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PubMedDate not supplied

The role of Chinese traditional medical practice as a form of health care in Singapore. I. Preliminary study.

A retrospective study of 672 sampled records of patients of a major institution providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for "infective" and "internal, emotional and weakness" diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.

Adolescent↗
PubMed1983

The role of Chinese traditional medical practice as a form of health care in Singapore--IV. Physicians in private practice.

Although the government of the Republic of Singapore do not give official recognition to the estimated 1000 Chinese physicians in the country, these practitioners of traditional herbal medicine still enjoy the patronage of a certain segment of the population, 76% of whom are ethnically Chinese. In an earlier paper, we have reported on the characteristics of Chinese physicians who volunteer their service for institutions that provide Chinese traditional health care in Singapore. This complementary paper reports the findings of a survey of 55 physicians who run their own private practice about whom, prior to our study, very little was known.

Adult↗
PubMed1987

Serum HDL cholesterol and apolipoprotein AI, AII and B levels in Singapore newborns.

The mortality from coronary artery disease (CAD) in Indians is more than three times that in the Chinese and Malays of Singapore. Serum total and HDL cholesterol as well as apolipoprotein (Apo) AI, AII and B levels were determined in a group of 349 newborns (cord blood) from both sexes in these three ethnic groups in order to examine if a trend is reflected at birth. Both serum LDL cholesterol and Apo B levels were low in the newborn, while HDL cholesterol and Apo AII levels were almost the same as in adults. Serum Apo AI levels were also low in newborns. No consistent difference as to ethnic group or sex was observed in any of the parameters investigated, except that the females had significantly higher levels of serum Apo AI in all the ethnic groups. Serum total and HDL cholesterol levels in Singapore newborns were comparable to those reported in Caucasians and Asians. The trends of incidence of CAD were not reflected in the lipid profiles studied at birth.

Apolipoprotein A-I↗
PubMed1979

University students and mental health. Canada, Britain and Singapore.

There are many crucial determinants of the individual outcome and benefit of a university education including the stressful interplay of cultural and socioeconomic factors which are of growing importance in the inflationary 1970's. An epidemiological study of university students from 1969-1972 in Canada, 1973-1974 in Britain, and 1975 in Singapore, attempted to identify stresses leading to mental ill-health in these students. Singapore was chosen as an example of a culture bridging the developed Northern and developing Southern nations of the world. Cultural differences affecting the results of the study are discussed as is the role of social change.

Adult↗
PubMed1998

A 10-year review of drug seizures in Singapore.

The trend of illicit drug seizures and analysis in Singapore over a 10-year period from 1986 to 1995 was examined and reviewed. The main drugs were heroin, opium, cannabis, and illicit tablets containing benzodiazepines and amphetamines. The emergence of amphetamines in early 1996 was a major departure from the traditional drug abuse pattern in Singapore. Changes in the legal definitions of opium and cannabis were also reviewed.

Cross-Sectional Studies↗
PubMed1996

Foreign domestic workers in Singapore.

"This paper discusses the regulatory and economic context of Filipina migration into domestic waged labor in Singapore. It places this migration in the history of female rural-urban migration as well as the history of domestic labor in Singapore. Finally, it raises the question as to why domestic waged labor has persisted in the global capitalist economy."

Asia↗
PubMed1990

Motorcyclist traffic accidents and risk factors: a Singapore study.

Motorcyclist accidents cause significant morbidity and mortality in Singapore. To elucidate personal and environmental factors associated with such accidents, we studied 198 motorcyclists who were hospitalized in Singapore General Hospital between April 1986 and June 1987. The patients were mostly young and almost exclusively male with a high proportion of Malays. Most accidents occurred on Sundays and at night. Ten percent of the victims took alcohol before the accident. Most had low injury severity scores (ISS). Less experienced drivers had a significantly higher ISS than those with one year or longer of driving experience. Vigorous control of drunken driving, through public education and intensive breath testing, should reduce the incidence of traffic accidents.

Accidents, Traffic↗
PubMed1991

Prevalence of human T-cell lymphotropic virus type I infection in Singapore: a preliminary report.

Human T-cell lymphotropic virus type I (HTLV-I) infection is endemic in southwestern Japan, the Caribbean basin, Colombia, Africa and in several isolated populations in Papua New Guinea, the Solomon Islands and Vanuatu. To determine the seroprevalence of HTLV-I infection in Singapore, we tested sera from 115 hospitalized patients with acute nephritis, 50 patients with suspected leptospirosis, 34 patients with non-A, non-B hepatitis, and from 28 healthy volunteers for IgG antibodies against HTLV-I using an enzyme-linked immunosorbent assay. Antibodies were detected in sera from 6 of the 199 patients and from 3 of the 28 healthy volunteers, but these positives could not be confirmed by Western immunoblotting. Our data are consistent with other reports of low seroprevalence of HTLV-I infection despite extensive Japanese contact in Korea, Taiwan, the People's Republic of China and Micronesia. Further studies on a larger sample size, however, are necessary to confirm the absence of any focus of infection in the Singapore population.

Adolescent↗
PubMed1995

Battered women: presentation at A&E departments in Singapore.

This study was undertaken to assess the characteristics of battered women seen at the A&E department in Singapore. The first part was conducted at the A&E department of a general hospital in Singapore from July 4, 1992 to November 9, 1992. Ninety-six victims were interviewed using a standard questionnaire. Information was obtained about the characteristics of victims, assailants and the assaults as well as the cause of presentation. In order to verify the universality of the findings, battered women seen at A&E departments of the four main general hospitals on the island from November 1, 1993 to January 31, 1994 were interviewed using a similar questionnaire. We found that the majority of the women were beaten by someone they knew and, for most, it was not a first-time assault. Most times, no weapon was used. Injuries were sustained mainly to the face and extremities. The majority of the victims were at the A&E department either because of the medical examination required in conjunction with a police report or because of the severity of their injuries.

Adolescent↗
PubMed1992

Common poisons in Singapore--past and present.

A study on past toxicological activities in Singapore enabled us to capture the trends of poisons abused in this country over the last 108 years. Until the early sixties, corrosive alkali and acids, alcohol (poisoning cases), inorganic chemicals, heavy metals and plant alkaloids were the mainstay of poisons principally used. The seventies and eighties saw a swing towards pharmaceuticals. The 1988-89 data gave alcohol (poisoning cases), pharmaceuticals, household items such as detergents, hypochlorite and antiseptic, carbon monoxide, paraquat, malathion, organic solvents (toluene and xylenes) and narcotics as the mainstay of poisons encountered. The last two classes of poisons reflect the continuing problems of glue sniffing and narcotics abuse facing Singapore.

Adult↗
PubMed1998

Prevalence of snoring and sleep breathing-related disorders in Chinese, Malay and Indian adults in Singapore.

This study investigated the prevalence of snoring and symptoms of sleep breathing-related disorders in the multi-ethnic population of Singapore (3 million people, comprising 75% Chinese, 15% Malay and 7% Indian). A multistaged, area cluster, disproportionate stratified, random sampling of adults aged 20-74 yrs was used to obtain a sample of 2,298 subjects (65% response), with approximately equal numbers of Chinese, Malay and Indian and in each 10 yr age group. An interviewer-administered field questionnaire was used to record symptoms of snoring and breathing disturbances during sleep witnessed by a room-mate and other personal and health-related data. The weighted point estimate (and 95% confidence interval) of the whole population prevalence of snoring was 6.8% (53-83). There were pronounced ethnic differences among Chinese, 6.2% (4.4-8.1); Malay, 8.1% (6.1-10.2) and Indian, 10.9% (85-13.4). The minimum whole population prevalence by the most restricted symptom criteria for defining sleep breathing-related disorder was 0.43% (0.05-0.8%). Similar marked ethnic differences in rates were observed using various symptom criteria. The ethnic differences in sleep breathing symptoms paralleled the differences in body mass index, neck circumference and hypertension, but statistically significant differences remained after adjustment for sex, age and these known associated factors. Marked ethnic differences in snoring and sleep breathing-related disorders were observed in Chinese, Malays and Indians in Singapore, which were only partly explained by known factors of sex, age and body habitus.

Adult↗
PubMed2006

Ethnic differences in the time trend of female breast cancer incidence: Singapore, 1968-2002.

BACKGROUND: From 1968 to 2002, Singapore experienced an almost three-fold increase in breast cancer incidence. This increase appeared to be different across the three main ethnic groups: Chinese, Malays and Indians. This paper used age-period-cohort (APC) modelling, to determine the effects of age at diagnosis, calendar period, and birth cohort on breast cancer incidence for each ethnic group. METHODS: This study included all breast cancer cases (n = 15,269) in the three ethnic groups, reported to the Singapore Cancer Registry from 1968 to 2002 between the ages 25 to 79. Age-specific fertility rates from the Department of Statistics were used to explore the role of fertility. RESULTS: In the 1970s, Indian women had the highest age-standardized breast cancer but by the mid-1980s the highest rates were seen among the Chinese. Remarkable differences were seen in the age-specific incidence rates by ethnic groups. After age 49, the incidence rates for the Chinese and Malays leveled off whereas it continued to rise in the Indians. While our analyses provided some evidence that an age-drift model described the trend seen in the Indians, age-period-cohort model and age-cohort model had the best fit for the Chinese and Malays aged 25 to 79 respectively. Overall, Chinese and Malay women born in later cohorts were at increased risk of developing breast cancer relative to their counterparts in the earlier cohorts. The three ethnic groups experienced similar changes in their fertility in the 1970s, which likely explained much of the increase in their breast cancer incidence but not the ethnic differences. There was a stronger inverse association between total fertility rate and pre-menopausal breast cancer incidence in the Chinese and Malays than the Indians. CONCLUSION: The observed dissimilarity among ethnic groups suggests ethnic differences in exposure or response to certain risk factors. It is likely that longer and subtler differences in childbearing trends and other risk factors may further explain these ethnic differences.

Adult↗
PubMed1999

Validation of the medical outcomes study family and marital functioning measures in SLE patients in Singapore.

OBJECTIVE: To validate the Medical Outcomes Study Family and Marital Functioning Measures (FMM and MFM) in a multi-ethnic, urban Asian population in Singapore. METHODS: English speaking Chinese, Malay or Indian SLE patients (n=120) completed a self-administered questionnaire containing the FFM and MFM at baseline, after 2 weeks and after 6 months. Lupus activity, disease-related damage and quality of life were assessed using the British Isles Lupus Assessment Group (BILAG), Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index and SF-36 Health Survey respectively. Scale psychometric properties were assessed through factor analysis, Cronbach's alpha, quantifying test-retest differences and known-groups construct validity. RESULTS: Factor analysis of scores obtained at baseline and after 6 months identified 3 factors corresponding to the FFM (1 factor) and the MFM (2 factors). Both scales showed acceptable internal consistency, with Cronbach's alpha of 0.95 for the FFM and 0.70 for the MFM. Mean (s.d.) test-retest differences were -0.31 (3.82) points for the FFM and -0.70 (4.26) points for the MFM. Eleven out of 13 a priori hypotheses relating both the FFM and MFM to demographic, disease and quality of life variables were confirmed, supporting the construct validity of these scales. CONCLUSION: The FFM and MFM are valid and reliable measures of family and marital functioning in a multi-ethnic cohort of Asian SLE patients in Singapore.

Adolescent↗
PubMed2002

Validation of the Medical Outcomes Study HIV Health Survey as a measure of quality of life in HIV-infected patients in Singapore.

Measurement of quality of life is crucial to assess the full impact of antiretroviral therapy on patient morbidity. No quality of life instruments have been validated in an Asian HIV-infected patient population, but it is important to do so given the increasing involvement of the region in clinical trials. We set out to validate the Medical Outcomes Study HIV Health Survey (MOS-HIV) in HIV infected patients in Singapore. Clinically stable outpatients were asked to complete the 30-item MOS-HIV (English or Chinese translation). Patients were also asked about the frequency of selected disease symptoms, and clinical and demographic data were recorded from the case sheet. 163 patients (90% Chinese, 96% male, mean age 38 years, mean CD4 count 159 cells/mm(3)) participated in the study and completed the questionnaire to a satisfactory standard. The questionnaire showed good internal consistency (Cronbach's alpha >0.7 in all cases). There were significant differences in quality of life scores between Centers for Disease Control disease stages, and significant correlations with CD4 count and symptom score, confirming the discriminant validity of the MOS-HIV. Factor analysis revealed two components corresponding to physical and mental health which were similar to those of studies in Western countries except that pain was more closely related to mental than physical health. Linear regression analysis identified symptom burden as the major predictor of physical and mental health. We concluded that the MOS-HIV is a valid measure of quality of life in this HIV patient population in Singapore, and is therefore likely to be useful in future clinical trials in the region. In the era of chronic HIV disease, close attention to symptoms (disease or drug-related) is warranted due to their major adverse influence on mental and physical aspects of quality of life.

Adult↗
PubMed2006

Seroprevalence of HSV-1 and 2 among sex workers attending a sexually transmitted infection clinic in Singapore.

We studied the seroprevalence of herpes simplex virus (HSV)-1 and 2 in sex workers attending a sexually transmitted infection clinic in Singapore and examined their knowledge and attitudes towards HSV infection. A total of 300 participants were recruited. Questionnaires were administered and blood was taken and analysed, using the HerpeSelect 1 and 2 Elisa IgG assays (type-specific serological test). HSV-1 serology was positive in 230 (76.7%), negative in 67 (22.3%) sex workers and indeterminate in three (1.0%) sex workers. HSV-2 serology was positive in 237 (79.0%) and negative in 63 (21.0%) sex workers. On univariate analysis, there was significant association between HSV-2 seropositivity and increasing age, nationality (locals) (P<0.001) and marital status (P<0.01). Adjusting for age, marital status and condom use, HSV-2 prevalence increased significantly with duration of years of practice of sex work. Most of the respondents (86.0%) were aware that HSV could be spread through sex without a condom and about two-thirds of them were aware that HSV could be spread in the absence of symptoms. In conclusion, HSV-2 is a common infection among sex workers in Singapore with the risk increasing with years of practice.

Adult↗
PubMed1997

Remote consultation for computerized tomography and magnetic resonance studies by means of teleradiology--experience at the Singapore General Hospital.

A teleradiology link was established between Singapore General Hospital in Singapore and Stanford University in California, USA. Over eight months, a total of 28 cases (involving 27 magnetic resonance investigations and three computerized tomography scans) were transmitted by ISDN to California. Our initial experience with teleradiology for remote consultation was encouraging, although the data transmission cost was higher than we anticipated. however, costs could be reduced by using data compression. Long-distance telecommunication charges continue to fall, so intercontinental teleradiology of this type may be financially viable in future.

Hospitals, General↗
PubMed2003

Child sexual abuse in Singapore with special reference to medico-legal implications: a review of 38 cases.

There is a paucity of studies on child sexual abuse in Asia. This study reviews the trends of child sexual abuse in Singapore and discusses the medico-legal considerations in the identification, assessment and management (including forensic implications) of such cases. It is a retrospective case review of 38 consecutive cases of child sexual abuse seen at a child guidance clinic in Singapore. Our study showed that most of the children were young (74% below age 9) and female (78.9%) with perpetrators who are males and usually known to the victims. There is a need to have integrated protocols to streamline assessment and reduce the need for repeated questioning. Adequate support of the victims in the form of specialised handling during the Court proceedings and in the use of new technology (such as video conferencing) for obtaining the child's testimony may be necessary. A child's fitness to testify is determined by the credibility and competence of the child. Repressed memories are of questionable validity.

Child↗
PubMed2004

Victims of falls from a height surviving to hospital admission in two Singapore hospitals.

Falls from a height are a common problem in Singapore. However, there has been no analysis of the injury patterns and outcomes of patients who survived initial resuscitation after falls from a height in Singapore. One hundred and thirty-nine patients admitted over a two-and-a-half year period after falls of greater than one storey were studied. The higher the fall, the greater the likelihood of hypotension and neurological injury. The length of stay in hospital, the number of operative procedures and mortality also correlated with the height of the fall. The overall mortality rate was 11% but rose to 47% among patients who were hypotensive on admission. About half of the deaths were due to head injury with haemorrhage being the second most common cause. The majority of patients who fell from five or more storeys did so intentionally, and had more severe torso and extremity injuries compared with those who fell accidentally. These findings suggest that efforts in injury prevention and aggressive evaluation and treatment of fall victims arriving alive at the hospital continue to be important.

Accidental Falls↗