Singapore medical journal最新文献

{"title":"Endoscope-assisted revision surgery for cochlear implant electrode array exposure: a case report.","authors":"Liting Wen, Yukai Zhang, Jun Chen, Jianhua Qiu","doi":"10.4103/singaporemedj.SMJ-2020-547","DOIUrl":"10.4103/singaporemedj.SMJ-2020-547","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"524-525"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222520","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":"Dual rheumatoid factor and anti-cyclic citrullinated peptide antibody positivity affects the manifestations of rheumatoid arthritis.","authors":"Li Huan Angela Marie Chan, Khai Pang Leong, Justina Wei Lynn Tan, Xiao Gao, Wei Qiang See, Ee Tzun Koh","doi":"10.4103/singaporemedj.SMJ-2021-104","DOIUrl":"10.4103/singaporemedj.SMJ-2021-104","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) are used in the diagnosis and prognostication of rheumatoid arthritis (RA). We wanted to determine the specific contributions of RF and ACPA to the biological nature of RA and whether they act synergistically.</p><p><strong>Methods: </strong>We identified 731 patients from our prospective multi-ethnic RA cohort and categorised them into four groups: ACPA-positive, RF-positive, doubly positive and doubly negative. We compared the demographics, Disease Activity Score-28, Health Assessment Questionnaire score, quality of life using Short Form 36 and the use of prednisolone and disease-modifying antirheumatic drugs (DMARDs) of these patient groups.</p><p><strong>Results: </strong>Four hundred and ninety-one patients (67.2%) were ACPA+RF+, 54 (7.4%) were ACPA+RF-, 82 (11.2%) were ACPA-RF+ and 104 (14.2%) were ACPA-RF-. Mean disease duration before the study entry was not different in the four groups. Patients with older age of onset were less likely to be positive for RF and ACPA. Fewer ACPA+RF+ patients were in remission compared to those in the other groups ( P < 0.05). Erythrocyte sedimentation rate (ESR) was higher at study entry in the ACPA+RF+ group (40.4 mm/h vs. 30.6-30.9 mm/h, P < 0.05). Prednisolone and number of DMARDs used were higher in the ACPA+RF+ group compared to the doubly negative group. There were no differences in the functional status and quality of life.</p><p><strong>Conclusions: </strong>RA patients who were positive for both ACPA and RF had lower remission rate, higher baseline ESR and required more corticosteroid and DMARD treatment compared to those who were singly positive or doubly negative. Being doubly positive confers a worse outcome to RA patients.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"486-491"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447022","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":"Anterior cruciate ligament reconstruction: the learning continues.","authors":"Dave Yee Han Lee, K Satku","doi":"10.4103/singaporemedj.SMJ-2021-308","DOIUrl":"10.4103/singaporemedj.SMJ-2021-308","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"495-496"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9180501","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":"First reported case of congenital perineal groove in Malaysia and Southeast Asia.","authors":"Chai Hoon Soh, John Emmanuel A/L Gilbert Fernandez, Nurdaliza Binti Mohd Badarudin, Mohamad Ikhwan Bin Rahizan, Pui Wah Chey","doi":"10.4103/singaporemedj.SMJ-2021-180","DOIUrl":"10.4103/singaporemedj.SMJ-2021-180","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"522-523"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447019","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":"Predicting late aortic complications after acute type A dissection surgery with volumetric measurements in a Singapore cohort.","authors":"Jasmine Ge, Vinay Bahadur Panday, Siew-Pang Chan, Bernard Wee, Julian Chi Leung Wong, Leok Kheng Kristine Teoh, Moe Thu San, Carlos A Mestres, Theodoros Kofidis, Vitaly A Sorokin","doi":"10.4103/singaporemedj.SMJ-2021-222","DOIUrl":"10.4103/singaporemedj.SMJ-2021-222","url":null,"abstract":"<p><strong>Introduction: </strong>This study was conducted to evaluate the efficacy of postoperative computed tomography (CT) measurements of aortic lumen volumes in predicting aortic-related complications following acute type A aortic dissection (ATAAD) repair.</p><p><strong>Methods: </strong>We conducted a single-institution retrospective aortic volumetric analysis of patients after ascending aorta replacement performed during 2001-2015. The volumetric measurements of total lumen (total-L), true lumen (TL), false lumen (FL), as well as the TL:FL ratio from the first and second postoperative computer angiograms were obtained. A generalised structural equation model was created to analyse the predictive utility of TL:FL ratio.</p><p><strong>Results: </strong>One hundred and twenty-five patients underwent surgical intervention, of whom 97 patients were eventually discharged and analysed for postoperative complications. A total of 19 patients were included in the final analysis. Patients with late postoperative aortic complications had a significantly higher FL volume and total-L volume on the first (FL volume P = 0.041, total-L volume P = 0.05) and second (FL volume P = 0.01, total-L volume P = 0.007) postoperative scans. The odds of having aortic complications were raised by 1% with a 1 cm 3 increase in total-L volume and by 2% with a 1 cm 3 increase in FL volume. The TL:FL ratio was significantly lower in patients who developed complications.</p><p><strong>Conclusion: </strong>Postoperative CT volumetric measurements in patients who developed complications are characterised by a significant increase in the FL volume and total-L volume from the first postoperative scans. Patients with disproportionately expanded FL presenting with TL:FL ratios less than 1 were associated with aortic complications. Hence, the TL:FL ratio may be a reliable and useful parameter to monitor postoperative disease progression and to evaluate the risk of late complications in ATAAD patients.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"469-475"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9447023","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":"Postoperative urinary retention following hip or knee arthroplasty under spinal anaesthesia with intrathecal morphine: a retrospective cohort study.","authors":"Elad Dana, Oz Ben-Zur, Sara Dichtwald, Guy Feigin, Noa Brin, Michael Markushevich, Brian Fredman, Yaron Shraga Brin","doi":"10.4103/singaporemedj.SMJ-2022-108","DOIUrl":"10.4103/singaporemedj.SMJ-2022-108","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative urinary retention (POUR) frequently complicates the course of patients following hip and knee arthroplasty. Intrathecal morphine (ITM) was identified as a significant risk factor for POUR. The objective of this study was to investigate the incidence and risk factors for POUR in fast-track total joint arthroplasty (TJA) under spinal anaesthesia (SA) with ITM.</p><p><strong>Methods: </strong>We conducted a retrospective study of our institutional joint registry of patients who underwent primary TJA under SA with ITM between October 2017 and May 2021. Preoperative (baseline demographics) and perioperative data were collected. The primary outcome was the incidence of POUR after 8 h or earlier, either due to lack of voiding or according to patient's complaints of bladder distension. Univariate and adjusted analyses were performed to identify predictors of POUR.</p><p><strong>Results: </strong>Sixty-nine patients who underwent total knee arthroplasty (TKA) and 36 patients who underwent total hip arthroplasty (THA) under SA with ITM were included in the study. POUR requiring bladder catheterisation was diagnosed in 21% of patients. Independent predictors of POUR were age over 65 years and male gender.</p><p><strong>Conclusions: </strong>SA with ITM for TJA is associated with high rates of POUR in males older than 65 years of age. Other previously identified risk factors such as intraoperative fluid administration or comorbidities may not be as influential.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"481-485"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020008","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 East Asian gut microbiome and its role in oncology: a narrative review.","authors":"Evelyn Yi Ting Wong, Jonathan Wei Jie Lee, Jeremy Fung Yen Lim, Han Chong Toh","doi":"10.4103/singaporemedj.SMJ-2022-042","DOIUrl":"10.4103/singaporemedj.SMJ-2022-042","url":null,"abstract":"<p><strong>Abstract: </strong>The field of onco-microbiome is rapidly expanding. Multiple studies have shown the crucial role of gut microbiota in the regulation of nutrient metabolism, immunomodulation and protection against pathogens. Tools for manipulating the gut microbiota include dietary modification and faecal microbiota transfer. Accumulating evidence has also documented the application of specific intestinal microbiome in cancer immunotherapy, notably in enhancing the efficacy of immune checkpoint inhibitors. The aim of this review is to focus on the East Asian microbiome and to provide a current overview of microbiome science and its clinical application in cancer biology and immunotherapy.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"426-430"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9717851","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":"Intraventricular and subarachnoid migration of silicone oil from previous intraocular injection mimicking intracranial haemorrhage: a case report.","authors":"Tai Long Evan Tan, Yan Rong Yong, Jia Ren Perry Liew","doi":"10.4103/singaporemedj.SMJ-2021-107","DOIUrl":"10.4103/singaporemedj.SMJ-2021-107","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"407-409"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237882","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":"Association between visual impairment and body mass index in students from rural China.","authors":"Hongyu Guan, Zhijie Wang, Yuxiu Ding, Yunyun Zhang, Kang Du, Yaojiang Shi","doi":"10.4103/singaporemedj.SMJ-2021-387","DOIUrl":"10.4103/singaporemedj.SMJ-2021-387","url":null,"abstract":"<p><strong>Introduction: </strong>Visual impairment and obesity remain the major public health issues among school-age students in rural areas of China. Obesity is an underlying risk of vision problems. This study aimed to assess the association between visual impairment and body mass index (BMI) among school-age students in rural northwest China.</p><p><strong>Methods: </strong>This study included 39,385 students from the 4 th to 9 th grade in rural northwest China. From 2018 to 2020, students underwent an assessment of visual acuity (VA) and completed a questionnaire on family demographics, and height and weight measurements. Multiple logistic regression analyses were used to analyse the data.</p><p><strong>Results: </strong>The association between visual impairment and BMI groups was significant in the study population ( P = 0.002) and in different groups (at the different educational, provincial and national levels) ( P < 0.001, separately). Multiple logistic regression analyses revealed a positive relationship between visual impairment and obesity in the study population, including those attending primary school, Han students and the residents of Ningxia autonomous region.</p><p><strong>Conclusion: </strong>The association between visual impairment and obesity was significant among school-age students in rural northwest China. There should be implementation of policies to address the problem about visual impairment and obesity among school-age students in rural areas.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"362-367"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9489196","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":"Post COVID-19 syndrome and new onset diseases: a prospective observational study.","authors":"Nitin Sinha, Mahinder Pal Singh Chawla, Desh Deepak, Amit Suri, Piyush Jain, Ankit Agarwal, Manoj Kumar Bhakhar","doi":"10.4103/singaporemedj.SMJ-2022-055","DOIUrl":"10.4103/singaporemedj.SMJ-2022-055","url":null,"abstract":"<p><strong>Introduction: </strong>The National Institute of Health and Care Excellence (NICE) has defined the terms, 'acute coronavirus disease 2019' (COVID-19), 'ongoing symptomatic COVID-19' and 'post-COVID-19 syndrome', with the latter two described as having persistent symptoms after the onset of COVID-19 symptoms for 4-12 weeks and >12 weeks, respectively. Persistent symptoms can either be due to the after-effects of COVID-19 or new-onset diseases after acute COVID-19. All symptoms observed beyond 4 weeks after the onset of COVID-19 need not be present at the time of onset. Previous studies on persistent post-COVID-19 symptoms have not mentioned new-onset diseases after acute COVID-19, and only a select few studies have discussed such new-onset symptoms.</p><p><strong>Methods: </strong>Ninety-five patients who attended the post-COVID-19 clinic completed the requisite follow-up till 16 weeks after COVID-19 symptom onset. Data was recorded on a predesigned proforma. Necessary investigations were conducted to rule out any other cause of persistent symptoms.</p><p><strong>Results: </strong>Fatigue (62.1%), breathlessness (50.5%) and cough (27.4%) were the most common symptoms present beyond 4 weeks after the onset of COVID-19 symptoms. Forty-nine (51.57%) patients developed post-COVID-19 syndrome - their severity of symptoms (odds ratio [OR] 17.77) and longer duration of hospital stay (OR 1.095) during acute disease were significantly associated with the development of post-COVID-19 syndrome. During follow-up, 25 patients developed new-onset symptoms, such as diabetes mellitus, hypertension and idiopathic tachycardia.</p><p><strong>Conclusion: </strong>Patients can have persistent symptoms, new-onset symptoms and new-onset diseases after recovery from acute COVID-19.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":" ","pages":"354-361"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9383464","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}