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Biomedical subjects

A Chong

Publications and source records attributed to A Chong.

63 records · Page 4Linked to original sources
PubMed1985

Thrombotic complication of umbilical arterial catheterization and its sequelae.

Umbilical arterial catheterization caused major complications including 5 deaths in 25 of 230 infants who underwent autopsy at the Kandang Kerbau Hospital in a two-and-a-half year period beginning May 1982. Arterial thrombosis developed in 25 of 129 (19.3%) autopsies with a history of umbilical arterial catheterization. Pathological sequelae of thrombosis occurred in 14 cases (peripheral gangrene 1, renal 6, gastrointestinal 3 and both renal and gastro-intestinal 4). The sequelae were clinically unsuspected in the majority. Early deaths were uncommon in the group with thrombosis. Comparison of neonatal factors revealed no significant differences between the group with sequelae and those without. Infants with indwelling umbilical arterial catheter should be actively monitored for complications.

Aorta, Abdominal↗
PubMed1982

Surgical division of right and left free wall accessory atrioventricular electrical connections in a child with incessant supraventricular tachycardia.

A child with Wolff-Parkinson-White syndrome developed incessant supraventricular tachycardia refractory to medical therapy and countershocks. Supraventricular tachycardias incorporating both right and left free wall accessory atrioventricular electrical connections were demonstrated. The more frequent, broad complex tachycardia utilised both the accessory connections and was independent of the atrioventricular node. The less frequent, narrow complex tachycardia utilised the atrioventricular node for anterograde conduction and the left sided accessory connection for retrograde conduction. Surgical division of the accessory connections restored normal sinus rhythm and eliminated supraventricular tachycardia.

Atrioventricular Node↗
PubMedDate not supplied

Group A streptococcal sepsis and ovarian vein thrombosis after an uncomplicated vaginal delivery.

BACKGROUND: Group A streptococcal puerperal sepsis is an uncommon peripartum infection that can quickly progress to a fulminant, multisystemic infection and life-threatening toxin-mediated shock. This infection can be asymptomatic during a short hospital stay after a routine delivery. Early treatment with antibiotics might not alter the course of tissue destruction caused by the exotoxin A. METHODS: Literature searches were performed using the key words "puerperal infections," "streptococcal infections," "septic sacroiliitis," "postpartum septic arthritis," and "postpartum ovarian vein thrombosis." After patient consent was obtained, a report was prepared documenting the disease course, diagnosis, and treatment of a case of puerperal sepsis with multiple serious complications. RESULTS AND CONCLUSION: Puerperal sepsis occurs when streptococci colonizing the genital tract or acquired nosocomially invade the endometrium, adjacent structures, lymphatics, and bloodstream. A lack of symptoms early in the course of infection is common; later, minor somatic complaints can quickly progress to septic shock as effects of the exotoxin A are manifest. Women who complain of fever, pelvic pain, or unexplained systemic symptoms in the early postpartum period should have a detailed history and physical examination. All sites of suspected infection should be cultured. If sepsis is suspected, diagnostic imaging includes chest radiographs, contrast-enhanced computed tomographic scans, or magnetic resonance imaging to rule out ovarian vein thrombosis, pelvic abscess, or sacroiliac septic arthritis. Broad-spectrum antibiotic coverage must be initiated immediately after collection of cultures. Clindamycin plus a beta-lactam antibiotic is preferred for streptococcal toxic shock syndrome.

Adult↗
PubMedDate not supplied

Work-related stress among paediatric non-consultant hospital doctors.

There have been many reports of Non-Consultant Hospital Doctors (NCHDs) deciding to leave hospital medicine in pursuit of a career with better hours and lifestyle such as general practice. It is not known, however, how widespread feelings of dissatisfaction are in paediatrics and whether work-related stress is a contributing factor. A postal survey of NCHDs in paediatric posts throughout the country was conducted in November 2000. Data collected included demographic and personal details. NCHDs were also asked their level of stress in relation to their daily work, patient-care, hospital environment and dealing with other staff members using an incremental scale from 1 to 5 (5 most stressed). 69% (71/103) of the questionnaires were returned. Equal numbers of males and females responded (48% vs 52%). 51% (36/71) of the NCHDs were registrars; 51% (36/71) were working within Dublin. More than three-quarters had graduated from a European Union (EU) medical school (77%, 55/71). While the majority (79%, 56/71) were either satisfied or very satisfied with paediatrics as their chosen specialty, 79% (56/71) admitted to work-related stress causing job dissatisfaction with 71% (50/71) having experienced 3 or more stressful situations in the previous week. 56% (41/71) graded their occupational stress level at 4 or 5. Routine non-medical work and poor job prospects were the main factors causing job dissatisfaction. With regard to daily duties, the situations causing stress were acute emergency situations (51%, 36/71), being solely responsible for patients when on-call (52%, 19/36) and making decisions after a night on-call (76%, 50/67). The general attitudes of nursing staff were stressful to 40% (28/71) with 39% (27/71) stating having a difference of opinion with a nurse at least once every week. Relating to consultants was moderately stressful to 26% (19/71) and very stressful to 4% (3/71). Uncomfortable sleeping quarters and having insufficient time for meals were noted to be at least moderately stressful (stress levels 3 to 5) for 70% (50/71) and 92% (65/71) respectively. 59% (42/71) felt that their social life was greatly affected by their work. 68% (48/71) have considered leaving paediatrics with almost half (48%, 23/48) considering this seriously or very seriously. More than half stated that their alternative career choice would be general practice (61%, 29/48). The results of our survey show that work-related stress is common among paediatric NCHDs and is associated mainly with long working hours, sub-optimal on-call conditions, and dealing with very ill patients.

Female↗