Strategies for Management of Peritoneal Dialysis Patients in Singapore during COVID-19 Pandemic

Peritoneal dialysis (PD) is the only well-established home-based dialysis therapy in Singapore. As it is a home-based modality, PD should be considered as a preferred mode of kidney replacement therapy (KRT) for patients with kidney failure during this COVID-19 pandemic as it avoids frequent visits to hospitals and/or satellite dialysis centres. The highly infectious nature of this virus has led to the implementation of the Disease Outbreak Response System Condition orange status in Singapore since early February 2020. This paper summarises the strategies for management of several aspects of PD in Singapore during this COVID-19 pandemic, including PD catheter insertion, PD training, home visit and assisted PD, outpatient PD clinic, inpatient management of PD patients with or without COVID-19 infection, PD as KRT for COVID-19 patients with acute kidney injury, management of common complications in PD (peritonitis and fluid overload), and management of PD inventory.

Virulence evaluation of entomopathogenic fungi to subterranean termites, Globitermes sulphureus (INSECTA: ISOPTERA)

Aims: Subterranean termites, Globitermes sulphureus is one of the significant pests for agricultural crops such as coconut and oil palm, and occasionally attacks building structure in Malaysia. Efforts to control subterranean termite infestations depended heavily on liquid termiticide applications. Natural pathogen of termites such as entomopathogenic fungi (EPF) is a promising alternative to chemical control. The objective of this study was to determine the most virulent EPF such as Metarhizium anisopliae, Beauveria bassiana and Paecilomyces sp. against the subterranean termites, G. sulphureus for the development of bio-insecticide for future use of termite control. Methodology and results: Subterranean termites were collected from mound-building termites found in Universiti Malaysia Terengganu (UMT). Cultivating, harvesting and counting of conidia of EPF were carried out to prepare the desired concentrations for screening test and bioassays, which were 1×103 , 1x105 , 1×107 and control. The pathogenicity testing was observed daily within 1 week under laboratory conditions. Screening showed that M. anisopliae was found to be the most virulent compared to B. bassiana and Paecilomyces sp., achieving 100% mortality within 3-4 days. M. anisopliae was then further tested on termites and it was found that concentration of 1×107 showed the lowest LT50 value, while LC50 of M. anisopliae in 1 day was 2.0151×106 . Conclusion, significance and impact of study: It could be concluded that M. anisopliae is the most virulent EPF against termites and the most effective concentration was ±107 followed by strains of B. bassiana and Paecilomyces sp. However, there is limited field evaluation of EPF against termites in Malaysia. Evaluation on the efficiency of M. anisopliae in the field should be conducted so that its efficacy could be proven and marketed.

Three Cases of Holoprosencephaly / 대한주산의학회잡지

Holoprosencephaly is a rare complex cerebral anomaly produced by a failure of cleavage of the prosencephalon. The association of brain anomalies and facial dysmorphism is a typical finding. There are three types(alobar, semilobar, and lobar) of holoprosencephaly. Among these the alobar type has the worst prognosis. The early antenatal diagnosis of the holoprosencephaly is very important determinant for initiating the therapeutic abortion. We report 3 cases of alobar holoprosencephaly with the brief review of the literature.

Two Cases of Fetal Arachnoid Cyst Diagnosed by Prenatal Ultrasonography / 대한주산의학회잡지

Fetal abnormalities in central nervous system are now recognized more often with the increasing use of high-resolution prenatal sonography. Arachnoid cysts, because of their compression of adjacent brain tissue, may require neurosurgical intervention but otherwise they have a good long- term prognosis. The differential diagnosis of intracranial lesions is important to allow accurate counselling and also to optimize neonatal management. We report the two cases of fetal arachnoid cyst diagnosed with prenatal ultrasonography