Factors influencing quality of life of Asian breast cancer patients and their caregivers at diagnosis: perceived medical and psychosocial needs.
CONCLUSION: Patients and caregivers have similar perceptions of needs at diagnosis. A supportive healthcare team can positively influence patients' QoL, highlighting the importance of tailoring support according to needs. PMID: 31423539 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - August 16, 2019 Category: General Medicine Authors: Chow WL, Tan SM, Aung KCY, Chua SYN, Sim HC Tags: Singapore Med J Source Type: research

The impact of caregiving on caregivers of older persons and its associated factors: a cross-sectional study.
CONCLUSION: Most caregivers gained satisfaction and felt supported in caregiving. Ethnicity and education level were associated with a caregiver being burdened. PMID: 31423540 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - August 16, 2019 Category: General Medicine Authors: Aman Z, Liew SM, Ramdzan SN, Philp I, Khoo EM Tags: Singapore Med J Source Type: research

Cross-sectional study of perceptions of qualities of a good medical teacher among medical students from first year to final year.
Abstract INTRODUCTION: Defining the characteristics of a good medical teacher has implications for faculty selection and development. Perceptions of characteristics may differ with cultural context and level of training, as medical students progress from didactic preclinical training based on cognitivist learning theory to more complex integration of theory and practice in specific contexts in clinical training based on constructivist learning theory. METHODS: We modified a validated questionnaire with permission from the original authors at Melaka Manipal Medical College, Melaka, Malaysia. Participants rated...
Source: Singapore Medical Journal - August 16, 2019 Category: General Medicine Authors: Low MJW, Khoo KSM, Kuan WS, Ooi SBS Tags: Singapore Med J Source Type: research

Integrating Advance Care Planning as part of Comprehensive Geriatric Assessment for hospitalised frail elderly patients: findings of a cross-sectional study.
Abstract INTRODUCTION: The integration of Advance Care Planning (ACP) as part of Comprehensive Geriatric Assessment (CGA) of hospitalised frail elderly patients, together with the clinical and demographic factors that determine successful ACP discussion, has not been previously explored. METHODS: A cross-sectional study on patients and family caregivers admitted under the geriatric medicine department of a tertiary hospital was conducted from October 2015 to December 2016. RESULTS: Among 311 eligible patients, 116 (37.3%) patients completed ACP discussion while 166 (53.4%) patients declined, of which 62 ...
Source: Singapore Medical Journal - August 16, 2019 Category: General Medicine Authors: Yip KF, Wong TH, Alhamid SM, Nadkarni N, Tan CKG, Pang A, Seow CCD Tags: Singapore Med J Source Type: research

Beneficial effects of early administration of recombinant human B-type natriuretic peptide in ST-elevation myocardial infarction patients receiving percutaneous coronary intervention treatment.
Abstract INTRODUCTION: We aimed to evaluate the clinical performance of early administration of recombinant human B-type natriuretic peptide (rhBNP) to ST-elevation myocardial infarction (STEMI) patients receiving percutaneous coronary intervention (PCI) treatment. METHODS: In total, 185 patients diagnosed with STEMI were enrolled and randomised into either the placebo-treated (n = 88) or rhBNP-treated (n = 97) group. Patients were given either saline or rhBNP 10 minutes before PCI and monitored with various cardiac parameters, including accelerated idioventricular rhythm, frequent ventricular premature beat ...
Source: Singapore Medical Journal - August 7, 2019 Category: General Medicine Authors: Wang L, Xie L, Wei X, Xie Z Tags: Singapore Med J Source Type: research

Evaluating the educational environment in a Singaporean residency programme: can we help reduce burnout rates?
CONCLUSION: Although our programme had a good EE, there were also areas of weaknesses revealed by specific questions, possibly contributing to burnout. We hope to implement interventions to these areas and subsequently assess for longitudinal changes in EE and burnout rates. PMID: 31388684 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - August 7, 2019 Category: General Medicine Authors: Ong AML, Fong WW, Chan AK, Phua GC, Tham CK Tags: Singapore Med J Source Type: research

Case control study of risk factors and ophthalmological outcomes of very low birth weight infants with Type 1 retinopathy of prematurity.
CONCLUSION: Increased episodes of blood transfusions and chronic lung disease requiring high oxygen supplementation at 7-10 weeks of life are significant risk factors associated with Type 1 ROP in VLBW infants in our study. Strabismus at four years is more common in this group of patients. This study highlights the importance of long-term ophthalmologic surveillance for these high-risk children. PMID: 31388685 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - August 7, 2019 Category: General Medicine Authors: Ng T, Wong IB, Ngo CS, Niduvaje K, Ngiam XY, Sensaki S, Lee LY Tags: Singapore Med J Source Type: research

Cost-effectiveness analysis of antiviral treatment for pregnant women with high viral load to prevent hepatitis B virus vertical transmission.
CONCLUSION: By analysing the decision-making process, our result explained the current low uptake rates of antenatal antiviral treatment for HBV among pregnant women. We also concluded that from the health system's perspective, it was worth providing subsidy for perinatal antiviral treatment to prevent huge expenses generated in the future by chronic HBV complications. PMID: 31388686 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - August 7, 2019 Category: General Medicine Authors: Ma T, Lee LY, Aw MM, Lee GH Tags: Singapore Med J Source Type: research

New peril on our roads: a retrospective study of electric scooter-related injuries.
CONCLUSION: The incidence of electric scooter-related injuries appears to be on the rise and may potentially incur significant morbidity and healthcare costs. Further efforts at safety education and enforcement should be made to prevent accidents and minimise the impact of these injuries. PMID: 31363782 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 30, 2019 Category: General Medicine Authors: Liew YK, Wee CPJ, Pek JH Tags: Singapore Med J Source Type: research

Injury patterns associated with personal mobility devices and electric bicycles: an analysis from an acute general hospital in Singapore.
Abstract INTRODUCTION: The increasing popularity of personal mobility devices (PMDs) and electric bicycles (e-bikes) in Singapore has met with growing public concern over safety. Following the passing of the Active Mobility Bill, there remains a gap in the local literature in terms of injury patterns arising from the use of these devices. METHODS: A retrospective study was conducted on the Singapore National Trauma Registry (SNTR) from the emergency department of an acute hospital from 1 January to 31 December 2016. All patients with injuries related to the use of PMDs and e-bikes were included. Data captured...
Source: Singapore Medical Journal - July 30, 2019 Category: General Medicine Authors: Cha Sow King C, Liu M, Patel S, Goo TT, Lim WW, Toh HC Tags: Singapore Med J Source Type: research

Short- and long-term predictors of spontaneous bacterial peritonitis in Singapore.
CONCLUSION: N-SBP was significantly associated with recent antibiotic use, longer hospitalisation, more resistant organisms and poorer survival among patients with SBP. N-SBP and MELD score predict higher mortality in SBP. Judicious use of antibiotics may reduce N-SBP and improve survival among cirrhotic patients. PMID: 31363784 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 30, 2019 Category: General Medicine Authors: Wong YJ, Kalki RC, Lin KW, Kumar R, Tan J, Teo EK, Li JW, Ang TL Tags: Singapore Med J Source Type: research

A descriptive study of the effect of a disciplinary proceeding decision on medical practitioners' practice behaviour in the context of providing a hydrocortisone and lignocaine injection.
CONCLUSION: The study demonstrated how a disciplinary decision can affect practice behaviour, and specifically how doctors may choose to not offer a service, an example of defensive medicine through avoidance behaviour. It also showed how prices for a service can rise following such a decision, which demonstrates the concept of negative general deterrence in sentencing. PMID: 31363785 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 30, 2019 Category: General Medicine Authors: Wong CY, Surajkumar S, Lee YV, Tan TL Tags: Singapore Med J Source Type: research

Knowledge and attitudes of healthcare professionals and the impact on willingness to donate organs: a tertiary hospital survey.
Abstract INTRODUCTION: Healthcare professionals (HCPs) working in critical care areas play an important role in the organ donation (OD) process. We studied HCPs' own willingness to be organ donors and its association with sociodemographic factors as well as their knowledge and attitudes about OD and transplantation. METHODS: A cross-sectional survey of HCPs working in four critical care units in a major transplant centre in Malaysia was undertaken using a validated structured questionnaire. Responses were analysed using multivariable analysis with willingness to donate as the dependent variable. RESULTS:...
Source: Singapore Medical Journal - July 22, 2019 Category: General Medicine Authors: Oo WL, Ong JS, Fong JW, Hossain MM, Baskaran ND, Haron H, Varadarajan R Tags: Singapore Med J Source Type: research

Self-reported hypoglycaemia in insulin-treated patients with diabetes mellitus: Results from the Singapore cohort of the International Operations Hypoglycaemia Assessment Tool study.
CONCLUSION: High proportions of insulin-treated patients with diabetes mellitus in Singapore reported hypoglycaemic events prospectively, showing that they had underreported hypoglycaemic episodes retrospectively. Patient education can help in improving hypoglycaemia awareness and its management in the region. PMID: 31328239 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 22, 2019 Category: General Medicine Authors: Tan NC, Goh SY, Khoo EY, Dalan R, Koong A, Khoo CM, Tan TS, Jain AB, Gadekar AV, Bee YM, IO HAT Investigator group Tags: Singapore Med J Source Type: research

Incidence and analysis of sharps injuries and splash exposures in a tertiary hospital in Southeast Asia: a ten-year review.
CONCLUSION: Overall incidence of SISE decreased over the decade. Improved training and increasing use of safety devices, education and awareness could have contributed to the fall in incidence of sharps injuries; these measures should be reinforced and continued. However, the incidence of splash exposures increased over the same period. Preventive measures such as the use of protective goggles and face shields, together with personal protective equipment, should be emphasised and encouraged. PMID: 31328240 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 22, 2019 Category: General Medicine Authors: Leong XYA, Yee FZY, Leong YY, Tan SG, Amin IBM, Ling ML, Tay SM Tags: Singapore Med J Source Type: research

Patients' feedback on the Changi General Hospital tinnitus counselling protocol.
CONCLUSION: Most patients found the counselling helpful at follow-up. Counselling offered them the opportunity to actively manage their tinnitus. PMID: 31317196 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 11, 2019 Category: General Medicine Authors: Lim JJBH, Lu PKS, Koh DSQ Tags: Singapore Med J Source Type: research

Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centre.
CONCLUSION: Cancer and iatrogenic complications were the most common causes of pericardial effusion in this large cohort of Singapore patients. Pericardiocentesis has a high success rate and relatively low complication rate. Prognosis and clinical course after pericardiocentesis is determined by the underlying cause of pericardial effusion. PMID: 31317197 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 11, 2019 Category: General Medicine Authors: Cheong XP, Law LKP, Seow SC, Tay LWE, Tan HC, Yeo WT, Low AF, Kojodjojo P Tags: Singapore Med J Source Type: research

Serum S100 β as a predictor of severity and outcomes for mixed subtype acute ischaemic stroke.
Serum S100β as a predictor of severity and outcomes for mixed subtype acute ischaemic stroke. Singapore Med J. 2019 Jul 11;: Authors: Sakdejayont S, Pruphetkaew N, Chongphattararot P, Nanphan P, Sathirapanya P Abstract INTRODUCTION: Serum S100β levels are mostly used for predicting outcomes of large vessel stroke (LVS). Its application for mixed subtypes of acute ischaemic stroke (AIS) is limited. METHODS: Patients with mixed subtype of AIS, aged over 18 years, who presented within 24 hours of stroke onset were consecutively enrolled. Serum S100β levels at presentation (S100βb...
Source: Singapore Medical Journal - July 11, 2019 Category: General Medicine Authors: Sakdejayont S, Pruphetkaew N, Chongphattararot P, Nanphan P, Sathirapanya P Tags: Singapore Med J Source Type: research

Generation of IgE-specific cytotoxic T lymphocytes as a novel immunotherapeutic approach for the treatment of allergic asthma.
CONCLUSION: IgE-specific CTLs generated ex vivo may provide a novel treatment for allergic asthma and lead to a new therapy for other immunological disorders. PMID: 31317199 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 11, 2019 Category: General Medicine Authors: Cui K, Chen Y, Zhou L, Yang C, Du Y, Shi W, Cai Z, Chen J Tags: Singapore Med J Source Type: research

Impact of an interstitial lung disease service in the diagnosis and management of interstitial lung disease in Singapore.
CONCLUSION: The ILD service allowed for more precise subtyping of various ILDs, particularly IPF, where patients can benefit from antifibrotic therapies. PMID: 31317200 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - July 11, 2019 Category: General Medicine Authors: Chai GT, Tan TC, Lee YS, Kaw GJ, Chuah KL, Lim YJ, Abisheganaden JA, Thong BY Tags: Singapore Med J Source Type: research

Medicine and artificial intelligence: a strategy for the future, employing Porter's classic framework.
PMID: 31197371 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Liew CJ Tags: Singapore Med J Source Type: research

Airway management in inhalation injury: a case series.
We present a case series of five patients with inhalational burns who presented to Singapore General Hospital and discuss our approach to their early management, including early evaluation and planning for the upper and lower airway, coexisting cutaneous burns, and monitoring their ICU (intensive care unit) severity of illness, sepsis and acute respiratory distress syndrome. All five patients suffered various grades of inhalation injury. The patients were initially assessed by nasolaryngoscopy, and three patients were prophylactically intubated before being sent to the emergency operating theatre for definitive airway and ...
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Desai SR, Zeng D, Chong SJ Tags: Singapore Med J Source Type: research

Validation of the World Health Organization Disability Assessment Schedule 2.0 among older adults in an Asian country.
CONCLUSION: WHODAS 2.0 was found to be a valid measure of disability among older adults. However, further research is required to determine its usefulness as a responsive instrument that can detect change following interventions. PMID: 31197373 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Subramaniam M, Abdin E, Vaingankar JA, Sagayadevan V, Shahwan S, Picco L, Chong SA Tags: Singapore Med J Source Type: research

Review of systems for recognising and responding to clinical deterioration in Singapore hospitals: a nationwide cross-sectional study.
CONCLUSION: A variance exists in supporting the system of recognising and responding to clinical deterioration. This calls for a national approach to enable the standardisation of clinical processes, sharing of educational resources and multisite evaluation. PMID: 31197374 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Liaw SY, Tee A, Carpio GAC, Ang SBL, Chua WL Tags: Singapore Med J Source Type: research

Scoping review and international multi-centre cohort study investigating teaching, knowledge and beliefs regarding physical activity as a health intervention among medical students: a comparison between Singapore and the UK.
CONCLUSION: There is considerable room for improvement in the knowledge of WHO guidelines and the role of PA in health. Education should begin during the undergraduate phase so that future doctors are better equipped to counsel their patients. PMID: 31197375 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Chew EJC, Ho YN, Kee GJ, Sirisena D Tags: Singapore Med J Source Type: research

Renal cortical stiffness is markedly increased in pre-diabetes mellitus and associated with albuminuria.
CONCLUSION: CS values are significantly higher in patients with impaired glucose metabolism. We recommend CS measurement as part of routine screening of nephropathy in patients with pre-DM and newly diagnosed Type II DM. PMID: 31197376 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Sumbul HE, Koc AS, Gülümsek E Tags: Singapore Med J Source Type: research

Nicotine dependence treatment: provision of a dedicated programme by the National Addictions Management Service.
Abstract Smoking is the top cause of death among lifestyle habits and continues to affect more than one billion people around the world. The current gold standard for smoking cessation is a combination of pharmacological and behavioural approaches. In March 2017, the National Addictions Management Service, Singapore, initiated a smoking cessation programme that combined the pharmacological treatment options of either nicotine replacement therapy, bupropion or varenicline with individual counselling to achieve optimal results. Treatment is customised to the individual based on demographics, individual preferences, ...
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Low LTK, Ng CWL, Lee C Tags: Singapore Med J Source Type: research

Electroconvulsive practice in Singapore: a cross-sectional national survey.
CONCLUSION: The practice of ECT in Singapore was highly uniform. The rates and indications for ECT were consistent with other developed countries, with more use for schizophrenia. Future advances for ECT in Singapore include the use of individualised dosing based on empirical seizure threshold titration, expanded electrode placements and increased utilisation of continuation/maintenance ECT. PMID: 31197378 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Tor PC, Gálvez V, Ang A, Fam J, Chan HN, Tan SN, Loo CK Tags: Singapore Med J Source Type: research

Effectiveness of near-peer simulation for managing the acutely deteriorating patient among residents of an internal medicine junior residency programme.
CONCLUSION: Near-peer simulation training was found to be a viable and valuable method of instruction for first-year residents for increasing experience, instilling confidence and improving perceived knowledge. Integration of such programmes within medical education curricula shows good promise of continuity, with many first-year residents inspired to organise subsequent sessions. PMID: 31197379 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Shen X, Tay BWR, Tan BY, Ngiam NJ, Mok JSR, Mok SF, Yap ES, Khoo SM Tags: Singapore Med J Source Type: research

Clinical spectrum, treatment and outcomes of uveal melanoma in a tertiary centre.
CONCLUSION: Our study supports the finding that UM in Chinese and Asian-Indian patients presents at a younger age than in Caucasians. Although rare, ophthalmologists should remain mindful of this life-threatening disease. We propose a national and regional registry for ocular tumours with genetic information to characterise the disease spectrum in Southeast Asia. PMID: 31197380 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Wong W, Sundar G, Chee C, Zhao PS, Rajagopalan R, Gopal L Tags: Singapore Med J Source Type: research

Singapore SPICE: Sedation Practices in Intensive Care Evaluation in Singapore - a prospective cohort study of the public healthcare system.
CONCLUSION: Sedation practices in Singapore ICUs are characterised by light sedation depth and low incidence of delirium. This may be due to the drugs used. PMID: 31197381 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 14, 2019 Category: General Medicine Authors: Ng SY, Phua J, Wong YL, Kalyanasundaram G, Mukhopadhyay A, Lim D, Chia N, Ho BCH, Bailey MJ, Shehabi Y, Ti LK Tags: Singapore Med J Source Type: research

Getting patient blood management Pillar 1 right in the Asia-Pacific: a call for action.
We examined PBM implementation under four different healthcare systems, identified challenges and proposed several measures. (a) Test for anaemia once patients are scheduled for surgery. (b) Inform patients about risks of preoperative anaemia and benefits of treatment. (c) Treat IDA and replenish iron stores before surgery, using intravenous iron when oral treatment is ineffective, not tolerated or rapid iron replenishment is needed; transfusion should not be the default management. (d) Harness support from multiple medical disciplines and relevant bodies to promote PBM implementation. (e) Demonstrate better outcomes and c...
Source: Singapore Medical Journal - May 2, 2019 Category: General Medicine Authors: Abdullah HR, Ang AL, Froessler B, Hofmann A, Jang JH, Kim YW, Lasocki S, Lee JJ, Lee SY, Lim KKC, Singh G, Spahn DR, Um TH, Asia-Pacific PBM Expert Consensus Meeting Working Group Tags: Singapore Med J Source Type: research

Lateral versus central tendon-splitting approach to insertional Achilles tendinopathy: a retrospective study.
CONCLUSION: Both approaches had comparable outcomes for IAT in terms of functional improvement, pain relief, overall enhancement of patients' health condition and overall postoperative complication rate. The LA provided better short-term pain relief and reduced delayed wound healing compared with the CA. PMID: 31044256 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 2, 2019 Category: General Medicine Authors: Xia Z, Yew KSA, Zhang TK, Rikhraj IS Tags: Singapore Med J Source Type: research

Impact of 24-hour specialist coverage and an on-site CT scanner on the timely diagnosis of acute aortic dissection.
CONCLUSION: The availability of 24-hour ED specialist coverage and an on-site CT scanner improved the diagnosis of AAD in our study. PMID: 31044257 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 2, 2019 Category: General Medicine Authors: Ibrahim I, Chua MT, Tan DW, Yap SH, Shen L, Ooi SBS Tags: Singapore Med J Source Type: research

What do caregivers value and is there agreement in perception of met needs between nurses and caregivers?
CONCLUSION: Although caregivers valued reassurance the most, there was poor agreement between acute care nurses and caregivers in the perception of caregiver needs being met. Hence, more attention should be paid to the caregiver's needs. Further studies can examine reasons for unmet caregiver needs and interventions to improve support for them. PMID: 31044258 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 2, 2019 Category: General Medicine Authors: Towle RM, Tan CG, Saptu K, Ong LJ, Yap MM, Kheng JH, Low LL Tags: Singapore Med J Source Type: research

Factors associated with inappropriate attendances at the emergency department of a tertiary hospital in Singapore.
CONCLUSION: This study identified subgroups in the population who were more likely to contribute to IAs at the ED. These findings offer relevant insights into future research directions and strategies that might potentially reduce avoidable IAs. PMID: 31044259 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 2, 2019 Category: General Medicine Authors: Oh HC, Chow WL, Gao Y, Tiah L, Goh SH, Mohan T Tags: Singapore Med J Source Type: research

Efficacy and safety of denosumab compared to bisphosphonates in improving bone strength in postmenopausal osteoporosis: a systematic review.
This study aimed to evaluate the efficacy and safety of denosumab compared to bisphosphonates in treating postmenopausal osteoporosis. METHODS: Databases including PubMed and the Cochrane Central Register of Controlled Trials were systematically searched for randomised controlled trials (RCTs) that directly compared denosumab and bisphosphonates. RCTs that studied both denosumab and bisphosphonates in postmenopausal women with osteoporosis and had a Jadad score ≥ 3 were included. RESULTS: Nine studies were eligible for inclusion. They were further categorised into six cohort groups. All studies had denosumab w...
Source: Singapore Medical Journal - March 11, 2019 Category: General Medicine Authors: Chandran T, Venkatachalam I Tags: Singapore Med J Source Type: research

Associated factors of blood transfusion for Caesarean sections in pure placenta praevia pregnancies.
This study aimed to evaluate associated factors of blood transfusion for Caesarean sections in pure placenta praevia pregnancies. METHODS: A case-control study was conducted among 405 pregnant women with placenta praevia who underwent Caesarean delivery between August 2004 and December 2013. 135 of the women received blood transfusions. Another 270 women who did not receive any blood transfusion were randomly selected and served as controls. Maternal demographic data, reproductive history, antepartum profiles and obstetric outcomes were compared between the two groups. RESULTS: Women in the case group were signif...
Source: Singapore Medical Journal - March 11, 2019 Category: General Medicine Authors: Titapant V, Chongsomboonsuk T Tags: Singapore Med J Source Type: research

Relation of blood pressure variability to left ventricular function and arterial stiffness in hypertensive patients.
We examined the impact of daytime systolic BP variability on left ventricular (LV) function and arterial stiffness in hypertensive patients. METHODS: Ambulatory BP monitoring (ABPM) and echocardiography were performed in 116 hypertensive patients. We assessed BP variability as standard deviations of daytime systolic BP on 24-hour ABPM. Conventional echocardiographic parameters, area strain and 3D diastolic index (3D-DI) using 3D speckle tracking were measured. Arterial stiffness was evaluated by acquiring pulse wave velocity (PWV) and augmentation index. RESULTS: Patients with higher BP variability showed signifi...
Source: Singapore Medical Journal - March 11, 2019 Category: General Medicine Authors: Shin SH, Jang JH, Baek YS, Kwon SW, Park SD, Woo SI, Kim DH, Kwan J Tags: Singapore Med J Source Type: research

The effects of gel-based manicure on pulse oximetry.
CONCLUSION: Gel-based manicures can result in overestimations of actual readings, delaying detection of hypoxaemia. Gel nail polish should be routinely removed or an alternative monitoring technique sought. PMID: 30854571 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 11, 2019 Category: General Medicine Authors: Yek JJL, Abdullah HR, Goh JPS, Chan YW Tags: Singapore Med J Source Type: research

Vulvar basal cell carcinoma: clinical features and treatment outcomes from a tertiary-care centre.
Abstract We retrospectively reviewed the clinical features, management and outcomes of patients diagnosed with basal cell carcinoma (BCC) of the vulva at the Gynaecological Cancer Centre, KK Women's and Children's Hospital, Singapore, between 1 January 2000 and 28 February 2014. Patients with vulvar BCC were identified from the cancer registry, and their medical records reviewed and analysed. A total of 11 patients with vulvar BCC were identified. Mean age at diagnosis was 63 (range 30¬-85) years. Ethnically, ten patients were Chinese and one was Malay. Average time from onset of symptoms to diagnosis was 13.8...
Source: Singapore Medical Journal - February 18, 2019 Category: General Medicine Authors: Namuduri RP, Lim TY, Yam PK, Gatsinga R, Lim-Tan SK, Chew SH, Koh MJ, Mansor S Tags: Singapore Med J Source Type: research

Cholesterol goal achievement and lipid-lowering therapy in patients with stable or acute coronary heart disease in Singapore: results from the Dyslipidemia International Study II.
Abstract INTRODUCTION: Dyslipidaemia is a major risk factor for coronary heart disease (CHD). There is a lack of data on the extent of lipid abnormalities and lipid-lowering therapy (LLT) in Singapore. METHODS: The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation. RESULTS: 325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126...
Source: Singapore Medical Journal - February 18, 2019 Category: General Medicine Authors: Poh KK, Chin CT, Tong KL, Tan JKB, Lim JS, Yu W, Horack M, Vyas A, Lautsch D, Ambegaonkar B, Brudi P, Gitt AK Tags: Singapore Med J Source Type: research

Endoscopic submucosal dissection of colorectal neoplasms: an audit of its safety and efficacy in a single tertiary centre in Singapore.
CONCLUSION: Our early outcome data was comparable to that from large published series. ESD is an effective and feasible treatment for colorectal lesions. PMID: 30773601 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - February 18, 2019 Category: General Medicine Authors: Li JW, Ang TL, Wong LM, Kuek ABE, Tan MTK, Fock KM, Teo EK Tags: Singapore Med J Source Type: research

High-sensitivity troponin T and long-term adverse cardiac events among patients presenting with suspected acute coronary syndrome in Singapore.
CONCLUSION: Patients with 0-, 2- or 7-hour hsTnT ≥ 30 ng/L and 0-2 hour delta-hsTnT ≥ 10 ng/L had PPV> 50% for 30-day and one-year MACE, and should be investigated thoroughly. PMID: 30773602 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - February 18, 2019 Category: General Medicine Authors: Lin Z, Lim SH, Chua SJT, Tai ES, Chan YH, Richards AM Tags: Singapore Med J Source Type: research

Parental knowledge and beliefs on the use of child car restraints in Singapore: a qualitative study.
CONCLUSION: Non-compliance to CCR use is multidimensional, including multiple potentially modifiable factors. This study could inform ongoing collaborative injury prevention efforts among healthcare professionals, industry partners and the traffic police, using public education and outreach to reduce the burden of road traffic injuries. PMID: 30773603 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - February 18, 2019 Category: General Medicine Authors: Tan RMR, Dong C, Shen GQ, Feng JXY, Piragasam R, Tyebally A, Chong SL Tags: Singapore Med J Source Type: research

Colonic stenting for malignant large bowel obstruction is safe and effective: a single-surgeon experience.
Abstract INTRODUCTION: Self-expanding metal stents (SEMS) can be used as a bridge to surgery (BTS) or for palliation in the treatment of malignant large bowel obstruction. This case series evaluates the short-term outcomes of SEMS and success rates over time. METHODS: A total of 75 consecutive patients who underwent colonic stenting for malignant colonic obstruction over a period of six years were included. This time period was subdivided into two equal parts for analysis. The procedure was carried out by a single surgeon from a tertiary institution in Singapore. RESULTS: Technical success was reported i...
Source: Singapore Medical Journal - January 15, 2019 Category: General Medicine Authors: Tang MH, Ross T, Yeo SA, Ng CY Tags: Singapore Med J Source Type: research

Initial experience of laparoscopic right hemicolectomy with complete mesocolic excision in Singapore: a case series.
CONCLUSION: Our initial experience with lapCME confirms the feasibility and safety of the procedure. PMID: 30644524 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - January 15, 2019 Category: General Medicine Authors: Ho ML, Chong C, Yeo SA, Ng CY Tags: Singapore Med J Source Type: research

Can we understand population healthcare needs using electronic medical records?
CONCLUSION: Pre-existing EMR systems may not capture sufficient information for reliable determination of healthcare needs. Thus, we should consider integrating policy-relevant healthcare need variables into EMRs. PMID: 30644525 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - January 15, 2019 Category: General Medicine Authors: Chong JL, Low LL, Chan DYL, Shen Y, Thin TN, Ong MEH, Matchar DB Tags: Singapore Med J Source Type: research

Bicycle injuries among the paediatric population at an emergency department in Singapore.
CONCLUSION: Our study demonstrated an increasing number of bicycle injuries among paediatric cyclists in the local setting. Parents, teachers, coaches and other caregivers should be educated regarding the need to use protective equipment and to seek medical care promptly in the case of trauma resulting from bicycle injuries. PMID: 30644526 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - January 15, 2019 Category: General Medicine Authors: Beckwith K, James V, Kalaiselvan K, Ganapathy S Tags: Singapore Med J Source Type: research

Knowledge and practice of colorectal cancer screening in an urban setting: cross-sectional survey of primary care physicians in government clinics in Malaysia.
CONCLUSION: Knowledge and practice of CRC screening was inadequate among PCPs. Knowledge of screening did not translate into its practice. PCPs' perceptions about cost-effectiveness of screening and adequate resources were important determinants of the practice of screening. PMID: 30644527 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - January 15, 2019 Category: General Medicine Authors: Ooi CY, Hanafi NS, Liew SM Tags: Singapore Med J Source Type: research