Articles: disease.
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In Africa, blood transfusions are frequently given to treat severe paediatric anaemia. Because of the risk of HIV transmission, identification of when transfusion will reduce the risk of death for severely anaemic children has become increasingly important. For all children admitted to a Kenyan hospital from October, 1989, to October, 1990, we collected data on clinical presentation, haemoglobin (Hb), receipt of transfusion, and in-hospital survival. ⋯ Based on a combination of laboratory and clinical criteria, children with clinical signs of respiratory distress and Hb less than 4.7 g/dl who were transfused had lower morality than those who were not (OR 0.19; 95% Cl 0.09, 0.41). Among children without respiratory distress, there was no association between receipt of transfusion and mortality, irrespective of admission Hb. The frequency of blood transfusion can be reduced and survival enhanced by targeting blood to those children with severe anaemia and clinical signs of respiratory distress, and by using transfusion early in the course of hospitalisation.
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With the use of oral rehydration, the need for the use of endovenous rehydration has decreased considerably. Albeit, the use is still necessary in severely dehydrated patients or when oral rehydration fails. Textbooks produced in developed countries recommend slow administration of fluids to correct dehydration in 12 to 24 hours. ⋯ It can be used in all patients, even newborns or malnourished. No laboratory tests are necessary. Only a small number of simple and readily available solutions are used to prepare the electrolyte mixtures.
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Anaesth Intensive Care · Aug 1992
Randomized Controlled Trial Clinical TrialPreoperative rectal indomethacin for analgesia after laparoscopic sterilisation.
A randomised, double-blind, placebo-controlled study was conducted among 56 day-case patients to determine the effect of the preoperative administration of rectal indomethacin on postoperative pain and opioid requirements after laparoscopic sterilisation. Outcome in women receiving indomethacin did not differ significantly from the placebo group, but there was a trend to lower subjective pain scores, reduction in early postoperative pain assessed objectively and lower parenteral pethidine requirements in the first three hours postoperatively. Indomethacin did not appear either to cause side-effects or to significantly reduce morbidity from the other postoperative sequelae of laparoscopy. Despite evidence for postoperative analgesic effect, the clinical benefits of premedication with rectal indomethacin were minor.
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Br J Obstet Gynaecol · Aug 1992
Randomized Controlled Trial Multicenter Study Clinical TrialGenital tract infections associated with the intrauterine contraceptive device can be reduced by inserting the threads into the uterine cavity.
To study the influence of the position of the threads of an intrauterine contraceptive device (IUCD) on the development of genital tract infection. ⋯ Infectious complications in women using an IUCD are more frequent if the threads lead from the uterine cavity to the vagina. This problem can be reduced by inserting the threads so that they remain entirely within the uterine cavity, a feasible procedure now that an effective instrument for IUCD thread retrieval is available.