A comparison of general anaesthesia versus regional anaesthesia for Caesarean section reveals that both techniques are safe. Spinal anaesthesia is associated with significantly less blood loss, fewer transfusions, better Apgar scores and with insignificant trends toward shorter hospital stay, fewer neonatal care unit admissions, fewer perinatal deaths but more frequent postoperative infection.

Coronary artery disease is increasing in developing countries as western lifestyles are adopted. Between 1990 and 2001, 250 patients were admitted to rule out myocardial infarction in Antigua, 55% were confirmed. Based on available population figures, the incidence of hospitalization was 0.73 per year per 1000 men and 0.24 per year per 1000 women age 35 to 74 years in Antigua. This rate is less than 20% of the rate for the United States of America.

In an Afro-Caribbean population of 111 treated hypertensive patients, electrocardiographic left ventricular hypertrophy by any criterion was seen in 42% of patients and increased left ventricular mass index on echocardiogram was seen in 50% of patients. The sensitivity of various left ventricular scoring systems of the electrocardiogram for predicting increased left ventricular mass index was 3 to 31%, the specificity 80 to 96%. The echocardiogram may be the tool of choice for predicting cardiovascular risk in the hypertensive Afro-Caribbean patient.

Antibiotic use was retrospectively examined in appendicectomy cases in Antigua. Antibiotics were given for a mean of 5.39 days in 96.7% of cases. A distinction between inflammation, contamination and infection was not clearly made. Three or more antibiotics were given in 83% of cases. Use of antibiotics does not follow guide-lines from the Surgery Infection Society regarding prophylaxis for appendicectomy.

A retrospective analysis of fetal ultrasound prediction of date of birth shows that ultrasound is significantly better than date of birth based on menstrual history in a primarily Afro-Caribbean population.

The status of addictive drug use in 100 persons from Antigua with addiction admitted for residential treatment was assessed at an average of 21 months following treatment. Abstinence was achieved in 46% of those entering treatment, in 51% completing treatment, in 60% in those whose families participated and in 92% of those accepting halfway house placement.