Editorial
Micronutrients and kidney health
Chronic kidney disease (CKD) is a structural and functional disorder of the kidney caused by many diseases, such as diabetes, hypertension and glomerular disease.1...
Editorial
Incorporating assessment of fibrinogen gene polymorphisms and bleeding risk in patients treated with direct oral anticoagulants
Direct oral anticoagulants (DOACs) have become entrenched as the dominant anticoagulant over the last decade for patients with venous thrombosis and atrial fibrillation.1 Compared...
Letter to the Editor
Association between self-care and chronic kidney disease in patients with type 2 diabetes mellitus
Dear Editor,
Chronic kidney disease (CKD) is one of the key complications occurring in 25–40% of patients with type 2 diabetes mellitus (T2DM).1 Our...
Original Article
Low skeletal muscle mass predicts poor prognosis of elderly patients after emergency laparotomy: A single Asian institution experience
Emergency laparotomy (ELAP) for elderly patients is associated with higher mortality and increased postoperative complications compared with those undergoing elective surgery.1-3 Elderly patients, who...
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...
Images in Medicine
White precipitate in a dialysis circuit
An 81-year-old man who had been fully vaccinated against COVID-19 was admitted to the medical intensive care unit on day 5 of his COVID-19-induced...
Letter to the Editor
Palliative dialysis in hospice: A paradox or promising answer?
Dear Editor,
End-stage renal disease (ESRD) patients have higher mortality, hospital admissions and invasive procedures towards the end of life.1 However, many of them (82%)...
Commentary
Health economics of kidney replacement therapy in Singapore: Taking stock and looking ahead
Burden of ESKD in Singapore. The incidence of chronic kidney disease (CKD) stage 5 in Singapore increased by 31% from 383.9 per million population...
Original Article
Comparison of planned-start, early-start and deferred-start strategies for peritoneal dialysis initiation in end-stage kidney disease
Peritoneal dialysis (PD) is a well-established long-term dialysis modality for patients with end-stage kidney disease (ESKD).1 It is recommended that a PD catheter should...
Original Article
Identifying high-risk hospitalised chronic kidney disease patient using electronic health records for serious illness conversation
In-hospital cardiopulmonary resuscitation (CPR) for chronic kidney disease (CKD) patients is shown to have lower survival1 and a higher proportion of survivors on maintenance...
Original Article
Death and cardiovascular outcomes in end-stage renal failure patients on different modalities of dialysis
End-stage renal failure (ESRF) is a major cause of morbidity and mortality worldwide, including Asia.1 In Singapore, incidence of chronic kidney disease (CKD) stage...
Editorial
Survival outcome of haemodialysis and peritoneal dialysis
End-stage renal disease (ESRD) is a challenging and growing health issue, with number of patients increasing globally. The use of dialysis has greatly improved...
Original Article
Risk Factors for Predicting Mortality in a Paediatric Intensive Care Unit
Following the rapid advances in medical therapy and critical care technology over the past 30 years, coupled with the spiralling cost of medical care,...
Original Article
Infections in Acute Lymphoblastic Leukaemia
Children undergoing chemotherapy for cancer are especially vulnerable to infection because of immunosuppression related to their underlying illness, the effects of chemotherapy and radiotherapy....
Original Article
Malaria Requiring Intensive Care
Malaria is an important and common infectious parasitic disease globally. It is associated with significant morbidity and mortality, especially in endemic areas.
This article is...
Original Article
APACHE II and SAPS II are Poorly Calibrated in a Hong Kong Intensive Care Unit
The Acute Physiology and Chronic Health Evaluation II (APACHE II) and the new Simplified Acute Physiology Score (SAPS II) scoring systems are widely used...
Original Article
Impact on Quality of Patient Care and Procedure Use in the Medical Intensive Care Unit (MICU) Following Reorganisation
Critical care is costly as it is labour intensive and involves expensive life support technology. In the United States, the intensive care units (ICUs)...
Original Article
Survey of Aerobic Bacterial Infections in Paediatric Surgical Intensive Care Unit Patients
Data on infections in paediatric surgical patients are few in the literature. Although there are many studies on infection in adult surgical and paediatric...
Original Article
Hospitalised Low-risk Community-acquired Pneumonia: Outcome and Potential for Cost-savings
Community-acquired pneumonia (CAP) is a common illness with nearly 4 million adults diagnosed each year in USA with more than 600,000 hospita1isations. The associated...
Original Article
Long-term Outcome and Disease Control in Near-fatal Asthma
Rising trends in mortality in asthma have been reported from many countries, including Asian countries such as Hong Kong. Asthma deaths have been associated...
Original Article
Extended Resection of Locally Advanced (T4) Stomach Cancer
Cancer is the most common cause of death in Singapore. Although there is a gradual decline in incidence of stomach cancer over the years,...
Original Article
Adverse Operative Risk Factors for Perforated Peptic Ulcer
Although there has been a significant decline in elective surgery for peptic ulcer disease with the introduction of H-2 blocker, the incidence of peptic...
Others
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...
Review Article
Quality of Life in Long-Term Survivors of Intensive Care
Intensive care has undergone rapid technological advancement in recent years enabling complex treatment of patients of advanced age and/or with advanced chronic diseases underlying...
Review Article
Limitation of Life Support in the Critically Ill: The Hong Kong Perspective
Technological advances over the last 30 years have had an enormous impact on the way in which medicine is delivered today. This is particularly...
Original Article
Obstetric Admissions to the Intensive Therapy Unit of a Tertiary Care Institution
Pregnancy is associated with physiological changes in various organ systems and complications arising from the interaction between these changes and disease processes may be...
Original Article
Abdominal Complications after Cardiac Surgery
Despite intensive therapeutic efforts, both the incidence and mortality of gastrointestinal complications after cardiac surgery employing cardiopulmonary bypass (CPB) have not decreased during the...
Original Article
Myocardial Infarction in Singapore: A Nationwide 10-year Study of Multiethnic Differences in Incidence and Mortality
Rapid urbanisation and increasing affluence have improved the socioeconomic status of Asians. This, however, has brought with it new socioeconomic and medical problems resulting...
Review Article
Rheumatic Heart Diseases in Pregnancy
Rheumatic heart disease comprises acute rheumatic fever following group A beta-haemolytic streptococcal infection of the tonsillopharynx, and its long-term sequelae of heart valve fibrosis...
Review Article
Management of Thromboembolic Disease in Pregnancy
Venous thromboembolism (VTE) refers specifically to 2 related entities: deep vein thrombosis (DVT) and pulmonary embolism. The management of arterial thrombo-embolism, in particular that...
Original Article
Influenza in Singapore: Assessing the Burden of Illness in the Community
Influenza is a major cause of morbidity and mortality worldwide. Morbidity in the working age group gives rise to frequent doctor visits and considerable...
Original Article
Evaluation on the Use of a Portable Unit Versus the Laboratory for the Monitoring of International Normalized Ratio (INR) in Orally Anticoagulated Patients
Oral anticoagulation therapy is used for a number of conditions, namely deep venous thrombosis, pulmonary embolism, mechanical heart valves, embolic stroke as well as...
Original Article
Epidemiology of Beta-haemolytic Group G Streptococcal Bacteraemia in Singapore (1996 to 1998)
Human isolates of group G streptococci (GGS) that form large colonies are similar to group A streptococci (GAS) in terms of virulence and cause...
Original Article
Osteoporotic Hip Fractures in Singapore—Costs and Patient’s Outcome
Singapore is facing a rapidly ageing population. Osteoporosis, which is an age-related illness, will become an increasing problem. Osteoporotic hip fracture, because of the...
Others
Critically Ill Elderly Who Require Mechanical Ventilation: The Effects of Age on Survival Outcomes and Resource Utilisation in the Medical Intensive Care Unit of a General Hospital
Increasing life expectancy and ageing of the “post-war baby boomer” generation have led to the rapidly ageing demographic of many Asian countries. Singapore’s elderly...
Review Article
Medical Therapy in Heart Failure – Is Polypharmacy Necessary?
The clinical syndrome of heart failure is recognised by a characteristic pattern of haemodynamic, renal, neural and hormonal responses. Heart failure is the end-stage...
Original Article
Deep Hypothermic Circulatory Arrest in Adults Undergoing Aortic Surgery: Local Experience
The use of deep hypothermic circulatory arrest (DHCA) as a method of cerebral protection during aortic surgery was first described in 1975. Its use...
Others
Severe Adult Chickenpox Infection Requiring Intensive Care
Chickenpox (varicella) in adults can be severe. It is frequently associated with pneumonia and immunosuppression as well as increased mortality rates.
This article is available...
Others
Neuroblastoma Screening in Japan: Population-based Cohort Study and Future Aspects of Screening
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Original Article
Early Predictors of Mortality in Pneumococcal Bacteraemia
Streptococcus pneumoniae infection is the most common cause of community-acquired pneumonia worldwide.1 It has been associated with an approximately 10% rate of bacteraemia.2-4 Despite...
Letter to the Editor
Nephrologists-led intervention increases utilisation of peritoneal dialysis in Singapore
Dear Editor,
Over the past decade, the utilisation of peritoneal dialysis (PD) among end-stage kidney disease (ESKD) patients in Singapore has been persistently low...
Original Article
Upper Limb Ischaemia – A Single Centre Experience
Upper limb ischaemia is an uncommon entity which presents less commonly as compared to lower limb ischaemia, and has a wide range of aetiology...
Original Article
A 5-year Profile of Trauma Admissions to the Surgical Intensive Care Unit of a Tertiary Hospital in Singapore
Our tertiary hospital has a 9-bed Surgical Intensive Care Unit (SICU) that caters to all surgical disciplines except Cardio-Thoracic and Vascular Surgery (which has...
Original Article
Causes of Death in Hospitalised Human Immunodeficiency Virus (HIV)-infected Patients at a National Referral Centre in Singapore: A Retrospective Review from 2008 to 2010
The advent of the highly active antiretroviral therapy (HAART) era has greatly reduced the mortality and incidence of new diagnoses of acquired immune deficiency...
Original Article
Antibiotic Therapy and Clinical Outcomes of Pseudomonas Aeruginosa (PA) Bacteraemia
Pseudomonas aeruginosa (PA) is a virulent nosocomial pathogen and PA bacteraemia is associated with high mortality ranging from 18% to 59%. It is ranked...
Original Article
A 10-Year Profile of Trauma Admissions Caused by Interpersonal Violence: A Major Trauma Centre’s Experience
The World Health Organization (WHO) has divided violence into 3 categories: interpersonal violence, self-directed violence, and collective violence. Violence is defined as “the intentional...
Original Article
Outcomes of second-tier rapid response activations in a tertiary referral hospital: A prospective observational study
Despite its widespread adoption, rapid response systems (RRS) and rapid response teams (RRT) vary significantly in composition and set-up.1-3 While implementation of RRSs appear...
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...
Original Article
Epidemiology and Clinical Evolution of Liver Cirrhosis in Singapore
Cirrhosis is the common end result of chronic damage to liver parenchyma caused by a variety of liver diseases. It results in replacement of...
Original Article
An External Independent Validation of APACHE IV in a Malaysian Intensive Care Unit
Over the past 30 years, different versions of severity of illness scoring systems and prognostic models have been developed for prediction of patient outcomes...
Original Article
Heterogeneity of non-cystic-fibrosis bronchiectasis in multiethnic Singapore: A prospective cohort study at a tertiary pulmonology centre
Bronchiectasis is a chronic lung disease of significant morbidity and mortality. The pathological hallmarks of the disease are abnormal dilatation of airways resulting from...
Letter to the Editor
Empagliflozin-induced severe osmotic nephrosis and acute renal injury in advanced chronic kidney disease
Diabetic kidney disease remains a significant disease burden globally and is associated with increased medical costs once chronic kidney disease (CKD) ensues. Therefore, optimisation...
Original Article
Survival and Predictors of Mortality in Acute Kidney Injury Patients Treated with Sustained Low Efficiency Dialysis
Approximately one in ten patients admitted to an intensive care unit (ICU) develops acute kidney injury (AKI), an important complication of ICU patients, and...
Original Article
Impact of Chronic Kidney Disease on Outcomes in Transcatheter Aortic Valve Implantation
With improvements in device technology as well as increasing experience, transcatheter aortic valve implantation (TAVI) has replaced open surgical aortic valve implantation as the...
Original Article
Characteristics and Outcomes of COVID-19 Patients with Respiratory Failure Admitted to a “Pandemic Ready” Intensive Care Unit – Lessons from Singapore
This article is available only as a PDF. Please click on "Download PDF" to view the full article.
Review Article
How to Feed the Critically Ill—A Review
This article is available only as a PDF. Please click on "Download PDF" to view the full article.
Review Article
Managing a Renal Transplant Programme During the COVID-19 Pandemic: Practical Experience from a Singapore Transplant Centre
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...
Review Article
Obesity in COVID-19: A Systematic Review and Meta-analysis
Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is established that increasing...
Review Article
Impact of cardiovascular diseases on severity of COVID-19 patients: A systematic review
Coronavirus disease 2019 (COVID-19) has spread rapidly from China to other countries around the world, with the World Health Organization characterising it as a...
Original Article
PLA2R1 and HLA-DQA1 gene variations in idiopathic membranous nephropathy in South China
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...
Review Article
Metformin use in patients with type 2 diabetes mellitus and chronic kidney disease: An evidence-based review
Diabetes is a chronic disease characterised by elevated levels of blood glucose. The most common type of diabetes is type 2 diabetes mellitus (T2DM)....