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GOUT

Gout is a condition that resulted from deposition of monosodium urate crystals in various tissues (eg joints, connective tissue, kidney).
The patient experiences acute and chronic arthritis, soft tissue inflammation, tophus formation, gouty nephropathy and nephrolithiasis.
Primary hyperuricemia occurs when uric acid saturation arises without coexisting diseases or drugs that alter uric acid production or excretion, while secondary hyperuricemia is a condition where excessive uric acid production or diminished renal clearance occurs as a result of a disease, drug, dietary product or toxin.

Gout Signs and Symptoms

Signs and Symptoms

Definition

Gout is a condition wherein there is increased urate in the body, also called hyperuricemia, that leads to deposition of monosodium urate monohydrate crystals in various tissues (eg joints, connective tissue, kidney)

Pathophysiology

Hyperuricemia is a necessary precondition for the development of monosodium urate monohydrate crystal deposition but this has to be distinguished from gout, the clinical syndrome
Results in acute and chronic inflammation associated with changes in articular and periarticular structures

Epidemiology

It is the most common inflammatory arthritis in men
In US and Europe, the estimated prevalence of gout is 3% of adults
Prevalence of gout in the Asia-Pacific region varies
- Ethnic groups in China and Malaysia (eg Malays, Tamils) were found to have higher uric levels as compared to the Japanese and Thai
- Taiwan is one of the countries in the world with highest prevalence of gout

Risk Factors

Risk factors for gout and associated comorbidity should be assessed

Risk Factors Associated with Gout

Hyperuricemia
- Single most important risk factor for developing gout
Male sex
Menopausal women
Age
Purine-rich diet (eg meat, seafood)
Alcohol intake
Drug use (eg diuretics, low-dose Aspirin, Ciclosporin)
Lead exposure
Obesity
Renal insufficiency

Metabolic Abnormalities/Comorbidities Associated with Gout

Hypertension
Obesity
Dyslipidemia
Hyperglycemia and insulin resistance
Coronary artery disease
Type 2 diabetes mellitus
Renal insufficiency
Metabolic syndrome
Kidney stone

Spotlight on multidrug-resistant gram-negative infections: New developments for an old problem

Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021

Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.

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