Forty-seven surgically confirmed cases of brain abscess treated from 1988 to 1992 are described. The most common cause was chronic ear infection with abscesses in the cerebellum and the temporo-parietal area. Patients in the second and third decade of life were most frequently affected. Clinical manifestation at the time of admission were headaches, vomiting and fever. Bacteriology revealed a predominance of microaerophilic streptococcus and staphylococcus aureus among the aerobes and peptostreptococcus sp. among the anaerobes. Majority were sensitive to Penicillin G and Chloramphenicol. Computerized tomographic scanning was the sole diagnostic procedure done with 100% accuracy. Excision was done on well encapsulated abscesses. The non-encapsulated ones were aspirated and drained. The overall mortality rate was 15 percent.(Author)

Human ; Male ; Female ; Middle Aged ; Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Staphylococcus Aureus ; Peptostreptococcus ; Brain Abscess ; Staphylococcal Infections ; Penicillin G ; Headache ; Otitis

Animals ; Gene Expression Regulation, Neoplastic ; Gene Silencing ; Gene Targeting ; Genes, Tumor Suppressor ; Genetic Therapy ; Humans ; Neoplasms ; therapy ; Neovascularization, Pathologic ; genetics ; Proto-Oncogenes ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; therapeutic use

Aggressive intravenous and oral dual antiplatelet therapy has established primary percutaneous coronary intervention (PCI) as the standard of care for acute myocardial infarction. Clopidogrel is currently the thienopyridine of choice for dual antiplatelet therapy in patients treated with PCI. The dose regime and duration of therapy of clopidogrel has undergone multiple refinements. Recently, 2 novel third generation oral inhibitors of P2Y12 receptors, prasugrel and ticagrelor, have undergone clinical evaluation with promising results. This article is a non-exhaustive review of the literature, concentrating on the role of current and novel oral antiplatelet agents for acute myocardial infarction particularly highlighting the limitations and issues associated with clopidogrel use.
Adenosine ; administration & dosage ; analogs & derivatives ; Angioplasty, Balloon, Coronary ; Drug Therapy, Combination ; Electrocardiography ; Humans ; Myocardial Infarction ; drug therapy ; surgery ; Piperazines ; administration & dosage ; Platelet Aggregation Inhibitors ; administration & dosage ; Prasugrel Hydrochloride ; Thiophenes ; administration & dosage ; Ticlopidine ; administration & dosage ; analogs & derivatives

INTRODUCTIONIntra-articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal method of treatment remains controversial.

MATERIALS AND METHODSThe aim of the paper is to compare the outcomes of external fixation (EF) with open reduction internal fixation (ORIF) with plates and screw fixation in the treatment of intra-articular fractures of the distal radius. Thirty-five patients were enlisted from December 2003 to September 2005 after a failure of initial conservative treatment. The patients were randomised into EF or ORIF groups. The patients were followed-up at 1 week, 3, 6, 12 and 24 months. Clinical and radiological outcomes were measured. They were scored using the Green and O'Brien or the Gartland and Wertley score.

RESULTSOf the 35 patients, 5 defaulted the 6-month follow-up and were excluded. We found that the clinical and radiological outcomes for the 2 groups were not significantly different. Complication rates were also similar.

CONCLUSIONThere is no significant difference in the outcome of intra-articular distal radius fractures treated with either EF or ORIF.

Adult ; Bone Plates ; Bone Screws ; External Fixators ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Radiography ; Radius Fractures ; diagnostic imaging ; surgery ; Range of Motion, Articular ; Recovery of Function ; Wrist Injuries ; diagnostic imaging ; surgery ; Young Adult

OBJECTIVE: To obtain reference values of bone mineral density (BMD) for Filipino women in order to make a population-specific diagnosis of osteoporosis.
SETTING: Osteoporosis Unit, Joint and Bone Center, Section of Rheumatology and Clinical Immunology, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
PARTICIPANTS: 442 healthy Filipino women volunteers recruited from the outpatient department, Rheumatology and Clinical Immunology Clinic of the University of Santo Tomas Hospital and from within the University of Santo Tomas campus. Subjects with known underlying illness or conditions or intake of drugs that predispose to osteoporosis were excluded from the study.
INTERVENTION: Bone mineral density (BMD) measurements, expressed in grams per square centimenter of the lumbar spine, non-dominant femur and non-dominant forearm were done in 442 consecutive healthy Filipino women using the LUNAR DPX-IQ machine.
RESULTS: Means and standard deviations of BMD measurements at each site were calculated using Kwikstat software Version 3.6, Release 7. Results were grouped in decades to serve as reference per decade.
CONCLUSION: BMD of these 442 healthy Filipino women may serve as an initial reference guide for the diagnosis of osteoporosis in Filipino women.

Human ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Osteoporosis ; Femur ; Forearm ; Chronic Pain ; Delivery Of Health Care ; Bone Density ; Body Mass Index

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease worldwide. The estimated global incidence of NAFLD is 47 cases per 1,000 population and is higher among males than females. The estimated global prevalence of NAFLD among adults is 32% and is higher among males (40%) compared to females (26%). The global prevalence of NAFLD has increased over time, from 26% in studies from 2005 or earlier to 38% in studies from 2016 or beyond. The prevalence of NAFLD varies substantially by world region, contributed by differing rates of obesity, and genetic and socioeconomic factors. The prevalence of NAFLD exceeds 40% in the Americas and South-East Asia. The prevalence of NAFLD is projected to increase significantly in multiple world regions by 2030 if current trends are left unchecked. In this review, we discuss trends in the global incidence and prevalence of NAFLD and discuss future projections.

INTRODUCTION: This study aimed to compare the incidence and mortality of ST-segment elevation myocardial infarction (STEMI) across the 3 main ethnic groups in Singapore, determine if there is any improvement in trends over the years and postulate the reasons underlying the ethnic disparity. MATERIALS AND METHODS: This study consisted of 16,983 consecutive STEMI patients who sought treatment from all public hospitals in Singapore from 2007 to 2014. RESULTS: Compared to the Chinese (58 per 100,000 population in 2014), higher STEMI incidence rate was consistently observed in the Malays (114 per 100,000 population) and Indians (126 per 100,000 population). While the incidence rate for the Chinese and Indians remained relatively stable over the years, the incidence rate for the Malays rose slightly. Relative to the Indians (30-day and 1-year all-cause mortality at 9% and 13%, respectively, in 2014), higher 30-day and 1-year all-cause mortality rates were observed in the Chinese (15% and 21%) and Malays (13% and 18%). Besides the Malays having higher adjusted 1-year all-cause mortality, all other ethnic disparities in 30-day and 1-year mortality risk were attenuated after adjusting for demographics, comorbidities and primary percutaneous coronary intervention. CONCLUSION It is important to continuously evaluate the effectiveness of existing programmes and practices as the aetiology of STEMI evolves with time, and to strike a balance between prevention and management efforts as well as between improving the outcome of "poorer" and "better" STEMI survivors with finite resources.

COVID-19 ; Dermatology ; Humans ; Inpatients ; SARS-CoV-2 ; Singapore

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive aged women. It is associated with metabolic problems such as obesity, insulin resistance and dyslipidemia. Obesity in itself is associated with insulin resistance and dyslipidemia. However, it remains unclear whether lean and obese PCOS women share the same metabolic profiles. Objective: The aim of this study was to identify the prevalence of abnormal glucose metabolism and dyslipidemia across different categories of body mass index among women with PCOS Methods: A retrospective cross – sectional study included 160 PCOS patients covering the years 2015 to 2017 was performed. Fisher’s exact test, one-way analysis of variance using Fisher-Hayter multiple comparisons procedure and independent-test were used to compare the prevalence of disease among the different categories of body mass index (i.e. non-obese, overweight and obese). Results: Among obese patients, the prevalence of pre-diabetes was 39.33% (35/89) and Type II diabetes mellitus was 8.99% (8/89). Among overweight, pre-diabetes patients were at 16.67% (5/30), while diabetics were only 6.67% (2). Among the non-obese population, only 17.07% (7/41) were classified as pre-diabetics while only 2.44% (1/41) were considered diabetic. For the prevalence of dyslipidemia, overweight and obese patients had the most proportion of affected individuals, at 90% (27/30) and 87.64% (78/89), respectively. Conclusion Abnormal glucose metabolism and dyslipidemia are more prevalent among obese and overweight women compared to non-obese PCOS patients.
Polycystic Ovary Syndrome ; Body Mass Index ; Insulin Resistance ; Dyslipidemias