Background: Eosinophilic gastroenteritis (EG) can mimic symptoms of common gastrointestinal (GI) disorders but responds well to appropriate treatment. Accurate diagnosis is central to effective management. Data on EG in Southeast Asia is lacking. We aim to describe the clinical profiles and treatment outcomes of adult patients with EG in a Singapore Tertiary Hospital. Materials and Methods: This retrospective study involved archival search of patients with GI biopsies that showed eosinophilic infiltration from January 2004 to December 2012. Patients’ clinical data from computerised hospital records and clinical notes was reviewed. Diagnostic criteria for EG included presence of GI symptoms with more than 30 eosinophils/high power field on GI biopsies. Patients with secondary causes for eosinophilia were excluded. Results: Eighteen patients with EG were identified (mean age 52 years; male/female: 11/7). Fifteen patients (83%) had peripheral blood eosinophilia. Seven patients (39%) had atopic conditions. Most common symptoms were diarrhoea and abdominal pain. Small intestine was the most common site involved. Endoscopic finding was non-specific. Ten patients were treated with corticosteroids (nine prednisolone, one budesonide): eight patients (89%) responded clinically to prednisolone but four patients (50%) relapsed following tapering-off of prednisolone and required maintenance dose. One patient each responded to diet elimination and montelukast respectively. Half of the remaining six patients who were treated with proton-pump inhibitors, antispasmodic or antidiarrheal agents still remained symptomatic. Conclusion: Prednisolone is an effective treatment though relapses are common. Small intestine is most commonly involved. EG should be considered in the evaluation of unexplained chronic recurrent GI symptoms.
Enteritis ; Gastroenteritis

Introduction: A recently published meta-analysis showed that each additional serving of rice increased risk of type 2 diabetes mellitus (DM) by an alarming 11%. We investigated whether this phenomenon is seen in the Malaysian population by studying the effect of rice intake and added sugar consumption on fasting plasma glucose (FPG) and fasting triacylglycerol (TAG). Methods: Ninety subjects (60 females, 30 males, aged 30-70 years), adequate to detect a weak-to-moderate Pearson correlation of r=0.26 at a=0.05 and power= 0.80, were recruited by convenience sampling from six communities in the Klang Valley, Malaysia. Fasting blood samples were collected by finger-prick and analysed for FPG (AccuCek, Roche) and TAG (Accutrend, Roche). Macronutrient intakes, including rice, were obtained by a single interview using a previously-evaluated food frequency questionnaire (FFQ) and quantitated as grams by the DietPLUS V2 programme. Added sugar intakes by subjects were estimated using an Added Sugar Intake excel programme. Results: Rice contributed to 85% of dietary carbohydrates, accounting for 41.8 % kcal of the average 1750- kcal diet. Rice intakes or added sugar consumption did not have a significant correlation (p>0.05) with FPG nor fasting TAG. Added sugar consumption, which averaged 44g/person/day (5% kcal) was markedly lower than the 137g/person/day reported elsewhere for the Malaysian population. Conclusion: High consumption of rice as a risk factor of type 2 DM was not indicated in the present study. Since white rice consumption varied 10-fold in the present subjects, the reduction in daily intake of this staple food represents a feasible option for cutting back on calorie intake for overweight or obese individuals.
Triglycerides

INTRODUCTIONIntertrochanteric (IT) fractures are associated with significant morbidity and mortality in the elderly population. We aim to compare the clinical outcome of unstable with stable IT fractures after treatment with dynamic hip screw (DHS).

MATERIALS AND METHODSPatients with IT fractures treated with DHS at National University Hospital between 2003 and 2005 were included in the study. Patients were divided into 2 groups: stable and unstable IT fractures. Clinical outcome parameters include perioperative complications, functional outcomes, and incidence of morbidity and mortality.

RESULTSOne hundred and thirty-six patients were analysed. Mean age was 77 years. There were 61 stable and 78 unstable fractures. Average length of follow-up was 30 months. The rates of local complications were not significantly different between the 2 groups. The incidence of malunion and excessive impaction were significantly higher in the unstable group. The ambulatory status at one year post-surgery was not significantly different between the 2 groups. In terms of general postoperative complications and one year mortality rate, there was no significant difference between the 2 groups. The need for blood transfusion was significantly higher in the unstable group.

CONCLUSIONIn summary, DHS fixation provides comparable postoperative outcomes in unstable IT fractures with relatively low rates of complications. Although it was associated with a higher incidence of malunion and excessive impaction in the unstable fracture group, there was no difference in functional status at one-year compared to the stable group.

Aged ; Aged, 80 and over ; Bone Screws ; Female ; Fracture Fixation, Internal ; Hip Fractures ; surgery ; Humans ; Male ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Singapore ; epidemiology ; Treatment Outcome

COVID-19 ; Heart Diseases ; Humans ; Incidence ; SARS-CoV-2 ; Singapore/epidemiology*

Biopsy, Fine-Needle ; Diagnosis, Differential ; Facial Paralysis ; diagnosis ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Parotid Gland ; pathology ; Sclerosis ; Sialadenitis ; diagnosis

Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable with early detection and intervention using high-quality endoscopy. Premalignant lesions and gastric epithelial polyps are commonly encountered in clinical practice. Surveillance of patients with premalignant gastric lesions may aid in early diagnosis of GC, and thus improve chances of survival. An expert professional workgroup was formed to summarise the current evidence and provide recommendations on the management of patients with gastric premalignant lesions in Singapore. Twenty-five recommendations were made to address screening and surveillance, strategies for detection and management of gastric premalignant lesions, management of gastric epithelial polyps, and pathological reporting of gastric premalignant lesions.
Adenomatous Polyps ; Endoscopy ; Humans ; Precancerous Conditions/therapy* ; Singapore ; Stomach Neoplasms/therapy*