Letter to the Editor
“Leveraging ChatGPT to aid patient education on coronary angiogram”: Correspondence
Dear Editor,
“Leveraging ChatGPT to aid patient education on coronary angiogram”1 is an interesting article. The study assessed ChatGPT’s ability to conversely provide information regarding the coronary angiography process, pointing out its advantages and disadvantages. Although ChatGPT provided information in an exhaustive and methodical manner, it also had flaws, including...
Review Article
Consensus statements and guideline for the diagnosis and management of plantar fasciitis in Singapore
Plantar fasciitis (PF) is a degenerative disorder of the plantar aponeurosis at the insertion of the plantar fascia into the calcaneus, most commonly at the medial tubercle of the calcaneus.1,2 Plantar fascia, or plantar aponeurosis, supports the medial longitudinal arch of the weight-bearing foot. With excessive mechanical loading of...
Editorial
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 on not only deadly diseases, but also on the quality of life and sexual functions of men and women. Digital media also play a considerable...
Editorial
Challenges with mainstreaming genetic testing for metastatic prostate cancer treatment in Singapore
Compared with other solid tumours, patients with metastatic prostate cancer typically have better survival in the range of years.1 The long survival translates to a high prevalence, and thus, a large number of men living with prostate cancer. Singapore has one of the highest age-standardised incidence rates of prostate...
Letter to the Editor
Erdheim-Chester disease: Imaging spectrum of multisystemic manifestations
Dear Editor,
Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytosis, usually affecting middle-aged to older adults. It is a multisystemic disease with protean clinical manifestations. It can involve single or multiple organs, and presentations range from asymptomatic lesions detected incidentally on imaging to severe organ dysfunction. Hence, accurate and timely...
Others
Cryptococcal Prostatic Abscess in an Immunocompromised Patient: A Case Report and Review of the Literature
Cryptococcosis is a well-recognised infection in immunocompromised patients, although its prevalence varies with the type of immune defect. We report a patient with myasthenia gravis (MG) on steroid therapy and non-insulin dependent diabetes mellitus (NIDDM) who developed cryptococcal meningitis and in whom a search for a persistent focus by...
Others
Repair of Complex Ureterovaginal and Vesicovaginal Fistulas with Ileal Cystoplasty and Ureteric Reimplantation into an Antireflux Ileal Nipple Valve—A Case Report
Urogenital fistulas are a known but uncommon complication of gynaecological surgery, especially those involving a malignant process. Its incidence does not exceed 2%.
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Others
A Case Report—Delayed Vesicocutaneous Fistula After Radiation Therapy for Advanced Vulvar Cancer
To our knowledge this is the first reported case of an isolated vesicocutaneous fistula related to previous radiation therapy for recurrent vulvar cancer.
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Original Article
Outcome of Obstructive Uropathy After Pelvic Irradiation in Patients with Carcinoma of the Uterine Cervix
Radiotherapy is the mainstay treatment for locally advanced carcinoma of the cervix. It is also administered as an adjuvant therapy to patients deemed at high risk for local recurrence after radical hysterectomy.
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Letter to the Editor
Re: Haematuria in the Diagnosis of Urinary Calculi. SBS Ooi, NW Kour, A Mahadev. Ann Acad Med Singapore 1998; 27:210-4
The above article highlights the insensitivity of urine microscopy compared with the Combur 9 test for detecting haematuria associated with urinary calculi. In the article, the equivalent microscopic RBC values for the Combur 9 are given as 5/ml (typo? it should be 5/µl) and 10 /ml (?10/µl) for intact...
Original Article
Outpatient Treatment of Middle and Lower Ureteric Stones: Extracorporeal Shock Wave Lithotripsy versus Ureteroscopic Laser Lithotripsy
Significant technological advances have been made in the management of ureteric calculi. The newer semirigid, fibreoptic ureteroscopes can now be passed with minimal trauma and in many cases without dilatation.
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Others
Traumatic Dislocation of the Testes
Traumatic dislocation of the testes is uncommon. The first case was reported by Claubry in 1818 in Paris, when a 20-year-old soldier was run over by a wagon resulting in bilateral suprapubic dislocation of his testes.
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Others
Verrucous Haemangioma—A Case Report
Verrucous haemangioma is an uncommon congenital vascular malformation which may grow to large sizes. It has a characteristic hyperkeratotic and verrucous surface which resembles angiokeratoma circumscriptum.
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Original Article
Haematuria in the Diagnosis of Urinary Calculi
Patients with renal or ureteric colic are commonly seen at our Emergency Department. We routinely check their urine for haematuria using the Combur 9 test (Boehringer Mannheim, Germany) alone without doing urine microscopy unless the patient shows pyuria on the Combur 9 test.
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Original Article
The Investigation and Management of Thyroid Nodules—A Retrospective Review of 183 Cases
Thyroid nodule is a common problem in surgical practice. In 1994, more than 350 thyroid operations were performed in our department, of which 183 were for thyroid nodules. Conventional preoperative assessment of a patient with a thyroid nodule, including history and physical examination, radionuclide scan and ultrasonography, has been...
Review Article
Osteoporosis—The Need for a Paradigm Shift
Osteoporosis is becoming an increasing public health problem in most countries. Osteoporosis literally means “porous bones” and involves skeletal fragility leading to an increased risk of fracture.
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Review Article
Rheumatoid Arthritis—A Review
Rheumatoid arthritis (RA) is a chronic inflammatory arthritis which is occasionally associated with extraarticular manifestations. Although the first good clinical description was by Landre-Beauvais in 1800, the term rheumatoid arthritis was first used only in 1878 by Alfred Garrod.
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Review Article
The Appropriate Use of Antineutrophil Cytoplasmic Antibody (ANCA) Testing in Rheumatic Diseases
In 1982, Davies and co-workers in Melbourne described the presence of a serum factor that stained the cytoplasm of neutrophil leukocytes by indirect immunofluorescence in 8 patients with generalised illness associated with segmental necrotising glomerulonephritis. This was followed two years later by a report by Hall and co-workers of...
Others
Chronic Subdural Haematoma Presenting with Transient Ischaemic Attacks— A Case Report
Transient ischaemic attacks (TIA) are commonly seen in neurologic practice. They are most commonly associated with cerebrovascular insufficiency, either from a thrombotic or embolic occlusion of a cerebral artery.
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Original Article
Is Staging of Benign Prostatic Hyperplasia (BPH) Feasible?
Staging of disease is important. It serves as a guide for further management and also for comparing the results of treatment. Traditionally this has been used for malignant disease.
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Original Article
The Outcome of Trial Off Catheter after Acute Retention of Urine
Acute retention of urine (ARU) is the commonest urological condition requiring emergency admission to hospital and is usually managed by urethral catheterisation. Previously, patients with long-standing bothersome symptoms and who present with first episode of ARU were offered transurethral resection of prostate (TURP).
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Original Article
Renal Cell Carcinoma in Patients with Chronic Renal Failure
Dunnil and associates first described the association of renal cell carcinoma (RCC) with acquired cystic kidney disease (ACKD) and end stage renal disease. The incidence of ACKD in dialysis patients ranges from 10% to 90% depending on the duration of dialysis.
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Original Article
Inferior Vena Cava Thrombectomy for Renal Cell Carcinoma with Thrombus
A characteristic feature of renal cell carcinoma is the development of tumour thrombus extending into the inferior vena cava (IVC). This takes place in 4% to 10% of cases.
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Others
Case Report: Percutaneous Balloon Dilatation and Ureteral Stenting for Tuberculous Renal Infundibular and Ureteral Strictures
The management of the non-functional tuberculous kidney is controversial and ranges from surgical intervention to conservative treatment. Intra-renal scarring with stricture formation is common in the late stages of renal tuberculosis and results in greater loss of renal function than direct involvement by tuberculosis alone.
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Original Article
Use of Ligase Chain Reaction and Polymerase Chain Reaction on Urine Specimens to Detect Chlamydia trachomatis Infections in a Sexually Transmitted Diseases Clinic in Singapore
Infections caused by Chlamydia trachomatis are amongst the most common bacterial sexually transmitted diseases (STDs) in the world, causing substantial morbidity in young sexually-active people. C. trachomatis causes a variety of clinical syndromes in males (including urethritis and epididymitis), females (including cervicitis and pelvic inflammatory disease), and new-borns (including...
Original Article
Current Indications for Open Stone Surgery in Singapore
The treatment of urinary calculi has changed tremendously since the introduction of extra corporeal shockwave lithotripsy (ESWL), percutaneous nephrostolithotomy (PCNL), and ureteroscopy over the past decade in our hospital. Patients previously requiring open surgical procedure are now treated successfully with these new therapeutic modalities.
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Commentary
Tissue Microangiography Using a Simplified Barium Sulphate Cadaver Injection Technique
The understanding of blood supply is the cornerstone of successful tissue transfer in reconstructive surgery. This understanding has been derived largely from cadaveric dissections, combined with injections to outline the blood supply.
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Original Article
Nitric Oxide Synthase-Its Distribution and Alteration in the Intramural Ganglia of the Urinary Bladder in Normal and Urethra-obstructed Guinea Pigs
Nitric oxide (NO) has been recognised as a nonadrenergic noncholinergic (NANC) inhibitory neurotransmitter at various sites in the nervous system. Its function as a NANC inhibitory transmitter has been documented in muscular and sphincter relaxation in the cardiovascular, digestive and urogenital system.
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Others
Retroperitoneal Castleman’s Disease in the Perinephric Space—Imaging Appearance: A Case Report and a Review of the Literature
Castleman’s disease (CD) was first proposed by Castleman in 1954. It is usually found in the mediastinum, but other sites have been described.
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Review Article
Diabetic Retinopathy
Diabetes mellitus affects some 9% of Singaporeans. Studies had shown that virtually all insulin dependent diabetes mellitus (Type 1) and 85% of non-insulin dependent diabetes mellitus (Type 2) patients would develop retinopathy after 20 years of disease.
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Original Article
Transurethral Alprostadil for the Treatment of Erectile Dysfunction: Results of a Multicentre Trial
As the population is growing older and the society getting more affluent, people are aiming for a better quality of life. This has resulted in greater awareness of erectile dysfunction (ED), thus increasing the number of patients approaching the doctor for consultation.
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Others
Laparoscopic Telesurgery Between the United States and Singapore
Telemedicine is the use of telecommunication technologies to provide medical information and healthcare services. Early applications include medical use of the telephone and facsimile.
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Others
The Genetics of Primary Vesico-Ureteric Reflux
Vesico-ureteric reflux (VUR, OMIM #193000), the name given to reflux of urine from the bladder into the ureter and towards the kidney, is believed to be due to a developmental abnormality of the ureteric bud during embryogenesis. Ureteral reflux has been known for centuries; in the 15th century Leonardo...
Commentary
Transurethral Surgery and the Adductor Spasm
Bladder tumours frequently arise from the posterolateral wall of the bladder1 over the course of the obturator nerve. It is during transurethral resection of these tumours that direct electrical stimulation of the obturator nerve occurs.
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Original Article
A Rational Alternative for the Diagnosis of Diabetes Mellitus in High Risk Individuals
The “gold standard” for the diagnosis of diabetes mellitus has all along been the oral glucose tolerance test (OGTT). As diabetes mellitus defines a group of individuals at high risk for macrovascular and microvascular disease, it is essential that the diagnosis be made promptly.
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Original Article
Six-Year Follow-Up of Untreated T1 Carcinoma of Prostate
It is well known that T1 carcinoma of the prostate has varying biologic behaviour. Attempts to identify those at higher risk of progression have led to the subclassification into T1a (focal, low grade) and T1b (diffuse, high grade).
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Original Article
Cystoscopic Diagnosis of Bladder Cancer by Intravesical Instillation of 5-Aminolevulinic Acid Induced Porphyrin Fluorescence—The Singapore Experience
Bladder cancer is the sixth most frequent malignant disease in the world. Superficial stages of the tumour are found in 75% to 85% of cases upon first diagnosis.
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Others
Bilateral Synchronous Renal Oncocytoma: A Case Report and Review
Oncocytomas are neoplasms characterised by large epithelial cells with finely granular eosinophilic cytoplasm called oncocytes. They were first described by Zippel in 1942 and have subsequently been identified in the thyroid, parathyroid, salivary and adrenal glands.
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Original Article
Acute Renal Colic: Value of Unenhanced Spiral Computed Tomography Compared with Intravenous Urography
The typical ureteric calculus presents with an acute onset of flank pain which may radiate to the groin. Intravenous urography (IVU) has classically been the gold standard for the diagnosis of urinary calculi.
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Original Article
Holmium Laser Lithotripsy in the Management of Ureteric Calculi
The introduction of extracorporeal shockwave lithotripsy (ESWL) in the 1980s revolutionised treatment of renal and ureteric calculi. Progress in the field of extracorporeal lithotripsy was paralleled by the introduction of smaller caliber ureteroscopes and various intracorporeal lithotripters.
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Original Article
The Singapore General Hospital Early Clinical Experience with the 7.5F Flexible Ureterorenoscope
Intravenous regional anaesthesia (IVRA) has a reported success rate of between 94% and 98% for upper limb surgery. Limitations to its use include the quality of intraoperative anaesthesia, tourniquet pain and lack of adequate postoperative analgesia.
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Original Article
Spectrum of Prostate Cancer in the Singapore General Hospital (1980 to 1985)
Prostate cancer is the most prevalent cancer among men in the United States. In Singapore, it is the sixth most common incidence of cancer among males and the age-adjusted rates have risen from 8.2 to 9.6 per 100,000 per year between 1987 and 1992.
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Others
Clinical Reasoning Learning Sessions
Many medical schools worldwide have made the shift toward problem-based learning (PBL) medical education. Some of them employ these new techniques in only part of their teaching, and usually in the pre-clinical phases, to make basic sciences easier and more attractive.
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Original Article
A Twelve-year Review of Radical Cystectomies in Singapore General Hospital
Bladder carcinoma is the tenth most common cancer affecting men in Singapore. It is more common in men with an age-standardised incidence rate of 6.9 per 100,000 per year for men and 1.7 per 100,000 per year for women in Singapore.
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Original Article
Percutaneous Nephrolithotomy in the Management of Complex Upper Urinary Tract Calculi: The Singapore General Hospital Experience
Open surgical removal had been the standard treatment for urolithiasis till the early 1980s when introduction of percutaneous techniques and extracorporeal shock wave lithotripsy (ESWL) revolutionised stone management.
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Others
Adrenal Myelolipoma Presenting with Spontaneous Retroperitoneal Haemorrhage Demonstrated on Computed Tomography and Angiogram—A Case Report
Adrenal myelolipoma is a rare, benign tumour, usually an incidental finding. Spontaneous retroperitoneal haemorrhage resulting from this tumour is rare.
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Original Article
The Role of BTA stat in Clinical Practice
Cystoscopy, supplemented by urine cytology, remains the gold standard in detecting primary and recurrent bladder cancer. Urine cytology, although highly specific, detects only 29% to 45% of bladder tumours and is subject to considerable inter- and intra-observer differences.
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Original Article
Penile Colour Duplex Ultrasonography as a Screening Tool for Venogenic Erectile Dysfunction
Penile colour flow Doppler imaging (PCDI) is a non-invasive, accurate and cost-effective technique. It has better patient acceptance as compared to cavernosometry and cavernosography, and it does not involve any ionising radiation.
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Original Article
Single Centre Review of Radiologically-guided Percutaneous Nephrostomies: A Report of 273 Procedures
Percutaneous nephrostomy (PCN) is a well-established technique in the armamentarium of an interventional radiologist when dealing with urinary obstruction. It provides temporary relief in obstructive uropathy and stabilises the patients for subsequent definitive treatment.
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Others
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 paradigm shift in the management of osteoporosis has resulted from the development of techniques which can diagnose osteoporosis before fractures occur, and effective medications which...
Review Article
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 aspects has been carried out in the West.
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Others
Imaging of Paediatric Mediastinal Masses
A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for thoracic masses in children.
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Original Article
Breast Cancer in Women Under 40 Years: Preoperative Detection by Mammography
The incidence of breast cancer peaks between the ages of 45 and 55 years. Approximately 7% of breast cancers occur below 40 years of age.
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Review Article
Melanocytic Lesions of the Face: Diagnostic Pitfalls
Cutaneous melanocytic lesions are amongst the commonest tumours in all races but are more common in Caucasians with fair skin. Although most are benign melanocytic naevi that are readily diagnosed clinically, melanocytic lesions are commonly excised because of the concern that they may represent a melanoma or because of...
Original Article
Transurethral Resection of Prostate (TURP) Through The Decades – A Comparison of Results Over the Last Thirty Years in a Single Institution in Asia
Over the last 70 years, transurethral resection of prostate (TURP) has been used in the surgical treatment of benign prostatic hyperplasia (BPH) and is still considered the gold standard. With improvements in operative techniques, video endoscopy, anaesthetic care and intraoperative monitoring of fluid and electrolytes, rates of intraoperative and...
Original Article
Morbidity and Significant Bacteriuria after Urodynamic Studies
Urodynamics or pressure flow studies (PFS) are defined as a functional assessment of the lower urinary tract (LUT) to provide a pathophysiological basis for urinary symptoms and signs. Advocates of PFS deem it a necessary investigation if continence surgery is contemplated, stating that the “bladder is an unreliable witness”...
Others
Supernumerary Testicle in a Case of Polyorchidism
The presence of more than 2 testicles is called polyorchidism. It is a rare anomaly.
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Others
Uncommon Benign Intrascrotal Tumours
Leiomyomas of the urinary tract are exceedingly rare. They can, however, arise from almost any site within the genito-urinary tract, most commonly in the renal capsule and bilateral tumours are very rare.
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Others
A Case Report of Occupational Asthma due to Gluteraldehyde Exposure
Worldwide, asthma is estimated to affect between 5% and 10% of the population and, among adults, 4% to 9% of these cases have been attributed to an occupational cause. Yet, only 3 cases were reported and confirmed in Singapore in the year 2000 – an incidence of only 0.14/100,000...
Original Article
Extracorporeal Shockwave Lithotripsy and Intracorporeal Lithotripsy for Proximal Ureteric Calculi – A Comparative Assessment of Efficacy and Safety
The introduction of extracorporeal shockwave lithotripsy (ESWL) by Chaussy and his co-workers in 1980 revolutionised the management of urinary calculi. Since then, ESWL has become the modality of choice of many urologists for proximal ureteric calculi.
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Others
Recurrent Non-immune Fetal Hydrops: A Case Report
The incidence of non-immune hydrops (NIH) has been reported to be 1/10001 and is associated with high perinatal morbidity and mortality at all gestational ages with an overall perinatal mortality rate (PNMR) of 86.6%. If the diagnosis is made before 24 weeks’ gestation, the PNMR is 95%, with 30%...
Others
Neonatal Priapism Associated With Spontaneous Bilateral Pyocavernositis
Priapism is a pathological state of prolonged, generally painful erection, unassociated with sexual desire and not ending in ejaculation. Rare before the 1980s, this entity became more frequent after the introduction of vasoactive drugs for intracavernosal injections.
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Others
Neonatal Hepatic Abscess in Preterm Infants: A Rare Entity
Liver abscess has been recognised since the time of Hippocrates. The first report on liver abscess was published by Bright in 1836.1 However, reports pertaining to liver abscess in the neonatal period have been published only since the 1930s. Neonatal liver abscess is a rare entity. To our knowledge,...
Review Article
Obesity and Obstructive Sleep Apnoea Hypopnoea Syndrome in Singapore Children
Obesity is becoming a problem of epidemic proportions and is perhaps, the most pervasive medical problem faced by medical providers today. It is a problem affecting about 10% to 15% of our school-going population in Singapore, affecting disease burden in virtually every medical subspecialty.
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Others
Rapid Identification of Pathogenic Rapidly Growing Mycobacteria by PCR-Restriction Endonuclease Analysis
The pathogenic rapidly growing mycobacteria (RGM) capable of producing disease in humans consist primarily of the Mycobacteriumabscessus (M. abscessus), Mycobacterium chelonae (M. chelonae), Mycobacterium fortuitum species group (M. fortuitum group), and the M.smegmatis group. Clinical features of RGM infections include post-traumatic wound infections, disseminated cutaneous disease, bone and joint...
Images in Medicine
Paediatric perineal skin pit: More than skin deep?
A 2.5-year-old boy was referred to our clinic for abnormal genitalia and a febrile urinary tract infection (Escherichia coli >105 colony-forming units/mL). At birth, his parents were informed that he had a “bilobed scrotum and a deep perineal skin pit” that may pose hygiene and cosmetic issues. They had...
Original Article
The Value of Joint Aspirations in the Diagnosis and Management of Arthritis in a Hospital-based Rheumatology Service
Joint aspiration with synovial fluid analysis can provide information which complements that which is available from the history and physical examination of the patient, and can help to differentiate various causes of arthritis. It is most useful in monoarthritis, where septic arthritis as a medical emergency needs to be...
Review Article
Hypoxic-ischaemic Brain Injury in Young Infants
In young infants, different types of hypoxic-ischaemic brain injury can occur.1-6 Brain injury can be localised or diffused.2-6 In localised brain injury, arterial or venous periventricular infarctions are encountered. Causes of arterial infarction in the paediatric population are coagulopathies, vasculopathies, polycythaemia, and emboli from cyanotic congenital heart disease.7 In...
Images in Medicine
A Tiny Stone Induced Ureteral Rupture
A 60-year-old previously healthy man with unremarkable medical history presented with a complaint of intractable flank pain for one day. The laboratory test results were within normal limits except for microscopic haematuria on urinalysis.
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Original Article
Evaluation of Data Completeness of the Prostate Cancer Registry after Robotic Radical Prostatectomy
Cancer data can be abstracted manually by cancer registrars or extracted automatically from the electronic medical systems. There may appear to be nothing in common between a manual Cancer Registry dealing with a few hundreds of new cases a year, and a large, highly computerised Cancer Registry as both...
Letter to the Editor
Management of Fournier’s Gangrene with Vacuum Assisted Closure® Dressing
Fournier’s gangrene is a surgical emergency. Treatment consists of fluid resuscitation, intravenous broad spectrum antibiotics and immediate surgical consultation with a view for early wound debridement and drainage.
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Original Article
Staging of Benign Prostate Hyperplasia is Helpful in Patients with Lower Urinary Tract Symptoms Suggestive of Benign Prostate Hyperplasia
Benign prostate hyperplasia (BPH), one of the most common diseases of ageing men, affects the quality of life by interfering with normal daily activities and sleep patterns. The current treatment options for patients with lower urinary tract symptoms (LUTS) suggestive of BPH mainly depend on the severity of the...
Original Article
Botulinum Toxin A for Idiopathic Detrusor Overactivity
Overactive bladder (OAB) is characterised by feelings of urgency to urinate, with or without incontinence and is usually accompanied by frequency and nocturia. These symptoms are due to involuntary contractions of the detrusor muscle.
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Letter to the Editor
Management of Thrombotic Thrombocytopenic Purpura in Metastatic Prostate Cancer with only Endocrine Therapy
Thrombotic thrombocytopenic purpura (TTP) is a systemic disorder that presents acutely with multiple organ failure. Although defined classically as a syndrome with a pentad of features, it is accepted now that a diagnosis can be made with the dyad of microangiopathic haemolytic anaemia and thrombocytopenia.
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Original Article
Incidence, Mortality and Five-year Relative Survival Ratio of Prostate Cancer among Chinese Residents in Singapore from 1968 to 2002 by Metastatic Staging
Prostate cancer is now the third most common cancer among Singapore males, with a world age-standardised incidence rate (ASIR) of 23.9 per 100,000 from 2003 to 2007. The average annual rate of increase between 1968 and 2002 was 5.6%, with a steeper increase seen in the last 10 years.
This...
Letter to the Editor
Renojejunal Fistula: An Extremely Rare Form of Renoenteric Fistula
Obstructive calculous disease of the kidney often results in infectious complications such as pyelonephritis and perinephric abscesses. Renojejunal fistula formation may occur as the inflammation becomes chronic.
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Letter to the Editor
Sustained Clinical Efficacy after Repeat Intradetrusor Botulinum Toxin Type A in the Treatment of Neurogenic Detrusor Overactivity
Despite the introduction of more potent and uroselective antimuscarinic agents, many patients with neurogenic detrusor overactivity still suffer from refractory incontinence. Intradetrusor botulinum toxin injections had been shown to be safe and effective in treating such patients who had failed medical therapy.
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Original Article
Diagnostic Value of Ultrasound-detected Calcification in Thyroid Nodules
Thyroid nodules which can be palpated are present in between 4% and 7% of the population. Solid nodules as small as 3 mm and cysts of 2 mm can be detected with high-frequency ultrasonography (US). US has been also commonly used to differentiate malignant nodules from all thyroid lesions...
Original Article
Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms
Benign prostatic hyperplasia (BPH) is one of the commonest diseases of ageing men. It can be associated with bothersome lower urinary tract symptoms (LUTS) that affect quality of life and it causes structural and functional changes in the bladder. Previous clinical guidelines had emphasised on managing symptoms; however current...
Review Article
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 as well. Similarly, the Renal Medicine Unit at the Singapore General Hospital, an academic medical centre, acted quickly to modify our services to (1) protect...