Ann Acad Med Singap
-
Ann Acad Med Singap · May 1993
Influence of basal cisterns, midline shift and pathology on outcome in head injury.
The relationship of outcome to the basal cisterns, midline shift and pathology as seen on initial CT scan was assessed in 107 moderate and severe head injured patients. The mortality rates were 82 cases (76%) and 29 cases (27%) among those with obliterated and normal basal cisterns, and 74 cases (69%) and 42 cases (39%) when the midline shift was present and absent, respectively. ⋯ The state of the above two parameters when correlated with GCS score, showed that they were important for those with higher GCS scores. This indicates that the status of the cisterns and midline shift is correlated with the type of pathology and GCS score rather than these parameters taken alone in prediction.
-
Ann Acad Med Singap · Nov 1992
Myopia and educational attainment in 421,116 young Singaporean males.
Data of 421,116 Singaporean males aged 15 to 25 (mean 17.75) years who underwent compulsory medical examination in 1974-84 and 1987-91 were used to estimate the prevalence of myopia and to study the correlation between the prevalence and severity of myopia and educational attainment. The estimated myopia prevalence rate was 26.3% in 1974-84 and 43.3% in 1987-91. This rise in the rate was accompanied by an increase in the proportion of males who achieved higher levels of education over the same period. ⋯ Seventy out of 173 (40%) myopes with no formal education compared to 1035 out of 1612 (64%) myopes with university degrees had unaided visual acuity worse than 6/60 in 1987-91. Our findings confirm indications from other sources that the association between the prevalence and severity of myopia and education attainment is real. A combination of genetic and environmental factors may be the cause of this association.
-
Ann Acad Med Singap · Nov 1992
Case ReportsTracheal rupture from incorrect positioning of endotracheal tube.
Significant ischaemic tracheal damage from endotracheal intubation is uncommon when the lateral wall pressure exerted by the cuff does not exceed the mean capillary perfusion pressure of the mucosa. This is facilitated by the modern endotracheal tubes with high-volume-low-pressure cuffs. We report a case of tracheal rupture due to an incorrectly positioned softcuffed tube. The need to review tube position radiologically and to make immediate adjustment cannot be overemphasised.
-
Ann Acad Med Singap · Nov 1992
Obstetric admissions to the intensive care unit--a retrospective review.
A five-year retrospective study of obstetric admissions to the Surgical Intensive Care Unit (SICU) in the National University Hospital, Singapore was carried out with the aim of determining the incidence, causes and outcome of these admissions. Most of the patients were admitted following emergency caesarean sections. Obstetric complications was the reason for admission in 56.8% with hypertensive disease of pregnancy being the major cause and haemorrhage accounting for the rest. ⋯ Medical complications due to cardiovascular disease, autoimmune disease and malignancy also accounted for 21.6% of admissions. Only 37 out of 16264 deliveries (0.22%) required intensive care support. The median of duration of stay was one day.
-
Ann Acad Med Singap · Sep 1992
Epidemiology of burns in Singapore children--an 11-year study of 2288 patients.
A retrospective review of 2288 children (12 years and below) admitted to the Burns Centre, Singapore General Hospital over an eleven year period (1978-1988) was made. Annual admissions from 1978-85 ranged from 208-290 cases annually (32-38% of all admissions). Between 1986 to 1988 annual admissions ranged from 73-104 cases annually (22-28% of all admissions). ⋯ Only one child died from burns of less than 40%. Case mortality in the 40-60% burns group was around 20% and it increased sharply when extent of burns reached or exceeded 70%. Burns in children exhibit anatomical, physiological, surgical, rehabilitative and psychological differences when compared to adults.