Singapore medical journal最新文献

{"title":"Neutropenia following rituximab in paediatric non-malignant diseases: case series and review of the literature.","authors":"Zhi Rui Samuel Lim, Kai Liang Teh, Lena Das, Thaschawee Arkachaisri","doi":"10.11622/smedj.2021188","DOIUrl":"10.11622/smedj.2021188","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"698-702"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39867765","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":"Compliance with face mask use during the COVID-19 pandemic: a community observational study in Singapore.","authors":"Sean Wei Xiang Ong, Ying Wei Tang, Kyaw Zaw Linn, Xiao Wei Huan, Allie Lim, Chu Ying Poon, Danielle Hui Ru Tan, Nur Hafizah Binte Hamed, Sharifah Farhanah Binte Syed Husen, Clara Chong Hui Ong, Monica Chan, Shawn Vasoo, Yee-Sin Leo, Oon-Tek Ng, Kalisvar Marimuthu","doi":"10.4103/singaporemedj.SMJ-2021-010","DOIUrl":"10.4103/singaporemedj.SMJ-2021-010","url":null,"abstract":"<p><strong>Introduction: </strong>Widespread mask use is an important intervention for control of the coronavirus disease 2019 pandemic. However, data on the factors affecting mask use are lacking. In this observational study, we evaluated the proportion of and factors influencing face mask use and related hygiene practices.</p><p><strong>Methods: </strong>We observed randomly selected members from the public in 367 venues across Singapore, and recorded the proportion of individuals with full compliance with mask use and mask hygiene (hand hygiene before and after touching the mask or face). Logistic regression analyses were used to determine variables associated with mask and hand hygiene compliance.</p><p><strong>Results: </strong>We made 3,821 observations - 2,149 (56.2%) females, 3,569 (93.4%) adults (≥21 years), 212 (5.5%) children (6-20 years) and 40 (1.0%) children (2-5 years). The overall full compliance rate (correct mask use), poor compliance rate (incorrect mask use) and absent mask use were 84.5%, 12.9% and 2.6%, respectively. The factors - male gender, fabric mask usage and crowded indoor venues - were associated with lower mask compliance. Face or mask touching behaviour was observed in 10.7% and 13.7% of individuals observed, respectively. Only one individual performed hand hygiene before and after touching the mask.</p><p><strong>Conclusion: </strong>The rate of mask compliance was high, probably due to legislation mandating mask usage. However, specific factors and crowded indoor venues associated with lower mask compliance were identified. We also noted an issue with the absence of hand hygiene before and after face or mask touching. These issues may benefit from targeted public health messaging.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"674-680"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817079","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":"Laryngeal mask airway in out-of-hospital cardiac arrest.","authors":"Yuet Nog Tang, Chun Tat Lui, Hin Tat Fung, Lap Yip Lee, Chu Leung Lau","doi":"10.11622/smedj.2021197","DOIUrl":"10.11622/smedj.2021197","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"703-707"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39758904","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":"A year of COVID-19: effects of a global pandemic on a hip fracture bundled care protocol.","authors":"Khai Cheong Wong, Kenny Xian Khing Tay, Suang Bee Koh, Tet Sen Howe","doi":"10.4103/singaporemedj.SMJ-2021-351","DOIUrl":"10.4103/singaporemedj.SMJ-2021-351","url":null,"abstract":"<p><strong>Introduction: </strong>Our aim was to analyse how the coronavirus disease 2019 (COVID-19) pandemic affects a hip fracture bundled care protocol. We hypothesised that key performance indicators, but not short-term outcomes, may be adversely affected.</p><p><strong>Methods: </strong>Patients admitted under a hip fracture bundled care protocol were divided into two arms: 'COVID' group included patients admitted in 2020 during the COVID-19 pandemic and 'PRE-COVID' group included patients admitted in 2019. We retrospectively analysed time to admission, time to surgery, length of stay, discharge disposition, as well as rates of 30-day revision surgery, 30-day readmission and inpatient mortality.</p><p><strong>Results: </strong>There were 307 patients in the PRE-COVID group and 350 patients in the COVID group. There was no significant difference in terms of gender, age and type of hip fracture. The COVID group had a higher proportion of American Society of Anesthesiologists classification III and IV patients (61.4% vs. 50.2% in the PRE-COVID group; P = 0.004). In the COVID group, similar proportion of patients were admitted to the ward within 4 h, but the mean time to surgery was longer (71.8 ± 73.0 h vs. 60.4 ± 72.8 h in the PRE-COVID group; P = 0.046) and few patients underwent operations within 48 h (41.7% vs. 60.3% in the PRE-COVID group; P < 0.001). Mean postoperative length of stay, discharge disposition, as well as rates of inpatient mortality, 30-day revision surgery and 30-day readmission were similar.</p><p><strong>Conclusion: </strong>The volume of hip fractures during the COVID-19 pandemic remained unchanged, although patients admitted during the COVID-19 pandemic appeared to be more deconditioned. Nevertheless, having robust protocols and staff familiar with hip fracture treatment can preserve short-term outcomes for this group of patients, even with strict isolation measures in place during a pandemic.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"669-673"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9439945","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":"Behavioural sleep problems in children.","authors":"Chun Yi Ting, Biju Thomas","doi":"10.4103/singaporemedj.SMJ-2021-102","DOIUrl":"10.4103/singaporemedj.SMJ-2021-102","url":null,"abstract":"<p><strong>Abstract: </strong>Behavioural sleep problems are very common in children and are concerns for many parents. This review discusses normal sleep physiology and sleep development and focuses on common behavioural sleep problems in childhood, including behavioural insomnia of childhood, parasomnias and sleep-related movement disorders, highlighting their clinical features and management. Behavioural insomnia of childhood is characterised by learned difficulties in falling asleep and/or staying asleep. Management includes establishing bedtime routines and behavioural techniques. Parasomnias include confusional arousals, sleepwalking, sleep terrors and nightmares, and these usually resolve with time. Management includes parental reassurance and behavioural interventions such as scheduled awakening. With regards to sleep enuresis, management includes behavioural modifications, enuresis alarm and desmopressin. Sleep-related movement disorders include sleep-related bruxism and sleep-related rhythmic movements, of which body rocking is the most common. Early identification and management of behavioural sleep problems may prevent their negative impact on children as well as their families.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"599-606"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183273","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":"The use of protocolised sedation to reduce benzodiazepine use and improve sedation practices in a medical intensive care unit in Singapore.","authors":"Roshni Sadashiv Gokhale, Ian Wee, Tan Poh Choo, Michelle See, Siau Chuin","doi":"10.4103/singaporemedj.SMJ-2021-060","DOIUrl":"10.4103/singaporemedj.SMJ-2021-060","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"631-634"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363619","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":"Factors associated with readmission after long-term administration of tolvaptan in patients with congestive heart failure.","authors":"Shoko Yamashita, Miki Takenaka, Masayuki Ohbayashi, Noriko Kohyama, Tatsuya Kurihara, Tomiko Sunaga, Hisaaki Ishiguro, Mari Kogo","doi":"10.4103/singaporemedj.SMJ-2021-348","DOIUrl":"10.4103/singaporemedj.SMJ-2021-348","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the factors associated with readmission in patients with congestive heart failure (HF) receiving long-term administration of tolvaptan (TLV) to support treatment decisions for HF.</p><p><strong>Methods: </strong>This retrospective cohort study included 181 patients with congestive HF who received long-term administration of TLV. Long-term administration of TLV was defined as the administration of TLV for 60 days or longer. The outcome was a readmission event for worsening HF within 1 year after discharge. Significant factors associated with readmission were selected using multivariate analysis. To compare the time to readmission using significant factors extracted in a multivariate analysis, readmission curves were constructed using the Kaplan-Meier method and analysed using the log-rank test.</p><p><strong>Results: </strong>The median age was 78 years (range, 38-96 years), 117 patients (64.6%) were males, and 77 patients (42.5%) had a hospitalisation history of HF. Readmission for worsening HF within 1 year after long-term TLV treatment occurred in 62 patients (34.3%). In the multivariate analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 (odds ratio, 3.22; 95% confidence interval, 1.661-6.249; P = 0.001) was an independent significant factor. When eGFR at discharge was divided into two groups (eGFR < 30 vs. eGFR ≥ 30), readmission rates within 1 year were 53.3% vs. 25.4%, respectively ( P = 0.001).</p><p><strong>Conclusion: </strong>We revealed that eGFR was strongly associated with readmission in patients with HF who received long-term administration of TLV. Furthermore, we showed that eGFR is an important indicator in guiding treatment of HF in patients receiving TLV.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"614-623"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222524","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":"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}