The rich corporate life of the medical student and the medical students' societies at our medical school (at the present National University of Singapore) is generally unappreciated by its graduates and regrettably, even more unknown to the medical student of today. The present generation of medical students of NUS do not know of their rich history. We have published documentation of student activities from the founding of the medical school in 1905 till the establishment of the then University of Malaya in 1950, reviewed herein. Materials presented after 1950 were gathered from personal communications from key players in the students' societies and from editors of the medical students' publications.
The Medical Alumni is unique in being the oldest alumni association with medical, dental and pharmacy graduates from our seminal medical school, that has now evolved into the faculties of medicine in 2 countries, namely Malaysia and Singapore. Founded in 1923, the medical alumni association has undergone several name changes with its evolution and activism. After the Japanese Occupation, it was given its present name in 1947, comprising 3 branches working under a common Constitution operating in 2 separate countries. It is also unique in being the only association recognised by the Registrar of Societies with membership in 2 countries. Following the development of medical professional and academic bodies, the medical alumni wound down its medico-political activities to concentrate on providing social and mutual support for its members and its alma mater.
Physical inactivity is strongly associated with obesity and an increased risk of cardiovascular disease in children and adolescents. A cross-sectional study using multistage random sampling was conducted to determine associations between demographic characteristics, sedentary behaviours and physical activity among adolescents. Data were collected from 785 (414 males and 371 females) Form four students attending 15 schools in Petaling District, Selangor using an adapted self-administered questionnaire. Results showed that more females (50.1%) were physically inactive compared to males (39.6%) (Adjusted odds ratio (OR): 1.55, 95% confidence interval (CI): 1.12-2.15). Physically inactive adolescents were less likely to participate in intramural/house league sports (OR: 1.71, 95% CI: 1.19-2.44), school team sports (OR: 1.45, 95% CI: 1.03-2.04) and individual physical activities outside school (OR: 1.53, 95% CI: 1.11-2.12) compared to their physically active counterparts. Physically inactive adolescents were also less engaged in sedentary activities, such as television watching (OR: 0.69, 95% CI: 0.50-0.94), playing computer/video game (OR: 0.44, 95% CI: 0.28-0.72), talking on the telephone/mobile phone text messaging (OR: 0.47, 95% CI: 0.32-0.69) and reading (OR:0.45, 95% CI: 0.24-0.86) compared to those who were physically active. In this study, physical activity coexists with sedentary behaviour in adolescents. Sedentary activities may not necessarily displace physical activity among youth. In addition, these data suggest that promoting organised sports in school and outside the school among youths may be a potential strategy for increasing physical activity in this population.
The diagnosis of disseminated tuberculosis should be entertained in all patients with unexplained fever associated with hepatomegaly and/or splenomegaly with or without anomalies in liver function tests and haemogram. It should be considered as a possible cause of septic shock especially in patients with typical risk factors such as advanced age, diabetes, alcoholism or immunosuppression. Prompt therapy could be life saving in an otherwise potentially fatal condition. It is therefore appropriate to initiate anti-tuberculosis treatment as soon as such a diagnosis is suspected and not await final confirmation.
This study aimed to evaluate dry powder inhaler naive asthmatic patients' perception and preference of the Accuhaler, a multidose dry powder inhaler and the pressurized metered dose inhaler (pMDI). After the first instruction, 66.7% of 48 patients enrolled in the study could demonstrate the correct use of the Accuhaler. When the patients were asked to compare the pMDI and the Accuhaler after using the Accuhaler to administer salmeterol for 4 weeks, the Accuhaler scored significantly better than the pMDI for the following features: knowing how many doses are left, presence of an attached cover, taste, instruction for use, attractiveness, ease of use, ease of holding, shape, and comfortable mouthpiece. The pMDI scored better to the Accuhaler in terms of size. More patients preferred the Accuhaler than the pMDI; the presence of a dose counter and perceived ease of use were the main reasons cited for their preference for the Accuhaler.
Study site: Asthma Clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Cryptococcal infection uncommonly presents with pulmonary manifestations and even more rarely so as massive bilateral effusions. Pleural involvement is usually associated with underlying pulmonary parenchymal lesions and is unusual while on antifungal therapy. We report a patient with cryptococcal meningitis who, while on intravenous 5-flucytosine and amphotericin B, developed life-threatening bilateral massive pleural effusions with evidence of spontaneous resolution, consistent with prior hypothesis of antigenic stimulation as the cause of pleural involvement.
This study aimed to determine whether the clinicopathological features of lung cancer in patients younger than 40 years differ from that of older patients in an Asian country.
The functional responses of different overnight-stored in vitro tissues are not clearly described in any animal model. The influence of overnight storage in an animal model may vary between tissue types. We employed Sprague-Dawley rat as our animal model and investigated the functional changes of rat aorta, trachea, bronchus and bladder that were used (i) immediately after surgical removal (denoted as fresh) and (ii) after storage in aerated (95% O2, 5% CO2) Krebs-Ringer bicarbonate solution at 4 °C for 24 h (denoted as stored). The aorta ring was pre-contracted with phenylephrine, and the functional response of the tissue was investigated using isoprenaline, forskolin and carbachol. Carbachol was also used to increase the tone in trachea, bronchus rings and bladder strips. A clear reduced function of endothelium, with a minor if any effect in the smooth muscle function in rat aorta was observed after overnight storage. The contractile response of overnight-stored rat airway (trachea and bronchus) and bladder smooth muscles remained unchanged. Among all tested tissues, only bronchus showed a reduced response rate (only 40% responded) after storage. In vitro rat tissues that are stored in Krebs solution at 4 °C for 24 h can still be used to investigate smooth muscle responses, however, not endothelium-mediated responses for aorta. The influence of overnight storage on different tissues from an animal model (Sprague-Dawley rat in our study) also provides an insight in maximising the use of sacrificed animals.
The objective of this study was to determine the relationship between asthma symptoms and the degree of airway obstruction as measured by the forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) in a group of 64 asthmatic patients with clinically stable disease attending a university-based urban asthma clinic. Asthma symptoms did not correlate with the degree of airway obstruction as measured by prebronchodilator PEFR (total asthma symptom score vs PEFR: r = -0.214, p = 0.104, n = 59) and only correlated poorly with prebronchodilator FEV1 (total asthma symptom score vs FEV1: r = -0.256, p = 0.041, n = 64). These results lend support to the recommendation that airway obstruction should be measured objectively when assessing patients with chronic persistent asthma.
Study site: Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia