breast pain 8504 women studied at edinburgh breast unit incidence of pain: 60-70% premenstrual pain:...

BREAST PAINBREAST PAIN8504 Women Studied at Edinburgh Breast Unit

Incidence of Pain: 60-70%

Premenstrual Pain: 75%

Incidence of CA: 2.7% of Women presenting with pain predominantfly

<5% of Painful Lumps Malignant (Reassuring)

The Practitioner June 99

BREAST PAINBREAST PAIN

AETIOLOGY:• Histol.Abnormality

• Sensitivity to Hormones

• Elevated Prolactin

• Water Retention

• Neurosis

• Excess Ess Fatty Acids

MANAGEMENT OF BREAST PAINMANAGEMENT OF BREAST PAIN

• Refer Discrete Masses & Non cyclical Severe Pain

• Reassure Mild & Moderate Cyclical Pain

• Drugs used:

Gamolenic Acid - Danazol Bromocriptine

NSAID - GnRHa - Tamoxifen

CREATOR & THE CLONECREATOR & THE CLONE

Wilmut and Dolly

QUESTIONS ON CLONINGQUESTIONS ON CLONING

Is Cloning unnatural?

Could Veerappan be cloned?

Could Clones be Farmed?

Would Clones have Souls & Consciousness?

Could Cloning create Super Man?

HAIR AS SUTURESHAIR AS SUTURES

Mentioned in Susruta Samhita - First used in Japan in 1996Reported from MRMC Gulbarga - HINDU 12 July 2000

CHARACTERISTICS OF CHARACTERISTICS OF FEMALE OBGFEMALE OBG

• PersonalCharacteristics, Health Behaviour,Career satisfaction & Loyalty to speciality Same

• Higher Income

• Assumed Fewer Domestic Responsibilities

• Provide more (Gyn oriented ) preventive care

(Compared to other Female Physicians in US)

Am J ObG Nov 99

CAESAREAN SECTION

THE MISGAV LADACH THE MISGAV LADACH METHODMETHOD

• Refined by Dr. M. Stark, Jerusalem

• Presented by Ole Fall at FIGO Congress ‘94 & ’97

• Trials on in Asia & Africa

Original Article - Acta Ob Gyn Scand 1999

OPERATIVE TECHNIQUEOPERATIVE TECHNIQUE

OPERATIVE TECHNIQUEOPERATIVE TECHNIQUE

ADVANTAGESADVANTAGES

• Working in Harmony with Anatomy

• Shorter Operating Time & Anaesthesia

• Practically Bloodless

• Less Post Op Antibiotics&Analgesics

• Quicker Recovery

THE INHS ASWINI THE INHS ASWINI EXPERIENCEEXPERIENCE

• Controlled Study of 197 Cases - Jan 96 to Dec 98

• Indian Naval Hospital Ship (INHS Aswini) Mumbai

KGPaul ObG Comm. Sept ‘99

MINILAP HYSTERECTOMYMINILAP HYSTERECTOMY• Uterine Manipulator

thru Cx to elevate uterus

• Suprapubic 4cm Incision

• Myoma screw for traction

• Mean op time:40mts-Less blood loss

Sharma JB ObG Com 99

CAUSE OF HIGH BP IN CAUSE OF HIGH BP IN PREGNANCYPREGNANCY

• Mutation of Mineralocorticoid Receptor which regulates Salt balance

• Just one of the causes of High BP

• More animal experiments needed

• Other Defective Genes altering response to Pregnancy Hormones may come to light

Lifton P et al Yale Univ. Science

Hindu 7 Nov 2000

CAUSE OF HIGH BP IN CAUSE OF HIGH BP IN PREGNANCYPREGNANCY

SingleGeneMutation of Mineralocorticoid Receptor

Triggered by aldosterone

Sensitivity to Progesterone

Salt RetentionPlasma ExpansionHigh BP

VIAGRA’S COMING!VIAGRA’S COMING!• Use with Caution in:

Peptic ulcer-Platelet Disorders- IHD

• Contraindicated when taking Nitrates

• Antibtotics-Antivirals-Antimicotics interfere with action of Viagra

• SE:37%-Headache-Flushing-Visual Symp-Fainting

BEYOND VIAGRABEYOND VIAGRA

• FDA has approved UPRIMA

• UPRIMA targets chemicals in Brain responsible for erection ( Viagra increases blood supply to penis )

• Acts within 10 mts & succeeds in 60%

• SE: Hypotension-Fainting TIME May 2000

QUEST FOR PERFECTIONQUEST FOR PERFECTION

THE FINE TUNED FEMALE & MADE OVER MALETHE FINE TUNED FEMALE & MADE OVER MALE

• Surgical Lift:

Forehead-Arm-Buttock-Thigh

• Injection of Collagen-Fat:Face-Neck-Trunk-Extremities

• Breast Implants-Augmentation-Reduction

• Tummy Tuck

• Reshaping:

Ear-Nose-Eye Lids-Chin• Face Lift• Antiwrinkle injection• Implants:Cheek-

Pectoral-Calf• Breast Reduction• Scalp Reduction• Liposuction

THANK YOUTHANK YOU