Ann Acad Med Singap
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Ann Acad Med Singap · Sep 1992
Case ReportsMass ammonia inhalational burns--experience in the management of 12 patients.
Twelve Korean crew members of a deep sea fishing vessel were admitted to the Burns Centre, Singapore General Hospital following exposure to ammonia gas. The injuries sustained were primarily respiratory burns with minor cutaneous and corneal burns. They were divided into three grades of severity based on the admission findings and subsequent clinical course. ⋯ Eight patients were intubated. Ten of the patients with mild and moderate involvement of the respiratory tract recovered without complication. Of the two patients with severe respiratory burns, one died while another progressed to chronic debilitating airway disease.
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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.
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Ann Acad Med Singap · Sep 1992
Randomized Controlled Trial Clinical TrialAn assessment of preoxygenation techniques using the pulse oximeter.
The effect of preoxygenation with varying inspired oxygen concentration on the arterial oxygen saturation during induction of anaesthesia and intubation was studied using the pulse oximeter. Sixty-five healthy, young adults, (American Society of Anaesthesiologists Class I) undergoing elective surgery were randomly divided into three groups. Group I patients were not preoxygenated. ⋯ No patient had clinical signs of hypoxaemia. Patients who were preoxygenated with either 50% oxygen and nitrous oxide or 100% oxygen showed similar and clinically insignificant desaturation during this period. One minute after intubation and manual ventilation with 100% oxygen, the saturations of all patients returned to preinduction levels.
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This is a five year retrospective study of chemical burn injury in our burn center between 1 January 1987 and 31 December 1991. Of the 1,226 total burn cases, 131 patients had chemical burns. We noted a constant prevailing incidence of 10.7% per year. ⋯ We had three mortality cases with deep third degree burns covering 60% of their total body surface area. Some clinical cases are demonstrated. Lastly, proposed solutions for the prevention of chemical burns are cited.
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Since the birth of Louise Brown in 1978, no other area in clinical practice and medical research has held the public interest to the same extent as the assisted reproductive technologies. This has led to the formation of committees of enquiry, guidelines from professional bodies, the passage of legislation, and the formation of legislative bodies. The ethical issues which arise in the clinical practice of assisted reproduction, the donation of gametes and embryos, and their cryopreservation, surrogacy, and human embryo research are reviewed.