1.A rare cause of acute abdomen-Spontaneous rectus sheath hematoma
Chong Chin Hock ; Chai Yih Feng ; Tan Eng Yew
Asian Pacific Journal of Tropical Biomedicine 2016;6(10):892-895
Spontaneous rectus sheath hematoma (SRSH) is a rare entity that mimics acute abdomen. Rectus sheath hematoma is the accumulation of blood in rectus sheath due to muscle or epigastric vessel injury. However, SRSH without a trauma or anticoagulation is rare. It frequently mimics acute abdomen and it may lead to misdiagnosis and unnecessary laparotomy. In this article, we described two cases of SRSH with their diagnostic and therapeutic strategy. Both of our patients in report were neither consumed antiplatelet nor coagulopathy. They both had abdominal muscle straining before their symptoms pre-sentation. We hypothesized that the SRSH may be induced by rectus muscle injury secondary to inappropriate straining or posture. To diagnose SRSH, clinical findings are important but radiologic imaging such as computed tomography, can be diagnostic. In expanding SRSH, percutaneous arterial embolization of epigastric artery is useful to secure the bleeding. If embolization is not feasible, surgical exploration hemostasis is curative. In non-expanding SRSH, it can be managed nonoperatively. SRSH is an important initial differential for acute abdomen. Radiologic imaging helps in diagnosis. Stable SRSH can be managed conservatively with good outcome.
2. A rare cause of acute abdomen – Spontaneous rectus sheath hematoma
Hock Chin CHONG ; Feng Yih CHAI ; Yew Eng TAN ; Sophia Si Ling HENG ; Siti Asilah MOHD DESA
Asian Pacific Journal of Tropical Biomedicine 2016;6(10):892-895
Spontaneous rectus sheath hematoma (SRSH) is a rare entity that mimics acute abdomen. Rectus sheath hematoma is the accumulation of blood in rectus sheath due to muscle or epigastric vessel injury. However, SRSH without a trauma or anticoagulation is rare. It frequently mimics acute abdomen and it may lead to misdiagnosis and unnecessary laparotomy. In this article, we described two cases of SRSH with their diagnostic and therapeutic strategy. Both of our patients in report were neither consumed antiplatelet nor coagulopathy. They both had abdominal muscle straining before their symptoms presentation. We hypothesized that the SRSH may be induced by rectus muscle injury secondary to inappropriate straining or posture. To diagnose SRSH, clinical findings are important but radiologic imaging such as computed tomography, can be diagnostic. In expanding SRSH, percutaneous arterial embolization of epigastric artery is useful to secure the bleeding. If embolization is not feasible, surgical exploration hemostasis is curative. In non-expanding SRSH, it can be managed nonoperatively. SRSH is an important initial differential for acute abdomen. Radiologic imaging helps in diagnosis. Stable SRSH can be managed conservatively with good outcome.
3.Academy of Medicine-Ministry of Health clinical practice guidelines: attention deficit hyperactivity disorder.
Daniel S S FUNG ; Choon Guan LIM ; John Chee Meng WONG ; Koon Hock NG ; Christopher Cheng Soon CHEOK ; Jennifer Sie Hee KIING ; Shang Chee CHONG ; June LOU ; Mary Lourdes DANIEL ; Desmond ONG ; Charity LOW ; Sharifah Mariam ALJUNIED ; Pui Meng CHOI ; Kala MEHROTRA ; Carolyn KEE ; Ivy LEUNG ; Lee Chen YEN ; Geraldine WONG ; Poh Yin LEE ; Bella CHIN ; Hwee Chien NG
Singapore medical journal 2014;55(8):411-quiz 415
The Academy of Medicine (AMS) and the Ministry of Health (MOH) have developed the clinical practice guidelines on Attention Deficit Hyperactivity Disorder (ADHD) to provide doctors and patients in Singapore with evidence-based treatment for ADHD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on ADHD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Attention Deficit Disorder with Hyperactivity
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diagnosis
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drug therapy
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therapy
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Caregivers
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Child
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Evidence-Based Medicine
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Humans
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Methylphenidate
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therapeutic use
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Parents
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Psychiatry
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methods
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standards
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Singapore
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Societies, Medical