Singap Med J
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To analyse the anatomical features of difficult airways encountered during general anaesthesia and study how difficult intubation was circumvented during anaesthesia in our local population. ⋯ Assessment of multiple anatomical features would improve prediction of difficult intubation. Assessment of receding chin, neck extension, mouth opening, teeth, tongue size, thyromental distance might pick up 81% of difficult airways. Unexpected problems with epiglottis and glottic inlet are the potential sources of danger that are difficult to predict pre-operatively.
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There has been an increase in the demand for coronal sinus CT scan since the introduction of functional endoscopic sinus surgery; as the information provided by the scans assist the surgeon in the pre-operative plannings. Babbel and colleagues had demonstrated five distinctive patterns of recurring inflammatory sinonasal disease on CT scan. The aim of this study was to evaluate the patterns in the local population and to see if there was a difference compared to the Caucasian population. ⋯ The smaller nasal passages of the Asians, particularly in the Chinese, could be the reason for the more prevalence of Type III and Type IV disease compared to the Caucasian population. The more constant and frequent exposure to allergens might also contribute to the increased prevalence of Type IV disease.
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Case Reports
Spiral computed tomography demonstration of active haemorrhage in blunt abdominal trauma.
In blunt abdominal trauma, patients may still be actively bleeding despite being physiologically stable. Fast computed tomography scanning permits the detection of active haemorrhage by localising the site of extravasation of contrast enhanced blood. ⋯ However, its presence will have a critical influence on further surgical intervention. The imaging features of this uncommon entity are demonstrated in our case report.
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Normalisation of heart rate after 24 hours of treatment is proposed to predict the survival outcome in septic shock patients. ⋯ Heart rate was concluded to be a simple predictor reflecting physiologic derangements in septic shock. It is recommended that further study needs to be carried out to unravel a predictor of clinical value in terms of practicality, especially that involving the inflammatory aspect of the disease process.