Biomedical subjects
Publications and source records attributed to S Ramsewak.
The rare condition of strings of a missing intrauterine contraceptive device presenting at the anus is described. Partial removal was achieved via the rectum and this was followed by a normal uncomplicated pregnancy and delivery.
The reproductive performance of primigravidae aged 30 years and over was compared with that of a group of younger primigravidae. Other patients were at greater risk for antepartum complications such as pre-eclampsia and uterine fibroids. Induction of labour was undertaken more frequently, and the Caesarean Section rate was higher but there was no worsening of perinatal mortality.
A postmortem study of the degree of displacement of the tracheal tube was performed on 13 neonates of varying birthweights. There was significant movement of the tube on flexion and extension of the neck, and on opening the infant's mouth. Our findings lend support to certain techniques of tracheal tube placement; the ultimate aim is to position it accurately.
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The mean birth weight in women with the sickle-cell trait (Hb-AS) was less than in a matched population (Hb-AA), and the difference was statistically significant. Ultrasonic fetal biparietal diameter measurements in 30 patients with Hb-AS fell within normal limits, but mean femur lengths were found to be reduced at each gestational period when compared with similar measurements in patients with normal hemoglobin.
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We hypothesized that apolipoprotein-E (apo-E) genotypes would be associated with plasma lipid indices in newborns of South Asian (SA) ancestry but not in newborns of African (Afr) ancestry. Cord blood was obtained by consecutive sampling at maternity hospitals in the Caribbean Islands of Trinidad and Curaçao. Apolipoprotein-E genotypes, cholesterol, triglycerides, apo-A, apo-B and Lipoprotein (a) (Lp(a)) were measured in 294 newborns in Trinidad and 234 in Curaçao. The apo-B/apo-AI ratio and an adapted lipid tetrad index (i.e. cholesterol x triglycerides x Lp(a)/apo-AI) were calculated. In Trinidad, apo-E allele frequencies and genotype distributions of Afr and SA were significantly (p < 0.001) different (Afr: n = 71: apo-e2 : e3 : e4 = 10.4 : 66.4 : 23.2%; SA: n = 98; e2 : e3 : e4 = 3.5 : 83.1: 13.4%). The Mixed group (SA + Afr) had apo-E allele frequencies in between those of SA and Afr groups (n = 115; e2 : e3 : e4 = 7 : 76 : 17%). Lipid indices of appropriate for gestational age and term newborns were comparable, except for lower Lp(a) (SA = 29+/-4; Afr = 46+/-5; Mixed = 41+/-5 mg L(-1)) and lower adapted lipid tetrad index (29.4+/-4.8; 41.9+/-5.4; 41.4+/-7.0) in SA. Apo-E allele frequencies of Curaçao newborns were: apo-e2 : e3 : e4 = 10.5 : 72.6 : 16.9%. Their Lp(a) levels were significantly higher (68+/-3 mg L(-1)) than that of the Trinidadian sample (38+/-3; p < 0.0001). Apolipoprotein-E4 had an apo-B-increasing effect and apo-E2 an apo-B-decreasing effect in Afr (r = 0.192, p = 0.003). Among Africans from Trinidad and Curaçao variations in apo-E4 and apo-E2 are associated with an apo-B-increasing effect and an apo-B-decreasing effect, respectively. There was no relationship between apo-E polymorphism and lipids among South Asians.