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Different strokes for different folks

Atrial fibrillation (AF) remains the most common arrhythmia since William Harvey’s observation of fibrillating auricles in open chest animal models in 1628. Willem Einthoven...

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...

Attitude towards screening for congenital cytomegalovirus infection in newborns in Singapore

Dear Editor, Cytomegalovirus (CMV) infection is the most common congenital infection.1 A systematic review that included 77 studies from 36 countries reported that the overall...

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...

A Randomized Trial of the Use of Print Material and Personal Contact to Improve Mammography Uptake Among Screening Non-attenders in Singapore

Breast cancer is the most common cancer among females in Singapore. Although lower than incidence rates in North America and the United Kingdom the...

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...

Adenocarcinoma of the Cervix

It is clear from studies in Canada, Scandinavia, and more recently the United Kingdom, that routine Pap smear screening has not only reduced the...

Use of Atypical Neuroleptics in a State Mental Institute

Schizophrenia is the most severe of all mental disorders and affects about 1% of the population. The main disturbances of schizophrenia comprise positive symptoms,...

Serum Selenium in the General Population of Singapore, 1993 to 1995

The current disease pattern in Singapore (an island state of 3.3 million people composed of 76% Chinese, 14% Malays, 7% Asian Indians and 3%...

Population-based Mammographic Screening in Singapore: What are Participants’ Views?

Breast cancer is the most common cancer among women in Singapore and has been increasing in incidence since 1968. This rise is particularly marked...

Plasma Vitamins A, C and E in the General Population of Singapore, 1993 to 1995

The current disease pattern in Singapore (an island state of 3.3 million people composed of 76% Chinese, 14% Malays, 7% Asian Indians and 3%...

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...

Spectrum of Abnormal Mammographic Findings and Their Predictive Value for Malignancy in Singaporean Women from a Population Screening Trial

While screening mammography can detect early breast cancers, a significant proportion of asymptomatic women are subject to unnecessary workup and surgery when biopsies for...

Microdochectomy for Single-duct Nipple Discharge

Nipple discharge is a common disturbing symptom for many women and often leads to a surgical referral. It accounts for 3% to 5% of...

Pathology of Ductal Carcinoma In situ of the Breast: A Heterogeneous Entity in Need of Greater Understanding

Breast cancer is the commonest malignancy in Singapore women, with an age-standardised rate of 46.1 per 100,000 per year and an annual increase in...

Isolated Non-compaction of Ventricular Myocardium: A Report of Three Cases

Non-compaction of ventricular myocardium is a rare morphogenic arrest of compaction of the ventricular myocardial fibres during intrauterine life. Usually, the left ventricle is...

The Views of Mental Health Professionals Towards Psychotherapy—A Singapore Survey

There is a trend in Asia towards a greater application of psychotherapeutic approaches in multidisciplinary settings to emotional and behavioural disturbances. The inaugural issue...

The Mastectomy Clinical Pathway: What Has It Achieved?

In an era of increasing healthcare cost and scarce resources, the tension between the cost and quality of healthcare demands not only effective but...

Current Understanding of Pre-eclampsia

Pre-eclampsia is a major cause of adverse obstetric outcome. It remains one of the leading causes of maternal mortality1 and continues to contribute significantly...

Osteoporosis Risk Factor Assessment and Bone Densitometry—Current Status and Future Trends

Osteoporosis affects predominantly elderly women; although younger women and men may also be affected. Demographically, the number and proportion of the elderly (aged 65...

Non-consensual Double Reading in the Singapore Breast Screening Project: Benefits and Limitations

Double reading of mammogram is not the standard practice in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). Rather, single reading of...

Measuring Quality of Life in Chinese Cancer Patients: A New Version of the Functional Living Index for Cancer (Chinese)

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....

Current Concepts of Tumour Metastasis

Tumour metastasis, or the spread of cancer cells from a primary tumour to distant sites, remains the principal cause of treatment failure and poor...

Breast Ultrasound in Women With Familial Risk of Breast Cancer

Mammography is the modality of choice to screen for breast cancer in asymptomatic women. However, it is known that about 10% to 12% of...

Clinico-pathological Analysis of Myelodysplastic Syndromes According to French-American-British Classification and International Prognostic Scoring System

Myelodysplastic syndromes (MDS) are a heterogeneous group of acquired clonal haemopoietic stem cell disorders characterised by ineffective haematopoiesis and peripheral cytopenia. The natural history...

Trends in Cancer Incidence Among Singapore Malays: A Low-risk Population

Cancer is now one of the most common causes of death in the world. Inspection of changes in cancer incidence in ethnically or geographically...

Cutaneous and Subcutaneous Metastases of Adenocarcinoma of the Colon and Rectum

Cutaneous metastasis from colorectal adenocarcinoma is an interesting condition not only because of its rarity, it occurs in less than 4% of patients with...

Diabetic Retinopathy in Type II Diabetics Detected by Targeted Screening Versus Newly Diagnosed in General Practice

The epidemic of type II diabetes mellitus is now recognised worldwide. In India, it has been estimated that the population with type II diabetes...

Developmental Dysplasia of the Hip: Universal or Selective Ultrasound Screening?

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Financing Newborn Screening Systems: US Experience

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Legal Issues in Neonatal Screening

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Neuroblastoma Screening in Japan: Population-based Cohort Study and Future Aspects of Screening

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Establishing a Universal Newborn Hearing Screening Programme

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Impact of the National Hearing Screening Programme in China

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Neuro-developmental Deficits in Early-treated Congenital Hypothyroidism

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Considerations in Choosing Screening Conditions: One (US) Approach

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Towards Universal Newborn Screening in Developing Countries: Obstacles and the Way Forward

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Parathyroid Carcinoma: A Case Series

Parathyroid carcinomas account for 1% to 3% of patients with primary hyperparathyroidism (PHPT).1 Patients usually present with a severe form of hyperparathyroidism at diagnosis,...

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)...

Diagnosis and Evaluation of Obstructive Sleep Apnoea in Children

Children with obstructive sleep apnoea (OSA) may present with nocturnal and/or diurnal symptoms. The history is best obtained from parents, or siblings who share...

Concurrent Chemoradiotherapy followed by Surgery in Locally Advanced Squamous Cell Carcinoma of the Oesophagus: A Single Centre Experience

Carcinoma of the oesophagus is a relatively uncommon malignancy in Singapore and incidence rates have been declining since 1968. A total of 506 cases...

An Unusual Case of an Intramuscular Lipoma of the Pectoralis Major Muscle Simulating a Malignant Breast Mass

Intramuscular lipomas of the pectoralis major muscle are rare tumours.1 We describe an unusual case of a lipoma of the pectoralis major muscle which...

Clinical Characteristics of Renal Infarction in an Asian Population

Renal infarction is a rare disease. Domanovits et al reported an incidence rate of 0.007% (17/248,842) during a study period of 45 months. This article...

Screening Tools for Bacteraemia in a Selected Population of Febrile Children

Bacteraemia refers to the presence of bacteria in the bloodstream. The presence or absence of toxicity differentiates occult bacteraemia, which is relatively asymptomatic, from...

Review of the Management Outcome of Slipped Capital Femoral Epiphysis and the Role of Prophylactic Contra-lateral Pinning Re-examined

Slipped capital femoral epiphysis is the commonest hip problem in the adolescent age group. The goals of treatment are aimed at avoiding the complications...

Thoracic Complications of Radiofrequency Ablation of Recurrent Hepatoma

Radiofrequency ablation (RFA) intended to produce complete thermal necrosis of unresectable primary or secondary hepatic malignancies have gained widespread availability and acceptance over the...

Application of the McDonald MRI Criteria in Multiple Sclerosis

Since its advent in 1982, magnetic resonance imaging (MRI) has become an important component in the evaluation of multiple sclerosis (MS). MRI is a...

Extracranial Non-vestibular Head and Neck Schwannomas: A Ten-year Experience

Schwannomas, also known as neurilemmomas, neuromas, or neurinomas, are uncommon nerve sheath neoplasms that may originate from any peripheral, cranial or autonomic nerve of...

Mohs micrographic surgery in Singapore: A long-term follow-up review

Dear Editor, Mohs micrographic surgery (MMS) has become the treatment of choice for high-risk non-melanoma skin cancers (NMSC) worldwide.1 Unlike wide local excision, MMS...

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features and the risk of malignancy in thyroid cytology: Data from Singapore

As only 5–10% of thyroid nodules harbour malignancy, fine-needle aspiration (FNA) is important in triaging nodules requiring surgical excision from nodules that may be...

Characteristics of unplanned hospitalisations among cancer patients in Singapore

Cancer is a pervasive global problem with growing healthcare utilisation and costs.1-3 This situation is similar in Singapore where cancer incidence is on the...

The case for better hospitalisation selection in cancer patients

Public hospital occupancy rates and resource utilisation in Singapore are perennially high. In the last 2 years of the COVID-19 pandemic, there has been...

Prevalence of Adolescent Idiopathic Scoliosis among Female School Children in Singapore

Scoliosis screening in schools is still widely practised worldwide despite some countries abandoning the practise in recent years. Screening usually consists of visual inspection...

Acceptability of Medical Students by Patients from Private and Public Family Practices and Specialist Outpatient Clinics

In recent decades, medical advances and economic pressures have shifted medical student training from hospital inpatient to ambulatory settings such as hospital outpatient and...

The Impact of Gender on the Outcomes of Invasive versus Conservative Management of Patients with Non-ST-Segment Elevation Myocardial Infarction

Recent studies have suggested differences in clinical outcomes between men and women following acute myocardial infarction (AMI). Some studies have indicated poorer survival of...

Socio-demographic Profile and Psychiatric Comorbidity of Subjects with Pathological Gambling

Gambling has been defined as a wager of any type of item or possession of value upon a game or event of uncertain outcome...

Human Immunodeficiency Virus (HIV) in Pregnancy: A Review of the Guidelines for Preventing Mother-to-Child Transmission in Malaysia

Pregnancy, whether actual or anticipated, has been a critical driver for the diagnosis, treatment and care of women with human immunodeficiency virus (HIV). Unlike...

Supplementary Breast Ultrasound Screening in Asian Women with Negative But Dense Mammograms—A Pilot Study

Mammogram has been the gold standard for breast cancer screening and Magnetic Resonance Imaging (MRI) has been advocated for screening of high- risk individuals....

Demographic Determinants of Survival in Osteosarcoma

The treatment of osteosarcoma has seen tremendous improvements over the last 3 decades of the twentieth century. Over the last decade it appears that...

National Health Survey on the Prevalence of Urinary Abnormalities in the Population: then and now (1975 to 2012)

In the planning of a tuberculosis prevalence survey in Singapore in 1975, it was decided to include a urine examination of the respondents using...

Male Breast Cancer in Singapore: 15 Years of Experience at a Single Tertiary Institution

Male breast cancer is a rare disease entity, traditionally said to represent <1% of all diagnosed breast cancers. Recent statistics, however, suggest that its...

The Hidden Impact of Childhood Cancer on the Family: A Multi-Institutional Study from Singapore

Chronic childhood illnesses have varying degrees of impact on the children and their families. Some chronic conditions that have little or no impact on...

Overcoming Barriers to Mammography Screening: A Quasi-randomised Pragmatic Trial in a Community-based Primary Care Setting

Breast cancer is the leading cancer among women in Singapore, accounting for 29% of all cancers occurring in women between 2006 and 2010. Evidence...

Causes and Features of Erythroderma

Erythroderma is a dermatological reaction characterised by extensive erythema and scaling of the skin secondary to a variety of causes. An improved understanding of...

Hearing Loss in Newborns with Cleft Lip and/or Palate

Cleft lip and/or palate (CL/P) is one of the commonest congenital malformations. A recent update collating data from international organisations for the years 2002...

Routine intraoperative frozen section adds little value to the management of thyroid nodules with Bethesda III cytology

Dear Editor, We would like to highlight the need to reduce intraoperative frozen section (FS) during diagnostic hemithyroidectomy performed on thyroid nodules with Bethesda III...

Telemedicine for palliative care: Current and future challenges

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...

Managing buccal space tumours

Dear Editor, The buccal space is an infrequently addressed fascial space of the head and neck region. Intrinsic tumours of the buccal space are...

Bone in the breast: Clinical, radiological and pathological correlation

An 84-year-old woman presented with a left breast mass that had been rapidly growing over a few months. On clinical examination, there was a...

Treatment of Ewing sarcoma in children: Results from a single centre

Dear Editor, Ewing sarcoma is a malignant mesenchymal tumour that presents as a bone or soft-tissue sarcoma. Translocations involving the EWS gene on chromosome 22q12...

Does pulmonary metastasectomy of colorectal metastases translate to better survival? A systematic review

Colorectal cancer (CRC) is the one of most common cancers worldwide. Metastatic disease occurs in approximately half of all CRC patients, in either synchronous...

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...

Carbamazepine-induced toxic epidermal necrolysis in a patient despite testing negative for HLA B*15:02 allele

Carbamazepine (CBZ) has been used in Singapore since 19881 as an effective drug for the treatment of conditions such as epilepsy, neuropathy, neuralgia and...

Endovenous cyanoacrylate ablation for chronic venous insufficiency and varicose veins among Asians

In the past 2 decades, the management of chronic venous insufficiency (CVI) has been revolutionised by the introduction of minimally invasive endovenous techniques, which...

Assessing the Content Validity of the EQ-5D Questionnaire Among Asians in Singapore: A Qualitative Study

EQ-5D is a tool to measure and value health status. It is a standardised questionnaire that comprises 2 components: a Descriptive System (DS) on...

Long-term outcomes of ischaemic stroke patients with diabetes in a multi-ethnic cohort in Singapore

Asia faces an epidemic of diabetes. The prevalence of diabetes in Asia is projected to grow from 114 million in 2007 to 180 million...

An unusual submandibular tumour

A woman in her 60s presented with a non-tender, non-enlarging swelling in the left submandibular triangle of the neck for 3 months. She had...

Penile preserving surgery in penile cancer management

Penile cancer is a condition that accounts for approximately 0.4% of cancers among Singapore males. Overall, this is an uncommon cancer with higher rates...