South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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A 25-year-old paraplegic man who had sustained a T3/T4 vertebral compression fracture 3 years previously presented with severe, painful spasm of the left hamstring muscle group of 2 hours' duration. This spasm produced extreme knee flexion of a degree which held the left foot posterior to the right buttock. An intravenous injection of 2 g magnesium sulphate produced immediate relief. Possible mechanisms of action of magnesium are discussed.
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Beriberi heart disease should be considered in all patients with cardiac failure and a history of alcohol abuse or dietary deficiency. We studied the haemodynamic changes which took place immediately after intravenous administration of thiamine to a patient with high-output beriberi. Cardiac output and stroke volume fell rapidly, but not below normal levels, and systemic vascular resistance rose.
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Many vital indices and scores have been proposed and used, particularly in relation to trauma. Most were primarily designed for and, within limits, are successful in hospital application. Attempts to use all or part of these in the prehospital context are misguided. ⋯ The value of the MVI lies in its adaptability to emergency medical care systems at all stages of development. The necessity for the MVI is outlined, as is the detailed working of the system. The hope is expressed that through adaptation of the MVI in different areas a consolidated prehospital scoring system may be achieved.
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A technique of blind nasal intubation for anaesthesia using the Samson modification of the Mapleson 'A' circuit is described. Adequate depth of anaesthesia is maintained by continuous insufflation, and scavenging is continuously used to remove waste anaesthetic gases. The position of the tube in relation to the larynx is estimated by movement of the reservoir bag and intermittent condensation of expired water vapour in the clear plastic of the circuit.