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Objectives: To assess the effect of midazolam 0.02 mg/kg administered with etomidate on the incid... more Objectives: To assess the effect of midazolam 0.02 mg/kg administered with etomidate on the incidence of myoclonus and the dose requirement for etomidate to induce general anaesthesia.Design: Double blind randomised control trial.Setting: Two urban teaching hospitals in Durban, Kwa Zulu Natal (KZN).Patients: 60 patients older than 60 years of age undergoing intraocular surgery.Outcome measures: Etomidate dose required for loss of verbal contact (dose V) and loss of eyelash reflex (dose E). Myoclonus assessed by means of a three-point scale (0-nil; 1-mild; 2-severe) 30 sec after the last dose of etomidate.Duration of recovery from cessation of anaesthesia to first response to verbal command.Results: No significant difference in myoclonus or dose requirement for etomidate could be demonstrated. There was no difference in haemodynamic variation between the groups and recovery time was not prolonged.Conclusion: Midazolam 0.02 mg/kg given with etomidate for induction of anaesthesia does ...

Medicine and law

Medical decision-making is based on the doctrine of informed consent which is, in turn, based on ... more Medical decision-making is based on the doctrine of informed consent which is, in turn, based on autonomy, which represents one of four pillars of medical ethics, the others being beneficence, non-malfeasance and social justice. Decision-making in intensive care with respect to the withdrawal of treatment, in particular ventilator therapy, is often extremely difficult for patients or their relatives and they would rather not make any decision other than to insist on the maintenance of therapy in spite of sound, reasonable medical advice that such therapy is of no value to the patient. Aside from issues of a dignified death, this is likely to be to the detriment of other patients who might be refused admission to intensive care and thus is counter to the dictates of social justice. Under these circumstances, there would appear to be a need to give authority to the reasonable medical decision to discontinue resuscitation.

Water Distribution Systems Analysis 2010, 2011

Critical care (London, England), 2002

Journal of Hydraulic Research, 2001

Flexible floating bottomless containment has recently been considered as a potential means of kee... more Flexible floating bottomless containment has recently been considered as a potential means of keeping freshwater separated from seawater in an estuary or coastal area. Speculative applications by the authors for marine located waste stabilisation ponds and for water quality management in salt intruded estuarial impoundments are cued herein. Viability assessment for such schemes calls for ihe study of, amongst other

Journal of Hydraulic Research, 2001

Flexible floating bottomless containment has recently been considered as a potential means of kee... more Flexible floating bottomless containment has recently been considered as a potential means of keeping freshwater separated from seawater in an estuary or coastal area. Speculative applications by the authors for marine located waste stabilisation ponds and for water ...

British Journal of Surgery, 2000

Background: Alternatives to fascial closure of the abdominal wall are increasingly used in critic... more Background: Alternatives to fascial closure of the abdominal wall are increasingly used in critically ill patients. They pose practical and logistical problems in management which are described in this singleinstitution study.

A method for impregnating a porous, non-metallic construction material with a solid phase-change ... more A method for impregnating a porous, non-metallic construction material with a solid phase-change material is described. The phase-change material in finely divided form is spread onto the surface of the porous material, after which the porous material is exposed to microwave energy for a time sufficient to melt the phase-change material. The melted material is spontaneously absorbed into the pores of the porous material. A sealing chemical may also be included with the phase-change material (or applied subsequent to the phase-change material) to seal the surface of the porous material. Fire retardant chemicals may also be included with the phase-change materials. The treated construction materials are better able to absorb thermal energy and exhibit increased heat storage capacity.

A composite material for thermal energy storage based upon polyhydric alcohols, such as pentaeryt... more A composite material for thermal energy storage based upon polyhydric alcohols, such as pentaerythritol, trimethylol ethane (also known as pentaglycerine), neopentyl glycol and related compounds including trimethylol propane, monoaminopentaerythritol, diamino-pentaerythritol and tris(hydroxymethyl)acetic acid, separately or in combinations, which provide reversible heat storage through crystalline phase transformations are discussed. These PCM's do not become liquid during use and are in contact with at least one material selected from the group consisting of metals, carbon, siliceous, plastic, cellulosic, natural fiber, artificial fiber, concrete, gypsum, porous rock, and mixtures thereof. Particulate additions such as aluminum or graphite powders, as well as metal and carbon fibers can also be incorporated therein. Particulate and/or fibrous additions can be introduced into molten phase change materials which can then be cast into various shapes. After the phase change materials have solidified, the additions will remain dispersed throughout the matrix of the cast solid. The polyol is in contact with at least one material selected from the group consisting of metals, carbon, siliceous, plastic, cellulosic, natural fiber, artificial fiber, concrete, gypsum, and mixtures thereof.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

Four patients are described in whom massive abdominal distension after laparotomy led to increase... more Four patients are described in whom massive abdominal distension after laparotomy led to increased airway and central venous pressure and severely reduced urine output. All cases were associated with massive fluid resuscitation and operative findings were a grossly oedematous bowel with free fluid under pressure in the abdomen. These findings are consistent with the diagnosis of intra-abdominal compartment syndrome. In 1 case trauma was remote from the abdomen indicating that abdominal surgery or trauma may not be a prerequisite for the development of the condition. Recognition of the features of the condition is essential as it can only be treated by decompression of the abdominal contents.

Anaesthesia and intensive care

Suxamethonium in the doses of 1.0, 0.5 and 0.25 mg/kg was compared with mivacurium 0.15 mg/kg in ... more Suxamethonium in the doses of 1.0, 0.5 and 0.25 mg/kg was compared with mivacurium 0.15 mg/kg in 80 patients requiring nasotracheal intubation for maxillofacial surgery in a double-blind randomized controlled trial. Anaesthesia was induced with thiopentone 5 mg/kg and alfentanil 15 micrograms/kg. Patients were randomly allocated to one of the four relaxant groups. Anaesthesia was maintained with enflurane in 70% nitrous oxide and 30% oxygen and analgesia provided with intravenous pethidine 0.5 to 1.5 mg/kg and rectal indomethacin 100mg. All patients given mivacurium or suxamethonium 1 mg/kg had acceptable intubating conditions. Significantly fewer patients given suxamethonium 0.5 mg or 0.25 mg/kg had acceptable intubating conditions (90% and 70% respectively) (P = 0.003). Poor intubating conditions requiring additional relaxation were seen in two patients given suxamethonium 0.25 mg/kg and two given 0.5 mg/kg, while no patients given suxamethonium 1.0 mg/kg or mivacurium 0.15 mg/kg ...

46th AIAA Aerospace Sciences Meeting and Exhibit, 2008

Objectives: To assess the effect of midazolam 0.02 mg/kg administered with etomidate on the incid... more Objectives: To assess the effect of midazolam 0.02 mg/kg administered with etomidate on the incidence of myoclonus and the dose requirement for etomidate to induce general anaesthesia.Design: Double blind randomised control trial.Setting: Two urban teaching hospitals in Durban, Kwa Zulu Natal (KZN).Patients: 60 patients older than 60 years of age undergoing intraocular surgery.Outcome measures: Etomidate dose required for loss of verbal contact (dose V) and loss of eyelash reflex (dose E). Myoclonus assessed by means of a three-point scale (0-nil; 1-mild; 2-severe) 30 sec after the last dose of etomidate.Duration of recovery from cessation of anaesthesia to first response to verbal command.Results: No significant difference in myoclonus or dose requirement for etomidate could be demonstrated. There was no difference in haemodynamic variation between the groups and recovery time was not prolonged.Conclusion: Midazolam 0.02 mg/kg given with etomidate for induction of anaesthesia does ...

Medicine and law

Medical decision-making is based on the doctrine of informed consent which is, in turn, based on ... more Medical decision-making is based on the doctrine of informed consent which is, in turn, based on autonomy, which represents one of four pillars of medical ethics, the others being beneficence, non-malfeasance and social justice. Decision-making in intensive care with respect to the withdrawal of treatment, in particular ventilator therapy, is often extremely difficult for patients or their relatives and they would rather not make any decision other than to insist on the maintenance of therapy in spite of sound, reasonable medical advice that such therapy is of no value to the patient. Aside from issues of a dignified death, this is likely to be to the detriment of other patients who might be refused admission to intensive care and thus is counter to the dictates of social justice. Under these circumstances, there would appear to be a need to give authority to the reasonable medical decision to discontinue resuscitation.

Water Distribution Systems Analysis 2010, 2011

Critical care (London, England), 2002

Journal of Hydraulic Research, 2001

Flexible floating bottomless containment has recently been considered as a potential means of kee... more Flexible floating bottomless containment has recently been considered as a potential means of keeping freshwater separated from seawater in an estuary or coastal area. Speculative applications by the authors for marine located waste stabilisation ponds and for water quality management in salt intruded estuarial impoundments are cued herein. Viability assessment for such schemes calls for ihe study of, amongst other

Journal of Hydraulic Research, 2001

Flexible floating bottomless containment has recently been considered as a potential means of kee... more Flexible floating bottomless containment has recently been considered as a potential means of keeping freshwater separated from seawater in an estuary or coastal area. Speculative applications by the authors for marine located waste stabilisation ponds and for water ...

British Journal of Surgery, 2000

Background: Alternatives to fascial closure of the abdominal wall are increasingly used in critic... more Background: Alternatives to fascial closure of the abdominal wall are increasingly used in critically ill patients. They pose practical and logistical problems in management which are described in this singleinstitution study.

A method for impregnating a porous, non-metallic construction material with a solid phase-change ... more A method for impregnating a porous, non-metallic construction material with a solid phase-change material is described. The phase-change material in finely divided form is spread onto the surface of the porous material, after which the porous material is exposed to microwave energy for a time sufficient to melt the phase-change material. The melted material is spontaneously absorbed into the pores of the porous material. A sealing chemical may also be included with the phase-change material (or applied subsequent to the phase-change material) to seal the surface of the porous material. Fire retardant chemicals may also be included with the phase-change materials. The treated construction materials are better able to absorb thermal energy and exhibit increased heat storage capacity.

A composite material for thermal energy storage based upon polyhydric alcohols, such as pentaeryt... more A composite material for thermal energy storage based upon polyhydric alcohols, such as pentaerythritol, trimethylol ethane (also known as pentaglycerine), neopentyl glycol and related compounds including trimethylol propane, monoaminopentaerythritol, diamino-pentaerythritol and tris(hydroxymethyl)acetic acid, separately or in combinations, which provide reversible heat storage through crystalline phase transformations are discussed. These PCM's do not become liquid during use and are in contact with at least one material selected from the group consisting of metals, carbon, siliceous, plastic, cellulosic, natural fiber, artificial fiber, concrete, gypsum, porous rock, and mixtures thereof. Particulate additions such as aluminum or graphite powders, as well as metal and carbon fibers can also be incorporated therein. Particulate and/or fibrous additions can be introduced into molten phase change materials which can then be cast into various shapes. After the phase change materials have solidified, the additions will remain dispersed throughout the matrix of the cast solid. The polyol is in contact with at least one material selected from the group consisting of metals, carbon, siliceous, plastic, cellulosic, natural fiber, artificial fiber, concrete, gypsum, and mixtures thereof.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

Four patients are described in whom massive abdominal distension after laparotomy led to increase... more Four patients are described in whom massive abdominal distension after laparotomy led to increased airway and central venous pressure and severely reduced urine output. All cases were associated with massive fluid resuscitation and operative findings were a grossly oedematous bowel with free fluid under pressure in the abdomen. These findings are consistent with the diagnosis of intra-abdominal compartment syndrome. In 1 case trauma was remote from the abdomen indicating that abdominal surgery or trauma may not be a prerequisite for the development of the condition. Recognition of the features of the condition is essential as it can only be treated by decompression of the abdominal contents.

Anaesthesia and intensive care

Suxamethonium in the doses of 1.0, 0.5 and 0.25 mg/kg was compared with mivacurium 0.15 mg/kg in ... more Suxamethonium in the doses of 1.0, 0.5 and 0.25 mg/kg was compared with mivacurium 0.15 mg/kg in 80 patients requiring nasotracheal intubation for maxillofacial surgery in a double-blind randomized controlled trial. Anaesthesia was induced with thiopentone 5 mg/kg and alfentanil 15 micrograms/kg. Patients were randomly allocated to one of the four relaxant groups. Anaesthesia was maintained with enflurane in 70% nitrous oxide and 30% oxygen and analgesia provided with intravenous pethidine 0.5 to 1.5 mg/kg and rectal indomethacin 100mg. All patients given mivacurium or suxamethonium 1 mg/kg had acceptable intubating conditions. Significantly fewer patients given suxamethonium 0.5 mg or 0.25 mg/kg had acceptable intubating conditions (90% and 70% respectively) (P = 0.003). Poor intubating conditions requiring additional relaxation were seen in two patients given suxamethonium 0.25 mg/kg and two given 0.5 mg/kg, while no patients given suxamethonium 1.0 mg/kg or mivacurium 0.15 mg/kg ...

46th AIAA Aerospace Sciences Meeting and Exhibit, 2008