1. June 2005

4. IVF-ET: Past, Present & Future Howard Jones Jr ObG Survey 2005 1.3 to 1.5 Million IVF Babies in the World – 1% of Births in USA Indication: Tubal Disease / Endometriosis / Male Factor

6. Future of IVF Non invasive detection of Oocyte with potential to achieve Singleton PGD to overcome Chromosomal aberration Fusion of Meisis-induced Somatic cells Exogenesis

8. RP6 Robots Sr Mary & Dr Robbie Start Ward Rounds from 18 May 05 at St Mary Hospital, London Face to Face interface with Consultant far away

9. Needle Suspension for SUI Systematic Review - Cochrane library Feb 2004 9 Trials – 347 women – 9 Different NS Procedures Abdominal Retropubic Suspension Vs NS: Failure after 1 year: 16% Vs 29% Morbidity same Anterior Vaginal Repair Vs NS: Failure: 36% Vs 33% (Same) Conclusion: NS probably not as good as Abdominal Suspension More Studies needed

11. DULOXETINE for Stress Incontinence Selective Serotinin (5-HT) & Nor Epinephrine Reuptake Inhibitor Rhabdosphincter Activity Efferent Pudendal nerve Activity Pelvic Floor Tonus Marketed as “ULOZET” - 40 mg bd (Inca) -Urol 2004;6 (Suppl 3)

12. RCT: BJOG March 2004 494 women 40 mg bid x 4 weeks Incontinence Episode Frequency (IEF) reduced by >50% Incontinence Quality Of Life (I-QOL) Improved after 4 to 12 weeks of treatment

13. Tolterodine L-tartarate Reduces Urinary Frequency Reduces Urgency

14. DESMOPRESSIN Controls Nocturia Minirin 0.1 mg OD Potent Antidiuretic Reduces Nocturnal Voids Better sleep

15. Parameters for Prediction of Caesarean Section

16. Variables Parity ( more in Primi ) Height: 5% at 170 cm Vs 30% at 140 cm McGuinness & Trivedi 1999 Increased Maternal Age Main et al 2000 Male Fetus: Delayed maturation of Sympatho adrenal system = Less catecholamine during hypoxia & acidosis Lieberman et al 1997 Anthropoid pelvis: Occ.Tr & Occ Postr caldwell & Moloy 1933

17. Occipito Posterior & CS CS Rate of 30-42% -Sizer&Nirmal 2000 Disproportion due to Deflexion -Floberg et al 1987 Inadequate Head to Cx Forces – Less uterine activity -Allman et al 1997 Increased Fetal Distress: Decelerations Longer labor Increased rate of Augmentation

18. USG Diagnosis of Occ Postr in Early labor to predict CS -Nicolaides et al Int J ObG June 2004 601 cephalic singletons at onset of labor Vaginal Delivery 86% & CS14% CS in Occ postr 19% Vs Non OP 11% Conclusion: Diagnosis of Occ postr at onset useful predictor of CS among other parameters

20. Intra Vaginal Ejaculation Latency Time ( IVELT ) Definition: ”Persistent or Recurrent ejaculation with minimal sexual stimulation before during or after intromission and before the man wishes it”

21. IVELT Systematic Review of 21 RCTs 79 Publications between 1944 & 2003 Incidence: 31% Traditionally Treated with Antibiotics / Neuroleptics / Anti depressants Anti Depressants effective Waldinger et al Int J Impotence Res 2004

23. Dapoxetine Anti depressant Increases Sexual Stamina (IVELT) 3-fold Will earn J&J $400 million by 2007 Am Urol Assocn 24 May 2005