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  1. #1
    dua_frank is offline Junior Member
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    Jan 2005
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    Obgyn chat: Antenatal care and Fetal testing...


    dua_frank has joined the chat.
    [erum] *harp* *beep*
    [an_bo_al] hey
    [an_bo_al] erum?
    [an_bo_al] erum?
    [erum] *bird*
    [tunemedic45] hi
    [tunemedic45] anyone awake
    [arian] hi there!
    [RussianJoo] hello
    [RussianJoo] any one out there
    Now entering USMLE_Step_2 subroom.
    dua_frank has joined subroom: USMLE_Step_2
    [dua_frank] back
    [dua_frank] finally
    [samantha] wc
    [dua_frank] thanks sammy
    [megs] ok start
    [lanny] ok guys start
    [lanny] rubella lets discuss
    [megs] what are BP CHANGES during pregnancy???
    [megs] ok lanny u r q first
    [lanny] BP increase
    [samantha] it dec during the 1st trimes
    [lanny] right
    [lanny] but inc later
    [megs] yes sammy right
    [lanny] diastolic dec more than syst
    [samantha] and diastolic dec by 15mmhg
    [megs] but never icr up to prepregnant levels
    [samantha] yes megs
    [lanny] ya
    [megs] what is congenital rubella syndrome??/
    [uniteus] hi everyone ..sorry for being late
    [lanny] hi uni
    [megs] hi uni
    [dua_frank] hi uni
    [lanny] deafness cataract heart dz
    [megs] congenital deafness cardiac anomalies
    [megs] yeah lanny
    [uniteus] blueberry muffin rash too
    [samantha] cong deafness cataracts thrombocytopenia and hepatospleenomegaly
    [lanny] mental retardation too
    [dua_frank] its called as a triad right?
    [dua_frank] or not?
    [lanny] yes dua the triad is the deafness cataract and heart dz
    [dua_frank] oh that was hutchinson triad, sorry
    [dua_frank] what triad is this?
    [dua_frank] any name to it lanny?
    [lanny] dont think so
    [megs] yes as dua said hepatosplenomegaly ln pathy and thrombocytopenia is always accompany cong infectious disease
    [dua_frank] sammy said that megs
    [megs] dua u said this in peds chat
    [megs] lol
    [dua_frank] oh
    [megs] i remember it ...good old
    [lanny] if a preg woman is infrected in 2 mths what to do?
    [megs] terminate pregnacy lanny
    [dua_frank] yeah those are common triats of all
    [lanny] its not an indication
    [lanny] the risk is still small
    [uniteus] so do nothing then lanny..just managed expentantly?
    [megs] but still lanny termination is adviced...
    [lanny] right uni megs
    [megs] who is right lanny
    [lanny] both are
    [lanny] megs term is not an indication so dont terminate
    [samantha] transplacental spread is 90% in the 1st trimes
    [megs] infected in 2 months is what lanny???
    [uniteus] which trimester is fetur prone to most serious infection to toxoplasmosis?
    [lanny] if woman gets inf before 3 mths of preg then term is not an indication
    [lanny] after 3 mths not sure???
    [samantha] 3rd trim lanny
    [samantha] sorry uni
    [megs] ok
    [uniteus] oh...its is first trimester sammy
    [lanny] no if woman gets infected and gets preg within the first 3 mths i mean
    [uniteus] but 3rd trimester has high risk to toxo
    [megs] yes uni
    [uniteus] yeah...i remember u megs..wen i was reading this
    [megs] lol
    [samantha] ok uni
    [dua_frank] lol
    [megs] what isrx of toxoplasma in prg???
    [megs] rx??
    [uniteus] pyrimethamine n sulfadiazine
    [megs] yes
    [lanny] megs same as non preg
    [megs] yes lanny
    [uniteus] what is the toxoplasmosis triad clin feature?
    [uniteus] to fetus/infant
    [dua_frank] hydrocephalus, periventricular calns and something else
    [lanny] choriretinitis intra cr calcify IUGR
    [lanny] dua its intra not peri
    [megs] microcephaly intracr calcification and mr uni
    [dua_frank] oh
    [megs] not hydrocephalous dua
    [lanny] peri is CMV
    [dua_frank] right sorry microcephaly
    [uniteus] yeah..it is hydrocephalus, INTRA cranial calcification n Chorioretinitis
    [megs] it hydrops fetalis
    [dua_frank] its hydro
    [uniteus] TOXO = INTRAcranial n CMV = PeriVentricular calcification
    [dua_frank] thanks uni
    [uniteus] urw
    [lanny] yes toxo is periventricular
    [lanny] there is no hydroceph in toxo dua
    [uniteus] yeah
    [dua_frank] what will happen to cholesterol in pregnancy?
    [lanny] sorry perivent is CMV
    [uniteus] rt lanny..opposite...
    [dua_frank] *)
    [lanny] no uni chk it toxo is intra
    [uniteus] oh sorry..dua..i mean...he corrected himself..n i am agreein to it
    [dua_frank] lol
    [lanny] i have a mnemonic for that uni
    [uniteus] tell me
    [uniteus] megs dey r same for fetal hydrops
    [lanny] difficulu its a weird way i remeber it
    [samantha] it will inc dua
    [lanny] difficult to explain here
    [dua_frank] sammy it remains same
    [uniteus] oh ok..
    [dua_frank] no effect thus, no atherosclerosis
    [uniteus] i just remeber : cmV = periVentricular calcif
    [dua_frank] nice
    [samantha] what about HDL and LDL?
    [dua_frank] what happens to tidal volume ?
    [megs] icr dua
    [lanny] increase
    [uniteus] increase tidal vol
    [dua_frank] right
    [dua_frank] they are not affected sammy
    [samantha] ok dua
    [samantha] inc in the 3rd trim
    [dua_frank] they have increased risk of DVT and PE not MI or atherosclerosis
    [lanny] which murmurs is normal in preg
    [dua_frank] systolic
    [uniteus] systolic?
    [megs] systolic
    [lanny] right both
    [samantha] systolic
    [uniteus] why do pregnant dont get thyroid problem despite increase t4?
    [dua_frank] when does quickening begin?
    [dua_frank] TBG inc too uni
    [uniteus] 16-20week gest
    [lanny] cause its inc TBG
    [dua_frank] right
    [megs] total t4 increse...
    [uniteus] rt all yeah..due to increase TBG
    [megs] not free t4
    [uniteus] thx megs
    [samantha] only total T$ inc free T4 is normal uni
    [samantha] 16 weeks/
    [uniteus] thx sammy
    [megs] quickening at16 in multigravida and at 20 wks in prii
    [megs] primi
    [dua_frank] thanks megs
    [lanny] whats quickenieng??
    [uniteus] fetal movement first time
    [uniteus] felt by mom
    [lanny] oh yes thanks
    [uniteus] urw
    [dua_frank] little buggers start kicking then
    [dua_frank] mc cause of abortion in second trimester is?
    [megs] uterine anomalies
    [megs] prob in uterus
    [lanny] incompete cervix
    [dua_frank] not cervix megs?
    [samantha] cervical incom
    [dua_frank] cervical structural abnormalities yes
    [dua_frank] usually incompetant cervix
    [megs] cx is part of uterus...i said in general
    [dua_frank] ok
    [megs] true incompitent cx
    [dua_frank] when does lightening happen?
    [lanny] at what time is cerclage placed
    [megs] commomest cause of 1 st trimester abortions??/
    [samantha] 36 weeks
    [dua_frank] chro abs
    [lanny] no sam i mean placed
    [dua_frank] third trimester sammy
    [dua_frank] 14 weeks lanny
    [dua_frank] removed at 32
    [lanny] 12 -16 wks right dua
    [lanny] removed at 34
    [megs] 14 wks lanny ideally
    [samantha] 36 is for lightening lanny dua's q
    [dua_frank] lightening is flattening of upper abdomen and increased prominence of lower abdomen
    [megs] or 2 weeks priar to previous abortions
    [dua_frank] baby comes down
    [lanny] os sorry sam
    [samantha] no prob lanny
    [dua_frank] average weight gain during pregnany and what is average baby weight?
    [megs] 11 to 12 kg
    [megs] noraml baby wt is 3 kg
    [lanny] use lbs guys american system
    [dua_frank] yes
    [dua_frank] 28 lbs and 7-8 lbs
    [lanny] dua i thought 20 lbs
    [lanny] youre right 7 lbs average
    [dua_frank] 12 kgs is 28 lbs lanny
    [uniteus] no maths please
    [dua_frank] lol
    [samantha] lol
    [dua_frank] what does g2p1002 mean?
    [dua_frank] math uni :P
    [uniteus] eck
    [samantha] gravida 2 para 4
    [samantha] dua
    [megs] *)
    [lanny] dua forgotten
    [uniteus] term 1, preterm 0, abortion ?
    [dua_frank] means this is her second pregnancy, previous pregnancy with twins
    [dua_frank] whats triple scan?
    [megs] b hcg ,esriol ,alfa fetoprt levle
    [lanny] screen you mean dua
    [dua_frank] oops
    [dua_frank] screen
    [dua_frank] yes
    [lanny] megs got it
    [dua_frank] what are their abnormal values?
    [uniteus] dua d p1002 is term=1, preterm=0, abortion=0, living = 2
    [dua_frank] tell me the conditions which change them
    [megs] all trisomies dua
    [dua_frank] right
    [uniteus] inc afp= ntd
    [dua_frank] the last 4 numbers are flap uni
    [uniteus] ok...thx
    [dua_frank] full term pregnancy, premature pregnancy, abortions, living children
    [lanny] ventral abdom wall def
    [dua_frank] this is for parity
    [dua_frank] 1002 would mean one full term pregnancy with twins
    [dua_frank] parity should previous prenancies
    [uniteus] ok..got it ..thx dua
    [dua_frank] welcome
    [dua_frank] afp decreased iN?
    [megs] dua can u explain seperately
    [megs] what is 1002
    [dua_frank] G2P1002
    [lanny] inc a FP ?
    [dua_frank] this was the equation
    [uniteus] NTD lanny
    [megs] ok
    [lanny] what else uni
    [dua_frank] G2 is gravida 2, just shows how many times she has become pregnany, including present one
    [uniteus] low afp, hcg, estriol is trisomy 18
    [megs] agree uni
    [dua_frank] P shows viable pregnancies, not number of fetetus deliverd, just pregnancies that have reached viability
    [lanny] i mean inc a FP seen in??
    [megs] yes dua
    [uniteus] NTD lanny..
    [lanny] what else uni
    [uniteus] dunno
    [megs] neural tube defects, germ cell tumors
    [dua_frank] in parity we have 4 numbers which denote full term pregnancies, premature pregnancies, abortions, living children (FLAP)
    [lanny] fetal death uni
    [megs] thanx dua
    [dua_frank] in our case lady had previously one full term pregnancy, no premature pregs no abortions and 2 live babies (twinS)
    [dua_frank] welcome megs
    [samantha] thanx dua
    [dua_frank] how about gastrorhesiS?
    [dua_frank] AFP in this?
    [lanny] inc dua
    [dua_frank] right lanny
    [dua_frank] what tests do you do on first visit?
    [lanny] OH DUA I JUST WAS GONNA ASK????
    [megs] lanny do u mean to say FP INCR IN FETAL DEATH???
    [dua_frank] lol telepathy lanny
    [lanny] yes
    [lanny] right dua
    [lanny] blood group
    [lanny] rubella titre
    [lanny] syph hiv hepB
    [dua_frank] rh cbc pap and gc for chlamydia too
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    [dua_frank] if family history of DM, 1 hr glucola
    [lanny] yes dua
    [lanny] if no fam hx then at 24 wks
    [dua_frank] triple screen too
    [dua_frank] yes
    [dua_frank] so many tests
    [lanny] ok second visit
    [lanny] at 16 -20 wks
    [lanny] what do we do???
    [dua_frank] sickle cell screen, hb
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    [lanny] aFP U sound for fetal age
    [dua_frank] but you do that at first visit
    [dua_frank] the triple screen
    [dua_frank] usg also at first visit
    [dua_frank] 28 weeks?
    [lanny] triple screen is done from 15 wks dua
    [lanny] between 15 -20 wks
    [megs] AGREE LANNY
    [lanny] so thats second visit
    [dua_frank] oh
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    [dua_frank] shouldn't we be going month wise then? instead of visit wise
    [lanny] 28 wks diab screen
    [dua_frank] lady can come at even 16 weeks for first visit
    [dua_frank] we never know
    [lanny] repeat RH
    [lanny] CBC
    [dua_frank] yes lanny
    [lanny] give rhogam
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    [dua_frank] what if rh is positive lanny?
    [lanny] give rhogam if RH neg
    [dua_frank] positive?
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    [lanny] no need
    [dua_frank] you should do amniocentesis, prepare for transfusion and delivery of baby
    [dua_frank] whats lyle curve?
    [lanny] so what if you have a rh pos at 8 weeks first visit?/
    [dua_frank] you dont do it then lanny
    [dua_frank] you do
    [dua_frank] dunno lanny
    [lanny] yes you do you do blood grp and RH
    [dua_frank] ask megs
    [megs] if mother is rh negative do husbands blood gr firs
    [megs] if husbands blood gr is negative...no need of rhogum
    [megs] if mother is negative....
    [uniteus] but if not husband but other? *)
    [lanny] correct megs
    [megs] and babies blood gr is suspected to be positive then as lanny said
    [dua_frank] uni lol
    [lanny] if father is pos and mum is neg give RHIGAM
    [lanny] if previous preg mum got rhogam do you give in this preg??
    [uniteus] yeah...collegeu of mine asked me dat...i was bit blank at that point..basically i learned to do grp n rh to all pregnant woman...n baby too no matter wat...husband not too reliable
    [megs] yes lanny u will give
    [dua_frank] right i agree uni lol
    [uniteus] lol
    [lanny] agree megs just wanted to let all know
    [uniteus] thx lanny
    [dua_frank] what do you look for in amniocentesis?
    [lanny] in short always give rhogam if mum is rh neg
    [dua_frank] of this rh pos mom
    [uniteus] if mom blood test is HBsAg,wat u give to baby just born?
    [dua_frank] right lanny
    [lanny] regardless of fathers status
    [dua_frank] ig uni
    [dua_frank] and vaccine
    [lanny] vacc and IG
    [megs] immunoglobulins and vaccination both
    [lanny] right megs
    [uniteus] rt dua n lanny...need to give both ..n rt megs
    [lanny] immed after birth and 6 wks later
    [dua_frank] bilirubin
    [dua_frank] how will you rx chlamydia inf in preg ldy?
    [lanny] doxycycline
    [lanny] oh sorry
    [uniteus] no lanny tetra
    [uniteus] teratogenic
    [lanny] no uni
    [dua_frank] ceph or erythro
    [lanny] erythro
    [megs] erythro dua
    [uniteus] erythromycin
    [dua_frank] can give both
    [lanny] doxy and tetra are contra in preg
    [dua_frank] yes lanny
    [dua_frank] what test at 37 weeks?
    [lanny] Grb B strep
    [lanny] chlamydia culture
    [lanny] GC
    [dua_frank] good lanny, if positive?
    [lanny] treat
    [dua_frank] drug
    Unrecognized Command or Action.
    [dua_frank] ?
    [uniteus] give intrapartum antibiotics
    [dua_frank] iv amp yes
    [uniteus] pcn
    [lanny] pen
    [dua_frank] uti rx/
    [dua_frank] ?
    [uniteus] amp n gent??
    [dua_frank] yep
    [lanny] amp gent clinda???
    [dua_frank] when do you give nitrofurantoin?
    [uniteus] allergic to PCN
    [lanny] agree
    [megs] uti dua..when alleric to pen
    [uniteus] or stable patient? as outpatient?
    [dua_frank] i thought you desensitize and give pens
    [dua_frank] you might be right though, thanks
    [lanny] thats in syphillis
    [megs] desensitization of pencillin..i know only for syphilis
    [dua_frank] yes syphillis, thanks
    [megs] for other disess we have alternate antobiotic..eqally effective
    [uniteus] Cocaine mother is at risk of what problem?
    [lanny] heart dz
    [megs] abruption uni
    [uniteus] rt megs
    [lanny] teratofens
    [lanny] lithium>??
    [uniteus] difference between placenta abruption n previa?
    [dua_frank] ebstein
    [megs] ebstiens anomaly lanny
    [uniteus] Ebstein
    [uniteus] triscupis valve mainly affected in ebstein
    [lanny] right
    [lanny] tetra/??
    [megs] previa painles bleeding due to malposition of placenta...
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    [lanny] abrupt is painful
    [megs] abruption painful..bleeding ..cause is premature seperation of normally situated placenta
    [uniteus] rt megs n lanny
    [megs] placental location is imp
    [megs] abnormal location...its previa...
    [megs] normal location its abruption
    [lanny] management of abruption??
    [samantha] delliver lanny
    [megs] amniotomy and termination...lanny
    [lanny] right all
    [lanny] C section
    [uniteus] speculum exam, USS, bed rest , if <34weeks give steroid for lung maturity...but if not stable allow v-deliver or Csection
    [lanny] if mother and child in jeopardy
    [uniteus] csection
    [uniteus] complication of abruption?
    [megs] DIC
    [lanny] DIC
    [uniteus] rt n?
    [samantha] dic
    [lanny] ATN
    [megs] RENAL FAILURE
    [samantha] embolii
    [uniteus] maternal shock n mother may get couvelair uterus
    [uniteus] what is couvelair uterus?
    [lanny] bleeding int uterine sall
    [lanny] wall
    [megs] it will resolve on its own...
    [uniteus] couvelair uterus is bruised , purple appearnce of serosa...
    [uniteus] agree megs..sorry for putting it as complication
    [megs] covulier uterus is just a finding during c section in abruption
    [lanny] its like a bruise on your skin
    [lanny] but this is on the uterus
    [megs] true lanny
    [lanny] what is metabolic state in preg??
    [dua_frank] when is amniocentesis done?
    [megs] what is tr of planta previa with 30 weeks bleeding profusely???
    [lanny] acidosis or alkao
    [uniteus] second trimester dua
    [uniteus] resp alkalosis in preg
    [dua_frank] 15 to 17th week
    [samantha] c section megs
    [dua_frank] what do you use amniocentesis for?
    [lanny] admit pt and give bed rest give steroid
    [megs] yes sammy
    [samantha] and iv fluids first
    [megs] for triple screen, in rh negative pregnancy dua
    [dua_frank] triple screen is done by blood megs
    [megs] also some times for feta karyotyping
    [megs] oh sorry dua..u r correct ..
    [uniteus] karyotype dua
    [dua_frank] we look for karyotyping, bilirubin in rh positive mom, blood, culture it and alpha feto protein
    [uniteus] y bilirubin dua?
    [dua_frank] you look for rh incompatibility uni
    [uniteus] oh ok..thx
    [dua_frank] if there is bilirubin it means hemolysis has begun already
    [dua_frank] got to do immediate delivery
    [dua_frank] or else hydrops fetalis
    [megs] dua lily s charting???
    [dua_frank] yes megs of bilirubin
    [dua_frank] by amniocentesis
    [dua_frank] when do we do CVS?
    [uniteus] first trimester 9-12wk
    [dua_frank] right
    [uniteus] for karyotype
    [dua_frank] just a little better than amniocentesis
    [dua_frank] and can be done earlier
    [uniteus] but has risk too..like miscarriae
    [uniteus] miscarriage
    [uniteus] most commonest cause of postpartum hemorrage?
    [dua_frank] remannts of placenta
    [megs] retained placenta pieces
    [uniteus] nope
    [dua_frank] no? :O
    [uniteus] think again
    [megs] atonic uni???
    [samantha] atonic uterus
    [uniteus] rt megs n samantha...uterine atony
    [megs] but uni retained is more common
    [dua_frank] so thats why you do massage?
    [dua_frank] yeah megs
    [uniteus] yup dua
    [uniteus] nurses always massage the uterus..
    [megs] in the era of PG AND ERGOMETRIN...ATONIC PPH IS ..NOT COMMON
    [dua_frank] okie dokie obgynologist megs jee :P
    [megs] dua lol
    [megs] are u making funn
    [uniteus] ur the boss megs...i only follow notes
    [megs] of me lol
    [dua_frank] no way megs, never
    [uniteus] lol
    [dua_frank] i would trust you more than kaplan on obgyn, i swear lol
    [uniteus] agree dua
    [megs] i do not worth that dua..
    [dua_frank] megs i never learnt obgyn with as much interest as now with you, thanks a lot for all your inputs here
    [megs] ok let it be...step 2 is a big ..big..topic..and obgy is a part of it
    [samantha] why not megs
    [uniteus] agree dua..thank u very much....
    [megs] ok guys
    [megs] move on next sub
    [dua_frank] aww shes blushing now :P
    [dua_frank] ok ok i'll stop teasing you noW :P
    [uniteus] lol ...ok megs go hit us q
    [megs] what is HELLP SYNDROME??/
    [uniteus] hemolysis, elev liver enxymes, low platelets seen in sever preeclampsia
    [megs] YES UNI
    [samantha] agree uni
    [dua_frank] megs can you please explain what normal triple screen is like?
    [dua_frank] and whats MOM
    [dua_frank] multiples of median
    [dua_frank] ok
    [dua_frank] talks here about moms of afp
    [dua_frank] was wondering what that was
    [megs] just remember it MOM ..in downs screening
    [dua_frank] ok teratogen,s me telling presentation you tell me teratogen
    [dua_frank] yeah low mom there megs
    [megs] ok dua
    [dua_frank] cns defects, deafness, congenital heart defecs
    [uniteus] cmv
    [megs] rubella
    [dua_frank] drug uni
    [megs] ok
    [dua_frank] sorry drugs please
    [uniteus] oh...
    [megs] streptomycin dua??
    [megs] not sure
    [dua_frank] isotretinoin
    [uniteus] eck
    [dua_frank] limb reduction?
    [megs] ok
    [megs] thalidomide
    [dua_frank] right
    [uniteus] warfarin or thalidomine
    [dua_frank] fetal cytotoxicity?
    [megs] tell us more dua
    [dua_frank] streptomycin
    [dua_frank] just that megs
    [dua_frank] ebstein anomlay?
    [megs] ok
    [megs] lithium
    [uniteus] li
    [dua_frank] neural tube defects, cleft lip, renal defectS?
    [uniteus] folic acid def...so phehytoin or valproic
    [megs] valproate
    [dua_frank] right valprioc
    [uniteus] no phenytoin dua..dunno?
    [dua_frank] stippling of uncalcified epiphysis, microcephaly, MR, optic atrophy?
    [uniteus] lead
    [samantha] lead
    [megs] dunno
    [dua_frank] uni i know of only valproate that is teratogenic in antiseizure medication
    [dua_frank] warfarin
    [megs] great dua
    [uniteus] ok..thx dua
    [dua_frank] yellow teeth?
    [megs] tetra
    [uniteus] tetracyclin
    [dua_frank] easy
    [samantha] i think uni is rt fetal hydantoin synd
    [samantha] phenytoin is there
    [uniteus] ok...just remembered..thx sammy
    [dua_frank] iugr, short palpebral fissure, long philtrum?
    [samantha] blocks folic acid
    [uniteus] alcohol dua
    [lanny] alcohol
    [dua_frank] oh yeah, thanks sammy, but with neural tube defects? can you please tell me the features of fetal hydantoin syndrome?
    [dua_frank] yes alcohol
    [dua_frank] t shape uterus?
    [megs] DEC
    [lanny] DES
    [megs] DE S
    [uniteus] what is dec?
    [uniteus] oh..got it megs
    [dua_frank] as far as i know there is only microcephaly in FHS
    [dua_frank] yes DES
    megs has left the chat.
    [dua_frank] IUGR, mr, microcephaly, inner epicanthal folds depressed nasal bridge, nail hypoplasia, oral clefts and heart defects?
    [samantha] that's rt dua
    [lanny] fetal alcohol??
    [dua_frank] right
    [dua_frank] thanks for reminding me about FHS uni and sammy
    [lanny] is hydantioin same a sphenytoin
    [dua_frank] yes lanny
    [uniteus] yes
    [lanny] thx
    [dua_frank] when are igs given?
    [dua_frank] name the infections
    [uniteus] ok
    [dua_frank] well? :P
    [uniteus] oh..kawasaki u mean
    [dua_frank] uni sleeping again lol wake up
    [uniteus] yeah..
    [lanny] whats the q dua??
    [dua_frank] kawasaki and ITP yes but in normal women
    [dua_frank] i'm talking about igs for infections
    [dua_frank] in pregnant women
    [dua_frank] hepatitis, rabies, tetanus, varicella, hep a and measles
    [uniteus] oh..ok..thx
    [dua_frank] welcome
    [dua_frank] ok i guess thats all from me today
    [uniteus] ok..me too
    [dua_frank] see you all tomorrow
    [uniteus] bye lanny, dua, sammy n megs...n thx
    [dua_frank] last day for obgyn tomorrow
    [dua_frank] bye uni
    [lanny] yes dua
    [dua_frank] thanks too
    [lanny] it went well
    [dua_frank] it did lanny
    [lanny] plz post todays dua
    [dua_frank] i will be doing that now
    [lanny] and thankyou as always
    [dua_frank] welcome
    [dua_frank] bye lanny and sammy
    [lanny] see you all tom guys!!!
    uniteus has left the chat.
    lanny has left the chat.
    [samantha] bye dua
    samantha has left the chat.

  2. #2
    lilb Guest

    i need to know if its ok

    i was wondering if i am low on iron and my doc told me to eat more food rich in iron, if i could take iron pills?

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    sibrahim is offline Newbie 510 points
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    Please let me know abou UW--it stands for?

  4. #4
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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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