Emergency medicine journal : EMJ
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Tuberculosis is a disease that should never be underestimated. It can affect anybody at any age. Doctors in the West do not have much experience of peritonitis secondary to tuberculosis. It is a condition that requires urgent and aggressive management as it can be fatal, even in the young and fit, as this case report illustrates.
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The surviving sepsis campaign developed guidelines in 2003 that were designed to increase physician awareness of sepsis and to develop a series of recommendations for the management of the patient with sepsis. The guidelines had the support of 11 international professional organisations across a variety of specialties, and advocate aggressive, early goal-oriented resuscitation in appropriate patients.
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A short-cut review was carried out to establish whether lidocaine is a useful adjuvant in the gastrointestinal cocktail of dyspepsia treatment. 325 citations were reviewed, of which two answered the three-part question. The clinical bottomline is that antacid alone should be used as preferred treatment for dyspesia. The addition of lidocaine and donnatal can be used on doctor's discretion in patients without contraindications to these agents.