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Page 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
Page 2: 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

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

Page 3: 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

BREAST PAINBREAST PAIN

AETIOLOGY:• Histol.Abnormality

• Sensitivity to Hormones

• Elevated Prolactin

• Water Retention

• Neurosis

• Excess Ess Fatty Acids

Page 4: 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

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

Page 5: 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

CREATOR & THE CLONECREATOR & THE CLONE

Wilmut and Dolly

Page 6: 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

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?

Page 7: 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

HAIR AS SUTURESHAIR AS SUTURES

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

Page 8: 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

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

Page 9: 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

CAESAREAN SECTION

Page 10: 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

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

Page 11: 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

OPERATIVE TECHNIQUEOPERATIVE TECHNIQUE

Page 12: 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

OPERATIVE TECHNIQUEOPERATIVE TECHNIQUE

Page 13: 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

ADVANTAGESADVANTAGES

• Working in Harmony with Anatomy

• Shorter Operating Time & Anaesthesia

• Practically Bloodless

• Less Post Op Antibiotics&Analgesics

• Quicker Recovery

Page 14: 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

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

Page 15: 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

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

Page 16: 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

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

Page 17: 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

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

Page 18: 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

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

Page 19: 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

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

Page 20: 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

QUEST FOR PERFECTIONQUEST FOR PERFECTION

Page 21: 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

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

Page 22: 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

THANK YOUTHANK YOU