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Proceedings of Singapore Healthcare.2007;16(2):77-86.

Resuscitation is the medical process of reviving a patient in cardiac arrest or impending cardiac arrest. In this paper, we describe some of the resuscitation research conducted by our group. The discussion will include: using Geographic Information Systems (GIS) technology to describe the geographic epidemiology of pre-hospital cardiac arrest in Singapore, therapeutic post resuscitation hypothermia, and automated cardio-pulmonary resuscitation (CPR) using a load-distributing band (LDB) device.
Cardiopulmonary Resuscitation - Education

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Comprehensive post-operative management after lower limb amputations: current concepts in rehabilitation

Heeyoune JUNG

Proceedings of Singapore Healthcare.2007;16(2):58-62.

The loss of a limb results in major disability and psychological trauma to the affected individual. Amputees of dysvascular origin usually have multiple co-morbidities and their complicated post-operative course frequently leads to a prolonged hospitalisation or a subsequent amputation in a higher level of the limb. The integrated comprehensive approach by a interdisciplinary team in post-operative management starts immediately after a limb amputation to assure successful surgical and functional outcomes. The programme comprises a variety of medical and rehabilitation aspects: to control acute medical co-morbidities, evaluate and alleviate different types of pain, optimal wound care, condition the residual limb to be well-fitted with a prosthesis, address patient’s functional goals and achieve maximal independence in mobility and self care, coach ideal coping skills and provide psychosocial support, and educate patient and family about risk factor modulation and residual limb care. Aggressive oedema control and early mobilisation became standardised practice in post-amputation care in view of a number of advantages.
Lower extremity - Surgery

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Diagnosis and management of depression in terminal cancer

Leslie LIM

Proceedings of Singapore Healthcare.2007;16(2):88-96.

Depression, a prevalent condition in cancer sufferers is unfortunately often unrecognised and untreated. Depressive symptoms can cause considerable morbidity and mortality thus giving rise to distress and reduced quality of life. Diagnosis is fraught with difficulties owing to overlaps between psychiatric and medical symptoms. One should therefore rely more on psychological symptoms and adopt an inclusive approach in diagnosing depression. Assessment should take into account medical complications which may contribute to or worsen depression as well as the availability and adequacy of social supports. Assessment of suicide risk is paramount since suicide rates are increased in the terminally ill. Psychosocial interventions play just an important a role as pharmacological treatment. Psychostimulants are of benefit. It is also important to manage pain symptoms as severe, unremitting pain may trigger depressive symptoms and suicidal action.
Depressive Disorder - Diagnosis

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Radiofrequency ablation of bone tumours and painful musculoskeletal metastases

Kenneth SHEAH

Proceedings of Singapore Healthcare.2007;16(2):72-76.

Radiofrequency (RF) ablation of painful bone tumours and metastasis has quickly progressed from an experimental procedure to an established minimally invasive method for pain control. This review will describe the physics behind RF ablation technology. Osteoid osteomas were the first primary bone tumours to be treated in this manner, establishing RF ablation as the treatment modality of choice. A more recent development involves the use of RF ablation in painful bone metastases. In this setting, RF ablation complements radiation therapy. Its advantage lies in a more rapid onset of pain reduction (often at least by 2 points on a 10-point scale), and that radiation therapy can be employed concomittantly. It is important to remember that the aim of RF ablation in painful bone metastases is not curative, but palliation.
Catheter Ablation - Methods

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Oncological emergencies: an overview and approach

Siyin HO

Proceedings of Singapore Healthcare.2007;16(2):63-71.

Malignant disease often produces a range of complications, some potentially life-threatening, either from the disease itself or from the effects of treatment. The early detection and accurate diagnosis and treatment of these complications can both improve quality of life and increase the survival time of a patient. It is thus important to be able to recognise oncological emergencies that may arise in cancer patients who may present in the general practice setting.
Brain Neoplasm - Diagnosis

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