Tan Tock Seng Hospital

Singapore, Singapore

Tan Tock Seng Hospital

Singapore, Singapore
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News Article | May 26, 2017
Site: www.cnet.com

Midwifery students now have to deliver babies as part of exams at Australia's University of Newcastle -- but they will do it in virtual reality. The Australia's University of Newcastle has begun a VR project that simulates a real-world delivery room. The program, which runs on PC, iOS and Android, puts midwifery students under the pressure of a "life-or-death situation" in the "safe, repeatable environment of VR," said co-project leader and lecturer, Jessica Williams, in a statement. The program is designed to ease the transition from an educational setting to a real-world emergency room for new graduates and boost their confidence at work, which is important because "15 percent of births in Australia and New Zealand [require] some form of resuscitation." In an email to CNET, Williams expressed optimism about the project. "We have demonstrated our app to our clinical partners and neonatologists, who see great value in using VR in teaching and learning when it comes to medical emergency situations," she said. Incorporating VR into midwifery training could prove useful in improving maternal and infant mortality rates and other consequences caused by medical error. According to a May 2016 letter from John Hopkins Medicine to the US Centers for Disease Control and Prevention (CDC), the number of maternal deaths due to medical error stands at 251,545. The University of Newcastle is not the only institution to use new tech in clinical training. At CommunicAsia this week, Singapore's Infocomm Media Development Authority (IMDA) announced a collaboration with Tan Tock Seng Hospital and visual effects company SideFX Studios to simulate scenarios in VR for training courses on medical procedures. How much VR could help in healthcare training overall remains to be seen, however. IMDA's project will see VR being used to complement traditional methods of clinical training, because current technology is unable to "fully replicate a number of different qualities" including tactile responses and other unpredictable conditions. Solving for XX: The industry seeks to overcome outdated ideas about "women in tech." Life, disrupted: In Europe, millions of refugees are still searching for a safe place to settle. Tech should be part of the solution. But is it?

Thong B.,Tan Tock Seng Hospital | Olsen N.J.,Penn Medicine
Rheumatology (Oxford, England) | Year: 2017

SLE presents many challenges for clinicians. The onset of disease may be insidious, with many different symptoms and signs, making early and accurate diagnosis challenging. Tests for SLE in the early stages lack specificity; those that are useful later often appear only after organ damage is manifest. Disease patterns are highly variable; flares are not predictable and not always associated with biomarkers. Children with SLE may have severe disease and present special management issues. Older SLE patients have complicating co-morbid conditions. Therapeutic interventions have improved over recent decades, but available drugs do not adequately control disease in many patients, and successful outcomes are limited by off-target effects; some of these become manifest with longer duration of treatment, now in part revealed by improved rates of survival. Despite all of these challenges, advances in understanding the biological basis of SLE have translated into more effective approaches to patient care. This review considers the current state of SLE diagnosis and management, with a focus on new approaches and anticipated advances. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

ABSTRACT: Syphilis has been known to present in a myriad of symptoms throughout the ages, and until this day, the diagnosis remains elusive to the modern physician. We present 2 unusual cases of syphilis that posed diagnostic challenges even in the current era of new and advancing diagnostic tests. © Copyright 2017 American Sexually Transmitted Diseases Association

Tan Tock Seng Hospital and Agency For Science | Date: 2010-07-07

The invention provides oligonucleotide(s) derived from the gene sequence encoding the gag region of HIV-I for simple, specific and/or sensitive test(s) for the presence of HIV-I. In particular, the present invention provides oligonucleotide(s) for test(s) for HIV-I. Kit(s) comprising the oligonucleotide(s) for use as probe(s) and/or primer(s) useful in the test(s) are also provided.

Tan Tock Seng Hospital and Agency For Science | Date: 2010-07-13

The invention provides oligonucleotide(s) for simple, specific and/or sensitive test(s) for the presence of Influenza A and/or B virus. Kit(s) comprising the oligonucleotide(s) for use as probe(s) and/or primer(s) useful in the test(s) are also provided.

Tan Tock Seng Hospital and Agency For Science | Date: 2010-11-08

There is provided a method of detecting the presence of oseltamivir-resistant Influenza A virus in a sample, the method comprising detecting the presence of an amplicon, a fragment and/or a derivative thereof, wherein the amplicon, fragment and/or derivative thereof (a) is amplified by a primer (SEQ ID NO:1), a fragment, or derivative therefore and/or a primer (SEQ ID NO:2), a fragment, or derivative thereof. There are also provided primer(s) and/or probe as well as kit for the detection of the presence of Influenza A in a sample and/or in a subject.

Hawkins R.,Tan Tock Seng Hospital
Annals of Laboratory Medicine | Year: 2012

For many years, the clinical laboratory's focus on analytical quality has resulted in an error rate of 4-5 sigma, which surpasses most other areas in healthcare. However, greater appreciation of the prevalence of errors in the pre- and post-analytical phases and their potential for patient harm has led to increasing requirements for laboratories to take greater responsibility for activities outside their immediate control. Accreditation bodies such as the Joint Commission International (JCI) and the College of American Pathologists (CAP) now require clear and effective procedures for patient/sample identification and communication of critical results. There are a variety of free on-line resources available to aid in managing the extra-analytical phase and the recent publication of quality indicators and proposed performance levels by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) working group on laboratory errors and patient safety provides particularly useful benchmarking data. Managing the extra-laboratory phase of the total testing cycle is the next challenge for laboratory medicine. By building on its existing quality management expertise, quantitative scientific background and familiarity with information technology, the clinical laboratory is well suited to play a greater role in reducing errors and improving patient safety outside the confines of the laboratory. © The Korean Society for Laboratory Medicine.

Lim W.C.,Tan Tock Seng Hospital
Cochrane database of systematic reviews (Online) | Year: 2010

Controlled clinical trials investigating the efficacy of aminosalicylates for the treatment of mildly to moderately active Crohn's disease have yielded conflicting results. A systematic review was conducted to critically examine current available data on the efficacy of sulfasalazine and mesalamine for inducing remission or clinical response in patients with mildly to moderately active Crohn's disease. To evaluate the efficacy of aminosalicylates compared to placebo, corticosteroids, and other aminosalicylates (alone or in combination with corticosteroids) for the treatment of mildly to moderately active Crohn's disease. Separate MEDLINE (1966-July 2010), Cochrane Central Register of Controlled Trials (CENTRAL; Issue 3, 2010) and EMBASE database searches (1985-July 2010) of all relevant English and non-English language articles were performed, followed by manual searches of the reference list from potentially relevant papers and review articles, as well as proceedings from annual meetings (1991-2010) of the American Gastroenterological Association (AGA) and American College of Gastroenterology (ACG). Randomized controlled trials that evaluated the efficacy of sulfasalazine or mesalamine in the treatment of mildly to moderately active Crohn's disease compared to placebo, corticosteroids, and other aminosalicylates (alone or in combination with corticosteroids) were included. Data extraction and assessment of methodological quality of each selected study was independently performed by the investigators and any disagreement was resolved by discussion and consensus. The primary outcome measure was a well defined clinical endpoint of induction of remission or response to treatment. Nineteen studies met the inclusion criteria and were analyzed. Pooled relative risks (RR) for inducing remission or clinical response and their 95% confidence intervals were calculated (random effects model) where appropriate. Sulfasalazine was more likely to induce remission (RR 1.38; 95% CI 1.02 to 1.87; n = 263) compared to placebo with benefit confined mainly to patients with colitis. Sulfasalazine was less effective than corticosteroids (RR 0.66; 95% CI 0.53 to 0.81; n = 260). Olsalazine was less effective than placebo in a single trial. Low dose mesalamine (1 to 2 g/day) was not superior to placebo (RR = 1.46, 95% CI 0.89-2.40; n = 302) and was less effective than corticosteroids. High dose mesalamine (3 to 4.5 g/day) was not superior to placebo for induction of remission (RR 2.02; 95% CI 0.75 to 5.45) or response (Weighted Mean Difference -19.8 points; 95% CI -46.2 to 6.7; n = 615). In a single randomized controlled trial, 5-ASA was inferior to budesonide (RR 0.56; 95% CI 0.40 to 0.78). No statistically significant difference was found between high dose mesalamine and conventional corticosteroids (RR 1.04; 95% CI 0.79 to 1.36; n = 178). However, relatively few patients were available for analysis. There was a lack of good quality clinical trials comparing sulfasalazine with other mesalamine formulations. Sulfasalazine has modest efficacy compared to placebo and is inferior to corticosteroids for the treatment of mild to moderately active Crohn's disease. Olsalazine and low dose mesalamine (1 to 2 g/day) are not superior to placebo. High dose mesalamine (3 to 4.5 g/day) is not more effective than placebo for inducing response or remission. High dose mesalamine was inferior to budesonide for inducing remission in a single trial. In conclusion, sulfasalazine shows modest efficacy for the treatment of active Crohn's disease. However, the existing data show little benefit for 5-aminosalicylates.

Lupus enteritis may occur as an acute presentation of systemic lupus erythematosus (SLE), and is not uncommonly associated with acute uretero-cystitis and/or hydronephrosis. Extensive involvement of the gastrointestinal tract from the stomach to the rectum in acute SLE is uncommon. We describe a 22-year-old Chinese female who presented with acute extensive gastrointestinal and genitourinary involvement who recovered following pulse intravenous methylprednisolone and cyclophosphamide. A high index of clinical suspicion is required to arrive at the diagnosis of SLE where only acute gastrointestinal and genitourinary manifestations are predominant, and other clinical, haematological and biochemical features of SLE are absent.

Lim K.S.,Tan Tock Seng Hospital
Clinical Radiology | Year: 2014

The internationally accepted diagnostic criteria for hepatocellular carcinoma (HCC) in cirrhosis are highly accurate for large tumours, but offer relatively low sensitivity for small (<2 cm) tumours. Diffusion-weighted imaging (DWI) is a functional magnetic resonance imaging (MRI) technique that has been studied extensively as an aid to visualize various abdominal malignancies, including HCC in cirrhosis. DWI maps water diffusivity, which in HCC may be restricted as a result of changes ensuing from hepatocarcinogenesis. The present review is based on up-to-date evidence and describes the strengths and weaknesses of DWI, both as a standalone technique and as an adjunct sequence to conventional protocols, in the diagnosis, staging, prognostication, and assessment of treatment response of HCC in cirrhosis. © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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