South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Fifty healthy mothers, with normal placental function, were anaesthetised with ketamine (2 mg/kg body mass) for Caesarean section. Surgery was conducted with the patient in the lateral tilt position and anaesthesia was maintained with nitrous oxide, oxygen, muscle relaxants and controlled ventilation. Eight of the 50 infants delivered were clinically depressed, judged on the basis of the modified Apgar score at 2 minutes after delivery. ⋯ Delirium on emergence from anesthesia was not encountered. In this study, ketamine appeared to maintain fetoplacental exchange adequately, but may have been responsible for some degree of drug-induced neonatal depression. It is suggested that ketamine should be re-evaluated, using a lower dosage schedule, for Caesarean section.
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The cytopathology of benign and malignant breast lesions is described and correlated with the histopathology. Problems in diagnosis and the advantages of fine-needle aspiration are discussed. The diagnostic accuracy is approximately 93% with this technique.
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Twenty-three children with chronic pulmonary symptoms following acute lower respiratory tract infection were investigated with a view to establishing their immune status. Cell-mediated immunity was depressed in the majority. Serial testing over some months showed improvement in some and fluctuation or non-recovery in others. The leucocyte function, gamma-globulin and immunoglobulin levels were normal.
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Two hundred Black women who required trial labour for suspected disproportion were adminstered continuous lumbar epidural analgesia by an obstetrician. The effects, side-effects, and results are described and discussed. Epidural block provides safe, effective analgesia for trial labour, and does not adversely affect the delivery or fetal condition.
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The antibody response to further-attenuated live virus measles vaccine was assessed in 67 Coloured children between the ages of 6 and 12 months. Children less than 9 months of age were found to have suboptimal seroconversion rates and it is recommended that the routine administration of measles vaccine should be restricted to children over the age of 8 months. High-risk groups and problems of vaccine administration and storage are discussed.