General or Spinal Anaesthetic for Vaginal Surgery in Pelvic Floor Disorders (GOSSIP): a feasibility randomised controlled trial.

INTRODUCTION AND HYPOTHESIS: Spinal anaesthesia (SA) and general anaesthesia (GA) are widely used techniques for vaginal surgery for pelvic floor disorders with inconclusive evidence of the superiority of either. We conducted a randomised controlled trial (RCT) to assess the feasibility of a full scale RCT aiming to examine the effect of anaesthetic mode for vaginal surgery on operative, patient reported and length of hospital stay (LOHS) outcomes. METHODS: Patients undergoing vaginal surgery, recruited through a urogynaecology service in a University teaching hospital, were randomised to receive either GA or SA. Patients were followed up for 12 weeks postoperatively. Pain was measured on a visual analogue scale; nausea was assessed with a four-point verbal rating scale. Patient's subjective perception of treatment outcome, quality of life (QoL) and functional outcomes were assessed using the International Consultation on Incontinence Modular Questionnaire (ICIQ) on vaginal symptoms and the SF-36 questionnaire. RESULTS: Sixty women were randomised, 29 to GA and 31 to SA. The groups were similar in terms of age and type of vaginal surgery performed. No statistically significant differences were noted between the groups with regard to pain, nausea, quality of life (QoL), functional outcomes as well as length of stay in the postoperative recovery room, use of analgesia postoperatively and LOHS. CONCLUSION: This study has demonstrated that a full RCT is feasible and should focus on the length of hospital stay in a subgroup of patients undergoing vaginal surgery where SA may help to facilitate enhanced recovery or day surgery.

Recto-vaginal sex leading to colostomy and recto-vaginal repair.

Recto-vaginal tears have been described in association with foreign bodies, rape and accidental trauma victims. We describe a case of upper recto-vaginal tear without involvement of perineum or sphincter following consensual heterosexual coitus, which has not been previously reported.

Awareness of issues related to torture among medical students in Mauritius.

Torture in custody is a global problem. Many declarations and conventions by different agencies throughout the world have sought to address this issue. Health professionals are required to detect, treat, and rehabilitate victims of torture. In the last few years, medical personnel have emphasised their stand against the practice of torture. We surveyed 155 second- and third-year medical graduates in Mauritius to assess their knowledge of and attitudes towards torture. A majority of the students have a basic awareness and would like to learn more about torture as a human rights issue. However, more than 37 per cent of students were in favour of beating in custody. Torture could be reduced if the medical profession maintains high standards of practice and ethics. Medical education for the prevention of torture should be included in the undergraduate medical curriculum.

Contribution of the regional drug information center towards drug safety.

Drug related complications may lead to huge economic impact and cause significant morbidity and mortality. The present study analyzed the services provided by our Drug Information Center (DIC) in relation to drug safety. Over a period of one year, the DIC received 336 drug related queries. Among these 127 queries were related to drug safety. Medical doctors asked 78% of queries and patient care was the purpose behind 64.6% of them. Half (50%) of the enquirers submitted their queries to the center personally or contacted the DIC staff. Forty one percentage of the queries were related to the causality of particular drug towards adverse drug reactions and 10 % regarding drug use in pregnancy and lactation. Centrally acting drugs accounted for 21% of the queries. Twenty two percentage of the enquirers required an immediate answer. DICs by providing unbiased and objective information can reduce the occurrences of drug related complications.

Domestic violence against women--an international concern.

Domestic violence is a pattern of assault and coercive behaviour including physical, sexual and psychological attacks, by a person against his/her own intimate partner. Women are more frequently the victims. After a global overview of the prevalence and nature of domestic violence against women especially in Mauritius, this articles provides a discussion about health problems and risk factors among the female victims with the objective of giving preventive measures to eradicate it from society. NGOs, along with legislative measures, have proven helpful in improving quality of life and preventing violence-related injuries among women. The health sector also plays an important role as part of multi-sector efforts in early detection and prevention of cases of domestic violence. Psychiatrists are in a unique position for early identification of such patients as well as intervention.