Lancet
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Comparative Study
Hypophosphataemia: A complication of "innocuous dextrose-saline".
Plasma and urinary phosphate levels were studied before and after operation in 13 patients undergoing uncomplicated major surgery. The maintenance intravenous fluid in six patients was 0.9% saline and in the other seven patients it was 4% dextrose with 0.18% saline. Although the plasma-phosphate fell in both groups, reaching minimum on the second postoperative day and then returning towards normal, it was significantly lower in the group receiving dextrose on the second, third, and fourth postoperative days when the levels were below the normal range. It is suggested that when dextrose-saline solutions are indicated in postoperative patients the addition of phosphate to the solution should be considered.
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With about 1 stillbirth occurring in every 80 deliveries, stillbirth is a common tragedy. Yet it is an event which, by common consent, is cloaked in secrecy, and which by its very nature seems unreal. ⋯ Bourne has produced statistical evidence to show that family docotrs are astonishingly reluctant to know or remember anything about the patient who has had a stillbirth. I would like to put forward some suggestions for helping doctors to overcome their reluctance to face the problem of stillbirth.