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Osteonecrosis of the jaw is a serious but rare complication of bisphosphonate and Prolia treatment for osteoporosis. It is diagnosed when maxillary or mandibular bone becomes exposed whilst medicated with bisphosphonates. The bisphosphonates are a group of drugs which are preferentially incorporated into sites of active bone re-modelling where they inhibit hydroxyapatite breakdown, thereby effectively suppressing bone resorption.Just how bisphosphonates cause osteonecrosis is not well underst...

Boundary violations occur when a doctor behaves in an unprofessional and untrustworthy manner by misusing their power in the doctor-patient relationship. This may result in harming the patient in some way. I guess many of us would have transgressed at least one such boundary such as treating family members. The following are examples of boundary violations:Examples of practitioner-patient boundary breaches include Having a personal and/or sexual relationship with a patient (even a former...

The RANZCOG and ATAGI recommend that pregnant women are routinely offered Pfizer mRNA vaccine (Cominarty) at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby. (9 June 2021) High risk women include those who: Are immunosuppressed Recent bone marrow transplant Graft versus host disease Leukaemia, lymphoma, Myelodysplastic syndrome Chemotherapy or radiotherapy O...

Recently I saw a woman with a BRCA gene mutation who had recently had both breasts removed and was now being urged to have both ovaries removed, she was 39 years of age. Understandably she was considerably anxious about the prospect of losing most physical vestiges of her femininity. She was keen to know how much risk she would incur of ovarian cancer if she deferred her bilateral oophorectomy until she reached 45 years of age. Hereditary Breast and Ovarian Cancer Syndrome (HBOC). The...

In this current pandemic of COVID-19 (SARS-CoV-2) it is easy to think that the health risks to Australia have never been more dire. In pregnant women there is understandable anxiety about the risks to them and their unborn babies. However in the first 3 months of this pandemic from March to June 2020 there have been no COVID 19 Australian maternal deaths and few SARS_COV 2 infections amongst the pregnant Australian population. By 10 May 2020 the COVID-19 pandemic had infected 3.7 million ...