Polyorchidism with presumed contralateral intrauterine testicular torsion.

Introduction: Polyorchidism was first described by Blasius in 1670(1) during a routine autopsy. We report a child with unilateral polyorchidism and a contralateral absent testis, a combination not reported previously.

Presentation Of Case: A 2-year-old boy was referred to the outpatient clinic with an impalpable left testis.

Alternative medicine use at Vila Central Hospital: a survey of 'custom medicine' use in patients and staff a decade later.

A structured questionnaire was administered to 50 medical patients, 50 surgical patients and 50 staff members at Vila Central Hospital, Vanuatu. A similar study was conducted 10 years earlier. In the intervening decade, Vanuatu has seen unprecedented population growth, increasing expatriate numbers, and the introduction of mobile phone and Internet networks.

SLE and dental erosion: a lethal cocktail.

A 13-year-old Pacific Island girl presented complaining of fever, joint pain and dry mouth. She was using limes to relieve her dry mouth. On examination, the most striking clinical finding was severe dental erosion and caries.

Kava drinking in Vanuatu--a hospital based survey.

Kava is an intoxicating non-fermented beverage native to the Pacific Islands. In Vanuatu men traditionally drank kava on ceremonial occasions. Now however men and women drink kava on a casual basis.

Intensive care in paradise--a review of 57 ventilated patients in ICU in Vanuatu over five years.

Intensive care is not a medical priority for developing nations. Vila Central Hospital is the major referral centre for the developing Pacific island nation of Vanuatu and runs an 'as-needed' intensive care service. Between January 1999 and January 2004, fifty-seven patients were ventilated at Vila Central Hospital.

Perinatal mortality 1982-2001 at Vila Central Hospital, Vanuatu.

Objective: To determine the perinatal mortality at Vila Central Hospital (VCH) and thereby make an estimate of Vanuatu's perinatal mortality.

Methods: Labour floor and nursery records from VCH, Vanuatu's only tertiary referral hospital, were examined and collated for the period 1982-2001. Death certificate books were also examined.

Twenty-three years of labour floor records, Vila Central Hospital, Vanuatu.

Vanuatu is an island nation in the south-west Pacific. Vila Central Hospital (VCH) is the country's major referral hospital. The handwritten labour floor records from VCH between 1979 and 2001 were examined and collated.

Travel insurance and medical evacuation: view from the far side.

Travel insurers and medical evacuation companies have a responsibility to provide an efficient high-quality service to their clients. These companies often deliver a standard far short of best practice and far short of their promotional brochures. Their services are overdue for governmental review and a lifting of standards.

The effect of variable-dose diazepam on dreaming and emergence phenomena in 400 cases of ketamine-fentanyl anaesthesia.

This randomised double-blind field study compared 400 anaesthetics using diazepam (0, 0.025, 0.5, 0.

Population, public health and tubal ligation in Vanuatu.

The association between population growth and public health is often neglected. Between 1989 and 1999 Vanuatu's population grew by 30%. Unless this growth slows existing public health problems will worsen.

Spontaneous respiration via an open trachea for resection of a high tracheal stenosis in a child.

The successful management of tracheal stenosis requires compromise between the competing interests of the surgical and anaesthetic teams and the resources available. A seven-year-old girl with marked tracheal stenosis was successfully managed spontaneously breathing via an open trachea and a laryngeal mask. Anaesthesia was maintained by propofol infusion.

Ivermectin is better than benzyl benzoate for childhood scabies in developing countries.

Objective: To compare single dose oral ivermectin with topical benzyl benzoate for the treatment of paediatric scabies.

Methods: An observer-blinded randomized controlled trial was undertaken at Vila Central Hospital, Vanuatu. One hundred and ten children aged from 6 months to 14 years were randomized to receive either ivermectin 200 micro g/kg orally or 10% benzyl benzoate topically.

A randomized comparison of low-dose ketamine and lignocaine infiltration with ketamine-diazepam anaesthesia for post partum tubal ligation in Vanuatu.

Ketamine remains one of the most commonly used anaesthetic agents around the world. Despite it being the anaesthetic agent of choice in many developing nations, there is a paucity of literature describing ketamine in the developing world. In what we believe is the first randomized controlled trial to be performed in Vanuatu (formerly the New Hebrides) we compared the use of ketamine 0.

Review of 17 cases of ectopic pregnancy at the Vila Central Hospital in Vanuatu.

A review of cases of ectopic pregnancy operated upon at Vila Central Hospital during 1992 with an analysis of clinical presenting features and diagnostic factors is presented. Comparison is made between hospital, regional and national figures and possible explanations for the differences are given. Recommendations are made to ensure that ectopic pregnancy is always at the forefront of differential diagnosis in women presenting with abdominal pain.

Malaria treatment in Vanuatu: new national treatment guidelines.

In Vanuatu malaria is a major killer, especially of young children. As most deaths occur outside the hospital it is very important to have simple, clear guidelines on the management of patients with suspected malaria for the primary health care workers who treat the majority of cases. Despite the encouragement of early treatment, malaria was the major cause of death in children after the neonatal period in 1988.

Reducing perinatal mortality in Vila Central Hospital, Vanuatu.

This paper provides accurate figures and detailed analysis of the causes of perinatal mortality in the main referral hospital in Vanuatu in 1992, and discusses possible improvements in management. The perinatal mortality rate for the Vila Central Hospital area was 30.4 per 1000 births (with a stillbirth rate of 14 per 1000).

Dapsone syndrome in Vanuatu: a high incidence during multidrug treatment (MDT) of leprosy.

Side-effects of leprosy treatment with dapsone are said to be uncommon, with drug allergy occurring in only one of every several hundred patients treated with dapsone. The dapsone or sulphone syndrome (DDS) has been recognized since the earliest days of sulphone therapy but until recently its incidence had been decreasing. In Vanuatu, during the years 1988-1991, nine leprosy patients have developed the dapsone syndrome, four of whom have died.

Scuba tanks as a compressed air source in positive-pressure ventilation.

Throughout the developing world there is a general problem of ensuring regular deliveries of medical supplies to hospitals. This includes the supply of compressed gases. At one regional hospital in Vanuatu, we were faced with the problem of how to provide economically a source of compressed gas at regulated pressure to drive an anaesthetic ventilator.