Singap Med J
-
This study aimed to evaluate the efficacy and safety of intra-articular glucocorticoid (IAG) injections in our institution in children with juvenile idiopathic arthritis (JIA). ⋯ As per the recommendations of the American College of Rheumatology, we safely used IAG injections as the first-line therapy in our group of patients with oligoarticular JIA, and/or as an adjunct to systemic therapy in our patients with JIA.
-
A 56-year-old man presented to the Accident and Emergency Department with pleuritic chest pain of sudden onset. He gave a history of short-distance air travel ten days earlier. Chest radiograph showed a peripheral-based opacity in the right lower zone, which was not seen in a previous study done three months ago, suggestive of Hampton's hump. ⋯ Computed tomography pulmonary angiography confirmed the diagnosis of pulmonary embolism in a right lower lobe segmental branch, with adjacent collapsed lung, consistent with lung infarction. The patient was started on heparin injection with significant relief of his symptoms. The clinical and imaging features of pulmonary embolism are described, with emphasis on the historical radiographic signs and the current dual-energy computed tomography innovations.
-
Sleep problems are a prominent feature in children with attention deficit hyperactivity disorder (ADHD). Unlike existing studies that focused on extreme samples (i.e. normal vs. ADHD), our study investigated the associations of sleep-related behaviours and ADHD features in nonclinical Chinese preschoolers. ⋯ Our study underpins the importance of understanding the relationship between sleep-related behaviours and ADHD characteristics before the usual age of clinical diagnosis in children with ADHD.
-
Case Reports
Ostraceous and inverse psoriasis with psoriatic arthritis as the presenting features of advanced HIV infection.
Knowledge of both the common and atypical presentations of human immunodeficiency virus (HIV)-associated dermatoses may be helpful in arousing suspicion of HIV, especially in patients with no reported risk factors. Herein, we report the case of an otherwise healthy, nonpromiscuous 29-year-old man who presented to our institution with an eight-week history of plaques with oyster shell-like scales on the trunk, extremities and genital area. The plaques were associated with fever, and intermittent knee pain and swelling. ⋯ Repeat skin punch biopsy and arthrocentesis revealed a diagnosis of psoriasis vulgaris with psoriatic arthritis. Due to the atypical presentation of psoriasis, the patient was counselled to undergo HIV testing, which came back positive. Clinicians should be attuned to the skin signs heralding HIV/acquired immunodeficiency syndrome, in order to facilitate early diagnosis and treatment.