Merry Christmas 2010!

Merry Christmas and a happy new year, good luck for all that 2011 brings! 

Save a Life in 5 Minutes

At Heathrow airport all you need now is 5 minutes to learn how to save a life. I saw this video on the BBC News website and thought it was a great initiative by the London Ambulance Service which could probably be rolled out to a greater number of people. In particular, I thought that it was a good idea including a demonstration of using a defibrillator. It seems that there's still a widespread opinion amongst the lay public that the 'old-school' paddle set-up and the whole 'clear' then 'shock' method as performed on TV is still being used.

Using a defibrillator is something which anyone who can do. It's really not that hard. A lot of busy places now have defibrillators available but there may still be people who are not trained how to use them. CPR and chest compressions is all about buying time, but really if a patient has a shockable rhythm, then access to a defibrillator as fast as possible is what is required. It was interesting talking to Helen Brady this week, who runs the Heartstart in Dundee, that defibrillators have now been included in Heartstart training videos shown at teaching sessions. The defibrillator has simple diagrams, instructions and a voice to tell the user how to use it. I'll put my hand up and say that I have not been needed to use one in a 'real-life' situation, but having done some training and used the defibrillator in a mock set-up, I would certainly feel confident about using one in a life-saving situation.

End of Life Assistance Bill and PCOS Discussed

This week the Scottish Government voted overwhelmingly against the End of Life Assistance Bill in parliament. It's interesting that when I started at medical school 6 years ago, euthanasia was a topical subject, and it still is today. As with many difficult ethical dilemmas, no doubt this is a subject which will come up time and time again over the next 100 years. The End of Life Assistance Bill was thoroughly studied and discussed by an ethical board consisting of doctors, legal experts, religious groups and experts from countries where end of life assistance has been legalised, such as in the Netherlands. I think it is possible to see where the arguments FOR the bill exist ie. not to prolong suffering, beneficence (doing good) etc. However I believe that there are few doctors out there who would agree to be involved in the process of assisting someone to die. The main reasons why the bill was rejected were because of a fear of how the system could be abused and the doubt as to whether there really was any need to change the current system. I'm going to sit on the fence with this one as I don't think there are good enough arguments for either side to have a majority. Besides, sometimes sitting on the fence is the best place to take a good look at the bigger picture.

When the post did finally arrive today for the first time in over a week, one of the things which dropped through the letterbox was this month's student BMJ. The editorial and center articles were about the shortage of jobs predicted for foundation programme applicants this year. We find out on Wednesday this week how we got on in our applications so fingers crossed for a good score. There were a couple of interesting edicational articles such as this one on Polycystic Ovarian Syndrome. This condition is the commonest cause of anovulatory infertility in women and affects up to 10% of women of reproductive age therefore it is common. There are several pathological abnormalities in the condition such as abnormal ovarian morphology, insulin resistance and increased androgenicity. It is recognised as a diagnosis of exclusion. Patients with clinical features matching the condition should have other endocrine abnormalities ruled out such as Cushing's syndrome and adrenal hyperplasia. The management of the condition is complex and requires consideration of subfertility, metabolic consequences such as diabetes and obesity, and symptoms of hyperandrogenism.