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Biomedical subjects

J A Tambyah

Publications and source records attributed to J A Tambyah.

14 recordsLinked to original sources
PubMed2001

Thyrotrophin (TSH)-secreting pituitary macroadenoma with cavernous sinus invasion.

Thyrotrophin (TSH)-secreting pituitary adenomas, although rare, should be recognised as a possible cause of normal or elevated serum TSH in the presence of elevated serum free thyroid hormone levels. Clinical hyperthyroidism may be mild or absent. Early recognition provides the best chance for surgical cure. We report a patient with a TSH-secreting pituitary tumour with cavernous sinus invasion. This case illustrates that multiple modalities of treatment are often necessary and complementary in achieving control of tumour growth and hormonal hypersecretion when these tumours are diagnosed late.

Adenoma↗
PubMed2001

A window on the current status of diabetes mellitus in Singapore--the Diabcare-Singapore 1998 study.

The Diabcare-Singapore project was carried out in 22 clinics (general hospitals, GH and primary healthcare centres, PHC) to provide an overview of diabetes management and metabolic control status. Data from 1697 diabetic patients were collected on paper forms and analysed centrally. Type 2 diabetes mellitus patients constituted 91.4% and type I patients constituted 8.1% of population. The proportion of type I patients was greater in GH (18.1%) vs PHC (3.4%). The mean age (+/- SD) was 58.1 +/- 14.4 years and mean duration of diabetes was 10.1 +/- 7.5 years. Mean body mass index (BMI) was 25.1 +/- 4.4 kg/m2 and more than half (53%) of patients were overweight (BMI >25 kg/m2). Mean HbA1c and FBG levels were 8.0 (1.9% and 9.1 +/- 3.1 mmol/l. A total of 51% of patients had HbA1c (1% above the Upper Limits of Normal (ULN). Fasting blood glucose (FBG) was >7.8 mmol/l in 61% of patients. The majority (70%) had satisfactory levels of fasting lipids (triglycerides, total cholesterol and HDL-cholesterol). Only 19.7% practised home blood glucose self-monitoring, while 99% reported receiving some diabetes education. Sixteen percent of patients had abnormal levels of protein (>500 mg/24 h) in the urine, 3% had elevated serum creatinine levels and 36% had microalbuminuria. Retinopathy (12%), cataract (16%) and neuropathy (12%) were commonly reported diabetic complications. The data revealed suboptimal glycaemic control in about half of patients studied.

Adolescent↗
PubMed2001

The status of diabetes mellitus in primary care institution and restructured hospitals in Singapore.

The Diabcare-Asia Singapore 1998 project was carried out using data from 22 centres collected on paper forms to provide an overview of diabetes management and metabolic control status in 1697 diabetic patients from both primary health care clinic (PHC) (67%) and restructured hospital (RH) (33%) settings. PHC patients were on average older than RH patients (61.3 +/- 11.2 years vs 51.5 +/- 17.7 years), and had a shorter duration of diagnosed diabetes (9.2 +/- 6.8 years vs 12.0 +/- 8.5 years). The mean body mass index (BMI) for PHC patients was 25.5 +/- 4.4 kg/m2 vs 24.5 +/- 4.2 kg/m2 for RH patients. Proportionately more PHC than RH patients were overweight (BMI >25 kg/m2) (49% vs 42%). Patients with type I diabetes constituted 3.5% of PHC vs 18.1% of the RH cohort. HbA1c information was available for 92.5% of RH vs 69% of PHC patients. HbA1c measurements were <1% above ULN in 50% of PHC vs 37% of RH patients, while FBG was >7.8 mmol/l in >61% of all patients. Proteinuria (>500 mg/24 hrs) was reported in 13% of PHC vs 26% of RH patients tested. Microalbuminuria (20-300 mg/l) was noted in 36% of 171 RH patients tested. Oral hypoglycaemic agents were used as sole therapy in 83.5% of PHC vs 43% of RH patients. Eye, feet, renal and severe late complications were more commonly reported by RH than PHC patients. There is a variation in the patient profiles and care between PHC and RH patients.

Diabetes Complications↗
PubMed1978

Non-specific aorto-arteritis in Singapore with special reference to hypertension.

Aorto-arteritis has recently emerged as a distinct disease entity with involvement of aorta and its major branches by a non-specific inflammation of unknown etiology. Though the distribution of this disease is worldwide, it is more prevalent in Japan, India, and South-east Asia. This paper describes a series of 48 cases seen in Singapore and emphasizes the protean nature of this disease. Though modes of clinical presentation were many, hypertension appeared to be the commonest as it occurred in 33 patients, giving an incidence of 69 per cent. This incidence was much higher than the 48 per cent reported among Europeans and 42 per cent reported among South Africans. It would therefore appear that hypertension was a far more common manifestation of aorto-arteritis among Asians. The commonest cause of hypertension in aorto-arteritis in this series was renovascular, with renal artery stenosis or occlusion occurring in 27 cases (85 per cent). The frequency of involvement of the renal artery is much greater than the 34 per cent reported by the Japanese. Therefore renovascular hypertension should be regarded as a predominant feature of aorto-arteritis in Singapore.

Adolescent↗
PubMed1976

Curry kidney.

Explore the source record for details and available documents.

Condiments↗
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↗
PubMed1975

Prevalence of diabetes mellitus among the ethnic groups in Singapore.

During a routine medical examination of 5280 government employees (2736 males, 2544 females; age range 17 to 66 years; 3386 Chinese, 1252 Malays, 508 Indians and 134 other ethnic groups) diabetes was found in 31 (0.59%). The prevalence was higher in males (0.95%) than in females (0.20%). The highest prevalence was in the age-group 50 to 59 years (5.4%); at ages 30 to 66 years, the overall prevalence was 2.18%. The prevalence of diabetes is higher in Indians (2.76%) than in Chinese (0.30%) and Malays (0.48%); the difference is statistically significant, as it also is in the age-group 30 to 66 years (Indians 6.36%, Malays 1.39%, Chinese 0.9%). Of the 31 cases, only four were previously known and only nine were overwieght. The possible reasons for the higher prevalence of diabetes in Indians are discussed.

Adolescent↗
PubMed1969

Effect of frusemide on calcium excretion.

After giving oral frusemide (Lasix) to 14 normal volunteers significant hypercalciuria occurred in all of them. This could not be accounted for by any change in glomerular filtration rate, but was possibly due to decreased tubular reabsorption.

Calcium↗