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

Dear Editor, Chronic hepatitis B (CHB) infection affects approximately 248 million individuals in the world1 and 3.6% of the Singapore population.2 Given the natural history...

Optimum follow-up period of arthroscopic and mini-open rotator cuff repairs

Dear Editor, Rotator cuff disorders are the most common cause of disability related to the shoulder,1 and rotator cuff repairs—via mini-open or arthroscopic techniques—are...

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...

Anthropometry of Anterior Cruciate Ligament in Singaporean Chinese

Anterior cruciate ligament (ACL) reconstruction is a technically precise and demanding operation. Attention to factors such as the tunnel position, graft selection, fixation and...

Surgical Results of Open Reduction and Plating of Humeral Shaft Fractures

Management of humeral shaft fractures has been the subject of controversy (Böhler, Ekkernkamp and Muhr, Nast-Kolb and Schweiberer). The problem of non-union, wound infection...

Operative Treatment of Displaced Talar Neck Fractures

Talus is a weight bearing bone with peculiar anatomy and blood supply. It forms the ankle joint with the medial and lateral malleoli, subtalar...

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

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

A Case Report of Atasoy Antenna Procedure

The hook nail deformity is a relatively common problem after fingertip amputations. It is usually ignored but can be quite disabling. This article is available...

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...

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...

Patients Admitted to an Intensive Care Unit for Poisoning

The study of poisoning has been relatively neglected in Singapore. A check through the Infogate database of the National University of Singapore Library revealed...

A Case Series of Paget’s Disease of Bone: Diagnosing a Rather Uncommon Condition in Singapore

Sir James Paget’s description in 1877 of “a form of chronic inflammation of bones” which now bears his name was based entirely on clinical...

Double Level Fractures of the Femur Treated with Closed Intramedullary Nailing

Closed locked intramedullary nailing of the femur has become the accepted means of treating fractures of the femur. The use of locking nails has...

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

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

9th Seah Cheng Siang Memorial Lecture: Gastric Cancer—Where are we now?

The last two decades have witnessed dramatic changes in the understanding of gastric cancer: a rapid decline in global incidence, its association with Helicobacter...

Osteoid Osteoma after a Stress Fracture of the Tibia: A Case Report

A 24-year-old man complained of left leg pain following 3 months of infantry training 6 years ago. There was no previous complaint of pain...

Reconstruction of a Supinated Hypoplastic Thumb with Combined Huber Transfer and Derotation Osteotomy: A Case Report

A 6-year-old Chinese girl presented with a deformity of the left thumb since birth. Her father has a similar deformity. This article is available only...

One-year Review of Pityriasis Rosea at the National Skin Centre, Singapore

Pityriasis rosea is a common, self-limited disorder of unknown but suspected viral aetiology, that develops abruptly with few or no prodromal symptoms. Classically, the...

Transscaphoid Perilunate Fracture/Dislocations—Results of Surgical Treatment

Transscaphoid perilunate fracture/dislocations are relatively uncommon injuries of the wrist, constituting about 3% of all carpal injuries. However, it accounts for more than half...

Excimer Laser Phototherapeutic Keratectomy for Recurrent Corneal Erosions

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

Extraarticular Villonodular Synovitis of the Tendoachilles: A Case Report

Pigmented villonodular synovitis is a progressive synovial lesion of uncertain aetiology associated with synovial-lined tissues of the joints, tendon sheaths and bursae. The incidence...

Embolisation of a Leaking Pseudoaneurysm of the Main Artery Supplying a Replanted Arm: A Case Report

Pseudoaneurysms are conventionally treated by surgery. In recent years, non-surgical methods are being considered, including embolisation with wires, coils or gelfoam and anticoagulation. This article...

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

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

Comparison of First Carpometacarpal Joint Arthrodesis with Contralateral Excision Arthroplasty in a Patient with Bilateral Saddle Joint Arthritis: A Case Report

The carpometacarpal joint (CMCJ) of the thumb is commonly afflicted with degenerative arthritis. Of the patients seeking surgical treatment, post-menopausal women outnumber men by...

9th Chapter of Surgeons’ Lecture: The Orthopaedic Surgeon: Historical Perspective, Ethical Considerations and the Future

The legacy of caring and humanitarianism has been the mission of the medical profession since the founding of Singapore by Sir Stamford Raffles in...

A Study of Joint Mobility in a Normal Population

Joint mobility varies between individuals and factors such as age, sex, race and heredity influence the range of motion of a joint. Excessive mobility...

Delayed Amputation in Lower Limb Trauma: An Analysis of Factors Leading to Delayed Amputation

The decision whether to amputate or to attempt a limb salvage procedure in a mangled extremity is a difficult one. Numerous protocols have been...

Establishment of Animal Models Using Experimental Rats for Allogeneic Tissue Transplantation and Quantitative Flow Cytometric Detection of Immunochimera

Allogeneic tissue and organ transplantation has long been an important medical issue, as it provides an effective treatment alternative for a broad spectrum of...

The Effect of Storage at -70°C and -150°C on the Torsion Properties of the Canine Femur

Allograft transplantation of bone has been established as a viable and useful reconstructive procedure when limb salvage is the option of choice. For bone...

Use of Titanium Prosthesis to Bridge a Vertebral Gap in the Spine—A Preliminary Experimental Study

Bridging a vertebral gap in the spine is one of the commonest problems facing the spine surgeon after dealing with a tumour, infection or...

The Results of Autogenous Tibial Periosteal Transplants for Full Thickness Cartilage Defects in the Knee Joints of Pigs

Articular cartilage injuries to the knee are commonly seen by team doctors, sports physicians and orthopaedic surgeons. Despite many clinical as well as experimental...

Cross-Sectional Study of Near-work and Myopia in Kindergarten Children in Singapore

Myopia is the commonest eye disease worldwide, and is especially prevalent in certain Asian countries such as Taiwan, Japan and Hong Kong. Physiologic myopia...

Granuloma Annulare: A Review of 41 Cases at the National Skin Centre

Granuloma annulare (GA) is a benign, inflammatory disorder of the skin that has no proven aetiology or widely accepted theory of pathogenesis. There are...

Use of Low Molecular Weight Heparin for Prevention of Deep Vein Thrombosis in Total Knee Arthroplasty—A Study of its Efficacy in an Asian Population

The role of thromboprophylaxis in total knee replacement (TKR) remains controversial. In several reports, the incidence of deep vein thrombosis (DVT) has been significant. This...

Deep Vein Thrombosis after Total Knee Replacement

Western literature reports a very high incidence of deep vein thrombosis in its population especially after orthopaedic surgery. In total knee replacement without prophylaxis,...

Myopia: Gene-environment Interaction

Myopia affects up to 70% of adults in Singapore, Taiwan, Hong Kong and Japan. The prevalence rates in these Asian countries are higher than...

Management of Growth Arrest with Tissue-engineered Cells

Before I go on to the scientific aspects of my talk, I would like to pay tribute to Dr Yahya Cohen. Dr Cohen was...

Subcutaneous Emphysema and Pneumomediastinum after Endotracheal Anaesthesia

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

Incidence of Ischaemic Heart Disease and Stroke in Chinese, Malays and Indians in Singapore: Singapore Cardiovascular Cohort Study

Comparisons of disease frequency in different ethnic groups help to unravel the contributions of nature and nurture in their aetiology and to identify environmental...

Surgical Results of Intercondylar Fractures of the Adult Femur

Fractures of the intercondylar region of the femur often resulted from high velocity accidents. This would lead to increased comminution and involvement of the...

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

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

A Case Report of Total Finger Joint Replacement Arthroplasty After Traumatic Amputation

A 41-year-old Chinese man had his dominant thumb, index and middle fingers caught by a wood-cutting machine while at work. He sustained a near-amputation...

Re: Rikhraj I S, Tan C T, Tan S K, Teoh S H, Hastings G W. Use of Titanium Prosthesis to Bridge a Vertebral Gap in the Spine–A Preliminary Experimental Study. Ann Acad Med Singapore 1999; 28:20-4

In a recent issue of the Annals, Academy of Medicine, Singapore the above-mentioned paper was published. Figures 6 and 7 of the paper plot...

Biomechanical Study of C2 (Axis) Fracture: Effect of Restraint

In human, the occipito-atlanto-axial (C0-C1-C2) joint complex is an important region of the spine and often susceptible to impact injury in trauma. Traffic accidents...

Results of Distal Radial Fractures Treated by Intra-focal Pin Fixation

Unstable fractures of the distal radius remain a challenge to orthopaedic surgeons. Unsatisfactory results are often associated with significant malunion. This article is available only...

An Introduction to Biodegradable Materials for Tissue Engineering Applications

The concept of tissue engineering arises from the need to develop an alternative method of treating patients suffering from tissue loss or organ failure....

Galeazzi-Equivalent Fracture in Children Associated with Tendon Entrapment—Report of Two Cases

A 12-year-old boy fell whilst running. On examination, there was swelling and deformity of the wrist and there was local tenderness of the distal...

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

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

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

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

The Posterior Cruciate Ligament: An Anthropometric Study in Asians and Evaluation of Safe Limits for Bony Tunnel Creation During Reconstruction

The posterior cruciate ligament (PCL) provides the main restraint to posterior translation of the tibia on the femur and is stronger than its anterior...

Advances in Surgical Treatment of Osteoporotic Fractures of the Spine

Osteoporosis is an important cause of fractures in the elderly. In the USA alone, at least 1.3 million fractures are attributed to osteoporosis a...

The Bone and Joint Decade 2000-2010

With the ageing population, degeneration of joints and osteoporosis and the resultant disability pose big public health problems in many countries of the world....

Magnetic Resonance Arthrography of the Labral-Ligamentous Complex of the Shoulder: An Update

Shoulder instability is a frequently encountered clinical problem in young active people following injury, particularly in athletes. The labral-ligamentous complex is increasingly recognised as...

A Deceptive Cervical Lymph Node: A Solitary Spinal Osteochondroma

Osteochondromas are cartilage-capped bony exostoses that arise mainly from the metaphyses of long bones from a lateral displacement of the epiphyseal growth cartilage, but...

Limited Magnetic Resonance Imaging (MRI) and the Occult Hip Fracture

Worldwide, in the past decade, the application of magnetic resonance imaging (MRI) has increased tremendously in the management of musculoskeletal trauma. Not least is...

Extremity Osteosarcoma—A Southeast Asian Experience

Osteosarcoma is a highly malignant bone cancer occurring primarily in young patients. Although rare, it is still the commonest primary bone cancer seen in...

Towards a Splint-free Repair for Flexor Tendon Injuries

The most problematic area in flexor tendon injuries is zone two. This zone is prone to injury as it is in the grasping part...

Biomechanics of the Shoulder

The shoulder is a complex of 5 articulating surfaces that together form the shoulder girdle. The glenohumeral joint together with the scapulothoracic articulation form...

Instrumentation in Spinal Surgery

Spinal instrumentation is defined as the use of mechanical devices that enhance or restore the segmental stability of the spine. Internal fixation of the...

The Growth and Development of Orthopaedic Sports Medicine in Singapore

Orthopaedic sports medicine in Singapore took form as a subspecialty of orthopaedic surgery over a number of years. Several individuals contributed to it being...

Paediatric Orthopaedics in Singapore

The name “Orthopaedic Surgery” is derived from the words “orthos” (meaning straight or to straighten) and “paido” (meaning child). Thus, it is not unexpected...

Addresses at the 50th Anniversary Celebration of the Department of Orthopaedic Surgery, National University of Singapore on 5 April 2002

Over 200 guests were gathered at the Fullerton Hotel Ballroom on the 5th of April 2002 to commemorate the 50th anniversary of the Department...

History of the Singapore Orthopaedic Association

The University of Malaya in Singapore was established in 1949. With this, the King Edward VII College of Medicine became the Faculty of Medicine,...

History of the Orthopaedic Specialty in Singapore

When the practice of orthopaedic surgery first began in Singapore, it was not a specialty in itself. There are no records as to when...

50th Anniversary Celebrations—Golden ……. but all is not gold

On an occasion such as this—the 50th anniversary of the inauguration of orthopaedic surgery as a specialty service in Singapore—acclaim, commendations, praise and endorsement...

Subdural Block—From a Spinal? A Case Report

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

Problems Related to Epidural Analgesia for Postoperative Pain Control

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

Sexually Transmitted Diseases in the Older Population in Singapore

Sexually transmitted diseases (STDs) in persons older than 50 years are rarely studied because STDs are more common in young people. There is very...

Audit of Total Parenteral Nutrition in an Adult Surgical Intensive Care

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

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...

Bullous Pemphigoid Seen at the National Skin Centre: A 2-year Retrospective Review

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disorder affecting mainly the elderly. It is characterised by autoantibodies to the basement membrane zone (BMZ),...

A Case Report of Neurologically Unstable Fracture of the Lumbosacral Spine in a Patient with Ankylosing Spondylitis

Ankylosing spondylitis is associated with progressive ossification of the spinal ligaments and ankylosing of the facet joints leading to a totally stiff spine. It...

Clinical Update on Osteoporosis

Fractures, the most serious complication of osteoporosis, are increasing and constitute an evolving public health problem in terms of disability, mortality and cost. A...

An Asian Perspective to the Problem of Osteoporosis

Osteoporosis is regarded as an important public health problem in many Caucasian populations. Much of the research on epidemiology, diagnosis, treatment, genetic and molecular...

Osteoporotic Hip Fractures in Singapore—Costs and Patient’s Outcome

Singapore is facing a rapidly ageing population. Osteoporosis, which is an age-related illness, will become an increasing problem. Osteoporotic hip fracture, because of the...

Outcomes of Acute Arthroscopic Repair and Conservative Treatment Following First Traumatic Dislocation of the Shoulder Joint in Young Patients

Traumatic dislocation of the shoulder is a serious problem especially in active and young patients. Shoulder instability and recurrent dislocation hinder patient activities. This article...

From Genesis to Genes

I would like to thank the Singapore Orthopaedic Association (SOA) for inviting me to deliver this year’s SOA lecture. When your President, Dr AK...

Book Review

A lot of young orthopaedic surgeons embark on research projects with little guidance. This book is especially directed towards young investigators in the Southeast...

Significance of the Lateral Epiphysis of the Acetabulum to Hip Joint Stability

Developmental dysplasia of the hip (DDH) remains one of the most difficult disorders to understand and treat in Paediatric Orthopaedics. The aetiology have not...

Patterns and predictors of sound levels in hospital rooms

Dear Editor,      Excessive sound levels in the hospital can impair the work performance of healthcare professionals and affect patient well-being.1 Previous studies have also...

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

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

Acute Isolated Sphenoid Sinusitis

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

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

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

Behcet’s Disease: Experience in a Tertiary Rheumatology Centre in Singapore and a Review of the Literature

The only published study on Behcet’s disease in Singapore by Tan E et al (34 patients at the National Skin Centre) found that only...

Condensing Osteitis of the Medial Clavicle – An Intermediate-term Follow-up

Condensing osteitis of the clavicle is an idiopathic condition affecting the medial end of the clavicle, and is characterised by sclerosis and expansion of...

Plantar Dislocation of Lateral Tarsometatarsal Joint: A Case of Subtle Lisfranc Injury

Lisfranc fracture dislocations are uncommon injuries and the diagnosis may be easily missed. There are several variations and we present one such variant. This article...

Thoracic Myelopathy Secondary to Ligamentum Flavum Ossification

Acquired thoracic spinal canal stenosis is an uncommon condition compared to myelopathy and radiculopathy frequently seen in the cervical and lumbar spine, respectively. Because...

Rising Trend of Anterior Cruciate Ligament Injuries in Females in a Regional Hospital

Female athletes are at a greater risk for injuries involving the anterior cruciate ligament (ACL) than their male counterparts in high schools and colleges...

Profunda Femoris Artery Pseudoaneurysm Presenting with Triad of Thigh Swelling, Bleeding and Anaemia

Pseudoaneurysms of the profunda femoris artery have been reported following blunt and penetrating trauma to the thigh, and orthopaedic procedures of the proximal femur....

Cancellous Screw Fixation for Femoral Neck Fractures: One Hundred and Sixteen Patients

The incidence of hip fractures rises with increasing age, doubling for each decade beyond 50 years of age. With the increase in life expectancy...

Spectrum of Dentofacial Deformities: A Retrospective Survey

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

Deep Vein Thrombosis Following Hip Fracture and Prevalence of Hyperhomocysteinaemia in the Elderly

Western literature reports a high incidence of deep vein thrombosis (DVT) after hip surgery in the absence of prophylaxis. It is reported to be...

Septic Arthritis after Arthroscopic Anterior Cruciate Ligament Reconstruction

Arthroscopic-guided reconstruction of the anterior cruciate ligament (ACL) is now recognised as the preferred reconstructive option in restoring anterior knee joint stability. According to...

Morbidity Following Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft

Rupture of the anterior cruciate ligament (ACL) impairs the stability of the knee, resulting in difficulty with athletic performance, increased risk of subsequent meniscal...

Twin Births in Singapore: A Population-Based Study Using the National Birth Registry

Twin studies are regarded as one of the better ways to study the effects and significance of gene, environment and interactions of both. The...

Eye Injuries in Singapore – Don’t Risk It. Do More. A Prospective Study

The issue of ophthalmic trauma is a major cause for concern. An estimated 55 million eye injuries occur each year worldwide, leaving 1.6 million...

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

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

Community-associated Methicillin-resistant Staphylococcus aureus: Overview and Local Situation

The emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA) isolates from the community that are distinct from their archetypal healthcare-associated counterparts (HA-MRSA) marked a...

Ethambutol-associated Optic Neuropathy

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

Necrotising Fasciitis and Traditional Medical Therapy – A Dangerous Liaison

The first case was a 54-year-old lady, with a history of insulin-dependent diabetes mellitus and hyperlipidaemia, who presented with bilateral hand pain and stiffness...

Modelling the Utility of Body Temperature Readings From Primary Care Consults for SARS Surveillance in an Army Medical Centre

There has been increasing interest in building surveillance systems capable of detecting outbreaks of infectious diseases, at the stage where clinical presentation would still...

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

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

Swallowed Foreign Bodies in Children: Report of Four Unusual Cases

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

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...

Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme

Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM)...

Obesity and Obstructive Sleep Apnoea Hypopnoea Syndrome in Singapore Children

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

The Relationship between Postoperative Complications and Outcomes after Hip Fracture Surgery

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

“Bone Block” and Congenital Spine Deformity

A 14-year-old female who presented with a limited range of neck motion with various congenital vertebral anomalies that included improper segmentation or extensive “fusion”...

Autologous Bone Marrow Plasma Injection after Arthroscopic Debridement for Elbow Tendinosis

Elbow tendinosis is a term used to describe a syndrome of pain involving the extensor or flexor tendon origin of the forearm musculature. It...

Primary Hydatid Disease of the Humerus

Hydatid disease is a parasitic tapeworm infection caused by Echinococcus species. E.granulosus and E.alveolaris are the most common causes of hydatid disease in humans. This...

Recurrent Patellar Dislocation: Reappraising our Approach to Surgery

Traumatic patellar dislocations affect mainly adolescents and young adults. Up to 44% of patients will develop recurrent dislocation. This article is available only as a...

Triple Endobuttton Technique in Acromioclavicular Joint Reduction and Reconstruction

Acromioclavicular joint (ACJ) dislocation is a common injury often affecting young athletes. Cyclist, ice hockey players, weight lifters, rugby players and martial exponents are...

Return to Sports After Anterior Cruciate Ligament Reconstruction – A Review of Patients with Minimum 5-year Follow-up

Complete anterior cruciate ligament (ACL) rupture results in a mechanically unstable knee. ACL reconstruction is recommended in athletes to help restore knee stability for...

Clinical Evaluation of Arthroscopic-assisted Allograft Meniscal Transplantation

The menisci of the knee are fibro-cartilaginous structures essential for the normal biomechanic of the knee joint. They play a critical role in shock...

Advanced Burkitt’s Lymphoma Presenting With Jejunal Perforation

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

Renal Cell Carcinoma Bony Metastasis Treatment

Patellar metastases are extremely rare, ironically, primary tumours of the patella are more common than metastatic disease. A Medline search from 1960 to the...

Osteochondral Lesions of the Talus

Osteochondral lesions of the talus are a known cause of chronic ankle pain. They are frequently found in the active population after ankle sprains. This...

Arteriovenous Fistula Aneurysm – Plicate, Not Ligate

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

Perforated Appendicitis in Children: Benefits of Early Laparoscopic Surgery

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

Survival of Small-cell Lung Cancer and its Determinants of Outcome in Singapore

Lung cancer is the leading cause of cancer mortality around the world.1 Small-cell lung cancer (SCLC) constitutes about 15% to 25% of all lung...

Lack of Awareness amongst Community Patients with Diabetes and Diabetic Retinopathy: The Singapore Malay Eye Study

Diabetes is a major public health problem, and diabetic retinopathy is the leading cause of blindness in working-aged people.1 Previous studies have documented poor...

Pain Prevalence in Singapore

Population studies on pain prevalence are useful in determining the impact that chronic pain has on the society. It draws the attention of healthcare...

An Update of Paediatric Intussusception Incidence in Singapore: 1997-2007, 11 Years of Intussusception Surveillance

This is an update to the previously published paper by Boudville et al1 on 8 years of intussusception (IS) surveillance in Singapore. IS is...

Peritoneo-Cutaneous Fistula Secondary to Skin Excoriation from a Large Chronic Incisional Hernia

Incisional hernias are common complications following abdominal surgery with an incidence of 2% to 20% after midline laparotomy. Umbilical fluid discharge is, however, an...

The Natural History and Prognosticative Factors of Adult Extremity Soft Tissue Sarcomas: An Asian Perspective

Soft tissue sarcomas (STSs) are extremely rare tumours, making up about 1% of all malignancies. In Singapore, they accounted for 0.7% of all cancers...

Venous Thromboembolism at the National Healthcare Group, Singapore

Venous thromboembolism (VTE) is a potentially fatal disease which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). About 30% of patients with VTE...

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...

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

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

Effect of Autologous Mesenchymal Stem Cells on Biological Healing of Allografts in Critical-sized Tibial Defects Simulated in Adult Rabbits

Bridging of large bone defects is a challenging problem in orthopedic and reconstructive surgery. Options include vascularised bone autografts, non-vascularised bone autografts, allografts, bioceramics...

Evaluation on the Effectiveness of the National Childhood Immunisation Programme in Singapore, 1982-2007

Singapore has a comprehensive National Childhood Immunisation Programme (NCIP) which first covered smallpox (1862), followed by diphtheria (1938), tuberculosis (TB) (1957), poliomyelitis (1958), pertussis...

The Need for a System of Prognostication in Skeletal Metastasis to Decide Best End-of-life Care – A Call to Arms

Decisions regarding potential surgery for metastatic disease are influenced by estimates of patient survival. For example, patients with long life expectancy may be appropriately...

Vascular Endothelial Growth Factor (VEGF) is Expressed During Articular Cartilage Growth and Re-expressed in Osteoarthritis

Growth factors are polypeptides that direct cells to proliferate, differentiate, migrate or produce matrix. They exert their effects by interacting with specific receptors on...

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

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

Effectiveness of Vacuum-assisted Closure (VAC) Therapy in the Healing of Chronic Diabetic Foot Ulcers

Diabetes mellitus is a common problem in Singapore, with an incidence of 8.2% in the local population aged between 18 and 69 in 2004....

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

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

Outbreak of Novel Influenza A (H1N1-2009) Linked to a Dance Club

Influenza A (H1N1-2009) is a novel strain of influenza virus. The infection is thought to have first occurred in Mexico in March 2009, and...

An Epidemiological Study of 1348 Cases of Pandemic H1N1 Influenza Admitted to Singapore Hospitals from July to September 2009

On 17 April 2009, the US Centers for Disease Control (CDC) determined that febrile respiratory illness occurring in 2 children residing in adjacent counties...

Outbreak of Pandemic Influenza A (H1N1-2009) in Singapore, May to September 2009

The first cases of infection with a novel influenza A (H1N1) strain were reported in 6 cases in California and 2 cases in Texas...

Functional Outcomes of Cancer Patients in an Inpatient Rehabilitation Setting

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

Prevalence of Metabolic Syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions and their Association with Coronary Heart Disease in an Elderly Iranian Population

Coronary heart disease (CHD) is one of the most common causes of morbidity and mortality in different communities.1,2 Despite the lack of accurate data,...

Chronic Achilles Tendon Rupture Treated with Two Turndown Flaps and Flexor Hallucis Longus Augmentation – Two-year Clinical Outcome

Chronic Achilles tendon rupture is a disabling condition resulting in ankle pain, weakened ankle plantarflexion and abnormal gait. Management of chronic ruptures is technically...

Policy Implications of The Singapore Mental Health Study

Mental health issues have taken on greater importance with the growing awareness among policy makers of the importance of mental health for the development...

Clinical Outcome and Cost Comparison Between Laparoscopic and Open Appendicectomy

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

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

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

Lemierre’s Syndrome: An Unusual Cause of Calf Abscess

Dear Editor, Lemierre’s syndrome is a rare disease caused by Fusobacterium necrophorum, a Gram-negative anaerobic bacillus that is associated with oropharyngeal infections. We describe a...

Electrocardiograph Changes, Troponin Levels and Cardiac Complications After Orthopaedic Surgery

Following orthopaedic surgery, approximately 5% of patients sustain cardiac complications which leads to increased morbidity and mortality. The mortality rate after hip fracture is...

Unipolar versus Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly: Is There a Difference?

Hip hemiarthoplasties are commonly performed for displaced femoral neck fractures. The advantages of hemiarthroplasty over internal fixation include earlier mobility, less reoperations and better...

Use of the Sole Flap to Convert an Above Knee Amputation to a Below Knee Amputation in Trauma

Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are performed for decompression of the spine when the primary compressive...

Single-level Anterior Corpectomy with Fusion versus 2-level Anterior Cervical Decompression with Fusion: A Prospective Controlled Study with 2-year Follow-up Using Cages for Fusion

Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are performed for decompression of the spine when the primary compressive...

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

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

Impact of unemployment on mental disorders, physical health and quality of life: Findings from the Singapore Mental Health Study

Several reviews and meta-analyses have established an association between unemployment and psychological distress. This relationship between unemployment and mental health is complex and likely...

Health-seeking behaviour of foreign workers in Singapore: Insights from emergency department visits

Singapore employs a large foreign worker (FW) population, defined as non-Singapore citizens and non-permanent residents working locally. Holders of “work permit” (WP), the work...

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

Overweight and obesity continue to be one of the most critical public health issues worldwide. Body mass index (BMI) derived from height and weight...

Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry

Ophthalmic cancers are commonly encountered in clinical practice and are an important cause of morbidity and mortality. Globally, the incidence of ophthalmic cancers have...

Optimum early orthopaedic surgery in COVID-19 patients

Multiple guidelines have been established regarding the management of COVID-19 patients. However, there remains a paucity regarding specific guidelines on the optimal timing for...

COVID-19 and Singapore: From Early Response to Circuit Breaker

The COVID-19 pandemic first broke out in Wuhan, China, in December 2019, where a cluster of pneumonia cases was reported and the novel coronavirus...

Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children

Singapore confirmed its first case of COVID-19 on 23 January 2020 in a Chinese national from Wuhan, and its first paediatric case on February...

Coronavirus Disease 2019 (COVID-19): The Singapore Experience. A Review of the First Eight Months

Singapore reported its first imported case of COVID-19 on 23 January 20201 and its first COVID-19 deaths on 21 March 2020.2 The WHO declared...