Related Articles | Annals Singapore

Letter to the Editor

How do current paediatrics residency selection criteria correlate with residency performance?

Jia Hui Teo, Cristelle Chow

Dear Editor, The selection process for potential residents needs to be reviewed regularly and assessed if effective in selecting the best-fit residents who can achieve...

Commentary

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

Eugene TC Koh, Kok Yong Fong, Si Jack Chong, Yvonne Koh, Joshua WX Tan, Raymond Chua, Yock Young Dan, Derrick Heng, Kenneth Mak

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...

Original Article

Long COVID prevalence, risk factors and impact of vaccination in the paediatric population: A survey study in Singapore

Jiahui Li, Karen Nadua, Chia Yin Chong, Chee Fu Yung

On 5 May 2023, more than 3 years since the start of the COVID-19 pandemic, the World Health Organization (WHO) declared that COVID-19 no...

Original Article

Fetal congenital heart diseases: Diagnosis by anatomical scans, echocardiography and genetic tests

Abhiram Kanneganti, Arundhati Tushar Gosavi, Mei Xian Karen Lim, Wei Ling Sarah Li, Dawn AK Chia, Mahesh Arjandas Choolani, Ching Kit Chen, Arijit Biswas

Congenital heart diseases (CHDs) are the most common major congenital anomaly at up to 28%1 and are responsible for 5.7% of all infant mortality.2...

Letter to the Editor

Improving neonatal counselling service for premature births

Yvonne Yee Voon Ng, Pih Lin Tan, Nirmal Kavalloor Visruthan, Yee Yin Tan, Bin Huey Quek

Dear Editor, Despite the substantial advancement of neonatal care leading to increased survival of infants of periviable gestation, as young as 22 weeks,1 the anticipated...

Review Article

Consensus statement on Singapore integrated 24-hour activity guide for early childhood

Benny Kai Guo Loo, Dinesh Sirisena, Falk Müller-Riemenschneider, Michael Yong Hwa Chia, Benedict Tan, Ngiap Chuan Tan, Oon Hoe Teoh, Ethel Jie Kai Lim, Mohammad Ashik Zainuddin, Joanne Shumin Gao, Poh Chong Chan, Teresa Shu Zhen Tan, Nirmal Kavalloor Visruthan, Victor Samuel Rajadurai, Moira Suyin Chia, Nur Adila Binte Ahmad Hatib, Shirong Cai, Ju Lynn Ong, June Chi Yan Lo, Mary Foong-Fong Chong, Le Ye Lee, Elaine Chu Shan Chew, Ratnaporn Siriamornsarp, Miriam Lee, Aaron Sim, Chui Mae Wong, Shelly-Anne Sherwood, Siao Hui Toh, Phaik Ling Quah, Kee Chong Ng, Kok Hian Tan, Yung Seng Lee

Early childhood is a critical period for growth and development, setting the foundation for future and lifelong well-being.1 Adopting healthy lifestyle behaviours in early...

Editorial

Proactive steps to population health: Starting early, starting right

Daniel Chan

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,...

Letter to the Editor

Sublingual ondansetron for treatment of acute gastroenteritis in children in the children’s emergency

Olivia Leow, Davina Neeta Paul, Anh Phuong Tran, Yang Chern Lim, Velda Xinying Han, Andrea Yeo

Dear Editor, Acute gastroenteritis (GE) is a leading cause of death globally in children aged below 5 years and the third most common indication for...

Letter to the Editor

Rash characteristics of paediatric patients with COVID-19 in Singapore

Syen Yee Leow, Shi Yun Chia, Valerie Pui Yoong Ho

Dear Editor, Children with COVID-19 infection can present with a variable spectrum of clinical manifestations, and sometimes mucocutaneous manifestations can be the only manifestation of...

Letter to the Editor

Rapid exome sequencing to aid diagnostics in genetic disorders: Implementation and challenges in the Singapore context

Nikki Fong, Jiin Ying Lim, Breana Cham, Sylvia Kam, Chew Yin Goh, Heming Wei, Yuen Ming Tan, Hai Yang Law, Weng Khong Lim, Ee Shien Tan, Ene Choo Tan, Saumya Shekhar Jamuar

Dear Editor, There is a high burden of genetic disorders in patients admitted to the intensive care unit (ICU), ranging from 45–56%,1,2 and delayed definitive...

Letter to the Editor

Implementation of an AI model to triage paediatric brain magnetic resonance imaging orders

Phua Hwee Tang, Alwin Yaoxian Zhang, Sean Shao Wei Lam, Marcus Eng Hock Ong, Ling Ling Chan

Dear Editor, Artificial intelligence (AI) is viewed as the most important recent advancement in radiology with the potential to achieve Singapore’s objective of delivering value-based...

Letter to the Editor

Early rehabilitation to improve functional outcomes in childhood cancer in Singapore

Lindsey Weller, Kayla Wong, Ce Yu Foo, Wei Zhi Leo, Beron Tan, Satyaki Sengupta, Jasper Tong, Mei Yoke Chan

Dear Editor, We conducted a prospective, single-centre cohort study to review the impact of a multidisciplinary rehabilitation programme in children with cancer in Singapore....

Original Article

Multisystem inflammatory syndrome in children in Singapore

Karen Donceras Nadua, Chia Yin Chong, Kai-Qian Kam, Yee Hui Mok, Jonathan Tze Liang Choo, Joyce Ching Mei Lam, Jiahui Li, Natalie Woon Hui Tan, Chee Fu Yung, Su-Wan Bianca Chan, Kai Liang Teh, Lena Das, Thaschawee Arkachaisri, Koh Cheng Thoon

While children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulting in coronavirus disease 2019 (COVID-19) have milder manifestations compared to adults,1,2 a...

Editorial

Multisystem inflammatory syndrome in children: A unique manifestation of COVID-19

Si Min Chan

During the coronavirus disease 2019 (COVID-19) pandemic, children have been relatively spared from the severe symptomatic infection affecting adults, particularly the elderly and those...

Letter to the Editor

Child passenger safety training for healthcare professionals in Singapore

Ronald Ming Ren Tan, Shelly-Anne Sherwood, Nirmal V Kavalloor, Jasmine XY Feng, Arif Tyebally, Shu-Ling Chong

Dear Editor, Road traffic injuries are a preventable cause of childhood morbidity and mortality.1,2 Use of age-appropriate child car seats (CCS) lowers the risk...

Letter to the Editor

Clinical characteristics of macrolide-resistant Mycoplasma pneumoniae infections among hospitalised children in Singapore

Jiahui Li, Matthias Maiwald, Liat Hui Loo, Han Yang Soong, Sophie Octavia, Koh Cheng Thoon, Chia Yin Chong

Dear Editor, Mycoplasma pneumoniae has become the leading cause of paediatric community-acquired pneumonia in countries where pneumococcal vaccination is included in the national immunisation programme,...

Letter to the Editor

Childhood interstitial lung disease: The end of a diagnostic odyssey

Kok Joo Chan, Meow-Keong Thong, Anna Marie Nathan, Surendran Thavagnanam, Yusnita Yakob, Chin Seng Gan

Dear Editor, Childhood interstitial lung disease is a heterogeneous group of rare disorders featuring pulmonary interstitial remodelling and diffuse parenchymal infiltrates on imaging.1 Incidence...

Original Article

Validation and comparison of the PECARN rule, Step-by-Step approach and Lab-score for predicting serious and invasive bacterial infections in young febrile infants

Natalia Sutiman, Zi Xean Khoo, Gene Yong-Kwang Ong, Rupini Piragasam, Shu-Ling Chong

The diagnostic approach and management of febrile infants <90 days of age remain a challenge, given that the majority of these infants have no...

Letter to the Editor

High burden of respiratory viral infection-associated mortality among critically ill children

Divyapoorani Ravichandran, Joel Kian Boon Lim, Poh Hui Wee, John C Allen, Chee Fu Yung, Jan Hau Lee, Kee Thai Yeo

Dear Editor, Acute lower respiratory infections (ALRIs) are a leading cause of under-5 mortality globally—two-thirds could be attributable to respiratory viral infections (RVIs).1,2 The burden...

Original Article

Non-motorised active mobility device use by children in Singapore: Injury patterns and risk factors for severe injury

Aletheia ZH Chia, Shu-Ling Chong, Sashikumar Ganapathy

The Active Mobility Act was introduced in Singapore in 2017 to promote the safe use of personal mobility devices. Non-motorised active mobility devices (AMDs)...

Letter to the Editor

Screening for somatisation in an Asian children’s hospital emergency setting

Siok Hoon Ang, Juliet SK Tan, Jiahui Lee, Vicknesan J Marimuttu, Xin Yi Lim, Lois LE Teo, Shannon N Edward, Mavis Teo, Joyce ST Lim, Sashikumar Ganapathy, Angelina Ang

Dear Editor, In recent years, self-harm is the leading cause of morbidity and mortality among adolescents in Singapore.1,2 This is just the tip of the...

Commentary

Congenital cytomegalovirus infection: Advocating for screening and education

Ching Yee Chan, Liying Yang, Jiun Fong Thong

Cytomegalovirus (CMV) infection is the leading non-genetic cause of congenital neurosensory hearing loss in children, accounting for 21% of cases of hearing loss at...

Original Article

Epidemiological trends and outcomes of children with aural foreign bodies in Singapore

Menghao Duan, Gayathry Morvil, Junaidah Badron, Sashikumar Ganapathy

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

Consensus statement on Singapore integrated 24-hour activity guide for children and adolescents

Benny Kai Guo Loo, Benedict Tan, Michael Yong Hwa Chia, Poh Chong Chan, Dinesh Sirisena, Mohammad Ashik Zainuddin, Jean Yin Oh, Oon Hoe Teoh, Teresa Shu Zhen Tan, Micheal Chee Meng Lim, Ethel Jie Kai Lim, Falk Müller-Riemenschneider, Ngiap Chuan Tan, Ratnaporn Siriamornsarp, Terry Chin Chye Teo, Phaik Ling Quah, Victor Samuel Rajadurai, Kok Hian Tan, Kee Chong Ng

The World Health Organization’s Global action plan for the prevention and control of noncommunicable diseases 2013–2020 provided guiding principles for national efforts in controlling...

Original Article

Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore

Vanessa ZY McLoughlin, Noor HA Suaini, Kewin Siah, Evelyn XL Loo, Wei Wei Pang, Yap Seng Chong, Keith M Godfrey, Kok Hian Tan, Jerry KY Chan, Anne EN Goh, Bee Wah Lee, Lynette P Shek, Johan G Eriksson, Marion M Aw, Elizabeth H Tham

Functional gastrointestinal (GI) disorders, such as colic, gastroesophageal reflux (GER) and constipation, are common in infants under 1 year. They are a frequent cause...

Editorial

Gastroesophageal reflux disease in Asian infants: Similar condition, different perceptions

Way Seah Lee, Kee Seang Chew

Gastroesophageal reflux disease (GERD), a common problem in infancy, may lead to troublesome symptoms or complications such as oesophagitis or oesophageal stricturing in a...

Others

A Case Report of Heparin Resistance due to Acquired Antithrombin III Deficiency

C K Leong, B C Ong

Intravenous heparin therapy is used in the management of angina and myocardial infarct with increasing frequency in recent years. Those patients who have been...

Original Article

Risk Factors for Predicting Mortality in a Paediatric Intensive Care Unit

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

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

Others

Thoracoscopic Thymectomy for Myasthenia Gravis: A Case Report

E K W Sim, J J Goh, A Durani, B K C Ong

Total thymectomy is the established surgical therapeutic method for generalised myasthenia gravis. Several approaches are used for the surgical removal of the thymus and...

Original Article

Infections in Acute Lymphoblastic Leukaemia

C Y Chong, A M Tan, J Lou

Children undergoing chemotherapy for cancer are especially vulnerable to infection because of immunosuppression related to their underlying illness, the effects of chemotherapy and radiotherapy....

Original Article

Childhood Leukaemia: Towards an Integrated Psychosocial Intervention Programme in Singapore

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

In the last two decades there has been a surge of interest concerning the psychosocial correlates of life-threatening illnesses. Research in this area has...

Original Article

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

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

The use of caudal preservative-free morphine for postoperative analgesia in children has gained popularity since it was first described by Jensen. Several studies have...

Original Article

A Retrospective Study of Infants with Severe Persistent Pulmonary Hypertension (PPHN) Managed without Extracorporeal Membrane Oxygenation (ECMO)

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

Persistent pulmonary hypertension (PPHN) is an important cause of neonatal mortality amongst infants who are of term or post-term gestation. The most severely ill...

Original Article

Five Paediatric Case Reports of the Use of Adenosine in Supraventricular Tachycardia

E Koh, I Chan, K Y Wong

Adenosine has been shown to be effective in terminating supraventricular tachycardia in adults and children. However, the use of adenosine has not been previously...

Original Article

Use of Central Venous Lines in Paediatrics—A Local Experience

M C Chua, I LY Chan

Peripheral access by venous cut down, once popular in the 1950s and 1960s, has almost become obsolete with the introduction of the Seldinger technique...

Original Article

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

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

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

Original Article

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

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

In recent years, perinatal drug abuse has been emerging as an area of major concern for the perinatologists. Chasnoff found the prevalence of substance...

Original Article

Changing the Institutional Practice of Prolonged Mechanical Ventilation after Coronary Artery Bypass Graft Surgery to Early Extubation

N C Hwang, S Shankar, B C Ong, C K Leong, E Chin, Y L Chua, Y S Tan, J Ng

In the past, cardiac patients in this institution were ventilated postoperatively for a prolonged period, frequently overnight. Since 1997 some of our cardiac anaesthetists...

Original Article

Parainfluenza Type 3 Viral Outbreak in a Neonatal Nursery

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

Parainfluenza viruses are relatively large RNA paramyxoviruses. Four serologic types cause disease in humans. This article is available only as a PDF. Please click on...

Others

T Wave Alternans and Acute Rheumatic Myocarditis: A Case Report

K S Tan, Y S Lau, W S Teo

T wave alternans, an electrical cardiac alternans in which there is a beat-to-beat variation in the amplitude, shape or the polarity of the T...

Others

The Future of Medicine from the Standpoint of the Practising Paediatrician

H B Wong

From the time of recorded history of medicine, the doctor whether he be the ancient healer or the modern medical practitioner, the doctor had...

Others

Hepatopulmonary Syndrome: A Rare Complication of Chronic Liver Disease in Children

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

Children with chronic liver disorders may present with dysfunction of other organ systems. Encephalopathy, gastrointestinal bleeding, failure to thrive and impaired renal function are...

Original Article

Retinopathy of Prematurity in Very Low Birth Weight Infants

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

Retinopathy of prematurity (ROP), which could lead to visual impairment and blindness, is a recognised serious morbidity amongst surviving premature infants. The inverse relationship...

Original Article

Efficacy of Contraction Uncoupling by 2,3-Butanedione Monoxime during Initial Reperfusion versus Cardioplegic Arrest for Protection of Isolated Hearts

H Habazettl, J Voigtländer, D Mühlbayer

Despite the recent developments of minimally invasive surgery, most cardiac surgery procedures still include ischaemic cardioplegic arrest and cardiopulmonary bypass. For decades the efforts...

Others

Echocardiographic Features and Management of Neonatal Ductal Aneurysm

T H Tan, K Y Wong, J T Heng

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

Others

Primitive Neuroectodermal Tumour of the Chest Wall—A Report of Two Cases and Review of Literature

C M Lim, M J Naik, S B Ng, F K Cheah, T Agasthian

Tumours of the chest wall are uncommon and are usually sarcomatous in nature. Primitive neuroectodermal tumours (PNETs) are rare and are thought to arise...

Original Article

Minimally Invasive Repair of Atrial Septal Defects—A Case Series

M J Naik, Y L Chua

Atrial septal defect (ASD) forms the commonest grown up congenital heart diseases seen in cardiac surgical practice. Repair of this has become so safe...

Original Article

Transaminitis in Duchenne’s Muscular Dystrophy

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

Raised aminotransferase levels, especially that of alanine transaminase (ALT), have been traditionally attributed to liver pathology rather than to muscle disorders. However, raised alanine...

Others

Twenty-four hour, Non-invasive, Neonatal Chromosome Analysis—Application in a Case of Mixed Gonadal Dysgenesis

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

Chromosome analysis in neonates requires venisection and this is sometimes both difficult and distressing. In addition, results can at best take 3 days but...

Others

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

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

Sandhoff disease is a rare inborn error of metabolism characterised by the absence of both β-hexosaminidase A and B, resulting in an accumulation of...

Others

A Case Report on the Perinatal Management of a 30-week Preterm Baby with Congenital Complete Heart Block

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

The association between congenital complete heart block (CHB) and maternal autoimmune disorders has been described for many years. Maternal systemic lupus erythematosus (SLE) is...

Original Article

Cardiopulmonary Exercise Testing in Heart Transplant Candidates

K C Ong, J P Benedicto, A H Chan, Y S Tan, Y Y Ong

Congestive heart failure (CHF) is a leading cause of cardiovascular morbidity and mortality. This syndrome tends to run a chronic course with a wide...

Original Article

Long-Term Outcome of Aortofemoral Bypass for Aortoiliac Occlusive Disease

H Lau, S W K Cheng

The management of aortoiliac occlusive disease has been evolving in the past few decades. Surgical options include aortofemoral bypass, endarterectomy, extraanatomical bypass and endovascular...

Others

Minimal Change Nephrotic Syndrome—A Complex Genetic Disorder

W K Gong, W Cheung, H K Yap

Minimal change nephrotic syndrome (MCNS) is the most common cause of childhood nephrotic syndrome. It is characterised by the presence of gross proteinuria, hypoalbuminaemia,...

Others

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

J A I Weigl

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

Original Article

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

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

Fragile X syndrome is the most common inherited cause of mental retardation, affecting approximately 1 in 1250 males and 1 in 2500 females. It...

Original Article

Initial Experience of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Paediatric Patients

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

Paroxysmal supraventricular tachycardia (SVT) is well-recognised as one of the commonest rhythm disorders in children. There may be few symptoms, but many experience palpitations,...

Letter to the Editor

Paediatric living-donor liver and kidney transplantation during COVID-19

Vidyadhar Padmakar Mali, Marion Aw, Kar-Hui Ng, Sivaramakrishnan Venkatesh Karthik, Michelle Tan, Sharon Teo, Perry Yew-Weng Lau, Yoke Lin Nyo, Dale Ser Kheng Lincoln Loh, Ho Yee Tiong, Seng Hock Quak, Hui-Kim Yap

Dear Editor, The coronavirus disease 2019 (COVID-19) pandemic has impacted global healthcare including paediatric solid organ transplantation (SOT). We report our experience of resuming paediatric...

Letter to the Editor

The evolution of severity of paediatric COVID-19 in Singapore: Vertical transmission and multisystem inflammatory syndrome in children

Olivia Min Yi Leow, Rie Aoyama, Si Min Chan

Dear Editor, Coronavirus disease 2019 (COVID-19) arrived in Singapore in January 2020 as imported cases, followed by local transmission predominantly involving dormitories, with later spread...

Letter to the Editor

Systemic antibiotic prophylaxis for recurrent infective flares in children and adolescents with atopic dermatitis

Yi Shan Ang, Lynette Wei Yi Wee, Mark Jean Aan Koh

Dear Editor, Atopic dermatitis (AD) is a chronic inflammatory skin disease, affecting approximately 20% of children in Singapore.1 It is associated with skin barrier defects2...

Original Article

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

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

Meningitis is an important cause of fever in young infants (infants 90 days old or younger). Most cases of meningitis are acute meningitis which...

Others

Book Review

J S Cheah

The above is a textbook of medicine written by Singapore doctors and published in Singapore. It is difficult not to be over-enthusiastic about it...

Original Article

Abdominal Complications after Cardiac Surgery

S Mierdl, D Meininger, S Dogan, T Aybek, G Wimmer-Greinecker, V Lischke, P Kessler

Despite intensive therapeutic efforts, both the incidence and mortality of gastrointestinal complications after cardiac surgery employing cardiopulmonary bypass (CPB) have not decreased during the...

Review Article

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

D K L Chan

Optimal nutrition is critical in the management of the preterm infant. The fetus in utero receives continuous intravenous nutrition that is interrupted when prematurely...

Original Article

A Case Series of Six Children with Primary Pulmonary Hypertension

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

Pulmonary arterial hypertension (PAH) is an uncommon but serious and debilitating disorder seen in children and adults. By definition, it is an elevation of...

Others

2nd Chapter of Paediatricians Lecture: The Future of Paediatrics in Singapore

C L Tan

When I was first invited to give this 2nd Chapter of Paediatricians Lecture by the Chapter, my obvious answer was no. I could think...

Others

Liver Transplantation in a Child With Severe Hypercholesterolaemia in Alagille Syndrome

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

Alagille syndrome (AS) or arteriohepatic dysplasia is a genetic disorder transmitted in an autosomal dominant inheritance. The chromosomal abnormality has been identified to the...

Original Article

The Use of Vigabatrin in Infantile Spasms in Asian Children

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

Infantile spasms are a form of age-dependent myoclonic epilepsy that is difficult to control. Agents such as adrenocorticotrophic hormone (ACTH) and prednisolone have been...

Original Article

Transesophageal Echocardiography or Fluoroscopy During Port-Access Surgery?

S Mierdl, D Meininger, C Byhahn, T Aybek, P Kessler, K Westphal

Minimally invasive techniques are increasingly being used in cardiac surgery. In particular, coronary artery bypass grafting (CABG) and mitral valve surgery are now often...

Original Article

Paediatric Extracranial Germ Cell Tumours: A Retrospective Review

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

Germ cell tumours (GCTs) in children account for 2% to 3% of childhood malignancies. They arise from primordial germ cells and constitute a heterogeneous...

Original Article

Two-year Outcome of Normal-birth-weight Infants Admitted to a Singapore Neonatal Intensive Care Unit

W B Lian, C L Yeo, L Y Ho

With the rapid advances in the field of neonatal intensive care, the focus of interest has been on the very-low-birthweight (VLBW) infant in recent...

Others

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

L Y Ho

Bronchopulmonary dysplasia (BPD) and chronic lung disease of infancy (CLD) are two chronic pulmonary conditions which are the result of incomplete resolution or abnormal...

Original Article

Intussusception: A Three-Year Review

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

Intussusception is the most common cause of intestinal obstruction in infants and young children. It occurs when one segment of the intestines telescopes into...

Others

Giant Pericardial Lipoma: Unusual Cause of Intrathoracic Mass

S J Vyas, C S Pramesh, S Sharma, R K Deshpande

Cardiac and pericardial lipomas are very rare tumours. They remain asymptomatic for a long time and produce symptoms, if at all, by the virtue...

Others

Severe Newborn Encephalopathy Unrelated to Intrapartum Hypoxic Events: 3 Case Reports

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

Since Little’s article of 1862, it was popularly believed that brain damage in the majority of cases of cerebral palsy occurs during labour and...

Others

A Case Series of Pre-Viable Severe Twin-Twin Transfusion Syndrome

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

Monozygotic twinning has an incidence of approximately 3.5 per 1000 pregnancies. Only 25% of monozygotic twins have a dichorionic placenta. This article is available only...

Others

Idiopathic Chronic Fetomaternal Haemorrhage Resulting in Hydrops – A Case Report

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

Small amounts (<0.1 mL) of fetal blood are commonly found in maternal circulation. Massive fetomaternal haemorrhage (FMH) involves fetal blood loss into the maternal...

Others

Imaging of Paediatric Mediastinal Masses

D P Frush

A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for...

Others

The Relationship Between Scoring Systems and Cytokine Levels in Neonatal Sepsis

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

In newborn infants, the early diagnosis of sepsis is an important problem because the early signs and symptoms of septicaemia in term or preterm...

Original Article

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

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

The enterovirus family causes a wide array of illnesses, some easily recognised clinically and others diagnosed as non-specific viral illnesses. This large family of...

Review Article

Perinatal Care at the Threshold of Viability—From Principles to Practice

L Y Ho

One of the major challenges in neonatal-perinatal medicine in the new century is the optimal management of the mother and infant when delivery is...

Original Article

Eight-year Outcome of Very-low-birth-weight Infants Born in KK Hospital

L M Daniel, S B Lim, L Clarke

The outcome of very-low-birth-weight (VLBW) premature babies with birth weights of <1500 g has remained an area of great concern for both parents and...

Review Article

Long-term Follow-up and Outcome of Extremely-low-birth-weight (ELBW) Infants

P Agarwal, S B Lim

With the progressive improvement in the survival of premature neonates, including those born at the extreme edge of viability, there has been a great...

Review Article

Exogenous Surfactant Therapy in Newborn Infants

G K Suresh, R F Soll

Exogenous surfactant therapy is widely used in the management of neonatal respiratory distress syndrome (RDS) and may have a role in the management of...

Others

The Use and Abuse of Steroids in Perinatal Medicine

V S Rajadurai, K H Tan

Preterm birth, delivery prior to 37 weeks of gestational age, accounts for a major and disproportionate amount of infant and neonatal morbidity and mortality....

Review Article

Mass Newborn Screening in Singapore—Position and Projections

R Joseph

Mass newborn screening is an essential preventative public health programme which aims to diagnose, in the presymptomatic phase, diseases that have a better outcome...

Others

Neonatology In Singapore: The Way We Were, The Way Forward

N K Ho

Over a span of 35 years of my working life, I have witnessed the growth of, and also grown together with, neonatology in Singapore....

Original Article

Chorioamnionitis and Outcome in Extremely Preterm Infants

G Fung, K Bawden, P Chow, V Yu

Preterm delivery is associated with considerable morbidity and mortality, especially among the 1% to 2% infants delivered at less than 32 weeks. Chorioamnionitis is...

Editorial

Challenges in Perinatal Medicine

V S Rajadurai

One of the significant milestones in the perinatal care in Singapore is the birth of the Perinatal Society of Singapore in March 1989. This...

Others

Predicting Significant Hyperbilirubinaemia and Early Discharge for Glucose-6-Phosphate Dehydrogenase Deficient Newborns

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

Glucose-6-phosphate dehydrogenase (G6PD) deficiency occurs in 2.5% of Singapore’s population, and affected newborns are at risk for severe neonatal hyperbilirubinaemia and kernicterus. In the...

Others

Autoimmune Liver Disease in Children

G Mieli-Vergani, D Vergani

Autoimmune liver disorders are inflammatory liver diseases characterised histologically by a dense mononuclear cell infiltrate, including plasma cells, in the portal tract (Fig. 1)...

Others

HIV/AIDS in Children

C Pancharoen, U Thisyakorn

The human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) epidemic in Asia has grown from a handful of cases to a major...

Review Article

Adolescent Health Education Programmes: Theoretical Principles in Design and Delivery

L Sanci, S Glover, C Coffey

Over the past three decades, the patterns of health need in youth have changed. Psychosocial problems such as depression, substance abuse, eating disorders, sexually...

Review Article

Art and “the Language of Well-Being” in Adolescent Health Care

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

Creative processes involve imagining, making unexpected connections, maintaining discipline while letting go of controlling the outcome, opening oneself to pleasure, and moving beyond frustration....

Review Article

From Recreation to Creative Expression: The Essential Features of an Adolescent Inpatient Psychosocial Support Programme

K McFerran-Skewes, S M Sawyer

In 1984, the Royal Children’s Hospital (RCH) in Melbourne, Australia opened a new ward specifically for adolescent inpatients. This initiative was the result of...

Original Article

Adolescent Admissions to a Tertiary Paediatric Hospital: A Dynamic Pattern

P Y Lam, M Yeo, S M Sawyer

The nature of paediatric practice is changing worldwide. In developing countries, infant mortality from infectious diseases continues to fall with improved immunisation, medical care...

Review Article

Clinical Assessment, Management and Outcomes of a Group of Adolescents Presenting with Complex Medico-psychosocial Conditions

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

Increased sensitivity to biological change can make adolescents particularly vulnerable to non-organic symptomatic disorders. A variety of pains, headaches, dizziness and fatigue may remain...

Original Article

Adolescent Chronic Illness: A Qualitative Study of Psychosocial Adjustment

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

Chronic illness during adolescence can have significant psychological and social consequences within many life domains. Growing up with a chronic medical condition presents many...

Review Article

Strategies to Promote Better Outcomes in Young People with Chronic Illnesses

M Yeo, S M Sawyer

The epidemiology of child health in the developed world is changing. Mortality from infectious diseases has fallen sharply over the past century due to...

Review Article

Adolescent Alcohol and Other Substance Use: Sharing the Australian Experience

Y Bonomo

The most common causes of morbidity in adolescence often have behavioural or social determinants, and can have enormous social and economic consequences for adolescent...

Review Article

Sexually Transmitted Infections in Singapore Teenagers

R K W Chan, H H Tan

Adolescence can be a difficult period for many individuals who have to navigate their way through complicated emotional, psychological, physical and social demands and...

Review Article

Eating Disorders in Singapore: A Review

E K Ung

Anorexia nervosa, bulimia and binge-eating disorder are the three best described ‘eating disorders’. All three are predominantly disorders of women with the core symptoms...

Review Article

Youth Suicide and Parasuicide in Singapore

E K Ung

The World Health Organization defines suicide as an act with a fatal outcome that is deliberately initiated and performed by the person himself or...

Original Article

Five-Year Review of Adolescent Mental Health Usage in Singapore

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

The past 20 years have seen much growth in the knowledge of child and adolescent psychiatric practice. Research has provided an improved understanding in...

Others

The Perils of Puberty

K Y Loke, R M Viner

Adolescence is a biopsychosocial maturational process, with the biological changes including completion of linear growth and sexual maturation (puberty), maturation of enzyme systems such...

Editorial

Adolescent Health—A New Perspective in Singapore

K Y Loke

In the past five decades, there have been significant advances in the fields of Paediatrics and Adult Medicine in Singapore. However, the bridging field...

Others

MELAS: A Case Report

B Singh, PS Low, JF Yeo

A 6-year-old Chinese boy presented at the Oral and Maxillofacial Surgery clinic with gingival bleeding due to poor oral hygiene, odontogenic pain due to...

Original Article

Oropharyngeal Carriage and Penicillin Resistance of Neisseria meningitidis in Primary School Children in Manisa, Turkey

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

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

Others

A Case of a Diaphragmatic Rupture Complicated With Lacerations of Stomach and Spleen Caused by a Violent Cough Presenting With Mediastinal Shift

E Kara, Y Kaya, R Zeybek, T Coskun, C Yavuz

Diaphragmatic rupture is a recognised consequence of high-velocity blunt trauma to the abdomen and chest and also has been reported in 0% to 5%...

Review Article

Surgery for Atrial Fibrillation

SL Lim, YL Chua

Atrial fibrillation is the most common sustained cardiac arrhythmia. The overall prevalence of atrial fibrillation is 0.4%. This article is available only as a PDF....

Editorial

Cardiovascular Medicine and Surgery in Singapore: The Next Lap

TSJ Chua, YL Chua

Fourteen years ago, an editorial in the Annals announced the coming of age of cardiology in Singapore. Among the issues raised in that editorial...

Original Article

Deep Hypothermic Circulatory Arrest in Adults Undergoing Aortic Surgery: Local Experience

SY Chong, MYH Chow, DSC Kang, YK Sin, EKW Sim, LK Ti

The use of deep hypothermic circulatory arrest (DHCA) as a method of cerebral protection during aortic surgery was first described in 1975. Its use...

Original Article

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

D Meininger, C Byhahn, D Maeser, S Martens, K Westphal

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

Letter to the Editor

A Fatal Turkish Case of Campomelic Dysplasia

H Çaksen, S Kurtoglu, A Öztürk

Paediatric Medicine (CD) is a rare form of congenital short-limbed dwarfism, classically characterised by campomelia (bowing of the long bones of the lower extremities)...

Original Article

Familial Risk of Allergic Rhinitis and Atopic Dermatitis among Chinese Families in Singapore

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

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

Others

Clinical Report: A Case of Williams Syndrome and Klinefelter Syndrome

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

Williams syndrome (WS) is a rare but well recognised neurodevelopmental disease affecting the connective tissue and the central nervous system. The syndrome was first...

Others

Skin Manifestation of Stenotrophomonas maltophilia Infection – A Case Report and Review Article

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

Stenotrophomonas maltophilia is an aerobic gram-negative bacillus that is found in aquatic environments. It is a frequent coloniser of fluids used in the hospital...

Original Article

Gender Disparity in Paediatric Hospital Admissions

Kam-lun E Hon, Edmund AS Nelson

Gender difference in the incidence of childhood diseases has long been recognised. but the magnitude of this effect and consistency across many disease categories...

Original Article

Study of Inherited Metabolic Disorders in Singapore – 13 Years Experience

It-Koon Tan, Bani Gajra, Maria SF Lim

Inborn errors of metabolism (IEMs) described in the early 1900s by Garrod were due to a block in a metabolic pathway, arising from an...

Original Article

Does Visual Turbidity Correlate With Serum Triglyceride Levels in Babies on Total Parenteral Nutrition?

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

Intravenous lipid infusion is commonly used as part of total parenteral nutrition (TPN) in newborn babies. Upon infusion, it forms an emulsion that resembles...

Original Article

Corticosteroids are not Present in a Traditional Chinese Medicine Formulation for Atopic Dermatitis in Children

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

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease. It has been estimated that 15% of schoolchildren aged 13 to 14 years have...

Original Article

Use of Complementary and Alternative Medicine in Paediatric Oncology Patients in Singapore

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

Complementary and alternative medicine (CAM) has been gaining acceptance throughout the world. The efficacy of CAM is unproven, yet it remains popular with the...

Original Article

The Epidemiology of Paediatric Intussusception in Singapore: 1997 to 2004

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

Intussusception (IS) is the most common cause of intestinal obstruction in infants and young children. The peak age of presentation is 4 to 8...

Others

A Report of Two Families with Sarcosinaemia in Hong Kong and Revisiting the Pathogenetic Potential of Hypersarcosinaemia

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

Sarcosinaemia (OMIN 268900) is an autosomal recessive condition due to the deficiency of sarcosine dehydrogenase (E.C. 1.5.99.1). It is a rare condition with an...

Others

Neonatal Priapism Associated With Spontaneous Bilateral Pyocavernositis

Rajeev Sood, Surender Nath Wadhwa, Vikas Jain

Priapism is a pathological state of prolonged, generally painful erection, unassociated with sexual desire and not ending in ejaculation. Rare before the 1980s, this...

Editorial

Paediatrics to Geriatrics: The Continuum

Hui-Kim Yap

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

Original Article

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

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

Severe acute respiratory syndrome (SARS) is a newly emerged atypical pneumonia caused by the SARS-associated coronavirus (SARS-CoV). It is easily transmitted via droplet infection...

Review Article

A Rotavirus Vaccine for Infants: The Asian Experience

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

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

Editorial

Therapeutic Hypothermia for Neonatal Hypoxic-Ischaemic Encephalopathy

VS Rajadurai

Hypoxic-ischaemic encephalopathy (HIE) is an important cause of death and later neurological disability in full-term neonates worldwide. Perinatal asphyxia causes about 19% of the...

Others

Outcome of Organic Acidurias in China

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