1、Local anesthesia numbs the vagina and the tissues around its opening. Commonly, this area is numbed by injecting a local anesthetic through the wall of the vagina into the area around the nerve. This procedure, called a pudendal block, is used only late in the second stage of labor, when the baby's head is about to emerge from the vagina. Another common but less effective procedure involves injecting a local anesthetic at the opening of the vagina. With both procedures, the woman can remain awake and push, and the fetus's functions are unaffected. These procedures are useful for deliveries that have no complications.
2、An estimated 10 t0 20 percent of adult Americans have varicose veins. While the cause of varicose veins is not known, a number of contributing risk factors have been identified, including heredity, female gender, age,obesity, pregnancy ( especially multiple pregnancies) and occupations that require prolonged periods of standing or sitting.
3、Peptic ulcers are very common causes of morbidity but rarely cause death of the patient. As many as one fourth of men and one sixth of women develop a peptic ulcer sometime during life,as judged by typical scars at cutopsy,but far fewer(5 to 10 per cent)develop symptomatic ulcers during life. Furthermore,the incidence of duodenal ulcer seems to be declining in the United States. Duodenal ulcers are more frequent than gastric ulcers; men have a higher incidence of duodenal ulcers but the same incidence of gastric ulcers when compared to women.
4、The differential white cell count and the total leukocyte count usually are abnormal in appendicitis, but the degree of abnormality does not correlate with degree of abnormality in the appendix. Up to one third of patients, particularly older adults and blacks, will have a normal total leukocyte count in the presence of acute appendicitis. Most patients, however, will have a shift to the left in the differential white count, even when the total count is normal. Less than four per cent of patients with acute appendicitis have both a normal differential count and a normal total white count. In cases of suspected appendicitis, whenever the clinical findings are at variance with the white cell count, clinical findings should take precedence.