Duane Retraction Syndrome With Mechanical and Innervational Upshoot and Secondary Superior Rectus Contracture: A Surgical Challenge.

Duane retraction syndrome (DRS) with mechanical and innervational upshoot poses a surgical challenge. We discuss a case of DRS with mechanical and innervational upshoot and its surgical management. An 11-year-old boy presented with left eye upward deviation since birth.

Optic Neuropathy in an Autistic Child With Vitamin A Deficiency: A Case Report and Literature Review.

An eight-year-old boy with autism developed gradual onset of vision loss and nyctalopia. Dietary history revealed a diet of only French fries and potato chips for the past four years. As a result, serum vitamin A was severely below the normal level.

No hospital is an island - emerging new roles of the acute general hospital in the Singapore healthcare ecosystem.

General hospitals in Singapore are undergoing a process of transformation, from being siloed providers of acute care, into vital hubs of a regional health system that integrates community and hospital-based care to meet the health and social needs of the population. Collaborations between the acute hospitals and other community providers, such as primary care and nursing homes, have been strengthened through clinical leadership supported by government policies that enable the sharing of key hospital clinical resources throughout the community. These collaborations have enabled better use of hospital resources while strengthening the capabilities of regional healthcare providers.

Effectiveness of a national transitional care program in reducing acute care use.

This study evaluated the effectiveness of a national transitional care program for elderly adults with complex care needs and limited social support. The Aged Care Transition (ACTION) Program was designed to improve coordination and continuity of care and reduce rehospitalizations and visits to emergency departments (EDs). Dedicated care coordinators provided coaching to help individuals and families understand the individuals' conditions, effectively articulate their preferences, and enable self-management and care planning.

Demographic and lifestyle characteristics associated with non-willingness to participate in health promotion programmes among adults of a lower socioeconomic status in Singapore.

Introduction/objective: Lower socioeconomic groups have been found to have poorer health outcomes and engage in fewer health promoting behaviours. Understanding the reasons behind adverse lifestyle habits and non-willingness to participate in health promotion programmes among lower socioeconomic groups will enable administrators to modify the programmes and increase participation in this population. This study aimed to determine reasons for non-exercise, smoking and non-willingness to participate, and characteristics associated with non-willingness to participate in health promotion programmes among residents in Singapore.

Self-reported chronic diseases and health status and health service utilization--results from a community health survey in Singapore.

Objective: To report the extent of self-reported chronic diseases, self-rated health status (SRH) and healthcare utilization among residents in 1-2 room Housing Development Board (HDB) apartments in Toa Payoh.

Materials & Methods: The study population included a convenience sample of residents from 931 housing development board (HDB) units residing in 1-2 room apartments in Toa Payoh. Convenience sampling was used since logistics precluded random selection.

Geriatric syndromes and depressed mood in lower-income Singaporeans with diabetes: implications for diabetes management and health promotion.

Introduction: This study aims to determine the association of geriatric syndromes and depressed mood among respondents with diabetes in a lower income community; and their association with self-management, lifestyle behaviour, and healthcare utilisation. This paper focuses primarily on the 114 respondents with diabetes aged 50+ to inform policy formulation at the community level.

Materials And Methods: A pilot community health assessment was conducted in 4 blocks of 1- and 2-room apartments in Toa Payoh district from July to November 2009.

The evolving role of the community pharmacist in chronic disease management - a literature review.

Introduction: We appraised the roles and responsibilities assigned to community pharmacists internationally and in Singapore.

Materials And Methods: A systematic search of international peer-reviewed literature was undertaken using Medline. Grey literature was identified through generic search engines.

Using spatial accessibility to identify polyclinic service gaps and volume of under-served population in Singapore using Geographic Information System.

Primary care services in Singapore are provided by 18 Government-funded polyclinics and about 1200 private General Practitioners (GPs). This study aims to examine the spatial accessibility to polyclinics and identify service gaps, and suggest optimal sites using Geographic Information System (GIS) to aid in future planning. A national database containing 3.

The Singapore National Healthcare Group Diabetes Registry--descriptive epidemiology of type 2 diabetes mellitus.

Introduction: The National Healthcare Group (NHG) launched an enterprise-wide diabetes registry in 2007. We describe the epidemiology of type 2 diabetes mellitus from 2005 to 2008.

Materials And Methods: Patients with encounters in NHG from 2005 were identified for inclusion into the Diabetes Registry from existing stand-alone diabetes registries, ICD9CM diagnosis codes, anti-hyperglycaemic medication and laboratory confirmation.

Bridging the gap between primary and specialist care--an integrative model for stroke.

Stroke is a major cause of death and disability in Singapore and many parts of the world. Chronic disease management programmes allow seamless care provision across a spectrum of healthcare facilities and allow appropriate services to be brought to the stroke patient and the family. Randomised controlled trials have provided evidence for efficacious interventions.

Measuring the quality of care of diabetic patients at the specialist outpatient clinics in public hospitals in Singapore.

Introduction: This study aims to measure the quality of care for patients with diabetes mellitus at selected Specialist Outpatient Clinics (SOCs) in the National Healthcare Group.

Materials And Methods: The cross-sectional study reviewed case-records of patients from 6 medical specialties who were on continuous care for a minimum of 15 months from October 2003 to April 2005. Disproportionate sampling of 60 patients from each specialty, excluding those co-managed by Diabetes Centres or primary care clinics for diabetes, was carried out.