Oral rehydration therapy.
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Biomedical subjects
Publications and source records attributed to J Biddulph.
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An International Code of Marketing of Breast-Milk Substitutes was passed by the World Health Assembly in 1981. Papua New Guinea had already introduced legislation to control feeding bottles in 1977. This legislation has been effective in reducing bottle feeding, severe malnutrition and diarrhoeal diseases and deaths amongst infants in Port Moresby. Several favourable conditions in Papua New Guinea have allowed the legislation to be successful, but constant vigilance is necessary to maintain the present success.
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Criticisms of deployment of national doctors have ranged from their lack in rural areas to their lack as clinical specialists. It has been charged that after 27 years of producing doctors there is not one national doctor working anywhere in the highlands. An analysis of all the Papua New Guinea medical graduates from Fiji School of Medicine, medical graduates from Papuan Medical College and medical graduates from University of Papua New Guinea has been done. There were 124 doctors trained during the past 27 years. Of these only 66 (59 national and 7 non-national) are currently available. These 66 doctors are evenly divided up as general duties medical officers throughout the country except in the highlands provinces, medical administrators including provincial health officers, specialists or trainee specialists and other categories including 9% in private practice. These 66 doctors comprise 28% of the total doctors in the country. They make up 82% of the medical administrators, 40% of provincial health officers, 20% of medically qualified lecturers, 17% of general duties medical officers, 12% of doctors staffing rural health centres and 9% of Health Department specialists. 38% of national Health Department or Church doctors available for service are rural-based compared to 49% of non-national Health Department or Church doctors. The basic problem is the small pool of national doctors available. Only 4 highlands doctors are available, the first two graduating as recently as 1975. The proportion of highlands medical students is increasing each year. Many national doctors worked in highland provinces in the past and the killing of Dr. Luke Rovin in 1972 has probably been a factor in the absence of national doctors from the highlands in recent years. When more highlands doctors become available there will be national doctors working in the highlands.
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Of 50 jaundiced neonatal patients studied at the Port Moresby General Hospital, 11 (22%) were found to be glucose-6-phosphate dehydrogenase-deficient. No apparent exogenous precipitating causes for the jaundice were noted. Serum bilirubin levels exceeded 20 mg/100 ml in seven of these glucose-6-phosphate dehydrogenase-deficient infants, and exchange transfusions were required for three subjects. Glucose-6-phosphate dehydrogenase deficiency must be considered in the differential diagnosis of neonatal jaundice in Papua New Guinea.
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Neonatal jaundice is a common problem in Port Moresby. A survey was carried out on 50 consecutive jaundiced neonates in an attempt to delineate the causes of severe neonatal jaundice (bilirubin 15 mg. % or more). ABO blood group incompatibility, G-6-P-D deficiency and infection accounted for 62% of cases while no cause could be found in 38% of cases. Low birth weight, multiple births, male sex, asphyxia, delivery occuring outside the hospital, and vacuum extraction were associated more commonly with jaundiced neonates than with the controls. There was a statistically significant association between the use of promethazine in the mother during and after labour and jaundice in the newborn. The association between the use of sulphonamides in the mother after delivery and neonatal jaundice was suggestive but not statistically significant.
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