Displaying publications 721 - 740 of 1323 in total

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  1. Koo SH, Ho WF, Lee EJ
    Br J Clin Pharmacol, 2006 Mar;61(3):301-8.
    PMID: 16487223
    To determine the genetic variability of long QT syndrome (LQTS)-associated genes (KCNQ1, HERG, KCNE1 and KCNE2) among three distinct ethnic groups in the Singapore population.
    Matched MeSH terms: Singapore/epidemiology
  2. Siow WM, Chin PL, Chia SL, Lo NN, Yeo SJ
    Clin Orthop Relat Res, 2013 May;471(5):1451-7.
    PMID: 23299954 DOI: 10.1007/s11999-012-2776-7
    There is marked racial disparity in TKA use rates, demographics, and outcomes between white and Afro-Caribbean Americans. Comparative studies of ethnicity in patients undergoing TKAs have been mostly in American populations with an underrepresentation of Asian groups. It is unclear whether these disparities exist in Chinese, Malays, and Indians.
    Matched MeSH terms: Singapore/epidemiology
  3. Chua Y, Limpaphayom KK, Cheng B, Ho CM, Sumapradja K, Altomare C, et al.
    Climacteric, 2017 Aug;20(4):367-373.
    PMID: 28453308 DOI: 10.1080/13697137.2017.1315091
    OBJECTIVES: The Pan-Asian REVIVE survey aimed to examine women's experiences with genitourinary syndrome of menopause (GSM) and their interactions with health-care professionals (HCPs).

    METHODS: Self-completed surveys were administered face-to-face to 5992 women (aged 45-75 years) in Indonesia, Malaysia, Singapore, Taiwan, and Thailand.

    RESULTS: Of 638 postmenopausal women with GSM symptoms, only 35% were aware of the GSM condition, most of whom first heard of GSM through their physician (32%). The most common symptoms were vaginal dryness (57%) and irritation (43%). GSM had the greatest impact on sexual enjoyment (65%) and intimacy (61%). Only 25% had discussed their GSM symptoms with a HCP, and such discussions were mostly patient-initiated (64%) rather than HCP-initiated (24%). Only 21% had been clinically diagnosed with GSM and only 24% had ever used treatment for their symptoms. Three-quarters of those who had used treatment for GSM had discussed their symptoms with a HCP compared to only 9% of those who were treatment-naïve.

    CONCLUSION: GSM is underdiagnosed and undertreated in Asia. As discussion of GSM with HCPs appears to be a factor influencing women's awareness and treatment status, a more active role by HCPs to facilitate early discussions on GSM and its treatment options is needed.

    Matched MeSH terms: Singapore/epidemiology
  4. Lim RBT, Cheung ONY, Tham DKT, La HH, Win TT, Chan R, et al.
    Global Health, 2018 04 16;14(1):36.
    PMID: 29661249 DOI: 10.1186/s12992-018-0358-5
    BACKGROUND: There is an increasing global movement of foreign female entertainment workers (FEWs), a hard-to-reach population vulnerable to HIV/STIs. This paper described the needs assessment phase before intervention implementation where the socio-organisation, sexual risk behaviours and access to health services of foreign FEWs in Singapore were explored. We also highlighted how qualitative inquiry, census enumeration technique and community-based engagement approaches were used to gain access and to develop a culturally appropriate STI prevention intervention.

    METHODS: In-depth interviews, observations, informal conversational interviews, mystery client and critical incident technique were used. We estimated the size of FEW population using the census enumeration technique. The findings were used to inform intervention development and implementation.

    RESULTS: We estimated 376 Vietnamese and 330 Thai FEWs in 2 geographical sites where they operated in Singapore. Their reasons for non-condom use included misconceptions on the transmission and consequences of STI/HIV, low risk perception of contracting HIV/STI from paid/casual partner, lack of skills to negotiate or to persuade partner to use condom, unavailability of condoms in entertainment establishments and fear of the police using condom as circumstantial evidence. They faced difficulties in accessing health services due to fear of identity exposure, stigmatisation, cost and language differences. To develop the intervention, we involved FEWs and peer educators, and ensured that the intervention was non-stigmatising and met their needs. To foster their participation, we used culturally-responsive recruitment strategies, and ensured that the trial was anonymous and acceptable to the FEWs. These strategies were effective as we achieved a participation rate of 90.3%, a follow-up rate of 70.5% for the comparison and 66.8% for the intervention group. The interventions group reported a significant increase in consistent condom use with a reduction in STI incidence compared to no significant change in the comparison group.

    CONCLUSIONS: The qualitative inquiry approaches to gain access, to foster participation and to develop a culturally appropriate intervention, along with the census enumeration technique application to estimate the FEW population sizes has led to successful intervention implementation as well as safer sexual behaviour and STI incidence reduction.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT02780986 . Registered 23 May 2016 (retrospectively registered).

    Matched MeSH terms: Singapore/epidemiology
  5. Whitton C, Ho JCY, Tay Z, Rebello SA, Lu Y, Ong CN, et al.
    Nutrients, 2017 Sep 25;9(10).
    PMID: 28946670 DOI: 10.3390/nu9101059
    The assessment of diets in multi-ethnic cosmopolitan settings is challenging. A semi-quantitative 163-item food frequency questionnaire (FFQ) was developed for the adult Singapore population, and this study aimed to assess its reproducibility and relative validity against 24-h dietary recalls (24 h DR) and biomarkers. The FFQ was administered twice within a six-month interval in 161 adults (59 Chinese, 46 Malay, and 56 Indian). Fasting plasma, overnight urine, and 24 h DR were collected after one month and five months. Intra-class correlation coefficients between the two FFQ were above 0.70 for most foods and nutrients. The median correlation coefficient between energy-adjusted deattenuated FFQ and 24 h DR nutrient intakes was 0.40 for FFQ1 and 0.39 for FFQ2, highest for calcium and iron, and lowest for energy and carbohydrates. Significant associations were observed between urinary isoflavones and soy protein intake (r = 0.46), serum carotenoids and fruit and vegetable intake (r = 0.34), plasma eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) and fish/seafood intake (r = 0.36), and plasma odd chain saturated fatty acids (SFA) and dairy fat intake (r = 0.25). Associations between plasma EPA + DHA and fish/seafood intake were consistent across ethnic groups (r = 0.28-0.49), while differences were observed for other associations. FFQ assessment of dietary intakes in modern cosmopolitan populations remains feasible for the purpose of ranking individuals' dietary exposures in epidemiological studies.
    Matched MeSH terms: Singapore/epidemiology
  6. Lim RB, Tham DK, Cheung ON, Tai BC, Chan R, Wong ML
    BMC Infect Dis, 2016 12 19;16(1):763.
    PMID: 27993135 DOI: 10.1186/s12879-016-2088-8
    BACKGROUND: Late presentation of human immunodeficiency virus (HIV) is associated with heterosexual transmission, particularly among heterosexual men in Asia. Although data on HIV/sexually transmitted infection (STI) testing behaviour is increasing, information is still lacking among heterosexual men who receive far lesser attention and are generally invisible in HIV/ STI prevention, particularly in the Asian urban setting. The aim of this study was to assess the prevalence of HIV/STI testing among heterosexual men patronising entertainment establishments (EEs) who engaged in casual or paid sex in Singapore, and the factors associated with this behaviour.

    METHODS: This was a cross-sectional survey involving 604 participants using time location sampling between March and May 2015. For multivariable analysis, we used a mixed effects Poisson regression model with backward stepwise approach to account for clustering by venue and to obtain the adjusted prevalence ratio (aPR) for the association of various factors with HIV/STI testing.

    RESULTS: Among 604 at-risk participants, only 163 (27.0%) had gone for HIV or STI testing in the past 6 months. Of this, 83.4% of them specifically underwent HIV testing. In multivariable analysis, HIV/STI testing increased with being non-Chinese (aPR 1.50; 95% CI: 1.08-2.06), having engaged in anal sex with casual or paid partner in the past 6 months (aPR 1.80; 95% CI: 1.27-2.57), number of partners in the past 6 months (aPR 1.03; 95% CI: 1.01-1.05) and HIV knowledge score (aPR 1.11; 95% CI: 1.05-1.16). Among those who reported non-consistent condom use with casual or paid partner, almost half of them (47.9%) perceived that they were at low risk for HIV/STI. Sigmatisation and discrimination was another common barrier for non-testing.

    CONCLUSIONS: Despite being at risk of HIV/STI, the low prevalence of testing coupled with a high prevalence of risky sexual behaviour among this group of heterosexual men in Singapore calls for a need for HIV/STI prevention interventions in the EE setting. Other than promoting testing and safer sex, the interventions should address the discordance between perceived risk and actual sexual behaviour, in addition to the stigma and discrimination associated with testing for this group.
    Matched MeSH terms: Singapore/epidemiology
  7. Thumboo J, Wu L, Leung YY
    Int J Rheum Dis, 2017 Sep;20(9):1105-1119.
    PMID: 26990791 DOI: 10.1111/1756-185X.12843
    OBJECTIVES: Hand osteoarthritis (HOA) is common but little is known about how HOA has impact on disability and quality of life (QoL).We aim to identify important domains of concern among participants suffering from symptomatic HOA in Singapore, representing an Asian socio-cultural context.
    METHODS: A qualitative study using a focus group technique was performed. We ran focus groups stratified by gender, ethnicity and language. Two independent, trained analysts identified relevant categories and assigned codes to text segments through open coding, with discrepancies resolved through consensus. The final lists of domains and subthemes descriptive of QoL were then compared to the following commonly used HOA specific instruments: Functional Index for Hand Osteoarthritis (FIHOA), Score for Assessment and quantification of Chronic Rheumatic Affections of the Hand (SACRAH), Australian/Canadian Hand Osteoarthritis Index (AUSCAN); and Health Assessment Questionnaire (HAQ).
    RESULTS: Twenty-six patients (23 women, three men; 24 Chinese and two Malay; mean ± SD age 62.9 ± 7.5 years) with symptomatic HOA according to the American College of Rheumatology Classification Criteria participated in seven focus groups. Two and five focus groups were conducted in Chinese and English, respectively. The qualitative analysis revealed pain, stiffness and functional disability as the main domains. However, psychological consequences, aesthetic concerns, participation in leisure activities, participation in family roles were important concepts from the focus groups which were not covered by existing instruments. Impact on work productivity by HOA and the unmet health care need is revealed.
    CONCLUSION: The domains of concepts important to people with HOA in an Asian socio-cultural context are not fully represented in the most commonly used instruments. Further studies on the selection of main domains relevant to HOA patients are necessary.
    Study site: Rheumatology outpatient clinic, Singapore General Hospital
    Matched MeSH terms: Singapore; Singapore/epidemiology
  8. Lim EWL, Chee ML, Sabanayagam C, Majithia S, Tao Y, Wong TY, et al.
    Invest Ophthalmol Vis Sci, 2019 05 01;60(6):1889-1897.
    PMID: 31042796 DOI: 10.1167/iovs.19-26810
    Purpose: The purpose of this study was to investigate the association between sleep (duration and quality) and symptoms of dry eye in Singapore Malay and Indian adults.

    Methods: This was a prospective cross-sectional study. A total of 3303 subjects aged 40 years and above from two large population-based cohorts, the Singapore Malay Eye Study-2 (n = 1191, 2011-2013) and the Singapore Indian Eye Study-2 (n = 2112, 2013-2015), were included. The presence of symptoms of dry eye was defined as having at least one of six symptoms often or all the time. Sleep questionnaires included the Epworth Sleepiness Scale, Berlin Questionnaire, STOP-bang questionnaire, and Insomnia Severity Index. Poor sleep quality was defined as meeting the respective questionnaire thresholds. General health questionnaires (including sleep duration) and standardized ocular and systemic tests were also used.

    Results: Of 3303 participants, 6.4% had excessive sleepiness, 20.5% had high risk for sleep apnea, 2.7% had clinical insomnia, and 7.8% had <5 hours of sleep. These sleep factors were associated with symptoms of dry eye. After adjusting for relevant demographic, medical, and social factors, the following were associated with higher odds of symptoms of dry eye: excessive sleepiness (Epworth Sleepiness Scale: odds ratio [OR] = 1.77 [1.15-2.71]), high risk of sleep apnea (Berlin Questionnaire: OR = 1.55 [1.17-2.07], STOP-Bang Questionnaire: OR = 2.66 [1.53-4.61]), clinical insomnia (Insomnia Severity Index: OR = 3.68 [2.17-6.26]) and <5 hours of sleep (OR = 1.73 [1.17-2.57], reference sleep duration 5-9 hours). Sleep apnea, insomnia, and sleep duration were each shown to be independently associated with symptoms of dry eye.

    Conclusion: Short sleep duration and poor quality are both significantly and independently associated with symptoms of dry eye.

    Matched MeSH terms: Singapore/epidemiology
  9. Moorthy V, Liu W, Chan SP, Chew STH, Ti LK
    J Diabetes, 2020 Jan;12(1):58-65.
    PMID: 31210000 DOI: 10.1111/1753-0407.12961
    BACKGROUND: Although diabetes is associated with ethnicity and worse cardiac surgery outcomes, no research has been done to study the effect of both diabetes and ethnicity on cardiac surgery outcomes in a multiethnic Southeast Asian cohort. Hence, this study aimed to delineate the association of ethnicity on outcomes after cardiac surgery among diabetics in a multiethnic Southeast Asian population.

    METHODS: Perioperative data from 3008 adult patients undergoing elective cardiac surgery from 2008 to 2011 at the two main heart centers in Singapore was analyzed prospectively, and confirmatory analysis was conducted with the generalized structural equation model.

    RESULTS: Diabetes was significantly associated with postoperative acute kidney injury (AKI) and postoperative hyperglycemia. Postoperative AKI, Malay ethnicity, and blood transfusion were associated with postoperative dialysis. Postoperative AKI and blood transfusion were also associated with postoperative arrhythmias. In turn, postoperative dialysis and arrhythmias increased the odds of 30-day mortality by 7.7- and 18-fold, respectively.

    CONCLUSIONS: This study identified that diabetes is directly associated with postoperative hyperglycemia and AKI, and indirectly associated with arrhythmias and 30-day mortality. Further, we showed that ethnicity not only affects the prevalence of diabetes, but also postoperative diabetes-related outcomes.

    Matched MeSH terms: Singapore/epidemiology
  10. Liu R, Tang AM, Tan YL, Limenta LM, Lee EJ
    Eur J Clin Pharmacol, 2009 Jan;65(1):65-70.
    PMID: 18766334 DOI: 10.1007/s00228-008-0488-4
    OBJECTIVES: The aims of this study were to characterize the population frequency of PEPT2 (SLC15A2) polymorphic variants in three Asian ethnic populations, namely Chinese, Malay and Asian Indian, and to investigate the associations of ethnicity (Chinese vs. Asian Indian), PEPT2 haplotype and cephalexin pharmacokinetics in healthy Asian subjects.

    METHODS: PEPT2 polymorphisms were screened from a cohort of 96 Chinese, 96 Malay and 96 Asian Indian subjects. Cephalexin (1000 mg, orally) pharmacokinetics was characterized in an additional 15 Chinese and 15 Asian Indian healthy subjects. These 30 subjects were subsequently genotyped for their PEPT2 polymorphisms.

    RESULTS: In total, ten common single nucleotide polymorphisms (SNPs) were detected in the three populations, forming two PEPT2 haplotypes. There were significant ethnic differences in PEPT2 haplotype distribution: the frequencies of the *1 and *2 alleles were 0.307 and 0.693 in the Chinese population, 0.495 and 0.505 in the Malay population and 0.729 and 0.271 in Asian Indian population, respectively. The C (max) of cephalexin was significantly lower in the Chinese (29.80 +/- 4.09 microg ml(-1)) population than in the Asian Indian one (33.29 +/- 4.97 microg ml(-1); P = 0.045). This difference could be explained by the higher average body weight of the Chinese population. There was no other significant difference in cephalexin pharmacokinetics between either ethnic or PEPT2 genotype groups.

    CONCLUSION: PEPT2 polymorphism distributions differ significantly between Chinese, Malay and Asian Indian populations. However, cephalexin pharmacokinetics is not meaningfully different between Chinese and Asian Indians. The association between the PEPT2 haplotype and cephalexin pharmacokinetics could not be confirmed, and future studies under better controlled conditions are needed.

    Matched MeSH terms: Singapore/epidemiology
  11. Lee WR
    Diabetes Res Clin Pract, 2000 Oct;50 Suppl 2:S35-9.
    PMID: 11024582 DOI: 10.1016/s0168-8227(00)00184-4
    Diabetes mellitus has been on the rise in Singapore, while Singaporeans are becoming more affluent, our lifestyles are more sedentary and our population is ageing rapidly. The prevalence of diabetes mellitus rose from 2% in 1975 to 4.7% in 1984, 8.6% in 1992 and 9.0% of adults 18-69 years old in 1998. Malay and Indian women and Indian men were at higher risk, with 14.3, 14.9 and 16.7% prevalence rates, respectively. A further 15% of the adult population have impaired glucose tolerance (IGT). Diabetes was a factor in 39.7% of strokes and in 9.3% of all deaths in Singapore, and is the sixth most common cause of death. In the Diabcare Singapore 1998 Study, 91% of participants were diagnosed with Type 2 diabetes, with mean BMI of 25.1+/-4.4 kg/m(2). The incidence of Type 1 diabetes in childhood is 2.46 per 100000 children 0-12 years of age, while Type 2 diabetes in childhood is an emerging problem. The prevalence of obesity (BMI >30 kg/m(2)) among persons aged 18-69 years rose to 6% in 1998, up from 5.1% in 1992. The prevalence of obesity was highest among the Malays (16.2%) followed by the Indians (12.2%) and the Chinese (3.8%). About 12% of schoolchildren are obese. Increased efforts must be made to change lifestyle and eating patterns in our society, reduce childhood obesity and encourage adults to make lifelong sports and exercise part of the Singaporean way of life. Singapore has one of the world's fastest ageing populations, and even now, 32.4% of Singaporeans 60-69 years of age have diabetes. We should consider screening for diabetes in obese schoolchildren and seek to improve quality of care for people with diabetes, including enlisting the aid of community organisations to improve access to diabetes education, monitoring, support and complications screening services.
    Matched MeSH terms: Singapore/epidemiology
  12. Fung FY, Koh YLE, Malhotra R, Ostbye T, Lee PY, Shariff Ghazali S, et al.
    BMC Geriatr, 2019 04 29;19(1):122.
    PMID: 31035928 DOI: 10.1186/s12877-019-1137-8
    BACKGROUND: Sarcopenia is the age-related loss of muscle mass and function, which increases fall risks in older persons. Hyperglycemia relating to Type-2 Diabetes Mellitus (T2DM) is postulated to aggravate sarcopenia. This study aimed to determine the prevalence of sarcopenia among ambulatory community-dwelling older patients, aged 60-89 years, with T2DM in a primary care setting and to identify factors which mitigate sarcopenia.

    METHODS: A total of 387 patients were recruited from a public primary care clinic in Singapore. Data on their socio-demography, clinical and functional status, levels of physical activity (International Physical Activity Questionnaire) and frailty status was collected. The Asian Working Group for Sarcopenia (AWGS) criteria were used to define sarcopenia based on muscle mass, grip strength and gait speed.

    RESULTS: The study population comprised men (53%), Chinese (69%), mean age = 68.3 ± SD5.66 years, lived in public housing (90%), had hypertension (88%) and dyslipidemia (96%). Their mean muscle mass was 6.3 ± SD1.2 kg/m2; mean gait speed was 1.0 ± SD0.2 m/s and mean grip strength was 25.5 ± SD8.1 kg. Overall, 30% had pre-sarcopenia, 24% with sarcopenia and 4% with severe sarcopenia. Age (OR = 1.14; 95%CI = 1.09-1.20;p 

    Matched MeSH terms: Singapore/epidemiology
  13. Ni Chin WH, Li Z, Jiang N, Lim EH, Suang Lim JY, Lu Y, et al.
    J Mol Diagn, 2021 10;23(10):1359-1372.
    PMID: 34365011 DOI: 10.1016/j.jmoldx.2021.07.013
    Despite the immense genetic heterogeneity of B-lymphoblastic leukemia [or precursor B-cell acute lymphoblastic leukemia (B-ALL)], RNA sequencing (RNA-Seq) could comprehensively interrogate its genetic drivers, assigning a specific molecular subtype in >90% of patients. However, study groups have only started to use RNA-Seq. For broader clinical use, technical, quality control, and appropriate performance validation are needed. We describe the development and validation of an RNA-Seq workflow for subtype classification, TPMT/NUDT15/TP53 variant discovery, and immunoglobulin heavy chain (IGH) disease clone identification for Malaysia-Singapore acute lymphoblastic leukemia (ALL) 2020. We validated this workflow in 377 patients in our preceding Malaysia-Singapore ALL 2003/Malaysia-Singapore ALL 2010 studies and proposed the quality control measures for RNA quality, library size, sequencing, and data analysis using the International Organization for Standardization 15189 quality and competence standard for medical laboratories. Compared with conventional methods, we achieved >95% accuracy in oncogene fusion identification, digital karyotyping, and TPMT and NUDT15 variant discovery. We found seven pathogenic TP53 mutations, confirmed with Sanger sequencing, which conferred a poorer outcome. Applying this workflow prospectively to the first 21 patients in Malaysia-Singapore ALL 2020, we identified the genetic drivers and IGH disease clones in >90% of patients with concordant TPMT, NUDT15, and TP53 variants using PCR-based methods. The median turnaround time was 12 days, which was clinically actionable. In conclusion, RNA-Seq workflow could be used clinically in management of B-cell ALL patients.
    Matched MeSH terms: Singapore/epidemiology
  14. Cheung CMG, Ong PG, Neelam K, Tan PC, Shi Y, Mitchell P, et al.
    Ophthalmology, 2017 09;124(9):1305-1313.
    PMID: 28501376 DOI: 10.1016/j.ophtha.2017.03.056
    PURPOSE: To determine the 6-year incidence of early and late age-related macular degeneration (AMD) in a Singaporean Malay population and to validate the Age-Related Eye Disease Study (AREDS) simplified severity scale in Asians.

    DESIGN: Prospective, population cohort study.

    PARTICIPANTS: The Singapore Malay Eye Study baseline participants (age, ≥40 years; 2006-2008) were followed up in 2011 through 2013, and 1901 of 3280 of eligible participants (72.1%) took part.

    METHODS: Fundus photographs were graded using the Wisconsin AMD grading system.

    MAIN OUTCOME MEASURES: Incidence of early and late AMD.

    RESULTS: Gradable fundus photographs were available for 1809 participants who attended both baseline and 6-year follow-up examinations. The age-standardized incidences of early and late AMD were 5.89% (95% confidence interval [CI], 4.81-7.16) and 0.76% (95% CI, 0.42-1.29), respectively. The 5-year age-standardized incidence of early AMD (calculated based on the 6-year incidence) was lower in our population (5.58%; 95% CI, 4.43-7.01) compared with the Beaver Dam Eye Study population (8.19%). The incidence of late AMD in our population was similar to that of the Beaver Dam Eye Study population (0.98% [95% CI, 0.49-1.86] vs. 0.91%), the Blue Mountains Eye Study population (1.10% [95% CI, 0.52-9.56] vs. 1.10%), and the Hisayama Study population (1.09% [95% CI, 0.54-4.25] vs. 0.84%). The incidence of late AMD increased markedly with increasing baseline AREDS score (step 0, 0.23%; step 4, 9.09%).

    CONCLUSIONS: This study documented the incidence of early and late AMD in a Malay population. The AREDS simplified severity scale is useful in predicting the risk of late AMD development in Asians.

    Matched MeSH terms: Singapore/epidemiology
  15. Kuan WS, Craig S, Kelly AM, Keijzers G, Klim S, Graham CA, et al.
    Clin Respir J, 2018 Jun;12(6):2117-2125.
    PMID: 29469993 DOI: 10.1111/crj.12782
    INTRODUCTION: Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes.

    OBJECTIVE: The aim of this study was to describe the demographic features, clinical characteristics, management and outcomes of adults with an ED diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea.

    METHODS: Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study. AANZDEM was a prospective cohort study conducted in 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia over three 72 hour periods in May, August and October 2014. Primary outcomes were patient epidemiology, clinical features, treatment and outcomes (hospital length of stay (LOS) and mortality).

    RESULTS: Of the 3044 patients with dyspnea, 387 (12.7%) patients had an ED diagnosis of asthma. The median age was 45 years, 60.1% were female, 16.1% were active or recent smokers and 30.4% arrived by ambulance. Inhaled bronchodilator therapy was initiated in 88.1% of patients, and 66.9% received both inhaled bronchodilators and systemic corticosteroids. After treatment in the ED, 65.4% were discharged. No death was reported.

    CONCLUSION: Asthma is common among patients presenting with a principal symptom of dyspnea in the ED of the Asia Pacific region. There was a suboptimal adherence to international guidelines on investigations and treatments of acute asthma exacerbations presenting an opportunity to improve the efficiency of care.

    Matched MeSH terms: Singapore/epidemiology
  16. Chia YC, Yeoh ES, Ng CJ, Khoo EM, Chua CT
    Singapore Med J, 2009 May;50(5):500-5.
    PMID: 19495520
    INTRODUCTION: Calcium channel blockers are well established modalities for the treatment of hypertension. However, in spite of the availability of many efficacious agents, hypertension control continues to be poor. One reason is poor tolerability due to adverse events. Racial differences also exist. Lercanidipine, a third-generation calcium channel blocker, is associated with better tolerability. However, it has not been studied in the Asian population. This study examines its efficacy and tolerability in Asian subjects of different ethnicities.
    METHODS: This was an eight-week open label study of adults with mild to moderate hypertension. Blood pressure (BP), pulse rate, self-administered symptom check and laboratory evaluations were done at baseline. Patients were prescribed 10 mg lercanidipine, with up-titration to 20 mg if BP was not controlled at Week 4. Baseline evaluations were repeated at Week 8. Adverse events were also enumerated.
    RESULTS: 27 patients (mean age 53.4 +/- 12.1 years) completed the study. The baseline systolic BP (SBP), diastolic BP (DBP) and heart rate was 159 +/- 12.2, 96.6 +/- 7.7 mmHg and 71 +/- 13/min, respectively. Three racial groups were represented. SBP and DBP decreased significantly after four weeks of therapy. A further reduction to 139 +/- 14.3 and 88 +/- 9.8 (p-value is less than 0.0001) was seen in Week 8. The absolute SBP and DBP reduction was 20.5 mmHg (95 percent confidence interval [CI] 16.5-24.5, p-value is less than 0.0001) and 9.3 mmHg (95 percent CI 6.2-12.5, p-value is less than 0.0001), respectively. All adverse symptoms, except for palpitations, were reduced at the end of the study.
    CONCLUSION: Lercanidipine is efficacious and well tolerated in Asians of different ethnicities. Its BP lowering effects and tolerability in Asians appear to be similar to other studies on Caucasians and other calcium channel blockers.
    Matched MeSH terms: Singapore/epidemiology
  17. Hong CY, Chia KS, Hughes K, Ling SL
    Singapore Med J, 2004 Apr;45(4):154-60.
    PMID: 15094983
    Ethnic differences exist in patients with diabetes mellitus. Not much is known about such differences in Asian populations. The aim of the study was to determine ethnic differences among Chinese, Malay and Indian patients with type 2 diabetes mellitus in Singapore.
    Matched MeSH terms: Singapore/epidemiology
  18. Lee WW, Ooi BC, Thai AC, Loke KY, Tan YT, Rajan U, et al.
    Singapore Med J, 1998 Aug;39(8):359-62.
    PMID: 9844497
    To determine the incidence of insulin dependent diabetes mellitus (IDDM) in children 0-12 years of age in Singapore, which has a population of 2.9 million.
    Matched MeSH terms: Singapore/epidemiology
  19. Poh KK, Chin CT, Tong KL, Tan JKB, Lim JS, Yu W, et al.
    Singapore Med J, 2019 Sep;60(9):454-462.
    PMID: 30773600 DOI: 10.11622/smedj.2019021
    INTRODUCTION: Dyslipidaemia is a major risk factor for coronary heart disease (CHD). There is a lack of data on the extent of lipid abnormalities and lipid-lowering therapy (LLT) in Singapore.

    METHODS: The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation.

    RESULTS: 325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126 were hospitalised with an ACS. At baseline, 96.5% of the CHD cohort and 66.4% of the ACS cohort were being treated with LLT. In both cohorts, low-density lipoprotein cholesterol (LDL-C) levels were lower for the treated than the non-treated patients; accordingly, a higher proportion of patients met the LDL-C goal of < 70 mg/dL (CHD: 28.1% vs. 0%, p = 0.10; ACS: 20.2% vs. 0%, p < 0.01). By the four-month follow-up, a higher proportion of the ACS patients that were originally not treated with LLT had met the LDL-C goal (from 0% to 54.5%), correlating with the increased use of medication. However, there was negligible improvement in the patients who were treated prior to the ACS.

    CONCLUSION: Dyslipidaemia is a significant concern in Singapore, with few patients with stable or acute CHD meeting the recommended European Society of Cardiology/European Atherosclerosis Society goal. LLT was widely used but not optimised, indicating considerable scope for improved management of these very-high-risk patients.

    Matched MeSH terms: Singapore/epidemiology
  20. Ang BSP, Lim TCC, Wang L
    J Clin Microbiol, 2018 06;56(6).
    PMID: 29643201 DOI: 10.1128/JCM.01875-17
    Nipah virus, a paramyxovirus related to Hendra virus, first emerged in Malaysia in 1998. Clinical presentation ranges from asymptomatic infection to fatal encephalitis. Malaysia has had no more cases since 1999, but outbreaks continue to occur in Bangladesh and India. In the Malaysia-Singapore outbreak, transmission occurred primarily through contact with pigs, whereas in Bangladesh and India, it is associated with ingestion of contaminated date palm sap and human-to-human transmission. Bats are the main reservoir for this virus, which can cause disease in humans and animals. There are currently no effective therapeutics, and supportive care and prevention are the mainstays of management.
    Matched MeSH terms: Singapore/epidemiology
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