Singap Med J
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Comparative Study
Burns mass disasters in Singapore--a three decade review with implications for future planning.
The main objective of this paper is to review three decades (1962-1991) of data relating to burns mass disasters in Singapore. ⋯ The recommendation is to plan and reorganise burn treatment facilities. This is to cope with existing pattern, frequency and projected patterns of burn mass disasters which have occurred in other highly urbanised and populated countries.
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A retrospective review of fifteen patients with Grade III open ankle fractures, admitted to the Singapore General Hospital from January 1980 to December 1990 was done. Nine of the patients were males with a mean age of 47 years. Road traffic and industrial accidents accounted for 12 of the cases. ⋯ Superficial infection was found in three cases and deep infection involving the bone and joint was present in three. Range of motion at one year was satisfactory in eleven but poor in two. Seven patients developed osteoarthritis of the ankle and three had ankle arthrodesis for pain and instability.
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Mobile right atrial thrombus is a rare echocardiographic diagnosis with important implications on further management. We report a case of 50-year-old woman with deep vein thrombosis of her left lower limb, who was found to have a large mobile serpiginous right atrial thrombus on both two-dimensional echocardiography (2DE) and transoesophageal echocardiography (TEE). ⋯ This case demonstrates the usefulness of echocardiography as a non-invasive tool in the investigation of suspected pulmonary thromboembolism. The detection of right atrial thrombus mandates serious consideration for prompt surgical action.
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Seventy-five adult asthmatic patients with clinical remission underwent spirometry. Only 8.3% of the subjects demonstrated normal spirometry. The others had reduced vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum mid-expiratory flow rate (MMF) and peak flow rate (PEFR). This study demonstrates that asthma can cause irreversible airflow obstruction and there is a poor relationship between symptoms in asthmatics and their respiratory function test results.
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The study was conducted to ascertain the time it takes an ambulance team to reach a patient and transport the patient to an emergency department after a 995 call. One hundred and sixty-two cases brought to two emergency departments (Singapore General Hospital and Tan Tock Seng Hospital) between 11 March 1992 and 16 March 1992 were studied. The information was obtained from ambulance officers of the Singapore Civil Defence Force. ⋯ With the present level of staff in Singapore, basic life support care starts 11.40 minutes and advanced life support care 30.50 minutes after a 995 call. These times are unacceptable if it involves a cardiac arrest or a trauma patient. Factors which cause these long time intervals include traffic congestion, inadequate public education, location of patient (whether on ground level or highrise) and distance from the emergency departments.