Singap Med J
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Randomized Controlled Trial Comparative Study Clinical Trial
The therapeutic efficacy of mometasone furoate cream 0.1% applied once daily vs clobetasol propionate cream 0.05% applied twice daily in chronic eczema.
Mometasone furoate [9a, 21-dichloro-llb, 17dihydroxy-16a-methyl-pregna-14-dione-3, 20-dione-17-(2furoate)] is a synthetic, 17-heterocyclic corticosteroid which has been shown to be highly effective as an anti-inflammatory agent which is approximately half as potent is suppressing hypothalamic-pituitary-adrenal (HPA) axis function as betamethasone valerate. ⋯ Overall, 53% of patients considered the MF treated sites to be good or excellent vs 88% for CP treated sites.
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There has been a gradual shift in the attitude of the medical community as well as the lay public towards greater acceptance of euthanasia as an option for care of the terminally ill and dying. There have also been calls by certain groups to actually legalize voluntary euthanasia and physician-assisted suicide for patients who meet certain conditions, some of which are as follows: that the patient be of a sound mind, suffering from an incurable or terminal illness, experiencing unbearable suffering and uncontrollable pain. The rationale for legalizing euthanasia is based on the principle of the patient's right of self-determination and the duty of doctors to relieve pain and suffering at all times. ⋯ Some even went as far as to suggest that euthanasia and palliative care be part of the continuum of care for terminally ill patients. When palliative medicine fails to fully control pain and suffering for the patient, euthanasia can be the logical next step in the continuum of care. This article seeks to discuss why the rationale for legalizing euthanasia is flawed, why euthanasia goes against the fundamental principles of Medicine in general and why it is incompatible with the practice of palliative medicine.
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Many patients with diabetes can lead a full life without developing diabetic lesions in their feet. This is because these patients have avoided the precipitating factors of which the most important is mechanical trauma and infections. We present five cases of diabetic patients who, out of ignorance, listened to bad advice by using hot therapy to treat their peripheral neuropathy. ⋯ All of them required large surgical debridement and prolonged costly hospital stay to treat their condition. Fortunately, none of them required amputation. This paper hopes to highlight the dangers of self treatment and medication in diabetic foot lesions.