Although OR and PACU are not designed for long-term care of critically ill patients, they may be adapted for ICU use with careful planning in the current pandemic.
  Obesity has been shown to be associated with adverse outcomes in viral infections such as influenza, but previous studies on coronavirus disease 2019 (COVID-19) had mixed results. The aim of this systematic review is to investigate the relationship between COVID-19 and obesity.
 
  We performed a systematic review and meta-analysis. A literature search of MEDLINE, EMBASE, Scopus, Web of Science, CENTRAL, OpenGrey and preprint servers medRxiv and bioRxiv was performed, with no restriction on language or date of publication. Primary outcomes of this study were intensive care unit (ICU) admission or critical disease, severe disease and mortality. Secondary outcome was a positive COVID-19 test. Meta-analysis was performed using OpenMeta-Analyst software, and heterogeneity was tested using Cochran's Q test and I2 statistic. The study protocol was registered on PROSPERO (CRD42020184953).
 
  A total of 1,493 articles were identified and 61 studies on 270,241 patients were included. The pooled prevalence of obesity wausceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and infected patients should be monitored closely for adverse outcomes.
  Advanced breast cancer (ABC) remains common in Singapore. In 2019, 22.1% of breast cancer patients presented with ABC in our institution. Despite increasing affluence and the advent of national mammographic screening, the incidence of ABC has not changed significantly. This suggests inherent differences in women who present late. We aim to explore the socio-economic background, knowledge and attitudes of women who present with ABC.
 
  Between December 2013 and July 2015, 100 patients who presented consecutively with ABC in a tertiary institution in Singapore were recruited to participate in an interviewer-led questionnaire exploring psychosocial and economic issues.
 
  Among the 100 patients, 63 and 37 presented with stages 3 and 4 breast cancer respectively. Median age was 57 (27-86), 52% had at least secondary education, 53% had no formal employment and 71% were married; 88% were aware of breast cancer symptoms, 82% were aware that mammography can help detect cancer, 82% believed that current treatment modality for breast cancer is effective, 96% had never undergone a mammography and 52.9% felt mammograms were unnecessary. A total of 64% presented symptomatic from the breast tumour, with a median duration of 3 months. Many of the patients were aware of breast cancer symptoms and the utility of mammography. However, a group of patients did not comply with screening. This may be due to poor understanding about breast screening and detection in its asymptomatic phase.
 
  Further public education to improve understanding of breast cancer and screening mammography may help to improve rates for earlier detection of breast cancer.
 Further public education to improve understanding of breast cancer and screening mammography may help to improve rates for earlier detection of breast cancer.
  This study aims to examine the factors associated with self-reported hearing disability and early reduction in disability after first-time hearing aid (HA) fitting in Singapore.
 
  Retrospective record review of 1,068 subjects issued with HAs at a tertiary hospital from 2001 to 2013.
 
  Subjects reporting ≥5 disabilities reduced from 90% to 24% after HA fitting. 'Difficulty hearing in noise' was the commonest disability before and after HA fitting, while 'needs to increase volume of TV/radio' was the disability with most improvement after fitting. In multivariable models, having worse pure tone audiometry (PTA) thresholds of the better hearing ear and being ethnically Chinese were associated with subjects reporting more hearing disabilities. A higher proportion of subjects reported a reduction rather than an absence of disability after HA fitting. In multivariable models, daily HA usage for ≥4 hours, sensorineural hearing loss (HL) and worse PTA thresholds of the better hearing ear were associated with reduct of patients' expectations could focus on reducing rather than eliminating disability.
  Pericardiocentesis is a potentially life-saving procedure. We compared two low-cost models-an agar-based model and a novel model, Centesys-in terms of ultrasound image quality and realism, effectiveness of the model, and learners' confidence and satisfaction after training.
 
  In this pilot randomised 2x2 crossover trial stratified by physician seniority, participants were assigned to undergo pericardiocentesis training either with the agar-based or Centesys model first, followed by the other model. Participants were asked to rate their confidence in performing ultrasound-guided pericardiocentesis, clarity and realism of cardiac structures on ultrasound imaging, and satisfaction on a 7-point Likert scale before and after training with each model.
 
  Twenty participants with median postgraduate year of 4 (interquartile range [IQR] 3.75-6) years were recruited.  https://www.selleckchem.com/products/bpv-hopic.html  Pre-training, participants rated themselves a median score of 2.5 (IQR 2-4) for level of confidence in performing pericardiocentesis, which improved to 5 (IQR 4-6) post-training with Centesys (
  =0.007). Centesys was recognised to be more realistic in simulating cardiac anatomy on ultrasound (median 5 [IQR 4-5] versus 3.5 [IQR 3-4], 
  =0.002) than the agar-based model. There was greater satisfaction with Centesys (median 5 [IQR 5-6] versus 4 [IQR 3.75-4], 
  <0.001). All 20 participants achieved successful insertion of a pericardial drain into the simulated pericardial sac with Centesys.
 
  Centesys achieved greater learner satisfaction as compared to the agar-based model, and was an effective tool for teaching ultrasound-guided pericardiocentesis and drain insertion.
 Centesys achieved greater learner satisfaction as compared to the agar-based model, and was an effective tool for teaching ultrasound-guided pericardiocentesis and drain insertion.
  To describe the maternal and fetal outcomes in systemic lupus erythematosus (SLE) pregnancies followed-up in a single tertiary referral centre.
 
  We performed a retrospective cohort study of 75 SLE pregnancies who were followed up in Singapore General Hospital over a 16-year period from 2000 to 2016. Adverse fetal and maternal outcomes including preterm delivery, miscarriages, fetal growth restriction, congenital heart block, neonatal lupus, pre-eclampsia and SLE flares were obtained from the medical records.
 
  The mean age at conception was 32 years old (SD 3.8). The mean SLE disease duration was 5.9 years (SD 5.2). The majority (88%) had quiescent SLE disease activity at baseline. Most pregnancies resulted in a live birth (74.7%). The mean gestational age at birth was 37.4 weeks (SD 3.4). Adverse fetal outcomes occurred in 53.3%. Preterm delivery (33.9%), miscarriages (20%) and fetal growth restriction (17.3%) were the most frequent adverse fetal outcomes. There was 1 neonatal death and SLE flares occurred in a third (33%).