Publications by authors named "Goh L"

Adverse local tissue reaction (ALTR) and osteolysis formation are more frequently described complications after total hip arthroplasty (THA) with metal-on-metal bearings. In this report, we present a unique case of ALTR and osteolysis formation with ceramic-on-ceramic bearing THA, which has been less commonly described in the existing literature. This rare case occurred in a 54-year-old patient who had a primary THA done 17 years prior to representing to our institution.

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Purpose: To compare clinical characteristics of patients with and without a known systemic malignancy at the time of diagnosis of orbital metastases.

Methods: Retrospective case note and imaging review for patients with orbital metastases presenting between 1980 and 2022. Patients were classified as having known malignancy at orbital presentation (group I) or without known malignancy (group II).

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In children with cancer, febrile neutropenia (FN) is one of the most common complications of treatment, a leading cause of unplanned and prolonged hospital admission and is the key driver of antibiotic exposure. Co-designed with key stakeholders, 'Early versus Late Stopping of Antibiotics in high-risk FN' (ELSA-FN) is a randomised controlled, non-inferiority trial that compares stopping antibiotics in clinically stable patients after 48 hours with the current standard of care, continuing antibiotics until absolute neutrophil recovery. As an Australian first, we will exploit the potential of electronic medical record (EMR) systems, embedding all key aspects of the trial including screening, consent, randomisation and data collection into standard clinical and EMR workflows.

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Article Synopsis
  • The study investigated the relationship between asthma self-management knowledge and factors like age and education in adult asthmatic patients at a Singapore polyclinic.
  • A survey of 141 patients revealed a mean self-management knowledge score of 46.8 out of 100, with education level being a significant factor affecting knowledge.
  • However, there was no link found between self-management knowledge and asthma control, indicating that patients, while somewhat knowledgeable, still face challenges in managing their condition effectively.
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Objective: More than 130 susceptibility loci for rheumatoid arthritis (RA) have been identified with genome-wide association studies (GWAS). To investigate the genetic predisposition of Chinese anti-cyclic-citrullinated-peptides-antibody-positive RA, we carried out an exome sequencing study.

Methods: Patients were recruited from three major public hospitals in Singapore, Tan Tock Seng Hospital (TTSH), Singapore General Hospital and National University Health System.

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Purpose: Conventional obstructive sleep apnea (OSA) diagnosis via polysomnography can be costly and inaccessible. Recent advances in artificial intelligence (AI) have enabled the use of craniofacial photographs to diagnose OSA. This meta-analysis aims to clarify the diagnostic accuracy of this innovative approach.

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Singapore's growing elderly population faces a rising burden of chronic wounds. Studies have shown the beneficial effects of shared wound management where the patient actively manages their wound with guidance from their healthcare professionals. However, this concept faces challenges due to patient resistance.

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Background: The current medical and nursing curricula place little emphasis on palliative and end-of-life care. Consequently, students are less comfortable in communicating about topics related to death and dying when providing palliative and end-of-life care. Death cafés utilizes a facilitator-led small group to encourage conversations about death and dying to take place alongside food and beverages in a safe environment.

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Purpose: Falls are a major concern for people with Parkinson's disease (PwPD) due to associated motor and non-motor impairments. Promoting safe mobility behaviour may be an effective fall prevention intervention, however this concept is poorly articulated in the literature. The aim of this scoping review was to map out the definition and concepts of safe mobility behaviour to draw implications for PwPD.

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Article Synopsis
  • Structural variants (SVs) play a crucial role in genetic differences that relate to traits and diseases, but most research has focused on European populations.
  • This study compiles a catalogue of over 73,000 SVs from a diverse group of 8,392 Singaporeans, revealing that about 65% of these SVs are novel and specific to Asian ancestry groups.
  • The findings help identify clinically relevant SVs and improve genetic research by addressing biases related to ancestry, which is important for equity and diversity in the field.
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Background: Evisceration surgery is an important part of an ophthalmologist's skillset but is an uncommon procedure. Therefore, it is important for training ophthalmologists to have adequate knowledge and confidence in this procedure to maximise learning opportunities. Mixed reality involves the intertwining of real and virtual environments and has been used successfully in surgical training.

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  • The discovery of hepatitis C virus (HCV) in 1989 has led to the development of effective direct-acting antiviral treatments that can cure the disease.
  • Increasing treatment rates and decreasing transmission could make HCV eradication possible, but achieving this goal involves significant challenges.
  • The article discusses the management of children with HCV in the Asia-Pacific region and highlights various difficulties and complexities in addressing the issue.
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Purpose: Managing wounds often requires frequent clinic visits, posing a burden on both patients and the healthcare system. Shared wound care, which encourages patients to manage dressings at home, has emerged as a potential solution. This study investigates factors influencing self-wound care adoption in Singapore.

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Mechanisms underlying p53-mediated protection of the replicating genome remain elusive, despite the quintessential role of p53 in maintaining genomic stability. Here, we uncover an unexpected function of p53 in curbing replication stress by limiting PARP1 activity and preventing the unscheduled degradation of deprotected stalled forks. We searched for p53-dependent factors and elucidated RRM2B as a prime factor.

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Background: The COVID-19 pandemic has reshaped healthcare delivery worldwide.

Objective: To explore potential changes in the reasons for visits and modality of care in primary care settings through the International Consortium of Primary Care Big Data Researchers (INTRePID).

Methods: We conducted a cross-sectional, retrospective study from 2018-2021.

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Introduction/objectives: Haemostatic spray (HS; Hemospray) is a powder agent for endoscopic haemostasis in patients with acute upper gastrointestinal bleeding (UGIB). It has been shown to be effective and easy to administer. However, published data on efficacy and safety in children remain scarce.

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This review delves into the interactions between hepatitis C virus (HCV) and the host immune system, shedding light on how by using the mechanism of molecular mimicry, the virus strategically evades the immune system, resulting in a cascade of diverse complications. HCV, notorious for its ability to persistently infect hepatocytes, employs molecular mimicry to resemble host proteins, thereby avoiding immune detection and mounting an effective defense. This mimicry also triggers systemic autoimmune responses that lead to various sequelae.

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Article Synopsis
  • Healthcare sustainability is an important issue globally; in Singapore, the Agency for Care Effectiveness has implemented strategies to promote the use of biosimilars to manage rising costs in biologics.
  • A study analyzed drug utilization data from public healthcare institutions, focusing on five monoclonal antibodies with biosimilars, and found significant increases in biosimilar adoption and substantial decreases in spending.
  • Overall, the subsidy for biosimilars led to over 95% adoption rates within a year and estimated savings of $136 million over five years, indicating the effectiveness of these healthcare strategies.
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Introduction: To develop and validate a click-based mobile "Audiclick" app employing click noises for hearing assessments.

Materials And Methods: This prospective comparative study compares the "AudiClick" app as a hearing screening tool to pure tone audiometry. Participants listened to sounds through wired earbud headphones that were connected to an Android or iOS device.

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BACKGROUND Crusted scabies is a severe skin infection resulting from hyper-infestation with the obligate parasite Sarcoptes scabiei var. hominis. In contrast to classic scabies, crusted scabies may involve as many as hundreds to millions of mites.

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Objectives: The majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses.

Design: Definitions for respiratory illness types were agreed on collectively.

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