Singap Med J
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A Singapore Mental Health Survey was designed to study the prevalence and pattern of psychiatric morbidity of the general population. Community surveys reveal the true pattern of mental disorders, free from any self-selection into, or referral within the health care system. ⋯ Two-staged methodology is an efficient, cost-effective approach to study population prevalence of mental illness. Screening instruments utilised should be validated specifically for the culture and setting. Information from population surveys of psychiatric morbidity are important for the planning of mental health services for the country.
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To estimate the values of transcranial doppler (TCD) in the determination of brain death in children. ⋯ TCD has a high sensitivity and specificity in the determination of brain death in children.
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Pleural biopsy is invaluable for the etiological diagnosis of pleural diseases in the presence of an exudative pleural effusion. Conventionally, pleural biopsy is either performed with the Cope's or the Abrams pleural biopsy needles. A few investigators have used the Tru-cut biopsy needle with or without ultrasound guidance. We report our experience in performing closed pleural biopsy using a Tru-cut needle without ultrasound guidance in moderate to large exudative pleural effusion. We used a perpendicular approach to biopsy the pleura instead of the tangential approach described earlier. ⋯ Closed pleural biopsy using a Tru-cut needle is effective for the specific diagnosis of exudative pleural effusion. The use of a perpendicular approach to biopsy the pleura does not seem to increase the complication in moderate to large pleural effusion.
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Review Case Reports
Prolonged cutaneous sequelae after intra-arterial injection of propofol.
Propofol is a popular drug for the induction of anaesthesia and sedation in the intensive care. Previous cases of inadvertent intra-arterial injection propofol injection have had no more than a few hours of hyperaemia. However in this case, residual cutaneous hyperaemia for 12 days were found after intra-arterial injection. ⋯ Early suspicion should be aroused if the patient complains of pain on injection that is not abolished by lignocaine and if blanching of the hand is seen on injection. A useful precaution is establishing a running intravenous line before the administration of drugs. The literature concerning prevention and treatment of inadvertent intra-arterial injection is discussed.
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While posterior fossa extradural haematomas (PFEDH) may lead to rapid neurological deterioration and death because of brainstem compression, prompt treatment often leads to a good outcome. The non-specific clinical signs and the rarity of this lesion in craniocerebral trauma adds to the difficulty in diagnosis. The aim of this study was to identify features which could lead to an early diagnosis. ⋯ An early CT scan head is recommended if a combination of the following features is present: occipital soft tissue injury, drowsiness, occipital fracture or diastasis of the lambdoid suture.