Introduction: Clinical bedside point-of-care ultrasonography (POCUS) is an important adjunct to history and physical examination. The objective of this pilot survey is to assess the level of exposure, perceptions, interest levels and possible barriers toward training of POCUS in internal medicine. Methods: In October 2015, all medical doctors who were working in the Singapore General Hospital Internal Medicine Department were invited to complete a hard-copy printed 27-question Likert-scale survey. Results: A total of 124 medical doctors participated in the survey (response rate 82.1%). The proportions of participants who have heard, witnessed, and performed POCUS were 65.6% (N = 82), 71.2% (N = 89) and 41.6% (N = 52), respectively. POCUS was rated highly on usefulness in the practice of internal medicine (M = 8.74; SD = 1.34). The top three POCUS skills that doctors would like to acquire would be (1) procedural guidance POCUS (70.8%); (2) point-of-care cardiac ultrasound (69%) and (3) lung ultrasound 58.4% (based on percentage ranked first through third). The sample mean of interest in undergoing further training in POCUS is 8.91 (SD = 1.27) (0 = not interested, 10 = very interested). The top three barriers identified were (1) lack of an ultrasound machine (M = 7.98 SD = 2.28); (2) cost of an ultrasound machine (M = 7.79 SD = 2.19) and (3) lack of a formal training curriculum (M = 7.25 SD = 2.08) (0 = not a barrier at all, 10 = severe barrier). Conclusions: There is a high level of exposure and interest in POCUS. Doctors perceived bedside POCUS as very useful in the practice of internal medicine. A lack of machine and formal curriculum impedes development of a training program. This pilot survey may serve as a basic needs assessment to an implementation of an internal medicine POCUS training curriculum.
Fascioliasis is a reemerging zoonosis endemic in many parts of the world. Reports of imported fascioliasis by migrants into nonendemic countries are common, but tourists and business travelers are rarely afflicted. Here, we report a case of a New Zealander traveler who acquired the infection on a business trip.
We report the first outbreak of vancomycin-resistant Enterococcus faecium colonization and infection among inpatients in the hematology ward of an acute tertiary care public hospital in Singapore. Two cases of bacteremia and 4 cases of gastrointestinal carriage were uncovered before implementation of strict infection control measures resulted in control of the outbreak.
Medical students were temporarily removed from direct patient contact activities during the COVID-19 pandemic, shortening the duration of ward-based attachment programs. Web-based workshops were organized to equip final year medical students with necessary skills to start work in a general medicine setting. Topics included case-based scenarios reviewing patients with new complaints, medical documentation, and inter-professional communication. They were conducted using an online video conference platform and utilized polling platforms, small group discussions, and the “Chat” function to promote interactivity. Web-based learning enables delivery of useful contents without compromising interactivity and clinical applicability during the COVID-19 pandemic.
Singapore reported the elimination of malaria in 1982, but this country remains vulnerable to imported malaria. We describe a large cluster of 16 cases of imported Plasmodium falciparum malaria in visiting Nigerian students. More than half were asymptomatic and diagnosed only on screening. Although early diagnosis and treatment of patients averted local transmission of disease, our report illustrates the vulnerability of malaria-free countries to the introduction of malaria in this age of increasing globalization and ease of travel.
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