Displaying publications 561 - 580 of 1316 in total

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  1. Loh JP, Gao QH, Lee VJ, Tetteh K, Drakeley C
    Singapore Med J, 2016 Dec;57(12):686-689.
    PMID: 26805667 DOI: 10.11622/smedj.2016016
    INTRODUCTION: Although there have been several phylogenetic studies on Plasmodium knowlesi (P. knowlesi), only cytochrome c oxidase subunit 1 (COX1) gene analysis has shown some geographical differentiation between the isolates of different countries.

    METHODS: Phylogenetic analysis of locally acquired P. knowlesi infections, based on circumsporozoite, small subunit ribosomal ribonucleic acid (SSU rRNA), merozoite surface protein 1 and COX1 gene targets, was performed. The results were compared with the published sequences of regional isolates from Malaysia and Thailand.

    RESULTS: Phylogenetic analysis of the circumsporozoite, SSU rRNA and merozoite surface protein 1 gene sequences for regional P. knowlesi isolates showed no obvious differentiation that could be attributed to their geographical origin. However, COX1 gene analysis showed that it was possible to differentiate between Singapore-acquired P. knowlesi infections and P. knowlesi infections from Peninsular Malaysia and Sarawak, Borneo, Malaysia.

    CONCLUSION: The ability to differentiate between locally acquired P. knowlesi infections and imported P. knowlesi infections has important utility for the monitoring of P. knowlesi malaria control programmes in Singapore.

    Matched MeSH terms: Singapore
  2. Lee HP, Chew CT, Consigliere DT, Heng D, Huang DT, Khoo J, et al.
    Singapore Med J, 2010 Feb;51(2):170-3; quiz 174-5.
    PMID: 20358158
    The Ministry of Health publishes national clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with key recommendations from the guidelines) from the Ministry of Health clinical practice guidelines on cancer screening, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website (http://www.moh.gov. sg/mohcorp/publications.aspx?id=24018). The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
    Matched MeSH terms: Singapore
  3. Arshad A, Kong KO
    Singapore Med J, 2007 Jan;48(1):25-30.
    PMID: 17245512
    INTRODUCTION: Fibromyalgia syndrome (FMS) is a common but controversial condition. There appears to be different levels of belief of its existence and awareness. We set out to explore the variations of perceptions and awareness of this condition among rheumatologists from Malaysia and Singapore.
    METHODS: 48 rheumatologists from Malaysia (28) and Singapore (20) were approached to participate in this survey by answering a specific questionnaire regarding their belief in FMS. 23 respondents from Malaysia and 20 from Singapore completed the questionnaire.
    RESULTS: 91 percent of Malaysian rheumatologists and 95 percent of the Singaporean believe that FMS is a distinct clinical entity and that this condition is considered an illness rather than a disease. 87 percent and 90 percent of rheumatologists from Malaysia and Singapore, respectively, believe that FMS is a mixture of medical and psychological illness. However, not many of those in the university setting include FMS in their undergraduate teaching. 87 percent and 80 percent of the respondents from Malaysia and Singapore, respectively, also ordered blood tests to exclude other serious pathologies, and 100 percent of the respondents from both countries also prescribed some form of drugs to their FMS patients.
    CONCLUSION: This study confirmed that there was a variation of perceptions and knowledge of FMS among rheumatologists from Malaysia and Singapore. The majority of rheumatologists recognise that FMS is a distinct clinical entity, and is diagnosed by excluding other well-defined clinical diseases through a combination of clinical evaluation and screening tests.
    Matched MeSH terms: Singapore
  4. Che' Man AB, Lim HH
    Singapore Med J, 1983 Jun;24(3):135-9.
    PMID: 6635675
    A study was carried out to determine ventilatory capacity (Forced Expiratory Volume or FEV1 and Forced Vital Capacity or FVC) in apparently normal Malay office workers in Malaysia. The subjects, 78 males and 113 females, were interviewed using a standardized questionnaire to exclude those with symptoms or past history of cardiopulmonary disease. Measurements of age, height, weight, FEV, and FVC were made on each subject; the FEV, and FVC were measured using Vitalograph spirometers. The mean FEV, and FVC for males were 3.35 litres and 3.76 Iitres, respectively. For females, the mean FEV, and FVC were 3.46 and 2.72 Iitres, respectively. Height was positively correlated with FEV, and FVC (p
    Matched MeSH terms: Singapore
  5. Lim TO, Ngah BA
    Singapore Med J, 1991 Aug;32(4):249-51.
    PMID: 1776004
    Sixty hypertensives admitted into medical wards were interviewed in depth to determine reasons for their previous drop out of treatment. Eighty five percent of the patients were lacking in motivation. This was related to patients' lack of understanding concerning hypertension and its treatment, erroneous beliefs concerning hypertension held by patients and patients' perceived barrier to treatment. The evidence for these reasons were as follows: 95% of the patients were unaware that hypertension is a long term condition requiring life-long treatment, 60% were unable to state the likely consequences of uncontrolled hypertension, 78% equated relief of symptoms like headache, dizziness with control of hypertension, 52% believed long term consumption of 'western' medication was harmful, 12% believed they had been cured by traditional (bomoh or sinseh) treatment, 72% complained of long waiting time required to obtain care. Economic reasons however were unimportant. Patient education and more convenient clinic locations are necessary but insufficient to ensure compliance. They are particular elements, among others, of a 'good' doctor-patient relationship, which fundamentally is the critical determinant of compliance.
    Matched MeSH terms: Singapore
  6. Chong AYH, Lee HP
    Singapore Med J, 1976 Sep;17(3):181-3.
    PMID: 1019617
    The incidence of congenital hypertrophic pyloric stenosis among 141,215 Chinese, Malay and Indian live births in Singapore from 1972 to 1974 was determined. The incidence per 100,000 live births among these ethnic groups are: Chinese 21.2, Malay 9.7 and Indian 35.0. Pyloric stenosis is not absent although rare in oriental babies.
    Matched MeSH terms: Singapore
  7. Phoon WO, Alfred ER
    Singapore Med J, 1965 Sep;6(3):158-63.
    PMID: 5851268
    The circumstances, clinical features, complications and progress of eighty-one cases of stonefish stings are described. There were no fatalities, few complications and no lasting ill-effects. The various forms of treatment are discussed. The venomous fishes of Malaysia are briefly reviewed. It is concluded that stonefish stings occur fairly frequently in this country and that they are attended by appreciable morbidity, but that fatal cases or cases with lasting ill-health are probably rare.
    Matched MeSH terms: Singapore
  8. Kadri ZN
    Singapore Med J, 1963 Sep;4(3):113-8.
    PMID: 14075734
    Matched MeSH terms: Singapore
  9. Tan NC, Goh SY, Khoo EY, Dalan R, Koong A, Khoo CM, et al.
    Singapore Med J, 2019 Jul 22.
    PMID: 31328239 DOI: 10.11622/smedj.2019081
    INTRODUCTION: Hypoglycaemia constitutes a significant barrier to achieving glycaemic control with insulin in both Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM). The International Operations Hypoglycaemia Assessment Tool (IO HAT) study was designed to determine the incidence of hypoglycaemia in insulin-treated patients with T1DM and T2DM.

    METHODS: The IO HAT study retrospectively and prospectively assessed the incidence of hypoglycaemia in patients with insulin-treated diabetes mellitus in nine countries. This sub-analysis included patients from Singapore with T1DM or T2DM who were aged ≥ 21 years and had completed two self-assessment questionnaires (SAQ1 and SAQ2).

    RESULTS: Of the 50 T1DM and 320 T2DM patients who completed the SAQ1, 39 T1DM and 265 T2DM patients completed SAQ2; 100% and 90.9%, respectively, experienced at least one hypoglycaemic event prospectively. The incidence rates of any hypoglycaemia were 49.5 events per patient-year (EPPY) and 16.1 EPPY for T1DM and T2DM patients, respectively, in the four-week prospective period. Hypoglycaemia rate did not differ in terms of HbA1c level. The vast majority of T1DM or T2DM patients (92.0% and 90.7%, respectively) knew the overall definition of hypoglycaemia before study participation, although over half of the patients (T1DM 54.0%, T2DM 51.9%) defined hypoglycaemia based only on symptoms.

    CONCLUSION: High proportions of insulin-treated patients with diabetes mellitus in Singapore reported hypoglycaemic events prospectively, showing that they had underreported hypoglycaemic episodes retrospectively. Patient education can help in improving hypoglycaemia awareness and its management in the region.
    Matched MeSH terms: Singapore
  10. Low MJW, Khoo KSM, Kuan WS, Ooi SBS
    Singapore Med J, 2020 Jan;61(1):28-33.
    PMID: 31423541 DOI: 10.11622/smedj.2019097
    INTRODUCTION: Defining the characteristics of a good medical teacher has implications for faculty selection and development. Perceptions of characteristics may differ with cultural context and level of training, as medical students progress from didactic preclinical training based on cognitivist learning theory to more complex integration of theory and practice in specific contexts in clinical training based on constructivist learning theory.

    METHODS: We modified a validated questionnaire with permission from the original authors at Melaka Manipal Medical College, Melaka, Malaysia. Participants rated 35 characteristics on a 5-point Likert scale. The modified questionnaire was validated in a pilot pool of medical students (n = 69), with a Cronbach's alpha of 0.90, and administered to Year 1-5 medical students (n = 917) at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

    RESULTS: Based on the proportion of favourable Likert scoring, four top desirable characteristics were common across Year 1-5 students: good communication skills (84.4%); sound knowledge of subject (82.7%); enthusiasm (78.4%); and providing effective explanations (74.4%). Approachability (p = 0.005), encouraging participation (p < 0.001) and constructive criticism (p < 0.001) were more important to clinical students (Year 3-5) than preclinical students (Year 1-2).

    CONCLUSION: The top four characteristics were consistent across all years of medical students in this study. Characteristics emphasised in the clinical years facilitate active learner participation, consistent with constructivist learning theory.

    Matched MeSH terms: Singapore
  11. Danaraj TJ, LaBrooy EB
    Singapore Med J, 1960 Mar;1(1):16-32.
    PMID: 13719549
    Six cases of Ebstein's malformation are reported. The notable clinical features seen in four patients were gross enlargement of the
    heart, venous congestion and marked hepatosplenomegaly. There was complete heart block in one patient and auricular fibrillation in the remaining three. The unusual pathologic features in the four cases that came to necropsy were the large pericardial effusions associated with the cardiomegaly, the absence of an atrial septal defect or patent foramen ovale, the gross enlargement of liver with cirrhotic changes and the large spleen. Histologic examination of heart muscle revealed certain unusual features which are described.
    Matched MeSH terms: Singapore
  12. O'Hara CA, Foon XL, Ng JC, Wong CS, Wang FY, Tan CY, et al.
    Med Educ Online, 2023 Dec;28(1):2172744.
    PMID: 36744296 DOI: 10.1080/10872981.2023.2172744
    PURPOSE: International studies document that lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) patients face significant health disparities. Studies exploring the attitudes, knowledge, preparedness and comfort levels of healthcare students towards LGBTQI+ health have been conducted in the United States, United Kingdom and Malaysia. This study aims to investigate stigma in healthcare for LGBTQI+ patients in Singapore, and possible upstream factors within medical education.

    METHODS: This mixed-methods study adopts a convergent parallel design. The Health Stigma and Discrimination Framework was referenced to devise in-depth interviews with representatives from 13 LGBTQI-affirming non-governmental organisations, analysed through thematic analysis. 320 clinical medical students were surveyed about attitudes, knowledge, comfort, preparedness, and perceived importance of/towards LGBTQI+ health, analysed via descriptive statistics and multivariate regression.

    RESULTS: Prevailing stigma in Singaporean society against LGBTQI+ individuals is exacerbated in healthcare settings. Doctors were cited as unfamiliar or uncomfortable with LGBTQI+ health, possibly from lack of training. Among medical students surveyed, the median composite attitudes, comfort and preparedness index was 3.30 (Interquartile Range (IQR) = 0.50), 3.17 (IQR = 0.83), 2.50 (IQR = 1.00) respectively. Only 12.19% of students answered all 11 true-false questions about LGBTQI+ health correctly.

    CONCLUSION: Medical students in Singapore have scored sub-optimally in their knowledge and preparedness towards LGBTQI+ health, while interpersonal and structural stigma in healthcare towards LGBTQI+ people in Singapore negatively affects health and wellbeing. These findings are an impetus to improve medical training in this area. High scores among medical students in attitudes, comfort and perceived importance of LGBTQI+ topics demonstrate that there is space for LGBTQI+ health in the local medical education curriculum. Curricular interventions can prioritise content knowledge, communication skills and sensitivity.

    Matched MeSH terms: Singapore
  13. Ali HS, Abdul-Rahim AS, Ribadu MB
    Environ Sci Pollut Res Int, 2017 Jan;24(2):1967-1974.
    PMID: 27798805 DOI: 10.1007/s11356-016-7935-z
    The main aim of this article is to examine empirically the impact of urbanization on carbon dioxide emissions in Singapore from 1970 to 2015. The autoregressive distributed lags (ARDL) approach is applied within the analysis. The main finding reveals a negative and significant impact of urbanization on carbon emissions in Singapore, which means that urban development in Singapore is not a barrier to the improvement of environmental quality. Thus, urbanization enhances environmental quality by reducing carbon emissions in the sample country. The result also highlighted that economic growth has a positive and significant impact on carbon emissions, which suggests that economic growth reduces environmental quality through its direct effect of increasing carbon emissions in the country. Despite the high level of urbanization in Singapore, which shows that 100 % of the populace is living in the urban center, it does not lead to more environmental degradation. Hence, urbanization will not be considered an obstacle when initiating policies that will be used to reduce environmental degradation in the country. Policy makers should consider the country's level of economic growth instead of urbanization when formulating policies to reduce environmental degradation, due to its direct impact on increasing carbon dioxide emissions.
    Matched MeSH terms: Singapore
  14. Guzel AE, Okumus İ
    Environ Sci Pollut Res Int, 2020 May;27(15):18157-18167.
    PMID: 32172423 DOI: 10.1007/s11356-020-08317-y
    Pollution haven hypothesis (PHH) has been investigated extensively in the existing literature due to global environmental issues such as global warming and climate change. However, there is still no consensus on whether this hypothesis is valid. Therefore, the aim of this study is to examine the validity of the PHH in ASEAN-5 countries (Indonesia, Malaysia, Philippines, Singapore, and Thailand) covering the period of 1981-2014. It is utilized the up-to-date panel data techniques taking cross-sectional dependence and slope heterogeneity into account to test the relationship. According to the results of CCEMG and AMG estimators, the validity of the PHH is confirmed in ASEAN-5 countries. The increase in foreign direct investments (FDI) increases environmental degradation in these countries. Our additional findings show that the environmental Kuznets curve (EKC) hypothesis (EKC) is also valid in these countries. There is an inverted U shape between economic growth and CO2 emissions. In addition, energy consumption exacerbates CO2 emissions.
    Matched MeSH terms: Singapore
  15. Chong HY, Allotey PA, Chaiyakunapruk N
    BMC Med Genomics, 2018 Oct 26;11(1):94.
    PMID: 30367635 DOI: 10.1186/s12920-018-0420-4
    BACKGROUND: The emergence of personalized medicine (PM) has raised some tensions in healthcare systems. PM is expensive and health budgets are constrained - efficient healthcare delivery is therefore critical. Notwithstanding the cost, many countries have started to adopt this novel technology, including resource-limited Southeast Asia (SEA) countries. This study aimed to describe the status of PM adoption in SEA, highlight the challenges and to propose strategies for future development.

    METHODS: The study included scoping review and key stakeholder interviews in four focus countries - Indonesia, Malaysia, Singapore, and Thailand. The current landscape of PM adoption was evaluated based on an assessment framework of six key themes - healthcare system, governance, access, awareness, implementation, and data. Six PM programs were evaluated for their financing and implementation mechanisms.

    RESULTS: The findings revealed SEA has progressed in adopting PM especially Singapore and Thailand. A regional pharmacogenomics research network has been established. However, PM policies and programs vary significantly. As most PM programs are champion-driven and the available funding is limited, the current PM distribution has the potential to widen existing health disparities. Low PM awareness in the society and the absence of political support with financial investment are fundamental barriers. There is a clear need to broaden opportunities for critical discourse about PM especially for policymakers. Multi-stakeholder, multi-country strategies need to be prioritized in order to leverage resources and expertise.

    CONCLUSIONS: Adopting PM remains in its infancy in SEA. To achieve an effective PM adoption, it is imperative to balance equity issues across diverse populations while improving efficiency in healthcare.

    Matched MeSH terms: Singapore
  16. Ling GHT, Md Suhud NAB, Leng PC, Yeo LB, Cheng CT, Ahmad MHH, et al.
    PMID: 33578829 DOI: 10.3390/ijerph18041704
    Little attention has been paid to the impacts of institutional-human-environment dimensions on the outcome of Coronavirus disease 2019 (COVID-19) abatement. Through the diagnostic social-ecological system (SES) framework, this review paper aimed to investigate what and how the multifaceted social, physical, and governance factors affected the success level of seven selected Asia-Pacific countries (namely, South Korea, Japan, Malaysia, Singapore, Vietnam, Indonesia, and New Zealand) in combatting COVID-19. Drawing on statistical data from the Our World In Data website, we measured the COVID-19 severity or abatement success level of the countries on the basis of cumulative positive cases, average daily cases, and mortality rates for the period of 1 February 2020 to 30 June 2020. A qualitative content analysis using three codes, i.e., present (P), partially present (PP), and absent (A) for each SES attribute, as well as score calculation and rank ordering for government response effectiveness and the abatement success level across the countries, was undertaken. Not only did the standard coding process ensure data comparability but the data were deemed substantially reliable with Cohen's kappa of 0.76. Among 13 attributes of the SES factors, high facility adequacy, comprehensive COVID-19 testing policies, strict lockdown measures, imposition of penalty, and the high trust level towards the government seemed to be significant in determining the COVID-19 severity in a country. The results show that Vietnam (ranked first) and New Zealand (ranked second), with a high presence of attributes/design principles contributing to high-level government stringency and health and containment indices, successfully controlled the virus, while Indonesia (ranked seventh) and Japan (ranked sixth), associated with the low presence of design principles, were deemed least successful. Two lessons can be drawn: (i) having high number of P for SES attributes does not always mean a panacea for the pandemic; however, it would be detrimental to a country if it lacked them severely, and (ii) some attributes (mostly from the governance factor) may carry higher weightage towards explaining the success level. This comparative study providing an overview of critical SES attributes in relation to COVID-19 offers novel policy insights, thus helping policymakers devise more strategic, coordinated measures, particularly for effective country preparedness and response in addressing the current and the future health crisis.
    Matched MeSH terms: Singapore
  17. López-Muñoz F, Povedano-Montero FJ, Chee KY, Shen WW, Fernández-Martín P, García-Pacios J, et al.
    Malays J Med Sci, 2018 May;25(3):40-55.
    PMID: 30899186 DOI: 10.21315/mjms2018.25.3.5
    Objective: We carried out a bibliometric study on the scientific papers related to second-generation antipsychotic drugs (SGAs) in Malaysia.

    Methods: With the SCOPUS database, we selected those documents made in Malaysia whose title included descriptors related to SGAs. We applied bibliometric indicators of production and dispersion, as Price's law and Bradford's law, respectively. We also calculated the participation index of the different countries. The bibliometric data were also been correlated with some social and health data from Malaysia (total per capita expenditure on health and gross domestic expenditure on R&D).

    Results: We found 105 original documents published between 2004 and 2016. Our results fulfilled Price's law, with scientific production on SGAs showing exponential growth (r = 0.401, vs. r = 0.260 after linear adjustment). The drugs most studied are olanzapine (9 documents), clozapine (7), and risperidone (7). Division into Bradford zones yields a nucleus occupied by the Medical Journal of Malaysia, Singapore Medical Journal, Australian and New Zealand Journal of Psychiatry, and Pharmacogenomics. Totally, 63 different journals were used, but only one in the top four journals had an impact factor being greater than 3.

    Conclusion: The publications on SGAs in Malaysia have undergone exponential growth, without evidence a saturation point.

    Matched MeSH terms: Singapore
  18. Gunasekaran K, Singh P, Ng DX, Koh EYL, Lee HY, Tan R, et al.
    Front Public Health, 2024;12:1359929.
    PMID: 39056076 DOI: 10.3389/fpubh.2024.1359929
    OBJECTIVES: Early smoking initiation has been associated with a higher risk of developing long-term smoking habit. There is a growing global consensus that demands raising the minimum legal age (MLA) for smoking as an approach to address this problem. Singapore successfully raised the MLA from 18 to 21 years in 2021. This study aimed to evaluate the awareness and attitude of multi-ethnic Asian youth (aged 15-24) on raising MLA to 21 and passive smoking.

    METHODS: A cross-sectional survey comprising of 23 items was circulated via a secure internet-based platform, FORMSG between September and November 2022. Data were analyzed for descriptive statistics. Categorical variables were compared for association with receptivity toward change in MLA using Chi-Squared test and multivariable logistic regression analysis using Rstudio. Post-hoc Bonferroni correction were further utilized for pairwise comparison.

    RESULTS: Majority (80.3%) of the 608 participants expressed their support for MLA 21 implementation. Participants' age was a significant variable as those aged 15-17 years old (OR = 2.1, 95%CI = 1.01-4.32, p = 0.048) showed a higher likelihood of supporting MLA implementation compared to those aged 21 and above. In addition, majority (89.8%) of them were also aware of the harmful effects of passive smoking. When it came to discouraging smoking among youth, family influence (64%) and school education (55.6%) emerged as the top strategies.

    CONCLUSION: Most of the youth express strong support for raising the MLA to 21, with over 80% in favor of such change, reflects a significant harmony among youth in favor of tobacco-free environment.

    Matched MeSH terms: Singapore
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