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Singapore Medical Journal

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https://www.readbyqxmd.com/read/30488082/midnight-salivary-cortisol-for-the-diagnosis-of-cushing-s-syndrome-in-a-chinese-population
#1
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://www.readbyqxmd.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
#2
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://www.readbyqxmd.com/read/30488080/improving-prescribing-for-older-patients-yes-s-i-r-e
#3
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://www.readbyqxmd.com/read/30488079/effects-of-proton-pump-inhibitor-on-the-human-gut-microbiome-profile-in-multi-ethnic-groups-in-singapore
#4
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://www.readbyqxmd.com/read/30488078/amblyopia-therapy-in-asian-children-factors-affecting-visual-outcome-and-parents-perception-of-children-s-attitudes-towards-amblyopia-treatment
#5
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://www.readbyqxmd.com/read/30488077/predictors-of-functional-outcome-in-patients-with-stroke-thrombolysis-in-a-tertiary-hospital-in-malaysia
#6
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
https://www.readbyqxmd.com/read/30402655/clinical-use-of-sodium-glucose-co-transporter-2-inhibitors-in-chinese-patients-with-type-2-diabetes-mellitus
#7
Wing Bun Chan
INTRODUCTION: Type 2 diabetes mellitus (T2DM), the tenth leading cause of death in Hong Kong, has a prevalence of approximately 10%. Sodium-glucose co-transporter-2 (SGLT2) inhibitors lower glycated haemoglobin A1c (HbA1c) levels in patients with T2DM via a non-insulin-dependent mechanism of action, but real-world data, particularly for Chinese patients, is limited. METHODS: A retrospective, single-centre study was performed among Chinese patients with T2DM who were prescribed SGLT2 inhibitor therapy in Hong Kong...
November 7, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30402654/rapamycin-reduces-mortality-in-acute-stage-paraquat-induced-toxicity-in-zebrafish
#8
Nan Feng, Zhaolian Bian, Xiaobin Zhang, Changsheng Wang, Jie Chen
INTRODUCTION: Paraquat (PQ) intoxication is frequently associated with a high mortality rate. No specific treatment has been shown to reduce mortality in victims within the first 72 hours. We investigated the protective effects of rapamycin (Rapa) against PQ-induced toxicity in a zebrafish model. METHODS: To determine the maximum nonlethal concentration (MNLC) and lethal concentration 50 (LC50) of Rapa, zebrafish were treated at 2-5 days post fertilisation (dpf) and their mortality was recorded every 24 hours...
November 7, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30402653/metabolic-and-endocrine-effects-of-epidural-glucocorticoid-injections
#9
Anuntapon Chutatape, Mahesh Menon, Stephanie Man Chung Fook-Chong, Jane Mary George
INTRODUCTION: Epidural steroid injections are an integral part of nonsurgical management of radicular pain from lumbar spine disorders. We studied the effect of dexamethasone 8 mg epidural injections on the hypothalamic-pituitary-adrenal axis and serum glucose control of Asian patients. METHODS: 18 patients were recruited: six diabetics and 12 non-diabetics. Each patient received a total of dexamethasone 8 mg mixed with a local anaesthetic solution of lignocaine or bupivacaine, delivered into the epidural space...
November 7, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30311629/relationship-of-salusin-alpha-and-salusin-beta-levels-with-atherosclerosis-in-patients-undergoing-haemodialysis
#10
Savas Sipahi, Ahmed Bilal Genc, Seyyid Bilal Acikgoz, Mehmet Yildirim, Yakup Ersel Aksoy, Mehmet Bulent Vatan, Hamad Dheir, Mustafa Altındis
INTRODUCTION: In patients undergoing haemodialysis, cardiovascular mortality and morbidity, characterised by accelerated atherosclerosis and increased inflammation, are elevated. Salusins are newly defined molecules in the atherosclerotic processes, and while salusin-alpha (Sal-α) acts as an antiatherogenic factor, salusin-beta (Sal-β) has a proatherogenic role. Their roles are as yet undefined in patients undergoing haemodialysis. METHODS: In this cross-sectional study, salusin levels, carotid intima-media thickness (CIMT) from the common carotid artery and pulse wave velocity (PWV) were measured for 180 patients undergoing haemodialysis and 90 healthy controls...
October 10, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30311628/complicated-intra-abdominal-infections-a-prospective-validation-study-of-the-wses-sepsis-severity-score
#11
Saleh Abdel-Kader, Massimo Sartelli, Fikri M Abu-Zidan
INTRODUCTION: The World Society of Emergency Surgery (WSES) has recently developed and validated a sepsis severity score for complicated intra-abdominal infections (cIAIs). We aimed to prospectively study the validity of this score in our local setting and compare it with global findings. METHODS: In a prospective study of 100 consecutive adult patients with cIAIs treated at Al-Ain Hospital, United Arab Emirates, from October 2014 to January 2016, we studied the demography of patients, disease, risk factors, WSES Sepsis Severity Score, management, hospital stay and mortality...
October 10, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30311627/ectopic-breast-tissue-in-the-vulva-masquerading-as-an-abscess
#12
Saleem Ahmed, Cristine Sl Ding, Vishal G Shelat
No abstract text is available yet for this article.
October 10, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30311626/incidence-risk-factors-and-outcomes-of-malignancies-after-kidney-transplantation-in-singapore-a-12-year-experience
#13
Su Hooi Teo, Kian-Guan Lee, Gek Hsiang Lim, Si Xuan Koo, Maria Erika Ramirez, Khuan Yew Chow, Terence Kee
INTRODUCTION: Data on post-kidney transplantation (KTX) malignancy is limited in our region, leading to challenges in the care of renal allograft recipients. We aimed to examine the epidemiology, risk factors and outcomes of post-KTX patients. METHODS: A retrospective cohort study was conducted of 491 patients who underwent KTX from 1 January 2000 to 31 December 2011. Data linkage analysis was done between our centre and the National Registry of Disease Office to determine the standardised incidence ratio (SIR), standardised mortality ratio (SMR) and risk factors for malignancy after KTX...
October 10, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30246215/effect-of-levodopa-on-frontal-subcortical-and-posterior-cortical-functioning-in-patients-with-parkinson-s-disease
#14
Amara Gul, Javed Yousaf
INTRODUCTION: Parkinson's disease (PD) is associated with cognitive decline but little is known about frontal-subcortical and posterior cortical cognitive functioning in patients with PD. The present study was designed to: (a) compare frontal and posterior cognitive functioning between patients with PD and healthy controls; (b) determine the effect of levodopa (L-dopa) on frontal-subcortical and posterior cortical cognitive functions; and (c) identify predictors of cognitive functions in patients with PD...
September 24, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30246214/cast-immobilisation-for-the-treatment-of-paediatric-distal-radius-fracture-fibreglass-versus-polyolefin
#15
Meng Zhu, Elvin Salioc Lokino, Cheri Su Hui Chan, Arlene Jeremie Gan, Ling Ling Ong, Kevin Boon Leong Lim
INTRODUCTION: Stable distal radius fractures in children are frequently treated by immobilisation with a cast and heal readily without complications. This randomised clinical trial aimed to assess patient satisfaction and casting-related clinical outcomes when using polyolefin cast, a new cast material, against conventional fibreglass cast. METHODS: A total of 80 patients, age range 7-16 years, with radiograph-confirmed stable distal radius fractures were recruited...
September 24, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30246212/a-national-trauma-database-analysis-of-alcohol-associated-injuries
#16
Maxine Aiting Lam, Su Xian Lee, Kenneth Wei Jian Heng
INTRODUCTION: Knowledge of the pattern of alcohol-associated injury (AAI) is lacking in Singapore. We aimed to determine the local demographic pattern, injury mechanism, injury severity and outcomes of AAI. METHODS: Data on trauma cases presenting to emergency departments in 2012-2013 was extracted from the National Trauma Registry. Cases with missing data fields and ages 1-15 years were excluded. Patients were classified as alcohol positive (A+) or negative (A-) based on clinical assessment...
September 24, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30498844/a-wolf-in-sheep-s-clothing-a-benign-perineurioma-like-lesion-that-is-not-what-it-seems
#17
Po Yin Tang, Sathiyamoorthy Selvarajan
No abstract text is available yet for this article.
November 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30498843/the-empowerment-of-all-modalities-against-cancer
#18
Shuting Han, Han Chong Toh
No abstract text is available yet for this article.
November 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30498842/automation-and-productivity-in-the-clinical-laboratory-experience-of-a-tertiary-healthcare-facility
#19
Chin Pin Yeo, Wai Yoong Ng
Clinical laboratories for in vitro diagnostics are facing pressure to preserve cost control while providing better services through new initiatives. Laboratory automation is a partial answer to this problem, having come a long way from the early days of clinical laboratory testing. The journey and implementation of automation in the Singapore General Hospital's Clinical Biochemistry Laboratory has allowed for sustained performance in the light of increasing workload and service commitments amid an evolving healthcare environment...
November 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/30498841/multivessel-coronary-artery-spasm-in-pericarditis
#20
Yinghao Lim, Devinder Singh, Poay Huan Loh, Kian Keong Poh
No abstract text is available yet for this article.
November 2018: Singapore Medical Journal
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