Singapore medical journal
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The treadmill electrocardiogram (ECG) stress test is widely used to screen for obstructive coronary artery disease (CAD). The presence of STsegment changes, either depression or elevation, on the ECG during the treadmill test often suggests presence of CAD and warrants further management. We herein present three cases, with evidence of ischaemia on the treadmill ECG stress test. In addition, we discuss the use of the treadmill ECG stress test, including its indications, contraindications, reasons for termination and interpretation of the ST-segment changes, heart rate, as well as blood pressure responses to exercise.
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Singapore medical journal · May 2016
Randomized Controlled TrialThe effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial.
Inadequate oral care has been implicated in the development of aspiration pneumonia in frail geriatric patients and is a major cause of mortality, due to the colonisation of microbes in vulnerable patients. This type of pneumonia has been associated with an increase in respiratory pathogens in the oral cavity. The aim of this study was to evaluate the effects of chlorhexidine compared to routine oral care in edentulous geriatric inpatients. ⋯ The use of chlorhexidine 0.2% significantly reduced oral colonisation and is recommended as an easier and more cost-effective alternative for oral hygiene.
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Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient's daily life. ⋯ A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis.