Singap Med J
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Bystander cardiopulmonary resuscitation (CPR) serves as a vital link to improve the chance of survival among the out-of-hospital cardiac arrest (OHA) patients. The frequency of bystander CPR in Malaysia is largely unknown. The aim of this study was to find out how frequently bystander CPR was performed among OHA patients with CPR performed at the Emergency Department (ED), Hospital Universiti Sains Malaysia (HUSM), prior to their arrival to the department. ⋯ Although this study has many limitations, it does indicate that the frequency of bystander CPR is dismally low in our community and the mere fact that bystander CPR was reported to be done does not seem to translate into a higher chance of survival to admission. The quality and effectiveness of the technique is equally important.
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The comparative anti-hypertensive drug trials conducted to assess their cardiovascular protective efficacy actually produce compatible, not conflicting, results. In the last decade, there were 13 major comparative hypertension drug trials with the cardiovascular primary outcome being statistically equivalent in 11 of these 13 trials, involving over 90 percent of the randomised 168,593 patients. Where secondary outcomes favour a drug in these trials, that arm has a significantly lower treated blood pressure as in LIFE, VALUE, ASCOT and ALLHAT. ⋯ The safety and value of diuretics, beta-blockers, calcium-blockers, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in reducing blood pressure, and in reducing clinical cardiovascular outcomes, is now clearly established. Overall, the importance of tight blood pressure control in reducing cardiovascular outcomes must be emphasised. Physicians should concentrate on achieving good blood pressure control, which often requires a combination of several antihypertensive drugs.
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Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia. ⋯ Patients' perceptions can be very subjective, but until further similar studies could be carried out in other parts of Malaysia, this set of data merely represents a numerical measure of public perception of the ambulance services from HUSM.
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Although there are numerous aetiologies for coccygodynia described in the medical literature, precoccygeal epidermal inclusion cyst presenting as a coccygodynia has not been reported. We report a 30-year-old woman with intractable coccygodynia. Magnetic resonance imaging showed a circumscribed precoccygeal cystic lesion. ⋯ The patient became asymptomatic and remained so at two years follow-up. This report suggests that precoccygeal epidermal inclusion cyst should be considered as one of the differential diagnosis of coccygodynia. Our experience suggests that patients with intractable coccygodynia should have a magnetic resonance imaging to rule out treatable causes of coccygodynia.