Infectious disease doctor, National Centre Infectious Diseases. Professor, Lee Kong Chian Medicine. #HighlyCitedResearcher2025
Singapore
Joined March 2014
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New antibiotics were approved in only a limited number of Asian countries. Countries had a median of 3.5 available new antibiotics, ranging from one to six. Approval lag was three to five years after US FDA approval in most cases.
sciencedirect.com/science/ar…
Lest we forget😇
Pandemic science is highly important for preparedness for next major outbreak.
Nature is predictable yet unpredictable.
Recent MERS CoV France and Nipah India are reminders we must remain alert.
linkedin.com/posts/pandemic-…
Get ready for APCCMI 2025
The largest ID and microbiology conference in Asia
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See you in the land of smiles in November
Asia Pacific Congress of Clinical Microbiology and #Infection (APCCMI) is taking place in in Bangkok, Thailand, on 2 – 4 November 2025, co-hosted by the Infectious Disease Association of Thailand (IDAT).
Read the latest newsletter⬇
apccmi2025.com/newsletter/pd…
Please join us by registering with Zoom link and share to your network to learn more about Nipah from @linfa_wang, severe fever with thrombocytopenia syndrome from Professor Dongmin Kim and one health AMR in China from Professor Yonghong Xiao
📢Webinar announcement
We invite you to a collaborative webinar with ISAC Member Society, Asia Pacific Society of Clinical Microbiology & Infection (APSCMI)
"One health aspects of AMR and infections in Asia"
📅9 May 2024
Register⬇️
tinyurl.com/5392xrj7
#Onehealth #IDxposts
If multiple airports especially connecting nodes do wastewater surveillance the probability of picking up a novel virus may be significant, a modelling study based on late 2019 early 2020 for SARS2. Lesson for next major epidemic or pandemic. journals.plos.org/globalpubl…
104,179 Delta and 375,903 Omicron cases. Higher risk of cognition/memory disorders reported in Omicron and Delta. Delta-variant —> increased anosmia/dysgeusia and psychosis. Omicron-variant —> abnormal involuntary movements. Risk in hospital COVID.
clinicalmicrobiologyandinfec…
Optimising antibiotic use to combat antibiotic resistance starts from right clinical diagnosis followed by right microbiology tests to guide antibiotic use. Feel free to share and use this e-learning module to teach medical students, doctors and any prescribers.
📢NEW Microbiology in Clinical Practice | #Elearning course
Sign up for this course by ISAC Member Society, Asia Pacific Society of Clinical #Microbiology and Infection (APSCMI) developed with @biomerieux
Access the accredited version ⬇
tinyurl.com/3w3tynw4
@davidlye70
Ten years of nationally funded antimicrobial stewardship in Singapore public hospitals: less broad spectrum antibiotic use and antibiotic resistant bacteria except beta lactamase inhibitors and carbapenemases. aricjournal.biomedcentral.co…
Bivalent Omicron mRNA vaccine reduced medical attendance and hospitalisation vs monovalent as 2nd booster in >18 years with 3 mRNA in Singapore during Omicron. No immune imprinting seen. thelancet.com/journals/lanin…
Pan-sarbecovirus monoclonal antibodies can be a good pandemic preparedness strategy for SARS3 buying time for specific mAb and vaccines. IC50 E7 dropped with XBB otherwise active SARS1 and SARS2.
1/2
science.org/doi/10.1126/scia…
This follows our work in NEJM in 2021 which has implications for pan-sarbecovirus vaccines and mAb @linfa_wang @CheeWahTan2 @Wanni_Chia
nejm.org/doi/full/10.1056/NE…
3 and 4 doses of mRNA vaccines highly effective in protecting patients with active cancer and cancer survivors from severe COVID in Delta and Omicron in Singapore with minimal waning of protection jamanetwork.com/journals/jam…
Even in highly vaccinated and boosted population >60 years, Paxlovid reduced risk of hospitalisation from milder BA2, BA5 and XBB.
clinicalmicrobiologyandinfec…
Parents often wonder if they should vaccinate kids after COVID. We showed better protection for BA5 to get two doses vaccine after COVID for both 5-11 and 12-17. If COVID after one dose, better to complete second dose for 12-17 while less so for 5-11. thelancet.com/journals/lanch…
Persistent cytokine elevation up to 1 year normalizing at 2 years in unvaccinated COVID survivors associated with severe COVID. Elevated HGF, VEGF-A, eotaxin, MIP-1 beta, SDF-1 alpha and IP-10 in acute infection predicted those with persistence. #longCOVID onlinelibrary.wiley.com/doi/…
A good collation of articles supporting zoonotic origin of SARS COV2.
The latest preprint on animal swab genomic sequence came from George Gao😉.
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A good thread on what works and what doesn’t with Pubmed links for fatty liver. I didn’t know about good sleep being beneficial😂.
People with fatty liver disease keep asking me in my DM's for treatment advice. Here are 10 points that you can do to modify/reverse fatty liver.
1. Exercise
Three types of exercise have benefits on fatty liver. Aerobic exercise, resistance training, high-intensity interval training. Include any in your routine.
▶️pubmed.ncbi.nlm.nih.gov/3380…
2. Diet
It is not the carbohydrates or the fat, but the calories. Low calorie dietary interventions are most effective. Low-calorie = 1000 to 1500 calories/d with deficits of 500-750 calories/d. Apart from low-calorie deficits, the only other diet intervention with proven use is Mediterranean type without alcohol.
▶️pubmed.ncbi.nlm.nih.gov/3594…
3. Sleep
Poor sleep, inadequate sleep (< 6h), non-restorative sleep and daytime napping >60 mins are all independently associated with new onset or worsening fatty liver. Pamper your liver by getting some good sleep in your routine.
▶️pubmed.ncbi.nlm.nih.gov/3591…
4. Coffee
Much to the offence and annoyance of tea connoisseurs, coffee intake has been shown to reduce fatty liver disease independent of other dietary modifications [limited evidence vs no evidence]. Ideally, it is black coffee, no sugar, no milk, a minimum of 3 cups a day, complete intake before late evening & never into the night. This dose will not affect your blood pressure, in fact may reduce it.
▶️pubmed.ncbi.nlm.nih.gov/3457…
5. Alcohol
The most common cause of fatty liver is possibly alcohol use. The safest level of alcohol in preventing fatty liver is ZERO. Stop alcohol use and switch to non-alcoholic alcohol-like low calorie beverages instead.
▶️pubmed.ncbi.nlm.nih.gov/3670…
6. Sugar-sweetened beverages and fructose-containing processed foods
Stay away from these two. These can increase liver fat immensely and has been linked to fatty liver in both children and adults.
▶️pubmed.ncbi.nlm.nih.gov/3588…
7. Artificial sweeteners
Artificial sweeteners are safer to use than natural sugars, even though preclinical studies have shown increased liver fat in animal models due to action on gut bacteria. Stevia is supposedly the safest bet among artificial sweeteners. In case of diabetes/obesity, speak with your specialist before you want to use them.
▶️pubmed.ncbi.nlm.nih.gov/3221…
8. Drug therapy
There are NO approved drugs for the treatment of fatty liver disease. Recommended drugs include vitamin E and pioglitazone. NO OTHER DRUGS ARE USEFUL. These are not used life long, but only until other associated risk factors are well-controlled. Drug therapy should be initiated in only those with CONFIRMED NASH (ideally biopsy proven or Fibroscan/Shearwave).
NEVER initiate treatment based on ONLY ultrasound scan fatty liver identification.
▶️pubmed.ncbi.nlm.nih.gov/3672…
9. Rational approach
Fatty liver disease is a misnomer. It is really not a disease, but an association. Treatments should be aimed at controlling causes of fatty liver disease (alcohol use, diabetes, obesity, hypothyroidism, sleep disorder, sedentary life etc.) rather than liver.
pharmacytimes.com/view/revie… [see management/updates section]
10. What does NOT work?
Ursodeoxycholic acid, milk-thistle, green tea, omega-3 supplements, detox products, yoga (because it is not aerobic), fruitarian diets, crash diets, turmeric/cinnamon supplements, shifting to honey or coconut sugars, herbal formulations, multiherbal products, any product with "liver detox" written on it & any product or advertisement with "reverse fatty liver" written on it.
