Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Audit on cardiotocographs(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Padumadasa, G.S.; Amarasena, J.M.T.; Ratnatilake, R.M.K.R.M.; Wijesinghe, P.S.METHOD: One hundred cardiotocographs taken in women who presented between 01 April 2005 and 22 April 2005 were analyzed. In those who had more than'one cardiotocograph (CTG), the first one was analyzed. Documentation about name, B.H.T No., date and time of CTG, time of seeing the CTG, whether reactive or not, action taken, signature and designation were assessed. Ninety percent was considered the target. RESULTS: The mean age of the subjects was 27.2 years ( SD 3.1 ). The period of gestation ranged from 29 to 41 weeks with a median of 38.7 weeks. Fifty six subjects had only one CTG while 19 had two CTGs and 25 had three or more CTGs. There was a median delay of 1.3 hours ( range 0.1 to 6 hours) in taking the CTGs. Eighty seven CTGs had the name documented while only 66 had the B.H.T. No. documented. The date was documented in 95 CTGs, but the time was documented only in 76. Time of seeing the CTG was documented only in 72. Eighty one CTGs had documentation on whether it was reactive or not. However, only 11 gave any details on the action taken. The signature was found in 84 CTGs, but only 78 had the designation of the person documented. CONCLUSION: The results were discussed at an audit meeting. It was concluded that documentation on CTGs was poor. The importance of proper documentation on CTGs was stressed to the team members. A re-audit is planned in three months to assess any improvement.Item Audit on management of past section(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Padumadasa, G.S.; Ratnatilake, R.M.K.R.M.; Amarasena, J.M.T.; Wijesinghe, P.S.OBJECTIVE: To audit management of women with one past section. DESIGN AND SETTING: A retrospective audit at the University Obstetric Unit, North Colombo Teaching Hospital. Method: Twenty five records of women with one past section awaiting delivery, who presented between 01 April 2005 and 22 May 2005 were analyzed. "Whether the placental site was checked, estimated fetal weight assessed and pelvic assessment done was assessed. Ninety percent was considered the target, Results: The mean age of the women was 33.1 years (SD 2.6). The mean period of gestation was 37.6 weeks (SD 0.7) and the mean height of the women was 152.4cm (SD 2.7). In eight women a decision was taken to subj ect them to a trial of scar and in 11, it was decided to perform an elective caesarean section. Six women underwent emergency caesarean section on admission. The placental site was checked in 13 (52 %), estimated fetal weight assessed in 12 (48 %) and pelvic assessment done in four (16 %) women. Out of the eight women who were awaiting a trial of scar, seven (87 %) had the placental site checked and seven (87 %) had the estimated fetal weight assessed. However only four (50 %) had a pelvic assessment performed. CONCLUSION: The results were discussed at an audit meeting. It was concluded that assessment in women with one past section awaiting delivery was not adequate. The importance of proper assessment was stressed to the team members. A re-audit is planned in three months to assess any improvement.Item Semen ph in infertile males and its association with semen parameters(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Dissanayake, D.M.A.B.; Palihawadana, T.S.; Amarasena, J.M.T.; Fernando, W.S.INTRODUCTION: Assessment of pH of the ejaculate is part of the basic seminal fluid analysis. The WHO defines the reference range for seminal fluid pH to be 7.2 or more. In practise we have observed that the pH is commonly in the alkaline range in patients with normal as well as abnormal seminal parameters. Furthermore, there are many others who question the reference range defined by the WHO, and claim it to be too low. Objective: To define the range of pH in seminal fluid in a infertile male population and to assess the association it shows to seminal fluid parameters. METHOD: Seminal fluid analysis including pH assessment was done on 168 males who sought infertility treatment at the university infertility clinic, at teaching hospital, Ragama. The pH was assessed within 30 minutes from collecting the sample using a pH meter. The seminal fluid analysis was done according to the WHO criteria. Log inversion of pH was done prior to calculation ofmeans. Results: The mean (±SD) pH of the sample population was 7.70 (±0.25) with a minimum of 6.78 and a maximum of 8.52. Only five patients (3%) had a pH less than 7.2. The distribution of the pH showed a 5" percentile value of 7.37 and a 95 'percentile of8.21.Thirty four percent (n=57) of subjects had a normal Seminal fluid analysis with regard to volume, concentration, motility and viability. Mean pH value showed a significant difference between the groups with a normal vs. abnormal volume of ejaculate, 7.75 vs. 7.59, P<0.05. Similar differences were not seen with any other semen parameter. Conclusion: The pH of ejaculate in this study sample is towards an alkaline range. Associations between semen pH and seminal parameters needs further study.