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Article ; Online: Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review.

Xu, Hongyun / Ang, Benson W G / Soh, Jian Yi / Ponnamperuma, Gominda G

2021 Volume 36, Issue 9, Page(s) 2745–2754

Abstract: Background: In recent years, there have been numerous studies exploring different teaching methods for improving diagnostic reasoning in undergraduate medical students. This systematic review examines and summarizes the evidence for the effectiveness of ...

Abstract	Background: In recent years, there have been numerous studies exploring different teaching methods for improving diagnostic reasoning in undergraduate medical students. This systematic review examines and summarizes the evidence for the effectiveness of these teaching methods during clinical training. Methods: PubMed, Embase, Scopus, and ERIC were searched. The inclusion criteria for the review consist of articles describing (1) methods to enhance diagnostic reasoning, (2) in a clinical setting (3) on medical students. Articles describing original research using qualitative, quantitative, or mixed study designs and published within the last 10 years (1 April 2009-2019) were included. Results were screened and evaluated for eligibility. Relevant data were then extracted from the studies that met the inclusion criteria. Results: Sixty-seven full-text articles were first identified. Seventeen articles were included in this review. There were 13 randomized controlled studies and four quasi-experimental studies. Of the randomized controlled studies, six discussed structured reflection, four self-explanation, and three prompts for generating differential diagnoses. Of the remaining four studies, two employed the SNAPPS Discussion: The authors posit a framework to teach diagnostic reasoning in the clinical setting. The framework targets specific deficiencies in the students' reasoning process. There remains a lack of studies comparing the effectiveness of different methods. More comparative studies with standardized assessment and evaluation of long-term effectiveness of these methods are recommended.
MeSH term(s)	Clinical Competence ; Education, Medical, Undergraduate ; Humans ; Problem Solving ; Students, Medical
Language	English
Publishing date	2021-06-22
Publishing country	United States
Document type	Systematic Review
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-021-06916-0
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Article: A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies.

Pannuto, Lucia / Soh, Jun Yi / Duah-Asante, Kwaku / Shaharan, Shazrinizam / Ward, Joseph / Bisase, Brian S / Norris, Paul / Koshima, Isao / Nduka, Charles / Kannan, Ruben Yap

Journal of clinical medicine

2024 Volume 13, Issue 8

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2024-04-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13082269
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Article: A Monster in the Chest: A Tale of a Goiter.

Sandasecra, Sanjeev / Yahya, Maya Mazuwin / Zuhdi Mamat, Ahmad / Soh, Jien Yen / Ramely, Rosnelifaizur / Aziz, Mohd E

Cureus

2022 Volume 14, Issue 6, Page(s) e25827

Abstract: Substernal goiter is usually presented in elderly patients and is mostly asymptomatic. A large substernal goiter is surgically challenging and can be managed through a transcervical incision and sternotomy. This case report is about a large substernal ... ...

Abstract	Substernal goiter is usually presented in elderly patients and is mostly asymptomatic. A large substernal goiter is surgically challenging and can be managed through a transcervical incision and sternotomy. This case report is about a large substernal goiter extending into the anterior mediastinum and causing superior vena cava syndrome that was resected via a transcervical and full sternotomy approach. The patient was a 47-year-old male, who visited our hospital for surgical treatment of substernal goiter. The computed tomography (CT) of the neck and thorax revealed a large substernal goiter extending into the mediastinum causing tracheal compression, vessel compression, and development of collateral vessels. Total thyroidectomy was performed via a full sternotomy and transcervical approaches. Postoperatively, the patient recovered well with no nerve palsy. Histopathological examination revealed the lesion as an adenomatous goiter. Substernal goiters are usually managed by transcervical approach, but a full sternotomy is required in cases of large substernal goiter with extension up to the pericardium and the presence of superior vena cava syndrome. A multidisciplinary team approach is necessary and can help reduce the risk of complications, such as nerve injury, major vessel injury, tracheal injury, and morbidity of the surgery.
Language	English
Publishing date	2022-06-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.25827
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Article: Giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence.

Teoh, Zhan Huai / Soh, Jien Yen / Mohamad, Nasibah / Zawawi, Norzaliana / Zakaria, Andee Dzulkarnaen / Zakaria, Zaidi / Wong, Michael Pak-Kai

Annals of coloproctology

2022

Abstract: Juvenile polyps (JPs) are the most common polyps in pediatric patients. We present the case of an 18-year-old male patient with a giant solitary JP resembling solitary rectal ulcer syndrome (SRUS). The presenting history was rectal bleeding and symptoms ... ...

Abstract	Juvenile polyps (JPs) are the most common polyps in pediatric patients. We present the case of an 18-year-old male patient with a giant solitary JP resembling solitary rectal ulcer syndrome (SRUS). The presenting history was rectal bleeding and symptoms of obstructed defecation syndrome. Colonoscopy revealed a polypoidal mass at the anorectal junction, with biopsy-confirmed SRUS. The symptoms worsened, and a protruding mass from the anus caused fecal incontinence. Pelvic magnetic resonance imaging showed a huge pedunculated mass occupying the low rectum with local compression of the urinary bladder. Transanal excision of the anal tumor was performed due to bleeding. A histopathological examination showed a JP with high-grade dysplasia. A histological examination to differentiate JPs and SRUS could be challenging based on a superficial forceps biopsy. Therefore, an excision biopsy is usually warranted with the understanding that adenomatous or malignant transformation is found in 5.6% to 12% of all JPs.
Language	English
Publishing date	2022-11-25
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2711906-3
ISSN	2287-9722 ; 2287-9714
ISSN (online)	2287-9722
ISSN	2287-9714
DOI	10.3393/ac.2022.00549.0078
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Article ; Online: Use of video-based telehealth services using a mobile app for workers in underserved areas during the COVID-19 pandemic: A prospective observational study.

Park, Hyun Sang / Jeong, Sungmoon / Chung, Ho-Young / Soh, Jae Young / Hyun, Young Ho / Bang, Seong Hwan / Kim, Hwa Sun

International journal of medical informatics

2022 Volume 166, Page(s) 104844

Abstract: Background: The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare.: Objective: This ... ...

Abstract	Background: The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare. Objective: This study aimed to investigate the effects of video-based telehealth services using a mobile personal health record (PHR) app for vulnerable workers with metabolic risk factors. Methods: A prospective observational study was conducted with 117 participants and 27 healthcare professionals for 16 weeks. Participants visited the research institution three times (at weeks 1, 8, and 16) and underwent health check-ups and used various features of the mobile PHR app. Healthcare professionals observed the participants's data using the monitoring system and performed appropriate interventions. The primary outcome measures were to evaluate the effects of services on changes in the participants' metabolic risk factors, and secondary outcome measures were to analyze changes in the participants' lifestyle and service satisfaction, and to observe service use through usage logs. One-way repeated measures ANOVA and Scheffé's test were performed to observe changes in participants' health status and lifestyle, and a paired t-test was performed to analyze changes in service satisfaction. Finally, in-depth interviews with healthcare professionals were performed using semi-structured questionnaires to understand service providers' perspectives after the end of the study. Results: Systolic blood pressure (F = 7.32, P <.001), diastolic blood pressure (F = 11.30, P <.001), body weight (F = 29.53, P <.001), BMI (F = 17.31, P <.001), waist circumference (F = 17.33, P <.001), fasting blood glucose (F = 5.11, P =.007), and triglycerides (F = 4.66, P =.01) showed significant improvements with time points, whereas high-density lipoprotein cholesterol (F = 3.35, P =.067) did not. The dietary score (F = 3.26, P =.04) showed a significant improvement with time points, whereas physical activity (F = 1.06, P =.34) did not. In terms of service satisfaction, only lifestyle improvement (P <.001) showed a significant difference. COVID-19 has affected the performance of healthcare professionals, thereby changing the perspectives toward healthcare technology services. Conclusions: We evaluated the effectiveness of video-based telehealth services supporting workers' health status and lifestyle interventions using healthcare technologies such as the mobile PHR app, tele-monitoring, and video teleconsultation. Our results indicate that as a complementary means, its utility can be expanded in the field of occupational safety and health to overcome the limitations of face-to-face treatment due to COVID-19 in the future.
MeSH term(s)	Blood Glucose ; COVID-19/epidemiology ; Cholesterol ; Humans ; Lipoproteins, HDL ; Medically Underserved Area ; Mobile Applications ; Pandemics ; Remote Consultation ; Triglycerides
Chemical Substances	Blood Glucose ; Lipoproteins, HDL ; Triglycerides ; Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	2022-08-17
Publishing country	Ireland
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2022.104844
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Article: Efficacy and safety of oral immunotherapy for peanut allergy: a pilot study in Singaporean children.

Zhong, Youjia / Chew, Jian-Ming Lamony / Tan, Michelle Meiling / Soh, Jian Yi

Asia Pacific allergy

2018 Volume 9, Issue 1, Page(s) e1

Abstract: Background: Peanut allergy is an increasing problem in Singapore and strict avoidance is difficult as peanut is ubiquitous in Asian cuisine.: Objective: We aimed to assess the efficacy and safety of peanut oral immunotherapy (OIT) in children with ... ...

Abstract	Background: Peanut allergy is an increasing problem in Singapore and strict avoidance is difficult as peanut is ubiquitous in Asian cuisine. Objective: We aimed to assess the efficacy and safety of peanut oral immunotherapy (OIT) in children with obvious peanut allergy in Singapore. Methods: This was an open-label study of peanut OIT in children living in Singapore, with 2 weekly dose escalation until final maintenance dose of 3,000 mg of peanut protein and a maintenance phase of 12 months. An oral food challenge was performed at 6 months to assess for desensitisation and at 4 weeks after discontinuation of OIT having completed 12 months of maintenance therapy to assess for possible sustained unresponsiveness. The adverse events were monitored using the symptom diaries. Results: Nine subjects were started on OIT, with 7 managing to complete maintenance phase of therapy. Of these 7, all were able to tolerate at least 3,000 mg of peanut protein by 6 months of maintenance therapy, showing that the OIT was effective. Of these 7, 3 patients complied with the 4-week abstinence period after completion of OIT before another peanut challenge; 2 of the 3 subjects showed a significant decrease from the initial ability to tolerate 3,000 mg of peanut protein. Side effects were mainly gastrointestinal in nature and were more common during the updosing phase than the maintenance phase. No episodes of anaphylaxis were observed in this study. Conclusion: Peanut OIT seemed to be effective and safe in our cohort of Singaporean children.
Language	English
Publishing date	2018-10-29
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2614800-6
ISSN	2233-8268 ; 2233-8276
ISSN (online)	2233-8268
ISSN	2233-8276
DOI	10.5415/apallergy.2019.9.e1
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Article: A Worker-Centered Personal Health Record App for Workplace Health Promotion Using National Health Care Data Sets: Design and Development Study.

Park, Hyun Sang / Kim, Kwang Il / Chung, Ho-Young / Jeong, Sungmoon / Soh, Jae Young / Hyun, Young Ho / Kim, Hwa Sun

JMIR medical informatics

2021 Volume 9, Issue 8, Page(s) e29184

Abstract: Background: Personal health record (PHR) technology can be used to support workplace health promotion, and prevent social and economic losses related to workers' health management. PHR services can not only ensure interoperability, security, privacy, ... ...

Abstract	Background: Personal health record (PHR) technology can be used to support workplace health promotion, and prevent social and economic losses related to workers' health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user's perspective in their design. Objective: Using Fast Healthcare Interoperability Resources (FHIR) and national health care data sets, this study aimed to design and develop an app for providing worker-centered, interconnected PHR services. Methods: This study considered the user's perspective, using the human-centered design (HCD) methodology, to develop a PHR app suitable for occupational health. We developed a prototype after analyzing quantitative and qualitative data collected from workers and a health care professional group, after which we performed a usability evaluation. We structured workers' PHR items based on the analyzed data, and ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), and Logical Observation Identifiers Names and Codes (LOINC). This study integrated workers' health information scattered across different Korean institutions through an interface method, and workers' PHRs were managed through a cloud server, using Azure API for FHIR. Results: In total, 562 workers from industrial parks participated in the quantitative study. The preferred data items for PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred features were ability to access medical checkup results, health information content provision, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on, among others, life logs, vital signs, and medical checkup results; offered health care services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected improvements in user convenience and app usability proposed by 19 participants (7 health care professionals and 12 end users) in the usability evaluation. The After-Scenario Questionnaire (ASQ) was evaluated with a mean score of 5.90 (SD 0.34) out of 7, and the System Usability Scale (SUS) was evaluated a mean score of 88.7 (SD 4.83) out of 100. Conclusions: The worker-centered PHR app integrates workers' health information from different institutions and provides a variety of health care services from linked institutions through workers' shared PHR. This app is expected to increase workers' autonomy over their health information and support medical personnel's decision making regarding workers' health in the workplace. Particularly, the app will provide solutions for current major PHR challenges, and its design, which considers the user's perspective, satisfies the prerequisites for its utilization in occupational health.
Language	English
Publishing date	2021-08-04
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2798261-0
ISSN	2291-9694
ISSN	2291-9694
DOI	10.2196/29184
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Article: Biliary ascariasis - A vicious cycle.

Che Husin, Nurfariza / Mohamad, Ikhwan Sani / Ho, Kah Yee / Soh, Jien Yen / Syed Aziz, Syed Hassan / Zakaria, Zaidi

Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

2021 Volume 16, Issue 2, Page(s) 83–85

Abstract: Biliary ascariasis is a rare disease in a non-endemic area. However, it is one of the possible etiological factors for retarded growth as well as malnutrition in children. It may cause intestinal obstruction, appendicitis, biliary obstruction, liver ... ...

Abstract	Biliary ascariasis is a rare disease in a non-endemic area. However, it is one of the possible etiological factors for retarded growth as well as malnutrition in children. It may cause intestinal obstruction, appendicitis, biliary obstruction, liver abscess, hepatolithiasis, and pancreatitis in adults. Herein, we report a patient with ascending cholangitis secondary to biliary ascariasis who was successfully managed with Endoscopic Retrograde Cholangio Pancreaticography.
Language	English
Publishing date	2021-05-27
Publishing country	Malaysia
Document type	Case Reports
ZDB-ID	2265769-1
ISSN	1985-207X
ISSN	1985-207X
DOI	10.51866/cr1078
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Article ; Online: Emergency Laparoscopic Cholecystectomy: Is Dedicated Hot Gall Bladder List Cost Effective?

Khan, Saad Ullah / Soh, Jun Yi / Muhibullah, Nazli / Peleki, Aikaterini / Abdullah, Muhammad / Waterland, Peter William

Journal of Ayub Medical College, Abbottabad : JAMC

2019 Volume 31, Issue 1, Page(s) 3–7

Abstract: Background: Acute presentation of gall stone disease is a common emergency. Resource limitation often results in unnecessary long waiting times and repeat hospital admissions. The aim of this study was to investigate if funding a dedicated hot gall ... ...

Abstract	Background: Acute presentation of gall stone disease is a common emergency. Resource limitation often results in unnecessary long waiting times and repeat hospital admissions. The aim of this study was to investigate if funding a dedicated hot gall bladder list is justified. Methods: Patients with acute gall stone related complications between 1st January 2016 and 31st December 2017 were studied. Outcome measures included the number of acute admissions, length of hospital stay (LOS), approximate cost per patient. The length of stay was identified as a critical outcome measure. Results: Fourteen hundred and ninety-five (11%) out of 14189 acute surgical admissions were related to gall stone complications. These included acute cholecystitis 576 (39%), biliary colic 485 (32%), pancreatitis 405 (27%) and jaundice 34 (2%). Twelve hundred and twenty-two patients accounted for 1461 admissions. 182 (15%) patients had recurrent admissions (35%) and on average stayed 11.2 days in the hospital compared to 5.8 days for that of single presentation. The cost of emergency LC (£2053) was less than half of elective LC following single emergency admission (£5661) and less than one third of Elective LC following recurrent admissions (£7453). A trust can save £1,891,784 per year by achieving 80% target. The savings can be used to fund a dedicated hot gall bladder list, releasing hospital beds and additional benefit of reducing the workforce days lost to sickness in general. Conclusions: Emergency LC is cost effective and savings made for such a service is sufficient to fund a dedicated hot gall bladder list..
MeSH term(s)	Cholecystectomy, Laparoscopic/economics ; Cost Savings ; Cost-Benefit Analysis ; Elective Surgical Procedures/economics ; Emergencies/economics ; Female ; Gallstones/complications ; Gallstones/surgery ; Hospital Costs/statistics & numerical data ; Humans ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Patient Admission/economics ; Patient Admission/statistics & numerical data
Language	English
Publishing date	2019-01-17
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	2192473-9
ISSN	1819-2718 ; 1025-9589
ISSN (online)	1819-2718
ISSN	1025-9589
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Zs.A 6109: Show issues

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Article ; Online: An Evaluation of the Mechanisms of Galacto-Oligosaccharide (GOS)-Induced IgE Cross-Linking on Basophils in GOS Allergy.

Lee, Li Yuan Gabriella Nadine / Leow, Si Yuan / Wen, Hongmei / Soh, Jian Yi / Chiang, Wen Chin / Zhong, Youjia / Tham, Elizabeth Huiwen / Loh, Wenyin / Delsing, Dianne J / Lee, Bee Wah / Huang, Chiung-Hui

Frontiers in allergy

2022 Volume 3, Page(s) 840454

Abstract: The prebiotics, galacto-oligosaccharides (GOS), are small carbohydrate molecules with 1-7 galactose units linked to glucose and have been shown to trigger IgE-mediated anaphylaxis in some cases following ingestion. It is still an unresolved question of ... ...

Abstract	The prebiotics, galacto-oligosaccharides (GOS), are small carbohydrate molecules with 1-7 galactose units linked to glucose and have been shown to trigger IgE-mediated anaphylaxis in some cases following ingestion. It is still an unresolved question of how GOS cross-links IgE on basophils. In this study, we examined whether human galectins, a class of lectins that bind specifically to β-galactoside carbohydrates, are involved in GOS-induced basophil activation. Basophil activation test to GOS and control allergen,
Language	English
Publishing date	2022-02-28
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-6101
ISSN (online)	2673-6101
DOI	10.3389/falgy.2022.840454
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