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Acute hypercapnic respiratory failure in thyroid storm and the role of plasma exchange

Dear Editor, Thyroid storm is a life-threatening condition due to excessive release of thyroid hormone. Cardiovascular, gastrointestinal and neurological manifestations have been described.1 Acute respiratory...

Invasive Cancer after Treatment of Cervical Intraepithelial Neoplasia

The objective of a cervical screening programme is to prevent invasive cancer of the cervix by detecting and treating pre-invasive disease of the cervix....

Systemic Sclerosis in DRw52-positive Silica-exposed Males: A Case Report

Familial scleroderma was first documented in 1953 by Rees and Bennett who described the occurrence of a localised disease in a father and daughter....

Osteoporosis—The Need for a Paradigm Shift

Osteoporosis is becoming an increasing public health problem in most countries. Osteoporosis literally means “porous bones” and involves skeletal fragility leading to an increased...

Managing Problem Gout

Gout occurs in 3 overlapping phases: a long phase of asymptomatic hyperuricaemia, a period of recurrent acute gouty attacks separated by asymptomatic intervals (interval...

Rheumatoid Arthritis—A Review

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis which is occasionally associated with extraarticular manifestations. Although the first good clinical description was by Landre-Beauvais...

Clinical Presentation and Disease Associations of Gout: A Hospital-based Study of 100 Patients in Singapore

Gout is a common metabolic disease that causes arthritis which is often painful and sometimes disabling. It results from the deposition of monosodium urate...

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...

Under-diagnosed Psychiatric Syndrome II: Pathologic Skin Picking

Pathologic skin picking may be defined as the habitual picking of skin lesions, which when chronic and extensive, can lead to significant distress, dysfunction...

Under-diagnosed Psychiatric Syndrome I: Trichotillomania

Trichotillomania (TTM) is a chronic psychiatric condition characterised by uncontrollable, self-inflicted, hair pulling, resulting in noticeable hair loss. First described by Hallopeau a century...

Current Therapeutic Strategies in Glomerulonephritis

Twenty years ago, the therapy of glomerulonephritis (GN) was relatively simple as it was believed that treatment with prednisolone should be confined to patients...

Case Reports of Low Dose Cyclosporine A Therapy in Adult Minimal Change Nephrotic Syndrome

There have been many reports on the use of conventional doses of cyclosporine A (CsA) in inducing remission among adults with minimal change nephrotic...

Update in the Management of Stroke

Stroke is the fourth leading cause of death and a leading cause of morbidity in Singapore. The number of hospital admissions for cerebrovascular disorders...

Clinical Update on Osteoporosis

Fractures, the most serious complication of osteoporosis, are increasing and constitute an evolving public health problem in terms of disability, mortality and cost. A...

An Asian Perspective to the Problem of Osteoporosis

Osteoporosis is regarded as an important public health problem in many Caucasian populations. Much of the research on epidemiology, diagnosis, treatment, genetic and molecular...

Contemporary Management of Fibroids

Fibroids are the most common, solid benign pelvic tumours occurring in about 30% of women beyond the age of 30. They are asymptomatic in...

Surgical Management of Colorectal Metastases to the Liver

Colorectal carcinoma is the second commonest cancer in both males and females in Singapore, accounting for about 15% of all cancer cases. The liver...

The Diagnosis and Management of Hypercalcaemia

Hypercalcaemia is a relatively common clinical problem with the widespread use of routine biochemical screening. Population studies have suggested a prevalence of 3% in...

Nipah Encephalitis Outbreak in Malaysia

From September 1998 to June 1999, there was an outbreak of viral encephalitis in several pig farming villages in Malaysia. The outbreak, which started...

A Case Report of Occupational Asthma due to Gluteraldehyde Exposure

Worldwide, asthma is estimated to affect between 5% and 10% of the population and, among adults, 4% to 9% of these cases have been...

Bile Duct Perforation in Children: Is it Truly Spontaneous?

Bile duct perforation (BDP) and biliary ascites in children is a rare clinical entity. The aetiopathogenesis is still elusive. This article is available only as...

Swallowed Foreign Bodies in Children: Report of Four Unusual Cases

Foreign body (FB) ingestion in children is a frequent and frightening experience to the patients and caregivers. It is a common paediatric problem necessitating...

Newborn Screening for all Identifiable Disorders with Tandem Mass Spectrometry is Cost Effective: The Negative Case

This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Facilitation of Students’ Discussion in Problem-based Learning Tutorials to Create Mechanisms: The Use of Five Key Questions

An important aspect of problem-based learning (PBL), particularly in the early years of the undergraduate medical, physiotherapy, nursing and dental courses, is teaching basic...

The NORSE (New-onset Refractory Status Epilepticus) Syndrome: Defining a Disease Entity

Status epilepticus (SE) describes a clinical condition characterised by an epileptic seizure or a series of seizures that lasts for at least 30 minutes...

Obesity and Obstructive Sleep Apnoea Hypopnoea Syndrome in Singapore Children

Obesity is becoming a problem of epidemic proportions and is perhaps, the most pervasive medical problem faced by medical providers today. It is a...

Assessment of Vertigo

Vertigo has been said to be the greatest “heartsink” symptom in medicine. That certainly is a possibility but every specialty has its similar conditions,...

A Walk Through the Management of Parkinson’s Disease

The management of idiopathic Parkinson’s disease is deceptively simple. Current practice, which consists of replacing dopamine on a twice or thrice daily regime may...

Perforated Appendicitis in Children: Benefits of Early Laparoscopic Surgery

Despite perforated appendicitis (PA) being a common surgical emergency in childhood, controversy still exists with regard to its management in this era of minimal...

Clinical Aspects and Management of Fibromyalgia Syndrome

Fibromyalgia syndrome (FMS) has been referred to as a medically unexplained syndrome;1,2 a rheumatological entity described in rheumatology textbooks and taught to all training...

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...

Singapore Rhabdomyosarcoma (RMS) Experience: Shall We Change Our Practice?

Rhabdomyosarcoma (RMS) constitutes nearly 4% of all children diagnosed with cancer in the ethnically diverse small island city of Singapore. It is the most...

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...

Incidence and trends of ophthalmic cancer in Singapore: Data from Singapore Cancer Registry

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