Ann Acad Med Singap
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Our understanding of haemostatic mechanisms has increased in the last decades. This knowledge at the cellular and molecular levels has helped us to appreciate the complexity of haemostatic mechanisms and their disturbance in various disorders. ⋯ More study needs to be done to define what constitutes normal haemostasis in newborns. The better understanding of control mechanisms of haemostasis will help us in diagnosis and treatment.
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Ann Acad Med Singap · Jul 1985
The role of fibreoptic bronchoscopy in the management of respiratory burns.
We found that fibreoptic bronchoscopy was a useful, simple, safe and accurate method in the diagnosis of inhalation injury, determining the type, the site and the extent of damage sustained. The most common mucosal damage was erythema and oedema of the supraglottic and glottic tissues, though in a few cases more severe and extensive injury was seen. ⋯ Endotracheal intubation could then be carried out promptly. Changes in clinical features and laboratory results were too slow to be of use in the prediction of upper airway obstruction, but could be indirect indicators of lower and peripheral airway injury.
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Hypoglycaemia in diabetes mellitus, occurring as a complication of treatment with insulin or oral hypoglycaemia drug therapy or spontaneously as a result of other medical conditions, is a frequent clinical problem. This paper will discuss the common causes of hypoglycaemia in diabetes mellitus, principles of treatment and prevention.
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Ann Acad Med Singap · Jan 1985
Case ReportsTreatment of acute deficits of moyamoya disease with verapamil.
A 7 year old girl with moyamoya disease presented with progressive right arm and leg weakness and muteness. Intravenous administration of verapamil was followed by immediate and lasting improvement in motor function and return of some expressive language. A second infusion of verapamil during angiography produced an increased opacification of collateral vessels in the left basal ganglia, suggesting drug-induced vasodilation and reversal of ischaemia as a mechanism for the observed clinical improvement. Calcium-channel blockers may be useful in the acute management of selected patients with moyamoya disease.
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Ann Acad Med Singap · Apr 1984
A quantitative evaluation of competing risks in occupational studies.
Mortality risk is competing because each individual is subject to several competing causes of death but can only die from one. Adjustment for competing risks will allow more meaningful comparisons of cause-specific mortality of two populations, especially if dying from all other causes is significantly different between the two populations. In this paper, a method has been developed for adjustment of competing causes of death in the calculation of relative risk. ⋯ Thus, the impact of competing risks is increased if the mortality risk of the study population is high, if the differential risk for all other causes is large or if wide age intervals are used in the mortality calculation. An example from refinery cohort data shows that in certain age groups unadjusted for competing risks the relative risk is overestimated by 9%. The impact of competing risks in this particular example is relatively small.