In clinical medicine the diagnosis is often established according to a known aetiology or an elucidated patho-physiology. A recent trend in management is to follow certain “evidence-based medicine” guidelines, which are often established by some consensus and then recommended as the “gold standard”.1 Psychiatric diagnoses, and the definition of...

Schwannomas, also known as neurilemmomas, neuromas, or neurinomas, are uncommon nerve sheath neoplasms that may originate from any peripheral, cranial or autonomic nerve of the body with the exception of the olfactory and optic nerve. Malignant change is unusual. Some 25% to 45%1 of schwannomas are located in the...

The incidence of malignancy in multinodular goitres have been found to vary from 4% to 17%.1 The incidence of malignancy in solitary nodules is not significantly higher.2 These studies alluded to the fact that the risk of malignancy in both multinodular goitres and solitary thyroid nodules is not negligible....

Intravenous thrombolysis in acute cerebral infarction has been proven to be efficacious in improving functional outcome if given within 3 hours from stroke onset.1 Singapore recently received national licensing for the use of intravenous thrombolysis for this indication. Delay in hospital presentation is an important hindrance to the administration...

Carotid stenosis is a clear marker of increased stroke risk and is an important parameter in clinical risk stratification. Grading carotid stenosis has a direct impact on management decisions in view of the benefit provided by carotid endarterectomy in symptomatic patients with 70% to 99% stenosis.1 Patients in this...