A5018104934- Acute Ischemic Stroke Management
- Multiple Sclerosis Research Studies
- Cerebrovascular and Carotid Artery Diseases
- Peripheral Neuropathies and Disorders
- Bacterial Infections and Vaccines
- Clinical Reasoning and Diagnostic Skills
- Autoimmune Neurological Disorders and Treatments
- Infectious Encephalopathies and Encephalitis
- Traumatic Brain Injury and Neurovascular Disturbances
- Hereditary Neurological Disorders
- Ophthalmology and Eye Disorders
- Polyomavirus and related diseases
- MRI in cancer diagnosis
- Mosquito-borne diseases and control
- Mitochondrial Function and Pathology
- Venous Thromboembolism Diagnosis and Management
- SARS-CoV-2 and COVID-19 Research
- Cell Image Analysis Techniques
- Ultrasound and Hyperthermia Applications
- Sympathectomy and Hyperhidrosis Treatments
- Immune responses and vaccinations
- Interprofessional Education and Collaboration
- Long-Term Effects of COVID-19
- Glycogen Storage Diseases and Myoclonus
- Medical Imaging and Analysis
National University Hospital
2013-2025
National University of Singapore
2014-2025
National University Health System
2014-2025
Ng Teng Fong General Hospital
2025
Raffles Institution
2016
Neurosciences Institute
2016
National Neuroscience Institute
2016
Heidelberg University
2014
Queen's Medical Centre
2011
University of Bari Aldo Moro
2008
In a 2-year, placebo-controlled trial (the Natalizumab Safety and Efficacy in Relapsing Remitting Multiple Sclerosis [AFFIRM] study), involving 942 patients with relapsing multiple sclerosis (MS), natalizumab significantly reduced the relapse rate by 68% progression of sustained disability 42% vs placebo. We report effect on MRI measures from AFFIRM study.The number volume gadolinium (Gd)-enhancing, new or enlarging T2-hyperintense, T1-hypointense lesions brain parenchymal fraction were...
This case series reports three patients initially managed for presumed infectious meningoencephalitis, who were ultimately diagnosed with myelin oligodendrocyte glycoprotein associated disease (MOGAD). Their clinical presentations strikingly similar to those of acute which posed a challenge the initial diagnostic process. Notably, despite absence typical radiological changes MOGAD, such as cerebral cortical encephalitis, these exhibited focal neurological and electroencephalographic changes....
Few attempts have been made to detect subtle blood-brain barrier (BBB) leakage in visibly non-enhancing MRI lesions multiple sclerosis (MS). For 19 patients, longitudinal relaxation time (T1) maps were generated from scans obtained before, and at 20, 40 60 minutes after injection of gadolinium (Gd)-DTPA (0.3 mmol/kg). Regions interest (ROI) placed around lesions, paired contralateral normal appearing brain tissue (NABT). Post-Gd rate R1 (=1/T1) rise (DeltaR1/Deltat), was used quantify...
We compared intracranial collaterals on pretreatment and day 2 brain CT angiograms (CTA) to assess their evolution relationship with functional outcomes in acute ischemic stroke (AIS) patients treated IV tissue plasminogen activator (tPA).Consecutive AIS who underwent CTA received tPA during 2010-2013 were included. Collaterals evaluated by independent neuroradiologists using 3 predefined criteria: the Miteff system, Maas 20-point collateral scale Alberta Stroke Program Early Score...
Headache accompanied by eosinophilia in blood or CSF presents a complex clinical challenge. We present case of 26-year-old woman with headache, peripheral meningeal enhancement, and intracranial vasculopathy on imaging. This illustrates systematic approach to patient meningitis, eosinophilia, cerebral vasculitis, which includes comprehensive history taking appropriate investigative workup differentiate between infectious noninfectious causes timely tissue sampling conclusively determine the...
<h3>Objective</h3> Clinical and immunological evaluation of 'incomplete' Bickerstaff brainstem encephalitis (BBE). <h3>Methods</h3> We studied two patients with postinfectious syndromes who presented at National University Hospital Singapore. Laboratory work-up included measurement antiganglioside antibodies. <h3>Results</h3> Both displayed hypersomnolence cerebellar-like ataxia in the absence external ophthalmoplegia carried high serum titres IgG anti-GQ1b antibodies, strongly indicative...
This article presents findings from a simulation-based interprofessional education (IPE) program involving trainee advanced practice nurses (APNs) and internal medicine residents (IMRs) based in Singapore. Trainee APNs IMRs participated semester-long series of high-fidelity simulations medical emergencies. Learners' attitudes toward the IPE intervention were assessed using validated Likert scaled surveys written comments. Overall satisfaction was high among learners, with strongly positive...
WHAT IS HEADACHE?Headache is the symptom of pain anywhere in region head or neck. HOW RELEVANT THIS TO MY PRACTICE?Headache a common presentation primary care.It affects patients' work, relationships and social activities, exacts significant financial cost. (1)(2(3)(4)(5)(6) While headaches make up 5% global disease burden terms disability, (7) Singapore lifetime prevalence headache has been reported to be 82.7%, that migraine 9.3%. (8) In addition, it appears medication overuse...
A considerable number of people with multiple sclerosis (pwMS) live in low- and middle-income countries (LMIC), where lack resource adversely affects access to effective disease-modifying treatment.The objective this commentary is propose a useful cost-effective treatment option for pwMS LMIC potential high efficacy convenience the treating physician.Viewpoint: We using generic 2-chloro-2'-deoxyadenosine (cladribine), small molecule licensed hairy cell leukaemia, as solution significant...
Abstract Central nervous system (CNS) infections cause substantial morbidity and mortality worldwide, with mounting concern about new emerging neurologic infections. Stratifying etiologies based on initial clinical laboratory data would facilitate etiology-based treatment rather than relying empirical treatment. Here, we report the epidemiology outcomes of patients CNS from a prospective surveillance study that took place between 2013 2016 in Singapore. Using multiple correspondence analysis...
Stroke is a significant cause of death and disability in Singapore; 2014, it was the fourth most common death. Transient ischaemic attack (TIA) defined as transient episode neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without evidence acute infarction. The diagnosis TIA/acute stroke needs to be considered all patients who present with sudden dysfunction. Prompt referral for assessment, neuroimaging intervention provides best chance recovery and/or...
Intractable vomiting or hiccups is fairly common in neuromyelitis optica spectrum disease (NMOSD) due to involvement of the area postrema that houses medullary centers.
A 46-year-old Chinese man with diabetes mellitus, hypertension, and hyperlipidemia, developed sudden onset of vertiginous dizziness diplopia that was worse on looking up. His symptoms were not preceded by any antecedent infections, neither there headache. Blood pressure arrival in the Emergency Department 145/95 mm Hg his neurologic examination revealed bilateral upward gaze restriction (video Neurology ® Web site at [Neurology.org][1]). There voluntary lid retraction patient. The pupils 3...