Arterialized venous blood was used to investigate maternal acid-base state during the first and second stages of normal labour. During labour the range of values obtained for acid-base variables is wide but patterns are discernible. At the beginning of labour Pco, was lower than it is in non-pregnant subjects, and the pH was higher despite a substantial base deficit. At the end of the first sta...

I am pleased to note on reading Dr Duncan’s letter in the January 2013 issue of the Journal that I am not the only person who waits a full 3 minutes after using local anaesthetic gel prior to fitting an intrauterine device/system. I totally agree that this makes a difference to the pain experienced by women. I have been fitting ‘coils’ for almost 30 years and when I started was totally reliant ...

Introduction Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Treatments involve Non Steroidal Anti-Inflammatory Drugs (NSAIDs), Disease Modifying Anti-Rheumatic Agents (DMARDs), steroids and various biologic drugs. Steroid injections directly into affected joints are an important part of the range of treatments available for children with JIA. The British S...

To the editor: Paramedics in Ontario provide prehospital care under the direction of their base hospital physicians. Most paramedics are certified at the primary care paramedic (PCP) level, and many communities, especially in rural areas, where transport times are longest, are served exclusively by PCPs. Despite having at least 2 years of college education, PCPs are unable to provide patients w...