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H Harding

The Role of Pre-induction Ketamine in the Management of Postoperative Pain in Patients Undergoing Elective Gynaecological Surgery at the University Hospital of the West Indies

Issue: 
Pages: 
224–9
Synopsis: 
A prospective case-controlled randomized study was performed to assess the effect of ketamine 0.15 mg/kg pre-induction on postoperative narcotic requirements and pain scores. There was no significant reduction in analgesic consumption or pain intensity; however, more patients who received ketamine reported higher levels of satisfaction with their pain management.

ABSTRACT

Objectives: To determine if a single preoperative dose of ketamine hydrochloride reduces the narcotic analgesic requirements and/or pain scores reported by patients in the first 24 hours postoperatively.

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e-Published: 21 Aug, 2013

Transfer of Head-injured Patients in Jamaica: Is there a Problem?

Issue: 
Pages: 
220–24
Synopsis: 
The transfer of head-injured patients, many with multiple injuries, is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardized protocol for the transfer of such patients in Jamaica.

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e-Published: 05 Jun, 2013

Microbial Isolates from Patients in an Intensive Care Unit, and Associated Risk Factors

Issue: 
Pages: 
225–31
Synopsis: 
Sputum, blood and urine cultures done in ICU patients at the UHWI showed a predominance of gram-negative organisms. Risk factors for positive cultures included mechanical ventilation > 5 days, CVP line insertion > 7 days, pre-admission infection, prior use of antibiotics, increasing APACHE II score and increasing age.

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e-Published: 05 Jun, 2013

Surgery in the Elderly: Is Age a Risk Factor?

Issue: 
Pages: 
171–75
Synopsis: 
Elderly surgical patients at the University Hospital of the West Indies, Kingston, Jamaica, had less emergency admissions, underwent more surgery, had a longer mean hospital stay, a higher mortality rate and a greater mortality amongst emergency admissions. Cancer was the commonest admission diagnosis and that amongst mortalities.

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e-Published: 05 Jun, 2013

Triage Decisions and Outcome among the Critically Ill at the University Hospital of the West Indies

Issue: 
Pages: 
181–86
Synopsis: 
The triage and outcome of patients referred for admission to the ICU at the University Hospital of the West Indies, Kingston, Jamaica, was investigated. The authors found that disease severity was the main determinant of admission to the ICU, and that a shortage of ICU beds is adversely affecting outcome.

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e-Published: 05 Jun, 2013

Neuroendoscopy in Jamaica

Issue: 
Pages: 
34–7
Synopsis: 
Neuroendoscopy is the treatment of choice for obstructive hydrocephalus due to aqueduct stenosis or posterior fossa tumours and has the advantage of avoiding shunt related complications. It is safe and effective for the majority of patients and has a significant role in the management of neurosurgical patients in the West Indies.

 

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e-Published: 04 Jun, 2013

Anaesthetic Morbidity at the University Hospital of the West Indies

Issue: 
Pages: 
452–7
Synopsis: 
Prospective analysis of 3185 anaesthetic procedures revealed a complication rate of 201 per 1000 intraoperatively and 93 per 1000 during recovery. Cardiovascular complications were most frequent intra-operatively, whilst hyperglycaemia, nausea and vomiting were most common during recovery. Risk factors included ASA status, age, co-morbid conditions, prolonged anaesthesia, high surgical risk and intubation.

ABSTRACT

Objective: There is little information on adverse anaesthetic outcomes from the Caribbean. The aim of this study was to investigate the occurrence of anaesthetic morbidity and mortality at the University Hospital of the West Indies (UHWI) and to identify possible risk factors.

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e-Published: 20 Sep, 2013
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