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OBJECTIVE: To compare the guidelines in the University Hospital of the West Indies (UHWI) acute asthma management protocol with actual practice in the Accident and Emergency Department. METHODS: A prospective docket audit was done of all consecutive medical records of patients, presenting with a diagnosed acute asthmatic attack between June 1 and September 30, 2010, to the emergency department of the UHWI. A convenient sample was used. The audit tool used was created from the UHWI protocol for the emergency management of asthma in adults and children, as well as the British Adult Asthma Audit Tool. The audit tool assessed three main sections: initial assessment, initial management, and discharge considerations. Data were coded and entered in Microsoft Excel 2007 and statistical analyses conducted using Stata version 10. Management patterns were compared to the actual protocol and then discussed. RESULTS: A total of 15 864 patients were seen during the study period. Of these, a total of 293 patients were seen for a presentation of acute asthma. More females (57.3%) than males were seen, with the mean age of 33.53 years. Only 31% of patients were given a severity assessment of mild, moderate, or severe. Peak expiratory flow rate (PEFR) was attempted and recorded in 62%, but only 18.1% of patients had both pre and post PEFR done. Only 4.4% of patients were administered nebulizations within the suggested time frame. Positively, 94.2% of patients were given a prescription for inhaled corticosteroids and bronchodilators to continue post-discharge. CONCLUSIONS: Acute asthma management still remains an area of medical practice that continues to have long-standing difficulties. Failure to assess and document the severity of asthma attacks along with the under-utilization of PEFR was noted.

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This article provides a brief description of the conceptual framework of some specific areas of research carried out either collaboratively or independently in the Emergency Department in an effort to positively impact on health issues in an era of evidence-based medicine. The paper focusses on epidemiological studies of infectious diseases, chronic non-communicable diseases, and a recent update on trauma patterns. Conduction of clinical trials is also highlighted. The role of collaboration in Emergency medicine is also discussed. Research must be developed deliberately to facilitate the primary goal of improved patient care and outcomes. Further recommendations are suggested.

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This article provides a brief description of the conceptual framework of some specific areas of research carried out either collaboratively or independently in the Emergency Department in an effort to positively impact on health issues in an era of evidence-based medicine. The paper focusses on epidemiological studies of infectious diseases, chronic non-communicable diseases, and a recent update on trauma patterns. Conduction of clinical trials is also highlighted. The role of collaboration in Emergency medicine is also discussed. Research must be developed deliberately to facilitate the primary goal of improved patient care and outcomes. Further recommendations are suggested.

Este artículo ofrece una descripción breve del marco conceptual de algunas áreas específicas de investigación llevada a cabo de forma colaborativa o independiente en el Departamento de Emergencias, en un esfuerzo por lograr un impacto positivo en los problemas de salud en una era de medicina basada en la evidencia. El trabajo se centra en los estudios epidemiológicos sobre enfermedades infecciosas, enfermedades crónicas no comunicables, y una actualización reciente de los patrones de trauma. También se subraya la conducción de ensayos clínicos, y se discute el papel de la colaboración en la medicina de la emergencia. Deben desarrollarse investigaciones con el propósito deliberado de facilitar el objetivo primario de mejorar la atención y los resultados clínicos del paciente. Se hacen algunas recomendaciones.

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OBJECTIVE: This study was conducted to identify the level of awareness of a sample of Jamaicans to symptoms of diabetes mellitus. METHODS: Diabetes mellitus is a common medical condition in the Jamaican population, and early recognition of symptoms and early diagnosis of this disease leads to better prognosis. A questionnaire was administered by way of an interview in public areas in Montego Bay, Buff Bay, Port Antonio, and Spanish Town to determine the mean level of awareness about some of the early and later symptoms of diabetes mellitus. One hundred and twenty persons were selected, 60 diabetics and 60 non-diabetics (49 males and 71 females), 40 persons from each of the three parishes. Correct recognition of early symptoms of diabetes attracted more points than did the recognition of late symptoms of diabetes mellitus. The sources from which this information was acquired were also recorded. RESULTS: There was a significant difference between the mean level of awareness of the symptoms of diabetes mellitus between the diabetic and non-diabetic study population (p = 0.0005); the diabetics were more aware of the symptoms than the non-diabetics (p = 0.001). Female subjects were more aware than the males, (p = 0.002); there was no statistically significant difference in awareness between the younger and older subjects, nor among the samples chosen from the three parishes. CONCLUSION: There is scope for more public health education to improve the level of awareness of the Jamaican Populace to the symptoms of diabetes mellitus.(Au)

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A case of facial palsy with lagophthalmos with exposure keratitis was corrected surgically by a method of temporalis transfer. When the slings were tightened leaving 1 cm gap in the palpebral aperture, lagophthalmos persisted. A secondary tightening procedure causing overlap of the upper lid over the lower yielded good results

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