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1 Kislev 5763 - November 6, 2002 | Mordecai Plaut, director Published Weekly
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Home and Family

Understanding the learning processes, applying it to reading comprehension in general

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

I was able to speak to another ENT on the subject of olive oil in the ears, and Dr. Tal, an English-speaking ENT at Tel HaShomer, is a big believer in it for prevention of wax buildup. It seems to perform as well as wax in lubricating the ear canal and controlling the overgrowth of the normal bacteria that grow there. Two points need to be made: it won't dissolve the wax that clogs up an ear, and furthermore, it isn't clear to me how it prevents buildup just because it serves the same purpose. We'll continue researching this subject and be in touch.

Pregnancy emergencies is our subject, and we discussed trauma. One of the complications of seemingly minor trauma is the problem called abruptio, where the placenta tears off the uterine lining. This could cause bleeding, fetal demise or clotting problems in the mother due to the release of factors that use up the clotting materials. This last problem is known as DIC and can be quite difficult to handle. Also it should be made clear that this tear can be in the upper part where the bleeding will not be noticed. The test of choice remains monitoring with a fetal monitor. Abruptio is usually a problem only in the third trimester.

Despite this problem, seat belts are still imperative in pregnancy and they save lives. The seat belt is fastened underneath the abdomen.

While bleeding from abruptio is not the only cause of bleeding in pregnancy, it is a reason to be careful about Rh problems. Bleeding in pregnancy can come from trauma, miscarriage, placenta previa (we'll discuss this), or because of rotation of the fetus. If the mother has a blood type that is called Rh negative-- meaning that she does not have specific material in her blood type--and the baby does have it (the baby can get it from the father), then the mother's blood may recognize the Rh factor as a foreign invader and attack all blood cells with this type. What would result is that the baby's blood cells are attacked and destroyed.

To prevent this, if any bleeding is noted and the mother is known to be Rh negative, Rhogam is given. This medication acts to "hide" the Rh type from the mother and prevent it from being recognized as an invader. Establishing your Rh status is just one of many reasons why prenatal care is essential.

This will be the recurrent theme in this article. Poor or no prenatal care causes more problems for the doctor and could result in disaster. Write me in care of the Yated.

A message from Glaxo, sponsor of this column. Parkinson's disease can be a tough management problem. Finding the right treatment needs to be individualized. Requip is Glaxo's contribution to the field and results have been very encouraging both in effectiveness and side effect profile. Requip should be considered for use for those suffering from this disease.

 

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