The EQ-5D is a preference-based, generic instrument that measures quality of life in three different ways.1 The first part is a descriptive system providing a profile of respondents’ health status in five dimensions. The second measure is a 0 to 100 visual analog scale for self-rating of own health....

The co-occurrence of mental and medical disorders in the same person, regardless of the chronological order in which they occurred or their causal relationship—commonly referred to as comorbidity—is not uncommon. The National Comorbidity Survey Replication (NCS-R), which was a nationally representative epidemiological survey in the US, found that at...

The rapid advancement of biomedical research in the recent years was propelled by a series of groundbreaking technological inventions and breakthrough discoveries. In this lecture, I will discuss about the scientific achievements that led to different eras of intense research with profound impact on biomedicine, focusing on the use...

A 59-year-old Chinese lady was scheduled for wide excision of an invasive ductal carcinoma of the left breast, with sentinel lymph node biopsy (SLNB). She had a history of mild depression treated with alprazolam and paroxetine. She was assessed to be ASA (American Society of Anaesthesiologists) Class 1. Her...

A 33-year-old male who was undergoing treatment with phosphodiesterase 5 inhibitor and anticoagulant for idiopathic pulmonary arterial hypertension presented to the emergency department with acute onset of dyspnoea and chest pain. His cardiovascular examination had shown features of cardiomegaly and pulmonary arterial hypertension with no pathological murmur. His blood...

A 55-year-old female presented in 2010 with a World Federation of Neurosurgeons (WFNS) grade 3 subarachnoid haemorrhage (SAH). She had aneurysms of the right middle cerebral artery (MCA) (Fig.1A) and anterior choroidal arteries, plus a left pericallosal and anterior cerebral aneurysm (ACA). Clipping was delayed by emergent Takotsubo cardiomyopathy....

Pulmonary epithelioid haemangioendothelioma is a rare vascular neoplasm of endothelial origin. We describe a case which involved solely the lungs and a novel therapeutic strategy using pegylated liposomal doxorubicin was attempted. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

In the past 20 years, an epidemic of adult and childhood obesity has swept through the developed world resulting in the “globesity” epidemic. This is clinically significant since obesity is a major risk factor for many chronic diseases which now occur earlier in life. Recent landmark research has identified...

Similar to other developed countries in Asia, including Japan, South Korea and Taiwan, the population of Singapore is ageing rapidly. In 2011, 9.3% of the population was 65 years of age or older. Due in part to decades of sub-replacement level fertility rates and increases in longevity, by 2030...

Nursing homes trace their evolution to American alms-houses in the 1930s where retired nurses welcomed the elderly and ill into their homes. In Singapore, community-based charitable organisations pioneered the earliest sheltered accommodations for homeless and destitute elderly immigrants. For instance, the local chapter of the Little Sisters of the...

Renal transplantation has become a successful means of treatment for patients with end-stage renal failure. However, in patients with kidney transplants, graft dysfunction can occur as a result of transplant renal artery stenosis (TxRAS). This can present with raised creatinine levels or as refractory hypertension resulting in increased use...

There is increasing evidence to show that good quality cardiopulmonary resuscitation (CPR) is important in achieving better resuscitative outcomes. One of the determinants for successful defibrillation is the effectiveness of chest compressions. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Thoracolumbar junction vertebrae are particularly vulnerable in traumatic injuries and up to 90% of all spinal fractures occur in this area. Treatment of thoracolumbar fractures has been a controversial subject for many years. Non-operative management recommended by some authors is effective when there is no evidence of neural compression...

In ischaemic stroke, acute reperfusion therapy aims to recanalise arterial obstruction leading to salvage of hypoperfused cerebral tissue with the goal of improving clinical outcomes. Reperfusion treatments include intravenous thrombolysis with alteplase which is licensed within the narrow therapeutic window of 4.5 hours, novel intravenous fibrinolytics which are under...

Singapore is experiencing an unprecedented age shift as the post-war baby boomers turn 65 years in 2012. Currently there are 378,700 people aged 65 and above, and these numbers are estimated to go up to 600,000 by 2020. These growing elderly population have multiple coexisting medical conditions which are...

Singapore is ageing rapidly. Whereas ageing symbolises advancements that the country has made in public health and medicine over the past few decades, it has brought new concerns regarding care for the elderly, and especially in the last years or months of life. A report commissioned by the Lien...

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 the first page and a hash-marked visual analogue scale (EQ-VAS) on the second page. Importantly, responses to the DS can be converted into a utility...