Letter to the Editor
Evaluation of a health screening protocol for recovered COVID-19 patients before “return-to-play” and strenuous physical activity
Dear Editor,
We conducted a prospective, single-centre cohort study to develop guidance for military personnel returning to strenuous activities following SARS-CoV-2 infection. The patients underwent...
Others
Case Series of Bronchoscopic Removal of Tracheobronchial Foreign Body in Six Adults
Gustav Killian reported the first case of bronchoscopic removal of foreign body (FB) from the trachea in 1897. Since then, rigid bronchoscopy under general...
Original Article
Glaucoma Pattern Amongst the Elderly Chinese in Singapore
Glaucoma is a major cause of world blindness in developing and developed nations. The WHO Global data on blindness show that over half of...
Original Article
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,...
Review Article
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...
Original Article
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....
Original Article
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...
Others
Combined High-frequency Ventilation (CHFV) in the Treatment of Acute Lung Injury—A Case Report
The role of ventilatory support in acute lung injury is supportive, whilst the damage to alveolar-capillary membranes resolves and alveolar stability is restored. The...
Review Article
Contributions of Respiratory Care Practitioners to Intensive Care: A Review
The intensive care unit (ICU) is a complex environment in which multidisciplinary expertise has been shown to enhance clinical outcomes. For example, the availability...
Review Article
Ventilatory Strategies for Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) was first described by Ashbaugh et al in 1967. The original authors detailed the presence of tachypnoea, hypoxaemia, decreased...
Review Article
The Oxygen Delivery Debate—A Review
Multisystem organ failure occurs in a large proportion of critically ill patients and is a major cause of death in this group of patients....
Review Article
Controlled Observations in Critical Care Medicine: The Therapeutic Trial
Central to the combined diagnostic and therapeutic approach to the critically ill subject is the evaluation of both the basal physiologic status and its...
Original Article
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...
Original Article
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...
Original Article
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...
Original Article
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...
Original Article
Impact on Quality of Patient Care and Procedure Use in the Medical Intensive Care Unit (MICU) Following Reorganisation
Critical care is costly as it is labour intensive and involves expensive life support technology. In the United States, the intensive care units (ICUs)...
Editorial
Intensivists for the Intensive Care Unit—Do They Make a Difference?
Does Critical Care Medicine exist and what defines its area of practice? Different countries have embarked on their own journeys of discovery, and have...
Original Article
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...
Review Article
Systemic Lupus Erythematosus in Singapore
Systemic lupus erythematosus (SLE) or lupus (“wolf” in Latin) in short, is an autoimmune disorder of unknown aetiology(ies) and characterised by diverse clinical manifestations...
Original Article
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...
Original Article
A Prospective Study of Infections with Atypical Pneumonia Organisms in Acute Exacerbations of Chronic Bronchitis
Chronic obstructive pulmonary disease (COPD) is a disease state characterised by the presence of airflow limitation that is generally progressive, partially reversible and caused...
Original Article
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...
Others
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...
Original Article
Hospitalised Low-risk Community-acquired Pneumonia: Outcome and Potential for Cost-savings
Community-acquired pneumonia (CAP) is a common illness with nearly 4 million adults diagnosed each year in USA with more than 600,000 hospita1isations. The associated...
Original Article
Long-term Outcome and Disease Control in Near-fatal Asthma
Rising trends in mortality in asthma have been reported from many countries, including Asian countries such as Hong Kong. Asthma deaths have been associated...
Others
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...
Others
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...
Original Article
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...
Original Article
Ethnicity, Obstructive Sleep Apnoea and Ischaemic Heart Disease
Obstructive sleep apnoea (OSA) is a condition whereby there is snoring associated with complete or partial cessation of breathing during sleep, associated with nocturnal...
Original Article
Rapid Mycobacterial Tuberculosis Detection in Bronchoalveolar Lavage Samples by Polymerase Chain Reaction in Patients with Upper Lobe Infiltrates and Bronchiectasis
Pulmonary tuberculosis (PTB), the incidence of which is rising, poses a major health problem. It is caused by <i>Mycobacterium tuberculosis</i>. The isolation of <i>Mycobacterium...
Original Article
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...
Others
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...
Others
Beneficial Effect of Combination Therapy with Ozagrel and Pranlukast in Exercise-induced Asthma Demonstrated by Krypton-81m Ventilation Scintigraphy—A Case Report
Exercise is a common stimulus of bronchoconstriction in subjects with asthma. Exercise-induced asthma is a temporary increase in airway resistance that occurs after several...
Original Article
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...
Others
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...
Others
Cardiopulmonary Exercise Testing in Patients with Chronic Obstructive Pulmonary Disease
Exercise intolerance is a hallmark of chronic obstructive pulmonary disease (COPD). Although exertional symptoms may be mild at the outset, exercise limitation is the...
Others
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...
Others
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...
Others
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,...
Others
Ethnic Differences in Genetic Susceptibility to Atopy and Asthma in Singapore
Twin studies have indicated that both asthma and atopy are largely regulated by genetic factors. However, the genetics is complex, involving an interaction of...
Others
Human Genetic Susceptibility to Tuberculosis
The World Health Organization has declared that the recent resurgence of tuberculosis (TB) is a global emergency. Southeast Asia, which is seeing the greatest...
Others
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,...
Others
A Case Report of Aspergillus Hypersensitivity Syndrome with Obstructing Bronchial Aspergillosis
The spectrum of pulmonary aspergillosis includes saprophytic colonisation, hypersensitivity syndromes and invasive lung disease. There has been a tendency to classify these syndromes as...
Others
Upper Airway Resistance Syndrome—Report of Three Cases
Sleep-related breathing disorders are widely recognised as important causes of morbidity and mortality over the past 3 decades. The obstructive sleep apnoea syndrome (OSAS)...
Original Article
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...
Original Article
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,...
Original Article
Audit of Oxygen Therapy in Acute General Medical Wards Following an Educational Programme
The rational basis for supplemental oxygen (O<sub>2</sub>) treatment is well established. Long-term O<sub>2</sub> therapy improves survival and quality of life in patients with chronic...
Others
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...
Others
Endobronchial Mass in a Patient with Burkholderia pseudomallei Infection
The diagnosis of Burkholderia pseudomallei infection is based on culture of clinical specimens such as blood or other body fluids, or serology using indirect...
Original Article
Endobronchial Stenting in Patients Requiring Mechanical Ventilation for Major Airway Obstruction
Few things are as dramatic as respiratory arrest from major airway obstruction. Major airway obstruction frequently leads to well-defined clinical sequelae, namely shunt-associated hypoxaemia...
Others
Clinical Update on Occupational Asthma
Occupational asthma is the most common occupational respiratory disease in the United Kingdom and also in Singapore. Recent estimates of the proportion of adult...
Original Article
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...
Others
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...
Original Article
Effect of Different Endotracheal Suctioning Systems on Cardiorespiratory Parameters of Ventilated Patients
Endotracheal suctioning is a routine procedure performed in the intensive care unit (ICU) to remove secretions from the tracheobronchial tree. This is to maintain...
Original Article
The Role of Early Tracheostomy in Critically Ill Neurosurgical Patients
In medical history, tracheostomy is one of the oldest operations performed. There are indications that the Egyptians first employed this procedure more than 3500...
Review Article
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...
Original Article
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...
Others
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...
Others
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...
Original Article
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...
Original Article
Effects of a Pulmonary Rehabilitation Programme on Physiologic and Psychosocial Outcomes in Patients with Chronic Respiratory Disorders
Pulmonary rehabilitation is a multi-disciplinary programme of care for patients with chronic respiratory impairment that is individually designed to optimise physical and social performance...
Review Article
Recent Advances in the Obstructive Sleep Apnoea/Hypopnoea Syndrome
The past decade has seen a rapid increase in the number of patients being referred for investigation for the obstructive sleep apnoea/hypopnoea syndrome (OSAHS)....
Original Article
Thyroid Dysfunction in Chronic Schizophrenia Within a State Psychiatric Hospital
Thyroid dysfunction can give rise to various psychiatric symptoms. While there is a persistent interest in the role of thyroid axis in affective disorders,...
Others
All that Wheezes is not Asthma—Broncholithiasis, a Forgotten Disease
Asthma is a very common condition which presents clinically with cough, shortness of breath and wheezing. However, ‘all that wheezes is not asthma’, is...
Others
Asthma Disease Management: A Provider’s Perspective
The burden of asthma appears to be increasing worldwide, especially in societies undergoing rapid urbanisation, and both morbidity and mortality from asthma have increased...
Original Article
Emergency Department Asthma: Compliance with an Evidence-based Management Algorithm
Attendance at the emergency medicine department (EMD) for acute exacerbation is an important milestone in the natural history of patients with asthma. It is...
Original Article
Are Maternal Deaths on the Ascent in Singapore? A Review of Maternal Mortality as Reflected by Coronial Casework from 1990 to 1999
It is said that, worldwide, over half a million maternal deaths occur annually. This might well be a conservative estimate, given the difficulties inherent...
Original Article
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...
Original Article
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...
Original Article
Four-month Chemotherapy in the Treatment of Smear-negative Pulmonary Tuberculosis: Results at 30 to 60 Months
Patients with active pulmonary tuberculosis (PTB) are usually treated with a 6-month regimen in which chemotherapy is administered daily, intermittently or as a combined...
Others
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...
Original Article
Bacteriologically-negative Pulmonary Tuberculosis—The Singapore Tuberculosis Control Unit Experience
The management of a patient as for pulmonary tuberculosis (PTB) in the setting of negative bacteriology would have to take into account not only...
Original Article
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...
Others
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...
Others
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...
Others
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...
Others
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...
Others
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...
Original Article
Asthma in Light of Patient Documents. A Factor Analytic Study
The lack of uniform criteria for asthma handicaps the diagnosis, the systematic documentation of cases and the consistent reporting of studies addressing asthma. It...
Original Article
Malignant Mesothelioma: Experience at the Singapore General Hospital
Malignant mesothelioma is a rare tumour and is typically associated with asbestos exposure. In endemic areas, it has an estimated incidence as high as...
Original Article
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...
Review Article
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...
Original Article
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...
Review Article
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...
Review Article
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...
Others
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....
Review Article
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...
Others
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....
Original Article
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...
Editorial
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...
Others
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...
Others
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)...
Others
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...
Review Article
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...
Review Article
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....
Review Article
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...
Original Article
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...
Review Article
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...
Original Article
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...
Review Article
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...
Review Article
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...
Review Article
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...
Review Article
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...
Review Article
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...
Original Article
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...
Others
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...
Editorial
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...
Others
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...
Original Article
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...
Original Article
A Study on SARS Awareness and Health-seeking Behaviour – Findings from a Sampled Population Attending National Healthcare Group Polyclinics
There was a worldwide outbreak of Severe Acute Respiratory Syndrome (SARS) caused by the novel coronavirus between November 2002 and July 2003. Singapore was...
Others
Pulmonary Hypereosinophilia
Eosinophilic lung diseases encompass a heterogenous spectrum of lung disorders defined by increased eosinophils in blood and/or tissue. In 1952, Crofton et al proposed...
Original Article
How Much do Diabetic Patients Know About Diabetes Mellitus and its Complications?
Diabetes mellitus (DM) is a common and growing healthcare problem in Singapore with a prevalence of 9% in 1998. Since the 1990s, the Ministry...
Others
An Unusual Cause of Pulmonary Haemorrhage in a Patient with Rheumatoid Arthritis
Strongyloides stercoralis is an intestinal nematode which causes a chronic but usually asymptomatic infection in humans. However, in immunocompromised patients, parasitic larvae can develop...
Others
A Case Report of Occupational Asthma due to Gluteraldehyde Exposure
Worldwide, asthma is estimated to affect between 5% and 10% of the population and, among adults, 4% to 9% of these cases have been...
Review Article
Clinical PET Imaging – An Asian Perspective
Positron emission tomography (PET) is distinct from other imaging modalities in its ability to probe the physiology and biochemistry of normal and abnormal tissues....
Letter to the Editor
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)...
Original Article
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...
Review Article
The Epidemiology of Myopia in Hong Kong
Myopia is a refractive condition in which the image of a distant object is formed anterior to the retina of the unaccommodated (relaxed) eye....
Review Article
Evidence for an “Epidemic” of Myopia
A number of authors have recently proposed that myopia is increasing at an “epidemic” rate, particularly in East Asia, and especially among populations of...
Commentary
The Haze and Health: A Blog About the Fog
The haze is an atmospheric phenomenon where pollutant particles accumulate in the air and obscure the normal clarity of the sky. In Singapore, this...
Others
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...
Others
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...
Original Article
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...
Original Article
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...
Original Article
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...
Original Article
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...
Original Article
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...
Original Article
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...
Others
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...
Others
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...
Editorial
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...
Commentary
SARS: How to Manage Future Outbreaks?
Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus (SARS-CoV), which crossed from wild animals at live markets to man in mid-November...
Original Article
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...
Review Article
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%...
Original Article
The Clinical Predictors of Hypertension and Sleepiness in an Asian Population with Sleep-disordered Breathing
Sleep physicians have only recently began to learn much about the epidemiology of sleep-disordered breathing (SDB) from large, well conducted prospective community-based studies. These...
Editorial
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...
Others
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.
Others
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.
Others
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.
Others
Newborn Screening in Bangladesh
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
Fatty Acid Oxidation Defects
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Others
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.
Original Article
Tuberculosis Peritonitis in Negara Brunei Darussalam
There has been a resurgence of tuberculosis (TB) in many countries, including developed nations, especially with the HIV pandemic and the increase in immigration.1,2...
Others
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.
Editorial
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.
Letter to the Editor
Sarcoidosis with Granulomatous Hepatitis and Autoimmune Endocrine Involvement
Sarcoidosis is a systemic granulomatous disease of unknown aetiology. It emerges in the form of hiler adenopathy and interstitial pulmonary disease in most cases.
This...
Original 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...
Letter to the Editor
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...
Commentary
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...
Original Article
Evidence-based Medicine (EBM) for Undergraduate Medical Students
The practice of evidence-based medicine (EBM), which integrates individual clinical expertise with the best available evidence from systematic research, demands a set of skills....
Review Article
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...
Review Article
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...
Review Article
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...
Review Article
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...
Review Article
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...
Original Article
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...
Original Article
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...
Original Article
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...
Original Article
Obstructive Sleep Apnoea in Singapore: Polysomnography Data From a Tertiary Sleep Disorders Unit
Overnight attended polysomnography (PSG) in the sleep laboratory has been the gold standard to confirm the presence and severity of obstructive sleep apnoea (OSA)....
Original Article
The Metabolic Syndrome in Hypertensive and Normotensive Subjects: The Isfahan Healthy Heart Programme
The metabolic syndrome (MS) is characterised by a clustering of metabolic risk factors and an insulin-resistant state.1 Its prevalence is high in Western, as...
Original Article
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...
Images in Medicine
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,...
Images in Medicine
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...
Others
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...
Original Article
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...
Others
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,...
Original Article
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...
Original Article
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...
Original Article
Impact of the Singapore National Asthma Program (SNAP) on Preventor-Reliever Prescription Ratio in Polyclinics
According to the World Health Organization/Global Initiative on Asthma (WHO/GINA) report on the global burden of asthma, Singapore is an intermediate-risk country for asthma...
Original Article
Public Misperceptions About Transmission of Hepatitis B Virus in Singapore
Chronic hepatitis B (CHB) is an important global health problem, with more than 350 million individuals affected worldwide. CHB is particularly important in Asia,...
Images in Medicine
Paediatric perineal skin pit: More than skin deep?
A 2.5-year-old boy was referred to our clinic for abnormal genitalia and a febrile urinary tract infection (Escherichia coli >105 colony-forming units/mL). At birth,...
Original Article
Diabetes and Associated Cardiovascular Risk Factors in Iran: The Isfahan Healthy Heart Programme
The incidence and prevalence of diabetes mellitus (DM) worldwide is increasing, due almost exclusively to an increase in non-insulin-dependent (type 2) DM, which represents...
Original Article
Characteristics, and Disease Control and Complications of Hypertensive Patients in Primary-care – A Community-based Study in Singapore
Essential hypertension is a chronic disease involving the primary elevation of systemic blood pressure (BP). While the main causes of essential hypertension has not...
Letter to the Editor
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...
Original Article
T Lymphocyte Activation Profiles in Peripheral Blood of Long-Versus Short-Term Residents of Kuwait: Comparison with Asthmatics
The Gulf Wars of 1991 and 2003 exposed the residents of Kuwait and several neighbouring countries to high levels toxicants with the capacity to...
Original Article
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....
Editorial
Lung Cancer: Recent Advances
Lung cancer is the leading cause of cancer related mortality in the world. It accounts for almost a million deaths annually and resulted in...
Original Article
Difference in Asthma Control Test™ (ACT) Scores in Three Different Clinical Practice Settings
The prevalence of asthma ranges from 1% to 18% worldwide and it remains a significant cause of morbidity and economic burden despite advances in...
Letter to the Editor
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...
Letter to the Editor
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...
Images in Medicine
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...
Images in Medicine
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...
Original Article
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...
Original Article
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...
Original Article
Clinical Features of Allergic Rhinitis and Skin Prick Test Analysis Based on the ARIA Classification: A Preliminary Study in Malaysia
Allergic rhinitis (AR) is a common disease worldwide and is known to cause serious implications to the physical and mental health status of the...
Letter to the Editor
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...
Images in Medicine
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...
Letter to the Editor
Inadvertent Haemodialysis in a Pulmonary Tuberculosis Patient with Hypercalcaemia
Malaysia is a country with an intermediate burden of tuberculosis (TB) with a prevalence of 121 cases per 100,000 population per year. TB usually...
Review Article
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...
Original Article
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...
Original Article
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...
Others
Sir John Wenman Crofton
Sir John Crofton, a world famous expert on the treatment of tuberculosis died in Edinburgh at the age of 97. John Crofton was born...
Letter to the Editor
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...
Letter to the Editor
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...
Original Article
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...
Original Article
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...
Original Article
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...
Images in Medicine
Rapidly Vanishing Pulmonary Pseudotumour
A 51-year-old male ex-smoker with a history of pulmonary tuberculosis was referred for exertional dyspnoea for 5 days. He had no fever, cough or...
Images in Medicine
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...
Original Article
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....
Original Article
Smoking and Nicotine Dependence in Singapore: Findings from a Cross-Sectional Epidemiological Study
Tobacco is the leading cause of preventable death and is the fourth most common risk factor for disease. Nearly 6 million deaths occur worldwide...
Original Article
Suicidal Ideation, Suicidal Plan and Suicidal Attempts Among Those with Major Depressive Disorder
The World Health Organization (WHO) estimates that every year, almost a million people die from suicide — a mortality rate of 16 per 100,000,...
Letter to the Editor
Plasma IP-10 could identify early lung disease in severe COVID-19 patients
Dear Editor,
The global pandemic of SARS-Coronavirus-2 (SARS-CoV-2) infection has imposed tremendous strain on healthcare resources worldwide, as a significant proportion of patients require...
Original Article
Outcomes of second-tier rapid response activations in a tertiary referral hospital: A prospective observational study
Despite its widespread adoption, rapid response systems (RRS) and rapid response teams (RRT) vary significantly in composition and set-up.1-3 While implementation of RRSs appear...
Letter to the Editor
An Unusual Cause of Severe Pulmonary Hypertension in a Young Woman
Dear Editor,
A 25-year-old Cambodian lady diagnosed with pulmonary hypertension in her native country came for second opinion on the further management of her condition....
Original Article
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...
Review Article
Cognitive Aspect of Diagnostic Errors
It was an unusually busy ward round. The newly promoted registrar was keen to review the patients handed over to him. But there were...
Original Article
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...
Letter to the Editor
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...
Letter to the Editor
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...
Original Article
Heterogeneity of non-cystic-fibrosis bronchiectasis in multiethnic Singapore: A prospective cohort study at a tertiary pulmonology centre
Bronchiectasis is a chronic lung disease of significant morbidity and mortality. The pathological hallmarks of the disease are abnormal dilatation of airways resulting from...
Original Article
Factors influencing protective behaviours during haze episodes in Singapore: A population-based study
Southeast Asia suffers from recurrent episodic air pollution from biomass smoke known as haze, which is mainly caused by human activities such as the...
Letter to the Editor
Impact of pulmonary rehabilitation in patients with interstitial lung disease in Singapore
Interstitial lung diseases (ILD) encompass a heterogeneous group of lung parenchymal disorders. ILD-related symptoms impact significantly on quality of life (QoL). Dyspnoea is the...
Letter to the Editor
Radiological changes on chest CT following COVID-19 infection
COVID-19 infection is associated with high rates of hospitalisation and mortality, placing healthcare systems under strain. There are many reports regarding the non-contrast-enhanced high-resolution...
Editorial
The Novel Coronavirus (SARS-CoV-2) Pandemic
The severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) pandemic began in early December in
Wuhan, the 7th most populous city in Mainland China,
and was reported to...
Original Article
Emergency airway management in a Singapore centre: A registry study
Emergency airways often present with little warning, and the need for airway management is necessary for a successful resuscitation. This is in contrast to...
Original Article
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...
Original Article
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...