Singap Med J
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Multicenter Study Comparative Study
Risk factors associated with necrotising enterocolitis in very low birth weight infants in Malaysian neonatal intensive care units.
This study aimed to identify the risk factors associated with necrotising enterocolitis (NEC) in very low birth weight (VLBW; weight < 1,501 g) infants in Malaysian neonatal intensive care units (NICUs). ⋯ Increasing maternal age, decreasing birth weight, surfactant therapy, congenital pneumonia and indomethacin therapy for the closure of PDA were associated with an increased risk of NEC in Malaysian VLBW infants. Infants that received intrapartum antibiotics were associated with a reduced risk of developing NEC.
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This study aimed to measure the basal metabolic rate (BMR) of elite athletes and develop a gender specific predictive equation to estimate their energy requirements. ⋯ The novel predictive equation presented in this study can be used to calculate BMR for adult Malaysian elite athletes. Further studies may be required to validate its predictive capabilities for other sports, nationalities and age groups.
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Case Reports
Agomelatine reduces craving in benzodiazepine addicts: a follow-up examination of three patients.
The treatment of benzodiazepine withdrawal is difficult, and the search continues for substances that can reduce craving and the risk of relapse. Here, we report three cases of benzodiazepine addicts with histories of unsuccessful withdrawal attempts who experienced marked reductions in craving and improved relapse prognoses under add-on administration of agomelatine. These cases demonstrate a possible area of use for the antidepressant agomelatine in the treatment of benzodiazepine withdrawal and addiction. The extent to which this effect is due to the anti-craving effects of agomelatine, or its profile of receptor activation, should be further investigated in larger clinical and experimental studies.
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Burn injury sustained during pregnancy is a serious clinical complication that requires individualisation of management. We describe the case of a 30-week pregnant woman who presented to the hospital in a state of shock with approximately 90% burn injuries. Resuscitation was carried out, and the patient's family consented to an emergency Caesarean section in view of the grave prognosis of such burn injuries. ⋯ However, the mother succumbed to her injuries two days after the operation, while the baby was successfully resuscitated and discharged after ten days. This case highlights the importance of timely decision-making and coordination, which are required to salvage a near-term foetus. It also underscores that emergent resuscitation and timely operative procedures might be able to salvage a living foetus, particularly in patients with burns covering more than 60% of total body surface area.
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Case Reports
Is there a role for TENS application in the control of diabetes mellitus in insulin-dependent patients?
An 80-year-old man with insulin-dependent diabetes mellitus presented to the hospital with low back pain. He was initially managed with non-steroidal anti-inflammatory drugs, tramadol and epidural steroid injection. Transcutaneous electrical nerve stimulation (TENS), applied on the back and buttocks, was subsequently advised. ⋯ When TENS was restarted, the same hypoglycaemic response was noted. The insulin dosage was adjusted to half of the patient's routine daily requirement with continued application of TENS. This incidental finding has alerted us to hypoglycaemic episodes following TENS application, which may be due to effective pain control, decreased sympathetic stimulation, enhanced insulin sensitivity or altered muscle metabolism due to electrical stimulation.