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national university hospital singapore

https://read.qxmd.com/read/33891279/transitioning-to-robotic-partial-nephrectomy-with-a-team-based-proctorship-achieves-the-desired-improved-outcomes-over-open-and-laparoscopic-partial-nephrectomy
#1
Asrif Chowdhury, Lincoln Guan Lim Tan, Edmund Chiong, Koon Ho Rha, Ho Yee Tiong
Proctoring may facilitate a safe transition to robotic-assisted partial nephrectomy (RAPN) for centres performing open (OPN) and laparoscopic partial nephrectomies (LPN). This study compared the 5-year outcomes of RAPN, initiated with a team-based proctorship, with OPN and LPN. Following an observation course at the proctor's institution and a 3-surgeon performance of proctored RAPN in August 2014, a review of 90 RAPN, 29 LPN and 43 OPN consecutively performed by the same team from 2013 to 2019 at National University Hospital, Singapore was conducted...
April 23, 2021: Updates in Surgery
https://read.qxmd.com/read/33812940/routine-antiseptic-baths-and-mrsa-decolonization-diverse-approaches-across-singapore-s-acute-care-hospitals
#2
F Hong, S Salmon, X Y Ong, K Liew, Y Koh, A Young, B Ang, M L Foo, L C Lee, M L Ling, K Marimuthu, S Pada, B F Poh, K C Thoon, D Fisher
To determine the variation in practices on meticillin-resistant Staphylococcus aureus (MRSA) surveillance and management of MRSA-colonized patients amongst 17 acute healthcare facilities in Singapore, the Ministry of Health convened a sharing session with Infection Prevention and Control Leads. All hospitals practised close to universal MRSA entry swabbing in keeping with national policy. There were, however, major variations in the response to both positive and negative surveillance swabs across facilities including the role of routine antiseptic bathing and MRSA decolonization...
April 1, 2021: Journal of Hospital Infection
https://read.qxmd.com/read/33797581/structured-re-training-to-reduce-peritonitis-in-a-pediatric-peritoneal-dialysis-program-a-quality-improvement-intervention
#3
Sharon Teo, Tin Wei Yuen, Clarissa Wei-Shuen Cheong, Md Azizur Rahman, Neha Bhandari, Noor-Haziah Hussain, Hamidah Mistam, Jing Geng, Charmaine Yan-Pin Goh, Mya Than, Yiong-Huak Chan, Hui-Kim Yap, Kar-Hui Ng
BACKGROUND: Decline in skills and knowledge among patients and/or caregivers contributes to peritoneal-dialysis (PD)-related peritonitis. Re-training is important, but no guidelines exist. We describe the implementation of a structured re-training program to decrease peritonitis rates. METHODS: This is a prospective quality improvement study involving pediatric patients on long-term home automated PD at National University Hospital, Singapore, between 2012 and 2018...
April 2, 2021: Pediatric Nephrology
https://read.qxmd.com/read/33735066/referral-for-disease-related-visual-impairment-using-retinal-photograph-based-deep-learning-a-proof-of-concept-model-development-study
#4
Yih-Chung Tham, Ayesha Anees, Liang Zhang, Jocelyn Hui Lin Goh, Tyler Hyungtaek Rim, Simon Nusinovici, Haslina Hamzah, Miao-Li Chee, Gabriel Tjio, Shaohua Li, Xinxing Xu, Rick Goh, Fangyao Tang, Carol Yim-Lui Cheung, Ya Xing Wang, Vinay Nangia, Jost B Jonas, Bamini Gopinath, Paul Mitchell, Rahat Husain, Ecosse Lamoureux, Charumathi Sabanayagam, Jie Jin Wang, Tin Aung, Yong Liu, Tien Yin Wong, Ching-Yu Cheng
BACKGROUND: In current approaches to vision screening in the community, a simple and efficient process is needed to identify individuals who should be referred to tertiary eye care centres for vision loss related to eye diseases. The emergence of deep learning technology offers new opportunities to revolutionise this clinical referral pathway. We aimed to assess the performance of a newly developed deep learning algorithm for detection of disease-related visual impairment. METHODS: In this proof-of-concept study, using retinal fundus images from 15 175 eyes with complete data related to best-corrected visual acuity or pinhole visual acuity from the Singapore Epidemiology of Eye Diseases Study, we first developed a single-modality deep learning algorithm based on retinal photographs alone for detection of any disease-related visual impairment (defined as eyes from patients with major eye diseases and best-corrected visual acuity of <20/40), and moderate or worse disease-related visual impairment (eyes with disease and best-corrected visual acuity of <20/60)...
January 2021: The Lancet. Digital health
https://read.qxmd.com/read/33733974/impact-of-fibrin-glue-versus-suture-closure-on-double-headed-pterygia-in-asian-eyes-a-7-year-study-in-a-tertiary-institution
#5
Wei Wei Dayna Yong, Liang Shen, Ray Manotosh, Wee Tien Anna Marie Tan, Hui Chen Charmaine Chai
BACKGROUND: To compare the recurrence rate and outcomes of double-headed pterygia using fibrin glue versus suture closure of conjunctival autograft. METHODS: All patients with double-headed pterygia who underwent pterygia excision with conjunctival autograft from January 2012 to January 2019 in the National University Hospital of Singapore were included. Patients were divided into 2 groups depending on whether fibrin glue or sutures were used to secure the conjunctival autograft in place...
December 2021: Annals of Medicine
https://read.qxmd.com/read/33733253/causes-functional-outcomes-and-healthcare-utilisation-of-people-with-cerebral-palsy-in-singapore
#6
Zhi Min Ng, Jeremy B Lin, Poh Choo Khoo, Victor Samuel Rajadurai, Derrick W S Chan, Hian Tat Ong, Janice Wong, Chew Thye Choong, Kim Whee Lim, Kevin B L Lim, Tong Hong Yeo
INTRODUCTION: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore. METHODS: People with CP born after 1994 were recruited through KK Women's and Children's Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records...
February 2021: Annals of the Academy of Medicine, Singapore
https://read.qxmd.com/read/33634869/low-dose-pembrolizumab-in-the-treatment-of-advanced-non-small-cell-lung-cancer
#7
Jia Li Low, Yiqing Huang, Kenneth Sooi, Yvonne Ang, Zhi Yao Chan, Katie Spencer, Anand Devaprasath Jeyasekharan, Raghav Sundar, Boon Cher Goh, Ross Soo, Wei Peng Yong
A dose of 200mg 3-weekly of pembrolizumab was approved by the FDA as treatment for advanced NSCLC without oncogenic drivers. This is despite evidence showing no difference in efficacy with 2mg/kg. This study aimed to assess the efficacy of a lower fixed dose of 100mg, which is closer to 2mg/kg weight-based dose in an average sized Asian patient. All patients receiving pembrolizumab for advanced NSCLC from January 2016 to March 2020 in National University Hospital, Singapore, were included in this retrospective observational study...
February 26, 2021: International Journal of Cancer. Journal International du Cancer
https://read.qxmd.com/read/33630355/the-effect-of-intracranial-stenosis-on-cognitive-decline-in-a-memory-clinic-cohort
#8
Mervyn Jun Rui Lim, Chuen Seng Tan, Bibek Gyanwali, Christopher Chen, Saima Hilal
BACKGROUND: Intracranial stenosis (ICS) is a risk factor for cognitive impairment and dementia in cross-sectional studies. However, data examining the effect of ICS on cognitive decline is limited. We investigated the effect of ICS on cognition over a period of three years in a memory-clinic cohort. METHODS: Patients were recruited from the National University Hospital in Singapore. Data was collected using a standardised questionnaire, physical examination and 3T MRI at baseline...
February 25, 2021: European Journal of Neurology
https://read.qxmd.com/read/33623957/emergency-airway-management-in-a-singapore-centre-a-registry-study
#9
Gene Wai Han Chan, Chew Yian Chai, Joy Su-Yue Teo, Calvin Kai En Tjio, Mui Teng Chua, Calvin A Brown III
INTRODUCTION: Intubations in the emergency department (ED) are often performed immediately without the benefit of pre-selection or the ability to defer. Multicentre observational data provide a framework for understanding emergency airway management but regional practice variation may exist. We aim to describe the intubation indications, prevalence of difficult airway features, peri-intubation adverse events and intubator characteristics in the ED of the National University Hospital, Singapore...
January 2021: Annals of the Academy of Medicine, Singapore
https://read.qxmd.com/read/33623954/long-term-outcomes-of-ischaemic-stroke-patients-with-diabetes-in-a-multi-ethnic-cohort-in-singapore
#10
Ei Zune The, Mei Yen Ng, Geelyn JL Ng, Bernadette GC Er, Amy ML Quek, Prakash Paliwal, Leonard L Yeo, Bernard Chan, Vijay K Sharma, Hock Luen Teoh, Eric YH Khoo, Raymond CS Seet
INTRODUCTION: Diabetes increases the risk of ischaemic stroke especially among Asians. This study aims to investigate contemporaneous long-term cardiovascular outcomes of ischaemic stroke patients with diabetes in a multi-ethnic Asian cohort. METHODS: Consecutive patients with ischaemic stroke were recruited from the National University Hospital, Singapore. Data on age, gender, ethnicity, risk factors (including diabetes status and body mass index [BMI]), stroke severity and mechanisms were collected...
January 2021: Annals of the Academy of Medicine, Singapore
https://read.qxmd.com/read/33561586/blood-biomarkers-to-detect-new-onset-atrial-fibrillation-and-cardioembolism-in-ischemic-stroke-patients
#11
Dorin Harpaz, Ram Bajpai, Geelyn J L Ng, Michael Soljak, Robert S Marks, Christine Cheung, Thiruma Valavan Arumugam, Amy M L Quek, Alfred I Y Tok, Raymond C S Seet
BACKGROUND: Accumulating data suggest blood biomarkers could inform stroke etiology. OBJECTIVE: The purpose of this study was to investigate the performance of multiple blood biomarkers in elucidating stroke etiology with a focus on new-onset atrial fibrillation (AF) and cardioembolism. METHODS: Between January and December 2017, information on clinical and laboratory parameters and stroke characteristics was prospectively collected from ischemic stroke patients recruited from the National University Hospital, Singapore...
February 6, 2021: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://read.qxmd.com/read/33441469/characteristics-and-outcomes-of-young-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-retrospective-analysis-in-a-multiethnic-asian-population
#12
Benjamin Wl Tung, Zhe Yan Ng, William Kristanto, Kalyar Win Saw, Siew-Pang Chan, Winnie Sia, Koo Hui Chan, Mark Chan, William Kong, Ronald Lee, Joshua P Loh, Adrian F Low, Kian Keong Poh, Edgar Tay, Huay Cheem Tan, Tiong-Cheng Yeo, Poay Huan Loh
OBJECTIVE: ST segment elevation myocardial infarction (STEMI) is associated with significant mortality leading to loss of productive life years, especially in younger patients. This study aims to compare the characteristics and outcomes of young versus older patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) to help focus public health efforts in STEMI prevention. METHODS: Data from the Coronary Care Unit database of the National University Hospital, Singapore from July 2015 to June 2019 were reviewed...
January 2021: Open Heart
https://read.qxmd.com/read/33420474/blood-pressure-and-adiposity-in-midlife-singaporean-women
#13
Win Pa Pa Thu, Inger Sundström-Poromaa, Susan Logan, Michael S Kramer, Eu-Leong Yong
Hypertension is a major risk factor for cardiac events and stroke. Visceral adipose tissue (VAT) is known to increase the risk of incident hypertension in adults. Although adiposity has been linked to markers of inflammation, few studies have examined these markers as potential mediators of the association between visceral adiposity and elevated blood pressure. We evaluated sociodemographic, reproductive, and lifestyle risk factors for elevated blood pressure among midlife Singaporean women. A total of 1189 women, with a mean age of 56...
January 8, 2021: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://read.qxmd.com/read/33343029/use-of-del-nido-cardioplegia-for-adult-heart-surgery-how-long-is-not-too-long
#14
Goh Si Guim, Cindy Goh Wah Hoon, Clara Anne Lim, Huang Shoo Chay-Nancy, Ashlynn Ai Li Ler, Qi Xuan Lim, Nurdiyana Binte Jaafar, Cheryl Lim, Faizus Sazzad, Theo Kofidis
The most apparent practical advantage of del Nido cardioplegia (DNC) is that it allows the surgeon a longer arrest period before a subsequent dose is needed, as opposed to the conventional St. Thomas' cardioplegia solution where the recommended ischemic time is ∼15-20 minutes. In this study, we explored the incidence of arrhythmia after cross-clamp removal as a surrogate for a safe myocardial ischemic time with the use of DNC in adult heart surgery. A total of 113 patients who had undergone heart valve repair and/or replacement surgery at the National University Hospital, Singapore, were investigated...
December 2020: Journal of Extra-corporeal Technology
https://read.qxmd.com/read/33246909/revascularisation-surgery-for-paediatric-moyamoya-disease-the-singapore-experience
#15
Jamie Ah Ong, Sharon Yy Low, Wan Tew Seow, Chun Peng Goh, Tseng Tsai Yeo, Ning Chou, David Cy Low, Vincent Nga
Moyamoya disease (MMD) is characterized by the spontaneous occlusion of the distal internal carotid arteries and resultant neo-angiogenesis of fragile collateral blood vessels. Direct and indirect revascularization surgeries have shown to effectively reduce stroke risks in paediatric MMD, whereby the latter is a more utilised technique in children. This study was undertaken to determine the outcomes of revascularization in Singapore's multi-ethnic, Southeast Asian paediatric population. This is an ethics-approved study conducted in Singapore's 2 tertiary children hospital units: KK Women's and Children's Hospital and National University Hospital...
November 25, 2020: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://read.qxmd.com/read/33179039/establishing-a-new-normal-for-hospital-care-a-whole-of-hospital-approach-to-covid-19
#16
Brandon X Lum, Eugene H Liu, Sophia Archuleta, Jyoti Somani, Natasha Bagdasarian, Catherine S Koh, Clara S Sin, Mushan Wong, Swee Chye Quek, Dale A Fisher
Singapore's hospitals had prepared operations to receive patients (potentially) infected with SARS-CoV-2, planning various scenarios and levels of surge with a policy of isolating all confirmed cases as inpatients. The National University Hospital, adopted a whole of hospital approach to COVID-19 with three primary goals: zero hospital-acquired COVID-19, all patients receive timely necessary care, and maintenance of staff morale. These goals to date have been met. A large influx of COVID-19 cases emerged requiring a significant transformation of clinical and operational processes...
November 12, 2020: Clinical Infectious Diseases
https://read.qxmd.com/read/33129913/impact-of-implementing-novel-automated-code-blue-activation-system-on-in-hospital-cardiac-arrest-a-single-center-study
#17
Faheem Ahmed Khan, Ting Lyu, Eng Kiang Lee, Shekhar Dhanvijay, Amit Kansal, Monika Gulati Kansal, Rou An Tan, Jared D'Souza, Yee Shay Lee, Nicholas Lim, Mei Pheng Liew, Ian Cerdana, Patricia Leong, Chee Keat Tan
BACKGROUND: Prompt identification and management of patients having clinical deterioration on wards is one of the key steps to reduce in-hospital cardiac arrests (IHCA). Our organization implemented a novel Automated Code Blue Alert and Activation (ACBAA) system since 1st March 2018. METHODS: We conducted a retrospective before-and-after ACBAA system implementation study in JurongHealth Campus (JHC) of National University Health system (NUHS), Singapore. In JHC, code blue can be activated by both manual activation and ACBAA system activation from 1st March 2018...
October 28, 2020: Resuscitation
https://read.qxmd.com/read/32980041/the-effect-of-patient-education-and-telemedicine-reminders-on-adherence-to-eye-drops-for-glaucoma
#18
Yien Lai, Yanlong Wu, Charmaine Chai, Ching-Chiuan Yen, Yvonne Ho, Teng Chuan Eng, Pravar Jain, Victor Koh
PURPOSE: To determine the improvement in patient adherence to topical ocular hypotensive therapy by introducing a personalized illustrated medication reference chart and telereminder. DESIGN: Prospective randomized controlled clinical trial. PARTICIPANTS: Fifty-nine patients with glaucoma who were using at least 3 or more eye drops were recruited from the ophthalmology clinic at the National University Hospital of Singapore. METHODS: Participants were randomized into 3 groups: control, reference chart only, and reference chart with telereminder...
September 2020: Ophthalmology. Glaucoma
https://read.qxmd.com/read/32945929/the-effect-of-a-simple-phone-call-intervention-on-fit-positive-individuals-an-exploratory-study
#19
Gretel Jianlin Wong, Jerrald Lau, Ker-Kan Tan
PURPOSE: Colorectal cancer (CRC) screening has been shown to improve patient outcomes. A widely utilised preliminary screening tool is the faecal immunochemical test (FIT). However, follow-up rates after a positive FIT result remain suboptimal. METHODS: In order to improve FIT-positive individuals' compliance to follow-up consultation and to elucidate barriers to action, a simple 5- to 10-min telephone intervention with a structured script based on the protection motivation theory (PMT) was conducted...
September 18, 2020: International Journal of Colorectal Disease
https://read.qxmd.com/read/32911554/the-effect-of-a-20-hour-baby-friendly-hospital-initiative-training-program-on-nurses-breastfeeding-knowledge-attitudes-and-confidence-in-a-tertiary-hospital-in-singapore
#20
Doris Fok, Hsin Fang Chang, Ling Yan Meng, Yvonne Peng Mei Ng
OBJECTIVE:  The Baby-Friendly Hospital Initiative (BFHI) enables maternity units to be centers of breastfeeding support to increase breastfeeding rates. This study evaluates the impact of the 20-hour BFHI training course on nurses' breastfeeding knowledge, attitude, and confidence in breastfeeding practice in a tertiary hospital in Singapore. STUDY DESIGN:  Seventeen sessions of the 20-hour BFHI training course were conducted by lactation consultants from 2010 to 2013 at the National University Hospital, Singapore...
September 10, 2020: American Journal of Perinatology
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