Ann Acad Med Singap
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Ann Acad Med Singap · Mar 2000
Comparative StudyPerioperative and rehabilitative outcomes after amputation for ischaemic leg gangrene.
Amputation of the severely ischaemic leg is often done when limb salvage is not possible or the patient is not fit enough for it. It is therefore important to determine the natural history of these amputees as our understanding of this will have significant impact on decision making. The aim of this study was to determine the early and late morbidity and mortality rates and rehabilitative outcome of these patients with lower limb amputation for end-stage arterial occlusive disease. ⋯ Early and late rehabilitation after amputation for critical limb ischaemia remain poor and efforts should be made to salvage critically ischaemic limbs wherever possible in patients who are fit enough.
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We report an unusual case of a patient with clinical and histological features of cutaneous vasculitis. CASE PICTURE: A middle-aged Chinese male presented with livedo reticularis and digital gangrene without visceral involvement. Skin biopsy showed features suggestive of cutaneous vasculitis. Repeated testing for anticardiolipin antibody was negative. ⋯ This is an interesting case of cutaneous vasculitis, which has features of polyarteritis nodosa and the antiphospholipid syndrome, who responded well to intravenous prostacyclin, steroids, pentoxifylline, aspirin, nifedipine and colchicine.
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Ann Acad Med Singap · Mar 2000
Comparative Study Clinical Trial Controlled Clinical TrialTotal intravenous anaesthesia using 3-in-1 mixture of propofol, alfentanil and mivacurium.
To avoid errors and confusion associated with 3 separate infusions, we conducted a feasibility study of total intravenous anaesthesia (TIVA) using 1 electrically-powered syringe pump to deliver a 3-in-1 mixture containing fixed proportions of propofol, alfentanil and mivacurium. ⋯ The 3-in-1 mixtures remained stable for up to 5 hours after preparation. It may be feasible to provide TIVA using the 3-in-1 mixture for induction and maintenance of anaesthesia in ASA 1 patients.
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Ann Acad Med Singap · Mar 2000
Case ReportsA case report of Aspergillus hypersensitivity syndrome with obstructing bronchial aspergillosis.
A 62-year-old Indian male with diabetes mellitus presented with atypical, overlap features of Aspergillus hypersensitivity syndrome and obstructing bronchial aspergillosis. ⋯ Culture and histologic examination of bronchoscopically identified tracheobronchial mucus plugs should be performed as early treatment may be life-saving.
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Ann Acad Med Singap · Mar 2000
Case ReportsSubcutaneous emphysema and pneumomediastinum after endotracheal anaesthesia.
We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation. ⋯ We discussed the possible causes.