Intrapartum Rupture of the Uterus Diagnosed by Ultrasound

Background

Spontaneous uterine rupture is a life threatening obstetrical emergency encountered infrequently in the emergency department. Its diagnosis is often missed or delayed, leading to maternal and fetal mortality.

Method

We present a case of ruptured uterus diagnosed by ultrasound in a 33-year-old gravid female with two previous cesarean sections.

Objective

To show the role of ultrasound in uterine rupture

Result

Ultrasound demonstrates uterine laceration and intra-abdominal dislocation of placenta and foetus

Conclusion

Because of the severity of the complication and the great variation of symptoms in connection with it, the authors encourage the use of ultrasound screening in the detection of this rare, but often catastrophic complication.     

The efficacy of local anaesthesia for percutaneous epididymal sperm aspiration and testicular sperm aspiration

A total of 37 percutaneous epididymal sperm aspiration (PESA) and/or testicular sperm aspiration (TESA) procedures were performed under local anaesthesia (LA) on 34 men between June and November 1996. Local anaesthesia was achieved by injecting 10 ml of 1% lignocaine solution along the sides of the vas deferens near the external inguinal ring (spermatic cord block). Sperm retrieval was successful in 92% of the procedures. Of the 37 procedures, in 29 the patients felt either no pain or mild discomfort while in six they experienced moderate but tolerable pain. Analgesia was incomplete in two procedures and was supplemented with i.v. sedation. Vasovagal reflex in two procedures was reversed by i.v. atropine. In 24 procedures patients felt relaxed, whilst in 13 they felt anxious. In 32 procedures the patients expressed overall satisfaction. If the procedure was to be repeated, after 29 procedures the patients requested LA again, while after four procedures they preferred i.v. sedation and after four were undecided. LA is adequate for PESA and TESA in a large proportion of patients. Prior discussion of LA technique with the patient is necessary. Back-up facilities for i.v. sedation and atropine should be available.      

农村地区女性自评抑郁量表中文版的信度效度分析

目的:对中文版自评抑郁量表SDS的信度和效度进行评价。方法:采用中文版抑郁量表对嘉定区某农村社区501名20～74岁女性进行问卷调查,用Cronbach α系数、因子分析、Pearson相关系数和t检验等方法考察量表的信度和效度。结果:量表的总Cronbach α系数为0.784,量表各维度的Cronbach α系数在0.350~0.737之间;分半信度的Cronbach α系数分别为0.662和0.819;因子分析的分析结果和量表的理论结构基本相符,各维度得分之间的相关系数在0.057～0.322之间,除精神性-情感症状维度和精神运动性障碍的相关性外,其余维度间的相关性均有统计学意义;抑郁组和非抑郁组在各维度得分的差异均有统计学意义。结论:中文版自评抑郁量表SDS除内容效度需做部分修订外,信度和效度较好,可以应用于中国文化背景下的女性抑郁情况等心理学状况评价。     

Changing prevalence of gastroesophageal reflux with changing time: longitudinal study in an Asian population

BACKGROUND: The purpose of the present paper was to study previously obtained population-based data on the prevalence of reflux symptoms in a random sample of community adults in Singapore. This sample was re-investigated 5 years later to determine changes in the prevalence of reflux symptoms. METHODS: In 1999, 237 (34%) of the original cohort of 696 persons who were interviewed in 1994, were re-interviewed using a validated Gastrointestinal Symptoms Questionnaire. The original cohort was a race-stratified random sample of residents in a Singaporean town. Reflux was defined as heartburn and/or acid regurgitation occurring at least once a month. RESULTS: Among the 237 respondents (aged 25-89 years; male : female, 49:51; Chinese n = 106, 45%; Malay n = 69, 29%; Indian n = 60, 25%), reflux was reported by 25 respondents, giving a prevalence of 10.5 +/- 2.0%. This compared with the prevalence of 5.5 +/- 1.5% (odds ratio [OR], 2.2; 95% confidence interval [CI]: 1.0-5.2; P = 0.05) among the same 237 respondents in the 1994 survey. Of the 25 subjects who reported reflux in the current survey, 22 (88.0%) did not complain of reflux symptoms in the 1994 survey. The ethnic-adjusted prevalence of reflux in 1999 was estimated to be 9.9 +/- 1.9%. This was an increase above the prevalence in 1994 of 1.6 +/- 1.0% (P = 0.051). The upward trend in the prevalence of reflux was not related to age, smoking, alcohol consumption, or increase in bodyweight. CONCLUSIONS: There is a rising trend of reflux symptoms frequency in the general population of Singapore over a 5-year period.     

Role of the autonomic nervous system in the development of cardiac arrhythmias in cats with acute myocardial ischemia receiving thyroliberin

The role of the autonomic nervous system in the development of ischemic cardiac arrhythmias was studied in acute experiments on cats receiving thyrotropin-releasing hormone. Bilateral vagotomy attenuated, while bilateral transection of cardiac branches of the stellate ganglia completely abolished the antiarrhythmic effect of thyrotropin-releasing hormone.     

Risk factors for sensorineural hearing loss in extremely premature infants

Objective: To identify potentially preventable risk factors for sensorineural hearing loss (SNHL) in extremely premature infants.
Methodology A case control study of survivors with gestational age (GA) <28 weeks or birthweight (BW) <1000 g using data collected prospectively in our Neonatal Intensive Care Unit database. Each subject with bilateral SNHL >40dB was matched according to GA, BW and sex with two controls who had neither sensorineural nor conductive hearing loss.
Results Infants with SNHL had increased mean (±s.d.) days ventilated (53 ± 21 vs 37±23 days, P = 0.006) and in oxygen (107±44 vs 69±28 days, P = 0.02) compared with controls. The risk for SNHL was increased for infants who spent >90 days in oxygen (OR 4.0 [95% Cl 1.1-15.6]), had maximum FiO₂ >0.90 (5.6 [1.2-26.9]), minimum plasma Na <125mmol/L (5.6 [1.1-27.8] or maximum pH >7.60 (5.6 [1.1-89.0]). Neither maximum serum bilirubin nor exposure to ototoxic drugs was associated with SNHL.
Conclusions: Avoidance of severe hyponatraemia and extreme alkalosis, as well as use of surfactant to minimize the severity of hyaline membrane disease, may result in a decreased incidence of SNHL in extremely premature infants.     

Experience with the treatment of patients with hypertrophic cardiomyopathy with obsidan and isoptin

Forty-five patients with hypertrophic cardiomyopathy were examined clinically and echocardiographically. The results of their treatment with obsidan and isoptin in relation to various types of central hemodynamic disorders are presented. The data have been obtained making it possible to treat patients differentially with regard to the form of the disease. The treatment of this category of patients requires the echocardiographic monitoring of the parameters of the central hemodynamics and myocardial contractility.     

丙谷胺对急性胰腺炎大鼠的治疗作用

观察CCK受体拮抗剂丙谷胺对急性胰腺炎(AP)大鼠治疗作用。应用胰胆管内注射5％牛磺胆酸钠溶液诱发大鼠急性胰腺炎模型,术后腹腔内注射丙谷胺溶液(剂量400mg/kg);观察术后6h各组腹水量、胰重、血清脂肪酶活性和病理变化,计算大鼠24h内死亡率。丙谷胺治疗组鼠腹水量、胰重、脂肪酶活性分别为2.04±0.39(g)、1.57±0.38(g)、577.97±8.38(U),均显著低于非治疗组(9.34±2.04、2.04±0.39、715.38±44.76),P<0.05;鼠死亡率由非治疗组的100％降至40％;病理损害程度减轻。丙谷胺对牛磺胆酸钠诱发的大鼠急性胰腺炎有一定治疗作用。     

Mechanism of protective effect of dalargin against ischemic arrhythmias

Acute tests on cats with altered sympathetic innervation of the heart show that the protective action exerted by dalargin against the development of ischemic ventricular fibrillation is due to a modulating influence of this leu-enkephalin analog on both the sympathetic and parasympathetic regulation of cardiac activity. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 8, pp. 176–178, August, 1996