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biomedgrid · 5 years ago

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Biomed Grid| Endometrial Sampling for Endometrial Cancer: Still the Gold Standard?

Endometrial Cancer (EC)

Is the most common gynaecological malignancy affecting women in developed countries and the second most common gynaecological malignancy world-wide, due to the higher rates of cervical cancer in the developing world [1]. The incidence of EC is steadily increasing, largely owing to an ageing population and escalating rates of obesity [2]. According to International Federation of Gynecology and Obstetrics (FIGO), EC is a major differential diagnosis of AUB in the reproductive women [3]. Despite the frequency of this disease, awareness amongst the general population is low and EC research is somewhat underfunded relative to its societal burden [4].

In the past, multiple attempts to evaluate the histological grade preoperatively were without significant success [5,6]. Dilation and curettage (D&C) were once the gold standard for endometria sampling and routinely used with an upgrade rate of 17-26%, compared to the final pathology [7-9]. In an attempt to develop a less invasive diagnostic method, office endometrial sampling became progressively popular. However, studies aimed at investigating office biopsies revealed an apparent inaccuracy in histological grading with an upgrade rate of nearly 30-50%, compared to hysterectomy pathology [10]. Cotillo et al. [11] investigated the accuracy of transcervical resectoscope (TCR) and revealed a rather optimistic finding of 97.1% correlation with the final pathology.

This could be a solution to overcome the hurdle of inevitable upgrades. This method allows direct visualization, a targeted biopsy, and theoretically a more accurate evaluation of preoperative tumour grading [11]. There is also recent progress with effort at improving the diagnostic accuracy of endometrial cancer through immunohistochemistry biomarkers targeting endometrial hyperplasia and predicting progression of endometrial hyperplasia to endometrial cancer [12]. There is need for the clinician to consider therefore the possibility of ECs when treating an abnormal uterine bleeding.

Furthermore, we experienced a case scenario where a colleague had multiple endometrial sampling done and each sample sent to different pathologist and the outcome of the histopathology reports was bizarre. The results were that of different reports establishing the inconsistencies associated with endometrial sampling for endometrial cancer. Similar, encounters have been reported in literature which is the bane of this editorial report. The great question we need an urgent answer for remains “is endometrial sampling for endometrial cancer still the gold standard?”

Abnormal Uterine Bleeding (AUB)

May be defined as any variation from the normal menstrual cycle related to reproductive status; as well as other bleeding not related to menses provides the terminology and descriptions are consistent with the FIGO Menstrual Disorders Working Group consensus statement [13,14]. AUB is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for this problem during their reproductive years [15-17]. Patients with AUB are at risk for endometrial carcinoma and therefore AUB warrants further investigation 18. Histological endometrial assessment is indicated when a patient presents with AUB and an increased endometrial thickness on transvaginal sonography (TVS) [19,20]. Outpatient endometrial biopsy is the least invasive technique to obtain tissue for histological assessment. Endometrial biopsies have a very high sensitivity for diagnosing an endometrial (pre)malignancy in AUB women (95%) [21].

Furthermore, performing an endometrial biopsy in women with AUB with increased endometrial thickness is the most cost-effective strategy [22]. Yet, 7-68% of outpatient endometrial biopsy samples are inconclusive because the amount of tissue obtained is insufficient for a reliable histopathological diagnosis [22-25]. In such cases, a more invasive hysteroscopy or dilatation and curettage (D&C) is necessary in order to rule out endometrial carcinoma or atypical hyperplasia, which is present in 6% of these women [23]. The high failure rate due to inconclusive endometrial biopsies might affect the cost-effectiveness of the diagnostic work-up.

Reports from the literature suggest that the attempts to increase the diagnostic efficiency of outpatient endometrial biopsy by structured assessment have not yielded significant improvement in outcome. Therefore, these women cannot be reassured without further invasive, diagnostics [23]. Reviewing hospital protocols revealed that standardized sampling methods was not available in most hospitals, let alone the recommendations on using a tenaculum, entering the uterine cavity more than once, or the use of analgesia in painful procedures. In the cost-effectiveness analysis by Clark et al, the failure rate due to inconclusive endometrial biopsy samples was 12% (95% CI 0.09-0.15) based on a systematic review [22,23]. Other studies reported a failure rate of 7-68% [22-25].

The Clinical Importance of a Diagnosis of Endometrial Hyperplasia (EH)

relates to the long-term risk of progression to endometrioid EC and it is generally accepted that cytological atypia is the principal histological characteristic when assessing EHs for malignant potential [26]. However, not all EHs will progress to malignancy; some EHs occur secondary to estrogenic proliferation without an underlying malignant mechanism. These patients may be asymptomatic and, in some cases, the EH may regress without ever being detected. Several histological classification methods have been proposed aiming to correlate EH architecture and cytological features with the risk of progression to endometrioid EC [27].

The two prominent classification systems are

a. The World Health Organization (WHO) system, established in 1994 with revision in 2003, which is widely known within current clinical gynaecological practice and

b. The endometrial intraepithelial neoplasia (EIN) system, introduced in 2000 [28] and was endorsed in 2014 by the WHO as part of their most recent classification of tumours of the female reproductive organs [29].

The Endometrial Intraepithelial Neoplasia (EIN)

Classification system divides hyperplastic endometrial lesions into two groups:

a. Benign EH and

b. EIN. This is based on objective diagnostic criteria that can be determined from a haematoxylin and eosin (H&E) stained endometrial section.

These criteria emulate what the D-score achieves; however, they can be ascertained quickly by a pathologist using routine light microscopy [30]. EIN lesions are defined as monoclonal proliferations of architecturally and cytologically altered premalignant endometrial glands, which are prone to transformation to endometrioid EC [28].

Conclusion

It is mandatory for clinicians assessing AUB to recognize this disease entity as a possible differential diagnosis. Reports from literature corroborate the fact that there is a high risk of missed diagnosis with less invasive pre-operative diagnostic method of office endometrial trial sampling. The new progress in search of immunohistochemical biomarkers may eventually lay to rest the inconsistent histopathology reports for endometrial biopsy in the nearest future.

Read More About this Article:https://biomedgrid.com/fulltext/volume2/endometrial-sampling-for-endometrial-cancer-still-the-gold-standard.000585.php

For more about: Journals on Biomedical Science :Biomed Grid

#biomedgrid #American medical journal #List of open access medical journal #Journals on medical research #medical and medicinal journal #Open access clinical and medical journal

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elajyoti-blog · 5 years ago

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Saraogi Hospital | IVF Doctors in Mumbai | Elawoman

Saraogi Hospital

Saraogi Hospital and IRIS IVF Center is an IVF and Surrogacy Hospital which was built up in the year 1980. The emergency clinic is situated at Malad West, Mumbai. The goal of the emergency clinic is to give world-class human services offices to all. The medical clinic gives different administrations, for example, Women Health Checkup, In Vitro Fertilization (IVF), Gynecology Endoscopy, Menopausal issues Treatment, Antenatal Care, Normal and Cesarean conveyance, Vaginal Surgery, Colposcopy, HPV Vaccination, Breast Cancer screening, and the board.

Saraogi Hospital have a solid group of doctors to treat who ensure that they give each patient an unattractive domain with heaps of consideration and concern. We are here to help destitute patients as we accept to serve the penniless which is the reason Saraogi emergency clinic is one of the top Mumbai fertility clinics.

Saraogi Hospital and IRIS IVF Center has the best IVF doctor in Mumbai and considered as perhaps the best place for IVF treatment in Mumbai. We have a fabulous group of doctors. Dr. Mohit and his associate doctors endeavor to give total consideration regarding the patients in order to give the best line of treatment. We work for trustworthiness and straightforwardness. Saraogi Hospital gives professional medicinal treatment to eager women and their infants. It offers specific maternity benefits under-talented and equipped doctors who monitor moms and infants during pregnancy, conveyance, and post-conveyance.

Dr. Hrishikesh Pai

Dr. Hrishikesh Pai is a Gynecologist and Obstetrician in Mumbai with an encounter of around 3 decades. He is related with Bloom IVF Center which is a unit of Lilavati Hospital and Research Center situated at Bandra West, Mumbai. He has specialization in giving fertility treatments, for example, Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF). He holds the situation of Secretary General at the Federation of Obstetric and Gynecological Societies of India (FOGSI). Dr. Hrishikesh Pai has contributed a ton in the field of infertility treatments. He has additionally included into different hysteroscopic and laparoscopic medical procedures. Dr. Hrishikesh Pai has been a flexible specialist working effectively for the improvement of ladies and youngster wellbeing. For more data about the specialist and administrations that he renders, visit elawoman.com

In vitro fertilization (IVF) is a type of assisted reproductive era (ART). It includes retrieving eggs from a female’s ovaries and fertilizing them with sperm. This fertilized egg is referred to as an embryo. The embryo can then be frozen and transferred to a woman’s uterus.

Depending on your situation, IVF can use:

your eggs and your companion’s sperm

your eggs and donor sperm

donor eggs and your partner’s sperm

donor eggs and donor sperm

donated embryos

Your health practitioner can also implant embryos in a surrogate, or gestational issuer. This is a lady who consists of your toddler for you.

The success rate of IVF varies. According to the American Pregnancy Association, the stay beginning rate for girls under age 35 present system IVF is forty one to forty three percent. This price falls to thirteen to 18 % for ladies over the age of 40.

Why Is In Vitro Fertilization Performed?

IVF helps humans with infertility who need to have a little one. IVF is high-priced and invasive, so couples regularly attempt unique fertility treatment first. These may also encompass taking fertility capsules or having intrauterine insemination. During that process, a physician transfers sperm immediately right into a female’s uterus.

Infertility troubles for which IVF may be critical include:

Reduced fertility in ladies over the age of 40

Blocked or damaged fallopian tubes

Reduced ovarian feature

Endometriosis

Uterine fibroids

Male infertility, which includes low sperm count number quantity or abnormalities in sperm shape

Unexplained infertility

Parents may additionally pick IVF within the occasion that they run the chance of passing a genetic disease at once to their offspring. A clinical lab can test the embryos for genetic abnormalities. Then, a clinical doctor simplest implants embryos without genetic defects.

How Do I Prepare for In Vitro Fertilization?

Before starting IVF, women will first undergo ovarian reserve testing. This involves taking a blood pattern and trying out it for the level of follicle stimulating hormone (FSH). The results of this take a look at will supply your clinical medical doctor facts about the size and outstanding of your eggs.

Your doctor may even study your uterus. This can also contain doing an ultrasound. Your medical doctor may also moreover insert a scope via your vagina and into your uterus. These exams can display the fitness of your uterus and help the medical doctor determine the extremely good way to implant the embryos.

Men will want to have sperm checking out. This includes giving a semen pattern, which a lab will analyze for the number, duration, and form of the sperm. If the sperm is susceptible or damaged, a system called intracytoplasmic sperm injection (ICSI) may be essential. During ICSI, a technician injects sperm right now into the egg. ICSI may be a part of the IVF technique.

IVF Doctors in Mumbai is a technique for treating infertility-inability to conceive after to three years of trying. This is a reality that every ladies and man have the same probability of hurt by infertility issues. Due to expanded paintings stress, the annoying and fast-paced urban manner of lifestyles with strain, environmental pollution, and delaying marriageable age - the probabilities of infertility are developing drastically.

Sometimes, it can occur with many couples that infertility can motive more frustration and depression in a couple. Therefore, it's far crucial to choose a fertility treatment device that offers you a warranty. Infertility experts are known as Gynaecologists who have been mainly knowledgeable inside the superior strategies in helping duplicate in infertile and subfertile couples and offer awesome Best IVF Doctors in Mumbai.

Here the listing of Best IVF Doctors in Mumbai :

Dr. Pinky Ronak Shah

Dr. Pinky Shah is running in the direction of Obstetrician and Gynaecologist for the purpose that 15 years and with eight years enjoy in field of Reproductive Medicine. Dr. Pinky Shah the Core Fertility Specialist Morpheus Juhu Fertility Center. She completed her FNB, fellowship in reproductive medicinal drug from Lilavati Hospital, Mumbai, in which she got knowledgeable in fundamentals of ART, and mastered abilties in severa IVF processes and endoscopy.

Dr. Mohit Saraogi

Dr. Mohit R Saraogi is a gynecologist, obstetrician, and infertility professional with over 12 years of experience. He is a member of Mumbai Obstetrics and Gynaec Society, Federation of Obstetrics and Gynaecological Societies of India (FOGSI) and Malad Medical Association. Dr. Mohit R Saraogi has completed MD - Obstetrics & Gynaecology, DGO, and FCPS from King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College in 2010.

Dr. Sachin Dalal

Dr. Sachin Dalal is a gynecologist, infertility expert and, obstetrician with over 17 years of revel in. He is a member of the Federation of Obstetric & Gynecological Societies of India (FOGSI), Medical Council of India (MCI) and Indian Association of Gynaecological Endoscopist (IAGE). Dr. Sachin Dalal has completed FCPS - Mid. & Gynae from Topiwala National Medical College & BYL Nair Charitable Hospital in 2002, DGO from Lokmanya Tilak Municipal Medical College, Sion, Mumbai in 2002 and MD - Obstetrics & Gynaecology from Mumbai University and National Board of Examinations, New Delhi in 2003. He is presently persevering with workout at Madhu Imagine & Fertility Centre in Jungle Mangal Road, Mumbai. His areas of knowledge are In-Vitro Fertilization (IVF), Intra-Uterine Insemination (IUI), Normal Vaginal Delivery (NVD), Artificial Insemination, Laparoscopic Surgery and Hysterectomy (Abdominal/Vaginal).

Dr. Mugdha Raut

Dr. Mugdha Raut is a Gynaecologist and Obstetrician in Vakola, Mumbai and has an experience of 21 years in those fields. Dr. Mugdha Raut practices at Dr. Rauts Maternity And Surgical Nursing Home in Vakola, Mumbai. She finished MBBS from Seth G.S Medical College & KEM Hospital in 1989, MD - Obstetrics & Gynaecology from Seth G.S Medical College & KEM Hospital in 1991 and DGO from Seth G.S Medical College & KEM Hospital. She is a member of Mumbai Obstetrics & Gynaecology Society - MOGS (Since 1989), Federation of Obstetric and Gynaecological Societies of India (FOGSI) and Federation of International Society of Gynaecology & Obstetrics (FIGO) (Since 1989). Some of the services provided through the medical health practitioner are: Immunotherapy, Well Woman Healthcheck, Operative Endoscopy, Assisted Reproductive Technique and Management of Repeated Miscarriages and so on. This clinical medical doctor is one of the well-known IVF medical doctors in Mumbai with maximum IVF achievement charges.

Dr. Kishori Dinendra Kadam

Dr. Kishori Kadam has unique regions of hobbies like Normal Delivery Subsequent to a preceding Caesarian Section, Laparoscopic Hysterectomy, Laparoscopic Myomectomy, Fertility Issues, Laparoscopic Removal of Ectopic Pregnancy and Operative Hysteroscopy PCOS Management. Dr. Kishori Kadam practices in Fortis Hospital and holds an experience of more than 33 years inside the area of infertility.

Dr. Vidya Patil

holds wealthy scientific experience in her area of hard work and is devoted to the welfare of the mother and infant during and after being pregnant and one of the exceptional IVF medical docs in Mumbai. Dr. Vidya Patil completed her MD, DNB, and DFB in Obstetrics and Gynaecology after her commencement. She is an expert in excessive-risk pregnancies, infertility remedies, caesarian section, hysterectomy, pap smear, obstetrics antenatal, laparoscopic surgical methods, dilatation, and curettage. A dedicated scientific professional Dr. Vidya Patil follows an moral method in her diagnosis and treatment techniques. She is presently persevering with practice at Arya Womens Hospital in Kandivali, Mumbai.

If you have any double about IVF Centre in Varanasi. You can contact us

+91-8929020600

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cancersfakianakis1 · 6 years ago

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The results of treatment with high-dose chemotherapy and peripheral blood stem cell support for gestational trophoblastic neoplasia

Publication date: March 2019

Source: European Journal of Cancer, Volume 109

Author(s): M.M. Frijstein, C.A.R. Lok, D. Short, K. Singh, R.A. Fisher, B.W. Hancock, J.A. Tidy, N. Sarwar, E. Kanfer, M.C. Winter, P.M. Savage, M.J. Seckl

Abstract

Objective

The objective of the study was to evaluate the effect of high-dose chemotherapy (HDC) with peripheral blood stem cell support (PBSCS) on survival of patients with gestational trophoblastic neoplasia (GTN) with either refractory choriocarcinomas or a poor-prognosis placental site/epithelioid trophoblastic tumours (PSTT/ETTs).

Methods

Databases of two referral centres for gestational trophoblastic disease were searched, and 32 patients treated with HDC between 1994 and 2015 were identified. Tissue samples were retrieved for genetic evaluation. Cox regression analyses were performed to identify possible predictors of overall survival (OS).

Results

HDC induced a sustained complete response in 7 patients. Overall, 41% (13/32) of the patients remained disease free after HDC with or without additional treatment. Patients who survived had much lower human chorionic gonadotropin (hCG) values (all ≤12 IU/L) before and after HDC than those who died of disease. Univariable Cox regression analysis demonstrated that hCG >12 IU/L before or after HDC, International Federation of Gynaecology and Obstetrics (FIGO) stage II-IV and presence of metastases at the time of diagnosis were significantly associated with adverse OS. However, only hCG values before HDC remained significant in a multivariable model (p < 0.001). Five of 11 (45%) patients with PSTT/ETT presenting ≥48 months after antecedent pregnancy and 6 of 14 (43%) patients with refractory choriocarcinoma were in remission. Three treatment-related deaths occurred.

Conclusions

Despite 3 treatment-induced deaths, HDC with PBSCS appears to be active in salvaging selected patients with poor-prognosis PSTT/ETTs and refractory choriocarcinomas. Low hCG values before HDC seems a beneficial predictor of OS and may suggest that HDC acts more like a consolidation therapy.

http://bit.ly/2UFvM6c

#Oncology-Sfakianakis

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urvashiela-blog · 6 years ago

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Best IVF Doctor in Mumbai | Dr. Pinky Ronak Shah | Elawoman

In Vitro Fertilization (IVF) is a type of Assisted Reproductive Technology (ART). It includes recovering eggs from a female’s ovaries and fertilizing them with sperm. This fertilized egg is referred to as an embryo. The embryo can then be frozen and transferred to a woman’s uterus.

Depending on your situation, IVF can use:

Your eggs and your companion’s sperm

Your eggs and donor sperm

Donor eggs and your partner’s sperm

Donor eggs and donor sperm

Donated embryos

Your health practitioner can also implant embryos in a surrogate, or gestational issuer. This is a lady who consists of your toddler for you.

The success rate of IVF varies. According to the American Pregnancy Association, the stay beginning rate for girls under age 35 present system IVF is 41 to 43 percent. This price falls to thirteen to 18 % for ladies over the age of 40.

Why Is In Vitro Fertilization Performed?

Infertility troubles for which IVF may be critical include:

Reduced fertility in ladies over the age of 40

Blocked or damaged fallopian tubes

Reduced ovarian feature

Endometriosis

Uterine fibroids

Male infertility, which includes low sperm count number quantity or abnormalities in sperm shape

Unexplained infertility

Your doctor may even study your uterus. This can also contain doing an ultrasound. Your medical doctor may also moreover insert a scope via your vagina and into your uterus. These exams can display the fitness of your uterus and help the medical doctor manage the extremely good way to implant the embryos.

Best IVF Doctor in Mumbai is a technique for treating infertility-inability to conceive after to three years of trying. This is a reality that every ladies and man have the same probability of hurt by infertility issues. Due to expanded paintings stress, the annoying and fast-paced urban manner of lifestyles with strain, environmental pollution, and delaying marriageable age - the probabilities of infertility are developing drastically.

Here the Listing of Best IVF Doctor in Mumbai :

1.Dr. Pinky Ronak Shah

Dr. Pinky Ronak Shah is running in the direction of Obstetrician and Gynaecologist for the purpose that 15 years and with eight years enjoy in the field of Reproductive Medicine. She completed her FNB, fellowship in the reproductive medicinal drug from Lilavati Hospital, Mumbai, in which she got trained in fundamentals of ART, and mastered abilities in severa IVF processes and endoscopy.

Success Rate: 53%

IVF Cost: Rs. 1,10,000

Services offered: IVF, Surrogacy, IUI, ICSI

Location: Juhu - Explore more IVF doctors in Juhu, Mumbai

Rating: 3.3 / 5

2.Dr. Mohit Saraogi

Dr. Mohit Saraogi is an Infertility Pro and Gynecologist in Mumbai who spends significant time in IUI, IVF treatments, Surrogacy, Breast Cancer Screening, Hysterectomy procedures and ICSI treatments. Dr. Mohit finished MBBS from Grant Therapeutic School and Sir JJ Doctor's facility, Mumbai in 2008. At that point, he proceeded with pursuing MD in Obstetrics and Gynecology and DNB in Obstetrics and Gynecology from Seth G.S. Restorative School, Mumbai. He has additionally effectively qualified MRCOG membership examination decisively and was a gold medalist during his post-graduation examinations. He is a member of the Federation of Obstetrics and Gynecological Social orders of India (FOGSI) and Indian Medicinal Affiliation (IMA). Dr. Mohit is practising her expertise at Saraogi Healing facility and IRIS IVF Center, Malad West, Mumbai

Success Rate: 51%

IVF Cost: Rs. 1,40,000

Services offered: IVF, Surrogacy, IUI, ICSI

Location: Malad West - Explore more IVF doctors in Malad West, Delhi

Rating: 4.6 / 5

Dr Sachin Dalal

Dr Sachin Dalal is a gynaecologist, infertility expert and, obstetrician with over 17 years of revel in. He is a member of the Federation of Obstetric & Gynecological Societies of India (FOGSI), Medical Council of India (MCI) and Indian Association of Gynaecological Endoscopist (IMAGE). Dr Sachin Dalal has completed FCPS - Mid. & Gynae from Topiwala National Medical College & BYL Nair Charitable Hospital in 2002, DGO from Lokmanya Tilak Municipal Medical College, Sion, Mumbai in 2002 and MD - Obstetrics & Gynaecology from Mumbai University and National Board of Examinations, New Delhi in 2003. He is presently persevering with the workout at Madhu Imagine & Fertility Centre in Jungle Mangal Road, Mumbai. His areas of knowledge are In-Vitro Fertilization (IVF), Intra-Uterine Insemination (IUI), Normal Vaginal Delivery (NVD), Artificial Insemination, Laparoscopic Surgery and Hysterectomy (Abdominal/Vaginal).

Success Rate: 48%

IVF Cost: Rs. 1,35,000

Services offered: IVF, Surrogacy, IUI, ICSI

Location: Bhandup West, Mumbai - Explore more IVF doctors in Bhandup West, Mumbai

Dr. Mugdha Raut

Dr. Mugdha Raut is a Gynaecologist and Obstetrician in Vakola, Mumbai and has an experience of 21 years in those fields. Dr. Mugdha Raut practices.She finished MBBS from Seth G.S Medical College & KEM Hospital in 1989, MD - Obstetrics & Gynaecology from Seth G.S Medical College & KEM Hospital in 1991.She is a member of Mumbai Obstetrics & Gynaecology Society - MOGS (Since 1989), Federation of Obstetric and Gynaecological Societies of India (FOGSI) and Federation of International Society of Gynaecology & Obstetrics (FIGO) (Since 1989). Some of the services provided through the medical health practitioner are: Immunotherapy, Well Woman Healthcheck, Operative Endoscopy, Assisted Reproductive Technique and Management of Repeated Miscarriages and so on. This clinical medical doctor is one of the well-known IVF medical doctors in Mumbai with maximum IVF achievement charges.

Success Rate: 38%

IVF Cost:Rs.1,75,000

Services offered: IVF, Surrogacy, IUI, Egg donation

Location: Vakola - Explore more IVF doctors in Vakola, Mumbai

Dr. Kishori Dinendra Kadam

Dr. Vidya Patil

Dr. Vidya Patil holds wealthy scientific experience in her area of hard work and is devoted to the welfare of the mother and infant during and after being pregnant and one of the exceptional IVF medical docs in Mumbai. Dr. Vidya Patil completed her MD, DNB, and DFB in Obstetrics and Gynaecology after her commencement. She is an expert in excessive-risk pregnancies, infertility remedies, caesarian section, hysterectomy, pap smear, obstetrics antenatal, laparoscopic surgical methods, dilatation, and curettage. A dedicated scientific professional Dr. Vidya Patil follows a moral method in her diagnosis and treatment techniques. She is presently persevering with practice at Arya Womens Hospital in Kandivali, Mumbai.

Dr. Swati Allahbadia

Dr. Swati Allahbadia is a Consultant Gynaecologist working towards at Rotunda Blue Fertility And Endoscopy Centre in Mumbai for the final 25 years and one of the remarkable IVFdoctorsin Mumbai. She completed her graduate and positioned up-graduate scientific schooling from the KEM Hospital and Seth G.S. Medical College and come to be the recipient of the V.N Mazumdar prize for the duration of the equal length. She has huge-ranging enjoy in each element of Gynaecology having laboured in the Family planning location for 2 years, as Lecturer after which Associate Professor on the Sion Hospital-a teaching Hospital in Mumbai.

Success Rate: 36%

IVF Cost:Rs.2,30,000

Services offered: IVF, Surrogacy, IUI, Egg Reserve

Location: Kandivali West - Explore more IVF doctors in Kandivali West, Mumbai

For more information, Call Us : +91 – 7899912611

Visit Website : www.elawoman.com

Contact Form : https://www.elawoman.com/contact

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endfistuladay · 10 years ago

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Improving the quality of obstetric care.

Obtaining robust and comprehensive data on fistula remains a challenge, particularly given the invisibility of fistula survivors and the lack of priority and resources directed towards the issue at the global and national levels. Progress has been made in improving the availability of data, including the development and application of a standardized fistula module for inclusion in demographic and health surveys in an increasing number of countries. In addition, the Global Fistula Map has been updated, enhanced and expanded and provides a snapshot of the landscape of fistula treatment capacity and gaps worldwide. During the International Federation of Gynaecology and Obstetrics meeting of fistula stakeholders in 2015, a call for improved data collection tools was made so that surgical centres in countries affected by fistula can share, collaborate and improve practice through evidence - based efforts. Recommendations have been made to integrate routine surveillance and monitoring of fistula into national health systems, instead of this being conducted only through small independent studies. Additional suggestions are to combine community and facility approaches to collecting data, continue surveillance of surgeries to track progress and train providers to diagnose and report fistula at post-partum visits.

While precise figures are not available, it is estimated that over two million women and girls are living with obstetric fistula. Responding to the call for cost-effective methods for obtaining robust data on fistula, a new model to estimate the global burden of fistula, known as the “Lives Saved Tool”, has been developed by the Johns Hopkins Bloomberg School of Public Health, which is piloting the model to generate global and country-specific estimates of fistula incidence and prevalence. The model will be applied to all countries supported by the Campaign to End Fistula so as to produce new global estimates on fistula. It constitutes a major step forward globally and a vital tool to advance the planning, implementation and monitoring of efforts towards ending fistula.

Evidence of the positive, powerful impact of midwives in preventing maternal and newborn mortality and morbidity was significantly strengthened over the past two years with the release of the State of the World’s Midwifery, 2014 and the Lancet Midwifery series. In the Lancet Midwifery series, the Lives Saved Tool wasas used to estimate deaths averted if midwifery was scaled up in 78 countries. With universal coverage of midwifery interventions for maternal and newborn health, including family planning, for the countries with the lowest indicators in relation to maternal mortality and morbidity, 83 per cent of all maternal, fetal and neonatal deaths could be prevented. The French version of the Lancet Midwifery series was jointly launched by the International Confederation of Midwives, UNFPA and WHO in early 2015 in Geneva.

Maternal death surveillance and response, a framework for addressing preventable maternal mortality and morbidity, is increasingly being promoted and institutionalized in several countries. Maternal death and severe morbidity near-miss case reviews are of crucial importance in improving the quality of obstetric care, which, in turn, prevents the occurrence of maternal death and disability, including obstetric fistula.

To prevent the occurrence of obstetric fistula, timely access to quality health care, including emergency obstetric services, is of paramount import ance. To that end, it is essential to assess the current level of care and provide the evidence needed for planning, monitoring, advocacy and resource mobilization to improve access to quality of care and scale up emergency services in every district. UNFPA, UNICEF, WHO and the Averting Maternal Death and Disabilities Programme at Columbia University support emergency obstetric and newborn care needs assessments in countries with high rates of maternal mortality and morbidity.

#Campaign to End Fistula #maternal and child health #Eliminating Obstetric Fistula #u.n. general assembly #Obstetric fistula #International Day to End Obstetric Fistula #International Federation of Gynaecology and Obstetrics (FIGO)#Johns Hopkins Bloomberg School of Public Health #Lives Saved Tool

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biomedgrid · 5 years ago

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Biomed Grid| Endometrial Sampling for Endometrial Cancer: Still the Gold Standard?

Endometrial Cancer (EC)

Abnormal Uterine Bleeding (AUB)

The Clinical Importance of a Diagnosis of Endometrial Hyperplasia (EH)

The two prominent classification systems are

a. The World Health Organization (WHO) system, established in 1994 with revision in 2003, which is widely known within current clinical gynaecological practice and

The Endometrial Intraepithelial Neoplasia (EIN)

Classification system divides hyperplastic endometrial lesions into two groups:

a. Benign EH and

b. EIN. This is based on objective diagnostic criteria that can be determined from a haematoxylin and eosin (H&E) stained endometrial section.

Conclusion

Read More About this Article:https://biomedgrid.com/fulltext/volume2/endometrial-sampling-for-endometrial-cancer-still-the-gold-standard.000585.php

For more about: Journals on Biomedical Science :Biomed Grid

#biomedgrid #Journals on Biomedical Imaging #Journals on Medical Microbiology #Journals on Medical Casereports #Journals on Medical drug and theraputics #Open Access journals on surgery

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cancersfakianakis1 · 7 years ago

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Exploring the clonal evolution of CD133/aldehyde-dehydrogenase-1 (ALDH1)-positive cancer stem-like cells from primary to recurrent high-grade serous ovarian cancer (HGSOC). A study of the Ovarian Cancer Therapy–Innovative Models Prolong Survival (OCTIPS) Consortium

Publication date: July 2017 Source:European Journal of Cancer, Volume 79 Author(s): Ilary Ruscito, Dan Cacsire Castillo-Tong, Ignace Vergote, Iulia Ignat, Mandy Stanske, Adriaan Vanderstichele, Ram N. Ganapathi, Jacek Glajzer, Hagen Kulbe, Fabian Trillsch, Alexander Mustea, Caroline Kreuzinger, Pierluigi Benedetti Panici, Charlie Gourley, Hani Gabra, Mirjana Kessler, Jalid Sehouli, Silvia Darb-Esfahani, Elena Ioana Braicu BackgroundHigh-grade serous ovarian cancer (HGSOC) causes 80% of all ovarian cancer (OC) deaths. In this setting, the role of cancer stem-like cells (CSCs) is still unclear. In particular, the evolution of CSC biomarkers from primary (pOC) to recurrent (rOC) HGSOCs is unknown. Aim of this study was to investigate changes in CD133 and aldehyde dehydrogenase-1 (ALDH1) CSC biomarker expression in pOC and rOC HGSOCs.MethodsTwo-hundred and twenty-four pOC and rOC intrapatient paired tissue samples derived from 112 HGSOC patients were evaluated for CD133 and ALDH1 expression using immunohistochemistry (IHC); pOCs and rOCs were compared for CD133 and/or ALDH1 levels. Expression profiles were also correlated with patients' clinicopathological and survival data.ResultsSome 49.1% of the patient population (55/112) and 37.5% (42/112) pOCs were CD133+ and ALDH1+ respectively. CD133+ and ALDH1+ samples were detected in 33.9% (38/112) and 36.6% (41/112) rOCs. CD133/ALDH1 coexpression was observed in 23.2% (26/112) and 15.2% (17/112) of pOCs and rOCs respectively. Pairwise analysis showed a significant shift of CD133 staining from higher (pOCs) to lower expression levels (rOCs) (p < 0.0001). Furthermore, all CD133 + pOC patients were International Federation of Gynaecology and Obstetrics (FIGO)-stage III/IV (p < 0.0001) and had significantly worse progression-free interval (PFI) (p = 0.04) and overall survival (OS) (p = 0.02). On multivariate analysis, CD133/ALDH1 coexpression in pOCs was identified as independent prognostic factor for PFI (HR: 1.64; 95% CI: 1.03–2.60; p = 0.036) and OS (HR: 1.71; 95% CI: 1.01–2.88; p = 0.045). Analysis on 52 pts patients with known somatic BRCA status revealed that BRCA mutations did not influence CSC biomarker expression.ConclusionsThe study showed that CD133/ALDH1 expression impacts HGSOC patients' survival and first suggests that CSCs might undergo phenotypic change during the disease course similarly to non stem-like cancer cells, providing also a first evidence that there is no correlation between CSCs and BRCA status. http://ift.tt/2ripN97

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