Original Article
Fetal congenital heart diseases: Diagnosis by anatomical scans, echocardiography and genetic tests
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
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
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
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
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
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
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
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
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
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
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
Clinical characteristics of macrolide-resistant Mycoplasma pneumoniae infections among hospitalised children in Singapore
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
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
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
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
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
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
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
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
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
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
Gastroesophageal reflux disease (GERD), a common problem in infancy, may lead to troublesome symptoms or complications such as oesophagitis or oesophageal stricturing in a...
Editorial
Development of Rheumatology in Singapore
Patients with rheumatic diseases frequently consult primary care physicians, internists and orthopaedic surgeons. In the past, few doctors took interest in these diseases.
This article...
Original Article
Aetiology and Distribution of Mandibular Fractures in the National University Hospital, Singapore
Apart from the nasal bone, the mandible is the most commonly fractured bone in the face. It is also the 10th most often broken...
Original Article
Bidirectional Cavopulmonary Anastomosis
Children with complex congenital heart disease and a functional single ventricle may not be ideal candidates for a Fontan procedure. A staged approach to...
Others
Post-Release Drug Treatment Risks: Strategies to Minimise Harm to Patients
Physicians have long accepted unreliable evaluations of the risks attached to pharmacotherapy, i.e. treating our patients with drugs. The reasons for the uncritical attitude...
Letter to the Editor
Paediatric living-donor liver and kidney transplantation during COVID-19
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
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
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...
Others
History of the Orthopaedic Specialty in Singapore
When the practice of orthopaedic surgery first began in Singapore, it was not a specialty in itself. There are no records as to when...
Letter to the Editor
Labour epidural practice in a tertiary training centre
Dear Editor,
Labour analgesia provided through the central neuraxial approach is offered for parturients who are in their active stage of labour, usually after 2–4cm...
Others
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...
Review Article
Laboratory Safety Aspects of SARS at Biosafety Level 2
In Singapore, the majority of patients suffering from the severe acute respiratory syndrome (SARS) were cared for at Tan Tock Seng Hospital. The dramatic...
Original Article
Laparoscopic Appendicectomy in Children: A Trainee’s Perspective
The advent of laparoendoscopic surgery in children has opened new avenues of treatment with added benefits but at the same time demands adequate training...
Others
Financing Newborn Screening Systems: US Experience
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Others
Considerations in Choosing Screening Conditions: One (US) Approach
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Original Article
An Intelligent Tutoring System for Trauma Management (Trauma-Teach): A Preliminary Report
In Singapore, trauma1-7 is the leading cause of hospitalisation and the fifth leading cause of morbidity and mortality.8,9 Common causes of trauma include road...
Commentary
A Systems Approach to Teach Core Topics across Graduate Medical Education Programmes
Core curricula including Ethics, Medico-legal issues, Socioeconomics, and Quality Improvement (QI) are relevant and significant for graduate medical education programmes, regardless of specialty. A...
Others
The History of Surgical Teaching and the Department of Surgery
On 3 July 2005, the Faculty of Medicine, National University of Singapore (NUS) and NUS will be celebrating their centenaries – a hundred years...
Others
A Brief History of the Chapter of Psychiatrists
The Inaugural Meeting of the Chapter of Psychiatrists and Chapter of Pathologists, Academy of Medicine, was held on 5 December 1986 at King’s Hotel.1,2...
Others
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...
Original Article
A Review of Fatal Road Traffic Accidents in Singapore from 2000 to 2004
As countries become more developed, there is often an accompanying rise in life expectancy. However, increasing motorisation that accompanies economic growth has led to...
Others
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...
Review Article
What Skills are Tested in the New PACES Examination?
Despite the continuing emergence of sophisticated technology to aid diagnosis, many experienced clinicians continue to believe that bedside clinical skills relating to communication and...
Original Article
Normative Data for Quantitative Calcaneal Ultrasound in Asian Children
Dual energy X-ray absorptiometry (DEXA) is currently the gold standard for the assessment of bone mineral density (BMD). It is the commonest tool used...
Original Article
Single Centre Experience of Transjugular Liver Biopsy in 152 Patients
The first reported case of liver biopsy was recorded in 1883 by Ehrlich. Since then, the technique of liver biopsy has been modified tremendously...
Original Article
Neonatal Outcome of the Late Preterm Infant (34 to 36 Weeks): The Singapore Story
Neonatologists were caught looking the other way in the early part of the millennium. While they were keenly following the progress of extreme preterms...
Letter to the Editor
Severe Vitamin B12 Deficiency in a 7-Month-Old Boy
Infantile vitamin B12 deficiency often affects children born to mothers whose nutritional intake is inadequate. We describe a 7-month-old boy with a 2-month history...
Original Article
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...
Letter to the Editor
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...
Original Article
Immunomodulator use in paediatric severe sepsis and septic shock
Paediatric sepsis is one of the main causes of childhood mortality.1 Globally, paediatric severe sepsis and septic shock accounts for 6.2% to 23.1% of...
Images in Medicine
A rare case of thigh asymmetry in an infant
A 6-month-old baby boy presented with asymmetry of thighs since birth. On clinical examination, anteromedial aspect of the left thigh was bulky with pale...
Letter to the Editor
Prevalence of vitamin D deficiency and insufficiency in Malaysian infants
Vitamin D deficiency, a worldwide health problem, is also prevalent in tropical countries. It is estimated that 15% of the world’s population are either...
Letter to the Editor
Impact of true fetal mosaicism on prenatal screening and diagnosis
Over the past decade, the non-invasive prenatal test (NIPT) has increasingly been used as a method for prenatal screening for trisomy 21 (T21) and...
Original Article
A review of child sexual abuse cases presenting to a paediatric emergency department
Child sexual abuse (CSA) is a global public health issue with adverse short- and long-term repercussions. Formal definitions of CSA and the age for...
Original Article
Prevalence of thyroid malignancy and hormonal dysfunction following radiation exposure in childhood
The incidence of thyroid cancer has been steadily increasing worldwide. Childhood radiation exposure is a known risk factor for thyroid malignancy. However, data on...
Letter to the Editor
A resuscitation course designed for a psychiatric hospital
It is challenging to maintain the resuscitation skills of doctors in a psychiatric hospital. Our study describes a resuscitation course designed specifically for the...
Commentary
Autism Spectrum Disorder and COVID-19: Helping Caregivers Navigate the Pandemic
The coronavirus disease 2019 (COVID-19) pandemic has disrupted societies globally. As of 11 May 2020, 53 children have been infected with COVID-19 in Singapore...
Original Article
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...
Letter to the Editor
Importance of antenatal blood group typing and antibody screening in non-ABO/Rh haemolytic disease of the newborn
Haemolytic disease of the fetus and newborn (HDFN) is a severe, potentially fatal alloimmune condition where maternal antibodies are produced, transported across the placenta...
Original Article
Cost of inpatient rehabilitation for children with moderate to severe traumatic brain injury
The cost of rehabilitation for children post-traumatic brain injury (TBI) is significant. The annual total healthcare cost of TBI had been estimated to range...
Letter to the Editor
Decrease in emergency department attendances during COVID-19 especially in school-going children
Health-seeking behaviour varies during a pandemic. Early reports have suggested reduced attendances at emergency departments (EDs), especially in paediatric patients and in patients with...
Letter to the Editor
Alternating hemiplegia of childhood presenting as recurrent apnoea in a term newborn infant
Recurrent apnoea in a term infant is usually pathologic, warranting a thorough aetiologic evaluation. An accurate diagnosis is essential in guiding subsequent management and...
Original Article
Paediatric emergency department attendances during COVID-19 and SARS in Singapore
Coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) on 11 March 2020, with over 110 million cumulative cases...
Original Article
Epidemiology and risk stratification of minor head injuries in school-going children
Head injuries are common childhood injuries that present to paediatric emergency departments. Falls are the most common cause in young children, while contact sports...
Original Article
Causes, functional outcomes and healthcare utilisation of people with cerebral palsy in Singapore
Cerebral palsy (CP) describes a group of permanent, but often changing, disorders that affect movement and posture, causing activity limitation, attributed to nonprogressive disturbances...
Editorial
The Singapore Cerebral Palsy Registry: An important new resource for cerebral palsy research
Cerebral palsy (CP) is a common, lifelong disorder of movement and posture resulting from an insult or maldevelopment of the developing brain. The movement...
Original Article
Epidemiology and Control of Hand, Foot and Mouth Disease in Singapore, 2001-2007
Hand, foot and mouth disease (HFMD) is a common childhood viral infection, which is typically mild and self-limiting. It is characterised by a brief...