The Duration of Exercise Tolerance in Terms of Circulatory Indices in the Inhabitants of the Sakha Republic (Yakutia) within a Ten-Year Period

The duration of exercise tolerance of the circulatory system in different ethnic populations of Yakutia early in and at the end of the last decade of the 20th century (1988–1989 and 1998–1999) was studied. Compared to the native population (Yakuts), those born in Yakutia (Europoids) demonstrated a higher tolerance at both stages of the study. It was found that the work capacity and exercise tolerance significantly decreased in both ethnic groups during the last decade of the 20th century.     

The epidemiology of tuberculosis in Phuentsholing General Hospital: a six-year retrospective study

ABSTRACT: BACKGROUND: This study was carried out to describe the epidemiology and treatment outcomes of TB infection in Bhutan at Phuentsholing General Hospital (PGH). Retrospective analysis of TB data was carried out using data from the TB registry of PGH from 2004-2009. Comparisons were made between TB, clinical presentation, diagnosis, and outcomes amongst male and female. RESULTS: A total of 735 patients were analyzed, 12.4% (91) of whom were children ([less than or equal to]14 years). The highest cases was reported in 2009 (148), lowest in 2004 (93). Males and females were equally infected with TB. The median age was 25 years, (range 11 months - 98 years; IQR=20-35). Extra-pulmonary Tuberculosis (EPT) 62.6% (57) was the commonest form of TB in children. Pleural effusion was more common in males 62.8% (27) (p=0.013). Smear positive pulmonary tuberculosis (SPPT) 54.3% (207) (p=0.02) and treatment defaulted 84.2% (16) (p=0.004) was higher in males. However, transfer-in cases 57.0% (90) (p=0.036) and treatment outcome-failure 92.3% (12) (p=0.002) were more in females than males. The cure rate for SPPT was 69.0% (293) and unknown treatment outcome for all forms of TB was 11.2% (82). CONCLUSION: TB infection has increase over the study period; SPPT increased more than other two forms of TB. The majority of the TB patients were in the age group of 15-34 years. Males and females were equally infected with TB and children made up 12.4% of TB patients. The cure rate amongst SPPT was 69%, which is much lower that the national target of 85% set by National Tuberculosis Control Programme (NTCP). Further studies need to be undertaken to identify the risk factor for TB in the economically productive age group. There is a need for improvement in the services, recording and reporting so as to meet the target of cure rate of 85% in SPPT patients.     

The American General Practitioner in Hospital

In the U.S.A. and Canada full access of general practitioners to hospital beds and facilities is regarded as an essential privilege of their work. All hospital constitutions require a review of the credentials of staff applicants and continuing evaluation of their performance. Staff appointment carries administrative as well as clinical responsibilities and hospital work occupies a considerable proportion of the general practitioner''s day. The disciplinary machinery for safeguarding standards is strict by comparison with British hospital practice.This system produces an obvious excellence of clinical standards, postgraduate education, and communication between specialist and general practitioner and is attractive to the more able young British graduate. A pilot experiment of hospital staffing on North American lines in one of our new district general hospitals would be a worthwhile proposition.     

Serial Electrocardiograms Recorded on One Subject Over a Period of 42 Years (1923-1965)

A longitudinal study of the range of normal in the electrocardiogram was carried out, using the author as the subject: 18 records were made in the course of 42 years (1923-1965). Only minor differences were demonstrated which are believed to represent differences in posture or in relation to meals, because the electrocardiograms were not recorded under standard basal conditions. The QRS was wider in the precordial than in the limb leads. The amplitude of T-waves varied within a range of 1-11.5 mv.     

Diagnosis of Tuberculosis in a General Hospital

In a survey of 71 new cases of tuberculosis diagnosed in a general hospital the average interval between admission and diagnosis of tuberculosis (the diagnostic interval) ranged between 10 days for intrathoracic tuberculosis and 20 days for genitourinary tuberculosis. The average diagnostic interval was 10·9 days when tuberculosis was included in the initial differential diagnosis, and 22·8 days when other diagnoses were made. Undue delay in diagnosis occurred in 17 patients (24%). In eight this was due to failure to include tuberculosis in the initial differential diagnosis. Earlier diagnosis might have saved three of the five patients who died.In 21 patients (30%) a history of predisposing factors or associated illness was obtained. Ten of these had suffered from previous tuberculosis.The vital factor in diagnosis of tuberculosis in general hospital patients is consideration of this condition in the diagnosis of any unexplained illness, especially where a history of previous tuberculosis or a recognized predisposing factor is obtained.