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Biomedical subjects

B Y Tan

Publications and source records attributed to B Y Tan.

At least 37 records · Page 2Linked to original sources
PubMed1986

Wilson's disease revisited in the tropics.

The clinical features and investigations of 17 patients were analysed. Thirteen of them were Chinese and the rest Indians. Their ages at presentation ranged from 8 to 63 years (mean 18.35 years). Thirteen patients (76%) were symptomatic; 8 with predominantly hepatic manifestations and 5 with neurological features. Four were asymptomatic siblings. At diagnosis, however, 10(59%) had features of liver involvement singly, 3 (18%) had neurological involvement alone and 4 (27%) had mixed presentations. Family histories were available in 15 patients; 26.9% of siblings had Wilson's Disease. Serum ceruloplasmin was low in 82% of the patients. 24-hour urinary copper was measured in 16 patients and was raised in all of them. About half the patients (41%) had evidence of concomittant renal tubular dysfunction with hypouricaemia and aminoaciduria. Three patients (18%) had joint involvement at presentation. All 17 patients were treated with Penicillamine. Complications due to therapy included pemphigus in one and toxic epidermal necrolysis and later a lupus like syndrome in another. The features of clinical improvement included fading of K-F rings, improvement of neurological signs and the normalisation of serum transaminases. One patient developed primary hepatocellular carcinoma 5 years after presentation. Delay in diagnosis was encountered in half of the patients reviewed. Being a treatable condition, Wilson's Disease, although rare, should always be thought of in patients with haemolysis, liver diseases or extrapyramidal disorders.

Adolescent↗
PubMed1985

Insulin secretory capacity in Singapore diabetic subjects.

The determination of serum C-peptide has been found to be a sensitive indicator of endogenous insulin secretion, and serves to define diabetic patients who require insulin therapy i.e., insulin-dependent (Type I, IDDM) and those non-insulin dependent (Type II, NIDDM). The aim of our study is to establish the types of diabetes mellitus with C-peptide measurement in a group of diabetic subjects on different modes of therapy. Eighty-eight diabetic patients (60 males, 28 females) were studied. Thirty-four were on insulin (age 40 +/- 2 years; means +/- SEM), 35 on oral agents (54 +/- 1 years), and 19 on diet alone (46 +/- 3 years). Twenty healthy subjects (10 males, 10 females) serve as normal controls (37 +/- 3 years). Blood samples for serum C-peptide and blood glucose estimations were obtained after an overnight fast and one hour after a 75 grams oral glucose load. Fasting C-peptide levels obtained for the various groups were: 0.62 +/- 0.07 (nmol/L, means +/- SEM) (normal), 0.16 +/- 0.02 (insulin), 0.79 +/- 0.06 (oral), 2.15 +/- 0.15 (diet). The C-peptide values after oral glucose were 1.80 +/- 0.20 (normal), 0.23 +/- 0.05 (insulin), 1.72 +/- 0.02 (oral), 2.15 +/- 0.15 (diet). Both the fasting and post-glucose C-peptide concentrations were significantly lower (p less than 0.001) in the insulin group compared to the normals, whereas values for the diet and oral groups were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Epidemiology of diabetes mellitus in Singapore: comparison with other ASEAN countries.

Singapore is a tropical island city-state with a population of 2.4178 million consisting of Chinese (76.7%), Malays (14.7%), Indians (6.4%) and other races (2.2%). A diabetic survey of the adult population, aged 15 years and above, carried out in 1975, shows that the prevalence of diabetes is 1.99%; it is higher in males (2.36%) than in females (1.64%). It occurs mainly in the age group 40 years and above (5.08%) and is uncommon in the age group 15-39 years (0.40%). In males, the highest prevalence of diabetes (7.0%) is in the age group 45-49 years while in females the highest prevalence (7.2%) is in the age group 55-59 years. 43.3% of the diabetics are of normal weight while 44.3% are overweight and 12.4% are underweight. 59.6% of the diabetics are newly diagnosed while 40.4% are known diabetics; 64.3% of the newly diagnosed diabetics have no symptoms. The prevalence of diabetes among the Indians (6.07%) is significantly higher than that in Malays (2.43%) and Chinese (1.55%). Indian diabetics have a slightly higher positive family history of diabetes (12.7%) than Malays (10.9%) and Chinese (6.5%). Obesity is commoner in Malay diabetics (64.7%) than in Chinese (41.6%) and Indians (35.7%). The possible factors leading to the significantly higher prevalence of diabetes among the Indians compared to the other ethnic groups in Singapore are discussed. It is suggested that the Indian gene is susceptible to diabetes (diabetic genotype) and increased food consumption, altered lifestyle and greater obesity leads to the expression of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Home blood glucose monitoring, glycaemic control and diabetic complications.

The aim of this study was to evaluate the effect of home blood glucose monitoring on diabetic complications and metabolic control. Forty Chinese and Indian patients participated in the Diabetic Society of Singapore National Home Blood Glucose Monitoring (HBGM) Programme. The clinical progress, the blood glucose and glycosylated haemoglobin concentrations, and the platelet aggregation of the aforementioned patients were studied over a 6-month period; the results were compared with those from a matched, albeit smaller, control group of 18 diabetic patients who were on treatment but not in the HBGM programme. At the end of the six month period, three patients in the control group showed clinical deterioration of peripheral neuropathy in contrast to one patient on HBGM. Due to the small number of patients, the difference in the findings was not statistically significant. Patients on HBGM demonstrated significant improvement in mean grouped blood glucose profile values, 135 +/- 8 to 118 +/- 5 mg/dl, p less than 0.01, and glycosylated haemoglobin levels, 10.3 +/- 0.4 to 9.3 +/- 0.3%, p less than 0.01. The platelet aggregability was unchanged. In contrast, patients in the control group developed a significant increase in platelet aggregation (30 +/- 4% to 37 +/- 5%, p less than 0.05), although the blood glucose and glycosylated haemoglobin concentrations were not significantly altered. This study demonstrated that patients on a six-month HBGM programme were able to achieve improved glycaemic control associated with a trend towards decreased deterioration of diabetic neuropathy and platelet aggregability.

Adult↗
PubMed1985

Pyogenic hepatic abscess and diabetes mellitus--a probable association.

Four patients with pyogenic hepatic abscesses are reported. There were three females and one male with an age range of 36-75 years. In all the cases, diabetes mellitus was associated. Confirmation of the abscesses was obtained by liver scanning or ultrasonography, or both. In one patient, the clinical course was complicated by sympathetic pericardial effusion with right heart failure. Two patients had percutaneous transhepatic drainage of the abscesses under fluoroscopy. All four patients eventually required laparotomy and open drainage of the abscesses. Diabetic control was achieved with insulin therapy. The common causative organism in all instances was the Klebsiella species. Three patients recovered. The remaining one developed hypotension post-operatively and died of brain-stem infarction and the hepato-renal syndrome.

Adult↗
PubMed1984

Infective endocarditis in Singapore: a six year survey.

Much has been written about the changing clinical spectrum of infective endocarditis. However our survey shows that the classical text book descriptions still hold good. The majority of our patients were young with 79% either 30 years or below. Fever was present in 93%, splenomegaly in 50% and cerebral embolism in 43% of our patients. Twelve patients had valvular heart disease and 2 patients had a ventricular septal defect. Eleven out of 14 patients had a positive blood culture. Echocardiography detected definite or probable vegetations in 66% of the examinations. Five patients responded satisfactorily to antibiotic therapy, 2 patients discharged themselves from hospital against medical advice, and 4 patients underwent successful cardiac surgery. Three patients died during medical therapy.

Adolescent↗
PubMed1976

T3 toxicosis and its relation to the iodide status in Singapore.

Baseline thyroid function tests (including total serum thyroxine iodide-T4I, total serum tri-iodothyronine T3 as well as T3 Sephadex Uptake Studies (T3U)) were determined in 82 normal Asian subjects. In addition, another group of normal volunteers (39) were assessed as regard serum and 24-hour urinary iodide levels to gauge the iodide status of the community; the results were comparable to that of goitre-free regions of the world. Having established the range of values of normal thyroid function tests, 103 consecutive clinically thyrotoxic patients (both new and relapsed cases) were similarly studied in an attempt to elucidate the magnitude of the problem of T3 toxicosis, and its relation to the iodide status in Singapore. Only three clinically hyperthyroid patients were foudn to have normal PBI T3 levels. A detailed analysis and discussion of the data is presented. It is concluded that T3 toxicosis is a rarity in Singapore.

Adult↗