Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A difficult resection and anastomosis of the high transverse vaginal septum at puberty may result in long-term vaginal stenosis. In this report, we describe an alternative approach to the patient with a transverse vaginal septum to include the following: (1) US-directed needle aspiration with broad spectrum antibiotic prophylaxis to decompress the hematocolpos and relieve the acute pain; (2) continuous suppression of ovulation to prevent acute recurrence of the hematocolpos; and, most importantly, (3) vaginal dilatation before resection of the obstructing membrane to lengthen the lower vagina and ensure postoperative compliance with dilatation before vaginal anastomosis is attempted. Using this approach, we have obtained excellent results in three patients. Further study is necessary to validate this surgical modification.
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PMID:Preoperative dilatation to facilitate repair of the high transverse vaginal septum. 160 Nov 64

A traditional practice that has attracted considerable attention in the last decade is female circumcision, the adverse effects of which are undeniable. 70 million women are estimated to be circumcised, with serveral thousand new operations performed each day. It is a custom that continues to be widespread only in Africa north of the equator, though mild forms of female circumcision are reported from some Asian countries. In 1979 a Seminar on Traditional Practices that Affect the Health of Women and Children was held in the Sudan. It was 1 of the 1st interregional and international efforts to exchange information on female circumcision and other traditional practices, to study their implications, and to make specific recommendations on the approach to be taken by the health services. There are 3 main types of female circumcision: circumcision proper is the mildest but also the rarest form and involves the removal only of the clitoral prepuce; excision involves the amputation of the entire clitoris and all or part of the labia minora; and infibulation, also known as Pharaonic circumcision, involves the amputation of the clitoris, the whole of the labia minora, and at least the anterior 2/3 and often the whole of the medial part of the labia majora. Initial circumcision is carried out before a girl reaches puberty. The operation generally is the responsibility of the traditional midwife, who rarely uses even a local anesthetic. She is assisted by a number of women to hold the child down, and these frequently include the child's own relatives. Most of the adverse health consequences are associated with Pharaonic circumcision. Hemorrhage and shock from the acute pain are immediate dangers of the operation, and, because it is usually performed in unhygienic circumstances, the risks of infection and tetanus are considerable. Retention of urine is common. Cases have been reported in which infibulated unmarried girls have developed swollen bellies, owing to obstruction of the menstrual flow. Implantion dermoid cysts are a very common complication. Infections of the vagina, urinary tract, and pelvis occur often. A women who has been infibulated suffers great difficulty and pain during sexual intercourse, which can be excruciating if a neuroma has formed at the point of section of the dorsal nerve of the clitoris. Consummation of marriage often necessitates the opening up of the scar. During childbirth infibulation causes a variety of serious problems includind prolonged labor and obstructed delivery, with increased risk of fetal brain damage and fetal loss. A variety of reasons are advanced by its adherents for continuing to support the practice of female circumcision, but the reasons are rationalizations, and none of the reasons bear close scrutiny. The campaing against female circumcision is reviewed.
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PMID:A traditional practice that threatens health--female circumcision. 373 35

This case report involves an adolescent primigravida at term who was admitted with urinary complaints to the labor and delivery unit of a medical center. Within an hour, she suddenly began screaming and complaining of severe pain running from her anterior pelvis through her vagina and up her spine. Three days of very challenging co-management of the patient, with several recurrences of acute pain, followed. Differential diagnoses that could explain this patient's symptoms are reviewed and discussed. Difficult management issues, including the stress of clinical management in the face of unidentified disease processes, are addressed. Lacking a certain diagnosis even retrospectively, the authors request comments from readers.
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PMID:Abrupt onset of severe pain at term. A case report. 903 34