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Biomedical subjects

K L Tan

Publications and source records attributed to K L Tan.

At least 109 records · Page 6Linked to original sources
PubMed1985

Combined team management of diabetes mellitus in pregnancy.

225 women with diabetes in pregnancy were managed by a team of obstetricians, physicians (endocrinologists) and paediatricians from the National University of Singapore. A protocol of management was formulated and followed. The incidence of 1.1% or 1 in 90 pregnancies was found, with significantly higher incidence in Indians and lower in Malays. There were 37 established diabetics and 188 diagnosed during pregnancy. Of these (188), 74 were gestational diabetics. All the women were treated with Insulin and Diet or Diet alone. 177 (79%) were treated with Insulin and Diet. Blood sugar profiles were done for monitoring diabetic control. 72.8% of the women were between para 0 and 1 and 85.2% between the ages of 20 and 34. 72.5% of the women delivered at 38 weeks gestation or later. 48.9% went into spontaneous labour, 32.4% were induced and 18.7% had elective caesarean section. 62.2% of the women had labour of less than 12 hours. The overall caesarean section rate was 41.7%. There were 3 stillbirths and 2 neonatal deaths. The perinatal mortality rate was 2.2%. Thirteen babies had congenital malformations (5.8%). 77.8% of the babies had Apgar score of 7 or more at 5 minutes after delivery. 79.1% of the babies weighed between 2.5 kgm and 3.9 kgm. Pre-eclamptic toxaemia was the commonest complication in pregnancy followed by Urinary Tract Infection and Polyhydramnios. Postpartum complications in the mother were confined to 14 women (6.2%), and wound infection or breakdown was the commonest cause.

Adult↗
PubMed1985

Extremes of foetal birthweight for gestation in infants of diabetic mothers.

100 patients were registered at the Diabetic Clinic in 1981, where they were managed by a team of physician, obstetrician and paediatrician, based on a preset protocol. Only 92 patients were eventually analysed. The study showed a 1.3% incidence of pregnancies complicated by diabetes mellitus. The mean birthweights of infants of both gestational and established diabetics were heavier than that of the general population by race and gestation. 25% of the 92 infants of diabetic mothers have birthweight exceeding the 90th centile of population. Further division of the 92 patients into the "true gestational" diabetics, as shown by an oral glucose tolerance test performed 6 weeks post-natally, also showed a 25% incidence of macrosomia. Late antenatal booking, delayed detection of abnormal glucose tolerance and treatment attributed to the high incidence of macrosomia. Only one infant had birthweight below the tenth centile. There were no perinatal mortality in the 92 patients studied. Macrosomia is a common complication in infants of diabetic mothers despite a physician-obstetrician joint-care system. Also, the risk of having macrosomia amongst gestational diabetics is high.

Birth Weight↗
PubMed1985

Growth, biochemical and haematological status of very low birth weight premature infants.

Very low birth weight (less than 1500 g) premature (less than 33/52) infants were studied while fed on Alprem for the first 10 weeks of life. After initial weight loss due to inadequate intake, weight gain was satisfactory and steady. The need for sodium and potassium exceeded the amount supplied in the milk only in the initial period. However, the serum calcium and phosphate levels were slightly decreased especially in the later period of the study, accompanied by marked elevation in alkaline phosphatase values. Alprem appears to be able to sustain adequate growth in small prematures though early sodium and potassium, and late calcium and phosphate supplements seem necessary.

Alkaline Phosphatase↗
PubMed1985

Haematological status of fullterm healthy infants in the first week of life.

The haematological status of 105 healthy fullterm neonates was studied daily during the first week of life. Hb, MCV, RBC, PCV and WBC were determined with a Coulter 5 Counter, white cell differential reticulocyte and platelet counts manually, and ESR by a micromethod on free flowing capillary blood from heel stabs. A decline in Hb, PCV, MCV, RBC values and reticulocyte count was observed over the 7 days. The platelet count however rose slightly. The white cell count initially declined. The polymorphs initially predominant declined as the lymphocytes increased; by 7 days, both were about equal in proportions and together accounted for about 85% of the white cell population. The micro-ESR was very low, rising only slightly over the week.

Blood Cell Count↗
PubMed1985

Thrombotic complication of umbilical arterial catheterization and its sequelae.

Umbilical arterial catheterization caused major complications including 5 deaths in 25 of 230 infants who underwent autopsy at the Kandang Kerbau Hospital in a two-and-a-half year period beginning May 1982. Arterial thrombosis developed in 25 of 129 (19.3%) autopsies with a history of umbilical arterial catheterization. Pathological sequelae of thrombosis occurred in 14 cases (peripheral gangrene 1, renal 6, gastrointestinal 3 and both renal and gastro-intestinal 4). The sequelae were clinically unsuspected in the majority. Early deaths were uncommon in the group with thrombosis. Comparison of neonatal factors revealed no significant differences between the group with sequelae and those without. Infants with indwelling umbilical arterial catheter should be actively monitored for complications.

Aorta, Abdominal↗
PubMed1985

Transcutaneous bilirubinometry in Chinese and Malay neonates.

An evaluation of the Minolta/Airshields transcutaneous bilirubinometer (TcB) was made in 68 Chinese and 57 Malay fullterm infants, 18 Chinese premature infants and 9 infants undergoing phototherapy. A close correlation between the TcB index and bilirubin values was observed at all three sites measured--forehead, sternum and upper back--in both Chinese and Malay infants; though this correlation was not as close in premature infants. A high degree of reproducibility was demonstrated. The correlation was significantly closer in bilirubin values not exceeding 200 umol/l compared with values exceeding 200 umol/l. The TcB is a useful screening device for neonatal jaundice.

Bilirubin↗
PubMed1984

Cord plasma alpha-fetoprotein values and neonatal jaundice.

Umbilical cord plasma alpha-fetoprotein (AFP) values were determined in 127 infants with hyperbilirubinemia (56 glucose-6-phosphate dehydrogenase (G-6-PD) deficient and 71 G-6-PD normal) and 136 control subjects (73 G-6-PD deficient and 63 G-6-PD normal). The mean alpha-fetoprotein value of 173 +/- 35.2 (SD) mg/L for the group of infants with hyperbilirubinemia was significantly greater than that (122 +/- 21.7 mg/L) for the control infants (P less than .001). G-6-PD status and sex did not significantly affect the alpha-fetoprotein values. Using an alpha-fetoprotein level of 130 mg/L as a "cut-off" value, the incidence of false-positive results was 25.5% and the incidence of false-negative results was 11.8%. This test can be used as a screening procedure to detect infants at high risk for hyperbilirubinemia.

China↗
PubMed1984

Perinatal mortality with particular reference to the Singapore situation.

Perinatal mortality rates have been gradually declining in all countries. The initial decline mainly resulted from improvements in the late foetal mortality rates. Later with improvements in neonatal care, early neonatal mortality rates also improved. The developed countries have consistently shown better results than the developing countries, an indication of the higher standard of living, general health as well as the delivery of health care in these countries. In the Singapore situation, a rapid improvement in perinatal mortality was initially observed due to improvements in the late foetal mortality, followed later by reduction in the early neonatal mortality due to upgrading of neonatal intensive care. The perinatal mortality rate is lowest in the Chinese compared to the Indians and Malays, most likely due to the dietary practices of the three ethnic groups in Singapore; while the Chinese encourage extra nutrition in the pregnant female, the Malays and Indians tend to practise dietary restriction during this period. The improved nutrition of the pregnant mother is a factor in improving the perinatal mortality.

Adult↗
PubMed1983

Oral glucose tolerance tests in newborn infants.

Oral glucose tolerance tests ( GTTs ) were performed on 15 fullterm (Group I), 12 preterm low birth weight (Group II) and 16 preterm very low birth weight (Group III) infants who were clinically stable. GTT was done on the third postnatal day in Groups I & II and serially at different postnatal ages in Group III (days 3, 7, 14, 21 & 28). After 4 hours of fasting capillary blood samples were collected for plasma glucose estimation at fasting and for a 3-hour period following oral intake of 1.75 gm/kg of glucose. Mean plasma glucose levels were comparable in Groups I & II at all stages. Group III infants had lower mean plasma glucose which increased with postnatal age. Significantly higher values were observed as late as 150 minutes in days 3, 7 & 14 groups compared with days 21 and 28 of Group III. Our data suggest that larger and more mature preterm low birth weight infants (greater than or equal to 1501 gm and greater than or equal to 34 weeks' gestation) were capable of handling glucose as efficiently as term infants. Preterm very low birth weight infants (less than or equal to 1500 gm and less than or equal to 33 weeks' gestation) exhibited impaired glucose tolerance during the first two weeks of life.

Blood Glucose↗
PubMed1983

Breast feeding: social, economic and medical considerations.

A certain attitude and lifestyle is needed if breast feeding is to be successful. It must have priority over all other activities save the very basic ones. The rural environment provides a situation in which breast feeding can flourish . With urbanisation and the accompanying change in lifestyle breast feeding becomes very difficult. Since successful breast feeding needs strong motivation, the change in attitude of urbanised wives makes it even more unlikely. The Singapore experience demonstrates this convincingly; even though awareness of the benefits of breast feeding is widespread, the motivation to breast feed is not. Remedial measures should take into consideration the need to motivate the mother and family, the prevention of commercial infant food companies influencing public opinion, and incentives for the working mothers to breast feed.

Adult↗
PubMed1983

The acardiac foetus.

Explore the source record for details and available documents.

Abnormalities, Severe Teratoid↗
PubMed1982

The bronze baby syndrome.

Phototherapy with either daylight or blue lamps resulted in the development of the bronze baby syndrome in 13 infants. 'Thermotherapy' with an incandescent bulb emitting light mainly in wavelengths not effective for phototherapy caused this syndrome in the 14th infant with respiratory failure. Hepatic dysfunction was present in all infants. The infants were well in spite of the bronzing, after their initial condition had improved. Bronzing disappeared within two months in all but one infant; in eight infants with regular blood examination, the hepatic function became normal by ten months of age, but spectroscopy demonstrated the presence of the pigment(s) even at one year. Normal development was observed.

Bilirubin↗