Two doctors opened an office in a small town and put up a sign reading "Dr. Smith and Dr. Jones, Psychiatry and Proctology."
The town council was not happy with the sign, so the doctors changed it to "Hysterias and Posteriors."
This was not acceptable either, so in an effort to satisfy the council they changed the sign to "Schizoids and Hemorrhoids." No go.
Next, they tried "Catatonics and High Colonics." Thumbs down again.
Then came "Manic Depressives and Anal Retentives." Still not good.
Another attempt resulted in "Minds and Behinds." Unacceptable again.
So they tried "Lost Souls and Ass Holes." No way.
"Analysis and Anal Cysts?" Nope.
"Nuts and Butts?" Uh uh.
"Freaks and Cheeks?" Still no go.
"Loons and Moons?" Forget it.
Almost at their wit's end, the doctors finally came up with: "Dr. Smith and Dr. Jones, Odds and Ends."
And they loved it.
Saturday, August 4, 2007
Friday, August 3, 2007
Roman Catholic Bishops say hybrid embryos have right to life
The human-animal hybrid embryo is formed from an animal egg cell (most likely from cows or rabbits). Scientists want to use such embryos to create genetically human embryonic stem (ES) cells. This method would overcome difficulties associated with the collection of human eggs from donors, and would provide a much more fruitful source of embryos for scientists.This egg cell's nuclear DNA is removed and replaced with nuclear DNA from an adult human. The cell is then 'kick-started' - with a small electric shock - into commencing cell division. The embryo would be almost 100 per cent human - the only non-human DNA in the cell comes as part of the cell's mitochondria: apparatus for providing the cell with energy.
Currently, the vast majority of human eggs given by donors are for IVF treatment and not for research. A recent consultation by the HFEA entitled 'Donating Eggs for Research: Safeguarding Donors' stressed both the ethical and safety concerns associated with methods used to collect human eggs. The creation of human-animal hybrid embryos is safe in that it involves no human participant, except for the collection of a few skin cells. The voices arguing against the work are few; indeed there has been a distinct lack of comment pieces in the press supporting a potential ban. Naysayers rely on two arguments: a moral argument, and the prediction that this avenue of research will be useless. The practise of creating human-animal hybrid embryos is, they say, unnatural, and therefore immoral. This is a familiar reaction to new biological technology: IVF is 'unnatural', but is now accepted as a useful technology to aid fertility treatment. And although no one yet knows whether this research will prove fruitful, this should not be used as argument for banning the work. The proper action should be to let the research commence, and to monitor the results for potential benefits, or ethical concerns.
Two important points must be brought to the attention of the public:
1) The enormous potential that this avenue of research could hold. The 'could' should also be stressed. Nothing tangible has resulted from this work at this stage, but scientists agree that this line of research should not be closed before its potential fruits can be assessed.
2) The fact that there is absolutely no likelihood that this work could result in a 'hybrid-human' or any other 'Frankenstein's monster' type result. The subject of the research is cells, not animals. These embryos are a potentially useful research tool, and the potential for exploring new avenues of research should be welcomed.
The Roman Catholic Bishops of England (RCBE) have told the UK parliament that inter-species embryos - those containing genetic information from both human and animals - should not be treated any differently from 'normal' embryos, and that women should be given the chance to carry their genetic offspring to term.
There is currently a real shortage of human eggs for use in embryonic stem (ES) cell research. It is hoped the problem can be overcome through creating embryos by transferring human genetic material into 'hollowed out' animal eggs. The resulting entity - a 'cybrid' - would be over 99 per cent genetically human and less than one per cent animal. As it stands, the new draft Human Tissue and Embryos Bill in the UK will ban the creation of embryos that contain genetic material from both animals and humans, but will make an exception for certain types of research, including cybrid embryos. The draft Bill imposes a strict 14 day time limit on the use of these entities in research, at which point they must be destroyed.
The RCBE and the Linacre Centre for Healthcare Ethics told the parliamentary committee who are scrutinising the draft Bill: 'At the very least, embryos with a preponderance of human genes should be assumed to be embryonic human beings, and should be treated accordingly. In particular, it should not be a crime to transfer them, or other human embryos, to the body of the women providing the ovum, in cases where a human ovum has been used to create them'.
The RCBE have been accused of misunderstanding the science involved in creating such embryos. Cybrid embryos will have no 'mother'; rather, an animal ovum will be stripped of its genetic identity and used as an empty vessel to cultivate hES cells from cloned human cells. It is hoped that such research will lead to advances in treatment for devastating diseases such as Parkinson's and Alzheimer's.
Liberal Democrat MP, Dr Evan Harris, has described the RCBE's position as 'absurd' and 'inconsistent', adding: 'Most of these embryos will be created using animal eggs, but even if they were created using human eggs, they would be created by cloning and the Catholic Church has previously opposed reproductive cloning of even fully human embryos'.
Currently, the vast majority of human eggs given by donors are for IVF treatment and not for research. A recent consultation by the HFEA entitled 'Donating Eggs for Research: Safeguarding Donors' stressed both the ethical and safety concerns associated with methods used to collect human eggs. The creation of human-animal hybrid embryos is safe in that it involves no human participant, except for the collection of a few skin cells. The voices arguing against the work are few; indeed there has been a distinct lack of comment pieces in the press supporting a potential ban. Naysayers rely on two arguments: a moral argument, and the prediction that this avenue of research will be useless. The practise of creating human-animal hybrid embryos is, they say, unnatural, and therefore immoral. This is a familiar reaction to new biological technology: IVF is 'unnatural', but is now accepted as a useful technology to aid fertility treatment. And although no one yet knows whether this research will prove fruitful, this should not be used as argument for banning the work. The proper action should be to let the research commence, and to monitor the results for potential benefits, or ethical concerns.
Two important points must be brought to the attention of the public:
1) The enormous potential that this avenue of research could hold. The 'could' should also be stressed. Nothing tangible has resulted from this work at this stage, but scientists agree that this line of research should not be closed before its potential fruits can be assessed.
2) The fact that there is absolutely no likelihood that this work could result in a 'hybrid-human' or any other 'Frankenstein's monster' type result. The subject of the research is cells, not animals. These embryos are a potentially useful research tool, and the potential for exploring new avenues of research should be welcomed.
The Roman Catholic Bishops of England (RCBE) have told the UK parliament that inter-species embryos - those containing genetic information from both human and animals - should not be treated any differently from 'normal' embryos, and that women should be given the chance to carry their genetic offspring to term.
There is currently a real shortage of human eggs for use in embryonic stem (ES) cell research. It is hoped the problem can be overcome through creating embryos by transferring human genetic material into 'hollowed out' animal eggs. The resulting entity - a 'cybrid' - would be over 99 per cent genetically human and less than one per cent animal. As it stands, the new draft Human Tissue and Embryos Bill in the UK will ban the creation of embryos that contain genetic material from both animals and humans, but will make an exception for certain types of research, including cybrid embryos. The draft Bill imposes a strict 14 day time limit on the use of these entities in research, at which point they must be destroyed.
The RCBE and the Linacre Centre for Healthcare Ethics told the parliamentary committee who are scrutinising the draft Bill: 'At the very least, embryos with a preponderance of human genes should be assumed to be embryonic human beings, and should be treated accordingly. In particular, it should not be a crime to transfer them, or other human embryos, to the body of the women providing the ovum, in cases where a human ovum has been used to create them'.
The RCBE have been accused of misunderstanding the science involved in creating such embryos. Cybrid embryos will have no 'mother'; rather, an animal ovum will be stripped of its genetic identity and used as an empty vessel to cultivate hES cells from cloned human cells. It is hoped that such research will lead to advances in treatment for devastating diseases such as Parkinson's and Alzheimer's.
Liberal Democrat MP, Dr Evan Harris, has described the RCBE's position as 'absurd' and 'inconsistent', adding: 'Most of these embryos will be created using animal eggs, but even if they were created using human eggs, they would be created by cloning and the Catholic Church has previously opposed reproductive cloning of even fully human embryos'.
Thursday, August 2, 2007
An IVF mortality: Lessons to learn
A report on the circumstances surrounding the 2003 death of Irish IVF patient Jacqueline Rushton has been published. The report was commissioned by the Republic of Ireland's Health Service Executive (HSE), and written by Alison Murdoch of the Newcastle Fertility Centre and independent healthcare consultant Stuart Emslie. Rushton, a 32-year-old nurse, was treated at the Human Assisted Reproduction Ireland unit of Dublin's Rotunda Hospital. She was admitted to this same hospital on 8 December 2002, after she was found to be overreacting to her IVF treatment, and was subsequently transferred to Dublin's Mater Private Hospital. Despite initially appearing to make a recovery, she collapsed and was placed on a ventilator, which was switched off on 14 January 2003. The cause of Rushton's death was found to be acute respiratory distress syndrome, a rare complication of ovarian hyperstimulation syndrome - itself a complication associated with IVF, where fluid from the bloodstream leaks into the abdominal cavity and causes it to swell.
The report concludes that there were problems with the management of Rushton's care, compounded by a lack of senior supervision and inconsistent compliance with official guidelines for treating her condition. The report recommends regular care audits, in which it is incumbent upon hospitals to prove standards rather than merely claiming to have them, together with and a review of in-house protocol in all general hospitals and IVF clinics.
Rushton's family have declared themselves satisfied with the outcome of the report, and they have instructed their solicitors to drop legal proceedings against the health authorities. They have also expressed their hope that the report's recommendations will prevent another family from going through the same ordeal. The Irish Patient Association has said that the episode raises significant questions about patient care. Irish health minister Mary Harney has announced that immediate steps are being taken to implement these recommendations across HSE hospitals.
The statement, issued by the Master of the Rotunda Hospital Dr Michael Geary acknowleged "lessons have been learned". "In all medical treatments, one cannot always be guaranteed that the outcome will be positive and every effort is made along the way to comply with best practice in patient care and treatment," Dr Geary said. "We sincerely hope, with the new insights and learnings available to us, that a similar incident can be prevented from occurring again in the future," he concluded. "There is always an onus on any healthcare provider to review their processes and systems and this report underlines again this requirement. It is very important for us to learn from this tragic event."
OHSS is the only medical emergency that a Fertility physician faces in his/her career. This report is important because it highlights the possibility of death in the event OHSS is not managed properly. For bloggers interested in the subject, Rotunda is hosting an International Congress on PCOS at Goa in August 2008. There will be an entire video session dedicated to the management of OHSS. The link to follow will be www.sisab.net/pcos2008
The report concludes that there were problems with the management of Rushton's care, compounded by a lack of senior supervision and inconsistent compliance with official guidelines for treating her condition. The report recommends regular care audits, in which it is incumbent upon hospitals to prove standards rather than merely claiming to have them, together with and a review of in-house protocol in all general hospitals and IVF clinics.
Rushton's family have declared themselves satisfied with the outcome of the report, and they have instructed their solicitors to drop legal proceedings against the health authorities. They have also expressed their hope that the report's recommendations will prevent another family from going through the same ordeal. The Irish Patient Association has said that the episode raises significant questions about patient care. Irish health minister Mary Harney has announced that immediate steps are being taken to implement these recommendations across HSE hospitals.
The statement, issued by the Master of the Rotunda Hospital Dr Michael Geary acknowleged "lessons have been learned". "In all medical treatments, one cannot always be guaranteed that the outcome will be positive and every effort is made along the way to comply with best practice in patient care and treatment," Dr Geary said. "We sincerely hope, with the new insights and learnings available to us, that a similar incident can be prevented from occurring again in the future," he concluded. "There is always an onus on any healthcare provider to review their processes and systems and this report underlines again this requirement. It is very important for us to learn from this tragic event."
OHSS is the only medical emergency that a Fertility physician faces in his/her career. This report is important because it highlights the possibility of death in the event OHSS is not managed properly. For bloggers interested in the subject, Rotunda is hosting an International Congress on PCOS at Goa in August 2008. There will be an entire video session dedicated to the management of OHSS. The link to follow will be www.sisab.net/pcos2008
Wednesday, August 1, 2007
The Laser Printer
Bad news, office drones: That laser printer sitting in your cubicle might be doing some serious damage to your health.
The humble office laser printer can damage lungs in much the same way as smoke particles from cigarettes, a team of Australian scientists has found. An investigation of a range of printer models showed that almost a third emit potentially dangerous levels of toner into the air. The Queensland University of Technology scientists have called on ministers to regulate these kinds of emissions. They say some printers should come with a health warning.
The researchers carried out tests on more than 60 machines. Almost one-third were found to emit ultra-tiny particles of toner-like material, so small that they can infiltrate the lungs and cause a range of health problems from respiratory irritation to more chronic illnesses. Conducted in an open-plan office, the test revealed that particle levels increased five-fold during working hours, a rise blamed on printer use. The problem was worse when new cartridges were used and when graphics and images required higher quantities of toner. The researchers have called on governments to regulate air quality in offices. They also want companies to ensure that printers are based in well-ventilated areas so that particles disperse.
That's such fun news, isn't it? And here you were eating salads, jogging and not smoking, and it's going to be your laser printer that does you in. Life sure is hilarious sometimes.
The humble office laser printer can damage lungs in much the same way as smoke particles from cigarettes, a team of Australian scientists has found. An investigation of a range of printer models showed that almost a third emit potentially dangerous levels of toner into the air. The Queensland University of Technology scientists have called on ministers to regulate these kinds of emissions. They say some printers should come with a health warning.
The researchers carried out tests on more than 60 machines. Almost one-third were found to emit ultra-tiny particles of toner-like material, so small that they can infiltrate the lungs and cause a range of health problems from respiratory irritation to more chronic illnesses. Conducted in an open-plan office, the test revealed that particle levels increased five-fold during working hours, a rise blamed on printer use. The problem was worse when new cartridges were used and when graphics and images required higher quantities of toner. The researchers have called on governments to regulate air quality in offices. They also want companies to ensure that printers are based in well-ventilated areas so that particles disperse.
That's such fun news, isn't it? And here you were eating salads, jogging and not smoking, and it's going to be your laser printer that does you in. Life sure is hilarious sometimes.
Tuesday, July 31, 2007
Artificial Wombs
Preliminary research, presented at the European Society for Human Reproduction and Embryology annual meeting held in Lyon, France, last month, suggests that a novel 'womb-on-a-chip' device may help to improve IVF success rates. The 2 millimetre wide chip, developed by Dr Teruo Fuji and colleagues at the University of Tokyo in Japan, acts like an artificial womb to nurture fertilised embryos - up to 20 at a time - to the stage at which they can be implanted into a real womb. According to the UK Human Fertilisation and Embryology Authority, over 30,000 women in the UK undergo IVF each year. However the success rates associated with conventional IVF methods are as low as 1 in 5, meaning that most of these expensive IVF cycles do not result in a successful pregnancy. Washing or moving the eggs during IVF treatment, a process which can cause harmful temperature or acidity changes, might be one possible reason for the low success rates seen in IVF says Dr Matt Wheeler from the University of Illinois in Urbana-Champaign, who is also working on automated IVF systems. Fuji's team believe that the new chip, which avoids these disruptive washing and moving processes, is closer to the real thing: 'We are providing the embryos with a much more comfortable environment, mimicking what happens in the body', he told New Scientist. Inside the chip, cells from the lining of the womb are cultured to provide nutrients to the growing embryos, helping them to develop to the stage at which they can be implanted into a real womb.
To test the device, the researchers carried out several experiments on mice, comparing the chip-grown embryos with those produced using conventional IVF. Their findings suggest that the chip-grown embryos outperformed conventional IVF embryos in several ways:
-More were successfully fertilised (43 out of 50, compared with 41 out 50).
-More developed to the stage at which they could be implanted into a real mother (35 out of 50 compared to 32 out of 50).
-Grew faster (containing around 77-119 cells compared to 58-94 cells, after 2 days).
-More continued to develop when implanted into female mice (44% compared to 40%).
Dr Wheeler commented: 'It's not just about more embryos surviving to be implanted...They also seem to be doing better once they are implanted'. Following these successful experiments in mice, Fuji's team have now been granted permission to begin trials on human embryos later this year. The next five years are going to see many path-breaking discoveries in the field of IVF. I personally believe that just a couple of years down the line all IVF culture systems will be automated based on principles such as the subject system.
To test the device, the researchers carried out several experiments on mice, comparing the chip-grown embryos with those produced using conventional IVF. Their findings suggest that the chip-grown embryos outperformed conventional IVF embryos in several ways:
-More were successfully fertilised (43 out of 50, compared with 41 out 50).
-More developed to the stage at which they could be implanted into a real mother (35 out of 50 compared to 32 out of 50).
-Grew faster (containing around 77-119 cells compared to 58-94 cells, after 2 days).
-More continued to develop when implanted into female mice (44% compared to 40%).
Dr Wheeler commented: 'It's not just about more embryos surviving to be implanted...They also seem to be doing better once they are implanted'. Following these successful experiments in mice, Fuji's team have now been granted permission to begin trials on human embryos later this year. The next five years are going to see many path-breaking discoveries in the field of IVF. I personally believe that just a couple of years down the line all IVF culture systems will be automated based on principles such as the subject system.
Monday, July 30, 2007
The Ant & The Grasshopper
I just received an E-mail from an Indian friend working in the UK. I just had to reproduce her E-mail here. I think this is very relevant in today's context. I hope it disturbs you as much as it has disturbed me. Let me introduce the Traditional version of the Ant & the Grasshopper as we were taught in school:
The Ant works hard in the withering heat all summer building its house and laying up supplies for the winter.
The Grasshopper thinks the Ant is a fool and laughs & dances & plays the summer away.
Come winter,the Ant is warm and well fed. The Grasshopper has no food or shelter so he dies out in the cold.
The Kalyug Version:
The Ant works hard in the withering heat all summer building its house and laying up supplies for the winter.
The Grasshopper thinks the Ant's a fool and laughs & dances & plays the summer away.
Come winter, the shivering Grasshopper calls a press conference and demands to know why the Ant should be allowed to be warm and well fed while others are cold and starving.
NDTV, BBC, CNN show up to provide pictures of the shivering Grasshopper next to a video of the Ant in his comfortable home with a table filled with food. The World is stunned by the sharp contrast. How can this be that this poor Grasshopper is allowed to suffer so? Arundhati Roy stages a demonstration in front of the Ant's house. Medha Patkar goes on a fast along with other Grasshoppers demanding that Grasshoppers be relocated to warmer climates during winter. Amnesty International and Koffi Annan criticizes the Indian Government for not upholding the fundamental rights of the Grasshopper. The Internet is flooded with online petitions seeking support to the Grasshopper (many promising Heaven and Everlasting Peace for prompt support as against the wrath of God for non-compliance).
Opposition MPs stage a walkout. Left parties call for "Bharat Bandh" in West Bengal and Kerala demanding a Judicial Enquiry.
CPM in Kerala immediately passes a law preventing Ants from working hard in the heat so as to bring about equality of poverty among Ants and Grasshoppers. Lalu Prasad allocates one free coach to Grasshoppers on all Indian Railway
Trains, aptly named as the 'Grasshopper Rath'. Finally, the Judicial Committee drafts the 'Prevention of Terrorism Against
Grasshoppers Act' [POTAGA], with effect from the beginning of the winter. Arjun Singh makes 'Special Reservation ' for Grasshoppers in Educational Institutions & in Government Services.
The Ant is fined for failing to comply with POTAGA and having nothing left to pay his retroactive taxes,it's home is confiscated by the Government and handed over to the Grasshopper in a ceremony covered by NDTV. Arundhati Roy calls it ' A Triumph of Justice'. Lalu calls it 'Socialistic Justice '. CPM calls it the 'Revolutionary Resurgence of the Downtrodden ' . Koffi Annan invites the Grasshopper to address the UN General Assembly .
Many years later...
The Ant has since migrated to the US and set up a multi-billion dollar company in Silicon Valley. 100s of Grasshoppers still die of starvation despite reservation somewhere in India ...
As a result of loosing lot of hard working Ants and feeding the Grasshoppers, India is still a developing country.... Jai Hind..
The Ant works hard in the withering heat all summer building its house and laying up supplies for the winter.
The Grasshopper thinks the Ant is a fool and laughs & dances & plays the summer away.
Come winter,the Ant is warm and well fed. The Grasshopper has no food or shelter so he dies out in the cold.
The Kalyug Version:
The Ant works hard in the withering heat all summer building its house and laying up supplies for the winter.
The Grasshopper thinks the Ant's a fool and laughs & dances & plays the summer away.
Come winter, the shivering Grasshopper calls a press conference and demands to know why the Ant should be allowed to be warm and well fed while others are cold and starving.
NDTV, BBC, CNN show up to provide pictures of the shivering Grasshopper next to a video of the Ant in his comfortable home with a table filled with food. The World is stunned by the sharp contrast. How can this be that this poor Grasshopper is allowed to suffer so? Arundhati Roy stages a demonstration in front of the Ant's house. Medha Patkar goes on a fast along with other Grasshoppers demanding that Grasshoppers be relocated to warmer climates during winter. Amnesty International and Koffi Annan criticizes the Indian Government for not upholding the fundamental rights of the Grasshopper. The Internet is flooded with online petitions seeking support to the Grasshopper (many promising Heaven and Everlasting Peace for prompt support as against the wrath of God for non-compliance).
Opposition MPs stage a walkout. Left parties call for "Bharat Bandh" in West Bengal and Kerala demanding a Judicial Enquiry.
CPM in Kerala immediately passes a law preventing Ants from working hard in the heat so as to bring about equality of poverty among Ants and Grasshoppers. Lalu Prasad allocates one free coach to Grasshoppers on all Indian Railway
Trains, aptly named as the 'Grasshopper Rath'. Finally, the Judicial Committee drafts the 'Prevention of Terrorism Against
Grasshoppers Act' [POTAGA], with effect from the beginning of the winter. Arjun Singh makes 'Special Reservation ' for Grasshoppers in Educational Institutions & in Government Services.
The Ant is fined for failing to comply with POTAGA and having nothing left to pay his retroactive taxes,it's home is confiscated by the Government and handed over to the Grasshopper in a ceremony covered by NDTV. Arundhati Roy calls it ' A Triumph of Justice'. Lalu calls it 'Socialistic Justice '. CPM calls it the 'Revolutionary Resurgence of the Downtrodden ' . Koffi Annan invites the Grasshopper to address the UN General Assembly .
Many years later...
The Ant has since migrated to the US and set up a multi-billion dollar company in Silicon Valley. 100s of Grasshoppers still die of starvation despite reservation somewhere in India ...
As a result of loosing lot of hard working Ants and feeding the Grasshoppers, India is still a developing country.... Jai Hind..
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."
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."
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