Purpose: No report of rigid bronchoscopy (RB) has been described from Singapore. Methods: We did a retrospective review of medical records of patients undergoing RB between November 2009 and November 2019 at Tan Tock Seng Hospital. Results: 135 patients underwent 203 RB. RB was done for malignant central airway obstruction (MCAO) in 91 and benign diseases in 44 patients. The techniques used were Nd: YAG laser (n= 56), stenting (n= 63), transbronchial needle aspiration (n= 5), clot removal (n= 9), ballooning (n= 15), argon plasma coagulation (n= 5), and electrocautery (n= 37). Procedural complications occurred in three (2.2%). Median survival was 10.1 months (interquartile range [IQR], 2.2 to 45.3) in the whole group, 7.8 (IQR, 2 to 18.3) in MCAO and 42.6 (IQR, 8.9 to 77.5) in benign diseases respectively. Twenty-two (16.3%) patients requiring intensive care unit survived for 7.1 months (IQR, 1.6 to 9.8) after RB. Twenty-eight (21%) patients required repeat RB 68 times. Of these 34 (50%) were for granulation tissue removal. Conclusion RB was safe and improved survival however, the demand was low. The most common indications were re-canalization of MCAO and granulation tissue removal. The later was the most resource consuming indication for repeat RB. Future research should focus on minimization of granulation tissue formation.

The Ministry of Health (MOH) has updated the Clinical Practice Guidelines on Chronic Obstructive Pulmonary Disease (COPD) to provide doctors and patients in Singapore with evidence-based treatment for COPD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH Clinical Practice Guidelines on COPD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: https://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Adult ; Aged ; Evidence-Based Medicine ; Humans ; Middle Aged ; Palliative Care ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; diagnosis ; therapy ; Pulmonary Medicine ; standards ; Quality Improvement ; Radiography, Thoracic ; Risk Factors ; Singapore ; Steroids ; therapeutic use

Acalculous Cholecystitis ; microbiology ; Adult ; Cholecystitis, Acute ; diagnosis ; microbiology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Leptospirosis ; complications ; diagnosis ; Male ; Pancreatitis ; etiology ; microbiology