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The Wider World
90 H. POPPER defined the cirrhotic lesion
as
showing
regenerative nodules and connective tissue septa joining portal vein and hepatic vein. The post-necrotic variety showed broader connective-tissue bands, and regenerative nodules of different sizes often containing more than one lobule. In the United States this was often found normal in women with values and
high serum-gamma-globulin
without a preceding history suggesting acute massivee necrosis of the liver. Rats given the methionine antagonist ethionine developed a post-necrotic type of cirrhosis with raised serum-gamma-globulins but without at any time being jaundiced. These animals showed gradual focal necrosis of liver cells and it was possible that postnecrotic cirrhosis in man might develop similarly. A. MARTINI (Hamburg) described patients with severe liver failure who were salt-depleted after some time on a salt-free diet, mercurial diuretics, and having abdominal paracenteses. They had severe abdominal cramps and
The Wider World THE NEW HOSPITAL AT QATAR QATAR is among the few peninsulas on this planet that point north. It is a sheikhdom on the Arabian side of the Persian Gulf, inhabited by some 35,000 people. Formerly they lived as best they could, chiefly by fishing and on the proceeds of a dwindling pearl industry; but in late years oil has been found there, and since its export began in 1949 the State has achieved enormous prosperity. Like his neighbour in Kuwait, the ruler, H.H. Sheikh Ali Bin Abdullah Bin Jasim Al-Thani, has decided that the new wealth should be used for the benefit of his subjects, and one of the fruits of this decision was the opening in February of the new State hospital, where all treatment is free. An international competition, in which 74 designs were submitted, was organised by the International ’Hospital Federation ; the assessor, Mr. A. S. Gray, F.R.I.B.A., awarded the prize to Mr. John R. Harris, A.R.r.B.A. His design was approved by the government in 1953. The building in profile looks strikingly like an ocean liner. It lies on a site not far from Doha, the capital, with fine views north to the sea, and it is so designed that every ward can enjoy these views as well as the prevailing northern breeze. In making a part basement to house air-conditioning plant and services, advantage has been taken of a 10-foot fall across the site. Ample residential accommodation is laid out to the west of the hospital. The site indicated the need for extensive prefabrication. The steel-work was designed and made in Britain, but much local material was used for the stone and concrete work. Special provision had to be made for expansion and contraction of the steel with changes in temperature. nitrous oxide, and suction pipes are supplied to operating-theatres, anaesthetic-rooms, and some surgical wards. About 1000 workmen were employed to build the
Oxygen,
acute dilatation of the stomach. Oliguria and ursemia associated with a glomerulitis at necropsy. The electro-encephalogram was typical of impending hepatic coma. Serum-sodium values ranged between 112 and 128 m.eq. per litre and the blood-pressure was low. Sodium administration sometimes caused transient P. improvement, but the outlook was very poor. DE’ScHEPPER and J. VANDENBROUCKE (Louvain) had investigated altered keto-acid metabolism in hepatic coma. Increased levels of alpha-ketoglutarate and pyruvic acid in the serum in acute hepatitis and cirrhosis were similar to the elevations which followed carbon-tetrachloride liver injury in rabbits. These were little changed by administration of ammonium chloride. Administration of glutamic acid increased the blood-alpha-ketoglutarate level in rabbits poisoned with carbon tetrachloride and in patients with liver disease. The mechanism must involve decarboxylation and was very complex.
were
hospital-the biggest project undertaken in Qatar, taking two and a half years. Among those responsible have been Mr. G. M. Hancock, O.B.E., His Highness’s adviser; Dr. G. R. C. Palmer, and his successor as State medical officer, Colonel A. E. Kingston, o.B.E. ; Dr. A. H. Samy, O.B.E., assistant State medical officer ; Lieut.-Colonel R. D. Ewing, the hospital surgeon ; Dr. A. G. Gotting, medical officer of health; and Mr. H. T. Hale, the State engineer. Dr. C. Elgood is the consultant physician, and other specialists are to be appointed. The hospital has a total of 130 beds (54 medical, 42 surgical, 20 traumatic, 6 recovery, and 8 isolation); these are already in use. A 66-bed tuberculosis annexe
is being built. There are 5 operating-theatres, a pharmacy and laboratory, and departments of diagnostic and therapeutic radiology and physiotherapy. On the staff are some 20 doctors and 70 nurses, and a modern signalling device has been installed. The men’s medical and surgical wards occupy the ground floor, on which there are separate orthopaedic and isolation units (the former hospital has been converted to a maternity and gynaecology unit). The women’s medical and surgical wards occupy the first floor. The wards consist of rooms each containing one to six beds, and the design of the building allows for the construction of additional wards adding over 80 beds. It also allows for cross-breezes to most parts of the hospital in case the air-conditioning system should fail : the steel windows are side-hung to form a scoop to the breeze. There are sunbreakers of wood and aluminium. Their importance is evident in an area where shade temperatures may reach 118°F with a high
humidity.
as
showing
regenerative nodules and connective tissue septa joining portal vein and hepatic vein. The post-necrotic variety showed broader connective-tissue bands, and regenerative nodules of different sizes often containing more than one lobule. In the United States this was often found normal in women with values and
high serum-gamma-globulin
without a preceding history suggesting acute massivee necrosis of the liver. Rats given the methionine antagonist ethionine developed a post-necrotic type of cirrhosis with raised serum-gamma-globulins but without at any time being jaundiced. These animals showed gradual focal necrosis of liver cells and it was possible that postnecrotic cirrhosis in man might develop similarly. A. MARTINI (Hamburg) described patients with severe liver failure who were salt-depleted after some time on a salt-free diet, mercurial diuretics, and having abdominal paracenteses. They had severe abdominal cramps and
The Wider World THE NEW HOSPITAL AT QATAR QATAR is among the few peninsulas on this planet that point north. It is a sheikhdom on the Arabian side of the Persian Gulf, inhabited by some 35,000 people. Formerly they lived as best they could, chiefly by fishing and on the proceeds of a dwindling pearl industry; but in late years oil has been found there, and since its export began in 1949 the State has achieved enormous prosperity. Like his neighbour in Kuwait, the ruler, H.H. Sheikh Ali Bin Abdullah Bin Jasim Al-Thani, has decided that the new wealth should be used for the benefit of his subjects, and one of the fruits of this decision was the opening in February of the new State hospital, where all treatment is free. An international competition, in which 74 designs were submitted, was organised by the International ’Hospital Federation ; the assessor, Mr. A. S. Gray, F.R.I.B.A., awarded the prize to Mr. John R. Harris, A.R.r.B.A. His design was approved by the government in 1953. The building in profile looks strikingly like an ocean liner. It lies on a site not far from Doha, the capital, with fine views north to the sea, and it is so designed that every ward can enjoy these views as well as the prevailing northern breeze. In making a part basement to house air-conditioning plant and services, advantage has been taken of a 10-foot fall across the site. Ample residential accommodation is laid out to the west of the hospital. The site indicated the need for extensive prefabrication. The steel-work was designed and made in Britain, but much local material was used for the stone and concrete work. Special provision had to be made for expansion and contraction of the steel with changes in temperature. nitrous oxide, and suction pipes are supplied to operating-theatres, anaesthetic-rooms, and some surgical wards. About 1000 workmen were employed to build the
Oxygen,
acute dilatation of the stomach. Oliguria and ursemia associated with a glomerulitis at necropsy. The electro-encephalogram was typical of impending hepatic coma. Serum-sodium values ranged between 112 and 128 m.eq. per litre and the blood-pressure was low. Sodium administration sometimes caused transient P. improvement, but the outlook was very poor. DE’ScHEPPER and J. VANDENBROUCKE (Louvain) had investigated altered keto-acid metabolism in hepatic coma. Increased levels of alpha-ketoglutarate and pyruvic acid in the serum in acute hepatitis and cirrhosis were similar to the elevations which followed carbon-tetrachloride liver injury in rabbits. These were little changed by administration of ammonium chloride. Administration of glutamic acid increased the blood-alpha-ketoglutarate level in rabbits poisoned with carbon tetrachloride and in patients with liver disease. The mechanism must involve decarboxylation and was very complex.
were
hospital-the biggest project undertaken in Qatar, taking two and a half years. Among those responsible have been Mr. G. M. Hancock, O.B.E., His Highness’s adviser; Dr. G. R. C. Palmer, and his successor as State medical officer, Colonel A. E. Kingston, o.B.E. ; Dr. A. H. Samy, O.B.E., assistant State medical officer ; Lieut.-Colonel R. D. Ewing, the hospital surgeon ; Dr. A. G. Gotting, medical officer of health; and Mr. H. T. Hale, the State engineer. Dr. C. Elgood is the consultant physician, and other specialists are to be appointed. The hospital has a total of 130 beds (54 medical, 42 surgical, 20 traumatic, 6 recovery, and 8 isolation); these are already in use. A 66-bed tuberculosis annexe
is being built. There are 5 operating-theatres, a pharmacy and laboratory, and departments of diagnostic and therapeutic radiology and physiotherapy. On the staff are some 20 doctors and 70 nurses, and a modern signalling device has been installed. The men’s medical and surgical wards occupy the ground floor, on which there are separate orthopaedic and isolation units (the former hospital has been converted to a maternity and gynaecology unit). The women’s medical and surgical wards occupy the first floor. The wards consist of rooms each containing one to six beds, and the design of the building allows for the construction of additional wards adding over 80 beds. It also allows for cross-breezes to most parts of the hospital in case the air-conditioning system should fail : the steel windows are side-hung to form a scoop to the breeze. There are sunbreakers of wood and aluminium. Their importance is evident in an area where shade temperatures may reach 118°F with a high
humidity.