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BMJ 1994; 309 doi: (Published 03 December 1994) Cite this as: BMJ 1994;309:1522

Brazil has the highest rate of caesarean sections in the world: 38% of deliveries in public hospitals and 75% in private clinics (Cambridge Quarterly of Healthcare Ethics 1994;3:358-66). Women have been persuaded that a caesarean section prevents the vagina stretching and damage to the perineum as well as avoiding the pain of labour. What they are not told is that the maternal mortality is now 1 in 500 in some parts of the country.

The chronic diarrhoea experienced by many patients with AIDS may sometimes be due to a specific HIV enteropathy: often no other pathogen may be detected. A controlled trial in Mexico reported in “AIDS” (1994;8:1563-7) has confirmed earlier reports that octreotide will reduce both the volume and the frequency of the stools in most patients.

A medical student developed a punctate, scaly, erythematous rash on her hands during her obstetric attachment, which was clearly associated with her use of rubber gloves (Occupational and Environmental Medicine 1994;51:786-92). Further inquiries found that she had worn rubber gloves before without problems, but four months earlier …

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