Obstetric Medicine Clinic (OMC):
This is a joint weekly clinic held on Friday afternoons at Royal Darwin Hospital. The clinic is staffed by Obstetric consultants, registrars and RMO’s, Endocrinologist (Dr Sridhar Chitturi), endocrine registrar, Diabetes Educators, Midwife Coordinator Karen Williams and midwives. Medical referrals are to be made in writing to Dr Chitturi and Obstetric referrals to Drs Thomas / McHattie.( Please Fax all referrals to 08-89226750 ) Aims of the clinic:
1. To provide high quality, evidence based treatment of medical conditions complicating pregnancy with a view to improving maternal and fetal outcomes 2. Improve patient satisfaction by providing multidisciplinary care and 3. Serve as a learning resource for the participating consultants, obstetric and physician registrars, medical students, midwives, diabetes nurse educators and dieticians in managing pregnant women with medical problems 4. To provide evidence based guidelines for management, and generate clinical research output into establishing cost effective and proven interventions for attaining good outcomes in remote indigenous patients with common medical problems viz.- what is viz T2DM Note: This clinic is not designed to manage the care of women with High Risk pregnancies without concurrent or pre-existing medical illnesses. The physician (either Obstetrician or Endocrinologist) after review of the patient will either: 1. Recommend transfer of care of the patient to the OMC to be managed by the Obstetric medical team (Dr Chitturi and Drs Thomas/McHattie) Department of Health and Families is a Smoke Free Workplace
2. Continue to manage the medical condition of concern while the patient remains under the care of the primary referring obstetric team. This form of joint care will be suitable for women with conditions such as primary hypothyroidism etc, and wlll be recommended on a case by case basis. Women diagnosed to have gestational diabetes are referred for diabetes
education to
1. Healthy Living NT via their referral form available in the antenatal clinic or 2. RDH DNEs (are available on pager #0284)for Indigenous remote clients Women with gestational diabetes should also be referred to the Diabetes In Pregnancy Clinical Register (the form is available in antenatal clinic or electronic referral can be done through Clinical Workstation). Women with gestational diabetes requiring insulin can be referred to RDH Diabetes Educators using the forms that are available in antenatal clinic. Blood sugar profiles will be monitored by the Diabetes Educators. Healthy Living NT Diabetes Educators will refer the patient back to the referring obstetrician if blood glucose levels are out of target. RDH Diabetes Educators in consultation with the Obstetrician will commence oral hypoglycaemics +/- Insulin therapy as required. These clients may remain with their primary obstetric team (metformin alone or Metformin + single dose of insulin), or receive care at the medical obstetric clinic (more complex insulin regimens) at the discretion of the Endocrinology and Obstetric Consultant in charge of care. For all patients who are to be seen in Obstetric Medical Clinic by Dr Chitturi a referral letter is required. Examples of coexisting medical conditions warranting referral to this clinic include: o Thyroid disease: Graves’ disease, Hashimoto’s thyroiditis and o Active hepatic/renal/haematological /rheumatological/ Infectious disease needing joint care with sub-specialty teams. o Cardiac disease - including mild valvular stenosis, moderate to severe degrees of valvular dysfunction, prosthetic heart valves, history of heart failure or prior surgery, myocardial dysfunction,congenital heart disease , pulmonary hypertension , Marfans syndrome o Current or past history of Venous or arterial thromboembolosim Department of Health and Families is a Smoke Free Workplace
Department of Health and Families is a Smoke Free Workplace

Source: http://www.ntml.org.au/sites/default/files/Service%20Referral%20Manual/Medical%20Obstetrics%20Clinic.pdf


Time-Skew Hebb Rule in a Nonisopotential Neuron Barak A. Pearlmutter   To appear (1995) in Neural Computation, 7 (4) 706–712 Abstract In an isopotential neuron with rapid response, it has been shown that the receptive fieldsformed by Hebbian synaptic modulation depend on the principal eigenspace of ✁ (0), the inputautocorrelation matrix, where Qij (τ) = ξ i ( t ) ξ j ( t τ) an


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