Night-shift work may adversely affect health. This study aimed to assess the effect of night-shift work on the level of urinary 6-sulphatoxymelatonin. Repeated measures of urinary 6-sulphatoxymelatonin on the morning before night-shift work and after first, third and fifth night-shift work was undertaken in 29 males, Malay, day-night-shift workers. A total of 29 male workers participated in this study. Median age was 29 years old. The highest level of urinary 6-sulphatoxymelatonin was at time point 1, followed by a significant reduction from time point 1 to time point 2. Subsequently, there was a progressive increase of urinary 6-sulphatoxymelatonin from time point 2 to 4. However, the urinary 6-sulphatoxymelatonin did not normalise at time point 4 and remained lower than the baseline
Circadian Rhythm

INTRODUCTION: Lifestyle activities, such as regular physical activity, are important for good metabolic health and the prevention of non-communicable diseases. Epidemiological studies highlight an increase in the proportion of overweight children in Singapore. A workgroup was formed to develop recommendations to encourage children and adolescents (aged 7-17 years) to adopt a holistic approach towards integrating beneficial activities within a daily 24-hour period for good metabolic and general health. METHODS: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision framework was employed to formulate the public health question, assess the evidence and draw conclusions for the guide. The evidence for international 24-hour movement guidelines, and guidelines for physical activity, sedentary behaviour, and sleep and eating habits were reviewed. An update of the literature review from August 2018 to end of September 2020 was conducted through an electronic search of Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. RESULTS: Ten consensus statements were developed. The statements focused on the overall aim of achieving good metabolic health through integration of these activities and initiatives: light and moderate- to vigorous-intensity physical activity on a regular basis; muscle- and bone-strengthening activities; limiting sedentary behaviour; regular and adequate sleep; good eating habits and choosing nutritionally balanced foods and drinks; practise safety in exercise; and aiming to achieve more or all aforementioned recommendations for the best results. CONCLUSION This set of recommendations provides guidance to encourage Singapore children and adolescents to adopt health-beneficial activities within a 24-hour period.
Adolescent ; Child ; Exercise ; Humans ; Public Health ; Sedentary Behavior ; Singapore ; Sleep

INTRODUCTION: Data on patients with small aortic annuli (SAA) undergoing transcatheter aortic valve implantation (TAVI) are limited. We aim to describe the impact of aortic annular size, particularly SAA and TAVI valve type on valve haemodynamics, durability and clinical outcomes. METHOD: All patients in National Heart Centre Singapore who underwent transfemoral TAVI for severe symptomatic native aortic stenosis from July 2012 to December 2019 were included. Outcome measures include valve haemodynamics, prosthesis-patient mismatch (PPM), structural valve degeneration (SVD) and mortality. RESULTS: A total of 244 patients were included. The mean Society of Thoracic Surgeons score was 6.22±6.08, with 52.5% patients with small aortic annulus (<23mm), 33.2% patients with medium aortic annulus (23-26mm) and 14.3% patients with large aortic annulus (>26mm). There were more patients with self-expanding valve (SEV) (65.2%) versus balloon-expandable valve (BEV) (34.8%). There were no significant differences in indexed aortic valve area (iAVA), mean pressure gradient (MPG), PPM, SVD or mortality across all aortic annular sizes. However, specific to the SAA group, patients with SEV had larger iAVA (SEV 1.19±0.35cm2/m2 vs BEV 0.88±0.15cm2/m2, P<0.01) and lower MPG (SEV 9.25±4.88 mmHg vs BEV 14.17±4.75 mmHg, P<0.01) at 1 year, without differences in PPM or mortality. Aortic annular size, TAVI valve type and PPM did not predict overall mortality up to 7 years. There was no significant difference in SVD between aortic annular sizes up to 5 years. CONCLUSION Valve haemodynamics and durability were similar across the different aortic annular sizes. In the SAA group, SEV had better haemodynamics than BEV at 1 year, but no differences in PPM or mortality. There were no significant differences in mortality between aortic annular sizes, TAVI valve types or PPM.
Humans ; Transcatheter Aortic Valve Replacement ; Heart Valve Prosthesis ; Aortic Valve Stenosis/surgery* ; Aortic Valve/surgery* ; Prosthesis Design ; Postoperative Complications/surgery* ; Treatment Outcome ; Hemodynamics

Objective: We reported a case of Descemet's membrane detachment (DMD) following ripcord removal of a Baerveldt shunt in a post-corneal transplant eye, and the interventions done. Method: This is a case report Results: A 65-year-old male with multiple surgeries (phacoemulsification, two corneal transplants, and Baerveldt shunt implantation) in the right eye developed increased intraocular pressures, prompting removal of the intraluminal stent (ripcord) of the shunt. This was complicated by hypotony and DMD. Ripcord reinsertion and viscoelastic injection were performed to reattach the Descemet's membrane (DM) but failed. 0.1mL of 14% perfluoropropane (C3F8) gas was injected into the anterior chamber that successfully reattached the DM with return to pre-operative best-corrected visual acuity after 1 week. Conclusion Injection of an expansive gas (C3F8) was effective in repairing a corneal graft DMD in an eye with a Baerveldt shunt.
Glaucoma Drainage Implants ; Corneal Transplantation

Background: Oxidative damage culminates in diabetic macrovascular complication. Ethanolic extract propolis of Heterotrigona itama exhibits antioxidative, antidiabetic and cardioprotective properties. However, vasoprotective activity has yet to be reported. This research was designed to investigate the effects of the ethanolic extract of propolis on histology and oxidative stress parameters in the aorta of diabetic rats. Methods: Raw propolis from Kelantan bee farm was ground, dissolved and distilled with ethanol into crude extract. Adult male Sprague Dawley rats were divided into four groups, n=8/group: normoglycemia (NG), untreated diabetes (DM), metformin-treated diabetes (DM+M, 300 mg/kg/day) and propolis-treated diabetes (DM+P, 300 mg/kg/day). A single injection of intraperitoneal streptozotocin (60 mg/kg) was used to induce diabetes mellitus, followed by a four-week treatment, via oral gavage, administered immediately after successful diabetes-induction with evidence of hyperglycaemia. Both NG and DM groups were given one millilitre of the vehicle. Rats were sacrificed at the end of the experiment; blood was collected for determination of serum lipid profile; the aorta was fixed and processed for histomorphology and histomorphometry evaluation; aortic tissue homogenate assay for oxidant/antioxidant activities. Differences in the parameters between groups were analysed using one-way analysis of variance (ANOVA) with post-hoc adjustment. Reults: Propolis treatment elevated the high-density lipoprotein level and suppressed protein oxidation in diabetic rats. Furthermore, propolis halted the thickening of tunica intima and aberrant proliferation of vascular smooth muscle cells in tunica media. Conclusion In conclusion, this proof-of-concept study indicated the potential of propolis as a vasoprotective agent against the early pathogenesis of diabetic macroangiopathy through anti-oxidative and anti- hyperglycaemic activities.
Antioxidants

OBJECTIVE: To evaluate the synergic effects of a novel oral supplement formulation, containing prebiotics, yeast β-glucans, minerals and silymarin (Silybum marianum), on lipid and glycidic metabolism, inflammatory and mitochondrial proteins of the liver, in control and high-fat diet-induced obese mice. METHODS: After an acclimation period, 32 male C57BL/6 mice were divided into the following groups: nonfat diet (NFD) vehicle, NFD supplemented, high-fat diet (HFD) vehicle and HFD supplemented. The vehicle and experimental formulation were administered orally by gavage once a day during the last four weeks of the diet (28 consecutive days). We then evaluated energy homeostasis, inflammation, and mitochondrial protein expression in these groups of mice. RESULTS: After four weeks of supplementation, study groups experienced reduced glycemia, dyslipidemia, fat, and hepatic fibrosis levels. Additionally, proliferator-activated receptor-α, AMP-activated protein kinase-1α, peroxisome proliferator-activated receptor γ co-activator-1α, and mitochondrial transcription factor A expression levels were augmented; however, levels of inhibitor of nuclear factor-κB kinase subunit α and p65 nuclear factor-κB expression, and oxidative markers were reduced. Notably, the cortisol/C-reactive protein ratio, a well-characterized marker of the hypothalamic-pituitary-adrenal axis immune interface status, was found to be modulated by the supplement. CONCLUSION We discovered that the novel supplement was able to modify different antioxidant, metabolic and inflammatory pathways, improving the energy homeostasis and inflammatory status, and consequently alleviated hepatic steatosis.
Animals ; Antioxidants ; Dietary Supplements ; Glucans ; Hypothalamo-Hypophyseal System ; Liver ; Mice ; Mice, Inbred C57BL ; Mice, Obese ; Milk Thistle ; Minerals ; Pituitary-Adrenal System ; Prebiotics ; Saccharomyces cerevisiae

INTRODUCTION: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore. METHODS: People with CP born after 1994 were recruited through KK Women's and Children's Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records. RESULTS: Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority (n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia. The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant functional impairment (Gross Motor Functional Classification System levels IV-V). Most participants (n=102, 67.5%) required frequent medical follow-up (≥4 times a year). CONCLUSION Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the burden of CP and their overall healthcare utilisation.