Occupational ; Electrical battery ; MALAYSIAN ; Lead

Assessment: Cognition ; Chronic cough

MAXILLA

BACKGROUND: Verrucae or warts, are benign epithelial growths caused by human papillomavirus (HPV) infection of the skin. They are unsightly and may affect a patient's quality of life, causing social embarrassment, discomfort, pain, and interference in certain activities.
OBJECTIVE: To evaluate the efficacy and safety of imiquimod 5 percent cream for sixteen weeks in the treatment of verruca vulgaris and verruca plana in an open-label trial involving healthy immunocompetent Filipino patients of the Dermatology out-patient clinic of the Philippine General Hospital.
METHODS: Imiquimod 5 percent cream was self-administered by patients with verruca vulgaris or verruca plana on their lesions, nightly for 16 weeks. Follow-up was done every two weeks to determine any change in size over time. Side effects were recorded.
RESULTS: Complete clearance was seen in 31.8% of verruca vulgaris cases, with improvement seen in 59 percent of cases. Shorter duration of lesions was associated with clearance. Complete clearance was seen in only 1 out of 8 patients with verruca plana treated. Minor side effects were reported.
CONCLUSION: Topical imiquimod 5 percent cream is a safe, well-tolerated, painless, convenient, patient-applied route which may be a preferred alternative treatment for verruca vulgaris.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Aminoquinolines ; Dermatology ; Hospitals, General ; Outpatients ; Pain ; Papillomavirus Infections ; Philippines ; Skin ; Warts

Methods: This is an experimental study of 12 rabbits implanted with ostrich eggshell (6 rabbits with 5mm- and 6 rabbits with 10mm-diameter grafts) subperiosteally in the right orbital floor. The right orbit was harvested en bloc 1, 2, and 3 months after onlay. Radiographic studies were done one day after implantation and prior to harvest. The specimens were submitted for gross and microscopic studies. Results: All animals showed normal wound healing. The grafts were stable and no foreign body reaction was observed 1, 2 and 3 months postimplantation. The size of the ostrich eggshell implants remained the same. There was no change in radiodensity at 3 months observation. Conclusion: The results of this study support the potential application of ostrich eggshell as bone substitute for orbital floor fractures.
Animal ; STRUTHIONIFORMES ; BONE TRANSPLANTATION ; TRANSPLANTS ; RABBITS ; ORBIT ; ORBITAL FRACTURES

INTRODUCTIONSpinal cord injury (SCI) often results in significant neurologic dysfunction and disability. An annual incidence of 15 to 40 traumatic SCI cases per million population has been reported worldwide, and a conservative estimate for Singapore would be 23 cases per million. With continued improvements in medical care, an increasing prevalence of SCI patients is expected, with corresponding need for comprehensive rehabilitation services led by specialist rehabilitation physicians.

METHODSA literature search, review, and summary of findings of recent studies relating to factors associated with recovery, as well as interventions for rehabilitation and promotion of healing of the injured spinal cord was performed.

CONCLUSIONSMany SCI patients show improvements in motoric and neurologic level, but those with complete injuries have poor chance of improving American Spinal Injury Association (ASIA) scores. SCI of violent aetiology tends to be more neurologic complete, and those without sacral sparing less likely to improve. Older patients generally do well in activities of daily living. Women have better motor score improvement, although men have better Functional Independence Measure (FIM) scores generally. Electrodiagnostic tests such as somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) can help with prognostication, as can imaging techniques such as magnetic resonance imaging (MRI). Immediate surgery for spinal decompression may improve recovery, but whether routine surgery after SCI improves function remains unclear, as does the timing. Methylprednisolone and similar agents appear to help limit secondary injury processes. Rehabilitation interventions such as functional electrical stimulation (FES) and body-weight supported treadmill ambulation training may be effective, as may neural-controlled prostheses and devices. Substances that promote repair and regeneration of the injured spinal cord such as GM-1, 4-AP, BDNG, GDNF, Nogo and MAG-inhibitors, have been studied. Transplanted tissues and cells, such as blood macrophages, bone marrow transplant with GM-CSF, olfactory ensheathing cells, fetal tissues, stem or progenitor cells, have been reported to produce neurological improvements.

Activities of Daily Living ; Animals ; Decompression, Surgical ; Electric Stimulation Therapy ; Evoked Potentials, Somatosensory ; Exercise Therapy ; Glucocorticoids ; therapeutic use ; Humans ; Methylprednisolone ; therapeutic use ; Nerve Regeneration ; Prostheses and Implants ; Recovery of Function ; Spinal Cord Injuries ; rehabilitation

INTRODUCTIONSingaporeans are superstitious, and medical staff are no exception to the rule. We conducted a survey to determine the prevalence of superstitious beliefs and practices amongst doctors, nurses and medical students in Singapore.

METHODSInternet and face-to-face surveys of 68 respondents, all of whom completed the survey after being threatened with curses and hexes.

RESULTSSixty-eight doctors, nurses and medical students responded to our survey. Only 11 admitted to being superstitious, yet 31 believed in the ill-fortune associated with eating bao or meat dumplings, 6 in the nefarious powers of black (5) or red (1) outfits on call, and 14 believed that bathing (6 insisting on the powers of the seven-flower bath) prior to the onset of a call portended good fortune, in terms of busy-ness of a call. Twenty-four believed in "black clouds", i.e. people who attracted bad luck whilst on call, and 32 refused to mouth the words "having a good call" until the day after the event. We discovered 2 hitherto undescribed and undiscovered superstitions, namely the benefits of eating bread and the need to avoid beef, for the good and ill fortune associated with their ingestion.

DISCUSSIONSuperstitious practices are alive and well in modern-day Singapore, the practice not necessarily being restricted to the poorly-educated or foolish.

Attitude of Health Personnel ; Humans ; Singapore ; Superstitions

Ailments afflicting wizarding folk are underreported in the muggle world. The recent integration of muggles and magical folk with the return of You-Know-Who (aka He Who Must Not Be Named) may result in a similar affliction of inhabitants of both worlds. We describe interesting maladies afflicting muggles and wizarding folk alike, arising from the use and misuse of magic. We also provide a basic glossary of magical ailments, and describe their muggle corollaries. Further studies will hopefully result in the development of immunity against the unforgivable curses.
Humans ; Wit and Humor as Topic ; Witchcraft

Escalating healthcare costs in Singapore have produced a significant movement of patients into ambulatory care, and the consequent dearth of clinical teaching materials. This deficiency has likewise prompted the creation of ambulatory teaching clinics and the use of standardised patients and simulators. In the last few decades, educators have utilised digital technology, for instance, digitally recorded heart and breath sounds, and digitised video vignettes, in medical education. We describe several pedagogical initiatives that we have undertaken at our university school of medicine.
Ambulatory Care ; Curriculum ; Diffusion of Innovation ; Education, Medical ; methods ; Humans ; Medical Informatics ; trends ; Singapore ; User-Computer Interface

INTRODUCTIONThis study objectively evaluates the effectiveness of a 6-week Preparatory Training Phase (PTP) programme prior to Basic Military Training (BMT) for less physically conditioned conscripts in the Singapore Armed Forces.

MATERIALS AND METHODSWe compared exercise test results of a group of less fi t recruits who underwent a 16-week modified-BMT (mBMT) programme (consisting of a 6-week PTP and 10-week BMT phase) with their 'fitter' counterparts enlisted in the traditional 10-week direct-intake BMT (dBMT) programme in this prospective cohort study consisting of 36 subjects. The main outcome measures included cardiopulmonary responses parameters (VO(2)max and V(O2AT)) with clinical exercise testing and distance run timings.

RESULTSAlthough starting off at a lower baseline in terms of physical fitness [VO(2)max 1.73 +/- 0.27 L/min (mBMT group) vs 1.97 +/- 0.43 L/min (dBMT), P = 0.032; V(O2AT) 1.02 +/- 0.19 vs 1.14 +/- 0.32 L/min respectively, P = 0.147], the mBMT group had greater improvement in cardiopulmonary indices and physical performance profiles than the dBMT cohort as determined by cardiopulmonary exercise testing [VO(2)max 2.34 +/- 0.24 (mBMT) vs 2.36 +/- 0.36 L/min (dBMT), P = 0.085; V(O2AT) 1.22 +/- 0.17 vs 1.21 +/- 0.24 L/min respectively, P = 0.303] and 2.4 kilometres timed-run [mBMT group 816.1 sec (pre-BMT) vs 611.1 sec (post-BMT), dBMT group 703.8 sec vs 577.7 sec, respectively; overall P value 0.613] at the end of the training period. Initial mean difference in fitness between mBMT and dBMT groups on enlistment was negated upon graduation from BMT.

CONCLUSIONPre-enlistment fitness stratification with training modification in a progressive albeit longer BMT programme for less-conditioned conscripts appears efficacious when measured by resultant physical fitness.

Adolescent ; Asian Continental Ancestry Group ; Body Mass Index ; Cohort Studies ; Exercise Test ; statistics & numerical data ; Humans ; Male ; Military Personnel ; statistics & numerical data ; Oxygen Consumption ; Physical Education and Training ; methods ; standards ; Physical Fitness ; Program Evaluation ; Prospective Studies ; Risk Assessment ; Running ; physiology ; Singapore ; Time Factors ; Young Adult