritoneal cavity is lavaged
& drained
ABOUBAKR ELNASHAR
13. ANTERIOR COLPORRHAPHY
Indications: Cystocele
Steps: 1. Anterior vaginal wall incision
2. The anterior vaginal wall is separated from the
bladder & the bladder is pushed to its normal
position as a pelvic organ
3. Plication of the the pubovesical fascia beneath
the bladder to form a shelf
4. Redundant vaginal wall is removed
5. Vagina is closed in the midline
ABOUBAKR ELNASHAR
17. Posterior colpoperineoraphy
Indication: Rectocele
Steps
1. Incision at the mucocutaneous junction.
2. The posterior vaginal wall is separated from the rectum
3. The 2 levator ani are approximated in front of the rectum
4. Redundant vaginal wall is removed
5. The superficial perineal muscles are approximated in the
midline
6. The vagina is closed
7. The skin of the perineum is closed
ABOUBAKR ELNASHAR
19. FOTHERGILLS OPERATION
Indication
Combined vaginal & uterine prolapse with
supravaginal elongation of the cervix
Steps
1.Dilatation & curettage: Dilatation to cover the
cervical stump. Curettage to exclude uterine
pathology
2.Anterior colporrhaphy: repair cystocele
ABOUBAKR ELNASHAR
20. 3. Amputation of the cervix: restore the normal
length of the cervix
4. Shortening & approximating of the
Mackenrodt ligaments in front of the cervix:
elevate the uterus & pull the cervix
posteriorly to correct the retroversion
5. Posterior colpoperineoraphy: repair
rectocele & to strengthen the lax pelvic floor
to prevent recurrence
ABOUBAKR ELNASHAR
21. MYOMECTOMY
Indication
Symptomatizing patient who did not complete her
family
Types
1.Abdominal
2.Vaginal
3.Hysteroscopic: submucous <5cm
4.Laparoscopic: Pedunculated subserous
ABOUBAKR ELNASHAR
29. Types of abdominal hysterectomy
• Subtotal: removal of the uterus with preservation of
the cervix
• Total: removal of the uterus & cervix
• Pan: total with bilateral salpingo-oophrectomy
• Radical: removal of the uterus, cervix, parametrial
tissue, endopelvic fascia, uterosacral ligaments &
pelvic lymph nodes
ABOUBAKR ELNASHAR
32. • Cesarean hysterectomy:
• removal of the uterus after C.S e.g. atonic postpartum
hemorhage or placenta accreta.
• Hysterectomy-en-toto: Removal of the uterus with a
contained dead fetus without opening the uterus to
decrease blood loss e.g. couvelaire uterus
ABOUBAKR ELNASHAR
33. Types
1. Extrafacial:
removal of the uterus with its fascial layer. It is the
operation usually performed
2. Intrafascial:
The outer (endopelvic) fascia is left attached to the
bladder. It is used when it is difficult to dissect the
bladder from front of the cervix e.g. adhesions from
previous CS.
ABOUBAKR ELNASHAR
35. Steps
1. Division & ligation of the round ligaments
2. Division & Ligation of the tubes & ovarian
ligaments if the ovaries will be left, or the infundibulo-
pelvic ligaments if the ovaries will be removed.
3. Incise the peritoneum of the vesicouterine pouch
by extending the incision in the anterior leaf of the
broad ligament, then dissect the bladder downward
ABOUBAKR ELNASHAR
36. 3. Clamp the uterine arteries & divide them
4. Uterosacral ligaments & Mackenrodtks ligaments
are divided & ligated.
5. The vagina is divided from its attachment to the
cervix.
ABOUBAKR ELNASHAR
37. Indications
(1) Prophylactic (elective).
Suspected cervical incompetence.
Cerclage at 14 weeks {early miscarriage caused by
other factors}.
(2) Urgent (therapeutic)
Asymptomatic women with sonographic evidence of
cervical shortening and/or funneling
(3) Emergency (salvage) cervical cerclage
ABOUBAKR ELNASHAR
38. • Indications:
(ACOG, 1996)
1. History compatible with incompetent cervix AND
2. Sonogram demonstrating funneling OR
3. Clinical evidence of extensive obstetric trauma
to cervix
Cerclage
should only be considered when the history of
miscarriage is preceded by spontaneous rupture
of membranes or painless cervical dilatation
(RCOG,2002).
ABOUBAKR ELNASHAR
43. Technique
No bladder dissection, and the cervix is closed using
four or five bites with the needle to create a purse
string around the cervix. placed high on the cervix,
with a non-absorbable suture or a 5 mm band of
permanent suture.
Burried technique
(Jenning, 1972)
The successive bites reenter the cervix at the
previous point of exit, so the suture remains
submucosal. Vaginal discharge & vaginitis are
less
ABOUBAKR ELNASHAR