Ann Acad Med Singap
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Ann Acad Med Singap · Jul 1998
Comparative StudyDay hospital rehabilitation for the elderly: a retrospective study.
Alexandra Hospital has the first day hospital for rehabilitation of the elderly in Singapore. To determine if functional skills and mobility improved significantly with a Day Hospital rehabilitation programme, and the factors influencing the outcome, a pre-test/post-test study was conducted on 30 male and 34 female patients discharged from the programme between 1 October 1995 and 30 June 1996. The Barthel Index was used to assess functional status and the Elderly Mobility Scale was used to assess mobility. ⋯ Improvement in functional skills and mobility were both inversely correlated with age. Multiple linear regression analysis showed that age and Barthel Index on admission were significant independent determinants of the Barthel Index at discharge, while age, Barthel Index and Elderly Mobility Score on admission significantly determined the Elderly Mobility Scale at discharge. This study showed that functional skills and mobility improved with rehabilitation in the elderly population, but younger and less severely disabled individuals tended to fare better.
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Ann Acad Med Singap · Jul 1998
Review Case ReportsA case series of ocular disease as the primary manifestation in sarcoidosis.
Sarcoidosis is an idiopathic, systemic, non-caseating, granulomatous disease with protean clinical manifestations. This disease is highly prevalent in the southern states of United States of America, especially among African-Americans, but uncommon among Asians. Though sarcoidosis concerns physicians of virtually all specialties, it is particularly important to ophthalmologists since a significant number of patients will seek initial medical examination because of ocular disease. ⋯ We report here 4 patients with active sarcoidosis who presented to us with ocular symptoms as the first and primary manifestation of the disease. All 4 patients developed symptoms and signs of systemic sarcoidosis at a later date. The ocular manifestations included simultaneous bilateral chronic granulomatous iridocyclitis, intermediate uveitis, posterior uveitis characterised by vasculitis with candle wax drippings, and optic nerve head granuloma.
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Ann Acad Med Singap · Jul 1998
Serum ferritin and iron status in the general population of Singapore, 1993 to 1995.
The National University of Singapore Heart Study is a cross-sectional survey of cardiovascular risk factors in persons aged 30 to 69 years from the general population of Singapore, with 957 persons having measurements of serum ferritin. For males aged 30 to 69 years, mean serum ferritin concentrations were highest in Chinese (236 micrograms/L), followed by Malays (175 micrograms/L) and then Indians (132 micrograms/L). For females aged 30 to 49 years (pre-menopausal), mean levels were higher in Chinese (61 micrograms/L) and Malays (55 micrograms/L) than Indians (30 micrograms/L), and likewise for the 50 to 69 years age group (post-menopausal) where the mean values were 144 micrograms/L for Chinese, 141 micrograms/L for Malays, and 85 micrograms/L for Indians. ⋯ Only 0.4% of males and no females had serum ferritin > or = 1000 micrograms/L. Levels of serum ferritin were somewhat higher than that reported in the USA. The overall iron status in Singapore seems to be satisfactory, although pre-menopausal females (especially Indians) have a fairly high rate of iron deficiency and these females need to be identified and treated with iron supplementation.
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Ann Acad Med Singap · Jul 1998
Review Case ReportsHyperthyroidism with gynaecomastia as the initial complaint: a case report.
Although gynaecomastia is a well-documented manifestation among male patients with hyperthyroidism, it is extremely rare to present as the initial or chief complaint in a subject with undiagnosed hyperthyroidism. We report a case of a 38-year-old Chinese man presenting with painful enlargement of both breasts of one month's duration. Examination revealed bilateral tender gynaecomastia. ⋯ Hyperthyroidism was confirmed biochemically. Treatment of thyrotoxicosis resulted in resolution of the gynaecomastia. This case report demonstrates that gynaecomastia may predominate over the commonly recognised, more manifest and urgent symptoms of hyperthyroidism.
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Ann Acad Med Singap · Jul 1998
Review Case ReportsThe alien hand sign--case report and review of the literature.
The alien hand sign refers to a group of signs which include a feeling that the hand is foreign together with autonomous activity, as if the hand is driven by an external agent. These features are commonly associated with frontal and callosal lesions. We report the alien hand sign in a man with left medial cortical infarct, presenting with autonomous grasping and groping with his right upper limb, denial of ownership of his limb, and dissociative phenomena including self restriction and intermanual conflict.