Ann Acad Med Singap
-
Ann Acad Med Singap · Dec 2009
Prevalence of adolescent idiopathic scoliosis among female school children in Singapore.
Screening for scoliosis started in Singapore schools in 1982 and is currently being done for both boys and girls, as part of the annual school-based health screening programme in all primary and secondary schools. The screening levels in the current protocol were based on the 1997 prevalence study by Wong et al. In the study, it appeared that there was a significant increase in prevalence rates between 9- and 11-year-old girls (i.e. between Primary 4 and Primary 6) but there was no data on the prevalence rates of scoliosis in 10-year-old girls (Primary 5) and in 12-year-old girls (Secondary 1). In order to decide on whether to make changes to the screening levels, a review was conducted to determine the prevalence of scoliosis among the 10-year-old girls (in Primary 5) and 12-year-old girls (in Secondary 1). ⋯ The study showed a significant increase in the prevalence rates of scoliosis in the 10- to 11-year-old female students and again a significant increase in the prevalence rates in the 12- to 13-year-old female students. Since the prevalence rate for the 9-year-old females was quite low (0.27%), and there was a significant increase in the prevalence rates in the 10- to 11-year-old and 12- to 13-year-old females, it was recommended that screening for females be performed every year commencing at 10 years old (Primary 5) until 13 years old (Secondary 2).
-
Ann Acad Med Singap · Nov 2009
ReviewThe role of interventional therapies in cancer pain management.
Cancer pain is complex and multifactorial. Most cancer pain can be effectively controlled using analgesics in accordance to the WHO analgesic ladder. However, in a small but significant percentage of cancer patients, systemic analgesics fail to provide adequate control of cancer pain. ⋯ These interventions can be used as sole agents or as useful adjuncts to supplement analgesics. This review will discuss interventional procedures such as epidural and intrathecal drug infusions, intrathecal neurolysis, sympathetic nervous system blockade, nerve blocks, vertebroplasty and the more invasive neurosurgical procedures. Intrathecal medications including opioids, local anaesthetics, clonidine, and ziconotide will also be discussed.
-
Ann Acad Med Singap · Nov 2009
Abnormal progesterone and corticotropin releasing hormone levels are associated with preterm labour.
This study examined whether maternal plasma progesterone and corticotropin releasing hormone (CRH) concentrations can predict the likelihood of preterm labour. ⋯ Maternal progesterone and CRH measurements taken early in the third trimester may be of use as biochemical markers of pregnancies at high risk of premature labour.
-
Ann Acad Med Singap · Nov 2009
Case ReportsEfficacy of limited-duration spinal cord stimulation for subacute postherpetic neuralgia.
Excellent outcomes were achieved with spinal cord stimulation (SCS) for 7 to 10 days on 2 patients who developed postherpetic neuralgia. Both patients were within 2 to 3 months of the onset of the condition, and nerve blocks provided only temporary pain relief and drug therapies had poor efficacy. The authors believe that limited-duration SCS for subacute postherpetic neuralgia is a useful treatment approach that may prevent the pain from progressing to chronic postherpetic neuralgia.
-
The use of opioids for the treatment of chronic non-cancer pain has become more widespread recently. Available data support the short-term use of opioids in clearly defined nociceptive and neuropathic pain states. Their use in 'pathological' pain states without a clear diagnosis, such as chronic low back pain, is more contentious. ⋯ Treatment should be initiated by a trial period with defined endpoints using slow-release or transdermal opioids. Ongoing management of the patient requires ideally a multi-disciplinary setting. Treatment should not be regarded as life-long and can be discontinued by tapering the dose.