Singap Med J
-
Randomized Controlled Trial Comparative Study
Comparison of two doses of corticosteroid in epidural steroid injection for lumbar radicular pain.
Low back pain and lumbar radicular pain are the leading causes of job loss worldwide. Therapeutic approaches to lumbar radicular pain, including sciatica and spinal canal stenosis, are diverse. Many clinicians use 80 mg long-acting glucocorticoids in epidural steroid injections (ESI). The aim of this study is to compare the clinical response of 80 mg versus 40 mg methylprednisolone in ESI. ⋯ In the case of lumbar radicular pain, ESI with low dose (40 mg) methylprednisolone is as effective as high dose (80 mg) with comparable results and less adverse profile.
-
In most of the medical colleges in India, unclaimed bodies from various mortuaries reach the dissection hall; and here, the body donors club has yet to gain the desired dimensions. In spite of all the adverse circumstances, the cadaver and the dissection both have survived the most rigorous test of pedagological fitness--the test of time. ⋯ Thailand's approach to body donors offers a role model for resolving the present situation. The spirit of volunteerism reflects the drastic shift in public perception and a global change in approach is needed in the present time.
-
Intratracheal metastasis from non-pulmonary neoplasm is extremely rare. We report a 53-year-old woman presenting with upper airway obstruction and stridor due to intratracheal metastasis from latissimus dorsi liposarcoma. ⋯ At rigid bronchoscopy, a 2-cm intratracheal mass was identified and resected with endobronchial electrosurgery to establish a satisfactory airway with marked symptomatic benefit. We discuss this unusual metastatic presentation.
-
This review assessed the incidence, predisposing conditions, and key surgical steps, where urological injuries occurred during laparoscopic hysterectomies at the Minimally Invasive Surgery Unit, KK Women's and Children's Hospital over a four-year period. ⋯ Urological injuries occurred in 1.6 percent of laparoscopic hysterectomies in our hospital. The predisposing factors include previous caesarean surgery, multiple fibroids and severe endometriosis. A definite learning curve exists with laparoscopic hysterectomy with a thorough knowledge of pelvic anatomy being an essential prerequisite for advanced pelvic surgery. Similarly, good exposure of the surgical field, vigilant dissection and judicious use of electro-surgery are important practices to adopt to prevent injuries.
-
Urinary retention is associated with an increased rate of urinary tract infections and deep sepsis following total joint arthroplasty. This study was carried out to investigate the incidence of urinary retention following total knee arthroplasty in a Singapore hospital, and to identify risk factors associated with the development of this complication in our patient population. ⋯ In our patient population, male patients and patients receiving epidural postoperative analgesia are at increased risk of developing urinary retention following total knee arthroplasty.