Ann Acad Med Singap
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Ann Acad Med Singap · Apr 2010
Outbreak of pandemic influenza A (H1N1-2009) in Singapore, May to September 2009.
The fi rst case of pandemic influenza A(H1N1) was detected in Singapore on 26 May 2009, 1 month after the fi rst cases of novel influenza A(H1N1) was reported in California and Texas in the United States. The World Health Organization declared the fi rst influenza pandemic of the 21st century on 11 June 2009. ⋯ The fi rst wave of the influenza pandemic lasted about 10 weeks. Morbidity and mortality resulting from pandemic influenza were low.
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Ann Acad Med Singap · Mar 2010
ReviewManagement of antiplatelet therapy during acute percutaneous coronary intervention: new strategies and therapeutics.
Aggressive intravenous and oral dual antiplatelet therapy has established primary percutaneous coronary intervention (PCI) as the standard of care for acute myocardial infarction. Clopidogrel is currently the thienopyridine of choice for dual antiplatelet therapy in patients treated with PCI. ⋯ Recently, 2 novel third generation oral inhibitors of P2Y12 receptors, prasugrel and ticagrelor, have undergone clinical evaluation with promising results. This article is a non-exhaustive review of the literature, concentrating on the role of current and novel oral antiplatelet agents for acute myocardial infarction particularly highlighting the limitations and issues associated with clopidogrel use.
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Ann Acad Med Singap · Feb 2010
Comparative StudyOff-pump versus on-pump coronary artery bypass procedures:postoperative renal complications in an Asian population.
Diabetes and habitual smoking cause advanced coronary artery disease (CAD) in Asian patients at a younger age. No definite data exist as to whether off-pump (OPCAB) is better than conventional on-pump coronary artery bypass grafting (CCAB) in terms of postoperative renal complications. Thus, we aimed to compare the renal outcomes of on-pump and off-pump coronary artery bypass grafting (CABG) on our patients, which constituted a predominantly Asian population. ⋯ OPCAB is a safe and equally efficient operative method compared to CCAB, and has a significant lower risk for postoperative renal complications as a treatment modality for surgical coronary revascularisation.
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Ann Acad Med Singap · Feb 2010
Profile of hospitalisation and death in the first year after diagnosis of end-stage renal disease in a multi-ethnic Asian population.
The increasing prevalence of end-stage renal disease (ESRD) is an important public health issue due to the high costs of kidney replacement therapies. We examined the impact of ethnicity and other factors in ESRD management and hospitalisation in a multiracial Asian population in the fi rst year after diagnosis. ⋯ The care of ESRD patients requires substantial commitment of healthcare resources particularly in the fi rst year after diagnosis. Steps to reduce urgent initiation of dialysis will help reduce resource utilisation and improve patient outcomes.