Featured Articles

Development and validation of odour identification tests for olfactory assessment in Singapore

Olfactory dysfunction affects patients under the care of various medical specialties. Its causes include post-viral upper respiratory tract infections, such as that caused by the SARS-CoV-2 virus, post-traumatic brain injury and neurodegenerative conditions such as Parkinson’s disease. The prevalence of olfactory impairment among community-dwelling, older Singapore residents is estimated...

Utilising a COM-B framework to modify antibiotic prescription behaviours following third molar surgeries

Antimicrobial resistance (AMR) is a critical global public health crisis, associated with 4.7 million deaths worldwide in 2021 alone.1 Antibiotic stewardship is one of the key interventions in the World Health Organization’s multipronged strategy to combat AMR.2 Antibiotic stewardship is a systematic approach aimed to educate and support healthcare...

Singapore clinical guideline on parenteral nutrition in adult patients in the acute hospital setting

Parenteral nutrition (PN) is an intravenous nutrition therapy used when oral and/or enteral nutrition (EN) is not possible or is insufficient for complete nutrition. It is an admixture formulation containing essential nutrients, including dextrose, amino acids, lipid emulsion, electrolytes, vitamins and trace elements, for the maintenance of life. The...

Preterm birth trends and risk factors in a multi-ethnic Asian population: A retrospective study from 2017 to 2023, can we screen and predict this?

Preterm birth (PTB), defined by the World Health Organization as delivery before 37 weeks of gestation, is the primary contributor to perinatal morbidity and mortality worldwide.1-3 Despite advances in clinical and public health interventions, global PTB rates have remained relatively constant at approximately 10%.4 Rates vary by region and...

Omicron SARS-CoV-2 outcomes in vaccinated individuals with heart failure and ischaemic heart disease

Respiratory viral infections are a relatively common cause of heart failure (HF) exacerbations, with higher risk of adverse outcomes observed in HF episodes precipitated by infection.1 Multiple reports from the initial phase of the COVID-19 pandemic reported higher mortality and in-hospital complications associated with a history of HF and...

Variations in management strategies for stable coronary artery disease in the Asia-Pacific region: Insights from a multinational survey

INTRODUCTION Ischaemic heart disease remains the leading cause of morbidity and mortality worldwide, and Asia being the most populous region in the world has shown an increasing prevalence of coronary artery disease (CAD) and related mortality compared to Western countries; 58% of cardiovascular deaths worldwide occurred in Asia in 2019...

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...

Machine learning to risk stratify chest pain patients with non-diagnostic electrocardiogram in an Asian emergency department

Risk stratification of patients presenting with chest pain poses a frequent, often difficult, challenge to the emergency physician. Cardiac biomarkers such as troponin are an important part of the evaluation of the patient suspected of having acute coronary syndrome (ACS). Serial readings are traditionally needed for troponin, given that...

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