Gastro-intestinal injuries in abdominal trauma

Management of 55 patients of gastro-intestinal injuries has been reviewed. Eighty percent of the patients presented with generalised peritonitis and jejunum was the commonest segment of the bowel injured. Pneumoperitoneum co-related poorly with intestinal disruption. It was present in 35.8 per cent of the cases. Repeated physical examination was found to be paramount importance. Sixty percent of the patients has associated intra-extra-abdominal injuries. Preoperative shock, multiple hollow visceral injury, septicemia, and location of injury (colon and duodenum) were significant prognostic factors associated with the high mortality. Mortality in the series was 25.4 per cent.     

Piroxicam gel, compared to EMLA cream is associated with less pain after venous cannulation in volunteers

PURPOSE: To evaluate and compare the analgesic efficacy and anti-inflammatory effects of topical piroxicam gel vs eutectic mixture of local anesthetic (EMLA) cream applied to the peripheral venous cannulation site in adult volunteers. METHODS: Piroxicam gel and EMLA cream were randomly applied on the dorsum of the right and left hand of ten volunteers who acted as their own control. A venous cannula was inserted (no iv infusion) and removed after one hour. Pain scores and signs of inflammation were noted at the cannulation site up to 48 hr. RESULTS: Pain scores with piroxicam gel were higher on cannulation and on advancement of the cannula (P < 0.05). Thereafter, pain scores were significantly higher with EMLA (P < 0.05). Blanching was present at all the peripheral venous sites treated with EMLA cream. Signs of inflammation (erythema, edema) were not more frequent with EMLA than with piroxicam (P > 0.05). Induration was more frequent with EMLA at six hours. CONCLUSION: In volunteers EMLA cream is associated with less pain on cannulation and cannula advancement compared to piroxicam gel. Topical application of piroxicam gel before peripheral venous cannulation alleviates pain and, possibly, inflammation in the period subsequent to cannulation itself.     

A general hospital psychiatric unit inpatient facility

Summary Patients admitted to the inpatient ward of a psychiatric unit in a general hospital have been studied with regard to their clinical characteristics, reasons for admission and discharge patterns. The results indicate that patients are most often admitted for the management of acute disturbance and detailed diagnostic evaluation and they are discharged in a semi-improved state. Implications of such a service pattern are discussed.     

Psychosocial effects of longterm cannabis use in India. A study of fifty heavy users and controls.

Fifty cases of heavy cannabis users in India (25 smokers of charas and 25 drinkers of bhang) were studied for their physical and mental health and compared with 25 non-user controls. The average duration of cannabis use was more than 10 years with an estimated average consumption of about 150 mg of THC daily. Physical health and nutrition were relatively poor in users and there were more respiratory complaints. No case of definite psychosis related to the use of cannabis was found in the series, though minor neurotic complaints were present in all groups. In the social sphere cannabis users gave more often a history of poor work record, family maladjustment and episodes of violent behaviour.     

The WHO collaborative study on strategies for extending mental health care, III: Evaluative design and illustrative results

Teams in seven developing countries have adopted a common research design to evaluate new community mental health care services. The nature of the intervention programs varied considerably according to the characteristics of each area. Observations made before the intervention and 18 to 24 months after showed significant changes in the attitudes, knowledge, and diagnostic accuracy of health staff and in community attitudes and reactions. A considerable number of individuals with serious mental disorders received effective care for the first time.     

Conditioned effects of kindling three different sites in the hippocampal complex of the rat

Rats received kindling stimulations to the perirhinal cortex (PRh), ventral hippocampus (VH), or dorsal hippocampus (DH) in 1 environment and an equivalent number of sham stimulations in a 2nd environment. The PRh-kindled rats displayed rapid kindling and a swift emergence of conditioned interictal defensiveness. In contrast, the VH- and DH-kindled rats displayed much slower kindling and slow or no conditioning, respectively. No effects of conditioning on the convulsions, comparable with those associated with amygdala kindling, were observed. These results establish the generality of some of the previously reported kindling-related conditioned effects, confirm the site specificity of some of these effects, and suggest that the convulsions, rather than the stimulations, function as the unconditioned stimuli for the conditioning of interictal behavior.