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Introduction: Personality Disorders have been commonly associated with crimes in many studies. However, we seldom come across patients with Schizoid Personality Disorder who commit crimes in Singapore. Objectives: Here we discuss the features of schizoid personality that might be associated with criminal offences and the clinical and ethical considerations in treating them. Methods: This is a case report. We present a patient with multiple criminal offences who was diagnosed with Schizoid Personality Disorder. We highlight how his schizoid personality features led him to offending and the challenges in his treatment. Results: A 43-year-old male with schizoid personality disorder was remanded for forensic assessment. He has a history of multiple criminal offences including criminal trespass, touting, public annoyance and harassment by taking photography and videography of students without permissions. He appeared indifferent with his offences and denied any wrong doings. He was assessed to have egocentric perception of self, impaired perspective-taking skills and cognitive rigidity. These could possibly contribute to and perpetuate his eccentric behaviours and thinking patterns. Prognosis for change is poor due to limited insight into the challenges his thinking and behaviour are posing him to. Conclusions: People with schizoid personality disorder rarely seek treatment due to limited insight. There is little data on the effectiveness of treatments. Psychotherapy can be considered aiming to increase insight and motivation regarding change. Ethical principles like autonomy, social justice and public safety must be considered. [ABSTRACT FROM AUTHOR]

Presentation 1 Background/Aim: Total parathyroidectomy (TPTX) with autotransplantation (AT) and subtotal parathyroidectomy (SPTX) are considered standard surgical treatments for refractory renal hyperparathyroidism. However, there is little data available comparing the long term outcomes of these procedures, including recurrence rate and morbidity, from an area with poor access to Renal transplant. Methods: Patients with renal hyperparathyroidism who underwent TPTX + AT and SPTX in a tertiary institution from 2006-2013 were studied. Patient characteristics, pre- and post-operative biochemical marker levels, and outcomes including recurrence rates, repeat surgeries and post- operative morbidity and mortality were analyzed. Results: 88 patients underwent TPTX + AT and SPTX for renal hyperthyroidism from 2006-2013. 85 patients (96.6%) were on chronic dialysis, with a median of 7 years from initiation of hemodialysis to parathyroidectomy. 76 patients (86.4%) underwent TPTX +AT while 12 (13.6%) underwent SPTX. Serum parathyroid hormone (PTH) levels decreased after surgery, with a median difference of 192.75pmol/L and median level of 1.75pmol/L post-operatively. Length of follow-up ranged from 1-8 years, with a median time of 4 years. A total of 22 patients (25%) developed biochemical recurrence, and were mostly managed medically with the exception of 1 patient who required resection of autotransplanted parathyroid tissue in the deltoid. Median value of PTH at recurrence was 25.9 (9.4-162.4), with a median of 18 months (3-69) to recurrence. Rate of recurrence was higher in patients who underwent SPTX (41.7%) compared to TPTX (22.4%). Post-operatively, symptomatic hypocalcaemia was more common in TPTX + AT (14.5%) compared to SPTX (8.4%). Cohort mortality was 10 patients (11.4%), with 3 deaths (3.4%) secondary to cardiovascular causes. Conclusion: Total parathyroidectomy with deltoid autoimplantation is the treatment of choice in renal parathyroid patients with no access to renal transplant. [ABSTRACT FROM AUTHOR]

An outbreak of gastroenteritis affected 453 attendees (attack rate 28·5%) of six separate events held at a hotel in Singapore. Active case detection, case-control studies, hygiene inspections and microbial analysis of food, environmental and stool samples were conducted to determine the aetiology of the outbreak and the modes of transmission. The only commonality was the food, crockery and cutlery provided and/or handled by the hotel's Chinese banquet kitchen. Stool specimens from 34 cases and 15 food handlers were positive for norovirus genogroup II. The putative index case was one of eight norovirus-positive food handlers who had worked while they were symptomatic. Several food samples and remnants tested positive for Escherichia coli or high faecal coliforms, aerobic plate counts and/or total coliforms, indicating poor food hygiene. This large common-source outbreak of norovirus gastroenteritis was caused by the consumption of contaminated food and/or contact with contaminated crockery or cutlery provided or handled by the hotel's Chinese banquet kitchen.