JPMA. The Journal of the Pakistan Medical Association
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To study the characteristics of infants and children presenting with iatrogenic Cushing's Syndrome due to nappy rash ointments. ⋯ Self-medication and prolonged use of potent steroid ointments are major contributors in development of iatrogenic Cushing's Syndrome in infants and children. Younger age, female gender and use of disposable diapers were other important predisposing factors.
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To determine the pharmacological and non-pharmacological methods used by neonatal intensive care unit nurses to reduce procedural pain. ⋯ Among the nurses in both groups, very little pain management was used for invasive procedures. Educational programmes for pain management in newborns should be arranged to develop an institutional culture. Guidelines for these patients' pain management should also be established.
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Diabetes is a multifactorial disease, with multiple pathophysiologic abnormalities. This means that a combination of drugs, acting upon as many pathologic mechanisms as possible, is necessary for optimal management of the syndrome. This article discusses how a rational combination of oral anti-diabetic drugs can be chosen and used in primary care practice.
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To assess levels of postoperative pain with reference to internationally validated protocols. ⋯ The achievement of absolute no pain for all patients in the post-operative phase is next to impossible, but it should remain the ultimate target.
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Nicotine withdrawal is not a well recognized cause of delirium. A few published cases are on post-operative, terminally ill cancer or neuro-intensive care unit patients. Because of the high incidence of morbidity and mortality of delirium it is important to identify and treat delirium promptly and effectively. We report a case of delirium after sudden cessation of smoking in a heavy smoker, with schizophrenia, hospitalized for stabilization of psychiatric illness.