The Central African journal of medicine
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Over a four week period in early 1993 all items used in the giving of anaesthesia were recorded. By relating the cost of items used to the number of patients treated in the same period, a per capita cost of US$3.96 per anaesthetic was calculated. By extrapolation, the total cost of running the service for a year, treating 9,560 patients, was estimated at US$37,940. The factors that increase expenditure are discussed, as in the association between reducing costs and maintaining safe anaesthesia practice.
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A retrospective analysis of 83 consecutive patients (42 males and 41 females) treated for snake bites at Mpilo Central Hospital between January 1990 and June 1992 is presented. In Zimbabwe poisonous snakes belong to four families; Colubrids (Boomslang), Vipers (Puff Adder), Elapids (Mambas and Cobras) and Atractaspids (Bibron Stilleto snake). The Puff Adder is responsible for three quarters of the bites. ⋯ The most common clinical features were; pain (95 pc), swelling (87 pc), tachycardia (20 pc), fever (13 pc) and vomiting (8 pc). This study, carried out at a time when there was no antivenom in stock at Mpilo Hospital, shows a considerable mortality (5 pc, 4/83) and morbidity (37 pc, 31/83) rate from poisonous snake bites in Zimbabwe. These observations highlight the need to maintain adequate stocks of antivenom in the major hospitals in Zimbabwe.
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The proportion of people with AIDS is increasing rapidly in Zimbabwe. Several strategies have been adopted to check the further spread of the disease. This paper discusses the behaviour patterns which may predispose to HIV infection and possible intervention strategies that may be taken in the City of Harare. ⋯ Forty eight pc of the married respondents who have engaged in casual sexual relationships never use condoms. The main source of information on AIDS/HIV was the radio (74 pc). Most parents (66 pc) had not talked about AIDS to their children.
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This paper examines research conducted in Zimbabwe over the past three decades on the patterns of use of traditional medicine in Zimbabwe. While much is known about patterns of choice between traditional vs. orthodox medicine, little is known about when and under what circumstances Zimbabweans use other medical therapies. A more inclusive model of health seeking behaviour that entails a more encompassing definition of traditional medicine and a broader spectrum of health care alternatives is advocated.
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The changes in intracranial pressure which occur following a change in one of the constituent volumes within the skull are governed by the Monro-Kellie doctrine, stated in the late 18th century and describes how an increase in one of the constituent volumes must be reflected by a reciprocal decrease in another volume to avoid any change in pressure and that if this does not occur, there is a rapid rise in intracranial pressure. Cerebral blood flow is affected by many physiological and pharmacological factors, and is relevant as a change in cerebral blood flow results in a similar alteration in cerebral arterial volume which will affect intracranial dynamics. Another important concept to be understood is cerebral perfusion pressure, how it is related to intracranial and arterial pressures and its relevance during the conduct of any neuroanaesthetic. ⋯ The volatile agents are reviewed and it is stressed that while isoflurane may have advantages over the older volatile agents it is not without complication and nitrous oxide which has always been regarded as an innocuous agent may also have some significant intracranial affects. The use of propofol, as an infusion and the neuromuscular blocking agents and narcotics are described. Recently the use of induced hypotension during clipping of cerebral aneurysms has been questioned and this view and the treatment of vasospasm is discussed in some detail.(ABSTRACT TRUNCATED AT 250 WORDS)