To validate a wrist-worn portable device (WatchPat 200) to diagnose OSA in an Asian cohort. To evaluate its cost-effectiveness. Twenty patients with suspected OSA were recruited and had simultaneous polysomnography (PSG) and WatchPAT assessments concurrently within the hospital's sleep laboratory. The study population consisted of 18 male and 2 female patients, whose mean age was 39 (±16) years, mean BMI was 27.2 (±5.5) kg/m, mean Epworth Sleepiness score was 8.55 (±4.8). The correlation between the AHI was assessed using Spearman's correlation coefficient and agreement was tested via the Bland Altman plot. Sensitivities and specificities were then applied to the various AHI groups. Spearman's coefficient was 0.94, which suggested that a very strong correlation between the AHI recorded by the WatchPat and the PSG. Bland-Altman plot showed good agreement with the AHI mean difference of about 4.23 with a slight tendency to overscore the AHI at the mild range of OSA and underscore the range at the severe end of OSA. The WatchPat showed 100% sensitivity when compared to PSG for mild OSA and is thus a good screening test for the undiagnosed general population. Furthermore, it also showed 100% specificity when compared to PSG for severe OSA suggesting that it is a good diagnostic test for people with a high suspicion of OSA. This facilitates a timelier diagnosis and a more economical approach with potential cost savings of up to $900 per patient.

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Introduction: The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on the risk of malignancy (ROM) in fine-needle aspiration cytology (FNAC) per The Bethesda System for Reporting Thyroid Cytopathology has not been well reported in Singapore. Methods: We retrospectively identified 821 thyroid nodules with preoperative FNAC from 788 patients out of 1,279 consecutive thyroidectomies performed between January 2010 and August 2016 in a tertiary general hospital in Singapore. Possible cases of NIFTP were reviewed for reclassification and the impact of NIFTP on ROM was analysed. Results: The incidence of NIFTP was 1.2% (10 out of 821). If NIFTP is considered benign, ROM in Bethesda I through VI were 8.6%, 3.5%, 26.3%, 20.0%, 87.7%, 97.0% versus 8.6%, 4.2%, 28.1%, 26.7%, 89.2% and 100% if NIFTP is considered malignant. Eight patients with NIFTP had follow-up of 15 to 110 months. One had possible rib metastasis as evidenced by I131 uptake but remained free of structural or biochemical disease during a follow-up period of 110 months. None had lymph node metastasis at presentation, nor locoregional or distant recurrence. Conclusion: Classifying NIFTP as benign decreased ROM in Bethesda II through VI, but the benignity of NIFTP requires more prospective studies to ascertain. The impact of NIFTP on ROM in our institution also appears to be lower than that reported in the Western studies Keywords: Bethesda, cytology, NIFTP, risk of malignancy, TBSRTC, thyroid nodule

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<p class="abstract"><strong>Backgrounds:</strong> The Video Head Impulse Test (vHIT) is used to test the function of each of the six semicircular canals. Each semicircular canal is tested by measuring eye rotation in response to head movements in the plane of the canal and is calculated as the Vestibulo-ocular reflex (VOR) gain. The aims of the study were firstly, to determine age-dependent normative values of VOR gain for the vHIT of semicircular canal function in healthy Asian subjects in each decade year of life. Secondly, to investigate if vHIT measured VOR gain decreases with age.</p><p class="abstract"><strong>Methods: </strong>A prospective cohort study of 60 healthy voluntary community-dwelling subjects, between 21 to 80 years of age. Subjects with prior history of vertigo were excluded. vHIT was conducted on each subject and analysed with the Interacoustics (EyeSeeCam) video goggles by the senior audiologist. The VOR gain for all six semicircular canals were calculated for each subject.</p><p class="abstract"><strong>Results: </strong>The mean (SD) vHIT (VOR) gain of all the 6 semicircular canals for the entire population were 1.18 (0.19). The mean of the VOR gain for each of the six semicircular canals were analysed to develop a normative guide. The mean VOR gain per decade year did not vary significantly with age (p=0.417). The correlation between age and mean VOR values was negligible (pearson’s r=0.121).</p><p class="abstract"><strong>Conclusions: </strong>We propose that our normative age-dependent data guide be used to improve the differentiation between normal and abnormal values of VOR gain in an Asian population. Our study shows that VOR gain is not associated with aging.</p>