Pub Date : 2024-09-01Epub Date: 2024-09-06DOI: 10.4103/singaporemedj.SMJ-2024-186
Poh Lian Lim, Wilnard Yeong Tze Tan, Shawn Vasoo
{"title":"Mpox clade I outbreak: how should Asia prepare and respond?","authors":"Poh Lian Lim, Wilnard Yeong Tze Tan, Shawn Vasoo","doi":"10.4103/singaporemedj.SMJ-2024-186","DOIUrl":"10.4103/singaporemedj.SMJ-2024-186","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.4103/singaporemedj.SMJ-2023-001
Pamela Qin Yi Chong, Muntasir Mannan Choudhury, Sze Ryn Chung, Robert Tze Jin Yap, Dawn Sinn Yi Chia, Jackson Kian Hong Jiang, Andrew Yuan Hui Chin, Duncan Angus McGrouther
Introduction: Hand tumours are frequently encountered in clinical practice. However, large-scale epidemiological data of soft tissue tumours in the hand are infrequently published. Epidemiological data provide diagnostic cues to guide the workup and management of hand tumours. Assessing significant independent demographic factors and tumour characteristics associated with hand tumours is essential in health care.
Methods: A retrospective review of patients who underwent excision of hand tumours in Singapore General Hospital between 2004 and 2015 was conducted. The data collected included age, gender, ethnicity, histological diagnosis, malignancy and location of tumour. Generalised linear latent and mixed models (GLLAMM) analyses were performed.
Results: A total of 4476 tumours were identified from 4226 patients with a mean age of 51.3 (range 8-101) years and male to female ratio of 1 to 1.15. Most patients were Chinese (75%), followed by Malay (9%), Indian (8%) and others (8%). The most common hand tumours excised were ganglions (43%) (majority in the wrist), followed by giant cell tumours (9%) (commonly in the digits). Most soft tissue tumours were benign (97%), with only 3% of malignant cases. The GLLAMM analyses revealed further potential factors on the status of malignancy, tumour origin and tumour location.
Conclusion: Most soft tissue tumours in the hand and wrist are benign. This can guide workup and counselling of patients before the operation. While malignant tumours are uncommon, they have the potential for significant morbidity and mortality if not appropriately evaluated or treated. The application of GLLAMM analyses showed that age, ethnicity and gender were significant predictors of malignancy.
{"title":"A multivariate analysis on characteristics of hand and wrist tumours: a multiethnic study.","authors":"Pamela Qin Yi Chong, Muntasir Mannan Choudhury, Sze Ryn Chung, Robert Tze Jin Yap, Dawn Sinn Yi Chia, Jackson Kian Hong Jiang, Andrew Yuan Hui Chin, Duncan Angus McGrouther","doi":"10.4103/singaporemedj.SMJ-2023-001","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-001","url":null,"abstract":"<p><strong>Introduction: </strong>Hand tumours are frequently encountered in clinical practice. However, large-scale epidemiological data of soft tissue tumours in the hand are infrequently published. Epidemiological data provide diagnostic cues to guide the workup and management of hand tumours. Assessing significant independent demographic factors and tumour characteristics associated with hand tumours is essential in health care.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent excision of hand tumours in Singapore General Hospital between 2004 and 2015 was conducted. The data collected included age, gender, ethnicity, histological diagnosis, malignancy and location of tumour. Generalised linear latent and mixed models (GLLAMM) analyses were performed.</p><p><strong>Results: </strong>A total of 4476 tumours were identified from 4226 patients with a mean age of 51.3 (range 8-101) years and male to female ratio of 1 to 1.15. Most patients were Chinese (75%), followed by Malay (9%), Indian (8%) and others (8%). The most common hand tumours excised were ganglions (43%) (majority in the wrist), followed by giant cell tumours (9%) (commonly in the digits). Most soft tissue tumours were benign (97%), with only 3% of malignant cases. The GLLAMM analyses revealed further potential factors on the status of malignancy, tumour origin and tumour location.</p><p><strong>Conclusion: </strong>Most soft tissue tumours in the hand and wrist are benign. This can guide workup and counselling of patients before the operation. While malignant tumours are uncommon, they have the potential for significant morbidity and mortality if not appropriately evaluated or treated. The application of GLLAMM analyses showed that age, ethnicity and gender were significant predictors of malignancy.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.4103/singaporemedj.SMJ-2024-011
Kay Yi Low, Le Roy Chong, Hui Yin Lim, Ivy Lim, Aik Khien Victor Tan
{"title":"Scapular dyskinesia with focal impingement of the hypertrophied serratus anterior muscle in a competitive swimmer.","authors":"Kay Yi Low, Le Roy Chong, Hui Yin Lim, Ivy Lim, Aik Khien Victor Tan","doi":"10.4103/singaporemedj.SMJ-2024-011","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2024-011","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-08-10DOI: 10.4103/singaporemedj.SMJ-2021-360
Pei Ling Tan, Tze Chao Wee, Ang Tee Lim
{"title":"Poststroke shoulder pain.","authors":"Pei Ling Tan, Tze Chao Wee, Ang Tee Lim","doi":"10.4103/singaporemedj.SMJ-2021-360","DOIUrl":"10.4103/singaporemedj.SMJ-2021-360","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a needs-based digital portal to support maternal and child health in Singapore.","authors":"Usha Chandraseharan, Priyanka Rajendram, Vasuki Utravathy, Vijaya Karuppiah, Shyamala Thilagaratnam","doi":"10.4103/singaporemedj.SMJ-2022-029","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2022-029","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.4103/singaporemedj.SMJ-2023-170
John Jian Xian Quek, Oliver James Nickalls, Bak Siew Steven Wong, Min On Tan
Introduction: Radiology plays an integral role in fracture detection in the emergency department (ED). After hours, when there are fewer reporting radiologists, most radiographs are interpreted by ED physicians. A minority of these interpretations may miss diagnoses, which later require the callback of patients for further management. Artificial intelligence (AI) has been viewed as a potential solution to augment the shortage of radiologists after hours. We explored the efficacy of an AI solution in the detection of appendicular and pelvic fractures for adult radiographs performed after hours at a general hospital ED in Singapore, and estimated the potential monetary and non-monetary benefits.
Methods: One hundred and fifty anonymised abnormal radiographs were retrospectively collected and fed through an AI fracture detection solution. The radiographs were re-read by two radiologist reviewers and their consensus was established as the reference standard. Cases were stratified based on the concordance between the AI solution and the reviewers' findings. Discordant cases were further analysed based on the nature of the discrepancy into overcall and undercall subgroups. Statistical analysis was performed to evaluate the accuracy, sensitivity and inter-rater reliability of the AI solution.
Results: Ninety-two examinations were included in the final study radiograph set. The AI solution had a sensitivity of 98.9%, an accuracy of 85.9% and an almost perfect agreement with the reference standard.
Conclusion: An AI fracture detection solution has similar sensitivity to human radiologists in the detection of fractures on ED appendicular and pelvic radiographs. Its implementation offers significant potential measurable cost, manpower and time savings.
导言:放射科在急诊科(ED)的骨折检测中发挥着不可或缺的作用。下班后,由于放射科报告医生较少,大多数放射照片都由急诊科医生判读。这些判读中的少数可能会漏诊,从而需要回访患者以进一步处理。人工智能(AI)被认为是解决下班后放射科医生短缺问题的潜在方法。我们探讨了人工智能解决方案在新加坡一家综合医院急诊室下班后对成人放射照片进行阑尾和骨盆骨折检测的功效,并估算了潜在的货币和非货币收益:方法:回顾性收集了 150 张匿名的异常 X 光片,并将其输入人工智能骨折检测解决方案。由两名放射科医生审查员重新读片,并将他们的共识作为参考标准。根据人工智能解决方案与审片专家结论的一致性对病例进行分层。根据差异的性质,将不一致的病例进一步分析为高估和低估亚组。进行统计分析以评估人工智能解决方案的准确性、灵敏度和评审员之间的可靠性:最终的研究放射照片集包括 92 张检查照片。人工智能解决方案的灵敏度为 98.9%,准确度为 85.9%,与参考标准几乎完全一致:人工智能骨折检测解决方案在 ED 阑尾和骨盆 X 光片上检测骨折的灵敏度与人类放射医师相似。该方案的实施可节省大量可衡量的潜在成本、人力和时间。
{"title":"Deploying artificial intelligence in the detection of adult appendicular and pelvic fractures in the Singapore emergency department after hours: efficacy, cost savings and non-monetary benefits.","authors":"John Jian Xian Quek, Oliver James Nickalls, Bak Siew Steven Wong, Min On Tan","doi":"10.4103/singaporemedj.SMJ-2023-170","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-170","url":null,"abstract":"<p><strong>Introduction: </strong>Radiology plays an integral role in fracture detection in the emergency department (ED). After hours, when there are fewer reporting radiologists, most radiographs are interpreted by ED physicians. A minority of these interpretations may miss diagnoses, which later require the callback of patients for further management. Artificial intelligence (AI) has been viewed as a potential solution to augment the shortage of radiologists after hours. We explored the efficacy of an AI solution in the detection of appendicular and pelvic fractures for adult radiographs performed after hours at a general hospital ED in Singapore, and estimated the potential monetary and non-monetary benefits.</p><p><strong>Methods: </strong>One hundred and fifty anonymised abnormal radiographs were retrospectively collected and fed through an AI fracture detection solution. The radiographs were re-read by two radiologist reviewers and their consensus was established as the reference standard. Cases were stratified based on the concordance between the AI solution and the reviewers' findings. Discordant cases were further analysed based on the nature of the discrepancy into overcall and undercall subgroups. Statistical analysis was performed to evaluate the accuracy, sensitivity and inter-rater reliability of the AI solution.</p><p><strong>Results: </strong>Ninety-two examinations were included in the final study radiograph set. The AI solution had a sensitivity of 98.9%, an accuracy of 85.9% and an almost perfect agreement with the reference standard.</p><p><strong>Conclusion: </strong>An AI fracture detection solution has similar sensitivity to human radiologists in the detection of fractures on ED appendicular and pelvic radiographs. Its implementation offers significant potential measurable cost, manpower and time savings.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.4103/singaporemedj.SMJ-2023-083
Choi Wah Kong, William Wing Kee To
Introduction: This study aimed to compare the pregnancy and perinatal outcomes of women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy.
Methods: Women who delivered in an obstetric unit from March 2022 to October 2022 were recruited. The history of vaccination and SARS-CoV-2 infection during pregnancy was recorded. The pregnancy and perinatal outcomes of women with and without SARS-CoV-2 infection were compared.
Results: A total of 1015 women were recruited - 41.5% had SARS-CoV-2 infection during pregnancy and 25.2% were unvaccinated. The incidences of preeclampsia, gestational diabetes mellitus and caesarean section were similar between the two groups. There were more preterm deliveries (9.0% vs 5.1%, P = 0.01) and more late preterm deliveries of between 33 and 36 + 6 weeks (6.2% vs. 3.7%, P = 0.03) in the SARS-CoV-2 infection group. There were no statistically significant differences between the two groups in perinatal outcomes, including birthweight, incidence of small for gestational age, low Apgar scores, and neonatal intensive care or special care baby unit admissions. There were no differences in pregnancy and perinatal outcomes between women infected in the first/second trimester and those infected in the third trimester, except for lower mean birthweight (3180 g vs. 3292 g, P = 0.04). There were no major differences in pregnancy outcome between vaccinated and unvaccinated women.
Conclusion: The pregnancy and perinatal outcomes of women who were infected with SARS-CoV-2 during gestation appear favourable.
{"title":"Pregnancy and perinatal outcomes of women with SARS-CoV-2 infection during pregnancy.","authors":"Choi Wah Kong, William Wing Kee To","doi":"10.4103/singaporemedj.SMJ-2023-083","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-083","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the pregnancy and perinatal outcomes of women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy.</p><p><strong>Methods: </strong>Women who delivered in an obstetric unit from March 2022 to October 2022 were recruited. The history of vaccination and SARS-CoV-2 infection during pregnancy was recorded. The pregnancy and perinatal outcomes of women with and without SARS-CoV-2 infection were compared.</p><p><strong>Results: </strong>A total of 1015 women were recruited - 41.5% had SARS-CoV-2 infection during pregnancy and 25.2% were unvaccinated. The incidences of preeclampsia, gestational diabetes mellitus and caesarean section were similar between the two groups. There were more preterm deliveries (9.0% vs 5.1%, P = 0.01) and more late preterm deliveries of between 33 and 36 + 6 weeks (6.2% vs. 3.7%, P = 0.03) in the SARS-CoV-2 infection group. There were no statistically significant differences between the two groups in perinatal outcomes, including birthweight, incidence of small for gestational age, low Apgar scores, and neonatal intensive care or special care baby unit admissions. There were no differences in pregnancy and perinatal outcomes between women infected in the first/second trimester and those infected in the third trimester, except for lower mean birthweight (3180 g vs. 3292 g, P = 0.04). There were no major differences in pregnancy outcome between vaccinated and unvaccinated women.</p><p><strong>Conclusion: </strong>The pregnancy and perinatal outcomes of women who were infected with SARS-CoV-2 during gestation appear favourable.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.4103/singaporemedj.SMJ-2023-179
Jinghao Nicholas Ngiam, Tze Sian Liong, Matthew Chung Yi Koh, Wilson Goh, Meng Ying Sim, Srishti Chhabra, Nicholas Wen Sheng Chew, Jayagowtham Krishan Annadurai, Sandi Myo Thant, Ping Chai, Tiong-Cheng Yeo, Kian Keong Poh, Paul Anantharajah Tambyah, Ching-Hui Sia
Introduction: Early in the coronavirus disease 2019 (COVID-19) pandemic, a low incidence of cardiovascular complications was reported in Singapore. Little was known about the trend of cardiovascular complications as the pandemic progressed. In this study, we examined the evolving trends in electrocardiographic and cardiovascular manifestations in patients hospitalised with COVID-19.
Methods: We examined the first 1781 consecutive hospitalised patients with polymerase chain reaction-confirmed COVID-19. We divided the population based on whether they had abnormal heart rate (HR) or electrocardiography (ECG) or normal HR and ECG, comparing the baseline characteristics and outcomes. Cardiovascular complications were defined as acute myocardial infarction, stroke, pulmonary embolism, myocarditis and mortality.
Results: The 253 (14.2%) patients who had abnormal HR/ECG at presentation were more likely to be symptomatic. Sinus tachycardia was commonly observed. Troponin I levels (97.0 ± 482.9 vs. 19.7 ± 68.4 ng/L, P = 0.047) and C-reactive protein levels (20.1 ± 50.7 vs. 13.9 ± 24.1 μmol/L, P = 0.003) were significantly higher among those with abnormal HR/ECGs, with a higher prevalence of myocarditis (2.0% vs. 0.5%, P = 0.019), pulmonary embolism (2.0% vs. 0.3%, P = 0.008) and acute myocardial infarction (1.2% vs. 0.1%, P = 0.023). After adjusting for age and comorbidities, abnormal HR/ECG (adjusted odds ratio 4.41, 95% confidence interval 2.21-8.77; P < 0.001) remained independently associated with adverse cardiovascular complications. Over time, there was a trend towards a higher proportion of hospitalised patients with cardiovascular complications.
Conclusion: Cardiovascular complications appear to be increasing in proportion over time among hospitalised patients with COVID-19. A baseline ECG and HR measurement may be helpful for predicting these complications.
导言:2019 年冠状病毒病(COVID-19)大流行初期,新加坡报告的心血管并发症发病率较低。随着疫情的发展,人们对心血管并发症的趋势知之甚少。在这项研究中,我们研究了 COVID-19 住院患者心电图和心血管表现的演变趋势:我们对经聚合酶链反应确诊为 COVID-19 的首批 1781 名连续住院患者进行了研究。我们根据患者的心率(HR)或心电图(ECG)是否异常或心率和心电图是否正常对患者进行了分类,并对基线特征和结果进行了比较。心血管并发症定义为急性心肌梗死、中风、肺栓塞、心肌炎和死亡率:发病时心率/心电图异常的 253 名患者(14.2%)更有可能出现症状。窦性心动过速很常见。肌钙蛋白 I 水平(97.0 ± 482.9 vs. 19.7 ± 68.4 ng/L,P = 0.047)和 C 反应蛋白水平(20.1 ± 50.7 vs. 13.9 ± 24.1 μmol/L,P = 0.003),心肌炎(2.0% vs. 0.5%,P = 0.019)、肺栓塞(2.0% vs. 0.3%,P = 0.008)和急性心肌梗死(1.2% vs. 0.1%,P = 0.023)的发病率更高。对年龄和合并症进行调整后,HR/ECG 异常(调整后的几率比为 4.41,95% 置信区间为 2.21-8.77;P<0.001)仍与不良心血管并发症密切相关。随着时间的推移,心血管并发症住院患者的比例呈上升趋势:结论:随着时间的推移,COVID-19住院患者中出现心血管并发症的比例似乎在增加。基线心电图和心率测量可能有助于预测这些并发症。
{"title":"Trends in electrocardiographic and cardiovascular manifestations of patients hospitalised with COVID-19.","authors":"Jinghao Nicholas Ngiam, Tze Sian Liong, Matthew Chung Yi Koh, Wilson Goh, Meng Ying Sim, Srishti Chhabra, Nicholas Wen Sheng Chew, Jayagowtham Krishan Annadurai, Sandi Myo Thant, Ping Chai, Tiong-Cheng Yeo, Kian Keong Poh, Paul Anantharajah Tambyah, Ching-Hui Sia","doi":"10.4103/singaporemedj.SMJ-2023-179","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2023-179","url":null,"abstract":"<p><strong>Introduction: </strong>Early in the coronavirus disease 2019 (COVID-19) pandemic, a low incidence of cardiovascular complications was reported in Singapore. Little was known about the trend of cardiovascular complications as the pandemic progressed. In this study, we examined the evolving trends in electrocardiographic and cardiovascular manifestations in patients hospitalised with COVID-19.</p><p><strong>Methods: </strong>We examined the first 1781 consecutive hospitalised patients with polymerase chain reaction-confirmed COVID-19. We divided the population based on whether they had abnormal heart rate (HR) or electrocardiography (ECG) or normal HR and ECG, comparing the baseline characteristics and outcomes. Cardiovascular complications were defined as acute myocardial infarction, stroke, pulmonary embolism, myocarditis and mortality.</p><p><strong>Results: </strong>The 253 (14.2%) patients who had abnormal HR/ECG at presentation were more likely to be symptomatic. Sinus tachycardia was commonly observed. Troponin I levels (97.0 ± 482.9 vs. 19.7 ± 68.4 ng/L, P = 0.047) and C-reactive protein levels (20.1 ± 50.7 vs. 13.9 ± 24.1 μmol/L, P = 0.003) were significantly higher among those with abnormal HR/ECGs, with a higher prevalence of myocarditis (2.0% vs. 0.5%, P = 0.019), pulmonary embolism (2.0% vs. 0.3%, P = 0.008) and acute myocardial infarction (1.2% vs. 0.1%, P = 0.023). After adjusting for age and comorbidities, abnormal HR/ECG (adjusted odds ratio 4.41, 95% confidence interval 2.21-8.77; P < 0.001) remained independently associated with adverse cardiovascular complications. Over time, there was a trend towards a higher proportion of hospitalised patients with cardiovascular complications.</p><p><strong>Conclusion: </strong>Cardiovascular complications appear to be increasing in proportion over time among hospitalised patients with COVID-19. A baseline ECG and HR measurement may be helpful for predicting these complications.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15DOI: 10.4103/singaporemedj.SMJ-2023-136
Yen Siong Andrew Tan, Li Ping Marianne Tsang, Seen Hang Smily Lock, Kayshini Vijakumar, Xin Yi Cassandra Ho, Ai Choo Seah, Pei Pei Gong, Yi Ling Eileen Koh, Ngiap Chuan Tan
{"title":"Barriers to postpartum diabetes mellitus screening among mothers with a recent history of gestational diabetes mellitus: a cross-sectional study.","authors":"Yen Siong Andrew Tan, Li Ping Marianne Tsang, Seen Hang Smily Lock, Kayshini Vijakumar, Xin Yi Cassandra Ho, Ai Choo Seah, Pei Pei Gong, Yi Ling Eileen Koh, Ngiap Chuan Tan","doi":"10.4103/singaporemedj.SMJ-2023-136","DOIUrl":"10.4103/singaporemedj.SMJ-2023-136","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}