AIMTo determine the views of new house officers (HO) on professionalism and unprofessional behaviour following dismissal in January 2007 of a HO who was caught video-taping nurses in the shower.

METHODSAn anonymous self-administered questionnaire was administered during new house officers' orientation. Using a Likert scale (1 = strongly disagree to 5 = strongly agree), HO were asked to rank statements regarding teaching and their understanding of professionalism and professional behaviour, role model-clinicians, their response to 3 real-life examples of unprofessional behaviour, and dismissal and Singapore Medical Council (SMC) registration of the sacked HO. Participation was voluntary.

RESULTSTwenty-eight out of twenty-nine (96.6%) international medical graduates (IMG) and 84/95 (88%) house officers who graduated from National University of Singapore (NUS) responded. Their median age was 24 years and 63 of them were male. All IMG compared to 63.1% NUS HO agreed that professionalism was well taught in their medical school (P <0.0001). Majority (82.1%) of IMG compared to 67.9% NUS HO agreed they had adequate role model-clinicians exemplifying professionalism (P <0.0001). Majority (90.8%) of the respondents agreed that the sacked HO's behaviour was not pardonable, a smaller proportion (83.9%) agreed with dismissal but only half (52.7%) agreed that SMC should not register the sacked HO.

CONCLUSIONIn this study, only two-thirds of NUS HO felt that professionalism was well taught and they had adequate role models. NUS should review this aspect of medical education. Majority of HO agreed with the dismissal but only half felt the misdemeanor was serious enough for SMC not to register the sacked HO.

Adult ; Attitude of Health Personnel ; Employment ; Female ; Humans ; Male ; Personnel Administration, Hospital ; Professional Misconduct ; Singapore ; Surveys and Questionnaires ; Videotape Recording ; Young Adult

INTRODUCTIONGas is rarely found within the viscera outside the lumen of the gastrointestinal tract. Emphysematous gastritis is a rare form of infection of the stomach wall by gas producing organisms.

CLINICAL PICTUREA 45-year-old Chinese lady underwent hepatectomy for hepatocellular carcinoma. Postoperatively, she turned septic and encephalopathic with worsening liver function. Computed tomography scan revealed a thickened, oedematous stomach wall with air pockets within.

TREATMENTThe patient was started on a course of broad spectrum antibiotics.

OUTCOMEShe responded and was discharged well.

CONCLUSIONEmphysematous gastritis is a rare condition with high mortality. There is however, still no preferable approach of treatment despite therapeutic advances.

Anti-Bacterial Agents ; therapeutic use ; Emphysema ; diagnostic imaging ; Female ; Gastritis ; drug therapy ; pathology ; Humans ; Middle Aged ; Portal Vein ; Radiography ; Thienamycins ; therapeutic use ; Ultrasonography ; Venous Thrombosis ; diagnostic imaging

INTRODUCTIONThe Singapore National Survey of 2004 reported the prevalence of obesity to have increased to 6.9%, thus reflecting the profound changes in our society's lifestyle and eating habits. Bariatric surgery has steadily been increasing to counter the ill effects of obesity.

MATERIALS AND METHODSWe audited our prospective series of 31 patients who had laparoscopic adjustable gastric banding (LABG) for morbid obesity performed by our multidisciplinary team at the National University Hospital, Singapore, between August 2004 and December 2006.

RESULTSThe median age at presentation was 40 years old including 6 males and 25 females. Their median BMI was 42.35 kg/m(2). At a median follow-up of 26 months, the median percentage of excess weight loss (%EWL) was 41.95%. The positive impact of gastric banding on comorbidities are evident whereby 15 (94%) of the diabetics had improved glycaemic control with HbA(1)C of 7.7% preoperatively improving to 5.9% postoperatively, and also 8 (58%) now take smaller doses of oral hypoglycaemic agents. Hypertension improved in 4 patients and 2 (11%) were cured. All our patients with dyslipidaemia had their statin doses reduced with marked lowering of serum lipid levels. We had 2 patients (6.45%) with band erosion and another 2 with reflux oesophagitis. Our article also summarises the available surgical procedures while discussing the pros and cons of each.

CONCLUSIONOur results showed that a multidisciplinary programme can achieve significant weight loss for obese patients in Singapore. To achieve long-term weight loss, a commitment of both the medical team and the patient is necessary. Laparoscopy has revolutionised the practice of bariatric surgery worldwide. LAGB is an effective and safe procedure.

Adult ; Bariatric Surgery ; methods ; statistics & numerical data ; Comorbidity ; Endoscopy, Gastrointestinal ; methods ; statistics & numerical data ; Female ; Gastric Bypass ; methods ; statistics & numerical data ; Hospitals, University ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Obesity, Morbid ; complications ; epidemiology ; surgery ; Prospective Studies ; Singapore ; epidemiology ; Time Factors ; Treatment Outcome ; Weight Loss ; Young Adult