Singap Med J
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To determine the causes of isolated prolonged activated partial thromboplastin time (APTT) in an acute care general hospital setting so as to rationalise fresh frozen plasma usage. ⋯ Our study suggests that most of the causes of isolated prolonged APTT do not lead to haemorrhagic complications. In fact, in a majority, it may signify an underlying thrombophilic condition. As a result, prolongation of APTT should be fully investigated and correction with fresh frozen plasma should be used only when appropriate.
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Randomized Controlled Trial Clinical Trial
Analgesic efficacy of pre-operative etoricoxib for termination of pregnancy in an ambulatory centre.
Etoricoxib is a second generation cyclooxygenase-2 inhibitor with a rapid-onset time and a long duration of action. It is ideal for providing pre-emptive analgesia for ambulatory surgeries. We hypothesised that pre-operative etoricoxib can decrease the use of fentanyl post-operatively, when compared with placebo in patients undergoing termination of pregnancy. We also compared their pain scores, time to discharge, side effects and satisfaction with analgesia post-operatively. ⋯ Pre-operative administration of oral etoricoxib 120 mg decreased the use of fentanyl and pain scores after minor gynaecological surgery without significant side effects.
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This study aimed to determine the proportions of normothermic infants who remained normothermic, and hypothermic infants who became normothermic following the use of a heated water-filled mattress (HWM) in the labour room. ⋯ The HWM is a reasonably effective simple device for the prevention and treatment of hypothermia in the labour room.
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Comparative Study Clinical Trial
Morphine for post-caesarean section analgesia: intrathecal, epidural or intravenous?
Good analgesia is important after a caesarean section but there are no studies to date that compared intrathecal (IT), epidural (EP) and intravenous patient-controlled analgesia (IV PCA) morphine for post-caesarean section analgesia. In this study, we compared the differences in the quality of analgesia and side effects rendered by IT, EP and IV PCA morphine for post-caesarean section analgesia. ⋯ The use of IT and EP morphine was associated with lower pain scores than IV PCA morphine at rest and on movement in the first 24 hours after caesarean section. No severe side effects were found.
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Persistent sciatic artery is a very uncommon embryological vascular variant. This case report highlights this rare vascular anomaly, diagnostic difficulty, complication and subsequent treatment in a 43-year-old man who presented with sudden onset of right leg pain for a few hours. ⋯ A below knee amputation was performed due to worsening ischaemia of the right leg. The persistent right sciatic artery was later obliterated using percutaneous stenting and endovascular grafting, with deployment of two wallstents.