2005

M Muttarak, WN ChiangMai, B Lojanapiwat
Correspondence: Prof Malai Muttarak, mmuttara@mail.med.cmu.ac.th

ABSTRACT
The prevalence of pulmonary and extrapulmonary tuberculosis (TB) has been increasing over the past decade, due to the rising number of people with acquired immunodeficiency syndrome and the development of drug-resistant strains of Mycobacterium tuberculosis. The genitourinary tract is the most common site of extrapulmonary TB. Diagnosis is often difficult because TB has a variety of clinical and radiological findings. It can mimic numerous other disease entities. A high level of clinical suspicion and familiarity with various radiological manifestations of TB allow early diagnosis and timely initiation of proper management. This pictorial essay illustrates the spectrum of imaging features of TB affecting the kidney, ureter, bladder, and the female and male genital tracts.

Keywords: bladder infection, genitourinary tract, genitourinary tuberculosis, kidney infection
Singapore Med J 2005; 46(10): 568-575

RSH Chung, RY Chew, KG Au-Eong
Correspondence: Dr Ronald Chung, ronald_chung2001@yahoo.com

ABSTRACT
We report a case of a Coleoptera cincindelidae beetle that accidentally buried itself into the conjunctiva of the right eye of a 27-year-old man for five days. The beetle was difficult to remove but the patient suffered no long-term sequelae after removal of the insect. The eye returned to normal within a few days. The size of the beetle is similar to toxic beetles found in East Africa and similar injuries caused by beetle landing in the eye may happen in other parts of the world.

Keywords: beetles, conjunctival injuries, eye foreign bodies, insect injuries, ocular injuries
Singapore Med J 2005; 46(10): 564-565

R RamachandranNair, M Parameswaran, AS Girija
Correspondence: Dr Rajesh RamachandranNair, drrajeshram@rediffmail.com

ABSTRACT
Accepted modes of therapy in acute disseminated encephalomyelitis include intravenous methyl prednisolone, intravenous immunoglobulin or a combination of both. Effectiveness of plasmapheresis has been demonstrated by previous case reports. We report two patients with steroid non-responsive acute disseminated encephalomyelitis in which plasmapheresis resulted in complete clinical and radiological recovery, though the therapy was initiated in the fifth week of illness. A total of 45-50 ml/kg body weight of plasma was removed in six equal exchanges over a period of two weeks. This report highlights that plasmapheresis could be of use even in the early second month of illness.

Keywords: acute disseminated encephalomyelitis, demyelinating disease, encephalomyelitis, immunotherapy, plasmapheresis
Singapore Med J 2005; 46(10): 561-563