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W C Leung

Publications and source records attributed to W C Leung.

At least 19 recordsLinked to original sources
PubMed2003

Unexpected reduction in the incidence of birth trauma and birth asphyxia related to instrumental deliveries during the study period: was this the Hawthorne effect?

OBJECTIVE: The study was originally designed to identify the risk factors that could predict those difficult instrumental deliveries resulting in birth trauma and birth asphyxia. DESIGN: A prospective study on all singleton deliveries in cephalic presentation with an attempt of instrumental delivery over a 12-month period (13 March 2000 to 12 March 2001). SETTING: A local teaching hospital. SAMPLE: Six hundred and seventy deliveries. METHODS: A codesheet was designed to record the demographic data, characteristics of first and second stages of labour and neonatal outcome. In particular, the doctor had to enter the pelvic examination findings before the attempt of instrumental delivery. MAIN OUTCOME MEASURES: Birth trauma and birth asphyxia. RESULTS: There was a significant reduction in the incidence of birth trauma and birth asphyxia related to instrumental deliveries during the study period (0.6%) when compared with that (2.8%) in the pre-study period (1998 and 1999) (RR 0.27, 95% CI 0.11-0.70). There was more trial of instrumental deliveries in the operating theatre although this was not statistically significant (RR 1.19, 95% CI 0.88-1.60). The instrumental delivery rate decreased during the study period (RR 0.88, 95% CI 0.82-0.94). The caesarean section rate for no progress of labour, the incidence of direct second stage caesarean section and the incidence of failed instrumental delivery did not increase during the study period. CONCLUSIONS: Apart from the merits of regular audit exercise and increasing experience of the staff, the Hawthorne effect might be the major contributing factor in the reduction of birth trauma and birth asphyxia related to instrumental deliveries during the study period.

Asphyxia Neonatorum↗
PubMed2002

A comparison of the prevalence of domestic violence between patients seeking termination of pregnancy and other general gynecology patients.

OBJECTIVES: (1) To determine and compare the prevalence of domestic violence among abortion-seeking patients with other general gynecology patients; (2) to see if a follow-up interview 6 weeks after abortion can improve the abuse disclosure rate; (3) to see if the abused victims accept direct referral to their gynecologists/social workers for help. METHODS: This is a prospective questionnaire survey in a university teaching hospital on patients seeking abortion and an approximately equal number of other general gynecology patients. Participants were interviewed by a designated project nurse in a private setting, using a structured questionnaire (Modified Abuse Assessment Screen Questionnaire) to assess the past and recent history of abuse. The interview was repeated 6 weeks after the abortion for the abortion-seeking group. RESULTS: Five hundred and one participants were interviewed, including 245 seeking abortion (TOP group) and 256 other general gynecology patients (non-TOP group). The lifetime prevalence of abuse in the TOP group (27.3%) was significantly higher than the non-TOP group (8.2%) (P<0.001). Repeating the interview 6 weeks after the abortion did not increase the disclosure rate. Most abused victims were unwilling to disclose their information of abuse to their gynecologists or social workers at the time of interview. CONCLUSIONS: Domestic violence is a significant problem among the gynecology patients, particularly those seeking abortion. A single interview prior to abortion is adequately effective for screening. However, the most effective and acceptable way of helping these victims needs to be explored further.

Abortion, Induced↗
PubMed2002

Domestic violence and postnatal depression in a Chinese community.

OBJECTIVES: To study the relationship between domestic violence and postnatal blues/depression in a Chinese community. METHODS: This was a prospective cohort study on 838 women after delivery in a local university teaching hospital. Between October, 2000 and February, 2001, all Chinese speaking women after delivery were invited to be interviewed by a designated research nurse using the Abuse Assessment Screen (AAS) to detect the incidence of domestic violence, the nature of violence and the perpetrator of abuse. Demographic data, pregnancy outcome, Stein's Daily Scoring System (SDSS) scores on day 2 or 3 postdelivery, Edinburgh Postnatal Depression Scale (EPDS) scores on day 2 or 3 postdelivery, 1-2 days after discharge from hospital and at 6 weeks postdelivery were compared between the abused and non-abused groups using Student's t-test, chi(2)-test and Fisher's exact test as appropriate. RESULTS: A total of 139 women (16.6%) had been abused in the last year (the abused group). Of these, 87 (10.4%) had been abused during the current pregnancy. The nature of abuse was mainly verbal. Fourteen women (1.7%) had been sexually abused in the last year. The husband/boyfriend, mother-in-law and employer/colleague were the most common perpetrators of abuse. Socio-demographic factors did not differ between the two groups except that pregnancy was more likely to be unplanned in the abused group (P=0.002). The pregnancy outcome did not differ. However, the abused group had significantly higher SDSS and EPDS scores at all stages of screening (P=0.003, P=0.000, P=0.010 and P=0.001, respectively). CONCLUSION: The findings supported our hypothesis that the effect of domestic violence on Chinese pregnant women is mainly on their psychological well-being.

Adult↗
PubMed2002

Serial sonographic findings of four fetuses with homozygous alpha-thalassemia-1 from 21 weeks onwards.

OBJECTIVES: To evaluate the potential usefulness of noninvasive ultrasound assessment of fetal anemia in the diagnosis and management of fetuses with homozygous alpha-thalassemia-1. METHODS: We describe four pregnancies complicated by fetal homozygous alpha-thalassemia-1. They presented with ultrasound abnormalities before the development of hydrops. As part of evaluating the fetal condition, we performed ultrasound and Doppler studies aimed at identifying fetal anemia. These studies included evaluation of intrahepatic umbilical venous maximum flow velocity, middle cerebral artery peak flow velocity, fetal liver length and spleen perimeter. RESULTS: In all four fetuses, ultrasound and Doppler studies suggested the presence of fetal anemia. Homozygous alpha-thalassemia-1 was diagnosed in all cases, with fetal blood sampling confirming anemia in three fetuses. The majority of the intrahepatic umbilical venous maximum flow velocity and middle cerebral artery peak flow velocity measurements were above the 95th centile. Two fetuses underwent intrauterine transfusion and fetal blood flow velocities returned to normal after correction of the fetal anemia. The fetal liver length and spleen perimeter measurements showed a similar trend, although they were less consistent before 28 weeks. CONCLUSION: Non-invasive ultrasound parameters, in particular quantification of intrahepatic umbilical venous maximum flow velocity and middle cerebral artery peak flow velocity, were found to be useful in the diagnosis and management of fetal anemia in pregnancies with fetal homozygous alpha-thalassemia-1.

Cerebral Arteries↗
PubMed2002

Consent to treatment in the A&E department.

Compared to other areas in nursing, nurses working in A&E Departments encounter a wide range of difficult and specific issues relating to consent to treatment, whether they are acting independently as nurse practitioners or carrying out the treatment prescribed by doctors. The law of consent must be taken into account in our daily practice to avoid a claim of battery or negligence from our patients. Emergency treatment can be given under the doctrine of necessity if an adult patient lacks capacity to give consent, but treatment cannot be imposed on competent adults who refuse it. Assessment of capacity may be difficult. Patients with mental disorders can pose specific consent difficulties, depending on whether the proposed treatment is directly related to the mental disorder. Problems may also arise from adult patients who refuse treatment due to undue influence from others. Obtaining consent to treatment for children depends on their age, maturity and understanding. Specific difficulties may arise if the child's wishes conflict with those with parental consent, or when those with parental responsibility unreasonably refuse to give consent.

Adolescent↗
PubMed2001

Term breech trial.

Explore the source record for details and available documents.

Breech Presentation↗
PubMed2001

Changes in fetal heart rate pattern after intrauterine paracentesis in one twin with meconium peritonitis.

We report a case of in utero paracentesis of ascites in a fetus with meconium peritonitis due to volvulus at 34 weeks which resulted in the correction of an abnormal fetal heart rate pattern and enabled vaginal delivery by preventing abdominal dystocia. The intrauterine intervention also helped to establish the diagnosis and potentially reduced the respiratory compromise after birth.

Adult↗
PubMed2001

Identification of BARD1 as mediator between proapoptotic stress and p53-dependent apoptosis.

The BRCA1-associated protein BARD1 is a putative tumor suppressor. We suggest that BARD1 is a mediator of apoptosis since (1) cell death in vivo (ischemic stroke) and in vitro is accompanied by increased levels of BARD1 protein and mRNA; (2) overexpression of BARD1 induces cell death with all features of apoptosis; and (3) BARD1-repressed cells are defective for the apoptotic response to genotoxic stress. The proapoptotic activity of BARD1 involves binding to and elevations of p53. BRCA1 is not required for but partially counteracts apoptosis induction by BARD1. A tumor-associated mutation Q564H of BARD1 is defective in apoptosis induction, thus suggesting a role of BARD1 in tumor suppression by mediating the signaling from proapoptotic stress toward induction of apoptosis.

Animals↗
PubMed2001

The new Mental Health Act: a guide for clinicians.

The White Paper proposals for a new Mental Health Act have recently been published. This article examines the controversial changes in this proposal and their implications for doctors.

Commitment of Persons with Psychiatric Disorders↗
PubMed2001

Biosorption of heavy metals by bacteria isolated from activated sludge.

Twelve aerobic bacteria from activated sludge were isolated and identified. These included both Gram-positive (e.g., Bacillus) and Gram-negative (e.g., Pseudomonas) bacteria. The biosorption capacity of these strains for three different heavy metals (copper, nickel, and lead) was determined at pH 5.0 and initial metal concentration of 100 mg/L. Among these 12 isolates, Pseudomonas pseudoalcaligenes was selected for further investigation owing to its high metal biosorption capacity. The lead and copper biosorption of this strain followed the Langmuir isotherm model quite well with maximum biosorption capacity (q(max)) reaching 271.7mg of Pb2+/g of dry cell and 46.8 mg of Cu2+/g of dry cell at pH 5.0. Study of the effect of pH on lead and copper removal indicated that the metal biosorption increased with increasing pH from 2.0 to 7.0. A mutual inhibitory effect was observed in the lead-copper system because the presence of either ion affected the sorption capacity of the other. Unequal inhibitions were observed in all the nickel binary systems. The increasing order of affinity of the three metals toward P. pseudoalcaligenes was Ni < Cu < Pb. The metal biosorptive potential of these isolates, especially P. pseudoalcaligenes, may have possible applications in the removal and recovery of metals from industrial effluents.

Adsorption↗
PubMed2001

Isolated foetal ascites.

The prenatal diagnosis and perinatal outcome of two patients with isolated foetal ascites compatible with chyloperitoneum is described. The foetal ascites resolved spontaneously after delivery with good perinatal outcome in both cases. A good prognosis can be anticipated in such cases. Antepartum and intrapartum interventions are seldom necessary.

Adult↗