Singap Med J
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An equation for accurate estimation of the glomerular filtration rate (GFR) is vital for staging and directing the treatment of chronic kidney disease (CKD), which is a source of considerable morbidity and mortality around the world. The Modification of Diet for Renal Disease (MDRD) equation, which includes a racial coefficient, is commonly used. The MDRD equation has been validated in Caucasian populations, but modifying the racial coefficient for Asian countries has resulted in substantially different values that may not be due to race alone. ⋯ Furthermore, the precision of the MDRD equation is poorer at the early stages of CKD. New markers, such as cystatin C, and new equations may be needed to accurately assess wider ranges of GFR in multi-ethnic countries. We review the development of GFR-estimating equations from an Asian perspective.
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The aortic arch gives rise to three classical branches, namely the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. We report a rare variation of the left common carotid artery and the right vertebral arteries originating from the brachiocephalic trunk, and the left vertebral artery that was arising from the arch of the aorta, proximal to the origin of the left subclavian artery. Variations in the branching pattern of the arch of aorta can alter the cerebral haemodynamics that leads to cerebral abnormalities. Knowledge of the variations in the classical branches of the arch of aorta is important in the diagnosis of intracranial aneurysm after subarachnoid haemorrhage.
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Comparative Study
Differential expression of galectin-3 in advancing thyroid cancer cells: a clue toward understanding tumour progression and metastasis.
Galectin-3 is a member of the beta-galactoside-binding protein family that plays an important role in cell-to-cell adhesion and in cell-to-matrix interaction. Cellular expression of galectin-3 is correlated with cancer aggressiveness and metastasis. ⋯ This finding supported the role of galectin-3 in its cell-to-cell adhesion and cell-to-matrix interaction. Galectin-3 is a potential tumour marker for indicating local and distance metastasis, especially in cases with PTC.
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The Shoulder Pain and Disability Index (SPADI) is a valid and reliable questionnaire used in shoulder disorders. The purpose of this study was to test the convergent validity and the reliability of the SPADI. ⋯ The results of the present study suggest that the SPADI is a valid and reliable instrument to assess shoulder pain in Turkish female patients.
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The Singapore Armed Forces (SAF) Medical Corps and the Ministry of Health (MOH) have published clinical practice guidelines on Management of Heat Injury to provide doctors and patients in Singapore with evidence-based guidance on the prevention and clinical management of exertional heat injuries. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the SAF Medical Corps-MOH clinical practice guidelines on Management of Heat Injury, for the information of readers of the Singapore Medical Journal. ⋯ The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.