Médecine tropicale : revue du Corps de santé colonial
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Spinal anesthesia (SA) is frequently used in tropical zones. Intracranial subdural hematoma is an uncommon complication of SA. The purpose of this report was to describe a case of intracranial subdural hematoma observed during SA performed for cesarean section in a 22-year-old women in Senegal. ⋯ Diagnosis, which may be difficult in Africa, should be suspected in patients with persistent headaches after SA. Confirmation requires computerized tomography of the brain. Prevention of this complication depends on the use of fine beveled-tipped puncture needle which are rarely available in the African setting.
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Prescribing treatment is the last act of a medical visit. A prescription is a written document that engages the medical and legal responsibility not only of the physician but of all those subsequently involved in its execution. In countries with weaker economies and more limited health care insurance the costs of filling a prescription can place a heavy financial burden on the families. ⋯ The cost was 50% lower at the hospital pharmacy. All prescribers and in particular medical students should receive instruction in prescription writing. Careful selection of brand and non-brand-name drugs in agreement with practitioners should achieve further reductions in the cost of filling a prescription in hospital pharmacy.
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Thanks to progress in serologic techniques evidence was obtained in 1980 showing that acute hepatitis epidemics observed in India were due to neither virus A nor virus B. The presence of another virus was confirmed and its genome was cloned and sequenced in 1991. Hepatitis virus E is a small RNA virus that differs from other known human viruses. ⋯ Prevention depends on protection of the water supply and proper sewage disposal. Successful active immunization of monkeys holds promise for development of a vaccine. Due to its magnitude and high mortality rate hepatitis E is a major health problem for numerous regions around the world including Southeast Asia.