necessary. Hospital treatment is available in the Queen Mary Hospital, the Grantham Hospital, the Ruttonjee Sanatorium and, for convalescent child cases, in the Sandy Bay Convalescent Home.
167. The results of treatment are so far encouraging and the attendances are mounting rapidly, the numbers recorded during the year being as follows:
Bacteriological Examination
174. Laboratory work in connexion with the Tuberculosis Service is controlled by the Government Pathologist and is carried out at the Pathological Institute or one of its branches. The numbers of examina- Lions done on behalf of the Tuberculosis Service were as follows:
TABLE 12
Consultations {
New cases Return visits
Total
543 768
1,311
168. This is more than double the attendances in 1956 and excludes attendances for chemotherapy.
The Surgical Chest Clinics
169. A session is held once each week in the chest clinic by the Government Chest Surgeon who sees patients referred either by the Clinic medical staff or by private practitioners. This session also affords the Chest Surgeon the opportunity to follow up cases after operation. The total attendances for the year were 593.
170. A further session is now held every two weeks by the Chest Surgeon to the Grantham Hospital who has agreed to assist in the treatment of the large number of cases who are considered to require surgery for the control of their pulmonary tuberculosis, usually after preliminary chemotherapy. This clinic started in January, 1958.
Radiological Examination
171. X-ray examinations are under the control of the Senior Radio- logical Specialist. Static units are installed in the main clinics and the mobile unit serves the branch clinics once each month. Special chest examinations and skeletal X-rays are carried out in the Queen Mary and Kowloon Hospitals.
172. The number of examinations carried out during the year was as follows:
35 mm films
Large films or paper
5" x 4" filmas
74,989
21,936
3,763
173. The total number of examinations has increased by 25% compared to last year. There has been a further fall in the number of 5" x 4" films taken.
Sputum
*Gastric Lavage culture
V.D.R.L.
1956
19.57
{
Positive Negative
7.208
7,162
26,033
31,216
Total
33,241
38,378
Positive
91
122
Negative
236
140
Total
329
262
Positive Negative
Total
12
18
37
46
175. *At Kowloon Chest Clinic, reliance is placed mainly on sputum cultures, of which 1,600 were done during the year, as there is neither time nor staff to undertake the requisite number of gastric lavages.
Ambulatory Chemotherapy
176. During the year there has been evidence of a change in world medical opinion in favour of ambulatory chemotherapy. Several investi- gations carried out in hospitals have indicated that under the controlled conditions prevailing in hospital, rest in bed adds little to the efficacy of chemotherapy. A recent publication has shown that, in the case of individuals with disease of minimal extent, there is no significant difference between the results of treatment by ambulatory chemotherapy when the patient continues at work and treatment by conventional hospital treatment plus chemotherapy. Testimony in favour of ambula- tory chemotherapy was given at the Fourteenth International Tuber- culosis Conference held in New Delhi in January 1957 and in the World Health Organization Technical Report Series No. 141 entitled "Chemotherapy and Chemoprophylaxis in Tuberculosis Control' anıbula- tory chemotherapy was recommended as an effective therapeutic measure in the control of tuberculosis.
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