Ann Acad Med Singap
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Ann Acad Med Singap · Nov 2005
Case ReportsFetus-in-fetu in the pelvis: report of a case and literature review.
Fetus-in-fetu is an extremely rare condition in which a malformed fetus is found in the body of its twin. To our knowledge, fewer than 100 cases have been reported. Wide variations of presentation have been described, although its embryo-pathogenesis and differentiation from a teratoma have not been well established. ⋯ Although an extremely rare clinical entity, fetus-in-fetu can be diagnosed prior to surgery with current imaging modalities. When it arises in the retroperitoneum of a male infant, it can hinder the descent of the testes. Complete excision is curative.
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Ann Acad Med Singap · Nov 2005
Case ReportsBeyond Ortner's syndrome--unusual pulmonary complications of the giant left atrium.
The giant left atrium (GLA) is a complication of severe mitral valve disease and causes morbidity by compressing adjacent intra-thoracic structures. ⋯ Pulmonary atelectasis may occur in patients with GLA due to bronchopulmonary compression. Surgical management with valve replacement and atrial reduction may be necessary to relieve airway compression.
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Ann Acad Med Singap · Nov 2005
ReviewTsunami in South Asia: what is the risk of post-disaster infectious disease outbreaks?
The World Health Organization has warned that in the aftermath of the recent tsunami, infectious disease outbreaks will add to the heavy toll of the disaster itself, possibly even doubling the number of casualties. However, many experts believe the risks of infectious disease outbreaks following natural disasters have been overemphasised and have led to unnecessary and potentially harmful public health activities. This paper discusses the risk and prevention strategies of potential infectious diseases in the aftermath of the tsunami based on a literature review of previous similar disasters and current evidence. ⋯ Lessons have been learned from previous large-scale humanitarian crises about the provision of aid and the mitigation of epidemics. This paper examines the risk and preventive strategies of vector- and food/water-borne diseases, measles, acute respiratory infections and meningitis. Alert thresholds at which to trigger outbreak investigations, and standardised guidelines with regard to their control are outlined, based on the Sphere Project.
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Ann Acad Med Singap · Nov 2005
Comparative StudyEvaluation of surgical and anaesthesia response times for crash caesarean sections--an audit of a Singapore hospital.
The Royal College of Obstetricians and Gynaecologists published the "Organisational Standards for Maternity Services" in 1995, in which they proposed that there be a maximum decision-to-delivery time of 30 minutes for urgent caesarean sections (CS). In 1997, our institution established a protocol for extremely urgent ("crash") CS to expedite delivery time and to conform to this standard. ⋯ We achieved 100% deliveries within the proposed 30-minute decision-to-delivery time interval by implementing a protocol for "crash" CS. Both general anaesthesia and extension of existing epidural block are acceptable modes of anaesthesia and do not delay delivery of the fetus.
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Ann Acad Med Singap · Nov 2005
Case ReportsDural sinus thrombosis after minor head injury in a child.
Dural sinus thrombosis following minor head injury is rare. We report such a case in a child after mild head injury. ⋯ Dural sinus thrombosis should be excluded in children presenting with persistent giddiness and vomiting after minor head injury.