1.Charles Bonnet syndrome following head trauma: a case report and literature review
Georgia WONG ; Josef D. WILLIAMS ; Uchenna OSUALA ; Jean-Paul BRYANT ; Nathan NAIR
Journal of Neurocritical Care 2024;17(1):29-33
Background:
Charles Bonnet syndrome (CBS) is a condition characterized by vivid, complex visual hallucinations in individuals with visual impairment. Despite its prevalence among the elderly and those with degenerative eye diseases, CBS remains underdiagnosed and undertreated due to a lack of awareness and misconceptions surrounding its etiology and management.Case Report: A 51-year-old man presented to the emergency room after falling off his bicycle without wearing a helmet. Head imaging revealed a small right frontoparietal traumatic subarachnoid hemorrhage with an associated trace subdural hematoma along the right parietal convexity. Subsequently, he developed non-light perceiving vision loss, after which he began experiencing visual hallucinations.
Conclusion
CBS is frequently overlooked or left untreated. Research on diagnosing and managing CBS following head trauma is limited. Therefore, clear diagnostic criteria for CBS and a better understanding of its underlying mechanisms are needed to improve diagnosis and management strategies.
2.Mapping out the surgical anatomy of the lingual nerve:a systematic review and meta-analysis
Sheena Xin Yi LIN ; Paul Ruiqi SIM ; Wei Ming Clement LAI ; Jacinta Xiaotong LU ; Jacob Ren Jie CHEW ; Raymond Chung Wen WONG
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2023;49(4):171-183
Objectives:
Understanding the lingual nerve’s precise location is crucial to prevent iatrogenic injury. This systematic review seeks to determine the lingual nerve’s most probable topographical location in the posterior mandible.
Materials and Methods:
Two electronic databases were searched, identifying studies reporting the lingual nerve’s position in the posterior mandible.Anatomical data in the vertical and horizontal dimensions at the retromolar and molar regions were collected for meta-analyses.
Results:
Of the 2,700 unique records identified, 18 studies were included in this review. In the vertical plane, 8.8% (95% confidence interval [CI], 1.0%-21.7%) and 6.3% (95% CI, 1.9%-12.5%) of the lingual nerves coursed above the alveolar crest at the retromolar and third molar regions. The mean vertical distance between the nerve and the alveolar crest ranged from 12.10 to 4.32 mm at the first to third molar regions. In the horizontal plane, 19.9% (95% CI, 0.0%-62.7%) and 35.2% (95% CI, 13.0%-61.1%) of the lingual nerves were in contact with the lingual plate at the retromolar and third molar regions.
Conclusion
This systematic review mapped out the anatomical location of the lingual nerve in the posterior mandible, highlighting regions that warrant additional caution during surgeries to avoid iatrogenic lingual nerve injuries.
3.Low incidence of cardiac complications from COVID-19 and its treatment among hospitalised patients in Singapore.
Tony Yi Wei LI ; Jinghao Nicholas NGIAM ; Nicholas W S CHEW ; Sai Meng THAM ; Zhen Yu LIM ; Shuyun CEN ; Shir Lynn LIM ; Robin CHERIAN ; Raymond C C WONG ; Ping CHAI ; Tiong Cheng YEO ; Paul Anantharajah TAMBYAH ; Amelia SANTOSA ; Gail Brenda CROSS ; Ching Hui SIA
Annals of the Academy of Medicine, Singapore 2021;50(6):490-493
5.Clinical spectrum, treatment and outcomes of uveal melanoma in a tertiary centre.
Wendy WONG ; Gangadhara SUNDAR ; Caroline CHEE ; Paul Songbo ZHAO ; Rajesh RAJAGOPALAN ; Lingam GOPAL
Singapore medical journal 2019;60(9):474-478
INTRODUCTION:
We aimed to describe the clinical characteristics, diagnostic challenges, treatment patterns and outcomes of uveal melanoma (UM) in a tertiary care centre.
METHODS:
This is a retrospective case series of 11 consecutive patients with UM who were managed in a tertiary referral centre between 2002 and 2017. Epidemiological, clinical, pathological and radiological characteristics were reviewed. Classification of choroidal melanoma as small, medium or large was based on the criteria established by the Collaborative Ocular Melanoma Study.
RESULTS:
Mean age at presentation was 42.9 (range 27‒67) years. In 7 (64%) patients, a definitive diagnosis of UM was made after a mean follow-up period of 6.4 (range 1‒17) months. There were one, six and four patients with small-, medium- and large-sized choroidal melanomas, respectively. Treatment was enucleation in 5 (45.5%) patients, plaque brachytherapy in 4 (36.4%) patients, transpupillary thermotherapy in 1 (9.1%) patient, and observation in 1 (9.1%) patient. Median follow-up was 29 months. Metastatic disease developed in 5 (45.5%) patients at the mean age of 46.6 (range 38‒56) years, with median overall survival of 20 months. Genetic mutations in three patients were monosomy 3 (n = 2), and gain of 3q and 8q (n = 1).
CONCLUSION
Our study supports the finding that UM in Chinese and Asian Indian patients presents at a younger age than in Caucasians. Although it is rare, ophthalmologists should remain mindful of this life-threatening disease. We propose establishing a national and regional registry for ocular tumours with genetic information to characterise the disease spectrum in Southeast Asia.
6.Prevalence and risk factors of colorectal cancer in Asia
Martin CS WONG ; Hanyue DING ; Jingxuan WANG ; Paul SF CHAN ; Junjie HUANG
Intestinal Research 2019;17(3):317-329
Globally, colorectal cancer (CRC) is a substantial public health burden, and it is increasingly affecting populations in Asian countries. The overall prevalence of CRC is reported to be low in Asia when compared with that in Western nations, yet it had the highest number of prevalent cases. This review described the prevalence of CRC in Asia according to the International Agency for Research on Cancer from World Health Organization (WHO) database and summarized its major risk factors. Non-modifiable factors include genetic factors, ethnicity, age, gender, family history and body height; smoking, alcohol drinking, weight, Westernized diet, physical inactivity, chronic diseases and microbiota were involved in environmental factors. These risk factors were separately discussed in this review according to published literature from Asian countries. CRC screening has been playing an important role in reducing its disease burden. Some recommendations on its screening practices have been formulated in guidelines for Asia Pacific countries.
Alcohol Drinking
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Asia
;
Asian Continental Ancestry Group
;
Body Height
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Chronic Disease
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Colorectal Neoplasms
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Diet
;
Epidemiology
;
Humans
;
International Agencies
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Mass Screening
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Microbiota
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Prevalence
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Public Health
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Risk Factors
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Smoke
;
Smoking
;
World Health Organization
7.Camera Cover Perforation after Arthroscopic Surgery.
Benjamin Fh ANG ; Henry SOEHARNO ; Kong Hwee LEE ; Shirlena Tk WONG ; Denny Tt LIE ; Paul Cc CHANG
Annals of the Academy of Medicine, Singapore 2018;47(7):263-265
Arthroscopy
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adverse effects
;
instrumentation
;
methods
;
Diagnostic Equipment
;
adverse effects
;
microbiology
;
Disinfection
;
methods
;
Equipment Failure
;
Humans
;
Materials Testing
;
methods
;
Orthopedic Equipment
;
adverse effects
;
microbiology
;
Postoperative Complications
;
etiology
;
prevention & control
8.Incipient Albuminuria in Persons with Newly Diagnosed Type 2 Diabetes Mellitus: A 5-Year Retrospective Cohort Study.
Shermin TAN ; Lai Yin WONG ; Matthias Paul Hs TOH
Annals of the Academy of Medicine, Singapore 2018;47(12):502-508
INTRODUCTION:
This study aimed to determine the 5-year incidence of albuminuria among Asian persons with newly diagnosed type 2 diabetes mellitus (DM), and to identify the risk factors at diagnosis for progression to albuminuria.
MATERIALS AND METHODS:
A retrospective 5-year closed cohort study was conducted among 1016 persons aged ≥18 years old who were diagnosed with type 2 DM between 1 January 2007 and 31 December 2009 at primary care facilities in Singapore. The cumulative incidence of progression from normoalbuminuria to albuminuria-termed "progression"-was determined. The risk factors associated with progression were evaluated using multiple logistic regression analysis.
RESULTS:
A total of 541 (53.2%) participants were men. The mean (SD) onset age of type 2 DM was 54 (11) years. From diagnosis of type 2 DM, the 5-year cumulative incidence of progression was 17.3% and mean (SD) duration to progression was 2.88 (1.23) years. Higher onset age (OR 1.02; 95% CI, 1.00-1.04), history of hypertension (OR, 1.88; 95% CI, 1.32-2.70) and higher glycated haemoglobin (HbA1c) (OR, 1.17; 95% CI, 1.09-1.26) at diagnosis were associated with progression. In addition, being on angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) treatment at baseline modified the effect of hypertension on progression.
CONCLUSION
This study highlighted the importance of early screening and treatment of diabetes as well as prevention of hypertension, which could potentially delay the onset of microalbuminuria in persons with type 2 DM. Persons on ACEI or ARB treatment should continue to be monitored regularly for progression to albuminuria.
Adult
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Age of Onset
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Aged
;
Albuminuria
;
epidemiology
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Angiotensin Receptor Antagonists
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therapeutic use
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Angiotensin-Converting Enzyme Inhibitors
;
therapeutic use
;
Cohort Studies
;
Diabetes Mellitus, Type 2
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diagnosis
;
epidemiology
;
metabolism
;
Disease Progression
;
Female
;
Glycated Hemoglobin A
;
metabolism
;
Humans
;
Hypertension
;
drug therapy
;
epidemiology
;
Logistic Models
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Male
;
Middle Aged
;
Retrospective Studies
;
Risk Factors
;
Singapore
;
epidemiology
9.Case-control study on individual osteotomy instrument and conventional total knee arthroplasty for the treatment of knee osteoarthritis.
Hua-chen YU ; Yu ZHANG ; Paul WONG
China Journal of Orthopaedics and Traumatology 2016;29(6):513-516
OBJECTIVETo compare clinical efficacy of individual osteotomy instrument and total knee arthrolplasty (TKA) in treating patients with knee osteoarthritis.
METHODSFrom June 2014 to December 2014, 40 patients with unilateral knee osteoarthritis were randomly divided into two groups and 20 cases were in each group. One group (individual group) were treated with TKA with individual osteotomy instrument,including 5 males and 15 females with an average age of (67.3 ± 6.5) years old; 8 cases on the left side and 12 cases on the right side. Another group (conventional group) were treated with conventional TKA , including 6 males and 14 females with an average age of (66.8 ± 7.3) years old; 9 cases on the left side and 11 cases on the right side. Operative time, blood loss, postoperative HSS score at 6 months, and changes of mechanical alignment before and after operation were analyzed.
RESULTSOperative time in individual group was (79.3 ± 4.7) min, and (83.5 ± 3.2) min in conventional group; blood loss in individual group was (287.1 ± 24.9) ml and (363.4 ± 47.2) ml in conventional group, there were statistical differences between two groups in these two items. There was no significant difference in postoperative HSS score at 6 months between individual group (84.8 ± 3.2) and conventional group (84.2 ± 2.5). Postoperative limb alignment in individual group was (2.8 ± 0.6)°, and (2.8 ± 0.6)° in conventional group, with no significant difference between two groups.
CONCLUSIONTKA with individual osteotomy instrument could reduce operative time and blood loss, but there was no differences in knee function, changes of mechanical alignment compared with TKA.
Adult ; Aged ; Arthroplasty, Replacement, Knee ; methods ; Case-Control Studies ; Female ; Humans ; Knee Joint ; surgery ; Male ; Operative Time ; Osteoarthritis, Knee ; surgery ; Osteotomy ; instrumentation ; methods ; Treatment Outcome
10.Evaluation of emotion-based messages designed to motivate Hispanic and Asian parents of early adolescents to engage in calcium-rich food and beverage parenting practices.
Jinan Corinne BANNA ; Marla REICKS ; Carolyn GUNTHER ; Rickelle RICHARDS ; Christine BRUHN ; Mary CLUSKEY ; Siew Sun WONG ; Scottie MISNER ; Nobuko HONGU ; N Paul JOHNSTON
Nutrition Research and Practice 2016;10(4):456-463
BACKGROUND/OBJECTIVES: Setting healthful beverage expectations, making calcium-rich foods and beverages (CRF/B) available, and role modeling are parenting practices promoting calcium intake among early adolescents. This study aimed to evaluate emotion-based messages designed to motivate parents of early adolescents to perform these practices. SUBJECTS/METHODS: Emotion-based messages were developed for each parenting practice and tested in 35 parents from 5 states. Findings were used to modify messages and develop a survey administered via Amazon MechanicalTurk to a convenience sample of Asian (n = 166) and Hispanic (n = 184) parents of children 10-13 years. Main outcome measures were message comprehension, motivation, relevance, acceptability, and novelty. Engagement in the parenting practices was also assessed. RESULTS: Message comprehension was acceptable for the majority of parents. Most also agreed that messages were motivational (setting healthful beverage expectations (69.0%), making CRF/B available (67.4%), and role modeling (80.0%)), relevant and acceptable. About 30-50% indicated they had not seen the information before. Many parents indicated they were already engaging in the practices (> 70%). No racial/ethnic differences were observed for responses to messages or engaging in parenting practices. CONCLUSIONS: Results indicate that emotion-based messages designed to motivate parents to engage in parenting practices that promote calcium intake among early adolescents were motivating, relevant, and acceptable.
Adolescent*
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Asian Continental Ancestry Group*
;
Beverages*
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Calcium
;
Child
;
Comprehension
;
Hispanic Americans*
;
Humans
;
Motivation
;
Outcome Assessment (Health Care)
;
Parenting*
;
Parents*

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