Singap Med J
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A 31-year-old Chinese man presented with complaint of acute chest pain. 12-lead electrocardiogram (ECG) showed sinus rhythm, with widespread upward concave ST segment elevations. The ECG changes along with a history of acute chest pain in a young man with minimal coronary risk factors are suggestive of acute pericarditis. He subsequently developed a pericardial effusion. Diagnosis, treatment and complications of acute percarditis are discussed.
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Acute acalculous cholecystitis is a very rare complication of typhoid fever, and may be due to multi-drug resistant and virulent forms of Salmonella infection. It is particularly rare in adults. A 21-year-old woman, presenting with fever, vomiting, diarrhoea and abdominal pain, was found to have acute acalculous cholecystitis due to typhoid fever on basis of ultrasonographical findings and a positive Widal's test for Salmonella typhi. She was treated with antibiotics and made a full recovery.
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Microalbuminuria is a marker of increased cardiovascular morbidity and mortality. It represents the earliest clinical evidence of diabetic nephropathy. Its early detection allows for implementation of individually-tailored cardiovascular risk reduction management programmes. Despite this, information on the prevalence of microalbuminuria in hypertensive patients with type 2 diabetes mellitus in Singapore is limited. ⋯ The high prevalence (72 percent) of microalbuminuria and macroalbuminuria found in hypertensive patients with type 2 diabetes mellitus in Singapore is a cause for concern. These findings highlight the need to screen for microalbuminuria and better manage hypertensive patients with type 2 diabetes mellitus, if we are to avoid a major increase in end-stage renal disease.
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Infants and children constitute a large proportion of the population in developing countries. In Nepal, studies on drug use patterns in the paediatric age group are lacking in hospitals in the western region. The present study was carried out to obtain demographical information and information on the prescribing patterns of drugs. The antibiotic sensitivity patterns of commonly-isolated micro-organisms and the mean cost of drugs were obtained. ⋯ Prescribing by generic name should be encouraged. Use of parenteral antibiotics was high and route conversion programmes should be instituted. Use of antibiotics for predominantly viral infections should be reduced. Treatment guidelines for common conditions should be formulated.