Ann Acad Med Singap
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Ann Acad Med Singap · Jul 1995
Common genital dermatoses in male patients attending a public sexually transmitted disease clinic in Singapore.
The male genitalia is a common site of various dermatoses. Male patients attending a sexually transmitted disease (STD) clinic may present with dermatoses that are not due to sexually transmitted diseases. ⋯ Most of the anatomical variants were incidental findings whereas most patients with the pathological dermatoses presented with these lesions. Unfamiliarity with these dermatoses may cause unnecessary anxiety to the patient and physician, resulting in inappropriate treatment.
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Despite many innovations in the management of hypoxic-ischaemic brain injury over the past 20 years, none has been proven to improve the outcome in patients. "Neuroresuscitation" with its emphasis on monitoring and control of intracranial pressure has not increased the number of neurologically intact survivors. New insights into the pathogenesis of hypoxic-ischaemic encephalopathy, particularly the role of calcium ions, excitatory amino acids and free-oxygen radicals, have led to potential treatment modalities which are now under experimental study but cannot as yet be recommended as standard therapy. At present, the cornerstone of management of hypoxic-ischaemic encephalopathy is still supportive care and careful maintenance of systemic homeostasis.
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This paper examines the legal rights of a patient and his family in a situation where the patient's life is maintained by a life support system. It examines the duty and liability of a doctor who is of the view that the life-support should be terminated and, whether, in such situations the consent of the patient or his family or the Court is required.
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Ann Acad Med Singap · Jan 1995
The use of transcutaneous electrical nerve stimulation (TENS) in the treatment of facial pain.
The purpose of this article is to provide guidelines for the use of transcutaneous electrical nerve stimulation (TENS) in the differential diagnosis and treatment of facial pain. Most practitioners familiar with electrical modalities are aware that TENS is a physiologically-specific therapy for treating and resolving facial pain related to various neurological and/or myofascial conditions. ⋯ The effect on the patient's pain level from the trials of various combinations of rate and width settings provides the practitioner specific information to aid in a diagnosis. Guidelines to differential diagnosis as well as protocols for office and home use of this non-invasive, non-addictive and effective modality will be presented.
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Ann Acad Med Singap · Nov 1994
Randomized Controlled Trial Comparative Study Clinical TrialSingle-blind comparative analgesic and safety study of single doses of intramuscularly administered ketorolac tromethamine and pethidine hydrochloride in patients with pain following orthopaedic surgery.
Ketorolac tromethamine, a potent non-narcotic prostaglandin synthetase inhibiting analgesic was compared with pethidine for relief of moderate to severe postoperative pain. Forty-eight patients received Ketorolac 0.5 mg/kg and 52 received pethidine 1.25 mg/kg. The degree of pain prior to the administration of the drug and pain relief that followed were quantified using a vertical visual analogue scale (VAS) and monitored at hourly intervals. ⋯ The incidence of side effects was significantly greater with pethidine (40.4%) as compared to Ketorolac (10.4%). The similar analgesic efficacy to pethidine makes Ketorolac an appropriate drug for the relief of postoperative pain especially in day surgery settings where observation following administration of the drug as in the case of pethidine can be dispensed with and patients sent home earlier because of the minimal side effects associated with its use. Caution must be exercised with the use of large doses of Ketorolac especially if the drug is used for more than 5 days to avoid serious complications like renal failure and gastrointestinal bleeding.