Singap Med J
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To determine the incidence of postoperative vomiting (POV) in the paediatric outpatient general surgical population, the factors affecting POV and the incidence of unplanned admissions contributed by POV. ⋯ The incidence of POV was 8.5%. Duration of general anaesthesia greater than one hour was associated with a significantly higher incidence of POV. Postoperative emesis did not contribute to unplanned admissions in these day surgical patients.
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The diagnosis of disseminated tuberculosis should be entertained in all patients with unexplained fever associated with hepatomegaly and/or splenomegaly with or without anomalies in liver function tests and haemogram. It should be considered as a possible cause of septic shock especially in patients with typical risk factors such as advanced age, diabetes, alcoholism or immunosuppression. Prompt therapy could be life saving in an otherwise potentially fatal condition. It is therefore appropriate to initiate anti-tuberculosis treatment as soon as such a diagnosis is suspected and not await final confirmation.
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Case Reports
Surfactant replacement therapy in RSV-induced acute respiratory distress syndrome (ARDS).
Acute respiratory distress syndrome (ARDS) associated with severe respiratory syncytial virus infection is rare. We report a 5-month-old Indian girl who was admitted to our intensive care ward with severe respiratory failure who fulfilled the criteria for ARDS using both Murray's Lung Injury Score of > 2.5 and the American-European Consensus Conference definition for ARDS. ⋯ She also had clinical features suggestive of a primary immunodeficiency and had laboratory evidence of combined T and B cell defect. There was unsustained clinical improvement with a dose of surfactant administered at 36 hours of PICU stay, and she continued to deteriorate and succumbed after 19 days in the PICU.
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To determine the characteristics of newly diagnosed epilepsy in the multiracial population of Malaysia. ⋯ The characteristics of epilepsy in Malaysia is largely similar to those reported elsewhere. Genetic factors may be playing a relatively minor role in causing epilepsy in this community.
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The concept of the 'good doctor' was systematically studied by determining the view of doctors and non-physicians regarding the qualities and attributes of an ideal physician. ⋯ Medical education should inculcate the values and qualities desired by both the medical profession and public. Basic medical knowledge and reasoning are of prime importance; moral-ethical issues and communication skills should also be emphasised. Selection criteria for admission to medical school should also consider humanistic, non-cognitive traits.