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.
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.
An 82-year-old lady with hypertension and hyperlipidaemia presented with 2 weeks’ history of increasing breathing difficulty. She had flu-like illness 2 weeks ago with some residual dry cough. Physical examination showed low-grade fever of 37.8°C with mildly elevated jugular venous pressure and mild pedal oedema. There was no obvious murmur, and chest auscultation revealed bilateral basal crepitations. Her blood pressure was 130/80 mm Hg. She required oxygen 1 L/min to maintain blood oxygen saturation level (SpO2) of 94 percent.
Chronic obstructive pulmonary disease (COPD) is currently the 10th commonest cause of death in Singapore, with a disease burden of 5.9 percent according to a 2015 population-based survey (EPIC-Asia survey) in Singapore. Pearl Toh spoke with Dr Augustine Tee, chief and senior consultant of the Department of Respiratory and Critical Care Medicine at Changi General Hospital (CGH) in Singapore, on how COPD is often underdetected in the primary care population as symptoms are not specific and diagnosis requires a combination of clinical risk factors, symptoms and spirometry testing.
There are various ear, nose, and throat (ENT) conditions which present to the GP’s clinic. Dr Jason Hwang, an ENT Consultant from the Department of Otolaryngology at Gleneagles Hospital in Singapore, speaks on how the majority of the conditions can be effectively managed at the primary care level seeing that these can be treated medically without the need for surgical intervention.
Lung cancer still poses a challenge in terms of diagnosis and treatment. In many countries in Asia, the condition remains a significant cause of mortality. The prevalence of tuberculosis in the region also confounds this problem, which necessitates a highly efficient means to differentiate these two entities. Electromagnetic navigation bronchoscopy (ENB), a state-of-the-art lung biopsy technique, was recently introduced in Hong Kong, placing the city as a pioneer in its utilization in the region. Dr Chung-Ming Chu, Specialist in Respiratory Medicine in Hong Kong, discusses the role of ENB in diagnosing pulmonary lesions and shares his experience on its use.
This is the case of a 77-year-old man with a history of pulmonary tuberculosis (TB). In September 2015, he was admitted to a regional hospital in Hong Kong due to fever and shortness of breath, and was diagnosed with pneumonia, the fourth episode in his life.
Dengue fever is caused by the dengue virus and borne by the Aedes mosquito. The virus causes flu-like symptoms that generally resolve on their own with supportive care but severe cases require further management and possibly hospitalization. Primary care doctors are frequently the first point of contact for people with dengue fever. Radha Chitale spoke with Dr. Jenny Low, a senior consultant in the Department of Infectious Diseases at Singapore General Hospital, about what they can do for affected patients.
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Patients admitted to the intensive care unit (ICU) with severe influenza have an elevated risk of developing invasive pulmonary aspergillosis, particularly if they are immunocompromised at time of admission, a recent study has shown.
An investigational device monitoring fluid accumulation in the lungs significantly reduced hospitalization due to heart failure and death by any cause among heart failure patients compared with standard monitoring and treatment methods, according to results from the IMPEDANCE-HF trial reported during the recent ACC meeting in Chicago, Illinois, US.