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Singapore Medical Journal

Pei Shan Tan, Jarrod Kah Hwee Tan, Eng Loy Tan, Lay Kok Tan
INTRODUCTION: This study aimed to compare instrumental vaginal deliveries (IDs) and Caesarean sections (CSs) performed at full cervical dilatation, including factors influencing delivery and differences in maternal and neonatal outcomes. METHODS: A retrospective review of patients who experienced prolonged second stage of labour at Singapore General Hospital from 2010 to 2012 was conducted. A comparison between CS and ID was made through the analysis of maternal/neonatal characteristics and peripartum outcomes...
April 19, 2018: Singapore Medical Journal
Takashi Kajiya, Hiroshi Yamaguchi, Junichiro Takaoka, Kengo Fukunaga, Ryoichi Arima, Akihiro Miyamura, Toshiko Ninomiya, Nobuhiko Atsuchi, Yoshihiko Atsuchi, Mitsuyasu Terashima, Hideaki Kaneda, Mitsuru Ohishi
INTRODUCTION: The pathophysiology and mechanism of in-stent restenosis (ISR) after implantation of second-generation drug-eluting stents (DESs) are not fully clear. We compared the morphological characteristics of ISR between first- and second-generation DESs using frequency-domain optical coherence tomography (OCT). METHODS: Patients who underwent follow-up coronary angiography (CAG) after first- (Cypher and Taxus) and second- (Nobori, Promus Element, Resolute Integrity and Xience) generation DES implantations were examined...
April 10, 2018: Singapore Medical Journal
Sui An Lie, Kwang Yang Aaron Lee, Meng Huat Goh, Sudha Harikrishnan, Ruban Poopalalingam
INTRODUCTION: Timely administration of prophylactic antibiotic within 60 minutes before surgical incision is important for reducing surgical site infections. This quality-improvement initiative aimed to work toward achieving 100% compliance to perioperative antibiotic administration. METHODS: We examined the workflow in our Anaesthesia Information Management System (AIMS) and proposed interventions using cause-and-effect analysis on anonymised anaesthetic records of eligible surgical cases extracted from it...
April 10, 2018: Singapore Medical Journal
Cebrail Akyuz, Necdet Fatih Yasar, Orhan Uzun, Kıvanc Derya Peker, Oguzhan Sunamak, Mustafa Duman, Ahmet Ozer Sehirli, Sinan Yol
INTRODUCTION: This study aimed to investigate the effect of melatonin on the healing of colon anastomosis following chemotherapy. METHODS: 32 rats were randomised into four groups: (a) control group (Group 1), which underwent sigmoid colon transaction and primary anastomosis; (b) melatonin group (Group 2), which received melatonin daily following anastomosis; (c) 5-fluorouracil (5-FU) group (Group 3), which received 5-FU for five days prior to anastomosis; and (d) 5-FU+melatonin group (Group 4), which received 5-FU for five days prior to anastomosis and melatonin daily following anastomosis...
March 19, 2018: Singapore Medical Journal
Jia Ming Low, Mae Yue Tan, Kay Choong See, Marion M Aw
INTRODUCTION: As traditional overnight on-call was shown to contribute to fatigue, Singapore moved to implement a shift system in 2014. We aimed to compare activity levels, sleep (using a wrist actigraph), fatigue and professional quality-of-life between residents working on night-float and those working on traditional overnight on-call. METHODS: All postgraduate year 1 (PGY1) residents at our institution were invited to participate. Participants were required to wear a wrist actigraph for four months, and complete two validated surveys (Epworth Sleepiness Scale [ESS] and Professional Quality of Life Scale [ProQOL]) once each at the start and at the end of study...
March 19, 2018: Singapore Medical Journal
Shiu Ming Pang, Jonathan Yi Yu Pang, Stephanie Fook-Chong, Ai Ling Tan
INTRODUCTION: Tinea unguium is a common nail infection. We conducted a retrospective ten-year study of the patient demographics and species distribution of dermatophytes causing tinea unguium in a tertiary hospital from Singapore. METHODS: Results of fungal nail cultures were retrieved from our hospital's microbiology department. Samples from nail scrapings and clippings were inoculated onto agar plates (Sabouraud dextrose agar with chloramphenicol and Mycosel agar)...
March 19, 2018: Singapore Medical Journal
Mehmet Akif Cakar, Ersun Tatli, Alptug Tokatli, Harun Kilic, Huseyin Gunduz, Ramazan Akdemir
INTRODUCTION: Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. METHODS: Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included...
March 16, 2018: Singapore Medical Journal
Augustine Tee, Wai Leng Chow, Colin Burke, Guruprasad Basavarajaiah
INTRODUCTION: In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations in the Singapore healthcare setting. METHODS: A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs...
March 16, 2018: Singapore Medical Journal
Chew Lip Ng, Xuan Dao Liu, Renuka Murali Govind, Jonathan Wei Jian Tan, Shirley Beng Suat Ooi, Sophia Archuleta
INTRODUCTION: Postgraduate medical education in Singapore underwent major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of residency sponsoring institutions (SIs) among medical students during this transition period. METHODS: A questionnaire-based cross-sectional study of Singaporean undergraduate medical students across all years of study was performed in 2011...
March 16, 2018: Singapore Medical Journal
Khadija Irfan Khawaja, Saqib Ali Mian, Aziz Fatima, Ghulam Murtaza Tahir, Fehmida Farrukh Khan, Saira Burney, Ali Hasan, Faisal Masud
INTRODUCTION: Metabolic heterogeneity among obese individuals is thought to translate into variation in cardiovascular risk. Identifying obese people with an unfavourable metabolic profile may allow targeting preventive strategies towards those at greatest risk. This study aimed to identify clinical, biochemical and immunological differences between insulin sensitive and resistant obese subgroups, to understand the population-specific pathophysiological basis of the adverse cardiovascular risk profile in the latter group...
February 12, 2018: Singapore Medical Journal
Saleha Shafie, Siau Pheng Lee, Samantha Bee Cheng Ong, Peizhi Wang, Esmond Seow, Hui Lin Ong, Siow Ann Chong, Mythily Subramaniam
INTRODUCTION: Patients with schizophrenia have shorter life expectancy and one of the main causes of death is cardiovascular disease (CVD). Modifiable risk factors for CVD include diabetes mellitus (DM) and dyslipidaemia. This study aimed to establish: (a) the prevalence and correlates of DM and dyslipidaemia; (b) the proportion of those whose condition was well controlled; and (c) the incidence of undiagnosed DM and dyslipidaemia in a long-stay inpatient schizophrenia population. METHODS: Data was collected to assess the physical health status of 110 inpatients with schizophrenia who had been in hospital for over one year...
February 12, 2018: Singapore Medical Journal
Phek Hui Jade Kua, Alexander E White, Wai Yee Ng, Stephanie Fook-Chong, Eileen Kai Xin Ng, Yih Yng Ng, Marcus Eng Hock Ong
INTRODUCTION: Victims of out-of-hospital cardiac arrests require timely cardiopulmonary resuscitation (CPR) and early defibrillation. Persons making the call to emergency medical services will be asked to provide dispatcher-guided response until an ambulance arrives. Knowing what to expect in such circumstances should reduce both delay and confusion. METHODS: We conducted this study among schoolchildren aged 11-17 years using ten-item pre- and post-training surveys...
February 12, 2018: Singapore Medical Journal
Lyn Li Lean, Ryan Yee Shiun Hong, Lian Kah Ti
INTRODUCTION: Integrity and willingness to contribute to society are desired traits of medical students beyond academic excellence. We investigated the personality traits of medical students at the National University of Singapore (NUS), Singapore, as they were about to become doctors. Personality traits were compared with a peer population of local university students. METHODS: This study was conducted between October 2013 and December 2014. Year 4 medical students were administered the Revised NEO (Neuroticism-Extraversion-Openness) Personality Inventory (NEO PI-R), a 240-item Likert scale personality test...
February 12, 2018: Singapore Medical Journal
Peng Soon Yoon, Chun How Ooi, Choon How How
Singapore has an ageing population with a projected 53,000 people aged ≥ 60 years living with dementia by 2020. Primary care doctors have the opportunity to initiate early work-up for reversible causes of cognitive dysfunction, allowing identification of comorbidities and discussion of medical therapy options. Early diagnosis confers the sick role on the patient, which allays frustration and explains events and behaviour that may have strained relationships with family and friends. The patient can be encouraged to plan for future health and personal care options with a Lasting Power of Attorney and/or Advance Care Planning...
March 2018: Singapore Medical Journal
Geraldine Pei Chin Cheong, Anusha Kannan, Kwong Fah Koh, Kumaresh Venkatesan, Edwin Seet
INTRODUCTION: Airway management during anaesthesia has potential difficulties and risks. We aimed to investigate the utility of routine airway assessment for predicting difficult tracheal intubation, review the prevailing practice of videolaryngoscope use amongst anaesthetists in a teaching hospital and determine the incidence of intraoperative and postoperative airway-related complications. METHODS: A prospective observational study of 1,654 patients undergoing general anaesthesia with endotracheal intubation over a seven-month period was performed...
March 2018: Singapore Medical Journal
Luca Cegolon, W C Heymann, John H Lange
No abstract text is available yet for this article.
March 2018: Singapore Medical Journal
John Ong, Carla Swift
No abstract text is available yet for this article.
March 2018: Singapore Medical Journal
Yee Wei Phoon, Xuling Lin, T Thirumoorthy, Soo Yong Tan, Hwei Yee Lee, Soon Thye Lim, Haur Yueh Lee
No abstract text is available yet for this article.
March 2018: Singapore Medical Journal
Dinesh R Singh, Ashish Chawla, Wilfred Cg Peh
A 23-year-old Indian man presented with shortness of breath and new-onset confusion along with a rash on his chest on Postoperative Day 2, following internal fixation of his femur fracture. Although computed tomography pulmonary angiography was negative for filling defects in the pulmonary vasculature, it showed mosaic attenuation changes with some interlobular septal thickening. Magnetic resonance imaging of the brain showed patchy signal abnormalities, predominantly in the grey-white matter junction region with extensive susceptibility artefacts, consistent with petechial haemorrhages...
March 2018: Singapore Medical Journal
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