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Singapore Medical Journal

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https://read.qxmd.com/read/30773603/parental-knowledge-and-beliefs-on-the-use-of-child-car-restraints-in-singapore-a-qualitative-study
#1
Ronald Ming Ren Tan, Chaoyan Dong, Germac Qiaoyue Shen, Jasmine Xun Yi Feng, Rupini Piragasam, Arif Tyebally, Shu-Ling Chong
INTRODUCTION: Road traffic injuries and fatalities represent a significant public health problem. In Singapore, compliance with appropriate child car restraints (CCRs) is poor. We aimed to understand parental knowledge, beliefs and barriers regarding the use of CCRs. METHODS: In this qualitative study, we conducted five focus group discussions with parents who drive with their children in private cars. Participants were recruited using the KK Women's and Children's Hospital's social media page...
February 18, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30773602/high-sensitivity-troponin-t-and-long-term-adverse-cardiac-events-among-patients-presenting-with-suspected-acute-coronary-syndrome-in-singapore
#2
Ziwei Lin, Swee Han Lim, Siang Jin Terrance Chua, E Shyong Tai, Yiong Huak Chan, Arthur Mark Richards
INTRODUCTION: Prognostic thresholds for 30-day major adverse cardiovascular events (MACE) have been studied for high-sensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome (ACS), but there is limited data on the prognostic performance of hsTnT for one-year MACE. METHODS: We prospectively measured hsTnT (in ng/mL to up to two decimal places) at 0, 2 and 7 hours for patients presenting with symptoms suggestive of ACS to our emergency department from March 2010 to April 2013...
February 18, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30773601/endoscopic-submucosal-dissection-of-colorectal-neoplasms-an-audit-of-its-safety-and-efficacy-in-a-single-tertiary-centre-in-singapore
#3
James Weiquan Li, Tiing Leong Ang, Lai Mun Wong, Andrew Boon Eu Kuek, Malcolm Teck Kiang Tan, Kwong Ming Fock, Eng Kiong Teo
INTRODUCTION: Endoscopic submucosal dissection (ESD) provides a higher en bloc and R0 resection rate than endoscopic mucosal resection (EMR). Colorectal ESD is not widely used because of its technical difficulty and risk of complications, especially for right-sided colonic lesions. We audited the clinical outcomes of our initial experience with colorectal ESD. METHODS: We reviewed data collected from a prospective registry of patients who underwent colorectal ESD from December 2014 to March 2018...
February 18, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30773600/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
#4
Kian-Keong Poh, Chee Tang Chin, Khim Leng Tong, Julian Ko Beng Tan, Jee Seong Lim, Weixuan Yu, Martin Horack, Ami Vyas, Dominik Lautsch, Baishali Ambegaonkar, Philippe Brudi, Anselm K Gitt
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...
February 18, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30773599/vulvar-basal-cell-carcinoma-clinical-features-and-treatment-outcomes-from-a-tertiary-care-centre
#5
Rama P Namuduri, Timothy Yk Lim, Philip Kl Yam, Rene Gatsinga, Soo Kim Lim-Tan, Sung Hock Chew, Mark Ja Koh, Sorsiah Mansor
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...
February 18, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30644527/knowledge-and-practice-of-colorectal-cancer-screening-in-an-urban-setting-cross-sectional-survey-of-primary-care-physicians-in-government-clinics-in-malaysia
#6
Chor Yau Ooi, Nik Sherina Hanafi, Su May Liew
INTRODUCTION: Colorectal cancer (CRC) was the third most commonly diagnosed cancer worldwide in 2008 (1.23 million cases, 9.7%). CRC screening was shown to be effective in reducing 70% of CRC mortality. However, the screening rate for CRC remains poor. METHODS: A cross-sectional survey was conducted among primary care physicians (PCPs) in public primary care clinics in Kuala Lumpur, Malaysia. A 30-item self-administered questionnaire was used to assess the knowledge and practice of CRC screening...
January 15, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30644526/bicycle-injuries-among-the-paediatric-population-at-an-emergency-department-in-singapore
#7
Kristy Beckwith, Vigil James, Karthigaiyan Kalaiselvan, Sashikumar Ganapathy
INTRODUCTION: Bicycles injuries are the leading cause of emergency department visits among all recreational activities and have been established as a significant worldwide public health burden. The purpose of this retrospective study was to describe the epidemiology and patterns of paediatric bicycle-related injuries in Singapore. METHODS: This was a single-centre retrospective study based on data collected from a trauma registry between 2011 and 2016. RESULTS: A total of 760 patients presented to the ED during this period, of whom 68...
January 15, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30644525/can-we-understand-population-healthcare-needs-using-electronic-medical-records
#8
Jia Loon Chong, Lian Leng Low, Darren Yak Leong Chan, Yuzeng Shen, Thiri Naing Thin, Marcus Eng Hock Ong, David Bruce Matchar
INTRODUCTION: The identification of population-level healthcare needs using hospital electronic medical records (EMRs) is a promising approach for the evaluation and development of tailored healthcare services. Population segmentation based on healthcare needs may be possible using information on health and social service needs from EMRs. However, it is currently unknown if EMRs from restructured hospitals in Singapore provide information of sufficient quality for this purpose. We compared the inter-rater reliability between a population segment that was assigned prospectively and one that was assigned retrospectively based on EMR review...
January 15, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30644524/initial-experience-of-laparoscopic-right-hemicolectomy-with-complete-mesocolic-excision-in-singapore-a-case-series
#9
Ming Li Ho, Cheryl Chong, Shen Ann Yeo, Chee Yung Ng
INTRODUCTION: Laparoscopic colorectal surgery is increasingly performed worldwide due to its multiple advantages over traditional open surgery. In the surgical treatment of right-sided colonic tumours, the latest technique is laparoscopic right hemicolectomy with complete mesocolic excision (lapCME), which aims to lower the rate of local recurrence and maximise survival as compared to standard laparoscopic right hemicolectomy (lapS). METHODS: We conducted a retrospective analysis of our initial experience with lapCME in Singapore General Hospital between 2012 and 2015...
January 15, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30644523/colonic-stenting-for-malignant-large-bowel-obstruction-is-safe-and-effective-a-single-surgeon-experience
#10
Man Hon Tang, Talisa Ross, Shen Ann Yeo, Chee Yung Ng
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...
January 15, 2019: Singapore Medical Journal
https://read.qxmd.com/read/30556093/prevalence-of-growth-and-endocrine-disorders-in-malaysian-children-with-transfusion-dependent-thalassaemia
#11
Khian Aun Tan, Su Han Lum, Abqariyah Yahya, Shekhar Krishnan, Muhammad Yazid Jalaludin, Way Seah Lee
INTRODUCTION: Endocrine dysfunction due to iron overload secondary to frequent blood transfusions is a common complication in children with transfusion-dependent thalassaemia (TDT). We ascertained the prevalence of endocrine dysfunction in children with TDT seen in a hospital setting in Malaysia. METHODS: We reviewed all patients with TDT who had ≥ 8 blood transfusions per year. Patients who had a history of stem cell transplantation, concurrent autoimmune diseases or were newly diagnosed to have TDT were excluded...
December 17, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30556092/short-term-outcomes-of-outpatient-surgery-for-total-knee-arthroplasty
#12
Muhammet Sadık Bilgen, Osman Yaray, Müren Mutlu, Ahmet İdil Çakır, Ömer Faruk Bilgen
INTRODUCTION: We have developed an accelerated clinical pathway involving outpatient surgery for patients undergoing total knee arthroplasty (TKA) who are healthy enough for early discharge. METHODS: Between March 2014 and April 2015, 89 TKAs were performed at a single institution by a single orthopaedic surgeon. 31 patients met the inclusion criteria for the study. All patients received 2 g tranexamic acid and 750 mg cefuroxime sodium intravenously 30 minutes prior to surgery...
December 17, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30556091/optimal-liver-stiffness-measurement-values-for-the-diagnosis-of-significant-fibrosis-and-cirrhosis-in-chronic-liver-disease-in-singapore
#13
Pik Eu Chang, Juanda Leo Hartono, Yee Lin Ngai, Yock Young Dan, Kieron Bl Lim, Wan Cheng Chow
INTRODUCTION: Despite the widespread use of transient elastography for non-invasive assessment of liver fibrosis, the optimal cut-off liver stiffness measurement (LSM) values remain unclear. This study aimed to validate the optimal cut-off LSM values for significant fibrosis and cirrhosis in patients with chronic liver disease (CLD). METHODS: Prospective multicentre data of CLD patients who underwent paired liver biopsy and LSM was analysed to determine the optimal cut-off LSM values for predicting significant fibrosis (METAVIR F ≥ 2) and cirrhosis (METAVIR F4)...
December 17, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30556090/safety-and-efficacy-of-spyglass-cholangiopancreatoscopy-in-routine-clinical-practice-in-a-regional-singapore-hospital
#14
Tiing Leong Ang, Andrew Boon Eu Kwek
INTRODUCTION: This study examined the efficacy and safety of cholangiopancreatoscopy via the SpyGlass™ system in routine clinical practice. METHODS: The clinical data of endoscopic retrograde cholangiopancreatography (ERCP) performed in a regional hospital from January 2013 to November 2016 was retrieved from an electronic database and reviewed. All patients who had undergone SpyGlass cholangiopancreatoscopy were enrolled. Patient demographics, procedure indication, technical success rates, clinical success rates and complication rates were analysed...
December 17, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30488082/midnight-salivary-cortisol-for-the-diagnosis-of-cushing-s-syndrome-in-a-chinese-population
#15
Dao-Chen Lin, Pei-Shan Tsai, Yi-Chun Lin
INTRODUCTION: Cushing's syndrome is defined as chronic excess free cortisol in circulation. According to recent studies, midnight salivary cortisol is an accurate and non-stress method for screening and diagnosing Cushing's syndrome. However, there is limited data on midnight salivary cortisol for diagnosing Cushing's syndrome in the Chinese population. METHODS: Among 61 suspected Chinese patients, 48 patients were confirmed to have Cushing's syndrome. We evaluated the midnight salivary cortisol, midnight serum cortisol and 24-hour urine free cortisol excretion for diagnosis...
November 29, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30488081/percutaneous-pulmonary-valve-implantation-as-an-alternative-to-repeat-open-heart-surgery-for-patients-with-pulmonary-outflow-obstruction-a-reality-in-singapore
#16
Lik Wui Edgar Tay, Wei Luen James Yip, Ting Ting Low, Chin Ling William Yip, Kok Fai William Kong, Tiong Cheng Yeo, Huay Cheem Tan, Shakeel Ahmed Quereshi, Swee Chye Quek
Right ventricle to pulmonary artery (RV-PA) conduits have been used for the surgical repair of congenital heart defects. These conduits frequently become stenosed or develop insufficiency with time, necessitating reoperations. Percutanous pulmonary valve implantation (PPVI) can delay the need for repeated surgeries in patients with congenital heart defects and degenerated RV-PA conduits. We present our first experience with PPVI, and describe in detail the procedural methods and the considerations that need to be taken for this intervention to be successful...
November 29, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30488080/improving-prescribing-for-older-patients-yes-s-i-r-e
#17
Ting Ting Selina Cheong, Sharifah Munirah Alhamid, Fu Yin Li, Swee Tee Wendy Ang, Kim Hwa Jim Lim
INTRODUCTION: Polypharmacy and inappropriate prescribing are associated with negative health outcomes in the elderly. Several prescribing tools have been developed to assess medication appropriateness. Explicit (criteria-based) tools often do not take into account patients' preferences and comorbidities, and have little room for individualised clinical judgement. METHODS: A prospective observational study was conducted in 243 elderly patients admitted to the Geriatric Medicine service in a Singapore tertiary hospital over one month...
November 29, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30488079/effects-of-proton-pump-inhibitor-on-the-human-gut-microbiome-profile-in-multi-ethnic-groups-in-singapore
#18
Seok Hwee Koo, Jing Deng, Daphne Shih Wen Ang, John Chen Hsiang, Lian Shien Lee, Shafiq Aazmi, Elsa Haniffah Mejia Mohamed, Hong Yang, Siew Yoon Yap, Lay Kek Teh, Mohd Zaki Salleh, Edmund Jon Deoon Lee, Tiing Leong Ang
INTRODUCTION: The objectives of this study were to examine the effects of ethnicity, gender, and a proton pump inhibitor (PPI), omeprazole, on the human gut microbiome. PPIs are commonly used for the treatment of acid-related disorders. We hypothesised that PPI therapy might perturb microbial communities and alter the gut microbiome. METHODS: Healthy subjects of Chinese (n = 12), Malay (n = 12) and Indian (n = 10) ancestry, aged 21-37 years, were enrolled. They provided a baseline stool sample (Day 1) and were then given a course of omeprazole at therapeutic dose (20 mg daily) for seven days...
November 29, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30488078/amblyopia-therapy-in-asian-children-factors-affecting-visual-outcome-and-parents-perception-of-children-s-attitudes-towards-amblyopia-treatment
#19
Swati Handa, Audrey Chia
INTRODUCTION: Amblyopia treatment in the form of glasses and/or patching in children poses a great challenge to parents. This study aimed to assess the factors that influence visual outcome in amblyopia and children's perception towards treatment. METHODS: 180 children (aged 3.0-7.0 years) with newly diagnosed amblyopia were recruited. The effects of age, gender, type of amblyopia, treatment and compliance on visual outcome at one year were assessed. Parents completed a questionnaire on children's attitudes towards amblyopia treatment...
November 29, 2018: Singapore Medical Journal
https://read.qxmd.com/read/30488077/predictors-of-functional-outcome-in-patients-with-stroke-thrombolysis-in-a-tertiary-hospital-in-malaysia
#20
Mei-Ling Sharon Tai, Khean Jin Goh, Khairul Azmi Abdul Kadir, Mohd Idzwan Zakaria, Jun Fai Yap, Kay Sin Tan
INTRODUCTION: Intravenous (IV) thrombolysis with alteplase (rt-PA) is effective in ischaemic stroke. The primary objective was to evaluate predictors of functional outcome in acute ischaemic stroke (AIS) patients treated with IV rt-PA. The secondary objective was to assess the outcome with the modified Rankin scale (mRS). We also examined the predictive value of the Totaled Health Risks in Vascular Events (THRIVE) score. METHODS: AIS patients treated with IV rt-PA from February 2012 to August 2016 were recruited...
November 29, 2018: Singapore Medical Journal
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