Objectives: Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients. Methods: This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis. Results: Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited. Conclusion Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.
Perception ; Students, Medical ; Curriculum

Objective: Bariatric surgery effectively treats non-alcoholic fatty liver disease (NAFLD). The glutamate-serine-glycine (GSG) index has emerged as a non-invasive diagnostic marker for NAFLD, but its ability to monitor treatment response remains unclear. This study investigates the GSG index's ability to monitor NAFLD's response to bariatric surgery. Methodology: Ten NAFLD participants were studied at baseline and 6 months post-bariatric surgery. Blood samples were collected for serum biomarkers and metabolomic profiling. Hepatic steatosis [proton density fat fraction (PDFF)] and fibroinflammation (cT1) were quantified with multiparametric magnetic resonance imaging (mpMRI), and hepatic stiffness with magnetic resonance elastography (MRE). Amino acids and acylcarnitines were measured with mass spectrometry. Statistical analyses included paired Student’s t-test, Wilcoxon-signed rank test, and Pearson’s correlation. Results: Eight participants provided complete data. At baseline, all had hepatic steatosis (BMI 39.3 ± 5.6 kg/m2, PDFF ≥ 5%). Post-surgery reductions in PDFF (from 12.4 ± 6.7% to 6.2 ± 2.8%, p = 0.013) and cT1 (from 823.3 ± 85.4ms to 757.5 ± 41.6ms, p = 0.039) were significant, along with the GSG index (from 0.272 ± 0.03 to 0.157 ± 0.05, p = 0.001). Conclusion The GSG index can potentially be developed as a marker for monitoring the response of patients with NAFLD to bariatric surgery.
Non-alcoholic Fatty Liver Disease ; Amino Acids ; Metabolomics

Musculoskeletal conditions are among the leading causes of consultations in Rehabilitation Medicine. A fellowship program in Musculoskeletal Rehabilitation Medicine was proposed to enrich physiatrists’ knowledge and skills in evaluating and managing musculoskeletal conditions. In this paper, we shared the process of developing the curriculum of the fellowship program, which was proposed to and eventually approved by the Postgraduate Institute of Medicine, College of Medicine, University of the Philippines Manila. A core group of consultants, considered as experienced clinicians and educators in Musculoskeletal Rehabilitation Medicine in the study institution, designed the program from the scope of training to learning competencies, outcomes, and assessment methods. To our knowledge, developing the fellowship program in this constantly evolving area in Rehabilitation Medicine is the first of its kind in the Philippines and a milestone in the history of postgraduate education in the longest-running training program for aspiring physiatrists.
Physical and Rehabilitation Medicine

COVID-19/prevention & control* ; COVID-19 Vaccines ; Health Personnel ; Humans ; Singapore ; Vaccination

INTRODUCTION: We aimed to assess the attitudes and learner needs of radiology residents and faculty radiologists regarding artificial intelligence (AI) and machine learning (ML) in radiology. METHODS: A web-based questionnaire, designed using SurveyMonkey, was sent out to residents and faculty radiologists in all three radiology residency programmes in Singapore. The questionnaire comprised four sections and aimed to evaluate respondents' current experience, attempts at self-learning, perceptions of career prospects and expectations of an AI/ML curriculum in their residency programme. Respondents' anonymity was ensured. RESULTS: A total of 125 respondents (86 male, 39 female; 70 residents, 55 faculty radiologists) completed the questionnaire. The majority agreed that AI/ML will drastically change radiology practice (88.8%) and makes radiology more exciting (76.0%), and most would still choose to specialise in radiology if given a choice (80.0%). 64.8% viewed themselves as novices in their understanding of AI/ML, 76.0% planned to further advance their AI/ML knowledge and 67.2% were keen to get involved in an AI/ML research project. An overwhelming majority (84.8%) believed that AI/ML knowledge should be taught during residency, and most opined that this was as important as imaging physics and clinical skills/knowledge curricula (80.0% and 72.8%, respectively). More than half thought that their residency programme had not adequately implemented AI/ML teaching (59.2%). In subgroup analyses, male and tech-savvy respondents were more involved in AI/ML activities, leading to better technical understanding. CONCLUSION A growing optimism towards radiology undergoing technological transformation and AI/ML implementation has led to a strong demand for an AI/ML curriculum in residency education.

Objectives: Perception about Physical and Rehabilitation Medicine provides information about awareness on identifying disabilities and managing their impact on activities of daily living; however, misconceptions about the field continue to exist among both students and physicians. This study aims to describe the perceptions of clinical clerks and interns towards the practice and role of Rehabilitation Medicine in management of patients. Methods: This is a descriptive cross-sectional study. Students from the Learning Unit 6 and 7 of UP College of Medicine answered adapted online survey forms from a previous study and participated in online focus group discussions. Qualitative data were used to infer the perception of medical students towards the specialty. The effect of the respondent’s profile, background and affiliation on their knowledge, attitudes and perceptions were analyzed using One-Way ANOVA (α = 0.05). Qualitative data were analyzed using thematic analysis. Results: Learning Unit 6 and 7 students were found to have a perceived broad level of knowledge with regards the specialty. The students associated the specialty with focus on holistic care, quality of life, interdisciplinary collaboration, and diversity of cases managed. No statistically significant differences were found between the perception among: 1) Learning Unit 6 and 7, 2) those with or without a previous encounter with the specialty, 3) allied medical and non-allied medical undergraduate courses in terms of: a) confidence in the knowledge (p = 0.489), b) familiarity with conditions managed (p = 0.93) and c) interest towards the specialty (p = 0.693). The Organ System Integrated (OSI) curriculum, which promotes horizontal and vertical integration of concepts, provided a wide understanding of the basic concepts related to physiatry. The students’ responses suggest a positive attitude towards Physical and Rehabilitation Medicine, as measured in their level of interest about knowing more regarding the specialty. Most common perceptions were that the specialty was multidisciplinary and holistic. However, the respondents’ perceptions regarding the roles of the Rehabilitation team were limited. Conclusion Learning unit level 6 and 7 students had a broad understanding of the practice and scope of the Physical and Rehabilitation Medicine specialty. Future researches can include other medical students in all year levels, including Learning Units 3, 4 and 5 of UPCM, to observe the development of their perceptions about the specialty throughout medical school.
Perception ; Students, Medical ; Curriculum

Leiomyoma of the urinary bladder is not often encountered, occurring in only 0.43% of all bladder tumors. Among the known cases, patients usually present with obstructive symptoms, irritative symptoms or hematuria. This is a rare case of a 50-year-old male who was incidentally diagnosed to have a bladder mass. After cystoscopy, an open partial cystectomy was done with complete resection of the bladder mass. Final histopathology and immunochemical stains confirmed the diagnosis of leiomyoma of the urinary bladder.
Leiomyoma

BACKGROUNDMuch is known about the cytogenetic lesions that characterize multiple myeloma (MM) patients from the USA, Europe, and East Asia. However, little has been published about the disease among Southeast Asians. The aim of this study was to determine the chromosomal abnormalities of MM patients in our Singapore population.

METHODSForty-five newly-diagnosed, morphologically confirmed patients comprising 18 males and 27 females, aged 46 - 84 years (median 65 years) were investigated by karyotyping and fluorescence in situ hybridization (FISH). FISH employing standard panel probes and 1p36/1q21 and 6q21/15q22 probes was performed on diagnostic bone marrow samples.

RESULTSThirty-four cases (75.6%) had karyotypic abnormalities. Including FISH, a total detection rate of 91.1% was attained. Numerical and complex structural aberrations were common to both hyperdiploid and non-hyperdiploid patients. Numerical gains of several recurring chromosomes were frequent among hyperdiploid patients while structural rearrangements of several chromosomes including 8q24.1 and 14q32 characterized non-hyperdiploid patients. With FISH, immunoglobulin heavy chain (IGH) gene rearrangements, especially fibroblast growth factor receptor 3 (FGFR3)/IGH and RB1 deletion/monosomy 13 were the most common abnormalities (43.4%). Amplification 1q21 was 10 times more frequent (42.5%) than del(1p36) and del(6q21).

CONCLUSIONSWe have successfully reported the comprehensive cytogenetic profiling of a cohort of newly-diagnosed myeloma patients in our population. This study indicates that the genetic and cytogenetic abnormalities, and their frequencies, in our study group are generally similar to other populations.

Aged ; Aged, 80 and over ; Chromosome Aberrations ; Cytogenetics ; Female ; Humans ; Immunoglobulin Heavy Chains ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Middle Aged ; Monosomy ; genetics ; Multiple Myeloma ; genetics ; pathology ; Receptor, Fibroblast Growth Factor, Type 3 ; genetics ; Retinoblastoma Protein ; genetics ; Singapore

Adenocarcinoma ; pathology ; therapy ; Choriocarcinoma, Non-gestational ; pathology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Lung Neoplasms ; secondary ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; pathology ; therapy ; Urinary Bladder Neoplasms ; pathology ; therapy ; Uterine Neoplasms ; pathology ; therapy

INTRODUCTIONHigh workload volumes in a Cytogenetics laboratory can lead to long result turn-around times (TAT). This study aimed to improve laboratory efficiency by adopting Lean Management System initiatives to increase productivity through the elimination of wastes. This study examined if the prerequisite 20-cell analysis was sufficient for a conclusive result or if additional cell workup was necessary to ascertain the presence of a previous chromosome abnormality among cases on follow-up, or when a single abnormal cell was encountered during the analysis to determine the presence of a clone.

MATERIALS AND METHODSThe karyotype results of cases that had additional workup were retrieved from among 8040 bone marrow cases of various haematological disorders performed between June 2003 and June 2008.

RESULTSOf 8040 cases analysed, 2915 cases (36.3%) had additional cell workup. Only 49 cases (1.7%) led to the establishment of a clone. The majority of these cases could have been resolved without the additional workup, especially if fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR)-based assays had been utilised.

CONCLUSIONThis study shows that the additional workup procedure is redundant. The time saved by discontinuing the workup procedure can be used to analyse other cases, leading to increased laboratory efficiency and a faster TAT without compromise to patient care. The practice of additional workup over and above the 20- cell analysis should be dispensed with as little benefit was derived for the amount of additional manpower expended. FISH or PCR-based assays should be utilised to elucidate a case further.

Adult ; Aged ; Aged, 80 and over ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Efficiency ; Efficiency, Organizational ; Female ; Hematologic Diseases ; diagnosis ; pathology ; Humans ; In Situ Hybridization, Fluorescence ; instrumentation ; methods ; Karyotyping ; instrumentation ; methods ; Male ; Polymerase Chain Reaction