Ashish Anil Sule

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mdcaas@nus.edu.sg


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    Potentially fatal paracetamol overdose and successful treatment with 3 days of intravenous N-acetylcysteine regime - A case report
    (2006) Sule A.A.; Tai D.Y.H.; Tze C.-C.; Deepa B.; Leow M.; MEDICINE; DUKE-NUS MEDICAL SCHOOL
    Introduction: Paracetamol overdose is the most common drug overdose worldwide. To our knowledge, the maximum number of paracetamol tablets ingested reported in the literature is 45 g. Clinical Picture: We describe a 21-year-old patient who acutely ingested 120 tablets, each 500 mg paracetamol (i.e., 60 g equivalent to 1200 mg/kg body weight) in a suicidal attempt. Our patient also drank 2 bottles of codeine-based cough syrup equivalent to 360 mg of codeine. At 6 hours post ingestion, her serum paracetamol level was 207 mg/L. The poor prognostic factors for paracetamol overdose in our patient included massive paracetamol ingestion (confirmed by blood levels), codeine co-ingestion and elevated serum amylase (189 U/L). Treatment: She was treated with a 3-day modified regimen of intravenous N-acetylcysteine. Outcome: The liver function tests and the prothrombin time remained normal over the second and third day of admission and the patient was discharged without complications on the fifth day. Conclusion: From this experience we feel that in very severe paracetamol poisoning, a modified regime of intravenous N-acetylcysteine for 3 days is safe and efficacious.
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    S-31-4: STROKE BURDEN AND HYPERTENSION IN THE ASIA-PACIFIC REGION
    (Ovid Technologies (Wolters Kluwer Health), 2023-01) Venketasubramanian, Narayanaswamy; Chadachan, Veerendra; Sule, Ashish Anil; Tay, Jam Chin; Chee, Tek Siong; Wong, Emmett Tsz Yeung; Koh, Tian Hai; Low, Lip Ping; Oh, Vernon Min Sen; Wu, Akira; Handa, Pankaj; Teo, Jimmy Boon Wee; Dr Emmett, Tsz Yeung Wong; MEDICINE; DEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
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    Publication
    Ministry of Health Clinical Practice Guidelines: Hypertension
    (SINGAPORE MEDICAL ASSOC, 2018-01-01) Tay, Jam Chin; Sule, Ashish Anil; Chew, Daniel; Tey, Jeannie; Lau, Titus; Lee, Simon; Lee, Sze Haur; Leong, Choon Kit; Lim, Soo Teik; Low, Lip Ping; Sen Oh, Vernon Min; Phoon, Ian; Tan, Kenneth Kian Wee; Wu, Akira; Yeo, Loo See; Prof Min Sen, Vernon Oh; MEDICINE; DUKE-NUS MEDICAL SCHOOL
    The Ministry of Health (MOH) has updated the clinical practice guidelines on hypertension to provide doctors and patients in Singapore with evidence-based treatment for hypertension. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on hypertension, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. © Singapore Medical Association