Most Read Articles
22 May 2017
Chronic obstructive pulmonary disease (COPD) is currently the 10th commonest cause of death in Singapore, with a disease burden of 5.9 percent according to a 2015 population-based survey (EPIC-Asia survey) in Singapore. Pearl Toh spoke with Dr Augustine Tee, chief and senior consultant of the Department of Respiratory and Critical Care Medicine at Changi General Hospital (CGH) in Singapore, on how COPD is often underdetected in the primary care population as symptoms are not specific and diagnosis requires a combination of clinical risk factors, symptoms and spirometry testing.
15 Aug 2017
New drug applications approved by US FDA as of 1 - 15 August 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
04 Aug 2017
Chronic obstructive pulmonary disease (COPD) is the fourth cause of global mortality, with experts predicting a potential future rise in the prevalence rates of COPD. 
11 May 2016

In conjunction with World Asthma Day which falls on 3rd May 2016, MIMS Doctor speaks to a renowned respiratory medicine specialist, Dato' Dr. Hj Abdul Razak Abdul Muttalif, regarding the chronic airway disease.

HbA1c admission levels do not predict outcomes in pulmonary tuberculosis

21 Apr 2017
Reduce TB prevalence to 10 per 100,000 by 2022

HbA1c levels on admission do not predict therapeutic outcomes in in-hospital, smear-positive, culture-proven, HIV-negative tuberculosis, a new study shows.

Medical and clinical records of 239 patients (62 percent male; median age 73 years) diagnosed with pulmonary tuberculosis were used for this study. Confirmation of tuberculosis was done through cultures and participants were consistently monitored for HIV. Those who had culture-negative tuberculosis, were HIV positive, had multidrug-resistant tuberculosis and were taking antituberculosis treatment were excluded.

After baseline blood, sputum, HbA1c and X-ray assessments, participants received isoniazid, rifampicin, pyranizamide and ethambutol (HRZE) or isoniacid, rifampicin and ethambutol for 2 months followed by isoniazid and rifampicin. In-hospital death, becoming noninfective and time to live discharge were the main outcomes of the study.

The median HbA1c and blood glucose levels were 5.9 percent (5.6 to 6.6) and 109 mg/dL (96 to 133), respectively. Of all participants, 81 percent (n=193) were discharged alive and 86 percent (n=206) became noninfective before death.

Admission HbA1c levels was above 7.0 percent in 44 patients. Over the course of 3 months, there were clear and significant downward trends in HbA1c levels 1, 2 and 3 months after admission(p<0.001 for months 1, 2 and 3).

There was no apparent correlation between the time to discharge alive and the levels of HbA1c on admission according to the Spearman’s rank correlation test (r=0.17), Kaplan-Meier curves (p=0.431) and multivariate Cox analysis (hazard ratio [HR], 1.03; 95 percent CI, 0.89 to 1.20; p=0.659).

Similarly, there were no significant correlations between the time to becoming noninfective and levels of HbA1c on admission (r=0.17; p=0.113; HR, 0.93; 0.80 to 1.06; p=0.277 for every 1 percent increase in HbA1c).

Finally, HbA1c levels were not significantly associated with in-hospital mortality (p=0.631) and time to in-hospital death (p=0.427).

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Most Read Articles
22 May 2017
Chronic obstructive pulmonary disease (COPD) is currently the 10th commonest cause of death in Singapore, with a disease burden of 5.9 percent according to a 2015 population-based survey (EPIC-Asia survey) in Singapore. Pearl Toh spoke with Dr Augustine Tee, chief and senior consultant of the Department of Respiratory and Critical Care Medicine at Changi General Hospital (CGH) in Singapore, on how COPD is often underdetected in the primary care population as symptoms are not specific and diagnosis requires a combination of clinical risk factors, symptoms and spirometry testing.
15 Aug 2017
New drug applications approved by US FDA as of 1 - 15 August 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
04 Aug 2017
Chronic obstructive pulmonary disease (COPD) is the fourth cause of global mortality, with experts predicting a potential future rise in the prevalence rates of COPD. 
11 May 2016

In conjunction with World Asthma Day which falls on 3rd May 2016, MIMS Doctor speaks to a renowned respiratory medicine specialist, Dato' Dr. Hj Abdul Razak Abdul Muttalif, regarding the chronic airway disease.