Singap Med J
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Infertility is defined as a failure to conceive in a couple trying to reproduce for a period of two years without conception. Approximately 15 percent of couples are infertile, and among these couples, male factor infertility accounts for approximately 50 percent of causes. Male infertility is a multifactorial syndrome encompassing a wide variety of disorders. ⋯ Its mutation affects the adenosine triphosphate production. The introduction of molecular techniques has provided great insight into the genetics of infertility. Yet, our understanding of the genetic causes of male infertility remains limited.
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This study aimed to evaluate the response rate, clinical efficacy and onset of action of sublingual captopril in patients diagnosed with hypertensive urgency. ⋯ Sublingual captopril can be used as an effective, easily applicable and safe treatment in the management of hypertensive urgency for 120 minutes for those who do not receive multidrug antihypertensive regimens.
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Randomized Controlled Trial
Therapeutic role of oral water soluble iodinated contrast agent in postoperative small bowel obstruction.
Nonoperative measures using an oral water soluble contrast agent is a significant development in the management of patients with postoperative small bowel obstruction. ⋯ Administration of an oral water soluble contrast agent in postoperative small bowel obstruction helps in the earlier resolution of the obstruction and decreases the length of hospital stay.
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Comparative Study
Exclusion of acute pulmonary embolism: computed tomography pulmonary angiogram or D-dimer?
The aim of our study was to determine the accuracy of the D-dimer test in the exclusion of pulmonary embolism. ⋯ The D-dimer test is suitable for screening patients with a clinical suspicion of pulmonary embolism. The indiscriminate use of CTPA results in unnecessary testing and elevates healthcare costs. Clinicians are urged to give due consideration to a D-dimer test result prior to requesting a CTPA examination.
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We present the first reported case of Aspergillus vertebral osteomyelitis and epidural abscess in Singapore in a 50-year-old man with post-tuberculous bronchiectasis. The patient presented with acute urinary retention and flaccid paraplegia. Despite surgical debridement and treatment with voriconazole, the patient developed multiorgan failure and died two weeks after presentation. Early diagnosis and prompt initiation of treatment are emphasised in the hope of improving the outcome of this aggressive condition.