Israel journal of medical sciences
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Hypobaric spinal anesthesia was administered to 40 patients undergoing lower limb surgery. Twenty-nine of the patients were debilitated geriatric patients who presented with orthopedic emergencies, in most cases a fractured hip. ⋯ Due to its inherent nature, hypobaric spinal anesthesia does not necessitate positioning of the patient on the injured, painful side (unlike hyperbaric spinal or epidural anesthesia) and, therefore, facilitates a smooth and painless transfer of the patient to the operating table. Complications encountered were similar to those following hyperbaric anesthesia.
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Eight freshwater near-drowning victims were treated in the General Intensive Care Unit. The most prominent findings upon arrival were respiratory failure, hypoxemia and coma. ⋯ Six patients were discharged fully recovered from the unit on the 3rd to 6th day; one patient who recovered fully but had amnesia was discharged after 8 months; and one patient remained decerebrated and died 5 months later. A more aggressive treatment of near-drowning victims is justified and recommended.
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In a prospective study on breast-feeding in Jerusalem, 274 middle-class Jewish women were interviewed about their breast-feeding practices, and symptoms and signs of disease, episodes of illness and hospitalization of the infant. Women of a higher education level breast-fed more often and for a longer period than did women with less education. Infants exclusively breast-fed had significantly fewer symptoms of disease than did those not breast-fed or partially breast-fed. ⋯ Infants who were breast-fed for 20 weeks had the least number of illness episodes; 52% of them had no episode compared with only 15% who were not breast-fed. Comparison of the numbers of illness episodes among non-breast-fed infants of mothers with low and high education levels indicated that the infants of better educated mothers had a significantly lower percentage of illness episodes (P less than 0.05). Even infants of a middle-class and well-educated population benefit from the breast-feeding practice and its protective effect, more so if they are exclusively breast-fed and for a longer period.
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African conditions and circumstances present specific challenges to health service providers. These conditions have implications for primary health care (PHC), including problems of communication (geographical, educational and cultural), maldistribution of health manpower, political unrest and wars. ⋯ Manpower training should be stressed at all levels of education of all medical and paramedical personnel. The status of PHC in the Republic of South Africa is now well recognized, and provision of the required services has a high priority.