Singap Med J
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Randomized Controlled Trial Comparative Study
Oral misoprostol versus intramuscular oxytocin in the active management of the third stage of labour.
Although the third stage of labour is usually uneventful, several significant complications may be encountered that may lead to maternal morbidity and mortality, especially primary postpartum haemorrhage. The objective of this study was to compare 400 ug oral misoprostol with 10 IU intramuscular oxytocin in the active management of the third stage of labour. ⋯ Oral misoprostol appeared to be as effective and as safe as intramuscular oxytocin in the active management of the third stage of labour.
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Acute appendicitis is one of the most common surgical emergencies. The Alvarado and modified Alvarado scores have been developed to aid diagnosis, but both scoring systems have poor sensitivity and specificity when applied in Middle Eastern and Asian populations. The aim of this study was to develop a new scoring system that is suitable for the local population. ⋯ The new appendicitis scoring system looked promising when applied to our settings, and had a better sensitivity and specificity than the Alvarado score when applied to Asian populations. A significant reduction in the negative appendicectomy rate was also predicted. A prospective evaluation of this new appendicitis scoring system, referred to as the RIPASA score, is ongoing.
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Computed tomography (CT) is currently a widely available imaging technique in clinical practice. Technical developments of CT imaging, especially the emergence of multislice CT, with increased scanning speed and volume as well as higher spatial and temporal resolution, have significantly enhanced the diagnostic value of CT in many clinical applications. ⋯ Justification of the application of CT is one of the main principles that physicians need to be aware of when choosing CT as the first-line technique for diagnosis. This article reviews the clinical applications of CT imaging in the emergency department, with a focus on patients presenting with headache, repeat and multiple CT imaging and whole body screening for trauma patients, and explores whether the applications are clinically justified.
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The purpose of this study was to investigate the results of minimally invasive treatment modalities in early stage multiloculated empyema thoracis. ⋯ In patients with early stage multiloculated empyema, VATS deloculation and debridement is superior to tube thoracostomy alone and fibrinolitic therapy in reducing drainage time and hospital stay. It has a relatively high success rate without significant morbidity. Therefore, VATS decortication may be recommended as a first-line therapy in early stage multiloculated empyema thoracis.
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Comparative Study
An anthropometric study of facial height among four endogamous communities in the Sunsari district of Nepal.
Facial anthropometry has well-known implications in health-related fields and has been utilised for forensic purposes in the past. It provides an indication of the variations in facial shape in a population. The facial anthropometric profile of a population can characterise the distinctive features of a likely face in that population. The present study aimed to examine the differences in facial height proportions and facial growth patterns in different communities in the Sunsari district of Nepal. ⋯ The study concluded that there is evidence of statistically significant differences of the upper and lower face height proportions among the different racial groups. A change in the facial height proportions of the various age groups was evident. However, differences in facial height proportions between male and female were found to be insignificant.