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Strategies to prevent cardiovascular disease in Singapore: A call to action from Singapore Heart Foundation, Singapore Cardiac Society and Chapter of Cardiologists of the Academy of Medicine, Singapore

Despite the success of Singapore’s public health systems in providing medical care through the country, there is still much to be achieved in terms of optimising the cardiovascular (CV) health of its 6 million residents. According to the 2019 Global Burden of Disease report, while the incidence rate of...

Comparison of existing methods of low-density lipoprotein cholesterol estimation in patients with type 2 diabetes mellitus

Elevated low-density lipoprotein cholesterol (LDL-C) levels are a major risk factor for the development of atherosclerotic cardiovascular disease (ASCVD). A reduction in LDL-C levels has been shown to significantly reduce the risk of incident ASCVD1 and all-cause mortality.2 LDL-C levels are hence key treatment targets in the prevention of...

Suboptimal adherence to medical therapy in patients undergoing lower limb angioplasty in Singapore

Dear Editor, Chronic limb-threatening ischaemia (CLTI) is the advanced stage of peripheral arterial disease (PAD) and patients with this condition face a very high risk of major adverse cardiovascular events and mortality. Several guidelines strongly recommend evidence-based medical therapy (EBMT) to reduce cardiovascular risk.1-3 Specifically, all CLTI patients should be...

Benefits of leisure-related physical activity and association between sedentary time and risk for hypertension and type 2 diabetes

Diabetes mellitus and hypertension are serious public health issues. Approximately 451 million individuals worldwide aged 18–99 years were living with diabetes in 2017, and this number is expected to increase to 693 million by 2045.1 More than 90% of all diabetes cases were type 2 diabetes mellitus (T2DM).2 For...

Association between lower phase angle and chronic kidney disease progression in type 2 diabetes patients

Chronic kidney disease (CKD) is a global public health problem with an estimated prevalence of 13.4%.1 One of the key drivers of the global increase in CKD is the rising prevalence of diabetes mellitus (DM).1 CKD affects about 25–40% of patients with type 2 diabetes mellitus (T2DM).2 A few...

Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore

Approximately 422 million people worldwide have diabetes and 1.6 million deaths are attributed to diabetes each year,1 contributing to high economic costs worldwide. Diabetes education and awareness of the disease contribute significantly to minimising complications and reducing morbidity and mortality.2 In addition, there is also a strong impetus to...

Diabetes: Know thy foe

During the COVID-19 pandemic in 2022, Singapore’s Minister for Health Ong Ye Kung mentioned, “After the COVID-19 pandemic has passed, we need to tackle a far more challenging pandemic—which is longer-term chronic illness, and diabetes is a major one.”1 Truly, in the past decade, there has been an invisible global...

Periodontal disease and systemic health: An update for medical practitioners

Care for the oral cavity lies in the intersection of dentistry and medicine. As the oral cavity serves as an entry to the gastrointestinal tract and the point where the digestion process begins, it is often recognised as an important gateway to dietary and nutritional health. Oral health, however,...

Diagnosis and management of polycystic ovary syndrome: Perspectives of clinicians in Singapore

Polycystic ovary syndrome (PCOS) is a common endocrine disorder estimated to affect 4–21% of women, depending on the diagnostic criteria used.1 Clinical manifestations of the syndrome are varied, and multiple parameters are needed for its diagnosis.2,3 This complicates the diagnosis of PCOS and may cause patient dissatisfaction arising from delayed...

Pressures, indexes and peripheral arterial disease: Time to rethink our approach?

Most patients with peripheral arterial disease (PAD) are asymptomatic. Despite the absence of symptoms, these patients have a significantly increased risk of death and adverse vascular events.1 Early detection of individuals with asymptomatic PAD facilitates prompt introduction of secondary prevention (lifestyle modification, smoking cessation, anti-platelet medications and lipid management)....

The Appropriate Use of Antineutrophil Cytoplasmic Antibody (ANCA) Testing in Rheumatic Diseases

In 1982, Davies and co-workers in Melbourne described the presence of a serum factor that stained the cytoplasm of neutrophil leukocytes by indirect immunofluorescence in 8 patients with generalised illness associated with segmental necrotising glomerulonephritis. This was followed two years later by a report by Hall and co-workers of...

A Case of Mycobacterium scrofulaceum Osteomyelitis of the Right Wrist

Whilst infections caused by Mycobacterium tuberculosis may be a common occurrence in this part of the world, those caused by atypical mycobacteria are rarely encountered. Many of the cases of atypical mycobacterial infections have been associated with underlying immunocompromised states. This article is available only as a PDF. Please click...

Multi-disease Health Screening in an Urban Low-income Setting: A Community-based Study

With the burden of chronic disease rising amongst rapidly urbanising Asian populations, active participation in health screening would allow for early detection and management of disease. However, participation in health screening can vary greatly within populations and is influenced significantly by sociodemographic and attitudinal factors. This article is available only...

Development of a Diabetes Registry to Improve Quality of Care in the National Healthcare Group in Singapore

In the last decade, the use of electronic medical records (EMR) has been widely recommended as a method for reducing errors, improving the quality of health care, and reducing costs in ambulatory care settings.1-9 EMRs have been shown to improve the quality of care for patients with chronic illnesses,...

Understanding of Diabetes Mellitus and Health-preventive Behaviour Among Singaporeans

The prevalence of diabetes mellitus is reaching epidemic levels worldwide.1,2 The World Health Organization (WHO) estimated that the number of people with diabetes mellitus is expected to rise from 171 million in 2000 to 366 million in 2030, as a result of population ageing and urbanisation.3 This will inevitably...

Measurement Properties of the Chinese Language Version of the Functional Assessment of Cancer Therapy-General in a Singaporean Population

Health-related quality of life (HRQoL) is an increasingly important concern in the care of cancer patients. In the approval of oncology drugs, the United States (US) Food and Drug Administration (FDA) and European Agency for the Evaluation of Medicinal Products consider HRQoL an important end-point.1 Most HRQoL instruments are...

Fasting during Ramadan and Associated Changes in Glycaemia, Caloric Intake and Body Composition with Gender Differences in Singapore

Muslim individuals worldwide participate in obligatory abstinence from oral consumption of medications, food and liquid during the fasting month of Ramadan. Fasting during Ramadan is one of the 5 pillars of Islam. However, Islam exempts individuals whose health may be significantly affected from fasting. Despite this, up to 80%...

Medical management of PAD: Expand or consolidate?

In this issue of the Annals, a rapid review of adherence to evidence-based medical treatment highlights an important and underappreciated aspect of the management of patients with peripheral arterial disease (PAD). It is easy, upon meeting a patient, to prescribe appropriate medication in an outpatient setting and believe that...

Empagliflozin-induced severe osmotic nephrosis and acute renal injury in advanced chronic kidney disease

Diabetic kidney disease remains a significant disease burden globally and is associated with increased medical costs once chronic kidney disease (CKD) ensues. Therefore, optimisation of CKD management through glycaemic control and albuminuria reduction are key strategies for retarding renal deterioration. Sodium glucose cotransporter-2 (SGLT-2) inhibitors are a new class...