Dear Editor, During the Ministry of Health workplan seminar held on 2 June 2022, Minister Ong Ye Kung expounded the notion of a good death and outlined the Ministry’s vision and strategy for better care (and experience) for all near the end of life.1 Specifically, he aimed to reduce the...

Telemedicine is the use of telecommunication technologies to provide medical information and healthcare services. Early applications include medical use of the telephone and facsimile. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

There has been a rapid increase in clinical trial activity in Singapore and other parts of Asia. Randomised clinical trials are the “gold standard” in study design, which enable the question of efficacy of different treatments or managements to be effectively compared. This article is available only as a PDF....

A syndrome of total functional dependence, poor mobility, lack of meaningful communication and incontinence of bowels and bladder appears to be the final common pathway for many neurodegenerative conditions such as the dementias, Parkinson’s disease (PD) and motor neurone disease (MND). In the United States, the National Hospice Organisation...

Health-related quality of life (QOL) is recognised as an important aspect of patient care. In oncology studies, it may stand as the primary end-point. Most QOL instruments are developed in English, although about one-fifth of the world’s population is ethnic Chinese. This article is available only as a PDF. Please...

Mr X, a 68-year-old Indian, was the chairman of a big corporation. He had had a history of bipolar disorder for the past 40 years, with an episode of depression and mania that started 40 years ago, and then 3 episodes of mania in the past 6 years. About...

Around two-thirds of people with incurable diseases in economically developed countries wish to die at home, but less than one third succeed in doing so. Developing primary care-based services for the dying in the community is essential to reach and serve the whole population, and to provide care where...

The term “placebo” is derived from St Jerome’s Latin Psalm, placebo domino in regione vivorum (I shall please the Lord in the land of the living).1 Placebos were fake substances or rituals used by medieval physicians to “please” patients for whom no cure was available. Arguably, acceptable uses for...

Opioid use in terminally ill cancer patients at the end of life has been a source of concern amongst many for fear of its perceived life shortening effects, despite evidence to the contrary. This fear has, in fact, contributed to the reluctance in utilising these drugs to provide adequate...

Decisions regarding potential surgery for metastatic disease are influenced by estimates of patient survival. For example, patients with long life expectancy may be appropriately treated with extensive resection and durable reconstruction to provide long lasting function and mobility; in contrast, a patient with a very short life expectancy may...

A hiccup is a result of an involuntary, intermittent spasmodic contraction of the diaphragm and the inspiratory intercostal muscles, resulting in a sudden inspiration and ends with an abrupt closure of the glottis. This article is available only as a PDF. Please click on “Download PDF” on top to view...

End-stage renal disease (ESRD) is reaching epidemic proportions and is increasingly a public health issue due to the cost of providing care to these patients. There are many kidney disease databases and registries tracking and studying trends in the epidemiology and care of ESRD patients. This article is available only...

Dear Editor, We read with interest the article published in the June 2021 issue of the Annals titled “Use of telemedicine in healthcare during COVID-19 in Pakistan: Lessons, legislation challenges and future perspective”.1 We would like to share our perspectives on using telemedicine to deliver palliative care during the COVID-19...

Understanding the way personhood or “what makes you, you” is conceptualised is pivotal to the practice of medicine. Conceptions of personhood determine the moral and legal status of an individual, is central to the protection of rights and privileges and is pivotal to the maintenance of the distinctiveness of...

The management of schizophrenia has advanced considerably since the term was first coined in 1911, with Kraepelin’s early pessimism tempered by more recent evidence examining outcome. The discovery of antipsychotics represented a major breakthrough in the treatment of schizophrenia, while more recently we have witnessed promising initiatives such as...

The World Health Organization declared coronavirus disease 2019 (COVID-19) a Public Health Emergency of International Concern on 30 January 2020. To control the outbreak, many countries have implemented nationwide lockdowns and social distancing measures, which have brought challenges to accessibility of healthcare services and continuation of long-term medical care,...