Forty children treated non operatively for fractures of the femoral shaft were reviewed with regard to differences in limb length after treatment. Follow up duration ranged from two to seven years. The average femoral overgrowth was 0.85cm (range 0 2.5cm) and was influenced by age at the time of fracture. We were not able to find any association between the quantity of overgrowth and race, gender, level or configuration of the fracture.

Kimura's disease is a rare chronic inflammatory condition characterized by proliferation of vascular endothelial cells, lymphoid infiltration, and mixed inflammatory cells infiltrated with numerous eosinophils. That was known in Western literature as angiolymphoid hyperplasia with eosinophilia and many reports have used the terms synonymously. But the histological features between the 2 disorders have been proved to be distinctive and the 2 terms should not be used synonymously. A case of huge sized(24x12x10cm) Kimura's disease, the patient was 20-year-old male who has painless soft mass on his right cheek. Preoperatively, proteinuria(2+), serum eosinophilia(27.7%), increased serum Ig E(above 2500 IU) were noted in laboratory tests. Histologically, mixed inflammatory cells infiltrated with numerous eosinophils and reactive lymphoid follicles with germinal center were observed, and the proliferation of typical high endothelial venules was observed, also. He was treated by surgical excision of mass, systemic steroid therapy, and focal radiotherapy. During the follow-up of 3 years, the lesion was not recurred and no proteinuria, decreased serum eosinophilia and serum Ig E were noted in laboratory test. We experienced the treatment of huge sized Kimura's disease without recurrence and a case is presented with the review of literature.
Angiolymphoid Hyperplasia with Eosinophilia ; Cheek ; Endothelial Cells ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Germinal Center ; Humans ; Male ; Proteinuria ; Radiotherapy ; Recurrence ; Venules ; Young Adult

OBJECTIVES: Nonagenarians with hip fractures represent a special group of people because of their advanced age and co-morbidities. We evaluated mortality after hip fractures in nonagenarians. METHODS: Fifty-one patients were studied over a 2-year period. There were 39 female and 12 male patients. Twenty seven patients sustained an intertrochanteric fracture of the femur, 24 suffered from femoral neck fracture. The American Society of Anaesthetists (ASA) score of II was the most frequent among 51. Forty-one of them had one or more co-morbidities. Patient review was done 2 years after the fracture. RESULTS: The mortality rate at one year was 53.4% in men, and 15.7% in women. After multivariate analysis, the type of fracture (intertrochanteric fracture) was identified as a risk factor for one-year mortality (P = 0.025). CONCLUSION: The outcome in nonagenarians with hip fractures is poor due to the high rates of mortality, especially in men, and this could be informed to patients and their families before hip fracture surgery.
Aged, 80 and over ; Female ; Femoral Neck Fractures ; Femur ; Hip ; Hip Fractures ; Humans ; Male ; Multivariate Analysis ; Risk Factors

Bone Marrow Transplantation ; history ; methods ; HLA Antigens ; immunology ; Hematopoietic Stem Cell Transplantation ; history ; methods ; History, 20th Century ; History, 21st Century ; Hospitals, General ; Humans ; Peripheral Blood Stem Cell Transplantation ; history ; methods ; Singapore ; Transplantation Conditioning ; history ; methods

The intrauterine device (IUD) is a widely used contraceptive method. One of the most serious and rare complications of using an IUD is colon perforation. We report a case of colonoscopic removal of an IUD that had perforated into the rectosigmoid colon in a 42-year-old woman who presented with no symptoms. Colonoscopy showed that the IUD had penetrated into rectosigmoid colon wall and that an arm of the IUD was embedded in the colon wall. We were able to remove the IUD easily by using colonoscopy. The endoscopic approach may be considered the first choice therapy for selected patients.
Adult ; Arm ; Colon* ; Colonoscopy ; Contraception ; Female ; Humans ; Intrauterine Devices*

The COVID-19 pandemic has resulted in significant challenges for the resuscitation of paediatric patients, especially for infants and children who are suspected or confirmed to be infected. Thus, the paediatric subcommittee of the Singapore Resuscitation and First Aid Council developed interim modifications to the current Singapore paediatric guidelines using extrapolated data from the available literature, local multidisciplinary expert consensus and institutional best practices. It is hoped that this it will provide a framework during the pandemic for improved outcomes in paediatric cardiac arrest patients in the local context, while taking into consideration the safety of all community first responders, medical frontline providers and healthcare workers.
Infant ; Child ; Humans ; Cardiopulmonary Resuscitation/methods* ; COVID-19/therapy* ; Pandemics ; Singapore ; Heart Arrest