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Biomedical subjects

S G Ralph

Publications and source records attributed to S G Ralph.

5 recordsLinked to original sources
PubMed2001

Over-the-counter advice for genital problems: the role of the community pharmacist.

This year, in the UK, levonorgestrel was approved for sale in pharmacies for emergency contraception. This study assessed, using a postal questionnaire, the ability of community pharmacists to provide advice relating to sexual health, their comfort and training in this area, and their knowledge of local genitourinary medicine (GUM) services. Fifty-four per cent of pharmacists responded. Most (79%) did not know where their nearest GUM department was; only 21% had ever advised a patient to attend a GUM clinic. Twenty-nine per cent said they were not able to broach the possibility of a sexually transmitted infection (STI) with a patient of both sexes. Forty-four per cent had received training related to post-coital contraception. Greater liaison between GUM departments and community pharmacists is suggested as a way of increasing the proportion of patients presenting to a pharmacist who are referred appropriately to a GUM clinic.

Attitude of Health Personnel↗
PubMed1999

Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study.

OBJECTIVES: To assess whether bacterial vaginosis affects the rates of conception and miscarriage in the first trimester. DESIGN: Cohort study. SETTING: Assisted conception unit of a teaching hospital in Leeds. PARTICIPANTS: 867 consecutive women undergoing in vitro fertilisation. INTERVENTIONS: Screening for bacterial vaginosis with a Gram stained vaginal smear before egg collection. MAIN OUTCOME MEASURES: The presence of bacterial vaginosis or normal vaginal flora, and the rate of conception and miscarriage in the first trimester. RESULTS: 190 of 771 (24.6%) women had bacterial vaginosis. No difference in conception rate was found between those women with bacterial vaginosis and those with normal vaginal flora: 61 women (32.1%) and 146 of 493 women (29.6%) respectively (relative risk 1. 08, 95% confidence interval 0.85 to 1.39; odds ratio 1.12, 0.77 to 1. 64). However, 22 women (31.6%) with bacterial vaginosis who conceived had a significantly increased risk of miscarriage in the first trimester compared with 27 women (18.5%) with normal vaginal flora (crude relative risk 1.95, 1.11 to 3.42; crude odds ratio 2.49, 1.21 to 5.12). This increased risk remained significant after adjustment for factors known to increase the rate of miscarriage: increasing maternal age, smoking, history of three or more miscarriages, no previous live birth, and polycystic ovaries (adjusted relative risk 2.03, 1.09 to 3.78; adjusted odds ratio 2.67, 1.26 to 5.63). CONCLUSIONS: Bacterial vaginosis does not affect conception but is associated with an increased risk of miscarriage in the first trimester in women undergoing in vitro fertilisation, independent of other risk factors.

Abortion, Spontaneous↗
PubMed1999

The normal range for inter-arm differences in blood pressure.

OBJECTIVE: to establish the mean and normal range for the difference in simultaneous systolic and diastolic blood pressure measurements between the right and left arm. SUBJECTS: 462 subjects, age range 20-89 years, in sinus rhythm and with no history of stroke, 98 of whom had a history of cardiovascular disease or were taking vasoactive medication. METHODS: four simultaneous recordings of blood pressure in both arms were made using two automated sphygmomanometers with the subject supine after resting for 10 min. RESULTS: inter-arm systolic and diastolic blood pressure differences show a near normal distribution of values. Some individuals had clinically important differences in systolic and diastolic blood pressure between their arms. The magnitude of these differences was not related to the mean baseline blood pressure. Linear regression analysis did not demonstrate any significant relationship between inter-arm systolic or diastolic blood pressure difference and age in patients of either sex. For systolic blood pressure the mean difference between the right and left arm was 1.1 mmHg and the normal range was -9 mmHg to 11 mmHg. For diastolic blood pressure the mean difference was 0 mmHg and the normal range -10 mmHg to 10 mmHg. CONCLUSION: the frequency of significant inter-arm systolic and diastolic blood pressure differences suggests that the blood pressure should be taken in both arms at the initial consultation. At subsequent visits, the arm in which measurements are taken should be recorded in the case notes. The higher of the two readings should be used to guide further management decisions.

Adult↗