Experiencias adquiridas por los residentes de Ginecología y Obstetricia en la instrumentación obstétrica del parto / Experiences acquired by Gynaecology and Obstetrics residents regarding delivery obstetrics instrumentation

Introducción: Los obstetras siempre han tratado de sujetar la cabeza del feto de la manera más segura posible para acelerar el parto y reducir el difícil trabajo de la mujer. La historia del uso de instrumentos obstétricos para facilitar el parto (ya sean fórceps o espátulas) es una parte pintoresca y particular de la historia de la medicina. Objetivos: Identificar la experiencia adquirida por los residentes en la instrumentación obstétrica. Métodos: Para cumplir los objetivos propuestos se revisó el plan temático de la residencia de Ginecobstetricia y posteriormente fueron seleccionados los aspectos referidos al tema en estudio. Resultados: Los resultados encontrados a partir de las encuestas realizadas y los datos aportados por los tutores de formación y la revisión de los libros de partos aportaron el nivel de aprendizaje de los residentes. Conclusiones: Se aprecia en los estudiantes demora en la aprehensión de los conocimientos relacionado con la instrumentación obstétrica(AU)

Introduction: Obstetricians have always tried to hold the fetus head as safely as possible to accelerate delivery and reduce the women's difficult work. The history of usage of obstetric instruments to facilitate labor (whether forceps or spatulas) is a colorful and particular passage in the history of medicine. Objectives: To identify the residents' acquired experience regarding the obstetric instrumentation, for which we decided to determine their received practical theoretical training. Methods: In order to meet the proposed objectives, we reviewed the system of contents for the Gynecology residence and, thereafter, we selected the aspects regarding the subject under study. Results: The results obtained from the surveys conducted and the data provided by the training professors and the review of delivery books contributed to the residents' level of learning. Conclusions: The students show delay in the apprehension of knowledge regarding obstetric instrumentation(AU)

Síndrome de Patau: a propósito de un caso / Patau syndrome: a purpose of a case

Patología causada por tres copias del cromosoma 13 en el cariotipo, en la mayoría de los casos por una disyunción meiótica principalmente del gameto materno que conlleva a un síndrome congénito polimalformativo caracterizado por microftalmia, fisura labio palatina y polidactilia; acompañado o no de otras malformaciones. La prevalencia es de 1/12000 nacidos vivos, con un tiempo de supervivencia corto. Reportamos un caso diagnóstico de Patau confirmado por estudio citogénico en el que describimos las características clínicas y asociación con las descritas por la literatura.

A Comparison of Cervical Smear Adequacy Using either the Cytobrush or the Ayre Spatula: a Practice Audit

Background: The study aimed to i) investigate the smoking habits of students attending tertiary institutions of learning in the Eastern Cape Province (ECP) and ii) determine the knowledge of the students about the health hazards of smoking and their attitude towards current government anti-smoking legislation.Methods: This was a questionnaire-based study involving all seven tertiary institutions of learning in the ECP; viz. the Universities of Transkei; Fort Hare; Port Elizabeth and Rhodes University; and the Border; Eastern Cape and Port Elizabeth technikons. A total of 1 728 students were interviewed out of a student population of 30;080. Stratified random sampling was used to select the students. Two-way tables were used to test the independence of the variables and chi-square tests were applied. A 'p' value of below 5 was used as a test of significance. Results : A total of 1 480 students completed the questionnaires (86). The racial classification of the respondents was 79 Black; 13 White; 7 Coloured and 2 Indian. Twenty-six per cent of the students were smokers; of which 37 were male and 15 were female. Forty-five per cent of the Coloured students smoked; while the figures for Whites and Blacks were 26 and 25 respectively. Seventy per cent of the students smoked less than 10 cigarettes a day. Fifty-two per cent of the smokers said they wanted to stop smoking. Sixty-one per cent had been influenced to start smoking by their friends and only 13 were influenced by advertisements. Ninety-four percent agreed that smoking was dangerous to the smoker's health; while 73 responded that there was a relationship between mothers who smoke and low birth weight. Thirteen per cent thought the legislation was too tough; while 30 said it was good as it was. On measures to reduce smoking; 86 favoured restricting smoking in public places.Conclusion: This study has demonstrated that smoking is prevalent in tertiary institutions of learning in the Eastern Cape Province. The demographic profile of the smokers reflects the national picture. The knowledge of the harmful effects of smoking is generally good

Non-surgical Treatment of Vaginal Agenesis Using a Simplified Version of Ingram's Method

Non-surgical vaginal dilation is a safe and effective method for the creation of neovagina in the patient with vaginal agenesis. Compared to surgical methods, non-surgical vaginal dilation has the advantage of low morbidity, the creation of a more physiologic vaginal milieu, and no surgical scarring. To overcome some technical limitations of original Frank's method, in 1981 Ingram proposed a modification of the technique that used dilators of gradually increasing size mounted on a bicycle seat stool. Although several studies have shown satisfactory outcomes using Ingram's method, there are some practical difficulties in making and handling the bicycle seat stool. This article reports a case of a 24-year-old woman with Mayer-Rokitansky-Kster-Hauser syndrome whose vaginal agenesis is successfully treated with a simplified version of Ingram's method. This method uses dilators of gradually increasing size mounted on an ordinary chair instead of a bicycle seat stool. When necessary, the patient may use a fulcrum under the dilator.

Non-surgical Treatment of Vaginal Agenesis Using a Simplified Version of Ingram's Method

Non-surgical vaginal dilation is a safe and effective method for the creation of neovagina in the patient with vaginal agenesis. Compared to surgical methods, non-surgical vaginal dilation has the advantage of low morbidity, the creation of a more physiologic vaginal milieu, and no surgical scarring. To overcome some technical limitations of original Frank's method, in 1981 Ingram proposed a modification of the technique that used dilators of gradually increasing size mounted on a bicycle seat stool. Although several studies have shown satisfactory outcomes using Ingram's method, there are some practical difficulties in making and handling the bicycle seat stool. This article reports a case of a 24-year-old woman with Mayer-Rokitansky-Kster-Hauser syndrome whose vaginal agenesis is successfully treated with a simplified version of Ingram's method. This method uses dilators of gradually increasing size mounted on an ordinary chair instead of a bicycle seat stool. When necessary, the patient may use a fulcrum under the dilator.

Incidencia de cefaleas post anestesi intrdural con aguja "21 y 25" / Incidence of post-intradural anesthes heaadacne in the 21 - 25 reedleia

Objetivo: El estudio se realizo en forma prospectiva longitudinal comparativo en 100 pacientes sometidos a cirugia programada, cirugia general, urològia, proctològica y traumatològica bajo anestesia intradural. Material y Mètodo: La edad media de los pacientes fue de 33,71 + 13,4 años. la anestesia intradural se efectùo con aguja Becton Dickinson de calibre 21 punta Quinke para el grupo 1 y calibre 25 para el grupo II. Una vez conseguido el goteo de liquido cefaloraquideo se administro lidocaina al 5 porciento 1 mg/kg/p. No se recomendò ninguna medida especial para el postoperatorio. A las 48 horas de la punción se interrogo a los pacientes para verificar si presentò cafelea. Resultados. Se observo una cefalea del 10 porciento para el grupo I, minetras que para el grupo II no se prsentò cefalea en ningun caso

Paralisia do nervo femoral consequente à cirurgia ginecológica / Paralysis of femoral nerve following surgery gynecologic

Os autores apresentam um caso de paralisia do nervo femoral, em paciente submetida à histerectomia total abdominal, devido à miomatose uterina. Trata-se de lesäo traumática do nervo femoral por afastador cirúrgico. Os aspectos anatômicos, funcionais e terapêuticos säo descritos a seguir.

Uso de anestesia tópica en procedimientos ginecológicos menores / Use of topic anesthesia in minor gynecologic procedures

Se evaluó la eficacia de la anestesia tópica (solución de Xylocaina, spray) aplicada el cuello uterino antes de realizar procedimientos ginecológicos que incluyeron histerometría, biopsia de exocervix, biopsia de canal endocervical, biopsia de endometrio, inserción de dispositivo intrauterino. Se evaluaron un total de 140 pacientes que acudieron a la consulta ginecológica entre marzo de 1992 y octubre de 1992 y los resultados mostraron una diferencia estadísticamente significativa en la disminución del dolor al momento de realizar las exploraciones ginecológicas en las pacientes que recibieron previamente anestesia tópica comparada con el grupo placebo

The use and maintenance of laparoscope in gynecology at Ramathibodi Hospital.

The average use of laparoscope in Ramathibodi Hospital during 1974-1986 was 656.9 cases per year (range = 394-830 cases). The light bulb was the most frequently damaged at the rate of 5 bulbs per 1,000 procedures. The life of the instrument can be prolonged through proper care and continuous maintenance as well as experienced operators and assisting team.

El factor regional en el tratamiento quirúrgico del cáncer de mama / The regional factor in breast cancer surgery

Se analiza los resultados obtenidos con 95 pacientes intervenidas quirúrgicamente por cáncer de mama durante el bienio 1983-85, según el tipo de intervención realizado. A la mayoría de las pacientes se les ha realizado un PATEY modificado, siguiendo en número el HALSTED y la mastectomía simple, mas limpieza axilar. Las cadenas ganglionares han sido clasificadas en 3 niveles o estadios. Nuestro criterio es mantener el pectoral mayor, siempre que no esté afectado por la tumoración, así como la extirpación del pectoral menor, para realizar mejor el tiempo quirúrgico subclavio