Current Issue

Volume 54, Number 4
April 2025

Myocardial infarction-ischaemic-injury index algorithm demonstrates accuracy in risk stratifying emergency patients presenting with chest pain. The algorithm is developed using gradient boosting that considers age, sex and troponin I results for the risk stratification. (See full article, p.219).

Illustration by Maria De-Castro

Striving for our most vulnerable children: Buffering against the impact of child maltreatment

One of the fundamental pillars of our society is the presence of strong and stable families. In 2024, the inaugural edition of the Domestic Violence Trends Report1 by the Ministry of Social and Family Development, which provides an overview of key domestic violence trends in Singapore, was published. From...

The impact of Anchor, a home visitation programme for maltreated children, on child developmental and behavioural outcomes

Adverse childhood experiences (ACEs) can occur in the form of abuse (physical, emotional, sexual), neglect (physical, emotional) and household dysfunction. The first ACEs study published in 1998 demonstrated the association between ACEs and multiple risk factors of mortality in adulthood.1 The greater the number of ACEs exposure, the higher...

Clinical and echocardiographic differences between rheumatic and degenerative mitral stenosis

Mitral stenosis (MS) commonly arises from either rheumatic heart disease or a degenerative calcification of the mitral valve (MV) apparatus.1 Rheumatic heart disease is overall the leading cause of valvular heart disease in the developing world, and rheumatic MS (RMS), with its association with rheumatic fever, remains prevalent in...

Pregnancy-associated breast cancer: Management of the mother, fetus and tumour

Breast cancer (BC) is the most common cancer affecting females worldwide, accounting for more than 50% of cancers in young females.1 It occurs in 1 in 3000–10,000 pregnancies, with reported incidence rising with delayed childbearing.2 The age standardised incidence rate in Singapore increased by 24.2% from 1993 to 2002.3...

Re-evaluating adjuvant systemic therapy in cancer treatment: Scientific rigour to guide policy and practice

In the 1980s, perioperative chemotherapy succeeded in improving survival for children with osteosarcoma and validated a fundamental premise: eradication of micrometastatic disease reduces distant relapse and improves survival for a proportion of patients with solid tumours undergoing curative surgery.1 This data was built upon preclinical insights suggesting that cytotoxic...

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