Singap Med J
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Dynamic perfusion magnetic resonance (MR) techniques may be used to track the susceptibility effects of gadolinium contrast material as it passes through the brain. We describe three intracranial tumours that showed progressively rising signal intensity above the baseline during first-pass contrast-enhanced echo-planar imaging (EPI) MR imaging. ⋯ Dynamic perfusion MR methods may be used to study intracranial tumours. However, in short relaxation time spin-echo EPI, the T1- effect of gadolinium becomes noticeable during the first-pass acquisition in extra-axial tumours that lack a well-developed blood-brain barrier. Careful selection of patients and pulse sequence is essential to avoid this potential pitfall.
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Apart from conventional epidural analgesia (EA), the combined spinal-epidural (CSE) modality is fast becoming a popular technique for treating labour pain. In this study, we investigated the differences in the patient profile and outcome between CSE and EA for labour pain in KK Women's and Children's Hospital. ⋯ CSE is a safe and good alternative to EA as a technique of neuraxial block for labour analgesia.
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Postoperative nausea and vomiting (PONV) is one of the commonest complaints following anaesthesia, and can result in morbidity like wound dehiscence, bleeding, pulmonary aspiration of gastric contents, fluid and electrolyte disturbances, delayed hospital discharge, unexpected hospital admission, and decreased patient satisfaction. ⋯ The use of risk models facilitates the judicious use of pharmacotherapy to ameliorate PONV especially in the high-risk patient and may lead to a more cost effective and efficient means of managing PONV.
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Pre-operative Chest X-ray (CXR) and electrocardiograms (ECG) are routinely ordered locally for patients above a certain age. This study examines the usefulness of such a practice and its clinical impact. ⋯ Targeted investigations should be performed as indicated by clinical findings rather than on the basis of arbitrary age cut-offs.