Complete Pectoralis Major Tendon Rupture in a Calisthenics Athlete: A Case Report

We report a rare case of pectoralis major rupture during a body weight calisthenics exercise that was treated surgically. We highlighted the rehabilitation protocol which enabled him to regain full strength and return to his sport in three months.

Clinical evaluation of risperidone in Asian patients with schizophrenia in Singapore

OBJECTIVE

To evaluate the short-term efficacy and safety of risperidone in a group of Asian patients with schizophrenia in an 8-week open-label, prospective study.

METHODS

Patients with DSM-IV schizophrenia were recruited from Woodbridge Hospital. After a washout period, they were started on a 56-day trial of risperidone. Outcome was assessed with the positive and negative syndrome scale (PANSS), the clinical global impression scale (CGI) and the extrapyramidal symptom rating scale (ESRS).

RESULTS

The mean daily risperidone dose at end point was 5.6 mg (range, 3 to 8 md/day). Mean PANSS scores were reduced significantly from 78 +/- 15.1 at baseline to 56.6 +/- 10.9 at end point. Seventeen patients (85%) who were treatment responders, showed at least a 20% reduction in total PANSS scores at end point while nine patients (45%) had a greater than 50% reduction in the total PANSS scores. According to the CGI scale, 85% improved at end point. The severity of extrapyramidal symptoms (mean ESRS scores) were significantly lower at end point than at baseline.

CONCLUSIONS

Risperidone was effective in the treatment of positive and negative symptoms of schizophrenia.

Initial experience with clozapine in Woodbridge Hospital

OBJECTIVES

This study was performed to evaluate the efficacy and side-effect profile of the atypical neuroleptic clozapine in local Asian patients with treatment-resistant schizophrenia.

METHOD

Patients were treated with 12 weeks of clozapine after undergoing a washout of all previous neuroleptics. They were assessed weekly on the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and the Simpson-Angus Scale for Extrapyramidal Side-Effects.

RESULTS

Clinical improvement (according to criteria established a priori) at study end point was shown in 78.9% of the patients. There was no statistical difference in the incidence of the extrapyramidal side-effects at starting and end points. The mean daily dosage was 356.6 mg. The most common adverse effect was hypersalivation.

CONCLUSION

Clozapine is effective and well tolerated in local patients with treatment-resistant schizophrenia.

Profile of patients seeking psychiatric treatment from the adult public mental health services in Singapore

This study examined the characteristics of patients seeking help from public mental health services and changes in the utilisation of the services over time. The sample included 198 consecutive new referrals above the age of 15 years to the adult psychiatric services provided by Woodbridge Hospital and the Institute of Mental Health from 1 January 1995 and followed up over a one-year period. The most common reason for seeking psychiatric treatment was for abnormal behaviour (26%) and the most common diagnostic group was schizophrenia/paranoid disorder (21.1%). The medical sector was the most common source of referral (56%). The primary health care services referred significantly more patients with anxiety disorders while the police and relatives/friends referred significantly more patients with schizophrenia/paranoid disorder. About one-third of the sample made their first contact with the services at the 24-hour Admission Room. One third received inpatient treatment after their first consultation and those with schizophrenia/paranoid disorders were more likely to be admitted (P < 0.05). At the end of one year, 23.2% remained in the services. There were significantly more elderly patients and those suffering from schizophrenia/paranoid disorder maintaining contact with the services after one year.

Immunogenicity of a plasma-derived hepatitis B vaccine in children and adults

Immunisation of health care workers and staff working in laboratory and hospital settings has been implemented since 1988. However due to the high cost of currently available HBV vaccine, many health personnel outside the Ministry of Health are not being immunised. This study sought to determine the immunogenicity of three doses of a low cost plasma-derived Korean HBV vaccine on employees of an institute for mentally handicapped and their spouses and children. We found that the Hepatitis B Vaccine-KGCC to be safe and immunogenic. The response to 10 mcg and 20 mcg Hepatitis B Vaccine-KGCC after third dose was good with 100% seroconversion.