Singap Med J
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Review Case Reports
Disseminated peritoneal leiomyomatosis: a devastating sequelae of unconfined laparoscopic morcellation.
There has been growing concern surrounding the use of unconfined power morcellation in laparoscopic surgeries for uterine leiomyoma due to its associated risks and long-term clinical sequelae, including parasitic leiomyomas and disseminated peritoneal leiomyomatosis (DPL). We present a case of DPL resulting from previous laparoscopic morcellation and a review of the existing literature. ⋯ A multidisciplinary approach is recommended in the management of DPL, especially in cases of multivisceral involvement. Clinical caution ought to be exercised when using power morcellators; when unavoidable, confined laparoscopic morcellation offers a promising mitigation and should be adopted if practicable.
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A 14-year-old boy presented with left anterior knee pain, which was aggravated by exercise and relieved by rest. On clinical examination, there was tenderness at the tibial tuberosity with reproducible pain on resisted active extension of the knee. ⋯ Clinical and radiological findings were consistent with Osgood-Schlatter disease, which is a traction apophysitis of the tibial tubercle commonly occurring in adolescents. The clinical presentation and imaging features are discussed.
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We aimed to report the ten-year incidence and trend of sharps injuries and splash exposures (SISE), and analyse the causative instruments and risk factors leading to these injuries to identify potential areas of improvement. ⋯ Overall incidence of SISE decreased over the decade. Improved training and increasing use of safety devices, education and awareness could have contributed to the fall in incidence of sharps injuries; these measures should be reinforced and continued. However, the incidence of splash exposures increased over the same period. Preventive measures such as the use of protective goggles and face shields, together with personal protective equipment, should be emphasised and encouraged.