Intravesical tube knot in a neonate: a case report

Catheterization of the neonate urethra may be required to relieve urinary retention, monitor fluid balance, or obtain access for radiological studies, or a urine specimen for culture when sepsis is suspected. The small calibred male urethra may resist the introduction of a standard catheter and an infant feeding tube, which is generally narrower and more flexible, is frequently used as a substitute. Complications attending this practice include trauma during insertion and subsequent haematuria. Acutal knotting of the tube within the bladder is rare, and its subsequent removal may pose a major challenge. We were recently presented with this problem and thought it would be useful to present the implications and management of such a situation (AU)

Percutaneous balloon mitral valvuloplasty for severe rheumatic mitral stenosis in Jamaica: the initial experience

Although percutaneous balloon mitral valvuloplasty has been performed in the Caribbean before, there has not been any detailed description in the English-speaking West Indian Medical literature hitherto. This report provides a description of the first four case of percutaneous balloon mitral valvuloplasty performed in Jamaica(AU)

Introducing total parenteral nutrition in a neonatal care unit - abstract

From October 1985 to November 1987, 150 out of 845 newborns hospitalized in the Pointe-a-Pitre Hospital Neonatal Care Unit have received total parenteral nutrition (TPN). Two hundred and four catheterizations have been performed on 150 newborns, 74 per cent less than 2,000 gm birth weight. Sixty-one per cent of the latter were less than 32 weeks of gestation. Indications for TPN were as follows: 66 (44 per cent)less than 1,500 gm birth weight (6 with necrotizing enterocolitis), 84 (56 per cent) 1,500 gm or more birth weight, 47 with pre-existing perpartum distress, 22 with gastrointestinal disorders, 11 with necrotizing enterocolitis and 4 with gastrointestinal congenital malformations. On average, central venous catheterization was performed on the eighth day of life, and infusion time was 25 days. The commonly observed TPN complications are glucose intolerance, hepatic cholestasis and phosphocalcific metabolism disorders (osteoporosis, ricketts). A clear-cut distinction is made between an introductory phase of the technique (1985-1986), and a second phase where better prevention of complications was achieved (1986-1987). TPN has become a necessary alternative for the management of newborns at high risk with gastrointestinal problems. In our patients, it has produced an average daily weight gain of 21 gm (AU)

Foley catheter hysterosalpingography - abstract

Radiologist and obstetricians normally perform hysterosalpinography by introducing a metallic cannula into the cervical canal, where contrast medium is injected in X-rays made for evaluation of uterine and tubal disease. This procedure is painful and cervical tears and perforation are no infrequent complications. Leakage of contrast medium from the cervix frequently results in inadequate studies. Dissatisfaction with this technique has resulted in the advocacy of uteroscopic and laparoscopic approaches. A simple Foley Catheter Technique is described. An 8F Foley Catheter is introduced into the cervix and balloon inflated. This occludes the cervix and permits good uterine and tubal filling by injected contrast medium. This procedure requires no special instrumentation and can be performed on a simple X-ray table. Ninety (90) consecutive studies performed between May, 1983 and December, 1983 are presented. Eighty-eight (88) were successfully performed and all were of good diagnostic quality. Patient tolerance was excellent with minimal pain. The Foley Catheter Technique is therefore highly recommended for safe and reliable hysterosalpingography (AU)

The in vivo sickle phenomenon: a reappraisal

Previous studies elsewhere have cast doubt on the in vivo relationship between oxygen saturation and red cell sickling. We have reinvestigated this relationship and find the expected correlation to occur at a variety of in vivo sampling sites. The correlation is apparent within data from single individuals, but may be lost when individual susceptibility to sickle cell formation is overlooked by pooling data from different patients. Samples from the hepatic vein did not usually fit the correlation and the unusual factors at this site are discussed (AU)

Some problems of cystometry

Cystometry is performed to evaluate deranged bladder function. In paraplegics the results are not always consistent with their clinical progress, nor have the results of treatment based on such tests always been satisfactory. The methods used involve a catheter in the urethra connected to a water manometer or a pressure recording device (Band 1956). At the same time filling of the bladder is artificially carried out by running in saline through the same catheter. This introduces several possible errors, and to avoid some of these, Comarr has used the normal excretion of the kidneys to fill the bladder (Comarr 1959) whilst von Garrelts uses a fine polythene tube in the urethra, instead of a catheter (von Garrelts 1956). Preliminary experiments have been made to record the pressure changes via a suprapubic polythene tube, avoiding a urethral catheter altogether. In this way a record of detrusor function unaffected by abnormal reflexes initiated at the level of the sphincters can be obtained (AU)