INTRODUCTION: Obstructive sleep apnoea (OSA) is common in Singapore, with moderate to severe OSA affecting around 30% of residents. These consensus statements aim to provide scientifically grounded recommendations for the management of OSA, standar-dise the management of OSA in Singapore and promote multidisciplinary collaboration. METHOD: An expert panel, which was convened in 2024, identified several areas of OSA management that require guidance. The expert panel reviewed the current literature and developed consensus statements, which were later independently voted on using a 3-point Likert scale (agree, neutral or disagree). Consensus (total ratings of agree and neutral) was set a priori at ≥80% agreement. Any statement not reaching consensus was excluded. RESULTS: The final consensus included 49 statements that provide guidance on the screening, diagnosis and management of adults with OSA. Additionally, 23 statements on the screening, diagnosis and management of paediatric OSA achieved consensus. These 72 consensus statements considered not only the latest clinical evidence but also the benefits and harms, resource implications, feasibility, acceptability and equity impact of the recommendations. CONCLUSION The statements presented in this paper aim to guide clinicians based on the most updated evidence and collective expert opinion from sleep specialists in Singapore. These recommendations should augment clinical judgement rather than replace it. Management decisions should be individualised, taking into account the patient's clinical characteristics, as well as patient and caregiver concerns and preferences.
Humans ; Sleep Apnea, Obstructive/diagnosis* ; Singapore ; Consensus ; Adult

Lysosomal dysfunction plays an important role in neurodegenerative diseases, including Parkinson’s disease (PD) and possibly Parkinson-plus syndromes such as progressive supranuclear palsy (PSP). This role is exemplified by the involvement of variants in the GBA1 gene, which results in a deficiency of the lysosomal enzyme glucocerebrosidase and is the most frequently identified genetic factor underlying PD worldwide. Pathogenic variants in the SMPD1 gene are a recessive cause of Niemann–Pick disease types A and B. Here, we provide the first report on an association between a loss-of-function variant in the SMPD1 gene present in a heterozygous state (p.Pro332Arg/p.P332R, which is known to result in reduced lysosomal acid sphingomyelinase activity), with PSP-Richardson syndrome in three unrelated patients of Chinese ancestry.

INTRODUCTION: Pityrosporum folliculitis (PF) is a common skin condition that can be easily misdiagnosed, especially by non-dermatologists. While the initial diagnosis is often made clinically, skin microscopy may help to confirm the same. However, there is scant literature regarding the clinical epidemiology of PF. To our knowledge, in Singapore, only one prior epidemiological study was performed in 1987. Through the present study, we aimed to provide an update regarding the epidemiology, diagnosis and treatment of patients with PF in Singapore. METHODS: We performed a retrospective review of patients with clinical presentations compatible with PF who presented to the dermatology clinic at the National University Hospital, Singapore, between 1 January 2011 and 31 December 2015. The medical records of patients identified as having clinical presentations that resembled PF were reviewed via written and electronic databases. Information regarding the demographics and clinical presentation of the patients was collected. RESULTS: Of the 375 patients identified, 214 (57.1%) were confirmed as having PF based on Gram-stain microscopy. Most (35.0%) of these 214 patients were aged between 21 and 30 years, with a male-to-female ratio of 3:1. The lesions predominantly occurred on the trunk and the back. The majority of patients presented with symptoms that lasted more than one month. 128 (59.8%) patients received oral antifungal treatment, whereas 82 (38.3%) patients were treated with topical antifungal treatment alone. CONCLUSION A typical Singapore patient with PF is a young man aged 21-30 years, with erythematous follicular papules or pustules over the trunk and the back.

INTRODUCTIONCentral aortic systolic pressure (CASP) has been shown to be a stronger predictor of cardiovascular events than brachial blood pressure (BP). Different classes of drugs have differential effects on CASP and brachial BP. This open prospective cohort study aimed to observe changes in CASP (measured using radial tonometry) among hypertensive Asians after 12 weeks of treatment with valsartan, an angiotensin receptor blocker (ARB).

METHODSPatients with treatment-naïve hypertension or uncontrolled hypertension who were on non-ARB therapy were eligible for inclusion. Patients with uncontrolled BP (i.e. ≥ 140/90 mmHg) received valsartan for 12 weeks. The patients' brachial systolic and diastolic BP (SBP and DBP), and CASP changes were monitored using the BPro® watch.

RESULTSThe mean age of the 44 enrolled patients was 35 years. At baseline, the mean BP and CASP were 150.2/91.4 ± 10.6/9.4 mmHg and 136.3 ± 12.2 mmHg, respectively. Valsartan reduced SBP, DBP and CASP by 14.9 ± 10.7 mmHg, 10.9 ± 8.4 mmHg and 15.3 ± 10.9 mmHg, respectively (all p < 0.001). Every 1.0-mmHg reduction in brachial SBP resulted in a 0.8-mmHg reduction in CASP (p < 0.001). A CASP cut-off of 122.5 mmHg discriminated between controlled and uncontrolled BP (sensitivity 74%, specificity 88%).

CONCLUSIONUsing radial tonometry, we demonstrated good correlation between CASP and brachial SBP reductions after 12 weeks of treatment with valsartan in our study cohort. Correlation analysis between CASP and SBP reductions may be useful for demonstrating whether a drug is able to lower CASP beyond lowering SBP.

Adult ; Angiotensin Receptor Antagonists ; pharmacology ; Aorta ; drug effects ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Diastole ; Female ; Humans ; Hypertension ; drug therapy ; Male ; Manometry ; methods ; Middle Aged ; Prospective Studies ; Receptors, Angiotensin ; metabolism ; Systole ; drug effects ; Valsartan ; therapeutic use ; Young Adult

Objectives: To develop a simple prediction model for the pre-screening of Retinopathy of Prematurity (ROP) among preterm babies. Methods: This was a prospective study. The test dataset (January 2007 until December 2010) was used to construct risk prediction models, and the validation dataset (January 2011 until March 2012) was used to validate the models developed from the test dataset. Two prediction models were produced using the test dataset based on logistic regression equations in which the development of ROP was used as the outcome. Results: The sensitivity and specificity for model 1 [gestational age (GA), birth weight (BW), intraventricular haemorrhage (IVH) and respiratory distress syndrome (RDS)] was 82 % and 81.7%, respectively; for model 2, (GA and BW) the sensitivity and specificity were 80.5% and 80.3%, respectively. Conclusion: Model 2 was preferable, as it only required two predictors (GA and BW). Our models can be used for the early prevention of ROP to avoid poor outcomes.

In this study, the potential of isolate Pseudomonas lundensis UTAR FPE2 as a hydrocarbon degrader was established. Their biodegradation activity was first detected with the formation of clearing zones on Bushnell-Hass agar plates, with the largest diameter observed on plates supplemented with paraffin, followed by mineral oil and petrol. Utilization of hydrocarbon sources were again detected in broth cultures supplemented with similar hydrocarbon substrates, where the mean viable cell count recovered from hydrocarbon-supplemented broth cultures were higher than the initial inoculum except for napthalene. In both tests, the isolate showed higher degradability towards aliphatic hydrocarbon sources, and the least activity towards the aromatic hydrocarbon naphthalene. The isolate P. lundensis UTAR FPE2 (8 log10 cfu/mL) also degraded crude diesel sample, with 69% degradation during the first three days. To conclude, this study suggests the potential use of this isolate for bioremediation of hydrocarbon-contaminated environments.