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PubMedDate not supplied

Reducing infusion phlebitis in Singapore hospitals using extended life end-line filters.

Two studies were conducted to investigate the impact of the 4-day end-line filter used to treat infusion phlebitis in Singapore. In the first study, conducted in 1997, 200 patients received IV antibiotics and chemotherapy. In the first 100 patients, end-line filters were not used during the infusions. This resulted in a phlebitis rate of 31%. In the second group of 100 patients, end-line filtration was used, resulting in a phlebitis rate of 5%. In 2000, a second study was conducted, measuring the outcome of end-line filtration versus no end-line filtration use. In this case, phlebitis developed in 35% of 100 patients receiving antibiotics, as compared with 8% of 394 patients with the use of 4-day end-line filtration. These are the first such studies performed in Southeast Asia that highlight identical benefits, namely the reduction of phlebitis by elimination of particulates, in two separate patient populations. End-line filtration, when used to deliver antibiotics and chemotherapy, will result in significantly fewer cases of infusion phlebitis, reduce the cost of delivering IV antibiotics and chemotherapy, increase nursing efficiency, and ultimately improve patient comfort.

Equipment Design↗
PubMed2003

A comprehensive public health approach to address the burden of renal disease in singapore.

With the epidemic rise of ESRD in multiple regions of the world, there is an urgent need to implement programs to address this increasing burden of kidney disease. We illustrate a public health approach using the program of the National Kidney Foundation of Singapore that incorporates stepwise primary, secondary, and tertiary strategies for prevention. Components of the program include an aggressive public education program, routine surveillance for kidney disease and associated chronic diseases, the implementation of a disease management program to improve physician practice patterns, and the provision of comprehensive services in the community through a network of Prevention Centers designed to optimize the care of patients at risk for kidney disease. Finally, an equally important aspect is the clinical and epidemiologic research component, because this will provide clear benchmarks to determine the program's effect on ESRD as well as generate information that can be used to identify future directions for this evolving program.

Female↗
PubMed2005

Comparisons of the handheld autorefractor, table-mounted autorefractor, and subjective refraction in Singapore adults.

PURPOSE: The purpose of this article was to compare the Retinomax with the table-mounted autorefractor and subjective refraction in Singapore adults. METHODS: Adults (n = 100) attending a tertiary eye hospital clinic were examined by an optometrist. First, subjective refraction testing was performed using a trial lens set, followed by handheld autorefractor tests using the Nikon Retinomax and the table-mounted autorefractor (Topcon RM8000B). Spherical equivalent and vector components of astigmatism were analyzed: J0 (Cartesian astigmatism) and J45 (oblique astigmatism). RESULTS: The Retinomax autorefractor readings (mean = -4.69 D) were more minus compared with the table-mounted autorefractor (mean = -4.05 D) and subjective refraction (mean = -3.90 D). There were significant differences in J0 and J45 for comparisons between subjective refraction and Retinomax autorefraction, and table-mounted autorefraction and Retinomax autorefraction. CONCLUSION: The Retinomax autorefractor measures were more minus compared with the table-mounted autorefractor and subjective refraction. The Retinomax autorefractor is not recommended for research purposes, unless in remote inaccessible areas where a portable instrument is necessary and cycloplegia is not possible.

Adult↗
PubMed2006

Impact of new legislation on presumed consent on organ donation on liver transplant in Singapore: a preliminary analysis.

Demand for the liver organ for transplantation vastly exceeded the availability of deceased donor organs. A new law, the revised Human Organ Transplant Act (HOTA), was implemented in Singapore in July 2004, which allowed for recovering four organs, including liver, for transplant unless the deceased give objection prior to their demise. We set to study the impact of the revised legislation by comparing the number of potential suitable donors, liver recovery surgery, and liver transplants two years before and one year after the implementation. There was no change in the number of suitable donors, but there was an increase in the number of liver recovery surgeries and liver transplantation, and a lower refusal rate among suitable donors. Although the revised legislation helped improve the availability of deceased donor organs moderately, other nonlegislative, supplementary measures are needed to further improve the low organ donation rate.

Female↗
PubMedDate not supplied

Ethnic variability in dementia: results from Singapore.

The diversity of Singapore's population affords a unique opportunity to study ethnic variability in the dementias. We sought to explore the effects of ethnicity on the frequency of Alzheimer disease and vascular dementia in a large Singaporean sample. A total of 357 patients were studied: 190 with vascular dementia and 167 with Alzheimer disease. Vascular dementia was more common among Chinese and Malays, whereas Alzheimer disease was more common in Indians and Eurasians. Factors that may contribute to the observed ethnic variability in dementia etiologies include differential frequency of the ApoE-e4 allele, frequency of vascular risk factors, lifestyle choices, and cultural attitudes toward health care utilization.

Adult↗
PubMed2007

Ethnic differences in the frequency of subtypes of childhood acute lymphoblastic leukemia: results of the Malaysia-Singapore Leukemia Study Group.

Childhood acute lymphoblastic leukemia (ALL) is clinically heterogeneous with prognostically and biologically distinct subtypes. Although racial differences in frequency of different types of childhood ALL have been reported, many are confounded by selected or limited population samples. The Malaysia-Singapore (MA-SPORE) Leukemia Study Group provided a unique platform for the study of the frequency of major subgroups of childhood ALL in a large cohort of unselected multiethnic Asian children. Screening for the prognostically important chromosome abnormalities (TEL-AML1, BCR-ABL, E2A-PBX1, and MLL) using multiplex reverse-transcription polymerase chain reaction was performed on 299 consecutive patients with ALL at 3 study centers (236 de novo, 63 at relapse), with the ethnic composition predominantly Chinese (51.8%) and Malay (34.8%). Reverse-transcription polymerase chain reaction was successful in 278 (93%) of cases screened. The commonest fusion transcript was TEL-AML1 (19.1%) followed by BCR-ABL (7.8%), MLL rearrangements (4.2%), and E2A-PBX1 (3.1%). Chinese have a significantly lower frequency of TEL-AML1 (13.3% in de novo patients) compared with Malays (22.2%) and Indians (21.7%) (P=0.04). Malays have a lower frequency of T-ALL (6.2%) compared with the Chinese and Indians (9.8%). Both Malays (7.4%) and Chinese (5.0%) have significantly higher frequency of BCR-ABL compared with the Indian population (P<0.05) despite a similar median age at presentation. Our study suggests that there are indeed significant and important racial differences in the frequency of subtypes of childhood ALL. Comprehensive subgrouping of childhood ALL may reveal interesting population frequency differences of the various subtypes, their risk factors and hopefully, its etiology.

Adolescent↗
PubMed2001

Determination of the complete nucleotide sequences of RNA1 and RNA2 from greasy grouper (Epinephelus tauvina) nervous necrosis virus, Singapore strain.

The complete nucleotide sequences of RNA1 and RNA2 from greasy grouper (Epinephelus tauvina) nervous necrosis virus (GGNNV), Singapore strain, were determined. 5' RACE and RNA ligation were used to obtain the complete nucleotide sequences of the 5' and 3' non-coding regions (NCRs). GGNNV RNA1 was determined to be 3103 nt long, containing an ORF of 982 aa, while GGNNV RNA2 was determined to be 1433 nt long, containing an ORF of 338 aa. Both GGNNV RNAs are longer than those of other published betanodavirus sequences and the additional nucleotides were located within the NCRs. Analysis of GGNNV RNA2 revealed that it is closely related to red-spotted grouper nervous necrosis virus and that both grouper viruses share the same neutralization epitope. Predicted domains for six RNA-dependent RNA polymerase motifs and two putative ORFs (proteins B1 and B2) were confirmed by sequence analysis of GGNNV RNA1.

Animals↗
PubMed2006

Temporal and differential gene expression of Singapore grouper iridovirus.

Singapore grouper iridovirus (SGIV), an iridovirus in the genus Ranavirus, is a major pathogen that results in significant economic losses in grouper aquaculture. To investigate further its infective mechanisms, for the first time, a viral DNA microarray was generated for the SGIV genome to measure the expression of its predicted open reading frames simultaneously in vitro. By using the viral DNA microarray, the temporal gene expression of SGIV was characterized and the DNA microarray data were consistent with the results of real-time RT-PCR studies. Furthermore, different-stage viral genes (i.e. immediate-early, early and late genes) of SGIV were uncovered by combining drug treatments and DNA microarray studies. These results should offer important insights into the replication and pathogenesis of iridoviruses.

Animals↗
PubMed2004

An international comparison of women's health issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong, and Singapore: the CIDA-SEAGEP Study.

This was an international study of women's health issues, based on an Official Study Tour in Southeast Asia (the Philippines, Thailand, Malaysia, Hong Kong, and Singapore) and Canada. The objectives of the study were to identify and compare current gaps in surveillance, research, and programs and policies, and to predict trends of women's health issues in developing countries based on the experience of developed countries. Key informant interviews (senior government officials, university researchers, and local experts), self-administered questionnaires, courtesy calls, and literature searches were used to collect data. The participating countries identified women's health as an important issue, especially for reproductive health (developing countries) and senior's health (developed countries). Cancer, lack of physical activity, high blood pressure, diabetes, poverty, social support, caring role for family, and informing, educating, and empowering people about women's health issues were the main concerns. Based on this study, 17 recommendations were made on surveillance, research, and programs and policies. A number of forthcoming changes in women''s health patterns in developing countries were also predicted.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Quality improvement in the healthcare industry: some evidence from Singapore.

Presents an exploratory field research on all hospitals in Singapore, highlighting the different routes hospitals have adopted in pursuing their corporate quality journey for the new millennium. In general, both continuous improvement and innovation-based approaches have generated cost and time savings and helped to streamline work processes. However, the initial survey results show that innovation-based programs require a longer time frame for implementation, are more prone to resistance to change and suffer from program failure. Also, large hospitals and public hospitals are more inclined to implement innovation based approaches while medium-sized hospitals tend to use continuous improvement as a medium for quality improvement.

Health Services Research↗
PubMed1984

Juvenile plantar dermatosis in Singapore.

Juvenile plantar dermatosis (JPD) is the most common form of foot dermatitis in children in Singapore. Sixty-four patients (29 boys) with an age range of 2-25 years were studied. The Chinese have a greater predisposition for JPD compared with the Malays and Indians. The mean age of onset was 8 years, but onset in adulthood is not uncommon. Friction and closed shoes are the main aggravating factors. Association with an atopic history (42%) and ichthyosis vulgaris (19%) is reported. Patch testing was not rewarding. The histology was essentially a subacute dermatitis. Women with no atopic background, in whom the type of shoes made no difference and had a family member with a similar dermatosis, tend to have a more prolonged course of disease.

Adolescent↗
PubMed2005

Metal allergy in Singapore.

This is a clinical epidemiologic study to determine the frequency of metal allergy among patch-tested patients in the years 2001-2003. The results are compared with those of previous studies. All patients diagnosed as having allergic contact dermatitis in the National Skin Centre, Singapore, from January 2001 to December 2003 were studied retrospectively. The frequency of positive patch tests to the following metals were nickel 19.9%, chromate 5.6%, cobalt 8.2% and gold 8.3%. The frequency of nickel allergy has been steadily rising over the last 20 years. The most common sources of nickel allergy are costume jewelry, belt buckles, wrist watches and spectacle frames. After declining from 1984 to 1990, chromate and cobalt allergies have also been steadily increasing subsequently. The most common sources of chromate allergy were cement, leather and metal objects. Most positive patch tests to cobalt are regarded as co-sensitization due to primary nickel or chromate allergies. There has been a steep increase in positive patch tests to gold from 2001 to 2003, which is difficult to explain because the relevance and sources of such positive patch tests can rarely be determined with certainty. There has been an overall rise in the frequency of metal allergy in the last 20 years.

Allergens↗
PubMed2006

Genetic polymorphisms in KCNQ1, HERG, KCNE1 and KCNE2 genes in the Chinese, Malay and Indian populations of Singapore.

AIMS: To determine the genetic variability of long QT syndrome (LQTS)-associated genes (KCNQ1, HERG, KCNE1 and KCNE2) among three distinct ethnic groups in the Singapore population. METHODS: Genomic DNA samples from up to 265 normal healthy Chinese, 118 Malay and 139 Indian volunteer subjects were screened for genetic variations in the coding region of the LQTS-associated genes using denaturing high-performance liquid chromatography and sequencing analyses. RESULTS: In total, 37 single nucleotide polymorphisms (SNPs) were identified in the coding exons of the LQTS-associated potassium ion channel genes, seven of which were novel nonsynonymous polymorphisms. SNPs 356G-->A (exon 1 of KCNQ1), 2624C-->T and 2893G-->A (exon 11 of HERG), 3164G-->A, 3322C-->G and 3460G-->A (exon 14 of HERG), and 79C-->T (exon 3 of KCNE2) resulted in Gly119Asp, Thr875Met, Gly965Arg, Arg1055Gln, Leu1108Val, Gly1154Ser and Arg27Cys amino acid substitutions, respectively. In addition, 16 intronic variants were detected. The functional consequence of these variants has not been studied and their association with risk of LQTS is unclear. CONCLUSIONS: There exist multiple genetic polymorphisms of the LQTS-associated genes in the three distinct Asian populations. Though the functional significance of many of these SNPs is unknown, this interindividual and interethnic genetic variability may underlie the different susceptibilities of individuals to developing LQTS.

Adolescent↗
PubMed2006

Distribution of the FcgammaRIIIa 176 F/V polymorphism amongst healthy Chinese, Malays and Asian Indians in Singapore.

AIMS: To determine and compare the distribution of the FcgammaRIIIa 176 F/V polymorphism across three ethnically distinct populations (Chinese, Asian Indians and Malays) in Singapore. METHODS: The FcgammaRIIIa 176 F/V polymorphism was genotyped by direct sequencing from genomic DNA samples obtained from normal healthy Chinese, Asian Indians and Malays (n = 192 from each population). RESULTS: The allelic frequencies of the high binding affinity FcgammaRIIIa 176 V allele for Chinese, Asian Indians and Malays were 35%, 33% and 46%, respectively (F allele frequencies were 65%, 67% and 54%, respectively). Genotype distributions were found to conform to the Hardy-Weinberg law (P > 0.05) in each group. chi(2) comparisons revealed significant differences in the genotype distributions of the FcgammaRIIIa 176 V/F polymorphism of Malays from the other two populations (Chinese and Asian Indians). However, no significant difference in the genotype distributions of the FcgammaRIIIa 176 V/F polymorphism was observed between Chinese and Asian Indian populations. CONCLUSIONS: The genotype distributions of the FcgammaRIIIa 176 V/F polymorphism in healthy Malays are significantly different from both Chinese and Indians. These observations provide the fundamentals on which future disease associations may be built and also present important implications for the design of therapeutic regimens amongst various ethnic groups.

Adult↗
PubMed2006

Cytology is useful in breast screening: results and long-term follow-up of the Singapore Breast Screening Pilot Project.

OBJECTIVE: The Singapore Breast Screening Pilot Project (SBSPP) was embarked upon (1994-1997) to determine if mammography was useful in early breast cancer detection among Asian women. PATIENTS AND MEASUREMENTS: Of 28 231 women screened, fine needle aspiration cytology (FNAC) was performed in 232 individuals as part of the triple assessment. RESULTS: Absolute and complete sensitivities for the diagnosis of carcinoma were 46.7% and 82.2%, respectively, based on the results of FNAC. Specificity was 63.3%. The inadequate rate was 31%. Five women who were considered cancer-free on triple assessment and, in two cases open diagnostic biopsy during the SBSPP, subsequently developed breast cancer after a median follow-up of 6 years. CONCLUSION: Although our FNAC results compared relatively well with international standards, they reflect a small cohort, and may face additional difficulties in a larger programme.

Biopsy, Fine-Needle↗
PubMed1995

Thymoma--a study of 60 cases in Singapore.

Of 60 cases of thymomas studied in Singapore between 1988 and 1992, the histogenetic classification proposed by Müller-Hermelink was successfully applied to subtype 58 cases. There were 20 (33%) cortical, six (10%) predominantly cortical, three (5%) medullary and 12 (20%) mixed thymomas. Twelve (20%) cases were well differentiated thymic carcinomas and five (8%) were classified as other thymic carcinomas. The pathological and clinical features are presented in detail. These subtypes showed significant correlation with invasive behaviour (stage) and myasthenia gravis. We conclude that the Müller-Hermelink classification has predictive utility and represents a major step towards the understanding of the biology of thymic epithelial tumours.

Adult↗
PubMed2005

Advice-giving on self-medication: perspectives of community pharmacists and consumers in Singapore.

BACKGROUND: In Singapore, community pharmacists provide an advice-giving service to consumers who seek self-medication for minor ailments management. This service has not been studied formally from the perspectives of pharmacists and consumers. OBJECTIVES: The study aimed to identify (i) the approach taken by pharmacists in providing advice for self-medication and (ii) consumers' behaviour in self-treatment and their perception of the advice-giving role of the community pharmacist. METHOD: The pharmacists and consumers were surveyed independently using two structured questionnaires. RESULTS AND DISCUSSION: All community pharmacists who participated in the survey were confident in providing advice on self-medication. However, none of them recorded the consultations and only 17.5% of them had documented their general physician referrals. Most consumers (66.3%) would self-medicate and only consult a professional when the desired outcome was not achieved. Less than 10% of consumers would approach the pharmacists as the first option for advice. More than half of the pharmacists felt that the advice they rendered deserved a fee whereas only 28.4% of the consumers were willing to pay. Both parties thought the fee should not be more than S5 dollars (US3 dollars). CONCLUSION: Generally, there is congruence in the perspectives on self-medication between the advice-giving pharmacist and the consumer. The consumers still lack awareness that pharmacists can help them to self-medicate more safely and effectively. Therefore, more effort in public education is warranted. The current state of poor documentation of the advisory function of community pharmacists should be improved.

Adult↗
PubMedDate not supplied

Benzoyl peroxide gel therapy in acne in Singapore.

The results of an open clinical trial of 200 patients in Singapore show that benzoyl peroxide, in a stable gel formulation, both in 2.5% and 5% strengths, was highly efficacious in the topical treatment of acne vulgaris without concomitant systemic therapy. The series included a small number of Caucasians (13 patients) who were also treated effectively. Side effects noted were generally mild and transient.

Acne Vulgaris↗