INTRODUCTION: The primary objective of this guideline is to establish evidence-based recommendations for the clinical use of parenteral nutrition (PN) in adult patients within the acute hospital setting in Singapore. METHOD: An expert workgroup, consisting of healthcare practitioners actively involved in clinical nutrition support across all public health institutions, systematically evaluated existing evidence and addressed clinical questions relating to PN therapy. RESULTS: This clinical practice guideline developed 30 recommendations for PN therapy, which cover these key aspects related to PN use: indications, patient assess-ment, titration and formulation of PN bags, access routes and devices, and monitoring and management of PN-related complications. CONCLUSION This guideline provides recommendations to ensure appropriate and safe clinical practice of PN therapy in adult patients within the acute hospital setting.
Humans ; Singapore ; Parenteral Nutrition/adverse effects* ; Adult

The original version of the author names was incorrect. The correct information is given above.

The original version of the author names was incorrect. The correct information is given above.

Introduction: There are two dosing methods for radioiodine dose administration including empirical fixed dose and calculated dose. Recent meta-analysis supported that dose calculation is better than empirical fixed dose. However, dose calculation by dosimetry or 24 hours radioiodine uptake ratio can be tedious. Pertechnetate thyroid scintigraphy is a simple nuclear imaging that can be completed on the same day and pertechnetate thyroid uptake ratio determined from the scintigraphy can be used to calculate the radioiodine dose. This research is done to measure the efficacy of the calculated dose regime. Methods: Hyperthyroidism patients referred for first radioiodine therapy were recruited. Pertechnetate thyroid scintigraphy was done and pertechnetate uptake ratio used for dose calculation. The outcome of the treatment was determined at six months. Results: A total of 95 patients were recruited. Six months after treatment, 82.1% of the calculated dose cohort achieved euthyroid or hypothyroid state. Participants with multinodular goitre had higher failure rate than those with Graves’ disease (p=0.032) although there was no difference in the median RAI dose given (p=0.866). Conclusion: This calculated dose method showed good outcome with 82.1% cure rate at six months post treatment.
Hyperthyroidism

Tenofovir, used in the treatment of chronic hepatitis B and HIV, is known for its side effects on the kidneys and bones. We share interesting images of a patient with tenofovir-induced osteomalacia on Technetium-99 m hydroxymethyelene (Tc-99 m HDP) bone scintigraphy. Pattern recognition of this bone scintigraphy and correlation with the clinical history is essential to avoid misdiagnosis.
Diagnostic Errors ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis, Chronic ; HIV ; Humans ; Kidney ; Osteomalacia ; Radionuclide Imaging ; Tenofovir