Articles: treatment.
-
Acta Anaesthesiol Scand · Jan 1992
Randomized Controlled Trial Comparative Study Clinical TrialPropofol anaesthesia versus paracervical blockade with alfentanil and midazolam sedation for outpatient abortion.
Propofol anaesthesia was compared with paracervical blockade in a prospective, randomized study of 59 abortion patients. All the patients received alfentanil 0.01 mg/kg i.v. at the start of anaesthesia and were randomized into two groups. Group R (regional, 31 patients): midazolam 0.1 mg/kg i.v. and paracervical blockade with 2 x 10 ml of mepivacaine 20 mg/ml + adrenaline 0.005 mg/ml. ⋯ Except for a better p-deletion score 30 min after the procedure in Group G, there was no difference in recovery function between the groups. Of the patients in Group G, 67% experienced postoperative pain compared with 23% in Group R. Maximum serum mepivacaine concentration (Group R) was reached at 15-30 min, range 1.5-5 micrograms/ml.
-
The case of a 33-year-old woman who presented with abdominal pain referable to the lower abdomen is discussed. She had had an uncomplicated intrauterine abortive procedure two weeks earlier. It was determined that a ruptured ectopic pregnancy was the etiology of her abdominal pain. The rare phenomenon of combined intrauterine and extrauterine pregnancy is discussed.
-
This article presents results from a population-based study of the magnitude and causes of maternal mortality in the Giza governorate of Egypt in 1985-86. Deaths to women in the reproductive ages were identified through the death registration system. Family members of the deceased were interviewed using the "verbal autopsy" approach. ⋯ An average of 2.3 causes per maternal death were reported; the most common causes were postpartum hemorrhage (31 percent of cases) and hypertensive diseases of pregnancy, such as toxemia and eclampsia (28 percent of cases). Women experiencing hemorrhage, hypertensive diseases of pregnancy, or other serious complications must have easy access to hospital and maternity centers equipped for handling these conditions. Since most deliveries occur at home, many with the help of traditional birth attendants, TBAs will need training in early diagnosis, treatment, and/or effective referral of problem pregnancies.
-
Bull. World Health Organ. · Jan 1992
Tuberculosis control and research strategies for the 1990s: memorandum from a WHO meeting.
Tuberculosis is the largest cause of death from a single infectious agent in the world, killing nearly 3 million people every year. This death toll represents 25% of avoidable adult deaths in developing countries. It imposes a heavy burden on the 8 million new individuals who contract the disease each year, and on their households; morbidity and mortality are concentrated in young adults. ⋯ Broad action is therefore warranted and should be aimed at introducing the effective strategies on as wide a scale as possible to reach the targets of 70% case detection and 85% cure of smear-positive patients, by the year 2000. Research is needed to implement these strategies throughout the world and to ensure that effective tools will remain available for controlling tuberculosis despite emerging problems such as resistance to the major drugs currently available. To make a real impact on the tuberculosis problem, a focused global programme must be created, under the leadership of WHO, to bring tuberculosis to the world's attention, to mobilize support on a major scale, and to provide direct guidance and support to national programmes.
-
The Journal of urology · Jan 1992
Randomized Controlled Trial Comparative Study Clinical TrialTopical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials.
Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. ⋯ There was significantly less pain on the sides with the anesthetic cream (p less than 0.001). Many patients would pay the price of the cream. In conclusion, EMLA cream cannot replace but it can supplement infiltration anesthesia during vasectomy.