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Biomedical subjects

M Wee

Publications and source records attributed to M Wee.

16 recordsLinked to original sources
PubMed2005

Use of an information leaflet to improve general practitioners' knowledge of post dural puncture headache.

BACKGROUND: The number of women receiving neuraxial anaesthesia for labour and delivery is increasing. Women are also being discharged into the community sooner after delivery. Thus, complications arising from neuraxial anaesthesia may present to general practitioners, so it is of vital importance that they are familiar with and can manage potential problems associated with these anaesthetic techniques. METHODS: A questionnaire was sent to 126 local general practitioners to discover their knowledge of the symptoms, diagnosis and treatment of post dural puncture headache in the parturient. An information leaflet was then circulated to all general practitioners in the region, detailing headaches and other potential problems following epidural analgesia for childbirth, and the questionnaire was reissued. RESULTS: The first questionnaire demonstrated that they had poor knowledge of the symptoms, diagnosis and treatment of post dural puncture headache in the parturient. Following the dissemination of the information leaflet, responses to the second questionnaire showed a significant improvement. CONCLUSION: By comparing the two sets of answers, we demonstrated that the leaflet has successfully improved knowledge of post dural puncture headache and other potential sequelae of obstetric epidural analgesia among general practitioners.

Analgesia, Epidural↗
PubMed2000

Urgency of caesarean section: a new classification.

A new classification for caesarean section was developed in a two-part study conducted at six hospitals. Initially, 90 anaesthetists and obstetricians graded ten clinical scenarios according to five different classification methods--visual analogue scale; suitable anaesthetic technique; maximum time to delivery; clinical definitions; and a 1-5 rating scale. Clinical definitions was the most consistent and useful, and this method was then applied prospectively to 407 caesarean sections at the same six hospitals. There was close agreement (86%) between anaesthetists and obstetricians for the five-point scale (weighted kappa 0.89), increasing to 90% if two categories were combined (weighted kappa 0.91). We suggest that the resultant four-grade classification system--(i) immediate threat to life of woman or fetus; (ii) maternal or fetal compromise which is not immediately life-threatening; (iii) needing early delivery but no maternal or fetal compromise; (iv) at a time to suit the patient and maternity team--should be adopted by multidisciplinary groups with an interest in maternity data collection.

Anesthesia, Obstetrical↗
PubMed2000

Sharps and needlestick injuries: the impact of hepatitis B vaccination as an intervention measure.

INTRODUCTION: This paper studies the epidemiology of sharps and needlestick injuries amongst health care workers and the effectiveness of intervention measures implemented at a regional hospital, Singapore. MATERIALS AND METHODS: A retrospective review of sharps and needlestick injuries among healthcare workers of a regional hospital at Singapore between 1992 and 1997. Various interventions namely education, policy changes and a hospital-wide hepatitis B immunisation programme were reviewed for effectiveness of programmes implementation. RESULTS: Of the 347 reported sharps and needlestick injuries, 45.7% occurred in the nursing staff, 25.1% medical staff, 7.5% health attendants, 5.2% hospital cleaners and 3.7% laboratory technicians. A steady rise in reporting was noted amongst the doctors from 1994 and this correlated with the implementation of educational talks given to new medical staff in May 1993. The number of healthcare workers with no previous history of hepatitis B immunisation decreased significantly from 17 in 1996 to 9 in 1997 (P < 0.001, odds ratio = 1.806 with 95% CI 1.443 to 2.261) after the implementation of the hospital-wide hepatitis B immunisation programme. CONCLUSIONS: Levels of awareness may contribute towards changes seen in the number of reporting of injuries. In our experience, we contend that education and appropriate policy changes towards easier reporting help to decrease sharps and needlestick injuries in healthcare workers. The hospital-wide hepatitis B immunisation programme helped to raise the immune status of the staff so as to reduce the costly prophylactic usage of hepatitis B immunoglobulin.

Allied Health Personnel↗
PubMed1996

Quality of life survey among long-stay mentally ill patients: patient and staff perspectives.

In order to improve the quality of life of the chronically mentally ill patients, their treatment programmes must be individualised to address their multiple disabilities and social impairment. The patient's perception of his quality of life (QoL) can be used as an organising framework for long-term care. Subjects in the study included staff and inpatients from the 10 rehabilitation wards in New Woodbridge Hospital which offers a wide range of rehabilitation activities. Using subjective indices, patient and staff perception of patients' quality of life were compared across several life domains. Significant differences between the 2 groups were noted in areas including living conditions, relationship with others and sense of purpose in life. Most patients found the new hospital a better place in terms of its physical comfort and the medical and psychiatric care received. The implications of these findings for improving existing care for our patients are discussed.

Chronic Disease↗
PubMed1995

Intraarterial cisplatin plus intravenous doxorubicin for inoperable recurrent meningiomas.

The majority of meningiomas are cured by surgical resection. There is little information in the literature on the use of chemotherapy in meningiomas. We report 2 patients with inoperable recurrences of meningiomas that responded (1 patient) or stabilized (1 patient) when treated with the combination of intracarotid cisplatin plus intravenous doxorubicin.

Adolescent↗
PubMed1988

Propofol for induction of anaesthesia in children. A comparison with thiopentone and halothane inhalational induction.

The induction characteristics, dosage requirements, cardiovascular and respiratory effects of propofol with added lignocaine were compared with those of thiopentone and halothane inhalational induction in two groups of children aged 1-5 years and 5-10 years. Propofol induction produced significantly greater decreases in blood pressure, particularly in the 1-5 year age group. Heart rate was maintained well with all three induction techniques. Pain on injection into a vein on the dorsum of the hand was significantly more common with propofol despite the addition of lignocaine. However, this was mild in the majority of children and did not interfere with the induction of anaesthesia. The incidence of respiratory depression and other adverse effects was low with all three induction methods. The mean induction doses of both intravenous agents were greater in the 1-5-year age group. The ratio of thiopentone to propofol dose was approximately 2.5:1 in both age groups. The high incidence of pain on injection with propofol may prove to be a significant drawback to its otherwise satisfactory use in children.

Anesthesia, Inhalation↗