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Illicit drug consumption in Singapore: Where are we in the fight against drugs?

Illicit drug consumption is associated with significant negative health, financial and social consequences. Yet, illicit drug consumption remains highly prevalent and continues to be...

HLA-B*5801 testing: Is it time to consider mandatory testing prior to prescribing allopurinol in Singapore?

Dear Editor, Stevens-Johnsons Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe, life- threatening mucocutaneous reactions that most commonly occur as drug-related reactions.1 In recent...

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...

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...

Transforming radiology to support population health

The recent launch of Healthier SG—a national initiative by Singapore’s Ministry of Health (MOH) focusing on preventive health—will have far-reaching effects on the delivery...

Perinatal mental health in Singapore: Implementation opportunities and relevance of gender-carer roles in screening

In this issue of the Annals, the consensus statement on perinatal mental health by Chen et al. covers the handling of depression and anxiety...

Evaluation on the adoption of eHealth App for electronic health record sharing system in Hong Kong

Dear Editor, In Hong Kong, the eHealth App was launched in January 2021, as part of Stage Two development of the Electronic Health Record Sharing...

Managing and preventing severe hand injuries among sugarcane juicer operators

Dear Editor, Of all hand injuries encountered at an emergency department, 54% are sustained in the workplace,1 in part contributed by occupational injuries among food...

Impact of pre-existing depression on severe COVID-19 outcomes

The outbreak of the COVID-19 virus in 2019 had rapidly developed into a global pandemic, causing more than 6.8 million deaths and impacting the...

Leveraging ChatGPT to aid patient education on coronary angiogram

Natural-language artificial intelligence (AI) is a promising technological advancement poised to revolutionise the delivery of healthcare.1 Traditionally, inclusion of technology in the augmentation of...

Preferences for oral anticoagulant medications for managing atrial fibrillation

Dear Editor, Stroke prevention in patients with atrial fibrillation (AF) using anticoagulants involves weighing the benefits of reduced ischemic stroke1,2 against the elevated risks of...

Evaluation of a return to work coordination programme for injured workers in a public hospital in Singapore

Workers who have sustained an injury at work often face difficulties returning to work, according to a study showing that over 40% of injured workers...

Proactive steps to population health: Starting early, starting right

The global burden of non-communicable diseases is rising, with continued projected increases in the prevalence of metabolic syndrome (MetS) in the future. This epidemic,...

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...

Artificial intelligence innovation in healthcare: Relevance of reporting guidelines for clinical translation from bench to bedside

Artificial intelligence (AI) and digital innovation have revolutionised many sectors and industries, prominently including healthcare during the coronavirus disease 2019 (COVID-19) pandemic.1 For example,...

Benefits of leisure-related physical activity and association between sedentary time and risk for hypertension and type 2 diabetes

Diabetes mellitus and hypertension are serious public health issues. Approximately 451 million individuals worldwide aged 18–99 years were living with diabetes in 2017, and...

Promoting physical activity for population health

The chronic disease burden has risen globally. In Singapore, between 2007 and 2021, the crude prevalence of hyperlipidaemia (8.2–13.9%), hypertension (12.7–15.7%) and diabetes (4.9–6.9%)...

Factors associated with deep infiltrating endometriosis, adenomyosis and ovarian endometrioma

Endometriosis is a chronic inflammatory gynaecologic disease marked by the presence of endometrial-like tissue outside the uterus.1 Debilitating chronic pelvic pain, dysmenorrhoea, and subfertility...

Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore

Approximately 422 million people worldwide have diabetes and 1.6 million deaths are attributed to diabetes each year,1 contributing to high economic costs worldwide. Diabetes...

Diabetes: Know thy foe

During the COVID-19 pandemic in 2022, Singapore’s Minister for Health Ong Ye Kung mentioned, “After the COVID-19 pandemic has passed, we need to tackle...

Combating a resurgence of poliomyelitis through public health surveillance and vaccination

Singapore was certified poliomyelitis (polio)-free by the World Health Organization (WHO) on 29 October 2000, together with 36 other countries in the Western Pacific...

Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients

The spread of the SARS-CoV-2 virus has led to the ongoing worldwide COVID-19 pandemic. Initial studies have reported an increased vulnerability of patients with...

Early COVID-19 booster is beneficial in cancer patients

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its corresponding coronavirus disease (COVID-19) was first reported as a cluster of pneumonia cases in...

Vaccination and surveillance: Two basic tools for a final poliomyelitis eradication

Over the past 3 decades, the Global Polio Eradication Initiative (GPEI) has strived to achieve a poliomyelitis (polio)-free world. Wild poliovirus (WPV) types 2...

Meeting today’s healthcare needs: Medicine at the interface

The demographic of Singapore has undergone dramatic changes. Historically, younger patients with communicable diseases predominated; however, patients are now older with chronic multimorbidity and...

A strategy to make COVID-19 vaccination more accessible to the elderly

Dear Editor, Singapore embarked on the COVID-19 National Vaccination Programme in early 2021. The main modality employed to achieve the mass vaccinations has been the...

Cost analysis of a Patient-Centred Medical Home for community-dwelling older adults with complex needs in Singapore

The Patient-Centred Medical Home (PCMH) is a model of chronic care that replaces episodic primary care, with the delivery of primary care to patients,...

From Astana to Singapore: Primary Health Care is key to the long-term success of Singapore’s health system

The Ministry of Health, Singapore (MOH) has launched a wide-ranging and ambitious initiative for a life-course approach to drive the population’s health.1 This approach...

Frequent attenders to multiple emergency departments in Singapore

The problem of overcrowding, of which access block is one of the main causes, continues to plague emergency departments (EDs) worldwide.1 Some of its...

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...

Attitude towards screening for congenital cytomegalovirus infection in newborns in Singapore

Dear Editor, Cytomegalovirus (CMV) infection is the most common congenital infection.1 A systematic review that included 77 studies from 36 countries reported that the overall...

COVID-19 vaccination acceptance of healthcare workers in Singapore

The Coronavirus disease 2019 (COVID-19) pandemic resulted in 511.0 million cases of confirmed SARS-CoV-2 infection and almost 6.2 million deaths globally as of end...

The Lancet Commission on diagnostics: What it means for Singapore

Effective healthcare systems depend on a functioning healthcare value chain—defined as a care cascade comprising screening, diagnosis, treatment and follow-up. The tremendous heterogeneity and...

Diagnosis and management of polycystic ovary syndrome: Perspectives of clinicians in Singapore

Polycystic ovary syndrome (PCOS) is a common endocrine disorder estimated to affect 4–21% of women, depending on the diagnostic criteria used.1 Clinical manifestations of the...

A Randomized Trial of the Use of Print Material and Personal Contact to Improve Mammography Uptake Among Screening Non-attenders in Singapore

Breast cancer is the most common cancer among females in Singapore. Although lower than incidence rates in North America and the United Kingdom the...

Serum Selenium 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%...

Serum Ferritin and Iron Status in the General Population of Singapore, 1993 to 1995

Iron, a dietary constituent, is an essential element. Body iron stores can be measured by haemoglobin, serum ferritin, transferrin saturation, and erythrocyte protoporphyrin. This article...

Epidemiological Surveillance of Melioidosis in Singapore

Melioidosis was first described in 1911 among vagrants and morphine addicts brought into the mortuary in Rangoon, Burma. However, the disease received little attention...

Population-based Mammographic Screening in Singapore: What are Participants’ Views?

Breast cancer is the most common cancer among women in Singapore and has been increasing in incidence since 1968. This rise is particularly marked...

Cardiovascular Disease: Genes and Public Health

The excitement surrounding the Human Genome Project and its impending completion has raised expectations of the possibilities for genetics in common disease. It is...

Body Mass Index Profile in Hong Kong Chinese Adults

Obesity is considered a chronic disease and not just a social stigma due to the associated morbidity and early mortality. Obesity has now become...

Evidence-based Health Promotion: Applying it in Practice

There has been a growing interest in health promotion among health professionals and policy makers in Singapore. This is partly in response to the...

Is Healthcare Competition Healthy?

There are many problems which all Health Ministers worry about. But we can generally boil them down to one common problem: “money no enough”. This...

Public Disclosure of Healthcare Performance Information and Its Application to the Singapore Context

It has been said that apart from the prevention of diseases, the best chance of improving health is through improving the quality of care...

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...

The Role of Public Health and Occupational Physicians in the New Millennium

I want to thank the Chapter and organisers for honouring me with this kind invitation to speak to you. This millennium is only 4...

How Much do Diabetic Patients Know About Diabetes Mellitus and its Complications?

Diabetes mellitus (DM) is a common and growing healthcare problem in Singapore with a prevalence of 9% in 1998. Since the 1990s, the Ministry...

Issues and Challenges for Myopia Research

Myopia is an ocular disorder of major public health and socioeconomic significance in many East Asian urban cities. In Singapore, the prevalence of myopia...

Environmental Planning and Urban Health

Environmental exposures to the adverse effects from climate change are expected to increase for many urban populations in the United States during the next...

SARS Revisited: Managing “Outbreaks” With “Communications”

In the short span of 3 years since SARS first appeared on the Asian landscape, terms like “risk communications” and “outbreak communications” have assumed...

SARS and Emerging Infectious Diseases: A Challenge to Place Global Solidarity above National Sovereignty

The majority of the world’s information about infectious disease outbreaks no longer comes from voluntary reporting by countries, the willingness of which is influenced...

SARS in Singapore – Key Lessons from an Epidemic

The 2003 severe acute respiratory syndrome (SARS) outbreak represented the most severe communicable disease challenge to the public health system and the government and...

Rising Trends of STIs and HIV Infection in Singapore – A Review of Epidemiology Over the last 10 Years (1994 to 2003)

A review of the epidemiology and trends of sexually transmitted infections (STIs) in Singapore from 1977 to 1996 showed a declining number of all...

Variables Determining Perceived Global Health Ranks: Findings from a Population-based Study

In 1982, Mossey and Shapiro first demonstrated that global self-rating of health was a better predictor of 7-year survival than medical records or self-reports...

Public Healthcare – Welfare, Market Share or Laissez-faire? – A Sentosa Carlsberg Skytower View

Recently, two doctor-administrators commented to me separately, “Singapore probably has the best public healthcare system in the world.” While I understand the basis for...

Disaster Relief and Initial Response to the Earthquake and Tsunami in Meulaboh, Indonesia

A massive earthquake and tsunami hit the South Asian region on 26 December 2004, killing more than 200,000 people and displacing countless more.1 The...

Graduate Public Health Education – Singapore’s Contribution to Strengthening Capacity in the Region and Beyond

The effectiveness with which the world tackles its most pressing public health problems depends crucially on the calibre of its public health workforce. Institutions...

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....

Sleep Disorders in Children: The Singapore Perspective

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

The Emerging Challenge of Age-related Eye Diseases in Singapore

Singapore has one of the fastest ageing populations in the world today. The current elderly population, defined as persons 65 years or older, comprises...

Risk Communications: In Search of a Pandemic

The first decade of the new millennium has seen a string of disasters worldwide – earthquakes, tsunamis, floods, typhoons and acts of terrorism –...

Prevention and Control of Avian Influenza in Singapore

Avian influenza (AI) or “bird flu” is a highly infectious disease of birds. AI viruses are negative single-stranded enveloped RNA viruses that belong to...

Preparing for an Influenza Pandemic in Singapore

The last influenza pandemics occurred in 1957 and 1968. Few remember the pandemic in 1968 in Singapore as it was relatively mild. This article is...

Avian Influenza and Pandemic Influenza Preparedness in Hong Kong

In 1997, Hong Kong became reputed by identifying the first instance of human infection with avian influenza H5N1. A total of 18 cases occurred...

Towards Mutual Trust, Transparency and Equity in Virus Sharing Mechanism: The Avian Influenza Case of Indonesia

Since July 2005 to December 2007, Indonesia has reported the highest number of influenza A (H5N1) human cases in the world, i.e., 116 cases...

A Global Perspective on Avian Influenza

The world is confronted by many important public health challenges, some of which constitute potentially devastating global threats. Prime among these is the threat...

Twentieth Century Influenza Pandemics in Singapore

Tropical countries such as Singapore, although without well-defined influenza seasons, are also affected by influenza epidemics and pandemics. Twenty per cent of Singapore’s population...

A Cross-sectional Study of Primary-care Physicians in Singapore on Their Concerns and Preparedness for an Avian Influenza Outbreak

Outbreaks of avian influenza (AI) caused by the H5N1 subtype in several Asian countries have raised concern all over the world. AI is endemic...

Singapore and the Tobacco Pandemic

The World Health Organization, in its 2008 Report on the Global Tobacco Epidemic, has framed the problem in almost apocalyptic terms, in stating that...

Concerns, Perceived Impact and Preparedness in an Avian Influenza Pandemic – a Comparative Study between Healthcare Workers in Primary and Tertiary Care

The danger posed by emerging infectious diseases has become greater in the past few years with the World Health Organization (WHO) warning that the...

Public Perceptions of Healthcare in Singapore

Healthcare is increasingly dominating the policy agenda in developed countries. In the United States, healthcare has been ranked only behind the war in Iraq...

Public Misperceptions About Transmission of Hepatitis B Virus in Singapore

Chronic hepatitis B (CHB) is an important global health problem, with more than 350 million individuals affected worldwide. CHB is particularly important in Asia,...

A History of the Chapter of Public Health and Occupational Physicians

The history of the Chapter of Public Health and Occupational Physicians began with the founding of the Academy of Medicine in 1957. It was...

The Evolving Role of the Community Pharmacist in Chronic Disease Management – A Literature Review

Pharmacy has matured as a clinical profession and is presently well positioned to transform itself from a product and task oriented (dispensing) to a...

Pathological Video-Gaming among Singaporean Youth

Video-gaming and internet use are a part of the lives of children and adolescents today. Among countries that are highly wired with high speed...

Trends in Importation of Communicable Diseases into Singapore

Singapore is a city-state in Southeast Asia, with a total population in 2007 of 4,839,400, of which 3,642,700 (75.3%) are Singaporean residents. The remaining...

Validity and Reliability of the Zarit Burden Interview in Assessing Caregiving Burden

Dementia is a growing public health issue in the Asia-Pacific region. The number of people with dementia in the Asia-Pacific region will increase from...

Multi-disease Health Screening in an Urban Low-income Setting: A Community-based Study

With the burden of chronic disease rising amongst rapidly urbanising Asian populations, active participation in health screening would allow for early detection and management...

The Pedagogical Value of a Student-run Community-based Experiential Learning Project: The Yong Loo Lin School of Medicine Public Health Screening

Experiential learning brings medical students out of the comfort zone of learning in their classrooms to acquire and apply knowledge and skills in an...

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

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

Acceptability of Medical Students by Patients from Private and Public Family Practices and Specialist Outpatient Clinics

In recent decades, medical advances and economic pressures have shifted medical student training from hospital inpatient to ambulatory settings such as hospital outpatient and...

Peripheral Arterial Disease in Community-based Patients with Diabetes in Singapore: Results from a Primary Healthcare Study

Peripheral arterial disease (PAD) is a significant complication of diabetes mellitus and accounts for the majority of amputations among these patients with diabetes. In...

Knowledge, Attitudes and Practices of the Advance Medical Directive in a Residential Estate in Singapore

The Advance Medical Directive (AMD) Act was passed in Parliament in May 1996. The AMD is a legal document that an individual can sign...

Attitudes of Patients, Visitors and Healthcare Workers at a Tertiary Hospital Towards Influenza A (H1N1) Response Measures

Following the announcement by the World Health Organization (WHO) that outbreaks of a novel influenza virus had occurred in Mexico and several parts of...

Research on Psychoneuroimmunology: Does Stress Influence Immunity and Cause Coronary Artery Disease?

In recent decades, there has been increasing interest in exploring the relationship between psychological stress and various health conditions. An enlarging body of evidence...

Trends in Long-term Cancer Survival in Singapore: 1968-2002

With increasing health awareness and the greater extent of healthcare provision over the years, the life expectancy of Singaporeans has increased from 75.3 in...

Knowledge and Practice of Household Mosquito Breeding Control Measures between a Dengue Hotspot and Non-Hotspot in Singapore

Dengue is the most common mosquito-borne viral disease in the world and its severity is reflected by a 30-fold increase over the last 50...

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

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

Sleep, Public Health and Wellness: The Elephant in the Room

The rising cost of health care and the burden of chronic illness are perennial concerns. Remarkably, there exists a measure that around 30% of...

Healthcare cost of patients with multiple chronic diseases in Singapore public primary care setting

The rising occurrence of individuals suffering from multiple chronic diseases, namely multimorbidity, is of public health concern globally.1 The current prevalence of multimorbidity in...

Prevention and management of multimorbidity to ensure healthcare sustainability

Singapore has a healthcare system that is distinguished by its ability to achieve top health outcomes at very low healthcare expenditures.1 Yet one of...

Prevalence of Overweight and Obesity in Chinese Preschoolers in Singapore

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

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...

A Review of Back Injury Cases Notified to the Ministry of Manpower from 2011 to 2012

Work-related low back disorders consist of both low back pain (LBP) and low back injuries. They are a significant and increasing problem all over...

How do English-speaking Cancer Patients Conceptualise Personhood?

Understanding the way personhood or “what makes you, you” is conceptualised is pivotal to the practice of medicine. Conceptions of personhood determine the moral...

Too Much Medicine: Time to Stop Indiscriminate Cancer Screening

Like most industrialised countries in the world, cancer has now become the leading cause of mortality in Singapore. Approximately 1 in 3 deaths in...

MERS-CoV: Where Are We Now?

Prior to 2002, coronaviruses were known mainly for causing mild human upper respiratory tract infections (URTIs) and enteric and respiratory infections in many animals....

An External Independent Validation of APACHE IV in a Malaysian Intensive Care Unit

Over the past 30 years, different versions of severity of illness scoring systems and prognostic models have been developed for prediction of patient outcomes...

Anaerobic Bacteraemia Revisited: Species and Susceptibilities

Over the last 2 decades, the importance of anaerobic bacteraemia has undergone various shifts in opinion. Early studies in the 1970s reported that anaerobes...

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...

Health professions education in pandemics and epidemics: A proposed framework for educators

The COVID-19 pandemic has disrupted healthcare systems and health professions education (HPE). There are few frameworks to help educators manage HPE before, during and...

The “Jeff Cut”: A simple innovation to minimise up-riding sleeves of protective gown

Personal protective equipment (PPE) including the N95 mask, face shield, cap, splash-resistant gown and gloves are worn by frontline healthcare workers for various duties...

Merits of a harmonised system to classify drug-related problems in Singapore

A drug-related problem (DRP) is commonly defined as an event or circumstance involving drug treatment that actually or potentially interferes with the optimal outcome...

Factors influencing protective behaviours during haze episodes in Singapore: A population-based study

Southeast Asia suffers from recurrent episodic air pollution from biomass smoke known as haze, which is mainly caused by human activities such as the...

Seasonal haze: Knowledge gaps and risk perception behaviours

The seasonal haze in Southeast Asia has been a recurrent concern whenever we enter the southwest monsoon season (June–September). This phenomenon, caused by agricultural...

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...

Vulnerability to rumours during the COVID-19 pandemic in Singapore

The global outbreak of coronavirus disease 2019 (COVID-19) has come with increased psychological burden. In several meta-analyses, depression and anxiety symptoms have been found...

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...

The Novel Coronavirus (SARS-CoV-2) Pandemic

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began in early December in Wuhan, the 7th most populous city in Mainland China, and...

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...

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

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

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...

Chronic disease self-management competency and care satisfaction between users of public and private primary care in Singapore

Primary care in Singapore is set to face challenges in managing a rapidly ageing population. The expected population of older adults aged 65 years...

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

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