South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Letter Case Reports
Ingestion of a laryngoscope light bulb during tracheal intubation.
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Letter Clinical Trial Controlled Clinical Trial
Clonidine in acute and chronic pain.
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Fifty-six patients admitted to hospital in normal spontaneous labour were given a continuous epidural infusion of 10 ml (12.5 mg) of 0.125% bupivacaine during the 1st stage of labour. Uterine contractions were monitored with an intra-uterine pressure transducer and uterine work expressed both in Alexandria units and the area under the curve of the intra-uterine pressure recording summated over 15 minutes. ⋯ If cervical dilatation was between 3 and 4 cm there was a 2.9% reduction. This reduction in uterine work was also not significant and in all patients spontaneously returned to its previous level within 91 minutes.
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Comparative Study
Extracapsular cataract extraction with and without intra-ocular lenses in black patients.
Cataracts are the commonest cause of blindness in Third-World countries and cataract extraction is the commonest eye operation performed anywhere. Patients require optical correction after surgery either in the form of an intra-ocular lens (IOL) or bifocal aphakic glasses. The standard operative procedure in First-World countries is an extracapsular cataract extraction with an IOL. ⋯ In the corrected IOL group, 98% of patients saw better than 6/24, whereas in the aphakic spectacle group, 87.5% saw 6/24 or better. Since the majority of black patients cannot afford costly prescribed spectacles, it was important to analyse the visual acuity in patients who had IOLs and were uncorrected; 81.6% saw 6/24 or better. IOLs in black patients are therefore indicated but the disadvantage is the cost.
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The creation of an improved burn-care capability was a long-awaited dream at Kalafong Hospital, one of the two academic (tertiary referral) hospitals of the University of Pretoria. When this recently became a reality, a prospective analysis of cost-effective burn care was initiated. For patients with burns of less than 10% body surface area (BSA), hospital stay (healing time) was shortened from a mean of 4.1 d/% BSA burnt to 2.7 d/% BSA burnt (34% reduction; P = 0.01). ⋯ Patients with the largest deep dermal burn injury to survive in our hospital improved from 35% BSA to 60%. It is concluded that the creation of better burn care facilities at our hospital has shortened the hospital stay of survivors by a mean of 35% and decreased the mortality rate by 30%. Hospital authorities should take note of the fact that better facilities not only improve cost-effective patient care but also survival figures.