Post on 20-Jan-2016
1. Entry by Droplet Infection2. Day 5 – Inflammation & Immune Response3. Alveoli fill with Fluid4. Oedema collapses Alveoli5. Day12 – Hypoxia & Resp
Failure
Dr Yung of HongKong University hasIsolated the corona virus from
CIVET CAT
Prof Vikramasinghe Director, Astrobiology,Cardiff University says
Virus came from OUTER SPACE
Lancet
Developing a Drug for SARS
Contributions from
The VIII World Congress
on
EndometriosisFebruary, 2002
AETIOPATHOLOGY
• Identification of Candidate Gene - Treolar• Endometriosis develops from reflux of specific
cell 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
DIAGNOSIS
Search for a specific Diagnostic Marker
• Serum CA-19-9 and CA-125 may be useful
- Harada
• Endometrial Biopsy & Aromatase assay
- Deenadayalu
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
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
GANGA & JAMUNABorn in May 2000 to aNepali Gurkha couple
CRANIOPAGUSIncidence: 1 in 2 millionSeparated successfully at
S’pore Gen Hospital
82 Hrs of Surgery + 17 Hrs To patch up Openings in Skull
usingSTEALTH computerised system to guide Vascular
Anastamosis
NeurosurgeonsKieth Goh
And Chumpon Chan
Source: Readers Digest April 2003
The Cochrane Review August 2000
• Comparison of Continuous 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
“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
EUTHANASIA
• PASSIVE : Withdrawal of Life Support
• ACTIVE : Through Direct Action
• PHYSICIAN-ASSISTED : By providing Information or Means
• INVOLUNTARY : With disregard to person’s wishes
“Doctor Death”Philip Nitschke
Demonstrating his “Death Machine”
which generates COIn Sydney
on 31 May 03
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
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