Sunday, July 29, 2007

Medical School

First-year students at Medical School were receiving their first anatomy class with a real dead human body.

All gathered around the surgery table with the body covered with a white sheet.

The professor started the class by telling them, "In medicine, it is necessary to have 2 important qualities as a doctor: The first is that you not be disgusted by anything involving the human body."

For an example, the Professor pulled back the sheet, stuck his finger in the butt of the corpse, withdrew it and stuck it in his mouth.

"Go ahead and do the same thing," he told his students.

The students freaked out, hesitated for several minutes, but eventually took turns sticking a finger in the butt of the dead body and sucking on it.

When everyone finished, the Professor looked at them calmly and told them, "The second most important quality is observation. I stuck in my middle finger and sucked on my index finger. Now learn to pay attention."

Saturday, July 28, 2007

Anal Glaucoma

A woman calls her boss one morning and tells him that she is staying home because she is not feeling well.

"What's the matter?" he asks

"I have a case of anal glaucoma," she says in a weak voice.

What the hell is anal glaucoma?"

"I can't see my ass coming into work today"

Friday, July 27, 2007

MRKH Syndrome

Mr. and Mrs. XYZ first approached our clinic with their problem of Primary Infertility on 31st January 2005. The couple has been married for the past two and a half years and came to us asking for IVF with gestational surrogacy. Mrs XYZ, 30 years of age, was aware that she had a rare a congenital uterine abnormality called Mayer- Rokitansky Kustner Hauser Syndrome. Patients with MRKH syndrome have failed development of the embryonic Mullerian ducts. They have absolutely normal secondary sexual characteristics like breast development etc. Normal development of these ducts result in the formation of the uterus, cervix and the upper 2/3 of the vagina. However, failure of the same results in a variety of abnormalities, most common being vaginal atresia and agenesis of the uterus and cervix. There is however normal ovarian development and normal ovarian function.

A preliminary examination and a basic hormonal screening test were done to rule out other hormonal imbalances. The patient was then advised to keep a Basal Body Temperature chart for a month to confirm the dates of ovulation to help us plan a cycle. As soon as a we localized her cycle dates, her treatment cycle was begun and synchronized with the surrogate's cycle. She was given gonadotropin injections to stimulate her ovaries to produce multiple mature eggs. A laparoscopic Ovum pick-up was scheduled as her ovaries high in the pelvis making vaginal ovum pick-up difficult. We managed to obtain
just three mature eggs which were then fertilized with her husband's sperms and finally two embryos were transferred into the surrogate on day 2 but her pregnancy test came negative.

The patient, however, did not lose hope and decided to do another treatment cycle. We started the cycle again with a little more ovarian stimulation with fertility injections to get more eggs. The surrogate was also started on hormonal replacement therapy to prepare her uterine lining. This time we managed to obtain 10 eggs of which 9 fertilized and we transferred four embryos. The surrogate got pregnant and subsequently delivered full term twins . The treatment has fulfilled the hopes and dreams of this woman who was born without a womb. We are now in the midst of treating three other women with MRKH syndrome.

Thursday, July 26, 2007

Maha - Mrityunjaya Mantra

(PRAYER FOR THE SICK)

Om Trayambakam Yajaamahe,

Sughandhim Pushtimvardanam,

Urvaarukamiva Bandhanaan,

Mrityor Mukshiya Maamritaat.

MEANING:

"We worship the Three - Eyed One (Lord Shiva), who is fragrant and nourishes well all beings. May He liberate us from death for the sake of Immortality, even as the cucumber is servered from its bondage to the creeper".

'NOTE'

This Maha - Mrityunjaya Mantra is a life-giving Mantra. In these days, when life is very complex and accidents are an everyday affair, this holy Mantra comes to your rescue. It wards off death by snake-bits, lightning, water accidents, motor accidents, air accidents, and accidents of all kinds. Besides, It has a great curative power. Diseases that are pronounced incurable by doctors arecured by this Mantra, when chanted with sincerity, faith and devotion. It is a Mantra too conquer death.

It is a Moksha Mantra as well, it is Lord Shiva's Mantra. It gives long life, health, prosperity, peace, satisfaction and immortality.

Wednesday, July 25, 2007

An E- mail sent by Dean IIT Madras, about our National Identity

"Dear Friends,

Here is a personal experience, as well as a moment of national pride, which I want to share with you. Hope you find it worth the time you put in reading it :

"In the middle of the 1965 India-Pakistan war, the US govt - then a close friend of Pakistan - threatened India with stopping food-aid (remember "PL-480"). For a food deficient India this threat was serious and humiliating. So much so that in the middle of war, Prime Minister (Late) Lal Bahadur Shastri went to Ram Leela Grounds in Delhi and appealed to each Indian to observe one-meal-fast every week to answer the American threat. As a school boy, I joined those millions who responded to Shastri ji's call. I continued the fast even when the war was over and India became self-sufficient in food. Hurt deep by the national humiliation suffered at the hands of the US govt, I had vowed to stop my weekly fast only when India starts giving aid to USA.

It took just 40 years. Last week THE day arrived. When the Indian ambassador in Washington DC handed over a cheque of US$ 50 million to the US govt, two plane loads of food, medical aid and other relief materials were waiting to fly to the USA. Time to break the fast? With no bad feeling about the USA, and good wishes for the Katrina victims, this humble Indian feels proud of the distance India has covered in 40 years. Let's celebrate a New India!"

We have miles to go, but let us feel proud of the direction our Nation is taking. Jai Hind.

Tuesday, July 24, 2007

Making Mothers Out of Grandmothers

After the Kargil war, we had the parents of the martyrs of the Punjab Battalion coming to us for Donor Egg IVF. The Punjab Battalion was the first to rush up the Kargil slopes when news of the Pakistani infiltration reached the Northern Command Army Headquarters. nearly 200 young men were killed & some of them were only sons of Jats & Jat-Sikhs in Punjab. There was a growing awreness about our work with Donor Egg IVF in the region. India Today, subsequently carried a color feature in their December 2003 issue called ; "Grand Old Parents". You can read this online at http://www.indiatodaygroup.com/itoday/20031222/ if you are a subscriber to India Today.

A 62-year old woman has become the UK's oldest woman to give birth to a child. Dr Patricia Rashbrook, who already has three children aged 18, 22 and 26, underwent IVF treatment using donor eggs in order to conceive her son, who was born by Caesarean section last month. Dr Rashbrook, who travelled to Eastern Europe for the fertility treatment with her second husband, 60-year old John Farrant, paid £7000 for the IVF with a donated egg. The treatment was carried out by Italian fertility doctor Severino Antinori, most famous for vowing to clone humans. Describing her new-born son, Dr Rashbrook, a child psychiatrist, said 'he is adorable', adding that 'having been through so much to have him we are overjoyed. His birth was absolutely wonderful and deeply moving for both of us'. Her husband, 61 year old John Farrant, said that he was 'awestruck' upon seeing his son. 'I felt transformed, as if fatherhood had fulfilled a need in me that I hadn't acknowledged before I met Patti', he added.

The oldest woman to have given birth following fertility treatment is Adriana Iliescu, a Romanian woman, who gave birth aged 66 in 2005. Clinics in India are not averse to treating women in their sixties - even though it is not recommended by the ICMR to do so. Most clinics have an upper age limit and few would treat women over the age of 50. One thing clinics in India have to take into account is the welfare of the prospective child - and many fertility physicians would not consider it to be in a child's best interests to be born to parents who are less likely to survive until it is an adult. Dr Rashbrook defends critics who say the couple have put their needs above those of the child: 'We would not have gone ahead if we felt we would not be good parents', she said, She added: 'I have always looked and felt very young, but nevertheless we have younger friends with children who have agreed to act as surrogate parents should anything happen to us'.

However, some fertility specialists have said they oppose the treatment of older women with IVF. Sam Abdalla, medical director of the infertility clinic at London's Lister hospital, said that although 'it is true we can easily get a 70 year old pregnant, or even someone older', he believes that 'it is much better to have the rules and framework that apply in Britain'. 'I hope this remains an individual case', he added. Patricia Hewitt, the Health Secretary, has however defended Dr Rashbrook, accusing critics of 'gender hypocrisy'. She said that the choice to undergo IVF should be a choice for individual couples and their doctors. But others have called this attitude 'irresponsible'. Ann Widdecombe MP said that it was not the right analogy, as men could conceive children naturally into old age and women could not. Josephine Quintavalle, from the pro-life campaign group Comment on Reproductive Ethics (Core), asked where Hewitt would draw the line: 'at 70, at 80, 100?'

Last month, the oldest woman to give birth to IVF twins did so in New York, aged 59, also following treatment using donated eggs. Mrs Cohen and her husband Frank Garcia, from Paramus, New Jersey, already have a daughter, Raquel, who was conceived in the same way.

Rotunda has a very successful Donor Egg IVF program and you can read more about this at
http://www.iwannagetpregnant.com/egg.asp

Monday, July 23, 2007

Posthumous Reproduction illegal in Japan

The supreme Court of Japan has overturned an earlier ruling that a child born after IVF using a dead man's sperm is legally the man's child. The child was conceived after the man's death from leukaemia in 1999, using his frozen sperm, and born in 2001. Originally, when the child's mother tried to register the birth, the local government refused to allow it, on the grounds that the father had died more than 300 days before the birth date and the normal length of human gestation is about 270 days. Under the Japanese Civil Code, a child is not recognised as having been born in wedlock if it is born more than 300 days after the end of a marital relationship. The mother filed a lawsuit to have her son legally recognised as the child of his father. In November 2003, the first court ruled against the mother on the grounds of 'common sense' saying it was impossible to recognise the father-child relationship in such a case, and that there was little social awareness for acknowledging a deceased man as a child's father, even if his sperm was used. However, in July 2004, the Takamatsu High Court overturned the lower court's ruling. Now, following an appeal, the Supreme Court has overturned the High Court decision, saying that this was not a parent-child relationship that the Civil Code had envisaged. 'No parent-child relationship in a legal sense can be recognised, given the father died before she got pregnant and there is no possibility of the baby being dependent or receiving inheritance', said Justice Ryoji Nakagawa, who heard the appeal. Some doctors believe that the ruling shows that regulation of this area of medicine in Japan lags behind progress in science and technologies available to help people have children. And they say it may present a challenge to doctors of reproductive medicine, as the field depends on voluntary self-regulation. Each institution is able to decide for itself what should happen to stored sperm when donors die. However, legislation on reproductive technologies, which had been planned for 2004, was shelved. A spokesman for the Health, Labour and Welfare Ministry said that 'though we believe some legislative steps are necessary, it is too early now because there is no national consensus'.
This is one area where the ICMR needs to come out with a consensus statement in our own country.