Anaesthesia for bronchoscopy in children with inhaled solid foreign body: a review of thirty-six cases.
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Biomedical subjects
Publications and source records attributed to E N Ayim.
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At the beginning of the century, splenectomy was used in the treatment of kala-azar, but now is rarely needed, the major indication being for drug resistant kala-azar. Inadvertent splenectomy prior to the diagnosis of kala-azar continues to occur, probably because of a reluctance to perform splenic aspiration in the investigation of splenomegaly. Five Kenyan children underwent splenectomy for drug resistant kala-azar. All were immediately improved, but one died of overwhelming post splenectomy infection (OPSI) two months later and another of a malignant lymphoma seven months after surgery. The other three patients appear to be cured. Splenectomy was considered in a sixth child with kala-azar because of a Salmonella abscess in the spleen, but the abscess ruptured catastrophically before surgery could be arranged.
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Percutaneous catheterisation techniques for the axillary vein and proximal portion of the basilic vein based on venepuncture on a visible or palpable vein are described. Results are presented on 73 catheterisation attempts on axillary veins and 68 on proximal basilic veins, in which the failure rate was 4-9% and 6-9% respectively. The advantages of the techniques include simplicity and the absence of acute life-threatening complications. The incidence of phlebitis from indwelling catheters maintained for an average of 5 days (range 1-28 days) is less than 2%. Several aspects of the techniques including background anatomy and anticipated risks are discussed.
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