South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Not one of the present tests for the correct position of an epidural catheter can reliably detect intravascular, intrathecal and extra-epidural placement. A simple rapid test has therefore been developed. Following placement of the epidural catheter an initial aspiration test for cerebrospinal fluid and blood is performed. ⋯ Not one of the 6 failures to establish epidural analgesia could be attributed to intravascular or intrathecal placement. The sensitivity, specificity and positive predictive value for correct epidural placement of the catheter were found to be 95.5%, 63.6% and 98.5% respectively. The time required to perform the test was less than 30 seconds in 92% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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Drug resistance is a serious problem in the treatment of tuberculosis and a threat to successful tuberculosis control programmes. Local health workers have expressed concern that the increasing tuberculosis epidemic in the Western Cape is partly attributable to drug resistance. The aim of this study was to determine the prevalence of tuberculosis drug resistance (including multidrug resistance) and to investigate possible relationships between drug resistance and patient demographic characteristics. ⋯ Results from this study indicated that drug resistance is currently not a major problem in the Western Cape, rates comparing favourably with those reported from developed countries and being much lower than those for developing countries. Every effort should therefore be made to maintain the status quo and to prevent the emergence of further resistance. The priority for tuberculosis control in the Western Cape should remain to limit transmission of the disease by reducing the infectious pool through improved cure of (especially) smear-positive cases.