- Email: [email protected]
R.M.B.F. CHRISTMAS GIFTS FUND
102 for these areas are of approximately size as operating suites and the number of people using them is approximately the same as in an operating team. We have, ever since we opened our factory, kept records of the results of plate exposures made in the various areas of our aseptic rooms under varying con. ditions of population, time, and temperature, and these results are available to anyone who is interested and would care to study them. We will be very pleased to place this, and any other information about air filtration, &c., at the disposal of hospital authorities who may be interested.
operating-theatres,
Letters to the Editor
the
R.M.B.F. CHRISTMAS GIFTS FUND
SiR,-It is a very great pleasure to report that the amount contributed to the Christmas Gifts Fund was most satisfactory and exceeded that of all
previous
years. It is
impossible for me to thank the contributors personally for their generous response to my appeal, but through you, Sir, I should like to thank all your readers who have helped. I am specially grateful to the many B.M.A. divisions and branches, medical societies, and local medical committees who either forwarded donations from their own funds or arranged for collections to be made at an autumn meeting. The many messages of goodwill sent with donations show how much this Christmas effort of the Royal Medical Benevolent Fund is approved of by the profession. It is hoped that as each Christmas comes round this work of kindness and good fellowship will be continued. I ask those who read the Christmas appeals in future to bear in mind the intense pleasure and gratitude felt and expressed by those who benefit from the appeal. ,desire to express my own very sincere appreciation of the generosity which has been shown.
WEBB-JOHNSON President, Royal Medical Benevolent Fund. *** We understand that the sum contributed was about JE2960.—ED. L. VISITING CHILDREN IN HOSPITAL 28 an important aspect of visiting children in hospitals is not mentionednamely, the introduction of secondary infections which sometimes be quite serious. Although it may may "
SiR,-In your annotation of Nov.
"
only.mean a common cold, the virus usually runs like wild-fire through the ward, holds up progress, prevents anesthesia, and lengthens the average stay of the children in hospital; and therefore adds very considerably indeed to the annual cost of running the ward. It would be interesting to obtain the average lengths of stay for similar cases in two hospitals, of which one allowed daily visiting and the other prohibited visiting. Bacteriological samples of the air in a ward after visitors have left might yield some interesting facts. We ourselves, because of these risks, practise mother-nursing in single rooms, with practically no visiting, for all our infant surgical cases, and we believe it should be all or none." Under these conditions, we get absolutely no crossinfection and very rarely a common cold, which never spreads. We have just concluded a successful year’s surgical work at our " mother and baby " hospital. There has - been no morbidity whatever, no mortality, and no failure of any operation, despite 3 full operation sessions a "
week. This we ascribe to no cross-infection and no introduced infection by visitors. H. P. PICKERILL CECILY PICKERILL. Wellington, New Zealand
* ** We hope to publish shortly an article by Mr. and Mrs. Pickerill describing their system of hospital nursing by the mother.-ED. L. OPERATING-THEATRE INFECTIONS SiB,—We have been following with great interest the correspondence in your columns on this subject. The letter by Mr. Fowler (Dec. 19) suggests consultation with pharmaceutical manufacturers, and this appears to us to be a valuable contribution. In our own case, the aseptic areas in our factory are of particular interest to those studying conditions in
same
Ethicon Suture Laboratories, Bankhead Avenue,
Edinburgh.
J. OWEN DAWSON Technical director.
TOXIC EFFECTS OF PRIMIDONE
SiR,—Primidone (’ Mysoline ’) was first introduced into clinical practice in the treatment of epilepsy about two Since then trials have been reported by years ago. Handley and Stewart(from the David Lewis Epileptic Colony), Butter2 (in sane epileptics), and Whitty3 (in a mixed group of epileptics attending a neurological out. patient clinic), and, in your issue of Jan. 2, by Dr. Briggs and Dr. Tucker (in children with petit mal), and by Dr. Nathan (in patients with non-idiopathic epilepsy). It is generally agreed that this drug has worthwhile advantages over the older anticonvulsant drugs in the control of grand-mal epilepsy and in the so-called temporal-lobe epilepsies," and that it may be beneficial in some cases of petit mal. All the reports have described toxic effects with the use of primidone but these were, on the whole, mild and transient. "
In Handley and Stewart’s series of 40 patients, there was patient with a morbilliform rash, 1 with slight nausea, and 2 with transient and mild feelings of drunkenness. In another series, several patients complained of dizziness, disturbance of accommodation, listlessness, and difficulty in rousing from their sleep. These symptoms arose during the first week of treatment and passed off in the course of a few days. In no 1
case was it necessary to stop the treatment because of a toxic effect. In’Butter’s series of 58 cases almost all patients complained of slight drowsiness or listlessness for a day or two, and in 8 patients the drowsiness was sufficiently persistent to warrant discontinuing the treatment. 2 other patients were slightly ataxic, 1 had slurred speech, and 1 complained of nausea. 5 out of 70 of Whitty’s patients on primidone had to dis. continue the drug, but in 2 cases this was probably unnecessary. In 2 cases the drug was withdrawn because of the development of a confusional psychosis, in another 2 because of persistent vomiting, -and in 1 because of transient nausea, giddiness, and ataxia, which also affected 3 other patients to a lesser degree. 58 patients complained of drowsiness initially, though in all but 12 it cleared up within a week. Urticarial rashes appeared in 2 cases.
Within the last month or two, 4 outpatients at this hospital have shown what might be best described as a peculiar idiosyncrasy to primidone, which became apparent after the administration of just one tablet of the drug and which necessitated stopping treatment. CASE I.-A woman, aged 38, complained of "peculiar
turns " during which she would become confused, feel faint, and act rather automatically. They usually occurred within a few days of her menstrual periods. The E.E.G. was com-
with a diagnosis of epilepsy, but showed no localising She was prescribed primidone but after taking one 0-25 g. tablet she became nauseated, violently sick, and drowsy. She complained of severe head pains, double vision, and " pins and needles " over her head, face, and neck. She felt ill for a day or two. Before this she had been taking gr. 1’/2 of phenobarbitone nightly.
patible signs.
1.
Handley, R., Stewart, A. S. R.
Lancet, 1952, i, 742.
2. Butter, A. J. M. Ibid, 1953, i, 1024. 3. Whitty, C. W. M. Brit. med. J. 1953, ii, 540.
operating-theatres,
Letters to the Editor
the
R.M.B.F. CHRISTMAS GIFTS FUND
SiR,-It is a very great pleasure to report that the amount contributed to the Christmas Gifts Fund was most satisfactory and exceeded that of all
previous
years. It is
impossible for me to thank the contributors personally for their generous response to my appeal, but through you, Sir, I should like to thank all your readers who have helped. I am specially grateful to the many B.M.A. divisions and branches, medical societies, and local medical committees who either forwarded donations from their own funds or arranged for collections to be made at an autumn meeting. The many messages of goodwill sent with donations show how much this Christmas effort of the Royal Medical Benevolent Fund is approved of by the profession. It is hoped that as each Christmas comes round this work of kindness and good fellowship will be continued. I ask those who read the Christmas appeals in future to bear in mind the intense pleasure and gratitude felt and expressed by those who benefit from the appeal. ,desire to express my own very sincere appreciation of the generosity which has been shown.
WEBB-JOHNSON President, Royal Medical Benevolent Fund. *** We understand that the sum contributed was about JE2960.—ED. L. VISITING CHILDREN IN HOSPITAL 28 an important aspect of visiting children in hospitals is not mentionednamely, the introduction of secondary infections which sometimes be quite serious. Although it may may "
SiR,-In your annotation of Nov.
"
only.mean a common cold, the virus usually runs like wild-fire through the ward, holds up progress, prevents anesthesia, and lengthens the average stay of the children in hospital; and therefore adds very considerably indeed to the annual cost of running the ward. It would be interesting to obtain the average lengths of stay for similar cases in two hospitals, of which one allowed daily visiting and the other prohibited visiting. Bacteriological samples of the air in a ward after visitors have left might yield some interesting facts. We ourselves, because of these risks, practise mother-nursing in single rooms, with practically no visiting, for all our infant surgical cases, and we believe it should be all or none." Under these conditions, we get absolutely no crossinfection and very rarely a common cold, which never spreads. We have just concluded a successful year’s surgical work at our " mother and baby " hospital. There has - been no morbidity whatever, no mortality, and no failure of any operation, despite 3 full operation sessions a "
week. This we ascribe to no cross-infection and no introduced infection by visitors. H. P. PICKERILL CECILY PICKERILL. Wellington, New Zealand
* ** We hope to publish shortly an article by Mr. and Mrs. Pickerill describing their system of hospital nursing by the mother.-ED. L. OPERATING-THEATRE INFECTIONS SiB,—We have been following with great interest the correspondence in your columns on this subject. The letter by Mr. Fowler (Dec. 19) suggests consultation with pharmaceutical manufacturers, and this appears to us to be a valuable contribution. In our own case, the aseptic areas in our factory are of particular interest to those studying conditions in
same
Ethicon Suture Laboratories, Bankhead Avenue,
Edinburgh.
J. OWEN DAWSON Technical director.
TOXIC EFFECTS OF PRIMIDONE
SiR,—Primidone (’ Mysoline ’) was first introduced into clinical practice in the treatment of epilepsy about two Since then trials have been reported by years ago. Handley and Stewart(from the David Lewis Epileptic Colony), Butter2 (in sane epileptics), and Whitty3 (in a mixed group of epileptics attending a neurological out. patient clinic), and, in your issue of Jan. 2, by Dr. Briggs and Dr. Tucker (in children with petit mal), and by Dr. Nathan (in patients with non-idiopathic epilepsy). It is generally agreed that this drug has worthwhile advantages over the older anticonvulsant drugs in the control of grand-mal epilepsy and in the so-called temporal-lobe epilepsies," and that it may be beneficial in some cases of petit mal. All the reports have described toxic effects with the use of primidone but these were, on the whole, mild and transient. "
In Handley and Stewart’s series of 40 patients, there was patient with a morbilliform rash, 1 with slight nausea, and 2 with transient and mild feelings of drunkenness. In another series, several patients complained of dizziness, disturbance of accommodation, listlessness, and difficulty in rousing from their sleep. These symptoms arose during the first week of treatment and passed off in the course of a few days. In no 1
case was it necessary to stop the treatment because of a toxic effect. In’Butter’s series of 58 cases almost all patients complained of slight drowsiness or listlessness for a day or two, and in 8 patients the drowsiness was sufficiently persistent to warrant discontinuing the treatment. 2 other patients were slightly ataxic, 1 had slurred speech, and 1 complained of nausea. 5 out of 70 of Whitty’s patients on primidone had to dis. continue the drug, but in 2 cases this was probably unnecessary. In 2 cases the drug was withdrawn because of the development of a confusional psychosis, in another 2 because of persistent vomiting, -and in 1 because of transient nausea, giddiness, and ataxia, which also affected 3 other patients to a lesser degree. 58 patients complained of drowsiness initially, though in all but 12 it cleared up within a week. Urticarial rashes appeared in 2 cases.
Within the last month or two, 4 outpatients at this hospital have shown what might be best described as a peculiar idiosyncrasy to primidone, which became apparent after the administration of just one tablet of the drug and which necessitated stopping treatment. CASE I.-A woman, aged 38, complained of "peculiar
turns " during which she would become confused, feel faint, and act rather automatically. They usually occurred within a few days of her menstrual periods. The E.E.G. was com-
with a diagnosis of epilepsy, but showed no localising She was prescribed primidone but after taking one 0-25 g. tablet she became nauseated, violently sick, and drowsy. She complained of severe head pains, double vision, and " pins and needles " over her head, face, and neck. She felt ill for a day or two. Before this she had been taking gr. 1’/2 of phenobarbitone nightly.
patible signs.
1.
Handley, R., Stewart, A. S. R.
Lancet, 1952, i, 742.
2. Butter, A. J. M. Ibid, 1953, i, 1024. 3. Whitty, C. W. M. Brit. med. J. 1953, ii, 540.