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Biomedical subjects

S L Tan

Publications and source records attributed to S L Tan.

At least 163 records · Page 9Linked to original sources
PubMed1990

Ovarian cyst aspiration and the outcome of in vitro fertilization.

This study was designed to ascertain whether any benefit would be derived from aspirating ovarian cysts identified before ovarian stimulation in patients undergoing in vitro fertilization. Thirty-seven patients who had ovarian cysts were categorized into two groups: group A (n = 14) with baseline ovarian cysts and group B (n = 23) with ovarian cysts that developed during pituitary suppression with the gonadotropin-releasing hormone analog. Each group was prospectively randomized into two subgroups depending on whether the ovarian cysts were aspirated or not. In group A, there was a significantly greater number of follicles and oocytes in the ovaries in which cysts were aspirated. However, there was no significant difference in the total number of follicles, oocytes retrieved and fertilized, or in the final outcome. In group B, there was no significant difference in folliculogenesis between the aspirated and nonaspirated subgroups. These observations suggest that the presence of a baseline ovarian cyst may reduce folliculogenesis but do not support routine cyst aspiration if the patient has two functional ovaries.

Adult↗
PubMed1990

The use of luteinising hormone releasing hormone and its analogues for induction of ovulation and ovarian stimulation for in-vitro fertilisation.

The use of subcutaneous pulsatile luteinising hormone releasing hormone (LHRH) for induction of ovulation in patients with hypogonadotrophic hypogonadism is efficacious and safer compared to human menopausal gonadotrophin (hMG) because of the lower risk of ovarian hyperstimulation and multiple pregnancy. In clomiphene citrate (CC) nonresponsive cases of polycystic ovarian disease (PCOD), the major advantage of pulsatile LHRH is that when ovulation occurs, it is usually uni-follicular. In cases of PCOD, we have found that if pulsatile LHRH alone fails to induce ovulation, addition of clomiphene citrate or a small dose of follicle stimulating hormone (FSH) will augment its action and allow, in the majority of cases, the threshold of stimulation to be reached that would be sufficient to induce ovulation but not produce clinical hyperstimulation or multiple pregnancy. LHRH analogues to desensitise the pituitary prior to ovarian stimulation with hMG have been recently used in in-vitro fertilisation (IVF). We have compared the use of the LHRH analogue, buserelin (Hoechst, UK) + hMG with clomiphene + hMG for ovarian stimulation in IVF in a number of prospective studies. In this review, the role of pituitary desensitisation in IVF is discussed in the light of our results. We have found that although the mean number of oocytes, the implantation rate and pregnancy rate per embryo transfer are higher in patients who receive buserelin + hMG, the differences are not statistically significant. The length of time taken to achieve pituitary desensitisation is increased in patients who have PCOD or who form ovarian cysts in response to the administration of buserelin.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1989

Bart's hydrops fetalis--clinical presentation and management--an analysis of 25 cases.

Twenty-nine hydropic infants were born in the Kandang Kerbau Hospital between 1980 and 1985, during which there were 131,658 deliveries, giving an incidence of 1 in 4,540 total births. Twenty-five of these cases were confirmed to be due to homozygous alpha thalassaemia. No case of fetal hydrops due to Rh isoimmunization was detected. The mean age of the mothers was 28.86 +/- 4.05 years (+/- SD). Eight patients had delivered 1 hydropic baby previously while 1 had a history of 2 babies with hydrops fetalis; 92% of the patients had been followed antenatally while 8% were first seen when they were admitted in labour; 25% of the patients had anaemia, 52% had polyhydramnios, 20% developed hypertension and 64% had bilateral lower limb oedema. None of the patients had concomitant hypertension, generalized oedema and proteinuria. In 4 cases of recurrent hydrops, serial ultrasound scans were performed from early pregnancy but ultrasonic features of hydrops fetalis were only seen from 27 weeks' gestation. Spontaneous labour occurred in 75% of patients at a mean of 32.3 +/- 3.3 weeks (+/- SD). All delivered vaginally and only 1 patient required abdominal decompression. Four patients required Caesarean section, 2 for failure to progress after induction of labour, 1 for major placenta praevia and the fourth for fetal distress; in the last case, diagnosis of hydrops fetalis was only made after delivery of the baby. All the babies in the series died within one hour of delivery. Homozygous alpha thalassaemia is the commonest cause of hydrops fetalis in Singapore and is an invariably fatal condition. It is associated with an increased incidence of maternal anaemia, polyhydramnios and prematurity.

Adult↗
PubMed1989

The treatment of breast engorgement with Serrapeptase (Danzen): a randomised double-blind controlled trial.

We evaluated an anti-inflammatory enzyme drug Danzen (Serrapeptase: Takeda Chemical Industries, Ltd.) on 70 patients complaining of breast engorgement. These patients were randomly divided into 2 groups, a treatment group and a placebo group. A single observer, unaware of the group the patients were in, assessed the severity of each of the symptoms and signs of breast engorgement before treatment was commenced, and daily for 3 days, during which therapy was administered. Danzen was noted to be superior to placebo for improvement of breast pain, breast swelling and induration and while 85.7% of the patients receiving Danzen had "Moderate to Marked" improvement, only 60.0% of the patients receiving placebo had a similar degree of improvement. "Marked" improvement was found in 22.9% of the treatment group and 2.9% of the placebo group. These differences were statistically significant (P less than 0.05). No adverse reactions were reported with the use of Danzen. Danzen is a safe and effective method for the treatment of breast engorgement.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1989

A prospective randomised controlled trial of external cephalic version comparing two methods of uterine tocolysis with a non-tocolysis group.

The use of tocolvtic agents to enhance uterine relaxation and facilitate external cephalic version (ECV) has come under recent debate. We studied 90 breech presentations in late pregnancy who did not have contra-indications to ECV. The patients were randomised into 3 groups of 30 patients each: one was administered oral salbutamol 4 mg t.d.s.; another had intravenous salbutamol infused until the maternal heart rate rose above 100 bpm for 30 mins; and the last served as a control group. All patients in each group were matched for parity and gestation, and each had an intravenous line, thereby masking the treatment group from the 2 doctors who performed half the number of ECVs each. There was no significant difference in the success of ECV between the treatment and control groups (46.6% vs 50.0% vs 46.6%). The gestational age, the placental site, the attitude of the breech, the abdominal girth, and the maternal weight and fetal birth weights did not seem to influence results. On the other hand, there was a significant difference in successful ECV between nullipara (26%) and multipara (75%) (p less than 0.001). There were no cases of abruptio placenta or foetal distress, and one patient entered labour one day after the ECV at 39 weeks gestation. There were 2 cases of spontaneous version after failed ECV, and one case of spontaneous reversion to breech after successful ECV. We conclude that the use of salbutamol does not increase the incidence of successful ECV, but multiparity predicts for a successful outcome.

Adult↗
PubMed1989

[Determination of micro-amount of dipyrone with a piezoelectric detector].

A new method for the determination of dipyrone (analgin) using a piezoelectric quartz crystal as detector has been proposed. An iodine-potassium iodide solution is added to the sample and the frequency shift of the crystal immersed in the sample solution with respect to the blank is directly proportional to the concentration of dipyrone over a range from 2 x 10(-7) to 3 x 10(-6) mol/L at pH 3.5-6.5 according to the equation C (mol/L) = 6.85 x 10(-9) delta F (Hz). No significant interferences were caused by commonly met inorganic substances, amino acids and a number of other organic substances. The method has been suggested for determining dipyrone at ppm level and in micro-samples of mg or microliters level.

Aminopyrine↗
PubMed1988

Uterine growth in the follicular phase of spontaneous ovulatory cycles and during luteinizing hormone-releasing hormone-induced cycles in women with normal or polycystic ovaries.

The uterine response to follicular growth in luteinizing hormone-releasing hormone (LH-RH)-induced ovulatory cycles was assessed by serial ultrasound measurement of uterine cross-sectional area and endometrial thickness in 23 cycles in women with normal ovaries and 24 cycles in women with polycystic ovaries. Nine women with spontaneous ovulatory cycles also were studied. The authors correlated uterine cross-sectional area and endometrial thickness with follicle diameter (FD) and serum estradiol-17 (E2). In women with either normal or polycystic ovaries, there was an E2-related increase in uterine cross-sectional area and endometrial thickness, but both uterine area and endometrial thickness were greater in the late follicular phase of women with polycystic ovaries compared with those with normal ovaries.

Endometrium↗
PubMed1988

Lamicel is more effective in preparing the cervix for midtrimester termination of pregnancy than Laminaria japonicum.

Laminaria tents are often used prior to prostaglandin termination of midtrimester pregnancy to reduce the induction-abortion interval. Natural laminaria suffers from a number of disadvantages and, recently, a synthetic form Lamicel (Cabot Medical, PA), has been produced. Uncontrolled evaluation has suggested that it is effective for dilating the cervix but scepticism remains because Lamicel does not exert radial force on the cervical canal. One hundred women who requested abortion between 12 and 24 weeks of pregnancy were studied. They were randomly divided into group A who had a Lamicel inserted for 6 hours and group B who had a laminaria tent inserted for 8 hours. The cervical dilatation was assessed at the end of this period and the patients were then given up to 6 injections of sulprostone at 4-hourly intervals. All patients in Group A aborted, but 7 of those in Group B did not. The mean cervical dilatation in Group A was 7.47 +/- 1.46 mm compared with 4.71 +/- 1.76 mm in Group B (p less than 0.001). The mean induction-abortion interval in Group A was also significantly shorter (p less than 0.05) than that in Group B: 11.79 +/- 7.24 hours compared with 12.51 +/- 6.52 hours in Group B (excluding 7 patients who failed to abort in Group B). The results of the study suggest that the degree of cervical dilatation that can be achieved using Lamicel is significantly greater than that by laminaria tents.

Abortifacient Agents, Nonsteroidal↗
PubMed1988

Breast stimulation--a new method for induction of cervical ripening in complicated term pregnancies.

We have studied the use of breast stimulation as a method of cervical ripening in 75 patients who had complicated term pregnancies and who required induction of labour. The indications for induction were prolonged pregnancy greater than 42 weeks (N = 12), hypertensive disorders of pregnancy (N = 26), suspected intra-uterine growth retardation (N = 30) and a combination of two or more of the above (N = 7). All patients had a modified Bishop score of less than 5 before the start of nine hours of unilateral breast stimulation spread over three days. Twenty-nine out of the 75 patients went into labour during the three day period and, of the remainder, there was a significant improvement in the cervical score of 2.87 +/- 1.99. Three patients, all of whom had prolonged pregnancy, had exaggerated uterine activity. Two patients had foetal heart rate deceleration on antenatal cardiotocography during their first session of breast stimulation but this did not recur in any of their subsequent sessions. No patient had both exaggerated uterine activity and foetal heart rate deceleration. There was no case of perinatal mortality or morbidity.

Breast↗
PubMed1987

Hypergonadotropic amenorrhea--etiology and outcome in 93 young women.

Ninety-three cases of amenorrheic women aged 40 years or less in whom serum FSH concentrations were found to be greater than 20 units/l have been reviewed. The etiology and diagnosis of this uncommon but serious condition and the potential for spontaneous recovery of ovarian follicular activity (17.1%) are discussed. Management is reviewed in the light of ultrasonic, karyotypic and immunological findings.

Adult↗
PubMed1987

The midcycle cervical microbial flora as studied by the weighed-swab method, and its possible correlation with results of sperm cervical mucus penetration tests.

Infertile couples undergoing routine investigation for infertility were randomly selected for the study. A quantitative method using weighed swabs was found satisfactory for the study of microbial flora in the midcycle cervical mucus. In 6 of the 20 women, the midcycle cervical mucus was hostile in the sperm cervical mucus penetration tests. The total bacterial counts and the number of species (average, 2.5) isolated from the hostile mucus were significantly greater than those from the receptive mucus (average, 1.3). Only normal vaginal/cervical flora was isolated. Ureaplasma urealyticum was found more frequently in patients undergoing clomiphene citrate therapy (6/10 versus 0/9, P less than 0.03, Fischer's Exact test).

Cervix Mucus↗