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Biomedical subjects

Y H Chan

Publications and source records attributed to Y H Chan.

At least 55 records · Page 3Linked to original sources
PubMed2004

Relationships between depression/somatization and self-reports of pain and disability.

AIMS: To examine the relationship between depression and somatization and pain during muscle and joint palpation as well as limitations related to mandibular functioning (LRMF) in patients with temporomandibular disorders. METHODS: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) data for Axes I and II for 196 consecutive patients (56 men and 140 women) with a history of facial pain were obtained. The mean age of the predominantly Chinese patient population (83.2%) was 33.4 years (range 18 to 55 years). A computerized diagnostic system was used to collect the RDC/TMD history data. The Symptom Check List (SCL-90) depression and somatization scales were generated on-line and archived. The mean muscle pain (MP), joint pain (JP), and LRMF scores were computed with depression and somatization as main effects. Data were subjected to analysis of variance (Scheffé test) and Pearson's correlation at a significance level of .05. RESULTS: Depression scores ranged from 4.03 to 8.16 (MP), from 0.67 to 1.03 (JP), and from 0.30 to 0.38 (LRMF); somatization scores ranged from 2.64 to 7.75 (MP), from 0.58 to 1.00 (JP), and from 0.30 to 0.41 (LRMF). Interaction effects between depression and somatization were not significant. Patients with severe depression had significantly higher MP scores than normal patients or patients with moderate depression. Patients with moderate and severe somatization had significantly higher MP scores than normal patients. LRMF scores of patients with severe somatization were significantly greater than those who were normal or suffered from moderate somatization. No significant difference in JP scores was observed for depression and somatization scales. Correlations between depression/somatization and MP, JP, and LRMF scores were significant and positive but weak; coefficients ranged from 0.15 to 0.41. CONCLUSION: The results suggest that depression and somatization are related to the self-report of MP. In addition, severe somatization may be associated with an increase in jaw disability.

Adolescent↗
PubMed2004

Medical students' behaviour, attitudes and knowledge of sleep medicine.

INTRODUCTION: A seminar on sleep disorders was recently introduced for third, fourth and final year medical students rotating through the psychiatry posting in the Institute of Mental Health. This survey was conducted to assess the attitudes as well as knowledge of medical students towards sleep medicine. METHODS: Verbal consent was taken from the students who were willing to take part in the survey. The MED Sleep Survey, which is an inventory to assess behavior, attitudes and knowledge about sleep, was used to assess the same in the students. RESULTS: A total of 240 medical students completed the survey. There were 149 male and 91 female medical students. In terms of their basic sleep knowledge, 46.7 percent scored between 1 and 10 points, 51.7 percent scored between 11 and 20 points, and 1.7 percent scored between 21 and 30 points. There was no significant difference between the different groups in their scores on basic sleep knowledge. CONCLUSION: Most of the medical students scored between 1 and 20 points on basic sleep knowledge items in part III of the survey. Of these, almost one-half had scores between 1 and 10 points. Education is clearly important, and the introduction of the teaching programme on sleep medicine is timely and necessary.

Adult↗
PubMed2004

Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore.

INTRODUCTION: The severe acute respiratory syndrome (SARS) outbreak has been unique in recent history in its rapidity of transmission, its concentration in healthcare settings, and the large number of healthcare workers who have been infected. This study aims to examine the psychological impact of SARS on general practitioners (GPs) and traditional Chinese medicine (TCM) practitioners in Singapore. MATERIALS AND METHODS: Two months after the SARS outbreak, all the GPs and TCM practitioners in Singapore were mailed a set of self-reported questionnaires, which included the General Health Questionnaire (GHQ), the Impact of Event Scale-R (IES-R), and a questionnaire to measure the perception of stigma. RESULTS: A total of 721 (29%) GPs and 329 (22%) TCM practitioners responded to the survey. Significantly more GPs had worked in SARS affected facilities and had been directly involved in the care of patients with SARS than the TCM practitioners (P <0.001). Those GPs who were directly involved in the care of patients with SARS were significantly more likely to be GHQ case as compared to those not involved in the care of patients with SARS (P = 0.02; OR = 2.9; 95% CI, 1.3-6.3). The mean score of the GHQ somatic, anxiety and social dysfunction subscales were significantly higher in GPs as compared to TCM Practitioners (P <0.001). The GHQ total score as well as the subscales was significantly correlated with the IES-R and stigma subscales (P <0.05). CONCLUSION: The fear, uncertainty and stigma caused by SARS are associated with psychological distress among some of the primary healthcare providers in Singapore.

Adult↗
PubMed2003

Thermosensory abnormalities and blood flow dysfunction in psoriatic skin.

BACKGROUND: Accumulating data have shown evidence of involvement of cutaneous nerve fibres and neuropeptides in psoriasis. Although ample evidence of structural and biochemical data exist no studies have been done on assessing the function of small nerve fibres in this disease. OBJECTIVES: To investigate the function of small nerve fibres in patients with psoriasis between psoriatic plaques and non-involved skin and in comparison with healthy controls. METHODS: We performed computerized psychophysical thermal sensory testing of warmth, cold and heat pain thresholds and skin blood flow using laser Doppler imaging in psoriatic lesions vs. non-involved skin and healthy skin. We evaluated these parameters before and immediately after barrier perturbation, and 1 week after as a measure of barrier repair. RESULTS: There is a significantly elevated warm and decreased cold sensation threshold in psoriatic skin compared with non-involved skin and skin of healthy controls in the same sites. These differences were particularly abnormal 1 week poststripping. The warm sensation threshold was significantly elevated in non-involved skin in psoriatics vs. skin of healthy controls after tape stripping. These findings suggest there is an abnormal function of cutaneous nerve fibres in response to trauma to the stratum corneum, which is not limited to the visible plaque but could be generalized and aggravated by stressful events. Skin blood flow was significantly elevated in psoriatic plaques and inversely correlated to warm sensation thresholds while in healthy controls a direct correlation was noted. CONCLUSIONS: Our data demonstrate an abnormal thermosensory response in psoriasis.

Adult↗
PubMed2003

Short term outcome and risk factors for adverse clinical outcomes in adults with severe acute respiratory syndrome (SARS).

BACKGROUND: Severe acute respiratory syndrome (SARS) was diagnosed in Hong Kong in over 1700 patients between March and early June 2003. METHODS: 115 patients diagnosed with SARS were admitted to Queen Elizabeth Hospital, a large regional hospital in Hong Kong, from March 2003, of whom 100 were either discharged or were dead at 31 May. The patients were prospectively studied after admission to assess their short term outcomes and the risk factors associated with adverse outcomes, defined as death or the need for mechanical ventilation RESULTS: At the time of writing 18 patients had died, with a crude mortality rate of 15.7% and a 21 day mortality of 10% (standard error 3%). Thirty nine patients (34%) were admitted to the intensive care unit, 30 of whom (26%) required mechanical ventilation. Multivariate analysis showed that age above 60 (hazards ratio (HR) 3.5, 95% CI 1.2 to 10.2; p=0.02), presence of diabetes mellitus or heart disease (HR 9.1, 95% CI 2.8 to 29.1; p<0.001), and the presence of other comorbid conditions (HR 5.2, 95% CI 1.4 to 19.7; p=0.01) were independently associated with mortality. However, only the presence of diabetes mellitus and/or cardiac disease (HR 7.3, 95% CI 3.1 to 17.4; p<0.001) was associated with adverse outcomes as a whole. CONCLUSION: SARS is a new disease entity that carries significant morbidity and mortality. Specific clinical and laboratory parameters predicting unfavourable outcomes have been identified.

Adult↗
PubMed2003

Five-year review of adolescent mental health usage in Singapore.

INTRODUCTION: To provide a review of adolescent mental health service utilisation in a child and adolescent mental health outpatient clinic in Singapore. MATERIALS AND METHODS: Data from all new adolescent cases seen over a 5-year period in the Child Guidance Clinic were analysed. A review of services provided is also included. RESULTS: Adolescent mental health usage has been on an increase with a rise in the number of cases diagnosed with depression. There has also been an increase in the number of forensic cases seen in the department. CONCLUSIONS: There is a growing demand for adolescent mental health services. As the demands and stresses on today's youth increase, there is likely to be a continued increase in the demand for such services. The challenge in the future is to provide adolescent mental health services in cost-effective packages that will meet the needs as well as stay financially viable.

Adolescent↗
PubMed2003

Emergency department usage by community step-down facilities--patterns and recommendations.

OBJECTIVE: This study examines the interface between institutional community step-down facilities (CSDFs) and acute hospital's Emergency Department (ED). It also provides a comprehensive description of the usage of an ED's services by CSDFs in its vicinity. MATERIALS AND METHODS: This is a prospective 12-week observational study conducted in the Accident and Emergency Department of Changi General Hospital in Singapore. All patients from CSDFs transferred to the department were eligible for the study. Hospital records were used to extract relevant clinical data after admission for the length of stay and final discharge diagnosis. RESULTS: There was a total of 201 referrals to the ED over the 3-month period. The age of the patients ranged from 32 to 107 years, with a median of 83 years. Ninety-two patients (45.8%) were male residents. There were more referrals from CSDF on weekdays than on weekends. In particular, the number of referrals from CSDFs on Mondays were significantly higher (P < 0.05, Poisson regression) than other days of the week. Fifty-one per cent of the ED visits occurred during regular working hours. Eighty-two per cent of the transfers were admitted. The main complaint was shortness of breath with cough, followed by fever and falls. The most common investigation ordered was chest radiograph, followed by electrocardiogram and other radiographs. The most common treatment procedure in the ED was placement of an intravenous line. For those admitted residents, average length of hospital stay was 8.27 +/- 8.19 days (median, 5 days). Seventeen patients (10.3%) died within 3 days of admission, while 31 patients (18.8%) stayed less than 3 days. The admitted residents had an average turnaround time (from time of registration to time of leaving the ED and proceeding to ward) of 97.94 minutes. For patients discharged from the ED, the average turnaround time (time from registration to time of leaving the ED) was 177 minutes. CONCLUSION: Residents from CSDFs are transferred to the ED for a variety of medical reasons. The most appropriate role of the ED in evaluation of residents of CSDFs is not yet clearly defined. There is increasing need to streamline processes in acute hospitals to cope with an increasing ageing population and to ensure that quality care is delivered to the institutionalised sick.

Aged↗