1.Intraduct papilloma of salivary gland: a case report.
Xiumin QI ; Rongrong ZHANG ; Hui LYN
Chinese Journal of Pathology 2015;44(2):130-131
2.Assessment of the risk posed to Singapore by the 2015 Middle East respiratory syndrome outbreak in the Republic of Korea
Emma Xuxiao Zhang ; Olivia Seen Huey Oh ; Wanhan See ; Preaj Raj ; Lyn James ; Kamran Khan ; Jeannie Su Hui Tey
Western Pacific Surveillance and Response 2016;7(2):17-25
OBJECTIVE: To assess the public health risk to Singapore posed by the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea in 2015.
METHODS: The likelihood of importation of MERS cases and the magnitude of the public health impact in Singapore were assessed to determine overall risk. Literature on the epidemiology and contextual factors associated with MERS coronavirus infection was collected and reviewed. Connectivity between the Republic of Korea and Singapore was analysed. Public health measures implemented by the two countries were reviewed.
RESULTS: The epidemiology of the 2015 MERS outbreak in the Republic of Korea remained similar to the MERS outbreaks in Saudi Arabia. In addition, strong infection control and response measures were effective in controlling the outbreak. In view of the air traffic between Singapore and MERS-affected areas, importation of MERS cases into Singapore is possible. Nonetheless, the risk of a serious public health impact to Singapore in the event of an imported case of MERS would be mitigated by its strong health-care system and established infection control practices.
DISCUSSION: The MERS outbreak was sparked by an exported case from the Middle East, which remains a concern as the reservoir of infection (thought to be camels) continues to exist in the Middle East, and sporadic cases in the community and outbreaks in health-care settings continue to occur there. This risk assessment highlights the need for Singapore to stay vigilant and to continue enhancing core public health capacities to detect and respond to MERS coronavirus.
3.Leveraging social networking sites for disease surveillance and public sensing: the case of the 2013 avian influenza A(H7N9) outbreak in China
Zhang Emma Xuxiao ; Yang Yinping ; Di Shang Richard ; Simons Joseph John Pyne ; Quek Boon Kiat ; Yin Xiao Feng ; See Wanhan ; Oh Olivia Seen Huey ; Nandar Khine Sein Tun ; Ling Vivienne Ruo Yun ; Chan Pei Pei ; Wang Zhaoxia ; Goh Rick Siow Mong ; James Lyn ; Tey Jeannie Su Hui
Western Pacific Surveillance and Response 2015;6(2):66-72
We conducted in-depth analysis on the use of a popular Chinese social networking and microblogging site, Sina Weibo, to monitor an avian influenza A(H7N9) outbreak in China and to assess the value of social networking sites in the surveillance of disease outbreaks that occur overseas. Two data sets were employed for our analysis: a line listing of confirmed cases obtained from conventional public health information channels and case information from Weibo posts. Our findings showed that the level of activity on Weibo corresponded with the number of new cases reported. In addition, the reporting of new cases on Weibo was significantly faster than those of conventional reporting sites and non-local news media. A qualitative review of the functions of Weibo also revealed that Weibo enabled timely monitoring of other outbreak-relevant information, provided access to additional crowd-sourced epidemiological information and was leveraged by the local government as an interactive platform for risk communication and monitoring public sentiment on the policy response. Our analysis demonstrated the potential for social networking sites to be used by public health agencies to enhance traditional communicable disease surveillance systems for the global surveillance of overseas public health threats. Social networking sites also can be used by governments for calibration of response policies and measures and for risk communication.
4.Impact of statin use on major adverse cardiovascular events in patients with normal stress myocardial perfusion imaging and elevated coronary artery calcium score.
Yi Hui TO ; Xi Min TAN ; Cher-Lyn LOW ; Htet Htet MIN ; Min Sen YEW
Singapore medical journal 2023;64(2):109-114
INTRODUCTION:
Normal stress myocardial perfusion imaging (MPI) carries a favourable prognosis. Conversely, elevated coronary artery calcium (CAC) is associated with increased major adverse cardiovascular events (MACE). There is limited information on the prognosis and management of patients with elevated CAC and normal MPI. We aimed to assess the outcomes of patients with elevated CAC and normal MPI in relation to post-MPI statin use.
METHODS:
A retrospective review of normal MPI with CAC score >300 was performed between 1 March 2016 and 31 January 2017 in a Singapore tertiary hospital. Patients with known atherosclerotic cardiovascular disease or left ventricular ejection fraction <50% on MPI were excluded. Patient demographics, prescriptions and MACE (cardiac death, nonfatal myocardial infarction and/or ischaemic stroke) at 24 months after MPI were traced using electronic records. Binary logistic regression was used to evaluate for independent predictors of MACE.
RESULTS:
We included 311 patients (median age 71 years, 56.3% male), of whom 65.0% were on moderate to high-intensity statins (MHIS) after MPI. MACE was significantly lower in the post-MPI MHIS group (3.5% vs. 9.2%, P = 0.035). On univariate binary logistic regression, post-MPI MHIS use was the only significant predictor for MACE (odds ratio [OR] 0.355 [95% confidence interval (CI) 0.131-0.962], P = 0.042), even after multivariate adjustment (adjusted OR 0.363, 95% confidence interval 0.134-0.984, P = 0.046).
CONCLUSION
Post-MPI MHIS use is associated with lower MACE and is an independent negative predictor for 24-month MACE among patients with normal MPI and CAC >300.
Humans
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Male
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Aged
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Female
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Coronary Artery Disease
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Myocardial Perfusion Imaging/methods*
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Calcium
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Stroke Volume
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Brain Ischemia
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Risk Factors
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Ventricular Function, Left
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Stroke
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Prognosis
5.Assessment of the risk posed to Singapore by the emergence of artemisinin-resistant malaria in the Greater Mekong Subregion
Emma Xuxiao Zhang ; Jean-Marc Chavatte ; Cherie See Xin Yi ; Charlene Tow ; Wong Jia Ying ; Kamran Khan ; Olivia Seen Huey Oh ; Sarah Ngeet Mei Chin ; Khong Wei Xin ; Zubaidah Said ; Lyn James ; Jeffery Cutter ; Marc Ho ; Jeannie Su Hui Tey
Western Pacific Surveillance and Response 2019;10(2):6-13
Objective:
To assess the public health risk to Singapore posed by the emergence of artemisinin-resistant (ART-R) malaria in the Greater Mekong Subregion (GMS).
Methods:
We assessed the likelihood of importation of drug-resistant malaria into Singapore and the impact on public health of its subsequent secondary spread in Singapore. Literature on the epidemiology and contextual factors associated with ART-R malaria was reviewed. The epidemiology of malaria cases in Singapore was analysed. The vulnerability and receptivity of Singapore were examined, including the connectivity with countries reporting ART-R malaria, as well as the preparedness of Singaporean health authorities. Sources of information include international journals, World Health Organization guidelines, data from the Singapore Ministry of Health and National Public Health Laboratory of the National Centre for Infectious Diseases, and the International Air Transport Association.
Results:
The importation of ART-R malaria into Singapore is possible given the close proximity and significant travel volume between Singapore and the GMS countries reporting artemisinin resistance. Singapore’s vulnerability is further enhanced by the presence of foreign workers from neighbouring endemic countries. Nonetheless, the overall likelihood of such an event is low based on the rarity and decreasing trend of imported malaria incidence.
With the presence of Anopheles vectors in Singapore, imported cases of drug-resistant malaria could cause secondary transmission. Nevertheless, the risk of sustained spread is likely to be mitigated by the comprehensive surveillance and control system in place for both infected vectors and human cases.
Discussion
This risk assessment highlights the need for a continued high degree of vigilance of ART-R malaria locally and globally to minimize the risk and public health impact of drug-resistant malaria in Singapore.
6.Chapter of Gastroenterologists professional guidance for management of patients with liver disease in Singapore during the COVID-19 pandemic.
Jason Pik Eu CHANG ; Yu Jun WONG ; Wei Lyn YANG ; Kieron Boon Leng LIM ; Poh Seng TAN ; Gim Hin HO ; Benjamin Cherng Hann YIP ; James Weiquan LI ; Chern Hao CHONG ; David Eng Hui ONG ; Tju Siang CHUA ; Charles Kien Fong VU ; Kok Ann GWEE ; Tiing Leong ANG ; Chee Kiat TAN
Singapore medical journal 2020;61(12):619-623
In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.
COVID-19/epidemiology*
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Carcinoma, Hepatocellular/therapy*
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Chronic Disease
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Hepatitis B, Chronic/therapy*
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Hepatitis C, Chronic/therapy*
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Humans
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Liver Cirrhosis/therapy*
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Liver Diseases/therapy*
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Liver Neoplasms/therapy*
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Liver Transplantation
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Singapore/epidemiology*