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Mesothelial Splenic Cyst—A Case Report

Non-parasitic cystic lesions of the spleen are unusual. They are classified essentially as primary (true, epithelial) and secondary (pseudo, non-epithelial) based on the presence...

A Review of Patients with High-risk Carcinoma of the Cervix Treated with Combined Surgery and Postoperative Radiotherapy

It is generally accepted that early stage invasive carcinoma of the cervix, stage I to stage IIA disease, can be treated with equal effectiveness...

Bronchoscopy in the Intensive Care Unit (ICU)

Flexible fibreoptic bronchoscopy (FFB) has become an indispensable tool in the optimal management of intensive care unit (ICU) patients with both diagnostic and therapeutic...

The StuI Polymorphism on Exon 8 of the Low Density Lipoprotein (LDL) Receptor Gene: Prevalence and Impact on Serum Lipid Levels in an Asian Cohort

The low density lipoprotein (LDL) particles in the plasma carry most of the cholesterol in circulation. High levels of plasma cholesterol and LDL-cholesterol are...

Use of Central Venous Lines in Paediatrics—A Local Experience

Peripheral access by venous cut down, once popular in the 1950s and 1960s, has almost become obsolete with the introduction of the Seldinger technique...

Soft Tissue Cover in Compound and Complicated Tibial Fractures Using Microvascular Flaps

Compound tibial fractures are high-energy traumatic injuries, which are frequently associated with high incidence of complications like infection and failure of bony union leading...

Non-diagnostic Smears in Aspiration Cytology of Palpable Breast Lumps

A wide variety of neoplastic and non-neoplastic lesions have been described in the breast. Breast tissue is also subjected to many physiologic changes such...

Excimer Laser Phototherapeutic Keratectomy for Recurrent Corneal Erosions

Recurrent cornea1 erosion (RCE) syndrome is a commonly encountered clinical condition which may be difficult to treat. Hansen first described it in 1872. This article...

Re-expansion Pulmonary Oedema Following One-lung Ventilation —A Case Report

A 15-year-old female patient weighing 40 kg with asymptomatic but severe scoliosis was admitted for correction of a skeletal deformity via a thoracoscopic anterior...

Hypoglycaemia from Islet Cell Hyperplasia and Nesidioblastosis in a Patient with Type 2 Diabetes Mellitus—A Case Report

A 57-year-old woman was admitted to our hospital for perforated left tubo-ovarian abscess and found to have newly diagnosed diabetes with an admission blood...

Subcutaneous Emphysema and Pneumomediastinum after Endotracheal Anaesthesia

Pneumomediastinum is a well-recognised clinical entity. It may present either intraoperatively or postoperatively from a number of possible causes. This article is available only as...

The Predictive Value of Intraoperative ST-segment Monitoring as a Marker of Myocardial Injury

Patients with ischaemic heart disease have a high incidence of perioperative ischaemia resulting in an increased risk of cardiac events in the post-surgical period.1...

Pathology of Ductal Carcinoma In situ of the Breast: A Heterogeneous Entity in Need of Greater Understanding

Breast cancer is the commonest malignancy in Singapore women, with an age-standardised rate of 46.1 per 100,000 per year and an annual increase in...

Sudden Death Due to Granulomatous Myocarditis: A Case of Sarcoidosis?

Granulomatous myocarditis and sarcoidosis are considered uncommon entities in our local community and sudden death due to either condition has not been described in...

CerbB2 Status in Breast Cancer: Pathologic Issues

The cerbB2 gene, also known as Her2/neu, encodes a transmembrane cell receptor with tyrosine kinase activity and epidermal growth factor receptor homology. All normal...

A Review of Cutaneous Granulomas and Lupus Vulgaris Following BCG Vaccination in a Skin Hospital in Singapore

BCG vaccines are live vaccines derived from a strain of Mycobacterium bovis that was attenuated by Calmette and Guerin at the Pasteur Institute in...

A Twelve-year Review of Radical Cystectomies in Singapore General Hospital

Bladder carcinoma is the tenth most common cancer affecting men in Singapore. It is more common in men with an age-standardised incidence rate of...

Subdural Block—From a Spinal? A Case Report

There have been multiple reports of accidental subdural blocks published in the last 20 years. Majority of these have been the result of an...

Problems Related to Epidural Analgesia for Postoperative Pain Control

Epidural analgesia has been shown to provide excellent pain relief following thoracotomy, abdominal and other surgery. Studies have shown improvement in specific variables with...

Audit of Total Parenteral Nutrition in an Adult Surgical Intensive Care

Total parenteral nutrition (TPN) may contribute to good outcome in selected groups of patients. Parenteral nutrition is highly effective in reversing effects attributable to...

Epidemiology of Beta-haemolytic Group G Streptococcal Bacteraemia in Singapore (1996 to 1998)

Human isolates of group G streptococci (GGS) that form large colonies are similar to group A streptococci (GAS) in terms of virulence and cause...

Nipah Encephalitis Outbreak in Malaysia

From September 1998 to June 1999, there was an outbreak of viral encephalitis in several pig farming villages in Malaysia. The outbreak, which started...

An intensely pruritic disseminated skin eruption

A 64-year-old man presented to the dermatology outpatient clinic with a 4-month history of pruritic papules. He had a significant medical history of thyrotoxicosis,...

Lymphomas Involving Waldeyer’s Ring: Placement, Paradigms, Peculiarities, Pitfalls, Patterns and Postulates

As the histopathological diagnosis of any lymphoma still largely hinges upon the demonstration of lymphoid architectural abnormality, the pathologist must first be cognizant of...

Melanocytic Lesions of the Face: Diagnostic Pitfalls

Cutaneous melanocytic lesions are amongst the commonest tumours in all races but are more common in Caucasians with fair skin. Although most are benign...

Transurethral Resection of Prostate (TURP) Through The Decades – A Comparison of Results Over the Last Thirty Years in a Single Institution in Asia

Over the last 70 years, transurethral resection of prostate (TURP) has been used in the surgical treatment of benign prostatic hyperplasia (BPH) and is...

Acute Isolated Sphenoid Sinusitis

Isolated infection of the sphenoid sinus is uncommon. It usually occurs in conjunction with infection of the other paranasal sinuses. Acute isolated sphenoid sinusitis...

Audit of Diagnostic and Interventional Craniocervical Catheter Angiographic Procedures at the Singapore General Hospital

Catheter angiography has long been considered the diagnostic standard by which the accuracy of other vascular imaging modalities are compared, given its superior contrast...

The HercepTest and Routine C-erbB2 Immunohistochemistry in Breast Cancer: Any Difference?

The proto-oncogene c-erbB2 (also known as HER2/neu) is located on chromosome 17q21 and encodes a 185-kD transmembrane glycoprotein. It belongs to the human epidermal...

Spectrum of Dentofacial Deformities: A Retrospective Survey

Deformity refers to distortion of any part of the body. The term dentofacial is related to the dental arches and their effects on facial...

Presumed Dapsone-induced Drug Hypersensitivity Syndrome Causing Reversible Hypersensitivity Myocarditis and Thyrotoxicosis

A 22-year-old Malay soldier doing his National Service was warded with a 6-day history of an itchy generalised rash associated with fever and lymphadenopathy....

Study of Inherited Metabolic Disorders in Singapore – 13 Years Experience

Inborn errors of metabolism (IEMs) described in the early 1900s by Garrod were due to a block in a metabolic pathway, arising from an...

External Proficiency Testing Programmes in Laboratory Diagnoses of Inherited Metabolic Disorders

In order to monitor and ensure the quality of our laboratory diagnoses for inherited metabolic disorders (IMDs), our laboratory participated in the proficiency testing...

Bodies Recovered from Wells, Sewerage Systems and Pits: What is the Cause of Death?

It may be difficult to determine the identities, and cause and time of death in corpses found in wells, sewer systems and pits because...

Buprenorphine-associated Deaths in Singapore

Buprenorphine is a thebaine derivative that was developed in the 1970s for pain relief. It was approved for substitution therapy in France in 1996,...

Can Long-term Corticosteroids Lead to Blindness? A Case Series of Central Serous Chorioretinopathy Induced by Corticosteroids

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterised by serous detachment of the macula, retinal pigment epithelial (RPE) detachment and areas of RPE...

Plasma and Urine Amino Acid Profiles in a Healthy Adult Population of Singapore

Analysis of blood plasma and urinary amino acids is required for the diagnosis and management of inherited metabolic disorders (IMDs) affecting one or more...

Ethambutol-associated Optic Neuropathy

Tuberculosis (TB) has been present since ancient times. Around 460 BC, Hippocrates identified phthisis, which is the Greek term for consumption (TB seemed to...

Carbon Monoxide Poisoning: A Five-year Review at Tan Tock Seng Hospital, Singapore

Carbon monoxide (CO) is an odourless, tasteless and toxic gas and is the most abundant pollutant in the lower atmosphere. It is produced largely...

Swallowed Foreign Bodies in Children: Report of Four Unusual Cases

Foreign body (FB) ingestion in children is a frequent and frightening experience to the patients and caregivers. It is a common paediatric problem necessitating...

A Review of Clinical Pathway Data of 1663 Total Knee Arthroplasties in a Tertiary Institution in Singapore

Total knee arthroplasty (TKA) has been established as an effective treatment modality for patients with symptomatic knee arthritis. It provides predictable decrement in pain,...

Obesity and Obstructive Sleep Apnoea Hypopnoea Syndrome in Singapore Children

Obesity is becoming a problem of epidemic proportions and is perhaps, the most pervasive medical problem faced by medical providers today. It is a...

The Relationship between Postoperative Complications and Outcomes after Hip Fracture Surgery

Hip fractures constitute a major health concern for older persons and are associated with significant morbidity and mortality, with 1-year mortality rates ranging from...

Prophylaxis Against Endopthalmitis in Cataract Surgery

Endophthalmitis is an uncommon but potentially devastating complication of cataract surgery and often carries a poor prognosis. Due to variations in study design and...

Pericardial Thymoma: An Unusual Cause of Sudden Death

Thymomas are located in the normal location of the thymus, the anterior mediastinum. It is very rare for thymomas to arise primarily intrapericardialy. This article...

Advanced Burkitt’s Lymphoma Presenting With Jejunal Perforation

Burkitt’s lymphoma (BL) is a high grade B-cell neoplasm under the umbrella of non-Hodgkin’s lymphomas. It is predominantly seen in children but may also...

Arteriovenous Fistula Aneurysm – Plicate, Not Ligate

Arteriovenous fistulae (AVF) are created for haemodialysis in patients with end-stage renal failure. While AVF is a lifeline for these patients, its creation is...

A Brief History of Pathology and the Chapter of Pathologists

A history of the Chapter of Pathologists would be incomplete without a history of the specialty of Pathology in Singapore. Pathology is in fact...

Perforated Appendicitis in Children: Benefits of Early Laparoscopic Surgery

Despite perforated appendicitis (PA) being a common surgical emergency in childhood, controversy still exists with regard to its management in this era of minimal...

Epidemiology and Management of Surgical Upper Limb Infections in Patients with End-stage Renal Failure

Hand infections are common in the general population, and their management is usually uncomplicated. Several papers have noted that patients with diabetes mellitus have...

Primary Epithelioid Angiosarcoma of the Lung Presenting as Left-sided Shoulder Pain

Primary angiosarcoma of the lung is a rare, often difficult to diagnose disorder with non-specific respiratory manifestations. Angiosarcoma involving the lung is usually a...

Macronodular Tuberculosis: Imaging Resemblance of Cholangiocarcinoma

The ability of multiphasic computed tomography (CT) and magnetic resonance (MR) studies in the diagnosis of liver tumours such as hepatocellular carcinoma and cholangiocarcinoma...

Phosph-Akt1 Expression is Associated with a Favourable Prognosis in Pancreatic Cancer

Pancreatic cancer is the fourth leading cause of cancer related mortality worldwide with an estimated 34,290 deaths recorded in the United States in 2008....

Brachial Approach for Coronary Angiography and Intervention: Totally Obsolete, or a Feasible Alternative When Radial Access is Not Possible?

The possible methods of reaching the coronary vasculature using a percutaneous technique are limitless: the radial, femoral, brachial, ulnar, subclavian and axillary arteries, and...

The Singapore National Healthcare Group Diabetes Registry – Descriptive Epidemiology of Type 2 Diabetes Mellitus

Diabetes mellitus is one of the most challenging global health problems in the 21st century. It is associated with excess mortality and significant morbidity...

Drug-induced Kidney Disease – Pathology and Current Concepts

Departing from the usual account of drug-induced renal disease according to the specific type of drug, we divide this discussion into 3 main areas...

Functional Outcomes of Cancer Patients in an Inpatient Rehabilitation Setting

Cancer is the leading cause of death and the second most common cause of hospitalisation in Singapore. Cancer rehabilitation aims to help the patient...

Genome-wide Association Studies: Promises and Pitfalls

Genetic testing is an important means to confirm the diagnosis of an inheritable disease. For this to be feasible, genes that are associated with...

Clinical Outcome and Cost Comparison Between Laparoscopic and Open Appendicectomy

Acute appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention. The traditional operation of choice was the open...

Neonatal and Paediatric Extracorporeal Membrane Oxygenation (ECMO) in a Single Asian Tertiary Centre

Extracorporeal membrane oxygenation (ECMO) is a cardiopulmonary bypass technique (CPB) introduced by Bartlett in 1972, which provides life-saving support in patients with refractory yet...

Diagnosing Bacteraemia Early in Older Adults

Sepsis is a prevalent and important cause of morbidity and mortality in the general population. Approximately 750,000 patients in the United States alone develop...

Risk Factors for Severe Adenovirus Infection in Children during an Outbreak in Singapore

Human adenoviruses (HAdVs) are well known pathogens that cause a variety of human illnesses. They are non-enveloped, linear double-stranded deoxyribonucleic acid (DNA) viruses. More...

Safety and Effectiveness of Improving Carbapenem Use via Prospective Review and Feedback in a Multidisciplinary Antimicrobial Stewardship Programme

Multidrug-resistant (MDR) bacteria coupled with a rapidly diminishing antimicrobial pipeline has made antimicrobial resistance an international public health problem. Control strategies of MDR bacteria...

Anaerobic Bacteraemia Revisited: Species and Susceptibilities

Over the last 2 decades, the importance of anaerobic bacteraemia has undergone various shifts in opinion. Early studies in the 1970s reported that anaerobes...

Hypervirulent Klebsiella pneumoniae carriage in polyclinic attendees and national servicemen presenting with diarrhoea

Klebsiella pneumoniae liver abscess is an invasive syndrome that mainly affects people living in East Asia. It especially affects adults with diabetes and is...

PLA2R1 and HLA-DQA1 gene variations in idiopathic membranous nephropathy in South China

Membranous nephropathy is an organ-specific autoimmune disease and is the most common cause of adult-onset nephrotic syndrome. The diagnosis of membranous nephropathy mainly depends...

Alternating hemiplegia of childhood presenting as recurrent apnoea in a term newborn infant

Recurrent apnoea in a term infant is usually pathologic, warranting a thorough aetiologic evaluation. An accurate diagnosis is essential in guiding subsequent management and...