This document discusses uterine fibroids, also known as leiomyomas. It defines a fibroid as a benign smooth muscle tumor of the uterine wall. Fibroids are very common, affecting 25-50% of women. While the exact cause is unknown, estrogen is thought to play a role in growth. Fibroids can cause heavy bleeding, pain, pressure effects, and infertility. Diagnosis involves imaging like ultrasound and treatment depends on factors like age, symptoms, and desire for future pregnancy. Options include observation, medication, myomectomy (surgical removal), or hysterectomy.
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor.
PELVIC ORGAN PROLAPSE, uterine prolapse , cystocele, rectocele, urethrocele, supports of uterus, sling surgeries, pessaries, grades of prolapse, uterine preserving surgery for pop, pelvic floor repair, vaginal hysterectomy, ward mayos surgery, pop q grading, grading of prolapse, laproscopic surgeries for prolapse, peregee, apogee , mesh repair, tot, tvt, colpo suspension, colpoclysis, SUI management, epidemiology of prolapse, decubitus ulcer, best ppt for pelvic organ prolapse, better understanding of pelvic organ prolapse and pelvic floor.
endometrial cancer
endometrial carcinoma
gynaecological oncology
uterine cancer
uterus
post menopausal bleeding
endometrial neoplasms
gynaecology
cancer
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)
endometrial cancer
endometrial carcinoma
gynaecological oncology
uterine cancer
uterus
post menopausal bleeding
endometrial neoplasms
gynaecology
cancer
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)
Benign growths in the uterus that can develop during a woman's childbearing years.Highest incidence was seen in Pakistani women 78%, then rural Indian women 37.65%, urban India 24% and Nigerian women 30%. Arobosoba from Nigeria has reported prevalence of uterine fibroids in black women was more (26%), in comparison to Caucasian women (17.9%).
Uterine fibroid (leiomyoma) and new treatment modalitiesMohammed Saadi
This presentation describes Uterine fibroid
Definition
Incidence
Etiology
Risk factors
Clinical manifestation
Red degeneration
Complications of fibroids
Management and the new modalities in treatment
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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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.
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.
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
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
2. LEIOMYOMA
WHAT IS A LEIOMYOMA?
It is a benign neoplasm of the muscular wall of
the uterus composed primarily of smooth
muscle
WHAT IS THE INCIDENCE OF LEIOMYOMAS?
They are the most common pelvic tumors
It is found in 25% of white women & 50% of
black women
3. ETIOLOGY
• Unknown
• Each individual myoma is unicellular in origin
• Estrogens no evidence that it is a causative factor , it
has been implicated in growth of myomas
• Myomas contain estrogen receptors in higher
concentration than surrounding myometrium
• Myomas may increase in size with estrogen therapy &
in pregnancy & decrease after menopause
• They are not detectable before puberty
• There may be genetic predisposition
4. PATHOLOGY
• Frequently multiple
• May reach 15 cm in size or larger
• Firm
• Spherical or irregularly lobulated
• Have a false capsule
7. 1-SYMPTOMS
• Symptomatic in only 35-50% of Pt
• Symptoms depend on location, size, changes &
pregnancy status
1-Abnormal uterine bleeding
• The most common 30%
• Heavy / prolonged bleeding (menorrhagia)
iron deficiency anemia
8. 1-Abnormal uterine bleeding (cont’d)
• Submucous myoma produce the most
pronounced symptoms of menorrhagia, pre &
post-menstrual spotting
• Bleeding is due to interruption of blood supply to
the endometrium, distortion & congestion of
surrounding vessels or ulceration of the overlying
endometrium
• Pedunculated submucous areas of venouse
thrombosis & necrosis on the surface
intermenstrtual bleeding
9. 2-PAIN
• Vascular occlusion necrosis, infection
• Torsion of a pedunculated fibroid acute pain
• Myometrial contractions to expel the myoma
• Heaviness fullness in the pelvic area
• Feeling a mass
• If the tumor gets impacted in the pelvis
pressure on nerves back pain radiating to
the lower extremities
• Dysparunea if it is protruding to vagina
10. 3-PRESSURE EFFECTS
• If large may distort or obstruct other organs like ureters,
bladder or rectum urinary symptoms, hydroureter,
constipation, pelvic venous congestion
• Rarely a posterior fundal tumor extreme retroflexion of
the uterus distorting the bladder base urinary retention
• Parasitic tumor may cause bowel obstruction
• Cervical tumors serosanguineous vaginal discharge,
bleeding, dyspareunia or infertility
11. 4-INFERTILITY
• The relationship is uncertain
• 27-40% of women with multiple fibroids are
infertile but other causes of infertility are
present
• Endocavitary tumors affect fertility more
5- SPONTANEOUS ABORTIONS
• incidence before myomectomy 40%
after myomectomy 20%
• More with intracavitary tumors
12. EXAMINATION
• Most myoma are discovered on routine bimanual pelvic
exam or abdominal examination
• Retroflexed retroverted uterus obscure the palpation of
myomas
LABORATORY FINDINGS
• Anemia
• Depletion of iron reserve
• Rarely erythrocytosis pressure on the ureters back
pressure on the kidneys erythropoietin
• Acute degeneration & infection ESR, leucocytosis, &
fever
13. IMAGING
• Pelvic U/S is very helpful in confirming the Dx & excluding
pregnancy / Particularly in obese Pt
• Saline hysterosonography can identify submucous
myoma that may be missed on U/S
• HSG will show intrauterine leiomyoma
• MRI highly accurate in delineating the size, location &
no. of myomas , but not always necessary
• IVP will show ureteral dilatation or deviation & urinary
anomalies
HYSTROSCOPY for identification & removal of submucous
myomas
14. DIFFERENTIAL DIAGNOSIS
Exclude other causes of abnormal bleeding
• Endometrial hyperplasia
• Endometrial or tubal Ca
• Uterine sarcoma
• Ovarian Ca
• Polyps
• Adenomyosis
• DUB
• Endometriosis
• Exogenouse estrogens
Endometrial biopsy or D&C is essential in the evaluation of
abnormal bleeding to exclude endometrial Ca
16. 1-COMPLICATIONS IN PREGNANCY
• ≥ 2/3 of women with fibroids &
unexplained infertility conceive after
myomectomy
• In the 2nd
or 3rd
trimester of pregnancy
rapid in size vascular deprivation
degeneration
• Causes pain & tenderness
• May initiate preterm labor
• Managed conservatively with bedrest &
narcotics + tocolytics if indicated
• After the acute phase pregnancy will
continue to term
17. COMPLICATIONS IN PREGNANCY
DURING LABOR
• Uterine inertia
• Malpresentation
• Obstruction of the birth canal
• Cervical or isthmeic myoma necessitate CS
• PPH
18. COMPLICATIONS IN NONPREGNANT WOMEN
• Heavy bleeding with anemia is the most common
• Urinary or bowel obstruction from large parasitic
myoma is much less common
• Malignant transformation is rare
• Ureteral injury or ligation is a recognized
complication of surgery for Cx myoma
• No evidence that COCP the size of myomas
• Postmenopausal women on HRT must be
followed up with pelvic exam or U/S every 6 M
20. TREATMENT
DEPENDS ON:
• Age
• Parity
• Pregnancy status
• Desire for future pregnancy
• General health
• Symptoms
• Size
• Location
21. SPECIFIC MEASURES
• Most cases asymptomatic no treatment
• Postmenopausal no treatment
• Other causes of pelvic mass must be excluded
• The Dx must be certain
• Initial follow up every 6 M to determine the rate of growth of
the myoma
• Surgery is contraindicated in pregnancy
• The only indication for myomectomy in pregnancy is torsion of a
pedunculated fibroid
• Myomectomy is not recommended during CS
• Pregnant women with previous multiple myomectomy / especially
if the cavity was entered should be delivered by CS to risk of
scar rupture in labor