BACKGROUND: Fibromyalgia syndrome (FMS) is a common but controversial condition. There appears to be different level of belief of its existence and awareness. We set out to explore the variations of perceptions and awareness of this condition among rheumatologists from the Southeast Asia (SEA) region.
METHODS: One hundred eight rheumatologists from the participating countries; 28 from Malaysia, 20 from Singapore, 26 from Thailand, 2 from Brunei, and 42 from Indonesia were approached to participate in this survey by answering specific questions regarding their beliefs in relation to FMS; 82% respondents from Malaysia, 100% from Singapore, 92% from Thailand, 100% from Brunei, and 90% from Indonesia completed the questionnaires.
RESULTS: Most rheumatologists (92.5%) from SEA believe that FMS is a distinct clinical entity, and also this condition is considered an illness rather than a disease. Eighty-seven percent rheumatologists from SEA believe that FMS is a mixture of medical and psychological illness, 9% believe that FMS is primarily a psychological illness, and 3% believe that it is a medical illness. Only 60% of those in a university setting include FMS in their undergraduate teaching. Eighty-five percent of the respondents ordered blood tests to exclude other serious pathologic conditions, and 100% of the respondents from SEA countries also prescribed some form of drugs to FMS patients.
CONCLUSION: FMS is apparently seen worldwide. This study confirmed that there was a variation of perceptions and knowledge of FMS among rheumatologists from SEA countries. However, most rheumatologists agreed that FMS is a distinct clinical entity with a mixture of medical and psychological factors.
We examined allozyme variation in two camaenid tree snails, Amphidromus atricallosus and A. inversus, across two principal regions of Thailand and from Singapore, plus for A. inversus, one site in peninsular Malaysia. Using horizontal starch gel electrophoresis, 13 allozyme loci (11 polymorphic) were screened for A. atricallosus and 18 (5 polymorphic) for A. inversus. Heterozygosity was higher in A. atricallosus (Hexp=0.018-0.201, mean=0.085) than in A. inversus (Hexp=0-0.023, mean= 0.002). Genetic heterogeneity among samples was higher in A. inversus (Fst=0.965) than in A. atricallosus (Fst=0.781). Within A. atricallosus, populations were more differentiated in southern Thailand (Fst=0.551) than in eastern Thailand (Fst=0.144). The high Fst and low Hexp in populations of A. inversus suggest that this species is likely to have experienced a series of strong bottlenecks, perhaps occurring chiefly on offshore continental-shelf islands. The low Fst values of A. atricallosus in eastern Thailand suggest frequent gene flows among populations in this region. The southern and eastern samples of A. atricallosus exhibited fixed allele differences at four loci and great genetic distance (Nei's D=0.485-0.946), suggesting that these two samples may actually represent, or else be evolving into, separate species.
Mitochondrial DNA sequences of the hypervariable regions HV1 and HV2 were analyzed in 205 unrelated ethnic Malays residing in Singapore as an initial effort to generate a database for forensic identification purposes. Sequence polymorphism was detected using PCR and direct sequencing analysis. A total of 152 haplotypes was found containing 152 polymorphisms. Out of the 152 haplotypes, 115 were observed only once and 37 types were seen in multiple individuals. The most common haplotype (16223T, 16295T, 16362C, 73G, 146C, 199C, 263G, and 315.1C) was shared by 7 (3.41%) individuals, two haplotypes were shared by 4 individuals, seven haplotypes were shared by 3 individuals, and 27 haplotypes by 2 individuals. Haplotype diversity and random match probability were estimated to be 0.9961% and 0.87%, respectively.
MiniSTR loci has demonstrated to be an effective approach to recover genetic information from degraded sample, due to the improved PCR efficiency of their reduced PCR amplicon sizes. This study constructed a partial miniSGM panel and investigated the performance of four miniSTR loci, D2S1338, D16S539, D18S51 and FGA, in three ethnic populations residing in Singapore. The suitability of the miniSTR primers for Singapore populations was assessed for loci D16S539, D18S51 and FGA.
Worldwide prohibitions on lead gasoline additives were a major international public health accomplishment, the results of which are still being documented in parts of the world. Although the need to remove lead from paints has been recognized for over a century, evidence reported in this article indicates that lead-based paints for household use, some containing more than 10% lead, are readily available for purchase in some of the largest countries in the world. Sixty-six percent of new paint samples from China, India, and Malaysia were found to contain 5000 ppm (0.5%) or more of lead, the US definition of lead-based paint in existing housing, and 78% contained 600 ppm (0.06%) or more, the limit for new paints. In contrast, the comparable levels in a nearby developed country, Singapore, were 0% and 9%. In examining lead levels in paints of the same brands purchased in different countries, it was found that some brands had lead-based paints in one of the countries and paints meeting US limits in another; another had lead-free paint available in all countries where samples were obtained. Lead-based paints have already poisoned millions of children and likely will cause similar damage in the future as paint use increases as countries in Asia and elsewhere continue their rapid development. The ready availability of lead-based paints documented in this article provides stark evidence of the urgent need for efforts to accomplish an effective worldwide ban on the use of lead in paint.
Dystonia is a heterogenous group of movement disorders whose clinical spectrum is very wide. At least 13 different genes and gene loci have been reported. While a 3-bp deletion in the DYT1 gene is the most frequent cause of early limb-onset, generalized dystonia, it has also been found in non-generalized forms of sporadic dystonia. An 18-bp deletion in the DYT1 gene has also been reported.
There is a need for country/population-specific databases because the existence of population-specific mutations for single gene disorders is well documented, and there is also good evidence for ethnic differences in the frequencies of genetic variations involved in complex disorders. Thus the Singapore Human Mutation/Polymorphism Database (SHMPD) was created to provide clinicians and scientists access to a central genetic database for the Singapore population. The data catalogued in the database include mutations identified in Singapore for Mendelian diseases, and frequencies of polymorphisms that have been investigated in either healthy controls or samples associated with specific phenotypes. Data from journal articles identified by searches in PubMed and other online resources, and via personal communications with researchers were compiled and assembled into a single database. Genes are categorized alphabetically and are also searchable by name and disease. The information provided for each variant of the gene includes the protein encoded, phenotype association, gender, size, and ethnic origin of the sample, as well as the reported genotype and allele frequencies, and direct links to the corresponding abstracts on PubMed. Our database will facilitate molecular diagnosis of Mendelian disorders and improve study designs for complex traits. It will be useful not only for researchers in Singapore, but also for those in countries with similar ethnic backgrounds, such as China, Taiwan, Hong Kong, Indonesia, and Malaysia.
Allele frequencies for the 13 CODIS (Combined DNA Index System, USA) STR loci included in the AmpFISTR Profiler Plus and AmpFISTR Cofiler kits (Applied Biosystems, Foster City, USA) were determined in a sample of 197 unrelated Malays in Singapore.
To review how tobacco transnational companies conducted their business in the hostile environment of Singapore, attempting to counter some of the government's tobacco control measures; to compare the Malaysian and the Singaporean governments' stance on tobacco control and the direct bearing of this on the way the tobacco companies conduct their business.
Whole-genome sequencing across multiple samples in a population provides an unprecedented opportunity for comprehensively characterizing the polymorphic variants in the population. Although the 1000 Genomes Project (1KGP) has offered brief insights into the value of population-level sequencing, the low coverage has compromised the ability to confidently detect rare and low-frequency variants. In addition, the composition of populations in the 1KGP is not complete, despite the fact that the study design has been extended to more than 2,500 samples from more than 20 population groups. The Malays are one of the Austronesian groups predominantly present in Southeast Asia and Oceania, and the Singapore Sequencing Malay Project (SSMP) aims to perform deep whole-genome sequencing of 100 healthy Malays. By sequencing at a minimum of 30× coverage, we have illustrated the higher sensitivity at detecting low-frequency and rare variants and the ability to investigate the presence of hotspots of functional mutations. Compared to the low-pass sequencing in the 1KGP, the deeper coverage allows more functional variants to be identified for each person. A comparison of the fidelity of genotype imputation of Malays indicated that a population-specific reference panel, such as the SSMP, outperforms a cosmopolitan panel with larger number of individuals for common SNPs. For lower-frequency (<5%) markers, a larger number of individuals might have to be whole-genome sequenced so that the accuracy currently afforded by the 1KGP can be achieved. The SSMP data are expected to be the benchmark for evaluating the value of deep population-level sequencing versus low-pass sequencing, especially in populations that are poorly represented in population-genetics studies.
This paper investigated the class characteristics in English handwriting of the Chinese, Malays and Indians in Singapore, many of whom learned their native language as a second language. One hundred and fifty-four handwriting exemplars were collected and features such as letter designs, pen-lifts, letter spacing and embellishments were studied. A number of characteristic features peculiar to the individual racial group were identified, which confirmed the impact of their native language writing systems on English handwriting.
The diversity of Singapore's population affords a unique opportunity to study ethnic variability in the dementias. We sought to explore the effects of ethnicity on the frequency of Alzheimer disease and vascular dementia in a large Singaporean sample. A total of 357 patients were studied: 190 with vascular dementia and 167 with Alzheimer disease. Vascular dementia was more common among Chinese and Malays, whereas Alzheimer disease was more common in Indians and Eurasians. Factors that may contribute to the observed ethnic variability in dementia etiologies include differential frequency of the ApoE-e4 allele, frequency of vascular risk factors, lifestyle choices, and cultural attitudes toward health care utilization.
The goal of this article is to provide couple therapists and relationship educators with information to enhance the cultural relevance of their work with Asian populations. Because of the rapid social, economic, cultural, and gender role changes, the various Asian interpretations of the institution of marriage are undergoing major transformation. This article describes the general trends in marriage in several Asian nations, with a focus on the swiftly rising divorce rates and changing cultural attitudes to marriage, and discusses current relationship education initiatives in these nations. Finally, based on my experiences working with Asian populations, I present a few humble insights regarding adaptation of marriage education to render it more culturally appropriate for Asians.
This retrospective study analysed the case records of 200 patients in the Department of Gastroenterology, Singapore General Hospital from February 2000 to January 2001 who had liver cirrhosis and underwent gastroscopy for the detection of varices. The aim of this study was to determine any relationship between leucopenia, thrombocytopenia and the occurrence of esophageal varices in a cirrhotic population. Our results showed that the diagnostic yield of varices grade 2 and 3 was 6.3% if platelet count was > 150,000/mm3, 25% if platelet count was 100,000 to 150,000/mm3, 38.9% if platelet count was 50,000-99,000/mm3 and 100% if platelet count was <50,000/mm3. Similarly, the diagnostic yield of varices grade 2 and 3 was 19.4% if total white count was > 4,000/mm3, 66.7% if total white count was 3,000- 4,000/mm3 and 94.8% if total white count was < 3,000/mm5. We conclude that thrombocytopenia and leucopenia can be used to stratify risk for occurrence of esophageal varices in cirrhotic patients and gastroscopy will have a high yield for varices when platelet count is < 150,000/mm3 or total white is < 4,000/mm.
The Oriental, Australasian and Oceanian genus Caiusa Surcouf, 1920 is revised, species concepts being based on male and female genitalia. A key to males for all known species, and a key to females for all except one are given. All relevant types still in existence have been studied, complete synonymies given and the geographical distribution reconsidered. The eight species included in the genus are: Caiusa borneoensis sp. nov. (Malaysia, Thailand, Vietnam); Caiusa coomani Séguy, 1948 (China, Malaysia, Singapore, Thailand, Vietnam); Caiusa indica Surcouf, 1920 (Australia, Cambodia, India, Indonesia, Malaysia, Papua New Guinea, Philippines, Singapore, Solomon Islands, Sri Lanka, Thailand, Vietnam); Caiusa karrakerae sp. nov. (Malaysia, Thailand); Caiusa kurahashii sp. nov. (Indonesia, Japan, Philippines); Caiusa pooae sp. nov. (Thailand); Caiusa testacea Senior-White, 1923 (India, Nepal, Sri Lanka) and Caiusa violacea Séguy, 1925, stat. rev. (Cambodia, China, Laos, Malaysia, Taiwan, Thailand, Vietnam). A lectotype is designated for Caiusa indica to fix the interpretation of the name. Caiusa nigronitens Senior-White, 1923, syn. nov. and Caiusa surcoufi Bezzi, 1927, syn. nov. are established as junior synonyms of Caiusa indica. Caiusa violacea is correctly diagnosed and errors in the original description of the female holotype are pointed out. Caiusa dubiosa Villeneuve, 1927 is established as a junior synonym of C. violacea, syn. nov. Seven Caiusa species have been reared from the egg mass of various species of frogs. The reproductive mode of the eighth species, i.e., C. indica, is unknown. Five species, i.e., C. borneoensis, C. coomani, C. karrakerae, C. kurahashii and C. violacea have been reared from one or more of the foam nesting frog species Chiromantis nongkhorensis (Cochran, 1927), Polypedates leucomystax (Gravenhorst, 1927), Polypedates megacephalus Hallowell, 1861, Rhacophorus annamensis Smith, 1924, Rhacophorus dulitensis Boulenger, 1892, Rhacophorus kio Ohler & Delorme, 2005 and Rhacophorus owstoni (Stejneger, 1907) all belonging in the family Rhacophoridae in Anura. These five Caiusa species all have a specialised ovipositor tip, with small spine-like setae on the ST8 and the hypoproct, probably enabling the flies to oviposit on a foam nest with a hardened outer surface. They form a monophyletic group on account of these features of the ovipositor, unique in the Oestroidea. The sixth species, C. testacea, has been reared from a frog egg mass, the frog species being unknown. Its ovipositor structure is also unknown. The seventh species, C. pooae, has been reared once from the jelly-like egg mass of Feihyla hansenae (Cochran, 1927), also in Rhacophoridae. Caiusa pooae females do not have spine-like setae on the ovipositor, a fact correlated with the soft outer surface of the jelly-like egg mass on which a C. pooae female had oviposited. The extreme rarity of C. pooae oviposition on Feihyla hansenae egg masses may indicate that this fly perhaps has another, unknown, regular oviposition substrate. Caiusa pooae and C. indica make up a second monophyletic group within Caiusa. Caiusa indica, the most common and most widespread species of the genus, has an ovipositor structure similar to C. pooae. Its breeding substrate is unknown and it occurs both within and outside the distributional area of Rhacophoridae. Possibly both C. indica and C. pooae share a regular oviposition substrate that has still to be discovered. The holotype female of Plinthomyia emimelania Rondani, 1875 from Sarawak is established as a member of the genus Bengalia Robineau-Desvoidy, 1830, thus Plinthomyia Rondani, 1875 becomes a junior synonym of Bengalia Robineau-Desvoidy, 1830, syn. nov. It is removed from the synonymy of Phumosia Robineau-Desvoidy, 1830.
OBJECTIVES:
To evaluate the efficacy, safety, and tolerability of oral sildenafil in Asian men with erectile dysfunction of various causes (organic, psychogenic, or mixed) and of more than 6 months' duration.
METHODS:
In this double-blind, parallel-group trial conducted at eight centers in Malaysia, the Philippines, and Singapore, 254 men, 26 to 78 years old, were randomized to 12 weeks of sildenafil or placebo taken as needed 1 hour before anticipated sexual activity. Initially, the sildenafil (n = 127) or matching placebo (n = 127) dose was 50 mg but could be increased to 100 mg or decreased to 25 mg because of a lack of efficacy or intolerance, respectively. Efficacy was assessed by the 15-question International Index of Erectile Function, patients' event logs of sexual activity, and a global efficacy question about erections.
RESULTS:
The two primary efficacy variables relating to achievement and maintenance of an erection sufficient for sexual intercourse, as assessed by the mean scores for International Index of Erectile Function question 3 (4.22 versus 2.59) and question 4 (4.15 versus 2.41), were both significantly higher with sildenafil than with placebo (P <0.0001). In addition, the five separate International Index of Erectile Function domains of sexual function, the percentage of successful intercourse attempts, and the global efficacy assessment of erections revealed significantly greater treatment effects in favor of sildenafil (P <0.0001 versus placebo for all variables). Treatment-related adverse events occurred in 22.8% of patients who received sildenafil and in 10.2% of those who received placebo.
CONCLUSIONS:
Sildenafil is an effective and well-tolerated treatment for Asian men with erectile dysfunction of broad-spectrum etiology.