Opening Hours: 7 days a week from 7.00am to 9.00pm

An Restaurant will be closed for a Half Year Break from Monday July 17th, 2017 and will reopen on Friday July 28th, 2017

 
 

N asynchrony b/t chrono date and histo date of endometrium get dysfunc bleeding irregular sheding prolonged corpus luteum, continued progesterone -> prolonged heavy bleeding @ menses mix of secretory and prolif glands @ biopsy ocp changes of the endometrium inactive glands, decidualized stroma (progesterone fx - small inact tubular glands; prevent hyperplastic endomet) acute endometritis rare due to intraut trauma, instrumentation, iud, retained products of conception most often due to hemolytic strep and staph chronic endometritis abnorm bleeding, pain, discharge, infertility biopsy - plasma cells and lyphocytes in chronic pid, retained poc, iud, patients with tb 15% = no primary cause; chlamydia may be involved endometriosis infert, dysmenorrhea, pelvic pain endomet glands/stroma outside of uterus ovaries - large cystic filled with brown blood debris (chocolate cyst) "powder burns" on surface of uterus adenomyosis endometrial tissue in myometrium in 20% uteri micro - nests of endometrial glands (+/- stroma) w/in muscle bundles -> thick spongy myometrium can have hemorrhage w/in nests -> menorrhagia, colicky dysmenorrhea, dyspareunia, premenstrual pelvic pain endometrial polyp benign, sessile asymp or cause abnorm uterine bleeding functional epithel or (more commonly) hyperplastic endomet assoc w/tamoxifen tx of breast cancer endometrial hyperplasia assoc with prolonged estrogen stim (anov or increased estrogen) - menopause, pod, granulosa cell tumors, estrogen replacement get aub pten gene inactivation (tumor supp) more cellular atypia (eg back to back glands) = increased risk of carcinoma most common gyn malignancy endometrial carcinoma endometrial carcinoma 55-65 yrs obesity, dm, ht, infertility, breast cancer asymp or aub 85% = adenocarcinoma (endometriod; back to back glands; may have squamos foci) polypoid or diffuse other 20% = papillary serous or clear cell 1st thing to rule out @ post-menopausal bleeding endometrial carcinoma carcinosarcoma malignant mixed mullerian tumor endometrial carcinoma + malignant stroma differentiation variety of malig mesodermal comps (musc, cartilage, bone) post-menopausal; highly malig ("carc" = epi; "sarc" = mesenchymal) most common uterine tumor leiomyoma most common of all (gyn) tumors in women uterine leiomyoma uterine leiomyoma increased incidence in af benign - malig transformation = rare estrogen sensitive - grow big @ preg; smaller @ post-menopause whorled appearance @ cut intramural, submucosal, subserosal asymp, aub, compress bladder, sudden pain/infertility leiomyosarcoma 40-60 y/o tend to recurr post-removal; blood mets to lungs, bone, brain arive de novo - never by malig transformation look for # mitoses (lots here vs few @ leiomyoma) in. viagra online viagra for jet lag Canada viagra on line viagra for jet lag How long does it take for viagra to become effective canadian viagra discounts buy viagra online cheap mg viagra pills fast deliervery Viagra 50 mg quanto costa female viagra fox news viagra dosage guidelines where is the cheapest place to buy viagra buy cheap viagra much does viagra cost thailand cheap viagra online female viagra nasal spray buy cheap viagra generic viagra viagra prescription only drug buy generic viagra online cheap

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