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ObG Watch

ObG Watch. June 2003. 1. Entry by Droplet Infection 2. Day 5 – Inflammation & Immune Response 3. Alveoli fill with Fluid 4. Oedema collapses Alveoli 5. Day12 – Hypoxia & Resp Failure. Dr Yung of HongKong University has Isolated the corona virus from CIVET CAT.

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ObG Watch

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  1. ObG Watch June 2003

  2. 1. Entry by Droplet Infection 2. Day 5 – Inflammation & Immune Response 3. Alveoli fill with Fluid 4. Oedema collapses Alveoli 5. Day12 – Hypoxia & Resp Failure

  3. Dr Yung of HongKong University has Isolated the corona virus from CIVET CAT Prof Vikramasinghe Director, Astrobiology, Cardiff University says Virus came from OUTER SPACE Lancet

  4. Developing a Drug for SARS

  5. ContributionsfromThe VIII World CongressonEndometriosisFebruary, 2002

  6. AETIOPATHOLOGY • Identification of Candidate Gene - Treolar • Endometriosis develops from reflux of specificcell types, altered by peritoneal environment & not from eutopic endometrium - Redwine &Taylor • Tumour Necrosis factor-a in peritoneal fluid - Lebovic • Decreased macrophage recruitment & Impaired Phagocytosis - Kharfi et al

  7. DIAGNOSIS Search for a specific Diagnostic Marker • Serum CA-19-9 and CA-125 may be useful - Harada • Endometrial Biopsy & Aromatase assay - Deenadayalu

  8. TREATMENT • No benefit with Post op Interferon-a2b or GnRHa - Randomized Trial by Acien • Surgery during Luteal phase doubled the incidence of Recurrence compared to Proliferative phase - Schweppe

  9. ENDOMETRIOSIS & INFERTILITY • Controlled Ovarian Stimulation & IUI and IVF result in acceptable Pregnancy rates - Dmowski • IVF is the most effective Treatment - Rickles • Laparoscopic excision of Endometrioma has no effect on IVF results - Marconi

  10. GANGA & JAMUNA Born in May 2000 to a Nepali Gurkha couple CRANIOPAGUS Incidence: 1 in 2 million Separated successfully at S’pore Gen Hospital 82 Hrs of Surgery + 17 Hrs To patch up Openings in Skull using STEALTH computerised system to guide Vascular Anastamosis

  11. Neurosurgeons Kieth Goh And Chumpon Chan

  12. GANGA & JAMUNA Source: Readers Digest April 2003

  13. The Cochrane Review August 2000 • Comparison ofContinuous EFM & Intermittent Auscultation in Labour • 9 Trials: >18,000 Mothers • Conclusion:No short term or long term benefit of continuous EFM in Labour • Increased incidence of Caesarean Section & Assisted vaginal Deliveries • Recommendation:Reduce or Abandon Continuous EFM in low risk cases

  14. “Yes we’re all cousins, That’s what I believe, Because we’re children Of Adam and Eve… But we’re kissing cousins” Elvis Presley song, 1964

  15. EUTHANASIA • PASSIVE : Withdrawal of Life Support • ACTIVE : Through Direct Action • PHYSICIAN-ASSISTED : By providing Information or Means • INVOLUNTARY : With disregard to person’s wishes

  16. Dying Softly... “Doctor Death” Philip Nitschke Demonstrating his “Death Machine” which generates CO In Sydney on 31 May 03

  17. EUTHANASIA • Some states in US & Australia allow passive euthanasia • Netherlands first in the world to legally sanction – April 2003 • Belgium & France to follow • Applies to continuous, unbearable & incurable pain • On request voluntarily, independently & persistently • Second opinion must be taken

  18. Second Opinions • Second opinion is Patient’s Right • Opinion only after review of History, All records & Physical Examination • From the book, • “Second Opinions” • by E Groupman of • Harvard Medical School

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