November 2014 Narayanan R. The evil of EBOLA The spread.
-
Upload
brianne-cook -
Category
Documents
-
view
217 -
download
0
Transcript of November 2014 Narayanan R. The evil of EBOLA The spread.
![Page 1: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/1.jpg)
November 2014 Narayanan R
![Page 2: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/2.jpg)
The evil of EBOLA
![Page 3: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/3.jpg)
The spread
![Page 4: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/4.jpg)
• Deadly Virus• Enters body thru
contact with body fluids
• Incubation period: 2-20 days
• Kills cells & Makes them explode
• Wrecks immune system
• Hemorrhagic crisis• Mortality >55%
![Page 5: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/5.jpg)
• No vaccine• No specific drug• Only supportive
therapy
Flu like symptoms
VomitingDiarrhoea
DIC
Multi organFailure
![Page 6: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/6.jpg)
Relevance to ObG
• Virus persists in semen for >3 mths• Transmitted through Breast milk• Mode of transmission to fetus not
known • Mortality in pregnancy higher even if
unaffected (Congo 1999: Overall: 77% - Pregnant: 95.5% -
NNM: 100%)
• Collateral damage
![Page 7: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/7.jpg)
Uterine Transplantation
![Page 8: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/8.jpg)
Indications:
Absence of uterusHypoplasia
Morbid adhesions Post Hysterectomy
Ethical:
Uterus not a vital organUnlike heart & kidneyConsider quality of life
Risks:
Need for ARTImmunosuppression
Organ or embryo rejection
Drawbacks:
Surgical skillMiscarriage
IUGRPreterm
![Page 9: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/9.jpg)
World’s First Child Born After Uterus Transplantation
• Research project 1999 at Gothenburg, Sweden
• Team led by Mats Brännström
• 9 women received a womb from live donors
• PE due to Immunosuppression
• 3 mild rejection episodes• First delivery in Sept 2014• At 32 wks – CS - fetal
distress
![Page 10: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/10.jpg)
Penile Transplantation
• Difficult to make this organ serving dual purposes of voiding urine and experiencing sexual response
• Penis made from regenerated tissue from the patient's own groin or from a donor
• Atala’s team transplanted the first bladder in1999 - urethra 2004 - vagina in 2005
Atala
![Page 11: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/11.jpg)
Fecal transplantation
Youngster et al, MGH Boston, JAMA 2014.
![Page 12: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/12.jpg)
Poop Pills
• Used to treat the dangerous Clostridium difficile, which kills 14,000 Americans annually
• Stool samples taken from healthy relatives is processed and the isolated bacteria bacteria alone are packed into pill cases that dissolve when they reach the intestines
• Single shot therapy• Canadian study: All 27 patients were cured
Infectious Diseases Society of America, Oct 2013
![Page 13: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/13.jpg)
Indian origin UK woman grows beard
• Harnaam Kaur 23, is suffering from PCOS
• She had been struggling with hair growth since she was 11 and was being teased in school
• She is now growing a beard after being baptised as a Sikh.
• She would never ever remove her facial hair because it’s the way God made her and she is happy with the way she is
![Page 14: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/14.jpg)
Frida Kahlo
![Page 15: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/15.jpg)
YELLOW / ORANGE Motility----------------------------------------------------------------RED Morphology----------------------------------------------------------------Sweet Potato /Melon / Oats Quantity & Quality
Fertil Steril Dec 2013
![Page 16: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/16.jpg)
Milk, Fractures and Death
• 61,433 women 39 to 74 years and 45,339 men 45 to 79 years • 22 years of follow-up • Women who drank >3 glasses of milk a day had twice the risk for death compared with women who drank less than one glass a day • Women who drank more milk also had a higher risk for any type of fracture Uppsala university, Sweden
![Page 17: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/17.jpg)
Plasma Kisspeptin Level May Predict Miscarriage
• Found in placenta & is critical for reproduction
• Low levels of K in 1st trimester predicts miscarriage even in asymptomatic women
• Single blood test may be better than serial hCG
• Kisspeptin level >1306 pmol/L strongly indicates reduced risk for miscarriage
• It may also prove to be an Indicator for PE/IUGR
Abbara A,Jt Meeting of the International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014; June 21, 2014.
![Page 18: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/18.jpg)
• 30-40% of Scottish women drink in excess
• Habit has doubled in 30 yrs
• 1 in 30 deaths in women are drink-related
• Scottish campaign for ‘Smaller glasses’
• ‘Drinking Mirror’ app for cell phones
![Page 19: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/19.jpg)
How you look today
10 years laterIf you drink in excess
If you reduce theSize of your glass
App shows women how booze affects looks
![Page 20: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/20.jpg)
The Moon and Menses
• Study of 823 women all over the world• >39451 cycles• >20% started periods around full moon• Best time to conceive?• Around new moon!
Philip Chennette 2014
![Page 21: November 2014 Narayanan R. The evil of EBOLA The spread.](https://reader036.fdocuments.us/reader036/viewer/2022062322/5697bfbf1a28abf838ca2e71/html5/thumbnails/21.jpg)
Thank you!