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Singapore Medical Journal

Phong Teck Lee, Julian Loh, Gerald Sng, Joshua Tung, Khung Keong Yeo
INTRODUCTION: Empathy and burnout are two entities that are important in a physician's career. They are likely to relate to one another and can be heavily influenced by surrounding factors, such as medical education, local practices and cultural expectations. Empathy and burnout studies have not been performed in Singapore. This study was designed to evaluate empathy and burnout levels using the Jefferson Scale of Physician Empathy (JSPE) and Maslach Burnout Inventory (MBI) among residents in Singapore, and compare them with US literature...
October 12, 2017: Singapore Medical Journal
Yan Li Shao, Kuan Hao Yee, Seow Ken Koh, Yip Fong Wong, Lee Ying Yeoh, Serena Low, Chee Fang Sum
INTRODUCTION: We aimed to evaluate the effectiveness and safety of canagliflozin when compared to sitagliptin in a real-world setting among multiethnic patients with type 2 diabetes mellitus (T2DM) in Singapore. METHODS: This was a new-user, active-comparator, single-centre retrospective cohort study. Patients aged 18-69 years with T2DM and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m² were eligible if they were initiated and on steady daily dose of canagliflozin 300 mg or sitagliptin 100 mg and had 24 weeks of follow-up subsequently...
October 12, 2017: Singapore Medical Journal
Chin Yee Woo, Han Loong Ho, Mohammad Bin Zainuddin Ashik, Kevin Boon Leong Lim
INTRODUCTION: The cross Kirschner wire (k-wire) configuration in closed reduction and percutaneous pinning of paediatric supracondylar humeral fracture afford superior stability. However, medial pin placement presents a risk of iatrogenic ulnar nerve injury. This study describes, in step-by-step detail, another safe method of percutaneous medial pin insertion. METHODS: The technique involved placing the patient's arm in external rotation, with elbow flexed no more than 45° after closed reduction...
October 12, 2017: Singapore Medical Journal
Dallan Dargan, Dmitrii Dolgunov, Khin Thida Soe, Pamela Er, Fathimath Naseer, Davide Lomanto, Jimmy By So, Asim Shabbir
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) outcomes among adolescents and adolescent obesity associated factors in Singapore were evaluated. METHODS: Prospectively collected data of patients aged 16-19 years at first presentation who underwent LSG was retrospectively reviewed. A questionnaire was completed incorporating cigarette, alcohol, dietary and exercise habits; family history of obesity; Berlin and Epworth scores; and Patient Health Questionnaire-9 (PHQ-9) scores...
October 6, 2017: Singapore Medical Journal
Sun Kuie Tay, Bee-Wah Lee, Woo Yun Sohn, I-Heng Lee, Gaurav Mathur, Melvin Sanicas, Georges Van Kriekinge
INTRODUCTION: Cervical cancer is the tenth most common cancer and the eighth most frequent cause of death among women in Singapore. Human papillomavirus (HPV) infection is the necessary cause of cervical cancer and therefore the risk of cervical cancer can be substantially reduced through vaccination. This study was conducted to evaluate the cost-effectiveness of two-dose HPV vaccination, as part of a national vaccination programme for 12-year-old girls in Singapore, from the perspective of the healthcare payer...
October 6, 2017: Singapore Medical Journal
Sashikumar Ganapathy, Joo Guan Yeo, Xing Hui Michelle Thia, Geok Mei Andrea Hei, Lai Peng Tham
INTRODUCTION: This study aimed to determine the usefulness and validity of the triaging scale used in our emergency department (ED) by analysing its association with surrogate clinical outcome measures of severity consisting of hospitalisation rate, intensive care unit (ICU) admission, length of ED stay, predictive value for admission and length of hospitalisation. METHODS: A retrospective observational study was conducted of the performance markers of Singapore Paediatric Triage Scale (SPTS) to identify children that needed immediate and greater care...
October 6, 2017: Singapore Medical Journal
Brian Kp Goh, Ser-Yee Lee, Chung-Yip Chan, Jen-San Wong, Peng-Chung Cheow, Alexander Yf Chung, London Lpj Ooi
INTRODUCTION: Presently, experience with robot-assisted laparoscopic (RAL) hepatobiliary and pancreatic (HPB) surgery remains limited worldwide. In this study, we report our early experience with RAL HPB surgery in Singapore. METHODS: A retrospective review was conducted of the first 20 consecutive patients who underwent RAL HPB surgery at a single institution over a 34-month period from February 2013 to November 2015. The 20 cases were performed by three principal surgeons, of which 17 (85...
October 6, 2017: Singapore Medical Journal
Judith Prakash
No abstract text is available yet for this article.
September 26, 2017: Singapore Medical Journal
Joo-Hyun Jun, Gaab-Soo Kim, Jeong Jin Lee, Justin S Ko, Sung Joo Kim, Pil Hyun Jeon
INTRODUCTION: This prospective observational study compared the postoperative analgesic effectiveness of intrathecal morphine (ITM) and surgical-site infusion (SSI) of ropivacaine as adjuncts to intravenous (IV) patient-controlled analgesia (PCA) (fentanyl) in living-donor kidney transplant recipients. METHODS: Patients undergoing living-donor kidney transplantation receiving ITM or SSI in addition to IV PCA were included. Rescue analgesia was achieved with IV meperidine, as required...
August 14, 2017: Singapore Medical Journal
Xinqi Look, May Un Sam Mok, Yan Sheng Tay, Hairil Rizal Abdullah
INTRODUCTION: Knowing how patients value quality of anaesthesia helps anaesthesiologists to customise their service. However, generalising findings from Western population-based willingness-to-pay (WTP) studies across different cultures and societies might overlook several important contextualised understandings of anaesthesia experience for Singapore patients. This study aimed to capture the Singapore perspective of undesired post-anaesthesia outcomes. METHODS: 132 patients recruited in the pre-anaesthetic evaluation clinic were given questionnaires describing ten possible post-anaesthetic outcomes to rank for undesirability and assign relative value through proportioning hypothetical SGD 100 to avoid their occurrence...
August 14, 2017: Singapore Medical Journal
Zoe Xz Zhang, Yang Yong, Wan C Tan, Liang Shen, Han Seong Ng, Kok Yong Fong
INTRODUCTION: Pneumonia is associated with considerable mortality. However, the information on age-specific prognostic factors for death from pneumonia is limited. METHODS: Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years; 65-84 years; and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction...
August 14, 2017: Singapore Medical Journal
Ho Lam Nguyen
No abstract text is available yet for this article.
September 2017: Singapore Medical Journal
Koo Hui Chan, Swee-Chong Seow, Huay Cheem Tan
No abstract text is available yet for this article.
September 2017: Singapore Medical Journal
Vijo Poulose, Choon How How
No abstract text is available yet for this article.
September 2017: Singapore Medical Journal
Si Wei Kheok, Keh Oon Ong
Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review illustrates the wide range of imaging presentations of these lesions at various sites and their pathognomonic features. The main lesions reviewed include intraosseous lipoma, liposclerosing myxofibrous tumour, lipoma arborescens and intra-articular lipoma.
September 2017: Singapore Medical Journal
Yi-Ting Laureen Wang, Swee-Chong Seow, Devinder Singh, Kian-Keong Poh, Ping Chai
Diagnostic errors can occur when physicians rely solely on computer electrocardiogram interpretation. Cardiologists often receive referrals for computer misdiagnoses of atrial fibrillation. Patients may have been inappropriately anticoagulated for pseudo atrial fibrillation. Anticoagulation carries significant risks, and such errors may carry a high cost. Have we become overreliant on machines and technology? In this article, we illustrate three such cases and briefly discuss how we can reduce these errors.
September 2017: Singapore Medical Journal
Annagrazia Cecere, Graziano Riccioni, Nicola Sforza, Riccardo Marano, Giuseppe Guglielmi
INTRODUCTION: The primary endpoint of this study was to determine the prevalence of coronary artery disease (CAD) and coronary artery calcium score (CACS) using coronary computed tomography angiography (CCTA) among patients with polyvascular atherosclerosis (PVA). Secondary endpoints were to evaluate the prevalence of cardiovascular risk factors and determine the predictors of PVA. METHODS: The presence of atherosclerotic disease was assessed using ultrasonographic vascular examination in 515 asymptomatic patients...
September 2017: Singapore Medical Journal
Huay Cheem Tan, Rajiv Ananthakrishna
In the field of percutaneous coronary intervention, the evolution of coronary metal stents has been well established for the past three decades, but research on bioresorbable scaffolds has only gained momentum in the recent past. Although second-generation drug-eluting metal stents are the gold standard for the treatment of obstructive coronary artery disease, a few drawbacks exist. The development of bioresorbable scaffolds is an attempt to overcome the limitations of metal stents. This review highlights the rationale for the bioresorbable scaffold, its properties and potential applications...
September 2017: 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. We 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 in Singapore...
September 2017: Singapore Medical Journal
Vasilios Galanis, Alice Fiska, Stylianos Kapetanakis, Konstantinos Kazakos, Thespis Demetriou
INTRODUCTION: This study evaluates the effect of autologous platelet-rich plasma (PRP) combined with xenogeneic demineralised bone matrix (DBM) on bone healing of critical-size ulnar defects (2-2.5 times the ulnar diameter) in New Zealand White rabbits. METHODS: Critical-size defects were created unilaterally in the ulna of 36 rabbits, while keeping the contralateral limb intact. They were divided into three groups. In Group A, the defect was filled with autologous PRP and in Group B, with autologous PRP combined with DBM; in Group C, the defect remained empty...
September 2017: Singapore Medical Journal
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