Women's sexuality after termination of pregnancy in Hong Kong Chinese

Objective: Our aim is to determine sexuality after termination of pregnancy (TOP) in Hong Kong Chinese. Design: This was a prospective study using self-administered questionnaires given before and eight weeks after abortion. Subjects: Women over age 18 years old requesting TOP were invited to participate in the study during the period 6 December 2005 to 28 March 2006. Main outcome measures: Sexual function, couple relationship and psychological well-being like depression and post-traumatic stress disorder (PTSD) were assessed. Contraception was also reviewed. Results: No significant change in the number of women who presented with sexual dysfunctions before and after abortion. However, women reported subjective decrease in sexual functions after TOP, ranging from 9.8% for those with increased vaginal pain to 24.5% for those with decreased sexual desire. Majority of them (74.8%) suffered from at least moderate degree of post-traumatic stress symptoms and 10.2% had symptoms suggestive of the presence of a PTSD. Significant associations were seen in subjective decrease of sexual functions with post-traumatic stress symptoms after termination of pregnancy. On the other hand, 41.6% felt less depressed after abortion. There was no significant change in couple relationship after abortion. Conclusion: Termination of pregnancy did not cause sexual dysfunctions. However, significant proportion of women did suffer from decreased sexual functions subjectively which may be due to stress related to unplanned pregnancy or the TOP. The abortion itself did not cause depression and women who had completed family were less depressed after abortion. Post-traumatic stress was prevalent in those having abortion and the symptoms were associated with the subjective decrease in sexual functions.published_or_final_versio

A genetic locus for adolescent idiopathic scoliosis linked to chromosome 19p13.3

Adolescent idiopathic scoliosis (ALS) is one of the most common orthopedic disorders, affecting up to 4% of schoolchildren worldwide. We studied seven unrelated multiplex families of southern Chinese descent with AIS, consisting of 25 affected members. A genomewide scan with >400 fluorescent microsatellite markers was performed. Multipoint linkage analysis by GENEHUNTER revealed significant linkage of the abnormal phenotype to the distal short arm of chromosome 19, with both a maximum multipoint LOD score and a nonparametric LOD score of 4.93. Two-point linkage analysis by MLINK gave a LOD score of 3.63 (recombination fraction θ [m=f] = 0.00) at D19S216. Further high-density mapping and informative recombinations defined the AIS critical region in the vicinity of D19S216, flanked by D19S894 and D19S1034, spanning 5.2 cM on the sex-averaged genetic map on chromosome 19p13.3.published_or_final_versio

A survey on knowledge of stroke in Hong Kong Chinese

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Early single-centre comparative results on non-thermal ablation of symptomatic incompetent great saphenous veins (GSV): cyanoacrylate glue (VenaSeal) versus mechanicochemical ablation (ClariVein)

Speakers' corner: Selected original research abstracts - supraaortic and venouspublished_or_final_versio

The effect of topical lignocaine gel in pain relief for colposcopic assessment and biopsy: Is it useful?

We investigated the use of topical ligocaine gel in pain relief for colposcopy and cervical punch biopsy. Ninety women referred for colposcopy due to abnormal cervical cytology were randomised to receive 5 ml of either 2% xylocaine gel or KY jelly to the cervix and the upper part of the vagina for at least 10 minutes prior to the colposcopic procedures. Pain score was obtained at several points of the procedure. Topical lignocaine gel did not significantly relieve pain from cervical punch biopsy and alleviate the stinging sensation from application of acetic acid and Lugol's iodine to cervix and vagina. However, it may be beneficial to a subgroup of women with prior unpleasant experience towards speculum examination. © 2008 The Authors.link_to_subscribed_fulltex

Latent tuberculosis infection testing strategies for HIV-positive individuals in Hong Kong.

Importance: With immune recovery following early initiation of antiretroviral therapy (ART), the risk of tuberculosis (TB) reactivation among individuals with HIV could be reduced. The current strategy of annual latent TB infection (LTBI) testing should be revisited to increase cost-effectiveness and reduce the intensity of testing for individuals. Objective: To analyze the cost-effectiveness of LTBI testing strategies for individuals in Hong Kong with HIV who had negative LTBI test results at baseline. Design, Setting, and Participants: This decision analytical model study using a cost-effectiveness analysis included 3130 individuals with HIV in Hong Kong, China, which has an intermediate TB burden and a low incidence of HIV-TB coinfection. A system dynamics model of individuals with HIV attending a major HIV specialist clinic in Hong Kong was developed and parameterized by longitudinal clinical and LTBI testing records of patients during a 15-year period. The study population was stratified by age group, CD4 lymphocyte level, ART status, and right of abode. Alternative strategies for LTBI testing after a baseline test were compared with annual testing under different coverages of ART, LTBI testing, and LTBI treatment scenarios in the model. An annual discounting rate of 3.5% was used in cost-effectiveness analysis. Main Outcomes and Measures: Proportion of new TB cases averted above base case scenario, discounted quality-adjusted life-years gained (QALYG), incremental cost, and incremental cost-effectiveness ratios in 2017 to 2023. Results: A total of 3130 patients with HIV (2740 [87.5%] male and 2800 [89.5%] younger than 50 years at HIV diagnosis) with 16 630 person-years of follow-up data from 2002 to 2017 were analyzed. Of these, 94 patients (0.67 [95% CI, 0.51-0.91] per 100 person-years) developed TB. Model estimates of cumulative number of TB cases would reach 146 by 2023, with the annual number of new TB diagnoses ranging from 6 to 8. For patients who had negative LTBI test results at baseline, subsequent LTBI testing strategies were ranked by ascending effectiveness as follows: (1) no testing, (2) test by risk factors, (3) biennial testing for all, (4) up to 3 tests for all, and (5) annual testing for all. Applying a willingness-to-pay threshold of $50 000 per QALYG, none of the subsequent testing strategies were cost-effective. Test by risk factors and up to 3 tests for all were cost-effective only if the willingness-to-pay threshold was increased to$100 000 per QALYG and $200 000 per QALYG, respectively. More new TB cases would be averted by expanding LTBI testing and/or treatment coverage. Conclusions and Relevance: Changing the current testing strategy to less intense testing strategies is likely to be cost-effective in the presence of an increased coverage of baseline LTBI testing and/or treatment

Vaginal misoprostol compared with oral misoprostol in termination of second-trimester pregnancy

Objective: To compare the efficacy of vaginal with oral misoprostol in termination of second-trimester pregnancy after pretreatment with mifepristone. Methods: Women requesting termination of second-trimester pregnancy were randomized into two groups. Thirty-six to 48 hours after oral administration of 200 mg of mifepristone, women were given either oral or vaginal misoprostol 200 μg every 3 hours for a maximum of five doses in the first 24 hours. Women receiving oral misoprostol also were given a vaginal placebo (vitamin B6), whereas those receiving vaginal misoprostol were given an oral placebo. If they failed to abort, a second course was given by the same route. Results: The median induction-abortion interval in the vaginal group (9 hours) was significantly shorter than that in the oral group (13 hours). The percentage of women aborting within 24 hours in the vaginal group (90%) was significantly higher than that in the oral group (69%). The median amount of misoprostol used in the vaginal group (600 μg) also was significantly less than that in the oral group (1000 μg). There was no significant difference in the incidence of side effects between the two groups except for fatigue and breast tenderness, which were more common in the oral group. Seventy-six percent of the women preferred the oral route, and 24.5% of the women preferred the vaginal route. Conclusion: Vaginal misoprostol is more effective than oral misoprostol in termination of second- trimester pregnancy after pretreatment with mifepristone, but more women preferred the oral route.link_to_subscribed_fulltex

The influence of diabetes mellitus on lower limb revascularisation

Free Paper Session 9: PAD 2: Combined with DM: FP9-6The 11th Annual Congress of Asian Society for Vascular Surgery (ASVS) and the 4th Annual Meeting of World Federation of Vascular Societies (WFVS), Kyoto, Japan, 29 June-2 July 2010