Letter to the Editor
Impact of an ageing population on the intensive care unit
Dear Editor,
Intensive care unit (ICU) resources are scarce and expensive, and deciding if intensive care is suitable for older patients involves complex clinical reasoning,...
Original Article
Clinical outcomes of hospitalised individuals with spin-induced exertional rhabdomyolysis
Rhabdomyolysis is a clinical and biochemical syndrome caused by the breakdown of myocytes and release of intracellular components into the bloodstream.1 A subset of...
Letter to the Editor
Emergency department falls interventions improve osteoporosis management in frail older adults
Dear Editor,
Singapore’s population is ageing rapidly and by 2030, around 1 in 4 citizens will be aged 65 and above.1 Older adults represent 21–40%...
Original Article
Transitional care strategies at emergency department for elderly patients: A multicentre study in Singapore
In Singapore, greater efforts are being directed towards developing an integrated health and social ecosystem under the new Healthier SG strategy announced by the...
Letter to the Editor
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...
Review Article
Nutrition therapy in the older critically ill patients: A scoping review
The increasing levels of life expectancy and decreasing fertility are shifting the age structure of the world population towards older ages.1 From year 2020...
Editorial
ICU nutrition: Bracing for the silver tsunami
The global population’s life expectancy is growing with a steady increase in the proportion of older patients admitted to the intensive care unit (ICU).1...
Original Article
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,...
Commentary
Activating Code Crimson in the emergency department: Expediting definitive care for trauma patients with severe haemorrhage in Singapore
Public healthcare institutions (PHIs) in Singapore have a range of policies and guidelines for the management of patients presenting to the emergency department (ED)...
Original Article
Nationwide study of the characteristics of frequent attenders with multiple emergency department attendance patterns
Emergency department (ED) overcrowding is a growing issue that threatens public health in various parts of the world,1 including the US,2 UK,3 Australia,4 Japan5...
Editorial
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...
Original Article
Epidemiological trends and outcomes of children with aural foreign bodies in Singapore
Aural foreign bodies (FBs) commonly present to the emergency department (ED) worldwide. Children represent the majority of the population, believed to be due to...
Review Article
Determinants of emergency department utilisation by older adults in Singapore: A systematic review
Older adults in Singapore contribute to a disproportionately higher number of visits to the emergency department (ED), mirroring trends around the world.1,2 For instance,...
Original Article
Identifying high-risk hospitalised chronic kidney disease patient using electronic health records for serious illness conversation
In-hospital cardiopulmonary resuscitation (CPR) for chronic kidney disease (CKD) patients is shown to have lower survival1 and a higher proportion of survivors on maintenance...
Original Article
Pre- and apnoeic high-flow oxygenation for rapid sequence intubation in the emergency department (the Pre-AeRATE trial): A multicentre randomised controlled trial
Critically ill patients in the emergency department (ED) have shorter safe apnoea times due to physiological distress from decreased cardiac output, increased shunting and...
Original Article
A Review of Pedestrian Fatalities in Singapore from 1990 to 1994
Fatal road accidents are by no means uncommon in Singapore, a modern tropical metropolis with a population of approximately 3 million. Statistics provided by...
Original Article
A Descriptive Study of the Demography, Symptomology, Management and Outcome of the First 300 Patients Admitted to an Independent Hospice in Singapore
Modern society views death as an aberration which has to be postponed and, if possible, prevented at all cost. Death is just unacceptable and...
Original Article
The Profile of Hospitalised Patients with Parkinson’s Disease
Prevalence studies in various parts of the world have shown that Parkinson’s disease (PD) is relatively common among the aged in all countries. Crude...
Original Article
Day Hospital Rehabilitation for the Elderly: A Retrospective Study
Alexandra Hospital is the first hospital in Singapore with a Day Hospital for the elderly. One of the main functions of the Day Hospital...
Original Article
Self-Perception of Health among Elderly Community Dwellers in Singapore
The single most important determinant of the quality of an elderly person’s life is health. In the elderly, health matters affect all other areas...
Original Article
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...
Original Article
Survival after Cardiopulmonary Resuscitation in the General Wards—The Results of a Dedicated “Code” Team
Cardiopulmonary resuscitation (CPR) is widely practised for cardiopulmonary arrests with variable success. The initial intention was to defibrillate patients with ventricular fibrillation after acute...
Others
Chryseobacterium meningosepticum (Flavobacterium meningosepticum)—A Report of Five Cases in a Local Hospital
Chryseobacterium meningosepticum has been known to be a causative agent of meningitis particularly in the premature and newborn infants. The first case of human...
Others
Bilateral Caudate Infarct—A Case Report
The head of caudate nucleus forms a prominent bulge in the lateral wall of the anterior horn of the lateral ventricle. Its blood supply...
Original Article
Hospitalised Low-risk Community-acquired Pneumonia: Outcome and Potential for Cost-savings
Community-acquired pneumonia (CAP) is a common illness with nearly 4 million adults diagnosed each year in USA with more than 600,000 hospita1isations. The associated...
Original Article
Perceived Need for Community Geriatric Services: A Survey at a Regional Hospital in Singapore in an Inpatient Setting
Singapore has one of the most rapidly ageing populations in the wor1d. The number of the very aged (>75 years old) has already increased...
Original Article
Swallowing Impairment and Feeding Dependency in the Hospitalised Elderly
Loss of ability to feed independently and swallowing impairment are common problems in the elderly and will be an increasing cause of disability as...
Original Article
Extent and Appropriateness of Emergency Department Services Usage by Foreign Workers in Singapore
Singapore employs more than 350,000 foreign workers currently. With this influx of foreign workers into our city-state which has limited land and resources, it...
Original Article
Drowning and Near-drowning—Some Lessons Learnt
Drowning is defined as suffocation from submersion in a liquid with death within the first twenty-four hours. Near-drowning implies that recovery has occurred, at...
Original Article
The Reliability and Validity of the Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the Elderly Chinese in Hong Kong
The Alzheimer’s Disease Assessment Scale (ADAS) is a 21-item scale designed to assess the severity of cognitive and non-cognitive impairment in patients with Alzheimer’s...
Original Article
Screening for Hearing Impairment in Hospitalised Elderly
The prevalence of hearing impairment in the local elderly population is not known. Hearing loss prevalence estimates that 25% to 40% of individuals over...
Original Article
End-of-life Issues—Preferences and Choices of a Group of Elderly Chinese Subjects Attending a Day Care Centre in Singapore
Doctors caring for elderly, dying and terminally ill patients are often faced with the dilemma of having to make difficult decisions especially regarding treatment...
Commentary
Preparing for the silver boom: A falls prevention tool for older adults in the emergency department
Each year, 28–35% of community dwelling adults over 65 years fall.1 This figure increases to about 50% for those above 80 years old.2 Falls...
Editorial
Delirium in patients following general anaesthesia
Delirium is a disturbance of consciousness characterised by an acute onset and fluctuating course of inattention, accompanied by either a change in cognition or...
Original Article
Critical Role of Functional Decline in Delayed Discharge from an Acute Geriatric Unit
In the last decade, many countries have experienced alarming transformation in their demographic patterns, with the elderly population emerging as the fastest growing segment...
Original Article
Urinary Retention in Hospitalised Older Women
Voiding dysfunction is a relatively common problem in hospitalised older patients. Up to one-third of hospitalised elderly were reported to have post-void residual urine...
Original Article
Body Mass Index and Its Related Factors in the Elderly
Cardiovascular disease is one of the leading causes of mortality and morbidity in developed countries, especially among the elderly. In Taiwan, cardiovascular disease is...
Others
Book Review
The above is a textbook of medicine written by Singapore doctors and published in Singapore. It is difficult not to be over-enthusiastic about it...
Original Article
The Practice of Foregoing Life Support in the Critically Ill “Old Old”: A Singapore Perspective
Studies on the foregoing of life support (FLS) in North America, Europe and Australia have shown diversity in terms of the incidence, decision-making process...
Review Article
The Impact of Swallowing Disorders in the Elderly
In 1898, Bastian first reported on the case of a man who had been admitted to hospital with hemiplegia and aphasia, but who had...
Original Article
Intravenous Adrenaline or Vasopressin in Sudden Cardiac Arrest: A Literature Review
Of the approximately 15,000 deaths that occur in Singapore every year, about 25% are from cardiac causes; of which, some 30% to 40% occur...
Original Article
Early Unplanned Readmission of Elderly in Singapore: A Retrospective Study
The number of elderly people in Singapore is expected to increase over the next 2 decades. The proportion of those 60 years and above...
Original Article
Audit of Total Parenteral Nutrition in an Adult Surgical Intensive Care
Total parenteral nutrition (TPN) may contribute to good outcome in selected groups of patients. Parenteral nutrition is highly effective in reversing effects attributable to...
Original Article
Acute Coronary Syndrome—Factors Causing Delayed Presentation at the Emergency Department
Acute coronary syndrome (ACS) refers to a continuum of clinical entities ranging from unstable angina pectoris (UAP) to Q-wave myocardial infarction. Mortality rates from...
Original Article
The Acute Presentation of Pulmonary Thromboembolism: A Retrospective Viewpoint
Pulmonary thromboembolism (PE) has historically been considered a rarity in the Asian population. Although well studied in the West, Asian literature on this condition...
Original Article
Influenza in Singapore: Assessing the Burden of Illness in the Community
Influenza is a major cause of morbidity and mortality worldwide. Morbidity in the working age group gives rise to frequent doctor visits and considerable...
Original Article
Epidemiology of Beta-haemolytic Group G Streptococcal Bacteraemia in Singapore (1996 to 1998)
Human isolates of group G streptococci (GGS) that form large colonies are similar to group A streptococci (GAS) in terms of virulence and cause...
Original Article
Correlates of Habitual Walking and Sports/Leisure-time Physical Activity in Older Persons in Singapore: Interaction Effects Between Educational Attainment and Gender
Physical inactivity has been identified as a major cause of morbidity and mortality secondary to cardiovascular disease, diabetes mellitus and hypertension. It contributes to...
Original Article
Nursing Home Falls: A Local Perspective
Falls in the elderly has been a well-studied subject and now occupies an important place in geriatric medicine. While many studies have been done...
Original Article
Bedside Clinical Methods Useful as Screening Test for Aspiration in Elderly Patients with Recent and Previous Strokes
Cerebrovascular disease is the fifth commonest cause of hospitalisation in Singapore, and accounts for 2.7% of all hospital discharges. Neurogenic dysphagia is a common...
Review Article
End-of-life Care: Challenges and Obligations in Setting Limits to Life-sustaining Therapy
A patient with recurrent stroke disease and severe pneumonia did not respond to the previous courses of antibiotics. The medical team decided to switch...
Review Article
Considerations in the Assessment and Management of Older People with Chronic Pain
Persistent pain has been estimated to occur in 50% of community dwelling older people of age 65 years and above. It has been associated...
Review Article
Late-life Depression: Current Issues and New Challenges
Depression in late life (>60 years old) is one of the most common and treatable psychiatric disorders in the elderly. It not only causes...
Review Article
Neurofibrillary and Ethico-legal Tangles: In Search of Surrogates for Dementia Patients Lacking Decision-making Capacity and Relatives
Dementia is an age-prevalent chronic degenerative disease that causes gradual and progressive deterioration of a patient’s cognitive abilities. With Singapore’s rapidly ageing population, the...
Review Article
Assessing Decision-making Capacity in Dementia Patients: A Semi-structured Approach
Given the rapid ageing of Singapore, all practising clinicians can expect to see an exponential rise in the medical and surgical problems of the...
Review Article
An Evidence-based Clinical Approach to the Diagnosis of Dementia
The prevalence of dementia or cognitive impairment in local studies has been shown to range from 2% to 13%. These differences in prevalence rates...
Review Article
Urinary Incontinence in Older Persons: A Simple Approach to a Complex Problem
Urinary incontinence is the involuntary loss of urine which is objectively demonstrable and is a social or hygienic problem. Trivial as it may sound,...
Review Article
The Development of Geriatric Psychiatry Services in Singapore
The population of Singapore is ageing. In 2002, it was estimated that there were 252,700 persons aged >65 years, forming 7.5% of the population....
Review Article
Aged Care Issues and Services in Australia
In Australia, the number of elderly people is increasing rapidly. In 2001, the population of Australia was approximately 19 million people and about 12.6%...
Review Article
Aged Care Services in Singapore – An Overview
The last century has witnessed the establishment of geriatric medicine as a well-recognised medical specialty supported by a respectable body of evidence, which shows...
Editorial
Challenges in Geriatric Medicine: Geriatric Services and Education
Ignatz Nascher first proposed disease and medical care of the aged as a separate specialty and invented the term “geriatrics” in 1909. However, the...
Others
Critically Ill Elderly Who Require Mechanical Ventilation: The Effects of Age on Survival Outcomes and Resource Utilisation in the Medical Intensive Care Unit of a General Hospital
Increasing life expectancy and ageing of the “post-war baby boomer” generation have led to the rapidly ageing demographic of many Asian countries. Singapore’s elderly...
Original Article
Thyroid Dysfunction in Elderly Patients
Symptoms and signs of thyroid dysfunction in the elderly tend to be atypical and may be mistakenly attributed to the ageing process. Currently, thyroid...
Review Article
Art and “the Language of Well-Being” in Adolescent Health Care
Creative processes involve imagining, making unexpected connections, maintaining discipline while letting go of controlling the outcome, opening oneself to pleasure, and moving beyond frustration....
Letter to the Editor
Stress among emergency medicine residents during the COVID-19 pandemic: A qualitative study
Dear Editor,
The COVID-19 pandemic has disrupted medical education1,2 and distressed clinicians.3,4 Understanding the impact of this pandemic on emergency medicine (EM) residents’ experience of...
Original Article
Improving the Diagnosis Related Grouping Model’s Ability to Explain Length of Stay of Elderly Medical Inpatients by Incorporating Function-linked Variables
Casemix refers to the numbers and types of patients within a healthcare setting and Diagnosis Related Groupings (DRGs) represent one mode of classifying casemix....
Original Article
Impact of a Pharmacist Consult Clinic on a Hospital-based Geriatric Outpatient Clinic in Singapore
A general philosophy in the care of elderly patients is to use the least drugs possible to achieve the desired clinical outcome. In the...
Original Article
Work-related Injury Sustained by Foreign Workers in Singapore
Singapore has a resident population of 3.26 million and 0.53 million foreign workers. Of these half a million foreigners, 450,000 are work permit holders,...
Original Article
Polypharmacy and Inappropriate Medication Use in Singapore Nursing Homes
The elderly usually have multiple medical problems, requiring prescription drugs to treat diseases and to prevent complications arising from them. Currently, in the United...
Original Article
Evaluation of Dementia: The Case for Neuroimaging All Mild to Moderate Cases
Dementia has been reported to affect 4% to 13% of individuals above the age of 65, with the difference in prevalence rates being dependent...
Original Article
Are Sensory and Cognitive Declines Associated in Older Persons Seeking Aged Care Services? Findings From a Pilot Study
Many cross-sectional and longitudinal studies have reported an association between sensory and cognitive functions in the normal ageing population. Few studies have assessed the...
Others
Potentially Fatal Paracetamol Overdose and Successful Treatment with 3 Days of Intravenous N-acetylcysteine Regime – A Case Report
Paracetamol overdose is one of the most common drug overdose in both children and adults in Singapore. Doses of paracetamol exceeding 150 mg/kg in...
Commentary
Clinical Cases Seen in Tsunami Hit Banda Aceh – From a Primary Health Care Perspective
Earthquakes and tsunamis can cause massive destruction over large areas, affecting the lives of many in areas hit by such disasters. The local health...
Original Article
Factors Causing Delay in Discharge of Elderly Patients in an Acute Care Hospital
With the introduction of block budget for acute care hospitals, cost containment is an important issue for all secondary and tertiary hospitals. Though health...
Original Article
Factors Associated With Functional Decline of Hospitalised Older Persons Following Discharge From an Acute Geriatric Unit
Hospitalisation is a stressful event for the older person. The physiological changes associated with ageing, such as decreased muscle strength and aerobic activity, reduced...
Original Article
Attitudes of First-year Medical Students in Singapore Towards Older People and Willingness to Consider a Career in Geriatric Medicine
With the exponential increase in the elderly population in Singapore, the training of young physicians of tomorrow in the care of elderly patients will...
Original Article
Observational Study to Determine Factors Associated with Blood Sample Haemolysis in the Emergency Department
Haemolysis of blood samples leads to inaccurate results and often necessitates a repeat sample. Escalating workloads and finite resources are an increasing problem in...
Others
Review of Children Hospitalised for Ingestion and Poisoning at a Tertiary Centre
Childhood ingestion and poisoning is an important problem in many countries,1-8 and accounts for a significant workload for emergency department consultations and hospital admissions.9,10...
Original Article
Improving Door-to-balloon Times in Primary Percutaneous Coronary Intervention for Acute ST-elevation Myocardial Infarction: The Value of an Audit-driven Quality Initiative
Primary percutaneous coronary intervention (PCI) for patients with acute ST-elevation myocardial infarction (STEMI) has been shown to be superior to thrombolytic therapy in terms...
Editorial
Alzheimer’s Disease – Towards More Patient-centred and Meaningful Clinical Outcomes
More than 100 years ago Alois Alzheimer first presented the clinical and pathological features of an unusual brain disease at his seminal lecture in...
Letter to the Editor
Renal Artery Embolism in a Patient with Vague Abdominal Pain
Thromboembolism is a well-known complication of mitral stenosis especially when it is associated with cardiac dysrhythmias. However, renal artery embolism is a disease that...
Others
Clinical Characteristics of Renal Infarction in an Asian Population
Renal infarction is a rare disease. Domanovits et al reported an incidence rate of 0.007% (17/248,842) during a study period of 45 months.
This article...
Original Article
Hip Fractures in the Elderly: The Impact of Comorbid Illnesses on Hospitalisation Costs
Management of hip fractures is costly and continues to generate significant costs throughout the one-year period after discharge.1 They demand considerable resources from a...
Commentary
A Review of Geriatric Education in Singapore
The United Nations International Plan of Action on Ageing (IPA), formulated during the First World Assembly on Ageing in Vienna in 1982, listed gerontological...
Original Article
Characteristics of unplanned hospitalisations among cancer patients in Singapore
Cancer is a pervasive global problem with growing healthcare utilisation and costs.1-3 This situation is similar in Singapore where cancer incidence is on the...
Editorial
The case for better hospitalisation selection in cancer patients
Public hospital occupancy rates and resource utilisation in Singapore are perennially high. In the last 2 years of the COVID-19 pandemic, there has been...
Original Article
Three-Year Experience of Primary Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction in a Hospital without On-site Cardiac Surgery
Primary percutaneous coronary intervention (PCI) is now well established as the best re-perfusion strategy for ST-elevation myocardial infarction (STEMI). A meta-analysis comparing primary PCI...
Original Article
Resource Consumption in Hospitalised, Frail Older Patients
The number of older adults in Singapore has been steadily increasing over the years and will continue to do so. In 2007, older adults...
Letter to the Editor
Reply from Author: Putting the Wedge under Pressure
We thank the authors for their interest in our study and their insightful comments. We agree that filling pressures such as the central venous...
Letter to the Editor
Putting the Wedge under Pressure
We would like to thank Dr Huck Chin Chew et al for sharing their findings and we are appreciative of their work, “Oesophageal Doppler...
Original Article
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...
Original Article
Profiling Acute Presenting Symptoms of Geriatric Patients Attending an Urban Hospital Emergency Department
Singapore’s population is ageing rapidly. Today 1 out of every 12 Singaporeans is aged 65 or above. In 2030, it is expected to be...
Original Article
Epidemiology of Snakebites from A General Hospital in Singapore: A 5-year Retrospective Review (2004-2008)
Snakes are present even in an industrialised country like Singapore. A bite from a venomous snake can inflict much morbidity and occasionally, it can...
Original Article
Are New Resuscitation Guidelines Better? Experience of an Asian Metropolitan Hospital
Out-of-hospital cardiac arrest (OHCA) is a substantial public health burden that has poor prognosis. Patients who receive “good” and “high-quality” cardio-pulmonary resuscitation (CPR) have...
Original Article
An Eight Year Review of Exercise-related Cardiac Arrests
Exercise-related cardiac arrest is uncommon, however it is devastating when it occurs in otherwise healthy adults. In young adults, vigorous physical exercise trigger cardiac...
Original Article
Validity and Reliability of the Expectations Regarding Aging (ERA-12) Instrument among Middle-Aged Singaporeans
With increasing life expectancy and low fertility rates, the proportion of the elderly is rapidly increasing in developed nations, Singapore being no exception. The...
Original Article
A 5-year Profile of Trauma Admissions to the Surgical Intensive Care Unit of a Tertiary Hospital in Singapore
Our tertiary hospital has a 9-bed Surgical Intensive Care Unit (SICU) that caters to all surgical disciplines except Cardio-Thoracic and Vascular Surgery (which has...
Original Article
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...
Original Article
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...
Original Article
Junior Doctors’ Attitudes Towards Older Adults and its Correlates in a Tertiary-care Public Hospital
Singapore is a rapidly ageing society. The proportion of older persons above the age of 65 was 6.8% of the population in 1995 and...
Original Article
Clinical Outcome Following Treatment of Stable and Unstable Intertrochanteric Fractures with Dynamic Hip Screw
Intertrochanteric (IT) fracture is among the most common orthopedic injuries in the elderly population, and is associated with osteoporosis. It usually occurs as a...
Original Article
Older Age at Initial Presentation to Human Immunodeficiency Virus (HIV) Care and Treatment at the Communicable Disease Centre (CDC) in Singapore, 2006 to 2011
Since the first case of human immunodeficiency virus (HIV) in Singapore was identified in 1985, the incidence of HIV/acquired immunodeficiency syndrome (AIDS) has steadily...
Original Article
Can Preoperative Scoring Systems be Applied to Asian Hip Fracture Populations? Validation of the Nottingham Hip Fracture Score (NHFS) and Identification of Preoperative Risk Factors in Hip Fractures
Osteoporotic hip fractures are common and have significant consequences on mortality and functional capability which indirectly has familial, social and economic repercussions. The inpatient...
Clinical Update
Anticoagulation Needs in Asians with Atrial Fibrillation: A Mythbuster
Atrial fibrillation (AF) increases the risk of stroke 5-fold in Caucasians. While the relative risk for stroke is somewhat lower in Asia, estimated at...
Original Article
Factors reducing inappropriate attendances to emergency departments before and during the COVID-19 pandemic: A multicentre study
Since the first case of coronavirus disease 2019 (COVID-19) was reported in China in late December 2019, the pandemic has spread throughout the world,...
Review Article
Cognitive Aspect of Diagnostic Errors
It was an unusually busy ward round. The newly promoted registrar was keen to review the patients handed over to him. But there were...
Editorial
Successful Ageing in Singapore—A Viable Goal?
Ageing is a complex process. Achieving it successfully has implications and significance not only for individuals on a personal level but for society at...
Review Article
Changing Landscape of Nursing Homes in Singapore: Challenges in the 21st Century
Nursing homes trace their evolution to American alms-houses in the 1930s where retired nurses welcomed the elderly and ill into their homes. In Singapore,...
Original Article
Determinants of Health-Related Quality of Life Among Community Dwelling Elderly
Singapore is experiencing an unprecedented age shift as the post-war baby boomers turn 65 years in 2012. Currently there are 378,700 people aged 65...
Original Article
Unipolar versus Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly: Is There a Difference?
Hip hemiarthoplasties are commonly performed for displaced femoral neck fractures. The advantages of hemiarthroplasty over internal fixation include earlier mobility, less reoperations and better...
Letter to the Editor
Use of the Sole Flap to Convert an Above Knee Amputation to a Below Knee Amputation in Trauma
Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are performed for decompression of the spine when the primary compressive...
Letter to the Editor
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...
Original Article
Anti-BP180 NC16A IgG Titres as an Indicator of Disease Activity and Outcome in Asian Patients with Bullous Pemphigoid
Bullous pemphigoid (BP) is a subepidermal blistering dermatosis characterised by circulating autoantibodies targeting BP180 and BP230 hemidesmosomal proteins. Anti-BP180 NC16A IgG antibodies have been...
Editorial
A Decade of Progress in the Understanding, Prevention and Treatment of Age-related Macular Degeneration in Singapore
The year 2014 had marked the 10th anniversary of the nationwide Age-related Macular Degeneration (AMD) Awareness Week in Singapore.1 This public health campaign, organised...
Editorial
Emergency Medicine Residency Programme in Singapore—Where Are We at Since Inception?
It has been 4.5 years since the Accreditation Council for Graduate Medical Education (ACGME-I) accredited competency-based emergency medicine residency programmes were started in July...
Editorial
Evidence-balanced Medicine: “Real” Evidence-based Medicine in the Elderly
Case 1: An 85-year-old male with past history of hypertension is otherwise healthy and enjoys his daily walks and good food. During a health...
Commentary
Prehabilitation and Its Role in Geriatric Surgery
The population in Singapore is ageing rapidly. According to statistics, by 2030, 1 in 2 adults in Singapore will be >65 years old. As...
Original Article
A review of child sexual abuse cases presenting to a paediatric emergency department
Child sexual abuse (CSA) is a global public health issue with adverse short- and long-term repercussions. Formal definitions of CSA and the age for...
Letter to the Editor
Antibiotic stewardship algorithm to rationalise antibiotic use among hospitalised COVID-19 patients
As presentation of COVID-19 may mimic that of bacterial pneumonia, antibiotics are often prescribed. Concerns regarding overuse of antibiotics are now being raised particularly...
Letter to the Editor
Attendance for ischaemic stroke before and during COVID-19 lockdown in Singapore
The coronavirus disease 2019 (COVID-19) outbreak has impacted healthcare systems worldwide. Globally, visits to the emergency department have fallen as much as 25% during...
Letter to the Editor
Congenital adhesion band causing recurrent subacute intestinal obstruction in a virgin abdomen
Intestinal obstruction (IO) caused by malignancy and adhesion bands from previous surgery is common among adults. However, IO caused by congenital adhesion bands (CAB)...
Original Article
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...
Editorial
Tackling osteoporosis and fragility fractures in Singapore
A shift in worldwide population ageing demographics has occurred in the 21st century. The longevity miracle is most keenly felt in Singapore, a young...
Original Article
Impact of dispatcher-assisted cardiopulmonary resuscitation and myResponder mobile app on bystander resuscitation
Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality worldwide, with a global incidence of 62 cases per 100,000 person-years. In addition, there...
Editorial
Community-level interventions for out-of-hospital cardiac arrests in Singapore: Yay or nay?
Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality and a significant public health problem globally. In Singapore, OHCA affected 11,061 adults between...
Letter to the Editor
Circulatory collapse from rupture of splenic artery aneurysm: A case study
Splenic artery aneurysms (SAAs) are uncommon and often asymptomatic. However, ruptured SAAs can be rapidly fatal. We reviewed the literature on SAAs and highlighted...
Original Article
Emergency airway management in a Singapore centre: A registry study
Emergency airways often present with little warning, and the need for airway management is necessary for a successful resuscitation. This is in contrast to...
Letter to the Editor
Decrease in emergency department attendances during COVID-19 especially in school-going children
Health-seeking behaviour varies during a pandemic. Early reports have suggested reduced attendances at emergency departments (EDs), especially in paediatric patients and in patients with...
Original Article
Virtual reality mobile application to improve videoscopic airway training: A randomised trial
Emergency airway management is a keystone of emergency medicine practice and critical skill in residency training. An accredited emergency attending is expected to handle...
Original Article
Paediatric emergency department attendances during COVID-19 and SARS in Singapore
Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) on 11 March 2020, with over 110 million cumulative cases...
Original Article
Epidemiology and risk stratification of minor head injuries in school-going children
Head injuries are common childhood injuries that present to paediatric emergency departments. Falls are the most common cause in young children, while contact sports...