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At least 811 records · Page 45Linked to original sources
PubMed2006

Spectrum of Vogt-Koyanagi-Harada disease in Singapore.

PURPOSE: Review of all cases of Vogt-Koyanagi-Harada disease (VKH) handled in the Uveitis Clinic of the Singapore National Eye Centre, with the aim of determining the clinical spectrum of this disease in these patients and the outcomes of treatment. METHODS: The case notes were retrospectively analyzed for patient demographics, clinical signs, investigations, complications and treatment received. The treatment groups were classified according to the steroid regimen (dose and timing). The early-high (EH) group received > or =1 mg/kg per day of systemic prednisolone within 2 weeks of presenting with symptoms, the late-high (LH) group received the same dose between 2 and 4 weeks of presenting with symptoms, and the low-dose (LD) group received no or lower doses of oral corticosteroids, or received the same high dose, but only after more than 1 month of presenting with symptoms. RESULTS: A total of 178 eyes of 89 patients, mainly of Chinese ethnicity, were examined. The mean age of the patients at onset of the study was 41.80 +/- 14.65 (SE) years, and there were nearly equal numbers of male and female patients. The mean duration of the follow-up was 9.42 years (+/-9.87 years). There were 60 eyes in the EH group, 18 in the LH group, and 68 in the LD group. When the results on our patient group were compared to known data on a number of other ethnic groups, our patients were found to be similar to the Japanese with respect to gender distribution and prevalence, to the Hispanics for alopecia, and to the non-Hispanics of North America for tinnitus and vitiligo. The EH group were more likely to achieve complete resolution, with fewer complications, than the LD group, but one third of the former still developed chronic disease. CONCLUSION: Higher doses of systemic steroids may be required to ensure adequate immunosuppression in VKH patients.

Acute Disease↗
PubMed2007

Do socioeconomic effects on health diminish with age? A Singapore case study.

This paper examines the effects of socioeconomic characteristics on older adult health and investigates whether these socioeconomic effects carry through from the young-old to the oldest-old ages among Singaporean adults. Previous research shows little consensus over whether the impact of socioeconomic factors on health diminish with age. The variation in these results may be due to different definitions of socio-economic status, or the use of different health indicators. We use a comprehensive set of socioeconomic indicators (income, education level, homeownership, asset possession, and perceived income adequacy) to predict three health outcomes; poor self-assessed health, the presence of chronic illness, and functional disability. We find that while socioeconomic differentials in health status exist, the associations are not as consistent, nor as strong, as those reported for Western settings. Health inequalities related with socioeconomic status decline slightly but do not disappear with old age in Singapore.

Activities of Daily Living↗
PubMedDate not supplied

Abattoir condemnation of pigs and its economic implications in Singapore.

Losses due to mortality and rejection of carcases and viscera in a population of 2,959,607 pigs admitted for slaughter in Singapore abattoirs between 1984 and 1986 were studied. Mortality losses were 2822 pigs (9.5 per 10,000 admissions) while 3039 whole carcases (10.3 per 10,000 admissions) were condemned at post-mortem examination. The main reason for rejection of carcases was pyaemia (30.3%). Kidneys and livers were the two main organs of economic value rejected. Rejection of kidneys was primarily due to nephritis (54.8%) while liver condemnation was mainly due to cirrhosis (38.6%). The financial loss from abattoir rejection was S$5.27 millions or S$1.78 per pig admitted. The value of abattoir condemnation data as a tool in preventive medicine is discussed.

Abattoirs↗
PubMed1988

Norplant contraceptive subdermal implants: one year experience in Singapore.

Norplant contraceptive implants are silastic implants containing levonorgestrel. This study describes our experience with 100 acceptors of Norplant implants in Singapore. There were no infections at the site after the implants were inserted. No pregnancies occurred during the first year of use. Disruptions of menstrual rhythm was the main complaint. However, the incidence of menstrual irregularities appeared to diminish with time. Implant users have tolerated this early disruption of their menstrual rhythm well and the continuation rate at the end of the year was 96.6 percent. Thus, it appears that Norplant contraceptive implants offer a highly effective means of contraception which should become well accepted in the near future.

Adolescent↗
PubMed1988

Norplant-2 rods: one year experience in Singapore.

Norplant-2 contraceptive implants consist of two silastic rods in which levonorgestrel has been incorporated with the polymer. This study describes our experience with 100 acceptors of the Norplant-2 rods in Singapore. No pregnancies occurred during the first year of use. Menstrual irregularities was the main complaint associated with the use of Norplant-2. However, the incidence of menstrual irregularities appeared to diminish with time and the continuation rate at the end of one year was 95.0 per cent. Thus, it appears that the Norplant-2 rod systems offer a highly effective, convenient means of contraception which should be well accepted in future.

Adult↗
PubMed1995

National Patient Master Index in Singapore.

It has been the practice of hospitals and medical institutions to keep their patients' medical records. Access to such valuable information will be confined within the respective health institutions if there is no proper infrastructure to facilitate sharing of the information. On the other hand, it has been the wish of medical professionals, as well as patients who frequent hospitals and medical institutions that patients' medical records, especially essential medical conditions, are readily available, whenever required, regardless of the health institution by which the patient is being attended to. In response, the National Patient Master Index (NPMI) system was conceived and implemented by the Singapore Ministry of Health in 1994. The NPMI system aims at providing a patient database at national level that allows authorised users faster access to a patient's essential medical data thereby facilitating patient management. This paper describes the implementation of the NPMI system, its data elements, system functionality and access control to address data confidentiality and privacy.

Computer Security↗
PubMed1984

Epidemiologic analysis of fetal death in utero in Singapore.

Records on 1777 cases of missed abortion and 1001 cases of intrauterine fetal death in three major maternity hospitals in Singapore between 1976 and 1980 were analyzed. The overall incidence of these two conditions was 10.35 and 5.82 per 1000 births, respectively. During the 5-year period, the incidence of missed abortion increased consistently, from 8.05 to 12.76 per 1000 births. In contrast, during the same period, the incidence of intrauterine fetal death declined steadily from 6.44 to 4.68 per 1000 births. Missed abortions occurred more frequently in the early part of the year, especially in the months of March, April and May. The incidence of missed abortion and its correlation with possible environmental factors are discussed.

Abortion, Missed↗
PubMed1989

Ethnic and other factors affecting birthweight in Singapore.

Data on 1800 term babies, 600 from each of the Chinese, Malay and Indian racial groups, were used to identify the factors affecting birthweight in Singapore. After adjustment for gestation, maternal height and other variables, the mean Indian birthweight was 100 g less than for the Chinese (P less than 0.001), 0.001), while the Malays averaged 33 g less than the Chinese. The shortfall in Indian birthweight is thought to be due, at least partly, to environmental factors.

Asian People↗
PubMed1987

Serum high density lipoprotein cholesterol, apolipoprotein A-I, A-II and B levels in Singapore ethnic groups.

The mortality rate from CAD in Indians is more than 3 times that in the Chinese and Malays in the population of Singapore. The serum total, HDL cholesterol and apolipoprotein levels (Apo A-I, Apo A-II and Apo B) were studied in a group of 344 healthy male adults from the 3 ethnic groups. Indians had a significantly lower level of HDL-cholesterol (38.4 +/- 9.8 mg/dl) than the Chinese (42.7 +/- 8.9 mg/dl) (P less than 0.005). The Apo A-I levels were higher in the Chinese (115.1 +/- 14.8 mg/dl) than in the Indians (108.6 +/- 28.8 mg/dl), but the difference was not statistically significant. The Chinese also had higher levels of Apo A-II (48.1 +/- 7.2 mg/dl) compared to those in the Indians (38.6 +/- 6.4 mg/dl) and Malays (38.0 +/- 4.9 mg/dl) (P less than 0.001). The ratio of Apo A-I/Apo B level was also higher in the Chinese (1.28) than in the Indians and Malays (1.09). Higher levels of Apo B and lower levels of HDL-cholesterol, Apo A-I and Apo A-II in Indians may partly explain the higher incidence of CAD in Indians.

Adolescent↗
PubMed1988

HLA association in Singapore children with Grave's disease.

HLA associations in patients with Grave's disease are B8 in whites and BW35 in Japanese. This study shows the HLA association of Singapore Chinese children with Grave's disease. Forty unrelated Chinese children with Grave's disease were typed. The control population consisted of 238 consecutive unrelated normal Chinese individuals. Patients with Grave's disease showed a significantly higher frequency of BW46 than control subjects (corrected P = .0005, relative risk (RR) = 4.61). Only two patients had BW35 and none had B8. There was an increased frequency of both homozygotes and heterozygotes in thyrotoxic patients compared with controls, the RR being slightly higher in the homozygotes. Among the patients, BW46 was most frequently associated with B40, B13, and B15. The joint occurrence of BW46/B40 in thyrotoxic children had a lower relative risk than BW46 alone, whereas the joint occurrence of BW46/B13 had a higher relative risk than BW46 alone.

Child↗
PubMed1987

Serological survey on dengue virus infection in Singapore.

A serological study on dengue infection conducted in Singapore during the period 1982 to 1984 showed that 54.4% of the healthy population between 6 months and over 50 years of age surveyed possessed no haemagglutination-inhibition antibody to dengue type 2 virus. Children below 10 years of age showed the lowest antibody prevalence and were at the greatest risk, with 96.6% susceptible to infection, whereas virtually all adults over 40 showed evidence of prior dengue infection. The geometric mean titre showed a rising trend indicating continuing acquisition of infection in the older age groups. The seropositivity rate of dengue infection of males was twice that of females. Among the 3 major ethnic groups, no significant difference in seropositivity was noted between the Malays and Indians, but the differences between Malays and Chinese and between Indians and Chinese were statistically significant. The study confirmed that the successful implementation of the nation-wide Aedes control programme is reducing endemic dengue virus transmission in the country.

Adolescent↗
PubMed1988

The prevalence of hepatitis B virus markers in dental personnel in Singapore.

A seroepidemiological survey of the prevalence of hepatitis B virus (HBV) markers was conducted in a group of 693 dental personnel in Singapore where HBV infection is endemic. The overall prevalence of HBsAg (4.5%) and anti-HBc (29%) was no higher than that in the general population. However, dentists had a significantly higher HBsAg prevalence (11.4%) compared with that in the general population (4.2%) (P less than 0.01) and of other categories of dental personnel (3.1%) (P less than 0.001). Similarly, the anti-HBc prevalence of the dentists (45.6%) was significantly higher than that of the general population (29.7%) (P less than 0.01) and of other categories of dental personnel (25.7%) (P less than 0.0001). It appears that dentists in the endemic area have a definite occupational risk of acquiring HBV infection.

Dental Staff↗
PubMedDate not supplied

Hantavirus infections in humans and commensal rodents in Singapore.

To determine the extent of hantavirus infection in Singapore, serological studies using the indirect immunofluorescent antibody (IFA) test were conducted on commensal rodents and on human patients in 4 diagnostic groups. Virus isolation using a Vero E6 cell line was performed on hantaviral antigen-positive rodent lung tissue. Of 142 rodents and 3 insectivores studied, 37 (26%) were seropositive for IFA. Rattus norvegicus was the predominant species captured, with the highest species-specific seropositive rate of 32% (36 of 113). A hantavirus strain, R36, was isolated from one R. norvegicus. Seropositive rates for human patients were: 8% respectively for dengue haemorrhagic fever suspects and for non-A non-B hepatitis patients, 3% for leptospirosis suspects and 2% for acute nephritis patients. 2 patients had marked liver dysfunction but mild renal involvement. This hepatitis-like manifestation appears to be a clinical variant of hantavirus infection.

Adult↗
PubMedDate not supplied

Horizontal or vertical transmission of hepatitis B virus? A serological survey in family members of hepatitis B carriers in Singapore.

Hepatitis B serology was performed on 270 family members of 78 hepatitis B carriers and hepatitis B e antigen status determined in those found to be HBsAg positive. The mean age of index patients was 38 years (range 3-74) and that of family members was 28 years (range 1-71). 67 family members (25%) were HBsAg positive. The proportions of family members positive for HBsAg and those negative for HBsAg but positive for anti-HBs and/or anti-HBc were 25% and 20% for children, 10% and 68% for spouses, 36% and 26% for siblings and 29% and 55% for parents. For children of index parents the proportions positive for HBsAg and those negative for HBsAg but positive for anti-HBs and/or anti-HBc were similar whether the index patient was the mother (24% and 24%) or the father (26% and 18%). Our results suggest that horizontal transmission is a significant mode of spread of hepatitis B within the family in Singapore.

Adolescent↗
PubMed1994

Blood cadmium levels in non-occupationally exposed adult subjects in Singapore.

Cadmium concentrations in whole blood were measured in subjects with no occupational exposure to cadmium. The study covered 128 males and 150 females from the three main ethnic groups in Singapore (namely Chinese, Malays and Indians). The geometric means (GM) of blood cadmium (CdB) levels of non-smoking males and females were 0.21 microgram/l and 0.26 microgram/l, respectively. Smokers had higher GM CdB levels than non-smokers. Significant ethnic differences were observed in both sexes, with Indian males having the highest GM CdB level of 0.48 microgram/l. Among the females, the Chinese had the highest GM CdB level: 0.33 microgram/l. Differences in dietary habits may have contributed to the observed ethnic differences in blood cadmium levels.

Adolescent↗
PubMed1991

Dietary effects on breast-cancer risk in Singapore.

It is suspected that diet influences the risk of getting breast cancer. A study of diet and breast cancer was done among 200 Singapore Chinese women with histologically confirmed disease and 420 matched controls. A quantitative food-frequency questionnaire was used to assess intakes of selected nutrients and foods 1 year before interview. Daily intakes were computed and risk analysed after adjustment for concomitant risk factors. In premenopausal women, high intakes of animal proteins and red meat were associated with increased risk. Decreased risk was associated with high intakes of polyunsaturated fatty acids (PUFA), beta-carotene, soya proteins, total soya products, a high PUFA to saturated fatty acid ratio, and a high proportion of soya to total protein. In multiple analysis, the variables which were significant after adjustment for each other were red meat (p less than 0.001) as a predisposing factor, and PUFA (p = 0.02), beta-carotene (p = 0.003), and soya protein (p = 0.02) as protective factors. The analysis of dietary variables in postmenopausal women gave uniformly non-significant results. Our finding that soya products may protect against breast cancer in younger women is of interest since these foods are rich in phyto-oestrogens.

Adult↗
PubMed1993

Prevalence in Singapore of enterococci with high-level resistance to aminoglycosides and comparison of three methods for their detection.

The first study of the prevalence in Singapore of enterococci with high-level resistance to aminoglycosides has been made in the National University Hospital. From March to June 1992, 225 isolates were studied by means of three methods: (1) use of brain-heart infusion (BHI) agar incorporating the antibiotic; (2) microdilution of the antibiotic in broth; and (3) use of high content antibiotic discs. The BHI agar was the reference method. Of the total, 49 (22%) isolates were resistant to gentamicin, 86 (38%) to streptomycin, 82 (36%) to kanamycin and 93 (41%) to one or more of the agents. Results of the disc diffusion method correlated completely with the BHI agar method. The broth microdilution method showed a 100, 90 and 96% sensitivity in relation to gentamicin, streptomycin and kanamycin, respectively, and a specificity of 100% for all three aminoglycosides. Statistical significance (P < 0.01 to P < 0.001) was demonstrated in (1) a greater incidence of enterococci with high-level resistance to aminoglycosides among blood isolates; (2) gentamicin resistance predicting kanamycin high-level resistance; and (3) more resistance to gentamicin, streptomycin and kanamycin among Enterococcus faecium isolates compared to those of Enterococcus faecalis. Beta-lactamase activity was not detected.

Aminoglycosides↗
PubMed1991

Knowledge and concerns of newly diagnosed NIDDM patients in Singapore.

This paper describes the findings of a questionnaire survey of the knowledge and concern of 152 newly diagnosed NIDDM patients presenting at the Government Polyclinic (primary health care centre). This study is part of a project on outpatient diabetic care in Singapore. It was found that 23.7% of the subjects had no education and 51.3% had only primary school education. More than eighty percent of the subjects understood the importance of diet control and weight control in their condition. More than half of the subjects, 61% of males and 52.7% of females were aware that diabetes could not be cured and that once diabetes is controlled, that medication cannot be stopped and that one must still take the medication even if one feels well. Less than 30% knew about the interpretation of blood and urine sugar findings. The two major concerns amongst the subjects were complications and the need for long-term medication. These findings will be incorporated into the next phase of the project where a health education programme for NIDDM patients will be developed and evaluated.

Adult↗