George D Nicholson

Systemic lupus erythematosus in an African Caribbean population: Incidence, clinical manifestations, and survival in the Barbados National Lupus Registry

To assess the epidemiology, clinical features, and outcomes of systemic lupus erythematosus (SLE) in the predominantly African Caribbean population of Barbados.

Systemic lupus erythematosus and sickle-cell anaemia.

The buccal route does not have any disadvantages when compared to the oral route of prostaglandin administration. The incidence of vomiting (25%) described for the oral route by other workers is similar.2 3 The buccal route also has the advantages of oral drug administration. These are staff convenience and patient comfort, the latter being without the discomfort of an intravenous infusion and the attendant danger of circulatory overload. It may, however, have the added advantage in that the tablet may be removed if uterine hypertonus, or any other side effect, maternal or fetal, should occur. Administering prostaglandin E2 by the buccal route is a satisfactory method for inducing labour at term. An incremental mode of administration is advantageous.

A comparison of the objective structured clinical examination results across campuses of The University of the West Indies (2001 and 2002)

OBJECTIVE To compare the performance of medical students in the Objective Structured Clinical Examination (OSCE) of thefinal MBBS Examination across the four campuses of The University of the West Indies, over a two-year period DESIGN AND METHODS All final examination results of the Medicine and Therapeutics OSCE were collectedfrom the Faculty of Medical Science at the four campuses of The University of the West Indies and analyzed using both parametric (t-tests and ANOVAs) and non-parametric tests (chi-squared tests). RESULTS Results indicated that students achieved significantly higher mean scores in the 2002 examination than in 2001 (t = 3.85, df = 415, p = 0.000). There were no significant differences between campuses with regards to the mean corrected score in 2001. Also in 2001, in adult stations, all campuses achieved significantly higher scores than Jamaica. However, in Jamaica, mean child health station scores were significantly higher than all other campuses and, the mean score in Trinidad and Tobago was higher than the Bahamas and Barbados. In 2002, all other campuses achieved significantly higher scores than Trinidad and Tobago and females performed significantly better than males with regards to overall mean scores (t = 2.814, df = 189, p = 0.005). Also in 2002, Barbados achieved significantly higher mean corrected scores than Trinidad and Tobago (F = 4.649, df = 3191; p = 0.004) and Barbados and Trinidad and Tobago both obtained significantly higher mean child health station scores than Jamaica. CONCLUSIONS The important conclusion from this study is that the OSCE scores in Medicine and Therapeutics are generally uniform across the four campuses of the University, thereby confirming the consistency of the approach to teaching and helping to validate the efficacy and veracity of the medical graduate being produced by The University of the West Indies.

Minoxidil in the management of moderate hypertension.

The effects of minoxidil used in combination with propranolol were assessed in the management of moderate hypertension. All patients had diastolic blood pressures above 95 mm Hg after therapy with thiazide diuretics for 2 weeks and were randomly assigned to treatment schedules which added minoxidil and propranolol in dosage ratios of 1:2, 1:4, and 1:8. diastolic pressures were reduced to less than 90 mm Hg by upward titration of minoxidil dosage while maintaining the appropriate ratio of propranolol. After 4 weeks at that dosage, minoxidil was discontinued: 2 weeks later propranolol was also withdrawn. A diastolic pressure less than 90 mm Hg was achieved with 5 mg of minoxidil in 50% of the patients. While vasodilator-induced tachycardia was blocked at all minoxidil/propranolol ratios, the 1:8 ratio group demonstrated the greatest percentage reduction in systolic and diastolic pressures at the end of the first week. We conclude that rapid control of moderate hypertension can be achieved by modest doses of minoxidil and with the production of only minor side effects, a minoxidil/propranolol ratio of 1:8 being adequate to prevent tachycardia.