Displaying publications 1 - 20 of 251 in total

Abstract:
Sort:
  1. Lim LC, Tan HH, Lee LH, Tien SL, Abdul Ghafar A
    Ann Acad Med Singap, 1999 Mar;28(2):252-5.
    PMID: 10497677
    Resistance to activated protein C (APC-R) is the commonest inherited cause of thrombosis among Caucasians. Few studies have been carried out on its prevalence in Asians. We conducted a prospective study on 60 patients with thromboembolism to determine its prevalence in our local population. The Factor V Leiden (VaQ506) mutation associated with this condition was detected by amplification of the Factor V gene by polymerase chain reaction (PCR) and digestion of the fragment with Mnl I. Three patients were found to be heterozygous for this mutation. None of the 3 patients had other concomitant hypercoagulable states. In addition, we studied the prevalence of this condition in Malays which was found to be 0.5%. Our study suggests that the incidence of APC-R is much lower here compared to the West.
  2. Huan NC, Ng KL, Tang JT, Kua HN, Daut UN, Muhammad NA, et al.
    Ann Acad Med Singap, 2020 12;49(12):1013-1017.
    PMID: 33463660 DOI: 10.47102/annals-acadmedsg.2020364
    The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists.
  3. Dayangku Norsuhazenah PS, Baki MM, Mohamad Yunus MR, Sabir Husin Athar PP, Abdullah S
    Ann Acad Med Singap, 2010 Jul;39(7):565-4.
    PMID: 20697675
    INTRODUCTION: In laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period.

    MATERIALS AND METHODS: A retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted.

    RESULTS: Eighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were ProvoxTM (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain.

    CONCLUSIONS: TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specific efforts and specialistic commitments in order to treat them.

  4. Abdullah S
    Ann Acad Med Singap, 1988 Jul;17(3):388-91.
    PMID: 3218930
    The results of speech, language and hearing assessment of repaired cleft palate children and adults over a 4-year period at the Speech/Language therapy unit, Department of ENT, Faculty of Medicine, UKM are reported. The subjects were 33 incomplete cleft lip palate (ICLP), 48 unilateral complete cleft lip and palate (UCLP) and 26 bilateral complete cleft lip and palate (BCLP). Results obtained for the following assessments are reported and discussed: (i) Hearing assessment, (ii) intelligibility rate, (iii) severity of hyper-nasality and (iv) types of articulation errors and school/behaviour problems and nasal grimace. Due to subject variability in ethnicity, language and dialects and the lack of normal data, it is difficult to compare or repeat previously reported results. Assessment of intelligibility, hypernasality and articulation were conducted using the Malay language. Results obtained were compared among the three groups of subjects. The significant findings were that hypernasality, intelligibility and articulation errors were more severe in the ICLP group than in the UCLP or BCLP groups of patients. This is contrary to expectations and cannot be explained in terms of the type and/or the degree of clefting. Hence, special attention should be paid to the less overt type of cleft patients in so far as their speech assessment and rehabilitation are concerned.
  5. Adam BA
    Ann Acad Med Singap, 1983 Jan;12(1):19-25.
    PMID: 6344741
    A prospective study of 77 consecutive patients with bullous diseases was done to study the pattern and natural history. Pemphigus was the commonest with 45 patients (59%) followed by pemphigoid with 21 patients (27%). Pemphigoid was more common in Indians than in other ethnic groups and its age of onset was a decade later than pemphigus. Unusual immunofluorescent findings in both diseases are discussed. Six of the 7 patients with dermatitis herpetiformis had linear IgA in the dermo-epidermal junction and the classical papillary IgA deposits were absent. Ultrastructural findings of pemphigoid and dermatitis herpetiformis confirmed earlier reports. Chronic bullous dermatoses of childhood was seen in 4 patients, all of whom had total remission within one year of onset disease.
  6. Kong NC, Asmah J, Lim VK, Ong PH, Adam PA
    Ann Acad Med Singap, 1996 Jul;25(4):609-11.
    PMID: 8893941
    Pyomyositis, purportedly a common tropical infection affecting mainly healthy adults and children, appears to be most uncommon in this region. We report a case of pyomyositis caused by a Methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy army officer. This case serves to illustrate the difficulty in recognising this disease entity, which is why many cases may have been missed. With the increasing incidence of MRSA nosocomial infections, the emergence of MRSA in a hitherto community-acquired infection poses a major concern especially since intravenous drug abuse and acquired immune deficiency syndrome (AIDS) are on the rise in our country. We hope to inculcate greater awareness of this infection.
  7. Neoh YL, Neoh PF, Salleh A, Yusof ZB, Gurusamy B, Ahmad Tajudin LS
    Ann Acad Med Singap, 2018 06;47(6):226-229.
    PMID: 30019068
  8. Gopalai AA, Lim SY, Aziz ZA, Lim SK, Tan LP, Chong YB, et al.
    Ann Acad Med Singap, 2013 May;42(5):237-40.
    PMID: 23771111
    INTRODUCTION: The G2385R and R1628P LRRK2 gene variants have been associated with an increased risk of Parkinson's disease (PD) in the Asian population. Recently, a new LRRK2 gene variant, A419V, was reported to be a third risk variant for PD in Asian patients. Our objective was to investigate this finding in our cohort of Asian subjects.

    MATERIALS AND METHODS: Eight hundred and twenty-eight subjects (404 PD patients, and 424 age and gender-matched control subjects without neurological disorders) were recruited. Genotyping was done by Taqman® allelic discrimination assay on an Applied Biosystems 7500 Fast Real-Time PCR machine.

    RESULTS: The heterozygous A419V genotype was found in only 1 patient with PD, compared to 3 in the control group (0.4% vs 1.3%), giving an odds ratio of 0.35 (95% confidence interval (CI), 0.01 to 3.79; P = 0.624).

    CONCLUSION: A419V is not an important LRRK2 risk variant in our Asian cohort of patients with PD. Our data are further supported by a literature review which showed that 4 out of 6 published studies reported a negative association of this variant in PD.

  9. Sakinah SO, Khalid BA, Aishah AB
    Ann Acad Med Singap, 1993 Jul;22(4):563-6.
    PMID: 8257059
    A study to determine the prevalence of goitre and abnormal thyroid status during pregnancy in Malaysian women was conducted. Two hundred and three women (Malay = 85, Chinese = 47 and Indian = 71) in the third trimester and with no known thyroid disease were studied. There was a marked racial disparity in the prevalence of goitre: Indian 61%, Malay 28% and Chinese 29% (p = 0.001). The serum thyrotropic hormone (TSH) was significantly higher in Indians (median: 1.36 uIU/ml) compared to Malays (1.14 uIU/ml, p = 0.009). The serum albumin was also significantly lower in Indians (mean +/- sd; 36.12 +/- 3.9 mmol/l) compared to Malays (39.3 +/- 4.8 mmol/l) or Chinese (39.1 +/- 5.2) (p < 0.001). Thyroid antibody was detected in 14.6% of these women with no significant racial difference in its prevalence. Three women were found to be thyrotoxic but none were hypothyroid. This study found a high prevalence of goitre among the pregnant Indian women, probably related to the protein malnutrition state. The high prevalence of positive thyroid antibody in our population indicates that a high percentage of women are at risk of developing postpartum thyroiditis.
  10. Liam CK, Looi LM, Pailoor J, Alhady SF
    Ann Acad Med Singap, 1989 Nov;18(6):713-6.
    PMID: 2624423
    Three cases of progressive dyspnoea in young female adults due to pulmonary lymphangitic carcinomatosis are reported. The underlying primary neoplasm was gastric carcinoma in all 3 cases. The diagnosis was not suspected in 2 patients because of their young age.
  11. Razak IA, Ali MM
    Ann Acad Med Singap, 1989 Sep;18(5):516-8.
    PMID: 2619242
    The present study analysed the records of 342 elderly subjects aged 55 years and above of different ethnic groups to ascertain the types and level of their unperceived dental needs. The overall percentage of unperceived needs was highest among the Malays (96.1% or 74/77 subjects) and among the men (88.5% or 139/157 subjects). The unperceived need for prosthetic treatment was highest among the Malays and Chinese as well as among women, whereas the unperceived need for treatment for periodontal disease was highest among the Indians. The data for unperceived needs for prosthetic treatment as well as for treatment for caries and periodontal disease were somewhat similar among men. Within each ethnic group, variations among sex in the unperceived needs for the various dental symptoms were also noticeable. Further research is indicated to ascertain the role of traditional and cultural concepts and dogmas in determining the importance attached to the various dental health symptoms within each ethnic group.
  12. Andrews GR
    Ann Acad Med Singap, 1987 Jan;16(1):3-10.
    PMID: 3592590
    While ageing is still clearly not a high priority issue for health planners, policy makers and clinicians in developing countries of Asia and the Pacific, there will be a growing need in coming years to pay more and more attention to the important health issues associated with population ageing in countries which make up this region of the world. This paper reports some of the relevant findings of a WHO sponsored cross national study of the health and social aspects of ageing in four of the countries, namely Korea, the Philippines, Fiji and Malaysia. The key findings are compared and contrasted with those of a similar WHO eleven country study in Europe. The paper argues that there is an urgent need to develop health care strategies which will minimise the impact of population ageing and will maintain the growing numbers of old people in relatively good physical and mental health through preventive measures and through programmes directed to the maintenance of physical and mental health.
  13. Bhullar M, Bhullar A, Arachchi NJ
    Ann Acad Med Singap, 2016 Oct;45(10):479-480.
    PMID: 27832225
  14. Arshad AR
    Ann Acad Med Singap, 2006 Dec;35(12):889-91.
    PMID: 17219001
    INTRODUCTION: Benign tumours of the parotid gland constitute about 80% of parotid tumours. The most common benign tumour of the parotid gland is pleomorphic adenoma. Other conditions, like Kimura's disease, may mimic a tumour when they present as a parotid mass. Various modes of treatment have been advocated for the treatment of benign parotid lesions, ranging from enucleation to near-total parotidectomy.

    MATERIAL AND METHODS: This is an audit of an 18-year period where 173 lesions of the parotid gland (34 malignant and 139 benign lesions) were treated by the author.

    RESULTS: There were 139 benign lesions, of which 123 were benign tumours and 16 non-tumour conditions. Fourteen cases of recurrent pleomorphic adenoma of parotid that had been treated elsewhere were also operated on. Near-total parotidectomy was performed on all these cases with benign lesions.

    CONCLUSIONS: There has been no recurrence in all the patients who was treated this way. Near-total parotidectomy should be considered when there is a need to treat benign parotid swellings.

  15. Azila NM, Sim SM, Atiya AS
    Ann Acad Med Singap, 2001 Jul;30(4):375-8.
    PMID: 11503543
    INTRODUCTION: Encouraging teaching practices such as problem-based learning (PBL) amongst undergraduate students within a lecture-based, system-based integrated curriculum is a challenge. Students are apprehensive about developing an organised framework for acquiring knowledge while lecturers are required to reframe their views on the educational process and their role as educators.

    MATERIALS AND METHODS: Lecturers and students in the Phase (Year) II programme were asked to fill questionnaires following the second and fourth PBL cases. The two sets of survey responses were compared to see whether the students' and teachers' perceptions had changed over the 5-month period.

    RESULTS: Students' responses from both surveys (1 and 2) were similar in that a majority agreed that the PBL tutorials had encouraged the seeking of information (66% and 67%, respectively), had improved understanding (57% and 56%), integration (65% and 70%) and application (50% and 64%) of knowledge. However, the views given in the form of written comments, following their positive responses, were somewhat contradictory. A large number of students (38% and 40%) faced difficulties in getting involved in discussions during the PBL tutorial and a majority (73% and 82%) preferred the normal subject-based tutorials. The reasons given by approximately 20% of the students were that the subject-based tutorials were more efficient for obtaining information and/or that the information had been pre-selected by the lecturers. More than 80% of the lecturers (in both surveys) perceived that the students had identified the appropriate learning objectives and covered the subject matter. The percentage of lecturers who agreed that PBL tutorials encouraged rapport and teamwork amongst students had increased in the second survey, from 70% to 92% and 55% to 83% respectively.

    CONCLUSION: Implementing PBL is not simply a matter of developing new teaching materials and new effective ways of presenting them. It requires a paradigm shift, a change in the roles of students and teachers, and time.

  16. Tan CS, Chen AH, Au Eong KG
    Ann Acad Med Singap, 2006 Feb;35(2):72-6.
    PMID: 16565757
    INTRODUCTION: During cataract surgery under regional (retrobulbar, peribulbar or sub- Tenon's) or topical anaesthesia, many patients experience a variety of visual sensations in their operated eye intraoperatively. Between 3% and 16.2% of patients are frightened by their intraoperative visual experiences, which may increase the risk of intraoperative complications and affect patients' satisfaction with the surgery. This study aims to determine optometry students' beliefs and knowledge of visual sensations experienced by patients during cataract surgery under regional and topical anaesthesia.

    MATERIALS AND METHODS: A nationwide survey of all Malaysian optometry students using a standardised, self-administered questionnaire.

    RESULTS: All 129 optometry students participated in the survey, giving a 100% response rate. Overall, 26.4% and 29.5% of the students believed that patients undergoing cataract surgery under regional and topical anaesthesia, respectively, may experience no light perception, while 78.3% and 72.9%, respectively, thought that patients would experience light perception. Many respondents also believed that patients might experience a variety of other visual sensations. Of all respondents, 70.5% and 74.4% of students believed that patients undergoing cataract surgery under regional and topical anaesthesia, respectively, may be frightened by their visual experience and 93.0% and 85.3%, respectively, felt that preoperative counselling might help to alleviate this fear.

    CONCLUSION: Many optometry students are aware that patients might encounter a variety of visual sensations during cataract surgery under local anaesthesia. A high proportion of students believe that patients may experience fear as a result of the intraoperative visual sensations and felt that preoperative counselling would be helpful.

  17. Barman A
    Ann Acad Med Singap, 2008 Nov;37(11):957-63.
    PMID: 19082204
    INTRODUCTION: Setting, maintaining and re-evaluation of assessment standard periodically are important issues in medical education. The cut-off scores are often "pulled from the air" or set to an arbitrary percentage. A large number of methods/procedures used to set standard or cut score are described in literature. There is a high degree of uncertainty in performance standard set by using these methods. Standards set using the existing methods reflect the subjective judgment of the standard setters. This review is not to describe the existing standard setting methods/procedures but to narrate the validity, reliability, feasibility and legal issues relating to standard setting.

    MATERIALS AND METHODS: This review is on some of the issues in standard setting based on the published articles of educational assessment researchers.

    RESULTS: Standard or cut-off score should be to determine whether the examinee attained the requirement to be certified competent. There is no perfect method to determine cut score on a test and none is agreed upon as the best method. Setting standard is not an exact science. Legitimacy of the standard is supported when performance standard is linked to the requirement of practice. Test-curriculum alignment and content validity are important for most educational test validity arguments.

    CONCLUSION: Representative percentage of must-know learning objectives in the curriculum may be the basis of test items and pass/fail marks. Practice analysis may help in identifying the must-know areas of curriculum. Cut score set by this procedure may give the credibility, validity, defensibility and comparability of the standard. Constructing the test items by subject experts and vetted by multi-disciplinary faculty members may ensure the reliability of the test as well as the standard.

  18. Barman A
    Ann Acad Med Singap, 2005 Sep;34(8):478-82.
    PMID: 16205824
    INTRODUCTION: The main aim of medical education is to foster the development of clinical competence in students at all levels. Differences in experiences, methods of instruction and ambiguous forms of assessment are obstacles to attaining this goal. Dissatisfaction with the conventional methods of clinical assessment on the part of teachers and students led assessors to search for appropriate alternatives and in 1975, Harden and his colleagues introduced the objective structured clinical examination (OSCE). It is nearly impossible to have a test that satisfies all the criteria of a good test. Sometimes, a compromise has to be made between the available resources (in terms of man, money and time), and the method and quality of assessment (in terms of reliability, validity, objectivity and practicability).

    METHODS: This critique on the OSCE is based on the published findings of researchers from its inception in 1975 to 2004.

    RESULTS: The reliability, validity, objectivity and practicability or feasibility of this examination are based on the number of stations, construction of stations, method of scoring (checklists and/ or global scoring) and number of students assessed. For a comprehensive assessment of clinical competence, other methods should be used in conjunction with the OSCE.

    CONCLUSION: The OSCE can be a reasonably reliable, valid and objective method of assessment, but its main drawback is that it is resource-intensive.

  19. Koh WH, Boey ML
    Ann Acad Med Singap, 1998 Jan;27(1):3-6.
    PMID: 9588266
    This paper presents the results of a clinical study of 150 patients in Singapore with ankylosing spondylitis (AS) and reviews recent developments locally with regards to the disease. The patients were predominantly males (ratio 7:1) and Chinese (n = 147). The onset of disease is usually in the early twenties and there was a mean delay of 6.3 years before diagnosis was made. Peripheral joint involvement is common but apart from uveitis (17%), extra-articular manifestations are rare. AS patients have abnormal lipid profiles and lower bone mineral density compared to healthy controls. HLA*B2704 is the predominant subtype in our Chinese patients whilst HLA*B2706 was found only in healthy controls. Intensive group physiotherapy is beneficial for patients with spondyloarthropathy.
  20. Boo NY
    Ann Acad Med Singap, 2008 Dec;37(12 Suppl):60-3.
    PMID: 19904452
    Auditory neuropathy is defined by the presence of normal evoked otoacoustic emissions (OAE) and absent or abnormal auditory brainstem responses (ABR). The sites of lesion could be at the cochlear inner hair cells, spiral ganglion cells of the cochlea, synapse between the inner hair cells and auditory nerve, or the auditory nerve itself. Genetic, infectious or neonatal/perinatal insults are the 3 most commonly identified underlying causes. Children usually present with delay in speech and language development while adult patients present with hearing loss and disproportionately poor speech discrimination for the degree of hearing loss. Although cochlear implant is the treatment of choice, current evidence show that it benefits only those patients with endocochlear lesions, but not those with cochlear nerve deficiency or central nervous system disorders. As auditory neuropathy is a disorder with potential long-term impact on a child's development, early hearing screen using both OAE and ABR should be carried out on all newborns and infants to allow early detection and intervention.
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links