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 TrialEpidural infusions of bupivacaine and fentanyl do not improve rehabilitation following one-stage bilateral total knee arthroplasty.
Epidural analgesia with local anaesthetic minimizes the catabolic response to surgery. To determine whether this could enhance the rate of recovery following orthopaedic surgery, 51 patients undergoing bilateral one-stage total knee arthroplasty were allocated to receive infusions of either continuous epidural bupivacaine/fentanyl or continuous intravenous fentanyl to compare the efficacy of these modes of pain relief on postoperative clinical outcomes and rates of rehabilitation. ⋯ Postoperatively, pain relief (visual analogue scale), attainment of physical therapy goals and cardiopulmonary complications were measured daily for 7 days. Epidural analgesia with a combination of bupivacaine and fentanyl did not result in any measurable improvement in rehabilitation milestones or reduction in postoperative complications following bilateral total knee arthroplasty than with fentanyl infusions alone.