INTRODUCTION: Infant gastroesophageal reflux disease (GERD) is a significant cause of concern to parents. This study seeks to describe GERD prevalence in infants, evaluate possible risk factors and assess common beliefs influencing management of GERD among Asian parents. METHODS: Mother-infant dyads in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort were prospectively followed from preconception to 12 months post-delivery. GERD diagnosis was ascertained through the revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R) administered at 4 time points during infancy. Data on parental perceptions and lifestyle modifications were also collected. RESULTS: The prevalence of infant GERD peaked at 26.5% at age 6 weeks, decreasing to 1.1% by 12 months. Infants exclusively breastfed at 3 weeks of life had reduced odds of GERD by 1 year (adjusted odds ratio 0.43, 95% confidence interval 0.19-0.97, P=0.04). Elimination of "cold or heaty food" and "gas producing" vegetables, massaging the infant's abdomen and application of medicated oil to the infant's abdomen were quoted as major lifestyle modifications in response to GERD symptoms. CONCLUSION Prevalence of GERD in infants is highest in the first 3 months of life, and the majority outgrow it by 1 year of age. Infants exclusively breastfed at 3 weeks had reduced odds of GERD. Cultural-based changes such as elimination of "heaty or cold" food influence parental perceptions in GERD, which are unique to the Asian population. Understanding the cultural basis for parental perceptions and health-seeking behaviours is crucial in tailoring patient education appropriately for optimal management of infant GERD.
Female ; Gastroesophageal Reflux/epidemiology* ; Humans ; Infant ; Infant, Newborn ; Male ; Parents/psychology* ; Prevalence ; Risk Factors ; Singapore/epidemiology*

Objectives: The highly polymorphic nature of the CYP2D6 gene and its central role in the metabolism of commonly used drugs make it an ideal candidate for pharmacogenetic screening. This study aims to determine the prevalence of CYP2D6 polymorphisms among Filipinos and their association to lung cancer. Method: Forty seven single nucleotide polymorphisms (SNPs) of the CYP2D6 gene were genotyped from DNA samples of 115 cases with lung cancer and age- and sex-matched 115 controls. Results: Results show that 18 out of 47 polymorphisms have significant genotypic variability (>1% for at least 2 genotypes). No variant is associated with lung cancer. However, rs1135840, rs16947 and rs28360521, were found to be highly variable among Filipinos. Conclusion This study demonstrated that CYP2D6 polymorphisms are present among Filipinos, which, although not found to be associated with lung cancer, can be useful biomarkers for future pharmacogenetic studies. The SNP rs16947 is found to be associated with cancer and timolol-induced bradycardia; the SNP rs1135840, on the other hand, is only shown to be linked with cancer. The genetic variant rs28360521 is known to be associated with low-dose aspirin-induced lower gastrointestinal bleeding.
Pharmacogenetics ; Cytochrome P-450 CYP2D6 ; Lung Neoplasms ; Biomarkers

Background: Community pharmacists are strategically positioned to dispense Complementary and Alternative Medicine (CAM) products as part of their innate roles in the provision of accurate drug information to patients. This unique position of the pharmacist could be best realized if equipped with good knowledge and skills in regard to CAM products. Objectives: This study aimed to assess the readiness of community pharmacists in the provision of CAM productrelated information to patients by assessing the knowledge and determined the attitudes and practices of community pharmacists regarding CAM products in Eastern Visayas, Philippines. Methods: A descriptive mixed-method (qualitative and quantitative) survey design was utilized in this study. Community pharmacists (n=58) in Eastern Visayas, Philippines were the research participants in the study. The survey questionnaire constituted four sections: socio-demographic profile, attitudes, practices, and knowledge of community pharmacists on CAM products. Descriptive statistical analysis was performed using SPSS Version 20. Results: Results revealed that the majority of respondents are female (87.93%), age range in between 21-30 (62.07%), working full-time (79.31%), and bachelor’s degree holder (98.28%). More than half of the participants (53.45%) did not receive any education or training on CAM products during undergraduate studies. Community pharmacists displayed strong positive attitudes (mean=3.74) and had a moderate frequency of practice on CAM products (mean=3.20). The knowledge test revealed that only a few of the community pharmacists (31.03%) were considered knowledgeable. A significant relationship between years of work experience in community pharmacy and knowledge was found in this study. Conclusion Despite having strong attitude and moderate level of practice, community pharmacists in Eastern Visayas showed a low level of knowledge on CAM products. Demand for CAM products by patients encouraged community pharmacists to dispense and provide information. Readiness of community pharmacists in terms of knowledge provision of CAM product-related information to patients were found to be insufficient while a moderate level of practice towards CAM products was reported. Community pharmacists displayed a strong positive attitude towards CAM products. Overall, the community pharmacists are not ready to provide CAM information service in the context of the knowledge, attitude, and practices.
Complementary Therapies ; Medicine, Traditional ; Philippines

Purinergic P2Y Receptor Antagonists ; Consensus ; Cardiovascular System ; Cardiology ; Asia

Objectives. Polymorphisms in metabolic genes which alter rates of bioactivation and detoxification have been shown to modulate susceptibility to colorectal cancer. This study sought to evaluate the colorectal cancer risk from environmental factors and to do polymorphism studies on genes that code for Phase I and II xenobiotic metabolic enzymes among Filipino colorectal cancer patients and matched controls. Methods. A total of 224 colorectal cancer cases and 276 controls from the Filipino population were genotyped for selected polymorphisms in GSTM1, GSTP1, GSTT1, NAT1 and NAT2. Medical and diet histories, occupational exposure and demographic data were also collected for all subject participants.Results. Univariate logistic regression of non-genetic factors identified exposure to UV (sunlight) (OR 1.99, 95% CI: 1.16-3.39) and wood dust (OR 2.66, 95% CI: 1.21-5.83) and moldy food exposure (OR 1.61, 95% CI:1.11-2.35) as risk factors; while the NAT2*6B allele (recessive model OR 1.51, 95% CI :1.06-2.16; dominant model OR 1.87, 95% CI: 1.05-3.33) and homozygous genotype (OR 2.19, 95% CI: 1.19-4.03) were found to be significant among the genetic factors. After multivariate logistic regression of both environmental and genetic factors, only UV radiation exposure (OR 2.08, 95% CI: 1.21-3.58) and wood dust exposure (OR 2.08, 95% CI: 0.95-5.30) remained to be significantly associated with increasing colorectal cancer risk in the study population.Conclusion. This study demonstrated that UV sunlight and wood dust exposure play a greater role in influencing colorectal cancer susceptibility than genotype status from genetic polymorphisms of the GST and the NAT` genes.
Colorectal Neoplasms ; Polymorphism, Genetic