Ann Acad Med Singap
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Ann Acad Med Singap · Jan 2001
Clinical TrialEffects of a pulmonary rehabilitation programme on physiologic and psychosocial outcomes in patients with chronic respiratory disorders.
The purpose of this prospective study is to determine the effects of a pulmonary rehabilitation programme (PRP) conducted at our centre for patients with chronic lung disease. ⋯ Patients who completed a comprehensive PRP at our centre showed significant increase in functional capacity, reduction of exertional dyspnoea and improvement in health status.
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Catheter-related spinal epidural abscesses are rare but increasing in incidence. ⋯ It is important to be vigilant and continue to maintain good clinical practice and a high index of suspicion for this procedural-related complication.
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Erythema induratum remains one of the rarely encountered tuberculid although tuberculosis is known to be endemic in the developing countries. We report a case of erythema induratum recently encountered in our centre. ⋯ A short review of the distinguishing features of erythema induratum, the associated classical histological spectrum and the usefulness of polymerase chain reaction in the diagnosis of erythema induratum is given. A search for active foci of tuberculosis is advocated in all cases.
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This paper presents the regulatory perspectives of the clinical drug evaluation process and the role of the newly established Centre for Drug Evaluation in Singapore in this process. It describes the major drug evaluation systems in the developed countries and their similarities and differences. ⋯ Building the capability for the evaluation of new drugs is essential as part of the regulatory infrastructure for a knowledge-based economy in Singapore. To conduct better clinical trials, investigators should develop a good understanding of the clinical drug evaluation process and an appreciation of the regulatory angle.
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Ann Acad Med Singap · Jul 2000
Randomized Controlled Trial Clinical TrialProphylactic esmolol infusion for the control of cardiovascular responses to extubation after intracranial surgery.
Emergence from general anaesthesia and extubation are often accompanied by significant surges in heart rate and blood pressure. To document these changes and the efficacy of low-dose beta-blocker infusions in ameliorating these rises, we undertook a descriptive dose-ranging study comparing the use of esmolol to placebo in patients emerging from neuro-anaesthesia. ⋯ Severe hypertension or tachycardia occurs in 92% of patients during extubation following neuro-anaesthesia and warrants the consideration of routine prophylaxis. Prophylactic esmolol infusion for the control of haemodynamic disturbances during extubation is feasible and safe. A modest level of obtundation is evident at 100 micrograms/kg/min but a rate of 200 micrograms/kg/min may prove to be more effective.