1.Giant Chondrosarcoma of Proximal Humerus in an Adult Female Patient: A Case Report
Ng CK ; Azuhairy A ; Tan LH ; Nordin A
Malaysian Orthopaedic Journal 2015;9(2):51-53
Chondrosarcoma is the third most common primary tumour
of the bone, after myeloma and osteosarcoma. Most of the
chondrosarcoma grow slowly and rarely metastasize, and
they have an excellent prognosis after adequate surgery.
However most of them are chemo or radio-resistant. We
report a case of primary chondrosarcoma of proximal
humerus in a 36-year-old female who presented with a six
years history of left shoulder swelling and restricted range of
motion. Trucut biopsy showed a well-differentiated
chondrosarcoma. The patient underwent forequarter
amputation of left upper limb and was started on
chemotherapy following operation.
Chondrosarcoma
2.A case of severe leptospirosis with pancytopaenia.
The Medical Journal of Malaysia 2003;58(5):777-779
Pancytopaenia is a rare clinical presentation of severe leptospirosis. We would like to report a case of severe leptospirosis that progressed to pancytopaenia despite initial penicillin therapy. The patient needed a second course of antibiotic with doxycycline to improve his persistent symptoms and cytopaenia. Persistent pancytopaenia in severe leptospirosis and its management were reviewed.
Doxycycline/administration & dosage
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Drug Therapy, Combination
;
Leptospirosis/*complications
;
Leptospirosis/drug therapy
;
Pancytopenia/drug therapy
;
Pancytopenia/*etiology
;
Penicillins/administration & dosage
3.Alcohol Use Disorders amongst Inpatients in a General Hospital in Singapore: Estimated Prevalence, Rates of Identification and Intervention.
Andre Ts TAY ; Andrew Lh PEH ; Sheng Neng TAN ; Herng Nieng CHAN ; Song GUO ; Yiong Huak CHAN
Annals of the Academy of Medicine, Singapore 2016;45(4):138-147
INTRODUCTIONMany alcohol-related problems often go undetected and untreated. In Singapore, no epidemiological studies have been done in general hospitals on alcohol use disorders (AUD), i.e. alcohol dependence and abuse (DSM-IV-TR). Such findings are useful in planning AUD liaison services. In this study, we aim to estimate the prevalence of AUD among non-psychiatric inpatients and to determine the rates of identification and intervention rendered by medical staff.
MATERIALS AND METHODSNon-psychiatric medical and surgical wards inpatients aged 21 years and above were recruited over a 3-month period. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen for AUD and the MINI International Neuropsychiatric Interview (MINI English Version 5.0.0) was administered to diagnose AUD if the AUDIT score was 8 or above. Case notes were independently reviewed for AUD identification and if interventions were offered during admissions.
RESULTSA total of 5599 inpatients were screened, of which 673 (12%) completed the screening using the AUDIT, and of these, 154 (2.8% of total sample) were positive for AUDIT. In this group, 107 were diagnosed with AUD. The estimated prevalence was 1.9% (approximately 400 cases per year per hospital). The medical staff identified only 25 (23.4%) cases of AUD, out of which, majority of them (76%) were rendered interventions.
CONCLUSIONThe rate of AUD identification by medical staff was low. Of those identified, majority were given interventions. Thus, the training of health care staff to identify AUD together with the implementation of brief interventions should be considered.
Adult ; Aged ; Alcoholism ; diagnosis ; epidemiology ; therapy ; Female ; Hospitalization ; Hospitals, General ; Humans ; Male ; Mass Screening ; utilization ; Mental Health Services ; Middle Aged ; Prevalence ; Referral and Consultation ; Singapore ; epidemiology ; Young Adult
6.Bridging the gap between primary and specialist care--an integrative model for stroke.
Narayanaswamy VENKETASUBRAMANIAN ; Yan Hoon ANG ; Bernard Pl CHAN ; Parvathi CHAN ; Bee Hoon HENG ; Keng He KONG ; Nanda KUMARI ; Linda Lh LIM ; Jonathan Sk PHANG ; Matthias Phs TOH ; Sutrisno WIDJAJA ; Loong Mun WONG ; Ann YIN ; Jason CHEAH
Annals of the Academy of Medicine, Singapore 2008;37(2):118-127
Stroke is a major cause of death and disability in Singapore and many parts of the world. Chronic disease management programmes allow seamless care provision across a spectrum of healthcare facilities and allow appropriate services to be brought to the stroke patient and the family. Randomised controlled trials have provided evidence for efficacious interventions. After the management of acute stroke in a stroke unit, most stable stroke patients can be sent to their family physician for continued treatment and rehabilitation supervision. Disabled stroke survivors may need added home-based services. Suitable community resources will need to be harnessed. Clinic-based stroke nurses may enhance service provision and coordination. Close collaboration between the specialist and family physician would be needed to right-site patients and also allow referrals in either direction where necessary. Barriers to integration can be surmounted by trust and improved communication. Audits would allow monitoring of care provision and quality care enhancement. The Wagner model of chronic care delivery involves self-management support, shared clinical information systems, delivery system redesign, decision support, healthcare organisation and community resources. The key and critical feature is the need for an informed, activated (or motivated) patient, working in collaboration with the specialist and family physician, and a team of nursing and allied healthcare professionals across the continuum of care. The 3-year Integrating Services and Interventions for Stroke (ISIS) project funded by the Ministry of Health will test such an integrative system.
Delivery of Health Care, Integrated
;
organization & administration
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Evidence-Based Medicine
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Humans
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Ischemic Attack, Transient
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Medicine
;
Middle Aged
;
Models, Organizational
;
Neurology
;
Primary Health Care
;
Rehabilitation Nursing
;
Singapore
;
Specialization
;
Stroke
;
nursing
;
Stroke Rehabilitation