Singap Med J
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We evaluated the progress in the self-perceived competence of medical students in a range of common clinical, practical and personal skills, in their final six months of training. ⋯ Significant progresses in clinical experience and confidence can be observed in the final stages of medical training. The findings of inadequate improvements in some skills call for dedicated training sessions and strengthening of on-site supervision.
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Review
Application of mental illness stigma theory to Chinese societies: synthesis and new directions.
The rapidly-evolving literature concerning stigma towards psychiatric illnesses among Chinese groups has demonstrated pervasive negative attitudes and discriminatory treatment towards people with mental illness. However, a systematic integration of current stigma theories and empirical findings to examine how stigma processes may occur among Chinese ethnic groups has yet to be undertaken. ⋯ These cultural meanings are reflected in severe and culturally-specific expressions of stigma in Chinese societies. Implications and directions to advance stigma research within Chinese cultural settings are provided.
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Immunosuppressive therapy has been shown to improve outcomes in patients with paraquat poisoning. The objective of this study was to evaluate the efficacy of immunosuppressive therapy in the management of lung injury due to paraquat poisoning. ⋯ One out of four patients (95 percent CI 3-5) were successfully treated with immunosuppressive therapy for paraquat poisoning. However, due to significant heterogeneity and publication bias, a large randomised controlled trial will be required to affirm the role of immunosuppression in paraquat poisoning.
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Point-of-care blood ketone testing: screening for diabetic ketoacidosis at the emergency department.
We piloted the use of a blood beta-hydroxybutyrate meter as a point-of-care testing in an emergency department (ED) to establish its role in distinguishing ketosis/ketoacidosis from simple hyperglycaemia, and develop guidelines for its use in the ED. ⋯ This is a useful tool that allows clinicians to immediately distinguish between simple hyperglycaemia and potentially life-threatening ketotic states. We formulated simple guidelines for its utilisation in an ED setting.
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This study analysed the complaint rates, profile and trend, and complainant profile of patients' complaints received by the National University Hospital Emergency Medicine Department. An earlier ten-year study (1986-1995) was done on the complaint profile. ⋯ Staff-patient communication and organisation/logistics must be continually improved to reduce complaints, while upholding a good standard of care. These would translate into cost savings for all parties. There must also be appropriate checks and balances particularly where complaints are not valid, so that doctors can practice cost-effective medicine.