This week in the BMJ

Volume 333, Number 7559, Issue of 15 Jul 2006

[Down]Lidocaine spray doesn't reduce perineal pain
[Down]Poor children are more likely to die from injury
[Down]Worm treatment improves weight gain in Ugandan preschool children
[Down]Improving knowledge on female genital mutilation
[Down]How to manage cataract

Lidocaine spray doesn't reduce perineal pain

The local anaesthetic lidocaine doesn't reduce perineal pain during spontaneous vaginal delivery. Sanders and colleagues (p 117) randomised 185 women who had a spontaneous vaginal delivery without epidural analgesia to topically applied local lidocaine spray or placebo spray. They assessed self reported pain during delivery on a scale of 0 to 100 (0 = no pain, 100 = worst possible pain) and found slightly worse results for the lidocaine group (77 v 72). They also found, however, that lidocaine may reduce genital trauma and was acceptable to both the women and midwives.



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Poor children are more likely to die from injury

Deaths rates from injury and poisoning in children have fallen in England and Wales in most socioeconomic groups over the last 20 years, but not for children in families without a working adult. Edwards and colleagues (p 119) analysed anonymised records from the last three censuses (1981, 1991, 2001). Overall, death rates for the poorest group were 13 times higher than for the wealthiest, with inequalities greatest for deaths in house fires and as pedestrians.


Figure 1
 Credit: ELLIE MEDDLE/REX

 



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Worm treatment improves weight gain in Ugandan preschool children

Giving anthelmintic treatments routinely as a part of regularly scheduled health services can lead to extra weight gain in preschool children in Uganda. Alderman and colleagues (p 122) randomised over 27 000 children aged 1-7 years from 48 parishes participating in child health days to an additional 400 mg albendazole or to standard services only over a three year period. When treatments were given twice a year children who received albendazole had a weight gain about 10% above that expected; when they were given annually the treated children gained about 5% more.


Figure 1
 Credit: ALISTAIR PENNY/STILL PICTURES

 



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Improving knowledge on female genital mutilation

Studies of female genital mutilation should not rely on women's self reporting or WHO classification to define the severity of the operation, say Elmusharaf and colleagues on page 124. They assessed reports of 255 girls aged 4-9 years and of 282 women aged 17-35 years from a paediatric hospital and a gynaecological outpatient clinic in Sudan. They verified the extent of cutting with clinical examination and compared the extent with the corresponding WHO classification. They found considerable under-reporting of the extent and that the WHO classification fails to relate the defined forms of female genital mutilation to the severity of the operation.


Figure 1
 Credit: SIPA/REX

 



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How to manage cataract

Every five seconds someone in the world goes blind—about 40% of those people do so because of cataract, say Allen and Vasavada on page 128. This clinical review revisits the aetiology and symptoms of cataract, and looks at surgery for cataract—the commonest surgical procedure in the developed world. The authors discuss decisions for surgery in the developed and developing world and describe techniques, outcomes, and complications of different types of cataract surgery. Tips for non-specialists, a patient's story, unanswered research questions, and useful links for patients complement the article.


Figure 1
 Credit: NATIONAL EYE INSTITUTE

 



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