Singap Med J
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Obesity is a growing problem worldwide that is closely related to type 2 diabetes mellitus (T2DM). The Roux-en-Y gastric bypass (RYGBP), a restrictive and malabsorptive bariatric procedure, shows mounting evidence of inducing improvement of T2DM. Few studies, especially those examining the early changes in diabetic parameters, have been done in the Asian population. ⋯ The cure rate of 28.6 percent and an improvement rate of 100 percent of T2DM in morbidly obese Asian patients within 12 weeks post operation are promising. Many patients discontinued their diabetic medications in the immediate postoperative period, even before significant weight loss had occurred, indicating that RYGBP has an effect on hormonal mechanisms that influence glucose homeostasis in the body.
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With an ageing population, policy makers need to balance active ageing needs with older driver safety. In 2009, a survey of licensing policies for taxi drivers in Singapore, Hong Kong and Australia was undertaken for an evidence-based review of policies. ⋯ Medical screening for at-risk drivers remains crucial. Age-based mandatory retirement policy at 73 years in Singapore is contrary to evidence-based practice. The lack of legislation for self-reporting of illness by drivers, the high minimum age criteria and therapy driving assessments for healthy taxi drivers are also unique to Singapore. There was stricter age-based relicensing from the age of 65 years in some Australian states and in Singapore. Continuing education for doctors, multi-tier screening for at-risk drivers and licensing policy changes are indicated.
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Case Reports
Persistent left superior vena cava: a possible site for haemodialysis catheter placement.
Persistent left superior vena cava (PLSVC) is a congenital variant of the thoracic venous system, which is associated with other congenital abnormalities. Asymptomatic cases are often diagnosed incidentally during invasive cardiovascular procedures such as the deployment of central venous access devices. It is important to be aware of the existence of a PLSVC and the clinical implications that it may pose to the proceduralist during catheter placement. We describe our experience and the lessons learnt during the placement of a haemodialysis catheter via the left internal jugular venous route in a patient with unsuspected PLSVC.
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This study aimed to estimate the prevalence of diagnosed and undiagnosed diabetes mellitus (DM) in the Eastern Province of Saudi Arabia, and to study its relationship with socioeconomic factors. ⋯ The prevalence of DM in Saudi Arabia is one of the highest reported in the world, and its yield of screening is high.
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Declarations of exclusive publication, author contribution, conflict-of-interest and copyright transfer are important formalities required by most biomedical journals. Conflict-of-interest may be personal, commercial, political, academic or financial. ⋯ Editors, editorial board members and reviewers should also declare any possible conflicts-of-interest. The handling of conflict-of-interest during manuscript preparation, peer review and editorial decision making impacts the credibility of published articles and scientific research in general.