Ann Acad Med Singap
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Ann Acad Med Singap · Aug 2006
Bodies recovered from wells, sewerage systems and pits: what is the cause of death?
The aim of this study was to determine the problems encountered during investigations into causes of death in corpses found in wells, sewer systems and pits, and to seek solutions to the problems. In fact, wells, sewer systems and pits have some common characteristics which may cause the problems. They contain water, have a hypoxic/anoxic environment and prevent corpses from being recognised. ⋯ It is a complicated process to determine the causes of death in bodies recovered from wells, pits, water supplies and sewer systems, etc. Thorough forensic investigations are required because death may result from a wide variety of factors, and lesions on the corpses may undergo some changes quickly or can be covered in wells, pits and water supplies. A complete crime scene investigation, a thorough autopsy and histopathological, toxicological and biochemical examinations would prevent potential problems in determining the causes of death in bodies recovered from wells, sewer systems and pits. Almost one-third of the bodies recovered from wells, sewer systems and pits were aged 10 years or younger, which indicates a public health problem. Extra safety precautions will help to solve this problem.
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Ann Acad Med Singap · Jul 2006
Case ReportsCan long-term corticosteriods lead to blindness? A case series of central serous chorioretinopathy induced by corticosteroids.
Long-term, high-dose corticosteroid therapy is well-known to cause systemic and ocular complications. A lesser known complication is chronic central serous chorioretinopathy (CSCR). Although idiopathic central serous chorioretinopathy (CSCR) is known to be mild with spontaneous recovery and minimal effects on the final visual acuity, chronic CSCR as a complication of long- term steroid therapy behaves differently, and may cause irreversible visual impairment. ⋯ Long-term corticosteroid therapy can be complicated by severe, chronic and recurrent CSCR and occasionally peripheral exudative retinal detachment. This may result in subretinal fibrosis and permanent loss of vision.
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Ann Acad Med Singap · Jul 2006
Utility and validity of the self-administered SF-36: findings from an older population.
The objectives of this study were to assess the utility and validity of the self-administered SF-36 and the effect of visual or cognitive impairment on these measures in an older population. ⋯ Attempt and completion rates, but not internal consistency and construct validity, of the SF-36 were influenced by age, gender, and presenting visual and cognitive impairments. The overall high attempt and completion rates, internal consistency and construct validity suggest that the self-administered SF-36 is a suitable healthrelated quality of life (HRQOL) measure in similar older community-living populations.
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Ann Acad Med Singap · May 2006
Comparative StudyThe outbreak of SARS at Tan Tock Seng Hospital--relating epidemiology to control.
The outbreak of severe acute respiratory syndrome (SARS) began after the index case was admitted on 1 March 2003. We profile the cases suspected to have acquired the infection in Tan Tock Seng Hospital (TTSH), focussing on major transmission foci, and also describe and discuss the impact of our outbreak control measures. ⋯ The outbreak of SARS at TTSH showed the challenges of dealing with an emerging infectious disease with efficient nosocomial spread. Super-spreading events and initial delays in outbreak response led to widespread dissemination of the outbreak to multiple wards.
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Ann Acad Med Singap · Feb 2006
Case ReportsSeptic monoarthritis and osteomyelitis in an elderly man following Klebsiella pneumoniae genitourinary infection: case report.
Klebsiella pneumoniae septic arthritis and osteomyelitis, albeit uncommon in adults, are important sites of disseminated infection. Many case reports have shown K. pneumoniae as a cause of nosocomial transmitted septic arthritis in neonates and children. We report a rare case of an elderly patient with K. pneumoniae genitourinary infection spreading to the liver and other extra hepatic sites like the prostate and peripheral joint. ⋯ This case emphasises the importance of timely and accurate diagnosis followed by appropriate treatment in disseminated K. pneumoniae infection to prevent significant morbidity and mortality.