South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The clinical presentation and management of a young child with renal failure caused by bilharzial obstructive uropathy is discussed. Children from areas in which bilharzia is endemic have a high incidence of urological disease. Ureteric obstruction from inflammatory reaction will respond to medical treatment, whereas true mechanical obstruction from fibrosis will require surgical intervention.
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In 40 women with acute pelvic inflammatory disease (APID) specimens for microbiological study were obtained from the rectum, urethra, vagina, cervix and peritoneal cavity. In most patients (83%) the aetiology of the infection was polymicrobial. ⋯ All the other positive Chlam. trachomatis and N. gonorrhoeae cultures were obtained from rectal, urethral and cervical specimens. The positive anaerobic and aerobic cultures were all from peritoneal cavity specimens.
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Clinical Trial Controlled Clinical Trial
Prevention of post-tonsillectomy pain with analgesic doses of ketamine.
The prevention of postoperative pain in children who had undergone tonsillectomy was investigated in a double-blind trial. Ketamine (Ketalar; Parke-Davis) 0.5 mg/kg was given intravenously before the operation to 20 children and saline to a control group of 20 children. Premedication consisted of oral trimeprazine 4 mg/kg given 2 hours pre-operatively. ⋯ Postoperatively there were significant differences in the measurement of pain but not in that of sedation. No hallucinations were encountered in those receiving ketamine. It is concluded that analgesic doses of ketamine are safe and effective.
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Two hundred and eleven children aged 1-5 years were studied after undergoing herniorrhaphy or orchiopexy. In 111 cases a caudal block was used for postoperative analgesia. This was administered immediately after induction of anaesthesia, using bupivacaine 0.25% plain (0.7 ml/kg lean body mass), and was successful in 100 patients. ⋯ The other 100 children acted as controls. Behaviour patterns were more restful in the caudal block group on awakening and less opiate was required during the first 5 postoperative hours. No complications resulted.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of a standard ibuprofen treatment regimen with a new ibuprofen/paracetamol/codeine combination in chronic osteo-arthritis.
Twenty-eight patients with osteoarthritis participated in a prospective, double-blind, cross-over study to compare the safety and efficacy of a new combination analgesic containing ibuprofen 200 mg, paracetamol 250 mg and codeine phosphate 10 mg per tablet (Myprodol; Rio Ethicals) with a standard treatment regimen (ibuprofen 200 mg per tablet). The combination tablet was found to provide significantly better pain relief than ibuprofen alone (P less than 0.05). Analysis of the results of haematological, hepatic and renal function tests showed no statistically significant differences between treatments. No serious side-effects or clinically important changes were encountered with either drug.