Low cost eco friendly conferences, workshops, training courses are conducted all the year round by the medicine department as per the mandate of our CBBLE research project toward continuing medical education and integrating it with medical practice.
Ecofriendly conferences asynchronous online for 2017:
Conference title: Patient centred clinical problem solving 2017
Workshop Title: Cyclical and non cyclical chronic mastalgia
Guest faculty: Dr Swagatha Brahmachari, Prof AIIMS, Bhopal
Active participants:
Rakesh Biswas , Prof Medicine, KIMs, Narketpally
Debasish Acharjee , Independent researcher, Bolpur, Shantiniketan
Aadipta Ghosh , MBBS Student, Kolkata
Avinash Kumar, MBBS Student, Bhaiarahva
Semi active participants:
Abbas Uddin , independent researcher
Shweta Gupta , senior Resident AIIMS Bhopal
Vivek Poddar , MBBS student, Dhaka
Arun Chaudhary, independent researcher
Passive participants: 1800 asynchronous online global participants
consisting of MBBS and MD students, question senior residents, independent researchers and faculty Professors in global locations but maximum represented from Indian subcontinent as well as Europe, US, Australia
Patient centered conversational learning outcomes:
Introductory session:
Conference host shares patient data from independent researcher in the conversational manner below followed by guest faculty and student responses generating conversational learning outcomes:
"A patient with a common problem shared recently by Debasish Acharjee from PIN Code area 736xxx for your inputs
Case report (non journal peer review format): http://ebpc-udhc-debasishacharjee.blogspot.in/2017/02/a-36-year-old-lady-suffering-from.html
Inputs from MBBS student Aadipta Ghosh:
Cyclic mastalgia is caused due to fibrocytic changes. As mentioned in the mammograms it may be fibroadenoma. One needs to find out the causes of non cyclic mastitis here in this patient.
Response from expert faculty, Dr Swagata Brahmachari:
It is not mastitis as per me it is mastalgia
Query from Medicine department host:
Is there anything in the imaging that needs or can be studied pathologically after a biopsy? What would you do for her pain that appears to be unbearable to her?
Inputs from MBBS student Avinash Gupta:
yes sir, squamous papilloma in histopathology report
opioids like tramadol for pain relief if unbearable as its due to papilloma
Cyclic Pain - The pain is usually most severe before a menstrual period and is often relieved when a period ends. Cyclic breast pain occurs more often in younger women. Most cyclic pain goes away without treatment and usually disappears at menopause. Danazol and tamoxifen citrate are prescription medicines used for the treatment of severe cyclic breast pain. http://www.webmd.com/women/tc/breast-pain-mastalgia-topic-overview#1
Inputs from MBBS student Aadipta Ghosh:
I would investigate the squamous papilloma , check for nipple discharges,ruptured cysts and any palpable masses if present Rakesh Biswas sir
Response from expert faculty, Dr Swagata Brahmachari:
First the levels of Sr Prolactin has to be assessed. Then Cabergolin is given if found raised
Current Medical Research and Opinion
Evidence for the Management of Mastalgia
R. Gumm; G. H. Cunnick; K. Mokbel | Disclosures
Curr Med Res Opin. 2004;20(5)
I have used Ormeloxifene (Sevista or Novex 30mg) in pts of mastalgia and small fibroadenoma (<2cm) with very good results clinically and radiologically
Response from host:
Any clinical trials that may have looked at the efficacy of ormeloxifene Swagata?
Response from expert faculty:
Int J Reprod Contracept Obstet Gynecol. 2015; 4(4): 1057-1060doi: 10.18203/2320-1770.ijrcog20150426
1.Efficacy of SEVISTA (Ormeloxifene) in treatment of mastalgia and fibrocystic breast disease
Vandana Bansal, Arpit Bansal, Ashwani Kumar Bansal.
Further addition from Dr Swagata:
This pts main problem is noncyclical mastalgia which was cyclical previously.Breast imaging is Birads 3 in which regular monitoring is must
Hence treatment should be symptomatic. Vulval pathology is not related to symptoms as it is most probably viral in origin (HPV) and also needs regular radiological screening
Response from host RB:
We reviewed this patient in the OPD and the mastalgia appeared to be part of a generalized problem of myalgia (or fibromyalgia if you will). There are many psychological issues that require addressing in this patient Debasish, Amy
originally hosted in the link below:
https://www.facebook.com/groups/tabularasa/permalink/1565508120143395/
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