Ann Acad Med Singap
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Feeling effective as a young person depends on a capacity to draw upon one's own resources in the service of healthy living and development. In adolescent health care, there is the need to call upon the talents and creativity of young people, to introduce new and exciting experiences, and to facilitate involvement in their own care in order to nurture optimal growth and development on a physical and psychological level. While hospitalisation can represent a major crisis point in adolescence, the provision of a stimulating environment and the opportunity for creative activities offers an exciting, transformative and healing experience. ⋯ In a project called Art Injection, art students worked with adolescents to make sculptures from old hospital equipment, with startling results. More recently, the development of personal totem poles and an imaginative mosaic mural has powerfully engaged creativity and community in care. Group and individual art sessions, including the media arts project Creative Well, are offered on weekdays as part of the general hospital routine, enabling hospitalised young people to experience creativity as a daily part of their lives.
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Ann Acad Med Singap · Jan 2003
Immediate and mid-term safety and efficacy of single lead VDD pacemakers for patients with atrioventricular block and normal sinus node function--a single centre experience.
Single lead atrial synchronous ventricular pacing (VDD) is increasingly being used in place of conventional dual chamber pacing (DDD) for patients with atrioventricular block and preserved sinus node function. Compared to the latter, VDD pacemakers provide similar haemodynamic benefits derived from atrial synchronous pacing, with the added benefit of an easier implant procedure. ⋯ In patients with atrioventricular block and preserved sinus node function, single lead VDD pacing is safe and effective in maintaining a physiological atrial synchronous pacing mode.
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Ann Acad Med Singap · Nov 2002
Comparative StudyAseptic meningitis in children--the Singapore experience.
To study the incidence, aetiology, clinical characteristics and management of paediatric aseptic meningitis in a paediatric hospital in Singapore. ⋯ Enteroviruses were the most common aetiologic agent identified. A method of early diagnosis using RT-PCR for enteroviruses is necessary to reduce the current duration of antibiotic usage and to decrease the length of hospital stay.
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Ann Acad Med Singap · Nov 2002
ReviewIntravenous adrenaline or vasopressin in sudden cardiac arrest: a literature review.
The chain of survival concept implies that provision of early access, early advanced care, including early intravenous drugs would improve survival in sudden cardiac arrest. Intravenous adrenaline (epinephrine) has been used as the drug of choice since 1906. What is the evidence for its effectiveness? Is vasopressin a better alternative? ⋯ More research is needed into this area, especially randomised controlled trials studying the effectiveness of vasopressin. Meanwhile, in order to improve survival from sudden cardiac arrest, continuing effort should be made to achieve early initiation of cardiopulmonary resuscitation, early defibrillation and early advanced care.
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Ann Acad Med Singap · Nov 2002
Comparative StudyA preliminary study of the utility of combined cardiac markers in the evaluation of patients presenting early with suspected acute coronary syndrome.
The aim of the study was to investigate and compare the usefulness and accuracy of various cardiac markers [troponin I, creatine kinase MB (CKMB) mass, creatine kinase (CK), CKMB activity] to aid early diagnosis of myocardial infarction. We also examined the ability of the various cardiac markers to prognosticate future adverse cardiac events. ⋯ Myoglobin is the most sensitive marker when compared to CK, CKMB and troponin I for diagnosing patients presenting early with chest pain and a non-diagnostic electrocardiogram and who subsequently develop either a ST-elevation myocardial infarction or non-ST elevation myocardial infarction. Patients with an elevated troponin I level but normal CK and myoglobin levels are at higher risk of an adverse clinical event.