november 2014 narayanan r. the evil of ebola the spread
TRANSCRIPT
November 2014 Narayanan R
The evil of EBOLA
The spread
• 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%
• No vaccine• No specific drug• Only supportive
therapy
Flu like symptoms
VomitingDiarrhoea
DIC
Multi organFailure
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
Uterine Transplantation
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
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
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
Fecal transplantation
Youngster et al, MGH Boston, JAMA 2014.
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
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
Frida Kahlo
YELLOW / ORANGE Motility----------------------------------------------------------------RED Morphology----------------------------------------------------------------Sweet Potato /Melon / Oats Quantity & Quality
Fertil Steril Dec 2013
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
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.
• 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
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
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
Thank you!