[metaslider id="5280"]

Related Articles

Cryptococcal Prostatic Abscess in an Immunocompromised Patient: A Case Report and Review of the Literature

Cryptococcosis is a well-recognised infection in immunocompromised patients, although its prevalence varies with the type of immune defect. We report a patient with myasthenia...

Risk Factors for Predicting Mortality in a Paediatric Intensive Care Unit

Following the rapid advances in medical therapy and critical care technology over the past 30 years, coupled with the spiralling cost of medical care,...

Repair of Complex Ureterovaginal and Vesicovaginal Fistulas with Ileal Cystoplasty and Ureteric Reimplantation into an Antireflux Ileal Nipple Valve—A Case Report

Urogenital fistulas are a known but uncommon complication of gynaecological surgery, especially those involving a malignant process. Its incidence does not exceed 2%. This article...

A Case Report—Delayed Vesicocutaneous Fistula After Radiation Therapy for Advanced Vulvar Cancer

To our knowledge this is the first reported case of an isolated vesicocutaneous fistula related to previous radiation therapy for recurrent vulvar cancer. This article...

Outcome of Obstructive Uropathy After Pelvic Irradiation in Patients with Carcinoma of the Uterine Cervix

Radiotherapy is the mainstay treatment for locally advanced carcinoma of the cervix. It is also administered as an adjuvant therapy to patients deemed at...

Re: Haematuria in the Diagnosis of Urinary Calculi. SBS Ooi, NW Kour, A Mahadev. Ann Acad Med Singapore 1998; 27:210-4

The above article highlights the insensitivity of urine microscopy compared with the Combur 9 test for detecting haematuria associated with urinary calculi. In the...

Outpatient Treatment of Middle and Lower Ureteric Stones: Extracorporeal Shock Wave Lithotripsy versus Ureteroscopic Laser Lithotripsy

Significant technological advances have been made in the management of ureteric calculi. The newer semirigid, fibreoptic ureteroscopes can now be passed with minimal trauma...

Infections in Acute Lymphoblastic Leukaemia

Children undergoing chemotherapy for cancer are especially vulnerable to infection because of immunosuppression related to their underlying illness, the effects of chemotherapy and radiotherapy....

Childhood Leukaemia: Towards an Integrated Psychosocial Intervention Programme in Singapore

In the last two decades there has been a surge of interest concerning the psychosocial correlates of life-threatening illnesses. Research in this area has...

Caudal Morphine in Paediatric Patients: A Comparison of Two Different Doses in Children after Major Urogenital Surgery

The use of caudal preservative-free morphine for postoperative analgesia in children has gained popularity since it was first described by Jensen. Several studies have...

A Retrospective Study of Infants with Severe Persistent Pulmonary Hypertension (PPHN) Managed without Extracorporeal Membrane Oxygenation (ECMO)

Persistent pulmonary hypertension (PPHN) is an important cause of neonatal mortality amongst infants who are of term or post-term gestation. The most severely ill...

Five Paediatric Case Reports of the Use of Adenosine in Supraventricular Tachycardia

Adenosine has been shown to be effective in terminating supraventricular tachycardia in adults and children. However, the use of adenosine has not been previously...

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...

Traumatic Dislocation of the Testes

Traumatic dislocation of the testes is uncommon. The first case was reported by Claubry in 1818 in Paris, when a 20-year-old soldier was run...

Survey of Aerobic Bacterial Infections in Paediatric Surgical Intensive Care Unit Patients

Data on infections in paediatric surgical patients are few in the literature. Although there are many studies on infection in adult surgical and paediatric...

Haematuria in the Diagnosis of Urinary Calculi

Patients with renal or ureteric colic are commonly seen at our Emergency Department. We routinely check their urine for haematuria using the Combur 9...

Is Staging of Benign Prostatic Hyperplasia (BPH) Feasible?

Staging of disease is important. It serves as a guide for further management and also for comparing the results of treatment. Traditionally this has...

Perinatal Drug Abuse in KK Women’s and Children’s Hospital

In recent years, perinatal drug abuse has been emerging as an area of major concern for the perinatologists. Chasnoff found the prevalence of substance...

The Outcome of Trial Off Catheter after Acute Retention of Urine

Acute retention of urine (ARU) is the commonest urological condition requiring emergency admission to hospital and is usually managed by urethral catheterisation. Previously, patients...

Renal Cell Carcinoma in Patients with Chronic Renal Failure

Dunnil and associates first described the association of renal cell carcinoma (RCC) with acquired cystic kidney disease (ACKD) and end stage renal disease. The...

Inferior Vena Cava Thrombectomy for Renal Cell Carcinoma with Thrombus

A characteristic feature of renal cell carcinoma is the development of tumour thrombus extending into the inferior vena cava (IVC). This takes place in...

Parainfluenza Type 3 Viral Outbreak in a Neonatal Nursery

Parainfluenza viruses are relatively large RNA paramyxoviruses. Four serologic types cause disease in humans. This article is available only as a PDF. Please click on...

T Wave Alternans and Acute Rheumatic Myocarditis: A Case Report

T wave alternans, an electrical cardiac alternans in which there is a beat-to-beat variation in the amplitude, shape or the polarity of the T...

The Future of Medicine from the Standpoint of the Practising Paediatrician

From the time of recorded history of medicine, the doctor whether he be the ancient healer or the modern medical practitioner, the doctor had...

Hepatopulmonary Syndrome: A Rare Complication of Chronic Liver Disease in Children

Children with chronic liver disorders may present with dysfunction of other organ systems. Encephalopathy, gastrointestinal bleeding, failure to thrive and impaired renal function are...

Case Report: Percutaneous Balloon Dilatation and Ureteral Stenting for Tuberculous Renal Infundibular and Ureteral Strictures

The management of the non-functional tuberculous kidney is controversial and ranges from surgical intervention to conservative treatment. Intra-renal scarring with stricture formation is common...

Current Indications for Open Stone Surgery in Singapore

The treatment of urinary calculi has changed tremendously since the introduction of extra corporeal shockwave lithotripsy (ESWL), percutaneous nephrostolithotomy (PCNL), and ureteroscopy over the...

Bidirectional Cavopulmonary Anastomosis

Children with complex congenital heart disease and a functional single ventricle may not be ideal candidates for a Fontan procedure. A staged approach to...

Retinopathy of Prematurity in Very Low Birth Weight Infants

Retinopathy of prematurity (ROP), which could lead to visual impairment and blindness, is a recognised serious morbidity amongst surviving premature infants. The inverse relationship...

Role of Ultrasonography in Screening for Urological Malignancies in Patients Presenting With Painless Haematuria

Haematuria of any degree should never be ignored and, in adults, it should be regarded as a symptom of urological malignancy until proven otherwise....

Nitric Oxide Synthase-Its Distribution and Alteration in the Intramural Ganglia of the Urinary Bladder in Normal and Urethra-obstructed Guinea Pigs

Nitric oxide (NO) has been recognised as a nonadrenergic noncholinergic (NANC) inhibitory neurotransmitter at various sites in the nervous system. Its function as a...

Echocardiographic Features and Management of Neonatal Ductal Aneurysm

Previously thought to be a rare condition, aneurysms of the ductus arteriosus have been increasingly reported in the medical literature over the past few...

Retroperitoneal Castleman’s Disease in the Perinephric Space—Imaging Appearance: A Case Report and a Review of the Literature

Castleman’s disease (CD) was first proposed by Castleman in 1954. It is usually found in the mediastinum, but other sites have been described. This article...

Transurethral Alprostadil for the Treatment of Erectile Dysfunction: Results of a Multicentre Trial

As the population is growing older and the society getting more affluent, people are aiming for a better quality of life. This has resulted...

Transaminitis in Duchenne’s Muscular Dystrophy

Raised aminotransferase levels, especially that of alanine transaminase (ALT), have been traditionally attributed to liver pathology rather than to muscle disorders. However, raised alanine...

Twenty-four hour, Non-invasive, Neonatal Chromosome Analysis—Application in a Case of Mixed Gonadal Dysgenesis

Chromosome analysis in neonates requires venisection and this is sometimes both difficult and distressing. In addition, results can at best take 3 days but...

Laparoscopic Telesurgery Between the United States and Singapore

Telemedicine is the use of telecommunication technologies to provide medical information and healthcare services. Early applications include medical use of the telephone and facsimile. This...

Sandhoff Disease—A Case Report of 3 Siblings and a Review of Potential Therapies

Sandhoff disease is a rare inborn error of metabolism characterised by the absence of both β-hexosaminidase A and B, resulting in an accumulation of...

A Case Report on the Perinatal Management of a 30-week Preterm Baby with Congenital Complete Heart Block

The association between congenital complete heart block (CHB) and maternal autoimmune disorders has been described for many years. Maternal systemic lupus erythematosus (SLE) is...

Minimal Change Nephrotic Syndrome—A Complex Genetic Disorder

Minimal change nephrotic syndrome (MCNS) is the most common cause of childhood nephrotic syndrome. It is characterised by the presence of gross proteinuria, hypoalbuminaemia,...

The Genetics of Primary Vesico-Ureteric Reflux

Vesico-ureteric reflux (VUR, OMIM #193000), the name given to reflux of urine from the bladder into the ureter and towards the kidney, is believed...

Transurethral Surgery and the Adductor Spasm

Bladder tumours frequently arise from the posterolateral wall of the bladder1 over the course of the obturator nerve. It is during transurethral resection of...

Candida Arthritis in a Premature Infant Treated Successfully with Oral Fluconazole for Six Months

Candida arthritis in premature infants is regarded as a rare condition. The largest published series of 8 cases from one institution was from Bombay,...

DNA Testing for Fragile X Syndrome in 255 Males from Special Schools in Singapore

Fragile X syndrome is the most common inherited cause of mental retardation, affecting approximately 1 in 1250 males and 1 in 2500 females. It...

Six-Year Follow-Up of Untreated T1 Carcinoma of Prostate

It is well known that T1 carcinoma of the prostate has varying biologic behaviour. Attempts to identify those at higher risk of progression have...

Initial Experience of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Paediatric Patients

Paroxysmal supraventricular tachycardia (SVT) is well-recognised as one of the commonest rhythm disorders in children. There may be few symptoms, but many experience palpitations,...

Cystoscopic Diagnosis of Bladder Cancer by Intravesical Instillation of 5-Aminolevulinic Acid Induced Porphyrin Fluorescence—The Singapore Experience

Bladder cancer is the sixth most frequent malignant disease in the world. Superficial stages of the tumour are found in 75% to 85% of...

Bilateral Synchronous Renal Oncocytoma: A Case Report and Review

Oncocytomas are neoplasms characterised by large epithelial cells with finely granular eosinophilic cytoplasm called oncocytes. They were first described by Zippel in 1942 and...

Acute Renal Colic: Value of Unenhanced Spiral Computed Tomography Compared with Intravenous Urography

The typical ureteric calculus presents with an acute onset of flank pain which may radiate to the groin. Intravenous urography (IVU) has classically been...

Holmium Laser Lithotripsy in the Management of Ureteric Calculi

The introduction of extracorporeal shockwave lithotripsy (ESWL) in the 1980s revolutionised treatment of renal and ureteric calculi. Progress in the field of extracorporeal lithotripsy...

The Singapore General Hospital Early Clinical Experience with the 7.5F Flexible Ureterorenoscope

Intravenous regional anaesthesia (IVRA) has a reported success rate of between 94% and 98% for upper limb surgery. Limitations to its use include the...

Spectrum of Prostate Cancer in the Singapore General Hospital (1980 to 1985)

Prostate cancer is the most prevalent cancer among men in the United States. In Singapore, it is the sixth most common incidence of cancer...

Diagnosing and Prognosticating Acute Meningitis in Young Infants within 24 Hours of Admission

Meningitis is an important cause of fever in young infants (infants 90 days old or younger). Most cases of meningitis are acute meningitis which...

Clinical Reasoning Learning Sessions

Many medical schools worldwide have made the shift toward problem-based learning (PBL) medical education. Some of them employ these new techniques in only part...

Book Review

The above is a textbook of medicine written by Singapore doctors and published in Singapore. It is difficult not to be over-enthusiastic about it...

Enteral Nutrition of the Very Low Birth Weight (VLBW) Infant

Optimal nutrition is critical in the management of the preterm infant. The fetus in utero receives continuous intravenous nutrition that is interrupted when prematurely...

A Case Series of Six Children with Primary Pulmonary Hypertension

Pulmonary arterial hypertension (PAH) is an uncommon but serious and debilitating disorder seen in children and adults. By definition, it is an elevation of...

2nd Chapter of Paediatricians Lecture: The Future of Paediatrics in Singapore

When I was first invited to give this 2nd Chapter of Paediatricians Lecture by the Chapter, my obvious answer was no. I could think...

Liver Transplantation in a Child With Severe Hypercholesterolaemia in Alagille Syndrome

Alagille syndrome (AS) or arteriohepatic dysplasia is a genetic disorder transmitted in an autosomal dominant inheritance. The chromosomal abnormality has been identified to the...

The Use of Vigabatrin in Infantile Spasms in Asian Children

Infantile spasms are a form of age-dependent myoclonic epilepsy that is difficult to control. Agents such as adrenocorticotrophic hormone (ACTH) and prednisolone have been...

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...

Percutaneous Nephrolithotomy in the Management of Complex Upper Urinary Tract Calculi: The Singapore General Hospital Experience

Open surgical removal had been the standard treatment for urolithiasis till the early 1980s when introduction of percutaneous techniques and extracorporeal shock wave lithotripsy...

Adrenal Myelolipoma Presenting with Spontaneous Retroperitoneal Haemorrhage Demonstrated on Computed Tomography and Angiogram—A Case Report

Adrenal myelolipoma is a rare, benign tumour, usually an incidental finding. Spontaneous retroperitoneal haemorrhage resulting from this tumour is rare. This article is available only...

The Role of BTA stat in Clinical Practice

Cystoscopy, supplemented by urine cytology, remains the gold standard in detecting primary and recurrent bladder cancer. Urine cytology, although highly specific, detects only 29%...

Paediatric Extracranial Germ Cell Tumours: A Retrospective Review

Germ cell tumours (GCTs) in children account for 2% to 3% of childhood malignancies. They arise from primordial germ cells and constitute a heterogeneous...

Two-year Outcome of Normal-birth-weight Infants Admitted to a Singapore Neonatal Intensive Care Unit

With the rapid advances in the field of neonatal intensive care, the focus of interest has been on the very-low-birthweight (VLBW) infant in recent...

Penile Colour Duplex Ultrasonography as a Screening Tool for Venogenic Erectile Dysfunction

Penile colour flow Doppler imaging (PCDI) is a non-invasive, accurate and cost-effective technique. It has better patient acceptance as compared to cavernosometry and cavernosography,...

Bronchopulmonary Dysplasia and Chronic Lung Disease of Infancy: Strategies for Prevention and Management

Bronchopulmonary dysplasia (BPD) and chronic lung disease of infancy (CLD) are two chronic pulmonary conditions which are the result of incomplete resolution or abnormal...

Intussusception: A Three-Year Review

Intussusception is the most common cause of intestinal obstruction in infants and young children. It occurs when one segment of the intestines telescopes into...

Single Centre Review of Radiologically-guided Percutaneous Nephrostomies: A Report of 273 Procedures

Percutaneous nephrostomy (PCN) is a well-established technique in the armamentarium of an interventional radiologist when dealing with urinary obstruction. It provides temporary relief in...

Severe Newborn Encephalopathy Unrelated to Intrapartum Hypoxic Events: 3 Case Reports

Since Little’s article of 1862, it was popularly believed that brain damage in the majority of cases of cerebral palsy occurs during labour and...

A Case Series of Pre-Viable Severe Twin-Twin Transfusion Syndrome

Monozygotic twinning has an incidence of approximately 3.5 per 1000 pregnancies. Only 25% of monozygotic twins have a dichorionic placenta. This article is available only...

Idiopathic Chronic Fetomaternal Haemorrhage Resulting in Hydrops – A Case Report

Small amounts (<0.1 mL) of fetal blood are commonly found in maternal circulation. Massive fetomaternal haemorrhage (FMH) involves fetal blood loss into the maternal...

Imaging of Paediatric Mediastinal Masses

A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for...

The Relationship Between Scoring Systems and Cytokine Levels in Neonatal Sepsis

In newborn infants, the early diagnosis of sepsis is an important problem because the early signs and symptoms of septicaemia in term or preterm...

Clinical Characteristics of an Outbreak of Hand, Foot and Mouth Disease in Singapore

The enterovirus family causes a wide array of illnesses, some easily recognised clinically and others diagnosed as non-specific viral illnesses. This large family of...

Perinatal Care at the Threshold of Viability—From Principles to Practice

One of the major challenges in neonatal-perinatal medicine in the new century is the optimal management of the mother and infant when delivery is...

Eight-year Outcome of Very-low-birth-weight Infants Born in KK Hospital

The outcome of very-low-birth-weight (VLBW) premature babies with birth weights of <1500 g has remained an area of great concern for both parents and...

Long-term Follow-up and Outcome of Extremely-low-birth-weight (ELBW) Infants

With the progressive improvement in the survival of premature neonates, including those born at the extreme edge of viability, there has been a great...

Exogenous Surfactant Therapy in Newborn Infants

Exogenous surfactant therapy is widely used in the management of neonatal respiratory distress syndrome (RDS) and may have a role in the management of...

The Use and Abuse of Steroids in Perinatal Medicine

Preterm birth, delivery prior to 37 weeks of gestational age, accounts for a major and disproportionate amount of infant and neonatal morbidity and mortality....

Mass Newborn Screening in Singapore—Position and Projections

Mass newborn screening is an essential preventative public health programme which aims to diagnose, in the presymptomatic phase, diseases that have a better outcome...

Neonatology In Singapore: The Way We Were, The Way Forward

Over a span of 35 years of my working life, I have witnessed the growth of, and also grown together with, neonatology in Singapore....

Chorioamnionitis and Outcome in Extremely Preterm Infants

Preterm delivery is associated with considerable morbidity and mortality, especially among the 1% to 2% infants delivered at less than 32 weeks. Chorioamnionitis is...

Challenges in Perinatal Medicine

One of the significant milestones in the perinatal care in Singapore is the birth of the Perinatal Society of Singapore in March 1989. This...

Predicting Significant Hyperbilirubinaemia and Early Discharge for Glucose-6-Phosphate Dehydrogenase Deficient Newborns

Glucose-6-phosphate dehydrogenase (G6PD) deficiency occurs in 2.5% of Singapore’s population, and affected newborns are at risk for severe neonatal hyperbilirubinaemia and kernicterus. In the...

Autoimmune Liver Disease in Children

Autoimmune liver disorders are inflammatory liver diseases characterised histologically by a dense mononuclear cell infiltrate, including plasma cells, in the portal tract (Fig. 1)...

HIV/AIDS in Children

The human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) epidemic in Asia has grown from a handful of cases to a major...

Adolescent Health Education Programmes: Theoretical Principles in Design and Delivery

Over the past three decades, the patterns of health need in youth have changed. Psychosocial problems such as depression, substance abuse, eating disorders, sexually...

Art and “the Language of Well-Being” in Adolescent Health Care

Creative processes involve imagining, making unexpected connections, maintaining discipline while letting go of controlling the outcome, opening oneself to pleasure, and moving beyond frustration....

From Recreation to Creative Expression: The Essential Features of an Adolescent Inpatient Psychosocial Support Programme

In 1984, the Royal Children’s Hospital (RCH) in Melbourne, Australia opened a new ward specifically for adolescent inpatients. This initiative was the result of...

Adolescent Admissions to a Tertiary Paediatric Hospital: A Dynamic Pattern

The nature of paediatric practice is changing worldwide. In developing countries, infant mortality from infectious diseases continues to fall with improved immunisation, medical care...

Clinical Assessment, Management and Outcomes of a Group of Adolescents Presenting with Complex Medico-psychosocial Conditions

Increased sensitivity to biological change can make adolescents particularly vulnerable to non-organic symptomatic disorders. A variety of pains, headaches, dizziness and fatigue may remain...

Adolescent Chronic Illness: A Qualitative Study of Psychosocial Adjustment

Chronic illness during adolescence can have significant psychological and social consequences within many life domains. Growing up with a chronic medical condition presents many...

Strategies to Promote Better Outcomes in Young People with Chronic Illnesses

The epidemiology of child health in the developed world is changing. Mortality from infectious diseases has fallen sharply over the past century due to...

Adolescent Alcohol and Other Substance Use: Sharing the Australian Experience

The most common causes of morbidity in adolescence often have behavioural or social determinants, and can have enormous social and economic consequences for adolescent...

Sexually Transmitted Infections in Singapore Teenagers

Adolescence can be a difficult period for many individuals who have to navigate their way through complicated emotional, psychological, physical and social demands and...

Eating Disorders in Singapore: A Review

Anorexia nervosa, bulimia and binge-eating disorder are the three best described ‘eating disorders’. All three are predominantly disorders of women with the core symptoms...

Youth Suicide and Parasuicide in Singapore

The World Health Organization defines suicide as an act with a fatal outcome that is deliberately initiated and performed by the person himself or...

Five-Year Review of Adolescent Mental Health Usage in Singapore

The past 20 years have seen much growth in the knowledge of child and adolescent psychiatric practice. Research has provided an improved understanding in...

The Perils of Puberty

Adolescence is a biopsychosocial maturational process, with the biological changes including completion of linear growth and sexual maturation (puberty), maturation of enzyme systems such...

Adolescent Health—A New Perspective in Singapore

In the past five decades, there have been significant advances in the fields of Paediatrics and Adult Medicine in Singapore. However, the bridging field...

MELAS: A Case Report

A 6-year-old Chinese boy presented at the Oral and Maxillofacial Surgery clinic with gingival bleeding due to poor oral hygiene, odontogenic pain due to...

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...

Oropharyngeal Carriage and Penicillin Resistance of Neisseria meningitidis in Primary School Children in Manisa, Turkey

Infections by Neisseria meningitidis are significant causes of mortality and morbidity in young children and adolescents. The epidemiology of serious meningococcal disease is an...

Morbidity and Significant Bacteriuria after Urodynamic Studies

Urodynamics or pressure flow studies (PFS) are defined as a functional assessment of the lower urinary tract (LUT) to provide a pathophysiological basis for...

Supernumerary Testicle in a Case of Polyorchidism

The presence of more than 2 testicles is called polyorchidism. It is a rare anomaly. This article is available only as a PDF. Please click...

Uncommon Benign Intrascrotal Tumours

Leiomyomas of the urinary tract are exceedingly rare. They can, however, arise from almost any site within the genito-urinary tract, most commonly in the...

A Fatal Turkish Case of Campomelic Dysplasia

Paediatric Medicine (CD) is a rare form of congenital short-limbed dwarfism, classically characterised by campomelia (bowing of the long bones of the lower extremities)...

Extracorporeal Shockwave Lithotripsy and Intracorporeal Lithotripsy for Proximal Ureteric Calculi – A Comparative Assessment of Efficacy and Safety

The introduction of extracorporeal shockwave lithotripsy (ESWL) by Chaussy and his co-workers in 1980 revolutionised the management of urinary calculi. Since then, ESWL has...

Familial Risk of Allergic Rhinitis and Atopic Dermatitis among Chinese Families in Singapore

Family history has been shown to be a risk factor for the development of allergic rhinitis (AR) and atopic dermatitis (AD). However, the increase...

Clinical Report: A Case of Williams Syndrome and Klinefelter Syndrome

Williams syndrome (WS) is a rare but well recognised neurodevelopmental disease affecting the connective tissue and the central nervous system. The syndrome was first...

Skin Manifestation of Stenotrophomonas maltophilia Infection – A Case Report and Review Article

Stenotrophomonas maltophilia is an aerobic gram-negative bacillus that is found in aquatic environments. It is a frequent coloniser of fluids used in the hospital...

Gender Disparity in Paediatric Hospital Admissions

Gender difference in the incidence of childhood diseases has long been recognised. but the magnitude of this effect and consistency across many disease categories...

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...

Does Visual Turbidity Correlate With Serum Triglyceride Levels in Babies on Total Parenteral Nutrition?

Intravenous lipid infusion is commonly used as part of total parenteral nutrition (TPN) in newborn babies. Upon infusion, it forms an emulsion that resembles...

Corticosteroids are not Present in a Traditional Chinese Medicine Formulation for Atopic Dermatitis in Children

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease. It has been estimated that 15% of schoolchildren aged 13 to 14 years have...

Use of Complementary and Alternative Medicine in Paediatric Oncology Patients in Singapore

Complementary and alternative medicine (CAM) has been gaining acceptance throughout the world. The efficacy of CAM is unproven, yet it remains popular with the...

The Epidemiology of Paediatric Intussusception in Singapore: 1997 to 2004

Intussusception (IS) is the most common cause of intestinal obstruction in infants and young children. The peak age of presentation is 4 to 8...

A Report of Two Families with Sarcosinaemia in Hong Kong and Revisiting the Pathogenetic Potential of Hypersarcosinaemia

Sarcosinaemia (OMIN 268900) is an autosomal recessive condition due to the deficiency of sarcosine dehydrogenase (E.C. 1.5.99.1). It is a rare condition with an...

Neonatal Priapism Associated With Spontaneous Bilateral Pyocavernositis

Priapism is a pathological state of prolonged, generally painful erection, unassociated with sexual desire and not ending in ejaculation. Rare before the 1980s, this...

Paediatrics to Geriatrics: The Continuum

In many parts of Asia today, paediatricians are still grappling with the childhood problems of infectious diseases, diarrhoeal diseases and malnutrition. In Singapore, it...

Radiographic Features of SARS in Paediatric Patients: A Review of Cases in Singapore

Severe acute respiratory syndrome (SARS) is a newly emerged atypical pneumonia caused by the SARS-associated coronavirus (SARS-CoV). It is easily transmitted via droplet infection...

A Rotavirus Vaccine for Infants: The Asian Experience

Of all the enteric pathogens that infect young children, rotavirus is recognised as the leading cause of severe gastroenteritis worldwide. Rotavirus accounts for 20%...

Therapeutic Hypothermia for Neonatal Hypoxic-Ischaemic Encephalopathy

Hypoxic-ischaemic encephalopathy (HIE) is an important cause of death and later neurological disability in full-term neonates worldwide. Perinatal asphyxia causes about 19% of the...

Outcome of Organic Acidurias in China

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Organising Services for IMD in Thailand: Twenty Years Experience

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Newborn Screening in Pakistan – Lessons from a Hospital-based Congenital Hypothyroidism Screening Programme

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Newborn Screening in Bangladesh

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Newborn Screening in China: Phenylketonuria, Congenital Hypothyroidism and Expanded Screening

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Minimising Harm from Newborn Screening Programmes

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Developmental Dysplasia of the Hip: Universal or Selective Ultrasound Screening?

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Financing Newborn Screening Systems: US Experience

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Inborn Errors of Metabolism Presenting as Neonatal Encephalopathy: Practical Tips for Clinicians

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Legal Issues in Neonatal Screening

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Neuroblastoma Screening in Japan: Population-based Cohort Study and Future Aspects of Screening

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

External Quality Assurance Programme for Newborn Screening of Glucose-6-Phosphate Dehydrogenase Deficiency

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Glucose-6-Phosphate Dehydrogenase Deficiency: Correlation between the Genotype, Biochemistry and Phenotype

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Disorders of Vitamin B12 Metabolism Presenting Through Newborn Screening

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Diagnosis of Tetrahydrobiopterin (BH4) Responsive Mild Phenylketonuria in Japan over the Past 10 Years

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Fatty Acid Oxidation Defects

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Disorders of the Carnitine Cycle and Detection by Newborn Screening

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Spectrum of Inherited Metabolic Disorders in Malaysia

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Establishing a Universal Newborn Hearing Screening Programme

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Current Understanding of Auditory Neuropathy

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

A Multidisciplinary Approach to Paediatric Hearing Loss: Programme at the Centre for Hearing Intervention and Language Development, National University Hospital, Singapore

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Early Intervention For Hearing Impairment: Appropriate, Accessible and Affordable

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Impact of the National Hearing Screening Programme in China

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Outcome of Early Cochlear Implantation

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Eliminating Iodine Deficiency: Obstacles and Their Removal

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Neuro-developmental Deficits in Early-treated Congenital Hypothyroidism

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Issues on Universal Screening for Galactosemia

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Newborn Screening for all Identifiable Disorders with Tandem Mass Spectrometry is Cost Effective: The Negative Case

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Newborn Screening for all Identifiable Disorders with Tandem Mass Spectrometry is Cost Effective: Supporting Arguments

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

My Early Experiences in Establishing Neonatal Screening and the Reason for Regional Meetings of the International Society for Neonatal Screening

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Diagnosis and Management Support for an Expanded Newborn Screening Programme

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Considerations in Choosing Screening Conditions: One (US) Approach

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Clinical Applications of Molecular Genetics: The Model of Congenital Adrenal Hyperplasia

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Newborn Screening in Japan: Restructuring for the New Era

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Improved Health and Development of Children who are Deaf and Hard of Hearing Following Early Intervention

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Towards Universal Newborn Screening in Developing Countries: Obstacles and the Way Forward

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Improving Child Health – Newborn Screening for All?

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Neonatal Screening – A Global Perspective

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Prevalence of Refractive Error in Malay Primary School Children in Suburban Area of Kota Bharu, Kelantan, Malaysia

Refractive error remains one of the primary causes of visual impairment in children worldwide. Prevalence of visual impairment in children, is defined as uncorrected...

Assessment of Medical Graduates Competencies

Medical professional proficiency comprises a set of skills, knowledge, and attitudes necessary to efficiently accomplish the practice of medicine. The major aim of undergraduate...

When Words Really Matter

I think a lot these days about doctors giving advice. Nobody taught me, back in medical school, how to give advice. This article is available...

Behavioural Sleep Disorders in Children and Adolescents

Overall, children spend one-third to one-half of their life sleeping. Although sleep comprises such a significant portion of a child’s day, sleep disturbances are...

Cardiovascular Changes in Children with Snoring and Obstructive Sleep Apnoea

Sleep disordered breathing (SDB) is a spectrum of diseases ranging from primary snoring to obstructive sleep apnoea (OSA). A recent review suggested that the...

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...

Sleep Disorders in Children: The Singapore Perspective

Sleep problems are common in children. For example, snoring occurs in more than 25% of Singapore children1 and obstructive sleep apnoea (OSA) occurs in...

Diagnosis and Evaluation of Obstructive Sleep Apnoea in Children

Children with obstructive sleep apnoea (OSA) may present with nocturnal and/or diurnal symptoms. The history is best obtained from parents, or siblings who share...

The Scope of Paediatric Sleep Medicine

Despite apparent similarities to adult sleep medicine, the disorders of paediatric sleep medicine have a distinct epidemiology and pathophysiology. During childhood, the physiology of...

Sleep Disturbances in Singaporean Children with Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is a common childhood psychiatric disorder with various studies reporting prevalence rates of between 1.7% and 16%. The most...

Inflammatory Cytokines and Childhood Obstructive Sleep Apnoea

Obstructive sleep apnoea (OSA) is characterised by repeated episodes of upper airway occlusion during sleep that are associated with daytime behavioural changes and abnormalities...

Nasal Obstruction in Children with Sleep-disordered Breathing

Nasal breathing is critical in infants and children; for example, neonatal choanal atresia often leads to respiratory distress and may require urgent intervention in...

Immunogenicity, Reactogenicity and Safety of a Diphtheria-Tetanus-Acellular Pertussis-Inactivated Polio and Haemophilus Influenzae Type b Combination Vaccine in a Placebo-controlled Rotavirus Vaccine Study

Singapore’s national immunisation programme for the 6 traditional Expanded Programme on Immunisation (EPI) vaccines (i.e. BCG, diphtheria, tetanus, pertussis, polio and measles) and hepatitis...

Transfusion-dependent Microcytic Anaemia in a 10-year-old Girl

A 10-year-girl from Bangladesh presented with a moderately severe anaemia (lowest recorded haemoglobin level of 5.6 g/dL) and a mild jaundice (latest serum bilirubin,...

Caudal Regression Syndrome

A white female with an uncomplicated history of birth delivery and a familial history of diabetes mellitus presented to the orthopaedic clinic at the...

3rd College of Paediatrics and Child Health Lecture – The Past, the Present and the Shape of Things to Come…

In the post-war days of the 1950s, Singapore children were faced with problems of malnutrition and infectious diseases. There was poverty, overcrowded housing and...

Auricular Anthropometry of Newborns at the Singapore General Hospital

Abnormalities of the external ear are described in many syndromes and genetic conditions. Melnick et al reported an incidence of 1 in 90 births...

Treatment of Cardiogenic Pulmonary Oedema by Helmet-delivered Non-invasive Pressure Support Ventilation in Children With Scorpion Sting Envenomation

Scorpion stings represent an important and serious public health problem worldwide due to their high incidence and potentially severe and often fatal clinical manifestations,...

Screening Tools for Bacteraemia in a Selected Population of Febrile Children

Bacteraemia refers to the presence of bacteria in the bloodstream. The presence or absence of toxicity differentiates occult bacteraemia, which is relatively asymptomatic, from...

Review of the Management Outcome of Slipped Capital Femoral Epiphysis and the Role of Prophylactic Contra-lateral Pinning Re-examined

Slipped capital femoral epiphysis is the commonest hip problem in the adolescent age group. The goals of treatment are aimed at avoiding the complications...

A Tiny Stone Induced Ureteral Rupture

A 60-year-old previously healthy man with unremarkable medical history presented with a complaint of intractable flank pain for one day. The laboratory test results...

Recurrent Group B Streptococcal Septicemia in a Very Low Birth Weight Infant with Infective Endocarditis and Submandibular Cellulitis

Maternal Group B streptococcal colonisation can lead to neonatal pneumonia, meningitis or sepsis. Neonatal Group B Streptococcal (GBS) sepsis is common, but infective endocarditis...

Evaluation of Data Completeness of the Prostate Cancer Registry after Robotic Radical Prostatectomy

Cancer data can be abstracted manually by cancer registrars or extracted automatically from the electronic medical systems. There may appear to be nothing in...

Morbidity of Parainfluenza 3 Outbreak in Preterm Infants in a Neonatal Unit

Parainfluenza type 3 virus (PIV-3) is an important nosocomial pathogen. It closely mimics respiratory syncytial virus (RSV) in its clinical presentations, and in infants....

Management of Fournier’s Gangrene with Vacuum Assisted Closure® Dressing

Fournier’s gangrene is a surgical emergency. Treatment consists of fluid resuscitation, intravenous broad spectrum antibiotics and immediate surgical consultation with a view for early...

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...

An Unexpected Outcome following Radial Head Excision for Jeffrey Type II Fracture-Dislocation of the Proximal Radius in a Child

We present a case of a 10-year-old child who sustained a traumatic fracture-dislocation of his proximal radius and subsequently underwent surgical removal of the...

Temporary Tattoo Associated Type IV Delayed Hypersensitivity Dermatitis in a Child – A Case Report and Call for Parental Caution in Singapore

A 5-year-old, previously healthy French Caucasian boy was seen at a Paediatric Emergency Department for a skin rash over his left forearm. This article is...

Botulinum Toxin A for Idiopathic Detrusor Overactivity

Overactive bladder (OAB) is characterised by feelings of urgency to urinate, with or without incontinence and is usually accompanied by frequency and nocturia. These...

A Case of Congenital Haemolytic Anaemia and Thrombocytopenia

A 20-month-old boy came from Bangladesh to Singapore for medical consultation. He presented with progressive pallor, easy bruising, intermittent dark-coloured urine, and failure to...

An Exanthem with An Annular Pattern in a 2-year-old Girl

A 2-year-old Chinese girl was seen in clinic with an erythematous annular itchy rash which began on the thighs and had spread to the...

Clinical Features Differentiating Biliary Atresia from Other Causes of Neonatal Cholestasis

Causes of neonatal cholestasis (NC) are long and diverse but the responses of newborn liver, either physiological or anatomical, are limited. This is because...

Comparison of Clinical Outcomes and Cost Between Surgical and Transcatheter Device Closure of Atrial Septal Defects in Singapore Children

Congenital heart defects (CHD), with an incidence of approximately 1 in 100 live births, are the most important and frequent congenital malformations. It can...

Management of Thrombotic Thrombocytopenic Purpura in Metastatic Prostate Cancer with only Endocrine Therapy

Thrombotic thrombocytopenic purpura (TTP) is a systemic disorder that presents acutely with multiple organ failure. Although defined classically as a syndrome with a pentad...

Bannayan Riley Ruvalcaba Syndrome

Bannayan-Riley-Ruvalcaba syndrome (BRRS) classically presents with macrocephaly, subcutaneous and visceral lipomata, haemangiomata, hamartomatous intestinal polyps and pigmented macules involving the genitalia. This autosomal dominant...

Dyke-Davidoff-Masson Syndrome

An 8-year-old boy presented with uncontrolled seizures. He was born as the second child to non-consanguineous parents. He had significant perinatal asphyxia in the...

Incidence, Mortality and Five-year Relative Survival Ratio of Prostate Cancer among Chinese Residents in Singapore from 1968 to 2002 by Metastatic Staging

Prostate cancer is now the third most common cancer among Singapore males, with a world age-standardised incidence rate (ASIR) of 23.9 per 100,000 from...

Renojejunal Fistula: An Extremely Rare Form of Renoenteric Fistula

Obstructive calculous disease of the kidney often results in infectious complications such as pyelonephritis and perinephric abscesses. Renojejunal fistula formation may occur as the...

Childhood Food Allergy: A Singaporean Perspective

Food allergy is defined as reaction to a food which has an immunologic mechanism. If immunoglobulin E (IgE) is involved in the reaction, the...

Transcatheter Closure of Atrial Septal Defects – Is Balloon Sizing Still Necessary?

Device closure of atrial septal defects through the transcatheter approach has now been well accepted as an option to surgical treatment. A range of...

Survey of Healthcare Workers’ Attitudes, Beliefs and Willingness to Receive the 2009 Pandemic Influenza A (H1N1) Vaccine and the Impact of Educational Campaigns

Since the first positive 2009 pandemic influenza A (H1N1) case was reported in Singapore on 26 May 2009, the country saw an exponential rise...

Reply from Author: Is It Time to Revise the Definition of Attention Deficit Hyperactivity Disorder?

We would like to thank the author for suggesting that the definition of ADHD should be revised. This is an important consideration in the...

Is It Time to Revise the Definition of Attention Deficit Hyperactivity Disorder?

I read with interest the article published in the Annals entitled “Attention Deficit Hyperactivity Disorder: Coping or Curing?”, which concluded that coping rather than...

Sustained Clinical Efficacy after Repeat Intradetrusor Botulinum Toxin Type A in the Treatment of Neurogenic Detrusor Overactivity

Despite the introduction of more potent and uroselective antimuscarinic agents, many patients with neurogenic detrusor overactivity still suffer from refractory incontinence. Intradetrusor botulinum toxin...

Dedicated Cytogenetics Factor is Critical for Improving Karyotyping Results for Childhood Leukaemias – Experience in the National University Hospital, Singapore 1989-2006

Acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) make up the bulk of childhood leukaemia cases. With risk stratified therapy being one of...

Epidemiological Surveillance and Control of Rubella in Singapore, 1991-2007

Rubella is a mild febrile viral exanthematous disease transmitted through droplets or direct contact with the nasopharyngeal secretion of an infected person. It is...

Emerging Trends in Breastfeeding Practices in Singaporean Chinese Women: Findings from a Population-based Study

The health benefits of breast milk have been well documented, with positive implications for infants’ metabolic, immunologic, respiratory and digestive health. The World Health...

A Missed Bilateral Choanal Atresia

What do you see in the image? a) Deviated posterior nasal septum b) Nasopharyngeal tumour c) Rhinolith with mucous plug d) Bilateral choanal atresia e) Nasal pyriform aperture stenosis This...

Health-related Quality of Life in Children with Cancer Undergoing Treatment: A First Look at the Singapore Experience

Health-related quality of life (HRQOL) has been progressively acknowledged as an essential health outcome measure in clinical trials and health services research and evaluation....

Prevalence of Overweight and Obesity in Chinese Preschoolers in Singapore

The increasing prevalence of childhood overweight and obesity and its associated adverse health outcomes have become an important health issue. Childhood obesity can persist...

Short- and Long-Term Outcomes at 2, 5 and 8 Years Old for Neonates at Borderline Viability—An 11-Year Experience

Singapore was listed consistently among the top 3 countries in the world with the lowest infant mortality rate. In particular, Asia had seen its...

Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms

Benign prostatic hyperplasia (BPH) is one of the commonest diseases of ageing men. It can be associated with bothersome lower urinary tract symptoms (LUTS)...

Prevalence of vitamin D deficiency and insufficiency in Malaysian infants

Vitamin D deficiency, a worldwide health problem, is also prevalent in tropical countries. It is estimated that 15% of the world’s population are either...

Impact of true fetal mosaicism on prenatal screening and diagnosis

Over the past decade, the non-invasive prenatal test (NIPT) has increasingly been used as a method for prenatal screening for trisomy 21 (T21) and...

Managing a Renal Transplant Programme During the COVID-19 Pandemic: Practical Experience from a Singapore Transplant Centre

As infrastructure and policies were being put in place to combat COVID-19, we recognised that specialty-specific policies and protocols had to be drawn up...

Paediatric emergency department attendances during COVID-19 and SARS in Singapore

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) on 11 March 2020, with over 110 million cumulative cases...

Epidemiology and risk stratification of minor head injuries in school-going children

Head injuries are common childhood injuries that present to paediatric emergency departments. Falls are the most common cause in young children, while contact sports...