Articles: treatment.
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Bull. Int. Union Tuberc. Lung Dis. · Dec 1991
The point of view of a high prevalence country: Malawi.
The National Tuberculosis Programme switched to short-course chemotherapy for smear-positive cases when the IUATLD started to assist in 1984. Treatment results in smear-positive cases improved from a 50-55% cure rate to an 87% cure rate in new cases (and 89% in retreatment cases). The hope of reducing the tuberculosis problem was then challenged by the occurrence of HIV-related cases of tuberculosis which are now considerably over-stretching services. ⋯ For them, standard chemotherapy has now been changed to 2 R3H3Z3/2 HE(or TH)/4H in order to try and save money on syringes, needles and water for injection as well as prevent transmission of HIV through injections. This regimen will also enable the programme to depart from hospitalization since patients will take medication on an ambulatory basis. It may also give more time to district tuberculosis officers for the supervision of health centers.
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Resurgence of malaria in the country during seventies and subsequent implementation of Modified Plan of Operation (MPO) through Primary Health Care (PHC) system highlighted the urgent need for short term courses for PHC medical officers and clinicians at the periphery. In pursuance of these objectives. Dte. of National Malaria Eradication Programme (NMEP) laid down series of "Orientation Courses" for medical officers of PHCs and "Workshops" in management of severe and complicated malaria for physicians, paediatricians and pathologists in hospitals/teaching institutions. ⋯ The workshops provided an update with current advances/researches in the treatment of severe and complicated cases of malaria. These were considered highly beneficial, as it cleared many doubts about pathological processes and clinical manifestations including induced by drugs. The study also highlighted the deficiencies in the delivery process by the faculty.
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Acta Anaesthesiol Scand · Nov 1991
Randomized Controlled Trial Comparative Study Clinical TrialOpioid supplementation to propofol anaesthesia for outpatient abortion: a comparison between alfentanil, fentanyl and placebo.
One hundred and sixty-four patients scheduled for elective termination of pregnancy under general anaesthesia were randomly assigned to receive one of three different supplements to propofol and oxygen in nitrous oxide anaesthesia: 0.1 mg fentanyl, 0.5 mg alfentanil or placebo. Postoperative pain and nausea, as well as complications during anaesthesia were studied. There were no differences in complications or complaints by surgeons during anaesthesia, and no patient in any group reacted unsatisfactorily to surgery. ⋯ In conclusion, opioid supplementation lowered the amount of propofol needed for anaesthesia. Alfentanil 0.5 mg did not improve the postoperative course. Fentanyl 0.1 mg decreased the frequency of postoperative pain without increasing the time to hospital discharge.
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Anesthesia and analgesia · Nov 1991
Randomized Controlled Trial Clinical TrialMetoclopramide: an analgesic adjunct to patient-controlled analgesia.
This randomized, double-blind trial evaluated the effect of metoclopramide on the pain and analgesic requirements associated with prostaglandin-induced labor for second-trimester termination of pregnancy. After receiving intrauterine prostaglandin, seven women were given intravenous metoclopramide (10 mg), and eight received saline, concurrent with initiation of patient controlled analgesia (PCA). ⋯ We conclude that a single dose of metoclopramide reduces the pain and PCA-morphine requirements of patients undergoing prostaglandin-induced labor and may facilitate passage of the fetus. Metoclopramide may have a similar application in treating other types of gynecologic pain.