Hippocratic Oath Revisited - Where do we stand?

The medical profession is said to be a natural art conceived in sympathy and born of necessity. It entails compassion and understanding in handling patients as whole human beings with dignity and decency. The forefathers in the profession ensured nobility by adhering to the Hippocratic oath and stressed a dignified moral conduct towards patients and upholding the sanctity of life. They were therefore able to draw much respect from the society. The issue now is whether doctors have lived up to the standards of our forebearers. Hippocrates (460-377 BC) is generally regarded as the father of scientific medicine. He separated medicine from magic and mythology of Galenic times; and introduced ethics in medicine with the formulation of the Hippocratic Oath (1;2;3;4). any doctor who draduates from medical school is sworn by that oath or any of its derived variations of his graduation day as a reminder of decent professional conduct (2). It is about a doctor's responsibility and obligation in upholding human life first and above anything else; keeping above board in conduct and relation to patients; the general public and with colleagues

Radiographic Appearances of Pulmonary Tuberculosis in HIV-1 Seropositive and Seronegative Adult Patients

Objective (of this study is): To describe the radiographic pattern of PTB in HIV-1 seropositive and seronegative patients and to study the relationship between radiographic pattern and degree of immunosuppression based on CD4 counts. Design: Cross-sectional; descriptive study. Setting: TB tratment centre and Department of Radiology; Mulago Referral Hospital and Makerere University Medical Teaching Hospital; Uganda. Subjects: One hundred and fiffty consecutive adult patients; suspected on clinical grounds to have TB. Interventions: Three early morning sputum specicimens and 10 mls of venous blood taken from each qualifying subject. Main outcome measures: Chest x-ray changes and CD4 counts. Results: More than sixty eight per cent of the patients were HIV-1 seropositive. Slightly over seventy two per cent of the seropositives were moderate to severely immunosuppresed; 27.2were mildly immunosuppressed; while 6.4were moderately immunosuppressed. Lung parenchymal opacities were demonstrated in 98.7of all patients. Intrathoracic lymphadenopathy and cavitation were noted in 43.3and 41.3respectively. Fibrosis and pleural effusion were observed in 25.0and 25.3respectively. Miliary disease occurred in 2.0. Seropositives accounted for 81.5and 76.3of patients with lymphadenopathy and pleural effusion; 18.5and 23.7respectively were seronegative. Seronegatives accounted for 64.9and 64.5of those with fibrosis and cavitation respectively; whereas 35.135.5of fibrosis and cavitation respectively were seropostive. Patients who were moderate to severely immunosuppressed accounted for 64.6and 63.2of patients with lymphadenopathy and pleural effusion; 35.4and 36.8respectively had normal immune status or were mildly immunosuppressed.Fibrosis and cavitary disease were more frequent in normal or mildly immunosupressed (78.4and 72.6) than in moderately to severely immunosuppressed patients (21.6and 27.4) (p0.001). Conclusion: HIV-seropositivity with moderate to severe immunosuppression are associated with atypical radiographic appearances in adult post primary PTB

Radiographic appearances of pulmonary tuberculosis in HIV-1 seropositive and seronegative adult patientsKawooya; M.Okwera; A

Objective: To describe the radiographic pattern of PTB in HIV - 1 seropositive and seronegative patients and to study the relationship between radiographic pattern and degree of immunosuppression based on CD4 counts.Design:Cross_sectional;descriptive study. Subjects: One hundred and fifty consecutive adult patients; suspected on clinical grounds to have PTB. Setting: TB treatment centre and Department of Radiology; Mulago Referral Hospital and Makerere University Medical Teaching Hospital; Uganda. Interventions: Three early morning sputum specimens and 10 mls of venous blood taken from each qualifying subject. Main out come measures: Chest X-ray changes and CD4 counts. Results:More than sixty eight per cent of the patients were HIV-1 seropositive. Slightly over seventy two per cent of the seropositives were moderately immunosuppressed; 27.2were mildly immunosuppressed or had normal immune status. Approximately ninety three per cent of the seronegative individuals had normal immune status or were mildly immunosuppressed; while 6.4were moderately immunosuppressed. Lung parenchymal opacities were demonstrated in 98.7 of all patients. Intrathoracic lymphadenopathy and cavitation were noted in 43.3respectively. Fibrosis and pleural effusion were observed in 25.3 and 41.3 respectively. Miliary disease occured in 2.0. Seropositives accounted for 81.5and 76.3 of patients with lymphadenopathy and pleural effusion; 18.5 and 23.7 respectively were seronegative. Seronegatives accounted for 64.9 and 64.5of those with fibrosis and cavitation respectively; whereas 35.1 and 35.5 of fibrosis and cavitation respectively were seropositive. Patients who were moderate to severely immunosuppressed accounted for 64;6and 63.2 of patients with lymphadenopathy and pleural effusion; 35.4 and 36.8 respectively had normal immune status or were mildly immunosuppressed (78.4and 72.6) than in moderately to severely immunosuppressed patients (21.6 and 27.4)(p0.001). Conclusion: HIV-seropositivity with moderate to severe immunesuppression are associated with atypical radiographic appearences in adult post primary PTB