Aspirin ; therapeutic use ; Bisoprolol ; therapeutic use ; Cardiomyopathies ; chemically induced ; etiology ; Cardiotonic Agents ; adverse effects ; Chest Pain ; diagnostic imaging ; Dobutamine ; adverse effects ; Echocardiography, Stress ; adverse effects ; Enalapril ; therapeutic use ; Humans ; Male ; Middle Aged ; Simvastatin ; therapeutic use

Acute Disease ; Aged ; Amylases ; blood ; Humans ; Lipase ; blood ; Magnetic Resonance Imaging ; Male ; Pancreatitis ; complications ; diagnosis ; diagnostic imaging ; Pancreatitis, Chronic ; complications ; diagnosis ; Panniculitis ; diagnosis ; diagnostic imaging ; etiology ; pathology

BACKGROUND: This study aimed to compare the topical anesthetic lignocaine, adrenaline, and tetracaine (LAT) (4% lignocaine, 1:2000 adrenaline, 1% tetracaine) with the conventional lignocaine infiltration(LI) for repair of minor lacerations, for the comfort of anesthetic administration, efficacy, adverse effects and cost. METHODS: This was a prospective randomized clinical trial. Forty Asian patients who required toilet and suture for minor lacerations in the emergency department of the Singapore General Hospital over a 4-month period. The patients were assigned randomly to 2 arms of treatment. The first was the LAT gel group who had LAT gel applied to the laceration prior to suturing. The second was the control group in whom the anesthetic administered was lignocaine infiltration (LI) via a syringe. The pain of the process of administering anesthetic and efficacy of anesthesia were scored using the visual pain scale included within. The efficacy of LAT vs. lignocaine infiltration as an anesthetic prior to the toilet and suture of minor lacerations and complications of therapy. RESULTS: Twenty patients were randomized to LAT gel and 16 to LI on an intention to treat analysis. The mean pain score by patients in the LAT gel group was 2.5 (0.52 SE), and 2.5 (0.58 SE) in the LI group. The pain score for pain during application of the anesthetic was 1.5 (0.40) in the LAT gel group, and 3.5 (0.46) in the LI group. There was no difference in complications between the LAT and LI groups. CONCLUSION: LAT gel prior to the toilet and suture of minor lacerations is proven to be as efficacious as LI in terms of patient comfort and effectiveness of anesthesia. The complications are also comparable to those treated with LI.

To examine the clinical features of male patients with eating disorders in Singapore; and determine the differences in clinical features between the patients across the diagnostic categories. Methods: This is a database analysis of all male cases presenting to the Eating Disorders Clinic at Singapore General Hospital between 2003 and 2012. Results: 72 cases were identified; 36.1% were diagnosed with anorexia nervosa, 33.3% had bulimia nervosa and 30.5% had the diagnosis of eating disorder not otherwise specified. The mean presenting age was 19.9 years. 63.9% were heterosexual, while 15.3% were homosexual/bisexual. 61.1% had comorbid psychiatric diagnoses, with depression being the most common. 59.7% recorded premorbid obesity, while 66.7% reported excessive exercise. The patients in the various diagnostic categories had more similarities than differences. Conclusion: With more male cases over the years, it is important to further understand this condition, to better refine prevention, detection and treatment strategies.
Eating Disorders ; Asian Continental Ancestry Group ; Men

INTRODUCTIONSince the emergence of the pandemic influenza A/H1N1/2009 virus in April 2009, diagnostic testing in many countries has revealed the rapid displacement and then replacement of circulating seasonal influenza viruses by this novel virus.

MATERIALS AND METHODSIn-house seasonal and pandemic influenza-specific polymerase chain reaction assays were introduced and/or developed at the Molecular Diagnosis Centre (MDC) at the National University Hospital (NUH), Singapore. These assays have been used to test all samples received from in-patients, out-patients, staff and visitors for suspected pandemic influenza A/H1N1/2009 infection.

RESULTSPrior to the arrival of the pandemic A/H1N1/2009 virus in Singapore at the end of May 2009, seasonal influenza A/H3N2 predominated in this population, with very little seasonal influenza A/H1N1 and B viruses detected. Within about 1 month of its arrival in Singapore (mainly during June to July 2009), this pandemic virus rapidly displaced seasonal influenza A/H3N2 to become the predominant strain in the Singaporean population served by MDC/NUH.

CONCLUSIONSRealtime molecular techniques have allowed the prompt detection of different influenza subtypes during this current pandemic, which has revealed the displacement/replacement of previously circulating seasonal subtypes with A/H1N1/2009. Although some of this may be explained by immunological cross-reactivity between influenza subtypes, more studies are required.

Communicable Diseases, Emerging ; Cross Reactions ; Disease Outbreaks ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza B virus ; isolation & purification ; Influenza, Human ; classification ; diagnosis ; epidemiology ; Influenzavirus C ; isolation & purification ; Molecular Diagnostic Techniques ; Polymerase Chain Reaction ; Singapore ; epidemiology

Owing to advancements in molecular diagnostics, recent years have seen an increasing number of laboratories adopting respiratory viral panels to detect respiratory pathogens. In December 2015, the NxTAG respiratory pathogen panel (NxTAG RPP) was approved by the United States Food and Drug Administration. We compared the clinical performance of this new assay with that of the xTAG respiratory viral panel (xTAG RVP) FAST v2 using 142 clinical samples and 12 external quality assessment samples. Discordant results were resolved by using a laboratory-developed respiratory viral panel. The NxTAG RPP achieved 100% concordant negative results and 86.6% concordant positive results. It detected one coronavirus 229E and eight influenza A/H3N2 viruses that were missed by the xTAG RVP FAST v2. On the other hand, the NxTAG RPP missed one enterovirus/rhinovirus and one metapneumovirus that were detected by FAST v2. Both panels correctly identified all the pathogens in the 12 external quality assessment samples. Overall, the NxTAG RPP demonstrated good diagnostic performance. Of note, it was better able to subtype the influenza A/H3N2 viruses compared with the xTAG RVP FAST v2.
Coronavirus ; Hand ; Influenza, Human ; Metapneumovirus ; Pathology, Molecular ; Respiratory Tract Infections ; United States Food and Drug Administration

The basidiomycete Laetiporus sulphureus var. miniatus belongs to the Aphyllophorales, Polyporaceae, and grows on the needleleaf tree. The fruiting bodies of Laetiporus species are known to produce N-methylated tyramine derivatives, polysaccharides, and various lanostane triterpenoids. As part of our ongoing effort to discover biologically active compounds from wood-rotting fungi, an anti-inflammatory triterpene, LSM-H7, has been isolated from the fruiting body of L. sulphureus var. miniatus and identified as acetyl eburicoic acid. LSM-H7 dose-dependently inhibited the NO production in RAW 264.7 cells without any cytotoxicity at the tested concentrations. Furthermore it suppressed the production of proinflammatory cytokines, mainly inducible nitric oxide synthase, cyclooxygenase-2, interleukin (IL)-1beta, IL-6 and tumor necrosis factor alpha, when compared with glyceraldehyde 3-phosphate dehydrogenase. These data suggest that LSM-H7 is a crucial component for the anti-inflammatory activity of L. sulphureus var. miniatus.
Basidiomycota ; Cyclooxygenase 2 ; Cytokines ; Fruit ; Fungi ; Glyceraldehyde 3-Phosphate ; Inflammation* ; Interleukin-6 ; Interleukins ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Oxidoreductases ; Polyporaceae ; Polyporales ; Polysaccharides ; Trees ; Tumor Necrosis Factor-alpha ; Tyramine

Genus Artemisia occurs as a hardy plant and has a wide range of culinary and medicinal features. In this study, we aimed to describe the melanin inhibitory activity of one Artemisia species, i.e., Artemisia capillaris Thunb. Ethanol extracts of fermented Artemisia capillaris (Art.EtOH.FT) and non-fermented Artemisia capillaris (Art.EtOH.CT) were tested for their ability to inhibit tyrosinase activity and melanin pigmentation. Both extracts showed dose-dependent inhibition against α-melanocyte stimulating hormone-stimulated melanin formation and tyrosinase activity, without cytotoxicity. At 100 µg/mL, both extracts showed greater inhibition than kojic acid, the positive control. Protein expressions of microphthalmia-associated transcription factor (MITF), tyrosinase (TYR), tyrosinase-related protein 1 (TRP-1), and tyrosinase-related protein 2 (TRP-2) at the transcriptional level were determined by using real-time and semi-quantitative polymerase chain reaction. To complete the mechanistic study, presences of upstream elements of MITF, the phosphorylated-extracellular signal-regulated kinase (p-ERK), and phosphorylated-mitogen-activated protein kinase kinase (p-MEK) were confirmed by using western blot analysis. Expressions of p-TYR, p-TRP-1 and p-TRP-2, downstream factors for p-ERK and p-MITF, were translationally inhibited by both extracts. Art.EtOH.FT induced more potent effects than Art.EtOH.CT, especially signal transduction effects. In summary, Artemisia capillaris extracts appear to act as potent hypopigmentation agents.
Artemisia ; Blotting, Western ; Ethanol ; Hypopigmentation ; Melanins ; Melanoma ; Microphthalmia-Associated Transcription Factor ; Monophenol Monooxygenase ; Phosphotransferases ; Pigmentation ; Plants ; Polymerase Chain Reaction ; Protein Kinases ; Signal Transduction

Genus Artemisia occurs as a hardy plant and has a wide range of culinary and medicinal features. In this study, we aimed to describe the melanin inhibitory activity of one Artemisia species, i.e., Artemisia capillaris Thunb. Ethanol extracts of fermented Artemisia capillaris (Art.EtOH.FT) and non-fermented Artemisia capillaris (Art.EtOH.CT) were tested for their ability to inhibit tyrosinase activity and melanin pigmentation. Both extracts showed dose-dependent inhibition against α-melanocyte stimulating hormone-stimulated melanin formation and tyrosinase activity, without cytotoxicity. At 100 µg/mL, both extracts showed greater inhibition than kojic acid, the positive control. Protein expressions of microphthalmia-associated transcription factor (MITF), tyrosinase (TYR), tyrosinase-related protein 1 (TRP-1), and tyrosinase-related protein 2 (TRP-2) at the transcriptional level were determined by using real-time and semi-quantitative polymerase chain reaction. To complete the mechanistic study, presences of upstream elements of MITF, the phosphorylated-extracellular signal-regulated kinase (p-ERK), and phosphorylated-mitogen-activated protein kinase kinase (p-MEK) were confirmed by using western blot analysis. Expressions of p-TYR, p-TRP-1 and p-TRP-2, downstream factors for p-ERK and p-MITF, were translationally inhibited by both extracts. Art.EtOH.FT induced more potent effects than Art.EtOH.CT, especially signal transduction effects. In summary, Artemisia capillaris extracts appear to act as potent hypopigmentation agents.