Anaesthetic related maternal deaths in Malaysia--a review.

The anaesthetic hazards for the obstetric patient are well known. Based on results of the first two reports on the confidential enquiry into maternal deaths in Malaysia for 1991 and 1992, ten cases of anaesthetic related deaths were analysed. There were 3 in 1991 and 7 in 1992 accounting for 1.34% and 2.8% of maternal deaths respectively. It was estimated that the crude mortality rate for the obstetric patient was 11.4 per 100,000 operative deliveries or a four-fold risk compared to the general surgical patient. One case resulted from administration of intravenous sedation while the rest involved general anaesthesia, seven of which were done under emergency conditions. Inadequate airway management and ventilation in the perioperative period, including during interhospital transfer was the single most important factor causing the majority of these deaths. The use of regional anaesthesia for Caesarean sections is strongly advocated. Substandard care was also present in all cases. Other issues pertinent to improvement of obstetric anaesthetic services are also discussed which include the quality of anaesthetic manpower, upgrading of infrastructure, facilities and staffing of operating and recovery areas, the use of regional anaesthesia, expanding the role of the anaesthetist and the quality of the anaesthetic services in general.

[The hemagglutinating properties of Pseudomonas aeruginosa strains isolated from patients with nonspecific lung diseases]. / Gemaggliutiniruiushchie svoistva shtammov Pseudomonas aeruginosa, vydelennykh ot bol'nykh s nespetsificheskimi zabolevaniiami legkikh.

To detect d-mannose-sensitive (MS) pili in 31 P. aeruginosa strains isolated from the respiratory tract of patients with inflammatory and purulent destructive pulmonary diseases, the hemagglutination (HA) test was used. The isolated Pseudomonas under study differed in the degree of manifestation of their MS adhesins. Among them microorganisms with pronounced HA activity (high HA titer) occurred, as well as those whose HA activity was less pronounced (low HA titer). P. aeruginosa strains with pronounced HA activity were more frequently isolated from patients with purulent destructive processes in the lungs. A correlation between the state of the patient at the moment of bacteriological examination and the degree of manifestation of MS pili in the P. aeruginosa strain isolated from this patients was established. The value of HA titer in the presence of d-mannose is indicative of the presence of MS adhesins in a P. aeruginosa strain.

[The adhesive properties of salmonellae in the dynamics of the infectious process]. / Adgezivnye svoistva sal'monell v dinamike infektsionnogo protsessa.

In patients with toxic infections salmonellae were identified in 31% of cases. The patients were divided into two groups: the control group receiving treatment with infusion solutions and the test group treated, in addition to the usual scheme of therapy, with indomethacin in a daily dose of 150 mg. The study revealed that salmonellae isolated at the initial stages of the disease possessed highly pronounced adhesive properties. The adhesive properties of salmonellae isolated at the stage of convalescence from the patients of the test group were considerably less pronounced than those of salmonellae isolated from the same patients at the peak of the disease. In the control group no differences in the adhesive properties of salmonellae isolated from the same patients were established.