2.Interleukin-28 Polymorphism: Ethnic variations and the response to chronic hepatitis C treatment in Malaysia
Chee-Hoong HOE ; Mohd Azri Mohd Suan ; Chee-Hock HOE ; Thean-Hock TANG ; Kuang-Kiat KIEW ; Muhammad Radzi Abu Hassan ; Huan-Keat CHAN
The Medical Journal of Malaysia 2018;73(4):260-260
comprehensive overview of chronic hepatitis C (CHC)management.1 The author highlighted the concern over theexorbitant cost of direct-acting antivirals, which is the reason for their limited use in Malaysia currently. Based on the findings of the previous studies, the author also underlined that Asians receiving the conventional, interferon-based treatment generally have a higher sustained virological response (SVR) rate as compared with Caucasians and African Americans, mainly due to the interleukin-28B (IL28) single nucleotide polymorphism (SNP) across different ethnic populations. Nonetheless, to date, information on the variations in IL-28 genotypes among different ethnic groups in Malaysia is still limited.
3.Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region
Do Young KIM ; Bao Nguyen TOAN ; Chee-Kiat TAN ; Irsan HASAN ; Lyana SETIAWAN ; Ming-Lung YU ; Namiki IZUMI ; Nguyen Nguyen HUYEN ; Pierce Kah-Hoe CHOW ; Rosmawati MOHAMED ; Stephen Lam CHAN ; Tawesak TANWANDEE ; Teng-Yu LEE ; Thi Thanh Nguyen HAI ; Tian YANG ; Woo-Chang LEE ; Henry Lik Yuen CHAN
Clinical and Molecular Hepatology 2023;29(2):277-292
Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.
4.Consensus statement on Singapore integrated 24-hour activity guide for children and adolescents.
Benny Kai Guo LOO ; Benedict TAN ; Michael Yong Hwa CHIA ; Poh Chong CHAN ; Dinesh SIRISENA ; Mohammad Ashik ZAINUDDIN ; Jean Yin OH ; Oon Hoe TEOH ; Teresa Shu Zhen TAN ; Micheal Chee Meng LIM ; Ethel Jie Kai LIM ; Falk MÜLLER-RIEMENSCHNEIDER ; Ngiap Chuan TAN ; Ratnaporn SIRIAMORNSARP ; Terry Chin Chye TEO ; Phaik Ling QUAH ; Victor Samuel RAJADURAI ; Kok Hian TAN ; Kee Chong NG
Annals of the Academy of Medicine, Singapore 2022;51(5):292-299
INTRODUCTION:
Lifestyle activities, such as regular physical activity, are important for good metabolic health and the prevention of non-communicable diseases. Epidemiological studies highlight an increase in the proportion of overweight children in Singapore. A workgroup was formed to develop recommendations to encourage children and adolescents (aged 7-17 years) to adopt a holistic approach towards integrating beneficial activities within a daily 24-hour period for good metabolic and general health.
METHODS:
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision framework was employed to formulate the public health question, assess the evidence and draw conclusions for the guide. The evidence for international 24-hour movement guidelines, and guidelines for physical activity, sedentary behaviour, and sleep and eating habits were reviewed. An update of the literature review from August 2018 to end of September 2020 was conducted through an electronic search of Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.
RESULTS:
Ten consensus statements were developed. The statements focused on the overall aim of achieving good metabolic health through integration of these activities and initiatives: light and moderate- to vigorous-intensity physical activity on a regular basis; muscle- and bone-strengthening activities; limiting sedentary behaviour; regular and adequate sleep; good eating habits and choosing nutritionally balanced foods and drinks; practise safety in exercise; and aiming to achieve more or all aforementioned recommendations for the best results.
CONCLUSION
This set of recommendations provides guidance to encourage Singapore children and adolescents to adopt health-beneficial activities within a 24-hour period.
Adolescent
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Child
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Exercise
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Humans
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Public Health
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Sedentary Behavior
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Singapore
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Sleep