The Medical journal of Malaysia
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The presentation and management of psoas abscess was studied prospectively in 5 patients and retrospectively in 4. 3 patients had bilateral abscesses. All patients had back pain and a mass in loin or iliac fossa. 7 patients had no hip findings. One patient had a perinephric abscess and another had radiological features of tuberculosis of the spine. ⋯ Biopsy of the abscess wall in 2 patients demonstrated tuberculosis. They, the patient with TB spine and 3 others put empirically on anti-tuberculosis chemotherapy responded well. The perinephric abscess grew Pseudomonas sensitive to gentamycin, but she and two other patients died due to multiorgan failure.
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A gravid patient with fetal supraventricular tachycardia is presented. A review of this rare condition and the present recommended mode of therapy are discussed.
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Case Reports
Chronic pain management--upper visceral malignancies coeliac plexus block with CT scanning--a case report.
Coeliac plexus block has been described more than seventy years ago and is widely used for chronic pain management in upper visceral malignancies. The technique described here is a posterior approach using CT scan guidance with absolute ethyl alcohol. A case illustration of a patient with carcinoma of pancreas managed with coeliac plexus block for pain control is presented.
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Out of 218 fractures of humeral shaft treated in the department, 23 (10.5%) of them developed non-union. 14/23 (60.9%) fracture were located in middle third. Transverse (52.2%), short oblique (17.4%) and comminuted fracture (13.0%) constituted about 82% of all initial fracture pattern. Twelve cases (52.5%) were initially treated with hanging cast. ⋯ Factors such as middle third comminuted opened fractures, soft tissue interposition, improper immobilization and poor patient compliance were found to be directly associated with the non-union. All non-unions healed following plating and bone grafting. Overall 17/23 patient (74%) had good results, 4/23 (17%) fair and 2/23 (9%) with poor functional results.
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There is now increased public awareness of the value and role of cardiopulmonary resuscitation (CPR). It is therefore not surprising that the public expects a reasonable level of expertise of medical doctors in the application of the CPR techniques during emergency situations. Newly qualified doctors often lack confidence and are usually at a loss when faced with such situations as they have never had practical training before graduation. ⋯ Medical schools are expected to produce well trained doctors who are competent in clinical practice which include the techniques of basic resuscitation. By virtue of their expertise in airway management and clinical resuscitation, anaesthesiologists can significantly contribute to the teaching of CPR in the undergraduate medical curriculum. This is a retrospective review of Basic Life Support programmes conducted at the Department of Anaesthesiology, Faculty of Medicine, Universiti Kebangsaan Malaysia.