PIP: With regard to HIV/AIDS, this editorial claims that attitude problems, communication difficulties, issues of confidentiality in connection with the prevention of disease spread, absence of uniformity in the management of patients, and lack of counseling skills all contribute to dilemmas in AIDS care. First, the author claims that, since attitude affects the way we communicate and reflects on every area of life, health care givers should change their negative attitudes in order to serve each patient with love and compassion. Next, the issue of confidentiality is addressed. The author writes that tracing of contacts is difficult when an HIV-infected individual is given his/her full right to confidentiality. Next, it is suggested that the management of HIV/AIDS patients should be made uniform by putting one person in charge in the hospital setting. Finally, the author concludes that all health workers ought to have basic counseling skills, as this is one of the most important aspects of care.
Acquired Immunodeficiency Syndrome - prevention & ; control ; Acquired Immunodeficiency Syndrome - therapy ; Attitude of Health Personnel ; Confidentiality ; Counseling - methods ; Male ; Papua New Guinea ; Physician-Patient Relations

Haematogenous osteomyelitis, especially in its more common chronic stage, is an important cause of morbidity in children in the Southern Highlands Province. Hospital stays are lengthy and the incidence of fractures is high. While awaiting, or in the absence of, culture and sensitivity results, cloxacillin 200 mg/kg/day plus probenecid 40 mg/kg/day is an appropriate first choice antibiotic when it is available. Antibiotic therapy in chronic disease should be limited to the specific settings of associated soft tissue infection; pre- and post-sequestrectomy; and radiological signs of ongoing bone necrosis and systemic signs of active infection. Surgical drainage of subperiosteal pus and possibly the medullary canal is required in all but the very early (less than 48 hours) cases of acute osteomyelitis that sometimes respond to antibiotics alone. Sequestrectomy should be reserved for cases where a sequestrum and adequate involucrum can be seen on X-ray. Effective management of this disease is possible only if ongoing communication exists between hospital-based medical staff and the staff of health centres or subcentres, including the network of aid post orderlies and their supervisors. Since the majority of patients present to facilities other than hospitals, any campaign directed at improving management must involve co-workers in rural areas, namely the health extension officer, nurse and aid post orderly. Only in this way can we hope to achieve earlier appropriate treatment and more systematic long-term follow-up.
Adolescent ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Chronic Disease ; Hospitals, Rural ; Humans ; Osteomyelitis ; drug therapy ; microbiology ; surgery ; Papua New Guinea ; Rural Health