What's New?

Are IUCDs appropriate for adolescents and women who have never been pregnant?

26th September 2008

There are only a few studies on the use of IUDs in adolescents. IUDs are a safe and effective long-term contraceptive method. IUDs are underutilized in the United States, especially by adolescents. Because adolescents contribute disproportionately to the epidemic of unintended pregnancy, IUDs should be considered as a first-line contraceptive choice regardless of parity.⁰⁸⁰¹

The levonorgestrel-releasing intrauterine system (Mirena -LNG IUS) is a particularly good choice for adolescents because of associated non-contraceptive benefits such as decreased menstrual bleeding, dysmenorrhea and pain associated with endometriosis. There is a clear need for further studies in the use of the IUD among adolescents.

Infertility Investigation - Tubal Factor - Hysterosalpingograms - Pain Relief

24th September 2008

Hysterosalpingograms are commonly performed to ensure that the woman's fallopian tubes are not blocked. One concern with hysterosalpingograms, is that some patients find them painful. In one study,⁰⁸⁰¹ the efficacy of oral naproxen with intrauterine instillation of 1% lignocaine was compared for pain relief. Intrauterine lignocaine was no more effective than a single oral dose of 375 mg of naproxen 1 hour prior to HSG. It seems appropriate to administer an oral analgesic about an hour before outpatient procedures, such as hysterosalpingograms to reduce pain.

Vaccination To Prevent Cancer of the Cervix

19th September 2008

Cancer of the cervix has been a potential danger for many sexually active women. Cervical screening and treatment of pre-malignant conditions of the cervix have resulted in less cervical cancer and less cervical cancer deaths. The cause has been shown to be certain strains of the HPV virus and we now have effective vaccinations for those who have never been exposed to the virus - particularly adolescents.  The recent literature on adolescent knowledge about HPV and attitudes about HPV vaccines supports the importance of designing developmentally appropriate educational materials for adolescents about HPV and HPV vaccines, and provides guidance for the development of key educational messages.⁰⁸⁰¹

Management of unexplained infertility.

10th August 2008

A randomised controlled trial has disappointingly found that empirical clomiphene and unstimulated intrauterine insemination are unlikely to offer superior live birth rates compared with expectant management.⁰⁸⁰³

A Genetic Predisposition to Obesity

28th July 2008

The FTO gene has consistently been associated with obesity across multiple populations. However, to date it was not known whether the association between genetic variation in FTO and obesity is mediated through effects on energy intake or energy expenditure. Wardle's group have recently demonstrated (July 2008) that the commonest known FTO obesity-risk gene is likely to exert at least some of its effects by influencing appetite. Those with this obesity-risk gene do not have their appetite satiated easily so that they have a genetic tendency which tends to make them eat more. ⁰⁸⁰²

Medical Treatment of Stress Urinary Incontinence

22nd July 2008

The efficacy of venlafaxine started early and the clinical efficacy associated with the use of the drug continued in the following months. Venlafaxine should be considered a clinically efficient alternative drug in the treatment of stress urinary incontinence.⁰⁸⁰¹

Preventing Spina Bifida

18th July 2008

A study from China suggests that multivitamin supplement containing folic acid taken from a time point of 2 months before conception and continuing until completion of the second month after conception and taken more than five times per week can significantly reduce the risks of NTDs.⁰⁸⁰¹