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31 July - 2 August 2015 the Academia @ Singhealth AAMS Annals of the Academy of Medicine, Singapore VOLUME 44 (SUPPLEMENT) NUMBER 7 SMCM 2015 JULY 2015 31 July - 2 August 2015 The Academia @ SingHealth www.smcm-ams.com Annals, Academy of Medicine, Singapore 81 Kim Keat Road, #11-00 & #12-00 NKF Centre, Singapore 328836 ORGANISED BY Tel: +65 6593 7800 Fax: +65 6593 7867 E-mail: [email protected] Homepage: http://www.annals.edu.sg ACADEMY OF MEDICINE SINGAPORE Annals Editorial Board Specialist Advisory Panel Editor Balram Chowbay Eng King Tan Fun Gee Chen Tou Choong Chang Deputy Editors Kok Yong Fong Erle CH Lim Kei Siong Khoo Hui Kim Yap London Lucien Ooi Bien Soo Tan Associate Editors Hugo van Bever Beng Yeong Ng Pierce KH Chow Emeritus Editor International Advisory Panel Vernon MS Oh Juliana C N Chan, Hong Kong, SAR China Richard N Fine, USA Board Members Yik Hong Ho, Australia Charles Chuah Edward Holmes, Singapore Chiea Chuen Khor Richard H Hunt, Canada Tchoyoson CC Lim Ranga Krishnan, Singapore Richard Sim Edison Liu, Singapore Min Han Tan Harvey Marcovitch, UK Stacey KH Tay Albert Singer, UK Immediate Past Editor Vernon MS Oh A Editorial Executives A Harcharan Kaur C Shih Hui Lim Noorazleena Bte Shahri C Kei Siong Khoo A A D D E E M M Y Y O O F F M M E E D D I I C C I I N N We welcome submissions of cover images from Fellows and Friends of the Academy of Medicine for consideration E for publication. Do submit interesting or unusual photographs or digitised images of original artwork, accompanied E by a short write-up of about 30 words. S S I Format: 8 by 12 cm, resolution of at least 300 dpi, in JPEG or TIFF. Please email your submission to [email protected] I N N G G A A Printed by Straits Printers (Pte) Ltd P P O O ISSN 0304-4602 MCI(P) 041/11/2014 R R E E 1 Annals, Academy of Medicine, Singapore Vol. 44 (Suppl) No. 7 July 2015 Proceedings of 49th Singapore Malaysia Congress of Medicine 2015 Contents Lectures 22nd Gordon Arthur Ransome Oration.........................................................................................................S1 18th Rumme Shaw Memorial Lecture...........................................................................................................S1 25th Seah Cheng Siang Memorial Lecture....................................................................................................S1 12th College of Physicians Singapore Lecture.............................................................................................S1 Speakers’ Abstracts Neurological Emergencies Update..............................................................................................................S3 Initial Management of Sepsis......................................................................................................................S3 Surgical Residency Training: “Winds of Change? Quality vs Quantity”...................................................S4 Care of Persons Lacking Capacity – Ethical/Legal Issues.........................................................................S5 Sports Medicine Symposium on Platelet Rich Plasma................................................................................S6 Pain Management and Medicine Symposium..............................................................................................S7 Medico-Legal Symposium...........................................................................................................................S8 Borderline Personality Disorder Symposium..............................................................................................S9 Intensive Primary Care: Managing Patients with Complex Needs Outside the Hospital..........................S9 Defi ning the Art of Counselling Within the Consultation: Brief Integrative Personalised Therapy (BIPT) ........................................................................................................................................S10 Oral Presentation.............................................................................................................................................S11 Poster Presentation..........................................................................................................................................S21 Young Surgeon’s Award...................................................................................................................................S34 Index of First Author.......................................................................................................................................S40 Organised by: ACADEMY OF MEDICINE SINGAPORE July 2015, Vol. 44 (Suppl) No. 7 Lectures 22nd Gordon Arthur Ransome Oration the exact mechanisms how brain cells communicate with each other within the most intricate biological systems L1 Is Medicine Still an Art? and the variable presentation of brain dysfunction and James Best disorders. Lee Kong Chian School of Medicine, Nanyang Technologicial University, Singapore Historically, much of the clinical discovery in neurological Advances in science and technology over the past 50 disorders has been based on astute identifi cation of years have transformed medical practice and we are neurological signs and symptoms and iconic neurological on the threshold of an era of precision medicine using syndromes have served as maxims for neurological genetic and molecular profi ling. There is no doubt about education. However, advances in molecular science and the great progress in medicine as a science which now genetics have challenged the classifi cation of neurological distinguishes the capabilities of doctors from those of syndromes based on clinical symptoms and signs, and other healing professions. But what about the art of many clinical diagnostic criteria need to be redefi ned. medicine? Do observational and clinical diagnostic skills Genetics have and will continue to infl uence treatment remain important in the scientifi c age? Are the roles of the options and change the clinical paradigm for many doctor as confi dante, advisor, comforter and even friend neurological disorders. In future precision medicine, redundant in this computerised world? Furthermore, are genetic testing will offer quicker and better diagnosis and the interpersonal skills that have underpinned medicine as potential therapeutic opportunities. We need to prepare and a caring profession innate or can they be learned? What is equip ourselves with the appropriate scientifi c knowledge the role of a medical school in imbuing our students with within the context of the larger ethical, social, legal and the traditional values of the medical profession? What psychological considerations in embracing these changes innovative approaches can we take to achieve this goal in our clinical practice. in the context of modern society? These are all questions that are important to defi ning and maintaining the art of medicine. My contention is that the attributes that make a 12th College of Physicians Singapore Lecture “good doctor” still include the human skills and the humane ethos demonstrated by Dr Gordon Arthur Ransome. L4 Acute Medicine – Past, Present and Future Derek Bell The Royal College of Physicians of Edinburgh, UK th 18 Rumme Shaw Memorial Lecture Acute Medicine initially developed in the United Kingdom L2 Scientifi c Basis of Cancer Care and was established as a specialty in 2003. Since then, it Soo Khee Chee has become the largest growing specialty within the United National Cancer Centre, Singapore Kingdom and has spread throughout parts of Europe and internationally. Acute medical care was established to (Abstract not available at time of publication) ensure the patients admitted as a medical emergency were managed in a well staffed and well equipped environment that could provide prompt assessment and treatment to 25th Seah Cheng Siang Memorial Lecture improve outcomes for patients. L3 Genes & the Brain: Changing the Clinical Paradigm Several reports have been produced based on acute Tan Eng King1,2,3,4 medical care; the most infl uential of which was the Royal 1National Neuroscience Institute, Singapore College of Physicians report published in 2007. This 2Duke NUS Graduate Medical School, Singapore 3Lee Kong Chian School of Medicine, Singapore made a number of key recommendations particularly in 4National Medical Research Council, Singapore relation to patient safety with a major recommendation to establish and deliver a unifi ed national early warning It has taken millions of years for the evolution from scoring system to assess illness severity. In addition to primitive human ancestor to modern day humans. The this, the acute medical unit is a specifi c geography and structure and complexity of the human brain represent recommendations were made into appropriate facilities one of the most striking last frontiers of modern medicine. and equipment which should support the infrastructure Despite technological advances, much is still unknown on of a dedicated acute medical unit. July 2015, Vol. 44 (Suppl) No. 7 S1 Importantly, the acute medical team in an acute medical unit were identifi ed as an essential part of undergraduate and postgraduate medical education and should have an appropriate training environment as well as consultant supervision. Acute Medicine is therefore a thriving specialty within the United Kingdom which is continuing to grow. For this to develop further, the evidence base and academic content of Acute Medicine must become fi rmly established. S2 Annals Academy of Medicine Speakers’ Abstracts Neurological Emergencies
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