Ann Acad Med Singap
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Ann Acad Med Singap · Jul 1995
ReviewSexually transmitted diseases in Australia: a decade of change. Epidemiology and surveillance.
Survival data in the last decade for sexually transmitted diseases (STDs) other than human immunodeficiency virus (HIV) are uneven across the states/territories. The incidence of gonorrhoea decreased by more than 80%, but at different times in different patient groups, different states, and different anatomical sites. There was a resurgence of rectal gonorrhoea in homosexual men in 1989-1991. ⋯ An epidemic of hepatitis A infection occurred in male homosexuals in 1989-1991. Changes in the Australian sex industry resulted in marked improvements in the sexual health of local (but not international) sex workers. The high levels of STDs in Aboriginal communities continues to cause concern.
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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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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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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
Case ReportsHigh resolution computed tomography of the temporal bone: preliminary experience.
High Resolution Computed Tomography (HRCT) can demonstrate the detailed anatomy and pathology of the temporal bone and is fast becoming an important imaging modality in the diagnosis and preoperative management of our local patients with temporal bone diseases. We present our experience in the usage of HRCT in temporal bone lesions in Tan Tock Seng Hospital, using 8 cases as illustration. ⋯ We also give an overview of those clinical conditions whereby HRCT can provide information which will help surgeons in the management of their patients. These clinical conditions are hearing loss, external auditory canal atresia, middle ear inflammation/cholesteatoma, temporal bone trauma, pulsatile tinnitus and vascular tympanic membrane.