Raymond Liang, Kalaiyarasi Kaliyaperumal, Wee Khoon Ng, Stephen Kin Kwok Tsao, Charles Kien Fong Vu
{"title":"Motorised spiral enteroscopy: pilot experience from a tertiary care centre in Singapore.","authors":"Raymond Liang, Kalaiyarasi Kaliyaperumal, Wee Khoon Ng, Stephen Kin Kwok Tsao, Charles Kien Fong Vu","doi":"10.11622/smedj.2022096","DOIUrl":"10.11622/smedj.2022096","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40516417","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}
Raymond Reinaldo Tanugroho, Lynette Wei Yi Wee, Mark Jean Aan Koh, Jin Ho Chong
Vascular anomalies consist of tumours or malformations made up of abnormal growth or collections of blood vessels that can result in functional or cosmetic problems. While many vascular anomalies are present at birth, some do not appear until later in life, making diagnosis more challenging. Although many vascular anomalies are benign, some are associated with serious complications and may involve multiple organ systems. This article highlights the important features of clinically significant vascular anomalies to help physicians promptly identify and refer these cases to a specialised multidisciplinary team for evaluation and management. The discussion includes the various presenting complaints of vascular anomalies in children, namely, rapidly growing birthmarks, painful lesions, seizures/neurological manifestations, bleeding diathesis, cardiac/airway abnormalities and part of an overgrowth syndrome.
{"title":"Approach to clinically significant vascular anomalies in children.","authors":"Raymond Reinaldo Tanugroho, Lynette Wei Yi Wee, Mark Jean Aan Koh, Jin Ho Chong","doi":"10.11622/smedj.2021209","DOIUrl":"10.11622/smedj.2021209","url":null,"abstract":"<p><p>Vascular anomalies consist of tumours or malformations made up of abnormal growth or collections of blood vessels that can result in functional or cosmetic problems. While many vascular anomalies are present at birth, some do not appear until later in life, making diagnosis more challenging. Although many vascular anomalies are benign, some are associated with serious complications and may involve multiple organ systems. This article highlights the important features of clinically significant vascular anomalies to help physicians promptly identify and refer these cases to a specialised multidisciplinary team for evaluation and management. The discussion includes the various presenting complaints of vascular anomalies in children, namely, rapidly growing birthmarks, painful lesions, seizures/neurological manifestations, bleeding diathesis, cardiac/airway abnormalities and part of an overgrowth syndrome.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39758901","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":"<i>Fusobacterium necrophorum</i> pharyngitis complicated by sepsis and extrapharyngeal dissemination in two young adults.","authors":"Raphael Wei Hao Tay, Shawn Vasoo","doi":"10.11622/smedj.2022084","DOIUrl":"10.11622/smedj.2022084","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342122","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}
Introduction: Postoperative day 1 (POD 1) mobilisation is a key clinical indicator for the fragility hip fracture surgery population. This study aimed to evaluate the current trends of POD 1 mobilisation at our institution and to review the relationships between early mobilisation and outcomes of early functional recovery, length of stay (LOS) and discharge destination.
Methods: In this preliminary observational study, data pertaining to demographics, premorbid function, health status, injury and surgical factors, POD 1 mobilisation status and clinical outcomes of interest were retrieved from eligible patients. Patients who attained POD 1 ambulation formed the early ambulation (EA) group, while the remaining patients formed the delayed ambulation (DA) group. Data were analysed for any significant difference between the groups.
Results: One hundred and fifteen patients were included in the analysis. The rate of patients achieving at least sitting out of bed on POD 1 was 80.0% (n=92), which was comparable to the data available from international hip fracture audit databases. There were 55 (47.8%) patients in the EA group and 60 (52.5%) patients in the DA group. The EA group was approximately nine times more likely to achieve independence in ambulation at discharge compared to the DA group (adjusted odds ratio 9.20, 95% confidence interval 1.50-56.45; P = 0.016). There were observed trends of shorter LOS and more proportion of home discharge in the EA group compared to the DA group (P > 0.05).
Conclusion: This is the first local study to offer benchmark of the POD 1 mobilisation status for this population. Patients who attained POD 1 ambulation had better early functional recovery.
{"title":"Early mobilisation following fragility hip fracture surgery: current trends and association with discharge outcomes in a local tertiary hospital.","authors":"Shumei Tan, Aswinkumar Vasireddy","doi":"10.11622/smedj.2021132","DOIUrl":"10.11622/smedj.2021132","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative day 1 (POD 1) mobilisation is a key clinical indicator for the fragility hip fracture surgery population. This study aimed to evaluate the current trends of POD 1 mobilisation at our institution and to review the relationships between early mobilisation and outcomes of early functional recovery, length of stay (LOS) and discharge destination.</p><p><strong>Methods: </strong>In this preliminary observational study, data pertaining to demographics, premorbid function, health status, injury and surgical factors, POD 1 mobilisation status and clinical outcomes of interest were retrieved from eligible patients. Patients who attained POD 1 ambulation formed the early ambulation (EA) group, while the remaining patients formed the delayed ambulation (DA) group. Data were analysed for any significant difference between the groups.</p><p><strong>Results: </strong>One hundred and fifteen patients were included in the analysis. The rate of patients achieving at least sitting out of bed on POD 1 was 80.0% (n=92), which was comparable to the data available from international hip fracture audit databases. There were 55 (47.8%) patients in the EA group and 60 (52.5%) patients in the DA group. The EA group was approximately nine times more likely to achieve independence in ambulation at discharge compared to the DA group (adjusted odds ratio 9.20, 95% confidence interval 1.50-56.45; P = 0.016). There were observed trends of shorter LOS and more proportion of home discharge in the EA group compared to the DA group (P > 0.05).</p><p><strong>Conclusion: </strong>This is the first local study to offer benchmark of the POD 1 mobilisation status for this population. Patients who attained POD 1 ambulation had better early functional recovery.</p>","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39494808","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}
Lester Wai Mon Chan, Daniel Xing Cheng Yin, Sean Cheng Gong, Daniel Wei Ren Seng, Mathew Hern Wang Cheng
{"title":"Soft tissue sarcomas of the extremity and superficial trunk: do we need radiotherapy?","authors":"Lester Wai Mon Chan, Daniel Xing Cheng Yin, Sean Cheng Gong, Daniel Wei Ren Seng, Mathew Hern Wang Cheng","doi":"10.11622/smedj.2022093","DOIUrl":"10.11622/smedj.2022093","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10775297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40516418","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}
Pub Date : 2023-11-30DOI: 10.4103/singaporemedj.smj-2021-419
Mae Yue Tan, Shuh Shing Lee, Marion Margaret Aw, Nasyitah Binte Abd Aziz, Yih Lin Lim, Suan Peen Foo, Ze Lei Tan, Andrew Anjian Sng, Yu Han Chee, Nicholas Beng Hui Ng, Jeremy Bingyuan Lin
{"title":"Mindfulness and reflective practice pilot programme of Postgraduate Year 1 doctors: perceptions on impact and sustainability","authors":"Mae Yue Tan, Shuh Shing Lee, Marion Margaret Aw, Nasyitah Binte Abd Aziz, Yih Lin Lim, Suan Peen Foo, Ze Lei Tan, Andrew Anjian Sng, Yu Han Chee, Nicholas Beng Hui Ng, Jeremy Bingyuan Lin","doi":"10.4103/singaporemedj.smj-2021-419","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-419","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139200150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-30DOI: 10.4103/singaporemedj.smj-2021-458
Ian Matthias Ng, Tzu-Jung Wong, Yong Yang, I. Venkatachalam, J. Sim, L. Wee, T. Liew, Evelyn Boon, Tong Yong Ng, Hwi Kwang Han, Diana Yuen Lan Tan
During the coronavirus disease 2019 (COVID-19) pandemic, contact tracers were under immense pressure to deliver effective and timely contact tracing, raising concerns of higher susceptibility to burnout. Our study aimed to determine burnout prevalence among hospital-based contact tracers and associated risk factors, so that interventions to reduce burnout risk could be formulated. One hundred and ninety-six active contact tracers across three hospitals within a healthcare cluster were invited to complete an anonymous online survey. To identify burntout, data such as demographics, work-related variables and contact tracing-related variables were collected using the Copenhagen Burnout Inventory. Associated factors were identified using multivariate statistics. Open-ended questions were included to understand the challenges and potential improvements through qualitative analysis. A total of 126 participants completed the survey, giving a completion rate of 64%, and almost half of these participants (42.9%) reported burnout. Protective factors included being on work-from-home arrangements (adjusted odds ratio [OR] 0.22, 95% confidence interval [CI] 0.08–0.56), perception of being well supported by their institution (adjusted OR 0.25, 95% CI 0.08–0.80) and being married (adjusted OR 0.28, 95% CI 0.12–0.64). Risk factors included having an administrative role pre–COVID-19 (adjusted OR 3.62, 95% CI 1.33–9.83). Work-related burnout was related to being activated for more than 1 day in the preceding week (unadjusted OR 3.25, 95% CI 1.33–7.94) and multiple activations in a day (unadjusted OR 3.54, 95% CI 1.44–4.41). Biggest challenges identified by participants were language barrier (62.7%), followed by workflow-related issues (42.1%). Our study demonstrated burnout and other challenges faced by a team of mostly hospital-based administrative staff redeployed on a part-time basis to ensure timely contact tracing. To mitigate burnout, we recommend choosing staff on work-from-home arrangements and ensuring adequate manpower and rostering arrangements.
在 2019 年冠状病毒病（COVID-19）大流行期间，接触追踪人员面临着及时有效地开展接触追踪工作的巨大压力，这引发了他们更容易产生职业倦怠的担忧。我们的研究旨在确定医院接触追踪人员的职业倦怠发生率及相关风险因素，从而制定降低职业倦怠风险的干预措施。 我们邀请了一个医疗集团内三家医院的 196 名活跃的联络追踪员完成匿名在线调查。为了识别职业倦怠，我们使用哥本哈根职业倦怠量表收集了人口统计学、工作相关变量和接触追踪相关变量等数据。使用多变量统计确定了相关因素。调查还包括开放式问题，以便通过定性分析了解所面临的挑战和可能的改进措施。 共有 126 名参与者完成了调查，完成率为 64%，其中近一半（42.9%）的参与者报告了职业倦怠。保护因素包括在家工作的安排（调整后的几率比[OR]0.22，95%置信区间[CI]0.08-0.56）、认为得到所在机构的良好支持（调整后的几率比0.25，95%置信区间[CI]0.08-0.80）和已婚（调整后的几率比0.28，95%置信区间[CI]0.12-0.64）。风险因素包括在COVID-19之前担任行政职务（调整后OR为3.62，95% CI为1.33-9.83）。与工作相关的倦怠与前一周被激活超过 1 天（未调整 OR 3.25，95% CI 1.33-7.94）和一天内多次激活（未调整 OR 3.54，95% CI 1.44-4.41）有关。参与者认为最大的挑战是语言障碍（62.7%），其次是工作流程相关问题（42.1%）。 我们的研究表明，为确保及时追踪联系人而重新部署的兼职行政人员团队面临着职业倦怠和其他挑战。为减轻职业倦怠，我们建议选择在家工作的员工，并确保充足的人力和轮岗安排。
{"title":"Burnout among COVID-19 hospital-based contact tracers in Singapore: results of a mixed-method, cross-sectional multicentre study","authors":"Ian Matthias Ng, Tzu-Jung Wong, Yong Yang, I. Venkatachalam, J. Sim, L. Wee, T. Liew, Evelyn Boon, Tong Yong Ng, Hwi Kwang Han, Diana Yuen Lan Tan","doi":"10.4103/singaporemedj.smj-2021-458","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-458","url":null,"abstract":"During the coronavirus disease 2019 (COVID-19) pandemic, contact tracers were under immense pressure to deliver effective and timely contact tracing, raising concerns of higher susceptibility to burnout. Our study aimed to determine burnout prevalence among hospital-based contact tracers and associated risk factors, so that interventions to reduce burnout risk could be formulated. One hundred and ninety-six active contact tracers across three hospitals within a healthcare cluster were invited to complete an anonymous online survey. To identify burntout, data such as demographics, work-related variables and contact tracing-related variables were collected using the Copenhagen Burnout Inventory. Associated factors were identified using multivariate statistics. Open-ended questions were included to understand the challenges and potential improvements through qualitative analysis. A total of 126 participants completed the survey, giving a completion rate of 64%, and almost half of these participants (42.9%) reported burnout. Protective factors included being on work-from-home arrangements (adjusted odds ratio [OR] 0.22, 95% confidence interval [CI] 0.08–0.56), perception of being well supported by their institution (adjusted OR 0.25, 95% CI 0.08–0.80) and being married (adjusted OR 0.28, 95% CI 0.12–0.64). Risk factors included having an administrative role pre–COVID-19 (adjusted OR 3.62, 95% CI 1.33–9.83). Work-related burnout was related to being activated for more than 1 day in the preceding week (unadjusted OR 3.25, 95% CI 1.33–7.94) and multiple activations in a day (unadjusted OR 3.54, 95% CI 1.44–4.41). Biggest challenges identified by participants were language barrier (62.7%), followed by workflow-related issues (42.1%). Our study demonstrated burnout and other challenges faced by a team of mostly hospital-based administrative staff redeployed on a part-time basis to ensure timely contact tracing. To mitigate burnout, we recommend choosing staff on work-from-home arrangements and ensuring adequate manpower and rostering arrangements.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139199265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-29DOI: 10.4103/singaporemedj.smj-2022-019
Valerie Huali Tan, Amaris Shu Min Lim, Sky Wei Chee Koh, Jun Hao Tan, Choon Chiet Hong
{"title":"Empowering primary care in the management of toe fractures: a quality improvement project","authors":"Valerie Huali Tan, Amaris Shu Min Lim, Sky Wei Chee Koh, Jun Hao Tan, Choon Chiet Hong","doi":"10.4103/singaporemedj.smj-2022-019","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2022-019","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-29DOI: 10.4103/singaporemedj.smj-2022-078
M. Tan, R. Y. Chua, Qiao Fan, M. Fortier, P. P. Chang
In this study, we aimed to compare the performance of a convolutional neural network (CNN)-based deep learning model that was trained on a dataset of normal and abnormal paediatric elbow radiographs with that of paediatric emergency department (ED) physicians on a binomial classification task. A total of 1,314 paediatric elbow lateral radiographs (patient mean age 8.2 years) were retrospectively retrieved and classified based on annotation as normal or abnormal (with pathology). They were then randomly partitioned to a development set (993 images); first and second tuning (validation) sets (109 and 100 images, respectively); and a test set (112 images). An artificial intelligence (AI) model was trained on the development set using the EfficientNet B1 network architecture. Its performance on the test set was compared to that of five physicians (inter-rater agreement: fair). Performance of the AI model and the physician group was tested using McNemar test. The accuracy of the AI model on the test set was 80.4% (95% confidence interval [CI] 71.8%–87.3%), and the area under the receiver operating characteristic curve (AUROC) was 0.872 (95% CI 0.831–0.947). The performance of the AI model vs. the physician group on the test set was: sensitivity 79.0% (95% CI: 68.4%–89.5%) vs. 64.9% (95% CI: 52.5%–77.3%; P = 0.088); and specificity 81.8% (95% CI: 71.6%–92.0%) vs. 87.3% (95% CI: 78.5%–96.1%; P = 0.439). The AI model showed good AUROC values and higher sensitivity, with the P-value at nominal significance when compared to the clinician group.
{"title":"Use of deep learning model for paediatric elbow radiograph binomial classification: initial experience, performance and lessons learnt","authors":"M. Tan, R. Y. Chua, Qiao Fan, M. Fortier, P. P. Chang","doi":"10.4103/singaporemedj.smj-2022-078","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2022-078","url":null,"abstract":"In this study, we aimed to compare the performance of a convolutional neural network (CNN)-based deep learning model that was trained on a dataset of normal and abnormal paediatric elbow radiographs with that of paediatric emergency department (ED) physicians on a binomial classification task. A total of 1,314 paediatric elbow lateral radiographs (patient mean age 8.2 years) were retrospectively retrieved and classified based on annotation as normal or abnormal (with pathology). They were then randomly partitioned to a development set (993 images); first and second tuning (validation) sets (109 and 100 images, respectively); and a test set (112 images). An artificial intelligence (AI) model was trained on the development set using the EfficientNet B1 network architecture. Its performance on the test set was compared to that of five physicians (inter-rater agreement: fair). Performance of the AI model and the physician group was tested using McNemar test. The accuracy of the AI model on the test set was 80.4% (95% confidence interval [CI] 71.8%–87.3%), and the area under the receiver operating characteristic curve (AUROC) was 0.872 (95% CI 0.831–0.947). The performance of the AI model vs. the physician group on the test set was: sensitivity 79.0% (95% CI: 68.4%–89.5%) vs. 64.9% (95% CI: 52.5%–77.3%; P = 0.088); and specificity 81.8% (95% CI: 71.6%–92.0%) vs. 87.3% (95% CI: 78.5%–96.1%; P = 0.439). The AI model showed good AUROC values and higher sensitivity, with the P-value at nominal significance when compared to the clinician group.","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139211279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-29DOI: 10.4103/singaporemedj.smj-2021-431
Jin Wen Rachael Nai, Jingyin Sophia Ng, Eng Kuang Lim, Claude Jeffrey Renaud, Fams Renal Medicine
{"title":"Diabetic myonecrosis in haemodialysis patients: importance of early recognition, noninvasive diagnosis and treatment","authors":"Jin Wen Rachael Nai, Jingyin Sophia Ng, Eng Kuang Lim, Claude Jeffrey Renaud, Fams Renal Medicine","doi":"10.4103/singaporemedj.smj-2021-431","DOIUrl":"https://doi.org/10.4103/singaporemedj.smj-2021-431","url":null,"abstract":"","PeriodicalId":21752,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139213230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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