Dr. Michael Sze, Dr. Tammy Ma, Dr. Yui-Ming Lam, 20180409000000
A 47-year-old gentleman with a known history of mitral valve prolapse (MVP) and mild-to-moderate mitral regurgitation since his 30s presented to Queen Mary Hospital with sudden onset of chest pain and palpitations for 1 day.
Chronic kidney disease (CKD) has a global prevalence of 7–12 percent, with a mortality risk that has increased over the past 25 years – ranking 25th in 1990 to 17th in 2015. While there is no sufficient data reflecting the incidence of CKD in South East Asia (SEA), in Singapore, 2.3 percent of adults aged 18–69 years have been found to have renal impairment (estimated glomerular filtration rate [eGFR] of <60 mL/min/1.73m2).
The syndrome of sensory neuronopathy and detection of anti-Hu antibody in 2010 were very strong indications of the presence of a malignant tumour. In a series of 200 patients positive for anti-Hu, 83.5 percent were found to have cancer, and 90 percent of the cancer cases were small-cell lung cancer.
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.
Antidepressants may be effective for treating depression in patients with schizophrenia, according to a meta-analysis that underscores qualifying conclusions based on the small number of low- or moderate-quality studies.
The sulfonylurea glimepiride may pose an increased risk of hypoglycaemia in a subgroup of elderly type 2 diabetes (T2D) patients with lower β-cell function when added to a metformin regimen, according to a post-hoc analysis of data from the GENERATION* trial.
Antiviral treatment for colonic cytomegalovirus (CMV) infection significantly improves short- and long-term surgery-free survival in patients with ulcerative colitis (UC), according to the results of a small-scale study.
Once-monthly and once-quarterly administration of paliperidone palmitate had similar efficacy in terms of relapse prevention for schizophrenia in an East Asian population, according to a subgroup analysis.