Respirator treatment of crushed chest injuries

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Disodium Cromoglycate (Lomudal) in Asthma with Emphasis on Lung Function Tests

Twenty allergic asthmatics were treated with inhaled disodium cromoglycate (Lomudallt in addition to extant therapy. Improvement was assessed by the patient, clinically by the physician, by analysis of the patients' diary cards and by a battery of pulmonary function tests, after 3 months' treatment. Eighteen patients were improved. At the end of 1 year's treatment, only 1 failed to maintain improvement. No serious side-effects were encountered. Lung function tests demonstrated less hyperinflation in 9 out of 11 patients tested, less airway obstruction in 14 out of 20, no change in a standardized exercise test and an improvement in acid-base balance from compensated respiratory alkalosis to normal. The results in this trial are discussed in relation to others in this literature. The value of DSCG in facilitating reduction of corticosteroid and sympathomimetic therapy for asthma is emphasized. Some practical points in the use of DSCG are listed. Disodium cromoglycate is safe and efficacious in allergic bronchial asthma and is a very useful adjunct in the therapy of this common, potentially serious condition

Snakebite care through the first two waves of COVID-19 in West Bengal, India: a qualitative study

Snakebite is a public health problem in many countries, with India having the highest number of deaths. Not much is known about the effect of the COVID-19 pandemic on snakebite care. We conducted 20 in-depth interviews with those bitten by venomous snakes through the two waves of COVID-19 (March–May 2020; May–November 2021), their caregivers, health care workers and social workers in two areas (Sundarbans and Hooghly) of West Bengal, India. We used a constructivist approach and conducted a thematic analysis. We identified the following themes: 1. Snakebite continued to be recognised as an acute emergency during successive waves of COVID-19; 2. COVID-19 magnified the financial woes of communities with high snakebite burden; 3. The choice of health care provider was driven by multiple factors and consideration of trade-offs, many of which leaned toward use of traditional providers during COVID-19; 4. Rurality, financial and social disadvantage and cultural safety, in and beyond the health system, affected snakebite care; 5. There is strong and shared felt need for multi-faceted community programs on snakebite. We mapped factors affecting snakebite care in the three-delay model (decision to seek care, reaching appropriate health facility, receiving appropriate care), originally developed for maternal mortality. The result of our study contextualises and brings forth evidence on impact of COVID-19 on snakebite care in West Bengal, India. Multi-faceted community programs, are needed for addressing factors affecting snakebite care, including during disease outbreaks - thus improving health systems resilience. Community programs for increasing formal health service usage, should be accompanied by health systems strengthening, instead of an exclusive focus on awareness against traditional providers

The introverted medical school - time to rethink medical education

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The lung in progressive systemic sclerosis (scleroderma)

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Alpha1-antitrypsin deficiency

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Changing the malaria treatment protocol policy in Timor-Leste: an examination of context, process, and actors’ involvement

In 2007 Timor-Leste, a malaria endemic country, changed its Malaria Treatment Protocol for uncomplicated falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. The change in treatment policy was based on the rise in morbidity due to malaria and perception of increasing drug resistance. Despite a lack of nationally available evidence on drug resistance, the Ministry of Health decided to change the protocol. The policy process leading to this change was examined through a qualitative study on how the country developed its revised treatment protocol for malaria. This process involved many actors and was led by the Timor-Leste Ministry of Health and the WHO country office. This paper examines the challenges and opportunities identified during this period of treatment protocol change

Recent Experiences in the Respiratory Unit of the Johannesburg Hospital

The importance of respiratory disease in medicine is emphasized. One hundred and thirtyfive cases were referred to the Respiratory Unit in a 5-month period. These cases 'have been analysed in terms of age, sex and major disease. Fifty-six patients,of whom 47 had intermittent positive pressure respiration, required treatment in an intensive care unit. Twenty-two patients died in the intensive care unit-a mortality rate of 39%. Also discussed and briefly illustrated are problems of intermittent positive pressure respiration, tracheostomy and endotracheal intubation, cardiac arrhythmias, oxygen toxicity, fat embolism and tetanus

Malaria control in Timor-Leste during a period of political instability: what lessons can be learned?

<p>Abstract</p> <p>Background</p> <p>Malaria is a major global health problem, often exacerbated by political instability, conflict, and forced migration.</p> <p>Objectives</p> <p>To examine the impact of political upheaval and population displacement in Timor-Leste (2006) on malaria in the country.</p> <p>Method</p> <p>Case study approach drawing on both qualitative and quantitative methods including document reviews, in-depth interviews, focus group discussions, site visits and analysis of routinely collected data.</p> <p>Findings</p> <p>The conflict had its most profound impact on Dili, the capital city, in which tens of thousands of people were displaced from their homes. The conflict interrupted routine malaria service programs and training, but did not lead to an increase in malaria incidence. Interventions covering treatment, insecticide treated nets (ITN) distribution, vector control, surveillance and health promotion were promptly organized for internally displaced people (IDPs) and routine health services were maintained. Vector control interventions were focused on IDP camps in the city rather than on the whole community. The crisis contributed to policy change with the introduction of Rapid Diagnostic Tests and artemether-lumefantrine for treatment.</p> <p>Conclusions</p> <p>Although the political crisis affected malaria programs there were no outbreaks of malaria. Emergency responses were quickly organized and beneficial long term changes in treatment and diagnosis were facilitated.</p