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.

The comparison of the efficacy among three different nimorazole regimens in the treatment of bacterial vaginosis.

The efficacy of 3 different nimorazole regimens in treating bacterial vaginosis in women was evaluated. The regimens consisted of: Nimorazole 2 g single dose (Group I), 1 g per day for 3 days (Group II), and 1 g per day for 7 days (Group III) orally. In a simple randomized trial of 90 cases (30 cases in each group) with demonstrated clinical bacterial vaginosis on the presence of 3 of 5 of the following signs: (1) Characteristic thin homogenous discharge; (2) vaginal pH greater than 4.5; (3) release of a fishy amine odor from vaginal fluid mixed with 10% KOH; (4) presence of clue cells (usually representing at least 20% of vaginal epithelial cells); and (5) vaginal fluid contains few or no lactobacilli. Cure rates for bacterial vaginosis by nimorazole were 70.0% (21/30), 83.3% (25/30), and 90.0% (27/30) in Group I, II, and III, respectively. Thus nimorazole is another effective drug for the treatment of bacterial vaginosis.

Postmenopausal sexuality in Thai women.

We evaluate sexuality in 100 natural menopausal women as pertains to hormones, symptoms related to intercourse, and marital relationship with sexual desire, orgasm and coital frequency. The mean age was 56.8 years while menopausal age was 50.3 years. The postmenopausal syndrome presented 55.0% occurring 1 to 7 years after menopause (mean 3.4 years). The common sexual problems after menopause were loss of libido, orgasmic dysfunction, and dyspareunia. Both sexual desire and activity decreased when compared with premenopausal period. Ninety percent of the subjects had sexual desire less than once a month. Only 14% of the subjects occasionally reached orgasm while the other 86% never had orgasm after menopause. The levels of FSH, LH, estradiol and testosterone were also reported. There was no correlation of hormone estradiol and testosterone, symptoms related to intercourse and marital relationship with sexual desire, orgasm, or coital frequency.

Efficacy of cefoxitin for the prevention of postoperative infection in abdominal hysterectomy.

Prophylactic effect of cefoxitin against postoperative infection at a dose of 2 g intravenous (single dose 30 minutes before the operation) was investigated using fever index in patients who underwent the elective, nonradical abdominal hysterectomy. The results obtained are summarized as follows. Total fever index values were 12.9 +/- 10.0 degree-hours in the control group (n = 39), 11.3 +/- 9.7 degree-hours in the study group (n = 39). There were no statistical significance between both groups. Data from this investigation does not suggest the concept that prophylactic antibiotics are beneficial in the reduction of postoperative infection. The results of this prospective study reflected in unnecessity of antibiotic prophylaxis in abdominal hysterectomy.

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.

Merkel cell carcinoma of the vulva: a case report.

The clinical and pathologic findings of Merkel cell carcinoma of the vulva were reported. The light microscopic findings of sheets of small, uniform cells were consistent with a diagnosis of neuroendocrine tumor. The electron microscopic characteristics revealed membrane-bound secretory granules, confirmed the diagnosis of Merkel cell carcinoma. Regional lymphnode metastases were present at the time of initial surgery and the adjunctive radiotherapy was also given. This case was unusual because Merkel cell carcinoma was usually found on the face, extremities and buttocks.

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.