王翠霞教授运用补中益气汤加减治疗缺乳经验

缺乳是指产后哺乳期内,产妇乳汁甚少或无乳可下者,称"缺乳"又称"产后乳汁不行,吾师认为导致缺乳的主要病因是由气血虚弱、肝郁气滞所致,根据产后多虚多瘀的特点产虚则宜补,塞则宜通,故导师运用补中益气汤加减治疗缺乳,临床上取得了显著的效果。     

Acetazolamide: A New Treatment for Visual Vertigo

Visual vertigo is a disorder characterised by symptoms of dizziness, vertigo, unsteadiness, disorientation, and general discomfort induced by visual triggers. It is currently treated with vestibular rehabilitation therapy, with no effective pharmacotherapy available for treatment-resistant cases. The objective of this study was to evaluate the efficacy of oral acetazolamide in improving symptoms of visual vertigo. A comparative case series of adult patients clinically diagnosed with visual vertigo was conducted from January 1992 to May 2015. Patients without a full neurologic or otorhinolaryngologic work-up, negative magnetic resonance imaging (MRI), and an organic cause for their symptoms were excluded. The identified patients were then contacted by phone to complete a voluntary symptom survey. Main outcome was the subjective reported percentage in symptom improvement. Secondary outcomes were subjective improvement by symptom triggers. The participants were retrospectively divided into three groups based on their treatment with acetazolamide: currently on acetazolamide, terminated acetazolamide, or never initiated acetazolamide. Fifty-seven patients met the inclusion criteria and were willing to complete the phone survey (19 currently on acetazolamide, 27 terminated acetazolamide, and 11 never initiated therapy). Overall symptomatic improvement was reported by 18 (94.7%) patients currently on acetazolamide, 18 (66.7 %) who terminated acetazolamide, and 5 (45.5%) who never initiated therapy, varying significantly by group (p = 0.0061). Greatest improvement was reported in symptoms triggered by being a passenger in a car. These results show that acetazolamide has a positive association with improvement of symptoms of visual vertigo.     

Maternal self-efficacy,postpartum depression,and their relationship with functional status in Iranian mothers

ABSTRACT

Readiness to care for family, infant, and self are important during the postpartum period. The objective of this study was to determine the relationships of self-efficacy and postpartum depressive symptoms with functional status in randomly sampled Iranian mothers (n = 437). The study was cross-sectional and conducted in 2015. The mean (SD) of the total functional status score was 2.3 (0.2) out of a possible score of 1–4. The maximum and minimum scores in infant care were 4.0 and 2.2 and, in social and community activity, levels were 3.5 and 1.0, respectively. Significant inverse correlations were observed between postpartum depressive symptoms and total scores for functional status, self-care, and levels of social and community activity. A significant positive relationship was observed between self-efficacy and functional status and all of its subscales. In the multivariate linear regression model, postpartum depressive symptoms, nulliparity, and low income were significantly negatively related with functional status; maternal self-efficacy, having a spouse aged 26–35 years, high school diploma, lower educational level, and the spouse’s job (shopkeeper) were significantly positively correlated with functional status. Early diagnosis and treatment of depressive symptoms and promotion of maternal self-efficacy may improve overall functional status of mothers in the postpartum.     

Short-term retention effect of rehabilitation using head position-based electrotactile feedback to the tongue: Influence of vestibular loss and old-age

Our objective was to evaluate whether the severity of vestibular loss and old-age (>65) affect a patient's ability to benefit from training using head-position based, tongue-placed electrotactile feedback. Seventy-one chronic dizzy patients, who had reached a plateau with their conventional rehabilitation, followed six 1-h training sessions during 4 consecutive days (once on days 1 and 4, twice on days 2 and 3). They presented bilateral vestibular areflexia (BVA), bilateral vestibular losses (BVL), unilateral vestibular areflexia or unilateral vestibular losses and were divided into two age-subgroups (≤65 and >65). Posturographic assessments were performed without the device, 4 h before and after the training. Patients were tested with eyes opened and eyes closed (EC) on static and dynamic (passively tilting) platforms. The studied posturographic scores improved significantly, especially under test conditions restricting either visual or somatosensory input. This 4-h retention effect was greater in older compared to younger patients and was proportional to the degree of vestibular loss, patients with increased vestibular losses showing greater improvements. In bilateral patients, who constantly fell under dynamic-EC condition at the baseline, the therapy effect was expressed by disappearance of falls in BVL and significant prolongation in time-to-fall in BVA subgroups.Globally, our data showed that short training with head-position based, tongue-placed electrotactile biofeedback improves balance in chronic vestibulopathic patients some 16.74% beyond that achieved with standard balance physiotherapy. Further studies with longer use of this biofeedback are needed to investigate whether this approach could have long-lasting retention effect on balance and quality of life.     

Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial

BACKGROUND: Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.OBJECTIVE: The aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision.DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: In this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratifi ed block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d.MAIN OUTCOME MEASURES: Perineal pain and wound healing were assessed using visual analogue scale(0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale(0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratifi ed factors.RESULTS: Follow-up rate was 100% up to the 8 h time point in both groups, and 86%(62 of 72) in the cinnamon group and 85%(61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was signifi cantly lower than that in the placebo group at(4±1) h(adjusted difference:-0.6, 95% confi dence interval:-1.0 to-0.2) and(8±1) h(-0.9,-1.4 to-0.3) after intervention, and on the 10-11 th day after delivery(-1.4,-2.0 to-0.7). Also the cinnamon group showed signifi cantly more improvement than the control group in healing score at(8±1) h(-0.2,-0.4 to-0.04) and the 10-11 th day after delivery(-1.6,-2.0 to-1.1). CONCLUSION: Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.     

Co-Occurring Psychiatric Symptoms in Opioid-Dependent Women: The Prevalence of Antenatal and Postnatal Depression

Background: Despite the high prevalence of psychiatric symptoms in substance-dependent women, little evidence is available on postpartum depression in this population. Objectives: To determine whether demographic variables and prenatal depression predict postpartum depression and select substance abuse treatment outcomes in a sample of pregnant women. Methods: A retrospective chart review was conducted on 125 pregnant women enrolled in a comprehensive substance abuse treatment program. Data on demographic variables, prenatal care attendance, urine drug screen (UDS) results, and psychiatric symptoms were abstracted from patient medical and substance abuse treatment charts. The Postpartum Depression Screening Scale (PDSS) was administered 6 weeks post-delivery. Multiple linear regression was conducted to identify predictors of prenatal care attendance and total PDSS scores at 6 weeks postpartum. Multiple logistic regression was used to examine predictors of positive UDS at delivery. Results: Nearly one-third (30.4%) of the sample screened positive for moderate or severe depression at treatment entry. Psychiatric symptoms did not predict either prenatal care compliance or UDS results at delivery. Almost half of the sample (43.7%) exhibited postpartum depression at 6 weeks post-delivery. No demographic variables correlated with incidence of postnatal depression. Only antenatal depression at treatment entry predicted PDSS scores. Conclusion: Prevalence of antenatal psychiatric disorders and postpartum depression was high in this sample of women seeking substance abuse treatment. Results support prior history of depression as a predictor of risk for developing postpartum depression. Scientific Significance: Routine screening for perinatal and postpartum depression is indicated for women diagnosed with substance abuse disorders.     

产妇对新生儿性别满意度对其产后出血量的影响

目的探讨产妇对新生儿性别满意度对其产后出血量的影响。方法选择2010年6月至2011年12月在温岭市妇幼保健院产科住院的单胎头位顺产的980例初产妇和528例经产妇,按照她们对新生儿性别的满意程度分为满意组和不满意组,记录产程时间,测量产时、产后2h及24h的出血量,计算产后出血的发生率。结果不满意组产后2h及24h出血量多于满意组,产后出血发生率也明显高于满意组(P<0.01),特别是不满意组经产妇产后出血率高达15.51%。结论产妇对新生儿性别的满意程度对其产后出血有一定影响,医护人员应及时发现潜在的高危因素,对新生儿性别不满意产妇进行必要的心理辅导,以减少产后出血量,降低产后出血发生率,确保产妇的身心健康。