Apnoea induced by airflow obstruction

Total obstruction of the airways caused all respiratory efforts to stop on 15 occasions in 10 preterm babies. This was not seen in 60 studies on 38 term babies. These findings suggest that failure to achieve an oral airway may not be the only mechanism by which upper airway obstruction might cause the cot death syndrome.     

An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment

Background  

The treatment guidelines for tuberculosis treatment under Directly Observed Treatment, Short-course (DOTS) have been a common strategy for TB treatment in Zambia. The study was carried out in Ndola, Zambia, to investigate factors contributing to treatment non-adherence and knowledge of TB transmission among patients on TB treatment, in order to design a community-based intervention, that would promote compliance.     

Continuous muscle fiber activity syndrome

A 5.5 year old Turkish boy who suffered from progressive muscle stiffness was diagnosed as having continuous muscle fiber activity syndrome. Electromyography showed continuous motor neuron activity at rest and following intravenous injection of diazepam. Peripheral nerve block, spinal and general anesthesia diminished the spontaneous activities. The clinical and electrophysiological findings of our case were compared to the previously reported cases with emphasis on the heterogeneity of the syndrome.     

Agnathia (severe microghathia), aglossia and choanal atresia in an infant

A neonate is reported here, who was born with severe mandibular hypoplasia, complete absence of the tongue, unilateral choanal atresia, contralateral choanal stenosis and developed severe airway obstruction at birth. Arrested development of the ventral first branchial arch most likely underlies the clinical deficits. Most reported cases of agnathia have been lethal but the infant reported here has survived into infancy with a tracheostomy and feeding gastrostomy. Her clinical features, assessment and management are discussed.     

INCREASING CAESAREAN SECTION AND PERINATAL OUTCOME

An analysis of births by caesarean sections for ten years at a service hospital was carried out to identify the benefit in terms of reduction in perinatal mortality over the period without increase in maternal mortality and morbidity. An increase of 43.25 per cent in caesarean section rate was observed. Since 1986 there had been no significant change in the indications for caesarean sections or obstetrical care in terms of man and machine modernisation at this hospital. New born''s care in this hospital is supervised by obstetrician and medical specialist. However, a definite reduction in perinatal mortality rate by 59.68 per cent was noted with no maternal mortality in caesarean cases. This retrospective study showed that the judicious increase of caesarean sections could improve perinatal outcome.KEY WORDS: Perinatal mortality in caesarean section, Perinatal outcome with increased caesarean section rate     

围术期焦虑及干预

本文以自评、医师评定两种方式对腹部手术患者１０３例（除外精神科病史）进行围术期焦虑及干预的描述性研究。发现术前明显焦虑者占３０％，疑有焦虑者占３４％，无焦虑者占３６％。特质焦虑直接影响术前状态焦虑，疾病、手术因素影响术后焦虑，此时特质焦虑仍起作用。支持性心理治疗能降低术前焦虑，提高无并发症者满意程度，但对躯体预后无直接影响。另外，腹部手术患者入院时血皮质醇浓度高于正常人群。