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Call for a Singapore National Action Plan for Sepsis (SNAPS): Stop sepsis, save lives

Sepsis is a life-threatening organ dysfunction syndrome caused by a dysregulated host response to an infection.1 It affects up to 48.9 million people globally...

Knowledge, attitudes and practices of doctors on constipation management in Singapore

Dear Editor, Constipation is a common gastrointestinal disorder, affecting about 15% of the global population and severely impacting patients’ quality of life.1 The global constipation...

Value the patient as a person: Answering the call for a person-centred model of care

There has been a change in patients’ attitudes towards healthcare professionals in recent decades, coupled with an increasingly evident shift in the care paradigm....

Singapore’s experience in managing the COVID-19 pandemic: Key lessons from the ground

In the early days of the pandemic when information on COVID-19 infection was lacking, all COVID-19 positive patients were admitted into acute hospitals for...

Script concordance test to assess diagnostic and management reasoning in acute medicine

Dear Editor,  Clinical reasoning, an essential skill for patient care, can be difficult to assess. We created and validated a script concordance test (SCT) to...

Risk and protective factors of mental health during the COVID-19 pandemic: A cross-sectional study in Singapore

The COVID-19 pandemic has significantly impacted people’s well-being globally.1 Individuals faced several stressors during the pandemic, including fear of contracting the disease, experiencing severe...

Self-esteem and positive body image to overcome female sexual dysfunction

Human sexuality is arguably one of the main pillars of health, like nutrition and sleep. Improvements in diagnostic and therapeutic biotechnologies have enabled focus...

Antiphospholipid and other autoantibodies in COVID-19 patients: A Singapore series

Dear Editor, Thrombosis is an unexpected complication of COVID-19 initially reported in 3 patients from China.1 These patients tested positive for immunoglobulin (Ig) A anticardiolipin...

Interaction of sex and diabetes in Asian patients with heart failure with mildly reduced left ventricular ejection fraction

Diabetes mellitus (DM) is a common comorbidity worldwide with global prevalence among adults above 18 years of age increasing from 4.7% in 1980 to...

Global monkeypox outbreak 2022: First case series in Singapore

Monkeypox has been declared a public health emergency of international concern. Up until 2022, most cases of monkeypox have been reported in parts of...

The global emergence of monkeypox

Monkeypox is so named because the poxvirus was first identified in 2 outbreaks among cynomolgus monkeys housed at the Statens Serum Institut, Denmark, in...

Treating acutely ill patients at home: Data from Singapore

Inpatient hospitalisation is the conventional strategy to care for acutely ill patients. However, demand for hospital beds and clinical manpower is escalating as populations...

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...

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...

Academic Medicine in Singapore

Academic medicine is currently grappling with the problem of whether the triple-threat academician is a species threatened with extinction in the 21st century, given...

Foregoing Life Support in Medically Futile Patients

The origins of withholding medical support are found in ancient times. More than two millennia ago, Hippocrates (460 to 361 BC) stated that the...

Nitric Oxide in Septic Shock: Directions for Future Therapy?

In 1980, Furchgott and Zawadzki demonstrated that the relaxation of isolated arteries to acetylcholine required the presence of endothelial cells. This response was mediated...

Critical Care Medicine in the Western Pacific Region

The Western Pacific region includes a very diverse group of countries varying in their culture, economic development and per capita income, disease prevalence and...

Critical Care—The Worldwide Perspective

Although special areas for postoperative patients existed 50 years ago, the modern specialty of Critical Care began during the polio epidemic of the 1950s....

Malaria Requiring Intensive Care

Malaria is an important and common infectious parasitic disease globally. It is associated with significant morbidity and mortality, especially in endemic areas. This article is...

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 Retrospective Study of Near-drowning Victims Admitted to the Intensive Care Unit

Drowning victims suffocate from submersion. This may lead to immediate death or, if they survive, brain damage if significant cerebral hypoxia is present. This article...

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...

Ergotism and Vascular Insufficiency: A Case Report and Review of Literature

Toxicity from ergot and its derivative is well known. Great epidemics occurred during the middle ages due to consumption of rye contaminated with the...

Plasma Vitamins A, C and E in the General Population of Singapore, 1993 to 1995

The current disease pattern in Singapore (an island state of 3.3 million people composed of 76% Chinese, 14% Malays, 7% Asian Indians and 3%...

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...

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...

Intravital Microscopy for the Study of the Microcirculation in Various Disease States

It is more than 150 years ago when the first detailed description of intravital microscopy was given by Waller, demonstrating in the frog tongue...

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...

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...

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...

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...

Gemella Empyema Cured without Antibiotics: A Case Report

Gemella are gram-positive anaerobic bacteria that rarely produce serious human infections. We describe a case of thoracic empyema that occurred in an elderly Chinese...

The Clinician Meets the Computer—Uneasy Bedfellows

Information technology has become a cornerstone of civilization as we know it. In its broadest definition, information technology encompasses all forms of technology required...

Leveraging on Information Technology to Enhance Patient Care: A Doctor’s Perspective of Implementation in a Singapore Academic Hospital

Information technology (IT) has become truly pervasive in everyday life; however, in the field of medicine, we have yet to fully harness its full...

Internal Medicine

It has taken a long time to plan for this November issue in Internal Medicine. The topic is so wide and often neglected as...

General Medicine—Revisited, Rejuvenated, Revitalised and Reemphasised

“The irresistible swing towards medical specialisation has brought advantages for patients but arguably this has gone too far.” It is time to review the...

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...

A Countrywide Approach to the Control of Non-communicable Diseases—The Singapore Experience

In the area of health, the last two decades has seen a decline or eradication of deadly diseases, such as smallpox and polio, the...

Causes for the Evolution of Case Management and the Development of a Working Model in an Acute Care Hospital in Singapore

In 1999, significant changes to the healthcare funding structure were introduced to public sector hospitals in Singapore. This was the advent of casemix-based funding...

Evidence-based Medicine: The Key to Guidelines, Disease and Care Management Programmes

Health care in America and the rest of the industrialised world continues to reinvent itself at an ever-accelerating rate. The societal pressures for high...

National Disease Management Plans for Key Chronic Non-communicable Diseases in Singapore

Like most other newly industrialised economies, Singapore has undergone a rapid epidemiological transition over the last 50 years. Chronic, non-communicable diseases have replaced infectious...

Chronic Disease Management: Challenges for Clinicians and the Way Forward

The healthcare, financial and social burden of chronic diseases, such as diabetes mellitus, coronary heart disease, asthma, chronic obstructive airway disease, hypertension, chronic depression,...

Measuring Health-related Quality of Life in Singapore: Normal Values for the English and Chinese SF-36 Health Survey

Advances in diagnosis and therapy in the second half of the 20th century have lead to impressive improvements in survival for patients with many...

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),...

Should Ethical Issues in Biotechnology Research be Decided by Physicians-Scientists or by Lawyers?

As with clinical practice, the practice of biomedical research is a moral activity. We have to think about what we should do, not just...

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...

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...

1st College of Physicians Lecture: The Role of Internal Medicine as a Specialty in the Era of Subspecialisation

It humbles me to accept the invitation to give this lecture, the First College of Physicians Lecture, titled “The Role of Internal Medicine as...

Standards and Revalidation or Recertification

In my Gordon Arthur Ransome Oration and other papers, I have described the nature and development of patient-centred professionalism, the key features of which...

Continuing Professional Development – a Surrogate for Recertification?

The Hong Kong Academy of Medicine is a statutory body set up in 1993 with the objectives of fostering the development of postgraduate medical...

Teaching and Learning of Professionalism in Medical Schools

There is now worldwide consensus that the elements of medical professionalism need to be enhanced and explicitly taught in medical schools. Medical schools in...

The Challenge of Teaching Professionalism

For the past 25 years, professionalisation, industrialisation, large-scale infusions of technology into the healthcare system and consumerism, to name a few factors, have definitely...

2004 Runme Shaw Memorial Lecture: Professionalism – A Concept in Need of Nurturing

It is a great honour to be invited to deliver the Runme Shaw Memorial Lecture. I am grateful to the Runme Shaw Foundation for...

17th Gordon Arthur Ransome Oration: Patient-centred Professionalism

When sickness strikes we all need doctors. People everywhere know that the quality of medical care can affect the outcome and possible consequences of...

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...

Refining Clinical Practice: Transforming Science Research into the Art of Medicine

I am humbled by the invitation given to me by Changi General Hospital to deliver this lecture at your 5th Annual Scientific Meeting with...

Extended-spectrum Beta-lactamases in Clinical Isolates of Escherichia coli and Klebsiella spp. in a Singapore Hospital: Clinical Spectrum

Extended-spectrum beta-lactamases (ESBLs) in gram-negative bacillary pathogens are a growing and important problem in hospital practice and it is tied to extensive use of...

Routine Microbiological Screening in Septic Patients in a Cardiac Surgical Intensive Care Unit

Compared to in-hospital patients, patients treated in an intensive care unit (ICU) have the highest risk of contracting an infection. The risk correlates well...

Medical Education in Asia: Is it a Time for Optimism?

Asia, the largest continent, is also an immensely diverse region with countries that vary in their socio-economic status, degree of urbanisation and health and...

Issues and Priorities of Medical Education Research in Asia

Medical schools traditionally rest on the “three-legged stool” of research, education and service. Hence, medical teachers are sometimes referred to as “triple-threat academicians”. This article...

Genital Herpes in a Sexually-transmitted Infection Clinic in Singapore: A 1-year Retrospective Study

Genital herpes simplex virus (HSV) infection is a commonly notified sexually transmitted infection (STI). Genital herpes can be caused by both herpes simplex virus...

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...

Professionalism: Looking For Your Blind Spots

In 1996 a major breakthrough was reported in the medical literature. A 5-week ectopic pregnancy was re-implanted into the uterus via the cervix, and...

Methodological Aspects of Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM) has a long history but its efficacy is not as well-documented as one would hope. Proof of efficacy has to...

A Practical Way of Research in Chinese Medicine

Chinese medicine individualises its treatment plan and practice and refutes any general law. Therefore, Chinese medicine practitioners do not have the tradition of research. This...

Complementary and Alternative Medicine, and Traditional Chinese Medicine: Time for Critical Engagement

Practice outside of mainstream or conventional medicine has always been an important part of public healthcare in some countries, particularly in the developing world....

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...

Student Academic Committees: An Approach to Obtain Students’ Feedback

The shift of medical curricula from a traditional subject based to an integrated module-based system can be seen in many medical schools worldwide. The...

Curricular Trends in Malaysian Medical Schools: Innovations Within

Medical educators continue to evaluate and introduce innovations into their curriculum with the objective of achieving appropriate outcomes for their graduates so that they...

A Problem-Based Learning Pathway for Medical Students: Improving the Process Through Action Research

Problem-based learning (PBL) is a student-centred, self-directed, integrated and contextual mode of learning. It has been widely perceived by many to confer advantages in...

A Simple Instrument for the Assessment of Student Performance in Problem-based Learning Tutorials

Assessment can be done in a variety of ways, for many purposes, and for different populations. It can occur at the classroom level, programme...

An Online Evaluation of Problem-based Learning (PBL) in Chung Shan Medical University, Taiwan – A Pilot Study

The goal of problem-based learning (PBL) is to motivate students to develop self-learning skills in a small group. PBL embraces principles of good learning...

Evidence-based Medicine in Clinical Curriculum

Evidence-based medicine (EBM) is “the conscientious, explicit, and judicious use of the best evidence in making decisions about the care of individual patients.” Considering...

Leadership and Professionalism Curriculum in the Gross Anatomy Course

Healthcare delivery systems worldwide are currently undergoing significant changes to create resilient learning organisations that are able to adapt with ever-increasing speed to shifting...

Constructing Multiple Choice Questions as a Method for Learning

Students in general and medical students in particular are often described as “strategic learners”, but in reality many become superficial learners out of necessity...

Computer-based Versus Pen-and-paper Testing: Students’ Perception

Computer-based testing (CBT) has gained popularity as a testing modality, with large-scale professional examinations such as the United States Medical Licensing Examination (USMLE) adopting...

Curriculum TIPS For All of Us

Medical education is a lifelong learning process. Just as we remind our students and ourselves that the practice of medicine is a lifelong process...

Translational Research – A Multidisciplinary Approach

Translational research aims to convert laboratory discoveries into therapeutic gains for patients – in oncology, drug development is a prime example. This multifaceted process...

A Complex, Contagious, Evolutionary Habit

Yawning is often noted in medical seminars and conferences – be they surgical, orthopaedic, gastroenterological, endocrinological or neurological. Yet, this condition receives little coverage...

Amendment of the Human Organ Transplant Act

Kidney transplants have been carried out in Singapore for more than 35 years, with the first cadaveric kidney transplant operation performed on 8 July...

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...

Interesting In- and Outpatient Attendances at Hogwarts Infirmary and St Mungo’s Hospital for Magical Maladies

With the return of “You Know Who” (YKW) and the rise of Death Eaters, injuries amongst both muggle and wizarding folk (MF and WF)...

The Doctor’s Multi-instrument Tool of the Future?

It is just another day in 2020, except that the eyes of the medical world are eagerly awaiting the latest invention to be revealed:...

Relationship Between Item Difficulty and Discrimination Indices in True/False-Type Multiple Choice Questions of a Para-clinical Multidisciplinary Paper

Multiple-choice questions (MCQs) are used more and more in departmental examinations or as comprehensive examinations at the end of an academic session. They may...

Towards a Global Educational Matrix for Tomorrow’s Health Systems

Society supports medical schools expecting them to produce physicians who can improve both the health of the population as well as the health system...

Harnessing the IT Factor in Medical Education

In this digital age, we are constantly inundated with breathtaking images worthy of an Ansel Adams photograph or a Zhang Yimou film. Is it...

A Systems Approach to Teach Core Topics across Graduate Medical Education Programmes

Core curricula including Ethics, Medico-legal issues, Socioeconomics, and Quality Improvement (QI) are relevant and significant for graduate medical education programmes, regardless of specialty. A...

World Federation for Medical Education Policy on International Recognition of Medical Schools’ Programme

There is an increasing need for international quality assurance of medical education. However, there are no present mechanisms for international recognition of medical educational...

Quality Management of Medical Education at the Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany

In Germany, medical education is an undergraduate programme for which the students applying at the “Zentralstelle für die Vergabe von Studienplätzen” (ZVS); the final...

Supporting Learners who are Studying or Training Using a Second Language: Preventing Problems and Maximising Potential

Travel and immigration are vibrant aspects of the international medical and educational field. Patients are increasingly mobile and finding healthcare professionals in a foreign...

Development of a Tool to Evaluate Health Science Students’ Experiences of an Interprofessional Education (IPE) Programme

A shortage of healthcare professionals and resources in rural areas is well documented. These workforce shortages necessitate new models of healthcare in rural areas...

Step-2 Thai Medical Licensing Examination Result: A Follow-up Study

The Center for Evaluating and Accrediting Medical Competency of the Thai Medical Council has established the regulation that Thai medical graduates matriculated as of...

Does Team Learning Motivate Students’ Engagement in an Evidence-based Medicine Course?

Team-based learning (TBL) is a well-defined instructional strategy that has generated considerable interest within the medical education community because of its potential to promote...

A Survey of Medical Students’ Perceptions of the Quality of their Medical Education upon Graduation

Founded in 1934, Tehran University of Medical Sciences School of Medicine (TUMS-SoM) is the oldest modern medical school in Iran. It has the most...

The Learning of 7th Year Medical Students at Internal Medical – Evaluation by Logbooks

In 1945, Taihoku (Taipei) Imperial University was renamed the National Taiwan University and the Japanese teaching system was replaced with a system implemented by...

Use of Knowledge-sharing Web-based Portal in Gross and Microscopic Anatomy

The extensive use of and the rate at which medical technology is becoming an integral force in medicine has impacted on the way in...

Assessment of Psychometric Properties of a Modified PHEEM Questionnaire

In Sri Lanka, after a 5-year medical undergraduate curriculum, graduates from the medical faculties undergo a one year mandatory internship or housemanship, 6 months...

Medical Education in a Flat World

In 2005 Thomas Friedman published the international best-seller The World is Flat: A Brief History of the Twenty-First Century. He asserted that as the...

Objective Structured Clinical Evaluation Should Not Only Be a Test of Clinical Skill

The Objective Structured Clinical Examination (OSCE) was originally a test (or summative assessment) specifically of clinical skills, using standardised patients (SP), anatomical models and...

5th College of Physicians Lecture – A Physician’s Odyssey: Recollections and Reflections

Allow me to thank you Mr President and your Council for asking me to deliver the 5th College of Physicians Lecture. Your President has...

Standard Setting in Student Assessment: Is a Defensible Method Yet to Come?

To validate any “adjective”, be it for living or non-living, a criteria or standard is needed. Globalisation, mobility of doctors and the rising number...

Innovative “Case-Based Integrated Teaching” in an Undergraduate Medical Curriculum: Development and Teachers’ and Students’ Responses

In Asia, the challenges facing medical education are similar across different countries. The learning process is still problematic with large classes, and most of...

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

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

Methicillin-resistant Staphylococcus aureus Control in Singapore – Moving Forward

The significance of methicillin-resistant Staphylococcus aureus (MRSA) is indisputable. Its successful establishment and maintenance as the most important endemic healthcare associated infection (HCAI) results...

Vancomycin-resistant Enterococcus – A Review From a Singapore Perspective

The first isolates of high-level vancomycin-resistant enterococci (VRE) were reported from the United Kingdom in the late 1980s. Since then rates of VRE infection...

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...

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....

Transudates in Malignancy: Still a Role for Pleural Fluid

According to Light’s criteria, an exudate is defined by at least one of the following: a total protein pleural fluid to serum ratio greater...

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)...

Self-directed Learning in Health Professions Education

More than 600,000 new citations were published in MEDLINE in 2005; this raised the total number of indexed citations to more than 14 million...

Sir Gordon Arthur Ransome (1910-1978) – His Teaching Style and His Legacy

Sir Gordon Arthur Ransome was born in Salop, England, in 1910.1 He came to Singapore in 1938, where he taught and practised medicine for...

Translating the Family Medicine Vision into Educational Programmes in Singapore

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. Modern day FM began its existence as...

Erysipelothrix rhuseopathiae Septicaemia with Prolonged Hypotension: A Case Report

Erysipelothrix sp. is a gram-positive, non-spore forming bacterium that was first isolated by Robert Koch. It has the unusual ability to infect a large...

The Hospitalist Movement – A Complex Adaptive Response to The Hospitalist Movement – A Complex Adaptive Response to Fragmentation of Care in Hospitals

Healthcare systems are complex adaptive systems. They are capable of self organisation through interacting agents that adapt to changes to the internal and external...

Medication Use in the Transition from Hospital to Home

Hospital discharge can be a complex and challenging time for physicians and patients alike. Patients are being discharged sooner, often in the process of...

Family Medicine Education in Singapore: A Long-standing Collaboration between Specialists and Family Physicians

In the US, Canada and Australia, the postgraduate training of family physicians (FPs) involves the attachment of family medicine (FM) trainees to specialist departments,...

Bridging the Gap between Primary and Specialist Care: Formidable Challenges Ahead

The strong guiding hand and deep pockets of the state have brought about the growth of hospitals and national specialist centres while leaving the...

Clinical Skills in Final-year Medical Students: The Relationship between Self-reported Confidence and Direct Observation by Faculty or Residents

In clinical medical education, instructors train students in their medical knowledge and clinical skills. Medical educators also aspire to develop students’ self-confidence in medical...

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...

The Challenges of “Continuing Medical Education” in a Pandemic Era

Although pandemics of influenza have occurred (albeit rarely, i.e. once every few decades) for more than 3 centuries, recent outbreaks of H1N1 and H5N1...

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...

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...

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...

Evaluation of Intensive Care Unit-acquired Urinary Tract Infections in Singapore

Urinary tract infection (UTI) is one of the most common types of nosocomial infections encountered in the inpatient settings including intensive care unit (ICU)....

Medical Professionalism in the Internet Age

Medical professionalism encompasses the conduct and practices of physicians, both as individuals and as a collective organisation. Professionalism enhances the trust and confidence of...

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...

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,...

Developing the “NUS Tummy Dummy”, A Low-Cost Simulator to Teach Medical Students to Perform the Abdominal Examination

Simulators may be used to provide adequate exposure to learning experiences that allow clinical skills to develop, that is, allow medical students and trainees...

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...

Is Cost-Effective Healthcare Compatible with Publicly Financed Academic Medical Centres?

Nearly all legislation involves a weighing of public needs as against private desires; and likewise a weighing of relative social values. —Louis D Brandeis As a...

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...

Academic Medicine Education Institute (AM∙EI): Transforming the Educational Culture of Health Professionals

In 2010, Duke-NUS Graduate Medical School (Duke-NUS) and Singapore Healthcare Services (SingHealth) launched an initiative to improve the lives of patients by combining their...

Diagnosing Bacteraemia Early in Older Adults

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

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

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

Factors and experiences associated with unscheduled 30-day hospital readmission: A mixed method study

Readmission leads to a greater demand for healthcare services, especially hospital beds, and contributes to the rising healthcare costs.1,2 With estimated one-third of the...

Potentially avoidable readmissions: Understanding drivers and technology-enabled solutions

Hospital admissions places high resource demands on the health system, and is a major cost-driver in Singapore and globally.1-3 Admissions have and will continue...

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...

Behavioural changes during the COVID-19 pandemic: Results of a nationwide survey in Singapore

In response to the global outbreak of coronavirus disease 2019 (COVID-19), Singapore undertook a multipronged approach to contain the pandemic. Of note, when community...

Precautions When Providing Dental Care During Coronavirus Disease 2019 (COVID-19) Pandemic

Coronavirus disease 2019 (COVID-19) is caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was first reported to the World Health Organization...

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...

Epidemiology and Control of Hand, Foot and Mouth Disease in Singapore, 2001-2007

Hand, foot and mouth disease (HFMD) is a common childhood viral infection, which is typically mild and self-limiting. It is characterised by a brief...