1/13. Loss of vision from distant haemorrhage: report of four cases.To describe the occurrence of visual loss from ischaemia of the optic nerve following distant haemorrhages. Four patients who sustained vision loss following distant haemorrhage, presenting to the neuro-ophthalmic clinic of the department of ophthalmology, Addis Ababa University, from 1995 to 1997 were evaluated. The clinical presentation, management and prognosis are discussed. Post-haemorrhagic vision loss, other than being a rare occurrence, is under-reported due to the fact that these patients are very sick with massive blood loss and hence little attention is given to the vision loss by attending physicians and sometimes even the patients themselves. It is hoped that this paper will increase awareness about this condition among physicians attending to patients with severe bleeding and thus facilitate early diagnosis and referral.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/13. Acute and post-traumatic stress disorder after spontaneous abortion.When a spontaneous abortion is followed by complicated bereavement, the primary care physician may not consider the diagnosis of acute stress disorder or post-traumatic stress disorder. The major difference between these two conditions is that, in acute stress disorder, symptoms such as dissociation, reliving the trauma, avoiding stimuli associated with the trauma and increased arousal are present for at least two days but not longer than four weeks. When the symptoms persist beyond four weeks, the patient may have post-traumatic stress disorder. The symptoms of distress response after spontaneous abortion include psychologic, physical, cognitive and behavioral effects; however, patients with distress response after spontaneous abortion often do not meet the criteria for acute or post-traumatic stress disorder. After spontaneous abortion, as many as 10 percent of women may have acute stress disorder and up to 1 percent may have post-traumatic stress disorder. Critical incident stress debriefing, which may be administered by trained family physicians or mental health practitioners, may help patients who are having a stress disorder after a spontaneous abortion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/13. Atypical eclampsia: a case report and review.Up to one-third of cases of eclampsia occur in the postpartum period. Often there is evidence of preeclampsia, which alerts the physician to be prepared for the possibility of seizures. eclampsia is an obstetrical emergency often requiring intensive care and monitoring. This reports the case of a 33-year-old gravida 5 para 4 abortus 1 who presented ten days postpartum with eclampsia. The patient had no history of hypertension, edema, or proteinuria during her prenatal visits or hospitalization, and has no history of preeclampsia or eclampsia in previous pregnancies. This case illustrates the rare occurrence of eclampsia late in the postpartum period and the equally rare onset of eclampsia without prior evidence of preeclampsia during her pregnancy. It is followed by a brief review of the relevant literature.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/13. brucellosis in immigrants in denmark.brucellosis is a rarely encountered infection in northern europe. We report 4 cases of brucella abortus bacteremia occurring in denmark during 1999-2000. The clinical presentation was characteristically vague and brucellosis was not suspected by the attending physicians, partly because incomplete patient histories were obtained as a result of language barriers. The diagnosis was finally established by means of blood cultures, which were performed because of fever of unknown origin.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/13. Reproductive and developmental hazards and employment policies.The task of informing workers of hazards in the workplace is seldom more difficult than with the subject of reproductive and developmental hazards. occupational health staff and physicians are faced with a paucity of relevant medical information. Workers, kept aware of the thalidomide spectre with every media report of the latest descriptive epidemiology study, are anxious to know more. Employers, knowing that few agents are regulated on the basis of reproductive hazards, are encouraged to lessen workplace exposure to all agents but need guidance from government and scientists in setting priorities. Understandable ethical and scientific limitations on human studies require researchers to study animals and cells. The difficulties of extrapolating the results of this research to humans are well known. The scientific, medical, and workplace difficulties in dealing with reproductive and developmental hazards are mirrored in the regulatory positions found in north america. Some regard fetal protection policies as sex discrimination whereas others consider such policies as reasonable. Guidelines are provided to allow employers and medical practitioners to consider this difficult problem.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
6/13. Meiotic segregation patterns and ICSI pregnancy outcome of a rare (13;21) Robertsonian translocation carrier: a case report.t(13;21) is an uncommon Robertsonian translocation (RT) with limited information in the literature. Hereby, we assessed the meiotic segregation and interchromosomal effect (ice) in sperm nuclei from a t(13;21) carrier. The pregnancy outcome following ICSI was also included as reference for physicians and patients. Dual-colour fluorescent in situ hybridization (FISH) was carried out to analyse the segregation pattern of chromosomes 13 and 21, while triple-colour FISH was used to investigate the possible concurrence of ice. With respect to chromosomal constitutions of 13 and 21, 88.39% of the spermatozoa were normal or balanced due to alternative segregations, and 11.08% showed nullisomy or disomy as a result of adjacent segregations. However, for chromosome 18 and sex chromosomes, the proportion of normal haploids was 98.79%. The rate of disomy was not significantly higher than the controls for either chromosome 18 or X/Y. The rare t(13;21) case exhibited a similar pattern of meiotic segregation as in the common RTs. ICEs were not observed in the current case.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
7/13. Ultrasonographic differentiation of cervical abortion from cervical pregnancy.Cervical abortion is a spontaneous abortion of a normal intrauterine pregnancy into the cervical canal where the abortus is retained by a closed external os, causing distention of the cervical canal. This entity closely simulates ectopic cervical pregnancy clinically. The ultrasonic findings in four patients with cervical abortion are described and these could alert the physician to the possibility of this condition.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
8/13. Maternal deaths associated with antepartum fetal death in utero, united states, 1972 to 1978.Little is known about the overall incidence of fetal death in utero (FDIU) in the united states or about the risks associated with its management. To address these questions, this study provides nationwide incidence data and reviews nine deaths of women with FDIU in the united states from 1972 to 1978. The crude death-to-case rate associated with FDIU is at least 4.5 deaths per 100,000 cases (95% confidence limits, 2.1 to 8.5). Existing information from comparative studies is inadequate to evaluate the comparative safety of different methods of evacuating the uterus after FDIU occurs at different gestational ages. Management of such cases should be determined by both the experience of the physician with uterine evacuation techniques and the medical and psychologic needs of the woman.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
9/13. Spontaneous abortion and grieving.Delayed, unresolved and pathologic grief reactions are common and often unrecognized occurrences following spontaneous abortion. The loss is frequently not appreciated, so the woman may not have the opportunity to work out her grief reaction. family physicians can facilitate normal grieving and can detect delayed or pathologic reactions. It is helpful to encourage the woman and her partner to ask questions and to discuss such issues as cause, blame and guilt.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
10/13. Conservative treatment with successful outcome of a triplet pregnancy after the miscarriage of one fetus in the second trimester.Due to the increased availability of infertility treatment, multiple pregnancies, with various resulting complications have become more common. A woman in the 19th week of a triplet pregnancy came to the hospital after the miscarriage of one of the fetuses at home. In keeping with our philosophy of minimal intervention in childbirth, we treated the woman conservatively. After confirming that the remaining two fetuses were in good condition, the woman was released home under ambulatory observation, with no antibiotics or tocolytic drugs. No further complications developed, and the woman gave birth in her 31st week to healthy twin girls 82 days later. The successful outcome of this case demonstrates that non-interventional, conservative methods could be a feasible alternative to invasive intervention. We hope that our case will encourage more physicians to try out and report noninterventional methods, so that enough information could be gathered to help make correct management decisions in the future.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
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