Objective: This case report highlights the complexity of eating disorder in schizophrenia and outlines the diagnostic dilemma and challenges associated with the treatment. Methods: We report a 13 years old female with early onset schizophrenia who developed anorexic symptoms and binge eating. Her eating disturbances worsened after olanzapine was commenced. Results: A combination of pharmacological and psychosocial intervention led to remission of schizophrenia co-morbid with eating disorder NOS. Conclusion: Co-morbid diagnosis of schizophrenia and eating disorder is not uncommon. Early diagnosis and evidence-based intervention are imperative as untreated illness greatly impacts the developmental trajectory of young people. Meeting family’s needs improves family functioning which in turn improves patient’s outcome.
Schizophrenia ; Eating Disorders ; Adolescent

This paper describes an extremely rare case of a huge aneurysmal bone cyst (ABC) in the pelvis, occurring in the patient’s 5th decade of life. The patient presented with a history of painless huge pelvic mass for 10 years. Plain radiograph and computed tomography showed huge expansile lytic lesion arising from the right iliac bone. A biopsy was performed and histology confirmed diagnosis of aneurysmal bone cyst. Unfortunately, the patient succumbed to profuse bleeding from the tumour.

Bone marrow stem cells (BMSC), known for its multipotency to differentiate into various mesenchymal cells such as chodrocyte, osteoblasts, adipocytes, etc, have been actively applied in tissue engineering. BMSC have been successfully isolated from bone marrow aspirate and bone marrow scraping from patients of various ages (13-56 years) with as little as 2ml to 5ml aspirate. BMSC isolated from our laboratory showed the presence of a heterogenous population that showed varying prevalence of surface antigens and the presence of telomerase activity albeit weak. Upon osteogenic induction, alkaline phosphatase activity and mineralization activity were observed.
Bone Marrow Cells/cytology ; *Bone Marrow Transplantation ; Bone Regeneration/physiology ; *Bone Transplantation ; Cell Differentiation/physiology ; *Mesenchymal Stem Cell Transplantation ; Telomerase/metabolism ; *Tissue Engineering

The strategy used to generate tissue-engineered bone construct, in view of future clinical application is presented here. Osteoprogenitor cells from periosteum of consenting scoliosis patients were isolated. Growth factors viz TGF-B2, bFGF and IGF-1 were used in concert to increase cell proliferation during in vitro cell expansion. Porous tricalcium phosphate (TCP)-hydroxyapatite (HA) scaffold was used as the scaffold to form 3D bone construct. We found that the addition of growth factors, greatly increased cell growth by 2 to 7 fold. TCP/HA proved to be the ideal scaffold for cell attachment and proliferation. Hence, this model will be further carried out on animal trial.
Bone Regeneration/*physiology ; *Bone Transplantation ; Cell Division/physiology ; Collagen/metabolism ; *Mesenchymal Stem Cell Transplantation ; Organ Culture Techniques ; Periosteum/*cytology ; Tissue Engineering/*methods

There are various modes of anaesthesia available in the community today. This gives anaesthesiologists the freedom to select those that are safe, efficacious and most suitable for patients. However, patients may not always agree with their anaesthesiologist on the preferred mode of anaesthesia because they may have a different set of priorities, with many of them electing to have the lack of intraoperative awareness as the primary objective. Hence, disagreements between anaesthesiologists and patients may arise and could potentially disrupt doctor-patient relationship. This paper attempts to explore the possible reasons for obstetric patients championing for certain modes of anaesthesia and to provide an insight into the need for adequate patient education.

The aim of this review was to analyze the gender disparities found as well as the life expectancies in Asia. An analysis of the data on gender disparities as well as life expectancies of the different Asian countries was done based on the World Health Organization (WHO) Global Health Observatory Data Repository as well as the regional government databases. Middle Eastern countries have the highest male to female population ratio. The results show that in terms of population pyramid, Asia is moving towards a more geriatric population. Qatar has the highest life expectancy for men and is the only country in Asia where men live longer than women (difference of 2 years). In general, women in Asia live longer than men. High income countries like Hong Kong, Japan and Singapore have higher life expectancies as compared to those on the lower income nations. The life expectancy of Asian men still lags women. Men’s health care needs to be addressed urgently. The disparity in income-status reflecting the lifespan of men is an impetus for us to narrow the gap of health in Asian countries.

INTRODUCTIONChloral hydrate (CH) sedation is routinely used in paediatric ophthalmic examination in Singapore as an alternative to examination under general anaesthesia. Despite CH's traditionally high success rates and relatively low rate of adverse events, there is little data on its safety and efficacy as a sedative for ophthalmic procedures in an Asian population.

MATERIALS AND METHODSA retrospective chart review was performed, including children who underwent CH sedation at the Singapore National Eye Centre from January 2012 to January 2015. Participants were given an initial dose of CH and a top-up dose if required. Univariate and multivariate analyses were performed on data collected.

RESULTSCH sedation was successful in 144 of 153 children (94.1%). Of the 20 (13.0%) who required a top-up dose, 4 failed to sedate. The mean sedation onset was 29.4 minutes (SD: 24.3) and mean sedation duration was 56.5 minutes (SD: 24.0), with more than a third lasting more than 1 hour. The age of children, rather than initial dose of CH, was more relevant in determining success of sedation. Children who were >6 years old were 20.3 times more likely to fail sedation than those aged <2 years. During sedation, depression in the heart rate and a transient reduction of oxygen saturation was documented. All children recovered well post-sedation.

CONCLUSIONCH is a very useful sedative for paediatric ophthalmic procedures, especially in younger children. Children over 4 years old were more likely to fail sedation and require top-up doses. Alternative means of sedation may need to be considered in these cases.

Bystander rate of cardiopulmonary resuscitation (CPR) is still low worldwide because of inadequate skills and knowledge. Training the public on CPR is one of the methods to increase the bystander CPR rate. This study aimed to compare the efficacy in acquiring and retaining CPR skills and knowledge among secondary school students in Klang Valley trained by school teachers and medical students. We recruited five school teachers and five medical students as trainers. They were trained in several sessions by American Heart Association (AHA)-certified instructors using the video-assisted CPR training module. The recipients were 44 secondary school students divided between the teacher’s group and the medical student’s group. We compared knowledge and psychomotor skills between these two groups prior, immediately after and at three months after CPR training. Students in the teacher’s group showed a higher increase in knowledge comparable to the medical student’s group (median score difference 3 vs 2, p>0.05) and in psychomotor skill (median score difference 5 vs. 7, p<0.05). The level of knowledge and skills decreased after 3 months but remained significantly higher than at baseline for both groups. In conclusion, teachers could provide CPR training to their students as effective and retainable as medical students. This study aims to create an opportunity to teach CPR to the public in a larger scale.

Ambulatory Care ; COVID-19 ; Health Facility Planning ; Hospital Bed Capacity ; Hospitals, Rehabilitation ; Humans ; Infection Control ; Rehabilitation ; Remote Consultation ; SARS-CoV-2 ; Singapore ; Telerehabilitation ; Triage