Online First

Online First articles are peer reviewed and published ahead of their volume issues. To see the final published article, refer to the article DOI link.

A novel opioid-sparing method for post-laparotomy pain management in gynaecologic oncology patients

Dear Editor, Midline laparotomy incisions often result in significant postoperative pain due to nociceptive stimulation of the skin, musculofascial layers and peritoneum. This pain can lead to tachycardia, tachypnoea, decreased intestinal motility, and stress responses such as hyperglycaemia and increased cortisol production.1 Poor pain control contributes to prolonged hospitalisation, increased...

Validation of clinical frailty scale scoring tools for older adults attending the emergency department of a tertiary hospital in Singapore

Dear Editor, Frailty increases vulnerability to dependency and death.1 With Singapore’s ageing population, early frailty identification in the emergency department (ED) is critical yet constrained by time and resources. Clinical Frailty Score (CFS) is a validated 9-point tool used for frailty identification, with scores ³5 indicating frailty (Supplementary materials Appendix...

Virtual reality-based cognitive training for MCI in the elderly: A feasibility randomised pilot study

Dear Editor, Mild cognitive impairment (MCI) is an at-risk state for progression to dementia where cognitive functions are objectively impaired but functional abilities remain preserved. Current prevalence of MCI among Singaporean Chinese older adults aged 60 and above stands at 12.5%, but this estimate is projected to rise with population...

Sniffin’ Sticks and Scentsor for integrating the “forgotten sense” into everyday practice

The sense of smell has been one of the most neglected of the 5 human senses, perhaps due to its intangible, amorphous, ephemeral and seemingly subjective nature. A survey of the UK public revealed that the sense of smell was valued behind sight, hearing, balance, touch and even taste!1...

Pulling teeth or pulling together? Time to improve antibiotic prescribing in dentistry

Antibiotic use in third molar (3M) surgeries is commonplace despite a growing body of evidence showing that routine prophylactic antibiotics offer little benefit in healthy patients. It also fuels the global public health crisis of antimicrobial resistance (AMR). This practice appears to remain deeply entrenched worldwide and is believed...

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...

Fluoride benefits and risks: Lessons from 70 years of water fluoridation in Singapore

On 6 January 2025, Taylor et al. published a systematic review and meta-analysis investigating fluoride exposure and children’s intelligence quotient (IQ) in the Journal of the American Medical Association Pediatrics (JAMA Pediatrics).1 They concluded that there were “inverse associations and a dose-response association between fluoride measurements in urine and...

It’s virtually a normal delivery! Revolutionising obstetric teaching with emerging technologies

Witnessing the start of life in the labour ward is the hallmark of every medical student’s obstetrics & gynaecology (O&G) rotation.1 In recent years, however, there has been a trend away from demonstrating competence in independently conducting routine vaginal births (VBs) towards one of participation or observation due to...

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