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Biomedical subjects

P Lim

Publications and source records attributed to P Lim.

At least 73 records · Page 4Linked to original sources
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

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↗
PubMed1983

Diabetic amputees in Singapore.

We studied the clinical features of 262 consecutive patients who had 289 limb amputations in the University Department of Orthopaedics, Singapore General Hospital from January, 1978 to June, 1980. Of these, 171 (59.2%) were done for diabetic complications, 43 (14.9%) for trauma and 27 (9.3%) for atherosclerosis. The mean age of the three groups were 65 +/- 10 (S.D.), 32 +/- 17, and 75 +/- 8 years respectively. The indications for amputation in diabetics were gangrene (36%), ulcer (25%), infection (14%), gangrene and ulcer (11%), gangrene and infection (8.2%), and ulcer and infection (6%). The majority of diabetics were treated with oral agents (80.2%) and diet (6.4%), with 13.4% on insulin. Most patients had their diabetes for less than ten years-38.6% less than five years and 30.7% six-ten years. The mean known duration of the lesion was 1.13 +/- 1.42 months, with 38.7% less than one week. To determine the prevalence of peripheral vascular disease in diabetics admitted for amputation, the ankle/arm systolic BP ratio at rest and post-exercise were determined. In the affected leg, 16/19 patients had decreased ankle/arm systolic BP ratio. In another study, 23/26 diabetic amputees had decreased ankle/arm systolic BP ratio in the remaining leg. These data suggest that diabetes is the most common indication for amputation in this study. Most of these patients are Type II diabetics and have peripheral vascular disease.

Adult↗
PubMed1982

Thyrotoxicosis and thyroid cancer.

It is generally held that thyroid cancer is uncommonly associated with thyrotoxicosis. We report here nine patients with thyroid cancer amongst 720 patients with thyrotoxicosis. Three patients presented with features of malignancy together with thyrotoxicosis (Group A), one of whom had triiodothyronine (T3)-toxicosis. The remaining six patients were diagnosed following histological examination of tissues removed during subtotal thyroidectomies for hyperthyroidism (Group B). Two patients in Group A had follicular carcinoma; the rest were papillary in type. All the patients were rendered euthyroid initially, followed by ablative therapy for two patients in Group A and four patients in Group B. All but one are alive after one to nine years (mean of 3 . 4 years). The diagnosis of thyroid carcinoma is infrequently considered in the presence of thyrotoxicosis. The association is not clinically apparent in the majority of patients. The optimum management of such occult malignancies in thyrotoxicosis remains to be defined.

Adenocarcinoma↗
PubMed1982

Risk factors for screening potential diabetics in pregnant Chinese patients.

An intensive screening programme for potential diabetics in pregnancy was conducted in the University Department of Obstetrics and Gynaecology, Kandang Kerbau Hospital, Singapore, from June 1978 to December 1980. All patients with one or more risk factors for potential diabetes underwent an oral glucose tolerance tests (OGTT) with 50 g glucose loads. An abnormal OGTT was defined as one in which the second hour venous plasma glucose value was 7.8 mmol/1 (140 mg%) or more. In a group of 789 Chinese patients aged between 20 and 40 years, the overall detection rate of abnormal OGTTs was 15.5%. A significantly high proportion of abnormal OGTTs was found in patients with a direct family history of diabetes associated with random glycosuria during pregnancy and those with a previous history of 2 or more consecutive spontaneous abortions. However, in view of the relatively low detection rate of abnormal OGTTs in pregnant potential diabetics, a preliminary blood screening test would be useful to select those patients who require full OGTTs.

Adult↗
PubMed1980

Acute carpal tunnel syndrome secondary to thrombosis of a persistent median artery (with high division of the median nerve). A case report.

An unusual case of median nerve compression due to thrombosis of a persistent median artery with a high division of the median nerve is described. The most probable case of the thrombosis is probably the repeated stretch and vibration that is associated with the use of a stiff clutch in a new motor cycle. This report serves to emphasise the need for early diagnosis and in immediate decompression in such cases. The use of an adequate incision for good exposure of the carpal tunnel and all its contents is recommended.

Adult↗