South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of tolmetin with aspirin in the treatment of osteo-arthritis of the knee.
A randomized, double-blind crossover study conducted on 55 patients showed tolmetin (Tolectin; Ethnor) (900 mg daily) to be as effective as aspirin (4 500 mg daily) in relieving the symptoms and signs of osteo-arthritis of the knee. Overall, aspirin produced significantly more side-effects, but the incidence of gastro-intestinal side-effects did not differ significantly. In almost every comparison tolmetin had the better score, but differences were not statistically significant; the only exception was the evaluation of the patients' well-being at mid-therapy, which significanlty favoured tolmetin.
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Four patients with bacterial meningitis are reported. On initial examination 1 patient had a slightly abnormal cerebrospinal fluid (CSF), and in the other 3 patients the CSF was completely normal. An obviously purulent CSF was obtained when lumbar puncture was repeated 14-48 hours later. ⋯ In 3 of the 4 patients a cause for pyrexia was found on initial examination but lumbar punctures were done for neck stiffness or convulsions to exclude meningitis. The problems and the need to repeat a lumbar puncture, as well as the importance of blood cultures in a patient with suspected meningitis, are discussed. The fact that a normal specimen of CSF does not exclude meningitis is stressed.
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This article sets out the issues involved in the consideration of noise-induced hearing damage. Exposure to noise can lead to a shift in the hearing threshold, resulting in loss of hearing. This shift may be either temporary or permanent. ⋯ Means have now been worked out to correlate the pressure of fluctuating sound (like music) with that of nonfluctuating sound (like industrial noise) and thus to equate statistics governing noise as an acoustic hazard with the hazard constituted by music. Table I shows the ambient sound levels which should be considered as unsafe per number of hours' exposure. I plead for better acoustic design in environmental planning and stress that people exposed to loud noise or music should undergo hearing tests regularly as the main preventive measure.