Malaria remains a military medical problem.

OBJECTIVE: To bring military medical problems concerning malaria to the attention of the Defence Medical Services. METHOD: Seven military medical problems related to malaria are illustrated by cases referred for secondary assessment over the past five years. Each is discussed in relation to published data. RESULTS: The cases of failure of various kinds of chemoprophylaxis, diagnosis and treatment of malaria may represent just a fraction of the magnitude of the overall problem but in the absence of reliable published military medical statistics concerning malaria cases, the situation is unclear. CONCLUSION: Present experience suggests there are a number of persisting problems affecting the military population in relation to malaria. Only publication of reliable statistics will define their magnitude. Interim remedies are proposed whose cost-effectiveness remains to be established.     

Surrogate motherhood as a medical treatment procedure for women's infertility

The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions.     

New realities and old classifications: a problem in medical ethics.

Advances in research and technology are forcing us to confront hitherto unknown forms of life on both macroscopic and microscopic levels. Genetically engineered cells, human embryos growing in Petri dishes or preserved in freezers, human beings without hearts or functioning brains, these are just a few examples of the new forms of life. The challenge now is to determine what actions relative to these unfamiliar realities are morally acceptable.     

Competency for military arrest as a psychiatric problem

Military law does not invest doctors with the authority to determine whether a soldier is competent to enter military arrest. This determination is legal in nature. Therefore, medical (or psychiatric) examination which is carried out before or within military arrest or detention, is aimed at preventing deterioration in the health of the soldier in prison. Hence, medical opinion serves only as 'credentials' of sorts. This is the formal language of the military law. In reality, the examining psychiatrist has to consider many factors, bearing in mind that his conclusions will probably become a prominent basis for the final decision on the military legal officer (whether to enforce military arrest). In order to illustrate the complicated considerations which are set forth before military psychiatrists, several case reports are presented of soldiers, who were examined in the Israel Defence Forces central psychiatric clinic for the determination of competency for military arrest.     

1. The myth of child rape as a cure for HIV/AIDS in Transkei: a case report

South Africa has one of the highest cases of HIV/AIDS infection in Africa, and Transkei, a former black homeland, now a part of the Eastern Cape Province, is one locality with a large number of HIV/AIDS sufferers. The unemployment level is very high and crime, including child rape, is very common. This report presents the case of a victim of rape, a nine-year old female child who was brought to the Umtata General Hospital, a victim of the mistaken belief that sex with a virgin will cure an HIV-infected person or AIDS sufferer of his illness. The alleged rapist was an HIV-positive uncle of the child. The myth of the 'HIV/AIDS virgin cure' is prevalent in the community. The history, physical examination and laboratory investigations of this case are given. A conclusion is drawn and preventive methods are suggested.     

Shoulder arthrography as a treatment modality.

Some patients undergoing shoulder arthrography with a stiff and painful joint have a small volume capsule or a frozen shoulder. In certain cases when the rotator cuff is intact, the arthrographic procedure has been therapeutic and joint distention has effected a return to normal function. Four such cases are presented.     

Vasovagal syncope: a new treatment for an old problem

Vasovagal syncope is an extremely common condition that is most often benign. However, in some individuals it can be far more severe, with frequent, sudden, and prolonged episodes of loss of consciousness. The effects can be traumatic, not only from the acute event but from the lifestyle changes that are necessitated by these attacks. We report on the presentation and diagnosis of once such individual and discuss the various treatment options. In addition, supported by recently published evidence, we demonstrate how a pacemaker with rate-drop response is an effective form of treatment.     

Radiologists as clinical tutors in a problem-based medical school curriculum.

RATIONALE AND OBJECTIVES: The authors sought to evaluate the experience of radiologists teaching in a problem-based pre-clinical medical school curriculum. MATERIALS AND METHODS: The undergraduate medical school curriculum at Wake Forest University includes 2 problem-based preclinical years that integrate basic and clinical sciences. Sixteen radiology fellows served as general clinical tutors for 5-9 weeks, each guiding the work of six 2nd-year students, often in tandem with a basic science tutor. On completion of the tutoring. the radiologists and the students were surveyed by means of a questionnaire. A follow-up group interview was conducted with the radiologists. RESULTS: The response rate to the questionnaire was 81% for the radiologists and 47% for the students. On average, radiologists spent 6.1 hours weekly on preparation and tutoring and 3.5 hours in total on administration and grading. All radiologists thought tutoring was rewarding, but seven of the 13 respondents (54%) disliked assigning grades. Radiologists spent less time teaching radiology residents and performing research, but few thought their clinical work was adversely affected. Nearly half of the radiologist-tutors thought that the preliminary orientation and training provided to them by the medical school was not adequate, and nearly all of them thought that they could have been better prepared. All of the medical students improved their perceptions of radiologists after having had a radiologist as a tutor, and most thought that the radiologist-tutors performed as well as or better than tutors from other disciplines. CONCLUSION: Radiologists can be successful as general tutors in a problem-based medical school curriculum. benefiting both radiologists and students. Better orientation and training by the medical school would improve the program.