New to Meducation?
Sign up
Already signed up? Log In
view moderators

SurgicalProcedures,Operative

Category

Preview
0
8

Largest Liquid Biopsy Study: Compares With Tissue Sampling

'Oncologists are excited about ctDNA analysis, although further refinement of these techniques is required,' said Rafael Rosell, MD.  
medscape.com
about 3 years ago
Preview
0
7

HDL Subtypes Mediate Bariatric Surgery's Metabolic Benefits

It's partly why dieting doesn't match surgery's favorable HDL and LDL effects: they depend more on changes in lipoprotein profile, therefore function, than on overall levels, say several new reports.  
medscape.com
about 3 years ago
Preview
0
6

The Aortic Dissection Team: Insights After a Decade

The authors describe the implementation of a high-volume, multidisciplinary acute aortic dissection team at a large university medical center. How has it impacted outcomes and systems of care?  
medscape.com
about 3 years ago
Preview
0
7

Catheter Ablation for Asymptomatic and Symptomatic AF

Do patients with asymptomatic atrial fibrillation benefit from radiofrequency catheter ablation?  
medscape.com
about 3 years ago
Preview
0
8

Stent in Colorectal Cancer Reduces Need for Stoma

The use of a stent to unblock the bowel in colorectal cancer patients before surgery, rather than emergency surgery, significantly reduces the need for a stoma.  
medscape.com
about 3 years ago
Preview
0
7

Bariatric Surgery Outcome Better in Early-Onset Diabetes

Bariatric surgery is associated with better and more long-lasting glycemic control in patients with early-onset type 2 diabetes than in those whose disease starts later, researchers have found.  
medscape.com
about 3 years ago
Preview
0
8

ECMO in Cardiac Arrest PechaKucha LITFL

PechaKucha presentation on the use of ECMO in the emergency department for refractory ventricular fibrillation in cardiac arrest  
lifeinthefastlane.com
about 3 years ago
Preview
0
7

Duodenal Mucosal Resurfacing Shows Early Promise in Diabetes

If these findings are reproduced in larger studies, clinicians may someday be able to offer certain diabetic patients this minimally invasive treatment rather than gastric-bypass surgery.  
medscape.com
about 3 years ago
Preview
2
97

Coronary Artery Bypass Grafting (CABG)

This surgery is one way to treat blocked areas in the arteries of the heart. See how the surgery is done, and what to expect before and after.  
youtube.com
about 3 years ago
Preview
13
294

Coronary Angioplasty and Stenting

Coronary angioplasty and stenting is done to open up blood vessels in the heart. You may need the procedure after a heart attack, or if your vessels are clog...  
youtube.com
almost 3 years ago
8
2
43

EXPERIENCE OF A MALE OB & GYN IN A MUSLIM CULTURE IN PAKISTAN.

As part of my post retirement ob & gyn activities, I spent two years in the early nineties, working at the Aga Kahn Medical School in Karachi, Pakistan. That is a most modern facility with excellent staff and resources and great medical students. One can imagine that the majority of obstetricians and gynecologists in a muslim country, like Pakistan, are female and that male ob & gyn might encounter some difficulties It was my distinct impression that often it is not the woman herself who objects to being examined and treated by a male, but rather the husband. An anecdote of a real situation which I encountered will illustrate this. One day I was sitting in my office next to the labor and delivery suite as one of the more junior female residents came running into my office, quite excited. “Doctor Le Maire, could you please come quickly? One of the laboring patients has some very major drop in the baby’s heartbeat. I am worried but cannot reach her private doctor and the doctor on call is in the operating room.” I ran over to the delivery suite with the resident and into the patient’s room. She was obviously in much discomfort and her husband was at her side. One of the first things an obstetrician may do when a woman in labor shows signs of some problem with the undelivered baby as evidenced by a drop in the baby’s heart rate, is to examine the woman vaginally. In doing so, the he or she can determine if the baby can be quickly delivered or if there is a reason for the drop in the baby’s heart rate, such as a loop of the umbilical cord being compressed by the head, in which case an immediate C- Section might be necessary. So I immediately put on a pair of sterile gloves and got ready to examine the woman. She herself was perfectly ready to let me do this, but her husband stopped me and told me that he objected to his wife being examined by a male. This was even in the face of a serious situation with potential for harm to his unborn baby. There was no time to be lost trying to reach one of the female attendings, so I did the next best thing and told the very junior resident to take the patient into the operating room and examine her there and let me know the findings, while I was getting the operating room organized to do a C-Section, if called for. The strange thing is that the husband would have let me do a C- Section on his wife, but not a vaginal exam. As it turned out, by the time the patient ended up in the operating room, her private doctor had been located and was in attendance. The outcome was good and a healthy baby was delivered soon after. However the situation could have been quite different and catastrophic. Even stranger to me was that the woman’s husband was not a lay person but actually a chief resident in anesthesiology in the same hospital, with whom I had worked together in the operating room on a number of occasions. I would never have thought that an educated person and a medically educated person at that, would jeopardize the well being of his unborn child and wife, based on cultural and religious beliefs. Later on in the year this same anesthesiology resident came to ask me for a letter of recommendation as he wanted to apply for a specialized fellowship in the USA. I hope that the reader can understand why I politely (perhaps not so politely) refused. Those interested can read more about my experiences in an e book, entitled "Crosscultural Doctoring. On and Off the Beaten Path." One can down load it for free to the reader device of your choice from Smashwords at: http://smashwords.com/books/view/161522. Or just Google Crooscultural Doctoring.  
DR William LeMaire
almost 3 years ago