Articles: disease.
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The demographic of Singapore has undergone dramatic change. Historically, younger patients with communicable diseases predominated, whereas patients are now older with chronic multimorbidity and functional impairment. This shift challenges existing health and social care systems in Singapore, which must pivot to meet the changing need. ⋯ These models include Acute Medical Units, Ambulatory Emergency Care, Extensivist-Comprehensivist Care, Virtual Wards, Hospital-at-Home and Acute Frailty Units. We describe these models of care across the acute care chain and explore how they may apply to the Singapore setting. We discuss how these models have evolved, appraise the evidence for clinical effectiveness, point out gaps in knowledge for further study and make recommendations for future progress.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsA Rare Complication of The Heart Rate Strap Use in A Marathon Runner: Mondor's Disease of the Breast.
This is the first case report of Mondor's disease diagnosed in a marathon runner developed due to tight heart rate strap. A 41-year female marathon runner was admitted to the hospital with a cord-like soft tissue swelling under her breast, which was confirmed by physical examination. ⋯ Doppler ultrasonography revealed a superficial non-compressible thrombosed vein compatible with Mondor's disease. Key Words: Mondor's disease, Ultrasonography, Heart rate strap.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsTakayasu Arteritis with Isolated Headache and Neck Pain.
Takayasu Arteritis (TA), a chronic inflammatory condition of the aorta and its major branches, causes narrowing and ultimate occlusion of major vessels and may manifest as cerebrovascular insufficiency, organ ischemia, and systemic arterial hypertension (HTN). Herein, we report a case of a 35-year female with the pulseless disease but no other clinical signs except headache and neck pain on exertion despite the fact that three out of four vessels of the aortic arch were occluded. ⋯ This case report highlights the clinical importance of unexplained headaches and absent peripheral pulses in the screening of TA. Key Words: Takayasu arteritis, Unexplained headache, Neck pain.
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HIV infections have always been a stigma, and the majority of transplant centres avoid liver transplantation in patients having end-stage liver disease patients with HIV coinfection. HIV patients with end-stage liver disease having undetectable HIV viral load, CD4+ cell count of >100/ml, and negative history of AIDS-specific opportunistic infections are considered suitable candidates for liver transplantation. Fulfilling the above-mentioned criteria, we performed successful living donor liver transplantation (LDLT) procedure on a 58-year-old gentleman who presented with end-stage liver disease and HIV coinfection. Key Words: HIV, Living donor, Liver transplantation.