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Singapore Medical Journal

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https://www.readbyqxmd.com/read/28805236/comparison-of-intrathecal-morphine-and-surgical-site-infusion-of-ropivacaine-as-adjuncts-to-intravenous-patient-controlled-analgesia-in-living-donor-kidney-transplant-recipients
#1
Joo-Hyun Jun, Gaab-Soo Kim, Jeong Jin Lee, Justin S Ko, Sung Joo Kim, Pil Hyun Jeon
INTRODUCTION: This prospective observational study compared the postoperative analgesic effectiveness of intrathecal morphine (ITM) and surgical-site infusion (SSI) of ropivacaine as adjuncts to intravenous (IV) patient-controlled analgesia (PCA) (fentanyl) in living-donor kidney transplant recipients. METHODS: Patients undergoing living-donor kidney transplantation receiving ITM or SSI in addition to IV PCA were included. Rescue analgesia was achieved with IV meperidine, as required...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28805235/how-do-singapore-patients-view-post-anaesthesia-adverse-outcomes-a-single-centre-willingness-to-pay-study
#2
Xinqi Look, May Un Sam Mok, Yan Sheng Tay, Hairil Rizal Abdullah
INTRODUCTION: Knowing how patients value quality of anaesthesia helps anaesthesiologists to customise their service. However, generalising findings from Western population-based willingness-to-pay (WTP) studies across different cultures and societies might overlook several important contextualised understandings of anaesthesia experience for Singapore patients. This study aimed to capture the Singapore perspective of undesired post-anaesthesia outcomes. METHODS: 132 patients recruited in the pre-anaesthetic evaluation clinic were given questionnaires describing ten possible post-anaesthetic outcomes to rank for undesirability and assign relative value through proportioning hypothetical SGD 100 to avoid their occurrence...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28805234/prognostic-factors-for-mortality-due-to-pneumonia-among-adults-from-different-age-groups-in-singapore-and-mortality-predictions-based-on-psi-and-curb-65
#3
Zoe Xz Zhang, Yang Yong, Wan C Tan, Liang Shen, Han Seong Ng, Kok Yong Fong
INTRODUCTION: Pneumonia is associated with considerable mortality. However, the information on age-specific prognostic factors for death from pneumonia is limited. METHODS: Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years; 65-84 years; and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741012/management-of-computed-tomography-detected-pneumothorax-in-patients-with-blunt-trauma-experience-from-a-community-based-hospital
#4
Ashraf F Hefny, Fathima T Kunhivalappil, Nikolay Matev, Norman A Avila, Masoud O Bashir, Fikri M Abu-Zidan
INTRODUCTION: With near-routine use of computed tomography (CT) for imaging trauma patients, the diagnosis of pneumothorax, especially occult pneumothorax, has increased. However, the need for chest tube insertion remains controversial. We aimed to study the management of pneumothorax detected on CT among patients with blunt trauma, including the decision for tube thoracostomy, in a community-based hospital. METHODS: Chest CT scans of patients with blunt trauma treated at Al Rahba Hospital, Abu Dhabi, from October 2010 to October 2014 were retrospectively studied...
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741011/medical-dispute-resolution-patient-safety-and-the-doctor-patient-relationship
#5
Kumaralingam Amirthalingam
No abstract text is available yet for this article.
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741010/perception-of-a-single-session-pre-in-vitro-fertilisation-counselling-service-and-attitudes-towards-support-group-a-survey-of-patients-in-singapore
#6
Gaik Suan Lim, Reshmi Karayan Kayanoth, Birit Fp Broekman, Cornelia Yi Chee
INTRODUCTION: This study aimed to investigate patients' evaluation of a compulsory pre-in vitro fertilisation (IVF) counselling session in Singapore and determine their attitudes towards attending a support group during IVF treatment. METHODS: 464 patients due to undergo their first IVF treatment were recruited at the Clinic for Human Reproduction, National University Hospital, Singapore. All patients attended a counselling session conducted by a clinical psychologist trained in infertility counselling prior to IVF treatment...
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28681058/appearance-of-bioresorbable-vascular-scaffolds-on-computed-tomography-coronary-angiography
#7
Siong Sung Wong, Gunasekaran Ramsamy
No abstract text is available yet for this article.
July 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28681057/comfort-and-exertion-while-using-filtering-facepiece-respirators-with-exhalation-valve-and-an-active-venting-system-among-male-military-personnel
#8
Melvin Seng, Liang En Wee, Xiahong Zhao, Alex R Cook, Sin Eng Chia, Vernon J Lee
INTRODUCTION: This study aimed to determine if disposable filtering facepiece respirators (FFRs), with exhalation valve (EV) and a novel active venting system (AVS), provided greater perceived comfort and exertion when compared to standard N95 FFRs without these features among male military personnel performing prolonged essential outdoor duties. METHODS: We used a randomised open-label controlled crossover study design to compare three FFR options: (a) standard FFR; (b) FFR with EV; and (c) FFR with EV+AVS...
July 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28681056/training-eldercare-workers-in-mental-healthcare
#9
Gwen Li Sin, Donald Yeo, Hwan Jing Koh, Jimmy Lee, Li Ling Ng
INTRODUCTION: A significant proportion of older persons requiring support or care services have mental health concerns. There is a need to equip frontline eldercare workers with the necessary skills in caring for older persons with mental illnesses. The Community Psychogeriatric Programme aims to support community eldercare providers with training and consultation. We set out to measure eldercare workers' perceived levels of stress and knowledge on caring for older persons with mental illness before (pre-workshop), immediately after (post-workshop) and three months after (three-month follow-up) undergoing standardised training workshops on dementia and depression...
July 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28681055/early-clinical-manifestations-of-vibrio-necrotising-fasciitis-a-case-series
#10
Thean Howe Bryan Koh, Jiong Hao Jonathan Tan, Choon-Chiet Hong, Wilson Wang, Aziz Nather
We present five patients with vibrio necrotising fasciitis, a lethal and disabling disease. Among our patients, two had a history of exposure to either warm seawater or raw/live seafood, three had underlying chronic liver disease, and four presented with hypotension and fever. There were three deaths and four patients required intensive care unit stay. Among the survivors, one had high morbidity. Only one patient met the criteria of Laboratory Risk Indicator for Necrotizing Fasciitis score > 6. A clinician should suspect possible vibrio necrotising fasciitis if there is contact with fresh seafood/warm seawater, known history of chronic liver disease and pain out of proportion to cutaneous signs...
July 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28681054/establishment-of-a-minimally-invasive-cardiac-surgery-programme-in-singapore
#11
Theo Kofidis, Guohao Chang, Chuen Neng Lee
In Singapore, although minimally invasive cardiac surgery is available, it is not widely practised. Local surgeons have pioneered technologies in Singapore following their launch in the West and introduced them, addressing various heart pathologies. However, the unique position and function of Singapore in the region, the structure and dynamics of cardiothoracic surgery practice in government centres and private practice, and the overall small volume of patients in the country may pose limitations, in spite of all possibilities, in thriving and sharing of such new technologies...
July 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28540395/management-of-atherosclerosis-risk-factors-for-patients-at-high-cardiovascular-risk-in-the-real-world-practice-a-multicentre-study
#12
Arintaya Phrommintikul, Rungroj Krittayaphong, Wanwarang Wongcharoen, Sukit Yamwong, Smonporn Boonyaratavej, Rapeephon Kunjara-Na-Ayudhya, Pyatat Tatsanavivat, Piyamitr Sritara
INTRODUCTION: Atherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions regarding the risk factors and clinical manifestations of atherosclerotic diseases as well as their management patterns. METHODS: We collected data from 25 centres in Thailand. Patients with documented coronary artery disease or cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28540394/clinical-efficacy-of-a-two-year-oral-health-programme-for-infants-and-toddlers-in-singapore
#13
Bien Lai, Wee Kiat Tan, Qing Shu Lu
INTRODUCTION: Dental caries, which is prevalent in Singapore preschoolers, is a disease that has a major impact on children's health and places a high cost on the society and health services. Oral health programmes for young children implemented in several parts of the world have been shown to be effective in the prevention of dental caries. We aimed to examine the clinical efficacy of an oral health programme for infants and toddlers in Singapore. METHODS: 90 children and their caregivers participated in the programme while 64 children who were 24 months older than the intervention group at initial visit were recruited as controls in a quasi-experimental study design...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28540393/computed-tomography-scans-of-the-head-for-adult-patients-with-minor-head-injury-are-clinical-decision-rules-a-necessary-evil
#14
Desmond Wei Tan, Annabelle Mei En Lim, Daniel Yuxuan Ong, Li Lee Peng, Yiong Huak Chan, Irwani Ibrahim, Win Sen Kuan
INTRODUCTION: This study aimed to evaluate compliance with and performance of the Canadian Computed Tomography Head Rule (CCHR), and its applicability in the local adult population with minor head injury. METHODS: We conducted a retrospective study of consecutive patients who presented to the adult emergency department (ED) with minor head injury over six months. Data on predictor variables indicated in the CCHR was collected and compliance with the CCHR assessed by comparing the recommendations for head computed tomography (CT) scans to its actual usage...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#15
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741013/prompt-use-of-mechanical-cardiopulmonary-resuscitation-in-out-of-hospital-cardiac-arrest-the-mecca-study-report
#16
Venkataraman Anantharaman, Boon Lui Benjamin Ng, Shiang Hu Ang, Chun Yue Francis Lee, Siew Hon Benjamin Leong, Marcus Eng Hock Ong, Siang Jin Terrance Chua, Antony Charles Rabind, Nagaraj Baglody Anjali, Ying Hao
INTRODUCTION: Early use of mechanical cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) may improve survival outcomes. Current evidence for such devices uses outcomes from an intention-to-treat (ITT) perspective. We aimed to determine whether early use of mechanical CPR using a LUCAS 2 device results in better outcomes. METHODS: A prospective, randomised, multicentre study was conducted over one year with LUCAS 2 devices in 14 ambulances and manual CPR in 32 ambulances to manage OHCA...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741009/the-role-of-dispatch-in-resuscitation
#17
Yih Yng Ng, Siew Hon Benjamin Leong, Marcus Eng Hock Ong
The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation. The dispatch centre is part of the first link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The influence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defibrillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European Resuscitation Council 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741008/the-national-resuscitation-council-singapore-and-34-years-of-resuscitation-training-1983-to-2017
#18
Venkataraman Anantharaman
Training in the modern form of cardiopulmonary resuscitation (CPR) started in Singapore in 1983. For the first 15 years, the expansion of training programmes was mainly owing to the interest of a few individuals. Public training in the skill was minimal. In an area of medical care where the greatest opportunity for benefit lies in employing core resuscitation skills in the prehospital environment, very little was being done to address such a need. In 1998, a group of physicians, working together with the Ministry of Health, set up the National Resuscitation Council (NRC)...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741007/role-of-peak-current-in-conversion-of-patients-with-ventricular-fibrillation
#19
Venkataraman Anantharaman, Paul Weng Wan, Seow Yian Tay, Peter George Manning, Swee Han Lim, Siang Jin Terrance Chua, Tiru Mohan, Antony Charles Rabind, Sudarshan Vidya, Ying Hao
INTRODUCTION: Peak currents are the final arbiter of defibrillation in patients with ventricular fibrillation (VF). However, biphasic defibrillators continue to use energy in joules for electrical conversion in hopes that their impedance compensation properties will address transthoracic impedance (TTI), which must be overcome when a fixed amount of energy is delivered. However, optimal peak currents for conversion of VF remain unclear. We aimed to determine the role of peak current and optimal peak levels for conversion in collapsed VF patients...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741006/measuring-the-effectiveness-of-a-novel-cprcard%C3%A2-feedback-device-during-simulated-chest-compressions-by-non-healthcare-workers
#20
Alexander E White, Han Xian Ng, Wai Yee Ng, Eileen Kai Xin Ng, Stephanie Fook-Chong, Phek Hui Jade Kua, Marcus Eng Hock Ong
INTRODUCTION: There is a need for a simple-to-use and easy-to-carry CPR feedback device for laypersons. We aimed to determine if a novel CPRcard™ feedback device improved the quality of chest compressions. METHODS: We compared participants' chest compression rate and depth with and without feedback. Compression data was captured through the CPRcard™ or Resusci Anne's SimPad® SkillReporter™. Compression quality was defined based on 2010 international guidelines for rate, depth and flow fraction...
July 2017: Singapore Medical Journal
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