Postpartum haemorrhage accounts for nearly 28% of maternal mortality in developing countries. Syntometrine is an effective and commonly used oxytocic in preventing postpartum haemorrhage, but it requires a controlled storage environment and i.m. administration. Misoprostol is an orally active uterotonic agent. A total of 2058 patients having a singleton pregnancy, low risk for postpartum haemorrhage and vaginal delivery were randomized to receive either 1 ml syntometrine or 600 microgram misoprostol for the management of the third stage of labour. There were no significant differences between the two groups in the mean blood loss, the incidence of postpartum haemorrhage and the fall in haemoglobin concentration. The need for additional oxytocic injection was significantly higher in the misoprostol group [relative risk (RR) 1.62, 95% confidence interval (CI) 1.34-1.96], but that of manual removal of placenta was reduced (RR 0.29, 95% CI 0.09-0.87). Shivering and transient pyrexia were more common in the misoprostol group. Oral misoprostol might be used in the management of the third stage, especially in situations where the use of syntometrine is contraindicated and facilities for storage and parenteral administration of oxytocics are limited.
A retrospective study of 316 ovarian neoplasms which had frozen section evaluation between January 1, 1990 to December 31, 1995 was conducted to determine the accuracy of frozen section diagnosis of ovarian neoplasms. The frozen section results were compared with final diagnoses from paraffin sections. The frozen section diagnosis was accurate in 95.2% of all cases and inaccurate in 4.8%. The positive predictive value of a positive (or malignant) frozen section was 100%, the negative predictive value of a negative (or benign) frozen section was 98.2%. The sensitivity for malignant tumors as 87%. For tumors of borderline malignancy, the sensitivity and specificity were 60% and 98.6% respectively. Of the false negative frozen section diagnoses, 73% (8 cases) occurred in tumors of borderline malignancy. We concluded that with the exception of the sensitivity for the diagnosis of tumors of borderline malignancy, the sensitivity and specificity of frozen section diagnosis for benign and overtly malignant ovarian neoplasms are high.
Levonorgestrel-releasing intrauterine system was effective in symptom control and prevention of recurrence. LNG-IUS users showed a better compliance. After three years, bone gain was noted with LNG-IUS, but bone loss with depot MPA.
Testicular size, semen characteristics and serum reproductive hormone levels were studied in 1239 normal Chinese men. The mean testicular size of 17 ml in this group of subjects was similar to other reports in Orientals but was smaller than that reported in Caucasians. Semen volume, and the sperm count, motility and morphology were comparable to those described for Caucasian subjects. The cervical mucus penetration test (Kremer's test) and the zona-free hamster egg penetration test were also studied in some of the subjects. Age showed a positive correlation with the serum levels of FSH and LH, which were highly correlated with each other. Sperm concentration and the total sperm count were positively correlated with testicular volume, the length of abstinence, the % of sperm with an oval head, and the zona-free hamster egg penetration test, but were negatively correlated with serum FSH. Sperm motility was negatively correlated with the duration of abstinence but was positively correlated with the % normal sperm. The results constitute a normal data base from Chinese men for comparison with studies in male infertility and fertility regulation.
Oral misoprostol 50 microg every 4 h is safe, cheap, and as effective as 100 microg in reducing the PROM to delivery time interval and labor duration in primiparous women. The same effect is not observed in a multiparous group.
Purpose
The purpose of this paper is to provide qualitative evidence from the experience of Chinese service users in the UK to expand the literature on the use of intersectionality analysis in research on the mental health of ethnic minority groups.
Design/methodology/approach
Repeated in-depth life-history interviews were carried out with 22 participants. Interviews were analysed using the constant comparative method.
Findings
Four areas of life are identified for their possible negative impact on mental health for this minority group: labour market and work conditions, marriage and family, education, and ageing. The findings illustrate how these intersecting variables may shape the social conditions this ethnic minority group face. For this ethnic minority group in the UK, inequalities can intersect at national as well as transnational level.
Originality/value
This paper highlights how power relations and structural inequalities including class, gender, age and ethnicity could be drawn upon to understand the interplay of determinants of mental health for ethnic minority groups. As the multi-factorial social forces are closely related to the emergence of poor mental health, it is suggested that interventions to reduce mental health problems in ethnic minority communities should be multi-level and not limited to individualised service responses.
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