Dr Michael Lim, consultant of the Division of Paediatric Pulmonary and Sleep in National University Hospital, Singapore, shares his insights with Pearl Toh on diagnosing and managing paediatric asthma in the primary care setting.
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 20180125045128
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Adjunct Associate Professor Chong Wei Sheng, Head of the Psoriasis Unit at the National Skin Centre, Singapore, speaks to Roshini Claire Anthony on the vital role played by primary care physicians (GPs) in tackling psoriasis.
A 45-year-old gentleman presented with nephrotic-range proteinuria (6 g/day) and acute renal impairment. Blood tests revealed active lupus serological markers. He had no other extra-renal lupus manifestations. Renal biopsy showed Class IV lupus nephritis (activity score, 12/24; chronicity score, 1/12; 3 out of 12 glomeruli showed cellular crescents).
Adjunct Assistant Prof Tang Tjun Yip, Consultant Vascular & Endovascular Surgeon, Department of Vascular Surgery, Singapore General Hospital, shares clinical pearls on how GPs can manage varicose veins and chronic venous insufficiency in the primary care setting.
Dr. Priscilla Wong, Dr. Lydia Tam, Prof. LS Tam, 20171110000000
This case report highlights that psoriatic arthritis is a heterogenous disease affecting multiple disease domains, and effective treatment requires thorough assessment of each of these different domains.
Pearl Toh spoke with Dr Teh Ming Ming, senior consultant at the Department of Endocrinology, Singapore General Hospital (SGH), on the major challenges of diagnosing and managing diabetes in primary care, in conjunction with the World Diabetes Day on 14 November. Awareness of the symptoms of diabetes is important, and patients should be empowered to manage their conditions.
Empagliflozin appears to be beneficial to type 2 diabetes (T2D) patients with established cardiovascular disease (CVD) and chronic kidney disease (CKD), yielding reductions in CV and all-cause mortality, as well as in heart failure and all-cause hospitalization compared with placebo, according to a study.
Short-term treatment with methotrexate at >0.5 defined daily dose (8.75 mg/week) may help reduce the risk of ischaemic stroke in rheumatoid arthritis (RA) patients, while hydroxychloroquine and sulfasalazine have neutral effects, a retrospective study has found.