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

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

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

Global monkeypox outbreak 2022: First case series in Singapore

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

The global emergence of monkeypox

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

Response to letters arising from publication of the Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting

Dear Editor, The Academy of Medicine, Singapore (AMS) guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting and an...

Sedation in gastrointestinal endoscopy in Singapore

Dear Editor, I refer to the editorial “Ensuring safe sedation during gastroendoscopy”1 and the original article “Academy of Medicine, Singapore clinical guideline on the use...

Non-anaesthesiologists administering propofol in the Singapore context

Dear Editor, Propofol is a potent intravenous sedative-hypnotic agent. Its popularity for sedation has increased in the last 3 decades because of its smooth, rapid...

Sedation by non-anaesthesiologists in gastrointestinal endoscopy

Dear Editor, We read with interest the paper by Ang et al.1 on Singapore guidelines in the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy...

Perception of disease, well-being and financial burden by patients with chronic hepatitis B: A self-reported assessment

Dear Editor, Chronic hepatitis B (CHB) infection affects approximately 248 million individuals in the world1 and 3.6% of the Singapore population.2 Given the natural history...

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

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

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

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

Glaucoma Pattern Amongst the Elderly Chinese in Singapore

Glaucoma is a major cause of world blindness in developing and developed nations. The WHO Global data on blindness show that over half of...

The Sixth SGH Lecture—Singapore: A New Venice of the 21st Century

Venice is one of the legendary cities of the world. Its beauty and physical setting make Venice unique. For almost 800 years, from 1000...

Patients Admitted to an Intensive Care Unit for Poisoning

The study of poisoning has been relatively neglected in Singapore. A check through the Infogate database of the National University of Singapore Library revealed...

A Case Series of Paget’s Disease of Bone: Diagnosing a Rather Uncommon Condition in Singapore

Sir James Paget’s description in 1877 of “a form of chronic inflammation of bones” which now bears his name was based entirely on clinical...

Are Antacids Necessary as Routine Prescriptives with Non-steroidal Anti-inflammatory Drugs?

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Medicine and Surgery—History, Change and Challenge

Mr Koh Yong Guan, guest-of-honour; Dr Tan Ser Kiat, Master, Academy of Medicine; Dr K C Tan, Chairman, Chapter of Surgeons; Dr Robert Jalleh...

Current Continuing Medical Education Provision in Singapore

It was in 1994 that as an overseas fellow of the College, I received a letter from Dr Peter Toghill, Director of Continuing Medical...

Early 21st Century Professional Practice: Change and Challenge

Today is a day of rejoicing for all of you, graduates, parents, relatives and loved ones. I can share in your joy and also...

One-year Review of Pityriasis Rosea at the National Skin Centre, Singapore

Pityriasis rosea is a common, self-limited disorder of unknown but suspected viral aetiology, that develops abruptly with few or no prodromal symptoms. Classically, the...

New Treatment and Research Strategies for the Improvement of Care of Cleft Lip and Palate Patients in the New Millennium

I have chosen as the title of my keynote address “New Treatment and Research Strategies for the Improvement of the Care of Cleft Lip...

Diagnosing and Managing Faecal Incontinence

Faecal incontinence is the inability to control the passage of gas, liquid or solid through the anus. Its severity varies from infrequent passage of...

Magnetic Resonance Cholangiopancreatography: Value of Using the Half-Fourier Acquisition Single-Shot Turbo Spin-Echo (HASTE) Sequence

Direct cholangiopancreatography has long been considered the standard of reference for assessment of the biliary tree and is generally safe, reliable and widely available....

Young Investigator’s Award: Induction of Apoptosis Following Traumatic Head Injury in Humans

The outlook for sufferers of severe head trauma is extremely poor. Some 20% of patients died before significant treatment can be administered, and nearly...

8th Seah Cheng Siang Memorial Lecture: New Antithrombotic Agents

The tremendous interest in finding new anti-aggregating agents stems from the preeminent role that platelets play, not only in haemostasis and thrombosis, but also...

3rd Yahya Cohen Lecture: The Role of the Myofibroblast-Like Cell in Hepatocellular Carcinoma—Host Defence?

It is indeed a great honour for me to be named the third Yahya Cohen lecturer and I would like to express my deepest...

9th Chapter of Surgeons’ Lecture: The Orthopaedic Surgeon: Historical Perspective, Ethical Considerations and the Future

The legacy of caring and humanitarianism has been the mission of the medical profession since the founding of Singapore by Sir Stamford Raffles in...

1998 Distinguished Academician Lecture: Hepatic Resection— A Western Perspective

Although debridement of portions of liver that prolapsed through war wounds was recorded from distant times, attempts at resection of a solid liver tumour...

1998 Runme Shaw Memorial Lecture: Somatic Evolution of Cancer

The interpretation of cancer as a somatic evolutionary process involving genetic mutation followed by selection, goes back to the early years of this century....

14th Gordon Arthur Ransome Oration: Continuity and Change

Deputy Prime Minister Lee Hsien Loong, Datuk Dr Yeoh Poh Hong, Dr Chee Yam Cheng, distinguished guests, ladies and gentlemen, I am deeply honoured...

The Future of Medicine from the Standpoint of the Practising Paediatrician

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

Standard Oesophageal Manometry in Healthy Adults in Singapore

Although standard oesophageal manometry has been widely used in the West for many years, normal manometric values that have been well described for healthy...

Gut Barrier Dysfunction in Experimental Acute Pancreatitis

Bacterial infections are devastating and potentially lethal complications of acute pancreatitis, responsible for up to 80% of deaths in the condition. Pathogenetic studies of...

Experimental Models of Pancreatitis

From a historical perspective, the first experimental pancreatitis was induced by Claude Bernard in 1856 by the injection of bile and olive oil into...

Experimental Models of Hepatic Fibrosis in the Rat

Hepatic fibrosis and cirrhosis of the liver are complex diseases which, in man, may be caused by such varied factors as alcohol, hepatitis, schistosomiasis,...

Development of the Human Intrahepatic Biliary System

The development of the human biliary system has been studied extensively. This knowledge is essential to the understanding of the pathogenesis of a spectrum...

Experimental Study of Hypovolaemic Shock-Induced Gastric Mucosal Lesions in the Rat

Hypoxic tissue injury is not only caused by lack of oxygen as was previously believed. Now it is clear that tissue injury associated with...

The Role of Mast Cell Degranulation in Ischaemia-reperfusion-induced Mucosal Injury in the Small Intestine

Although a number of data support the notion that mast cell (MC) degranulation Is an important component of the tissue response elicited by ischaemia-reperfusion,...

Direct Mucosal Targeting of Colonic Receptors by Prokinetic Drugs in an Experimental Model

The direct intraluminal (IL) administration of drugs into the intestine may have an important regional action and therefore clinical implications in the effective management...

Cross-Sectional Study of Near-work and Myopia in Kindergarten Children in Singapore

Myopia is the commonest eye disease worldwide, and is especially prevalent in certain Asian countries such as Taiwan, Japan and Hong Kong. Physiologic myopia...

Granuloma Annulare: A Review of 41 Cases at the National Skin Centre

Granuloma annulare (GA) is a benign, inflammatory disorder of the skin that has no proven aetiology or widely accepted theory of pathogenesis. There are...

Antineutrophil Cytoplasmic Antibodies (ANCAs) in Patients with Inflammatory Bowel Disease Show No Correlation with Proteinase 3, Lactoferrin, Myeloperoxidase, Elastase, Cathepsin G and Lysozyme: A Singapore Study

The diagnostic tests currently employed to diagnose inflammatory bowel disease (IBD) and to differentiate between Crohn’s disease (CD) and ulcerative colitis (UC) are both...

Address by the Master, Academy of Medicine, Singapore at the 2000 Annual Induction Dinner—Learn the Past, Ensure the Future

I am delighted to share this celebratory occasion with you. It is a time for congratulations all round not only to our new Fellows...

Response by the Representative of Inductees, Academy of Medicine, Singapore at the 2000 Annual Induction Ceremony—A Call to Patient Advocacy

I count myself fortunate to be allowed to join the ranks of the Academy. On behalf of my fellow inductees, may I extend a...

Address by the Master, Academy of Medicine, Singapore at the 2000 Annual Induction Ceremony—The EQ & IQ of Specialist Doctors

First, let me warmly welcome you to this pristine auditorium with its well preserved ceiling architectural details. Probably none of the new Fellows is...

8th SGH Lecture: Genomics, Talent and the Development of the Life Sciences Industry in Singapore

In a few months’ time, one of the most significant advances, possibly the most significant advance ever in the history of biology and medicine,...

Myopia: Gene-environment Interaction

Myopia affects up to 70% of adults in Singapore, Taiwan, Hong Kong and Japan. The prevalence rates in these Asian countries are higher than...

3rd Tan Tock Seng Hospital Oration: The Changing Fabric of Medicine—An Ethical and Social Revolution

The legacy of Tan Tock Seng Hospital began with the founding of the Pauper Hospital in Pearl’s Hill in 1844. This article is available only...

Management of Growth Arrest with Tissue-engineered Cells

Before I go on to the scientific aspects of my talk, I would like to pay tribute to Dr Yahya Cohen. Dr Cohen was...

Incidence of Ischaemic Heart Disease and Stroke in Chinese, Malays and Indians in Singapore: Singapore Cardiovascular Cohort Study

Comparisons of disease frequency in different ethnic groups help to unravel the contributions of nature and nurture in their aetiology and to identify environmental...

10th Chapter of Surgeons’ Lecture: The Challenges in Surgery—Past, Present and Future, and in Search of the 4Cs

Firstly may I thank the Academy of Medicine and the Chapter of Surgeons for giving me this great privilege and honour to deliver the...

Opening Address by Dr Chee Yam Cheng, Master, Academy of Medicine, Singapore at the 33rd Annual Combined Surgical Meeting on 4 November 1999 at the COMB Auditorium

It is a pleasure to be present with you all at your 33rd Annual Combined Surgical Meeting for 1999 with less than 60 days...

Pseudomembranous Colitis in a Patient Treated with Paclitaxel for Carcinoma of the Breast: A Case Report

Paclitaxel was discovered in 1963 as a crude extract from the bark of the pacific yew Taxus brevifolia. Since its development, a range of...

Early Hepatocellular Carcinoma Presenting with Biliary Ductal Invasion—A Case Report

Hepatocellular carcinoma (HCC) is a common malignant tumour worldwide. The local incidence of HCC is 40 per 100,000 in males and 20 per 100,000...

Survival of Colorectal Cancer Patients in Singapore by Anatomic Subsite: A Population-based Study

Colorectal cancer incidence rates rank second in most developed countries and have been rising rapidly in urban societies of East Asia. Despite much effort...

Funding and Future Diagnosis Related Group Development

Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore This article is available only as a PDF. Please click on “Download...

Clinical Pathways or Case Management

Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore This article is available only as a PDF. Please click on “Download...

Getting Clinicians Involved: The Australian Experience

Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore This article is available only as a PDF. Please click on “Download...

Shigella Septicaemia in Adults: Report of Two Cases and Mini-Review

Shigellosis is generally considered to be confined to the gastrointestinal tract. Septicaemic infections with Shigella species are extremely rare in adults. This article is available...

Psychiatric Illness, Personality Traits and the Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder seen by gastroenterologists and has been found to account for 50% of referrals...

The 4th Tan Tock Seng Hospital Oration: Challenge for the Medical Profession in the 21st Century

I am greatly honoured to speak at the 4th TTSH Oration following such distinguished luminaries like Dr Chew Chin Hin, Dr Chen Ai Ju...

Clinical Update on Helicobacter pylori

Helicobacter pylori is one of the commonest infections in human, affecting 30% to 50% of people worldwide. It is associated with the development of...

Perioperative Treatment with Bactericidal/Permeability-Increasing Protein (rBPI21) in Major Liver Surgery: A Concise Summary

Primary and secondary hepatic malignancies constitute a major health problem. Hepatocellular carcinoma accounts for 90% of all primary hepatic malignancies in the world. While...

Alternate Modes of Financing Health Care Technology

Alternative financing of health care delivery is one of the most vexing problems facing medicine today. Intensive care in many ways is a perfect...

Book Review

The third edition of this manual of gastroenterology by regional experts from Malaysia and Singapore consists of 27 short chapters packaged in 2 sections...

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

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

10th Seah Cheng Siang Memorial Lecture: Going Places—A Rheumatological Odyssey

I am greatly honoured to deliver the 10th Seah Cheng Siang memorial lecture. I came into direct contact with Professor Seah in January 1965...

5th Yahya Cohen Lecture: Angiosomes and Extension of Skin Flaps—Anatomic Study and Clinical Implications

I would like to express my gratitude to the Chapter of Surgeons and the Academy of Medicine, Singapore for the honour of presenting this...

11th Chapter of Surgeons Lecture—The Art of Letting Go

These observations were made by a Persian mathematician some 900 years ago. His sentiments are self-evident but no less easy to accept especially for...

15th Gordon Arthur Ransome Oration: A Journey of Care—Mission Impossible?

I am deeply honoured by the invitation to deliver the 15th Sir Gordon Arthur Ransome Oration. This article is available only as a PDF. Please...

The Runme Shaw Memorial Lecture 2000—Treating VIPs in Washington

My lecture is about people, power, illness, and the patient-physician relationship. It is the personality of the politician or official, the ego elevation conferred...

12th Chapter of Surgeons Lecture: Shifting Paradigms in the Management of Breast Cancer—A Surgical Perspective

The recorded history of breast cancer management spans four millennia. This story about breast cancer management is also one about change, about resistance to...

5th Tan Tock Seng Hospital Oration: Advances for Life

I am honoured and privileged to have been invited to deliver the 5th Tan Tock Seng Hospital (TTSH) Oration at the Opening of your...

6th Yahya Cohen Lecture: Visual Experience During Cataract Surgery

What a patient can see during his or her surgery can be a cause of anxiety for the patient. It may cause additional stress...

Sexually Transmitted Diseases in the Older Population in Singapore

Sexually transmitted diseases (STDs) in persons older than 50 years are rarely studied because STDs are more common in young people. There is very...

Current Status in the Surgical Management of Adult Polycystic Liver Disease

Adult polycystic liver disease (APLD) is a rare benign condition that is characterised by the growth of multiple cystic lesions in the liver. More...

Paediatric Extracranial Germ Cell Tumours: A Retrospective Review

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

Bullous Pemphigoid Seen at the National Skin Centre: A 2-year Retrospective Review

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disorder affecting mainly the elderly. It is characterised by autoantibodies to the basement membrane zone (BMZ),...

Clinical Update on Osteoporosis

Fractures, the most serious complication of osteoporosis, are increasing and constitute an evolving public health problem in terms of disability, mortality and cost. A...

An Asian Perspective to the Problem of Osteoporosis

Osteoporosis is regarded as an important public health problem in many Caucasian populations. Much of the research on epidemiology, diagnosis, treatment, genetic and molecular...

Is Healthcare Competition Healthy?

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

Boerhaave’s Syndrome Presenting as a Right-sided Pleural Effusion

A 79-year-old Chinese woman with no significant past medical history was admitted to another hospital with symptoms of abdominal pain and haemetemesis of approximately...

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

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

Modern Management of Colorectal Polyps: Are They All Premalignant?

Polyps of the colon and rectum are relatively common lesions. Most colorectal polyps are either adenomas or hyperplastic polyps. This article is available only as...

Significance of the Lateral Epiphysis of the Acetabulum to Hip Joint Stability

Developmental dysplasia of the hip (DDH) remains one of the most difficult disorders to understand and treat in Paediatric Orthopaedics. The aetiology have not...

Craniofacial Anomalies: Clinical and Molecular Perspectives

Cleidocranial dysplasia is an autosomal dominant skeletal disorder characterized by short stature, brachycephaly, delayed closure of the fontanelles and sutures, Wormian bones, midface hypoplasia,...

Autoimmune Liver Disease in Children

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

HIV/AIDS in Children

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

Patterns and predictors of sound levels in hospital rooms

Dear Editor,      Excessive sound levels in the hospital can impair the work performance of healthcare professionals and affect patient well-being.1 Previous studies have also...

Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting

The practice of gastrointestinal (GI) endoscopy over the last 3 decades has seen both a rise in volume of routine procedures, and an increase...

The impact of deprescribing interventions on oral proton pump inhibitor utilisation in a Singapore tertiary hospital: A quality improvement initiative

The established efficacy of proton pump inhibitors (PPIs) in the treatment of upper gastrointestinal (GI) disorders, coupled with their perceived safety, have led to...

Ensuring safe sedation during gastroendoscopy

Gastrointestinal (GI) endoscopy started in Singapore in 1968 with diagnostic endoscopic gastric examination, using flexible fibre-optics GI endoscopy. Fibre-optic flexible sigmoidoscopy and colonoscopy were...

Inflammatory Fibroid Polyp of the Caecum in a Patient with Neurofibromatosis

Inflammatory fibroid polyp is an uncommon nonneoplastic lesion found in the gastrointestinal tract. It is a benign, non-encapsulated submucosal lesion, composed mainly of loose...

Inaugural College of Obstetricians & Gynaecologists Lecture: Recent Developments in Obstetric Care and Maternal Fetal Medicine in Singapore

Has it done any good to pregnancy outcome as promised? This article is available only as a PDF. Please click on “Download PDF” on top...

Citation on Dr Andrew Chew Guan Kuan for Admission to Honorary Fellowship on 19 August 2004

It is indeed a great pleasure and honour to present to you Dr Andrew Chew Guan Khuan, who is already a Fellow of the...

Citation on Sir Donald Irvine – 17th Gordon Arthur Ransome Orator

It is my pleasure and privilege to introduce Sir Donald Irvine as the 17th Gordon Arthur Ransome Orator. This article is available only as a...

Address by Master, Academy of Medicine, Singapore at the Opening Ceremony of the 38th Singapore-Malaysia Congress of Medicine and Induction Ceremony

It is my pleasure to welcome you to the Opening Ceremony of the 38th Singapore-Malaysia Congress of Medicine with participation of the Hong Kong...

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

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

15th Chapter of Surgeons Lecture: Surgeon of the New Millennium – Surgeon, Scientist and Scholar

Next year, we celebrate a hundred years of medical education in Singapore. We have come a long way since 1821 – from a small,...

Standards and Revalidation or Recertification

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

Continuing Professional Development – a Surrogate for Recertification?

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

Teaching and Learning of Professionalism in Medical Schools

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

The Challenge of Teaching Professionalism

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

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

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

17th Gordon Arthur Ransome Oration: Patient-centred Professionalism

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

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

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

Flap Prefabrication – The Bridge Between Conventional Flaps and Tissue-engineered Flaps

Flap prefabrication is one of the most exciting areas in Plastic Surgery because of its bridging role between conventional reconstructive surgery and tissue engineering....

Behcet’s Disease: Experience in a Tertiary Rheumatology Centre in Singapore and a Review of the Literature

The only published study on Behcet’s disease in Singapore by Tan E et al (34 patients at the National Skin Centre) found that only...

Appropriateness of the Use of Parenteral Nutrition in a Local Tertiary-Care Hospital

Parenteral nutrition (PN) is an important supportive and often life-saving therapy for patients with gut failure. However, it is expensive and carries significant complications...

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

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

14th Chapter of Surgeons Lecture: Back to Basics

I am happy to be among old friends. As surgeons, we share a kindred spirit. I wish to thank the Academy for the honour...

Twin Births in Singapore: A Population-Based Study Using the National Birth Registry

Twin studies are regarded as one of the better ways to study the effects and significance of gene, environment and interactions of both. The...

3rd College of Physicians’ Lecture – Translational Research: From Bench to Bedside and From Bedside to Bench; Incorporating a Clinical Research Journey in IgA Nephritis (1976 to 2006)

In our quest to pursue knowledge regarding a patient’s illness or seek a cure for the disease, as doctors we have to derive the...

16th Seah Cheng Siang Memorial Lecture – The Changing Face of Cardiology Practice, Training and Research in Singapore

Professor Seah Cheng Siang was one of the most illustrious physicians of his era. During his professional career, he held the following positions: Head,...

Eye Injuries in Singapore – Don’t Risk It. Do More. A Prospective Study

The issue of ophthalmic trauma is a major cause for concern. An estimated 55 million eye injuries occur each year worldwide, leaving 1.6 million...

3rd FY Khoo Memorial Lecture – Education, Professionalism, Outsourcing and the Future of Radiology

Radiology is undergoing unprecedented changes. Not only is the technology evolving rapidly, providing images of breathtaking anatomical clarity, but functional information has also become...

A Bolt Out of the Blue: A Case of Unexpected Acute Liver Failure

Acute hepatitis could result from viral, autoimmune or drug-reaction causes, among others. In areas endemic with hepatitis B, acute exacerbations of chronic hepatitis B...

Community-associated Methicillin-resistant Staphylococcus aureus: Overview and Local Situation

The emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA) isolates from the community that are distinct from their archetypal healthcare-associated counterparts (HA-MRSA) marked a...

Modelling the Utility of Body Temperature Readings From Primary Care Consults for SARS Surveillance in an Army Medical Centre

There has been increasing interest in building surveillance systems capable of detecting outbreaks of infectious diseases, at the stage where clinical presentation would still...

Does the Advent of Endoscopic Ultrasound (EUS) Sound the Death Knell for Endoscopic Retrograde Cholangiopancreatography (ERCP)?

Endoscopic retrograde cholangiopancreatography (ERCP) has been the primary method of diagnosing and treating many pancreatic and biliary diseases (PBD) over the last 3 decades....

10th Yahya Cohen Memorial Lecture: Clinical Predictors in Obstructive Sleep Apnoea Patients with Computer-assisted Quantitative Videoendoscopic Upper Airway Analysis

Obstructive sleep apnoea (OSA) is a common disease, which is estimated to affect up to 2% of middle-aged women and 4% of middle-aged men.1...

Re-defining Neurological Syndromes: The Genotype Meets the Phenotype

Since time immemorial, generations of medical students and physicians have always been taught that a thorough and detailed history and examination is the foundation...

New Treatments for Atopic Dermatitis – Facts, Comparisons and Uncertainties

Atopic dermatitis is associated with asthma and allergic rhinitis, and presents with a typical morphology and distribution. Eighty-four per cent of cases of atopic...

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

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

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

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

Hepatitis B Virus Infection and the Risk of Coronary Atherosclerosis

Coronary artery disease (CAD), also called coronary heart disease, is the leading cause of death for both men and women. CAD is usually caused...

Ceftriaxone-resistant Salmonella spp. in Singapore

The utility of ceftriaxone for the treatment of Salmonella typhi bacteraemia was first demonstrated in Singapore as early as 1985. Since then, ceftriaxone has...

Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme

Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM)...

Ten-year Series of Splenic Abscesses in a General Hospital in Singapore

Splenic abscess is an uncommon clinical problem. Fewer than 800 cases have been reported in the literature. This article is available only as a PDF....

Brachytherapy – One Man’s Meat, A Personal Journey in Radiation Oncology

Dr Tan Kim Ping, Chairman for the Dr FY Khoo Memorial Lecture, Ladies and Gentlemen – It is a signal honour for me to...

Retinal and Cardiovascular Diseases: The “Common Soil” Theory

There is increasing evidence that retinal and cardiovascular diseases share a “common soil”. Risk factors for cardiovascular disease, such as hypertension, diabetes, hyperlipidaemia and...

4th FY Khoo Memorial Lecture 2008: Nasopharyngeal Cancer Workgroup – The Past, The Present and The Future

Thank you Madam Chairman. First, I would like to thank the Singapore Radiological Society and the College of Radiologists, Academy of Medicine Singapore for...

3rd College of Paediatrics and Child Health Lecture – The Past, the Present and the Shape of Things to Come…

In the post-war days of the 1950s, Singapore children were faced with problems of malnutrition and infectious diseases. There was poverty, overcrowded housing and...

Charity Colonoscopy Event to Commemorate the 185th Anniversary of Singapore General Hospital

Colorectal cancer is now the cancer with the highest incidence in Singapore. Similar to many developed countries, individuals here have a moderate to high...

The Role of Electrophysiology in the Diagnosis and Management of Cervical Spondylotic Myelopathy

Cervical spondylosis is an extremely common condition managed by both physicians and surgeons in daily clinical practice. Cervical spondylotic myelopathy (CSM), resulting from longstanding...

Demands and Challenges of Modern Medicine

I am deeply honoured by the invitation to deliver the 16th Tun Dr Ismail Oration and I wish to thank the Master and Council...

Happenings in Histopathology – A Post-World War II Perspective

During the past few decades, there have been many significant developments in the practice of histopathology, the specialty that is also referred to as...

Survival of Small-cell Lung Cancer and its Determinants of Outcome in Singapore

Lung cancer is the leading cause of cancer mortality around the world.1 Small-cell lung cancer (SCLC) constitutes about 15% to 25% of all lung...

Lack of Awareness amongst Community Patients with Diabetes and Diabetic Retinopathy: The Singapore Malay Eye Study

Diabetes is a major public health problem, and diabetic retinopathy is the leading cause of blindness in working-aged people.1 Previous studies have documented poor...

Tumour Interstitial Fluid Pressure May Regulate Angiogenic Factors in Osteosarcoma

Solid tumours have states of raised interstitial fluid pressure (IFP) that cause significant changes to their physiology.1-3 We have previously shown that human osteosarcomas...

Surgical Training – The Challenge of Change

President of the College of Surgeons, distinguished guests, friends, ladies and gentlemen. It is a great honour and a unique privilege for me to...

Preparedness for Terrorism: Managing Nuclear, Biological and Chemical Threats

Preparedness for terrorism in the 21st century includes addressing the management of nuclear, biological and chemical (NBC) terrorism events. Understanding the terrorist threat and...

Pain Prevalence in Singapore

Population studies on pain prevalence are useful in determining the impact that chronic pain has on the society. It draws the attention of healthcare...

An Update of Paediatric Intussusception Incidence in Singapore: 1997-2007, 11 Years of Intussusception Surveillance

This is an update to the previously published paper by Boudville et al1 on 8 years of intussusception (IS) surveillance in Singapore. IS is...

5th College of Surgeons Lectureship: Surgery beyond Scalpels

The training of surgeons composed of two aspects: (1) Clinical skill and competence; (2) The ‘soft’ skill and ‘art’ of surgery. With the gradual...

The Evolution of Radiology from Paraclinical to Clinical

I would like to thank the Academy of Medicine and the Singapore Radiological Society for giving me the honour of delivering this year’s F...

Venous Thromboembolism at the National Healthcare Group, Singapore

Venous thromboembolism (VTE) is a potentially fatal disease which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). About 30% of patients with VTE...

Evaluation on the Effectiveness of the National Childhood Immunisation Programme in Singapore, 1982-2007

Singapore has a comprehensive National Childhood Immunisation Programme (NCIP) which first covered smallpox (1862), followed by diphtheria (1938), tuberculosis (TB) (1957), poliomyelitis (1958), pertussis...

Guidelines for Endoscopic Ultrasonography

This guideline addresses the use of endoscopic ultrasound (EUS) as part of the diagnostic evaluation of certain conditions. In addition, issues of training and...

Outbreak of Novel Influenza A (H1N1-2009) Linked to a Dance Club

Influenza A (H1N1-2009) is a novel strain of influenza virus. The infection is thought to have first occurred in Mexico in March 2009, and...

An Epidemiological Study of 1348 Cases of Pandemic H1N1 Influenza Admitted to Singapore Hospitals from July to September 2009

On 17 April 2009, the US Centers for Disease Control (CDC) determined that febrile respiratory illness occurring in 2 children residing in adjacent counties...

Outbreak of Pandemic Influenza A (H1N1-2009) in Singapore, May to September 2009

The first cases of infection with a novel influenza A (H1N1) strain were reported in 6 cases in California and 2 cases in Texas...

3rd College of Surgeons Lecture — Bringing up Surgeons

I am greatly honoured to be given the privilege of delivering the 3rd College of Surgeons Lecture, especially when I have retired from surgery...

Prevalence of Metabolic Syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions and their Association with Coronary Heart Disease in an Elderly Iranian Population

Coronary heart disease (CHD) is one of the most common causes of morbidity and mortality in different communities.1,2 Despite the lack of accurate data,...

Diagnostic Challenge: A 79-Year-Old Woman with Calcified Lower Abdomen Mass

A 79-year-old woman presented with fever, diarrhoea, vomiting and abdominal pain for several hours. Her temperature was 39.2°C, pulse 102 beats/minute, respiratory rate 19...

12th Yahya Cohen Memorial Lecture – The Cellular and Molecular Basis of Radiation-induced Sensori-neural Hearing Loss

Radiation-induced sensori-neural hearing loss (SNHL) has long been recognised as a complication of radiotherapy (RT) for head and neck tumours, if the auditory pathways...

11th Yahya Cohen Memorial Lecture – An In vivo Comparative Study of the Ability of Derived Mesenchymal Stem Cells in the Treatment of Partial Growth Arrest

It has been my greatest pleasure and honour to accept this, the 11th Yahya Cohen Memorial Lectureship on the anniversary of a half century...

Laparoscopic Common Bile Duct Exploration: Our First 50 Cases

Since its introduction a few decades ago, endoscopic retrograde cholangiopancreatography (ERCP) has brought about a significant change in the management of choledocholithiasis. With continual...

Peutz-Jeghers Syndrome: Data from the Singapore Polyposis Registry and a Shifting Paradigm in Management

Peutz-Jeghers Syndrome (PJS) is an uncommon autosomal dominant hamartomatous polyposis syndrome associated with mucocutaneous melanocytic macules. Melanin deposition occurs most commonly in the perioral...

Thrombocytopenia and its Related Factors: A Hospital-based, Cross-sectional Study

Thrombocytopenia is a common clinical problem found in laboratory results during health examinations. Blood platelets play an essential role in haemostasis, thrombosis and coagulation...

Challenges and Pitfalls in the Introduction of Pharmacogenetics for Cancer

Pharmacogenetics, by definition, refers to the study of genetic differences in metabolic pathways which can affect an individual’s responses to drugs in terms of...

7th College of Physicians Lecture — The Changing Face of Medicine, Medicine – Past, Present and Future

When we think about medicine, just like we do about other things in life in the past and the present, we usually reflect on...

15th Yahya Cohen Memorial Lecture – The Relationship between the Air-bone Gap and the Size of Superior Semicircular Canal Dehiscence

Superior semicircular canal dehiscence (SSCD) can result in a characteristic constellation of vestibular and auditory features, including autophony, oscillopsia, and vertigo, and characteristic eye...

5th Chao Tze Cheng Memorial Lecture—Recent Developments in Informed Consent

The question of informed consent is a concern of recent origin and has engaged the mind of the medical profession here for only some...

7th Tan Tock Seng Oration: Surgical Excellence at TTSH—100 Years on and onward

Mr SR Nathan, our guest of honour, Mr Gan Kim Yong, Minister for Health, Madam Kay Kuok, Chairman of NHG Board, Board members, colleagues,...

8th FY Khoo Memorial Lecture 2012 —Why Radiologists Need Philosophy

Firstly, I wish to thank the Singapore Radiological Society and the College of Radiologists, Singapore for deeply honouring me with the invitation to give...

Policy Implications of The Singapore Mental Health Study

Mental health issues have taken on greater importance with the growing awareness among policy makers of the importance of mental health for the development...

6th College of Surgeons Lecture The Philosophy of Balance: The Art of Healing

With the rise of high tech medicine, and emphasis on the scientific aspects of medicine, there is danger that we may lose the balanced...

2013 Runme Shaw Memorial Lecture: Clinical Applications of Stem Cells in Modern Medicine—21st Century and Beyond

The rapid advancement of biomedical research in the recent years was propelled by a series of groundbreaking technological inventions and breakthrough discoveries. In this...

22nd Gordon Arthur Ransome Oration: Is Medicine Still an Art?

Distinguished guests and colleagues in medicine, I am deeply honoured to have been invited to deliver this 22nd oration in honour of Sir Gordon...

Fasting during Ramadan and Associated Changes in Glycaemia, Caloric Intake and Body Composition with Gender Differences in Singapore

Muslim individuals worldwide participate in obligatory abstinence from oral consumption of medications, food and liquid during the fasting month of Ramadan. Fasting during Ramadan...

Assessment of Age in Ulcerative Colitis Patients with Ileal Pouch Creation—An Evaluation of Outcomes

A total proctocolectomy is considered the standard of care in patients with ulcerative colitis (UC). The indications for this operation in patients with UC...

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

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

24th Seah Cheng Siang Lecture: Seeing Better, Doing Better—Evolution and Application of Gastrointestinal (GI) Endoscopy

Man’s innate curiosity to study the internal organs of the human body dates back to the time of Hippocrates where basic speculums were invented...

Impact of unemployment on mental disorders, physical health and quality of life: Findings from the Singapore Mental Health Study

Several reviews and meta-analyses have established an association between unemployment and psychological distress. This relationship between unemployment and mental health is complex and likely...

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)...

Health-seeking behaviour of foreign workers in Singapore: Insights from emergency department visits

Singapore employs a large foreign worker (FW) population, defined as non-Singapore citizens and non-permanent residents working locally. Holders of “work permit” (WP), the work...

Accuracy of self-reported height, weight and BMI in a multiethnic Asian population

Overweight and obesity continue to be one of the most critical public health issues worldwide. Body mass index (BMI) derived from height and weight...

Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry

Ophthalmic cancers are commonly encountered in clinical practice and are an important cause of morbidity and mortality. Globally, the incidence of ophthalmic cancers have...

COVID-19 and Singapore: From Early Response to Circuit Breaker

The COVID-19 pandemic first broke out in Wuhan, China, in December 2019, where a cluster of pneumonia cases was reported and the novel coronavirus...

Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children

Singapore confirmed its first case of COVID-19 on 23 January 2020 in a Chinese national from Wuhan, and its first paediatric case on February...

Coronavirus Disease 2019 (COVID-19): The Singapore Experience. A Review of the First Eight Months

Singapore reported its first imported case of COVID-19 on 23 January 20201 and its first COVID-19 deaths on 21 March 2020.2 The WHO declared...