Tropical doctor
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Randomized Controlled Trial Clinical Trial
A randomized trial of pain relief in termination of pregnancy in South Africa.
The aim of this prospective trial was to evaluate and compare paracervical block with diclofenac for pain relief during manual vacuum aspiration (MVA) for surgical termination of pregnancy. Participants were randomized into three groups, viz. group (i) diclofenac 75 mg intramuscularly (i.m.) 30 min before the procedure; (ii) diclofenac 75 mg i.m. 30 min before the procedure, together with local infiltration of the cervix with lignocaine 1% (10 mL); (iii) diclofenac 75 mg i.m. 30 min before the procedure together with local infiltration of the cervix with lignocaine 1% (10 mL) and paracervical block with lignocaine 1% (5 mL). ⋯ Post procedure analysis of pain score also showed significant difference between group (i) on one hand, and groups (ii) and (iii) (P < 0.001), but no significant difference between groups (ii) and (iii)(P = 0.029). The local anaesthetic infiltration of the cervix in combination with diclofenac or together with diclofenac and paracervical block provides better pain relief during and after the MVA.
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Randomized Controlled Trial Clinical Trial
Efficacy of garlic paste in oral candidiasis.
In a randomized trial of 56 patients, topical application of garlic paste for 14 days was found to be as effective as that of clotrimazole solution in suppressing clinical signs of oral candidiasis. The results of this preliminary study explore the possible role of garlic paste in the treatment of oral candidiasis.
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Data were collected from hospital records on all patients who received non-invasive ventilation (NIV) during the period 1999-2000. Patients were treated with NIV if they had type I or type II respiratory failure or if they had respiratory distress with a respiratory rate above 30/min. A total of 68 patients (35 males) were studied. ⋯ A successful outcome with NIV was achieved in 70% (26/37) of patients with type II failure, 65% (11/17) patients with type I failure and 64% (9/14) patients with respiratory distress. Of the 16 patients considered to be inappropriate for invasive ventilation on admission, eight were treated successfully with NIV. NIV can be applied successfully in developing countries.
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Streptococcus pneumoniae is the most important bacterial cause of pneumonia and meningitis among adults world wide. It is a particularly common cause of these infections and also bacteraemia among HIV infected adults with rates of disease increasing to more than 100 times the normal as HIV infection progresses to AIDS. ⋯ Factors underlying susceptibility to pneumococcal infection in HIV infected adults are then reviewed, along with the effectiveness of current vaccines. Finally, novel approaches that will be needed to combat PD in HIV afflicted parts of the world are suggested.