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Monoallelic or biallelic RAD51C germline mutations results in chromosome instability disorders such as fanconi anemia (FA) and cancers. The bona fide function of RAD51C is to assist RAD51 nucleoprotein filament onto single strand DNA to complete Homologous Recombination (HR) repair. In addition to HR repair, the role of RAD51C in DNA replication is emerging when replication forks are transiently or irreversibly stalled. We identified novel RAD51C variants of uncertain significance (VUS) from breast, ovarian, pancreatic, and gastric cancer patients and functionally characterized the effect of these variants in replication fork protection and double-strand breaks (DSB's) repair. In RAD51C deficient chinese hamster CL-V4B cells, expression of RAD51C F164S, A87E, L134S and E49K variants heightened sensitivity to mitomycin C (MMC), etoposide and PARP inhibition. Differently, expression of a subset RAD51C variants R24L, R24W, and R212H displayed mild sensitivity to MMC, etoposide and PARP inhibition. Further functional characterization of a subset of variants revealed that Rad51C F164S, A87E, L134S and E49K variants displayed reduced RAD51 foci formation and increased overall nuclear single strand DNA levels in the presence of replication stress. Additionally, DNA fiber assay revealed that RAD51C F164S, A87E, L134S and E49K variants displayed defective replication fork protection upon prolonged fork stalling. Investigations using patient-derived lymphoblastoid cell line carrying heterozygous RAD51C L134S variant showed an impairment in RAD51 chromatin association and replication fork protection, suggestive of deleteriousness of this VUS variant. Overall, our findings provide more insights into molecular roles of RAD51C in replication fork integrity maintenance and in DSB repair. Disclosure Summary The authors report no relevant conflicts of interest in this work. Ministry of Education (MOE) National Medical Research Council (NMRC) Singapore Ministry of Education (MOE) under its Academic Research Fund ( AcRF) Tier 1 [2019-T1-001-018]; National Cancer Centre Research Fund Terry Fox Grant [NCCRF-YR2018-NOV-1]; National Medical Research Council (NMRC) Clinician Scientist Award [MOH-000654].

BACKGROUND: Recognizing food groups consumption in young adults offers an opportunity to improve dietary pattern in early adulthood. OBJECTIVE: Hence, this cross-sectional study aimed to determine food groups’ intake of young adults and to identify food groups associated with adiposity. METHODS: Youths aged 18–25 years old from private universities in Klang Valley, Malaysia, participated in the study (n = 294). Three days 24-hour dietary recall assessed youths’ food groups intake. Adiposity (BMI, body fat percentage, visceral fat level, waist circumference) was determined based on standard protocol. Height was measured using SECA 206 body meter, while weight, body fat percentage, and visceral fat level were measured using the Omron HBF-356 Body Fat Analyzer. Waist circumference was determined using a measuring tape. RESULTS: In total, 49.3% and 34.7% of youths were overweight/obese and abdominally obese, respectively. The median visceral fat level was 4 (6). Youths consumed 214 (247) kcal of ultra-processed foods daily and exceeded the sugar [32.43 (41.20) g] and sodium recommendation [2425.26 (1455.18) mg]. Fruits [0.29±0.72 servings/day], vegetables [0.95±0.77 servings/day] and milk [0.24±0.38 servings/day] were below recommendations. Increased intake of meat and sodium were associated with higher BMI, waist circumference, body fat percentage, and visceral fat (p

Introduction: Amlodipine besylate is a calcium channel blocker indicated for hypertension and angina. It is described as slightly soluble in water and due to its limited solubility, it may result in poor bioavailability. The aim of this study is to enhance the solubility of amlodipine besylate using solvent evaporation method and microemulsion technique and to compare the two methods. Method: Solid dispersions (SD) of amlodipine besylate were developed by employing solvent evaporation method. PEG6000 was the polymer of choice and different drug:polymer ratios were used. Evaluation of the prepared SDs include solubility studies, dissolution studies and scanning electron microscopy (SEM). As for the microemulsion technique, microemulsions were prepared by phase titration method and the optimized microemulsion formulation was then characterized for solubility studies and dissolution studies. Results: SD3 with drug:polymer ratio of 1:4 achieved the highest solubility which was 96.97 mg/ml ± 0.92 whereas the solubility of the optimized microemulsion was found to be 112.54 mg/ml ± 0.92. In solvent evaporation method, as the drug:polymer ratio increases, the solubility and dissolution rate of SDs increases. Conclusion: The two methods had significantly enhance the solubility of amlodipine besylate however the microemulsion technique showed better solubility profile.

In this study, valuable low-gluten flour and gum were fractionated simultaneously from durian seed via a green and safe aqueous extraction method at maximum atom economy. As the extraction process significantly affected the properties and hence, the application of the flour and gum, the process-properties relationship of extraction temperature and W/S ratio were investigated and presented in this paper. The demucilaged durian seed flour (DDSF) and durian seed gum (DSG) solubilities and water absorption capacity (WAC) were found improved at higher extraction temperature (85 °C) due to bond cleavage and retention of amylose and hydrophilic amino acids. Furthermore, DSG with a solubility of 46.67% was the highest that can be achieved by current aqueous extraction method as further increase of W/S ratio and DSG yield exerted no effect on the solubility. Besides, the oil absorption capacity (OAC) of DSG was found higher than the DDSF due to the presence of nonpolar amino acids and fatty acids that tended to bind with the hydrophobic oil. OAC was mainly determined by the extraction yield and distribution of these hydrophobic fraction, instead of the degree of degradation. Higher overall yield was found at higher extraction temperature of 85 °C for simultaneous extraction of DDSF and DSG. While lower W/S ratio at 1:1 was preferable to obtain higher yield of DDSF, a higher W/S ratio at 5:1 was required for higher yield of DSG. Other than the extraction temperature, drying temperature and duration were key factors determining the colour of the extracted DDSF and DSG.

Abstract: Boehmeria nivea, commonly known as ramie, is a functional food ingredient used by Asians. It is also cultivated for its leaf fibres with excellent tensile strength, resistance to shrinkage, and antimildew, antibacterial, and antifungal properties. Ramie leaves and roots are also consumed as food, beverages, and medicinal herbs. This plant has been used as ethnomedicine for various health complications, including hepatoprotective, antiviral, antipyretic, detoxification, reduced swelling, etc. The ethnomedicinal uses of ramie in multiple countries, including China, Taiwan, Japan, Korea, Sri Lanka, Bangladesh, and Malaysia, have been reviewed. The phytochemicals or secondary metabolites reported in ramie have also been listed. Ramie has been found to exhibit numerous promising pharmacological activities. Four pharmacological activities of ramie that are closely related to treating and preventing inflammatory bowel disease (IBD) have been thoroughly reviewed: anti-inflammatory, anti-colitis, anti-oxidative, and laxative.

Research background and Objectives: Age is an independent risk factor for cardiovascular disease (CVD), but CVD risk factors are preventable, and lack of awareness of its risk factors is a contributing factor to CVDs. Middle-aged people may be more likely to engage in unhealthy lifestyle behaviours which can increase the risk of CVD. Health self-assessment is crucial for early detection and management of health issues and early lifestyle intervention for better personalised health management. This study aims to determine the self-assessment of INTERHEART risk classification among the middle-aged community in Malaysia. Method: Local community members aged 40–60 years and who are currently residing in Malaysia were recruited via non-randomised sampling. Sociodemographic characteristics and dietary pattern related to salt, fibre, fat (deep fried/snacks), poultry/meat intakes, and other cardiovascular risk factors (waist-hip ratio, medical history related to diabetes/hypertension, history/exposure of tobacco use, psychosocial status, and level of physical activity) were assessed; INTERHEART risk scores were then computed and stratified into low, medium and high risks. Results: Approximately 45% (n = 273/602) of middle-aged respondents in Malaysia are at moderate-to-high risk of cardiovascular events, with men being more likely to develop CVD compared to women. The results of the survey indicated that poultry/meat intake (61%), physical inactivity (59%), and second-hand smoke (SHS) exposure (54%) are the most prevalent risk factors among the respondents. One-third of the respondents consumed excessive salty food and deep fried foods/snacks/fast food, and only one-third of them consumed vegetables/fruits at a recommended level. It is worrying that about a quarter of the respondents felt several periodical/permanent stresses and even felt sad/blue/depressed for two weeks or more in a row. Males, labour workers, and those with lower educational levels are more likely to develop CVD events. Conclusions: This study found that 45% of the middle-aged respondents were having moderate-to-high risk for cardiovascular events with multiple risk factors related to unhealthy lifestyle habits and environmental factors. In addition to non-modifiable factors such as gender and age, sociodemographic factors, i.e., educational level and occupation, are equally important factors to determine CVD risk. Overall, the findings of this study emphasize the clinical relevance of assessing multiple factors in the determination of CVD risks for early prevention and management of cardiovascular diseases.

Co-processed excipients were prepared by incorporating one excipient into the particle structure of another and a combination of two or more compendia or noncompendia excipients to physically modify their properties, which cannot be achievable by simple physical mixing. The co-processed multicomponent-based excipients were introduced to achieve better characteristics and tableting properties. This objective of this study was to develop and evaluate a co-processed excipient for amlodipine orally disintegrating tablets to simplify the compounding process. The co-processed excipients were prepared by wet granulation with 5% of polyvinylpyrrolidone and croscarmellose sodium, five different percentages of microcrystalline cellulose, and lactose monohydrate. After sieving and drying, the co-processed excipients were evaluated for flowability and compressibility. The co-processed excipients were mixed with the amlodipine powder and magnesium stearate and compressed into tablets. The amlodipine tablets were evaluated for weight variation, content uniformity, thickness, hardness, friability, disintegration, and dissolution tests. Formulation 4 was chosen as the optimum formulation because the results showed this formulation had the excellent flowability and compressibility of a co-processed excipient. It showed uniformity of weight, content, thickness, and hardness, weight loss less than 1%, fast disintegration time, and dissolution results. The developed co-processed excipient can be used by the pharmaceutical industry in the future to compound amlodipine orally disintegrating tablets in a fast and economical way.

PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.

Flibanserin has been recently approved by the USFDA for treating female sexual interest disorder. It is currently not included in any of the Pharmacopoeias. No stability indicating method information about flibanserin has been reported in the literature. Flibanserin stock solution (1 mg/mL) was prepared and serially diluted (concentration ranged 1-20 μg/mL). Flibanserin solutions (1-20 μg/mL) were analysed using RP-HPLC under isocratic elution of mobile phase acetonitrile and ammonium acetate (60:40; V/V) at 1 mL/minute. This HPLC method was validated for linearity, accuracy, precision, robustness, limit of detection (LOD) and limit of quantification (LOQ), according to ICH guidelines. Results showed that the method developed has promising linearity (r2= 0.9993), accuracy, precision (0.92-1.61%), robustness, LOD and LOQ. The developed HPLC method for evaluation of flibanserin was found reliable, precise, sensitive, accurate and repeatable for routine analysis and quality control of flibanserin. It is suitable to be used as stability indicating method in pharmaceutical analysis.

PURPOSE Genetic testing has clinical utility in the management of patients with hereditary cancer syndromes. However, the increased likelihood of encountering a variant of uncertain significance in individuals of non-European descent such as Asians may be challenging to both clinicians and patients. This study aims to evaluate the impact of variant reclassification in an Asian country with variants of uncertain significance reported in cancer predisposition genes. METHODS A retrospective analysis of patients seen at the Cancer Genetics Service at the National Cancer Centre Singapore between February 2014 and March 2020 was conducted. The frequency, direction, and time to variant reclassification were evaluated by comparing the reclassified report against the original report. RESULTS A total of 1,412 variants of uncertain significance were reported in 49.9% (845 of 1,695) of patients. Over 6 years, 6.7% (94 of 1,412) of variants were reclassified. Most variants of uncertain significance (94.1%, 80 of 85) were downgraded to benign or likely benign variant, with a smaller proportion of variants of uncertain significance (5.9%, 5 of 85) upgraded to pathogenic or likely pathogenic variant. Actionable variants of uncertain significance upgrades and pathogenic or likely pathogenic variant downgrades, which resulted in management changes, happened in 31.0% (39 of 126) of patients. The median and mean time taken for reclassification were 1 and 1.62 year(s), respectively. CONCLUSION We propose a clinical guideline to standardize management of patients reported to have variants of uncertain significance. Management should be based on the patient’s personal history, family history, and variant interpretation. For clinically relevant or suspicious variants of uncertain significance, follow-up is recommended every 2 years, as actionable reclassifications may happen during this period.

Motivation DNA fibre assay has a potential application in genomic medicine, cancer and stem cell research at the single-molecule level. A major challenge for the clinical and research implementation of DNA fibre assays is the slow speed in which manual analysis takes place as it limits the clinical actionability. While automatic detection of DNA fibres speeds up this process considerably, current publicly available software have limited features in terms of their user interface for manual correction of results, which in turn limit their accuracy and ability to account for atypical structures that may be important in diagnosis or investigative studies. We recognize that core improvements can be made to the GUI to allow for direct interaction with automatic results to preserve accuracy as well as enhance the versatility of automatic DNA fibre detection for use in variety of situations. Results To address the unmet needs of diverse DNA fibre analysis investigations, we propose DNA Stranding, an open-source software that is able to perform accurate fibre length quantification (13.22% mean relative error) and fibre pattern recognition (R > 0.93) with up to six fibre patterns supported. With the graphical interface, we developed, user can conduct semi-automatic analyses which benefits from the advantages of both automatic and manual processes to improve workflow efficiency without compromising accuracy. Availability and implementation The software package is available at https://github.com/lgole/DNAStranding. Supplementary information Supplementary data are available at Bioinformatics online.

Following the introduction of penicillin in the 1940s, the incidence of infectious syphilis in the United States dramatically declined from a high of 70.9 per 100,000 in 1946 to a historic low of 2.1 in 20001. In the decade since, syphilis has shown signs of re-emergence, with the incidence rate of infectious syphilis in the U.S. increasing to 5.5 per 100,000 in 2013. Infectious syphilis trends in California have largely paralleled those of the rest of the country, but with an incidence rate consistently above the national average. After decades of substantial progress in syphilis control, the incidence of infectious syphilis in California increased from a low of 0.9 per 100,000 (284 cases) in 1999 to 9.3 in 2013 (3,554 cases)2. As in other major metropolitan areas in the U.S., the majority of syphilis cases in California are among men who have sex with men (MSM), with a high proportion reporting HIV co-infection. Syphilis infection can result in major health complications if untreated, and also facilitates the transmission and acquisition of HIV3-5.In addition to mandated reporting to health departments, syphilis partner services – in particular, partner notification - are a standard public health practice for identifying potentially infectious individuals for testing and treatment, thereby interrupting transmission of syphilis within sexual networks and reducing incidence of the illness in the general population6. However, the increasing incidence of syphilis in California, the frequent reporting by patients with syphilis of anonymous sex partners, and the lack of a clear measure of partner services effectiveness raise questions concerning the impact this intervention is having on spread of disease, and to what extent the data acquired through syphilis partner services provide meaningful information about how the underlying sexual networks contribute to trends in syphilis morbidity in various populations.The objectives of this dissertation are 1) to review studies evaluating syphilis partner notification efforts and compare outcome definitions and measures of effectiveness, 2) to analyze the structure and characteristics of sexual networks detected through routine syphilis surveillance and partner notification efforts in the San Francisco Bay Area Region, and 3) to make recommendations concerning how public health departments might use syphilis surveillance data to better understand such networks and to provide opportunities for case-finding and disease prevention.This dissertation will directly inform a common public health intervention by assessing the utility of existing public health data for understanding and preventing transmission of syphilis within networks, and by discussing ways in which resources might be deployed to reduce the incidence of syphilis more effectively.

Traditional medicine is critical in disease treatment and management. Herbs are gaining popularity for disease management and treatment. Therefore, they can be utilised as complementary and alternative treatment (CAT) ingredients. Atopic dermatitis (AD) is one of the common non-communicable diseases. It is characterised by chronic inflammatory skin disease with intense pruritus and eczematous lesions. AD is associated with oxidative stress, microbial infection, and upregulation of inflammatory cytokines. Both children and adults could be affected by this skin disorder. The prevalence of AD is increasing along with the country’s level of development. This review revisited the literature on four medicinal herbs widely used as complementary medicine to manage AD. These therapeutic herbs are commonly eaten as food and used as spices in Asian cuisine. The four food herbs reviewed are Cassia alata, Coriandrum sativum, Curcuma longa Linn, and Azadirachta indica. Their traditional uses and phytochemical content will be covered. Four relevant pharmacological and biological activities of the plants crucial in AD management have been reviewed and discussed, including anti-inflammatory, anti-microbial, antioxidant, and wound recovery.

Background Despite a global call for action and growing burden of non-communicable diseases (NCD) associated with physical inactivity, effective interventions to increase community-wide physical activity (PA) remain few. NCDs accounted for 80% of Singapore’s disease burden (2015) and yet 40% of Singaporeans did not meet minimum recommended weekly PA despite evidence of the benefits to cardiorespiratory health, diabetes and cancer prevention. Methods A large-scale public health intervention was initiated in 2015 to increase population-level PA through incidental daily walking. Intervention components included fitness trackers, redeemable rewards and gamification, implemented in a mutually-reinforcing manner within an eco-system supportive of PA and informed by real-time data analytics. Mean daily step count at baseline and post-intervention were compared across periods, and the influence of participant sub-groups characteristics on overall results, using significance tests. Standards for Reporting on Implementation Studies (StaRI) were adhered to. Results Intervention reach increased fourfold from 129,677 participants in wave 1 (2015–16) to 690,233 in wave 3 (2017–18) amounting to a total of 1,184,410 Step Challenge participations. Mean days of fitness tracker use increased from 2.4 to 5.0 days/week among participants completing the Challenge in wave 1 and from 5.3 to 6.0 days/week in wave 3. The mean number of daily steps between pre-Challenge and Challenge periods increased by 4163 (sd=1360; p Conclusion Population-level PA was effectively increased through multi-level interventions integrating technology, behavioural economics, gamification, marketing, communications and community linkages within a supportive context- and climate-appropriate environment. Responsive data analytics were instrumental to strengthen implementation by tailoring modalities that maximise effectiveness at population-level. Further analyses are needed to explore potential barriers, challenges or unmet needs in sub-groups with lower uptake to tailor future interventions for greater reach and impact.

BACKGROUND Multimorbidity, the coexistence of multiple chronic conditions in an individual, is a growing public health challenge. Amidst the COVID-19 pandemic, physical distancing remains an indispensable measure to limit the spread of the virus. This pertains especially to those belonging to high-risk groups, namely older adults with multimorbidity. In-person visits are discouraged for this cohort; hence, there is a need for an alternative form of consultation such as video consultations to continue the provision of care. OBJECTIVE The potential of video consultations has been explored in several studies. However, the emergence of COVID-19 presents us with an unprecedented opportunity to explore the use of this technological innovation in a time when physical distancing is imperative. This study will evaluate the sustainability of video consultations on a micro-, meso-, and macro-level by assessing the views of patients, physicians, and organizational and national policymakers, respectively. METHODS The NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework was designed as a guide for the development of health care technologies. In this study, the implementation of and experiences related to video consultations will be studied using the NASSS framework. Individual in-depth interviews or focus group discussions will be conducted with participants using the Zoom platform. Data will be analyzed by at least two investigators trained in qualitative methodology, organized thematically, and coded in two phases—an initial phase and a focused selective phase. All disagreements will be resolved by consulting the larger research team until consensus is reached. RESULTS This study was approved for funding from the Geriatric Education and Research Institute. Ethics approval was obtained from the National Healthcare Group Domain Specific Review Board (reference #2020/00760). Study recruitment commenced in July 2020. The results of the data analysis are expected to be available by the end of the year. CONCLUSIONS This study aims to evaluate the adoption and sustainability of video consultations for older adults with multimorbidity during the pandemic as well as post COVID-19. The study will yield knowledge that will challenge the current paradigm on how care is being delivered for community-dwelling older adults with multimorbidity. Findings will be shared with administrators in the health care sector in order to enhance the safety and quality of these video consultations to improve patient care for this group of population. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/22679

Previous flavivirus (dengue and Zika viruses) studies showed largely spherical particles either with smooth or bumpy surfaces. Here, we demonstrate flavivirus particles have high structural plasticity by the induction of a non-spherical morphology at elevated temperatures: the club-shaped particle (clubSP), which contains a cylindrical tail and a disc-like head. Complex formation of DENV and ZIKV with Fab C10 stabilize the viruses allowing cryoEM structural determination to ~10 Å resolution. The caterpillar-shaped (catSP) Fab C10:ZIKV complex shows Fabs locking the E protein raft structure containing three E dimers. However, compared to the original spherical structure, the rafts have rotated relative to each other. The helical tail structure of Fab C10:DENV3 clubSP showed although the Fab locked an E protein dimer, the dimers have shifted laterally. Morphological diversity, including clubSP and the previously identified bumpy and smooth-surfaced spherical particles, may help flavivirus survival and immune evasion., Dengue (DENV) and Zika (ZIKV) viruses normally display as smooth spherical particles, while DENV can also become bumpy-surfaced, resulting in immune evasion. Here, Morrone et al. report DENV and ZIKV infectious club-shaped particles (clubSP) that display distinct antibody binding properties.

Background: Garcinia genus plants are a group of well-known fruit trees in Malaysia.The botanical parts of the trees are used for medicinal purposes, where they are prepared as decoction, pastes for wound infections, and some have been consumed as food. Objectives: This paper focused on the assessment of antioxidant potential of three selected Garcinia species commonly used in Malaysia. Materials and Methods: Fresh plant materials were extracted using maceration, and various antioxidant activities of the extracts were evaluated. In vitro antioxidant properties studied were total phenolic and anthocyanin content, free radical scavenging (FRS), ferric reducing power (FRP) and ferrous ion chelating (FIC) activities. Results: G. mangostana leaves and pericarps were found to consist of the highest TPC, FRS and FRP activities, followed by G. hombroniana and G. atroviridis. TAC was found only in G. mangostana pericarps. For fruit pulps, G. hombroniana exhibited the highest antioxidant activities (TPC, FRS and FRP), while G. mangostana had the lowest activities. FIC activity of the Garcinia samples behaved in dose-dependent manner and not correlated with TPC and other antioxidant activities. Conclusion: In general, G. mangostana and G. hombroniana leaves and pericarps exhibited good antioxidant activities, but the antioxidant activities in their fruit pulps were relatively low. G. atroviridis leaves and pericarps generally have lower antioxidant activities than the other species.

Background Atopic dermatitis (AD) is a chronic relapsing, noncontagious skin inflammation characterized by dry skin and itch. Mutation in filaggrin gene leads to defective skin barrier, allowing entry of allergen and eliciting immunological response. Objectives The aims of this study were to investigate the prevalence of AD in Malaysian children and to understand the pattern of drug therapy. Such information could be useful to establish the relationship between ethnicity and family history of atopy and the development of associated signs and symptoms. Methods A cross-sectional survey was conducted among children attending kindergartens and nurseries. Standardized questionnaires were filled out by parents. Results Overall prevalence of AD was 13.4%. Of 384 participants recruited, the highest prevalence was observed in males, Malays, participants younger than 2 years, and those with atopic background such as asthma, hay fever, and family history of atopic diseases. Calamine and white soft paraffin were the preferred choice of nonprescription drugs, whereas topical hydrocortisone seemed to be the preferred choice of prescription drug in the management of AD. Conclusions The overall prevalence is comparable to that reported in the International Study of Asthma and Allergies in Childhood Phase One. There is an association between ethnicity and AD prevalence. Topical corticosteroids and emollients are the mainstay of AD management among Malaysians.

Atopic dermatitis (AD) is a common dermatological disease characterized by relapsing pruritus and rash accompanied by cutaneous physiological dysfunction. This disease could affect certain population worldwide, including infants, children and adults. The prevalence of AD has been increased rapidly over the past few decades and the severity of the disease, symptoms, and effects on patients’ quality of life may vary among individuals. AD could be caused or triggered by several factors, such as genotypic, climatic, food allergens and environmental. Many treatments are available to alleviate the symptoms and severity of AD, including topical therapy, immunosuppressant and systemic therapy, phytotherapeutic approach, traditional Chinese medicine (TCM), as well as complementary and adjunct therapies. Topical therapies involve moisturizers, emollients, topical corticosteroids, topical pimecrolimus and tacrolimus and antipruitic/antihistamine therapy. Whereas, systemic therapies and immunosuppressant prescribed for AD treatment include cyclosporine A, azathioprine and methotrexate. Nowadays, not only the modern medicines are used for treatment of AD but also the phytotherapy using herbs and TCM are commonly incorporated into the therapy. In addition some studies have been showed that complementary/adjunct therapies are effective as preventive approaches for managing AD. In this review some examples of these therapies and approaches will be discussed with relevant supporting literatures.

Background Like several Southeast Asian countries, Singapore has a complex eating-out environment and a rising eating-out prevalence. However the determinants and drivers of eating-out in urban Asian environments are poorly understood. Methods We examined the socio-demographic characteristics of persons who frequently ate away from home in local eateries called hawker centres and Western fast-food restaurants, using data from 1647 Singaporean adults participating in the National Nutrition Survey (NNS) 2010. We also assessed the underlying drivers of eating out and evaluated if these were different for eating at local eateries compared to Western fast-food restaurants using 18 focus group discussions of women (130 women). Results Participants reported a high eating-out frequency with 77.3% usually eating either breakfast, lunch or dinner at eateries. Main venues for eating-out included hawker centres (61.1% usually ate at least 1 of 3 daily meals at this venue) and school/workplace canteens (20.4%). A minority of participants (1.9%) reported usually eating at Western fast-food restaurants. Younger participants and those of Chinese and Malay ethnicity compared to Indians were more likely to eat at Western fast-food restaurants. Chinese and employed persons were more likely to eat at hawker centres. The ready availability of a large variety of affordable and appealing foods appeared to be a primary driver of eating out, particularly at hawker centres. Conclusions Our findings highlight the growing importance of eating-out in an urban Asian population where local eating venues play a more dominant role compared with Western fast-food chains. Interventions focusing on improving the food quality at venues for eating out are important to improve the diet of urban Asian populations. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0515-x) contains supplementary material, which is available to authorized users.