1.The maternal infant dyadic relationship-looking beyond postpartum depression
ASEAN Journal of Psychiatry 2013;14(2):1-9
Postpartum mental illness arises from a culmination of factors at the time of the motherhood transition, and bears impact on maternal wellbeing, as well as the
infant. Whilst traditional psychiatric approach focuses primarily on symptomatology, diagnostic assessment, and treatment aimed largely at symptoms
relief, the infant’s wellbeing and development is of key concern. And thus follows the need to address the space between mother and infant – the dyadic experience.
Understanding the world of the infant, the nature of mother-infant bonding, and possible disorders allows us to care better for mothers with perinatal mental illness.
Methods: Literature review of the evidence and possible approaches to addressing the mother-infant relational disorder will be discussed based on case reports. In
particular, the Watch Wait and Wonder technique, an infant/child-led psychotherapy will be demonstrated with case studies. Results: The case studies
demonstrate important themes of mother-infant bonding difficulties common to mothers with postpartum mental illness. Therapy specifically addressing these issues
can enable mothers to process feelings of ambivalence and conflicts that hamper the development of the dyadic relationship. Conclusion: The maternal-infant dyadic
relationship is a key focus in postpartum mental illness, and mental healthcare for postpartum depression and other illness should consider interventions as needed.
2.Understanding How Postnatal Depression Screening and Early Intervention Work in the Real World - A Singaporean Perspective.
Theresa My LEE ; Dianne BAUTISTA ; Helen Y CHEN
Annals of the Academy of Medicine, Singapore 2016;45(10):466-470
Postnatal depression is a major public health problem with clearly established adverse effects in child outcomes. This study examines the 4-year outcomes of a screening and early intervention programme, in relation to improvement in symptoms, functioning and health quality of life. Women were prospectively recruited up to 6 months postdelivery, using the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool. High-scorers (EPDS >13), were offered psychiatric consultation, and those with borderline scores (EPDS 10-12) were provided counselling, and offered follow-up phone counselling by the assigned case manager. Outcome measures were obtained at baseline, and at 6 months or discharge if earlier, for levels of symptoms, functioning, and health quality of life. From 2008 to 2012, 5245 women were screened, with 307 (5.9%) women with EPDS >13 receiving intervention. Of these, 70.0% had depression, 4.6% anxiety and 3.4% psychosis. In the depression subgroup, the net change was improvement of 93.4% EPDS symptom scores, 92.2% Global Assessment of Functioning (GAF) scores, and 88.3% visual analogue scale (EQ VAS) health quality of life scores. Outcome scores across diagnostic categories demonstrated median changes of 10 points on EPDS, 20 points on GAF, and 25 points on EQ VAS, reflecting 73.9%, 36.4% and 41.7% change from baseline scores. Women with psychosis showed the biggest (80.0%) relative change in GAF functioning scores from baseline to discharge but had the lowest median change in EPDS symptom scores. A screening and intervention programme rightly-sited within an obstetric setting can improve clinical outcomes because of early detection and intervention.
Adult
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Anxiety Disorders
;
diagnosis
;
therapy
;
Case Management
;
Counselors
;
Delivery of Health Care
;
Depression, Postpartum
;
diagnosis
;
therapy
;
Early Medical Intervention
;
Female
;
Health Status
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Humans
;
Mass Screening
;
Obstetrics
;
Outcome Assessment (Health Care)
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Prospective Studies
;
Psychiatry
;
Psychotic Disorders
;
diagnosis
;
therapy
;
Puerperal Disorders
;
diagnosis
;
therapy
;
Quality of Life
;
Referral and Consultation
;
Singapore
3.A Case of Primary Malignant Hemangiopericytoma of the Lung.
Kang Moon LEE ; Joong Hyun AHN ; Kyo Young LEE ; Theresa JANG ; Hwa Sik MOON ; Sung Hak PARK ; Jeong Sup SONG
Tuberculosis and Respiratory Diseases 1997;44(3):655-660
Hemangiopericytoma is a rare vascular tumor arising from pericytes. The tumor usually develops in the skin or subcutaneous tissue, particularly in the extremities.4 pulmonary origin of hemangiopericytoma is known to be quite rare. It has the potential to become a highly malignant lesion, so wide excision is the treatment of choice. We present a case of primary malignant hemangiopericytoma of the lung and discuss the clinical symptoms, diagnosis, therapy and prognosis within the context of a brief review.
Diagnosis
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Hemangiopericytoma*
;
Lung*
;
Pericytes
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Prognosis
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Skin
;
Subcutaneous Tissue
4.Clinics in diagnostic imaging (144). Lateral meniscal ossicle.
Steven B S WONG ; Theresa L C LEE ; Bruce B FORSTER ; Gordon T ANDREWS
Singapore medical journal 2013;54(2):108-quiz 113
A 35-year-old female patient with previous left knee anterior cruciate ligament repair for a skiing injury presented six years later with a traumatic lateral patellar subluxation. Radiographs and magnetic resonance imaging of her left knee joint showed an ossific structure in the region of the lateral meniscus. This was diagnosed as a meniscal ossicle and confirmed during successful arthroscopic excision. The imaging features of meniscal ossicles are reported.
Adult
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Anterior Cruciate Ligament
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surgery
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Anterior Cruciate Ligament Injuries
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Arthroscopy
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Bone and Bones
;
pathology
;
Diagnostic Imaging
;
methods
;
Female
;
Humans
;
Knee Joint
;
diagnostic imaging
;
pathology
;
Magnetic Resonance Imaging
;
Menisci, Tibial
;
diagnostic imaging
;
pathology
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Postoperative Complications
;
Radiographic Image Interpretation, Computer-Assisted
;
Tibial Meniscus Injuries
5.A Case of Mediastinal Tuberculous Abscess and Lymphadenitis after Bone Marrow Transplantation.
Chang Wook KIM ; Dong Jun LIM ; Theresa JANG ; Tae Seo SOHN ; Dong Gun LEE ; Mi Young KIM ; Jung Hyun CHOI ; Wan Shik SHIN ; Chun Choo KIM
Korean Journal of Infectious Diseases 1999;31(3):247-251
After bone marrow transplantation (BMT), recipients can be complicated by infectious or non-infectious chest lesions such as mycobacterial infections or post- transplant lymphoproliferative disorders (PTLDs). BMT recipients usually face a lot of risks of mycobacterial infection because they have severely impaired cell- mediated immunity as a result of their underlying disease, chemotherapy, radiotherapy, acute or chronic graft-versus-host diesase (GVHD) and their treatment. We report a case of mediastinal tuberculous abscess and lymphadenitis after BMT, which mimicks PTLDs. 20 months before admission, BMT was performed on a 41 year-old woman who was diagnosed as chronic myelocytic leukemia. She showed acute and chronic GVHD with several infections of bacteria or viruses after BMT. In endemic area of tuberculosis such as Korea, PTLDs should be differentiated from pulmonary tuberculosis and tuberculous lymphadenitis.
Abscess*
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Adult
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Bacteria
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Bone Marrow Transplantation*
;
Bone Marrow*
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Drug Therapy
;
Female
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Humans
;
Korea
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
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Lymphadenitis*
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Lymphoproliferative Disorders
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Radiotherapy
;
Thorax
;
Tuberculosis
;
Tuberculosis, Lymph Node
;
Tuberculosis, Pulmonary
6.Overcoming Barriers to Mammography Screening: A Quasi-randomised Pragmatic Trial in a Community-based Primary Care Setting.
Theresa SEETOH ; Wei Fong SIEW ; Alvin KOH ; Wei Fong LIAU ; Gerald C H KOH ; Jeannette J M LEE ; Mee Lian WONG ; Adeline SEOW
Annals of the Academy of Medicine, Singapore 2014;43(12):588-594
INTRODUCTIONBreast cancer is the leading cancer among women in Singapore. Five years after a population-wide breast cancer screening programme was introduced, screening rates remained relatively low at 41%. Studies have shown decreased screening propensity among medically underserved women typically of minority or socioeconomically disadvantaged status. We conducted a quasi-randomised pragmatic trial aimed at encouraging mammography screening among underscreened or unscreened women in a publicly funded primary care facility in Singapore.
MATERIALS AND METHODSThe study was conducted from May to August 2010. Components of intervention included (1) tailored education, (2) doctor's reminder, and (3) cost reduction. Researchers administered a structured questionnaire to eligible female polyclinic attendees and patient companions aged 40 to 69 years. Individual knowledge, attitudes, beliefs, and barriers towards mammography screening were identified and educational messages tailored. Doctor's reminder and cost reduction were implemented additively.
RESULTSOverall, out of 448 participants, 87 (19.4%, 95% confidence interval (CI), 15.8% to 23.1%) completed mammography screening across 3 arms of study. Participants who received a cost reduction were more likely to attend screening compared to participants in other intervention arms (adjusted odds ratio (OR) 2.4, 95% CI, 1.2 to 4.5, P = 0.009). Cost of screening, ethnicity, prior screening history, and attitudes towards mammography screening were identified as significant factors predicting mammogram attendance.
CONCLUSIONIncluding a cost reduction component was the most effective intervention that increased mammography screening rates. Women's underlying beliefs, attitudes, and other predisposing factors should also be considered for integration into existing breast cancer screening programmes.
Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; economics ; Community Health Services ; Costs and Cost Analysis ; Early Detection of Cancer ; economics ; Female ; Health Services Accessibility ; Humans ; Mammography ; economics ; Middle Aged ; Patient Education as Topic ; Pilot Projects ; Primary Health Care ; Reminder Systems ; Singapore
7.Motivating and hindering factors affecting muslim mothers' Infant and Young Child Feeding (IYCF) practices in select municipalities of Maguindanao, BARMM, Philippines
Paul Alteo A. Bagabaldo ; Maria Theresa M. Talavera ; Divine Grace C. Domingo ; Angelina R. Bustos ; Leila S. Africa ; Angelina DR. Felix ; Anna Teresa O. Orillo ; Nancy A. Tandang ; Warren TK Lee ; Maria Cecilia F. Pastores
Acta Medica Philippina 2024;58(Early Access 2024):1-11
Objectives:
This study aimed to determine the motivating and hindering factors affecting the Infant and Young Child Feeding (IYCF) practices of Muslim mothers in select municipalities of Maguindanao.
Methods:
A pretested questionnaire was administered through face-to-face interviews conducted among 320 randomly selected Muslim mothers with a child aged 6-23 months.
Results :
Results revealed that prelacteal feeding was practiced by 16.6% of the Muslim mothers, giving mostly plain water. Solid/semi-solid foods were introduced at a mean age of 6.1 ± 1.4 months, with home-cooked lugao (porridge) (55.0%) and commercial baby food (31.3%) as the top foods introduced. The majority of Muslim mothers (82.5%) fed processed foods as complementary food to their children, including instant noodles (85.2%) and canned goods (51.5%).
Conclusion
The results revealed suboptimal practices in prelacteal feeding and the reliance on processed foods among Muslim mothers, with economic factors, availability, and convenience as motivating factors in complementary feeding practices. Challenges such as household duties, low milk output, and financial constraints hinder breastfeeding and nutritious food provision for infants and young children. The study reinforced the necessity for holistic strategies in IYCF promotion among Muslim mothers.
breast feeding, Islam, malnutrition