Singap Med J
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A 29-year-old man was operated on for an intracranial tumour with the gross features of a meningioma. Histology showed features of a rhabdoid tumour. ⋯ Meningiomas with rhabdoid change are very rare. The clinicopathologic features are presented and the differential diagnoses discussed.
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In Caucasian populations, premature infants with retinopathy of prematurity (ROP) have been reported to have higher risks of developing refractive errors and strabimus. The purpose of this study is to evaluate the rate of these complications in Asian premature infants with and without ROP. ⋯ Premature babies with ROP had higher rates of myopia and strabismus than those without ROP. Long-term follow-up of these babies is important for early detection and treatment of these ocular problems.
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To evaluate the roles and effectiveness of US and CT in a clinical algorithm for the evaluation of children with suspected appendicitis. ⋯ US and CT are accurate modalities in the diagnosis of acute appendicitis in children. US is most useful in patients with equivocal clinical findings. US should be the first modality used to evaluate children with suspected appendicitis. CT should be reserved for cases where US is sub-optimal or where the findings are inconsistent with the clinical findings.
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One lung anaesthesia in paediatric patients may not always be achievable by bronchial blockade or double lumen tube intubation due to inadequate experiences or facilities. We attempted to isolate right lung by selectively intubating the left bronchus with single lumen tube on a 10 kg child. Optimal surgical condition and satisfactory oxygenation achieved but complicated with severe respiratory acidosis. The possible causes for hypercapnea in this child were discussed.
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Comparative Study
Clinical pathways--an evaluation of its impact on the quality of care in an acute care general hospital in Singapore.
A critical or clinical pathway defines the optimal care process, sequencing and timing of interventions by healthcare professionals for a particular diagnosis or procedure. It is a relatively new clinical process improvement tool that has been gaining popularity across hospitals and various healthcare organisations in many parts of the world. It is now slowly gaining momentum and popularity in Asia and Singapore. ⋯ This was achieved without any adverse effect on short term clinical outcomes such as in-hospital mortality, complication rate and morbidity. There were no significant difference in readmission rates at 6 months after discharge. The paper concludes that clinical pathways, implemented in the context of an acute care general hospital, is able to significantly improve care processes through better collaboration among healthcare professionals and improvements in work systems.