Parental, Perinatal, and Childhood Risk Factors for Development of Irritable Bowel Syndrome: A Systematic Review

( En X S Low ),( Maimouna N K Al Mandhari ),( Charles C Herndon ),( Evelyn X L Loo ),( Elizabeth H Tham ),( Kewin T H Siah ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2020 Journal of Neurogastroenterology and Motility (JNM Vol.26 No.4

Background/Aims Adverse early life experiences are associated with the development of stroke, cancer, diabetes, and chronic respiratory and ischemic heart diseases. These negative experiences may also play a role in the development of irritable bowel syndrome (IBS)--a functional gastrointestinal disease. This review discusses the research to date on the parental, perinatal, and childhood risk and protective factors associated with the development of IBS. Methods A literature search was completed for studies published between 1966 and 2018 that investigated premorbid factors occurring during the perinatal and childhood periods as well as parental factors that were associated with the development of IBS. Results Twenty-seven studies fulfilled the review criteria. Risk factors that appeared in more than one study included: (1) parental IBS, substance abuse, parental punishment, and rejection as parental risk factors; (2) low birth weight as a perinatal risk factor; and (3) crowded living conditions in low-income families, childhood anxiety, depression, or child abuse as childhood risk factors. Protective factors for IBS were emotional warmth from the parents and being born to an older mother. Conclusions More effort is needed to identify what fetal and maternal factors are associated with low birth weight and IBS. A well-executed prospective birth cohort with a collection of bio-samples and functional data will provide a better understanding of how adversity and the interplay between genetics, epigenetics, and numerous risk factors affect the development of IBS. (J Neurogastroenterol Motil 2020;26:437-446)

Drug induced liver injury: East versus West – a systematic review and meta-analysis

En Xian Sarah Low,Qishi Zheng,Edwin Chan,Seng Gee Lim 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.2

Drug induced liver injury (DILI) may be different in the East compared to the West due to differing disease prevalence, prescribing patterns and pharmacogenetic profiles. To review existing literature on causative agents of DILI in the East compared to the West, a comprehensive literature search was performed on electronic databases: MEDLINE/PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure without language restrictions. Studies which involve patients having DILI and reported the frequency of causative agents were included. A random effects model was applied to synthesize the current evidence using prevalence of class-specific and agent-specific causative drugs with 95% confidence intervals. Of 6,914 articles found, 12 showed the distribution of drugs implicated in DILI in the East with a total of 33,294 patients and 16 in the West with a total of 26,069 DILI cases. In the East, the most common agents by class were anti-tuberculosis drugs (26.6%), herbal and alternative medications (25.3%), and antibiotics (15.7%), while in the West, antibiotics (34.9%), cardiovascular agents (17.3%), and non-steroidal anti-inflammatory drugs (12.5%) were the commonest. For individual agents, the most common agents in the East were isoniazid-rifampicin-pyrazinamide (25.4%), phenytoin (3.5%), and cephalosporin (2.9%) while in the West, amoxicillin-potassium clavulanate combination acid (11.3%), nimesulide (6.3%), and ibuprofen (6.1%) were the commonest. There was significant heterogeneity due to variability in single-centre compared to multi-centre studies. Differences in DILI in the East versus the West both in drug classes and individual agents are important for clinicians to recognize.

Sea, Connecting the Dots: On the Cusp of Greatness

Germaine Tyo,Jasper Low Cheng En,Lee Jia En,Too Fang Jing,Andrew Karl Delios Academy of Asian Business (AAB) 2019 Academy of Asian Business Review Vol.5 No.2

Sea Limited (formerly Garena Limited) was founded in Singapore in 2009 as a digital entertainment services provider. Since then, Sea has ventured into digital financial services and e-commerce, achieved “unicorn” status, and undergone a successful Initial Public Offering. Sea has now arrived at a crucial juncture in its ascent and must make several important decisions to reach its next milestone. In 2014, Sea launched its digital financial services business: AirPay. AirPay was born out of necessity and strategy as part of Garena’s solution to avoid paying exorbitant transaction fees through third-party transaction services and to act as the foundation of other platforms in Sea’s development pipeline. Following AirPay, Sea launched its e-commerce platform: Shopee. Shopee was Sea’s highly ambitious and aggressive entry into a hotly contested space. Sea has invested significant resources into Shopee which have reaped correspondingly encouraging results. Keys to Sea’s success lie in its service orientation, adaptability, and the speed and decisiveness exhibited in the execution of strategy. These traits have allowed Sea to design the right platforms and products, change with the times and boldly implement planned changes. Asian firms can learn from how Sea manages to navigate the increasingly complex and tumultuous global business environment. Sea now faces major challenges in its way of becoming a truly global brand and faces some uncertainty. Nevertheless, Sea’s trajectory and positioning inspire optimism and will continue on its rise to the top.

Evaluation of a Mobile Wound Care Device for Assessment of Wounds: A Time Motion Study

Choo Bryan Peide,Low Jeremy Ting En,Oh Hong Choon,Ong Ling,Loh Jocelyn Kaibin,Png Gek Kheng 대한창상학회 2022 Journal of Wound Management and Research Vol.18 No.3

Background: Comprehensive wound assessments are critical in identifying potential complications that affect wound healing and determining appropriate interventions for the patient. A wound care device (WCD) comprising a mobile device integrated with multi-spectral sensors that can capture stereoscopic and thermal images was recently introduced. A trial was conducted to assess potential productivity gains of the device.Methods: A total of 30 inpatients who required wound care were recruited and assessed via a time motion study. For every patient recruited in this study, wound measurements and documentation steps were repeated twice for a total of 55 wounds, once using the WCD and the other using a conventional manual process, with the order of assessment determined using a random group assignment generator. A t-test was used for statistical analysis.Results: The use of the WCD had a mean process time 4.86 minutes shorter than the conventional manual process (P<0.001). This constituted an increase in productivity by 44% for wound measurement, photography, and documentation. With estimated time savings of 5 minutes per patient, this amounts to 6,631 hours per year or a total of 3.42 nursing full-time equivalent savings per year based on an estimated load of 218 patients per day requiring wound care at an acute care institution in Singapore.Conclusion: The adoption of a mobile WCD has potential to improve work productivity and result in full-time equivalent savings for wound care nurses. Most importantly, the WCD could provide clinically beneficial outcomes for the patient by enhancing the management and documentation of wound care.

A novel practical method to predict anterior cruciate ligament hamstring graft size using preoperative MRI

( Zi Qiang Glen Liau ),( Matthew Song Peng Ng ),( Shawn Shao En Low ),( Brian Zhaojie Chin ),( James Hoi Po Hui ),( Fareed Husain Yusuf Kagda ) 대한슬관절학회 2024 대한슬관절학회지 Vol.36 No.-

Background Predicting hamstring graft size preoperatively for anterior cruciate ligament (ACL) reconstruction is important for preempting an insufficient diameter in graft size intraoperatively, possibly leading to graft failure. While there are multiple published methods using magnetic resonance imaging (MRI) picture archiving and communication systems (PACS), most are not feasible and practical. Our study aims to (1) practically predict the ACL hamstring graft size in a numerically continuous manner using the preoperative MRI from any native MRI PACS system, (2) determine the degree of correlation between the predicted and actual graft size, and (3) determine the performance of our prediction method if we define an adequate actual graft size as ≥ 8 mm. Methods A retrospective review of 112 patients who underwent primary ACL reconstruction with quadrupled hamstring semitendinosus-gracilis grafts at a tertiary institution was conducted between January 2018 and December 2018. Graft diameter can be predicted in a numerically continuous manner as √[2*(AB + CD)], where A and B are the semitendinosus cross-sectional length and breath, respectively, and C and D are the gracilis cross-sectional length and breath, respectively. Results A moderately positive correlation exists between the predicted and actual graft diameter (r = 0.661 and p < .001). Our method yields a high specificity of 92.6% and a moderate sensitivity of 67.2% if we define an adequate actual graft size as ≥ 8 mm. An area under receiver-operating characteristic curve shows good discrimination (AUC = 0.856). Conclusions We present a practical method to predict the ACL hamstring graft size with high specificity using preoperative MRI measurements.