South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Biography Historical Article
George Warwick Bampfylde Daniell, 1864-1937.
In 1907 Dr G. W. ⋯ Little is known about his work, but due acknowledgement must be made to his pioneering efforts to place anaesthesia on a sound scientific basis, and to his various contributions towards making the specialty safe and comfortable. During his career in South Africa, he played an active role in the then Cape of Good Hope, Western Branch, of the British Medical Association.
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A patient developed accidental total spinal anaesthesia, 75 minutes after administration of epidural anaesthesia, despite conventional precautions to prevent this complication. The anaesthetic technique and the intra- and postoperative course are detailed, and possible explanations for the sequence of events discussed.
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Case Reports
The adult respiratory distress syndrome in association with diabetic keto-acidosis. A case report.
A 41-year-old man presented in stupor, with ketoacidosis and acute severe respiratory failure. He had a history of alcohol abuse and had been on insulin therapy for diabetes secondary to chronic pancreatitis for 11 years. the condition was rapidly progressive and the patient died within 5 hours of presentation of profound hypoxia and hypotension despite aggressive therapy. Autopsy confirmed the clinical diagnosis of 'shock lung'. None of the more commonly associated precipitating factors of adult respiratory distress syndrome could be detected clinically or at autopsy and the pathogenesis of the condition remains elusive.
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A new protamine sulphate titration kit has been developed and tested in patients undergoing cardiac bypass surgery. When a prototype of the kit was used, protamine sulphate dosage was significantly reduced (P less than 0.01) without a significant increase in 24-hour postoperative blood loss (P greater than 0.05).