Singap Med J
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Knowledge of blood usage patterns helps to address major issues such as the management of massive transfusion events, minimisation of transfusion risks, as well as in dealing with blood shortages. The aim of our study was to audit blood component usage at a Level I trauma centre blood bank. ⋯ The rate of transfusion of trauma patients was high (94 percent). Using the C:T ratio as a marker, optimal blood utilisation was noted in all departments. The methods of reporting transfusion reactions need to be revised. Future studies on the appropriateness of blood use and blood ordering schedules are required.
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Case Reports
Spontaneous resolution of sinoatrial exit block and atrioventricular dissociation in a child with dengue fever.
Cardiac rhythm abnormalities, including ventricular arrhythmia, atrial fibrillation and atrioventricular block, have been observed during the acute stage of dengue haemorrhagic fever. Atrioventricular or complete heart block can be fatal and may require a temporary pacemaker. We report a ten-year-old girl who presented with dengue haemorrhagic fever with sinoatrial block and atrioventricular dissociation that had a spontaneous resolution.
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Stress fractures of the tibia secondary to tibial deformities from osteoarthritis are rare, and may be difficult to manage. We treated two patients with stress fractures of the proximal tibial diaphyses over a period of two years. Both patients had osteoarthritis of the knee; one with genu valgus deformity and the other, genu varus deformity. ⋯ The stress fractures of both the patients had been treated conservatively by nonoperative means, but their fractures failed to unite. They then underwent a modular total knee prosthesis with a long tibial stem extension, and subsequently, their fractures united. Both patients recovered uneventfully.