Download or read book Polycystic Ovary Syndrome ECAB written by Gita Ganguly Mukherjee and published by Elsevier Health Sciences. This book was released on 2012-07-05 with total page 159 pages. Available in PDF, EPUB and Kindle. Book excerpt: PCOS is a complex endocrinopathy with wide-ranging variations and clinical manifestations. In the field of gynecology, the clinician is called upon to treat problems of menstrual irregularity, acne and hirsutism, infertility, obesity, and for education on long-term consequences. The mainstay of pharmacological treatment aims at ovarian suppression of androgen secretion. The most effective medical therapy for hirsutism in these cases thus appears to be antiandrogen drugs. The patients need to undergo the therapies for long periods and also understand the need of maintenance. Electrolysis and laser photothermolysis are considered the most effective cosmetic procedures. PCOS is a heterogeneous disorder and no single etiological factor fully accounts for the whole spectrum of the abnormalities in this condition. Only a few genes and mutations show considerable evidence of association with PCOS. Variable manifestation observed within PCOS patients may be due to the interaction with environmental factors with protective genomic variant and predisposing genes. The eminent authors of "Polycystic Ovary Syndrome" have enumerated the various options available described in detail their experiences regarding the various aspects of the condition.

Download or read book Insulin Resistance ECAB written by Gita Ganguly Mukherjee and published by Elsevier Health Sciences. This book was released on 2012-06-07 with total page 147 pages. Available in PDF, EPUB and Kindle. Book excerpt: The insulin resistance syndrome can be defined as insulin resistance, compensatory hyperinsulinemia, and their associated co-morbidities. Clinically, the term insulin resistance syndrome describes a constellation of abnormalities such as obesity, hypertension, dyslipidemia, type 2 diabetes/hyperglycemia, and coronary artery disease. Insulin is responsible for glucose uptake into the body cells and tissues. The response of the cells to insulin varies from individual to individual. In some individuals, the tissue response to insulin may be diminished. This means that even with adequate levels of insulin, the glucose uptake into the cells and tissues is not optimal. This results in a compensatory over-secretion of insulin from the pancreas. The persistence of high levels of insulin in the blood or hyperinsulinemia is thought to be responsible for some of the abnormalities associated with this condition. However, the exact causal association of the condition with these disorders and the pathophysiology of their evolution are unclear. The most common underlying mechanism proposed is increased free fatty acids from abdominal fat in individuals with central obesity. This leads to deranged insulin signaling, reduced muscular glucose uptake, increased triglyceride synthesis, and hepatic gluconeogenesis. A genetic basis of the disease as well as several other factors such as tumor necrosis factor-α, adiponectin, leptin, Interleukin-6, and some adipokines have also been implicated. Insulin resistance syndrome is of clinical significance because of its association with potentially debilitating conditions that contribute to long-term morbidity and even mortality of the individual. People with insulin resistance syndrome are at an increased risk of developing type 2 diabetes, hypertension, dyslipidemia, myocardial infarction, polycystic ovarian disease, and fatty liver. In this book, we have tried to collate the experiences of the pioneers of this field on the subject and provide the reader a comprehensive view on the topic along with practical management points, which we are sure will benefit the physicians in their clinical practice. The contributors have focused on the condition as is prevalent in our subcontinent and have tried to give an insight on the issues pertaining to the same with a topical flavor.

Download or read book Critical Issues in Obstetrics and Gynecology ECAB E Book written by Gita Ganguly Mukherjee and published by Elsevier Health Sciences. This book was released on 2014-12-11 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: Critical Issues in Obstetrics and Gynecology - ECAB - E-Book

Download or read book ECAB Clinical Update OBS GYN May June Issue 3 written by Daftary and published by Elsevier India. This book was released on with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Managing Infertility ECAB written by Kamini Rao and published by Elsevier Health Sciences. This book was released on 2012-06-15 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: Assisted reproduction refers to a number of advanced techniques that aid fertilization in a couple diagnosed to have reduced fertility such as in women who have irreversible damage to their fallopian tubes or cervical mucous problems. These techniques can also benefit couples with unexplained infertility. Before 1978, infertility diagnosis and treatment revolved around surgical interventions such as fallopian tube(s) repair or inserting sperms into the uterus. Thus, the management was applicable and aimed at removing the mechanical blockage that prevented the fertilization of egg. Then ca.me Louise Brown and Dr. Patrick Steptoe, a couple who were destined to be associated forever in the infertility history books forever. This is because in 1978, Dr. Steptoe made it possible for Louise to conceive in a laboratory in England with IVF. From this turning point in the science of infertility, came techniques that addressed the biochemical and hormonal aspects of infertility thus marking the beginning of a whole new subspecialty called Reproductive Endocrinology. With Dr. Steptoe’s technique, called IVF (In Vitro Fertilization), couples who otherwise had no problems that could be surgically treated now had another option. With the inclusion of Information technology in all aspects of our life, the explosion of Assisted Reproduction Technologies (ART) has resulted in further sophistication of additional techniques, now responsible for the existence of over 20,000 human beings a year that would never have existed. ART deals with all aspects of the science of conception, be it investigating the couple, or determining their ovarian reserve to application of the most appropriate technique to aid conception in that couple.

Download or read book Critical Issues and Diabetes ECAB E Book written by Samar Banerjee and published by Elsevier Health Sciences. This book was released on 2014-12-12 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: Critical Issues and Diabetes - ECAB - E-Book

Download or read book Medical Disorders in Pregnancy ECAB written by Hema Divakar and published by Elsevier Health Sciences. This book was released on 2009-11-15 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: The management of medical disorders in pregnancy has undergone significant changes in the recent years. The pattern of disease has changed with improvements in socio-economic conditions. For example, the incidence of antenatal anemia has decreased progressively in the past few decades, and pulmonary tuberculosis (which used to be prevalent) is now seen only rarely. Chronic rheumatic heart disease has also become less common. On the other hand, gestational diabetes has become more common. This may be due partly to the setting up of screening services for gestational diabetes in many hospitals. The four most common medical disorders complicating pregnancy are anemia, diabetes mellitus, cardiac disease, and thyroid disorders. In addition, because of the improvements in the medical, obstetric, and anesthetic management of pregnancy, many women with medical disorders can go through a pregnancy without major problems. There has also been a progressive decrease in the perinatal mortality associated with some medical disorders, such as diabetes. It is important for all healthcare professionals involved in the management of pregnant women with medical disorders to be conversant with the latest developments in order to provide the best care to these women. The chapters in this issue are certainly helpful in this respect. The eminent authors for the various chapters have discussed the various options available describing in detail their experiences regarding the various aspects of the condition.

Download or read book Oral Hypoglycemic Agents ECAB written by Abdul Hamid Zargar and published by Elsevier Health Sciences. This book was released on 2013-07-12 with total page 111 pages. Available in PDF, EPUB and Kindle. Book excerpt: Even though we have many advances in the development of oral hypoglycemic agents, an ideal drug for treating type 2 diabetes is still a distant reality. Today, physicians can choose from a variety of medications targeting numerous facets of disease, but each drug class poses some limitations. The age-old molecules, such as sulfonylureas and biguanides, are still valued because of their well-studied mode of action, safety, tolerability, and predictable pharmacodynamic effects. This book attempts to describe the historical aspects and advances in the arena of oral hypoglycemic agents, extended- and sustained-release formulations of glipizide and metformin (both of which have great promise in the treatment of type 2 diabetes mellitus) as well as evaluates the role of the group in diabetic foot infections.

Download or read book Endometriosis ECAB written by Sadhana Desai and published by Elsevier Health Sciences. This book was released on 2012-06-15 with total page 126 pages. Available in PDF, EPUB and Kindle. Book excerpt: Endometriosis is a condition that often leads to a variety of symptoms that range from pain complaints to infertility. Endometriosis is also found in women who are asymptomatic. The diagnosis of endometriosis can be made clinically with reliability similar to that of one made surgically. Medical treatment options are effective, as are surgical treatment options. Complications associated with surgery, however, push the balance in favor of medical therapy whenever possible. Based on the body of evidence available at present, women with endometriosis-related complaints should be treated with a first-line medical therapy. If that fails, a second-line medical therapy is warranted under most conditions. Laparoscopic surgery should be reserved for patients in whom second-line medical therapy has failed or is contraindicated by desire to conceive immediately or as soon as possible.

Download or read book Obstetrics Counseling ECAB written by Uday Thanawala and published by Elsevier Health Sciences. This book was released on 2012-07-05 with total page 127 pages. Available in PDF, EPUB and Kindle. Book excerpt: Informed choice is the right of an individual. Gynecologists have immense responsibility and a unique opportunity to guide their patients through the various milestones/changes in their life by good counseling—menarche, sexuality, pregnancy, pelvic operations, and menopause. Adolescents should be taught about safe sex practices, premarital counseling, and contraception. Preconception counseling is also important in the identification of risk factors, disease states, and potential teratogens in the pregnancy. The availability of first-trimester prenatal diagnosis and the advent of presymptomatic diagnosis by DNA analysis have created increasing opportunities to avoid disorders characterized by early death, severe disease, or irreparable mental retardation, for example, periconceptional maternal folic acid supplementation has now been shown to provide high protective effect against neural tube defects. Similarly, certain maternal diseases, including diabetes, lupus, and myotonic muscular dystrophy, impose potential maternal, fetal, neonatal, and other complications. The preconception visits provide important opportunities for intervention, avoidance, or prevention in these cases. The patients’ ethnicity and medical and genetic family history are key elements in their evaluation, whereas patients with prolonged infertility of unknown cause or recurrent spontaneous abortion may have a 3–10% risk of a parental chromosome abnormality, which may also require chromosome analysis, as do their spouses.

Download or read book Endoscopy in Infertility Part II A Perspective on Laparoscopy ECAB written by Urvashi Prasad Jha and published by Elsevier Health Sciences. This book was released on 2013-07-12 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Historically, gynecologic endoscopy began in the 1930s with the development of diagnostic laparoscopy, but today gynecologic endoscopy, both laparoscopy and hysteroscopy, has become an essential part of gynecologic surgery. In present practice, the benefits of laparoscopy, hysteroscopy, and minimally invasive surgical procedures have become safely entrenched behind undeniable facts, to the patients as well as the hospitals. The endoscopic gynecologic surgery now involves the whole gamut of fetal surgery, embryoscopy, outpatient local anesthetic laparoscopy, total laparoscopic hysterectomy, and embolization of myomas. Another interesting fact to come to the fore is that, increasingly, the traditional treatments for infertility are being rendered obsolete by advanced reproductive technologies and gynecologic endoscopy. Endoscopy in Infertility has addressed the relevant issues with dexterity by substantiating with relevant clinical experiences of its authors, who are among the pioneers in this field.

Download or read book Menopause ECAB written by Rama Vaidya and published by Elsevier Health Sciences. This book was released on 2009-02-01 with total page 176 pages. Available in PDF, EPUB and Kindle. Book excerpt: Menopause is defined by the World Health Organization (WHO) and the Stages of Reproductive Ageing and Workshop (STRAW) working group as the permanent cessation of menstrual periods that occurs naturally or is induced by surgery, chemotherapy, or radiation. Natural menopause is recognized after 12 consecutive months without menstrual periods that are not associated with other causes. Although surprising, it is interesting to note the plethora of complaints that menopausal women present with all over the world. In the US, UK, and the United Arab Emirates, hot flushes are the most common symptom reported, while women from Japan, India, and Singapore suffer mostly from joint pain. A postmenopausal woman should take into her stride the fact that menopause is a change in life, and not the end of life. Support groups should be functional in counseling these women who often face menopause in the midst of many other crises in life, like elderly parents and grown-up children leaving their nests empty to move ahead in life. Menopause is best tolerated when it is already anticipated, and social workers, doctors, and other paramedical personnel should all join hands in providing the necessary information, education, and communicating with these women at their hour of need.

Download or read book High Risk Labor and Delivery ECAB written by Shirish N Daftary and published by Elsevier Health Sciences. This book was released on 2012-06-19 with total page 272 pages. Available in PDF, EPUB and Kindle. Book excerpt: The high-risk pregnant patient can present to the labor and delivery setup with significant complications that can result in morbidity and mortality. The goal of the obstetricians is always to have a safe outcome for both the mother and the baby, irrespective of the severity of the illness. Therefore, a thorough understanding of the underlying problems and expert management by the obstetrician are extremely important. Further, these parturient can be critically ill, requiring intensive care management. So, good communication among the various teams and the latest information on the management of such patients are critical in order to provide the highest possible level of care. The information in this text will hopefully give the reader the best and most up-to-date knowledge with regard to management of problems and challenges in dealing with a high-risk parturient. This book brings together an outstanding group of authors from the discipline of Obstetrics and Gynaecology in an attempt to present a comprehensive and current summary of high-risk labor and delivery and will be useful to both the practitioner in academic medicine and in private practice.

Download or read book Perinatal Medicine ECAB written by Shirish N Daftary and published by Elsevier Health Sciences. This book was released on 2012-07-05 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: Perinatal medicine encompasses various current topics in fetal diagnosis and management, besides preconception counseling. The concept of preconception counseling and healthcare evaluation optimizes a couple’s readiness for childbearing. This helps to minimize any foreseeable adverse factors through a careful diagnostic review and provision of appropriate intervention and therapy in advance. This has been dealt with in detail. The section on etiology and management aspects of Intrauterine Growth Retardation (IUGR) covers investigation and management of suspected or known fetal abnormalities, placental failure, and fetal growth retardation. Prenatal diagnostic procedures had limited access and safety so far, but this is a thing of the past today, especially after the advent of real-time ultrasonography. It brings an increasingly clearer visualization of the intrauterine space and has vastly broadened the scope for fetal diagnosis and treatment. The currently available ultrasound-guided procedures for fetal diagnosis and therapy are discussed at length in the chapter invasive ultrasound procedures. The discussed invasive ultrasound procedures include amniocentesis, cordocentesis, and chorionic villus sampling, done to detect neural tube defects, fetal lung maturity, and chromosomal abnormalities. The controversies surrounding the evaluation of fetal anomalies by ultrasound procedures are covered at length which we expect would be of special interest to the readers. Opinions abound as well as differ on the interpretation of the findings and counseling of couples, based on the same. This section focuses on the implications of missed fetal anomalies in this background and its impact on pregnancy outcome.

Download or read book Recurrent Pregnancy Loss ECAB written by Kamini Rao and published by Elsevier Health Sciences. This book was released on 2009-12-15 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recurrent miscarriage is a distressing problem that affects 1% of all women in the reproductive age group. This incidence is greater than that expected by chance alone, since 10–15% of all clinically recognised pregnancies end in a miscarriage. The calculated risk of three consecutive pregnancy losses is estimated to be 0.34%. Hence, only a proportion of women presenting with recurrent miscarriage will have a persistent underlying cause for their pregnancy losses. Maternal age and previous number of miscarriages are two independent risk factors for a further miscarriage. The advanced maternal age adversely affects ovarian function, giving rise to a decline in the number of good quality oocytes, resulting in chromosomally abnormal conceptions that rarely develop further. The eminent authors for "Recurrent Pregnancy Loss" have enumerated the various options available described in detail their experiences regarding the various aspects of the condition.

Download or read book Endoscopy in Infertility ECAB written by Urvashi P Jha and published by Elsevier Health Sciences. This book was released on 2009-12-15 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Historically, gynecologic endoscopy began in the 1930s with the development of diagnostic laparoscopy, but today gynecologic endoscopy has become an essential part of gynecologic surgery. In present practice, the benefits of hysteroscopy have become safely entrenched behind undeniable facts, to the hospitals as well as the patients. Hysteroscopy can be regarded as the gold standard for the evaluation of the uterine cavity in cases of abnormal uterine bleeding, infertility, recurrent pregnancy loss, and suspected intrauterine out-growth. It can be performed in the office setting (outpatient hysteroscopy) or as a day-case procedure, under general anesthesia (inpatient hysteroscopy). Outpatient hysteroscopy has been shown to be as accurate as inpatient hysteroscopy, and it has the advantage of reduced anesthetic risks, enhanced time–cost effectiveness, and patient preference. The factors behind the success of outpatient hysteroscopy are instrument quality, characteristics of the distension medium, the ability and experience of the operators, and recent technical advances, such as the introduction of small-diameter rigid and flexible hysteroscopes. The future looks to further simplification of instrumentation and hence, high safety and accuracy and expedited performance. "Hysteroscopy in Infertility" has addressed the relevant issues with dexterity by substantiating with relevant clinical experiences of authors, who are among the pioneers in this field.

Download or read book Critical Issues in Obstetrics ECAB written by Prakash Trivedi and published by Elsevier Health Sciences. This book was released on 2009-09-15 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: Globally, pregnancy and childbirth are periods of high morbidity and mortality for women. The key to reducing the risks associated with pregnancy and childbirth is early recognition and provision of high quality care. The aims of critical care issues’ management are broad, the need to address the defects in conceiving followed by early recognition, prevention, and management of preterm births and threatened miscarriages along with studying the essential factors responsible for the same. Infertility has been ranked as one of the greatest sources of stress in a person’s life, comparable to a somatic disease such as cancer and ranked second to that involving the death of a family member or divorce. The role of stress and immunomodulation as a causative factor for infertility has been studied in greater details in recent times due to the changing lifestyles and a relevant discussion has been provided by the author with specific considerations in the Indian clinical settings. Endometriosis is the disease of the millennium, a sticky, perplexing and unconquerable pathology, which has remained an enigma. With increased awareness about endometriosis, improved methods of diagnosis like transvaginal sonography, liberal use of laparoscopy and more frequent evaluation of CA 125, the incidence of endometriosis is rising and thus, a clear understanding of the condition with application of the various advances in the recognition and also the new management protocols being followed, are the need of the day for the practitioners across the country. The polycystic ovary syndrome (PCOS), which features amenorrhea, hirsutism, and obesity, which was initially considered a reproductive and cosmetic concern of young women of reproductive age group, has more recently been recognized to have metabolic and cardiovascular associations that make it of major consequence for women of all age groups worldwide. Keeping in mind the requirements of the society, the practitioners need to update themselves on the current approach and the wide variety of choices now available. This book encompasses the rich experience of the specialists in India who are among the stalwarts in this field.