Biomedical subjects
J S Samra
Publications and source records attributed to J S Samra.
Caesarean section for the birth of the second twin.
Twin pregnancies delivered after 28 weeks gestation between 1980 and 1988 were reviewed. Of 510 twin pregnancies, 184 (36%) were delivered by caesarean section. There were 22 (4.3%) combined vaginal/abdominal deliveries which comprised 12% of the 184 twin pregnancies delivered by caesarean section. Persistent transverse lie or a high breech presentation was the commonest indication for caesarean section for the second twin.
Birth in the squatting position.
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Changing trends in the cesarean section rates for stillbirths.
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Clinical characteristics of subfertile men with antisperm antibodies.
This study investigated the clinical features which could serve as markers to identify subfertile men with antisperm antibodies including age, duration of infertility, history of abdominal or perineal surgery and previous genital trauma. Of the 162 men studied, 43 had a positive test for antisperm antibodies. A significantly greater number of these patients had a history of genital trauma and appendicectomy. Whereas the aetiological role of genital trauma in spermatozoal autoimmunity is readily explicable, that of appendicectomy is not. It can only be postulated that inflammation of the appendix may sometimes affect the vas deferens or that there is some inadvertent injury to the vas deferens during appendicectomy.
Vulval intraepithelial neoplasia--management and outcome.
Forty-six patients with a primary diagnosis of vulval intraepithelial neoplasia (VIN) have been managed over a 10-year period. The prevalence of VIN has increased and the age at presentation has decreased over the last decade; 59% of our patients had histological evidence of human papillomavirus infection. Pruritus was the commonest symptom at presentation (59%). Of the 46 patients 44 were treated by laser skinning vulvectomy, local excision or simple vulvectomy. Symptomatic relief was best achieved by local excision. Clinical and definitive relapse occurred more often in the laser-treated group. The median time to relapse was 38 months in the laser-treated group and 74 months in the surgically treated group (excision and simple vulvectomy). Two patients have not been treated and their disease has not progressed. The carbon dioxide laser almost certainly has a role in conservative management and although our data possibly do not reflect its full potential they demonstrate a need for a controlled prospective study.
Parvovirus infection in pregnancy.
A case is presented of serologically proved parvovirus infection leading to intrauterine death of the hydropic fetus at 20 weeks' gestation. Although serologic studies of the population indicate that 30-50% of women are susceptible to parvovirus infection, the prevalence of parvovirus infection in pregnancy and the consequences of such an infection are not well understood. A review of reported cases in the world literature indicates a high risk to the fetus once the virus crosses the placenta.
Changes in body weight between consecutive pregnancies.
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Ectopic pregnancy after abortion.
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Neonatal morbidity: an audit with medicolegal implications.
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Obstetrics on the labour ward.
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