BC HEALTH
Saved by @Mollyycolllinss

🧵 on Importance of correct indication of colonoscopic surveillance studies (English 🇺🇸🇬🇧)
@KM_Pawlak @KMonkemuller @drkeithsiau @JacquelineChuMD @PerelmansPearls @stevenbollipo @SWexner @DrBloodandGuts @ebtapper @DCharabaty @RashidLui @AdvaniRashmiMD @AtoosaRabiee @DrMohdZein

 @SultanMahmoodMD @GI_Guy @RodriguezParra_ @DrHarryThomas @TennysonMD @AustinChiangMD @KralJan @thomaskroner @alinkmd #GITwitter
1/ The implementation of screening and surveillance programs can reduce the incidence and mortality of CRC
https://t.co/P0SCUGxmne
2 / But for these to be effective and to guarantee protection against CCR, they must meet a series of conditions. One of them is the correct indication for endoscopic studies for both screening and surveillance.
3 / According to a recent meta-analysis, the minority of patients who undergo colonoscopies have a correct indication, with less than 50% adherence to the surveillance intervals proposed by scientific guidelines.
https://t.co/ysjo3zRhXb
4/ In a survey of different clinical scenarios on CRC surveillance carried out in 1432 physicians by Patel et al., Only 37% correctly answered the questions according to the recommendations (CPG9)
https://t.co/RYPlT6hKnA
5/ This revealed that the knowledge of gastroenterologists about CPG was poor. Although there are many reasons for lack of adherence, adequate knowledge of their recommendations is essential to achieve an acceptable level of adherence.
6/ Lack of adherence can manifest itself in the form of overindication as well as underindication, and both can undermine the effectiveness of a prevention program.
7/ Regarding overindication, a retrospective study of 1500 patients showed a shortening of the surveillance interval in almost 30% of the sample and up to 50% in those patients who had adenomas detected in the index colonoscopy
https://t.co/gwxKqC6euL
8/ Although colonoscopy is a safe study, it is not exempt from complications such as perforation (0.05%), bleeding (0.25%) and death (0.003%), and its overindication generates a net increase in these adverse events
https://t.co/07geSpoUA2
9/ Overuse then generates an increase in costs with marginal benefits ...
https://t.co/ZBT321p0T9
10/ ... and only contributes to the overload and subsequent fatigue of endoscopy units that must attend a higher percentage of patients under unnecessary surveillance.
https://t.co/rIo3OLKFvT
11/ Overindication can also generate a delay in screening, follow-up, or surveillance studies in patients with the correct indication, threatening the effectiveness of CRC prevention.
12/ In order to incorporate new individuals into the programs and perform colonoscopies in this naive population, unnecessary repetition of studies should be avoided, the overuse of the practice should be minimized ...
13/ ... and put more energy into also identifying people at increased risk of CRC who have not yet performed screening procedures.
4/ On the other hand, underindication also carries significant risks, since we can delay the control of patients at high risk of developing metachronous lesions and cancer
15/ A longitudinal cohort study showed that 76% of deaths from CRC were due to failures in the indication of screening and surveillance studies, and that patients with delays in surveillance studies …
16/ .... showed up to 7 times increase the risk of developing CRC
https://t.co/JI4yU3NTbl
17/ For all the aforementioned, the adequate indication for colonoscopic surveillance is considered a quality marker of endoscopy units and represents a key element in achieving an effective prevention program.
https://t.co/90wfYZYUns
That's all folks!

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ECTOPIC PREGNANCY

A woman just lost her life due to ectopic pregnancy!

It's a pregnancy in which the embryo attaches outside the womb. It can be life-threatening.

But we can save lives by helping educate women on our Timelines with this.

THREAD 🧵


In the human body, a fertilized egg hardly survives outside the womb. If allowed to grow, it may damage nearby organs & cause severe blood loss.

The bulk of ectopic pregnancies occur in/along the Fallopian tubes.

Some in the ovaries, cervix or a random location in the abdomen.


The usual symptoms of ectopic pregnancy a woman may experience esp. in early pregnancy are;

* Abdominal pain
* Vaginal bleeding, &
* Amenorrhea (missing your period)

Other pregnancy symptoms like breast fullness & occasional nausea may be there too.

But the common DANGER SIGNS of ectopic pregnancy that may signify rupture are;

🔴 Rigid abdomen

🔴 Severe abdominal pain

🔴 Shoulder tip pain, &

🔴 Signs of shock such as cold hands & feet.

With these signs, immediate medical attention is needed to save the woman's life!

Your chances of having an ectopic pregnancy are higher if you have;

1. Previous ectopic pregnancy

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\U0001f1ee\U0001f1ea & \U0001f1ec\U0001f1e7 COVID \U0001f9f5 \U0001f9f5 \U0001f9f5
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Shri Hanuman had boon to be immortal. And be present where ever there is Ram stuti.
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Where Ravan's brother ruled for many years..
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I will give them Darshan. But there are two conditions
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He promised to come after every 41 yrs
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https://t.co/uo4sGp7mUm

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