A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel.
While most doctors delve into healthcare because of a desire to heal, geriatricians tend to care with a little more compassion. Dealing with the elderly and frail naturally dictates that the person involved be more patient, gentle, communicative, encouraging than another person dealing with an otherwise healthy person. Ability to communicate in the person’s mother tongue will allay their anxieties. Speaking slowly and clearly are important especially those who are hard in hearing may compensate with lip reading.
Dr Paul Chiam, a senior consultant cardiologist at The Heart & Vascular Centre, Mount Elizabeth Hospital, Singapore, and an Adjunct Associate Professor at the National University of Singapore, shares his insights with Pearl Toh on diagnosing and managing hypertension in the primary care setting.
According to the Singapore Cancer Registry, ovarian cancer was the fifth most frequent cancer among women in Singapore and accounted for 5.4 percent of all female cancers diagnosed between 2011 and 2015, with an increasing incidence rate through the last four decades.
MIMS Pharmacist speaks to Khaled bin Ghazali, assistant treasurer of the Malaysian Pharmaceutical Society (MPS), and Nik Nurma Nik Yahya, vice-president of the Kelantan Malaysian Community Pharmacy Guild (MCPG) to find out more about their experiences with state-wide collaboration among the Kelantanese pharmacy community.
Dr. Fanny Wai-San Ko, Dr. Wing-Ho Yip, 20180815064342
Although a majority of patients can achieve good asthma control with the use of inhaled corticosteroid (ICS) and bronchodilators, some patients’ asthma remain uncontrolled despite the use of these medications.
Associate Professor Reshma A Merchant, Head & Senior Consultant of the Division of Geriatric Medicine at the National University Hospital, Singapore, speaks with Audrey Abella to discuss the challenges associated with dementia, its impact on the ageing population, and how this condition can be best managed in primary care.
Dr Sue-Ann Ng, Associate Consultant at the Department of Rheumatology & Immunology, Singapore General Hospital, speaks to Roshini Claire Anthony on the multisystemic autoimmune disease that is systemic sclerosis (SSc) and the importance of early identification of the condition.
Dr. Kelvin Ki-Wan Chan, Dr. Chun-Ka Wong, 20180710000000
Case 1: Madam A became pregnant at 38 years of age. She carried a class IV risk under the modified WHO classification of maternal cardiovascular risk, for which pregnancy was contraindicated. Termination of pregnancy was repeatedly suggested, but the couple opted to continue with the pregnancy.
Case 2: Madam B had had hypertension since early adolescence. Apart from being obese with a Body Mass Index of 34 kg/m2and fatty liver disease, extensive investigations were unrevealing. Her family history was unremarkable. She was then lost to follow-up. At 24 years of age, madam B was referred back to our hospital for a high-risk pregnancy situation during her first trimester.