Singap Med J
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Case Reports
Incipient non-arteritic anterior ischaemic optic neuropathy: a distinct clinical entity, the Singapore scene 3.
We report five cases of non-arteritic anterior ischaemic optic neuropathy (NA-AION) where spontaneous resolution of the optic disc swelling occurred, and all relevant visual modalities were normal at presentation and remained so until resolution of the process after a median time of 9.6 weeks. This condition, which can be termed 'incipient NA‑AION' or 'threatened NA-AION', should be recognised so that unnecessary investigations for other and more serious causes of optic disc swelling can be prevented.
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We discuss two cases of incessant atrial tachycardia (AT), including the presentation and clinical course. It is important to differentiate AT from other causes of supraventricular tachycardia, such as atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT), as it would have implications on clinical management. Electrocardiographic features of AT, especially the presence of an AV Wenckebach phenomenon with 'grouped beating', are critical for differentiating AT from AVRT and AVNRT. It is also vital to identify the P waves and their relations to QRS on electrocardiography, as this would aid in the differentiation of various supraventricular tachycardias.
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Mediastinal impalement injuries are uncommon and often fatal. There have been very few reported cases of survival following mediastinal impalement. ⋯ We herein present a case of mediastinal impalement injury, where a sheet of fibreglass had fractured the manubrium and entered the anterior mediastinum with no associated great vessel injury. The fibreglass sheet was removed via a partial sternotomy and the patient made an uneventful postoperative recovery.
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For over 100 years, controlled human infection (CHI) studies have been performed to advance the understanding of the pathogenesis, treatment and prevention of infectious diseases. This methodology has seen a resurgence, as it offers an efficient model for selecting the most promising agents for further development from available candidates. ⋯ This review examines the regulatory differences for CHI studies between countries and summarises other regulatory differences in clinical trials as a whole. We found that the regulations that would apply to CHI studies in Singapore closely mirror those in the United Kingdom, and conclude that the regulatory and ethical guidelines in Singapore are compatible with the conduct of CHI studies.