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Search Results: 1 - 10 of 4701 matches for " Wong HS "
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Pregnancy complicated by morbidly adherent placenta in a patient with bilateral ovarian agenesis: a case report
Wong HS
International Journal of Women's Health , 2013, DOI: http://dx.doi.org/10.2147/IJWH.S37380
Abstract: egnancy complicated by morbidly adherent placenta in a patient with bilateral ovarian agenesis: a case report Case report (500) Total Article Views Authors: Wong HS Published Date February 2013 Volume 2013:5 Pages 53 - 55 DOI: http://dx.doi.org/10.2147/IJWH.S37380 Received: 27 August 2012 Accepted: 25 September 2012 Published: 05 February 2013 Hong Soo Wong Australian Women's Ultrasound Centre, Brisbane, Australia Abstract: The author presents a case of in vitro fertilization pregnancy complicated by morbidly adherent placenta in a patient with congenital bilateral ovarian agenesis. A 31-year-old woman with congenital bilateral ovarian agenesis who had undergone two previous dilatation and curettage procedures conceived following in vitro fertilization with a donor egg. Spontaneous labor occurred at 38 weeks and 5 days' gestation. The labor was augmented in the active phase and resulted in instrumental vaginal delivery. The third stage was complicated by hemorrhage and retained placenta. Morbidly adherent placenta was diagnosed on attempt at manual removal of the placenta, and the adherent part of the placenta was left in situ. This was removed uneventfully at 5 weeks following childbirth when there was no blood flow observed between the placenta and the myometrium on Doppler ultrasound examination. In conclusion, successful parturition is possible in patients with congenital bilateral ovarian agenesis. When morbidly adherent placenta is managed conservatively, the placenta may be safely removed if there is no vascularity between the placenta and the myometrium.
Pregnancy complicated by morbidly adherent placenta in a patient with bilateral ovarian agenesis: a case report
Wong HS
International Journal of Women's Health , 2013,
Abstract: Hong Soo WongAustralian Women's Ultrasound Centre, Brisbane, AustraliaAbstract: The author presents a case of in vitro fertilization pregnancy complicated by morbidly adherent placenta in a patient with congenital bilateral ovarian agenesis. A 31-year-old woman with congenital bilateral ovarian agenesis who had undergone two previous dilatation and curettage procedures conceived following in vitro fertilization with a donor egg. Spontaneous labor occurred at 38 weeks and 5 days' gestation. The labor was augmented in the active phase and resulted in instrumental vaginal delivery. The third stage was complicated by hemorrhage and retained placenta. Morbidly adherent placenta was diagnosed on attempt at manual removal of the placenta, and the adherent part of the placenta was left in situ. This was removed uneventfully at 5 weeks following childbirth when there was no blood flow observed between the placenta and the myometrium on Doppler ultrasound examination. In conclusion, successful parturition is possible in patients with congenital bilateral ovarian agenesis. When morbidly adherent placenta is managed conservatively, the placenta may be safely removed if there is no vascularity between the placenta and the myometrium.Keywords: IVF, placenta accreta, parturition, myometrium
Patient self-management and pharmacist-led patient self-management in Hong Kong: A focus group study from different healthcare professionals' perspectives
Fiona YY Wong, Frank WK Chan, Joyce HS You, Eliza LY Wong, EK Yeoh
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-121
Abstract: Participants were invited through the University as well as professional networks. Fifty-one participants comprised of physicians, pharmacists, TCM practitioners and dispensers participated in homogenous focus group discussions. Perspectives in patient self-management and pharmacist-led patient self-management were discussed. The discussions were audio recorded, transcribed and analysed accordingly.The majority of the participants were in support of patients with stable chronic diseases engaging in self-management. Medication compliance, monitoring of disease parameters and complications, lifestyle modification and identifying situations to seek help from health professionals were generally agreed to be covered in patient self-management. All pharmacists believed that they had extended roles in addition to drug management but the other three professionals believed that pharmacists were drug experts only and could only play an assisting role. Physicians, TCM practitioners, and dispensers were concerned that pharmacist-led patient self-management could be hindered, due to unfamiliarity with the pharmacy profession, the perception of insufficient training in disease management, and lack of trust of patients.An effective chronic disease management model should involve patients in stable condition to participate in self-management in order to prevent health deterioration and to save healthcare costs. The role of pharmacists should not be limited to drugs and should be extended in the primary healthcare system. Pharmacist-led patient self-management could be developed gradually with the support of government by enhancing pharmacists' responsibilities in health services and developing public-private partnership with community pharmacists. Developing facilitating measures to enhance the implementation of the pharmacist-led approach should also be considered, such as allowing pharmacists to access electronic health records, as well as deregulation of more prescription-only m
Information Mining from Multimedia Databases
Guan Ling,Ip Horace HS,Lewis Paul H,Wong Hau San
EURASIP Journal on Advances in Signal Processing , 2006,
Abstract:
Cytokine Profiles in Human Immunodeficiency Virus-Infected Children Treated With Highly Active Antiretroviral Therapy
Jones Brian M,Chiu Susan SS,Wong Wilfred HS,Lim Wilina WL
Journal of the International AIDS Society , 2005, DOI: 10.1186/1758-2652-7-2-71
Abstract: Context There have been few longitudinal studies of cytokine production in neonatally acquired HIV-1 infection and none in Asian or Chinese children. Objective To determine whether monitoring cytokine production could contribute to the better management of pediatric patients with HIV-1 infection. Setting Clinical Immunology Laboratory and Pediatrics Department, University Hospital, Hong Kong. Patients Ten Asian and 2 Eurasian children infected with HIV-1 by mother-to-child transmission were followed for up to 5 years while on treatment with highly active antiretroviral therapy (HAART). Main Outcome Measures Numbers of unstimulated and mitogen-activated cytokine-secreting cells (IFN-gamma, interleukin [IL]-2, IL-4, IL-6, IL-10, IL-12, and TNF-alpha) were measured by ELISPOT assay at frequent intervals, and correlations were sought with CD4+ and CD8+ cell counts and viral loads. Results Mitogen-stimulated IL-2-secreting cells were directly associated with recovery of CD4+ cells. Correlations with viral load were found for Con A-induced IFN-gamma, Con A-induced IL-4, and unstimulated IL-10, suggesting that these cytokines were either suppressed by high virus levels or that higher cytokine levels suppressed virus. IFN-gamma, IL-2-, IL-4-, and IL-12-secreting cells induced by PHA, Con A, and/or SAC tended to increase for the first 3-4 years of treatment but declined thereafter. Conclusion Alterations in cytokine profiles were not associated with adverse clinical events and there was little evidence to indicate that monitoring cytokine enzyme-linked immunospots (ELISPOTs) could contribute to pediatric patient management.
Kynurenine and serotonin pathways: A review
HS Adegbusi
Bayero Journal of Pure and Applied Sciences , 2012,
Abstract: This paper seeks to elucidate the two-key pathways involving tryptophan matabolism, namely, kynurenine and serotonin pathways. In the kynurenine pathway (KP), the discussion considers the steps of the oxidative degradation of tryptophan to yield nicotinate mononucleotide, a precursors for the biosynthesis of nicotinate nucleotides ( NAD+ and NADP+), while serotonin pathway (SP) considers the biosynthesis of serotonin from tryptophan. Two different isoforms of tryptophan hydroxylase (TPH) are involved in SP: Tryptophan hydroxylase -1 (TPH1) catalysis SP in enterochromaffin cells of the gut, while Tryptophan hydroxylase-2 (TPH2) catalysis SP in the nerve cells of the central nervous system, the brain. Emphasis is given to the relevance of pyridoxal phosphate (PLP) in KP and also identified in the pathway of KP is the liberation of alanine as a biproduct, a basis for the gluconeogenecity of tryptophan. Serotonin, a major bioactive end-product of SP is a potent neurotransmitter, vasoconstrictor, regulation of intestinal motility and a player in cognitive function. Foods that give an increased ratio of tryptophan to phenylalanine and leucine such as nuts of walnut, plantains, bananas, dates, pineapples and tomatoes are good sources of serotonin. Research suggests a diet rich in carbohydrates and low protein is also a good source. Owning to the significance of some the major bioactive end-products, intermediates and byproducts of these pathways for the well-being and happiness of human beings, more research should be carried out therein not only to unravel some of the disorders they may be associated with but to also help in the development and production of; therapeutic drugs for psychiatric and sexual disorders, and intestinal antidote.
Considerations in selecting rapid-onset opioids for the management of breakthrough pain
Smith HS
Journal of Pain Research , 2013, DOI: http://dx.doi.org/10.2147/JPR.S40745
Abstract: nsiderations in selecting rapid-onset opioids for the management of breakthrough pain Review (492) Total Article Views Authors: Smith HS Published Date March 2013 Volume 2013:6 Pages 189 - 200 DOI: http://dx.doi.org/10.2147/JPR.S40745 Received: 26 November 2012 Accepted: 17 January 2013 Published: 06 March 2013 Howard S Smith Departments of Anesthesiology, Medicine, and Physical Medicine and Rehabilitation Albany Medical College, Albany, NY, USA Abstract: Breakthrough pain (BTP) is a transitory pain that occurs despite the use of long-term, around-the-clock analgesia. It is highly prevalent in certain populations and places a significant burden on patients, their families, caregivers, and health-care systems. Despite its prevalence and impact, BTP is sometimes unrecognized and often undertreated. Various formulations of fentanyl – a rapid-onset opioid with short duration of action – are available for the management of BTP. The efficacy of formulations using transmucosal, transbuccal, sublingual, and intranasal administration routes has been demonstrated for BTP treatment in clinical trials. However, a lack of head-to-head trials evaluating their relative efficacy makes it challenging for physicians to reach informed decisions on the most efficacious intervention for individual patients. In the absence of clear data on the relative efficacy of fentanyl formulations, prescribing decisions need to be based on physician understanding and experience and product cost and availability, taking into account the individual patient's needs, the ability of the patient or caregivers to administer medication, and the patient's wishes. This review evaluates current pharmacologic methods of alleviating BTP and discusses factors that should be considered when selecting the most appropriate formulation for individual patients. With the range of fentanyl formulations available, it is now possible to successfully address BTP in the majority of patients.
Surgical approach to the cerebellopontine angle and dissection of the temporal bone: a continuing medical education course at Hacettepe University
Surucu HS
Neuroanatomy , 2004,
Abstract: When two complex structures like cerebellum and pons build up anangle, the one formed is not simple like the ones formed by twointersecting lines in geometry, but one, difficult to understand even by thepeople who see and cut it every day. To get close to a tumor here, onewill have to cut the complex temporal bone but from which direction andhow? Answering to a question like this and many difficult others in oneday was the aim of this meeting. Diverging the attention to the surgicaltechniques and anatomy, rather than the indications of surgery made thisgoal accomplished successfully.There were 30 participants, of almost equal numbers of anatomists,otolaryngologists and neurosurgeons, by coincidence. Even this was givinga good clue about how the chosen field was in the center of clinical andbasic science cooperation. The plenary session started and chaired byRuhgun Basar. The first presentation by Nuran Yener was giving everydetail of clinical anatomy of the temporal bone. Following, Sarp Saracpresented mastoidectomy and facial nerve decompression techniques withbeautiful schematic slides and real operation movies. The movies werecleverly montaged focusing on the important moments and landmarks andcropping out the intervals in between. Otherwise the movies of these longoperations can be more difficult to watch than doing the operation.After a fifteen minute coffee break, the second session started with thebeautiful presentation of Levent Sennaroglu about labyrnthectomy andtranslabyrenthal approach to the cerebellopontine angle. He describedmedial, lateral and inferior approaches which are used for different purposes.The next presentation was about anatomy of the neurovascular structures ofthe cerebellopontine angle by Beliz Tascioglu. Her presentation was mostlyby real photographs and their explanory drawings at each slide. This typeof presentation supplied extreme good orientation to the surgeons besidesteaching the complex anatomy of the region.Ibrahim Ziyal presented the middle cranial and retrosigmoid approach ofthe neurosurgeons. He also demonstrated some operational movies andgave important clues to the surgeons. The discussion became interesting byparticipation of Dr Gokhan Akdemir and his experiences from his studieswith the famous surgeon Dr Mecit Sami.At the lunch everybody was fascinated with the presentations of the morningand waiting impatiently for the practical part which would be held in theanatomy dissection laboratory. The practicals were not less successful. Theanatomy laboratory has almost turned to an operation hall or even betterwith
Considerations in selecting rapid-onset opioids for the management of breakthrough pain
Smith HS
Journal of Pain Research , 2013,
Abstract: Howard S SmithDepartments of Anesthesiology, Medicine, and Physical Medicine and Rehabilitation Albany Medical College, Albany, NY, USAAbstract: Breakthrough pain (BTP) is a transitory pain that occurs despite the use of long-term, around-the-clock analgesia. It is highly prevalent in certain populations and places a significant burden on patients, their families, caregivers, and health-care systems. Despite its prevalence and impact, BTP is sometimes unrecognized and often undertreated. Various formulations of fentanyl – a rapid-onset opioid with short duration of action – are available for the management of BTP. The efficacy of formulations using transmucosal, transbuccal, sublingual, and intranasal administration routes has been demonstrated for BTP treatment in clinical trials. However, a lack of head-to-head trials evaluating their relative efficacy makes it challenging for physicians to reach informed decisions on the most efficacious intervention for individual patients. In the absence of clear data on the relative efficacy of fentanyl formulations, prescribing decisions need to be based on physician understanding and experience and product cost and availability, taking into account the individual patient's needs, the ability of the patient or caregivers to administer medication, and the patient's wishes. This review evaluates current pharmacologic methods of alleviating BTP and discusses factors that should be considered when selecting the most appropriate formulation for individual patients. With the range of fentanyl formulations available, it is now possible to successfully address BTP in the majority of patients.Keywords: rapid-onset opioid, breakthrough pain, pain, fentanyl
Updated status of Nepal’s wetland birds
HS Baral
Banko Janakari , 2009, DOI: 10.3126/banko.v19i3.2209
Abstract: Wetland birds in Nepal comprise significant portion of avian fauna of Nepal. However, they are also highly threatened because of several factors. A thorough study on wetland bird communities is lacking which is hampering conservation of wetlands and bird communities dependent on them. Proper management of the wetland beyond the protected areas is essential to conserve wetland birds in Nepal. Key words: Wetlands, birds, threatened, management ? doi: 10.3126/banko.v19i3.2209 Banko Janakari , Special Issue February 2009, 30-35
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