Cardiomyopathies/therapy* ; Humans ; Sarcoidosis/therapy*

INTRODUCTIONMyopia is a significant public health problem in Singapore with estimates that more than 50% of the population is affected by it by the time of adulthood. Childhood obesity is also increasing and has been linked to long-term health problems. Recent studies have found that Singaporean children in Primary 1 spend less than 3 hours a day outdoors which is less than children in other countries. Physical activity has been shown to be protective against obesity and recently, there has been some evidence to suggest that time spent outdoors may reduce the prevalence and severity of myopia. This study aims to explore the barriers and enablers to children in Singapore participating in outdoor activities.

MATERIALS AND METHODSQualitative data, gathered from focus group discussions was thematically analysed against the PRECEDE component of the PRECEDE-PROCEED model which provided a conceptual framework for examining factors relevant to children participating in an outdoor activity intervention. A total of 31 people participated in 4 focus groups held over a 6-month period.

RESULTSThis feasibility study was exploratory in nature but provided valuable information concerning barriers and enablers to participation. Data informed the development of a larger study.

CONCLUSIONResults indicated that families preferred structured activities such as orienteering and a choice of weekend attendance days and times.

Attitude to Health ; Child ; Child, Preschool ; Community Participation ; Counseling ; Feasibility Studies ; Focus Groups ; Health Behavior ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Jogging ; physiology ; Medical Records ; Motivation ; Motor Activity ; Myopia ; prevention & control ; Parents ; psychology ; Program Development ; Reinforcement (Psychology) ; Running ; physiology ; Singapore ; Walking ; physiology

Primary angiitis of the central nervous system (PACNS) is a rare vasculitis restricted to the central nervous system without systemic involvement. Delay in diagnosis and treatment is common due to its non-specific symptoms and lack of non-invasive diagnostic tests. Myelopathy can occur in PACNS, during the clinical course of the illness, with or without cerebral symptoms. We describe here a 51 year-old ethnic Chinese woman who presented initially with paraparesis without cerebral symptoms. The diagnosis of PACNS was eventually made from brain biopsy when she subsequently developed cerebral involvement. Despite aggressive treatment, the patient developed progressive neurological deterioration and died. This patient demonstrates the rare occurrence of myelopathy as the sole initial presentation of PACNS.
Central Nervous System ; Spinal Cord Diseases

OBJECTIVETo investigate the hypocholesterolemic activity of red yeast rice (RYR) and its underlying mechanism.

METHODSThree groups of hamsters were fed either the control diet or one of the two experimental diets containing by weight 0.1% RYR (0.1RYR) or 0.3% RYR (0.3RYR). Blood (0.5 mL) was collected from the retro-orbital sinus into a heparinized capillary tube at the end of week 0, 3, and 6. Plasma lipoproteins were measured using enzymatic kits, while fecal neutral and acidic sterols were quantified using a gas-liquid chromatography.

RESULTSPlasma total cholesterol was reduced by 12% in 0.1RYR group and by 18% in 0.3RYR group compared with the control value. Similarly, plasma triacylglycerol was decreased by 11% in 0.1RYR group and by 24% in 0.3RYR group. Western blotting analysis demonstrated that RYR had no effect on sterol regulatory element binding protein 2, liver X receptor, 3-hydroxy-3-methylglutary-CoA reductase, LDL receptor, and cholesterol-7alpha-hydroxylase. HPLC analysis confirmed that RYR contained 0.88% monacolin K. It was recently found that RYR supplementation increased excretion of fecal acidic sterols by 3-4 folds compared with the control value.

CONCLUSIONHypocholesterolemic activity of RYR is mediated at least partially by enhancement of acidic sterol excretion.

Animals ; Bile Acids and Salts ; secretion ; Biological Products ; pharmacology ; Blotting, Western ; Body Weight ; drug effects ; Cholesterol ; metabolism ; Cholesterol 7-alpha-Hydroxylase ; metabolism ; Cricetinae ; Dietary Supplements ; Feces ; chemistry ; Feeding Behavior ; drug effects ; Hydroxymethylglutaryl CoA Reductases ; metabolism ; Lipoproteins ; blood ; Liver ; enzymology ; Liver X Receptors ; Naphthalenes ; analysis ; Organ Size ; drug effects ; Orphan Nuclear Receptors ; metabolism ; Receptors, LDL ; metabolism ; Sterol Regulatory Element Binding Protein 2 ; metabolism ; Weight Gain ; drug effects

INTRODUCTIONThis study records the prevalence and patterns of breastfeeding in Singaporean Chinese mothers who gave birth between 2000 and 2008.

MATERIALS AND METHODSThe Strabismus, Amblyopia and Refractive Error in Singaporean Children (STARS) study is a population-based survey conducted in South-Western Singapore. Disproportionate random sampling by 6-month age groups of Chinese children born from 2000 to 2008 was performed. The mothers (n = 3009) completed a standard questionnaire which recorded the initiation, content, method and duration of breastfeeding. World Health Organization (WHO) definitions for feeding content were used: Replacement (exclusive commercial formula or any liquid or solid/semi-solid food, excluding breast milk), Complementary (breast milk, solid/semi-solid foods, and any non-human liquid), and Exclusive (breast milk only, without additional food, drink or water). STARS-specific definitions for feeding method were used: Expressed (breast milk only fed via bottle, with no additional food or non-human liquid), Combination (breast milk and non-breast milk, fed via bottle and breast), and Direct (breast milk only fed via breast).

RESULTSBreastfeeding initiation (overall prevalence 77.0%) and duration increased over time, and were independently associated with higher maternal education: in 2000 and 2001, 68.6% of mothers initiated breastfeeding and 12.9% breast fed for or=6 months, vs 90.9% and 35.3%, respectively, of university-educated women (P <0.001). Expressed, Combination and Complementary feeding also increased, while Replacement feeding decreased (P <0.001). There was no difference in breastfeeding patterns by the child's gender.

CONCLUSIONSIn a population-based sample of Singaporean Chinese mothers giving birth from 2000 to 2008, breastfeeding initiation and duration increased over time and were independently associated with higher maternal education. This increase was associated with increased milk expression and complementary feeding. Thus awareness of breastfeeding benefits is rising in Singapore, but future health policies may need to target less-educated mothers.

Breast Feeding ; epidemiology ; ethnology ; Child ; Child, Preschool ; China ; ethnology ; Educational Status ; Female ; Humans ; Infant ; Male ; Mothers ; Singapore ; epidemiology ; Surveys and Questionnaires

INTRODUCTIONThis study describes the pathologic changes in the retina of a group of young Asian subjects with myopia worse than -10 diopters spherical equivalent (SE) refraction.

MATERIALS AND METHODSThe study population consists of 20 male subjects undergoing preemployment screening for public service for a 1-year period from 2009 to 2010. A detailed series of visual tests of function, fundus examination and grading, ocular biometry and posterior segment optical coherence tomography were performed for all eyes.

RESULTSA total of 21 eyes with mean SE of -10.88 diopters, [standard deviation (SD) , 1.28 diopters], and mean age of 21.8 years (SD, 1.3 years) were included. Out of 21 eyes, 17 (81.0%) had beta peripapillary atrophy, 10 (47.6%) had clinically detectable optic disc tilt, 1 (4.8%) had positive T-sign and 18 (85.7%) had retinal tessellation, 4 (19.0%) had posterior vitreous detachment and 14 (66.7%) had peripheral retina degeneration. The mean retinal nerve fibre layer (RNFL) thickness was 92.48 mm (SD, 9.99 mm).

CONCLUSIONNone of the 21 highly myopic eyes had features of myopic retinopathy but most of these young males had clinically visible myopia-associated abnormalities of the optic disc, vitreous and peripheral retina. Generally, these eyes had thinner RNFL. Further longitudinal studies are required to investigate if these eyes will eventually develop complications of pathological myopia.

Adolescent ; Adult ; Age of Onset ; Choroid Diseases ; diagnosis ; Fluorescein Angiography ; Humans ; Male ; Myopia ; classification ; pathology ; Nerve Fibers ; pathology ; Ophthalmoscopy ; Optic Atrophy ; diagnosis ; Optic Disk ; pathology ; Optic Nerve Diseases ; diagnosis ; Posterior Eye Segment ; pathology ; Retina ; pathology ; Retinal Degeneration ; diagnosis ; Retinal Diseases ; diagnosis ; Retinal Vessels ; pathology ; Singapore ; Tomography, Optical Coherence ; methods ; Vision Tests ; Visual Acuity ; Vitreous Detachment ; diagnosis ; Young Adult

This study aimed to evaluate the effectiveness of an educational intervention (Safe D.U.M.P) to improve the knowledge, attitude, and practice regarding the return and disposal of unused medications. Community-dwelling adults in Malaysia who could understand English were recruited from two healthcare events. Participants were asked to fill out the validated Return and Disposal of Unused Medications (ReDiUM) questionnaire (pre-intervention), view six educational intervention posters on how to dispose of unused medications (Safe D.U.M.P), then answer the ReDiUM questionnaire immediately after viewing the posters (post-intervention). A total of 390 out of 456 participants participated (response rate=85.5%). Most were female (71%) with a median age of 42 years. The overall knowledge of participants significantly increased from 60% to 80% (p<0.001). However, no improvement was seen regarding their overall attitude and practice. This outcome was as expected as it may be more difficult to improve attitude and practice (when compared to knowledge) with a single educational session.