Ann Acad Med Singap
-
Laparoscopic common bile duct exploration (CBDE) is becoming more popular in the management of choledocholithiasis due to improved laparoscopic expertise and advancement in endoscopic technology and equipment. This study aimed to evaluate the safety and short-term outcome of laparoscopic CBDE in a single institution over a 3-year period. ⋯ Laparoscopic CBDE is a safe operation with good outcome in managing choledocholithasis. Its dividends include the numerous benefits of minimally invasive surgery. If possible, transcystic extraction is preferred to choledochotomy, as this obviates the need for biliary diversion. ERCP will still hold an important role in certain instances in the management of choledocholithiasis.
-
Patients with peritoneal carcinomatosis (PC) usually have dismal prognoses, even with traditional systemic therapy. Peritonectomy or cytoreductive surgery (CRS) has been used to treat selected patients. It is also commonly used in the management of pseudomyxoma peritonei (PMP), often in combination with hyperthermic intraperitoneal chemotherapy (HIPEC). ⋯ It is important to recognise the role of and indications for CRS and HIPEC. Biologic factors of the disease and completeness of resection are important prognostic factors. Cytoreductive surgery, combined with intraperitoneal chemotherapy, can improve survival in selected patients with peritoneal-based malignancies.
-
Ann Acad Med Singap · Jan 2010
Thrombocytopenia and its related factors: a hospital-based, cross-sectional study.
The objective of this study was to explore the association between thrombocytopenia and its related factors. ⋯ It is advisable to further check the hepatic status, if thrombocytopenia is noted.
-
Ann Acad Med Singap · Dec 2009
The effect of temperature on illness severity in emergency department congestive heart failure patients.
Previous studies revealed fewer visits for congestive heart failure (CHF) to emergency departments (EDs) in New Jersey, USA and fewer admissions for CHF to a Southern Indian and an Israeli hospital during warmer months. Using hospital admission rate for CHF as a marker for illness severity, we hypothesized that CHF would also be less severe in warmer months. ⋯ Contrary to our hypothesis, we found a statistically significant increase in the percentage of CHF visits admitted to the hospital during the warmer months. This suggests that although there are less ED CHF visits in the warmer months, a greater percentage tend to be severe.
-
Ann Acad Med Singap · Dec 2009
Plasmid-mediated quinolone resistance determinants in urinary isolates of Escherichia coli and Klebsiella pneumoniae in a large Singapore hospital.
At the time of the study, 3 plasmid-borne qnr determinants (qnrA, qnrB and qnrS) and 1 plasmid-borne aminoglycoside-modifying enzyme determinant that confers quinolone resistance (aac(6')-Ib-cr) had been described in the literature. ⋯ A high prevalence of plasmid-mediated quinolone resistance determinants [i.e., qnrS, qnrB and aac(6')-Ib-cr] was found in quinolone-resistant K. pneumoniae isolated in a large hospital in Singapore.