Singap Med J
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Review Case Reports
Successful treatment of Candida albicans endocarditis in a child with leukemia--a case report and review of the literature.
Candida species is now being increasingly recognised as an important cause of endocarditis especially in immunocompromised patients. A case of Candida albicans endocarditis in a child with acute lymphoblastic leukemia (ALL) is reported. ⋯ No surgical resection was necessary. We highlight here the importance of echocardiography in the management of prolonged febrile neutropenia and discuss the dilemma of continuing chemotherapy in such patients.
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An 80-year-old woman presented with an embolic stroke secondary to atrial fibrillation and mitral stenosis. She was initially on intravenous heparin and was subsequently maintained on oral warfarin. She was also given digoxin for atrial fibrillation and colchicine for gouty arthritis as well as fluvoxamine in her fourth week in hospital, to treat her depression. ⋯ When warfarin was reintroduced 6 days later, her INR value increased again. The coagulation profile only became stable after 2 weeks of cessation of fluvoxamine. Low dose fluvoxamine can interact significantly with warfarin in the elderly and the effect may persist for up to 2 weeks of stopping the antidepressant.
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Traumatic bronchial rupture is a rare entity. The severity of the trauma often causes lethal injury to other thoracic organs. ⋯ We describe an unusual case of bronchial rupture which was diagnosed 15 days after blunt chest trauma and was treated by bronchial stenting. The success of this case involving the left main bronchial rupture provides a feasible alternative to the repair of partial airway disruption and greatly reduces the morbidity.
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To assess the clinical presentation of patients with spontaneous subarachnoid haemorrhage (SAH) at a local Emergency Department (ED). ⋯ Patients with spontaneous SAH often present with classical symptoms such as headache or vomiting at the ED locally. Neck stiffness, however, is often not present at the ED.
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Randomized Controlled Trial Comparative Study Clinical Trial
The therapeutic efficacy of mometasone furoate cream 0.1% applied once daily vs clobetasol propionate cream 0.05% applied twice daily in chronic eczema.
Mometasone furoate [9a, 21-dichloro-llb, 17dihydroxy-16a-methyl-pregna-14-dione-3, 20-dione-17-(2furoate)] is a synthetic, 17-heterocyclic corticosteroid which has been shown to be highly effective as an anti-inflammatory agent which is approximately half as potent is suppressing hypothalamic-pituitary-adrenal (HPA) axis function as betamethasone valerate. ⋯ Overall, 53% of patients considered the MF treated sites to be good or excellent vs 88% for CP treated sites.