Manpower imbalance in obstetrics and gynaecology.
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Biomedical subjects
Publications and source records attributed to H K Basu.
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A multicentre clinical trial comparing a novel formulation (the Paper Pill) of a combined oral contraceptive containing 30 microgram ethinyloestradiol and 150 microgram levonorgestrel with a conventional tablet formulation (Microgynon 30) has been carried out in 336 women over 6 cycles. There were no pill failures in women taking either preparation with one exception in the Microgynon 30 group which was due to poor patient compliance. Cycle control judged by cycle length, duration and amount of withdrawal bleeding and the incidence of intermenstrual bleeding was good in both groups. The number of adverse effects was slightly less in the Paper Pill group and fewer withdrawals for questionnaire reasons were noted than in the Microgynon 30 group. A questionnaire showed that the Paper Pill was accepted well by the majority of women in the trial.
Prostaglandin E2 was administered orally in doses of 0.5 mg. to 2.0 mg. every 2 hours to 169 women for induction of labour. Induction was successful in 153 women (90%). In 99 of these women, low amniotomy was performed at the beginning. Performance of amniotomy at the beginning of induction did not alter the incidence of successful induction but did lead to a mean induction-delivery interval shorter than that in women who had amniotomy performed in the active phase of labour. Vomiting and/or diarrhoea occurred in 34 women (20%). Uterine hypertonus of only transient nature occurred in 3 women. One woman suffered from atonic post-partum haemorrhage. No adverse effects on the fetus were apparent. The presence of fetopelvic disproportion was associated with a slow rate of cervical dilatation and unsuccessful induction.
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Serum concentrations of fibrin degradation products were found to be higher during menstruation than in the intermenstrual phase. Higher concentrations were present in cases of menorrhagia as compared with healthy women and women with various gynaecological disorders but with normal menstrual function. Higher serum concentrations of fibrin degradation products in cases of menorrhagia may indicate increased local fibrinolytic activity in the uterus.
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