Uterine Fibroids (Leiomyomata): Investigations and Treatment Michelle Fynes
Uterine fibroids (UF) are the most common benign neoplastic threat to women's health, costing hundreds of billions of health care dollars worldwide. The objective of this presentation is to review risk factors, aetiology, classification and clinical presentation of Uterine fibroids.
Gestational trophoblastic disease (GTD) is a group of pregnancy-related conditions that develop inside a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta. The placenta is the organ that develops during pregnancy to feed the fetus.
Uterine Fibroids (Leiomyomata): Investigations and Treatment Michelle Fynes
Uterine fibroids (UF) are the most common benign neoplastic threat to women's health, costing hundreds of billions of health care dollars worldwide. The objective of this presentation is to review risk factors, aetiology, classification and clinical presentation of Uterine fibroids.
Gestational trophoblastic disease (GTD) is a group of pregnancy-related conditions that develop inside a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta. The placenta is the organ that develops during pregnancy to feed the fetus.
this lecture involves full, simple and easy description of cervicitis
including acute and chronic cervicitis and the major causes for it as Neisseria gonorrhea and chlamydia trachomatous
also chronic infection and ectopy
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
Endometrial hyperplasia - irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium
Endometrial Ca - most common gynaecological maglinancy in the western country, endometrial hyperplasia as the precursor
Incidence of endometrial hyperplasia 3 folds higher than endometrial Ca
Fourth most common cancer in women in Peninsular Malaysia
Presentation at Chittaranjan Seva Sadan, Kolkata where Dr Dasgupta was invited as faculty in the CME organized by Medical Education and research Committee, Bengal Obstetrics and Gynaecological Society
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
female Genital tuberculosis,TB-PCR, female infertility, veerendrakumar cm
female genital TB poses stiffest challenge in the diagnosis, rapid molecular techniques have helped in arriving at a definitive diagnosis in suspicious clinical setting
this lecture involves full, simple and easy description of cervicitis
including acute and chronic cervicitis and the major causes for it as Neisseria gonorrhea and chlamydia trachomatous
also chronic infection and ectopy
Preterm labor is the labor that starts before the 37th completed week. In this presentation, we will discover causes, pathogenesis, diagnosis, clinical features, and management principles for preterm labor along with the most recent evidence.
Endometrial hyperplasia - irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium
Endometrial Ca - most common gynaecological maglinancy in the western country, endometrial hyperplasia as the precursor
Incidence of endometrial hyperplasia 3 folds higher than endometrial Ca
Fourth most common cancer in women in Peninsular Malaysia
Presentation at Chittaranjan Seva Sadan, Kolkata where Dr Dasgupta was invited as faculty in the CME organized by Medical Education and research Committee, Bengal Obstetrics and Gynaecological Society
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
female Genital tuberculosis,TB-PCR, female infertility, veerendrakumar cm
female genital TB poses stiffest challenge in the diagnosis, rapid molecular techniques have helped in arriving at a definitive diagnosis in suspicious clinical setting
genitourinary tb - contains radiological findings of genitourinary tuberculosis including ivp,, hsg, usg and ct findings in kidney, ureter, urinary bladder, uterus and prostate
Tuberculosis (TB) is a very common disease worldwide including India. Tuberculosis of the female genital tract is
common enough to be found in 1% of women with DUB (Sutherland 1949) and in 4% of adolescent with excessive
menstrual loss (Sutherland 1953). The commonest site of involvement is the fallopian tubes (90e100%). The next
common site is endometrium (60%). The infection is from the tubes either by lymphatics or direct spread through
continuity. Symptoms vary according to the severity site and stage of the disease. Anti tuberculosis chemotherapy is the mainstay of tt. Initially drugs are used for 2 months. These are isoniazid, rifampicin, pyrazinamide and ethambutal. Treatment is continued for another 4 months with isoniazid and rifampicin.
a presentation about UTI. information from various textbooks and different journals and also from many peoples presentation is accumulated in this one file. i worked very hard for this project.
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
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Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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
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.
2. INCIDENCE
0.75-1%
5% in all female pelvic infections
Occurs in 10% cases of pulmonary tuberculosis
Mostly effects-reproductive age group
3. INC TREND….
Inc in population with overall rise in tuberculosis cases
HIV infection with inc incidence of pulmonary and
extrapulmonary forms of tuberculosis including drug
resistant forms.
4. SOURCE
Sec to focus elsewhere in body
Direct innoculation over vulva,vagina during sexual
intercourse with a partner suffering from tuberculous
lesions of genitilia
5. MODE OF SPREAD
Blood stream
7%-bovine org
1-2%-ascends through the genital tract
10. Tuberculous endosalphingitis
Tube- thickened, enlarged, tortuous
5%- fimbrial end is pouting, everted, open
Periodic spill of tubal exudate - frequent exacerbations
After HSG –with oil contrast –in the wall of flare up
Caseation in wall of tube, collection of cheesy material –
pyosalphinx
Dense adhesions
11. Contents-sterile
But liable to recurrent attacks by pyogenic organisms
wrong diag -subacute,recurrent PID
Sometimes endosalphinx - hyperplastic oedematous
pattern- ectopic preg
Mucosa- granulomatous lesion with chr inflam infiltration
Caseation –late stage
12. TUBERCULOUS EXOSALPHINGITIS
Direct extension from adjacent organs
Peritoneal surface –miliary tubercules
Ampullary portion-dilated
Fimbrial end-open,pouting
TOBACCO – POUCH APP
FROZEN PELVIS
Trauma,Fistula-attempt to separate adhesions
14. Diagnosis-
Histopathology- caseation, gaint cells, clusters of epithelial cells
,lymphocytic infiltration
Early- several sections need to be studied before tubercles
detected
Late- typical gaint cells
DD-
oil granuloma after HSG
Catgut reaction in case of prev sx foreign body reac
Sarcoidosis
Fungus infection
25. Abdominal mass
Usually mass is immobile
A doughy feel –tb peritonitis
FISTULA FORMATION-
Following sx for abscess
26. CLINICAL SIGNS
General cond- good mostly
Tb peritonitis- abd doughy
Tb encysyed cyst- immobile,sometimes tender
-tymphanic on percussion
Pelvic adnexal mass- small,fixed
-frozen pelvis
27. HSG in asymptomatic-
Lead pipe app
Beading & variation in filling density
Calcification of tube
Cornual block
Jagged fluffiness of tubal outline
Vascular and lymphatic invasion of dye
Tobacco-pouch and dilated distal end of tubes due to
hydro/pyosalphinx
In proven case CI-spred the infection
28. PID fail to respond, recurrent infec without
polymorphonuclear leucocytosis
Healed extragenital lesion suff from infertility, menstrual
disorders,pelvic mass –suspect
Cx ulcer- mimic ca
30. Blood- wbc,ESR raised….
-periodic examination is of value
Montoux test-
positive test-sensitised by tuberculoprotein
negative excludes tb
Chestxray-healed/active pulmonary infection
31. Diagnostic uterine curretage-
Done-week preceeding menstruation
Tubercles likely to come to the surface
Material sent in two portions-
1)formol saline-HPE to detect gaint cell system
Histology-detect tubercles in 10%
FP-chr lesions(talk/catgut granuloma),sarcoidosis
FN-improper timing of uterine curretage/less incidence of
uterine infection
32. 2)normal saline-
Culture in L-J medium
Identification of AFB by ziel-neelsens stain
Nucleic acid amplification
Guinea pig inoculation
A positive culture-suggestive
A positive innoculation test-diagnostic
Bacteriologic test-if positive-type the bcilli,report their
drug sensitivity
33. Nucleic acid amplification(16S ribosomal DNA)-
PCR-identify in endometrium,menstual blood
Sensitivity-85-90%
Detect- 10 org in clinical specimens compared to 10,000
for smea positivity
Genital tb- always paucibacillary
34. First day menstrual discharge
Collected by pipette
Subjected to nucleic acid amplification, culture, guinea pig
innoculation
Positive-tb
Negetive-not rule out tb
35. Sputum,urine- culture for tb
Lymohnode biopsy- neck in lymphadenitis
Biopsy- lesion in cx,vagina,vulva
36. HSG-
Proved case-CI –reactivation of lesion
Routine work up in investigation of infertility may reveal –
b/l tubal block
Coiling of tubes/calcified shadow of places
Tubal diverticula/fluffiness of tubal outline
Uterine cavity- irreg outline. honeycomb app/uterine
synaechiae
37.
38.
39.
40.
41.
42. Imaging-
usg-abd,pelvis,CT/MRI helpful when there is mass/ascites
Doesnot confirm the diagnosis
Laproscopy
-absence of endometrial evidence
Identify tubercles on peritoneal surgace
Nodular app of tubes
Biopsy from tubercles can be taken
Aspiration of fluid-culture
Accidentally discovered during diag lap for infertility
43. DIAGNOSIS
The physician should Be conscious of entity
Suspect and exclude genital tb in –
1. Unexplained infertility/amenorrhoea
2. Recurr episodes of pelvic infections,not responding with
usual course of antibiotics
3. Presence of pelvic mass with nodules in the POD
47. general
Pulmonary tb perse –no need of admission
Except in acute exacerbations
Imp body resistence
Regular diet
Correct anaemia
until infectn is controlled, husband should use condom
during intercourse- prevent urogenital tb
48. chemotherapy
INTIAL PHASE-
4 drugs are used for 2 mnths-
red bacterial population
prevent emergence of drug-resistence
Drugs-
Isoniazid
Ehambutol
Rifampicin
Pyrazinamide
Ethambutol-prev treated/immunocompromised
49. Continuation phase-
Treatment is continued for a period of further 4mnths
with isoniazid,rifampicin
About a yr of treatment,diagnostic endometrial
curretage is to be done….
Positive- treatment contd..
Negetive- endometrium is examined at interval of six
mnths…
50. patient must be considered cured –
At least 2 reports including histological and
bacteriological examination becomes negetive
Majority of pts respond well to chemotherapy
51. Multidrug resistent tb-
Infection with myc tb that is resistant to 2 or more
agentsincluding isoniazid
HIV negative patients who r MDR have high mortality
rate
Such patients treated with-5 drug regimens(CDC)
53. Itermittentdose shedule
Treatment should be supervised by DOTS provider
RNTCP &DOTS-
Isoniazid-15mg/kg-3 times a week for 6 mnths
Pyrazinamide-30mg/kg-3 times a week for first 2 mnths
only
Ethambutol-30mg/kg-3 times a week-2mnths only
Rifampicin-600mg-3 times a week for 6mnths
55. SURGERY
INDICATIONS-
Unresponsiveness of active disease in spite of adequate
anti-tubercular tx
Tubercular pyosalphinx
Ovarian abscess
Pyometra
Persistent menorrhagiachr pelvic pain causing
deteriorating health status
56. CI-
presence of active tb in extragenital region
favourable respose with dec in mass size
Accidental discovery of tubercular tubo ovarian mass on
laprotomy in young pt.-abdomen is closed after taking
tissue for biopsy
58. Types of surgery-
TAH+BSO –rare today
Hypertrophied vulva-vulvectomy
Removal of adnexal mass in young woman
Drainage of pyometra
Fistula repair
Tuboplasty-CI
Any sx on tube will reactivate diseaSe
Fertility cannot be restored when tubal walls are
damaged
59. PROGNOSIS
90%-cured
only 10%-fertiliy restored
Of these who conceived 50% -tubal preg
20-30%-abort
Only 2%-live births
INVITRO FERTILIZATION-
Sucessfully tx r offered .
40%-success- provided endometrium normal
