Norethisterone enantate in the treatment of premenstrual syndrome

The aim of this prospective study was to assess whether norethisterone enantate can  be recommended for use in patients with premenstrual Syndrome (PMS) who also require effective contraception. The subjects were 20 patillnts with severe PMS who required effective contraceptiol1. Premenstrual symptom scores on norethisterone enllntate and oral contraceptives were compared. Significantly fewer and less severe symptoms were experienced by patients on horethisterone enantate than those on oral contraceptive. Norethisterone enantate can therefore be recommended lor use in  patients with PMS who also require effective Cl:lntraception

Towards understanding the quantitative literacy demands of a first-year medical curriculum

Setting. When designing a medical curriculum, assumptions that are made about students' quantitative literacy (QL) competencies often lead to demands that students are unable to meet. In order to improve the match between the literacy demands of the curriculum and the literacy competencies of students, the demands need to be examined critically and the assumptions made explicit. Curriculum changes that reduce the articulation gap between demands and competencies are particularly important for broadening access and promoting success, in tertiary study, for students with disadvantaged educational backgrounds. Objectives. The objectives of this study are to survey the QL implicitly and explicitly contained in a course curriculum, in a manner that could be useful for the following purposes: raising awareness in health science lecturers of the nature and extent of the QL demands of their course materials, developing the theory relating to best practice for QL development in health sciences and informing the design of QL interventions. Method. We focus on the analysis of the QL competencies required of a student engaging with text-based learning materials in the curriculum of a first-year integrated human biology/epidemiology/biochemistry course. For the analysis we use a framework, which classifies quantitative material according to a mathematical and statistical dimension and a competencies dimension. Results and conclusions. A range of examples is presented which illustrate that the implicit QL demands of this first-year course curriculum are substantial and varied

Iron dextran in the treatment of iron-deficiency anaemia of pregnancy - Haematological response and incidence of side-effects

Sixty pregnant patients with a haemoglobin (Hb) < 8 g/dl arid proven iron-deficiency anaemia were randomly allocated to two treatment groups. Group A received the usual recommended dose of iron dextran (Imferon; Fisons) and group 8 received two-thirds of the recommended dose. A further 30 patients received oral iron (group C). There was no difference in Hb value between the three groups 4 weeks after treatment or 3 months after delivery. At 6 months after delivery, a higher mean Hb value was found in the patients in group A than those in groups 8 and C. Significantly higher serum ferritin levels were found in group A and this difference was still present 6 months postnatally. There was no significant difference in the incidence of delayed reactions between the two groups who received iron dextran

Writing As a Study Skill in the Classroom Learning Spiral

As a cognitive operation, writing is acknowledged to involve the generation of language through assimilation of the known in the form of prior knowledge (Sanacore, 1983). The process also incorporates organizational functions such as categorization in order to create a conceptual flow of information. Further, the act of writing involves a multisensory interaction with language, for it is written, seen and often heard as the writer\u27s thoughts are given permanence in the form of print. Writing is a study skill that teachers can ill afford to neglect in the learning classroom

Pregnancy after tubal occlusion A 5-year study

During the 5-year period 1976 - 19809430 patients underwenttubal occlusion at Groote Schuur Hospital, Cape Town. Of these patients 24, or 2,5/1 ODD, became pregnant after the procedure. An analysis of the pregnancy rate for each method of tubal occlusion is reported. Bilateral tubal occlusion by laparotomy'or falope rings has a low failure rate; cauterization has not

Morbidity after total abdominal hysterectomy

Total abdominal hysterectomy (TAH), the commonest major gynaecological operation performed at the Groote Schuur and Somerset Hospitals, is associated with considerable financial and social problems for the family. A retrospective series of 300 consecutive patients who had undergone TAH is presented. This series was analysed for factors influencing the prevalence of wound haematoma, sepsis and dehiscence, pain and decreased mobility, the main parameters of postoperative morbidity. The four factors found to be important in minimizing postoperative complications of TAH were: (i) the experience of the surgeon; (ii) the use of the Pfannenstiel rather than the subumbilical midline incision; (iii) closure of the skin with Dermalon rather than with black silk; and (iv) drainage of the wound

Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom

Introduction The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients. Methods This retrospective observational study included all patients admitted to the Royal Stoke University Hospital in Stokeon-Trent, UK, with a stroke or transient ischaemic attack between March 15th and April 14th, 2020 (COVID). Patient demographics, characteristics of the stroke, treatment details and logistics were compared with patients admitted in the corresponding weeks in the year before (2019). Results There was a 39.5% (n = 101 vs n = 167) reduction in admissions in the COVID cohort compared with 2019 with more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) 7 vs 4, p = 0.02), and fewer strokes with no visible acute pathology (21.8 vs 37.1%, p = 0.01) on computed tomography. There was no statistically significant difference in the rates of thrombolysis (10.9 vs 13.2%, p = 0.72) and/or thrombectomy (5.9 vs 4.8%, p = 0.90) and no statistically significant difference in time from stroke onset to arrival at hospital (734 vs 576 min, p = 0.34), door-to-needle time for thrombolysis (54 vs 64 min, p = 0.43) and door-to-thrombectomy time (181 vs 445 min, p = 0.72). Thirty-day mortality was not significantly higher in the COVID year (10.9 vs 8.9%, p = 0.77). None of the 7 stroke patients infected with COVID-19 died. Conclusions During the COVID-19 pandemic, the number of stroke admissions fell, and stroke severity increased. There was no statistically significant change in the delivery of thrombolysis and mechanical thrombectomy and no increase in mortality

Atherosclerotic lesions in the thoracic aorta: A South African anatomical and histological mortuary study

Background. Worldwide, the prevalence of cardiovascular diseases such as atherosclerosis is on the increase. Younger people may be especially vulnerable owing to their exposure to risk factors such as drug abuse and HIV. Methods. The thoracic aortas of 149 South Africans under the age of 50 years were collected at the Salt River Mortuary, Cape Town, and examined macroscopically and microscopically for evidence of anomalies. The sample comprised predominantly males, and included black, coloured and white individuals. Results. A significantly higher level of macroscopic pathology was found in coloured males, although overall prevalence of pathology in this sample was lower than expected. A positive association was also found between body mass index and vascular pathology in the black and coloured population groups. Microscopic anomalies were common and present at high levels, irrespective of age and racial grouping. Conclusions. The widespread prevalence of microscopic anomalies in all groups suggests that these are normal variations that result from haemodynamic forces. The higher prevalence of atherosclerotic lesions in coloured males, however, probably results from specific genetic conditions such as hypercholesterolaemia or lifestyle factors such as diet or tik abuse. The findings suggest that coloured individuals may be at increased risk of developing cardiovascular disease

Atherosclerotic lesions in the thoracic aorta: A South African anatomical and histological mortuary study

Background. Worldwide, the prevalence of cardiovascular diseases such as atherosclerosis is on the increase. Younger people may be especially vulnerable owing to their exposure to risk factors such as drug abuse and HIV. Methods. The thoracic aortas of 149 South Africans under the age of 50 years were collected at the Salt River Mortuary, Cape Town, and examined macroscopically and microscopically for evidence of anomalies. The sample comprised predominantly males, and included black, coloured and white individuals. Results. A significantly higher level of macroscopic pathology was found in coloured males, although overall prevalence of pathology in this sample was lower than expected. A positive association was also found between body mass index and vascular pathology in the black and coloured population groups. Microscopic anomalies were common and present at high levels, irrespective of age and racial grouping. Conclusions. The widespread prevalence of microscopic anomalies in all groups suggests that these are normal variations that result from haemodynamic forces. The higher prevalence of atherosclerotic lesions in coloured males, however, probably results from specific genetic conditions such as hypercholesterolaemia or lifestyle factors such as diet or tik abuse. The findings suggest that coloured individuals may be at increased risk of developing cardiovascular disease