Related Articles | Annals Singapore

Original Article

Risk Factors for Predicting Mortality in a Paediatric Intensive Care Unit

G H Tan, T H Tan, D Y T Goh, H K Yap

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

Original Article

Infections in Acute Lymphoblastic Leukaemia

C Y Chong, A M Tan, J Lou

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

B Macner-Licht, V Rajalingam, V Bernard-Opitz

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...

Original Article

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

C K Leong, A S B Ng, S L Chew

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)

S P L Ng, T H Tan, J M Gomez

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

E Koh, I Chan, K Y Wong

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

M C Chua, I LY Chan

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

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

K P L Yap, M L Tan, C E L Tan

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

Original Article

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

P Agarwal, V S Rajadurai, S Bhavani, K W Tan

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

Parainfluenza Type 3 Viral Outbreak in a Neonatal Nursery

W Ng, V S Rajadurai, V K Pradeepkumar, K W Tan, K P Chan

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

K S Tan, Y S Lau, W S Teo

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...

Others

The Future of Medicine from the Standpoint of the Practising Paediatrician

H B Wong

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

F K P Yap, M M Aw, S C Quek, S H Quak

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

M L Wong, E K W Sim, J J Goh, S C Quek, J C L Wong, W C L Yip, C N Lee

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

Retinopathy of Prematurity in Very Low Birth Weight Infants

J K Chye, C T Lim, H L Leong, P K Wong

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

T H Tan, K Y Wong, J T Heng

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

Original Article

Transaminitis in Duchenne’s Muscular Dystrophy

S K H Tay, H T Ong, P S Low

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

R Quaife, S H Leong, C L W Yip, K H Chan

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

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

S K H Tay, P S Low, H T Ong, K Y Loke

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

S C Quek, K T Low, E K W Sim, R Joseph

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

W K Gong, W Cheung, H K Yap

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

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

J A I Weigl

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

Original Article

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

B S Tan, H Y Law, Y Zhao, C S Yoon, I S L Ng

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

S C Quek, K S Ng, W L Ng, A Cheng, B L Chia

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

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

K C See, S K H Tay, P S Low

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

J S Cheah

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...

Review Article

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

D K L Chan

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

S C Quek, C L Yip, M L Wong, K Y Chan, C L Wong

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

C L Tan

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

S C Quek, M Aw, S H Quak, K Prabhakaran, K C Tan

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

S K H Tay, H T Ong, P S Low

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

Paediatric Extracranial Germ Cell Tumours: A Retrospective Review

L P N Lim, A M Tan, M Y Chan, V Rajalingam, J Lou, C L Tan

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

W B Lian, C L Yeo, L Y Ho

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...

Others

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

L Y Ho

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

Intussusception: A Three-Year Review

A H M Lai, K B Phua, E L H J Teo, A S Jacobsen

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

T C Tan, T Y T Tan, K Y C Kwek, J C S Tee, V S Rajadurai, G S H Yeo

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

H Y Wee, T Y T Tan, P C Khoo, P Agarwal, G S H Yeo

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

M S K Lau, J V K Tan, T Y T Tan, J M Gomez, G S H Yeo

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

D P Frush

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

H Çaksen, S Kurtoglu, I K Hallaç, H B Üstünbas, K Üzüm, H Kiliç

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

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

V A Shah, C Y Chong, K P Chan, W Ng, A E Ling

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

L Y Ho

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

L M Daniel, S B Lim, L Clarke

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

P Agarwal, S B Lim

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

G K Suresh, R F Soll

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

V S Rajadurai, K H Tan

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

R Joseph

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

N K Ho

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

G Fung, K Bawden, P Chow, V Yu

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

V S Rajadurai

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

H H Lim, L M Daniel, J Lee, M C Tan

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

G Mieli-Vergani, D Vergani

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

C Pancharoen, U Thisyakorn

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

L Sanci, S Glover, C Coffey

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

P Thwaite, D L Bennett, H Pynor, H Zigmond

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

K McFerran-Skewes, S M Sawyer

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

P Y Lam, M Yeo, S M Sawyer

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

J E Szyndler, S Towns, R C Hoffman, D L Bennett

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

C A Olsson, L Bond, M W Johnson, D L Forer, M F Boyce, S M Sawyer

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

M Yeo, S M Sawyer

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

Y Bonomo

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

R K W Chan, H H Tan

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

E K Ung

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

E K Ung

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

N B C Lee, D S S Fung, J Teo, Y H Chan, Y M Cai

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

K Y Loke, R M Viner

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

K Y Loke

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

B Singh, PS Low, JF Yeo

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

H Gazi, S Surucuoglu, B Ozbakkaloglu, S Akcali, N Ozkutuk, K Degerli, S Kurutepe

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

Letter to the Editor

A Fatal Turkish Case of Campomelic Dysplasia

H Çaksen, S Kurtoglu, A Öztürk

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

JT Lee, ZCM Lam, WT Lee, LCT Kuo, V Jayant, G Singh, J Lee

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

Others

Clinical Report: A Case of Williams Syndrome and Klinefelter Syndrome

Le Ye Lee, Swee Chye Quek, Samuel S Chong, Arnold SC Tan, Josephine MS Lum, Denise Li-Meng Goh

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

Wan-Yee Teo, Mei-Yoke Chan, Ching-Mei Lam, Chia-Yin Chong

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

Kam-lun E Hon, Edmund AS Nelson

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

It-Koon Tan, Bani Gajra, Maria SF Lim

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?

Kwang-Hsien Lim, Wee-Bin Lian, Cheo-Lian Yeo

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

Kam-Lun E Hon, Vivian WY Lee, Ting-Fan Leung, Kenneth KC Lee, Andrew KW Chan, Tai-Fai Fok, Ping-Chung Leung

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

Joeanne Lim, Manzhi Wong, Mei Yoke Chan, Ah Moy Tan, Vasanthi Rajalingam, Lillian PN Lim, June Lou, Cheng Lim Tan

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

Irving Charles Boudville, Kong-Boo Phua, Seng-Hock Quak, Bee-Wah Lee, Htay-Htay Han, Thomas Verstraeten, Hans Ludwig Bock

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

Shing-Yan Lee, Kwok-Yin Chan, Albert YW Chan, Chi-Kong Lai

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

Rajeev Sood, Surender Nath Wadhwa, Vikas Jain

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

Hui-Kim Yap

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

Original Article

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

Jaiman V Emmanuel, Uei Pua, Gervais KL Wansaicheong, Julian PN Goh, Ian YY Tsou

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

KB Phua, SC Emmanuel, P Goh, SH Quak, BW Lee, HH Han, RL Ward, DI Bernstein, B De Vos, HL Bock

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

Editorial

Therapeutic Hypothermia for Neonatal Hypoxic-Ischaemic Encephalopathy

VS Rajadurai

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

Yanling Yang, Zhang Yao, Jinqing Song, Yuki Hasegawa, Masahiko Kimura, Seiji Yamaguchi, Yuwu Jiang, Jiong Qin, Xiru Wu