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Singapore Medical Journal

Hui Min Lim, Lee Gan Goh, T Thirumoorthy
Medical reports are required to support court applications to appoint a deputy to make decisions on behalf of a person who has lost mental capacity. The doctor writing such a medical report needs to be able to systematically assess the mental capacity of the person in question, in order to gather the necessary evidence for the Court to make a decision. If the medical report is not adequate, the application will be rejected and the appointment of the deputy delayed. This article sets out the best practices for performing the assessment, and the common errors, issues of concern and best practices in writing the medical report...
October 18, 2016: Singapore Medical Journal
Christina Jiun-Yu Tan, Grant E Sklar
INTRODUCTION: Paracetamol is the most common pharmaceutical agent implicated in toxic exposure in Singapore. This study aimed to describe the characteristics of paracetamol overdose in the adult population managed at a tertiary healthcare facility in Singapore. METHODS: Medical records of adult patients hospitalised with a diagnosis of paracetamol overdose at National University Hospital, Singapore, over a three-year period from January 2011 to December 2013 were retrospectively reviewed...
October 18, 2016: Singapore Medical Journal
Ira Sun, Jia Xu Lim, Chun Peng Goh, Shiong Wen Low, Ramez W Kirollos, Chuen Seng Tan, Sein Lwin, Tseng Tsai Yeo
INTRODUCTION: Postoperative cerebrospinal fluid (CSF) leak is a serious complication following trans-sphenoidal surgery for which elevated body mass index (BMI) has been implicated as a risk factor, albeit only in two recent North American studies. Given the paucity of evidence, we sought to determine if this association held true in an Asian population, where BMI criteria for obesity differ from the international standard. METHODS: A retrospective study of 119 patients who underwent 123 trans-sphenoidal procedures for sellar lesions between May 2000 and May 2012 was conducted...
September 22, 2016: Singapore Medical Journal
Wann Jia Loh, Yue Yu, Chian Min Loo, Su Ying Low
INTRODUCTION: The aim of this study was to identify patient characteristics and risk factors associated with in-hospital mortality of patients with pulmonary tuberculosis (PTB) requiring intensive care unit (ICU) management. METHODS: A retrospective chart review was conducted of all patients with active PTB admitted to the ICU at Singapore General Hospital, Singapore, between January 2005 and December 2010. RESULTS: There were 2,155 patients with active PTB diagnosed, of whom 83 (3...
September 22, 2016: Singapore Medical Journal
Tamra Lysaght, Tsung-Ling Lee, Sangeetha Watson, Zohar Lederman, Michele Bailey, Paul Anantharajah Tambyah
No abstract text is available yet for this article.
September 19, 2016: Singapore Medical Journal
Sanjay de Mel, Yunxin Chen, Sathish Kumar Gopalakrishnan, Melissa Ooi, Constance Teo, Daryl Tan, Min Li Claire Teo, Allison Cy Tso, Lian King Lee, Chandramouli Nagarajan, Yeow Tee Goh, Wee Joo Chng
Multiple myeloma (MM) is an incurable plasma cell neoplasm with an incidence of 100 patients per year in Singapore. Major advances have been made in the diagnosis, risk stratification and treatment of MM in the recent past. The reclassification of a subset of patients with smouldering MM, based on high-risk biomarkers, and the development of the revised international staging system are among the key new developments in diagnosis and staging. The use of novel agent-based treatment has resulted in significant improvements in the survival and quality of life of many patients with MM...
September 9, 2016: Singapore Medical Journal
Hui Jin Toh, Zhen Yu Lim, Philip Yap, Terence Tang
INTRODUCTION: Prolonged stay in acute hospitals increases the risks of hospital-acquired infections in older patients, and disrupts patient flow and access to care due to bed shortages. Therefore, factors associated with prolonged length of stay (pLOS) among older patients (aged over 78 years) in a tertiary hospital were investigated to identify potentially modifiable risk factors that could help direct interventions to reduce pLOS. METHODS: During a three-month period from January 2013 to March 2013, 72 patients with pLOS (length of stay [LOS] ≥ 21 days) were identified and compared to 281 randomly selected control patients (LOS < 21 days) for demographic and clinical variables using univariate and multivariate logistic regression analyses...
September 9, 2016: Singapore Medical Journal
Alice Kurien, Sarita Narang, How Chuan Han
INTRODUCTION: We aimed to study the efficacy and safety of the tension-free vaginal tape (TVT)-Abbrevo procedure for female stress urinary incontinence (SUI). METHODS: This was a prospective cohort study that aimed to determine the subjective and objective cure, improvement of SUI and incidence of complications among women who underwent TVT-Abbrevo for SUI during a period of 22 months from September 2011 to June 2013. RESULTS: A total of 76 patients, with a mean age of 48...
September 9, 2016: Singapore Medical Journal
Kim Hwee Koh
Adhesive capsulitis is a common cause of shoulder pain and limited movement. The objectives of this review are to assess the efficacy and safety of corticosteroid injections for adhesive capsulitis and to evaluate the optimum dose and anatomical site of injections. PubMed and CENTRAL databases were searched for randomised trials and a total of ten trials were included. Results revealed that corticosteroid injection is superior to placebo and physiotherapy in the short-term (up to 12 weeks). There was no difference in outcomes between corticosteroid injection and oral nonsteroidal anti-inflammatory drugs at 24 weeks...
August 29, 2016: Singapore Medical Journal
Zhi Hao Tang, Ching Sing Nicholas Yeoh, Gek Meng Jeffrey Tan
INTRODUCTION: This study aimed to determine differences in the proximal femur morphology of elderly patients with femoral neck fractures among the ethnic groups in Singapore. METHODS: The medical records of 101 men and 288 women aged 60-109 (mean 76.3) years who underwent hip hemiarthroplasty for femoral neck fractures between June 1, 2010 and December 31, 2015 were reviewed. The patients' age, gender and race were recorded. Plain anteroposterior radiograph was used to measure the following: calcar width to canal width ratio of the ipsilateral femur; neck-shaft angle; hip offset; neck length; and neck width of the contralateral proximal femur...
August 29, 2016: Singapore Medical Journal
Zhi Hao Tang, Vaikunthan Rajaratnam, Vijayadwaja Desai
INTRODUCTION: Hand tumours are frequently encountered in clinical practice. A list of differential diagnoses of the most common hand tumours based on anatomical location would be helpful for clinicians. We aimed to determine the anatomical distribution of hand tumours seen at a hand surgery practice in Singapore. METHODS: The medical records of 50 men and 65 women (mean age 41.7 [range 17-74] years) who underwent excision of hand tumours between 1 June 2010 and 31 December 2012 were reviewed...
August 29, 2016: Singapore Medical Journal
Shu Fang Ho, Thirumoorthy Thamotharampillai, Benjamin Boon Lui Ng
No abstract text is available yet for this article.
August 29, 2016: Singapore Medical Journal
Louisa Picco, Mythily Subramaniam, Edimansyah Abdin, Janhavi Ajit Vaingankar, Siow Ann Chong
INTRODUCTION: Major depressive disorder (MDD) is one of the most common psychiatric disorders worldwide, and various sociodemographic risk factors including age, gender and ethnicity have been associated with MDD. The present study aimed to establish whether gender-specific differences relating to the prevalence and correlates of MDD existed in the Singapore adult resident population. METHODS: The Singapore Mental Health Study was a population-based, cross-sectional, epidemiological study among Singapore citizens and permanent residents aged 18 years and above...
August 16, 2016: Singapore Medical Journal
Anandan Gerard Thiagarajah
INTRODUCTION: Plantar fasciitis is a commonly seen outpatient condition that has numerous treatment modalities of varying degrees of efficacy. This systematic review aimed to determine the effectiveness of acupuncture in reducing pain due to plantar fasciitis. METHODS: Online literature searches on the PubMed and Cochrane Library databases were done for studies on the use of acupuncture for pain due to plantar fasciitis. Studies designed as randomised controlled trials and which compared acupuncture with standard treatments or had real versus sham acupuncture arms were selected...
August 16, 2016: Singapore Medical Journal
Andrew Arjun Sayampanathan, Yeong Tze Wilnard Tan, Jie Ming Nigel Fong, Yun Qing Koh, Chew Lip Ng, Niraj Mohan, Jin Hao Justin Jang, Paul Anantharajah Tambyah
INTRODUCTION: Increasing financial challenges have resulted in great debt among medical graduates worldwide. In Singapore, more scholarships and bursaries have been disbursed in recent years to support students who are financially challenged. We aimed to study the financial status among medical students in the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), and the financial support available to them. METHODS: A cross-sectional quantitative study was performed...
August 12, 2016: Singapore Medical Journal
Nicholas Chew, Jimmy Kim Fatt Hon, Wei Luen James Yip, Siew Pang Chan, Kian-Keong Poh, William Kok-Fai Kong, Kristine Leok Kheng Teoh, Tiong Cheng Yeo, Huay Cheem Tan, Edgar Lik Wui Tay
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is an effective treatment for high-risk or inoperative patients with severe aortic stenosis. Given the unique characteristics of Asian populations, questions regarding mid-term outcomes in Asians undergoing TAVI have yet to be addressed. This registry evaluated the two-year clinical outcomes of TAVI in an Asian population using Valve Academic Research Consortium-2 definitions. METHODS: This prospective study recruited 59 patients from a major academic medical centre...
August 12, 2016: Singapore Medical Journal
Jia Loon Chong
Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation...
October 2016: Singapore Medical Journal
Beuy Joob, Viroj Wiwanitkit
No abstract text is available yet for this article.
October 2016: Singapore Medical Journal
Jung Ii Lee, Duk Hee Lee
No abstract text is available yet for this article.
October 2016: Singapore Medical Journal
Yiru Lorna Fan, Mohamad Isham Bin Othman, Niraj Dubey, Wilfred Cg Peh
Adult-onset brachial plexopathy can be classified into traumatic and non-traumatic aetiologies. Traumatic brachial plexopathies can affect the pre- or postganglionic segments of the plexus. Non-traumatic brachial plexopathies may be due to neoplasia, radiotherapy, thoracic outlet syndrome and idiopathic neuralgic amyotrophy. Conventional magnetic resonance imaging (MRI) is useful to localise the area of injury or disease, and identify the likely cause. This review discusses some of the common causes of adult-onset brachial plexopathy and their imaging features on MRI...
October 2016: Singapore Medical Journal
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