Ann Acad Med Singap
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Ann Acad Med Singap · May 1990
Comparative StudyRewarming after cardiopulmonary bypass--a comparison of two methods.
Patients returning to the Intensive Care Unit following cardiac surgery with cardiopulmonary bypass are almost always hypothermic despite having been rewarmed prior to termination of bypass. The study compared the effect of an overhead radiant heat source with a reflective metallised blanket. ⋯ Rectal, tympanic membrane and great toe temperatures were measured. Patients nursed under the radiant heat source had higher temperatures at the end of the study period as compared to those nursed with conventional means (p less than 0.05).
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Ann Acad Med Singap · Jan 1990
The role of protamine dose assay in reversal of heparin following extracorporeal circulation for open heart surgery.
The amount of protamine required for the neutralisation of heparin following cardiopulmonary bypass was determined by a Protamine Titration Assay using the principle of the dose--response curve and the patient's estimated blood volume. In 300 open heart surgery patients, infusion of the determined dose of protamine normalised the Activated Clotting Time (ACT) to baseline levels in 97% of these patients and produced adequate hemostasis. Our present study showed that the dose of protamine dropped to 75% of the dose calculated by conventional method of heparin to protamine ratio of 1:1. This had minimised the adverse effects of excessive protamine administration and optimised coagulation control after extracorporeal circulation.
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Ann Acad Med Singap · Jul 1989
Case ReportsHypoglycaemia misdiagnosed by capillary glucose measurement.
The diagnosis of hypoglycaemia has become much easier with the introduction of bedside capillary glucose measurements which require a single drop of blood from a finger prick. However, such a diagnosis may be wrongly made in patients with poor peripheral circulation. This case report illustrates the common circumstances where misdiagnosis occurs A drop of venous blood should be used for bedside glucose measurement if the diagnosis is in doubt.
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Ann Acad Med Singap · Jul 1988
Nonsurgical correction of cleft lip nasal deformity in the early neonate.
Auricular cartilage is soft and plastic, and congenital auricular deformities are easily corrected nonsurgically in the early neonatal period. Alar cartilage is the same kind of elastic cartilage as auricular cartilage. Therefore, alar cartilage is also malleable in the early neonate. ⋯ In 10 cases, preoperative nonsurgical correction with a special retainer began in the early neonatal period and the lip repair was done at about three months of age. Following observation of 40 infants for 12 months or longer, their nasal shapes and symmetry were considered superior to those conventionally operated on at about three months of age without nonsurgical correction of their nasal deformity during the early neonatal period. Except for one case of nasal infection, there were no other complications.
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Ann Acad Med Singap · Jan 1988
The use of serum transferrin in the evaluation of protein-calorie malnutrition in cancer patients.
Forty-five patients with various malignancies of the gastrointestinal tract had their nutritional status assessed pre-operatively to determine the prevalence of malnutrition and to establish the correlation of malnutrition with post-operative outcome. Ten nutritional parameters were assessed. Based on these markers, we found a significant degree of malnutrition. ⋯ We feel that serum transferrin is a useful nutritional marker to predict post-operative outcome and also to monitor the effect of nutritional support. However, based on a preliminary study, nutritional support may be required for periods longer than two weeks to show significant improvement in protein-calorie malnutrition. We will consider giving adequate support for a longer period on a further study using serum transferrin as a marker to determine its value in monitoring any reversal of malnutrition.