Singap Med J
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Tuberculosis (TB) is a major health issue in the Philippines. TB-Care was introduced in 2011 to tackle pulmonary TB among the urban poor in Payatas, Quezon City, Philippines. We evaluated the efficacy of TB-Care in increasing treatment success and compliance rates. ⋯ The average 100% compliance rate was 90.8% over six months. The programme successfully treated 39 (88.6%) patients. This was comparable to the overall national treatment success rate of 90% for Philippines and 79% for Singapore, with higher compliance rates than were previously reported in this community.
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A 48-year-old woman presented with progressive left hip pain over six months, along with left lower limb weakness for two weeks. Magnetic resonance imaging of the left hip showed narrowing of the left ischiofemoral space, oedema of the left quadratus femoris muscle and left sciatic nerve, and mild bone marrow oedema of the left ischial tuberosity. The diagnosis of left ischiofemoral impingement syndrome was made. The imaging features of ischiofemoral impingement syndrome and the associated aetiologies and complications are discussed.
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Cushing's syndrome is defined as chronic excess free cortisol in circulation. According to recent studies, midnight salivary cortisol is an accurate and non-stress method for screening and diagnosing Cushing's syndrome. However, there is limited data on midnight salivary cortisol for diagnosing Cushing's syndrome in the Chinese population. ⋯ Our study confirmed the good diagnostic performance of midnight salivary cortisol for diagnosing Cushing's syndrome in a Chinese population. Correlation between midnight salivary cortisol and either urine free cortisol or midnight serum cortisol was good. Midnight salivary cortisol is a convenient and precise tool for diagnosing Cushing's syndrome and can be the screening test of choice for Chinese populations.
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Autism spectrum disorder (ASD) is characterised by persistent deficits in social communication and interaction as well as restricted, repetitive patterns of behaviour and interests. Early detection and early intervention programmes improve functional outcomes. ⋯ Early warning signs of ASD include the lack of social gestures at 12 months, using no meaningful single words at 18 months, and having no interest in other children or no spontaneous two-word phrases at 24 months. Children with suspected ASD should be referred to appropriate specialist centres as early as possible for multidisciplinary assessment and diagnosis.
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Medical students rely on patients and their families as teachers during the learning journey. However, ill patients and their families may not welcome having students participating in their care, and anecdotal instances of abuse against clinical medical students are not uncommon. We aimed to determine the prevalence of medical student mistreatment by patients and their families and describe students' self-reported responses to such incidents. ⋯ Incidents of mistreatment in our school are not uncommon. Our study revealed a need for more clarity and guidance about how students can manage such situations. This is an important topic because such mistreatment is known to inflict emotional disturbance in students. We proposed a workflow to help students deal with mistreatment.