Obstetrics and Gynaecology Forum - Volume 16, Issue 4, 2006
Volume 16, Issue 4, 2006
Author Dennis A. DaveySource: Obstetrics and Gynaecology Forum 16 (2006)More Less
Extracted from text ... GUEST EDITORIAL O&G Forum 2006;16:101 Measurement of bone mineral density The method of measuring BMD is of critical importance in diagnosis and in decisions regarding treatment. The value of the BMD expressed as a T-score depends on (a) the method of measurement and the measuring device (b) the particular bone and the site chosen and (c) the mean and distribution of the values of BMD in the chosen reference population of young healthy adults. BMD can be measured by several different methods and many devices and machines are available. The BMD of the peripheral skeleton can be measured by ultrasonography ..
Author D.A. DaveySource: Obstetrics and Gynaecology Forum 16, pp 105 –111 (2006)More Less
Osteoporosis is a bone disorder characterised by low bone mass and an increase in bone fragility and susceptibility to fracture. Diagnostic categories of osteoporosis and osteopenia (a less severe form of osteoporosis) have been defined on the basis of bone mineral density measurements (BMD). The relation between BMD and fracture risk is a continuum; the lower the BMD the greater the risk. Only 20% to 30% of women and men with fragility fractures have osteoporosis. A much larger number of those with fragility fractures have osteopenia. The risk of a fragility fracture depends on many factors in addition to BMD including age and propensity to falls. The assessment of fracture risk should be based on clinical risk factors combined with BMD measurements rather than on a fixed level of BMD and expressed as the absolute risk of fracture. With increasing fracture risk dietary supplements of calcium and vitamin D, exercise and measures to prevent falls are of increasing importance. Pharmacological therapy is indicated in those assessed to be at high fracture risk. A tool for the 5 and 10 year assessment of the absolute fracture risk based on clinical risk factors together with BMD is being developed by the World Health Organization. This tool should enable appropriate treatment to be targeted to women and men at increased fracture risk and the term osteopenia to be dropped.
Author M.E. MossSource: Obstetrics and Gynaecology Forum 16, pp 113 –118 (2006)More Less
Modern Copper Intrauterine Devices [Cu IUDs] are extremely safe, highly effective, long acting yet rapidly reversible contraceptives. They are also very cost effective and suitable for use by a wide range of women, including nulliparous as well as HIV infected women. Despite a large body of scientific evidence attesting to its safety and efficacy, the IUD remains underutilized except in a few countries such as China where it provides 43% of contraceptive use. Use in other countries varies from a low 1% in USA, 5% in UK to around 20% in France and Germany. The DHS (1998) reported that Cu IUDs accounted for less than 3% of total contraceptive use in South Africa. <br>Much of the resistance to use can be traced back in history. Various IUDs were developed in the early 1900s but only achieved wide acceptance in the 1960s in the form of the Lippes Loop<sup>(TM)</sup>. In the 70s reports of numerous pregnancies, many of which resulted in septic spontaneous miscarriages with several maternal deaths, were associated with the use of the Dalkon Shield <sup>(TM)</sup>, a device specifically marketed for nullipara. Clearly this device was of poor design, being far less effective than other IUDs of the time. More important was the unique structure of the multifilament thread passing through the cervix, all other IUDs had monofilament threads. This braided thread acted like a wick actively drawing infection up from the lower genital tract. The Dalkon Shield<sup>(TM)</sup> was taken off the market and the manufacturer forced out of business by massive litigation. Sadly, but perhaps not surprisingly, both the public and health professionals alike regarded all IUDs in the same light, despite clear evidence to the contrary. This was the start of the IUD's undeserved reputation for causing pelvic inflammatory disease [PID] and fears about subsequent infertility.
Author L. WhiteSource: Obstetrics and Gynaecology Forum 16, pp 121 –124 (2006)More Less
Extracted from text ... Obstetrics & Gynaecology Forum ? October 2006 121 REVIEW O&G Forum 2006;16:121-124 Correspondence: Dr Lizette White firstname.lastname@example.org Ovulation induction L White Department of Obstetrics and Gynaecology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa Introduction Ovulatory dysfunction is identified in 18 - 25% of couples with infertility.1 The aim of ovulation induction is to induce the development of at least one dominant follicle, while superovulation is used to increase the number of follicles, either for specific therapeutic strategies e.g. artificial insemination or for in vitro fertilisation. In 1961 Greenblatt et al reported the new anti-estrogen MRL- 41(clomiphene ..
Author N. SigcuSource: Obstetrics and Gynaecology Forum 16, pp 127 –130 (2006)More Less
Extracted from text ... Obstetrics & Gynaecology Forum ? October 2006 127 CASE REPORT O&G Forum 2006;16:127-130 Correspondence: Dr Noluyolo Sigcu email@example.com Leiomyomatosis peritonealis disseminata - a case report and literature review N Sigcu Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital, South Africa Introduction Leiomyomatosis peritonealis disseminata (LPD) is an extremely rare benign condition, which occurs in the reproductive age group.1 This pathological form of leiomyoma is characterized by firm, multiple white to grey nodules, covering the peritoneal cavity, omentum, ovaries, uterine ligaments and/or intestines, which are of varying size, ranging from 0.5cm to 10cm.1, ..
Source: Obstetrics and Gynaecology Forum 16, pp 133 –134 (2006)More Less
Bleeding from a uterine leiomyoma is a rare cause of haemoperitoneum Spontaneous rupture of a superficial vein is extremely rare. Fewer than 100 cases have been reported. We report a case of a massive intraperitoneal bleed and hypovolaemia in a 40 year old woman known to have uterine leiomyomata. Hypovolaemic shock was due to bleeding from the superficial vessels of a leiomyoma and was treated by myomectomy.
Source: Obstetrics and Gynaecology Forum 16 (2006)More Less
Extracted from text ... O&G CPD ANSWER FORM - OCTOBER 2006 Subscribe to the O&G Forum CPD programme and earn 16 CPD points per year CPD reference number A008/024/02/2006 Continuing Professional Development Point Questionnaire Accredited by the Wits CPD Office Instructions 1. Read the journal to find all the answers 2. Answer the questions and mark the answer form by putting an "X" in the appropriate square. 3. Make a photocopy for your records in case the form is lost in the mail. 4. Tear out page and place the answer form in a envelope, seal it and send to:- In House Publications, O&G ..