Diagnostic performance of diffusion weighted imaging for early response assessment after Y-90 transarterial radioembolization of Hepatocellular Carcinoma (HCC) - A systematic review and meta-analysis.

Objective: To systematically determine the diagnostic performance of diffusion weighted imaging (DWI) in early imaging assessment following Y-90 transarterial radioembolization (TARE) of HCC.

Materials And Methods: Searches were conducted in PubMed and Cochrane library electronic databases up to July 2024 to identify original studies that reported the diagnostic performance of DWI/apparent diffusion coefficient (DWI/ADC) for assessing early treatment response following TARE. The summary measures of diagnostic accuracy were estimated using bivariate random effect meta-analysis.

Inhaler adherence, associated factors and outcomes among adult asthma patients in Singapore.

Introduction: Inhaler therapy is paramount in asthma management, yet non-adherence poses a significant challenge. This study investigates inhaler adherence patterns among adult asthma patients, employing the Test of Adherence to Inhalers (TAIs) questionnaire.

Methods: This cross-sectional study recruited 99 eligible patients from a specialist outpatient clinic over six months.

Barriers and facilitators of physical activity and exercise among adults with type 2 diabetes mellitus in Singapore - A mixed-methods sequential explanatory study mapped to the COM-B model, theoretical domains framework and behavioural change wheel.

Aims: Exercise is a cornerstone in type 2 diabetes mellitus (T2DM) management. This study investigates physical activity, its barriers, and facilitators among adults with T2DM in Singapore.

Methods: In Phase I of this sequential explanatory mixed-methods study, participants with T2DM were recruited to complete the Physical Activity Stage of Change Questionnaire and were examined for metabolic profiles, physical activity and cardiorespiratory fitness (via a 3-min step test) across different stages of change.

Patient-physician communication of health and risk information in the management of cardiovascular diseases and diabetes: a systematic scoping review.

Background: The communication of health and risk information is an integral part of patient-physician interaction. Effective communication of risk information for cardiovascular diseases and diabetes has been shown to improve medication adherence, increase physical activity levels, and improve dietary control. Patients who understand their risk profile are better able to work towards modifying their lifestyle behaviours as part of a shared decision-making process with physicians.

Real-World Evaluation of Point-of-Care Testing for Hepatitis C Antibodies: Navigating Hepatitis C Elimination Effort.

An HCV elimination program aims to diagnose more than 90% of Chronic HCV cases. We critically evaluated the performance of a point-of-care test (POCT) using an HCV Rapid Antibody Test. PWID from 4 Halfway Houses (HWH) in Singapore were recruited from March 2022 to April 2023.

Daratumumab-Based Therapeutic Approaches and Clinical Outcomes in Multiple Myeloma and other Plasma Cell Dyscrasias: Insights from a Nationwide Real-World Chart Review Study.

Singapore leads Southeast Asia in the routine use of daratumumab for multiple myeloma and other plasma cell dyscrasias. This retrospective review analyzed 112 patients who received daratumumab between 2012 and 2020. Tolerability, and efficacy based on prior lines (PL) of therapy, cytogenetic risk group, and the presence of renal impairment were presented.

Deltoid tuberosity index for proximal humerus fracture: reliability and a predictor of systemic osteoporosis in an Asian population.

Hypothesis And Background: Fragility fracture of the proximal humerus is a common occurrence. Current literature suggests that poor local bone density is a significant predictor of surgical fixation failure. The deltoid tuberosity index (DTI) is a simple radiographic tool that strongly correlates with local humeral bone mineral density (BMD), aiding surgical planning to consider adjuncts or arthroplasty.

A Retrospective Review of Secondary Hemophagocytic Lymphohistiocytosis (HLH) and Dengue-associated HLH from a Teaching Hospital in Singapore.

Real-world data on the outcome of Asian patients with secondary hemophagocytic lymphohistiocytosis (HLH), especially on dengue-associated HLH, are limited to small case series. This is a retrospective records review of adult patients with secondary HLH between 2015 and 2020. Thirty-two adult patients were followed up for a median of 6.

Recovery of surgery in the elderly (ROSE) program: The efficacy of a multi-modal prehabilitation program implemented in frail and pre-frail elderly undergoing major abdominal surgery.

Background: Major abdominal surgery is associated with a high rate of post-operative complications with increased risk of adverse surgical outcomes due to the presence of frailty. This study aims to evaluate the effectiveness of the multimodal Recovery of Surgery in the Elderly (ROSE) prehabilitation program with supervised exercise in mitigating postoperative functional decline when compared to standard care.

Method: The ROSE program enrolled ambulant patients who were 65 years and above, had a Clinical Frailty Scale score of 4 or more and were planned for major abdominal surgery.

Efficacy of plastinated specimens in anatomy education: A systematic review and meta-analysis.

Plastination, a permanent preservation method for human tissues and organs, is increasingly being used in anatomy education. However, there is a paucity of systematic reviews and meta-analyses summarizing the educational efficacy of plastinated specimens. This meta-analysis compared the assessment scores of students exposed to plastinated specimens against those exposed to other common instructional methods.

Extending the diabetic retinopathy screening intervals in Singapore: methodology and preliminary findings of a cohort study.

Background: The Diabetic Retinopathy Extended Screening Study (DRESS) aims to develop and validate a new DR/diabetic macular edema (DME) risk stratification model in patients with Type 2 diabetes (DM) to identify low-risk groups who can be safely assigned to biennial or triennial screening intervals. We describe the study methodology, participants' baseline characteristics, and preliminary DR progression rates at the first annual follow-up.

Methods: DRESS is a 3-year ongoing longitudinal study of patients with T2DM and no or mild non-proliferative DR (NPDR, non-referable) who underwent teleophthalmic screening under the Singapore integrated Diabetic Retinopathy Programme (SiDRP) at four SingHealth Polyclinics.

Transient Elastography Is the Best-Performing Non-Invasive Test of Liver Fibrosis in Obese Asian Patients with Non-Alcoholic Fatty Liver Disease: A Pilot, Cross-Sectional Study.

: The prevalence of NAFLD (non-alcoholic fatty liver disease) is increasing, and up to 64% of Asian patients with NAFLD are obese. Non-invasive tests (NITs) for the assessment of liver fibrosis are increasingly being used, but data on their performance in obese Asian patients are lacking. In this pilot cross-sectional study, we aim to compare the distribution of serum and radiological markers of fibrosis between obese Asian biopsy-proven NAFLD patients with and without fibrosis and estimate the diagnostic accuracies of these indices.

When is it safe to return to driving after distal radius fracture fixation? A prospective study.

Introduction: After surgical fixation of distal radius fractures, many patients are keen to return to driving. There are however limited guidelines assisting surgeons. The aims of this study were to determine when patients could return to driving safely after distal radius fracture fixation and determine the clinical parameters (range of motion and grip strength) that patients needed to achieve before return to safe driving could be advised.

Innovative dual-function protective scope mask and filtration system for aerosol generating ENT scope procedures.

Background: Aerosol-generating procedures (AGPs), such as nasoendoscopy, are considered high-risk during the COVID-19 pandemic due to risk of virus aerosol transmission. We aim to evaluate the efficacy of an innovative system in reduction of aerosol contamination.

Methods: Pilot study involving 15 healthy volunteers performing aerosol-generating activities with the prototype, compared with and without a standard surgical mask.

Short-Term Effect of Peer Volunteers in Providing Inpatient Rehabilitative Exercises for Patients After Total Knee Arthroplasty.

Objective: To investigate the short-term outcomes at discharge of patients who receive additional postoperative rehabilitative exercises by peer volunteers after total knee arthroplasty (TKA).

Design: Retrospective cohort study.

Setting: Tertiary teaching hospital.

Anaesthetic modality and post-surgical oncological outcomes for paediatric tumours: is there a link?

Introduction: Children with solid organ tumours often present for curative surgery. Even with the best surgical technique, micrometastases can occur. Preclinical studies support the postulation that neuraxial anaesthesia maintains the body's immune and inflammatory milieu against metastasis.

Effects of Cast Immobilisation on Skin Barrier Function.

Introduction: Cast immobilisation remains the mainstay of treatment for various fractures in paediatric patients, yet patients commonly complain of skin irritation and discomfort. This study aimed to perform a qualitative and quantitative evaluation of the effects of cast immobilisation on the skin of children and adolescents.

Materials And Methods: Patients aged 6-17 years of age with a fracture treated in a fiberglass short-arm or short-leg cast were recruited.

Randomized control trial comparing an Alvarado Score-based management algorithm and current best practice in the evaluation of suspected appendicitis.

Background: An objective algorithm for the management of suspected appendicitis guided by the Alvarado Score had previously been proposed. This algorithm was expected to reduce computed tomography (CT) utilization without compromising the negative appendectomy rate. This study attempts to validate the proposed algorithm in a randomized control trial.

Clinical Outcomes of Zone 2 Flexor Tendon Repairs Using the Modified Lim/Tsai Technique.

Background: The single looped suture modified Lim/Tsai technique is widely used for flexor tendon repairs. It has been shown to possess better biomechanical properties and require less repair time per tendon as compared to the double looped suture original Lim/Tsai technique. However, there is no clinical data on the modified technique.

Predictors of Midterm Outcomes after Medial Unicompartmental Knee Arthroplasty in Asians.

Background: This study was designed to evaluate predictors of good outcomes following medial unicompartmental knee arthroplasty (UKA) in Asian patients.

Methods: Registry data of patients who underwent primary unilateral medial UKA from 2006 to 2011 were collected. Outcomes studied were the Oxford Knee Score (OKS) and the Physical Component Score (PCS) of the Short Form 36 (SF-36) questionnaire.