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 901 records · Page 50Linked to original sources

Prevalence and ethnic differences of autosomal-dominant cerebellar ataxia in Singapore.

We report the prevalence and ethnic differences of autosomal-dominant cerebellar ataxia (ADCA) in Singapore. Amongst 204 patients with ataxia who underwent genetic testing for dentatorubral-pallidoluysian atrophy (DRPLA) and for spinocerebellar ataxias (SCA) 1, 2, 3, 6, 7, 8, 10 and 12, 58 (28.4%) patients from 36 families tested positive. SCA 3 was identified in 31 (53.4%) patients from 15 families, SCA 2 in 17 (29.3%) patients from 12 families and SCA 1 in four (6.9%) patients from four families. Other SCA subtypes were rare. SCA 2 was the only subtype identified amongst ethnic Malay and ethnic Indian families. The estimated prevalence of ADCA in Singaporean families was at least 1 : 27,000. Based on the history and ancestry of Singaporeans, our study supported a founder effect for specific SCA subtypes and the association of ethnicity-specific SCA subtypes. Our findings suggest that SCA 2 is relatively common amongst the Malay race and that priority testing for SCA 3 and SCA 2 for ethnic Chinese, and SCA 2 for ethnic Malay, may be cost effective and relevant for the region.

Cerebellar Ataxia↗

The TaqIB and -629C>A polymorphisms at the cholesteryl ester transfer protein locus: associations with lipid levels in a multiethnic population. The 1998 Singapore National Health Survey.

The Singapore population comprises Chinese, Malays and Asian Indians. Within this population, Asian Indians have the highest rates of coronary heart disease, whereas Chinese have the lowest. Conversely, Indians have the lowest high-density lipoprotein cholesterol (HDL-C) concentrations, followed by Malays and Chinese. We studied the TaqIB and -629C>A polymorphisms at the CETP locus in 1300 Chinese, 364 Malay and 282 Asian Indian men, and in 1558 Chinese, 397 Malay and 306 Asian Indian women, to determine whether these polymorphisms are responsible for the ethnic difference in HDL-C concentration. The frequency of the B2 allele in Chinese, Malays and Indians was 0.384, 0.339 and 0.449 in men, and 0.379, 0.329 and 0.415 in women, respectively (p < 0.001). For the A-629 allele, the relative frequencies were 0.477, 0.423 and 0.592 in men and 0.486, 0.416 and 0.575 in women (p < 0.001). The two polymorphisms were in linkage disequilibrium (D / Dmax= 0.9772, p < 0.00001). The B2 and the A-629 alleles were associated with increased HDL-C concentrations in a dose-dependent manner. The B2 allele continued to show an association with HDL-C concentration, even after controlling for the genotype at position -629. Dietary cholesterol showed a significant interaction with the TaqIB polymorphism in determining HDL-C concentrations in Indians and Malays, but not in Chinese. In conclusion, the high frequencies of these polymorphisms in Asian Indians could not explain the observed ethnic differences in HDL-C concentration. Moreover, we observed an ethnic-specific interaction among dietary cholesterol, the TaqIB polymorphism and HDL-C concentrations.

Alcohol Drinking↗

A 20-year follow-up study on schizophrenia in Singapore.

OBJECTIVE: To assess the outcome and predictors of patients with schizophrenia 20 years later. METHOD: The patients, aged 15-39 years, with diagnosis of schizophrenia and first admitted to a national mental hospital in Singapore in 1975 were included. In 1980, 1985, 1990 and 1995, their hospital records were examined and the patients were interviewed to determine their working and treatment status. Possible predictors of good outcome and suicide data were determined. RESULTS: A total of 402 patients were included. Over 20 years, there was lower percentage of patients working full time and proportionately more patients were receiving out-patient treatment. Overall, about two-third of the patients had a good/fair outcome. Shorter illness duration before admission was significantly associated with a good outcome. The suicide rate was the highest in the first 10 years. CONCLUSION: Most patients with schizophrenia had a good/fair outcome at 20 years.

Adolescent↗

Examination stress in Singapore primary schoolchildren: how compliance by subjects can impact on study results.

OBJECTIVE: Examinations are anecdotally viewed as extremely stressful to Singapore schoolchildren. We test this postulate by obtaining parental ratings of children's emotional stress levels longitudinally in a large representative sample of sixth (P6) and fifth (P5) class primary schoolchildren, respectively, exposed and unexposed to a streaming examination. METHOD: Children's stress levels were rated monthly by a parent for 10 months. RESULTS: Analyses failed to find evidence of any differential stress impact across P6 and P5 comparison groups, apart from a subset of P6 children whose parents complied with every monthly survey. CONCLUSION: The streaming examination in the final year of primary school did not emerge as a general stressor to children, but achieved salience within a defined subset of children whose parents were highly study compliant. Study compliance may be a proxy variable of some import, and have wider relevance to other cohort studies and to intervention trials.

Child↗

Dental trauma management awareness of Singapore pre-school teachers.

The purpose of this study was to assess the awareness of pre-school teachers concerning the management of traumatized teeth. A questionnaire survey of teachers' backgrounds, attitudes/practices and knowledge was distributed to all teachers who attended a dental education program organized by the Singapore Dental Health Foundation. Of a total of 291 teachers surveyed, 29% had received tertiary education, while the rest (71%) had received secondary education. The mean teaching experience was 6.8 +/- 6.9 years. About a quarter had previous experience in handling dental trauma. Sixty-three percent admitted having no knowledge of dental trauma; 79% were unsatisfied with their level of knowledge in this area; 95% were keen to have further education in dental trauma; 65% thought dental trauma emergency should be dealt with as soon as possible. Concerning knowledge, during-office hour emergency services were more familiar (84%) than after-office hour emergency services (15%), as was the concept of management of avulsed teeth (71%) compared to that of fractured teeth (51%). Knowledge about optimal storage media for avulsed permanent teeth was especially poor--being as low as 15%. Using multiple logistic regression analysis, it was found that teaching experience significantly influenced the respondents' self-assessed knowledge and their level of satisfaction with their knowledge (P = 0.012). Teachers with more teaching experience had better knowledge about the replantation of permanent teeth (P = 0.003). It is recommended that public education targeted at teachers should be carried out to increase dental trauma management awareness.

Attitude to Health↗

A case-control study of cervix cancer in Singapore.

Cervix cancer is about twice as common in Asia as in the Western world and its incidence varies among different Asian ethnic groups. A study based in Singapore, the population of which comprises Chinese, Indians and Malaysians, offers the opportunity to evaluate whether the same risk factors are important in this part of the world as in the West. A total of 135 cases and an equal number of controls were interviewed and details concerning reproductive and sexual history, smoking, hygiene, socio-economic status and education were collected. Seventy-three cases had invasive cancer while 62 had micro-invasive disease or CIN III. The most important risk factors were parity and number of sexual partners. Smoking was rare in cases and controls and did not appear to be an important determinant of risk. Of the socio-economic factors, education appeared most predictive and lowered the risk. Age at first intercourse was strongly correlated with education (positively) and parity (negatively), but not with number of sexual partners. Biopsies were available for HPV DNA analysis in 38 cases and 37% were positive, mostly for HPV type 16. All these factors gave similar risks in invasive and preinvasive disease.

Adult↗

Codon 249 mutation of the p53 gene is a rare event in hepatocellular carcinomas from ethnic Chinese in Singapore.

The present study characterised p53 mutations in 44 hepatocellular carcinomas (HCCs) from Chinese patients residing in a high-incidence area. Twelve point mutations (27%) were detected in tumour tissues using single-strand conformation polymorphism analysis followed by direct DNA sequencing. Remarkably, no mutations were observed at codon 249. This is in contrast to HCCs from other high HCC incidence areas with endemic aflatoxin exposures, in which codon 249 is a mutational hot spot. It is therefore suggested that risk factors other than dietary exposure to aflatoxin may contribute to the high HCC incidence in Singapore.

Adult↗

Nasal-type extranodal natural killer/T-cell lymphomas: a clinicopathologic and genotypic study of 42 cases in Singapore.

We studied the clinicopathologic features of 42 cases of nasal-type extranodal natural killer (NK)/T-cell lymphoma in Singapore and compared our findings with other series reported in the Asian and Western populations. A panel of immunohistochemical stains, which included CD2, CD3, CD4, CD8, CD56, T-cell intracellular Antigen-1 and granzyme B, and in situ hybridization for Epstein-Barr virus encoded RNA (EBER) were performed. Polymerase chain reaction for T-cell receptor-gamma gene rearrangement using both gel and capillary electrophoresis were evaluated to determine the proportion of tumors which are of true T-cell lineage. We also studied the functional status of the overexpressed p53 protein in these lymphomas by correlating p53 expression with its downstream target protein, p21. In all, 31 out of 42 cases presented in the upper aerodigestive tract. The other sites of involvement included gastrointestinal tract, skin, soft tissue, testis, liver, spleen, bone marrow and brain. The tumors displayed characteristic morphologic features. In situ hybridization for EBER was detected in 41 out of 42 cases (97.6%). The only significant adverse prognostic factor identified was an International Prognostic Index of two or more. A significantly higher proportion of the tumors (27%), compared to previous studies, demonstrated monoclonal T-cell receptor-gamma gene rearrangement. There was, however, no difference in survival or clinicopathologic features between the true NK-cell tumors and their T-cell counterparts. Overexpression of p53 was present in 40% of the cases, but no significant difference in survival rate was detected in patients with p53 overexpression and there was no association between p53 overexpression with large cell morphology, and advanced stage of disease. These findings suggest that molecular aberrations other than those of the p53 pathway may be operative in the pathogenesis of this malignancy.

Adult↗

Hangman's fracture in Singapore (1975-1988).

A retrospective study of 33 patients with fracture of the ring of the axis (hangman's fracture) admitted to the Spinal Unit of the Department of Rehabilitation Medicine in the Tan Tock Seng Hospital between 1975 and 1988 was carried out. The aims were to establish the causes, mechanism and outcome of injuries that lead to Hangman's fracture in Singapore. The majority were males (27) and their ages ranged from 16 to 82 with a mean age of 33.7 years. 63.6% (21 cases) were due to road traffic accidents of whom 33% (11 cases) were motorcyclists or pillion riders and 30.3% (10 cases) were drivers or passengers of four wheel vehicles such as cars and vans. Using Effendi et al's classification, we have 21 type I, 11 type II and one type III fractures. Thirteen type I, 6 type II and one type III cases had no neurological deficit on admission. The rest had deficits ranging from tetraparesis to pure bladder dysfunction. After rehabilitation, 28 (84.8%) of them were able to return to gainful employment within a year of their injuries.

Adolescent↗

Interaction between cyclooxygenase-2 gene polymorphism and dietary n-6 polyunsaturated fatty acids on colon cancer risk: the Singapore Chinese Health Study.

This case-control study of 310 colorectal cancer cases and 1177 controls in a nested prospective, population-based cohort of Singapore Chinese subjects found a statistically significant association between the cyclooxygenase (COX)-2 -765G>C gene polymorphism and colon cancer risk among high consumers of dietary n-6 polyunsaturated fatty acids (odds ratio=2.38, 95% confidence interval=1.23-4.59).

Aged↗

The relationship between insulin resistance and cardiovascular risk factors in overweight/obese non-diabetic Asian adults: the 1992 Singapore National Health Survey.

OBJECTIVE: Insulin resistance (IR) is associated with cardiovascular risk factors including hypertension, dyslipidemia, glucose intolerance and hyperuricemia. The relationship between IR and these cardiovascular risk factors in obese non-diabetic individuals is not well studied. We explore this relationship by comparing the cardiovascular risk factors among insulin-sensitive and insulin-resistant overweight/obese non-diabetic Asian adults in the 1992 National Health Survey of Singapore. DESIGN AND MEASUREMENTS: A total of 3568 subjects were examined in the survey, which involved a combination of disproportionate stratified sampling and systematic sampling. Anthropometric measurements, level of physical activity, blood pressure, insulin, lipid profile, uric acid and standard 75 g oral glucose tolerance test were performed after a 10 h overnight fast. Subjects with diabetes were excluded from the analysis. Homeostasis model assessment (HOMA) was used to assess insulin sensitivity. Relative LDL size was derived from the formula LDL/ApoB. We defined insulin-sensitive individuals as having a HOMA value <1.479 (below median in individuals without diabetes; n=3226) and overweight/obesity as body mass index (BMI) >or=25.0 kg/m(2). RESULTS: There were 156 insulin-sensitive (S) and 679 insulin-resistant (R) overweight/obese individuals, respectively. The groups did not differ in terms of gender and ethnic distribution and level of physical activity. However, subjects in group S were younger than those in group R (mean+/-s.d.; 40.1+/-12.1 vs 42.4+/-12.7 y; P<0.05). Group R individuals were also slightly more obese globally and centrally than group S (BMI=28.2+/-3.2 vs 27.1+/-2.8 kg/m(2); waist circumference (WC)=86.7+/-9.3 vs 82.5+/-8.3 cm; P<0.01). There were more subjects with impaired glucose tolerance (IGT) in group R than in group S (29.7 vs 16.0%; P<0.01). After adjustment for age and indices of global and regional obesity (ie BMI and WC), insulin-resistant individuals showed higher apolipoprotein B, triglyceride, fasting (FPG) and 2 h post-load plasma glucose (2hPG) but lower HDL and LDL size. Further adjustment for FPG, 2hPG and level of physical activity had minimal impact on the results. CONCLUSIONS: Insulin-resistant overweight/obese non-diabetic Asian adults had greater burden of the cardiovascular dysmetabolic syndrome than insulin-sensitive overweight/obese individuals. This could not be fully explained by differences in global and regional obesity, glucose tolerance and level of physical activity.

Adult↗

Evaluation of biological and chemical insecticide mixture against Aedes aegypti larvae and adults by thermal fogging in Singapore.

To improve the operational efficiency of dengue vector control in Singapore, larvicide and adulticide were applied together by thermal fog generator (Agrofog AF40). The mixture consisted of Bacillus thuringiensis var. israelensis (Vectobac 12 AS) as biological larvicide at 1.5 L/ha and pirimiphos-methyl (Actellic 50 EC) as adulticide at 100 g ai/ha, diluted 10-fold with water. Aerosol of this mixture was evaluated against the mosquito Aedes aegypti (L.) (Diptera: Culicidae) in bioassays using cages of 10 adult females exposed at heights of 0.3-2.4 m and distances of 3-12 m from the hand-held generator. Cups containing 200 mL water were treated at ground level by exposure to the aerosol application at the same distances from the generator. Subsequent larval bioassays on days 1, 7, 14, 21 and 28 post-spray involved exposing 20 larvae/cup for 48 h. Droplets had VMD 57 microm and female mosquitoes were killed by 2 s exposure to the aerosol at 3 m. We obtained 92-100% mortality of the adult mosquitoes and 100% control of larvae at 3 m distance, but only 10-13% mortality at 12 m from the fogger. In treated cups, larvae showed high mortality (92%) when exposed for 48 h even 1 month post-treatment. Results demonstrate the practical advantage of using this mixture of Vectobac 12AS and Actellic 50 EC for simultaneous control of Aedes adults and larvae, with prolonged larvicidal efficacy in treated containers.

Aedes↗

A community-based study of headache diagnosis and prevalence in Singapore.

We present the results of a community survey based on the diagnostic criteria of the International Headache Society (IHS) describing headache prevalence and symptomatology in the Singapore population. A questionnaire administered by trained personnel was completed by 2096 individuals from a randomized sample of 1400 households. The overall lifetime prevalence of headache was 82.7%. The migraine prevalence was 2.4% in males and 3.6% in females; for episodic tension-type headache and chronic tension-type headache the corresponding figures were 11.1%/11.8% and 0.9%/1.8%, respectively. Inclusion of borderline cases (IHS codes 1.7 and 2.3) resulted in prevalences of 9.3% for migraine, 39.9% for episodic tension headache and 2.4% for chronic tension headache. Headaches described by 31.2% of the respondents were unclassifiable. The different premonitory symptoms, precipitants and aggravating factors in migraine and tension-type headache in our study population suggest that they represent two distinct syndromes rather than opposite ends of a clinical spectrum.

Adolescent↗

Low risk of transmission of severe acute respiratory syndrome on airplanes: the Singapore experience.

The risk of transmission of severe acute respiratory syndrome (SARS) on airplanes is of major concern to the public and airline industry. We examined data from flights to Singapore with SARS patients on board in order to assess this risk. In-flight transmission occurred only in one of the three flights with symptomatic SARS patients on board. The incidence was estimated to be 1 out of 156 passengers. The risk of in-flight transmission of SARS appears to be far lower than that reported for influenza, but may be increased with superspreaders on board.

Aircraft↗

Cutaneous lymphomas other than mycosis fungoides in Singapore: a clinicopathological analysis using recent classification systems.

BACKGROUND: Cutaneous lymphomas other than mycosis fungoides (MF) are a heterogeneous group with wide variations in clinical presentation, biological behaviour and prognosis. New classification systems have been designed or proposed in recent years, with well-defined disease entities and emphasis on the importance of site. OBJECTIVES: This study aims to analyse a series of non-MF lymphomas in an institution-based dermatological setting in Singapore, based on the European Organization for Research and Treatment of Cancer (EORTC) classification and the World Health Organization (WHO) classification. A secondary objective is to highlight the clinical utility of both classification systems. PATIENTS AND METHODS: Forty cases diagnosed over a 12-year period were examined by immunohistochemistry with antibodies targeting CD3, CD4, CD5, CD8, CD20, CD30, CD43, CD45RO, CD56 and CD68 in paraffin-embedded specimens. The immunohistological diagnosis was correlated with the clinical presentation and staging investigations for the final diagnosis and the course of disease recorded. RESULTS: Non-MF T-cell lymphomas presenting in the skin comprised 31 cases (78%) and were 3(1/2) times more common than B-cell lymphomas, which comprised nine cases (22%). The common subtypes were lymphomatoid papulosis, CD30+ large cell cutaneous T-cell lymphoma and subcutaneous panniculitis-like T-cell lymphoma. The commonly ascribed B-cell pattern with infiltrates in the mid and deep dermis and perivascular spaces was seen in 60% of T-cell lymphomas. Overall, there were equal numbers of primary cutaneous T-cell lymphomas and those due to concurrent or secondary cutaneous lymphoma. Five of six cases of subcutaneous panniculitis-like T-cell lymphoma had concurrent cutaneous and systemic involvement and their median survival was 7 months. CONCLUSIONS: The predominance of cutaneous T-cell lymphomas in this case series closely matched that reported from east Asia; cutaneous B-cell lymphomas are much less common than in Europe. The EORTC classification, which is designed only for primary cutaneous lymphomas, should be used in conjunction with the WHO classification because of the high prevalence of cutaneous lymphomas as the secondary site of disease from systemic lymphoma. In addition, subcutaneous panniculitis-like T-cell lymphoma is a primary cutaneous lymphoma where systemic involvement is common at initial presentation. We propose full immunophenotyping and complete clinical evaluation with staging investigations for all patients presenting with cutaneous lymphomas other than MF.

Adolescent↗

Retrospective study of the epidemiology of nodular vasculitis followed up in the National Skin Centre, Singapore.

A seven-year retrospective study was done on histologically proven nodular vasculitis presenting at the National Skin Centre, Singapore. We collected 25 patients and found that they differed from the classical European model. They most commonly involved the shins and did not ulcerate. A tuberculous aetiology accounted for 28% of cases. Useful indicators of tuberculosis were a past history of tuberculosis, an abnormal chest X-ray and a strongly positive Mantoux test.

Adolescent↗

Evaluation of Amplicor- and IS6110-PCR for direct detection of Mycobacterium tuberculosis complex in Singapore.

One hundred and seventy-eight samples from 168 individuals were tested for Mycobacterum tuberculosis complex (Mtc) using Amplicor PCR, IS6110-PCR (in-house), acid fast (AF)-staining and culture. Thirty-one samples were positive by culture, but 37 samples were later resolved to be truly positive for Mtc. Of these, Amplicor detected 32 (86.5%), IS6110-PCR detected 31 (83.6%), and AF-staining 21 (56.8%). None of the 141 Mtc-negative samples was positive by these tests, thus giving 100% specificity. Although the IS6110-PCR was more sensitive than Amplicor in detecting spiked Mtc DNA, it was not more sensitive than the latter in detecting Mtc in clinical samples. Reasons likely to account for the PCR false negativity were (i) sample inoculum size, (ii) nonuniform samples due to clumping effect of Mtc and (iii) the absence of target gene sequences for IS6110-PCR. Culture negativity, on the other hand, was likely to be associated with nonviable Mtc. Amplicor PCR is promising for direct detection of Mtc. The IS6110-PCR, however, may not be as suitable because of possible existence of IS6110-deleted Mtc strain in Singapore.

DNA, Bacterial↗

The profile and outcome of pustular psoriasis in Singapore: a report of 28 cases.

BACKGROUND: Pustular psoriasis is a rare form of psoriasis that can be divided into generalized and localized forms. The aim of this study is to describe the patient profile and outcome of pustular psoriasis seen at a tertiary referral skin center in a tropical country. METHODS: The records of all patients with pustular psoriasis during the 4 years from 1989 to 1993 were reviewed. Diagnostic criteria for selection included at least one episode of either generalized or localized macroscopic noninfective pustulation. RESULTS: There were 28 patients with pustular psoriasis, with an age range of 4-77 years. Nineteen patients had generalized pustular psoriasis: Von Zumbusch (seven), annular form (two), juvenile form (six), pustular psoriasis of pregnancy (one), and the localized form of generalized pustular psoriasis (three). Nine patients had localized pustular psoriasis: palmoplantar pustulosis (five) and acrodermatitis continua (four). Patients with the acute Von Zumbusch pattern had recalcitrant disease with multiple flares and significant morbidity and mortality. Patients with the annular form had a subacute onset and a chronic course. In patients with the juvenile form of generalized pustular psoriasis, two patterns could be recognized: Zumbusch form (four) and annular form (two). Despite significant morbidity, each of our young patients had a relatively benign course with no deaths and an excellent response to etretinate therapy. Our nine patients with localized pustular psoriasis all had a chronic course: the average duration of disease was 6 years for patients with palmoplantar pustulosis and 12 years for patients with acrodermatitis continua. CONCLUSIONS: The pattern of pustular psoriasis seen in Singapore is similar to that reported in the Western literature. Using these categories we can provide guidelines for treatment and prognosis.

Adolescent↗