1.Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore.
Khai Wei TAN ; Jeremy Kaiwei LEW ; Poay Sian Sabrina LEE ; Sin Kee ONG ; Hui Li KOH ; Doris Yee Ling YOUNG ; Eng Sing LEE
Annals of the Academy of Medicine, Singapore 2023;52(2):62-70
INTRODUCTION:
Studies of concordance between patients' self-report of diseases and a criterion standard (e.g. chart review) are usually conducted in epidemiological studies to evaluate the agreement of self-reported data for use in public health research. To our knowledge, there are no published studies on concordance for highly prevalent chronic diseases such as diabetes and pre-diabetes. The aims of this study were to evaluate the concordance between patients' self-report and their medical records of diabetes and pre-diabetes diagnoses, and to identify factors associated with diabetes concordance.
METHOD:
A cross-sectional, interviewer-administered survey was conducted on patients with chronic diseases after obtaining written consent to assess their medical notes. Interviewers were blinded to the participants' profiles. Concordance was evaluated using Cohen's kappa (κ). A multivariable logistic regression model was used to identify factors associated with diabetes concordance.
RESULTS:
There was substantial agreement between self-reported and medical records of diabetes diagnoses (κ=0.76) and fair agreement for pre-diabetes diagnoses (κ=0.36). The logistic regression model suggested that non-Chinese patients had higher odds of diabetes concordance than Chinese patients (odds ratio [OR]=4.10, 95% confidence interval [CI] 1.19-14.13, P=0.03). Patients with 3 or more chronic diseases (i.e. multimorbidity) had lower odds of diabetes concordance than patients without multimorbidity (OR=0.21, 95% CI 0.09-0.48, P<0.001).
CONCLUSION
Diabetes concordance was substantial, supporting the use of self-report of diabetes by patients with chronic diseases in the primary care setting for future research. Pre-diabetes concordance was fair and may have important clinical implications. Further studies to explore and improve health literacy and patient-physician communication are needed.
Humans
;
Prediabetic State
;
Singapore/epidemiology*
;
Cross-Sectional Studies
;
Diabetes Mellitus/epidemiology*
;
Medical Records
;
Self Report
2.Fear of Covid-19 and Burnout Among Healthcare Providers in Malaysia: Is Resilience a Missing Link?
Siew-Mooi Ching ; Ramayah Thurasamy ; Ai Theng Cheong ; Anne Yee ; Poh Ying Ling ; Irmi Ismail Zarina ; Kai Wei Lee ; Jun Ying Ng ; Rofina Abdul Rahim ; Mohd Khairi Mohd Noor ; Chang Li Cheng ; Ahmad Iqmer Nashriq Mohd Nazan ; Hafizah Md Salleh ; Noor Hasliza Hassan
Malaysian Journal of Medicine and Health Sciences 2023;19(No.4):265-272
Introduction: During the COVID-19 pandemic, healthcare providers have been in great fear due to the high risk of
contracting COVID-19 infection at any time. This study aimed to determine the mediating role of resilience on the
relationship between fear of COVID-19 and burnout in primary care healthcare providers in Malaysia. Methods: This
was an online cross-sectional study involving 1280 healthcare providers aged 18 years and older from 30 government primary care clinics in Malaysia. We used the COVID-19 Fear Scale, the Copenhagen Burnout Inventory Scale,
and the Short Brief Resilience Scale to collect data from the respondents. Smart-PLS was used to perform mediation
analysis. Results: The mean age of the respondents was 36 years old and mean duration of working experience was
11 years. The majority of the respondents were female (82.4%) and Malays (82.3%). The study population consisted of nurses (47.4%), doctors (26%), medical assistants (11.9), healthcare assistant (7.1%), medical laboratory
technicians (6.4%) and drivers(1.3).The results show that fear of COVID-19 positively predicts burnout. According
to the results, resilience mediates the relationship between fear of COVID-19 and all the three burnout domains,
namely personal burnout (β=0.175,p<0.001), work-related burnout (β=0.175,p<0.001) and client-related burnout
(β=0.172,p<0.001). Additionally, resilience reduces the impact of COVID-19 fear on the three domains of burnout.
Conclusion: Our study has reported a mediating effect of resilience on the relationship between fear of COVID-19
and burnout.
3.Calibration Practices in Clinical Mass Spectrometry: Review and Recommendations
Wan Ling CHENG ; Corey MARKUS ; Chun Yee LIM ; Rui Zhen TAN ; Sunil Kumar SETHI ; Tze Ping LOH ;
Annals of Laboratory Medicine 2023;43(1):5-18
Background:
Calibration is a critical component for the reliability, accuracy, and precision of mass spectrometry measurements. Optimal practice in the construction, evaluation, and implementation of a new calibration curve is often underappreciated. This systematic review examined how calibration practices are applied to liquid chromatography-tandem mass spectrometry measurement procedures.
Methods:
The electronic database PubMed was searched from the date of database inception to April 1, 2022. The search terms used were “calibration,” “mass spectrometry,” and “regression.” Twenty-one articles were identified and included in this review, following evaluation of the titles, abstracts, full text, and reference lists of the search results.
Results:
The use of matrix-matched calibrators and stable isotope-labeled internal standards helps to mitigate the impact of matrix effects. A higher number of calibration standards or replicate measurements improves the mapping of the detector response and hence the accuracy and precision of the regression model. Constructing a calibration curve with each analytical batch recharacterizes the instrument detector but does not reduce the actual variability. The analytical response and measurand concentrations should be considered when constructing a calibration curve, along with subsequent use of quality controls to confirm assay performance. It is important to assess the linearity of the calibration curve by using actual experimental data and appropriate statistics. The heteroscedasticity of the calibration data should be investigated, and appropriate weighting should be applied during regression modeling.
Conclusions
This review provides an outline and guidance for optimal calibration practices in clinical mass spectrometry laboratories.
4. Anti-obesity effect and UHPLC-QTOF-MS/MS based metabolite profiling of Solanum nigrum leaf extract
Zain AABIDEEN ; Muhammad MUMTAZ ; Muhammad RAZA ; Muhammad NADEEM ; Muhammad Tayyab AKHTAR ; Hamid MUKHTAR ; Ahmad IRFAN ; Ahmad IRFAN ; Syed RAZA ; Yee LING
Asian Pacific Journal of Tropical Biomedicine 2022;12(4):164-174
Objective: To evaluate the antioxidant potential and pancreatic lipase inhibitory action of optimized hydroethanolic extracts of Solanum nigrum. Methods: Optimized extraction for maximum recovery of metabolites was performed using a combination of freeze-drying and ultrasonication followed by determination of antioxidant and antiobesity properties. The ultra-high performance liquid chromatography equipped with mass spectrometry was used to analyze metabolite profiling of Solanum nigrum. Computational studies were performed using molecular docking and electrostatic potential analysis for individual compounds. The hypolipidemic potential of the most potent extract was assessed in the obese mice fed on fat rich diet. Results: The 80% hydroethanolic extract exhibited the highest extract yield, total phenolic contents, total flavonoid contents along with the strongest 2,2-diphenyl-1-picrylhydrazyl scavenging activity, total antioxidant power, and pancreatic lipase inhibitory properties. The 80% hydroethanolic extract not only regulated the lipid profile of obese mice but also restricted the weight gain in the liver, kidney, and heart. The 80% hydroethanolic extract also reduced alanine transaminase and aspartate transaminase concentrations in serum. The effects of plant extract at 300 mg/kg body weight were quite comparable with the standard drug orlistat. Conclusions: Solanum nigrum is proved as an excellent and potent source of secondary metabolites that might be responsible for obesity mitigation.
5.Safety, tolerability and efficacy of LEGA-Kid® mechanical percussion device versus conventional chest physiotherapy in children: a randomised, single-blind controlled study.
Yuen Ling HUE ; Lucy Chai See LUM ; Siti Hawa AHMAD ; Soon Sin TAN ; Shin Yee WONG ; Anna Marie NATHAN ; Kah Peng EG ; Melissa de Bruyne Ming May CHOON
Singapore medical journal 2022;63(2):105-110
INTRODUCTION:
Chest physiotherapy (CPT) may benefit children aged below five years who suffer from lower respiratory tract infection (LRTI). However, its effects depend on the technique used. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI.
METHODS:
Children aged five months to five years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid. Outcomes measured before intervention and two hours after intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score.
RESULTS:
All 30 enrolled patients showed significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT.
CONCLUSION
Children receiving both manual and mechanical CPT showed improvements in respiratory distress symptoms, with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements in moderately severe respiratory distress. The LEGA-Kid mechanical CPT method is superior to manual CPT in reducing the RR.
Child
;
Humans
;
Percussion/methods*
;
Physical Therapy Modalities
;
Respiratory Distress Syndrome
;
Respiratory Therapy/methods*
;
Respiratory Tract Infections
;
Single-Blind Method
6.Pericarditis and myocarditis after COVID-19 mRNA vaccination in a nationwide setting.
Jonathan YAP ; Mun Yee THAM ; Jalene POH ; Dorothy TOH ; Cheng Leng CHAN ; Toon Wei LIM ; Shir Lynn LIM ; Yew Woon CHIA ; Yean Teng LIM ; Jonathan CHOO ; Zee Pin DING ; Ling Li FOO ; Simin KUO ; Yee How LAU ; Annie LEE ; Khung Keong YEO
Annals of the Academy of Medicine, Singapore 2022;51(2):96-100
INTRODUCTION:
Despite reports suggesting an association between COVID-19 mRNA vaccination and pericarditis and myocarditis, detailed nationwide population-based data are sparsely available. We describe the incidence of pericarditis and myocarditis by age categories and sex after COVID-19 mRNA vaccination from a nationwide mass vaccination programme in Singapore.
METHODS:
The incidence of adjudicated cases of pericarditis and myocarditis following COVID-19 mRNA vaccination that were reported to the vaccine safety committee between January to July 2021 was compared with the background incidence of myocarditis in Singapore.
RESULTS:
As of end July 2021, a total of 34 cases were reported (9 pericarditis only, 14 myocarditis only, and 11 concomitant pericarditis and myocarditis) with 7,183,889 doses of COVID-19 mRNA vaccine administered. Of the 9 cases of pericarditis only, all were male except one. The highest incidence of pericarditis was in males aged 12-19 years with an incidence of 1.11 cases per 100,000 doses. Of the 25 cases of myocarditis, 80% (20 cases) were male and the median age was 23 years (range 12-55 years) with 16 cases after the second dose. A higher-than-expected number of cases were seen in males aged 12-19 and 20-29 years, with incidence rates of 3.72 and 0.98 case per 100,000 doses, respectively.
CONCLUSION
Data from the national registry in Singapore indicate an increased incidence of pericarditis and myocarditis in younger men after COVID-19 mRNA vaccination.
Adolescent
;
Adult
;
COVID-19/prevention & control*
;
COVID-19 Vaccines/adverse effects*
;
Child
;
Female
;
Humans
;
Male
;
Middle Aged
;
Myocarditis/etiology*
;
Pericarditis/etiology*
;
RNA, Messenger
;
SARS-CoV-2
;
Vaccination/adverse effects*
;
Vaccines, Synthetic
;
Young Adult
;
mRNA Vaccines
7.Construct Validity and Reliability of Malay Language-Perception towards Smoking Questionnaire (BM-PTSQ) Among Secondary School Adolescents
Lim Jia Hui ; Lim Kuang Hock ; Sumarni Mohd Ghazali ; Heng Pei Pei ; Cheong Yoon Ling ; Lim Hui Li ; Kee Chee Cheong ; Goh Yee Lin ; Ng Khuen Yen
International Journal of Public Health Research 2022;12(no.1):1486-1492
Introduction:
Multitude studies have shown perception is an integral factor associated with smoking, However, no such tool was available in Malay language. In this study, we established a Bahasa Malaysia version of PTSQ (BM-PTSQ) and tested the validity and reliability among secondary school adolescents.
Methods:
The English version of PTSQ originally consists of 12 items. It was translated into Bahasa Malaysia and back-translated again into English to check for consistency. After face validity (face-to-face query) was determined among 20 secondary school adolescents, only 10 items were included in the survey. Construct validity was established from 407 school adolescents through random selection in the same locality. More than 60% of the respondents were female, a majority (67.3%) were schooling in rural areas. Then, the reliability of the questionnaire was determined with Cronbach's alpha.
Results:
EFA has grouped PTSQ into two components, they are associated with either knowledge or attitude towards smoking. The variance and Cronbach's alpha for the first and second component were 38.24% and 0.861 (7 items) and 21.62% and 0.661 (3 items) respectively.
Conclusion
The PTSQ showed good validity and reliability for measurement of perception in smoking among school adolescents in Malaysia, thus this is a viable measurement tool. More importantly this study shows an urgent need to improve the smoking education among adolescents in Malaysia.
8.Kinetic metrics of 68Ga-FAPI-04 in patients with pancreatic cancer identified by total-body PET/CT dynamic imaging
Ruohua CHEN ; Xinlan YANG ; Yanmiao HUO ; Yining WANG ; Xiaofeng YU ; Ling Yee NG ; Chaojie ZHENG ; Haitao ZHAO ; Lianghua LI ; Yun ZHOU ; Gang HUANG ; Jianjun LIU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2022;42(12):729-733
Objective:To investigate the kinetic metrics of 68Ga-fibroblast activation protein inhibitor (FAPI)-04 in pancreatic cancers and normal organs by using total-body PET dynamic imaging. Methods:From December 2020 to December 2021, 68Ga-FAPI-04 total-body PET/CT dynamic imaging were performed on 6 pancreatic cancer patients (3 males, 3 females, median age 55.5 years) in Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University. Images were respectively analyzed. Manual delineations of volume of interests (VOIs) on multiple normal organs and pathological lesions were performed and time-to-activity curves (TACs) were generated. A reversible two-tissue compartment model (2TCM) was fitted for each tissue TAC. Rate constants including K1, k2, k3 and k4, and the total volume of distribution ( Vt) were obtained and compared by tissue types. Wilcoxon rank sum test and Spearman correlation analysis were used for data analysis. Results:Kinetic metrics varied significantly among normal organs and pancreatic cancer lesions ( z values: 2.00-1 240.00, all P<0.05). The highest K1 among lesions was observed in primary tumor (0.30 min -1), which was observed in the spleen (1.42 min -1) among normal organs. The highest k2 among lesions was observed in peritoneal metastases (0.24 min -1), which was observed in the spleen (2.59 min -1) among normal organs. Primary tumor showed the highest k3 of 0.17 min -1 among lesions, and the pancreas had the highest k3 of 0.16 min -1 among normal organs. Primary tumor had the highest k4 of 0.03 min -1 among lesions, and the heart, lungs, parotid glands had high k4(0.06 min -1) among normal organs. Vt were higher in pathological lesions compared to normal organs, with the highest in primary tumor (13.78 ml/cm 3). There were correlations between Vt in lesions and SUV mean( rs=0.86, P<0.001) or SUV max ( rs=0.77, P<0.001). Conclusion:The rate constants including K1, k2, k3 and k4, and Vt of 68Ga-FAPI-04 vary among normal organs and lesions.
10.Oral Presentation – Clinical and Translational Research
Choon Hoong Chung ; Yee Lynn Soh ; Thinaesh Manoharan ; Arwind Raj ; Dulmini Perera ; Htoo Htoo Kyaw Soe ; Nan Nitra Than ; Lilija Bancevica ; Žanna Kovalova ; Dzintars Ozols ; Ksenija Soldatenkova ; Lim Pyae Ying ; Tay Siow Phing ; Wong Jin Shyan ; Andrew Steven Sinsoon ; Nursabrina Alya Ricky Ramsis ; Nina Azwina Kimri ; Henry Rantai Gudum ; Man Le Ng ; Sze Er Lim ; Hui Yu Kim ; Yee Wan Lee ; Soo Kun Lim ; Sharven Raj ; Mohd Nasir Mohd Desa ; Nurul Syazrah Anuar ; Nurshahira Sulaiman ; Hui Chin Ting ; Zhi Ling Loo ; Choey Yee Lew ; Alfand Marl F Dy Closas ; Tzi Shin Toh ; Jia Wei Hor ; Yi Wen Tay ; Jia Lun Lim ; Lu Yian Tan ; Jie Ping Schee ; Lei Cheng Lit ; Ai Huey Tan ; Shen Yang Lim ; Zhu Shi Wong ; Nur Raziana binti Rozi ; Soo Kun Lim
International e-Journal of Science, Medicine and Education 2022;16(Suppl1):7-14


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