Ann Acad Med Singap
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Ann Acad Med Singap · Apr 2013
Comparative StudyRevision total knee arthroplasty: causes and outcomes.
Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the causes and outcomes of revision TKA in a single institution, with a 2-year follow-up. ⋯ Indications for revision TKA locally are similar to those in other large centres. Revision total knee arthroplasty results in significantly improved function and quality of life for patients, which is maintained over a 2-year follow-up period. In our series, we obtained 100% implant survivorship.
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Ann Acad Med Singap · Apr 2013
ReviewThe mental capacity act: implications for patients and doctors faced with difficult choices.
The Mental Capacity Act (MCA) came into effect in March 2010 but the impact of this groundbreaking legislation on the doctor-patient relationship has not yet been studied in Singapore. It is evident that communication between healthcare professionals, patients and their loved ones has never been so critical. Translating this into practice, healthcare professionals must identify the decision-maker to obtain consent from the correct person. ⋯ However, the doctor is the decision-maker for patients lacking capacity in matters of life-sustaining treatment or treatment to prevent a serious deterioration of the patient's health. All decisions made on behalf of persons lacking capacity must be made in their best interests. Capacity assessments must be properly conducted and if a patient has the capacity to make the decision then healthcare professionals must take practicable steps to help them make a decision.
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Ann Acad Med Singap · Apr 2013
Comparative StudyClinical characteristics and outcomes of patients undergoing drug provocation tests (DPTs).
Patients who have an adverse drug reaction are frequently labelled drug allergic without undergoing proper evaluation and confirmatory testing. These drug allergy labels may be inaccurate, leading to unnecessary lifelong avoidance. The aim of this study was to review the patients that underwent drug provocation tests (DPTs) in our centre and examine the usefulness of DPTs in confirming or rejecting a diagnosis of drug hypersensitivity. ⋯ Suspected drug hypersensitivity is common but true drug allergy is rare. DPTs remain the gold standard and should be included as part of an investigative protocol. DPTs are a safe and valuable diagnostic tool in the hands of the experienced clinician.