mean duration of labour for primiparous women was less than six hours.7 Only 5% of the women had labours lasting longer than 10 hours. Afteractive management oflabour had been introduced their definition of prolonged labour was reduced from 36 hours to 12 hours. The prevalence of caesarean section varied from 4i00/o to 5-3%. The other components of active-management include the artficial rupturing of the membranes if labour does not progress according to a predetermined schedule and the use of intravenous oxytocin if the desired progress is not achieved by rupturing the membranes. These measures were used in 300/o of the cases. Although the effect of each of the three components has never been evaluated separately, the continuous support given by the midwife in this system could have effects similar to those observed in our two studies. We;can only speculate about the mechanisms by which social support reduces the duration oflabour and perinatal complications. Although the presence of a companion might account for the obstetrician making fewer interventions, it cannot also account for the reduced duration of labour. We favour explanations based on the effects the companion may have on-the mother.-Adrenaline is known to reduce uterine muscle contractions.' Lederman et al noted a correlation between plasma adrenaline concentrations and self reported anxiety.9 Increased concentrations of plasma adrenaline were associated with both anxiety and prolonged duration oflabour. By lessening anxiety in women in labour social support may prevent an increase in catecholamine concentrations and thus shorten the duration of labour. Studies in pregnant pigs and monkeys reveal that psychological stress can reduce uterine and placental blood flow and thereby fetal oxygenation.10 It By reducing the stress of labour social support mgt reduce the number of infants admitted for intensive care. If the results of this study can be replicated in other obstetric units in other hospitals present practices may be appreciably altered. This model may be useful in exploring the m'ech-; anss by which s'upport influences physiological processes.
The erect penis has always been a symbol of power, virility, and fertility. Inability to obtain or maintain an erection, known clinically as erectile dysfunction, is a major health problem. It can cause considerable distress, unhappiness, and relationship problems. The search has therefore continued from time immemorial to find an effective safe, and easy to administer treatment for erectile problems. Although a number of these treatments became available in the last two decades, they all had problems with efficacy, safety, or ease of administration. Clinicians in this field often are told at the end of an assessment interview, "I wish you have a magic pill". An effective and safe oral treatment is, no doubt, the most acceptable and easy to use option. Finding such a treatment has always been the dream of many scientists, and many attempts have been made over the years. These ranged from herbal remedies used by native healers, mostly in Eastern countries, to the more sophisticated designer drugs, which are based on a better understanding of the physiological mechanism of erection. This article describes some of these attempts.
Pure erotomania was first described in 1920 by the French psychiatrist de Clérembault. It is a delusional condition, usually in a woman who believes that a man, unattainable because of his much higher social class or married state, is very much in love with her. The belief has a precise onset and occurs suddenly in a state of clear consciousness. Enoch and his colleagues (1967) claim that ‘some instances of this syndrome may be distinct from ordinary paranoid psychoses and deserve a separate place in psychiatric nosology’, while Arieti thinks that it is not a clinical entity but a symptom of paranoia or paranoid schizophrenia (Arieti and Meth, 1959).
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