Journal of the Royal Society of Medicine
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Bier introduced his intravenous technique of local anaesthesia to facilitate palliative surgery on the elbow or knee. He cannulated a suitably large vein in the vicinity of the joint to inject procaine after first isolating the operating site with a proximal and a distal tourniquet. This extra containment of the local anaesthetic solution made it feasible to flush out any unfixed drug with saline before release of the main tourniquet, an advantage which has been lost in the currently fashionable technique of intravenous regional anaesthesia (IVRA) involving a single tourniquet above the elbow or knee and a fine butterfly needle in a vein on the dorsum of the hand or foot. A modern version of Bier's original method is described, conveniently called an intercuff block (ICB), which reintroduces the possibility of effective flushing, offers better operating conditions and engenders new ideas for further study.
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Propolis (bee glue) was found to have antibacterial activity against a range of commonly encountered cocci and Gram-positive rods, including the human tubercle bacillus, but only limited activity against Gram-negative bacilli. These findings confirm previous reports of antimicrobial properties of this material, possibly attributable to its high flavonoid content.
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Fifty-six cases seen consecutively in a young adult physically handicapped clinic were assessed with regard to their mobility. In addition an attempt was made to review the long term outcome of lower limb orthopaedic operations in these patients with physical handicap. The patients were subdivided into four groups and it was found that in three of the groups, patients who could only walk with a walking aid or who were wheelchair bound had had more surgical procedures than those who walked independently in adulthood. As problems in the young adult physically handicapped patients are defined so further work will be required to determine the best way they should be treated.