Symptomatology and hormonal levels among Thai women with natural menopause.

The hormonal levels and symptoms after natural menopause have been studied in 100 patients. The mean age was 56.8 years while menopausal age was 50.3 years. Postmenopausal symptoms presented 55.0 per cent with the three most common complaints of hot flushes, emotional lability and vaginal dryness, respectively. The levels of plasma FSH, estradiol and testosterone were also reported corresponding to the years after menopause. Both gonadotropins reach a maximum concentration at two to three years after the menopause and then gradually declined. The LH/FSH ratio was 0.6. The mean concentration of estradiol was 10.07 pg/ml, the level remained consistently low during the menopausal period. Testosterone concentration declined little in postmenopausal women.

True 47,XXX in a patient with premature ovarian failure: the first reported case in Thailand.

A case of triple-X female with premature ovarian failure was reported. The patient was a 23-year-old, single, Thai woman who presented with primary amenorrhea, incomplete development of the secondary sex characteristics, elevated levels of serum gonadotropins, and decreased estrogen concentration. Immunological abnormalities were not identified by antinuclear antibody, rheumatoid factor, antimicrosomal antibody and antithyroglobulin antibody studies. Cyclic estrogen-progestin was given and withdrawal bleeding occurred. The present case represents the utilization of chromosomal analysis in a patient with delayed sexual development, or primary amenorrhea and elevated serum gonadotropin levels.

Incidental appendectomy at cesarean section: a prospective study.

In conclusion, the present study describes a controlled series and demonstrates the safety of incidental appendectomy at cesarean section. A slight increase in operative time accompanied appendectomy group, but the length of hospital stay and postoperative morbidity were not different. It's our recommendation that at cesarean section if the abnormal appendix is found, appendectomy should be done. Normal appendix can also be removed whenever the opportunity presents in non-risk patients.

Evaluation of ofloxacin in the treatment of mucopurulent cervicitis: response of chlamydia-positive and chlamydia-negative forms.

The treatment of mucopurulent cervicitis in nonpregnant women was evaluated in a randomized study. Subjective and objective criteria were used to assess the response of cervicitis to therapy. Forty-three patients (Group I) were treated with Ofloxacin, 100 mg orally twice daily for 10 days, and forty-five patients (Group II) were treated with Ofloxacin, 200 mg orally twice daily for 7 days. Both produced significant improvement in subjective and objective signs of cervicitis; decreasing clinical symptoms, eliminating mucopurulent endocervical findings, and eradicating C. trachomatis. Overall, of the chlamydia-positive form the complete response of Ofloxacin treatment in mucopurulent cervicitis was 18 (60.0%), the partial response was 10 (33.3%), and resistance was 2 (6.6%) of the 30 patients (p = 0.6592). Of the chlamydia-negative form the complete response was 38 (65.5%), the partial response was 20 (34.5%) of the 58 patients (p = 0.9463). C. trachomatis eradication was satisfactory between both treatment regimens; 28 (93.3%) of the 30 women in chlamydia-positive form. This trial shows that both regimens are also beneficial in the treatment of mucopurulent cervicitis either C. trachomatis positive or C. trachomatis negative, and do not differ significantly between both groups (p = 0.1375). No side effects were observed.

Endometriosis during pregnancy: report of 3 cases.

Three cases of asymptomatic pelvic endometriosis during pregnancy were reported. All cases denied abnormal vaginal bleeding, dyspareunia or dysmenorrhea; but only one case was noted to have a problem of infertility. Conservative operations were performed at the second trimester and during cesarean section with an uneventful postoperative course. Cyclic menses have been resumed.

Sublingual buprenorphine and pethidine for immediate postoperative pain relief in major gynecologic surgery: a comparative study.

The analgesic effect of sublingual buprenorphine 0.4 mg has been compared with pethidine 1 mg/kg given intramuscularly in 80 patients following major gynecologic operation. The results indicate a slower onset of action for sublingual buprenorphine in the first two hours (p less than 0.001), but it has a much longer duration and is more effective for pain relief (p less than 0.001) than pethidine. The main side-effects were nausea and vomiting which occurred after both treatments but with no significant difference.