BACKGROUND

Musculoskeletal injuries are common in collegiate athletes and can be linked to having elevated levels of kinesiophobia. Kinesiophobia, the fear of re-injury or movement, can be related to an athlete’s self-esteem, as studies have shown that both variables may influence an athlete’s rehabilitation. High athletic identity and low levels of kinesiophobia were seen in athletes who successfully returned to their pre-injury level of competition after rehabilitation. The working theory of this research is if an athlete has an elevated level of kinesiophobia, it decreases one’s self-esteem.

OBJECTIVE

This study aims to determine the association between kinesiophobia and self-esteem among collegiateathletes in Greater Manila who have chronic lower extremity musculoskeletal injuries. The secondary objective of this study is to determine the association of kinesiophobia with demographic variables (sex, sport, and type of injury).

METHODOLOGY

The study will be conducted from January 2023 to April 2024. The researchers will utilize online platforms and/or onsite data collection to disseminate their publication materials and questionnaires. The target participants of this study are collegiate athletes, ages 18-26, representing universities/colleges in Greater Manila, who currently have a lower extremity musculoskeletal injury lasting for 3 months or more and are not receiving physical therapy or other forms of professional treatment. The questionnaire includes the participant’s name, age, sex, university, sport, type of injury, and measuring tools: Tampa Scale of Kinesiophobia, Rosenberg Self-Esteem Scale, and Numerical Pain Rating Scale. The results gathered will be analyzed using the Spearman Correlation Test to associate the variable and the Shapiro-Wilk Test to determine the normality of data.

EXPECTED RESULTS

The results of the study are expected to determine the association between kinesiophobia and self-esteem among collegiate athletes with chronic lower extremity musculoskeletal injuries. The study is also expected to determine if demographic variables such as sex, type of sport, and type of injury are linked to the athletes’ kinesiophobia levels. Thus, this study will aid in establishing the importance of psychological aspects in injury rehabilitation, thereby assisting healthcare professionals in determining the appropriate interventions for an athlete recovering from an injury.

Kinesiophobia

Introduction: Coronavirus disease 2019 (COVID-19) has severely influenced all aspects of life since its emergence and one of the strategies to end this pandemic rests on the vaccination to achieve herd immunity. While vaccinations are usually a safe and effective tool, the abbreviated development process of the available COVID-19 vaccines has increased uncertainties about the safety among the general population especially among patients with rheumatic and musculoskeletal diseases (RMD). Methods: A cross-sectional analysis was performed on rheumatic disease (RMD) patients from the rheumatology clinic at Hospital Tuanku Ja’afar Seremban (HTJS), investigating adverse events occurring within one month of receiving COVID-19 vaccines administered from 1st May 2021 to 30th September 2021. Results: 549 RMD patients were recruited in this study. Pfizer/BioNTech was the predominant vaccine (n = 257, 64.3%), followed by Sinovac (n = 60, 47.2%), Oxford/AstraZeneca (n = 7, 1.3%) and Moderna (n = 1, 0.2%). 330 (60.1%) patients experienced at least one adverse event, none of which required hospitalisation. Common side effects included pain at the site of injection (n = 169, 30.8%), generalised muscle pain (n = 91, 16.4%), fever (n = 90, 16.4%), arthralgia (n = 55, 10.0%), and lethargy (n = 43, 7.7%). Female patients (OR = 0.88, CI 0.79-0.97, p = 0.012), Sinovac recipients (OR = 0.51, CI 0.34-0.76, p = 0.001) and age >50 years (OR = 0.62, CI 0.44-0.89, p = 0.009) had significantly lower risks of experiencing adverse events. Among patients with autoimmune rheumatic disease (AIRD), 28 (6.4%) experienced disease flare. Patients with spondyloarthropathy (SpA) and overlap syndrome were more likely to experience disease flare following COVID-19 vaccination compared to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (OR = 2.87, CI 1.23 – 6.69, p = 0.014). The use of combination conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was associated with a tendency toward increased risk of disease flare (OR = 2.34, CI: 0.97–5.64, p = 0.056). However, the use of glucocorticoids (OR = 2.02, CI 0.72–5.61, p = 0.17) and an active disease state (OR = 1.94, CI 0.75–5.02, p = 0.171) did not show a statistically significant impact on the frequency of disease flares. Conclusions The study affirms the overall safety of COVID-19 vaccines in rheumatic musculoskeletal disease patients, supporting efforts to address vaccine hesitancy in this population.
COVID-19 ; SARS-CoV-2 ; Vaccination

INTRODUCTION: The understanding of gender dysphoria (GD) in children and adolescents is limited in Singapore. This study aims to review the presentation of GD in an outpatient psychiatric clinic, to gain insights into its prevalence and associated factors. METHOD: We conducted a retrospective review of medical records for patients diagnosed with GD according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth and Fifth editions, at the clinic between 1 January 2017 and 31 December 2021. We collected and analysed demographic, medical and other GD-specific clinical variables. RESULTS: The study included 107 participants (mean age 16.6 years), comprising 47 natal males and 60 natal females. The prevalence of GD was found to be 1:5434 (0.019%). Incidence rates increased from 2.17 to 5.85 per 100,000 population between 2017 and 2021. The mean age of diagnosis was 15.6 years, with an average delay of 5 years between experiencing gender identity-related concerns and seeking formal assistance. Approximately 45% of participants reported social and physical transitions, and 20.6% reported self-harm or suicidal thoughts. CONCLUSION The study highlights the presentation of GD in an under-researched Asian setting. Supporting individuals with GD in Asia requires sensitivity to cultural and societal factors with a holistic approach to individual well-being.
Humans ; Singapore/epidemiology* ; Adolescent ; Gender Dysphoria/psychology* ; Retrospective Studies ; Female ; Male ; Suicidal Ideation ; Child ; Prevalence ; Incidence ; Self-Injurious Behavior/psychology*

INTRODUCTION: Pharmacogenomic testing in psychiatry is an emerging area with potential clinical application of guiding medication choice and dosing. Interest has been fanned by commercial pharmacogenomic providers who have commonly marketed combinatorial panels that are direct-to-consumer. However, this has not been adopted widely due to a combination of barriers that include a varying evidence base, clinician and patient familiarity and acceptance, uncertainty about cost-effectiveness, and regulatory requirements. This review aims to examine recent updates in this field and provide a contextualised summary and recom-mendations for Asian populations in order to guide healthcare professionals in psychiatric practice. METHOD: A review of recent literature about current evidence and guidelines surrounding pharmacoge-nomics in psychiatric practice was carried out with particular attention paid to literature evaluating Asian populations. The Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework was applied. Consensus meetings comprising workgroup psychiatrists from the public and private sectors were held prior to arriving at the key recommendations. RESULTS: Pharmacogenomic testing should be mainly limited to drug-gene pairs with established clinical evidence, such as antidepressants and CYP2C19/ CYP2D6. Direct-to-consumer pharmacogenomic panels that assay multiple genes and analyse them via proprietary algorithms, are not presently recommended in Singapore's psychiatric setting due to inconclusive evidence on clinical outcomes. CONCLUSION Pharmacogenomic testing in psychiatry is not recommended as standard clinical practice. Exceptions may include concerns about drug concentrations or potential severe adverse drug reactions. Studies investigating newly identified drug-gene associations, and clinical effectiveness and cost-effectiveness of utilising pharmacogenomic testing in psychiatry is encouraged.
Humans ; Psychiatry/methods* ; Pharmacogenetics ; Cytochrome P-450 CYP2C19/genetics* ; Asian People/genetics* ; Pharmacogenomic Testing/methods* ; Antidepressive Agents/therapeutic use* ; Cytochrome P-450 CYP2D6/genetics* ; Practice Guidelines as Topic ; Singapore ; Mental Disorders/genetics* ; Psychotropic Drugs/therapeutic use*

The personal recovery movement is beginning to gain traction within Singapore's mental healthcare systems. We believe it is timely to give a broad overview of how it developed and provide suggestions on how it can evolve further. From the early custodial care in the 1800s to the community-centric programmes of the 1900s and early 2000s, we now find ourselves at the forefront of yet another paradigm shift towards a more consumer-centric model of care. The following decades will allow personal recovery practitioners and researchers to innovate and identify unique but culturally appropriate care frameworks. We also discuss how the movement can continue to complement existing mental healthcare systems and efforts.
Forecasting ; Humans ; Singapore

INTRODUCTIONRemote monitoring of cardiac implantable electronic devices (CIED) has been shown to improve patient safety and reduce in-office visits. We report our experience with remote monitoring via the Medtronic CareLink(®) network.

METHODSPatients were followed up for six months with scheduled monthly remote monitoring transmissions in addition to routine in-office checks. The efficacy of remote monitoring was evaluated by recording compliance to transmissions, number of device alerts requiring intervention and time from transmission to review. Questionnaires were administered to evaluate the experiences of patients, physicians and medical technicians.

RESULTSA total of 57 patients were enrolled; 16 (28.1%) had permanent pacemakers, 34 (59.6%) had implantable cardioverter defibrillators and 7 (12.3%) had cardiac resynchronisation therapy defibrillators. Overall, of 334 remote transmissions scheduled, 73.7% were on time, 14.5% were overdue and 11.8% were missed. 84.6% of wireless transmissions were on time, compared to 53.8% of non-wireless transmissions. Among all transmissions, 4.4% contained alerts for which physicians were informed and only 1.8% required intervention. 98.6% of remote transmissions were reviewed by the second working day. 73.2% of patients preferred remote monitoring. Physicians agreed that remote transmissions provided information equivalent to in-office checks 97.1% of the time. 77.8% of medical technicians felt that remote monitoring would help the hospital improve patient management. No adverse events were reported.

CONCLUSIONRemote monitoring of CIED is safe and feasible. It has possible benefits to patient safety through earlier detection of arrhythmias or device malfunction, permitting earlier intervention. Wireless remote monitoring, in particular, may improve compliance to device monitoring. Patients may prefer remote monitoring due to possible improvements in quality of life.

Aged ; Arrhythmias, Cardiac ; diagnosis ; Defibrillators, Implantable ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; methods ; Pacemaker, Artificial ; Patient Safety ; Pilot Projects ; Prospective Studies ; Quality of Life ; Remote Consultation ; methods ; Singapore ; Surveys and Questionnaires

OBJECTIVES: To report a benign tonsillar lesion presenting as a pedunculated polyp and discuss its diagnosis and management.
METHODS:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
RESULTS: A 14-year-old lad presented with a seven-year history of an elongated right tonsillar mass without  associated  bleeding, pain,  dysphagia or obstructive sleep  apnea.  Physical  examination revealed  a  pedunculated  mass  about  2  x  1  x  0.5cm  in  size  located  in  the  superior  pole.  After unilateral  tonsillectomy, histopathological  examination  revealed  lymphangectatic  lipomatous fibrotic polyp.
CONCLUSION: Lymphangiomatous polyp of the palatine tonsils  is  an  unusual benign lesion of the head and neck. These  are  commonly  present  as  unilateral,  polypoidal  mass  that  cannot be clinically  differentiated  from  other  benign  tonsillar  lesions. Tonsillectomy  is  the  recommended surgical  approach  for  both  diagnostic  and  therapeutic  purposes.  Histopathological  study  must be done to confirm diagnosis.

Human ; Male ; Adolescent ; Palatine Tonsil ; Hamartoma ; Tonsillectomy ; Lymphangioma ; Deglutition Disorders ; Neck ; Head ; Sleep Apnea, Obstructive ; Polyps ; Pain ; Physical Examination

We report five cases of non-arteritic anterior ischaemic optic neuropathy (NA-AION) where spontaneous resolution of the optic disc swelling occurred, and all relevant visual modalities were normal at presentation and remained so until resolution of the process after a median time of 9.6 weeks. This condition, which can be termed 'incipient NA‑AION' or 'threatened NA-AION', should be recognised so that unnecessary investigations for other and more serious causes of optic disc swelling can be prevented.
Adrenergic alpha-2 Receptor Agonists ; therapeutic use ; Adult ; Brimonidine Tartrate ; therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Ophthalmic Solutions ; Optic Disk ; pathology ; Optic Neuropathy, Ischemic ; diagnosis ; Singapore ; Time Factors ; Vision, Ocular ; Visual Acuity

OBJECTIVES: To report a case of foreign lodged within the sphenoid sinus and its extraction.METHODS:Design: Case report Setting: Tertiary Government Hospital Patient: OneRESULTS: An 11-year-old girl was hit in the eye by an unknown object from an improvised slingshot. She had loss of vision of the left eye and headache without loss of consciousness. A plain craniofacial Computed Tomography (CT) scan showed a round opaque foreign body abutting the left sphenoid sinus, left posterior ethmoid cells and medial aspect of the left orbital region with adjacent soft tissue densities extending into the apparently ruptured, irregular left globe. The left posterior part of the lamina papyracea was not visualized probably fractured or ruptured. Transorbital enucleation of the left eye and endoscopy-assisted removal of the foreign body (a glass marble) were performed with no intra-operative and post - operative complications.CONCLUSION:Foreign body of the sphenoid sinus is a rare condition. Adequate imaging is important for localization and planning the optimal surgical approach. Endoscopic guidance may aid in extraction.
Human ; Female ; Child ; Sphenoid Sinus ; FOREIGN BODIES ; Tomography Scanners, X-Ray Computed

p style=text-align: justify;strongOBJECTIVE:/strong To determine the mean distance of the main trunk of the facial nerve from two commonly employed surgical landmarks (tragal pointer and tympanomastoid suture line) among a sample a Filipino adults undergoing parotidectomy.METHODS:br /Design:/strong Prospective descriptive studybr /strongSetting: /strongTertiary Government Training Studybr /strongSubjects:/strong 22 patients without facial paralysis undergoing surgery for parotid neoplasms were evaluated intraoperatively.RESULTS/strong: The main trunk of the facial nerve was found to be 9.0 mm (standard deviation of 2.8 mm) from the tragal pointer and 6.1 mm (standard deviation of 2.0 mm) from the tympanomastoid suture line.CONCLUSION/strong: The mean distance from the main trunk of the facial nerve to two of the most commonly utilized landmarks in identification of the nerve during parotidectomy was 9.0 mm (standard deviation of 2.8 mm) from the tragal pointer and 6.1 mm (standard deviation of 2.0 mm) from the tympanomastoid suture line. These may serve as reference values for surgeons in safer identification and preservation of the facial nerve during parotidectomy.
Human ; Male ; Female ; Adult ; Facial Nerve ; Sutures ; Anatomic Landmarks ; body regions