W Indian Med J
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To assess patient and graft survival outcomes of renal transplant recipients from the National Organ Transplant Unit, Trinidad and Tobago. ⋯ The patient and graft survival rates in this new transplant programme are acceptable. Complications which can occur in transplant recipients are common and have a significant impact on post-transplantation quality of life and survival. Thus, continuing assessment of co-morbid factors pre and post-transplantation as well as the analysis of donor and recipient factors will lead to an increase in both patient and graft survival.
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Historical Article
Decolonization of psychiatric public policy in Jamaica.
Involuntary commitment and custodialization were the principal tenets of British colonial public policy provisions for the management of the violent, disturbed mentally ill in Jamaica and the West Indies. Over the fifty years following Jamaica's political independence from Britain, a community engagement mental health programme has developed through a decolonization process that has negated involuntary certification, incarceration and custodialization, has promoted family therapy and short stay treatment in conventional primary and secondary care health facilities, and has promoted reliance on traditional and cultural therapies that have been extremely successful in the treatment of mental illness and the reduction of stigma in Jamaica. Collaborations involving The University of the West Indies, the Jamaican Ministry of Health and the Pan American Health Organization have been seminal in the development of the decolonizing of public policy initiatives, negating the effects of involuntary certification that had been imposed on the population by slavery and colonization. This collaboration also catalysed the psychiatric training of medical, nursing and mental health practitioners and the execution of community mental health policy in Jamaica.
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Randomized Controlled Trial
The role of pre-induction ketamine in the management of postoperative pain in patients undergoing elective gynaecological surgery at the University Hospital of the West Indies.
To determine if a single preoperative dose of ketamine hydrochloride reduces the narcotic analgesic requirements and/or pain scores reported by patients in the first 24 hours postoperatively. ⋯ Despite no significant reduction in postoperative narcotic requirements or pain intensity, more patients who received ketamine reported higher levels of satisfaction with their pain management.
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Randomized Controlled Trial
Effect of gabapentin on postoperative pain and operation complications: a randomized placebo controlled trial.
Prevention and treatment of postoperative pain and operation complications such as nausea and vomiting are most important concerns in postoperative care. There are several mechanisms involved in postoperative pain. Gabapentin is a gamma aminobutyric acid analogue that is known as an anticonvulsant drug. This drug is tolerated well and has known effects on pain and anxiety. This study has compared the effect of gabapentin on postoperative pain, operation complications and haemodynamics. ⋯ Results show that gabapentin can decrease the need for morphine use in the first hour after operation only and has no significant effect on operation complications. Thus, we suggest gabapentin for pain management, and not to decrease opium use.
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Abortions performed by persons lacking the requisite skills or in environments lacking minimal medical standards or both are considered unsafe. It is estimated that over 20 million unsafe abortions are performed annually and about 70 000 women die globally as a result, with the majority occurring in the developing world. This study aims to determine the sociodemographic factors involved in complicated unsafe abortions. ⋯ Unfavourable sociodemographic factors are major determinants of the high incidence of unsafe abortion in the Niger Delta despite strict abortion laws. Concrete measures must be put in place to address these, as unsafe abortion and its complications are a major cause of maternal morbidity and mortality in the environment.