Dear Editor,Asia has a lower incidence of breast cancer than North America, Oceania, and Western Europe. However, breast cancer rates have been rising fast...

Dear Editor,Alpha-fetoprotein (AFP) is the most established biomarker for surveillance of hepatocellular carcinoma (HCC) in at-risk individuals. However, its sensitivity and specificity are...

Dear Editor,Breast-conserving surgery (BCS) followed by radiation therapy for breast cancer offers improved cosmetic results and comparable long-term survival rates as mastectomy.1 However,...

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...

Dear Editor,Lung cancer management is progressively complex and multidisciplinary input is often needed. The recent publication of CheckMate 816 heralds a paradigm shift...

Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of acquired, systemic autoimmune conditions characterised by muscular and extramuscular manifestations. As a subset within the...

A 56-year-old Chinese man presented to the Ear, Nose and Throat clinic with months of unilateral right-sided nasal obstruction. He reported occasional mucopurulent discharge...

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....

INTRODUCTIONIn March 2022, the European Commission on cancer screening suggested the inclusion of low-dose computerised tomography (LDCT) for lung cancer, targeted at current...

A 77-year-old Chinese woman with a past medical history of Sjogren’s syndrome, nodular goitre and right-sided neck lymphadenopathy, presented to the gynaecological service for...

Dear Editor,Haemoglobin H (HbH) disease is a haemoglobinopathy affecting 3 of 4 α-globin genes on chromosome 16. It results from the deletion of 2...

Dear Editor,Mucormycosis is a life-threatening fungal infection that mainly affects immunocompromised patients. It typically has low prevalence, but fatality rate is as high...

Cryptococcosis is a well-recognised infection in immunocompromised patients, although its prevalence varies with the type of immune defect. We report a patient with myasthenia...

Urogenital fistulas are a known but uncommon complication of gynaecological surgery, especially those involving a malignant process. Its incidence does not exceed 2%.This article...

To our knowledge this is the first reported case of an isolated vesicocutaneous fistula related to previous radiation therapy for recurrent vulvar cancer.This article...

Radiotherapy is the mainstay treatment for locally advanced carcinoma of the cervix. It is also administered as an adjuvant therapy to patients deemed at...

The above article highlights the insensitivity of urine microscopy compared with the Combur 9 test for detecting haematuria associated with urinary calculi. In the...

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%...

Significant technological advances have been made in the management of ureteric calculi. The newer semirigid, fibreoptic ureteroscopes can now be passed with minimal trauma...

Traumatic dislocation of the testes is uncommon. The first case was reported by Claubry in 1818 in Paris, when a 20-year-old soldier was run...

Patients with renal or ureteric colic are commonly seen at our Emergency Department. We routinely check their urine for haematuria using the Combur 9...

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%...

Systemic lupus erythematosus (SLE) or lupus (“wolf” in Latin) in short, is an autoimmune disorder of unknown aetiology(ies) and characterised by diverse clinical manifestations...

Staging of disease is important. It serves as a guide for further management and also for comparing the results of treatment. Traditionally this has...

The current explosion of molecular biology encompassing genetics, morphogenesis, teratogenesis and pharmacogenomics for targeted drug therapy is about to have a profound impact upon...

Acute retention of urine (ARU) is the commonest urological condition requiring emergency admission to hospital and is usually managed by urethral catheterisation. Previously, patients...

Dunnil and associates first described the association of renal cell carcinoma (RCC) with acquired cystic kidney disease (ACKD) and end stage renal disease. The...

A characteristic feature of renal cell carcinoma is the development of tumour thrombus extending into the inferior vena cava (IVC). This takes place in...

The management of the non-functional tuberculous kidney is controversial and ranges from surgical intervention to conservative treatment. Intra-renal scarring with stricture formation is common...

The treatment of urinary calculi has changed tremendously since the introduction of extra corporeal shockwave lithotripsy (ESWL), percutaneous nephrostolithotomy (PCNL), and ureteroscopy over the...

Haematuria of any degree should never be ignored and, in adults, it should be regarded as a symptom of urological malignancy until proven otherwise....

Nitric oxide (NO) has been recognised as a nonadrenergic noncholinergic (NANC) inhibitory neurotransmitter at various sites in the nervous system. Its function as a...

Castleman’s disease (CD) was first proposed by Castleman in 1954. It is usually found in the mediastinum, but other sites have been described.This article...

As the population is growing older and the society getting more affluent, people are aiming for a better quality of life. This has resulted...

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...

Vesico-ureteric reflux (VUR, OMIM #193000), the name given to reflux of urine from the bladder into the ureter and towards the kidney, is believed...

It was Charcot (1868) who first made the formal pathological correlation between lesions in the central nervous system (CNS) and a disorder termed, ‘la...

Bladder tumours frequently arise from the posterolateral wall of the bladder1 over the course of the obturator nerve. It is during transurethral resection of...

It is well known that T1 carcinoma of the prostate has varying biologic behaviour. Attempts to identify those at higher risk of progression have...

Bladder cancer is the sixth most frequent malignant disease in the world. Superficial stages of the tumour are found in 75% to 85% of...

Oncocytomas are neoplasms characterised by large epithelial cells with finely granular eosinophilic cytoplasm called oncocytes. They were first described by Zippel in 1942 and...

The typical ureteric calculus presents with an acute onset of flank pain which may radiate to the groin. Intravenous urography (IVU) has classically been...

The introduction of extracorporeal shockwave lithotripsy (ESWL) in the 1980s revolutionised treatment of renal and ureteric calculi. Progress in the field of extracorporeal lithotripsy...

Intravenous regional anaesthesia (IVRA) has a reported success rate of between 94% and 98% for upper limb surgery. Limitations to its use include the...

Prostate cancer is the most prevalent cancer among men in the United States. In Singapore, it is the sixth most common incidence of cancer...

Many medical schools worldwide have made the shift toward problem-based learning (PBL) medical education. Some of them employ these new techniques in only part...

Bladder carcinoma is the tenth most common cancer affecting men in Singapore. It is more common in men with an age-standardised incidence rate of...

Open surgical removal had been the standard treatment for urolithiasis till the early 1980s when introduction of percutaneous techniques and extracorporeal shock wave lithotripsy...

Health care in America and the rest of the industrialised world continues to reinvent itself at an ever-accelerating rate. The societal pressures for high...

Adrenal myelolipoma is a rare, benign tumour, usually an incidental finding. Spontaneous retroperitoneal haemorrhage resulting from this tumour is rare.This article is available only...

Cystoscopy, supplemented by urine cytology, remains the gold standard in detecting primary and recurrent bladder cancer. Urine cytology, although highly specific, detects only 29%...

Penile colour flow Doppler imaging (PCDI) is a non-invasive, accurate and cost-effective technique. It has better patient acceptance as compared to cavernosometry and cavernosography,...

Percutaneous nephrostomy (PCN) is a well-established technique in the armamentarium of an interventional radiologist when dealing with urinary obstruction. It provides temporary relief in...

Prostate cancer is usually suspected due to an abnormal digital rectal examination, elevated serum prostate specific antigen (PSA) level or both. The diagnosis of...

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....

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

Over the last 70 years, transurethral resection of prostate (TURP) has been used in the surgical treatment of benign prostatic hyperplasia (BPH) and is...

Urodynamics or pressure flow studies (PFS) are defined as a functional assessment of the lower urinary tract (LUT) to provide a pathophysiological basis for...

The presence of more than 2 testicles is called polyorchidism. It is a rare anomaly.This article is available only as a PDF. Please click...

Leiomyomas of the urinary tract are exceedingly rare. They can, however, arise from almost any site within the genito-urinary tract, most commonly in the...

The introduction of extracorporeal shockwave lithotripsy (ESWL) by Chaussy and his co-workers in 1980 revolutionised the management of urinary calculi. Since then, ESWL has...

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

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

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

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,...

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

A 2.5-year-old boy was referred to our clinic for abnormal genitalia and a febrile urinary tract infection (Escherichia coli >105 colony-forming units/mL). At birth,...

Seronegative spondyloarthropathies (SpA), a group of arthritides characterised by axial skeletal involvement and the absence of rheumatoid factor, are now enjoying a resurgence of...

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...

A 60-year-old previously healthy man with unremarkable medical history presented with a complaint of intractable flank pain for one day. The laboratory test results...

Cancer data can be abstracted manually by cancer registrars or extracted automatically from the electronic medical systems. There may appear to be nothing in...

Fournier’s gangrene is a surgical emergency. Treatment consists of fluid resuscitation, intravenous broad spectrum antibiotics and immediate surgical consultation with a view for early...

Benign prostate hyperplasia (BPH), one of the most common diseases of ageing men, affects the quality of life by interfering with normal daily activities...

Overactive bladder (OAB) is characterised by feelings of urgency to urinate, with or without incontinence and is usually accompanied by frequency and nocturia. These...

Thrombotic thrombocytopenic purpura (TTP) is a systemic disorder that presents acutely with multiple organ failure. Although defined classically as a syndrome with a pentad...

Prostate cancer is now the third most common cancer among Singapore males, with a world age-standardised incidence rate (ASIR) of 23.9 per 100,000 from...

Obstructive calculous disease of the kidney often results in infectious complications such as pyelonephritis and perinephric abscesses. Renojejunal fistula formation may occur as the...

Despite the introduction of more potent and uroselective antimuscarinic agents, many patients with neurogenic detrusor overactivity still suffer from refractory incontinence. Intradetrusor botulinum toxin...

Worldwide, the use of Complementary and Alternative Medicine (CAM) by cancer patients is highly prevalent. For cancer specialists, knowledge on CAM use in their...

About 5% to 15% of all cancers are hereditary and due to germline mutations in cancer predisposition genes. With the human genome project and...

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

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

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

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...

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...

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

Understanding the way personhood or “what makes you, you” is conceptualised is pivotal to the practice of medicine. Conceptions of personhood determine the moral...

Benign prostatic hyperplasia (BPH) is one of the commonest diseases of ageing men. It can be associated with bothersome lower urinary tract symptoms (LUTS)...

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...

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...

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...

The incidence of thyroid cancer has been steadily increasing worldwide. Childhood radiation exposure is a known risk factor for thyroid malignancy. However, data on...

A 49-year-old woman presented with mild pain in her lower abdomen and changes in bowel habits for 2 months. She also experienced 20kg of...

Little is known about the genetics of Parkinson’s disease (PD) in Southeast Asian populations.1 We extended knowledge of the Southeast Asian monogenic PD landscape...

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

As infrastructure and policies were being put in place to combat COVID-19, we recognised that specialty-specific policies and protocols had to be drawn up...

Membranous nephropathy is an organ-specific autoimmune disease and is the most common cause of adult-onset nephrotic syndrome. The diagnosis of membranous nephropathy mainly depends...

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

A 59-year-old woman with a pre-existing asymptomatic pigmented nevus on the umbilicus for the past 20 years was seen in the outpatient dermatology clinic...

Cervical cancer is the most common gynaecological cancer in many countries in Southeast Asia, with a cumulative age-standardised incidence rate (ASRI) of 17.2 per...