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PubMed2001

Myopia in Singapore kindergarten children.

PURPOSE: The purpose of this study was to examine whether close-up work was related to myopia in Singapore kindergarten children. METHODS: One hundred twenty-eight children, ages 3 to 7 years, from a kindergarten in Singapore were examined by cycloplegic autorefraction. The parents also completed a questionnaire on the different types of close-up work activities each child was engaged in, socioeconomic status, and parental history of myopia. RESULTS: Myopic children spent 3.0 hours per day (median) on close-up work activity, while nonmyopic children spent 2.0 hours per day (median) on close-up work activity. The prevalence of myopia in the sample was 8.6%. CONCLUSION: Close-up work activity was not related to myopia in pre-school children.

Child↗
PubMed1999

Newborn screening in Singapore.

Neonatal screening in Singapore for G6PD deficiency started in 1965. Screening for congenital hypothyroidism started in 1981 as a pilot research program and by 1990, it became nationwide. Screening for congenital hypothyroidism is by the measurement of TSH in the cord serum with recall of those exceeding the 99th percentile, by about 3-4 days of life. Treatment is usually started within a week of life. Over 400,000 newborns have been screened and the screening rate has been about 99.95%. The incidence rate is about 1 in 3,000. G6PD activity in the cord blood is measured using semi-quantitative rapid screening tests. Those identified are physically protected from environmental triggers by keeping them in hospital for a variable period of time. Parents are counseled. Data obtained from 22,830 newborns from the National University Hospital revealed incidence rates of 1.62% in all newborns, 3.15% in males and 0.11% in females. The Chinese and Malay males had a higher (3.94% and 2.95%) incidence respectively when compared to the Indian males with (0.66% incidence). The application of the preventive measures has resulted in no report of kernicterus in the last 20 years. Our efforts are now focused on minimizing the recall rate in the case of hypothyroidism screening, reducing the period of stay in hospital in those with G6PD deficiency and considering the introduction of a PKU screening program in Singapore.

Congenital Hypothyroidism↗
PubMed2000

Survey of dental fees charged by dentists in Singapore.

A survey on dental fees was conducted among all private dental clinics registered with the Medical Audit and Accreditation Unit of the Ministry of Health in Singapore. Replies were received from 74 dental clinics. Analysis of results showed that there was a general increase in the median of fees charged in 1998 compared to the fees listed in the Minimum Fee Schedule issued by the Singapore Dental Association in 1994. 93% of the respondents indicated that there is a need to revise the Minimum Fee Schedule.

Fee Schedules↗
PubMed2001

Oral manifestations of human immunodeficiency virus (HIV)-infected patients in Singapore.

INTRODUCTION: Oral lesions have been recognised as prominent features of acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection since the beginning of the epidemic. OBJECTIVE: This descriptive study was conducted to study the types of oral lesions among HIV-infected patients in Singapore. MATERIALS AND METHODS: Oral examination was done on 81 randomly selected HIV-infected patients attending the specialist outpatient clinic at the Communicable Disease Centre. RESULTS: A total of 9 different lesions were observed in 45 (56%) patients. The lesions observed were oral candidosis (35%), periodontal disease (16%), aphthous-like ulcers (5%), oral hairy leukoplakia (5%) and lymphoma (1%). CONCLUSION: The oral manifestations of HIV-infected patients in Singapore appear to be less frequent in comparison with those patients from Africa and Europe. Similarities in oral findings among the HIV-infected patients in Asia are evident with a notable lack of oral Kaposi's sarcoma (KS) and a low prevalence of non-Hodgkin's lymphoma and oral hairy leukoplakia.

Adult↗
PubMed2001

Men who commit rape in Singapore.

INTRODUCTION: Rape is regarded as one of the most serious forms of sexual assault, yet there has been a lack of clinical information on convicted rapists in Singapore. This paper attempts to confirm the hypotheses that rapists come from disordered backgrounds, from large families and are poorly educated. We further hypothesize that they are more likely to have a history of antisocial behaviour and to have had recent exposure to pornography. METHODS: Rapists serving sentence in a Singapore prison were compared with 2 control groups, one consisting of violent non-sexual offenders and another comprising non-violent non-sexual offenders. RESULTS: Rapists tended to be men in their late thirties who rape women in their early twenties. A large majority of the rapists and their victims are known to each other. Rapists are more likely to come from large, disordered families, attaining low educational levels but seemingly less antisocial when compared with the controls. More rapists and violent controls reported recent viewing of pornography before committing their offenses. CONCLUSION: The demonstrated similarities between rapists and violent controls lend support to the view that rape is an act of violence carried out in a sexual manner rather than a sexual act violently expressed.

Adult↗
PubMed2002

To establish the normal bone mineral density reference database for the Singapore male.

INTRODUCTION: The objective of this study was to establish the normal bone mineral density (BMD) reference curve for the Asian Singapore male. MATERIALS AND METHODS: Three hundred and eighty-three male subjects were enrolled; comprising of 309 Chinese, 44 Malays and 30 Indians resident in Singapore. Bone mineral density was measured at the lumbar spine and left hip using a Hologic QDR 4500 Elite dual-energy X-ray absorptiometry (DXA) scanner. RESULTS: The mean peak BMD for the average lumbar spine and the neck of femur was 1.006 g/cm2 and 0.97 g/cm2, respectively. The mean peak BMD was taken at the 20 to 24 years age group at both the hip and spine based on data distribution for the various age groups. The BMD corresponding to -2.5 standard deviations from the peak adult value was 0.719 g/cm2 for the average lumbar spine and 0.655 g/cm2 for the neck of femur. CONCLUSION: This Asian male BMD reference database, which is 10% and 5% lower than corresponding values from the Caucasian reference database, allows for more accurate diagnosis of osteoporosis in Asian males.

Absorptiometry, Photon↗
PubMed1975

Serum IgE levels in normal subjects and allergy patients among the Chinese in Singapore.

Serum IgE was determined in four groups of Singapore Chinese consisting of 292 normal subjects, 15 patients with atopic dermatitis, 39 with drug allergy and 14 with bronchial asthma. The results were compared with the findings of similar groups in western countries. In the normal subjects the range and means (numerical and geometrical) of serum IgE were four to seven times higher in the Singapore Chinese than reported in the western countries. However, the circulating levels in atopic dermatitis and bronchial asthma patients were comparable. In drug allergy moderate IgE elevation was noted. The serum IgE levels of the normal subjects and patients with atopic dermatitis and bronchial asthma were markedly lower than those found in nearby Papua New Guinea. The significance of these observations is discussed.

Adolescent↗
PubMed2002

Two-year outcome of normal-birth-weight infants admitted to a Singapore neonatal intensive care unit.

INTRODUCTION: To describe the characteristics, the immediate and short-term outcome and predictors of mortality in normal-birth-weight (NBW) infants admitted to a tertiary neonatal intensive care unit (NICU) in Singapore. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 137 consecutive NBW infants admitted to the NICU of the Singapore General Hospital from January 1991 to December 1992. Data on the diagnoses, clinical presentation of illness, intervention received, complications and outcome as well as follow-up patterns for the first 2 years of life, were collected and analysed. RESULTS: NBW NICU infants comprised 1.8% of births in our hospital and 40.8% of all NICU admissions. The main reasons for NICU admissions were respiratory disorders (61.3%), congenital anomalies (15.3%) and asphyxia neonatorum (11.7%). Respiratory support was necessary in 81.8%. Among those ventilated, the only predictive factor contributing to mortality was the mean inspired oxygen concentration. The mortality rate was 11.7%. Causes of death included congenital anomalies (43.75%), asphyxia neonatorum (31.25%) and pulmonary failure secondary to meconium aspiration syndrome (12.5%). The median hospital stay among survivors (88.3%) was 11.0 (range, 4 to 70) days. Of 42 patients (out of 117 survivors) who received follow-up for at least 6 months, 39 infants did not have evidence of any major neurodevelopmental abnormalities at their last follow-up visit, prior to or at 2 years of age. CONCLUSIONS: Despite their short hospital stay (compared to very-low-birth-weight infants), the high volume of NBW admissions make the care of this population an important area for review to enhance advances in and hence, reduce the cost of NICU care. With improved antenatal diagnostic techniques (allowing earlier and more accurate diagnosis of congenital malformations) and better antenatal and perinatal care (allowing better management of at-risk pregnancies), it is anticipated that there should be a reduction in such admissions with better outcomes. Close follow-up of this high-risk group of infants is also important in order to offer early intervention to those who may possibly have perinatally-related developmental difficulties.

Birth Weight↗
PubMed2001

The disability profile of patients with schizophrenia in psychiatric hospital and community settings in Singapore.

The disability profile of persons with schizophrenia in Singapore and how disability levels vary in patients cared for in the community and in the long-stay wards of a state mental hospital were studied using the Life Skills Profile (LSP). The inter-rater reliability of the LSP assessed by the intraclass correlation coefficient (ICC), was lower than in the Australian studies. The test-retest ICCs for the total LSP score and the five subscale scores were satisfactory for the hospitalised subjects and for the community psychiatric nurse subjects, but generally poor for the community care facility subjects. The average ICCs were lower compared to the Australian study. Female hospitalised subjects but not male hospitalised subjects returned higher disability scores on all LSP scales compared to community subjects. This study provided some preliminary data on the usefulness and validity of the LSP in a multi-ethnic Asian setting like Singapore. If the LSP is used as a measure of disability in schizophrenia, it would appear that ratings should only be made by those who know the subject well, and that raters should be formally trained mental health professionals.

Community Mental Health Centers↗
PubMed2002

Prevalence of hepatitis G virus infection in patients with liver diseases in Singapore.

The prevalence of hepatitis G virus (HGV) infection in patients with liver diseases in Singapore and its pathogenic role in these patients was studied. One hundred and forty-eight patients who had chronic hepatitis or acute non A-E hepatitis were studied. Presence of HGV RNA was determined by nested polymerase chain reaction of the 5'non-coding region of the virus in all the patients. Hepatitis G IgG antibody to the envelope (E2) antigen was tested with an enzyme immunoassay (Boehringer Mannheim, Singapore) in 76 of them. Most patients (93%) were ethnically Chinese, predominantly males (74%) and chronic hepatitis B (72%) patients. Others had chronic hepatitis C (19%) or cryptogenic cirrhosis (6%). Four patients had acute non A-E hepatitis. HGV RNA and anti-HGenv were present in 3.5% and 8.3% of those with chronic liver disease. HGV infection did not account for any of the acute non A-E hepatitis and most of the cryptogenic cirrhosis.

China↗
PubMed2002

Are maternal deaths on the ascent in Singapore? A review of maternal mortality as reflected by coronial casework from 1990 to 1999.

INTRODUCTION: In Singapore, published maternal mortality rates (MMR) over the last decade (1990 to 1999) have been so low (0.0 to 1.0 per 1000 live births and still births) as to imply that maternal deaths are rare to the point of being non-existent in some years. This inference is counterintuitive, and earlier studies on maternal mortality, amniotic fluid embolism (AFE) and pulmonary thromboembolism (PTE) have also suggested otherwise. Accordingly, local trends in maternal mortality warrant further examination. MATERIALS AND METHODS: A descriptive and comparative study, comprising a clinico-pathological review of maternal deaths, for which autopsies were conducted by the Centre for Forensic Medicine, during a 10-year period from 1990 to 1999. The annual necropsy-based, MMR (estimated MMR), as well as the prevalence of maternal deaths during this time, were estimated with the aid of the relevant, published demographic data on live births and still births. These were compared with the corresponding rates calculated (calculated MMR) from raw demographic data on maternal deaths classified as such in the published data. RESULTS: Coronial autopsies were conducted on a total of 51 cases of maternal death, of which 33, 17 and 1 were direct, indirect and fortuitous deaths, respectively. The annual, estimated MMR ranged from 0.4 to 1.8 per 10,000 live births and still births. The estimated MMR was twice as high as the calculated MMR and a statistically significant upward linear trend was demonstrated for the former (P = 0.046). AFE (16/51) and PTE (10/51) were the two most common causes of maternal death; their corresponding cause-specific, 10-year prevalence being 0.33 and 0.21 per 10,000 live births and still births, respectively. There was apparent clustering of the cases of PTE during the earlier part of the last decade (1990 to 1995), corresponding to a statistically significant, upward trend in its overall necropsy incidence during that time (P = 0.019). Cardiovascular and pulmonary disorders constituted the bulk of indirect deaths (13/17), while antenatal suicides accounted for 3 of these deaths (0.06 per 10,000 live births and still births). CONCLUSIONS: This was an upward trend in MMR, as reflected in coronial casework, over the last decade. It would appear that the local, estimated (direct and indirect) maternal mortality prevalence compares favourably with the MMR reported in developed countries. The apparent rate of AFE was no less than 4 times higher than that reported in the United Kingdom, while the maternal mortality rate from PTE was at least as high. Allowing for the possibility that such deaths were under-reported, the actual annual MMR and 10-year prevalence could be appreciably higher than the estimates presented here. There may well be a case for the establishment of a comprehensive database of maternal deaths, that is updated continually and contemporaneously, in Singapore.

Adult↗
PubMed2002

Physiological characteristics of Singapore national water polo team players.

BACKGROUND: The purpose of this study is to describe the physiological characteristics of members of the Singapore national water polo team. METHODS EXPERIMENTAL DESIGN: a descriptive study on the physiological characteristics of members of a winning water polo team. SETTING: the study was conducted at the Sports Medicine and Research Centre. PARTICIPANTS: 13 male players (22.5+/-7.2 yrs; 178.5+/-3.9 cm and 71.0+/-8.4 kg). MEASURES: players completed body fat measurements, a submaximal cycling test to determine aerobic fitness and all-out maximal efforts (of arm-cranking and cycling) for 10 and 30 sec duration to determine anaerobic peak power, alactic and lactic acid work capacity for the upper and lower body. RESULTS: The physical measurements were compared with data of national players of various countries. The exercise test results were compared with available published data. CONCLUSIONS: Compared with elite water polo players from other countries, the Singapore water polo players are smaller in stature with a lower body mass. Relative to the limited published data, they are shown to possess a high level of aerobic fitness and anaerobic power and capacity for short-term work.

Adolescent↗
PubMed2002

A countrywide approach to the control of non-communicable diseases--the Singapore experience.

INTRODUCTION: Many developed and developing countries are grappling with recent epidemics of non-communicable diseases and how to effectively control them. Singapore as a small, compact and highly urbanized country has similarly experienced a rapid increase in its chronic disease load and has adopted a national approach to control them. METHODS: This paper traces the strategies taken in the 80s and the 90s to control non-communicable diseases and evaluates the effectiveness of the two approaches. RESULTS: In the 80s, the control programme was largely a Ministry of Health responsibility using a persuasive approach to reach out to the target groups. This produced some results through the lowering of hypertension and cholesterol. For the 90s, the approach was one of leadership by government working with relevant agencies to reach out to all relevant sectors in the population. This National Healthy Lifestyle Programme was given top political support. The integrated and comprehensive approach used showed some improvements in health and gave the direction where efforts should be channelled. CONCLUSION: The countrywide approach taken in Singapore for the control of non-communicable diseases illustrates a model where a national framework was adopted, harnessing health promotion and disease prevention and involving personal responsibility as a key success factor. This rides on a well-developed continuum of healthcare which aims to become an integrated and seamless one.

Chronic Disease↗
PubMed2002

Soy intake and other lifestyle determinants of serum estrogen levels among postmenopausal Chinese women in Singapore.

Endogenous estrogen levels are strongly associated with breast cancer risk, but its determinants are not well understood. We conducted a cross-sectional study of 144 healthy postmenopausal women, participants in a population-based prospective investigation of diet and cancer risk among Chinese in Singapore. The relationships between plasma levels of estrone (E(1)), estradiol (E(2)), and androstenedione and dietary intake of soy and other food groups were investigated. Data on diet and other lifestyle factors were obtained from a structured questionnaire with a validated dietary component that was administered in-person to all participants. Few dietary factors emerged as determinants of plasma estrogen levels in this population. An exception was soy, which was significantly associated with plasma E(1) levels. Specifically, E(1) levels were 15% lower among individuals in the highest quartile of soy protein intake compared with those in the lower three quartiles of intake (P = 0.047). E(1) levels did not differ between individuals in the lower three quartiles of soy protein intake. Similar patterns of differences in E(1) levels emerged in analyses by intake of isoflavones and total soy products. These findings on soy were independent of the four nondietary factors (see below) that significantly influenced estrogen levels. Both E(1) and E(2) levels increased with high body mass index [BMI (weight/height(2))]; the respective levels were 41% (two-sided P = 0.02) and 17% higher (P = 0.34) among women in the highest BMI category (BMI >/= 24) compared with those in the lowest category (BMI < 20). After adjustment for BMI and age, women with a late age at menarche (age 17 years or older) showed significantly lower E(1) (30% lower; P = 0.02) and E(2) levels (24% lower; P = 0.02) compared with women with earlier age at menarche (before age 17 years) and who were nulliparous or had a late age at first live birth (after age 31 years). Current smokers showed significantly higher E(2) levels (28%) than nonsmokers (P = 0.04). These findings are discussed in relation to the recent doubling of breast cancer incidence among Chinese women in Singapore.

Aged↗
PubMed1978

Heroin abuse and a gas chromatographic method for determining illicit heroin samples in Singapore.

The abuse of heroin (diacetylmorphine) in Singapore escalated sharply in 1975 and 1976, as indicated by the 35-fold increase in the number of heroin seizures and the 20-fold increase in the urine samples containing morphine since 1974. A rapid and simple GC method has been described to estimate diacetylmorphine (and caffeine). Monoacetylmorphine and acetylcodeine may be ascertained by an additional step involving acetylation. All gas chromatograms of a large number of samples analyzed consistently had the same pattern, indicating that they possibly had a common origin. This GC "fingerprint," together with the quantitative data, appears to be characteristic of the illicit Asian or Chinese type of heroin found in Singapore. The proportions of the four major ingredients in some twelve typical samples have been tabulated. Statistical data confirming the accuracy and reproducibility of the analytical method have also been presented.

Calibration↗
PubMedDate not supplied

Muslim divorce trends and patterns in Singapore.

"This paper attempts to discuss the general trends in the incidence of divorce among the Muslim population in Singapore since 1921 and the patterns of divorce in the 1980s when detailed statistics were made available.... The Singapore Muslims experienced an extremely high and steady incidence of divorce during the period up to 1958 when the procedures for processing divorce petitions were not well organised. Following the introduction of new legislation and the creation of the Syariah Court to handle marital disputes in 1958, there occurred an immediate and dramatic downturn in the rate of Muslim divorce. By 1970 the decline appeared to have stalled and a slight upturn has even taken place in the 1980s." The impact of rapid social and economic development is assessed. (SUMMARY IN FRE AND ITA)

Asia↗
PubMed1984

Singapore's foreign workforce: some reflections on its benefits and costs.

"This article provides some empirical information pertaining to the benefits and costs of foreign labor to Singapore and subjects to critical analysis some of Pang and Lim's hypotheses concerning the costs of labor importation presented in a previous article.... The article concludes with a discussion of the real cost to Malaysia of Singapore's labor importation policies and its potential for disruption of Malaysia's development plans."

Asia↗
PubMed1994

AIDS infection rising in Singapore.

Singapore reported a rise in the number of people with HIV, with most being single men infected through casual sex with women. In its latest report, the government said 65 new cases of HIV infection were detected in the first 10 months of 1994, up 30% from the 50 new cases in January-October 1993. The number of HIV patients in Singapore has been rising steadily since the first two cases were reported in 1985. Among 1994's patients, 56 are men--almost 80% of them single and below 40 years of age. All reportedly contracted the infection through sexual relations. In all of Asia, an estimated 2.5 million people are infected with the virus, with HIV spreading faster than anywhere else in the world. According to the WHO (World Health Organization), the figure is expected to increase to 10 million by the year 2000. Worldwide there are 16 million adults and 1 million children infected with HIV. Since 1985, 287 Singaporeans have been found to be HIV-infected. Of them, 37 have advanced AIDS.

Asia↗