An educational case series of electrocardiographs during the COVID-19 pandemic and their implications on therapy.
PMID: 32480434 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 2, 2020 Category: General Medicine Authors: Sia CH, Ngiam JN, Chew N, Beh DLL, Poh KK Tags: Singapore Med J Source Type: research

Laparoscopic surgery in a patient with atypical presentation of COVID-19: salient points to reduce the perils of surgery.
PMID: 32480435 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - June 2, 2020 Category: General Medicine Authors: Oh SL, Chia CLK, Chen YR, Goo TTJ, Rao AD, Tan KY, Ong MW Tags: Singapore Med J Source Type: research

Financial burden and financial aid for medical students in Singapore: a national survey across all three medical schools.
Abstract INTRODUCTION: Singapore has had three medical schools since 2013. We undertook a cross-sectional quantitative national survey to determine the financial impact of medical education on medical students in Singapore. METHODS: All 1,829 medical students in Singapore were invited to participate in this study. Information on demographics, financial aid utilisation and outside work was collected and analysed. RESULTS: 1,241 (67.9%) of 1,829 students participated in the survey. While the overall proportion of students from households with monthly incomes SGD 75,000. There were significant differences i...
Source: Singapore Medical Journal - June 2, 2020 Category: General Medicine Authors: Tan YTW, Sayampanathan AA, Chidambaram K, Koh YQ, Fong JMN, Low JI, Ng CL, Tambyah PA Tags: Singapore Med J Source Type: research

Safety, tolerability and efficacy of LEGA-Kid ® mechanical percussion device versus conventional chest physiotherapy in children: a randomised, single-blind controlled study.
Safety, tolerability and efficacy of LEGA-Kid® mechanical percussion device versus conventional chest physiotherapy in children: a randomised, single-blind controlled study. Singapore Med J. 2020 Jun 02;: Authors: Hue YL, Lum LCS, Ahmad SH, Tan SS, Wong SY, Nathan AM, Eg KP, Choon MBMM Abstract INTRODUCTION: Chest physiotherapy (CPT) may benefit children aged
Source: Singapore Medical Journal - June 2, 2020 Category: General Medicine Authors: Hue YL, Lum LCS, Ahmad SH, Tan SS, Wong SY, Nathan AM, Eg KP, Choon MBMM Tags: Singapore Med J Source Type: research

Clinical depression among patients with post-acute coronary syndrome: a prospective single-tertiary centre analysis.
Abstract INTRODUCTION: Clinical depression is a known consequence of acute coronary syndrome (ACS), and carries an adverse outcome among these patients, although this is often under-recognised. We investigated the incidence of depression in post-ACS patients and its associated factors. METHODS: We conducted a prospective cohort study in 95 ACS patients admitted to University Malaya Medical Centre. Clinical depression was assessed during the index admission and at 30 days post discharge using the Patient Health Questionnaire-9 (PHQ-9). Data was analysed using IBM SPSS Statistics, and binary logistic regression...
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Leong LK, Mahmood Zuhdi AS, Abdul Hafidz MI Tags: Singapore Med J Source Type: research

Simplified instructional phrasing in dispatcher-assisted cardiopulmonary resuscitation - when 'less is more'.
Abstract INTRODUCTION: In our national emergency dispatch centre, the standard protocol for dispatcher-assisted cardiopulmonary resuscitation (DACPR) in out-of-hospital cardiac arrests (OHCAs) involves the instruction "push 100 times a minute 5 cm deep". As part of quality improvement, the instruction was simplified to "push hard and fast". METHODS: We analysed all dispatcher-diagnosed OHCAs over four months in 2018: January to February ("push 100 times a minute 5 cm deep") and August to September ("push hard and fast"). We also performed secondary per-protocol analysis...
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Leong PWK, Leong BS, Arulanandam S, Ng MXR, Ng YY, Ong MEH, Mao DRH Tags: Singapore Med J Source Type: research

Impact of the coronavirus disease 2019 pandemic on spinal surgery in Singapore.
PMID: 32460452 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Tan BJ, Teo HLT, Loo WL, Dinesh SK Tags: Singapore Med J Source Type: research

COVID-19 in Singapore - a case series from primary care.
We describe our experiences with four COVID-19 cases at the polyclinics in January and February 2020. This retrospective case series highlights the challenges primary care clinicians face in the early identification of suspect cases based on clinical criteria only. To improve case detection, clinicians can sharpen their clinical acumen by keeping abreast with the latest COVID-19 developments and by maintaining a high state of vigilance. PMID: 32460453 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Sim SZ, Teo SH, Kong JW, Lim Z, Ng MYK, Tang WE Tags: Singapore Med J Source Type: research

Health ethics in COVID-19: no better time for solidarity.
PMID: 32460454 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Fong JMN, Devanand A Tags: Singapore Med J Source Type: research

Mortality in children hospitalised with respiratory syncytial virus infection in Singapore.
This study aimed to investigate the trend and seasonality of infection due to respiratory syncytial virus (RSV) at KK Women's and Children's Hospital (KKH) in Singapore and to examine the risk factors for mortality among children with RSV infection requiring admission to the paediatric intensive care unit (PICU). METHODS: A retrospective study was conducted at KKH on children with RSV infections who were admitted to the PICU between January 2004 and December 2010. The medical records of children who died from RSV infections were reviewed. Linear regression was performed to determine the risk factors of RSV mortality. ...
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Lee MW, Goh AE Tags: Singapore Med J Source Type: research

Factors influencing decisions on contralateral symmetrisation procedure among patients with breast cancer.
CONCLUSION: A combination of factors may deter patients from symmetrisation. The most significant factors deterring OBCS among patients were worry and desire to treat breast cancer first for immediate symmetrisation, and not being overly concerned about breast cosmesis and fear of breast cancer recurrence for delayed symmetrisation. Reassurance of these patients may increase their uptake of symmetrisation, thereby improving patient cosmesis and satisfaction. PMID: 32460447 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Lim GH, Choo CH, Allen JC, Ng RP Tags: Singapore Med J Source Type: research

Providing assisted reproduction treatment during the COVID-19 pandemic in Singapore.
PMID: 32460448 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Tan SQ, Phoon JWL, Chan MLH, Wong HY, Durgahshree M, Nadarajah S, Chan JKY Tags: Singapore Med J Source Type: research

Safety of a rapid outpatient hydration protocol for patients with renal impairment requiring intravenous iodinated contrast media for CT.
CONCLUSION: We defined a shorter hydration regimen that is safe to use in the outpatient setting. PMID: 32460449 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - May 27, 2020 Category: General Medicine Authors: Wee NK, Tiong SC, Lee CH, H'ng MWC Tags: Singapore Med J Source Type: research

Deeply reconsidering elective surgery: worldwide concerns regarding colorectal surgery in a COVID-19 pandemic and a Singapore perspective.
PMID: 32349195 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 29, 2020 Category: General Medicine Authors: Chew MH, Tan WJ, Ng CY, Ng KH Tags: Singapore Med J Source Type: research

Assessment of knowledge and perceptions of medical radiation among caregivers and adolescent patients in the paediatric emergency department.
CONCLUSION: Medical radiation awareness needs to be improved in our patient population. There is a mismatch between caregiver expectations and the actual procedure of radiation risk disclosure. PMID: 32349196 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 29, 2020 Category: General Medicine Authors: Chew SY, Ang IWL, Lim DXY, Tan MQS, Wee ZY Tags: Singapore Med J Source Type: research

An update on pityrosporum folliculitis in Singapore from a single tertiary care dermatological centre.
CONCLUSION: The typical Singapore patient with PF is a young man in the age group 21-30 years, with erythematous follicular papules or pustules over the trunk and back. PMID: 32349197 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 29, 2020 Category: General Medicine Authors: Yong AM, Tan SY, Tan CL Tags: Singapore Med J Source Type: research

Chapter of Gastroenterologists professional guidance for management of patients with liver disease in Singapore during the COVID-19 pandemic.
Abstract In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation. PMID: 32349198 [PubMed - as supplied by publisher] (Source: ...
Source: Singapore Medical Journal - April 29, 2020 Category: General Medicine Authors: Chang JPE, Wong YJ, Yang WL, Lim KBL, Tan PS, Ho GH, Yip BCH, Li JW, Chong CH, Ong DEH, Chua TS, Vu CKF, Gwee KA, Ang TL, Tan CK Tags: Singapore Med J Source Type: research

Trauma and orthopaedics in the COVID-19 pandemic: breaking every wave.
PMID: 32312024 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 21, 2020 Category: General Medicine Authors: Tay KJD, Lee YHD Tags: Singapore Med J Source Type: research

Variable computed tomography appearances of COVID-19.
We present a case series with virologically confirmed COVID-19 pneumonia. Variable CT features were observed: consolidation with ground-glass opacities, ground-glass opacities with subpleural reticular bands, and an anterior-posterior gradient of lung abnormalities resembling that of acute respiratory distress syndrome. In one patient, we noted evolution of CT findings, where there was interval resolution of bilateral lung consolidation with development of bronchiolectasis and subpleural fibrotic bands. While sensitive for detecting lung parenchymal abnormalities in COVID-19 pneumonia, CT for initial diagnosis is discourag...
Source: Singapore Medical Journal - April 21, 2020 Category: General Medicine Authors: Lim ZY, Khoo HW, Hui TCH, Kok SSX, Kwan KEL, Young BE, Tan CH, Kaw GJL Tags: Singapore Med J Source Type: research

An elderly couple with COVID-19 pneumonia treated in Singapore: contrasting clinical course and management.
PMID: 32312026 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 21, 2020 Category: General Medicine Authors: Wong SY, Leong KH, Ng KS, Tan SH, Lo PLC, Chan K Tags: Singapore Med J Source Type: research

Doctors and social media: knowledge gaps and unsafe practices.
CONCLUSION: Knowledge of institutional social media policy and privacy settings of social media accounts is inadequate among doctors. Regarding practices in social media use, while most agree that caution should be exercised for online posts involving patients, ambiguity still exists. The emerging knowledge deficit and potentially unsafe practices that are identified can be addressed through continuing medical education and training on social media use. PMID: 32312027 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 21, 2020 Category: General Medicine Authors: Low JM, Tan MY, Joseph R Tags: Singapore Med J Source Type: research

Controversies and discrepancies in the effect of dietary fat and cholesterol on cardiovascular risk.
Abstract Cardiovascular disease (CVD) is the leading cause of death worldwide. The top ten causes of death in Singapore include many cardiovascular-related diseases such as ischemic heart disease. The increasing prevalence of CVD poses a burden to both the economy and healthcare system of a country. Dietary habits, in particular dietary fats and cholesterol intake, have been shown to greatly influence CVD risks. Therefore, reference and adherence to relevant dietary guidelines could be crucial in CVD prevention. Recent research findings have provided novel insights into the relationship between certain dietary fat...
Source: Singapore Medical Journal - April 21, 2020 Category: General Medicine Authors: Leong WYA, Ngiam JN, Tan RS, Lim SL, Poh KK Tags: Singapore Med J Source Type: research

Striving as a nation to become an academic leader in the COVID-19 crisis.
PMID: 32299183 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 17, 2020 Category: General Medicine Authors: Seah I Tags: Singapore Med J Source Type: research

COVID-19 - where do we go from here?
PMID: 32299184 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 17, 2020 Category: General Medicine Authors: Lee PH, Vasoo S Tags: Singapore Med J Source Type: research

Difficulties that patients with chronic diseases face in the primary care setting in Singapore: a cross-sectional study.
Abstract INTRODUCTION: Patients with chronic diseases face difficulties when navigating the healthcare system. Using the Healthcare System Hassles Questionnaire (HSHQ) developed by Parchman et al, this study aimed to explore the degree of hassles faced by primary care patients in Singapore and identify the characteristics associated with higher hassles. METHODS: A cross-sectional study was conducted among patients with chronic disease at Hougang Polyclinic, Singapore, using interviewer-administered HSHQ. Mean HSHQ score was compared with Parchman et al's study. The associations between number of chronic disea...
Source: Singapore Medical Journal - April 17, 2020 Category: General Medicine Authors: Koh LJ, Teo SH, Jiang Y, Hwang EHJ, Lee ES Tags: Singapore Med J Source Type: research

Perfluorobutane contrast-enhanced ultrasonography: a new standard for ultrasonography-guided thermal ablation of sonographically occult liver tumours?
CONCLUSION: pCEUS has a role in US-guided thermal ablation of liver tumours, offering a high technical success rate that is comparable to reported data. Additional benefits may include improved procedural time and freedom from ionising radiation. PMID: 32299186 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 17, 2020 Category: General Medicine Authors: Shi H, Ong YT, Gogna A, Venkatanarasimha N, Sanamandra SK, Leong S, Irani FG, Lo RHG, Too CW Tags: Singapore Med J Source Type: research

Negative affect moderates the link between body image dissatisfaction and disordered eating among psychiatric outpatients in a multiethnic Asian setting.
Abstract INTRODUCTION: Disordered eating in psychiatric patients is considerably high, yet few studies have investigated the relevant factors that affect the relationship between body image dissatisfaction and disordered eating in the local context. Our study aimed to investigate the moderating effects of depression and anxiety levels on the body dissatisfaction-disordered eating link in a multicultural Asian context. METHODS: After written informed consent was obtained, participants completed a set of questionnaires, which included various scales pertaining to eating behaviours, body image, psychological dis...
Source: Singapore Medical Journal - April 17, 2020 Category: General Medicine Authors: Teh WL, Mahesh MV, Abdin E, Tan J, Rahman RFBA, Satghare P, Sim K, Basu S, Kandasami G, Gupta B, Chong SA, Subramaniam M Tags: Singapore Med J Source Type: research

Love in the time of coronavirus: training and service during COVID-19.
PMID: 32283886 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 14, 2020 Category: General Medicine Authors: Wong CS, Tay WC, Hap XF, Chia FL Tags: Singapore Med J Source Type: research

Impact of COVID 19: perspectives from gastroenterology.
PMID: 32279480 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 13, 2020 Category: General Medicine Authors: Tay SW, Teh KKJ, Wang LM, Ang TL Tags: Singapore Med J Source Type: research

Review of stentless, tubeless, apposed renal (STAR) transplant wound management programme.
CONCLUSION: The routine use of ureteric stents, drains or skin staples may not be necessary for uncomplicated renal transplants. Potential complications associated with the placement of these interventions can be avoided without compromising on the safety of patients and/or the outcome of transplants. PMID: 32279481 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 13, 2020 Category: General Medicine Authors: Tay HWM, Sim PY, Teo YA, Rahman L, Tiong HY Tags: Singapore Med J Source Type: research

A call to arms: a perspective of safe general surgery in Singapore during the COVID-19 pandemic.
PMID: 32241064 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Chew MH, Koh FH, Ng KH Tags: Singapore Med J Source Type: research

Chapter of Gastroenterologists professional guidance on risk mitigation for gastrointestinal endoscopy during COVID-19 pandemic in Singapore.
Abstract In this paper, we aimed to provide professional guidance to practising gastrointestinal (GI) endoscopists for the safe conduct of GI endoscopy procedures during the current coronavirus disease 2019 (COVID-19) pandemic and future outbreaks of similar severe respiratory tract infections in Singapore. It draws on the lessons learnt during the severe acute respiratory syndrome (SARS) epidemic and available published data concerning the COVID-19 pandemic. It addresses measures before, during and after endoscopy that must be considered for both non- infected and infected patients, and provides recommendations f...
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Ang TL, Li JW, Vu CK, Ho GH, Chang JPE, Chong CH, Chua TS, Ong D, Yip BCH, Gwee KA Tags: Singapore Med J Source Type: research

Clinics in Diagnostic Imaging: COVID-19 atypical pneumonia.
Abstract A 53-year-old man presented with high fever and a non-productive cough but had no recent travel history. He deteriorated clinically very rapidly and was intubated. The endotracheal tube microbiological culture isolated Klebsiella pneumoniae. On chest computed tomography, the presence of mixed ground-glass airspace opacities, patchy consolidation and a ‘crazy paving’ appearance was atypical for Klebsiella infection. As there was also a lack of cavitating nodules, lymphadenopathy and pleural effusion, atypical pneumonia due to COVID-19 was diagnosed. The patient tested positive for COVID-19. He ...
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Liew JRP, Lim YRD, Liew JYC, Poh CCA Tags: Singapore Med J Source Type: research

Influence of chronic kidney disease and haemodialysis on stroke outcome
CONCLUSION: Despite significant functional and neurological improvements following rehabilitation, stroke patients with underlying CKD had higher average duration of hospital stay, more recurrent hospitalisations and poorer survival outcomes than those without underlying CKD. This could be attributed to the complications associated with CKD rather than stroke. Multidisciplinary community rehabilitation may be an alternative to reduce recurrent hospitalisations and morbidity in this group of patients. PMID: 32241068 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Pande SD, Morris J Tags: Singapore Med J Source Type: research

Long-term effects of bariatric surgery on cardiovascular risk factors in Singapore.
CONCLUSION: Bariatric surgery does not confer a uniform improvement in lipid profile in the long term. It does, however, induce efficient weight loss and improvement in diabetic profile, even in those on preoperative statins. PMID: 32241069 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Panday VB, Shabbir A, Kuntjoro I, Khoo EYH, So JBY, Poh KK Tags: Singapore Med J Source Type: research

Management of HIV-positive pregnant women: a Singapore experience.
CONCLUSION: Having high standards of care for HIV-positive women has successfully reduced our perinatal transmission rate to zero. PMID: 32241070 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Loh M, Thoon KC, Mathur M, Kathirvel R Tags: Singapore Med J Source Type: research

Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic.
CONCLUSION: Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self- care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak. PMID: 32241071 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - April 3, 2020 Category: General Medicine Authors: Chew QH, Wei KC, Vasoo S, Chua HC, Sim K Tags: Singapore Med J Source Type: research

ACT-FAST: a quality improvement project to increase the percentage of acute stroke patients receiving intravenous thrombolysis within 60 minutes of arrival at the emergency department.
Abstract INTRODUCTION: Stroke is a leading cause of death and disability, with the administration of reverse transcriptase-plasminogen activator (rtPA) improving outcomes in a time-dependent manner. Only 52.3% of our eligible stroke patients received rtPA within 60 minutes of arrival. We aimed to better the percentage of acute stroke patients receiving rtPA within 60 minutes of arrival at the emergency department (ED). METHODS: Results from the first year of a clinical practice improvement project, where quality improvement interventions were implemented, are presented. Primary outcome measure was percentage ...
Source: Singapore Medical Journal - March 31, 2020 Category: General Medicine Authors: Chiu LQ, Quek DYJ, Salihan RB, Ng WM, Othman RB, Lee CH, Oh DCT Tags: Singapore Med J Source Type: research

Clinical presentation of cardiac myxoma in a Singapore national cardiac centre.
CONCLUSION: In our study, a majority of patients were women, with a wide age range of 18–78 years. The diagnosis of asymptomatic cardiac myxoma was present in 28.4% of patients, with an increasing trend for incidence over the years. This is possibly due to increased opportunistic screening (with electrocardiogram and clinical examination) as well as higher usage of medical imaging. PMID: 32227792 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 31, 2020 Category: General Medicine Authors: Lee PT, Hong R, Pang PY, Chua YL, Ding ZP Tags: Singapore Med J Source Type: research

Dealing with COVID-19: initial perspectives of a small radiology department.
PMID: 32227793 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 31, 2020 Category: General Medicine Authors: Kok SSX, Mohamed Shah MTB, Cheong WK, Cheng AKC, Sng LH, Salkade PR, Wong SBS Tags: Singapore Med J Source Type: research

At the ‘heart’ of the COVID-19 outbreak: early cardiac implications and mitigating strategies.
At the ‘heart’ of the COVID-19 outbreak: early cardiac implications and mitigating strategies. Singapore Med J. 2020 Mar 31;: Authors: Cherian R, Poh KK PMID: 32227794 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 31, 2020 Category: General Medicine Authors: Cherian R, Poh KK Tags: Singapore Med J Source Type: research

Severe radiation thyroiditis after radioactive iodine for treatment of Graves ’ disease.
Severe radiation thyroiditis after radioactive iodine for treatment of Graves’ disease. Singapore Med J. 2020 Mar 31;: Authors: Tay WL, Lee LMY, Tong AKT, Chng CL Abstract Radiation thyroiditis resulting from radioactive iodine-131 treatment for Graves’ disease is an uncommon complication. Although a majority of patients are asymptomatic or manifest mild symptoms that can be managed conservatively, published literature describing severe radiation thyroiditis resulting in significant morbidity is lacking. We herein report six patients with severe radiation thyroiditis that resulted in hospi...
Source: Singapore Medical Journal - March 31, 2020 Category: General Medicine Authors: Tay WL, Lee LMY, Tong AKT, Chng CL Tags: Singapore Med J Source Type: research

A midpoint perspective on the COVID-19 pandemic.
Abstract The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) epidemic has spread to virtually every continent in the world. Despite Singapore's efforts, sustained community transmission of the virus has continued. We herein describe several key experiences and lessons learnt during the early course of the outbreak. First, it is critical to evaluate the outbreak objectively based on its own characteristics and not those of past epidemics. Second, the great advancements in speed and power of science and international collaboration have been critical in providing knowledge about the virus and disease. Th...
Source: Singapore Medical Journal - March 25, 2020 Category: General Medicine Authors: Hsu LY, Chia PY, Vasoo S Tags: Singapore Med J Source Type: research

Geospatial analysis of severe road traffic accidents in Singapore in 2013-2014.
Abstract INTRODUCTION: Injury is a significant cause of mortality and morbidity. We aimed to investigate which areas in Singapore have a significantly higher incidence of road traffic accidents (RTA) resulting in severe injuries (Tier 1), which is defined as an Injury Severity Score (ISS) greater than 15, and to develop a spatiotemporal model. METHODS: Data was obtained from the National Trauma Registry. The RTA locations were geo-mapped onto the Singapore map, and spatial statistical techniques were used to identify hotspots with the Getis-Ord-Gi* algorithm. RESULTS: From 1 January 2013 till 31 December...
Source: Singapore Medical Journal - March 25, 2020 Category: General Medicine Authors: Wee CPJ, He DX, Win W, Ong MEH Tags: Singapore Med J Source Type: research

Injury patterns in elderly cyclists and motorcyclists presenting to a tertiary trauma centre in Singapore.
CONCLUSION: Elderly riders have unique injury patterns and consume significant healthcare resources. Trauma systems need to acknowledge this changing injury epidemiology and equip trauma centres with necessary resources targeted at elderly patients. Future work should focus on strategies to minimise extremity and chest injuries. PMID: 32211913 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 25, 2020 Category: General Medicine Authors: Cheong HS, Tham KY, Chiu LQ Tags: Singapore Med J Source Type: research

Comparison of inhalational methoxyflurane (Penthrox ®) and intramuscular tramadol for prehospital analgesia.
CONCLUSION: For the doses of medication used in this implementation study, methoxyflurane was superior in efficacy, speed of onset and administration, but with more minor adverse effects when compared to IM tramadol. PMID: 32179922 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 17, 2020 Category: General Medicine Authors: Lim KJ, Koh ZX, Ng YY, Fook-Chong S, Ho AFW, Doctor NE, Said NAZM, Ong MEH Tags: Singapore Med J Source Type: research

Help-seeking patterns and funding strategies in patients with pulmonary arterial hypertension on phosphodiesterase-5 inhibitors: an orphan disease with effective but costly treatment.
CONCLUSION: Fewer than expected patients were found to be receiving drug subsidies for PAH. This was partly due to insufficient referrals and lack of requests for financial assistance. Patients on combination therapy had greater financial challenges. This study should spur us on to study funding gaps further and address them. PMID: 32179923 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 17, 2020 Category: General Medicine Authors: Lim Y, Maaroof SMB, Low TT, Kuntjoro I, Yip JW, Tay E Tags: Singapore Med J Source Type: research

Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population.
Abstract INTRODUCTION: There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS: A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocar...
Source: Singapore Medical Journal - March 17, 2020 Category: General Medicine Authors: Fam JM, Khoo CY, Lau YH, Lye WK, Cai XJ, Choong LHL, Allen JC, Yeo KK Tags: Singapore Med J Source Type: research

Smear-positive pulmonary tuberculosis patients with previously abnormal chest radiographs: missed opportunities for early diagnosis.
CONCLUSION: PTB patients may be asymptomatic or have chronic indolent disease and remain undiagnosed for years. There is a need for vigilance within our healthcare system to seize opportunities for early diagnosis and treatment to prevent the spread of this infectious disease in Singapore. PMID: 32179925 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 17, 2020 Category: General Medicine Authors: Galamay LC, Chee CBE, Khin Mar KW, Lau BQ, Wang YT Tags: Singapore Med J Source Type: research

Misuse of prescription medicines is as prevalent as the use of recreational drugs and novel psychoactive substances in Singapore: an unrecognised public health issue?
CONCLUSION: Misuse of prescription medicine in Singapore was common, with prevalence comparable to the use of recreational drugs/NPS. A common source for misused drugs was physicians. Further studies are required to determine whether this is more widespread in Singapore and establish the different forms of drug diversion, so that appropriate prevention strategies can be implemented. PMID: 32179926 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - March 17, 2020 Category: General Medicine Authors: Chan WL, Dargan PI, Haynes CM, Green JL, Black JC, Dart RC, Wood DM Tags: Singapore Med J Source Type: research