Singap Med J
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Comparative Study
The safety of simultaneous bilateral versus unilateral total knee arthroplasty: the experience in a Korean hospital.
The safety of simultaneous bilateral total knee arthroplasty (SBTKA) remains controversial. This study aimed to compare the postoperative outcomes of SBTKA versus unilateral total knee arthroplasty (UTKA) performed by a single surgeon at a tertiary teaching hospital in Korea. ⋯ It was concluded that SBTKA under CSE may be considered to be relatively safe in Korean female patients.
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We report a delayed diagnosis of osteomyelitis of the scapula involving the inferior angle and extending to the glenoid, with secondary septic arthritis of the glenohumeral joint in a 7-month-old female infant. The patient was treated with arthrotomy of the shoulder joint, anterior drainage of pus and intravenous antibiotics. The diagnosis was delayed as the patient was found to have bilateral lung abscess and other foci of infection, for which she was treated in the neonatal intensive care unit, with all the medical efforts directed towards saving her life. The diagnosis of septic shoulder arthritis is uncommon and difficult, requiring a high index of suspicion, which was another reason for the delayed diagnosis.
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Anaerobic organisms are a rare cause of spondylodiscitis. Eggerthella lenta is an organism that is not commonly associated with spondylodiscitis. We describe a case of spondylodiscitis due to Eggerthella lenta in an 82-year-old Chinese woman presenting with back pain. The organism was isolated from tissue cultures obtained via radiology-guided biopsy.
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We report a rare case of spontaneous "idiopathic" rupture of the urinary bladder in a 38-year-old previously-fit and -well woman, who presented with symptoms of severe lower abdominal pain. Computed tomography of the abdomen and pelvis indicated the preliminary findings, but the final diagnosis was confirmed only at laparoscopy. The bladder was repaired. The postoperative cystogram showed excellent healing of the bladder, with no further intra-abdominal urinary leakage.
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The correlation between clinical and histopathology findings in appendicitis has been highlighted by many studies. However, the impact of this correlation on the surgical decision to remove a normal-looking appendix is still vague, with no clear definition of positive appendicitis. The aim of this study was to correlate the histological, operative and clinical diagnoses of acute appendicitis (AA). ⋯ The correlation of the clinical, microscopical and macroscopical findings in AA is important in order to understand the natural history of appendicitis, and this may help to formulate a sound surgical decision. These findings are supportive of justifying appendectomy for normal-looking appendices, if no other pathology is found.