1.Introduction to Motivational Interviewing (MI)
The Singapore Family Physician 2012;38(1):19-22
Changing our patients’ health behaviour has always been difficult. To enhance their intrinsic motivation to change, we need to explore and resolve their ambivalence through motivational interviewing (MI). The four broad principles in MI are expressing empathy, developing discrepancy, rolling with resistance and supporting self-efficacy. Key skills in the practice of MI include using open ended questions, reflective listening and pulling change. While full blown MI may not be practical in our primary care setting, understanding the concept and principles of MI can help us be more patient-centred and collaborative which will help build motivation for change. Though time is a limiting factor for using MI in medical and public health settings, brief strategies like the Elicit-Provide-Elicit model can be used to give patients feedback and information about their health.
2.A mini review on the basic knowledge on tendon: revisiting the normal & injured tendon
Tan SL ; Selvaratnam L ; Ahmad TS
Journal of University of Malaya Medical Centre 2015;18(2):1-14
Tendon is a dense connective tissue that connects muscle to bone. Tendon can adapt to mechanical forces
passing across it, through a reciprocal relationship between its cellular components (tenocytes and tenoblasts)
and the extracellular matrix (ECM). In early development, the formation of scleraxis-expressing tendon
progenitor population in the sclerotome is induced by a fibroblast growth factor signal secreted by the myotome.
Tendon injury has been defined as a loss of cells or ECM caused by trauma. It represents a failure of cells
and matrix adaptation to mechanical loading. Injury initiates attempts of tendon to repair itself, which has
been defined as replacement of damaged or lost cells and ECM by new cells or new matrices. Tendon healing
generally consists of four different phases: the inflammatory, proliferation, differentiation and remodelling
phases. Clinically, tendons are repaired with a variety of surgical techniques, which show various degrees
of success. In order to improve the conventional tendon repair methods, current tendon tissue engineering
aims to investigate a repair method which can restore tissue defects with living cells, or cell based therapy.
Advances in tissue engineering techniques would potentially yield to a cell-based product that could regenerate
functional tendon tissue.
Tissue Engineering
3.Dietary Compliance and its Association with Glycemic Control among Poorly Controlled Type 2 Diabetic Outpatients in Hospital Universiti Sains Malaysia
Tan SL ; Juliana S ; Sakinah H
Malaysian Journal of Nutrition 2011;17(3):287-299
Introduction: Compliance with medical nutrition therapy is important to improve
patient outcomes. The purpose of this study was to determine dietary compliance
and its association with glycemic control among outpatients with poorly
controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia
(HUSM). Methods: In this cross-sectional study, patients who had a glycosylated
hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling
session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic
patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women)
agreed to participate in this study. A questionnaire-based interview was used to
collect socio-demographic, clinical and diabetes self-care data. The patient’s
dietary compliance rate was determined by the Summary of Diabetes Self-Care
Activities (SDSCA) measure. Anthropometric and biological measurements were
also taken. Results: Only 16.4% of the respondents adhered to the dietary regimen
provided by dietitians. Among the 7 dietary self-care behaviours, item number
6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest
compliant rate (54.1%); whereas item number 3 (eat five or more servings of
fruits and vegetables per day) had the lowest compliant rate (23.0%). There was
a significant association between gender (p=0.037) and fasting blood sugar (FBS)
(p=0.007) with the compliance status. Conclusion: Dietary non-compliance is
still common among T2DM patients. Dietitians need to improve their skills and
use more effective intervention approaches in providing dietary counseling to
patients.
4.Are We Working Too Hard?-A Functional Scoring of Orthopaedic Surgeons.
Nicholas Sl NG ; Ernest Bk KWEK
Annals of the Academy of Medicine, Singapore 2016;45(5):212-214
Adult
;
Age Factors
;
Burnout, Professional
;
epidemiology
;
Female
;
Health Status
;
Humans
;
Male
;
Marital Status
;
Mental Health
;
Occupational Health
;
Orthopedic Surgeons
;
statistics & numerical data
;
Pain
;
epidemiology
;
Personnel Staffing and Scheduling
;
Sex Factors
;
Singapore
;
epidemiology
;
Social Behavior
;
Stress, Psychological
;
epidemiology
;
Surveys and Questionnaires
;
Work Schedule Tolerance
5.Placenta Praevia: Preach and Perception
Tan KC ; Chuah CY ; Fong KY ; Phang SL ; Nor Azlin MI
Medicine and Health 2007;2(2):139-145
Placenta praevia is a known obstetric condition that causes complications to mother and
fetus. This study was done to evaluate the knowledge of placenta praevia amongst the
obstetric patients. A cross sectional study was carried out in Hospital Ipoh, Perak among
323 antenatal and postnatal patients. Socio-demographic parameters (ie age, race, parity,
occupation, educational level) and history of placenta praevia were studied in relation to
level of knowledge and attitude towards placenta praevia. Twenty (6.2%) from 323 women
had current or past history of placenta praevia. Three had history of placenta praevia while
17 had current placenta praevia with prevalence of 5.3%. The mean score of knowledge
achieved by patients was 11.8of education and history of placenta praevia were found to have a relationship with level of
knowledge regarding placenta praevia in all obstetric patients. There was a significant
relationship between attitude of patients with current and history of placenta praevia to
level of knowledge regarding placenta praevia. (p=0.037, <0.05). In conclusion, the
knowledge and attitude towards placenta praevia among obstetric patients in Hospital Ipoh
was better in those who had higher education status, white-collar occupation and currently
pregnant with placenta praevia. which indicated overall poor knowledge. Occupation, level
6.A clinical appraisal of adult psoriasis patients in Serdang Hospital
Shalini Devi P ; Quek SL ; Siti Farah M ; Tan YJ ; Norashikin S ; Norhafizah M
Malaysian Journal of Dermatology 2011;27(-):26-26
Objectives
To determine the socio-demographic profile, clinical characteristics and quality of life of adult psoriasis patients as well as the association between the first two variables with the latter.
Methods
A cross-sectional study of 30 adult psoriasis patients was conducted in the Dermatology Clinic, Serdang Hospital from 9th to 23rd May 2011. A questionnaire regarding clinical data containing multilingual Dermatology Life Quality Index (DLQI) was used in a face-to-face interview.
Results
Male-to-female ratio was 1:1.5. Psoriasis was more common in Malays (76.7%) compared to Chinese (10%) and Indians
(10%), however this ethnic distribution was proportionate to that of the clinic attendance. The onset of psoriasis was during the second to third decade of life in most patients (53.3%) with a mean of 31 years (range 7 - 62). Nine (30%) patients had positive family history of psoriasis. The main aggravating factors were stress and sunlight. Hyperlipidemia was the commonest associated co-morbidity. Plaque psoriasis was the commonest clinical type (66.7%) and majority (66.7%) had <10% body surface area affected. Nail changes were present in 15 (50%) patients and psoriatic arthropathy
occurred in 11 (36.7%), with mono/oligoarticular type being as common as symmetrical polyarthropathy. All patients were treated with topical therapy, six were on systemic medication and only one underwent phototherapy. The mean DLQI score was 10.77 ± 6.22. The duration of disease and the age group were negatively correlated with the DLQI scores (r= -0.45 and -0.42 respectively, p < 0.05).
Conclusion
The clinical findings are similar to previous local studies and are valuable to improve patient care.
7.Biofunctionalization of Modified Surfaces of Titanium
Annals of Dentistry 2017;24(2):24-32
The aim of this study was to assess the viability of coating collagen to Hydroxyapatite (HA) coated commercially pure Titanium (cpTi) samples. Five samples of cpTi were immersed in a simulated body fluid (Tas-SBF) after stages of gritting, sandblasting and acid etching. One sample was taken out after 3, 5 and 7 days of immersion in Tas-SBF respectively. The 7 days Tas-SBF coated sample was coated with collagen by physical adsorption method. Analysis was performed to study the surface roughness, morphology and elemental analysis of the coated surfaces.The equipment used wereAlicona, Scanning Electron Microscope (SEM), Energy-dispersive X-ray Spectroscopy (EDS) and Fourier Transform Infrared Spectroscopy (FTIR). Process of sand blasting and acid etching were able to produce desired morphology and surface roughness. The average surface roughness, Sa of sand blasted cpTi surface and acid etched cpTi were 2.17 ± 0.75 μm and 2.12 ± 0.15μm respectively. Immersion in Tas-SBF produced a crystalline coating and morphology that were similar to bone-like apatite. Roughness value of cpTi after being immersed in SBF for 7 days was 2.23 ± 0.31 μm and the Ca/P ratio was 7.076. Collagen coated samples had the highest Sa value which was 3.91 ± 0.31 μm and the Ca/P ratio was 1.190. This study showed that it is possible to achieve apatite and collagen coating on a modified cpTi surface using physical adsorption method.
9.Otolaryngology Surgery in Time of COVID-19-What PPE to Use When?
Jian Li TAN ; Valerie Sl TAY ; Hao LI ; Jin Keat SIOW ; Brenda Sp ANG ; Seng Beng YEO
Annals of the Academy of Medicine, Singapore 2020;49(6):387-392
Anesthesia, General
;
Coronavirus Infections
;
prevention & control
;
transmission
;
Humans
;
Infectious Disease Transmission, Patient-to-Professional
;
prevention & control
;
Occupational Exposure
;
prevention & control
;
Operating Rooms
;
Otorhinolaryngologic Surgical Procedures
;
Pandemics
;
prevention & control
;
Personal Protective Equipment
;
classification
;
Pneumonia, Viral
;
prevention & control
;
transmission
;
Practice Guidelines as Topic