Ann Acad Med Singap
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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.
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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.
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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.
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Ann Acad Med Singap · Dec 2009
Prevalence of adolescent idiopathic scoliosis among female school children in Singapore.
Screening for scoliosis started in Singapore schools in 1982 and is currently being done for both boys and girls, as part of the annual school-based health screening programme in all primary and secondary schools. The screening levels in the current protocol were based on the 1997 prevalence study by Wong et al. In the study, it appeared that there was a significant increase in prevalence rates between 9- and 11-year-old girls (i.e. between Primary 4 and Primary 6) but there was no data on the prevalence rates of scoliosis in 10-year-old girls (Primary 5) and in 12-year-old girls (Secondary 1). In order to decide on whether to make changes to the screening levels, a review was conducted to determine the prevalence of scoliosis among the 10-year-old girls (in Primary 5) and 12-year-old girls (in Secondary 1). ⋯ The study showed a significant increase in the prevalence rates of scoliosis in the 10- to 11-year-old female students and again a significant increase in the prevalence rates in the 12- to 13-year-old female students. Since the prevalence rate for the 9-year-old females was quite low (0.27%), and there was a significant increase in the prevalence rates in the 10- to 11-year-old and 12- to 13-year-old females, it was recommended that screening for females be performed every year commencing at 10 years old (Primary 5) until 13 years old (Secondary 2).
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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.