BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1452 (Published 16 March 2010) Cite this as: BMJ 2010;340:c1452

At a time when most news from Afghanistan is bad, Minerva was delighted to read a success story. Community health workers have made good progress at spreading the word about contraception choices and improving access to injectables, pills, and condoms. Two of the most useful messages about birth spacing are that contraceptive use is 300 times safer than pregnancy in Afghanistan, and that the Quran promotes two years of breast feeding. In rural areas the prevalence of contraceptive use rose from 24% to 27% over eight months, and much of the increase was because of the uptake of injectable contraceptives (Bulletin of the World Health Organization 2010;88:227-31, doi:10.2471/BLT.08.059410).

Decades ago it was thought that the earlier renal dialysis was started, the longer patients survived. But in the era of modern dialysis technology the question of timing has been ignored; what constitutes early versus late is not defined. Discussing the wide variation in current practice in Critical Care, authors of a commentary suggest that dialysis should be used to support organ function and to prevent complications, rather than waiting for renal shutdown …

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