[RECURRENT PUREPERAL PSYCHOSES].
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The manner in which menstruation, femininity and the role of the mother are perceived, along with the social influences, are emphasized in the psychosocial dimension of premenstrual syndrome. This study attempts to investigate the perception of mothers and attitudes toward menstruation of a group of women diagnosed with premenstrual dysphoric disorder (PMDD) in a secular Muslim country. Thirty women with PMDD and 24 healthy women were studied using a semi-structured questionnaire. Menstrual attitude and the way the mother was perceived in the childhood-to-puberty period by women with PMDD, were significantly negative in comparison to the control group. In conclusion, menstrual attitudes and premenstrual experiences of women should be investigated cross-culturally and prospectively.
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UNLABELLED: Clerkship encounter forms were used to assess the types of diagnoses seen, the level of activities performed (student responsibility), and self-reported competence (comfort level) in dealing with patients. INTRODUCTION: Many medical schools require a family medicine clerkship, yet little is known about the quantity and diversity of the diagnoses encountered by the students. This study examines clerkship students' experience with women's health care diagnoses. METHODS: Over a 2-year period, 445 students completed 3320 patient encounter forms for patients with a women's health diagnosis, noting patient age, location of care (office, hospital, etc.), up to four presenting diagnoses, the degree to which the student was involved with selected activities (taking a history, performing a physical examination, observing only, etc.) and the degree of self-reported competence. RESULTS: Of the 78 854 diagnoses presented, 3677 (6.1%) were women's health conditions, most commonly normal pregnancy (47.5%), disorders of menstruation (8.2%), menopausal and postmenopausal disorders (7.4%), disorders of the breast (6.0%), pain in female genital organs (5.7%), and disease of the cervix, vagina and vulva (5.2%). Students reported a high level of competence in diagnosing and treating these patients. The students routinely discussed women's health cases with their preceptors. DISCUSSION: Students reported that they were 'unskilled' or 'marginally competent' with approximately 10% of the women's health patient encounters, compared with 6% for all other encounters. The clerkship provided students with the greatest opportunity to observe and discuss individual cases with a preceptor. However, students infrequently suggested a treatment or provided patient education or women's health counselling.
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Thyroid-stimulating hormone and prolactin (PRL) were measured in a group of 149 women with galactorrhea. Three of these patients were found to have primary hypothyroidism. In the remaining 146 patients, the PRL assay was correlated with the menstrual history and the results of hypocycloidal polytomography. Sixty-two per cent of these patients had hyperprolactinemia and 35 per cent had abnormal tomograms. Nine patients with abnormal x-rays had normal prolactin levels. None of the patients with normal menses and normal PRL was found to have an abnormal x-ray. Fourteen of the 15 patients with PRL levels greater than 200 ng. per milliliter had abnormal tomograms. Almost 70 per cent of patients with secondary amenorrhea and low estrogen status had abnormal x-rays. In patients with oligomenorrhea and secondary amenorrhea with normal estrogen status, it was not possible to differentiate between patients with normal or abnormal tomograms based on the level of serum PRL. Polytomography remains the single most important diagnostic test in establishing the presence of a pituitary tumor.
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