I grew up in church, but to be honest with you, I don't think I ever heard a message preached on the person I'm going to preach on today. I'm continuing my series, God's Anointed, and I'm talking about a woman who was used of God. Her name is Anna the prophetess, and we're going to be looking at her life as we continue this series. And I know this is going to bless you. I'm even going to get into a little bit to talking about women in the ministry. I know this is a topic that some of you have wanted me to address for a while. So, although the whole lesson is not devoted to it, I will be touching on that just a bit. Stephen Moctezuma is here with me as usual. He's going to lead you in worship. And then we're going to get right into this lesson.  Here is Stephen Moctezuma.  Won't you? Pour it, won't you? Pour it, I want more of I down in my soul That I can't contain, that I can't control, I want more, I want more of you God. So I'm going to talk to you about Anna the prophetess. Now you don't really hear many messages about Anna the prophetess. In fact, I've never heard one and I've grown up in church.  Now let me be clear, this message is for both men and women. Though I'm talking about Anna the prophetess, this applies to men too. Even though this message is for both men and women, there's still something I have to address. You see, as I was preparing for this series and as I was teaching this series, I knew that eventually I would have to address this very controversial subject because I talked about Isaiah the prophet, I talked about King David, I talked about Saul, I talked about Paul, I talked about Moses. And while I was going through all of those characters, I knew that there were some women in the Bible that I wanted to present to you as powerful, mighty, anointed examples of God's called. But then I knew that as soon as I presented to you a woman who God anointed, that this controversy would arise, and sadly so. So there is a controversy surrounding the idea of women in the ministry or women being used by God. And I want to just let you know where I stand on the issue. I know that the Bible teaches with 100% clarity that God uses women too. And I want you to be at peace knowing what the scripture teaches. So I'll share a few thoughts on this matter in just a little bit and then I'll get into the main portion of the lesson on Anna the prophetess. But I do want to say this as well. I know that I'm not going to settle this issue on this edition of Spirit Church, nor could I settle this issue on multiple editions of Spirit Church because this debate is going to continue, I believe, until the Lord returns. But I want to talk to some women who've been oppressed by this idea that God doesn't want to use them because of their gender, because of how he created them. Think about that. That's so sad that people actually believe that. But God wants to liberate you from that religious doctrine. God wants to liberate you from that way of thinking, that mindset. And I pray that that be broken over your life today in Jesus' name.  God has anointed you. God has gifted you. And he wants you to operate in those gifts in the body of Christ. So there are those who will say, well, you know, the Old Testament makes it so perfectly clear. God's plan, God's pattern, they'll say, all of the patriarchs were men. All of the prophets were men. All of the priests were men. All of the kings were men. All of the armies were made of men. And they'll list all of these powerful men of God and say, you see, that's God's way of doing things. And so anytime you present to them any scripture where God uses a woman, they'll say, well, that's just an anomaly. That's just an unclear scripture that you have to interpret in the light of all of the clear scripture that we have. But what's interesting to me is that these same people who invoke the Old Testament to assert this idea that God doesn't want to use women, immediately reject that same Testament as soon as you start pointing out people like Esther, like Deborah, and other anointed women who God used. So they will say, well, that lays the groundwork, but the moment you use that groundwork, the Old Testament, to show that in fact God does use women, they say, well, wait a minute, wait a minute, wait a minute. That has nothing to do with the New Testament church, yet they were the ones who invoked it. You see, they like the Old Testament until it messes with their theology. And we've seen women being used by God in the Old Testament. Even in the New Testament, we find scriptures such as Romans chapter 16 verse seven, where the Bible says, greet Andronicus and Junia, my fellow Jews, who were in prison with me. Junia is a woman, by the way. They are highly respected among the apostles and became followers of Christ before I did. And again, they'll say, well, wait a minute, that's one scripture, that's one thought. And it's so unclear, what does it mean among the apostles? Maybe she wasn't really counted among the apostles. And I will admit that that verse is debatable. But they will take verses like that and they'll say, well, it's not so clear. We have to take the unclear and compare it with the clear teachings of scripture. Then what about scriptures like this? Romans chapter 16 verse one. I commend to you our sister Phoebe, who was a deacon in the church of Centria. Now wait a minute, that is a direct contradiction to those who believe that God doesn't want to use women in the ministry. Let's say, well, yes, she was a deacon, but God doesn't want women to instruct men. Nonsense, Acts chapter 18 verses 24 through 26. Meanwhile, a Jew named Apollos, an eloquent speaker who knew the scriptures well, had arrived in Ephesus from Alexandria in Egypt. He had been taught the way of the Lord and he taught others about Jesus with an enthusiastic spirit and with accuracy. However, he knew only about John's baptism when Priscilla and Aquila heard him preaching boldly in the synagogue. They took him aside and explained the way of God even more accurately. There's a woman teaching a man. See, the scripture teaches in Galatians chapter three there was no longer Jew or Gentile, slave or free, male and female. For you are all one in Christ Jesus and at that verse, they will roll their eyes and they'll say, but wait a minute, you can't take those verses and compare them with the clear teachings of scripture and not be convinced. But the truth is that these scriptures are just as clear, if not more clear than the verses that they present. So when you have two very clear teachings of scripture that seem to contradict one another, you have to rethink one of them. And in my opinion, or I should say from what I've gathered in scripture, you see God using women again and again. How does that not clear the debate for you? You see, it seems to me that you have to do some searching of scripture yourself. You have to study, you can't just be lazy and open the Bible and say, well, there it is, it's right there. You have to study the context, the culture, the intent of the writer, the letter itself. And once you've done those things, it's very clear that God in fact wants to use women, God has used women, God is using women and God will continue to use women whether they like it or not. Now again, I know that didn't settle the debate but I just wanted to share a few thoughts, again, to get you thinking in the right direction. And I know there will be many who comment even on this video probably, they'll put the theology on display and we'll all be very impressed at how smart they are. But the truth is the debate is not going to be settled but again, I at least want you, those of you who watch this channel and those of you who watch the teachings to think in the right direction. So here's another example of a woman that God used and that's gonna be found in Luke chapter two versus 36 to 38. There was also a prophet Anna, the daughter of Fanuel of the tribe of Asher. She was very old. She had lived with her husband seven years after her marriage and then was a widow until she was 84. She never left the temple but worshiped night and day, fasting and praying. Coming up to them at that very moment, she gave thanks to God and spoke about the child to all who were looking forward to the redemption of Jerusalem. Here is a woman, Anna, a prophet in the temple at the time that Joseph and Mary had taken Jesus with them. And immediately upon looking at Jesus, she recognizes who the Messiah is. She had a prophetic discernment about her. In fact, this woman who was constantly in the temple, constantly fasting, constantly praying was among the first to preach the gospel in the New Testament. I want you to think about that. This woman, Anna the prophetess, was among the first to ever preach the gospel in the New Testament. God used her powerfully. It says it right there that she had seen Jesus and she gave thanks to God and spoke about the child to all who were looking forward to the redemption of Jerusalem. Now I wanna point out something here. During this time, women were not considered equal. This woman, if anyone in the minds of others at least, was disqualified from being a prophet. She was old in age, she was a widow, and she was a woman. Those things in the minds of others should have disqualified her, but number one, the called are qualified. I love that saying, God does not call the qualified, he qualifies the called. I wish I came up with that, but I didn't. So those two things, those two primary things that she was a woman and that she was old should have disqualified her. And again, at least in the minds of others. But God still used this woman, God still anointed this woman, God still empowered this woman as a prophet. I think about Abraham, Genesis chapter 24, verse one. The scripture says Abraham was now a very old man and the Lord had blessed him in every way. Abraham was old when God called him to be the father of many nations. Timothy was young, first Timothy chapter four, verse 12.   It doesn't matter your age, it doesn't matter your gender, it doesn't matter your race, it doesn't matter.   I know Lord that there are things in my mind that may disqualify me. I know there are many things about me that I would never use but Lord you created me, you formed me and you placed me in the earth for such a time as this, God, you know what you're doing, but Lord knows what he's doing.   We know that because the scripture teaches it. God has blessed you. So we must say, Lord, though there are things about me that I feel may disqualify me, though there are things about me that make me insecure, Lord, I don't speak very well or Lord, I'm not eloquent or Lord, I'm not charismatic or Lord, I'm not intelligent or Lord, I in the minds of others am not what you would use. Let me tell you something, neither was Anna the prophetess. She was not someone that you would look at and say, now there is a mighty servant of the Lord. Now there is someone who God is using. Now there is someone who is going to be recorded in the scripture, no, but Anna the prophetess was spoken of in the scripture. Anna the prophetess was used of God mightily. She was a prophet. So number one, the called are qualified. Number two, the called will face tragedy. The scripture tells us that she was with her husband married for seven years when she became a widow. I want you to imagine that. Think about that. And it doesn't say how he died. It doesn't say how she lost her husband. We don't have a backstory before us. We don't see all of those years that she went through grieving and pain. We don't see the love story between her and her husband. We don't see how they met or the plans they made or the things they did together or the places they visited. We don't see the heartache. We don't see the emotion. We don't see the human element necessarily behind this record in scripture. But we do see that here was a woman who went through tragedy, yet came out declaring the gospel of Jesus Christ. Here was a woman who was alone. Here was a woman who was discouraged. Here was a woman who went through some things yet God anointed her. God used her. Now we don't know. In fact, the scripture says, let's go back and read it again. And then was a widow until she was 84. Now what's interesting is the way that scripture is written in the original language is a bit ambiguous. So it's possible that she was 84 years old, but it's also possible that she was actually a widow for 84 years. And she would have been married, they say no younger than 14 in those days. Then seven years married, you do the math. So she probably was much older, likely much older than what the scripture with some of the English versions translate her age to be. Still my point is that she suffered a long time, that she went through this tragedy and she carried that pain with her. Yes, the Lord healed her, yes, the Lord helped her, but you know when you lose somebody, even though you grieve and even though you find a certain degree of healing, you'll always carry that person with you in some way or another. And so this woman carried that burden, but the truth is that the called will face tragedy. James chapter one verses two through four say, Dear brothers and sisters, when troubles of any kind come your way, consider it an opportunity for great joy. For you know that when your faith is tested, your endurance has a chance to grow. So let it grow, for when your endurance is fully developed, you will be perfect and complete, needing nothing. The called will face tragedy. These hardships, these trials are opportunities for us to grow. The scripture says when troubles of any kind, not if troubles, trouble will come, trials will come, tragedy will come, but God can still use your life. Don't let the tragedy of yesterday rob you of your destiny. Don't let yesterday's worries, yesterday's burdens, yesterday's sadness, keep you from walking in joy and in the fullness of what God has called you to do. Number one, the called are qualified. Number two, the called will face tragedy. Number three, the called fast and pray. Now I know I've done many messages on prayer, but I wanna talk to you real quickly, specifically about fasting. You see, the scripture says she never left the temple, but worshiped night and day, fasting and praying. This woman was disciplined. This woman was devoted. This woman was dedicated to God's work and she would subject the flesh regularly to prayer and fasting. Matthew chapter six, verse 16 says, and when you fast, don't make it obvious as the hypocrites do, for they try to look miserable and disheveled so people will admire them for their fasting. I tell you the truth, that is the only reward they will ever get. Jesus did not say if you fast, Jesus said when you fast. The believer who is called must make it a priority to regularly fast, to make it a part of their own life. Now you believer can start, maybe start with one day fasts and then work your way up from there, but fasting is a good way to regularly subject the flesh so that you become trained in subjecting the flesh. Fasting, what it does is it weakens the sinful carnal nature. It weakens self and it strengthens the spirit. And when you do this regularly, you live in a place of power. So number one, the called are qualified. Number two, the called will face tragedy. And number three, the called fast and pray. Finally, number four, we find that truth gleaned from this portion of the scripture. I read it and I'll read it again. Coming up to them at that very moment, she gave thanks to God and spoke about the child to all who were looking forward to the redemption of Jerusalem. She spoke about the child. Number four, the called preach Jesus. The called do not preach money. The called do not preach success. The called do not preach three keys to a better life. The called preach Jesus. Let me tell you something. If you want the power of God on your preaching, then you need to preach Jesus. If you do not preach Jesus, there is no substance to what you are preaching. If Christ is missing from the message that you declare, yet you move in power, then you are operating in new age power, not in the power of the Holy Ghost. The power of the Holy Ghost backs the message of the cross. The power of the Holy Ghost backs the message of Jesus. He backs the person, the Son of God. The scripture says in first Corinthians chapter two, verse two, for I decided that while I was with you, I would forget everything except Jesus Christ, the one who was crucified. First Corinthians chapter 12, verse three says, so I want you to know that no one speaking by the spirit of God will curse Jesus, and no one can say Jesus is Lord, except by the Holy Spirit. We understand from those scriptures that the focus should be Jesus. The focus of Paul was Jesus and him crucified. The focus of the Holy Spirit is the declaration of the Lordship of Christ. The Holy Spirit points to Jesus. The Holy Spirit guides us to Jesus. The message of the Holy Spirit is Jesus. There is no one on earth who loves Jesus more than the Holy Spirit loves Jesus. And when you begin to declare the gospel of Jesus Christ, the Holy Spirit will come alongside of you, partner with you, and bring power to your preaching. You know, a Christ list gospel is a powerless gospel. When Christ is missing from our message, so is the power, so is salvation, so is the substance behind what we declare. The called preach Jesus. Listen to me, believer, because many are becoming sidetracked in these days. Do not go wayward. Do not start preaching self-help. It's, look, it's okay to every once in a while encourage the believers. It's okay to pull from the proverbs of the scripture and bring about wisdom for everyday living. That's fine. But when that is the entirety of what you declare, you're missing the substance. You're missing the person and you're missing the point. When you begin to preach things other than Jesus, you start to become sidetracked. It becomes humanism. Listen, people will begin to adapt to what you declare. And if what you are declaring is self, self, self, self, then people will begin to worship self because of new age preaching. Many of the churches nowadays have gone this route and it breaks my heart. And I am pleading with you, those of you who are influenced by this ministry, those of you who receive from these teachings, I am pleading with you, stand your ground in these days. Hold fast to the faith. Keep your focus clearly placed upon Jesus.  Do not move to the left or to the right. Instead, preach and declare the one who died on that cross, the one who rose again from the dead, the one who is returning and the one who is the salvation of all of humanity. Don't become sidetracked. I see preachers and it is so hard to watch, especially in my generation. They come alongside and I see them as co-laborers and I see many of them beginning to preach success. And they get on their social media and they just put out an image of success and it's all about material gain. And look, I know God wants to bless his people and I appreciate that truth of scripture. But we must come to preach the way to your matters which is the gospel and Christ. Do not be, I'm pleading with you. Do not be sidetracked. Preach the cross. Preach the blood. Preach repentance. Preach Jesus. And do not go either way. Be like the prophetess Anna who in everywhere telling of the child who in everywhere talking about Jesus. She had a passion for Jesus. She had a love for Jesus. She was obsessed with Jesus. Do not start preaching money.   It's okay to give wisdom for successful living but don't let all you preach be success. Declare this message. Woe is me if I preach not the gospel. Woe is you if you preach not the gospel. We have to declare Jesus. He is the substance behind our message. He is the purpose behind our declaration. So number one, the called are qualified. Number two, the called will face tragedy. Number three, the called fast and pray. And number four, the called preach Jesus. That's it for the lesson from the life of Anna the prophetess. I pray, I bless you, I wanna pray with you now. Let's just pray that God would raise you and that God would use you. I know you're watching this and you're so hungry. You're saying, Lord, use me. There are some of you who are watching this right now. You're gonna become a different person the moment we're done praying.  God's called you. Lord, I pray in Jesus' name. I lift that one receiving his prayer to you. And I ask in the name of Jesus that you would raise them. Raise them and use them for your glory. Clothe them in the fire of the Holy ghost.  I stretch my hands in faith toward that one receiving this now. And I pray, Father, that the anointing of the Holy Spirit would flow through me. Holy Spirit flow through us and make our lives what they ought to be. Mold us. We bend to your will. We yield to your guidance. Thank you, Lord, for all that you're doing. In Jesus' name we pray. I want you to say it if you believe it. Say amen. Well, I'm happy to have prayed with you. I want to welcome now new members of Spirit Church. There you are up on the screen. We love you. We are praying for you. I always say that because I always mean it. I want to read now the comments from last week's video, God's Anointed, King David. Here are those comments. Mary March writes, Thank you, Brother David. I'm really enjoying this series, God's Anointed. They are amazing and deep teachings. I am looking forward to the next one.  I actually came across your book, 25 truths about demons and spiritual warfare at our local bookshop called Exclusive Books. I eventually got myself a copy and I've been following your teachings ever since. Thank you and you're watching from South Africa. God bless you. C. Nobert writes, I pray that the Lord strengthens and keeps you and your team. There are great things ahead, brother. May the Lord strengthen and bless you in every area of your life in Jesus' name. Thank you, C. Nobert. We appreciate the encouragement. Another commenter writes, Thank you, Brother David for this anointed teaching as all your teachings are. It has stirred my faith to the core. I love that. May God bless your heart even more. I hope you know how much your anointing has helped me grow my faith in Jesus, sending hearts from the Philippines. Well, let's make one thing clear. It's his anointing and to Jesus belongs all to glory and I appreciate your encouragement. And finally, Yanni writes, I stumbled upon your videos a few weeks back and ever since then have been watching many on a daily basis. With each video, I have felt the presence of Jesus near to me and it makes me more hungry to know the Lord Almighty even more. Thank you, Brother David for teaching all of us every week and helping us come closer to God. May God bless all of you at Spirit Church and I pray that someday I can see you preach live in my country. And that's Yanni writing from the United Arab Emirates. Wow, all the way from the UAE. God bless you and I would love to come and preach live in your country and this is where I need your help. I want to tell you, let me just give you a quick breakdown because you know the motive of this ministry. The motive, our goal is simple. We want to win souls and we win souls two ways. Direct evangelism and edifying the believer because when you edify the believer you actually multiply your effect in winning souls. So we are in the middle of a ministry campaign. We want to raise 1,000 new $30 monthly supporters to help us take this ministry to the next level. Now, here's where that support is going to go. That support is going to help us get into a new facility and that support is going to help us to do more events in more places and it's also going to help us to bring staff members on to help with that expansion. Now, with that new facility is going to come more production. We're going to be able to do more programs in different sorts. We're going to be able to do live programs from the studio. We're going to be able to do weekly events where people can come into Southern California and attend the services. We're even going to be able to do live studio audiences for different tapings. So like when I bring guests in, you get to come and be a part of those tapings. On the other hand, we're also going to do more events more often in more locations. You know when we do events, it takes money to fly there. It takes money to get the venue. It takes money to put our team in hotels. It takes money to bring in the musicians and the camera operators. It takes money to let people know about the event. So all of those finances go to the next phase of ministry. So when we reach 1,000 new $30 a month partners, we will be able to move into that new facility and we'll be able to expand the ministry in those ways are described. So I know we've talked about a lot of different things. Later on down the line, we want to do more translations later on down the line. We want to add that 24 seven prayer room to that facility, which won't be hard to do once we get the facility. But the primary reason we're raising these funds is for those two things, that new facility where we'll do more production and more live events and also studio audience accommodations and weekly services. And we're going to do more events more often in more locations. That's what we're going to do primarily with the finances and the other things that I just described will come along after those things are in place. So be a part of that. Sign on board, become a $30 a month partner today. Here's where we are in the campaign. That's how much support we need left. Look at that. We have over 700 of you who have signed up to become a partner. We have less than 300 to go. Sign up today, become a $30 a month partner. You sign up to become a $30 a month partner today and I'll send you either carriers of the glory or 25 truths about demons and spiritual warfare that will be a signed copy sent to you as our initiation gift or thank you for supporting the ministry and becoming a partner. Go do that today. Become either a monthly donor or a one-time giver. You can use the information at the bottom of the screen or you can wait until the end of the video. If you're watching this on YouTube, there's going to be a link that appears at the end. It's going to be a red button and you're going to click that red button and it's going to take you to where you can sign up to become a monthly supporter. I pray you do that today. Let's do this. Let's just finish this campaign off so we can start working on these things. Well, that is it for this edition of Spirit Church. Until next time, remember, nothing is impossible with God. Thank you for watching EncounterTV. Don't forget to subscribe. Also, help me win souls by spreading the gospel through events and media. Make a one-time donation or become a monthly supporter by clicking on the donate link now.


Thank you everybody for coming to our pediatric grand rounds presentations We're gonna start with dr. Aparna Ramasubramanian and she is going to present a three-year-old with retinoblastoma So we have at presentation a two-year-old who was noted to have a white reflex by the Grand Sardar And this is the white reflex that you see in the left eye on close closer examination of the loco Korea You see it as a nasal loco Korea So on the first examination on the general anesthesia it was a large nasal tumor with a lot of vitreous seeding and Some hemer right here and lot of vitreous heme inferiorly So by the international classification of retinoblastoma this would be a group e tumor and The other I was perfectly normal. There was no family history of retinoblastoma and And this is the ultrasound really large nasal tumor measuring 13 millimeters with a lot of intra tumor Calcification so definitely no doubt that this is a retinoblastoma And this is the fluorescein angiography showing lot of hyperfluorescence in the tumor There was no new escalation of the iris and the intraclopressure was normal So the options at that time where we could of course enucleate the eye we could do systemic chemo though The penetration into the vitreous is not very good. So that was not an option at that time Radiation therapy we do not use it as a primary Primary treatment anymore because these kids are radio sensitive and that and are at a risk for secondary cancers So definitely these two were not options So the main two options available to us that in Inuclation or intra arterial if we go back To our pictures this kid actually has an intact macula. It's all an acyl tumor Though it is a group II and had a lot of vitreous eating We discussed with the family and the plan was to go ahead with the intra arterial chemotherapy No for people who are who have not seen the intra arterial chemotherapy technique It is done by the interventional radiologist We have dr. Fiola at primary children's who's doing it right now So basically what we do is we go through the femoral artery We can only the internal carotid artery and you see here you're right up to this is the ophthalmic artery branch You go up to the ostium of the ophthalmic artery You do a fluoroscopy to confirm that the the arteries perfusing and then you deliver chemo There are a lot of chemo's that are being used for intra arterial Intra arterial chemotherapy primary treatment is with Melphalan and if there is no response There are some people who do topotic and in addition to Melphalan for this kid we did only Melphalan and after we do the chemo we have to do Cerebral angiography to make sure you've not thrown a clot anywhere So this kid actually had three sessions of Melphalan five milligram every month and You know from the systemic standpoint this treatment is really good. These kids don't have to be hospitalized They never require blood transfusion But you have to do weekly CBCs and usually you do see a dip in the in the WBC count and the ANC can come down Almost up to a zero in some cases But I've never had to give transfusion to any of them We just give the regular chemo precautions saying you know stay away from sick people and that kind of stuff So you see here after the first chemo the ANC dip down to zero point nine with subsequent intra arterials Usually the dip is more and the lowest this kid got was zero point six and never got any serious infection or needed antibiotics So that is the nice thing about the intra arterial that it is very concentrated in the eye and the systemic side effects are You know hardly hardly there So this is the tumor response after the three cycles of Intra arterial you see that the main tumor has shown a very nice response But you see the ton of vitreous seeds because some of the mean tumor has also broken off as seeds and This is the ultrasound if we do a before and after you see this was the original tumor and has shown a very nice response The tumor itself has gone from a 13 to a three point five nine So the tumor has shrunk very nicely, but then you have all these vitreous seeds and People who do retinoblastoma will tell you that you know in the story of retinoblastoma the vitreous seeds are the villains They are the hardest to treat. They are just you know, they are just a lot of trouble So the options at this time again we again have we could still enucleate this eye We could do systemic chemo Kimo really does not penetrate into the vitreous. So that's really not an option Radiation. Yes, it does work for vitreous seeds But again only a 50 percentage response for vitreous seeds and then we have the newer treatment Intra vitreal chemotherapy which was a taboo many many years ago saying you never stick a needle in a retinoblastoma Patients eye, but that has changed now and they found that Intra vitreal chemotherapy has a success rate close to 83 percentage, which is higher than radiation therapy So after discussion with the family we decided to go ahead with the intra vitreal chemotherapy because like you said before the skits macula is still intact and Has good potential for version So we went ahead with the intra vitreal chemotherapy before we do the intra vitreal chemotherapy we decide the quadrant that has the least number of vitreous seeds and We always inject through the same quadrant for all the sessions Because the quadrant in which you're injecting you do compromise RP in that region because there'll be a lot of RP modeling in that area, so you always go through the same same quadrant and Before you do it you do a UBM to make sure there is no c-leary body involvement in the region where you're injecting and then You do a vitreous tab the first time you do an anterior chamber vitreous tab to make sure there are no retinoblastoma cells In the anterior chamber. You don't have to do that with subsequent Injections just the first one and if there are no cells seen then like any intra vitreal injection you mark So somewhere between three and a three point five base on the child's age You inject the intra vitreal and as soon as you withdraw the needle you do cryotherapy right at the site Where the needle has gone in and you do a triple-free stall Cryotherapy this is so that even if some cells are trying to come out You are going to freeze them right then and there and after that you kind of juggle the eye so that you let the Medication penetrate all around the vitreous So after five cycles of Melphalan alone We started with a 20 microgram of Melphalan and we slowly escalated it up to a maximum of 25 for this kid There are some there are some people who would go up to 30 micrograms and Dr. Hoffman here would you know tell you about a patient that had severe toxicity with a 30 microgram So I actually never go up to a 30 I just do it between 20 and 25 is kind of like my limit after I've tried 20 for a few times I know that I is able to tolerate it then I might go up to a 25 so with the Melphalan alone the inferior vitreous seeds you see have really nicely responded all these are just calcified seeds But there is a central glob Which really has maybe shrunk a little bit because it's not as fuzzy as the other one But really not a very good response So this time we could have continued giving the Melphalan But I decided to go ahead and add topotican Along with the Melphalan and this kid got three additional cycles of Melphalan with topotican The other thing that I started doing at that point I'm not sure if that helps and it's not been reported is to keep the child in the required position 15 minutes after I do the injection Melphalan is supposed to last up to half an hour in the vitreous cavity So kind of like 15 minutes in this case it was all anterior vitreous So maybe a prone position would help. I don't know if that helps, but I started doing that and We did Melphalan I've stepped down the dosage of Melphalan because it will just be too toxic for the eye so Melphalan 20 and topotican 20 this kid got three cycles and It's hard to appreciate on the photographs, but this is all Non-calcified vitreous seeds whereas these are all calcified except this one is not completely calcified But still these are predominantly this Bulk of vitreous seed here. I would say 90 percentage calcified So there is still that 10 percentage that's not calcified but we kind of reached the eight cycle maximum for this kid and after this I've been watching him for two months now and the seeds haven't changed at all and Sometimes they say that the time you inject to the time you see respond There's sometimes a lag of two to three months. So we're just closely watching this kid. He's very stable He actually has a vision of 2060 because that macular is intact and we are doing patching treatment right now So hopefully he might get a little better or maybe not so So it is a little bothersome to see those seeds But as long as you monitor them very closely and see that they haven't changed some of the seeds never get calcified So so this kid is going to be closely monitored up till age five We did do genetic analysis for the for the kid and he did not have the germline mutation Very narrow I The same kid like that's central glob of seeds I thought in my subsequent follow-up they're getting more calcified So maybe six months down the line, you know, it'll get more calcified than it is now It's hard to say after three cycles of intra arterial, which will be three months Yes, so intra arterial is given monthly So all these kids I usually have them see an oncologist right at the time of diagnosis That's more so that you know, they are aware of this patient in case I need system IKIMO at some point At least we're not starting the whole process again So I usually have them see a oncologist and when I do the intra arterial, you know I usually have them look at the CBC also and I have the you know, primary care Involved in the care also in case, you know, there's an infection or something But I usually don't have them see an oncologist at a regular interval But you know, they are in the loop. They you know So this came from Switzerland, Dr. Francis Nuneer was the first person to start investigating Intravitial for Dr. Blastoma and he did a really large study and you know, if I remember right It was 143 eyes, but somewhere around that range it was somewhere between hundred and hundred and fifty eyes that he studied And he has followed them for like four or five years now and has had no problems with metastasis so I think it is the cryotherapy that you do right at the at the exit of the needle that is beneficial, but I Agree every time I inject, you know, I've done so many now But every time I inject, you know my heart stops because it's always in your mind that never ever inject a retinolus to my eye But it works very well, and we really did not have any options for intravitrials prior to this Sorry for vitreous seeds prior to this so but we still have to find the right medication I do not think Melphalan is the right medication We have to find a better medicine So since they make him out now We are using it predominantly only for bilateral retinoblastomas for unilateral retinoblastomas Most people would go to the intra arterial as the first to round because you really don't need to you know Give chemo to the whole body if you need to get it only to a one eye There are some people who do bilateral inter arterials for bilateral retinoblastoma I do not believe in that at all so for definitely systemic he was a huge role for bilateral retinoblastomas. Thank you


Live from Boston, Massachusetts, it's theCUBE. Covering AWS Reinforce 2019. Brought to you by Amazon Web Services and its ecosystem partners. Everyone, welcome back to theCUBE's live coverage here in Boston, Massachusetts for AWS Reinforce, Amazon Web Services first inaugural conference around cloud security. I'm John Furrier, my co-host Dave Vellante. Our next guest is Katie Jenkins, SVP, Senior Vice President, CISA, Chief Information Security Officer with Liberty Mutual, big company, lot of activity, insurance, probably a lot of action on your side, welcome to theCUBE. Thanks so much. Thanks for coming on. Don't be here. So you've been in the job for about a year, tell us about what's going on in Liberty Mutual.  You're the CISA, you're in charge, you're running everything. We're at a security conference, tell us the reality, what's going on in the real world? Yeah, well this is super exciting that Reinforce of course is in Boston, this is Liberty Mutual's hometown. As you mentioned, a hundred and seven year old security, not security company, insurance company, but we're doing really cool things in technology and security specifically. I would say to kind of bring this gathering together where you have a real rich pool of security talent, of security innovators that really mashes up with what we're doing. So Liberty Mutual has made a very significant commitment to moving to the public cloud for our technology and computing needs. We're in about year three of that journey, maybe 25% of our workload in the public cloud. And it's really been a catalyst for not just transforming our technology organization but transforming the way security does its work and the way security engages with our development community.  This is now kind of a new category with Reinforce being a branded show for AWS. Obviously this deserves its own conversation and industry, there's a lot of action going on. What does cloud security mean to you? Because this is the focus of this show. I mean it's not just pure cloud, there's a lot of on premise and on cloud interactions with hybrid, et cetera. You guys have been doing tons of IT over the generations with Liberty Mutual, but cloud security is the focus. What does that mean to you guys from a cyber security standpoint? Yeah, in a word, enablement, I think that the public cloud offers us a really interesting opportunity to reinvent security, right? So if you think about all of the technologies and processes and many of which are manual over the years, I think we have an opportunity to leverage automation to make our work easier in some ways to avoid the situation where we have error or oversight. Gosh, we encrypted everything, but this set of assets over here, so through using automation and enforcement, it's an exciting opportunity to further develop our security capabilities. But also cloud security, cloud in general has a transformation of the way that our practitioners do work through agile and it means that security has to work with our technologists in a different way. Right? So you've had a really interesting background. You've worked for a company that does audits, I can infer from that. You've worked for services company, you've worked for a technology vendor, you've worked as a practitioner, so you've seen it all sides. And Amazon made some comments yesterday that said, look, the narrative in the security industry has always been fear, fear, fear. And we'd like to put forth a narrative that is about, listen, the state of security is really good and strong, the union is strong, and we got to work together on a positive message. So my question is, are you an optimist? A reluctant optimist. I think the days of having security be something that's fearful are just not, they're not doing us any justice in that area. I mean, security is an area of partnership. There's very little of what we do in security that's just done by security practitioners. We need asset managers. We need compliance people. We need the privacy team. We need our auditors. We need procurement. I mean, there's just so many different parties involved in security that if we're just instilling fear in everyone, I think it'll be difficult for us to get that partnership. And we need to empower people, right? We need to both empower our developers to do their work in a secure manner, and we have to empower our whole workforce and our trusted third parties to make good decision. We're educating them on how to prevent phishing attacks. We're doing all sorts of kind of culture-based initiatives, recognizing that if it's just the security folks doing security, we're going to have a big gap. One of the things that we were discussing with a lot of other CISOs who we've been talking privately off the record in the hallways and private briefings is the common theme of integration as a big part of dealing with ecosystem, either suppliers and or different teams within their different pillars of how they're organized internally and externally. And then also reducing the number of security vendors that they've been buying products from to get some also in-house coding teams working more closely on the use cases that matter. So this has become kind of a CISO conversation where what is that criteria? How do you figure out? Who do you have as suppliers? Who's going to be around for the long haul? Who's going to be that partnership for the enablement? So rather than having hundreds of vendors, we want to get them down to a handful. Is that something that you think about or is that the trend that you see is happening now? It is a trend. I think it starts at how we even procure and select our suppliers. I mean, we are really giving a lot of thought to the area of third party risk management and do we understand not just the elements of cyber risk and engaging with a third party, but privacy and continuity kind of risk too. So it starts there. I don't have a sort of fabricated number in terms of I'm trying to go from X number of vendors down to Y, but I think that there's a very purposeful thought process that we're undergoing to say, yeah, we recognize for certain technologies we want to have different providers to provide some of that redundancy. So let's be smart about that and let's make sure we really understand where those overlapping capabilities are because we don't want to be wasteful either, right? And the spend question comes up too around DevOps because what we're seeing is the DevOps and security paradigms are kind of coming together in terms of the concepts, agility. You can do some prototyping, hackathon, do some things and then ultimately trying to get into production are two different animals. So that enablement of doing innovative things is agility, right? That's been a key theme, a positive theme. And the question is, is there a funding model? Does it automatically get security funding and where's the spend? Is your spend going up?  How do you deal with that holistically and how do you think about the spend conversation? Yeah, it's a really interesting one because of course, expense pressures, I'm not immune to those. But I also think that we're in a position where our executive leadership team understands the value of the work that we're doing, understands the important to our policy holders. So it's less often a need to justify why we need more spend. It's a demonstration of using that spend responsibly. An understanding where we might have an uplift from something that we've automated to say, well now we have these resources that could be doing something else. There's always a something else in security, right? So if we're committed to re-skilling and making sure that people are evolving, the work that they do and the talents that they have to address a different kind of... So no rule of thumb per se, it's more of your management recognizes the criticality of it. Therefore, you can make those calls on your own, build it in, build it in the projects. I ask tough questions and it demonstrates that we're making responsible decisions but I think it comes down to knowing your technology and your team. So the skills gap obviously is a huge challenge in your industry. We talked to somebody yesterday, they said we just can't find people, so we have to bring them in and train them ourselves. We have to homegrown and take the long view. Amazon talks about the shared responsibility model and a lot of small companies don't really understand that and things misunderstood. Obviously Liberty Mutual gets it. My question is, as you see Amazon focusing on the compute and the storage and the database layer and you guys have the opportunity to focus on other areas that are your responsibility, that shared responsibility model. Have you been able to shift resources? How have you handled that? Do you retrain people? Has it freed up? Has it freed up time to do some of those more strategic things that you want to do, maybe respond more quickly, prioritize better, automate, et cetera, et cetera. Can you talk about that from your perspective? So the shared responsibility model is, I think that's an important speaking point to this whole ecosystem. At the end of the day, Liberty Mutual, our duty is to protect policy holder data. It doesn't matter if it's in the cloud, if it's in our data setters, we have that duty to protect. So I think a lot about the skills that we will need in the future. So I've referenced sort of vaguely that yeah, the compliance area is a particularly interesting area where we have opportunities to be able to more easily and cleanly produce artifacts that our auditors need to really bring automation to a process that just has a very steep history and being manual in nature. So yeah, I understand that tomorrow we're not going to ask everyone to make a big switch and all become developers, but we do. We send plenty of people to this conference and they are participating in the tracks on how to bring automation to compliance. And I think we invest pretty heavily in training opportunities for people. How do you look about the vendor lock-in conversation because of cloud, the value purpose certainly shifts. And the old model was, oh, you buy a supplier and you're in, you're locked in with database or whatever. With cloud, there's a lot of switching cost opportunities to move around, but also people are generally settling in on one main cloud and having maybe a hybrid backup cloud or multi-cloud as a secondary because of the focus of the teams. How do you view the lock-in when you deal with suppliers because you don't want to be stuck with one supplier if you have the need to be agile. You want to have options. How do you guys think about that? Because it being agility is key for you guys to be successful, not so much just dealing with the vendors. Yeah, it does come down to balance. We do leverage multiple cloud providers, right? I think that if we're too focused on making sure that we have that portability and we could quickly move from one to another, then we miss an opportunity to kind of deeply leverage some of the services, for example, that the AWS provides. But we also, you know, we've been around the block a few times, right? Not your first rodeo. Yeah, exactly. And I think that it's important to have that perspective and prepare for the future. Do you attend board meetings regularly? I do. I do present out to our board of directors. Is that a sort of frequent thing, once a year, once a quarter? I'm interested in what the board conversation is like with the CISO. It happens in a couple of different contexts, whether it's specific to sort of an audit readout or sort of a general state of security type report out. But yeah, we have a really engaged board that asks great questions about our partners, right? About things that are more culture based in terms of how we're doing with our anti-fishing protection. And we talk about technology architectures too and the work that we're doing to make sure that we're being more fine grain in the way that we're authenticating users and devices no matter where they work in a more secure way. They're interested in that. So I feel pretty lucky to both have the opportunity and get to speak pretty deeply to our program. Would you say the conversation is more of a strategic nature with the board? Is it more tactical? You just mentioned some tactical items. Is it more metrics driven or sort of a combination of all three? It's a combination, right? I think they want to see demonstrated progress against areas that we've self identified as areas that we'd like to improve, but they're also looking to see that I have a vision for where we're going. They're fully cognizant of the work that we've done in the public cloud and want to understand that the level of trust that they had in our security program on-premise will perpetuate and advance into the cloud, so. When you look at cloud security and now security and Joe, you guys have, you've had a perspective on both sides and clouds certainly accelerating and evolving fast. When you find a legacy app that you're working with, we've heard other ceaseless we've talked to who have had frank conversations and said, look it, we're deciding whether we're going to lift and shift it or rebuild. And so there's been some visibility into when it's great to lift and shift and when it's great to rebuild. So that's been a conversation that, I don't think it's been fully baked out yet in the full narrative in the industry, but it's one people are talking about. What's your view on when you have a legacy app and you want to lift and shift it or rebuild it, what goes through your mind? What's the conversation like in Liberty? It's a conversation that we have. We have legacy, I won't hide behind that. But it's not a conversation and a decision that's just made by technologists, right? I think we have to articulate what the options are and that has to be a joint decision with our business partners. I think generally I'm not preferring a lift and shift because I think that we are maybe overlooking some of the opportunities to make some of those as security improvements that I see. But when we can get an application that's using our software development pipelines that we have embedded security controls, we have better visibility, we have better enforcement in ensuring what we know, that we know what's going into the cloud, has met a number of our security standards, so to speak. That's a much better position for us to be in. So this notion of multiple clouds, I'm interested in how you handle that. You take separate teams, is it the same team, sort of handling everything? And it's sort of a follow-up on that is, I'm interested in your relationship with AWS and how that's affected your business. Yeah, so the security team does not own the cloud environment, so to speak. That's a secure DevOps team within our infrastructure organization and they're very close partner of ours, right? So yes, I do have resources that are specialists in AWS versus other clouds and others that are identity and access management specialists and are able to work on the development of those patterns across different cloud environments, right? There's nothing bad that I can say about the relationship with our AWS partners. I think we felt very supported in understanding what we're trying to do and introduce us to new services and introducing, probably most importantly, introducing us to other customers that have been, you know, are a little bit ahead of us in their journey so we can hopefully not repeat any of these things. Amazon helping you with the security piece as well. I mean that's something that they, with the sheer responsibility there, they're working with you on this. Sure. Securing those workloads as you move to the cloud. We've definitely leveraged their expertise. And you mentioned that you guys kind of made a decision a few years ago to go all in on the cloud. How has that affected your business? What kind of results have you seen? Has it met expectations? Has it exceeded, you know, behind? I mean, as I mentioned, we do still have a lot of our technology on-premise, but for the use cases that have, you know, really seen that rapid acceleration, you know, agile practices of allowed teams to develop code so much more quickly, I think that business is generally delighted that their needs are being far more quickly met, Ben. Yeah. So I can ask you, there's a perpetual line in the men's room. It's quite long. So what's it like to be- It's not long in the ladies' room. I was going to say, I don't think it is because I would say the proportion of women here is actually lower than even the industry and most conferences that we attend.  I've been in it so long that I certainly have grown a little bit accustomed to it, but not so accustomed that I'm not motivated on a daily basis to bring more women in. I think that security just has tremendous opportunities and, you know, certainly the marketing of security professionals is hoody, wearing, white male, kind of persona. Just- And there were opportunities for women. What are some of those opportunities for women who are STEM, science, like my two daughters all STEM, love public policy, the sociology impact, society impact that's here. There's a lot of range of skills. What are some of those that you would inspire someone to- I studied math as an undergrad. We didn't have security back then. I've since gotten a master's degree in cybersecurity, so that's cool. But, you know, I think a great security professional is a great communicator, a great collaborator. I need technologists, I need developers, I need process experts.  So, we have tried to attract people out of other, you know, technology realms. And it's just not just math or computer science. There's creativity involved. There's a lot of, you know, things that blend itself to all kinds of diversity. There is. I mean, you think about human psychology, right? I mean, we just totally transformed one of the systems that we use for approving, for managers to approve the access of their people, right? The past system was ugly. People didn't know how to interact with it. I mean, that user experience expertise that overlaid and how we developed our new platform just makes all the difference to make sure that it's actually a valuable process. Now, like, I'm so frustrated, I'm just going to sign off on this, because I give up for what I want to do. That's really interesting, because you spend a lot of time and effort and money on things that drive revenue. But this drives so much productivity and business value that, you know, it's not maybe direct dollars, but clearly there. I have a question. When you recruit people, presumably you tap your network, and it's not just the good old boys network, you're tapping women.  Have you had much success there? Yeah, so we definitely are outpacing industry numbers in terms of women insecurity. We have a long way to go. You know, historically excluded people, right? Not just women, people of color. I mean, we just have a long ways to go, right? And I think it takes more than sitting back and waiting for a recruiter to bring me a slate of candidates to say, no, I know people, and I know people that know people, and I really have to invest myself and make sure that my leaders know that that's my expectation of them, right? I mean, I think that we feel that the diversity of thought, no matter how that diversity is expressed, is really important to doing the work that we do. So let us know how we can help in Silicon Valley. Days here in Boston as well. Love to help get the word out. So anything you need from us, let us know. Katie, thanks so much for those great insights. Thank you. Love to have you on theCUBE again sometime. Thanks for coming on. Very good. SVPC, so Liberty Mutual here on theCUBE, extracting the signal, sharing the reality of what's going on in the security equation for cloud security. I'm John Furrier, Dave Vellante. We'll be right back after this short break.


Hello everyone, I'm Alicia Woodruff, and welcome to the Fort Report. You may have noticed a mile-long train working its way along the track in East Fort Worth lately. One with dozens of workers scurrying along beside it? Well, that's because it's part of Union Pacific Railroad's efforts to reconstruct rail lines between Fort Worth and Dallas. Union Pacific's track renewal train, known as the TRT-909, is a one-of-a-kind tool that allows Union Pacific to perform maintenance to its infrastructure more efficiently and quickly by replacing an entire rail corridor during one continuous project. The machine has evolved a lot. The operation is state-of-the-art now. It's got a lot of new technology from when we first started doing it. We started in Fort Worth on Thursday and we've already covered six and a half, seven miles. As you can see, we moved pretty swiftly across the railroad. Nearly fifty pieces of equipment make up the several-mile-long convoy that supports the TRT-909 project. These include an in-track welder, several tampers, a rail train for loading used rail, a multi-purpose machine for ditching and material removal, and other specialty equipment.  If there's a lot of obstacles ahead of us, that kind of dictates the speed of the machine. So it's more efficient for us. Clearly a higher cost to our operation, but we figure it's a good way to come through a metropolitan area, get through here fast so we don't have to impact our railroad as well as the communities as many times as we normally would. It's pretty cool to see, and if you can't get out to the tracks to check it out, you can see a video on YouTube about the technology. Just search for a new TRT video on YouTube. And a quick shift from iron horses to cowboys and horses. The 117th Fort Worth Stock Show in Rodeo kicks off January 18th. 23 days of pure western fun. It's Fort Worth tradition for show regulars and new visitors. It's family fun. It's a western heritage. It's a big part of the tradition of Fort Worth. We have everything from rodeo actions, a livestock, carnival in Midway, unique shopping. There's just a whole lot to see and do. We have live music on the course light stage every evening, so there's a lot for everyone to do. Always a highlight is the Stock Show Parade, which is at 11 a.m. on January 19th this year. Nearly 100,000 spectators line the streets of downtown annually for this big event. And the unique thing about the Stock Show is it's always free. It always has been and always will be free to go to the Stock Show Parade. But this year we have a new twist to an old tradition and we're using bleacher style seating. It's very limited. It's in some of the sections of the parade route. The tickets are $15, but that ticket, people will want to keep their tickets if they do purchase those seats because it also serves as general admission to the Stock Show anytime during the 23 day run of the show. For more about this year's Stock Show and for information on tickets, parking and more, just visit the show's website. Here's a look at other events happening in and around Fort Worth through the rest of January. For a listing of more events and city meetings, you can always check the calendar at the city's website.


Ausbillahi Minash-Shaitwan, your regime, Bismillahir Rahmanir Rahim. Today's topic is Interim Financial Reporting. First of all, let's see the objective and scope. Learning outcome of students will be able to understand what is meant by Interim Financial Reporting as per IS-34. Why it is important to prepare and share financial information before the year ends. Learn what information is important to be shared, disclosed as a part of Interim Financial Reports. Now, to provide financial information as early as possible rather waiting for the year end for decision making, particularly the chief operating decision makers. That is the important thing. They need to take certain decisions so they are not supposed to wait for the whole year accounting to be finalized. They will see quarterly basis or half yearly basis that what basically they need to take a further decision. So that's why they need quarterly or half yearly statements and not only the current quarters or current year, current half year but previous year also. We must compare the two that how we performed last quarters and how we are performing this quarter and then they take a decision. The standard require only headings and subtotal. Here we are not supposed to give the details account and see detailed accounts of it. No, we need condensed statements. This means a brief that let the people understand quickly that how the trend is whether we are going better or we are going worse. We look into that and selected explanatory note, not the detailed notes of 20 pages, just few notes, which are very important for the decision makers. They want to see disclosure with particular focus on new events. Something happened, something new during the quarter that you should be having detailed about those events at the notes to the accounts activities and circumstances. You know, it happens like in particular case in Pakistan in all over the world. What is happening now because of this COVID, the things have been moving very fast here and there. So they want to see how these circumstances effects our results. The interim period could be quarterly and it can be half yearly or comparative of similar period of last year. Now there is very simple thing here that you need to prepare. Currently accounting is being done by the computer. Previously we used to prepare accounts monthly basis and it takes time, but then it comes to computer and now you simply transact a figure and then it goes straight away to the income statement, to the balance sheet. So it won't take much time basically. I mean now it doesn't take much time to prepare accounts, it takes time for us to prepare accounts. Because now the computer has facilitated a lot that you don't have to make a lot of mistakes.  So it is easy to make a quarterly statement or monthly statement and the limited company that is listed on the stock exchange, the requirement of law is that they are supposed to produce their quarterly accounts and if they don't produce it, then they do the same. That is why you have to make quarterly accounts and you have to publish them too. It is not that you have to make it and keep it with you, it is not just for decision making purpose. You need to publish it and you have to do proper publication and the details that you give should be condensed. That is, it shouldn't be in too much detail and the other thing is that if you have to make a quarterly account on the 31st of March 2020, then similarly, you have to make a quarterly account on the last year of 2019. Because they want to compare the quarter results, how last year quarters we were performed and how this year quarter we have performed, so they need a comparison. And if they feel there is something wrong somewhere, so then they take a decision there and then. So that is why we need to produce interim financial reports. And they are very much recognized all over the world that they let the people come up so that they can take earlier decision rather than waiting for the whole year. Because in a whole year time, then it is too late basically. But if you know the quarterly, then it means you can take there and then for the remaining quarters. That is why interim financial reports are important for publication purpose. Thank you very much.