Ann Acad Med Singap
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Obstetrical palsy has been described since a long time. Unfortunately, until the last 20 years, few options were available to correct its sequelae. During the last two decades, there has been a regain of interest because of the possibility to microsurgically repair these lesions. ⋯ Physiotherapy and long-term follow-up of these patients are primordial to prevent joint ankylosis and to identify the patients who will benefit from secondary surgery. Our results are presented either after early treatment or after secondary procedures. These results justify aggressive management of obstetrical brachial plexus palsy because of children's great capacity for regeneration and accommodation.
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Three cases of tetanus in Singapore are presented. One local resident had cephalic tetanus most likely secondary to otitis media and the other two, residents from surrounding Asean countries, had generalised tetanus. The portal of entry was a puncture wound on the foot in one patient and the ear in another. ⋯ In spite of the availability of intensive care management, it continues to be a disease with significant morbidity and mortality. Early recognition and treatment of the disease are critical factors in determining the prognosis. This is a disease that may be largely prevented by adequate immunization.
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Traumatic bronchial rupture is a rarity. Its incidence is about 1.5% to 3% in most series of blunt chest trauma. We report a patient who presented after a road traffic accident with an apparently persistent pneumothorax which failed to respond to emergency treatment. ⋯ The authors would like to recommend that emergency bronchoscopy be carried out in patients with blunt chest trauma to exclude this potentially treatable condition. This is especially so if there are suggestive clinical features, such as the presence of extensive and spreading subcutaneous emphysema, pneumomediastinum, pneumothorax, haemoptysis, fractures of the first two ribs and respiratory distress. A history of massive blunt force to the chest wall as a mechanism of injury should also prompt the trauma team to consider the need for emergency bronchoscopy.
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This study was undertaken to ascertain the incidence of postoperative hypoxaemia in the recovery area and during transfer to the recovery area while adhering to the current practice of anaesthesia and recovery room care. Attempts were also made to determine some of the risk factors for the development of hypoxaemia. There were 546 patients who had general or regional anaesthesia observed in the recovery area and of these, 534 patients were also observed during transfer using Critikon Oxyshuttle pulse oximeters. ⋯ The occurrence of hypoxaemia during transfer was significantly related to the duration of surgery. In the recovery area, age and weight were found to be statistically significant risk factors. The incidence of hypoxaemia in this study is much lower than that reported in other studies.