Singapore medical journal最新文献

{"title":"Rehabilitation outcome after acute subarachnoid haemorrhage: the role of early functional predictors and complications.","authors":"Karen Sui Geok Chua, Jonathan Jin Yuan Loke, Chien Joo Lim, Jocelyn Mei Lin Thio, Rathi Ratha Krishnan","doi":"10.11622/smedj.2021198","DOIUrl":"10.11622/smedj.2021198","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"650-653"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39647261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and outcomes in patients with moderate to severe aortic stenosis with or without concomitant chronic kidney disease.","authors":"Jinghao Nicholas Ngiam, Ching-Hui Sia, Nicholas Wen Sheng Chew, Tze Sian Liong, Zi Yun Chang, Chi Hang Lee, Wen Ruan, Edgar Lik-Wui Tay, William Kok-Fai Kong, Huay Cheem Tan, Tiong-Cheng Yeo, Kian Keong Poh","doi":"10.4103/singaporemedj.SMJ-2021-427","DOIUrl":"10.4103/singaporemedj.SMJ-2021-427","url":null,"abstract":"<p><strong>Introduction: </strong>Management of aortic stenosis (AS) in patients with chronic kidney disease (CKD) may often be overlooked, and this could confer poorer outcomes.</p><p><strong>Methods: </strong>Consecutive patients ( n = 727) with index echocardiographic diagnosis of moderate to severe AS (aortic valve area <1.5 cm 2 ) were examined. They were divided into those with CKD (estimated glomerular filtration rate < 60 mL/min) and those without. Baseline clinical and echocardiographic parameters were compared, and a multivariate Cox regression model was constructed. Clinical outcomes were compared using Kaplan-Meier curves.</p><p><strong>Results: </strong>There were 270 (37.1%) patients with concomitant CKD. The CKD group was older (78.0 ± 10.3 vs. 72.1 ± 12.9 years, P < 0.001), with a higher prevalence of hypertension, diabetes mellitus, hyperlipidaemia and ischaemic heart disease. AS severity did not differ significantly, but left ventricular (LV) mass index (119.4 ± 43.7 vs. 112.3 ± 40.6 g/m 2 , P = 0.027) and Doppler mitral inflow E to annular tissue Doppler e' ratio (E: e' 21.5 ± 14.6 vs. 17.8 ± 12.2, P = 0.001) were higher in the CKD group. There was higher mortality (log-rank 51.5, P < 0.001) and more frequent admissions for cardiac failure (log-rank 25.9, P < 0.001) in the CKD group, with a lower incidence of aortic valve replacement (log-rank 7.12, P = 0.008). On multivariate analyses, after adjusting for aortic valve area, age, left ventricular ejection fraction and clinical comorbidities, CKD remained independently associated with mortality (hazard ratio 1.96, 95% confidence interval 1.50-2.57, P < 0.001).</p><p><strong>Conclusion: </strong>Concomitant CKD in patients with moderate to severe AS was associated with increased mortality, more frequent admissions for cardiac failure and a lower incidence of aortic valve replacement.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"624-630"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are surgical fees between specialties fair?","authors":"Arshvin Kesavan, Priya Tiwari, Sanjeev Shanker, Kesavan Esuvaranathan","doi":"10.11622/smedj.2021186","DOIUrl":"10.11622/smedj.2021186","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"645-649"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39854527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of testosterone replacement therapy in the rehabilitation of patients with intensive care unit-associated weakness and hospital-associated deconditioning: the Singapore General Hospital rehabilitation experience.","authors":"Geoffrey Sithamparapillai Samuel, Du Soon Swee","doi":"10.4103/singaporemedj.SMJ-2021-307","DOIUrl":"10.4103/singaporemedj.SMJ-2021-307","url":null,"abstract":"<p><strong>Introduction: </strong>Rehabilitation medicine in a tertiary care hospital involves attending to many patients affected by intensive care unit (ICU)-associated weakness (ICU-AW) and hospital-associated deconditioning (HAD). These conditions contribute to poor long-term functional outcomes and increased mortality. We explored the role of short-term adjunctive androgen therapy in this group of patients in improving the rehabilitative outcomes.</p><p><strong>Methods: </strong>This was a retrospective analysis of five patients with either ICU-AW or HAD who were given testosterone replacement therapy (TRT) or oxandrolone for a total of 2 weeks during the period from April to November 2020 was undertaken. During the 2-week trial period, the subjects underwent standard rehabilitation therapy.</p><p><strong>Results: </strong>Grip strength was used as the primary outcome measure, and the mean improvement was 4.2 kg (+24.9%), which is encouraging in a 2-week timeframe. This was matched with good functional recovery in terms of distance ambulated and less assistance needed for ambulation. Sex hormone analysis was also done before initiation of TRT, and it showed that four out of five of the subjects were biochemically hypogonadal. None of the subjects dropped out or experienced any significant adverse events over the 2-week trial period. All the subjects except one improved to full independence at 3 months post-discharge.</p><p><strong>Conclusion: </strong>TRT has the potential to be used as a useful adjunct to standard rehabilitation in enhancing functional recovery in critically ill patients. A multidisciplinary approach would ensure that suitable patients benefit from optimal nutrition, optimal rehabilitation and synergistic testosterone therapy in a clinically sound and resource-efficient fashion.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"607-613"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining diabetic kidney disease severity using traditional Chinese medicine syndrome classification.","authors":"Amanda Yun Rui Lam, Huang Fang Zheng, Kok Keong Teo, Xiao Hui Xin, Chieh Suai Tan, Jean-Paul Kovalik, Sujoy Ghosh, Hong Chang Tan","doi":"10.11622/smedj.2021179","DOIUrl":"10.11622/smedj.2021179","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"519-524"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and acceptance of COVID-19 vaccine among pregnant and lactating women in Singapore: a pre-vaccine rollout cross-sectional study.","authors":"Pooja Agarwal Jayagobi, Chengsi Ong, Kee Thai Yeo, Caleb Chun Wei Lim, Meei Jiun Seet, Lee Koon Kwek, Chee Wai Ku, Jerry Kok Yen Chan, Manisha Mathur, Mei Chien Chua","doi":"10.4103/singaporemedj.SMJ-2021-259","DOIUrl":"10.4103/singaporemedj.SMJ-2021-259","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccination is critical in controlling the coronavirus disease 2019 (COVID-19) pandemic. However, vaccine perception and acceptance among pregnant and lactating women is unknown in Singapore. We aimed to determine the acceptance of COVID-19 vaccination among these two groups of women in Singapore and the factors associated with vaccine acceptance.</p><p><strong>Methods: </strong>We conducted an anonymous, online survey on the perceptions of the COVID-19 vaccine and its acceptance by pregnant and lactating women at a tertiary maternal and child hospital in Singapore from 1 March to 31 May 2021. Information on their demographics and knowledge was collected. These factors were assessed for their relationship with vaccine acceptance.</p><p><strong>Results: </strong>A total of 201 pregnant and 207 lactating women participated. Vaccine acceptance rates in pregnant and lactating women were 30.3% and 16.9%, respectively. Pregnant women who were unsure or unwilling to take the vaccine cited concerns about safety of the vaccine during pregnancy (92.9%), while lactating women were concerned about its potential long-term negative effects on the breastfeeding child (75.6%). Factors that were positively associated with vaccine acceptance included a lower monthly household income or education level, appropriate knowledge regarding vaccine mechanism and higher perceived maternal risk of COVID-19. Most pregnant (70.0%) and lactating women (83.7%) were willing to take the vaccine only when more safety data during pregnancy and breastfeeding were available.</p><p><strong>Conclusion: </strong>COVID-19 vaccine acceptance was low among pregnant and lactating women in Singapore. Addressing the safety concerns when more data are available and education on the mechanism of vaccine action will likely improve acceptance among these women.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"494-501"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on end-of-life care of critically ill surgical patients: a survey of anaesthesiology residents.","authors":"Yi Lin Lee, Shin Yi Ng","doi":"10.11622/smedj.2021180","DOIUrl":"10.11622/smedj.2021180","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"525-529"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11478999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes and practices of exercise among pregnant mothers in Singapore.","authors":"Yin Ru Tan, Kok Hian Tan, Fei Dai, Hak Koon Tan, Lay Kok Tan","doi":"10.4103/singaporemedj.SMJ-2021-247","DOIUrl":"10.4103/singaporemedj.SMJ-2021-247","url":null,"abstract":"<p><strong>Introduction: </strong>There is increasing evidence demonstrating the safety and benefits of physical activity (PA) in uncomplicated pregnancies. Literature has shown that pregnant women around the world do not engage in adequate exercise. This study aims to assess the current practices of exercise among pregnant women in Singapore, determine the proportion of women meeting different PA targets and evaluate the factors influencing the practice of exercise.</p><p><strong>Methods: </strong>In this cross-sectional study, pregnant women in different trimesters of pregnancy from KK Women's and Children's Hospital and Singapore General Hospital were surveyed. Information regarding patient demographics, attitudes and perceptions of exercise, and practice of exercise was collected. The International Physical Activity Questionnaire (IPAQ) was used to determine the amount of PA.</p><p><strong>Results: </strong>A total of 201 pregnant women aged 20-44 years were surveyed. Almost all (99.0%) participants thought that exercise was beneficial in pregnancy. Only 31.6% of them engaged in any moderate or vigorous leisure-time PA (LTPA) and they were active for a median of 120 min/week. Only 12.6% of the pregnant women met the national recommendations of at least 150 min of moderate exercise per week. The amount of total PA performed was lower among women in later trimesters of pregnancy and higher among working mothers.</p><p><strong>Conclusion: </strong>Although most Singaporean pregnant women perceived exercise as beneficial, the majority did not engage in PA. Most of the participants did not meet the international PA targets and recently published national guidelines. More can be done to promote the uptake of exercise in pregnancy and optimise metabolic management of pregnant women in Singapore.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"488-493"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11478998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and awareness of perinatal antiviral use in the prevention of mother-to-child hepatitis B virus transmission among maternal chronic hepatitis carriers.","authors":"Jia Ming Low, Ting Ma, Guan-Huei Lee, Le Ye Lee","doi":"10.11622/smedj.2021187","DOIUrl":"10.11622/smedj.2021187","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"514-518"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are primary care referrals to the paediatric orthopaedic speciality clinic always clinically indicated?","authors":"Nazrul Nashi, Selena Xueli Choo, Chintan Doshi, Keng Lin Francis Wong, Kean Seng Andrew Lim","doi":"10.11622/smedj.2021178","DOIUrl":"10.11622/smedj.2021178","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"471-475"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39550058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}