Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SINGAPORE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMed2003

Public disclosure of healthcare performance information and its application to the Singapore context.

The increasing worldwide trend towards publicly and actively disclosing healthcare provider performance information requires that healthcare professionals in Singapore understand the relevant issues and implications. The current evidence suggests that there needs to be caution in any related move here in Singapore, since the benefits have not been entirely established and the associated problems not inconsequential. This article identifies public accountability and the commercial need to demonstrate value as possibly the main drivers for local public disclosure. It concludes that a proper needs analysis and true stakeholder involvement are necessary in contemplating such an initiative locally.

Benchmarking↗
PubMed2003

Primary immunodeficiency diseases in Singapore--the last 11 years.

OBJECTIVES: To describe the clinical features, disease complications, treatment modalities and overall outcome of 39 local patients with Primary Immunodeficiency Diseases (PID) in Singapore over the last 11 years. METHODS: Paediatric and adult patients who presented to the The Children's Medical Institute, National University Hospital, Tan Tock Seng Hospital and KK Women's and Children's Hospital between January 1990 and December 2000 were identified. Their diagnoses were categorised into six groups according to the IUIS (International Union of Immunological Societies, affiliated to World Health Organisation) classification: antibody deficiencies, combined immunodeficiencies, immunodeficiencies associated with other major defects, congenital phagocytic defects, complement deficiencies and other well-defined immunodeficiency syndromes. Patients were selected from screening of inpatients with discharge diagnoses associated with primary immunodeficiency and of patients undergoing tests for immunodeficiency. Patient data were collated from case files and compiled using a standard questionnaire. RESULTS: There were 39 Singaporean patients diagnosed and treated for PID during the study period. The age at diagnosis ranged from three weeks to 69 years. Antibody deficiency (41%) was the most common form of PID. Seven patients had a family history of PID. Recurrent bacterial respiratory tract infections were the most common clinical manifestation. Associated conditions included autoimmune diseases, allergies and malignancies. Infection was the commonest cause of mortality. Eighteen patients (46.2%) with antibody or combined deficiencies received regular intravenous immunoglobulin (IVIG) as the primary treatment modality. Two children successfully received sibling-matched haematopoietic stem cell transplantation (HSCT). CONCLUSIONS: Antibody deficiencies are the most common form of PID in Singapore. Treatment with antibiotics, IVIG and HSCT are the main therapeutic modalities currently available. Early referral to an immunologist is needed to achieve good outcomes.

Adolescent↗
PubMed2004

Hemifacial spasm in Singapore: clinical characteristics and patients ' perceptions.

INTRODUCTION: The aim of this study was to determine the clinical characteristics and patients ' perception of hemifacial spasm (HFS) in Singapore. MATERIALS AND METHODS: A clinical survey of 137 consecutive patients with HFS seen in our Botulinum Toxin Clinic over a 15-month period was undertaken. RESULTS: Forty-six men and 91 women were interviewed. Their mean age at onset of HFS was 48 years. The median disease duration was 60 months (range, 2 to 360 months). Left-sided spasm was common in 51.8 % of patients, and the orbicularis oculi was the first muscle to be affected in 86.1 % of them. The majority (65 %) had the spasm aggravated by stress and anxiety. In fact, 32 patients perceived stress and anxiety as a possible aetiology of HFS. Stroke was a main concern in 17 patients and 7 patients thought the spasm was a sign of demonic possession or a bad omen. The spasm embarrassed 75.2 % of the patients, rendered 65 % of them depressed, affected the vision in 60.6 % of them and compromised their work performance in 35.8 %. Overall, treatment was delayed by a median interval of 6 months from onset of symptoms (range, 0 to 132). More than half (53.3 %) tried traditional therapies (acupuncture or herbal medicine), while only 48.2 % had botulinum toxin as the initial treatment. All patients eventually received botulinum toxin injections and more than 90 % showed improvement at 1 month posttreatment. CONCLUSIONS: The clinical characteristics and patients ' perception of HFS in Singapore were presented. HFS affects patients both psychosocially and functionally. Effective treatment with botulinum toxin exists and should be provided early to the patients.

Adolescent↗
PubMed2004

Effects of cruciferous vegetable consumption on urinary metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone in singapore chinese.

Vegetable consumption, including cruciferous vegetables, is protective against lung cancer, but the mechanisms are poorly understood. The purpose of this study was to investigate the effects of cruciferous vegetable consumption on the metabolism of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokers. The study was carried out in Singapore Chinese, whose mean daily intake of cruciferous vegetables is three times greater than that of people in the United States. Eighty-four smokers provided urine samples and were interviewed about dietary habits using a structured questionnaire, which included questions on consumption of nine commonly consumed cruciferous vegetables. Samples of these vegetables obtained in Singapore markets at three different times of year were analyzed for glucosinolates. Urine was analyzed for metabolites of NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (NNAL-Glucs). Glucobrassicins, which release indole-3-carbinols on chewing, were the major glucosinolates in seven of the nine cruciferous vegetables, accounting for 70.0% to 93.2% of all glucosinolates in these vegetables. There was a significant correlation (P = 0.01) between increased consumption of glucobrassicins and decreased levels of NNAL in urine after adjustment for number of cigarettes smoked per day; similar trends were observed for NNAL-Glucs (P = 0.08) and NNAL plus NNAL-Glucs (P = 0.03). These results are consistent with those of previous studies, which demonstrate that indole-3-carbinol decreases levels of urinary NNAL probably by inducing hepatic metabolism of NNK. The results are discussed with respect to the known chemopreventive activity of indole-3-carbinol against lung tumorigenesis by NNK in mice and the effects of isothiocyanates, which are also formed on consumption of cruciferous vegetables, on NNK metabolism. The results of this study demonstrate the complexities in assessing effects of cruciferous vegetables on carcinogen metabolism.

Aged↗
PubMed1992

Prevalence of varicella-zoster virus infection in Singapore.

The incidence of chickenpox in Singapore has been increasing since 1984. A seroepidemiological survey was conducted in 1989-90 to determine the prevalence of varicella-zoster virus-specific IgG antibody in the healthy population in Singapore aged from 6 months to over 45 years. Overall, 42.8% of 500 samples assayed qualitatively by the ELISA method were positive, with less than one fifth of those aged under 15 years and less than half of the 15-24 year olds possessing antibody to the virus. However, antibody prevalence increased markedly to between 86% and 98% in those over 25 years of age. No significant sex or ethnic difference was noted. The survey confirmed the low herd immunity and the higher susceptibility of the young adult population to varicella infection in a tropical city compared to that of temperate countries.

Adolescent↗
PubMed1992

Parasuicide in male conscripts: a Singapore experience.

This is a retrospective study of 156 cases of parasuicide in a homogenous population of male conscripts in the Singapore Armed Forces. The rate of parasuicide was 12.5 per 100,000 soldiers at risk. Suicide attempters were from the lower rank and one-third were undergoing basic military training at the time of their attempts. Drug ingestion was the commonest method and this was followed by jumping from a height, a method unique to the Singapore experience. Most of the conscripts gave no prior warning and appeared to have no strong desire to kill themselves. Interpersonal problems was the predominant reason given for their suicide attempts.

Adolescent↗
PubMed2004

The majority of hepatitis B carriers are not on regular surveillance in Singapore.

INTRODUCTION: Carriers of hepatitis B virus (HBV) are at risk of developing long-term complications. Regular surveillance helps detect treatable chronic hepatitis, cirrhosis and liver cancer, and is recommended by practice guidelines in the United States, Europe and Singapore. However, there have been few studies evaluating the follow-up of HBV carriers. This study seeks to determine the proportion of HBV carriers on regular follow-up in Singapore and the impact on hepatitis B disease. METHODS: An advertisement was taken in local newspapers advertising for free screening to HBV carriers. 387 persons answered the advertisement. The screening comprised history-taking, physical examination, blood tests (liver panel, alphafoetoprotein, hepatitis B surface antigen (Ag) and hepatitis B eAg) and ultrasonography of liver. Further evaluation was conducted if the screening results were abnormal. RESULTS: Of the 387 HBV carriers, 346 (89 percent) were male and 375 (97 percent) were Chinese. Their mean age was 39 years (range 20-60 years) and 36 percent were positive for HBeAg. 247 (64 percent) were not on regular screening over the past 12 months. 19 (5.4 percent) patients were diagnosed to have complications, namely: 13 had HBeAg-positive chronic hepatitis, two had HBeAg-negative chronic hepatitis, one had early liver cancer who recovered well after a curative resection and three had compensated cirrhosis. CONCLUSION: Our screening programme diagnosed 5.4 percent of complications among 387 asymptomatic HBV carriers. However, 64 percent of the study subjects were not screened regularly and may pose an important public health threat if they develop long-term complications. Further studies are needed to evaluate and improve patient compliance for screening.

Adult↗
PubMed2004

Smoking cessation programme: the Singapore General Hospital experience.

INTRODUCTION: The National Health Survey in Singapore reported that the prevalence of smoking had decreased from 20 percent in 1984 to 15 percent in 1998. This may be due to the efforts of smoking cessation education established island-wide. In this study, we review the efficacy of the Singapore General Hospital smoking cessation programme and examine the efficacy of different treatment modalities. METHODS: We studied the immediate quit rate and point prevalence abstinence rates at six and 12 months in our telephone survey. Subjects were patients who attended our programme from June 1999 to December 2002. Pharmacotherapeutic aids utilised with counselling sessions were individualised. RESULTS: The study populations for outpatient and inpatient arms were 394 patients and 425 patients, respectively. In the outpatient programme, mean age was 46 years (range of 12 to 80 years), and the ratio between males and females was 8.6. The outpatient immediate quit rate was 33 percent, and the six and 12 month quit rates were both 36 percent. However, in the inpatient programme, mean age was 65 years (range of 15 to 93 years), and the ratio between males and females was 4.9. The six and 12 month quit rates of the inpatient arms were 30 percent and 32 percent, respectively. Although there is no statistically significant difference in the different treatment modalities, the immediate quit rates for bupropion only and counselling only were relatively higher (36 percent and 41 percent, respectively). These were sustained at more than 35 percent at six and 12 months follow-up. We achieved comparable efficacy compared to published data. Counselling, as a sole therapy, can be effective in a select patient group. One-time inpatient counselling achieved a quit rate (32 percent at 12 months) far superior to previously-reported self-quit rate (3 percent and 8 percent at 12 months). CONCLUSION: We strongly recommend that all inpatients who are smokers to be routinely referred for counselling.

Adolescent↗
PubMed2004

We did the right thing: an intervention analysis approach to modeling intervened SARS propagation in Singapore.

In this paper, we adopt the Intervention Analysis approach to model an intervened natural process, i.e., propagation of the severe acute respiratory syndrome (SARS) in Singapore, which is affected not only by its own evolutionary history but also by the control measures taken. Using this model, the propagation trend of the epidemic and the effects of different control measures on the outcomes of this epidemic can be simulated and quantitatively analyzed. Based on the model, we have performed an evaluation and sensitivity analysis of the Singapore government's responses to this epidemic. Preliminary results have shown that the control measures taken are effective in controlling the outbreak.

Communicable Disease Control↗
PubMed2004

Cadaveric & living organ donation. Natural limitations. Possible solutions. Singapore experience.

Singapore is a country with different cultures and beliefs. Over the last thirty eight years since independance, it has blossomed close to being a developed nation. Having performed the first cadaver donor renal transplantation in 1970, there has been a tremendous amount of health literacy injected into the Singaporeans, with the able support of the National Kidney Foundation. Never ending waiting list for organ donation has facilitated a march of events from Volunatary Organ Pledging under the Medical Therapy, Education and Research Act to passing the Human Organ Transplant Act to extension of the presumed consent law to include Heart, Liver and Cornea and non-accidental brain deaths. In the years to come, Singapore will certainly see an increase in the number of organ transplantations both Cadaveric and Living related.

Cadaver↗
PubMed2004

A molecular epidemiologic study of thalassemia using newborns' cord blood in a multiracial Asian population in Singapore: results and recommendations for a population screening program.

DNA technology provides a new avenue to perform neonatal screening tests for single-gene diseases in populations of high frequency. Thalassemia is one of the high-frequency single-gene disorders affecting Singapore and many countries in the malaria belt. The authors explored the feasibility of using PCR-based diagnostic screening on 1,116 unselected sequential cord blood samples for neonatal screening. The cord blood samples were screened for the most common reported alpha- and beta-thalassemia mutations in each ethnic group (Chinese, Malays, and Indians) in a multiracial population. The carrier frequency for alpha-thalassemia mutations was about 6.4% in the Chinese (alpha deletions = 3.9%, alpha deletions = 2.5%), 4.8% in Malays, and 5.2% in Indians. Only alpha deletions were observed in the Chinese. The carrier frequency for beta-thalassemia mutations was 2.7% in the Chinese, 6.3% in Malays, and 0.7% in Indians. Extrapolating to the population distribution of Singapore, the authors found a higher overall expected carrier frequency for alpha- and beta-thalassemia mutations of 9% compared with a previous population study of 6% by phenotype. The highly accurate results make this molecular epidemiologic screening an ideal method to screen for and prevent severe thalassemia in high-risk populations.

China↗
PubMed2005

Domestic violence in Singapore: a ten year comparison of victim profile.

INTRODUCTION: To investigate whether the profile of female victims of domestic violence in Singapore has changed over the past ten years. METHODS: 163 female victims of domestic violence presenting to an emergency department in Singapore were surveyed. The survey included information on the victims' demographics, assault characteristics and knowledge of help services. The results were compared against a similar survey done locally ten years ago, which involved 233 victims. RESULTS: There were no significant differences in the racial composition, marital status, weapon use and admission rates of victims ten years on. However, a significantly higher proportion of female victims in 2002 knew where to seek help, compared to a decade ago (50.9 percent versus 20.6 percent, p-value is less than 0.0001). CONCLUSION: The proportion of victims with an awareness of community and legal help services has more than doubled over the past ten years.

Adult↗
PubMed2005

Use of polymerase chain reaction on pooled cervical swabs to detect Chlamydia trachomatis infections in female sex workers in Singapore.

INTRODUCTION: Infections caused by Chlamydia trachomatis (C. trachomatis) is one of the commonest sexually transmitted infections (STI). As there is currently no laboratory in Singapore that offers the chlamydia culture tests, alternative laboratory methods were developed and antigen detection methods such as enzyme immunoassays (EIA) proved to be even less sensitive than cell culture. This study was done to assess the accuracy and sensitivity of pooling five endocervical swabs collected for C. trachomatis testing by polymerase chain reaction (PCR) technology, as compared to the currently used EIA on individual swabs, in female sex workers who were seen at a STI clinic in Singapore. METHODS: A total of 1,182 endocervical swab specimens were analysed by EIA as well as in pools of five specimens using PCR. Any pool with a positive PCR result for C. trachomatis infections was subjected to repeat PCR testing of the five individual specimens in the pool. RESULTS: There were a total of 48 confirmed cases of C. trachomatis infection. EIA detected 19 positive samples for C. trachomatis, yielding a prevalence of 1.6 percent among the sex workers tested. Pooled PCR testing showed a higher prevalence rate of 4.1 percent, with 48 PCR positive samples. All cases that were EIA positive were also PCR positive. Individual runs on 200 random samples as well as on 220 individual samples from positive pooled results showed PCR inhibition rates ranging from 1.5 percent to 2.3 percent. However, the PCR inhibition rate was 0 percent with the use of pooling. Sensitivity of EIA was 39.6 percent, with 100 percent specificity. EIA tests had a false negative rate of 60.4 percent. PCR was found to be 100 percent sensitive and specific. CONCLUSION: C. trachomatis infections among female sex workers attending the clinic were found to be higher using PCR technology. Less sensitive methods such as EIA result in undertreatment of otherwise undetected cases. The pooling strategy using pool sizes of five specimens, with a disease prevalence of 4.1 percent is reliable and cost-effective, and has since been introduced in the current medical surveillance scheme for sex workers in the clinic.

Cervix Uteri↗
PubMed1992

The role of the Singapore Sports Council in coronary artery disease prevention.

The Singapore Sports Council (SSC) is a statutory board (government body) which was set up in 1973. Its main responsibility is to implement the "SPORTS FOR ALL" policy of the Singapore Government. Physical activity has been found to be an important factor in coronary artery disease prevention. It is through its "SPORTS FOR ALL" policy, by promoting physical activity to all Singaporeans, that the SSC helps in coronary artery disease prevention. The SSC promotes physical activities (and sports) by providing facilities, running fitness schemes, organising instructional schemes for sports, sports training schemes and sports activities. The facilities available to the public include swimming pools, stadia with running tracks and playing fields, tennis courts, squash courts and badminton courts. A 1987 national survey showed that 28.3% of the population aged 15 and above engaged in sports one or more times a week. Those who exercised three or more times a week accounted for only 7.9%. The SSC will continue in its efforts to improve this rate of physical activity in the population, with coronary artery disease prevention as one of its main objectives.

Coronary Disease↗
PubMed2005

Universal newborn hearing screening in Singapore: the need, implementation and challenges.

With about 1 in 1000 born with severe to profound hearing loss and about 5 in 1000 with lesser degrees of loss, congenital deafness is the commonest major birth defect. It is the recommended standard that hearing loss in newborns be detected by 3 months of age and intervention implemented by 6 months of age. Delayed detection and intervention may affect speech, language and psychosocial development, resulting in poor academic achievements. Universal newborn hearing screening (UNHS) is the only effective way of detecting all babies with hearing loss, within the recommended time frame. A survey in Singapore revealed that traditional childhood hearing screening programmes resulted in late detection (mean age, 20.8 months; range, 0 to 86 months) and late intervention (mean age, 42.4 months; range, 1 to 120 months). Increasingly, UNHS is becoming standard medical care in developed countries. In Singapore, UNHS has been implemented in all hospitals with obstetric services. Although a screening rate of more than 99% has been achieved in public hospitals, private hospitals have a screening rate of only about 77%. Parents' awareness and acceptance of early detection is still lacking, and this needs to be addressed by appropriate public education. Support from obstetricians and paediatricians will significantly contribute towards this objective. Effective programme management is essential; this includes the use of data management systems, the maintenance of a team of experienced screeners, and efficient coordination between screening and diagnostic services. Early detection of childhood deafness, together with early and effective intervention, maximises the chances of successful integration into mainstream education and society.

Audiometry, Evoked Response↗
PubMed1992

Drinking and driving in Singapore 1987 to 1989.

In the period 1987 to 1989 there were about 5,000 cases of fatal and injury-sustained road traffic accidents, of which 2.3 to 3.0% were alcohol-related (Blood alcohol levels greater than the legal limit of 80 mg % ethanol). The offenders of alcohol-related accidents are mostly Chinese (greater than 79%), predominantly of the male gender (greater than 98%), and more often than not in the 30 to 40 age-range. The majority of the alcohol-related accidents took place between 8 p.m. to 4 a.m. (greater than 74%) under fine weather and light traffic. Rear-end, head-on and side-on collisions comprised over 60% of all the alcohol-related accidents and losing control of vehicles about 30%. Drunken driving non-accident cases for the same period showed a number of characteristics similar to those for alcohol-related accident cases. In Singapore motorcycle riders and pedestrians are more prone to road fatality than other road-user groups. International comparisons of road fatalities per 100,000 population gave Singapore one of the lowest accident rates (8.1 to 8.4) as compared to countries such as Australia, the United Kingdom, the United States, New Zealand, Canada and Japan.

Accidents, Traffic↗
PubMed2005

Milestones of the medical school and medical progress of Singapore over the past 100 years.

The Medical School started off in an old female lunatic asylum on the site of the general hospital at Sepoy Lines. It was founded on 3 July 1905 and was called the Straits and Federated Malay States Government Medical School. In 1916, the Licentiate in Medicine and Surgery (LMS) was recognised fully by the General Medical Council of Britain as a registrable qualification. In 1921, the medical school was renamed King Edward VII College of Medicine to reflect its academic status. In 1926, the College and its hospitals were inspected by Sir Richard Needham, who had been sent by the General Medical Council of Great Britain. In his report, he told the Council that in his opinion, the graduates should be given the MBBS degree because of the high standard of the Medical School. The medical school was closed by the Japanese on 16 February 1942. After the end of World War II, the College of Medicine resumed classes in June 1946. In 1962, the medical faculty became the Faculty of Medicine of the University of Singapore. From 1984 to 1986, following the university's move to Kent Ridge, the Faculty's clinical school also moved to the National University Hospital. In 2004, plans were well underway for the opening of the country's second medical school on the grounds of the Singapore General Hospital.

Education, Medical↗
PubMed2005

The 1926 General Hospital, Singapore.

This article mentions briefly the history of the early General Hospitals of Singapore, and the events leading to the opening of the 1926 General Hospital (the predecessor of the present General Hospital). There is a detailed description of this hospital. During the next four decades there were many changes (alterations and additions) to cater to changing circumstances. The hospital also underwent an upheaval caused by the war with Japan and the Japanese Occupation of Singapore. The Japanese Armed Forces used the General Hospital for their own patients. The British General Hospital with its Maternity Wards were transferred to Kandang Kerbau Hospital which became the main Civil General Hospital for Singaporeans during the Japanese Occupation. There are brief descriptions of these alterations and additions as well as those made after the rehabilitation of the General Hospital after the war. The Obstetric and Gynaecological Service remained at Kandang Kerbau Hospital and did not return to the General Hospital. From 1975, with the commencement of the construction of the present General Hospital, the third to be built in the same locality, the 1926 General Hospital was demolished in stages. Some parts still stand, e.g., the porch of Bowyer Block, and the shell of Mistri Wing (now the National Heart Centre).

History, 19th Century↗