| Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy). |
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| Indications - |
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- Hysteroscopy is useful in a number of uterine conditions:
- Asherman's syndrome (i.e. intrauterine adhesions).
- Endometrial polyp. Polypectomy.
- Gynecologic bleeding
- Endometrial ablation
- Myomectomy for uterine fibroids.[1]
- Congenital Uterine malformations (also known as Mullerian malformations). Eg.septum,[2][3]
- Evacuation of retained products of conception in selected cases.
- Removal of embedded IUDs (copper T)
- Hysteroscopy allows access to the utero-tubal junction for entry into the fallopian tube; this is useful for tubal occlusion procedures for sterilization and for falloposcopy.
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| Post Menopausal Osteoporosis |
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| How Common is PMO - |
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| Osteoporosis is highly prevalent in India. An estimated 61 million people in india are reported to be affected by it. Out of total osteoporotic population, 50% are women and in actual numbers it accounts for 30 million women. In india, it is projected that by the year 2030, the population of postmenopausal women will be 2nd. Highest in the world |
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| Understanding PMO - |
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| Osteoporosis is a disease that causes bone loss. Over time, the bones can become thinner and weaker. The inner bones, which are full of tiny holes, like a sponge, become lighter and have more empty space. As bones thin, they are more likely to break or fracture. This happens more often in the hip, spine (back) and wrist. |
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| Osteoporosis occurs more often in women after menopause. This happens because the body produces little estrogen after menopause. Estrogen is the female sex hormone that helps keep bones strong. |
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| Who is likely to get osteoporosis? |
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- Women who have gone through menopause
- Women who haved having periods early for any reason (such as hysterectomy, too much exercise, anorexia, bulimia)
- Anyone who has a had a bone fracture after age 50
- Small boned or thin women
- Those who didn’t get enough calcium and vitamin D3 in their diets
- Those who didn’t get enough weight bearing exercise (such as walking, jogging, dancing)
- Those who smoke and/ or drink alcohol
- Those who take certain medications e.g. for asthma, rheumatoid arthritis, thyroid conditions, seizures, gastrointestinal disease)
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| Signs and Symptoms of Osteoporosis |
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| The osteoporosis condition can operate silently for decades because osteoporosis doesn’t cause symptoms unless bone fractures. In the early stages of bone loss you usually have no pain or symptoms. |
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| But once bones have been weakened by osteoporosis you may have signs and symptoms that include |
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- Back pain, which may be sever if you have a fractured or collapsed vertebra.
- Reduced Height over time with an accompanying stooped posture
- Fracture of the vertebrae, wrists, hips or other bones.
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| Importance of Early Diagnosis |
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| People with osteopenia(low bone mass) or osteoporosis can take action to stop the progressive loss of bone mass through early detection. By making positive lifestyle changes and following appropriate treatment strategies in consultation with a doctor, osteoporotic fractures can be prevented. |
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| Diagnosis of Post Menopausal Osteoporosis - |
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| In order to detect osteoporosis your doctor may advise : |
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1) Bone densitometry using either ultrasound or dual energy X-ray absorptionmetry(DEXA) which helps in:
a) Early detection osteoporosis
b) Predicting the risk of fractures in future
c) Determining the rate of bone loss
d) Monitoring the effect of treatment
2) X-ray can detect osteoporosis but only in advanced cases. By the time approximately 30-40% of bone mass has already been lost.
3) Blood test to detect the calcium and phosphorous levels. |
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| To know if you are at risk of PMO, check following Parameters - |
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- Answer following questions. The more number of YES you get, the greater is the risk.
- The most significant risk factor for osteoporosis is if you are a postmenopausal woman.
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| Question |
Yes |
No |
| I have gone through menopause (naturally or surgically induced) |
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| I have had an early menopause (before age 45) |
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| I have a bone fracture as an adult |
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| There is a family history of osteoporosis |
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| I have a small thin frame |
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| I do not get much calcium through my diet or supplements |
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| I am not physically active |
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| I smoke cigarettes |
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| I consume excessive amount of alcohol |
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| If you are at Risk - |
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| If the results show that you have osteoporosis or osteopenia consult your doctor. |
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| Coping with PMO - |
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- Once osteoporosis develops, the main objective of treatment is to prevent further bone loss and maintain bone strength in order to avoid fractures.
- Every menopausal woman should take adequate calcium to avoid risk of osteoporosis. Calcium can slow bone loss and may decrease fractures. Menopausal woman should consume 1500 mg of calcium and 400/800 IU of vitamin D per day.
- Add soy to your diet: the plant estrogens found in soy help maintain bone density and may reduce the risk of fractures, particularly in the first 10 years after menopause.
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| Self Care in PMO is Best Care - |
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| Maintain good posture - |
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- Good posture involves keeping your head held high; chin in, shoulders back, upper back flat and keeping lower spine arched helps you avoid stress on your spine.
- When you sit or drive, place a rolled towel in the small of your back
- Don’t lean over while reading or doing handwork.
- When lifting, bend at your knees, not your waist and lift your legs, keeping your upper back straight.
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| Prevent Falls - |
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| Wear low-heeled shoes with non slip soles and check your house for electrical cords, area rugs and slippery surfaces that might cause you to trip or fall |
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| .Keep rooms brightly lit, install grab bars just inside and outside your shower door, and make sure you can get in and out of your bed easily. |
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| Manage Pain - |
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| Discuss pain management strategies with your doctor. Don’t ignore chronic pain. Left untreated, it can limit your mobility and cause even more pain. |
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| Diet - |
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- Eat plenty of fruits and vegetables
- Eat chapatti, carbohydrates like brown rice, oats
- Eat beans such as lentils and soya products which are natural sources of estrogens
- Reduce your intake of saturated form dairy products
- Drink enough fluids
- Increase your intake of fibre
- Avoid additives, preservatives and chemical such as artificial sweetners
- Reduce your intake of caffeine
- Reduce alcohol
- Avoid excess intake of sugar
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