Inspiratory vocal cord dysfunction, a new approach in treatment.

Vocal cord dysfunction is a well recognized respiratory condition in which adduction of the vocal cords during either inspiration or expiration, or both, causes functional airways obstruction. Diagnosis is usually made by laryngofibreoscopy, however treatment of this condition has generally been unsatisfactory, requiring a multi-disciplinary approach consisting of speech therapy, psychological counselling, sedatives and anaesthetic agents. Here we use an innovative approach which requires relatively inexpensive and simple anaesthetic equipment in order to manipulate airways resistance and thus reduce any vocal cord dysfunction as it occurs. The patient involved found instant relief when using this simple device which is easy to use and is portable.

Gastric tuberculosis presenting with massive hematemesis in association with acute myeloid leukemia.

This case report presents a patient with gastric tuberculosis, in remission from acute myeloid leukemia, who suffered a massive hematemesis, ultimately proving to be fatal. The literature of gastric tuberculosis is reviewed with particular reference to its clinical presentation and diagnosis.

Results of simple aspiration of pneumothoraces.

The results of simple aspiration in 30 cases of pneumothorax are presented. The procedure was successful in 33% of cases with known pre-existing lung disease, and in 83% of those without. Aspiration was also more successful in those patients under 50 years of age and if the estimated degree of lung collapse was less than 50%.

Treatment of pneumothorax by simple aspiration.

Ten patients with pneumothoraces were treated by simple aspiration. Treatment was successful in seven after single or multiple aspirations. Only one of these pneumothoraces has recurred and surgical treatment was then required.

Intranasal betamethasone valerate in the treatment of seasonal rhinitis.

Betamethasone valerate aerosol given in doses of 100 mug into each nostril twice daily was compared with a placebo in a double-blind, cross-over trial involving thirty patients with seasonal rhinitis. Patients recorded symptoms of eye irritation and watering, sneezing, rhinorrhoea, and nasal blockage, on a diary card. Analysis of the symptom scores showed that nasal symptoms were significantly better on betamethasone valerate than on placebo (P less than 0.01) and that nasal blockage in particular was improved (P less than 0.001). The patients' preference was significantly in favour of the active compound (p less than 0.02) and no side-effects were noted. It is concluded that betamethasone valerate offers a safe and effective form of treatment for seasonal rhinitis.