The document provides an overview of the legislative and ethical framework for organ donation and transplantation in Malaysia. It discusses the current laws and policies governing transplantation, including the Human Tissues Act 1974, Anti-Trafficking in Persons Act 2007, and proposed new Organ and Tissue Transplantation Bill. It also addresses the gap between organ supply and demand, ethical issues around organ trading, and efforts to increase rates of deceased and living donation in Malaysia.
Some beautiful sunnahs of Rasulallah SAW when first waking up in the morning include:
1) Rubbing the palms on the face and eyes to remove the effects of sleep.
2) Reciting duas praising Allah for restoring life and asking for forgiveness.
3) Making miswak is also sunnah when awakening.
4) When dressing, put on clothes starting with the right side first, like the right leg/sleeve of trousers/shirt.
The document discusses laparoscopic ovarian drilling (LOD) as a treatment for ovulation induction in women with polycystic ovary syndrome who are clomiphene citrate resistant. It outlines the advantages and disadvantages of LOD. The optimal amount of thermal energy needed during LOD is debated, with studies suggesting 600 Joules per ovary or 60 Joules per cubic centimeter of ovarian volume may be most effective doses. Unilateral LOD appears to have similar outcomes as bilateral LOD but with fewer risks of adhesions. Larger ovarian volume, especially in the right ovary, correlates with higher ovulation and pregnancy rates.
Basic principle of medicolegal management in emergency departmentLee Oi Wah
This document provides guidelines for managing patients' property in healthcare facilities. It states that hospitals are responsible for safely storing any valuable items patients arrive with while unconscious, and must record any movements of patient property. Signs should also inform patients not to bring valuables, and that the hospital is not liable for lost, stolen or damaged personal items. When property is unclaimed, hospitals must handle it according to established guidelines. Proper documentation in property log books is required from all relevant departments.
This document discusses abnormal uterine bleeding (AUB) or menorrhagia in puberty. It lists various potential causes of AUB including anovulation, polyps, adenomyosis, leiomyoma, and bleeding disorders. Anovulation due to an immature hypothalamic-pituitary-ovarian axis is the most common cause. The document provides guidelines on evaluating AUB, including taking a detailed history, physical exam, lab tests, and ultrasound. Differential diagnoses are discussed. Bleeding disorders are more commonly platelet dysfunction disorders in Southeast Asia, unlike the West where Von Willebrand disease is more common.
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Puberty menorrhagia Dr Sharda Jain , Dr Jyoti Agarwal Lifecare Centre
Puberty menorrhagia refers to heavy menstrual bleeding lasting longer than 7 days or exceeding 80 ml of blood loss during puberty. Common causes include dysfunctional uterine bleeding due to immature hypothalamic-pituitary-ovarian axis, bleeding disorders, polycystic ovary syndrome, and complications of pregnancy. Evaluation involves detailed history, physical exam, ultrasound, blood counts, pregnancy test, and tests for underlying causes as needed. Treatment is usually medical, focusing on controlling bleeding through hemostatic agents like tranexamic acid or desmopressin, correcting anemia, and treating any underlying disorders found. Surgery is rarely needed.
Entry technique with veress needle in LaparoscopyDrVarun Raju
The document summarizes the Veress needle technique for establishing pneumoperitoneum during laparoscopic surgery. It describes how Janos Veress first developed the spring-loaded needle in 1932 for tuberculosis treatment. Modern Veress needles are 12-15 cm long and have a blunt inner stylet and sharp outer cannula. Placement is typically at the umbilicus using various tests like aspiration and insufflation pressure to confirm intraperitoneal placement before trocar insertion. Complications can occur if not properly positioned.
Some beautiful sunnahs of Rasulallah SAW when first waking up in the morning include:
1) Rubbing the palms on the face and eyes to remove the effects of sleep.
2) Reciting duas praising Allah for restoring life and asking for forgiveness.
3) Making miswak is also sunnah when awakening.
4) When dressing, put on clothes starting with the right side first, like the right leg/sleeve of trousers/shirt.
The document discusses laparoscopic ovarian drilling (LOD) as a treatment for ovulation induction in women with polycystic ovary syndrome who are clomiphene citrate resistant. It outlines the advantages and disadvantages of LOD. The optimal amount of thermal energy needed during LOD is debated, with studies suggesting 600 Joules per ovary or 60 Joules per cubic centimeter of ovarian volume may be most effective doses. Unilateral LOD appears to have similar outcomes as bilateral LOD but with fewer risks of adhesions. Larger ovarian volume, especially in the right ovary, correlates with higher ovulation and pregnancy rates.
Basic principle of medicolegal management in emergency departmentLee Oi Wah
This document provides guidelines for managing patients' property in healthcare facilities. It states that hospitals are responsible for safely storing any valuable items patients arrive with while unconscious, and must record any movements of patient property. Signs should also inform patients not to bring valuables, and that the hospital is not liable for lost, stolen or damaged personal items. When property is unclaimed, hospitals must handle it according to established guidelines. Proper documentation in property log books is required from all relevant departments.
This document discusses abnormal uterine bleeding (AUB) or menorrhagia in puberty. It lists various potential causes of AUB including anovulation, polyps, adenomyosis, leiomyoma, and bleeding disorders. Anovulation due to an immature hypothalamic-pituitary-ovarian axis is the most common cause. The document provides guidelines on evaluating AUB, including taking a detailed history, physical exam, lab tests, and ultrasound. Differential diagnoses are discussed. Bleeding disorders are more commonly platelet dysfunction disorders in Southeast Asia, unlike the West where Von Willebrand disease is more common.
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Puberty menorrhagia Dr Sharda Jain , Dr Jyoti Agarwal Lifecare Centre
Puberty menorrhagia refers to heavy menstrual bleeding lasting longer than 7 days or exceeding 80 ml of blood loss during puberty. Common causes include dysfunctional uterine bleeding due to immature hypothalamic-pituitary-ovarian axis, bleeding disorders, polycystic ovary syndrome, and complications of pregnancy. Evaluation involves detailed history, physical exam, ultrasound, blood counts, pregnancy test, and tests for underlying causes as needed. Treatment is usually medical, focusing on controlling bleeding through hemostatic agents like tranexamic acid or desmopressin, correcting anemia, and treating any underlying disorders found. Surgery is rarely needed.
Entry technique with veress needle in LaparoscopyDrVarun Raju
The document summarizes the Veress needle technique for establishing pneumoperitoneum during laparoscopic surgery. It describes how Janos Veress first developed the spring-loaded needle in 1932 for tuberculosis treatment. Modern Veress needles are 12-15 cm long and have a blunt inner stylet and sharp outer cannula. Placement is typically at the umbilicus using various tests like aspiration and insufflation pressure to confirm intraperitoneal placement before trocar insertion. Complications can occur if not properly positioned.
Post menopausal bleeding is defined as bleeding occurring more than 12 months after a woman's last menstrual period or continuing menstruation after age 55. It is more likely to be caused by a pathological disease than bleeding in younger women and must always be investigated. Common causes include the use of exogenous hormones, vaginal atrophy, and tumors of the reproductive tract such as endometrial hyperplasia, polyps, and cancer. Evaluation involves examination, ultrasound, endometrial sampling, and directed biopsy if needed to diagnose and treat the underlying cause.
FOGSI FOCUS Medicolegal Issues in Obstetrics and Gynecology PracticeNARENDRA C MALHOTRA
This document provides an overview of the FOGSI FOCUS publication titled "Medicolegal Issues in Obstetrics and Gynecology Practice". It includes contributors and editors. The publication aims to help obstetricians and gynecologists avoid litigation by providing guidance on key Indian laws and regulations pertaining to their practice. These include the Pre-conception and Pre-natal Diagnostic Techniques Act, Clinical Establishments Act, Birth and Death Registration Act, among others. The editors hope this reference book will help practitioners navigate difficult medicolegal situations.
Recurrence of endometriosis is fairly common; some studies suggest the rate of recurrence to be as high as 40%. Most common cause of recurrence is incomplete resection in primary surgery and microscopic foci which escapes detection.
Uterine-Sparing Surgery for Adenomyosis Prof. Aboubakr ElnasharAboubakr Elnashar
This document discusses uterine-sparing surgery for adenomyosis to improve fertility. It describes how adenomyosis can negatively impact fertility and IVF success rates. There are two types of uterine-sparing surgery discussed - complete excision (adenomyomectomy) for localized adenomyosis and partial excision (cytoreductive surgery) for diffuse adenomyosis. The techniques, indications, complications, and outcomes of these surgeries are examined, including improved fertility and pregnancy rates compared to hormonal therapies. However, risks like uterine rupture during subsequent pregnancy must be considered. Overall, the document concludes uterine-sparing surgery is a feasible option for improving fertility in qualified patients with adenomyosis, but it requires
This document discusses uterine fibroids and laparoscopic myomectomy. It defines different types of fibroids and their locations in the uterus. Laparoscopic myomectomy is described as a technique for removing fibroids through small incisions instead of open surgery. While it has advantages over traditional laparotomy, laparoscopic myomectomy requires skill and experience to perform carefully without complications. Factors such as fibroid size and location can increase the difficulty of the procedure and risk of conversion to open surgery.
This is the course on Medical/clinical ethics presented to the MBE (Master of Bioethics) students at Prince Sattam bin Abdulaziz University. It includes the main topics only. Please note that the sources of almost all slides are listed as links at the bottom of the slide itself.
1. The document discusses Ayat ul Kursi, a verse from the Quran that describes Allah as the eternal, all-powerful creator of the heavens and earth.
2. It provides 4 hadiths relating to Ayat ul Kursi, including ones stating that reciting it after each prayer will prevent anything from coming between a person and Paradise except death.
3. The document encourages Muslims to take the couple seconds needed to recite this verse after prayers due to the immense benefits and protections it provides according to the Prophet Muhammad.
management of endometrial_hyperplasia 2016_ small one water mark.pdfMuhamedAlBellehy1
This document provides guidelines for the management of endometrial hyperplasia. It defines endometrial hyperplasia and discusses risk factors, classification systems, diagnostic workup, natural history, and treatment options. The main treatment approaches are progestogen therapy, typically using a levonorgestrel-releasing IUS, and hysterectomy for cases of progression or failure to respond to medical treatment. Hysterectomy is generally not recommended as first-line treatment due to the high rate of regression with progestogen therapy in most women.
This document provides information on operative hysteroscopy, including prerequisites, contraindications, instrumentation, anaesthesia, distension media, indications, and techniques for various procedures like endometrial ablation, uterine septum resection, myomectomy, and adhesiolysis. It discusses the advantages and disadvantages of hysteroscopic morcellators. Complications of hysteroscopic myomectomy and post-operative care are also outlined. Various classifications for submucous fibroids and intrauterine adhesions are presented.
This document provides information about hysteroscopy, including:
- A hysteroscope is an endoscope used to visualize the uterine cavity and perform procedures.
- It describes the historical development of hysteroscopy from the 19th century to modern techniques.
- The types of hysteroscopes and instrumentation used are outlined, including distention media, electrodes, sheaths, and cameras.
- The document discusses the procedures, indications, contraindications and complications of diagnostic and operative hysteroscopy.
Acromegaly is caused by excessive growth hormone (GH) secretion from the pituitary gland, usually presenting in adults aged 30-50 years old. Signs and symptoms include enlarged features of the face, hands, and feet; joint pain; headaches; and increased sweating. Treatment options include trans-sphenoidal surgery to remove the pituitary tumor, radiation therapy, and medication like somatostatin analogues to control GH levels. Complications can develop if acromegaly goes untreated and includes heart failure, arthritis, sleep apnea, and visual impairments.
Chronic renal failure concise long case approach & crf with fluid overload m...Dr. Rubz
This document provides a concise long case approach for chronic renal failure. It outlines the key presenting complaints, history, physical exam findings, investigations, complications, and management strategies for chronic renal failure. The management involves addressing issues related to calcium/phosphate metabolism, anemia, osteodystrophy, fluid overload, and nutritional management. Treatment plans include diuresis, dialysis/filtration, erythropoietin therapy, calcium supplementation, and dietary restrictions. Referrals to other specialists are recommended based on the severity of renal failure and patient needs.
Post menopausal bleeding is defined as bleeding occurring more than 12 months after a woman's last menstrual period or continuing menstruation after age 55. It is more likely to be caused by a pathological disease than bleeding in younger women and must always be investigated. Common causes include the use of exogenous hormones, vaginal atrophy, and tumors of the reproductive tract such as endometrial hyperplasia, polyps, and cancer. Evaluation involves examination, ultrasound, endometrial sampling, and directed biopsy if needed to diagnose and treat the underlying cause.
FOGSI FOCUS Medicolegal Issues in Obstetrics and Gynecology PracticeNARENDRA C MALHOTRA
This document provides an overview of the FOGSI FOCUS publication titled "Medicolegal Issues in Obstetrics and Gynecology Practice". It includes contributors and editors. The publication aims to help obstetricians and gynecologists avoid litigation by providing guidance on key Indian laws and regulations pertaining to their practice. These include the Pre-conception and Pre-natal Diagnostic Techniques Act, Clinical Establishments Act, Birth and Death Registration Act, among others. The editors hope this reference book will help practitioners navigate difficult medicolegal situations.
Recurrence of endometriosis is fairly common; some studies suggest the rate of recurrence to be as high as 40%. Most common cause of recurrence is incomplete resection in primary surgery and microscopic foci which escapes detection.
Uterine-Sparing Surgery for Adenomyosis Prof. Aboubakr ElnasharAboubakr Elnashar
This document discusses uterine-sparing surgery for adenomyosis to improve fertility. It describes how adenomyosis can negatively impact fertility and IVF success rates. There are two types of uterine-sparing surgery discussed - complete excision (adenomyomectomy) for localized adenomyosis and partial excision (cytoreductive surgery) for diffuse adenomyosis. The techniques, indications, complications, and outcomes of these surgeries are examined, including improved fertility and pregnancy rates compared to hormonal therapies. However, risks like uterine rupture during subsequent pregnancy must be considered. Overall, the document concludes uterine-sparing surgery is a feasible option for improving fertility in qualified patients with adenomyosis, but it requires
This document discusses uterine fibroids and laparoscopic myomectomy. It defines different types of fibroids and their locations in the uterus. Laparoscopic myomectomy is described as a technique for removing fibroids through small incisions instead of open surgery. While it has advantages over traditional laparotomy, laparoscopic myomectomy requires skill and experience to perform carefully without complications. Factors such as fibroid size and location can increase the difficulty of the procedure and risk of conversion to open surgery.
This is the course on Medical/clinical ethics presented to the MBE (Master of Bioethics) students at Prince Sattam bin Abdulaziz University. It includes the main topics only. Please note that the sources of almost all slides are listed as links at the bottom of the slide itself.
1. The document discusses Ayat ul Kursi, a verse from the Quran that describes Allah as the eternal, all-powerful creator of the heavens and earth.
2. It provides 4 hadiths relating to Ayat ul Kursi, including ones stating that reciting it after each prayer will prevent anything from coming between a person and Paradise except death.
3. The document encourages Muslims to take the couple seconds needed to recite this verse after prayers due to the immense benefits and protections it provides according to the Prophet Muhammad.
management of endometrial_hyperplasia 2016_ small one water mark.pdfMuhamedAlBellehy1
This document provides guidelines for the management of endometrial hyperplasia. It defines endometrial hyperplasia and discusses risk factors, classification systems, diagnostic workup, natural history, and treatment options. The main treatment approaches are progestogen therapy, typically using a levonorgestrel-releasing IUS, and hysterectomy for cases of progression or failure to respond to medical treatment. Hysterectomy is generally not recommended as first-line treatment due to the high rate of regression with progestogen therapy in most women.
This document provides information on operative hysteroscopy, including prerequisites, contraindications, instrumentation, anaesthesia, distension media, indications, and techniques for various procedures like endometrial ablation, uterine septum resection, myomectomy, and adhesiolysis. It discusses the advantages and disadvantages of hysteroscopic morcellators. Complications of hysteroscopic myomectomy and post-operative care are also outlined. Various classifications for submucous fibroids and intrauterine adhesions are presented.
This document provides information about hysteroscopy, including:
- A hysteroscope is an endoscope used to visualize the uterine cavity and perform procedures.
- It describes the historical development of hysteroscopy from the 19th century to modern techniques.
- The types of hysteroscopes and instrumentation used are outlined, including distention media, electrodes, sheaths, and cameras.
- The document discusses the procedures, indications, contraindications and complications of diagnostic and operative hysteroscopy.
Acromegaly is caused by excessive growth hormone (GH) secretion from the pituitary gland, usually presenting in adults aged 30-50 years old. Signs and symptoms include enlarged features of the face, hands, and feet; joint pain; headaches; and increased sweating. Treatment options include trans-sphenoidal surgery to remove the pituitary tumor, radiation therapy, and medication like somatostatin analogues to control GH levels. Complications can develop if acromegaly goes untreated and includes heart failure, arthritis, sleep apnea, and visual impairments.
Chronic renal failure concise long case approach & crf with fluid overload m...Dr. Rubz
This document provides a concise long case approach for chronic renal failure. It outlines the key presenting complaints, history, physical exam findings, investigations, complications, and management strategies for chronic renal failure. The management involves addressing issues related to calcium/phosphate metabolism, anemia, osteodystrophy, fluid overload, and nutritional management. Treatment plans include diuresis, dialysis/filtration, erythropoietin therapy, calcium supplementation, and dietary restrictions. Referrals to other specialists are recommended based on the severity of renal failure and patient needs.
This document discusses various classes of antibiotics including their mechanisms of action, antimicrobial spectrum, therapeutic uses, and dosages. It covers penicillins, cephalosporins, macrolides, lincosamines, chloramphenicol, and aminoglycosides. For each class, it provides examples of specific antibiotics, the types of bacteria they are active against, common infections they are used to treat, and recommended dosages depending on the route of administration. Potential side effects are also outlined. The document provides a comprehensive overview of different antibiotic classes.
Chronic liver disease ( concise long case approach )Dr. Rubz
This document discusses the identification, diagnosis, and management of chronic liver disease (CLD). It identifies the main etiologies and risk factors for CLD, including infections like hepatitis B and C, alcohol, drugs, and metabolic disorders. It outlines the approach to diagnosing CLD based on symptoms, signs, laboratory tests, and imaging. Factors are assessed to determine if the CLD is compensated or decompensated. Management involves treating complications like ascites, bacterial peritonitis, variceal bleeding, and hepatic encephalopathy. Treatment may also include procedures like paracentesis or transplantation.
This document appears to be a set of slides for a lecture or teaching session on rapidly interpreting electrocardiograms (ECGs) given by Dr. James Smitt of Monash University on July 25, 2013 for third year medical students. The slides provide instruction on efficiently analyzing ECG readings to identify potential cardiac issues or abnormalities.
Epilepsy is a chronic neurological condition characterized by recurrent seizures. The majority of childhood epilepsy is idiopathic or genetic in origin. Seizures can be generalized, arising from both hemispheres, or focal, arising from one hemisphere. Common generalized seizures include tonic-clonic, absence, and myoclonic seizures. Diagnosis involves a clinical history and may include EEG and imaging. Treatment primarily involves antiepileptic drug therapy to control seizures.
Alcoholism has genetic, personality, and environmental risk factors. It is characterized by impaired control over alcohol use and dependence. Signs include tolerance, withdrawal, neglecting responsibilities, and continued use despite harm. Complications involve the liver, brain, heart, pancreas, and mental health. Treatment focuses on detoxification, counseling, support groups, and preventing relapse. The long-term prognosis remains guarded as 30% relapse within a year of stopping heavy drinking.
The document discusses cancer (neoplasia) including definitions, classifications, staging, diagnostic methods, hereditary factors, symptoms, and treatments. It provides an overview of the history and development of cancer research from Hippocrates to modern classifications and therapies. Key topics covered include the TNM staging system, common cancer types and locations, diagnostic imaging techniques, hereditary cancer syndromes, and approaches to chemotherapy and combined modality treatment.
The document discusses the second stage of labor and normal childbirth procedures. It describes:
1) The second stage of labor involves full dilation of the cervix over 1 hour followed by birth of the fetus. The fetus is born through a series of movements including extension, restitution, and external rotation of the head.
2) Proper techniques for assisting a normal vaginal delivery include encouraging the woman to push in her preferred position, suctioning the baby's mouth and nose after crowning, and gently guiding the shoulders and rest of the baby out one at a time to avoid tears.
3) Standard steps after birth include promptly placing the baby skin to skin on the mother, clamping and
The document discusses the stages of normal labor, including:
- The first stage of labor involves cervical dilation from 0-10 cm over 8-12 hours and has latent and active phases.
- The second stage involves pushing and lasts up to 1 hour.
- The third stage involves delivery of the placenta within 30 minutes.
- Labor is diagnosed based on cervical effacement and dilation which are assessed through vaginal examinations every 4 hours in the first stage and hourly in the second stage.
This document provides information on the diagnosis, symptoms, signs, screening, and treatment of diabetes mellitus. It defines the main types of diabetes as type 1, type 2, gestational diabetes, and prediabetes conditions. It outlines the diagnostic criteria and recommendations for screening asymptomatic individuals. Signs and symptoms of diabetes as well as potential complications are described. Treatment aims and options including lifestyle modifications, oral hypoglycemic agents, and insulin therapy are summarized. The document also discusses prevention and management of diabetes complications focused on cardiovascular, renal, foot, and eye health.
Pneumonia is an inflammation of the lungs that can be caused by bacteria, viruses, or other pathogens. It is a major cause of illness and death in children worldwide, especially in those under 5 years old. Common symptoms include fever, cough, difficulty breathing, and fatigue. Diagnosis involves examination for signs of respiratory distress, chest x-ray, and tests of blood and sputum samples. Treatment depends on the identified cause but generally involves antibiotics, oxygen, fluids, and fever control. Complications can include pleural effusions, lung abscesses, or respiratory failure.
The document discusses various conditions that can affect the male genital tract including hydrocele, hematocele, spermatocele, varicocele, testicular tumors, testicular torsion, epididymo-orchitis, and undescended testis. It provides information on the presentation, risk factors, investigations, management, and complications of each condition. The document is a reference for doctors on evaluating and treating various scrotal and testicular issues.
This document discusses different types of hernias, including ventral, incisional, and Spigelian hernias. It defines a hernia as an abnormal protrusion of an organ outside its normal cavity. It classifies hernias based on their location, such as inguinal or femoral. Incisional hernias occur through a previous surgical wound. Signs and symptoms vary from a painless lump to a painful, swollen protrusion. Management typically involves surgical repair to excise the hernia sac and close the defect.
1. The document summarizes Malaysia's HIV/AIDS situation and recommendations for interventions. It reports that while HIV transmission is declining overall, sexual transmission now accounts for over 50% of new cases, especially among heterosexuals and men who have sex with men. 2. Key recommendations include expanding access to antiretroviral treatment, strengthening prevention services for at-risk groups, and implementing proven interventions like condom promotion and harm reduction programs. 3. Achieving the UNAIDS 90-90-90 targets of diagnosing 90% of HIV cases, treating 90% of those diagnosed, and virally suppressing 90% of those treated is an important goal.
1. Orchitis and epididymo-orchitis are usually caused by blood-borne infections like Chlamydia, gonorrhea, or E. coli. They present with acute pain and swelling of the testes or epididymis.
2. Undescended testes occur in 1% of boys after 1 year of age and can lead to infertility if not treated. Risk factors include prematurity and family history. Treatment is orchidopexy to bring the testes into the scrotum.
3. Testicular torsion occurs when the spermatic cord twists, cutting off blood supply to the testes. It requires urgent surgery to untwist the cord or
Chronic lower limb arterial disease is commonly caused by atherosclerosis and presents as intermittent claudication (IC) or critical limb ischemia (CLI). IC involves pain in the calf on walking that resolves with rest, while CLI includes tissue loss and gangrene. Treatment focuses on risk factor modification and exercise, with revascularization considered if best medical therapy fails. Endovascular procedures and bypass surgery aim to restore blood flow and relieve symptoms. Amputation may be necessary in advanced CLI if revascularization is not possible.
The document discusses pyogenic meningitis, including the pathophysiology of convulsions which can result from meningitis due to imbalances in excitatory and inhibitory neurotransmitters. It also outlines the clinical features, investigations, treatment including antibiotics and dexamethasone, and complications of acute bacterial meningitis, with a focus on different age groups. Prevention methods like vaccination and prophylactic antibiotics for contacts are also covered.
PUO refers to a fever that lasts for more than 3 weeks and whose cause cannot be determined after 1 week of investigations. Common causes include infections affecting the lungs, heart, liver or GU/GI tract, as well as certain bacterial, fungal, parasitic and viral infections. Other potential causes are neoplasms, connective tissue diseases, and other inflammatory conditions. A thorough history, physical examination, and laboratory tests are needed to arrive at a diagnosis, including blood cultures, serological tests, sputum analysis, urine analysis, stool exams, imaging studies and biopsies. Empiric treatment may involve antibiotics, antifungals, antitubercular drugs, or a trial of steroids or aspirin while
HIV/AIDS data Hub Asia Pacific -Malaysia 2014Dr. Rubz
This document provides a summary of HIV/AIDS data for Malaysia across multiple indicators:
- HIV prevalence is highest among key populations like people who inject drugs, female sex workers, and men who have sex with men. Condom use and safe injection practices have increased over time but remain below optimal levels.
- The number of reported HIV infections and AIDS-related deaths has declined in recent years. Most HIV transmissions are through heterosexual contact and injecting drug use.
- Vulnerability remains high as many key populations lack comprehensive HIV knowledge and access to prevention programs, testing, and treatment.
- Government spending on HIV has increased but more funding needs to be directed towards programs for key populations at higher
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Role of Mukta Pishti in the Management of Hyperthyroidism
Legislative and Ethical Framework of Organ Donation and Transplantation in Malaysia
1. Legislative and ethical
framework on organ
donation and
transplantation in
Malaysia
Hirman Ismail MD (UKM) MPH (Nottingham)
Head of Transplantation Unit, Medical Development Division &
Honorary Secretary to the Malaysian Society of Transplantation
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
IMAM 18TH Annual Scientific Conference, 20 August 2016,
Seremban
2. Objective
Main objective of this presentation is provide
overview on how the practice of transplantation is
regulated in Malaysia.
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
3. Content
Introduction
Why ethics is a main concern in transplant?
Transplant legal and ethical framework in
Malaysia
Conclusion
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
7. No. of patients in the transplant national waiting list in
Malaysia by organ (until April 2016)
ORGAN NUMBER
Kidney 20,777
Liver 5
Heart 5
Lungs 2
Heart & lungs 6
TOTAL 20,795
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
Source: National Transplant Resource Centre, National Renal Registry 2016
15. Situational analysis
Huge gap demand and supply
“Market force” has driven overseas commercial
transplants
We are placed among the lowest in the world in terms
of deceased organ donation rate
Awareness is improving especially among the Malay
Muslim
Racial discrepancy is still evident
Living donation programme has not been optimised
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
16. Why ethics is a main
concern in transplant?
Huge disparity| Organ trading | Crime
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
36. Immunosuppressant policy
Since 2012, no free
supply of IS to
overseas transplant
patients
To discourage cross
boundaries unethical
practices, exploitation
and crime
Current patients are
being informed about
the policy
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
38. Unrelated living organ donation
Limiting related living
organ donation to 2nd
degree and below &
legal spouse
Unrelated living organ
donation requires MOH
approval
Any cases involving
foreigners requires
approval as well
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
42. Organ and Tissue Transplantation
Bill
A more comprehensive law to cover both living
and deceased donation (unlike Human Tissue
Act 1975)
Covers a wide range of issues including ethics
like certification of death, prohibition on organ
trading and advertising, consent and
authorisation, accreditation and credentialing,
organ allocation
Draft currently being reviewed by AG Chamber
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
44. Conclusion
The potential of organ donation and
transplantation has yet to be optimised
The risk of unethical practices is present like in
many other countries (due to shortage of organs)
The control measures through law and policy
exist but need to be enhanced through the new
proposed law
Ensuring self sufficiency of organ is everyone’s
responsibility (increasing supply and reducing
demand)
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
45.
46.
47.
48.
49.
50.
51. References
Jennifer Dolling. (2009) Opting In To An Opt-Out System: Presumed Consent As A Valid Policy Choice
For Ontario’s Cadaveric Organ Shortage [Unpublished thesis]. Graduate Department of the Faculty of
Law University of Toronto. Available from :
https://tspace.library.utoronto.ca/bitstream/1807/18276/1/Dolling_Jennifer_M_200911_LLM_thesis.pdf
[Accessed 16 June 2016]
Medical Practice Division. (2013) Online Public Engagement on Proposed New Law on Organ
Transplantation. [Unpublished Report]. Ministry of Health Malaysia
Shepherd et al. 2014. An international comparison of deceased and living organ donation/transplant rates
in opt-in and opt-out systems: a panel study. BMC Medicine.12:131. Available from :
http://www.biomedcentral.com/1741-7015/12/131 [Accessed 17 June 2016]
Medical Development Division, 2007. National Organ Tissue and Cell Transplantation Policy. Putrajaya:
Ministry of Health Malaysia.
Medical Development Division, 2011. Unrelated Living Organ Donation: Policy and Procedures. Putrajaya:
Ministry of Health Malaysia.
Ministry of Health Malaysia, 2012. Policy on Unrelated Living Organ Donation. [Circular Letter by the
Director General of Health], 4 January 2012, available at: http://www.moh.gov.my/attachments/1763
[accessed 6 February 2012]
World Health Organization, 2010. WHO Guiding Principles on Human Cell, Tissue and Organ
Transplantation. New York: WHO.
Copyrights 2016 Hirman Ismail | www.about.me/hirmanismail | hirmanmd@gmail.com
TOTAL Transplant Recipients (2005 – 2014) = 1,248
Overseas = 579 (46.40%)
Local = 649 (52.00%)
Total kidney transplant recipients has dropped in general
More significantly, overseas kidney transplant recipients has dropped significantly since 2007 – 2008 - ? Cause – ? China has consolidated their effort to curb transplant tourism especially since Olympic China 2008, ? Enforcement of law in China, IS policy by MOH Malaysia was implemented in 2012
More worrying is the number of locally performed has plateaued and dropped in 2014
TOTAL Transplant Recipients (2005 – 2014) = 1,248
Overseas = 579 (46.40%)
Local = 649 (52.00%)
Total kidney transplant recipients has dropped in general
More significantly, overseas kidney transplant recipients has dropped significantly since 2007 – 2008 - ? Cause – ? China has consolidated their effort to curb transplant tourism especially since Olympic China 2008, ? Enforcement of law in China, IS policy by MOH Malaysia was implemented in 2012
More worrying is the number of locally performed has plateaued and dropped in 2014
TOTAL Transplant Recipients (2005 – 2014) = 1,248
Overseas = 579 (46.40%)
Local = 649 (52.00%)
Total kidney transplant recipients has dropped in general
More significantly, overseas kidney transplant recipients has dropped significantly since 2007 – 2008 - ? Cause – ? China has consolidated their effort to curb transplant tourism especially since Olympic China 2008, ? Enforcement of law in China, IS policy by MOH Malaysia was implemented in 2012
More worrying is the number of locally performed has plateaued and dropped in 2014
What I would like to impress here apart from the reduction in overall overseas kidney transplantation recipients;
No. local kidney transplantation has not changed that much. It seems that cadaveric increasing a bit but the live donation programme has not improved much over the years.
It is important again to re emphasise that curbing commercial kidney transplant requires also efforts to ensure self sufficiency of organs locally, and therefore optimising the capacity of local programme shall always be our priority.
TOTAL Transplant Recipients (2005 – 2014) = 1,248
Overseas = 579 (46.40%)
Local = 649 (52.00%)
Total kidney transplant recipients has dropped in general
More significantly, overseas kidney transplant recipients has dropped significantly since 2007 – 2008 - ? Cause – ? China has consolidated their effort to curb transplant tourism especially since Olympic China 2008, ? Enforcement of law in China, IS policy by MOH Malaysia was implemented in 2012
More worrying is the number of locally performed has plateaued and dropped in 2014
TOTAL Transplant Recipients (2005 – 2014) = 1,248
Overseas = 579 (46.40%)
Local = 649 (52.00%)
Total kidney transplant recipients has dropped in general
More significantly, overseas kidney transplant recipients has dropped significantly since 2007 – 2008 - ? Cause – ? China has consolidated their effort to curb transplant tourism especially since Olympic China 2008, ? Enforcement of law in China, IS policy by MOH Malaysia was implemented in 2012
More worrying is the number of locally performed has plateaued and dropped in 2014