INTRODUCTIONWhile benign prostatic hyperplasia (BPH) incidence has been shown to vary by race and ethnicity, data is lacking among Asians. This study aimed to describe the baseline symptom profile and response to medical therapy in a multiracial Singaporean cohort with BPH.

MATERIALS AND METHODSInternational Prostate Symptom Score (IPSS), uroflowmetry and prostate specific antigen (PSA) levels were retrospectively analysed for 887 men at presentation and on follow-up 1 year later. Following diagnosis, 150 men were managed conservatively and 586 men with drugs; 151 received surgery.

RESULTSOverall median IPSS scores were 9.0 at baseline. Malay men most often had severe symptoms (17.3%), compared to other groups (Chinese 11.7%, Others 11.1%, Indians 10.7%). Indians most frequently showed improvement in the Quality of Life (QOL) score following intervention (64.3%). Malays had the poorest initial mean peak-flow rates (9.6 mL/s) and Chinese, the highest (12.0 mL/s). Initial post-void residual urine volume was highest in Malays (100.1 mL) but showed greatest reduction with medical treatment. Median IPSS scores decreased from 10.5 below 50 years old to 7.0 above 80 years old. Peak-flow rates were 12.6 to 7.2 mL/s respectively, with a corresponding upward trend in RU. Treatment with a combination of 5-alpha-reductase inhibitor and alpha-blocker yielded the greatest improvement in IPSS and QOL scores, and residual urine volume (71.4%, 60% and 68.8%, respectively). Indians had the lowest initial and follow-up PSA (1.5 and 1.2, P = 0.8 and 0.6, respectively).

CONCLUSIONSInter-ethnic differences in symptom perception and quantitative assessment of BPH were evident among our multiracial urban study cohort, as well as varied degrees of response to the medical treatments instituted.

Aged ; Cohort Studies ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; analysis ; Prostatic Hyperplasia ; ethnology ; physiopathology ; Severity of Illness Index ; Singapore

Aims: Bacteria on chicken egg surfaces can be potential sources of food borne diseases. The aim of this study was to determine the prevalence of E. coli, Salmonella and enterococci on the surface of conventional broiler eggs, “Kampung” chicken eggs and carrying trays and to determine the antimicrobial resistant profile of these isolates. Methodology and results: Conventional broiler eggs, “Kampung” chicken eggs and carrying trays were sampled randomly from nine wet markets in Selangor, Malaysia. The surface of the eggs and carrying trays were swabbed and E. coli, Salmonella and enterococci were isolated using selective agars. Antimicrobial susceptibility testing (AST) was performed on the isolates against different antimicrobials via disk diffusion test. A large proportion of E. coli isolates (>50% of isolates from conventional broiler eggs and “Kampung” chicken eggs) was resistant to chloramphenicol and tetracycline whereas enterococci (>60% of isolates from conventional broiler eggs and “Kampung” chicken eggs) isolates were resistant to tetracycline and erythromycin. Salmonella isolates were found to be susceptible to all of the antimicrobials tested except for tetracycline. There was also presence of isolates showing multiple resistances in this study. E. coli isolates (8.8%) from the surface of “Kampung” chicken eggs were resistant against 10 different antimicrobials whereas 17.8% of the enterococci isolates from the surface of “Kampung” chicken eggs were resistant to 11 different antimicrobials. Conclusion, significance and impact of study: The presence of multiple-antimicrobial resistant bacteria especially on the surface of “Kampung” chicken eggs that are ready to be sold to consumers is a serious concern. However, further study has to be conducted to determine the ultimate source of the bacterial contamination before specific food safety measures can be introduced.
Drug Resistance, Microbial ; Salmonella

Literature has documented that student nurses undergo stress in their academic and clinical setting. This raises concerns because stress during undergraduate training may result in psychological or emotional impairment during the nurses’ professional life and ultimately affect the quality of patient care. The Objective of the study was to study the prevalence of stress, and the association between sociodemographic factors, stressors and coping strategies with stress. This was a cross-sectional study on 96-year 1-3 nursing students from a government university done between 2015-2018. Bahasa Malaysia translated The General Health Questionnaire, Stressors in Nursing Student Scale Questionnaire and Brief COPE Questionnaire was used in this study. This study had Malay (95.9%) and female (91.7%) dominated population. The prevalence of stress in student nurses was 25%. No association was reported between sociodemographic factors and stress. Among the 4 stressors educational, clinical, confidence and financial, clinical stressor scored the highest mean 6.40 (SD±3.66). Confidence stressor (AOR=1.26 95% CI 1.04-1.53) was the only stressor associated with stress. The top 3 coping strategies practiced by the student nurses were religion (praying), acceptance and planning. Self-blame (AOR 8.18 95% CI 1.86-35.91) was the only coping strategy associated with stress. Stress management programmes, and workshops on stress and coping strategies should be conducted yearly to ensure a well-balanced environment for good learning experiences and prevent stress related health problems and improved academic performance.

INTRODUCTION: In Singapore, non-anaesthesiologists generally administer sedation during gastrointestinal endoscopy. The drugs used for sedation in hospital endoscopy centres now include propofol in addition to benzodiazepines and opiates. The requirements for peri-procedural monitoring and discharge protocols have also evolved. There is a need to develop an evidence-based clinical guideline on the safe and effective use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting. METHODS: The Academy of Medicine, Singapore appointed an expert workgroup comprising 18 gastroenterologists, general surgeons and anaesthesiologists to develop guidelines on the use of sedation during gastrointestinal endoscopy. The workgroup formulated clinical questions related to different aspects of endoscopic sedation, conducted a relevant literature search, adopted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology and developed recommendations by consensus using a modified Delphi process. RESULTS: The workgroup made 16 recommendations encompassing 7 areas: (1) purpose of sedation, benefits and disadvantages of sedation during gastrointestinal endoscopy; (2) pre-procedural assessment, preparation and consent taking for sedation; (3) Efficacy and safety of drugs used in sedation; (4) the role of anaesthesiologist administered sedation during gastrointestinal endoscopy; (5) performance of sedation; (6) post-sedation care and discharge after sedation; and (7) training in sedation for gastrointestinal endoscopy for non-anaesthesiologists. CONCLUSION These recommendations serve to guide clinical practice during sedation for gastrointestinal endoscopy by non-anaesthesiologists in the hospital setting.
Conscious Sedation ; Endoscopy, Gastrointestinal ; Hospitals ; Humans ; Hypnotics and Sedatives ; Singapore