South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The susceptibility of 175 clinical isolates of Neisseria gonorrhoeae to penicillin G, ampicillin, erythromycin, tetracycline and spectinomycin was determined. Almost one-fifth of strains were relatively resistant to penicillin G. ⋯ No penicillinase-producing or spectinomycin-resistant strains were encountered in this study. The relevance of the findings to the management of gonococcal urethritis is discussed.
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Review
Anaesthesia for caesarean section. An updated review of its special problems and their management.
We have attempted to update a previous review of the hazards and problems confronting the mother, fetus and anaesthetist at caesarean section. A recent survey of obstetric anaesthesia within the Republic and South West Africa indicates that a significant proportion of anaesthetic services for midwifery are provided by non-specialist practitioners in hospitals outside major population centres. We believe that both mothers and their infants will gain from the careful perusal by their doctors of this review.
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Randomized Controlled Trial Comparative Study Clinical Trial
Advantages of left over right lateral tilt for caesarean section.
The relative merits of right and left lateral tilt were assessed in 75 parturients at elective caesarean section. Significant maternal hypotension (aortocaval occlusion) occurred more frequently with rightward tilt (left hip supported). The clinical and biochemical status of the fetus was generally more favourable with left lateral tilt, as were the maternal-to-fetal blood gas gradients and relationships. The routine use of left lateral tilt is advocated.
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Randomized Controlled Trial Comparative Study Clinical Trial
Plasma cortisol levels in normal volunteers receiving either betamethasone valerate or desoximetasone by topical application.
Desoximetasone (Topisolon; Hoechst), a new topical steroid, and betamethasone 17-valerate were compared with respect to their effects on hypothalamic-pituitary-adrenal function as evidenced by plasma cortisol concentrations. Three grams of each test preparation were applied daily for 21 days to intact skin of the ventral aspects of alternate forearms of 15 normal volunteers. Five received betamethasone 17-valerate 0.1%, 5 desoximetasone 0.05%, and 5 desoximetasone 0.25%. ⋯ These values were compared with the mean control values by analysis of covariance. There was no significant difference in plasma cortisol levels. The value of performing similar studies on larger skin areas and with larger doses is discussed.
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A summary of the literature shows that there are well-marked seasonal variations in mortality for total deaths, for respiratory and cardiovascular diseases and for diabetes, the mortality rate being higher in winter than in summer. These seasonal variations in mortality are seen in infants under 1 year of age and in older people but not in youths and young adults. The amplitude of the seasonal variation in mortality increases with increasing age because of the higher incidence of cardiovascular and respiratory mortality in older people. ⋯ Comparison was made of the seasonal variations in mortality rates for all causes of death and for respiratory and ischaemic heart disease (IHD) deaths of Whites over 40 years of age in Durban and Johannesburg. This showed that the seasonal variation for all causes of death is greater in Johannesburg than in Durban, i.e. proportionately more older Whites die during winter in Johannesburg than in Durban. The reason for this difference is that the seasonal variation in respiratory disease mortality is much greater in Johannesburg than it is in Durban, but the seasonal variation in IHD mortality is the same in the two cities.