Singapore medical journal最新文献

{"title":"Motorised spiral enteroscopy: pilot experience from a tertiary care centre in Singapore.","authors":"Raymond Liang, Kalaiyarasi Kaliyaperumal, Wee Khoon Ng, Stephen Kin Kwok Tsao, Charles Kien Fong Vu","doi":"10.11622/smedj.2022096","DOIUrl":"10.11622/smedj.2022096","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40516417","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":"Approach to clinically significant vascular anomalies in children.","authors":"Raymond Reinaldo Tanugroho, Lynette Wei Yi Wee, Mark Jean Aan Koh, Jin Ho Chong","doi":"10.11622/smedj.2021209","DOIUrl":"10.11622/smedj.2021209","url":null,"abstract":"<p><p>Vascular anomalies consist of tumours or malformations made up of abnormal growth or collections of blood vessels that can result in functional or cosmetic problems. While many vascular anomalies are present at birth, some do not appear until later in life, making diagnosis more challenging. Although many vascular anomalies are benign, some are associated with serious complications and may involve multiple organ systems. This article highlights the important features of clinically significant vascular anomalies to help physicians promptly identify and refer these cases to a specialised multidisciplinary team for evaluation and management. The discussion includes the various presenting complaints of vascular anomalies in children, namely, rapidly growing birthmarks, painful lesions, seizures/neurological manifestations, bleeding diathesis, cardiac/airway abnormalities and part of an overgrowth syndrome.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39758901","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":"<i>Fusobacterium necrophorum</i> pharyngitis complicated by sepsis and extrapharyngeal dissemination in two young adults.","authors":"Raphael Wei Hao Tay, Shawn Vasoo","doi":"10.11622/smedj.2022084","DOIUrl":"10.11622/smedj.2022084","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342122","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":"Early mobilisation following fragility hip fracture surgery: current trends and association with discharge outcomes in a local tertiary hospital.","authors":"Shumei Tan, Aswinkumar Vasireddy","doi":"10.11622/smedj.2021132","DOIUrl":"10.11622/smedj.2021132","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative day 1 (POD 1) mobilisation is a key clinical indicator for the fragility hip fracture surgery population. This study aimed to evaluate the current trends of POD 1 mobilisation at our institution and to review the relationships between early mobilisation and outcomes of early functional recovery, length of stay (LOS) and discharge destination.</p><p><strong>Methods: </strong>In this preliminary observational study, data pertaining to demographics, premorbid function, health status, injury and surgical factors, POD 1 mobilisation status and clinical outcomes of interest were retrieved from eligible patients. Patients who attained POD 1 ambulation formed the early ambulation (EA) group, while the remaining patients formed the delayed ambulation (DA) group. Data were analysed for any significant difference between the groups.</p><p><strong>Results: </strong>One hundred and fifteen patients were included in the analysis. The rate of patients achieving at least sitting out of bed on POD 1 was 80.0% (n=92), which was comparable to the data available from international hip fracture audit databases. There were 55 (47.8%) patients in the EA group and 60 (52.5%) patients in the DA group. The EA group was approximately nine times more likely to achieve independence in ambulation at discharge compared to the DA group (adjusted odds ratio 9.20, 95% confidence interval 1.50-56.45; P = 0.016). There were observed trends of shorter LOS and more proportion of home discharge in the EA group compared to the DA group (P > 0.05).</p><p><strong>Conclusion: </strong>This is the first local study to offer benchmark of the POD 1 mobilisation status for this population. Patients who attained POD 1 ambulation had better early functional recovery.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39494808","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":"Soft tissue sarcomas of the extremity and superficial trunk: do we need radiotherapy?","authors":"Lester Wai Mon Chan, Daniel Xing Cheng Yin, Sean Cheng Gong, Daniel Wei Ren Seng, Mathew Hern Wang Cheng","doi":"10.11622/smedj.2022093","DOIUrl":"10.11622/smedj.2022093","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40516418","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":"Mindfulness and reflective practice pilot programme of Postgraduate Year 1 doctors: perceptions on impact and sustainability","authors":"Mae Yue Tan, Shuh Shing Lee, Marion Margaret Aw, Nasyitah Binte Abd Aziz, Yih Lin Lim, Suan Peen Foo, Ze Lei Tan, Andrew Anjian Sng, Yu Han Chee, Nicholas Beng Hui Ng, Jeremy Bingyuan Lin","doi":"10.4103/singaporemedj.smj-2021-419","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-419","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139200150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout among COVID-19 hospital-based contact tracers in Singapore: results of a mixed-method, cross-sectional multicentre study","authors":"Ian Matthias Ng, Tzu-Jung Wong, Yong Yang, I. Venkatachalam, J. Sim, L. Wee, T. Liew, Evelyn Boon, Tong Yong Ng, Hwi Kwang Han, Diana Yuen Lan Tan","doi":"10.4103/singaporemedj.smj-2021-458","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-458","url":null,"abstract":"During the coronavirus disease 2019 (COVID-19) pandemic, contact tracers were under immense pressure to deliver effective and timely contact tracing, raising concerns of higher susceptibility to burnout. Our study aimed to determine burnout prevalence among hospital-based contact tracers and associated risk factors, so that interventions to reduce burnout risk could be formulated. One hundred and ninety-six active contact tracers across three hospitals within a healthcare cluster were invited to complete an anonymous online survey. To identify burntout, data such as demographics, work-related variables and contact tracing-related variables were collected using the Copenhagen Burnout Inventory. Associated factors were identified using multivariate statistics. Open-ended questions were included to understand the challenges and potential improvements through qualitative analysis. A total of 126 participants completed the survey, giving a completion rate of 64%, and almost half of these participants (42.9%) reported burnout. Protective factors included being on work-from-home arrangements (adjusted odds ratio [OR] 0.22, 95% confidence interval [CI] 0.08–0.56), perception of being well supported by their institution (adjusted OR 0.25, 95% CI 0.08–0.80) and being married (adjusted OR 0.28, 95% CI 0.12–0.64). Risk factors included having an administrative role pre–COVID-19 (adjusted OR 3.62, 95% CI 1.33–9.83). Work-related burnout was related to being activated for more than 1 day in the preceding week (unadjusted OR 3.25, 95% CI 1.33–7.94) and multiple activations in a day (unadjusted OR 3.54, 95% CI 1.44–4.41). Biggest challenges identified by participants were language barrier (62.7%), followed by workflow-related issues (42.1%). Our study demonstrated burnout and other challenges faced by a team of mostly hospital-based administrative staff redeployed on a part-time basis to ensure timely contact tracing. To mitigate burnout, we recommend choosing staff on work-from-home arrangements and ensuring adequate manpower and rostering arrangements.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139199265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering primary care in the management of toe fractures: a quality improvement project","authors":"Valerie Huali Tan, Amaris Shu Min Lim, Sky Wei Chee Koh, Jun Hao Tan, Choon Chiet Hong","doi":"10.4103/singaporemedj.smj-2022-019","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2022-019","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of deep learning model for paediatric elbow radiograph binomial classification: initial experience, performance and lessons learnt","authors":"M. Tan, R. Y. Chua, Qiao Fan, M. Fortier, P. P. Chang","doi":"10.4103/singaporemedj.smj-2022-078","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2022-078","url":null,"abstract":"In this study, we aimed to compare the performance of a convolutional neural network (CNN)-based deep learning model that was trained on a dataset of normal and abnormal paediatric elbow radiographs with that of paediatric emergency department (ED) physicians on a binomial classification task. A total of 1,314 paediatric elbow lateral radiographs (patient mean age 8.2 years) were retrospectively retrieved and classified based on annotation as normal or abnormal (with pathology). They were then randomly partitioned to a development set (993 images); first and second tuning (validation) sets (109 and 100 images, respectively); and a test set (112 images). An artificial intelligence (AI) model was trained on the development set using the EfficientNet B1 network architecture. Its performance on the test set was compared to that of five physicians (inter-rater agreement: fair). Performance of the AI model and the physician group was tested using McNemar test. The accuracy of the AI model on the test set was 80.4% (95% confidence interval [CI] 71.8%–87.3%), and the area under the receiver operating characteristic curve (AUROC) was 0.872 (95% CI 0.831–0.947). The performance of the AI model vs. the physician group on the test set was: sensitivity 79.0% (95% CI: 68.4%–89.5%) vs. 64.9% (95% CI: 52.5%–77.3%; P = 0.088); and specificity 81.8% (95% CI: 71.6%–92.0%) vs. 87.3% (95% CI: 78.5%–96.1%; P = 0.439). The AI model showed good AUROC values and higher sensitivity, with the P-value at nominal significance when compared to the clinician group.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139211279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic myonecrosis in haemodialysis patients: importance of early recognition, noninvasive diagnosis and treatment","authors":"Jin Wen Rachael Nai, Jingyin Sophia Ng, Eng Kuang Lim, Claude Jeffrey Renaud, Fams Renal Medicine","doi":"10.4103/singaporemedj.smj-2021-431","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-431","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139213230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}