Singap Med J
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Biography Historical Article
Harvey Cushing (1869-1939): father of neurosurgery.
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Comparative Study
Management of ruptured intracranial aneurysms in the post-ISAT era: outcome of surgical clipping versus endovascular coiling in a Singapore tertiary institution.
The results of the International Subarachnoid Aneurysm Trial (ISAT) in 2002 have significantly influenced the management of ruptured intracranial aneurysms. There is now an established shift worldwide toward endovascular coiling as the initial treatment of choice. We assessed the outcomes of patients admitted to our institution for aneurysmal subarachnoid haemorrhage (SAH), comparing the outcomes of patients (World Federation of Neurosurgical Societies [WFNS] grades 1-3) who underwent surgical clipping versus those who underwent endovascular coiling. ⋯ Although we acknowledge the presence of management bias in our institution, our findings were similar to those of the ISAT trial. Upon correlation between our results and current evidence-based findings, our findings show that clipping provides similar long-term outcomes as endovascular coiling. In the event that an aneurysm is deemed unsuitable for coiling, clipping remains an effective option.
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Review Case Reports
A case of systemic nocardiosis in systemic vasculitis and a review of the literature.
Systemic nocardiosis is rarely reported in patients with systemic vasculitis, and is mostly described in patients experiencing long-term immunosuppression following organ transplantation. In this report, we describe a 71-year-old man who developed disseminated Nocardia infection during treatment of his underlying microscopic polyangiitis. He had no other associated risk factors. This case highlights the importance of considering rare pathogens in immunosuppressed patients who present with nonspecific symptoms, as well as the impact of such pathogens on clinical management.
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Observational Study
The modified Medical Research Council dyspnoea scale is a good indicator of health-related quality of life in patients with chronic obstructive pulmonary disease.
Health-related quality of life (HRQoL) is an important patient-centred outcome in chronic obstructive pulmonary disease (COPD). The aim of the current study is to compare the discriminative capacity of the modified Medical Research Council (mMRC) dyspnoea scale and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric classification of COPD on HRQoL, as well as determine other factors that are simple and determinative of HRQoL. ⋯ The mMRC dyspnoea scale is a concise and practical tool to assess the HRQoL of patients with COPD in daily clinical practice.
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The objective of this study was to assess the feasibility, reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 Short Form 15 Generic Core Scales (PedsQL™ 4.0 SF15) in a sample of Iranian schoolchildren and children with chronic health conditions. ⋯ This study supports the feasibility, reliability and validity of the Iranian version of the PedsQL™ 4.0 SF15 among Iranian children and their parents.