Withdrawal of parenteral phenobarbitone - Implications for resource-poor countries

Parenteral phenobarbitone is an integral part of the management of status epilepticus, especially in the context of resource-poor countries. It is highly effective at controlling seizures. It is safe, cheap, can be given by rapid intravenous push or intramuscular route, boluses can be repeated, and it is recommended as part of the Advanced Paediatric Life Support guidelines. The proposed alternatives lack efficacy, practicality and/or place the child in status epilepticus at risk of respiratory compromise. The impact of the loss of parenteral phenobarbitone would be increased cardiac complications, lack of early seizure control, prolonged seizures resulting in brain damage and systemic complications. Increased numbers of patients will require artificial ventilation in centres without facilities, and centres with facilities will be unable to cope with the load of ventilated patients because of lack of safe transport systems and bed space

Variability of <i>Phragmites australis</i> (Cav.) Trin ex Steudel in relation to the environment

Een onderzoek werd uitgevoerd naar de variabiliteit van Phragmites australis (Cav.) Trin ex Steudel, het Riet, in Nederland, waarbij werd nagegaan in hoeverredeze in verband staat met het milieu. ...Zie: Samenvattin

Clinical approach to the floppy child

No Abstract

International Course Landscape Architecture.

The Wageningen international course: some backgrounds on a twelf week cours

Eshem-Bethel and Herem-Bethel:New Evidence from Amherst Papyrus 63

The pluralism that characterized the religious life of the Jewish community at Elephantine (5th century BCE) included the veneration of Eshem-Bethel and Herem-Bethel. This contribution seeks to illuminate the identity of these gods on the basis of new evidence from the Aramaic texts in Demotic script known as papyrus Amherst 63. It shows that Eshem-Bethel and Herem-Bethel are particular manifestations of Bethel; the one in his role as fiery storm-god; the other in his capacity as sexual mate of a divine consort