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PubMed1983

The use of one gram daily cimetidine in the treatment of peptic ulcer in Singapore.

An open study was conducted to assess the efficacy of Cimetidine one gram daily in the treatment of peptic ulcer amongst outpatients in Singapore. Forty patients with duodenal ulcer and fourteen patients with gastric ulcer were entered into the study. Ulcer healing was assessed by endoscopy. At six weeks 85% of duodenal ulcers and 64% of gastric ulcers healed. Although the study is uncontrolled the figures suggest that Cimetidine I gram daily is effective in the treatment of duodenal ulcer in Singapore outpatients. The efficacy of Cimetidine in gastric ulcer, however requires further study.

Adult↗
PubMed1980

Hepatitis B surveillance in Singapore.

257 cases of acute hepatitis B were reported between January 1977 and June 1979. This constituted about one-third of all reported acute viral hepatitis cases in Singapore. The mean annual morbidity and mortality rates per 100,000 was 4.4 and 0.12 respectively. The case-fatality rate was 2.7%. The age-specific morbidity rates were high in the 15-24 and 25-34 years age groups, while the ethnic specific morbidity rate was highest in Indians. The male to female ratio was 4.6: 1. Cases were concentrated in urban and suburban areas with high population density. Three outbreaks, one traced to contaminated needles and syringes, one to contaminated tattoo neeedles, and amongst close contacts, were described. Although parenteral procedures were associated with hepatitis B infection (p < 0.005), non-parenteral or inapparent parenteral mode of transmission probably contributes to a significant extent in the transmission of hepatitis B in Singapore. Studies to determine the role of perinatal transmission, and of vectors, in maintaining the endemicity of the disease, were suggested.

Adolescent↗
PubMed1981

Salmonella infections in Singapore.

The incidence of typhoid and paratyphoid in Singapore from 1976 to 1979 is reviewed. Common Vi-phage types were A, B1, B2, D1, D2 and E1. Most of the paratyphoid cases were imported but an outbreak of paratyphoid A started in 1979 for the first time in Singapore with a predominance of untypable phage type strains. Most of the strains of Salmonella typi and Salmonella paratyphi A & B were susceptible to antibiotics, except for 4 strains of S typhi isolated from imported cases. Infections caused by Salmonella typhimurium were most common in children under five. The strains were initially multiple-resistant to antibiotics, but gradually became more susceptible with decline in the number of cases. Among the salmonella serotypes isolated from clinical materials, Salmonella oranienburg showed multiple-resistance to antibiotics and started an outbreak among children in October 1978. A total of 55 serotypes other than salmonella typhimurium was isolated between 1976 and 1979, with most of them susceptible to the antibiotics except triple-sulpha.

Child, Preschool↗
PubMed1982

Child health in Singapore--past, present and future.

The state of child health in Singapore from 1914 to the present is chronicled. In 1914, there were 225 reported cases of tetanus neonatorum out of 7,420 births and 340 deaths from gastroenteritis with an infant mortality rate (IMR) of 292.9 per 1000 livebirths. In 1936 the infant mortality rate was 167.74, and in 1962, it was still high at 31.2, a figure which exceeded the IMR of USA, UK, Australia and New Zealand. However, by 1976, the IMR had fallen to 11.8 which was lower than that of the above countries and the neonatal mortality rate (NMR) was 8.4 which was also lower than the other four developed countries. In 1981, the IMR fell further still to 10.8 and the NMR was 7.7. The causes of the improvement of child health in Singapore are discussed, and the prospects and priorities for the future are described.

Child↗
PubMed1982

Thoracic and cardiovascular surgery in Singapore.

Thoracic and Cardiovascular Surgery started in Singapore on the initiative of a number of the leading general surgeons working in general surgical units in the public institutions. Initially, only thoracic surgery was done. This was followed about 15 years later with cardiovascular surgery. A decision was made to establish a Thoracic Surgical Unit at the Tan Tock Seng Hospital in 1965. The Head of Department was appointed. Space had become available at this hospital following the very successful anti-tuberculosis chemotherapy programme. The department was set up in December 1966. It grew steadily over the years. As in other similar centres, the spectrum of patients that underwent operations in the department became predominantly cardiovascular in nature. In December 1981, this department was transferred to the Singapore General Hospital where specialised facilities based on the experience of the surgical team had been installed.

Cardiac Surgical Procedures↗
PubMed1982

Immunology in Singapore--past and future.

In the past, immunology in Singapore was mainly confined to serology for the diagnosis of certain infectious diseases. Postgraduate education for immunology was not well developed and its undergraduate training was restricted to a few lectures within bacteriology. With the establishment of the W.H.O. IRTC in 1969, training and research in immunology were further developed and a group of scientists and technicians to conduct research work was subsequently built up. This enabled the Centre to provide some immunological services to the Government and University, and soon extended these to our neighbouring countries as well. Further research and the maintenance of international standards are essential for the future development of immunology in Singapore. And this is only possible with the moral and financial support of the Government, University and private granting bodies.

Allergy and Immunology↗
PubMed1982

Thyroid cancers in Singapore 1968-'77.

Thyroid cancers from the Cancer Registry of Singapore over a ten . year period were analysed in two separate periods 1968-'72 and 1973-'77. Biopsy materials were reviewed and classified according to the WHO Classification of thyroid cancers. The crude incidence rates per 100.000 population per year was 1 in males and 3 in females. No definite ethnic group differences were observed. Papillary carcinoma was by far the commonest cancer followed by follicular carcinoma. Comparison between the two periods of study revealed a slight tendency to decline in incidence among the females. The papillary-follicular carcinoma ratio showed a progressive increase with time. The incidence of undifferentiated carcinoma had also declined over the same period. This may reflect changes in the environment which have an influence on the incidence and histological types of thyroid cancers in Singapore.

Adenocarcinoma↗
PubMed1981

Vibrio infections in Singapore.

Both symptomatic and asymptomatic Vibrio infections, caused by V cholerae, V parahaemolyticus and NAG vibrios, occurred in Singapore. V cholerae are introduced into the country from time to time, but the risk of transmission of infection in the community is negligible in the presence of a high standard of environmental sanitation and a well-established system of epidemiological surveillance. As cholera is probably transmitted through contaminated food, shellfish imported from cholera-endemic countries are regularly monitored for the presence of V cholerae. Vigilance has also been stepped up in the laboratory in view of the possibility of introduction of multiple-antibiotic resistant V cholerae strains into the country. V parahaemolyticus is one of the commonest causes of bacterial food poisoning in Singapore because of the preference of the local population to consume raw or partially cooked seafood. 78% of a variety of imported seafood were found to be contaminated with V parahaemolyticus. Infections caused by NAG vibrios are infrequent, and the mode of transmission has not been established.

Adolescent↗
PubMed1981

Selective area tuberculosis surveys in Singapore 1978.

A random population sample survey in Singapore 1975 revealed that a relatively high proportion of active pulmonary tuberculosis patients remained undiagnosed, mainly in the older age groups. Previous studies disclosed the cause to the lack of symptoms of concern in these patients. A new programme was devised to discover hidden elderly patients by mass chest X-ray screening of population aged 45 years and older living in areas with known high incidence of tuberculosis. The yield of cases was less than expected mainly due to the dislocation and dispersion of population from recent extensive urban re-development in Singapore. Nevertheless the results were comparable to the most productive case finding programme carried out in this department.

Aged↗
PubMed1980

Epidemiology or primary liver cancer in Singapore.

Primary Liver Cancer occurs with high frequency in most parts of the East and South East Asia. The age standarised rates for most Western countries are below 2 per 100,000 per year for males and below 1 for females. In Singapore, the rate is 29.1 for males and 7.7 for females. There is a male preponderance in Singapore by a ratio of male to female of 3.8 in age standardised incidence rates. The peak incidence is the 6th decade (30.1% of cases) and in the 7th decade (31.7% of cases). The Chinese have the highest incidence amongst the different ethnic races. Epidemiological studies done on migrant population strongly suggest that environmental factors are more important than genetic factors in the aetiology of liver cancer.

Aged↗
PubMedDate not supplied

Factors influencing the outcome of health campaigns: a case study in Singapore.

Singapore, located in South-east Asia, enjoys a high standard of health care. However, certain diseases are still of major concern to the health authorities, who feel these could be more easily controlled if the public were more aware of their modes of transmission. A "Combat infectious diseases" campaign was therefore launched to educate the public on food-borne diseases (cholera, enteric fever), malaria, dengue/dengue haemmorrhagic fever, leprosy, tuberculosis, and sexually transmitted diseases (syphilis, gonorrhoea). Educational activities in the form of talks, film shows and exhibitions in schools, community centres and other institutions were carried out over a 15-month period. This paper analyzes some of the factors which affected the results of the campaign, as revealed by a health survey conducted in a selected lower-middle income urban community, where sub-groups of the adult population (aged above 15) were tested to assess their health knowledge. Findings indicate that educational level, age of respondents and language proficiency--four languages are used in Singapore--seem to be the three variables that affect the likelihood of the respondents' receptivity to campaign information.

Adult↗
PubMed1995

A computer-based surveillance system for human immunodeficiency virus infection in Singapore.

The first case of the human immunodeficiency virus (HIV) infection was detected in Singapore in 1985 and the first case of the acquired immunodeficiency syndrome (AIDS) in 1986. Since then, the number of infections had increased. By the end of 1993, there were 222 residents with HIV infection, including 75 cases of AIDS. In view of the rapidly increasing magnitude of HIV infection, a microcomputer-based surveillance system was designed and developed in 1992 to better monitor epidemiological trends of HIV infection in Singapore. OBJECTIVE--The objective was to define a composite model of a successful HIV and AIDS registry that included: (a) patient data forms, (b) patient's contact data forms, (c) data analysis, and (d) report generation. METHODOLOGY--An IBM-compatible desk-top microcomputer was used for the project. The main software used for computer programming and data analysis were DBase IV (Version 1.5) and Epi Info (Version 5.0), respectively. Security features were incorporated into the programme to ensure confidentiality of information and that only authorized personnel could gain access to the programme. MAIN FINDINGS--The system functioned as the National HIV Notification Registry and was able to track notifications, analyse data and enabled prompt dissemination of information. The system was also linked to another database system for tuberculosis to enhance surveillance of both HIV infection and tuberculosis. CONCLUSION--The authors believe that this system would enhance surveillance and provide timely information for national AIDS control programmes. However, the effectiveness of this computer-based surveillance system is dependent on an established notification structure with notifications of sufficient completeness for both HIV infection and AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Occupational burns in the Burns Centre at the Singapore General Hospital.

This study reviewed all work-related burn injuries within the period 1 April 1992 to 31 March 1993 for the purpose of establishing data on occupational burns in Singapore to identify the specific at-risk population and formulate prevention strategies. All 163 patients who were admitted to the Burns Centre, Singapore General Hospital, as a result of burns suffered in the workplace were reviewed using the World Health Organisation Burns Data Protocol. Burns data recorded included demography, industrial sector involved, aetiology, extent of injury and eventual outcome in terms of mortality and morbidity. Occupational burns accounted for 45% of all admissions to the Burns Centre. Male workers in the 20 to 40-year age group predominated with 90% of admissions. The most common aetiology was flame burns and explosions (52.8%) followed by scalds (24.5%) and electrical (10.4%), chemical (6.1%) and contact (6.1%) burns. The average body surface area (BSA) involved was 8% (range 0.25% to 90%). Twenty-seven patients suffered full-thickness burns and the average area of involvement was 2% (range 0.25% to 90%). The most common anatomical regions involved were the upper limbs (46.3%) followed by lower limbs (31.9%). Eighteen patients (11.0%) sustained major burns requiring fluid resuscitation and 39 patients (23.9%) sustained respiratory burns. Seven patients died, giving a mortality rate of 4.3%. The average BSA for these patients was 46.4% and all had respiratory burns. In all, occupational burns accounted for 2011 patient-days of hospitalization, 630,637 lost days at work and inpatient treatment costs amounting to S $1.32 million.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Occupational health through primary health care clinics in Singapore.

The training of primary health care workers in occupational health is important for the provision of occupational health care to the workforce. In Singapore, over 400 Designated Factory Doctors, mostly general practitioners, have been trained. Occupational health is also incorporated in the training of family medicine trainees. Referral centres for cases of suspected work-related diseases are also available. Two specialist occupational health clinics function within Government polyclinics serving the large working population in Singapore. One such clinic operates every Wednesday morning at the Jurong Polyclinic. In the last four years, 485 patients with work-related complaints were seen. There were 268 cases (55%) of occupational skin disease, 74 patients (15%) with respiratory complaints, 38 patients (8%) with acute toxic exposures and 36 patients (7%) with musculoskeletal complaints. Three hundred and forty-nine of the referrals (72%) came from the Jurong Polyclinic doctors, with small numbers from other polyclinics and neighbouring private practitioners. The experience gained in conducting this clinic demonstrated that significant numbers of diseases seen at the polyclinic are work-related in varying degrees. Hence, there is a need for the further development of occupational health care delivery within the primary health care system. This can be achieved by improving occupational health training for all primary health care workers, providing an occupational health resource person at primary health care centres, and raising the awareness of such referral facilities in occupational medicine.

Humans↗
PubMed1994

Racial differences in fetal morphometry in Singapore.

A systematic collection of fetal morphometric measurements was started seven years ago in 1987 with the prospective entry of data into personal computer-based stations in the Department of Obstetrics and Gynaecology, Singapore General Hospital. A cross-sectional study was done, comparing 2392 Chinese fetuses with 2117 Malay fetuses and 459 Indian fetuses from 18 to 40 weeks. The mean values of the head circumference (HC), abdominal circumference (AC) and femur length (FL) of the 3 ethnic groups were analysed. There were no statistical significant differences in the head circumference and abdominal circumference of Chinese, Malay and Indian fetuses in Singapore. The Chinese and Malay fetal femur length appeared similar but were apparently shorter than the Indian femur length. Nomograms of head circumference, abdominal circumference and femur length were constructed for application to fetuses of all 3 ethnic groups.

Abdomen↗
PubMed1994

Evolution of a hospice home care service in Singapore.

The hospice movement in Singapore was started in 1985 when St Joseph's Home opened its doors to terminally ill patients by setting aside 16 beds for hospice care. A newspaper article about this work brought together a group of volunteers who started a hospice home care service under the auspices of the Singapore Cancer Society in 1987. This service was originally entirely staffed by volunteers until a charitable foundation made possible the employment of a nurse coordinator in 1988. Nearly two years later, in December 1989, the Hospice Care Association, a new charitable organization specifically devoted to the promotion and provision of hospice care, was formed. With charitable funding from the community, the new organization built on the experience of the volunteer-run hospice home care service and developed it into one in which professionals provide most of the care, supported by volunteers. Full-time staff were responsible for the day-to-day running of the service, providing for reliability and setting and maintaining of standards, while the role of volunteers changed to that of supporting, supplementing and enhancing the quality of the care given to patients. This paper chronicles the evolution of this service and describes its present functioning.

Health Personnel↗
PubMed1993

Condom knowledge, attitudes and use among patients attending the public STD clinic in Singapore.

Three hundred patients (255 males and 45 females) attending the public STD clinic in Singapore were interviewed regarding their frequency of condom use, attitudes towards condoms, problems related to condom use and places of purchase of the condoms. Among respondents with regular partners, 55.2% of males and 48.8% of females never used condoms, only 12.4% of males and 16.3% of females used condoms consistently. Among respondents with non-regular partners, only 2.2% of males used condoms consistently. The commonest reasons why male respondents did not use condoms consistently were that condoms decreased sensation, condoms made sex mechanical, the use of other forms of contraception, no condoms were available, and the perception that there was no risk of contracting STD/AIDS. Condoms were most commonly obtained from sex partners, supermarkets, roadside sundry shops and the Maternal & Child Health Clinics (MCHCs). About 8% of both males and females had experienced some problems with condoms before. Greater efforts to promote the practice of protected intercourse among the STD patient population as well as in the general population are required in order to control the spread of STD and AIDS in Singapore.

Adult↗
PubMed1993

The Singapore Renal Registry: an overview.

The Singapore Renal Registry (SRR) is created to collect and analyse information on incidence, prevalence, morbidity and mortality of End Stage Renal Disease (ESRD) in Singapore. Its objectives include the implementation of a consolidated renal disease data system, report on incidence and trends over time of renal disease, analyse aggregate data on effect of various modalities of therapy, identify problems and opportunities for special studies and research. The framework of the Registry encompasses the following areas: incidence, demographics and causes of ESRD, utilization of treatment modalities, institutions providing treatment, morbidity and survival rates of various treatment modalities, the paediatric sector, the private sector, international comparisons and research areas. This overview will present whatever existing data and renal statistics that are currently available on a regional or national basis. The collection of nationwide statistics will provide a database to formulate national averages of individual renal statistics. Statistics can also be collected to provide valuable data for planning and projection for future needs.

Adult↗