Singap Med J
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Profuse bleeding after voluntary sexual intercourse is an uncommon reason for admission to the gynaecological wards. Out of 12 such patients admitted to the Ipoh Hospital over a three-year period, one patient had life-threatening upper vaginal injury after coitus. Blood replacement and conventional suturing failed to arrest the bleeding. ⋯ Vigorous intercourse increases intra-abdominal pressure in women causing tensing of the cul-de-sac, decreasing the elasticity of the posterior fornix, resulting in vaginal laceration. Bilateral internal iliac artery ligation produces a 'pelvic compartment hypotension' converting a high arterial flow system to that of a low one resembling venous flow. The useful role of this procedure to contain pelvic haemorrhage is discussed.
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Case Reports
Malposition of a long central venous catheter in the right inferior thyroid vein--a case report.
This case report hopes to bring to attention the possibility of malposition and ligation of a long central venous catheter in a central venous tributary in the course of major neck surgery. A 49-year-old gentleman underwent total laryngectomy and right radical neck dissection for laryngeal carcinoma. ⋯ This was subsequently found to have malpositioned into the right inferior thyroid vein and ligated. It required an exploration of the neck wound to remove the ligated catheter.
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Previously published papers on the success of trabeculectomy as a treatment for glaucoma show success rates between 67% and 84%. The success rate of trabeculectomy in Afro-Carribean patients was observed to be lower than in Caucasian patients. It has been commonly believed that the success rate of trabeculectomy in Oriental/Asian eyes would lie somewhere between these. We reviewed the records of 51 consecutive trabeculectomies performed in the National University Hospital, Singapore and found that our success rate was lower-43.1% overall and 48.7% for primary glaucomas.