David

Fisherman (freshwater) in the north-east of Thailnd. Wife and many children, monogamous, HIV negative. Lives in jungle area, near river, many dogs, chickens, monkeys, goats, cows, pigs. Toilet is outside. No fever, very thin.

Eats a normal Thai diet - Som Tam, Koi Pla, lots of rice. Does not feel ill - came in to clinic because he is getting yellowing of skin and whites of eyes - jaundiced. Previously healthy, no prior med prob or surgery. No diseases running in family.

Distension going on for months. Getting bigger. Exam: jaundiced, has large palpable non-tender mass below liver on his right side. No enlarged liver or spleen

Obviously has liver problem but what are possible causes?

A group of 125 scientists from institutions such as Oxford University and Harvard and Yale in the US claim going ahead with the games would be "unethical" as the "Brazilian strain of Zika harms health in ways that have not observed before."

"An unnecessary risk is posed when 500,000 foreign tourists from all countries attend the Games, potentially acquire that strain, and return home to places where it can become endemic."

http://rioolympicslater.org/

If a friend or relative with a terminal medical condition asked you to help them commit suicide would you help them?

Would you be able to ensure a painless death?

If assisted suicide is illegal in your country would you be able to help someone die in a way that left no evidence?

A friend does not get on with her step mother, her father has diabetes and gas now developed epilepsy. She would like to visit her father without stepmother there.

Stepmother claims that this would be dangerous as the stress of meeting his daughter could trigger a seizure.

My friend is not able to contact her father as the stepmother controls all his contacts and communication.

I am at a loss as to what to advise.

I was invited to a wedding, but the day before the wedding I became ill and was unable to go. I sent my apology saying that I was Ill.

The following week I received a letter from the bride saying that my cancellation had arrived too late for the caterers and here was an invoice for the food that I had not been there to eat.

What would you do in this situation.

I ignored the invoice.

Compare and contrast the antidotes naloxone and flumazenil.

Which one is safer for empiric use in a comatose patient (you do not know what the patient has taken to render him comatose)?

Naloxone is used to treat opiate overdose.

Flumazenil is used to treat benzodiazepine overdose.

What serious complications could occur with use of these drugs?

Patient is female in her early twenties, she feels hot, her pulse is 150 bpm, and the paramedics are unable to obtain her blood pressure due to agitation.

What three pieces of advice can you provide to the paramedics to transport this patient safely to hospital.

....a man who called saying that he was just bitten or stung on his foot while walking barefoot through some brush.

What questions would be asked to determine the most likely creature to have bitten or stung him if he did not actually see what did it?

Can someone explain in reasonably simple terms the basic idea of counterfactual theories of causation.

I too have occasionally come across people that like to feign being hurt or offended.

It is rather like he child who has learned that crying will always make the adults assume that they are the wronged party.

I find it interesting interesting that they can be cunning and deceptive enough to feign offence or hurt and yet be so unaware that they are oblivious to the fact that the vast majority can see right through their attempts at manipulation and are entirely unconvinced by them.

I think such behaviour is probably some form of personality disorder but does it have name or classification.

They don't announce every Samsung launch and Samsung sell more phones than Apple.

Are there are plain brown envelopes being exchanged between Apple and the Media?

http://www.virology.ws/are-viruses-alive/

Do you find multicellular parasites like parasitic worms and lice more interesting than microbes like protoza, bacteria and viruses.

There have been spam emails sent from my yahoo account.

How can I stop this?

If so were you aware at the time that it was an hallucination?

What form did the hallucination take - images, sounds/voices, smell/taste, touch?