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BREAST PAIN

BREAST PAIN. 8504 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 PAIN. AETIOLOGY: Histol.Abnormality

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BREAST PAIN

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  1. BREAST PAIN 8504 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

  2. BREAST PAIN AETIOLOGY: • Histol.Abnormality • Sensitivity to Hormones • Elevated Prolactin • Water Retention • Neurosis • Excess Ess Fatty Acids

  3. MANAGEMENT OF BREAST PAIN • Refer Discrete Masses & Non cyclical Severe Pain • Reassure Mild & Moderate Cyclical Pain • Drugs used: Gamolenic Acid - Danazol Bromocriptine NSAID - GnRHa - Tamoxifen

  4. CREATOR & THE CLONE Wilmut and Dolly

  5. QUESTIONS ON CLONING Is Cloning unnatural? Could Veerappan be cloned? Could Clones be Farmed? Would Clones have Souls & Consciousness? Could Cloning create Super Man?

  6. HAIR AS SUTURES Mentioned in Susruta Samhita - First used in Japan in 1996 Reported from MRMC Gulbarga - HINDU 12 July 2000

  7. CHARACTERISTICS OF FEMALE 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

  8. CAESAREAN SECTION

  9. THE MISGAV LADACH METHOD • 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

  10. OPERATIVE TECHNIQUE

  11. OPERATIVE TECHNIQUE

  12. ADVANTAGES • Working in Harmony with Anatomy • Shorter Operating Time & Anaesthesia • Practically Bloodless • Less Post Op Antibiotics&Analgesics • Quicker Recovery

  13. THE INHS ASWINI EXPERIENCE • Controlled Study of 197 Cases - Jan 96 to Dec 98 • Indian Naval Hospital Ship (INHS Aswini) Mumbai KGPaul ObG Comm. Sept ‘99

  14. MINILAP 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

  15. CAUSE OF HIGH BP IN PREGNANCY • 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

  16. CAUSE OF HIGH BP IN PREGNANCY SingleGene Mutation of Mineralocorticoid Receptor Triggered by aldosterone Salt Retention Plasma Expansion High BP Sensitivity to Progesterone

  17. 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

  18. BEYOND 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

  19. QUEST FOR PERFECTION

  20. 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 THE FINE TUNED FEMALE & MADE OVER MALE

  21. THANK YOU

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