Biomedical subjects
Publications and source records attributed to J Parboosingh.
Decreased fetal heart rate variability was noted 90 seconds after the induction of general anesthesia with sodium thiopentone and fentanyl in a patient undergoing basket extraction of a renal calculus at 30 weeks' gestation. The fetal sleep pattern lasted for 105 minutes after the anesthetic was discontinued, 45 minutes after the mother was fully awake.
Answers are required by family physicians to numerous questions during a day of patient care. This study examined the number of questions that arose during one day to which family physicians did not have an answer, the library resources to which the family physicians had access and used, and the relationship between the number of questions that arose in practice and library resources or use. Volunteer family physicians (N = 87) reported a mean of 6.8 questions. When accessing libraries, physicians relied primarily on their office and home libraries. Personal libraries had fewer than ten textbooks published since 1980 and subscriptions to fewer than five journals. T-test analysis indicated that the physician with the most questions practiced in the medical school community, was a graduate of a Canadian or United States medical school, and attended a course on problem raising and solving. The number of questions did not differ by the holdings in the physician's library, the age or sex profile of the patients, the number of patients seen or the frequency with which the physician used his personal library. Medical educators and librarians should provide educational opportunities to assist family physicians develop their personal libraries, their problem solving skills and their use of modern technology to access the literature.
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Cord plasma vasopressin concentration, determined by radioimmunoassay, was higher in arterial than in venous blood in 122 (84%) infants; the highest vasopressin values were recorded in 21 acidotic infants (mean cord pH, 7.13) delivered per vaginam and the lowest values in 50 infants delivered by cesarean section. Cord vasopressin levels were not elevated in infants delivered by cesarean section because of obstructed labor. There was a lack of correlation between vasopressin levels and the length of labor or cervical dilatation; a significant correlation was found between cord arterial vasopressin values and pH. Low vasopressin values were recorded in a group of 22 healthy infants (mean cord pH, 7.29) delivered by low forceps operation.
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Simulated patients have been used to foster active learning and problem solving skills in an undergraduate programme of reproductive medicine. These simulators were trained to present a series of clinical problems and were used in a variety of approaches. They served to highlight communication skills and to force attention on the recognition, assessment and management of patient problems.
Androstenedione, testosterone, progesterone and human chorionic gonadotrophin (HCG) in plasma and total oestrogens, luteinizing hormone (LH) and HCG in urine were measured in five women during conceptual cycles and in early pregnancy. There were increased levels in plasma and urine of all the hormones measured between 12 to 48 days after ovulation except progesterone. The concentration of this hormone in plasma decreased during this time. The possible sources of these hormones in early pregnancy are discussed.
Compared with a group of normal pregnant women, matched for age, parity, posture, and length of gestation, women with hypertension and proteinuria in the last trimester had significantly lower plasma concentrations of renin, renin substrate and angiotensin II. Plasma aldosterone and DOC concentrations were also lower in the hypertensive group. The plasma levels of cortisol, corticosterone, and ADH showed no significant difference. Plasma renin concentration was raised throughout normal pregnancy, and part of this increase appeared to be due to the presence of an inactive form of renin. Plasma concentrations of renin substrate, angiotensin II, and aldosterone were also raised in normal pregnant women, but concurrent measurement of these substances showed no significant relationship between them, renin, and plasma electrolytes in mid- or late gestation. A study of five women in the weeks immediately after conception showed increases in plasma angiotensin II and aldosterone concentrations, which were significantly related at this very early stage of pregnancy. Total 24-hour urinary sodium increased gradually from about two weeks after gestation to the end of the study five weeks later. This increase was due mainly to a rise in overnight sodium excretion, with a fall in the day/night ratio. No relationship was found between plasma angiotension II or aldosterone concentrations and day, night, or total 24 hour sodium excretion.
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