Childbearing and maternal sexuality: a prospective survey of 119 primiparae.
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Biomedical subjects
Publications and source records attributed to R Kumar.
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Information about sexual activity, enjoyment and libido was obtained at intervals from 119 primiparous women during a longitudinal survey of maternal emotional health in pregnancy and for a year after delivery. Most subjects described some reduction in the frequency of sexual intercourse and a diminution of libido and sexual enjoyment during pregnancy; this was most marked in the third trimester. After delivery, about a third of subjects had resumed intercourse by six weeks and nearly everyone had done so by three months. Nevertheless, 77% and 57% of the women were having intercourse less often at three and 12 months after delivery respectively, in comparison with the month before they became pregnant. Selected variables were examined for relationship with a low, or reduced frequency of intercourse and with a lack of enjoyment. Significant associations were found with aspects of maternal personality and childhood relationships, marital conflict, maternal depression, previous miscarriages, difficulties in conceiving and fears of harming the fetus. Nausea and vomiting during pregnancy, the mode of delivery and related obstetric and medical variables, breast-feeding and characteristics of the baby, did not appear to significantly influence maternal sexuality.
One hundred and fifty patients requiring maintenance haemodialysis were investigated to determine the incidence and pattern of tuberculosis. Twenty patients were found to have tuberculosis, giving an incidence of 13.3 times that of the general population. The most frequent clinical presentations of tuberculosis in these patients were pyrexia, pleural effusion and lymphadenopathy. Diagnostic difficulties were encountered in 7 patients in whom therapeutic trial with anti-tubercular drugs had to be undertaken. Two patients died from tuberculosis. Five patients received renal transplants after initial treatment of tuberculosis.
An immunomodulatory drug levamisole (l-tetramisole) was used in the treatment of 50 patients with newly diagnosed sputum-positive pulmonary tuberculosis in addition to routine chemotherapy. A control group received routine chemotherapy for tuberculosis only. Patients in both groups had been chosen because of mild immunodepression, as shown by their insensitivity to skin tests with dinitrochlorobenzene (DNCB). The patients were followed for 3 months, and their clinical recovery was assessed and compared by recording the rate of sputum clearance, rate of weight gain, decrease in erythrocyte sedimentation rate (ESR), and clearance of radiologic lesions. The results showed that at the end of 3 months, 48% of the patients in the group receiving levamisole reacted to DNCB as against only 18% of the control group. The levamisole-treated group also showed significant radiologic clearing compared with the control group. However, the rate of sputum clearance, decrease in ESR, and weight gain did not show any significant difference.
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Experimental uremia created by obstructing the urethra of 7 cross-bred bulls was associated with significant (P less than 0.05) increases in PCV, blood urea nitrogen concentration, arterial and venous pH and PCO2, arterial bicarbonate, and base excess. Total serum protein concentration decreased nonsignificantly. Arterial PO2 reduced significantly during later stages of uremia. Arterial and venous oxygen saturation, arteriovenous oxygen difference, oxygen extraction ratio, and arteriovenous pH difference were not affected significantly. Uremia was characterized by progressive metabolic alkalosis with, as a compensation, hypercapnia, and arterial hypoxemia. There was no evidence of systemic shunting of blood except in 1 animal.
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The development of O, H and Vi antibodies to Salmonella typhi antigens, immunoglobulins and C3 levels, and the presence of rheumatoid factor and circulating immune complexes were determined in the sera of patients with typhoid fever and appropriate age and sex-matched controls. IgM, and both O and H antibodies were raised in typhoid patients. Rheumatoid factor, a possible indicator of persistent circulating immune complexes, was also present in these patients. Immune complexes were more often present in patients with typhoid fever than in controls, their presence was much more marked in complicated cases of typhoid fever. A high ratio of alpha 1-antitrypsin to C3 was found in these patients suggesting complement consumption.
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Renal functional status was evaluated in 122 patients with lepromatous leprosy. Renal functions were found to be markedly impaired in patients with erythema nodosum leprosum (ENL) in the active or quiescent phases. Although uncomplicated lepromatous leprosy patients did show significant renal impairment as compared to healthy controls, the degree of impairment was less than that of the reactive cases. Diminished endogenous creatinine clearance and proteinuria were the common abnormalities detected. Serum creatinine was significantly increased only in reactive cases. Blood urea was found to be marginally increased in a few patients although not to a statistically significant degree. Renal involvement did not bear any relation to the duration of illness or to the Bacteriological Index.
Twenty one patients of lepromatous leprosy were investigated for evidence of renal diseases. Histological lesions were observed in 76 percent cases. Sixty two percent of the cases showed a proliferative type of glomerulonephritis. Amyloidosis was present in 14 percent. The remaining 24 percent had either non-specific changes confined to renal tubules or were normal.
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For experimental evaluation of double contrast gastrography in 9 dogs, sodium iothalamate and air were used for positive and negative contrast, respectively, to delineate the gastric mucosa. The technic was simple and reasonably safe. Results were satisfactory when the stomach was empty, and appropriate volumes of contrast materials were evenly distributed.
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