Activating transcription factor 3(ATF3)is a member of the ATF/cyclic adenosine monophosphate(cAMP)-response element binding protein(CREB)family of transcription factors.In response to stress stimuli,ATF3 forms dimers to activate or repress gene expression.Further,ATF3 modulates the immune response,atherogenesis,cell cycle,apoptosis,and glucose homeostasis.Recent studies have shown that ATF3 may also be involved in pathogenesis of other diseases.However,more studies are needed to determine the role of ATF3 in metabolic regulation.

Methods: Thirty patients aged 18–45 years with a complaint of pain in the neck that had persisted for 2–12 weeks radiating to the arm and fulfilling Elvey’s criteria were randomly selected and divided into two groups. Group A received NMTT plus conventional treatment (hot pack and postural advice with cervical lateral glide), and group B received only conventional treatment 3 times a week for 2 weeks. The outcome measures were Wernicke’s scale score for the centralization of symptoms and Visual Analog Scale score for pain intensity. Within- and between-group comparisons were made before initiating treatment and at the end of the 3rd and 6th sessions. Within group analyses for the centralization values were performed using Friedmann test, and between-group analyses were performed using Mann-Whitney test. A 2×3 mixed model of the analysis of variance was used for analyzing the pain levels. Results: There was a significant difference (p<0.05) within and between the groups for both the measures at the end of the 3rd and 6th sessions. Thus, NMTT may be beneficial in decreasing the peripheralization of symptoms and pain intensity in patients with CBPS. Conclusions NMTT can be used as an alternative and effective treatment option for patients with CBPS.

Objective: Mesial temporal sclerosis with associated extra hippocampal pathology is considered ‘dual pathology’ that could influence the progression and clinical outcome of complex partial seizures. This study is undertaken to evaluate and compare the clinical outcome and pathology of the temporal lobe and hippocampus in cases of mesial temporal sclerosis (MTS) alone and MTS with associated pathological changes in the extrahippocampal temporal lobe (dual pathology). Methods: The clinical and presurgical evaluation data and post surgical follow up (2 years) were reviewed retrospectively from medical records of 15 cases with MTS alone and 11 cases having dual pathology. Specific pathological changes were recorded after reviewing the material from hippocampus and temporal lobe and immunostaining with antibodies to synaptophysin, and neurofilament to delineate dystrophic neurons and synaptic pathology and S-100 protein for glial elements. Results: Among the 11 patients with dual pathology, 2 patients had mild cortical dysplasia (MCD) and 9 had focal cortical dysplasia (FCD) in the adjacent temporal cortex, as described by Palmini et al. High resolution MRI (1.5 Tesla) did not detect the presence of the second pathology reported in this series. Thirteen of the 15 patients with MTS alone and 6 of the 11 patients with dual pathology had good post surgical outcome. Six (2 MTS + 4 dual pathology) out of 7 patients who failed to show good clinical outcome had significant loss of neurons in CA3 sub-field of Ammon’s horn, whereas only 12 out of 19 patients who had good outcome had CA3 neuronal loss. Various types of cytoskeletal and synaptic pathology are found in the dysplastic neurons in the zones of cortical dysplasia. Conclusion: Two types of structural lesions underlie complex partial seizures, MTS with or without associated extrahippocampal lesions of neuronal cytoarchitectural abnormality may influence the prognosis. Neuronal loss in CA3 subfield of Ammon’s horn seems to have a role in negative clinical outcome, though this feature needs to be further validated.

INTRODUCTIONDiabetes mellitus is a burgeoning global health epidemic, with an estimated 422 million people living with diabetes in 2014. The number of adult diabetic patients in Singapore is expected to rise to 1 million in 2050. Despite advances made in the management of diabetes and improvements in healthcare accessibility and delivery, the rate and complications of diabetes (myocardial infarction, stroke, kidney failure and lower limb amputation) in Singapore have not decreased. Gaps between guidelines and practice have been reported in several parts of the world. In this narrative review, we aimed to describe the control of diabetes in Singapore over the past 20 years.

MATERIALS AND METHODSWe reviewed studies describing, or trials intervening in, the glycaemic, blood pressure (BP) and low density lipoprotein cholesterol (LDL-C) control of adult diabetic patients in Singapore published over the past 20 years (1997-2016). Studies selected from comprehensive electronic databases searches were reviewed by 4 reviewers (2 primary care physicians, 1 diabetologist and 1 public health epidemiologist). The GRADE approach was used to evaluate the quality of evidence.

RESULTSWe included 23 articles involving 257,097 subjects. There were 9 longitudinal, 12 cross-sectional and 2 case-control studies. All studies reported mean/median HbA1c between 7.2%-8.6%. BP ranged between 126.5-144 mmHg (systolic) and 70-84 mmHg (diastolic) in 9 studies. Nine studies reported LDL-C between 2.4-3.3 mmol/L.

CONCLUSIONMirroring global patterns, the glycaemic, BP and LDL-C control in adult diabetic patients in Singapore do not appear to be treated to target in the majority of patients.

Aicardi syndrome is a rare neurodevelopmental disease characterised by congenital chorioretinal lacunae, corpus callosum dysgenesis, seizures, polymicrogyria, cerebral callosum, chorioretinopathy and electroencephalogram abnormality. We present a case of Aicardi syndrome with callosal hypogenesis in a 4.5-month-old baby who presented with infantile spasms. Ophthalmoscopy revealed chorioretinal lacunae. The clinical and magnetic resonance imaging features were diagnostic of Aicardi syndrome.
Agenesis of Corpus Callosum ; diagnosis ; Aicardi Syndrome ; diagnosis ; Brain ; diagnostic imaging ; pathology ; Choroid ; abnormalities ; Cornea ; physiopathology ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; methods ; Malformations of Cortical Development ; diagnosis ; Ophthalmoscopy ; methods ; Radiography ; Retina ; abnormalities ; Spasms, Infantile ; diagnosis

Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.
Blood Platelets* ; Dentistry ; Fibrin* ; Humans ; Molecular Biology ; Research Personnel ; Stomatognathic Diseases

Bariatric Surgery ; Follow-Up Studies ; Humans ; Patient Compliance ; Singapore

No abstract available.

IgG4-related disease of the stomach is a rare disorder, and only a few cases have been reported. We present two cases that were identified over a 2-month period in our center. Two male patients aged 52 and 48 years presented with mass lesion in the stomach, which were clinically thought to be gastrointestinal stromal tumor, and they underwent excision of the lesion. Microscopic examination revealed marked fibrosis, which was storiform in one case, associated with diffuse lymphoplasmacytic infiltration and an increase in IgG4-positive plasma cells on immunohistochemistry. Serum IgG4 level was markedly elevated. Although rare, IgG4-related disease should be considered in the differential diagnosis of gastric submucosal mass lesions.