The Medical journal of Malaysia
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Review Case Reports
Fibreoptic intubation--a case series and brief review.
Fibreoptic intubation has been established as a major advance in the management of difficult or failed intubation in the awake patient. If necessary, it may be performed under general anaesthesia with either spontaneous or controlled ventilation. ⋯ We describe here selected case reports to illustrate this in 8 different situations. This is followed by a brief review of the technique and indications of fibreoptic intubation.
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Historical Article
Changing patterns in the treatment of early breast cancer: a historical perspective and a review of changing local trends.
Over the past 50 years, a variety of surgical procedures have been advocated for the treatment of operable breast cancer, ranging from local excision to supraradical mastectomy. Today, the surgical treatment of breast cancer remains highly contentious. We review the historical development of breast cancer surgery and analyse the available evidence supporting conservative procedures. We also express our opinions on the treatment of early breast cancer and illustrate the changing patterns of surgery with our experience at National University Hospital.
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Spinal anaesthesia was performed on 101 patients with a 25-Gauge (0.52 mm) needle. We found a 13.9% overall incidence of postdural puncture headache (PDPH) in an orthopaedic population whose mean age was 33.6 years. This incidence is too high and an alternative technique may be needed.
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This is a case report of ascaris worm in the common bile duct in a 61 year old lady. Ultrasound diagnosis was initially made based on the presence of linear hyperreflective foci within the common bile duct. ⋯ Balloon extraction was then successfully carried out following papillotomy. This case illustrates the value of ultrasound in the definitive diagnosis of biliary ascariasis and the therapeutic role of ERCP.
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Case Reports
Recurrent re-expansion pulmonary oedema complicating rapid decompression of large pneumothoraces.
A young male who developed ipsilateral pulmonary oedema on two occasions as a complication of treatment of pneumothoraces involving the left lung is reported. The importance of large pneumothoraces, the rapidity of decompression and the application of suction to the pleural space as factors predisposing to the development of re-expansion pulmonary oedema is well demonstrated by this case. The re-expansion pulmonary oedema was more severe on the second occasion when the lung had collapsed for a longer duration compared to the first pneumothorax which was of more recent onset.