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Beyond survival: Addressing gaps in psychosocial support for survivors of childhood cancer

I read with great interest the study conducted by Fong et al. published in this issue of Annals, which evaluated psychological symptoms and health-related quality of life (HRQOL) among a cohort of 143 young adult survivors of childhood cancer in Singapore.1 Almost 1 in 4 survivors demonstrated significant psychological...

Mental wellness and health-related quality of life of young adult survivors of childhood cancer in Singapore

Advancements in technology and cancer treatments have improved childhood cancer survival rates, with up to 85% surviving 5 years or more.1 The Malaysia-Singapore Leukaemia Study Group reported an improvement in overall 5-year survival for the past 20 years in Singapore, from 69% to 91% for acute lymphoblastic leukaemia, which...

Quality of life of family caregivers of children and young adults with Down syndrome: A systematic review and meta-analysis

The family caregiver is “any relative, partner, friend or neighbor who has a significant personal relationship with, and provides a broad range of assistance for a person with a chronic or disabling condition.”1 Family caregivers for children with chronic illnesses are commonly parents, who fulfil their children’s physical and...

Living longer and stronger: Are children and young adults with Down syndrome experiencing healthier and better lives?

Down syndrome (DS) is the most common genetic cause of intellectual disability and is associated with multiple medical conditions affecting various organ systems, impacting the individual’s health, development and function.1 In Singapore, the life-birth prevalence of DS was 0.89 per 1000 births in the 1990s, a figure expected to...

Challenges in genetic screening for inherited endocrinopathy affecting the thyroid, parathyroid and adrenal glands in Singapore

In the current landscape of medicine, it is well known that most diseases incorporate a genetic component to some degree. Genetic testing of human diseases originated in the 1950s, and screening for genetic disorders followed a decade after.1 It is worthwhile noting that the Human Genome Project (1990–2003), which...

VOWELS: A communication framework for disclosing medical errors in medical oncology and palliative care

Dear Editor, Recognising the impact of medical errors on patients and the doctor-patient relationship has underscored the need for better communication.1,2 For the most part, these efforts are informed by Chafe et al.’s 6 steps that entail: (1) the identification of the error in a timely fashion; (2) determination of...

Value the patient as a person: Answering the call for a person-centred model of care

There has been a change in patients’ attitudes towards healthcare professionals in recent decades, coupled with an increasingly evident shift in the care paradigm. In 2015, the World Health Organization released a framework of care that recommends healthcare professionals consciously consider the perspectives of individuals, carers, families and communities....

Impact of pre-existing depression on severe COVID-19 outcomes

The outbreak of the COVID-19 virus in 2019 had rapidly developed into a global pandemic, causing more than 6.8 million deaths and impacting the lives of billions of individuals around the world.1 Public healthcare around the work have mainly focused on the clinical manifestations and treatment of the deadly...

Leveraging ChatGPT to aid patient education on coronary angiogram

Natural-language artificial intelligence (AI) is a promising technological advancement poised to revolutionise the delivery of healthcare.1 Traditionally, inclusion of technology in the augmentation of healthcare communication comprised the use of chatbots, which is limited by a predetermined set of queries and matched answers.2 However, natural-language AI models prompt a...

Surgical margins assessment reduces re-excision rates in breast-conserving surgery

Dear Editor, Breast-conserving surgery (BCS) followed by radiation therapy for breast cancer offers improved cosmetic results and comparable long-term survival rates as mastectomy.1 However, BCS is associated with a higher risk for local recurrence, and published literature has reported re-excision rates as high as 20–70% due to positive resection...

Effects of electroconvulsive therapy on cognition and quality of life in schizophrenia

Schizophrenia is a severe mental disorder with a profound impact on patients, their families, caregivers and society. The global prevalence of lifetime schizophrenia is 0.2–0.4% without significant differences between sex and ethnicity, nor between urban and rural environments.1 The health and economic burden of schizophrenia is significant, given the...

Bridging electroconvulsive therapy in schizophrenia with cognition and quality of life

Schizophrenia is one of the most debilitating severe mental illnesses with significant impact,1 irrespective of culture or socioeconomic class.2 Over the decades, antipsychotic medication has been the mainstay of treatment for patients with schizophrenia. Nevertheless, about 25% of patients do not respond to first-line antipsychotic medication, with more than...

Perception of disease, well-being and financial burden by patients with chronic hepatitis B: A self-reported assessment

Dear Editor, Chronic hepatitis B (CHB) infection affects approximately 248 million individuals in the world1 and 3.6% of the Singapore population.2 Given the natural history of CHB, regular surveillance with blood tests is necessary to ensure early detection of complications such as cirrhosis and hepatocellular carcinoma in patients. Our study...

Psychosocial impact and treatment trends of hidradenitis suppurativa in Singapore

Dear Editor, Hidradenitis suppurativa (HS) is a common disease with a prevalence of about 1%.1 Patients commonly suffer from pain, disfigurement and psychosocial embarrassment, and have a worse quality of life compared to other dermatologic conditions.2,3 It is frequently misdiagnosed as other skin infections and delays in diagnosis are associated...

Diagnostic thresholds for absolute systolic toe pressure and toe-brachial index in diabetic foot screening

Diabetes mellitus is a global healthcare problem. In Singapore, the rising disease burden of this metabolic condition places considerable strain on the healthcare system, with healthcare costs for diabetes mellitus exceeding 1 billion Singapore dollars a year.1 An important complication of diabetes is lower limb loss. As diabetic foot...

The Appropriate Use of Antineutrophil Cytoplasmic Antibody (ANCA) Testing in Rheumatic Diseases

In 1982, Davies and co-workers in Melbourne described the presence of a serum factor that stained the cytoplasm of neutrophil leukocytes by indirect immunofluorescence in 8 patients with generalised illness associated with segmental necrotising glomerulonephritis. This was followed two years later by a report by Hall and co-workers of...

Surface Laser Scanning of the Cleft Palate Deformity —Validation of the Method

Cleft palate morphology and palatal dimensional changes due to growth and treatment have been analysed by numerous quantitative techniques. Many of these methods, however, produce two-dimensional measurements of the three-dimensional cleft palate deformity. This article is available only as a PDF. Please click on “Download PDF” on top to view...

Active Management of a Patient with Endstage Pulmonary Emphysema Using Lung Volume Reduction Surgery and Intensive Rehabilitation

A 65-year-old Chinese man with a 30-pack year history of cigarette smoking was referred to our institution for further management of chronic obstructive pulmonary disease (COPD). Despite smoking cessation for 5 years, and pharmacological treatment with oral theophylline, inhaled ipratropium bromide and ventolin, his dyspnoea had progressed to the...

Measuring Health-related Quality of Life in Singapore: Normal Values for the English and Chinese SF-36 Health Survey

Advances in diagnosis and therapy in the second half of the 20th century have lead to impressive improvements in survival for patients with many chronic illnesses. With improvements in survival, patients’ perceptions of health are increasingly being recognised as an important outcome in clinical medicine, especially in illnesses where...

Validity and Reliability of the EQ-5D Self-report Questionnaire in Chinese-speaking Patients with Rheumatic Diseases in Singapore

Health-related quality of life (HRQoL) refers to patients’ perceptions of their own functioning and well-being. HRQoL is increasingly being used as a primary or secondary endpoint in clinical research and is essential in economic evaluation of new and often expensive therapies. This article is available only as a PDF. Please...

Measuring Quality of Life in Chinese Cancer Patients: A New Version of the Functional Living Index for Cancer (Chinese)

Health-related quality of life (QOL) is recognised as an important aspect of patient care. In oncology studies, it may stand as the primary end-point. Most QOL instruments are developed in English, although about one-fifth of the world’s population is ethnic Chinese. This article is available only as a PDF. Please...

Utility and Validity of the Self-administered SF-36: Findings From an Older Population

The shift towards broader health perspectives and the emphasis on patient preferences have led to the development of many health questionnaires and their inclusion as primary and secondary outcome measures in clinical trials. Measurements of health-related quality of life (HRQOL), a multidimensional concept encompassing physical, emotional and social aspects...

Critiques on the Objective Structured Clinical Examination

Assessment techniques appear to have an impact on study strategies1 and to influence the performance of students.2,3 The proper selection of a method of assessment can improve student performance.2 Faulty methods of assessment can lead to wrong decisions (pass or fail in certain areas) that might be deleterious to...

Standard Setting in Student Assessment: Is a Defensible Method Yet to Come?

To validate any “adjective”, be it for living or non-living, a criteria or standard is needed. Globalisation, mobility of doctors and the rising number of medical institutions make it imperative to have comparable standards in medical teaching learning and assessment. This article is available only as a PDF. Please click...

Isokinetic Dynamometry in Anterior Cruciate Ligament Injury and Reconstruction

Of all the ligaments of the knee joint, the anterior cruciate ligament (ACL) is the most frequently injured despite its structural proficiency and its ability to adjust the stiffness of the knee muscles. ACL injuries typically occur during activities that involve abrupt deceleration or change of direction when the...

Concurrent Validity of Power Output Derived from the Non-motorised Treadmill Test in Sedentary Adults

The use of the Wingate Anaerobic Test (WAnT) for assessing all-out intensity short-duration sprint cycling lasting between 10 and 40 seconds is pervasive. Many consider the WAnT as the reference standard for the assessment of short-duration sprint performance. This article is available only as a PDF. Please click on “Download...

Cross-Cultural Adaptation and Validation of Singapore Malay and Tamil Versions of the EQ-5D

The EQ-5D is a widely used preference-based instrument (available in at least 60 language versions and used in more than 800 published studies to date1 ) that provides both a health profile (for assessing health status) and health utility index for individuals or groups, thus allowing clinical and economic...

Staging of Benign Prostate Hyperplasia is Helpful in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostate Hyperplasia

Benign prostate hyperplasia (BPH), one of the most common diseases of ageing men, affects the quality of life by interfering with normal daily activities and sleep patterns. The current treatment options for patients with lower urinary tract symptoms (LUTS) suggestive of BPH mainly depend on the severity of the...

Psychological Symptoms in People Presenting for Weight Management

Multiple factors contribute to the genesis and maintenance of obesity which is a difficult condition to treat and weight loss is often not maintained. The psychological problems found in obese patients have recently received increasing attention. This article is available only as a PDF. Please click on “Download PDF” on...

Diagnostic Accuracy of Anthropometric Indices for Obesity Screening Among Asian Adolescents

Obesity or excess body fat is strongly associated with enhanced risks of morbidity and mortality, and its prevalence is rapidly escalating worldwide. Despite these concerns, no standard definition of obesity for screening, diagnosis and subsequent intervention has been agreed upon internationally. The current definitions are mostly defined statistically, and...

Complementary and Alternative Medicine among Singapore Cancer Patients

Worldwide, the use of Complementary and Alternative Medicine (CAM) by cancer patients is highly prevalent. For cancer specialists, knowledge on CAM use in their patients is particularly important as there can be potentially hazardous drug interactions between some forms of oral CAM and chemotherapy or radiotherapy. This article is available...

Health-related Quality of Life is Associated with Diabetic Complications, but not with Short-term Diabetic Control in Primary Care

Type 2 diabetes mellitus is a major chronic disease globally. With increasing life expectancy, long-term complications of diabetes mellitus leading to significant morbidity and mortality have great impact on each patient’s health. Health-related quality of life refers to a person’s self-perceived functioning and well-being, and is increasingly used to...

Quality of Life in Pathological Gamblers in a Multiethnic Asian Setting

Pathological gambling is categorized under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) as an impulse control disorder not elsewhere classified. The disorder is characterised by an excess preoccupation with gambling, need to gamble with increasing amounts of money in order to achieve the desired excitement,...

Asian Adaptation and Validation of an English Version of the Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL)

Multiple sclerosis (MS) is one of the most common disorders of the central nervous system with a lifetime risk of 1 in 400. In about 75% of MS patients, activities of daily living will become affected at later stages. In up to 15% of patients, the disabilities will become...

The Health-Related Quality of Life of Junior Doctors

It is widely reported that junior doctors experience a large amount of work-related stress and fatigue. This has detrimental effects both on the well-being of the junior physicians and the health and well-being of the patients that they are treating. Junior doctors, especially those undergoing traineeship, have shown high...

Accuracy of self-reported height, weight and BMI in a multiethnic Asian population

Overweight and obesity continue to be one of the most critical public health issues worldwide. Body mass index (BMI) derived from height and weight has been directly linked to a number of debilitating diseases, including diabetes, heart disease and cancer, and has gained increased popularity as a measure of...