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Singapore Medical Journal

Sayra M Cristancho, Mark Goldszmidt, Lorelei Lingard, Christopher Watling
This paper offers a selective overview of the increasingly popular paradigm of qualitative research. We consider the nature of qualitative research questions, describe common methodologies, discuss data collection and analysis methods, highlight recent innovations and outline principles of rigour. Examples are provided from our own and other authors' published qualitative medical education research. Our aim is to provide both an introduction to some qualitative essentials for readers new to this research paradigm and a resource for more experienced readers, such as those who are currently engaged in a qualitative research project and would like a better sense of where their work sits within the broader paradigm...
July 16, 2018: Singapore Medical Journal
Jolin Wong, John Song En Lee, Theodore Gar Ling Wong, Rehana Iqbal, Patrick Wong
Since the first use of the flexible fibreoptic bronchoscope, a plethora of new airway equipment has become available. It is essential for clinicians to understand the role and limitations of the available equipment to make appropriate choices. The recent 4th National Audit Project conducted in the United Kingdom found that poor judgement with inappropriate choice of equipment was a contributory factor in airway morbidity and mortality. Given the many modern airway adjuncts that are available, we aimed to define the role of flexible fibreoptic intubation in decision-making and management of anticipated and unanticipated difficult airways...
July 16, 2018: Singapore Medical Journal
Dinesh Sirisena, Yong-Yeow Chong, Teck-Yew Chin
No abstract text is available yet for this article.
July 16, 2018: Singapore Medical Journal
Rupeng Mong, Ling Tiah, Michelle Wong, Camlyn Tan
INTRODUCTION: Telestroke allows for remote determination of suitability for treatment with thrombolysis in patients with acute ischaemic stroke. However, this approach is time-dependent and most centres have yet to achieve the recommended treatment times. We describe a quality improvement initiative aimed at improving the telestroke workflow and treatment times at our centre. METHODS: A multidisciplinary workgroup comprising clinicians, stroke case managers and radiology staff was formed to oversee the initiative...
July 16, 2018: Singapore Medical Journal
Ann Chuan En Loh, Phek Hui Jade Kua, Ze Lei Tan
INTRODUCTION: Kawasaki disease (KD) is a challenging diagnosis. Erythema and induration of the Bacillus Calmette-Guérin (BCG) site is increasingly recognised as a significant clinical clue. However, there is little data to support its specificity or KD as compared to other febrile illnesses. We aimed to evaluate BCG reaction or induration as a diagnostic tool for KD. METHODS: A retrospective case-controlled study of patients discharged with a diagnosis of KD from 2007 to 2010 was conducted...
July 16, 2018: Singapore Medical Journal
Yean Chin Lim, How Yow Kelvin Quek, Wai Heng Jimmy Phoo, Chou Liang Mah, Shumei Tan
INTRODUCTION: Adductor canal block (ACB) is hypothesised to provide superior analgesia to femoral nerve block (FNB) for total knee arthroplasty (TKA) while preserving quadriceps strength. METHODS: 30 patients undergoing TKA were randomised to receive either ACB or FNB. Baseline tests of quadriceps strength were performed. Ultrasound-guided blocks with 30 mL of 0.5% ropivacaine were administered before induction of general anaesthesia. Patient-controlled analgesia (morphine) was prescribed for postoperative analgesia...
July 16, 2018: Singapore Medical Journal
Zheng Kang Lum, Ma Serrie P Suministrado, N Venketasubramanian, M Kamran Ikram, Christopher Chen
INTRODUCTION: Singapore has a rapidly ageing population and an increasing prevalence of Alzheimer's disease (AD). Compliance to AD medications is associated with treatment effectiveness. We investigated compliance to acetylcholinesterase inhibitors (AChEIs) and N-methyl-D-aspartate (NMDA) receptor antagonist and treatment persistence among patients seen at the General Memory Clinic of National University Hospital, Singapore. We also identified the reasons for non-compliance. METHODS: Patients seen at the General Memory Clinic between 1 January 2013 and 31 December 2014, who were prescribed AChEIs and NMDA receptor antagonist, were included in this retrospective cohort study...
June 22, 2018: Singapore Medical Journal
Ellie Choi, Chris Lixian Tan, Derrick Aw
No abstract text is available yet for this article.
June 21, 2018: Singapore Medical Journal
Benjy Yi-Min Soh, Rajneesh Kumar, Victoria Sze-Min Ekstrom, Clement Yi-Hao Lin, Sobhana D/O Thangaraju, Hwee Huang Tan, Kwai Peng Chan, Lina Hui Lin Choong, Diana Teo, Wan Cheng Chow
INTRODUCTION: To study the prevalence of hepatitis C virus (HCV)-infection in blood donor (BD), haemodialysis (HD) and intravenous drug user (IVDU) populations in Singapore and assess the IL28B polymorphism if HCV positive. METHODS: The BD population were healthy volunteers, the HD population were patients who were on haemodialysis for at least 6 months of follow-up between Jan 2009 and Dec2014. IVDU population was from inmates at half-way houses who consented. RESULTS: Between 2011 and 2014, of 161,658 individuals screened for blood donation, 42 (0...
June 21, 2018: Singapore Medical Journal
Jolin Wong, Serene Siu Tin Lim
INTRODUCTION: Paediatric epidurals can present technical challenges due to wide variations in age and weight among children, ranging from neonates to teenagers. This study evaluated the skin-to-epidural distance in the thoracic and lumbar regions to determine the relationship between age, weight and ethnicity and depth to the epidural space in our Singapore paediatric population. METHODS: Data from the Acute Pain Service was prospectively collected over 16 years...
June 21, 2018: Singapore Medical Journal
Aytül Karabekiroğlu, Esra Yancar Demir, Servet Aker, Birsen Kocamanoğlu, Gamze Sırmalı Karabulut
INTRODUCTION: Cancer is a chronic disease that requires long-term treatment and care. Caregivers of cancer patients are at greater risk of developing depression than the general population. The effect of caregivers' cognitive flexibility on depression and anxiety has not been studied. We aimed to investigate the social characteristics, burden level and cognitive flexibility of caregivers of advanced cancer patients, and determine the relationship between these factors and depression and anxiety...
June 7, 2018: Singapore Medical Journal
Saw Ohn Mar, Osman Ali, Sugathan Sandheep, Zul Husayni, Muhammad Zuhri
INTRODUCTION: This study explored the attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students, and determined the association between their demographic characteristics, and attitudes and acceptance. METHODS: A cross-sectional survey was conducted among clinical-year medical students from a Malaysian private medical college using a self-administered questionnaire. RESULTS: Among 330 participants with a female preponderance, mean age was 22...
June 7, 2018: Singapore Medical Journal
Jie Ming Nigel Fong, Yeong Tze Wilnard Tan, Andrew Arjun Sayampanathan, Niraj Mohan, Yun Qing Koh, Jin Hao Justin Jang, Jin Rong Ivan Low, Anupama Vasudevan, Chew Lip Ng, Paul Ananth Tambyah
INTRODUCTION: Medical school fees are rising globally. Student debt and financial background may affect residency choices, but few studies have been conducted in Asia. This study aimed to explore the relationship between financial background, student debt and postgraduate residency choices among medical students in Singapore. METHODS: An anonymised survey of all medical students in Singapore was conducted, with a response rate of 67.9%. RESULTS: 40...
June 7, 2018: Singapore Medical Journal
Doris Fok, Izzuddin Mohd Aris, Jiahui Ho, Yiong-Huak Chan, Mary Rauff, James Kc Lui, Mark D Cregan, Peter Hartmann, Yap Seng Chong, Citra Nz Mattar
INTRODUCTION: Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump. METHODS: Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control groups (n = 29). The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding...
June 7, 2018: Singapore Medical Journal
Xu Cong Ruan, Wai Loong Wong, Hui Qing Yeong, Yong Kuei Timothy Lim
INTRODUCTION: Endometrial carcinoma is the most common gynaecological malignancy. Studies have shown that laparoscopic total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection was advantageous compared to laparotomy in reducing length of stay and intraoperative blood loss. However, these studies had a predominantly Caucasian population. A comparison study was conducted among the Singapore population to investigate the differences in oncological and surgical outcomes between these two methods...
July 2018: Singapore Medical Journal
Anselm Chi-Wai Lee
INTRODUCTION: Childhood immune thrombocytopenia (ITP) remains a diagnosis of exclusion when isolated thrombocytopenia is not part of another disease process. In practice, the diagnosis of ITP can only be confirmed when thrombocytopenia resolves or is excluded after the recognition of a primary cause. METHODS: The records of 87 consecutive children with isolated thrombocytopenia seen over a nine-year period in a private paediatric haematology practice were reviewed retrospectively...
July 2018: Singapore Medical Journal
Mark Christopher Pearce, Garry Choy, Robert Chun Chen
A 60-year-old woman was travelling on a plane with her spouse when she suddenly developed acute-onset disorientation to time and space. According to her husband, she repetitively questioned her whereabouts and complained of a minor headache. Upon landing, she was immediately brought to the emergency room and subsequent magnetic resonance imaging was performed, which showed multiple punctate 2-3 mm regions of diffusion-weighted imaging hyperintensity in the medial aspects of both temporal lobes. The conglomeration of clinical history and radiological findings was most suggestive of transient global amnesia...
July 2018: Singapore Medical Journal
Siang Yong Tan, Catherine Allday Davis
No abstract text is available yet for this article.
July 2018: Singapore Medical Journal
C Rajasoorya
No abstract text is available yet for this article.
July 2018: Singapore Medical Journal
Muhammad Bilal Abid, Shi Wang, Hoi Yin Loi, Esther Hian Li Chan, Li Mei Poon, Sanjay de Mel
No abstract text is available yet for this article.
July 2018: Singapore Medical Journal
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