Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature

INTRODUCTION@#In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor.@*METHODS@#A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out. Treatment consisted of intensive chemotherapy, surgery aimed at gross total resection of residual disease after chemotherapy, consolidation with high-dose therapy followed by autologous stem cell rescue, and radiotherapy to the primary and metastatic sites followed by maintenance treatment with either cis-retinoic acid or anti-disialoganglioside monoclonal antibody therapy. Survival data were examined on certain clinical and laboratory factors.@*RESULTS@#There were 57 children (32 male) treated for high-risk neuroblastoma. Their mean age was 3.9 (range 0.7-14.9) years. The median follow-up time was 5.5 (range 1.8-13.0) years for the surviving patients. There were 31 survivors, with 27 patients surviving in first remission, and the five-year overall survival and event-free survival rates were 52.5% and 47.4%, respectively. On log-rank testing, only the group of 17 patients who were exclusively treated at our centre had a survival advantage. Their five-year overall survival rate compared to patients whose initial chemotherapy was done elsewhere was 81.6% versus 41.1% (P = 0.011), and that of event-free survival was 69.7% versus 36.1% (P = 0.032). Published treatment results were obtained from four countries in Southeast Asia with five-year overall survival rates from 13.5% to 28.2%.@*CONCLUSION@#Intensified medical and surgical treatment for high-risk neuroblastoma proved to be effective, with superior survival rates compared to previous data from Southeast Asia.

Associations of motor neuron disease research productivity and socioeconomic factors in Southeast Asia: a bibliometric analysis / Associações entre produtividade em pesquisa sobre doenças do neurônio motor e fatores socioeconômicos no sudeste asiático: uma análise bibliométrica

ABSTRACT Background: Scientific productivity on motor neuron disease (MND) research has been hypothesized to be low in Southeast Asia (SEA). Objective: To investigate the scientific productivity of SEA countries on MND and the associations between research metric indices and various country-specific socioeconomic parameters. Methods: We searched electronic databases for relevant articles from SEA on MND from the earliest indexed record to June 30, 2020. We obtained the following research productivity indices: bibliometric (number of publications in journals with impact factor (IF) and Scopus citations) and altmetric indices (PlumX metrics). We also collected data from published literature and reliable sources on the following socioeconomic variables: population, gross domestic product (GDP), GDP per capita, %GDP allocated for research and development (R&D) and the number of neurologists per country. Results: We included 196 articles that satisfied our inclusion criteria. Amyotrophic lateral sclerosis studies comprised the majority of the articles (n = 112; 57.1%). The top three countries in terms of the numbers of publications in journals with IF and in PlumX metrics were Singapore (n = 129), Malaysia (n = 26), and Thailand (n = 18). GDP per capita, %GDP for R&D and number of neurologists per one million population had strong positive correlations with the bibliometric and altmetric indices. Conclusions: This study highlights that although the scientific productivity of MND research in SEA has been low, it is continuously growing. This also emphasizes the imperative to improve economic indices and the number of neurologists in SEA to enhance scientific output on MND.

Resumo Antecedentes: A produtividade científica em pesquisa sobre doenças do neurônio motor (DNM) tem sido considerada baixa no sudeste asiático. Objetivo: Investigar a produtividade científica sobre DNM em países do sudeste asiático e as associações entre os índices métricos de pesquisa e vários parâmetros socioeconômicos específicos de cada país. Métodos: Foram consultadas bases de dados eletrônicas em busca de artigos relevantes sobre DNM provenientes do sudeste asiático, partindo do registro indexado mais antigo até 30 de junho de 2020. Obtivemos os seguintes índices de produtividade em pesquisa: bibliométrico (número de publicações em periódicos com fator de impacto (FI) e citações na base Scopus) e índices altmétricos (métrica PlumX). Também coletamos dados da literatura publicada e fontes confiáveis ​​sobre as seguintes variáveis ​​socioeconômicas: população, produto interno bruto (PIB), PIB per capita, % do PIB alocada para pesquisa e desenvolvimento (P & D) e o número de neurologistas por país. Resultados: Selecionamos 196 artigos que atenderam aos nossos critérios de inclusão. Estudos sobre esclerose lateral amiotrófica representaram a maioria dos artigos (n = 112; 57,1%). Os três principais países em termos de número de publicações em periódicos com FI e em métricas PlumX foram Cingapura (n = 129), Malásia (n = 26) e Tailândia (n = 18). O PIB per capita, a % do PIB para P & D e o número de neurologistas por um milhão de habitantes tiveram fortes correlações positivas com os índices bibliométricos e altmétricos. Conclusões: Embora a produtividade científica em pesquisa sobre DNM no sudeste asiático ainda seja baixa, este estudo mostra que ela vem crescendo continuamente. Isto também enfatiza a necessidade de melhorar os índices econômicos e o número de neurologistas na região para aumentar a produção científica sobre o assunto.

Factors influencing protective behaviours during haze episodes in Singapore: A population-based study

INTRODUCTION@#Haze is a recurrent problem in Southeast Asia. Exposure to haze is linked to ophthalmic, respiratory and cardiovascular diseases, and mortality. In this study, we investigated the role of demographic factors, knowledge and perceived risk in influencing protective behaviours during the 2013 haze in Singapore.@*METHODS@#We evaluated 696 adults in a cross-sectional study. Participants were sampled via a 2-stage simple random sampling without replacement from a large residential district in Singapore in 2015. The questionnaire measured the participant's knowledge, perceived risk and behaviours during the Southeast Asian haze crisis in 2013. Reliability and validity of the questionnaire were assessed using comparative fit index (≥0.96) and root mean square error of approximation (≤0.05). We performed structural equation modelling to examine the relationship between the hypothesised factors and protective behaviours.@*RESULTS@#More than 95% of the individuals engaged in at least 1 form of protective behaviour. Knowledge was strongly associated with protective behaviours via direct effect (β=0.45, 95% CI 0.19-0.69, @*CONCLUSION@#Knowledge was associated with protective behaviours, suggesting the importance of public education. Efforts should target those of lower education level and smokers. The wearing of N95 masks correlates with uptake of other protective behaviours.

AFES A.S.-O.N.E.: ASEAN survey of needs in Endocrinologyin the time of the COVID-19 pandemic / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#The COVID-19 pandemic has made a major impact on hospital services globally, including the care of persons with diabetes and endocrine disorders. The aim of this study is to describe the epidemiology of COVID-19 in the ASEAN Federation of Endocrine Societies (AFES) member countries; to describe challenges, changes and opportunities in caring for patients with endocrine diseases, as well as in fellowship training programs, and endocrine-related research in the AFES countries.@*Methodology@#The AFES ASEAN Survey Of Needs in Endocrinology (AFES A.S.-O.N.E.) was an open-ended questionnaire that was sent to the presidents and representatives of the AFES member countries by email. Responses from Societies were collated and synthesized to obtain perspectives on the emergent issues in endocrinology in the Southeast Asian region during this pandemic.@*Results@#The burden of COVID-19 cases varied widely across the AFES member countries, with the least number of cases in Vietnam and Myanmar, and the greatest number of cases in either the most populous countries (Indonesia and the Philippines), or a country with the highest capability for testing (Singapore). The case fatality rate was also the highest for Indonesia and the Philippines at around 6%, and lowest for Vietnam at no fatalities. The percentage with diabetes among patients with COVID-19 ranged from 5% in Indonesia to 20% in Singapore, approximating the reported percentages in China and the United States. The major challenges in managing patients with endocrine diseases involved inaccessibility of health care providers, clinics and hospitals due to the implementation of lockdowns, community quarantines or movement control among the member countries. This led to disruptions in the continuity of care, testing and monitoring, and for some, provision of both preventive care and active management including surgery for thyroid cancer or pituitary and adrenal tumors, and radioactive iodine therapy. Major disruptions in the endocrine fellowship training programs were also noted across the region, so that some countries have had to freeze hiring of new trainees or to revise both program requirements and approaches to training due to the closure of outpatient endocrine clinics. The same observations are seen for endocrine-related researches, as most research papers have focused on the pandemic. Finally, the report ends by describing innovative approaches to fill in the gap in training and in improving patient access to endocrine services by Telemedicine.@*Conclusion@#The burden of COVID-19 cases and its case fatality rate varies across the AFES member countries but its impact is almost uniform: it has disrupted the provision of care for patients with endocrine diseases, and has also disrupted endocrine fellowship training and endocrine-related research across the region. Telemedicine and innovations in training have been operationalized across the AFES countries in an attempt to cope with the disruptions from COVID-19, but its over-all impact on the practice of endocrinology across the region will only become apparent once we conquer this pandemic.

Effectiveness of the Otago Exercise Programme in falls reduction among community-dwelling older people in Southeast Asia: a systematic review

@#BACKGROUND: Falls are common in older people and a leading cause of injury. Exercise programmes are available for falls prevention, including the Otago Exercise Programme (OEP). The Southeast Asia region has a rapidly ageing population with unique aspects to consider in falls prevention. This systematic review aims to explore the effectiveness of OEP in Southeast Asia for falls prevention. METHODS: A literature search conducted in April 2020 of PubMed and Google Scholar databases was performed to identify randomised controlled trials on OEP in Southeast Asia. RESULTS: Three studies met inclusion criteria for the systematic review. The studies in Malaysia and Thailand did not identify any differences in the rate of falls with the modified OEP intervention compared to conventional treatment. The study from Indonesia inferred a reduced fall risk with improved Timed Up and Go with the intervention, but did not quantify fall rates. CONCLUSION: The three studies identified used a modified OEP, with limited evidence of efficacy or reduction in fall rates. Further research is required, particularly randomized controlled trials to evaluate OEP for falls prevention in Southeast Asia.

Rethinking mental health services during the COVID-19 pandemic; Proceedings of the Fourth Southeast Asia Mental Health Forum, 08-09 October 2020, Philippines

@#The COVID-19 pandemic has had pervasive effects on society at large, specifically disrupting routine and established processes at the household, organizational, and community levels. The Philippine Psychiatric Association organized the Fourth Southeast Asia Mental Health Forum to discuss issues and share experiences on how this community can respond to the challenges brought about by the COVID-19 pandemic. Three common challenges for the mental health community were identified – (a) ensuring the continuity of services for persons with psychiatric disorders in different settings; (b) preventing spread of COVID-19 infection in in-patient or residential mental health facilities; and (c) addressing the emergent demand for mental health services from health workers and the general population experiencing psychological symptoms because of the pandemic situation. In the face of these challenges, two broad groups of good practices and innovations were conceptualized and implemented by professionals and institutions: (a) development of alternative arrangements for the delivery of mental health services; and (b) mobilization of stakeholders and resources to ensure whole-of-government and whole-of-society approaches. The lessons and ideas that emerged from the forum may find applicability not only in the next few months during which COVID-19 may persist in our midst (i.e., the “new normal”), but also in other future events that may cause the same level of societal impact and disruption.

Engaging the ASEAN diaspora: Type 2 diabetes prevalence, pathophysiology, and unique risk factors among Filipino migrants in the United States / Journal of the ASEAN Federation of Endocrine Societies

@#<p style="text-align: justify;">Type 2 diabetes prevalence is rising rapidly in Southeast Asia (SEA) where urbanization and adoption of 'western' behavioral lifestyles are attributed as predominant risk factors. The Southeast Asian diaspora to the United States has resulted in a sizable portion of migrant and US born SEAs, with approximately 4 million Filipino Americans, 2 million Vietnamese-Americans, Cambodians (330,000), and Thai (300,000) as the most populous. Their longer exposure to a western lifestyle and participation in clinical studies with other racial/ethnic groups, provide opportunities to evaluate etiologic factors which might inform trends and intervention opportunities among residents of Southeast Asia.</p><p style="text-align: justify;">Epidemiologic studies in the US have identified higher T2D prevalence among Filipinos (16.1%) compared to groups perceived to be at highest risk for T2D, namely Latinos (14.0%), Black (13.7%), and Native Americans (13.4%), while SEAs (including Burmese, Cambodian, Indonesian, Laotian, Malaysian, and Thai, 10.5%) and Vietnamese (9.9%) had higher T2D risk compared to Whites (7.7%), despite their absence of general obesity. Asian-Americans, including SEAs, East and South Asians, collectively have higher rates of undiagnosed T2D compared to other racial/ethnic groups in the US. Almost half (44%) of Filipinos with newly diagnosed T2D have isolated post-challenge hyperglycemia and will remain undiagnosed if current screening practices remain limited to measures of glycosylated hemoglobin and fasting plasma glucose.</p><p style="text-align: justify;">The University of California San Diego Filipino Health Study found excess visceral adipose tissue accumulation, low ratio of muscle to total abdominal mass area, low adiponectin concentration, multiparity (?6 live births), and sleep insufficiency (</p>

Molecular characterization of Plasmodium juxtanucleare in Thai native fowls based on partial cytochrome C oxidase subunit I gene / 대한수의학회지

Avian malaria is one of the most important general blood parasites of poultry in Southeast Asia. Plasmodium (P.) juxtanucleare causes avian malaria in wild and domestic fowl. This study aimed to identify and characterize the Plasmodium species infecting in Thai native fowl. Blood samples were collected for microscopic examination, followed by detection of the Plasmodium cox I gene by using PCR. Five of the 10 sampled fowl had the desired 588 base pair amplicons. Sequence analysis of the five amplicons indicated that the nucleotide and amino acid sequences were homologous to each other and were closely related (100% identity) to a P. juxtanucleare strain isolated in Japan (AB250415). Furthermore, the phylogenetic tree of the cox I gene showed that the P. juxtanucleare in this study were grouped together and clustered with the Japan strain. The presence of P. juxtanucleare described in this study is the first report of P. juxtanucleare in the Thai native fowl of Thailand.

The global prevalence of dental healthcare needs and unmet dental needs among adolescents: a systematic review and meta-analysis / 한국역학회지

OBJECTIVES: Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents.METHODS: PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included.RESULTS: The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0).CONCLUSIONS: The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.

Estimation of the Size of Dengue and Zika Infection Among Korean Travelers to Southeast Asia and Latin America, 2016–2017

OBJECTIVES: To estimate the number and risk of imported infections resulting from people visiting Asian and Latin American countries.METHODS: The dataset of visitors to 5 Asian countries with dengue were analyzed for 2016 and 2017, and in the Philippines, Thailand and Vietnam, imported cases of zika virus infection were also reported. For zika virus, a single imported case was reported from Brazil in 2016, and 2 imported cases reported from the Maldives in 2017. To understand the transmissibility in 5 Southeast Asian countries, the estimate of the force of infection, i.e., the hazard of infection per year and the average duration of travel has been extracted. Outbound travel numbers were retrieved from the World Tourism Organization, including business travelers.RESULTS: The incidence of imported dengue in 2016 was estimated at 7.46, 15.00, 2.14, 4.73 and 2.40 per 100,000 travelers visiting Philippines, Indonesia, Thailand, Malaysia and Vietnam, respectively. Similarly, 2.55, 1.65, 1.53, 1.86 and 1.70 per 100,000 travelers in 2017, respectively. It was estimated that there were 60.1 infections (range: from 16.8 to 150.7 infections) with zika virus in Brazil, 2016, and 345.6 infections (range: from 85.4 to 425.5 infections) with zika virus in the Maldives, 2017.CONCLUSION: This study emphasizes that dengue and zika virus infections are mild in their nature, and a substantial number of infections may go undetected. An appropriate risk assessment of zika virus infection must use the estimated total size of infections.

Effect of Temperature on the Killing of Opisthorchis viverrini Eggs In Vitro

Contaminated liver fluke egg in the environment has led to the high prevalence of human opisthorchiasis associated with cholangiocarcinoma in Southeast Asia. To find the effective lessening methods of Opisthorchis viverrini eggs in the contaminated environment, we investigated the temperature conditions for killing of these trematode eggs in vitro. Numerous O. viverrini eggs were obtained in the proximal part of uteri of adult worms from experimental hamsters. Mature eggs with miracidium were allocated by experimental groups (2 control: positive and negative and 4 treatment: 50, 60, 70, and 80°C) with 0.85% saline, and treated by the experimental plan. Eggs in each experimental groups were observed under the confocal microscope after stain with Propidium Iodide (PI) to evaluate the effect of temperatures. Eggs in 70 and 80°C groups were all killed after over 10 min heated. Majority of eggs in 60°C (10, 15, and 30 min heated), 70 and 80°C (5 min heated) groups were inactivated. However in 50°C group, below half of eggs were to be killed in all time lapse (10, 15 and 30 min). In order to prevent O. viverrini infection and cholangiocarcinoma, direct treatment of sewage by heating at 70 or 80°C at least 10 min is essential. Therefore, treatment of O. viverrini eggs at a high temperature is a potential method for controlling egg contamination in sewage.

How far can African swine fever spread?

African Swine Fever (ASF) is a highly contagious and deadly viral disease affecting both domestic pig and wild boar populations. Once introduced, it is a terrible disease that can devastate the swine industry in many countries. ASF has spread most recently beyond China to Southeast Asia, and parts of the Korean Peninsula. The majority of Asian countries consume pork as the primary source of meat compared to all other meat products. Particular emphasis is on the spread of ASF within North Korea and on future perspectives including protective guidelines. Thus far, the Korean peninsula has endured an extensive history of diseases, most notably from foot and mouth disease. For this reason, the Korean swine industries are familiar with the detrimental impacts of such a disease. On the other hand, exposure to a disease like ASF will decimate the swine industry even further. Therefore, it is crucial to bring urgent awareness to the spread of ASF.

New foot-and-mouth disease vaccine, O JC-R, induce complete protection to pigs against SEA topotype viruses occurred in South Korea, 2014–2015

Foot-and-mouth disease (FMD) is an acute epidemic that spreads rapidly among cattle and pigs. In 2014, in Korea, despite enforced vaccination, the type O Southeast Asia (SEA) topotype viruses (Mya-98 lineage) infected mainly cattle and pigs simultaneously, thereby causing enormous damage. If a vaccine that is completely protective against this FMD virus is developed and used, it can become a very important preventive measure in Asia, which is where this type of virus mainly circulates. The SEA topotype has been steadily evolving and transforming into new variations since it became epidemic in Asia. Therefore, it became necessary to develop a new vaccine that could provide protection against the FMD virus strain that was responsible for the 2014–2015 outbreak in Korea. This study aimed to develop a vaccine that would provide complete protection against the SEA topotype FMD virus to control sporadic FMD outbreaks, which occur despite the enforcement of vaccination, and to completely prevent virus shedding, thereby preventing the virus from spreading. The vaccine candidate virus developed in this study showed low pathogenicity and can be distinguished from the wild-type FMD virus strain. The developed vaccine was able to protect mice from SEA and Middle East–South Asia topotype virus strains and induced high titers of antibodies against both virus strains in pigs, thereby confirming the sufficiency of its protective function. In particular, the results of the SEA topotype virus challenge test in pigs revealed that perfect immunity was created in the vaccinated pigs, without virus shedding and viremia.

Acanthamoeba in Southeast Asia – Overview and Challenges

Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hot-spring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.

Risk of Water and Food-Borne Communicable Diseases in Travelers Entering Korea

OBJECTIVES: It was supposed to analyze status and affecting factors in water and food-borne communicable disease by screening entrants with diarrhea symptom at the point of entry in Korea METHODS: Symptomatic travelers with water and food-borne communicable diseases who entered Korea were diagnosed by a health declaration and detection of causative agents in water and food using laboratory tests. Among those entered in 2017, the affecting factors in the incidence of communicable diseases among those who had diarrhea at the entry into Korea, were analyzed, with frequency and chi-square test. RESULTS: The number of travel entrants with gastrointestinal communicable diseases increased by 40.19% from 2013 to 2017. The percentage of causative agents of water and food-borne communicable diseases was the highest at 69.2% from July to September. The rate of detection of causative agents of communicable disease pathogens in travelers from Southeast Asia entering Korea was 70.2%, which was higher than people arriving from East Asia and Central Asia (57.5%; p < 0.001). CONCLUSION: The positive ratio of causative agents of water and food-borne communicable diseases was high among travelers that had entered Korea from July to September, with a high number among entrants from Southeast Asia. Based on the positive detection of causative agents, the entry period and countries visited were statistically significant affecting factors (p < 0.001).

Breast augmentation surgery using an inframammary fold incision in Southeast Asian women: Patient-reported outcomes

BACKGROUND: This analysis presents patient-reported outcomes of breast augmentation procedures performed in Singapore using an inframammary fold incision and the “5 Ps” best practice principles for breast augmentation. These data are the first of their kind in Southeast Asian patients. METHODS: Through a retrospective chart review, patients who underwent primary breast augmentation with anatomical form-stable silicone gel breast implants using an inframammary fold incision were followed for ≥6 months postoperatively. The BREAST-Q Augmentation Module (scores standardized to 0 [worst] – 100 [best]) and Patient and Observer Scar Assessment Scale (POSAS; 1 [normal skin] to 10 [worst scar imaginable]) were administered. Responses were summarized using descriptive statistics. Patient-reported events were collected. RESULTS: Twenty-two Southeast Asian patients (mean age, 35.1 years) completed ≥1 postoperative BREAST-Q and POSAS assessment and were assessed 11 months to 5.5 years postoperatively. The mean postoperative BREAST-Q satisfaction with breasts and psychosocial well-being scores were 69.2 and 84.0, respectively. The mean POSAS score for their overall opinion of the scar was 4.2; the mean scores for all scar characteristics ranged from 1.2 to 4.2. Over 90% of patients (20/22) said that they would recommend the procedure. Patient complaints following surgery included anisomastia (possibly pre-existing; n=2), sensory loss at the nipple (n=2) or around the nipple (n=3), scarring (n=4), and slight capsular contracture (n=1). No patients required reoperation. CONCLUSIONS: Southeast Asian patients reported high long-term satisfaction scores on the BREAST-Q scale and with their scar characteristics following breast augmentation using an inframammary fold incision, and nearly all said they would recommend this procedure. No reoperations were necessary in patients assessed for up to 5.5 years postoperatively.

An Electronic Questionnaire Survey Evaluating the Perceived Prevalence and Practices of Lactose Intolerance in 1 to 5 Year Old Children in South East Asia / 대한소아소화기영양학회지

PURPOSE: Lactose intolerance (LI) is perceived to be frequent in Asia and has been reported to have considerable impact on dietary intake, nutritional status and the quality of life. We aimed to gather information from healthcare professionals on the perceived incidence, diagnosis and management of LI in 1 to 5 year old children in Southeast Asia. METHODS: An anonymous electronic survey was sent randomly among healthcare professionals registered in the database of the pediatric societies in Thailand, Indonesia, and Singapore between June and October 2016. RESULTS: In total, 259 health care professionals responded of which 45.5% (n=118) were from Thailand, 37.4% (n=97) from Indonesia and 16.9% (n=44) from Singapore. Of the participants who responded (n=248), primary LI prevalence among children 1 to 3 years of age was estimated to be less than 5% by 56.8%. However, about 18.9% (n=47) answered they did not know/unsure. Regarding secondary LI, 61.6% of respondents (n=153) estimated the prevalence to be less than 15%. But again, 10.8% (n=27) answered they did not know or unsure. Rotavirus gastroenteritis was ranked as the top cause for secondary LI. There was considerable heterogeneity in the diagnostic methods used. The majority of respondents (75%) recommended lactose-free milk to manage primary and secondary LI. CONCLUSION: More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required.

Seroepidemiology of Hepatitis Viruses and Hepatitis B Genotypes of Female Marriage Immigrants in Korea

PURPOSE: The Korean society has moved rapidly toward becoming a multicultural society. This study aimed to estimate the seroprevalence of hepatitis viruses and investigate hepatitis B virus (HBV) genotypic diversity in female marriage immigrants. MATERIALS AND METHODS: Screening program was conducted at support centers for multicultural families in 21 administrative districts in Korea between July 2011 and January 2017. A total of 963 female marriage immigrants were included in this study. Blood samples were tested for hepatitis viral markers and HBV genotype. RESULTS: Subjects' median age was 33 years (20–40 years), and they originated from nine countries including Vietnam (n=422, 43.8%), China (n=311, 32.3%), the Philippines (n=85, 8.8%), Cambodia (n=58, 6.0%), and Japan (n=39, 4.0%). About 30% (n=288) of subjects required hepatitis A vaccination. HBsAg positive rate was 5.4% (n=52). Positive HBsAg results were the highest in subjects from Southeast Asia (6.6%, n=38). Anti-HBs positive rate was 60.4% (n=582). About 34% (n=329) of subjects who were negative for anti-HBs and HBsAg required HBV vaccinations. Genotypes B and C were found in 54.6% (n=12) and 45.4% (n=10) of the 22 subjects with HBV, in whom genotypes were tested. Eight (0.8%) subjects were positive for anti-HCV. Positive anti-HCV results were the highest in subjects from Central Asia (7.9%, n=3). CONCLUSION: Testing for hepatitis viral marker (hepatitis A virus IgG and HBsAg/anti-HBs) is needed for female marriage immigrants. Especially, HBV genotype B is different from genotype C of Koreans. Therefore, interest and attention to vaccination programs for female marriage immigrants are necessary for both clinicians and public health institutes.

Photogrammetric Facial Analysis of Attractive Celebrities Using the Glabella for Planning Rhinoplasty and Analyzing Surgical Outcomes

BACKGROUND: Identifying problems and making a surgical plan through a preoperative analysis is important in facial aesthetic surgery. Thus, popular conceptions of an attractive face must be analyzed beforehand. The landmarks used as reference points may change after rhinoplasty, resulting in errors in the prediction and assessment of outcomes. To reduce such errors, it is advantageous to use reference points and landmarks that are subject to minimal variation. This study measured and analyzed landmarks with little preoperative and postoperative variation in rhinoplasty, and established appropriate standards for landmarks indicative of ideal profiles. METHODS: A photogrammetric analysis was performed of 80 famous and attractive celebrities from Korea, Southeast Asia, Japan, China, and America. The nasofrontal angle, nasal angle, nasolabial angle, angle of facial convexity, and angle of total facial convexity were measured. RESULTS: The angle of total facial convexity differed significantly among countries (P=0.013). No significant difference in nasal angle, facial convexity, or total facial convexity was observed between Western and Eastern countries. A significant difference in the nasofrontal angle (Asian: 138.66°, Western: 134.35°; P=0.006) was observed. The nasolabial angle (Asian: 97.09°, Western: 104.59° degrees; P=0.007) was significantly more acute in Asian than in Western subjects. CONCLUSIONS: In this study, we performed a more accurate analysis using the glabella instead of the nasion to measure the facial profiles of patients planning to undergo rhinoplasty and proposed standard values through an analysis of ideal and attractive facial profiles.

A Case of Life-Threating Streptococcus suis Infection Presented as Septic Shock and Multiple Abscesses

Streptococcus suis is a zoonotic pathogen that can cause severe systemic infections in humans as well as swine. In recent decades, the number of S. suis infections in humans has increased, particularly in Southeast Asia. Although most cases of S. suis human infections are reported as sporadic, a few outbreaks have been noted. Interestingly, these outbreaks have been proposed to be associated with concomitant outbreaks in swine. In Korea, four sporadic and non-fatal cases of S. suis infection have been reported. We herein report a case of life-threating S. suis infection with sepsis for the first time in Korea. The patient was a healthy pig farmer, and the gastrointestinal tract was considered the route of infection. This case emphasized the need for awareness and recognition of S. suis as a zoonotic pathogen.