Le Journal médical libanais. The Lebanese medical journal
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Randomized Controlled Trial Comparative Study
Prevention of hypotension after spinal anesthesia for cesarean section: 6% hydroxyethyl starch 130/0.4 (Voluven) versus lactated Ringer's solution.
The aim of this study is to compare the efficacy of HES 130/0.4, a new hydroxyethyl starch, to lactated Ringer's solution (LR) in the prevention of hypotension after spinal anesthesia for cesarean section (CS). ⋯ HES 130/0.4 is more effective than LR to prevent hypotension following spinal anesthesia for CS; its routine use in this purpose should be considered.
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Comparative Study
Obstetric admissions to the intensive care unit: an eight-year review.
Between 0.1 and 0.9% of women develop complications of pregnancy that require admission to an intensive care unit (ICU). The purpose of this study was to review all obstetric patients admitted to the ICU over an 8-year period to determine the causes and outcomes of these admissions and the frequency and causes of maternal mortality. ⋯ The need for maternal intensive care should be one of the most important measure considered in the quality of maternal care. Early admission and management of critically ill obstetric patients in the ICU may decrease maternal mortality and morbidity.
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Duchenne's muscular dystrophy (DMD) is the most common and severe form of myopathy occurring in pediatric patients. Sensitivity of patients with DMD to sedative, anesthetic and neuromuscular blocking agents may result in intraoperative and early postoperative cardiovascular and respiratory complications, as well as prolonged recovery from anesthesia. Anesthetic management of these patients is challenging and may cause serious problems to the anesthesiologist. ⋯ The intraoperative course of these patients was uneventful. Controlled hypotension, rapid recovery and uneventful postoperative period were achieved with this technique. In conclusion, good conditions for tracheal intubation, controlled hypotension, rapid recovery and uneventful postoperative period can be achieved with this anesthesia technique in patients with DMD.
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Within the framework of medical and nursing education, formal attention to training in palliative care (PC) continues to be overlooked by the majority of training programs. PC is defined by the World Health Organization (WHO) as an "approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness...". ⋯ The purpose of this article is to describe present endeavors in Lebanon, and to recommend a model for future outlook. In conclusion PC education needs to be developed in Lebanon warranting the need for a foundation course in palliative and end-of-life care.