Ann Acad Med Singap
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Ann Acad Med Singap · Jan 2000
Endobronchial stenting in patients requiring mechanical ventilation for major airway obstruction.
To examine the value of therapeutic rigid bronchoscopy on subsequent ventilator weaning in ventilated patients with major airway obstruction. ⋯ Therapeutic rigid bronchoscopy is effective in the acute management of respiratory distress from central airway obstruction. Dramatic improvements in ventilatory status following therapeutic rigid bronchoscopy allow ventilator liberation in a select group of patients with an otherwise good performance status.
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Ann Acad Med Singap · Jan 2000
Proerectile pharmacological effects of Tribulus terrestris extract on the rabbit corpus cavernosum.
The objective of the present study was to investigate the effect of oral treatment of Tribulus terrestris (TT) extract on the isolated corpus cavernosal tissue of New Zealand white (NZW) rabbits and to determine the mechanism by which protodioscin (PTN), a constituent of the TT, exerts its pharmacological effects. ⋯ The relaxant responses to acetylcholine, nitroglycerin and EFS by more than 10%, 24% and 10% respectively compared to their control values and the lack of such effect on the contractile response to noradrenaline and histamine indicate that PTN has a proerectile activity. The enhanced relaxant effect observed is probably due to increase in the release of nitric oxide from the endothelium and nitrergic nerve endings, which may account for its claims as an aphrodisiac. However, further study is needed to clarify the precise mechanism of its action.
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Ann Acad Med Singap · Nov 1999
Comparative Study Clinical Trial Controlled Clinical TrialUse of EMLA cream or alfentanil for analgesia during ophthalmic nerve blocks.
This prospective double-blind study compared the effectiveness of EMLA with alfentanil and placebo in reducing the overall pain during ophthalmic nerve blocks. Seventy-five patients scheduled for cataract surgery were divided into three groups. ⋯ Patients then received facial nerve blocks and retrobulbar block by the same surgeon. Pain scores by patients and independent observers were significantly lower in the EMLA and alfentanil groups compared to placebo (P < 0.005) with no significant difference between the EMLA and alfentanil groups.
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This study aims to examine the feasibility of applying the focused ultrasound examination (FAST) in the initial assessment of the trauma patient. Its advantage over diagnostic peritoneal lavage lies in the speed in which it can be performed, its non-invasiveness and repeatability. Over the period January 1997 to July 1998, the FAST examination (Acuson 128XP/10, 3.5 MHz probe) was used to assess the presence of haemopericardium or haemoperitoneum in 38 multi-trauma patients admitted to the Singapore General Hospital. ⋯ Overall sensitivity was 67% and specificity 97%. Although the FAST examination missed the small amount of free fluid seen in the CT scan of 2 patients, these patients did not have to undergo laparotomy as their abdominal examination was normal. We conclude that the FAST examination is feasible and should be part of a general surgeon's armamentarium in the initial assessment of trauma.
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Ann Acad Med Singap · Nov 1999
An in vitro evaluation of epidural catheters: tensile strength and resistance to kinking.
The tensile strengths of 12 commercially available brands of epidural catheters were assessed using an Instron material testing device. The mean values of the tensile strengths ranged from 1.89 to 3.74 kilogram force. The extent of catheter occlusion due to kinking was also studied using an in vitro apparatus designed to simulate drug delivery at various degrees of flow restriction. It was determined that reinforced catheters were less likely to be occluded secondary to kinking.