Le Journal médical libanais. The Lebanese medical journal
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We relate the experience of 506 consecutive deliveries under epidural analgesia in the same hospital, by the same obstetrician (JSS). 336 patients delivered without epidural analgesia during the same period. In the epidural group (n = 506), 93 patients had a normal spontaneous vaginal delivery, 357 had a low forceps, 22 had a mid-forceps, 4 had an assisted breech extraction, and 30 delivered by cesarean section. There were 24 cases (out of 506) of significant hypotension; all of them responded to an intravenous bolus of ephedrine. ⋯ Eleven newborns in the epidural group had one-minute Apgar scores between 4 and 6, but they all had excellent Apgar scores at five minutes. None had a one-minute Apgar score below 4. We conclude that epidural analgesia is a safe and highly effective method of pain relief during labor.
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Comparative Study
Rates of perinatal mortality and low birth weight among 3367 consecutive births in south of Beirut.
3367 consecutive births were reviewed prospectively. Population belongs mainly to a community with relatively underprivileged living conditions. Perinatal mortality was found at a rate of 22.4/1000 B. ⋯ Our medical schools are called to encourage pediatricians to specialize in neonatal intensive care and to create more opportunities for this specialty to meet the national requirement. It is suggested, too, to subject ICN units in Lebanon to standardized requirements concerning attendance and facilities before obtaining official recognition. Centralization of care given to severely sick neonates and to women with high risk pregnancy in optimal conditions is most needed.
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Comparative Study
[Health financing in Lebanon. I. Organization of health care services, coverage system and contribution of the Ministry of Public Health].
This paper intends to analyze the health care system in Lebanon from the organizational and financial points of view. It allows for an understanding of the health services' market by tackling it from different angles: supply versus demand, private versus public sectors, curative versus preventive services, hospital versus ambulatory care. This study necessitated a review of all previous surveys made in this field, during the after-war period. ⋯ But, at the price of an ever escalating cost, threatening the sustainability of the system. This is what is attained in this paper, as it shows clearly that expenditures on health have reached an alarming level of the GDP share. Our purpose being providing solid arguments in favor of reforming the health system.
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The authors report a retrospective study (April 92-April 95) of 60 CT guided stereotactic biopsies. The procedure offered accurate histological diagnosis in 56 cases. There were 38 glial tumors, the majority being of high grade (III-IV). ⋯ These results are compatible with those reported in the literature. The simplicity and accuracy of stereotactic procedure are confirmed, making it an imperative step in the management of intraxial space occupying lesion when surgical resection is negotiable. The other applications of the stereotactic procedure are exposed.