Articles: health.
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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.
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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.
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Available data indicate that pertussis remains an important disease during infancy and childhood, particularly among those who are inadequately immunized. Over the past 15 years, successful immunization programmes have been implemented in most countries in the world. Some problems have arisen in the industrialized world where pertussis had been well controlled previously. ⋯ All efforts should be directed to increase or maintain high immunization coverage with DPT immunization at the level of at least 90% in all districts. Surveillance of pertussis morbidity should be strengthened in all countries and ideally, pertussis should be a reportable disease. More information on the present epidemiological pattern of pertussis, especially age distribution of pertussis cases in developing countries, is needed to develop the policy of booster doses of DPT vaccine in children > 1 year.
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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.