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Biomedical subjects

T H Goh

Publications and source records attributed to T H Goh.

At least 37 records · Page 2Linked to original sources

A multicenter randomized comparative investigation of ML Cu250, TCu-220C and Cu7 IUDs.

The final analysis of 1725 interval insertions of the 3 IUDs is presented. The earlier observations were confirmed at: at 24 months, no significant differences were found between the TCu-220C and ML Cu250 IUDs though the TCu-220C had a lower gross pregnancy rate (2.0 versus 2.9) and the ML Cu250 had a lower expulsion rate (2.3 versus 4.1). Expulsions were more common with the Cu7 when compared to the ML Cu250 (p 0.001) and T-220C (p 0.01); pregnancy rates were also higher with p values of 0.05 and 0.01 respectively. Other use-related terminations were not significantly different among the 3 IUDs and continuation rates at 24 months were: Cu7, 69, TCu-220C, 73, and ML Cu250, 74.

Birth Rate↗

Anaemia and menstrual blood loss studies in women using multiload Cu250 and progestasert IUDs.

Two to 9 months following insertion of the ML Cu250 (n = 54) and Alza T (n = 30) IUDs, mean menstrual blood losses (MBL) were 46.3 ml and 32.7 ml, respectively (p less than 0.005). Significantly more of the Alza T users had losses below 40 ml and they also perceived their menses to be lighter. Based on a haemoglobin level of 12gm/dL, the upper normal limit of MBL was about 40 ml. These findings are consistent with earlier observations that during the first year, ferritin levels fall in ML Cu250 users whereas they are unaltered in Alza T users.

Adult↗

Effect of laparoscopic sterilization and insertion of Multiload Cu 250 and Progestasert IUDs on serum ferritin levels.

Blood haemoglobin and serum ferritin levels were measured at the initial visit and 12 months following sterilization and IUD insertion. Ferritin levels were unaltered in Progestasert users after 12 months but haemoglobin values increased though not significantly. Ferritin levels fell in Multiload Cu 250 users and in sterilized women; haemoglobin levels were also observed to fall but significantly only in the latter group. Iron-deficiency anaemia was prevalent at initial contact and there appeared to be an increased risk subsequently in Multiload Cu 250 users and in those who were sterilized. Screening and monitoring for anaemia is indicated. From the viewpoint of iron status, the Progestasert is preferable to the Multiload Cu 250 but it suffers the major disadvantages of needing frequent replacement and of causing menstrual disturbances which might compromise its acceptability. Menstrual blood loss studies may help explain why anaemia develops after sterilization.

Adult↗

A randomised comparative evaluation of the copper 7, multiload copper 250 and T copper-22OC IUDs.

Two new Cu-IUDs, the TCu-22OC and Multiload Cu250, were evaluated against the Cu7 in 1,199 subjects in a randomised, multicentric trial using a common study protocol. During the 2 years following insertion, cumulative first-segment rates for total use-related terminations showed no significant differences between the 3 devices; however, the Cu7 had a significantly higher termination rate for accidental pregnancy compared to the TCu-22OC and its expulsion rate was significantly higher than the ML Cu250. The rate of accidental pregnancy was higher and the expulsion rate lower with the ML Cu250 compared to the TCu-22OC but these differences were not significant. The results are discussed in relation to IUD design and their application in family planning.

Adult↗

Surgical treatment of absent pulmonary valve syndrome in infants: relief of bronchial obstruction.

Congenital absence of the pulmonary valve is usually associated with a malalignment type of ventricular septal defect as well as right ventricular outflow obstruction and aneurysmal dilatation of the pulmonary arteries. Symptomatic infants primarily have severe tracheobronchial obstruction caused by aneurysmal dilatation of the proximal pulmonary arteries; pulmonic and systemic blood flow are usually balanced. Surgical intervention to relieve the obstruction by plicating the pulmonary artery and its branches under deep hypothermia and circulatory arrest, together with patch closure of the ventricular septal defect, is advocated.

Airway Obstruction↗

Iron-deficiency anemia and long-term use of copper-bearing IUDs.

The increase in menstrual blood loss (MBL) caused by IUDs may result in iron deficiency anemia. 60 women completing 2 years of Cu-IUD use were investigated for this risk, using hemoglobin concentration serum iron indices. No significant differences were found compared to a control group of women requesting interval Cu-IUD insertion. A decrease in the MBL increment with time following insertion, self-selection of the study population, and increased dietary iron absorption are suggested explanations for these results. 15.4% of patients suffered from iron deficiency anemia. Measurement of serum ferritin is advocated to identify these women for treatment, in order to enhance maternal health.

Age Factors↗

A study of menstrual patterns following laparoscopic sterilization with silastic rings.

The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.

Dysmenorrhea↗

A longitudinal study of serum iron indices and haemoglobin concentration following copper-IUD insertion.

The increase in menstrual blood loss associated with copper-bearing IUDs may cause or aggravate pre-existing anaemia. In order to evaluate this risk, 84 Malaysian women wearing copper-IUDs were studied longitudinally by means of serial measurements of blood haemoglobin concentration (Hb), serum iron (S/Fe) and transferrin saturation (T/S). The initial Hb was under 12 gm% in 33.7% of patients. The mean Hb showed no significant change up to 12 months while S/Fe fell significantly at the end of this time; the T/S was significantly reduced as early as 6 months post-insertion. There is a significant risk of anaemia following copper-IUD insertion, particularly with long-term usage. Progestogen-releasing IUDs may offer the most feasible solution to this problem in our local context since oral medication with iron or drugs to reduce menstrual blood loss is not practicable.

Adult↗

Scanning suprasternal echocardiography.

Scanning suprasternal echocardiography was performed in 280 patients with a variety of cardiac anomalies. By using the special suprasternal transducer on the suprasternal notch, the aortic arch, right pulmonary artery, and left atrium were recorded superoinferiorly. From this reference position various scanning techniques were made to record the main pulmonary artery, pulmonary valve, ascending aorta, aortic valve, and distal aortic arch, wherever possible. These scans made it possible to assess (a) the integrity and size of right pulmonary artery and main pulmonary artery in pulmonary atresia, stenosis of origin of right pulmonary artery, pulmonary artery banding, kinked Waterston anastomosis, and aneurysm of pulmonary artery; (b) relative positions of aortic valve and pulmonary valve in malposition complexes; (c) the position and size of the aortic arch in tetralogy of Fallot and aortic coarctation. Measurements of the left atrium made by suprasternal echocardiography were consistently larger than those made by praecordial echocardiography. Changes in relative sizes of aortic arch, right pulmonary artery, main pulmonary artery, and left atrium were also documented in the various cardiac anomalies. The atrial baffle after Mustard repair for d-transposition of the great arteries and the atrial membrane in cor triatriatum were also demonstrated. The introduction of scanning techniques has thus widened the scope of suprasternal echocardiography.

Adolescent↗