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PubMed1987

Acute hepatitis A in Singapore: importance of shellfish ingestion in a non-epidemic period.

A case-control study based on 28 serologically confirmed cases of hepatitis A and 42 home contacts with no recent or past evidence of hepatitis A virus (HAV) infection was conducted to determine the importance of shellfish exposure in the transmission of HAV during a non-epidemic period in Singapore. It was found that consumption of partially-cooked cockles (Anadara granosa) was significantly associated with the illness (p less than 0.001). No other types of locally available shellfish including oysters, mussels and clams were incriminated. The public should be constantly reminded to refrain from consuming raw and inadequately cooked bivalve molluscs all the time, and not just during epidemics.

Acute Disease↗
PubMed1985

Disease-bearing insects brought in by international aircraft into Singapore.

Fifty-seven (17.3%) of 330 incoming aircraft landing at Changi International Airport were found to harbour mosquitoes and other insects on board. The frequency of insects detected in aircraft from the Southeast Asian countries varied from 7.1% to 32.2%. Live insects were found in 5 (6.1%) of 82 aircraft disinsectized by the "block away" method. The species of mosquitoes brought in were: Culex quinquefasciatus (96), Culex tritaeniorhynchus (1), Aedes albopictus (2) and Aedes aegypti (1). None of the 51 female Culex quinquefasciatus dissected was found to be infected with microfilariae. They key to the prevention of introduction of exotic vectors and transmission of vector- borne diseases is to continue with the existing system of vector surveillance and control at the international airport, rather than routine disinsecting of aircraft landing in Singapore.

Aircraft↗
PubMed1987

Ulcerative colitis in Singapore: a clinical study of sixty-one patients.

Sixty-one consecutive cases of ulcerative colitis from the Department of Medicine, Singapore General Hospital, over a 16-year period (1971 to 1986) were reviewed. Mean duration of follow-up was 35.9 months (range 2 months to 16 years). Fifty-one (83.6%) cases were diagnosed in the last 8 years. Sex ratio was almost equal (males 30, females 31) and mean age was 38.2 years. All racial groups were affected but a predilection among Indians (21.3%) was observed. At presentation, the disease was mild in 36 (59.0%), moderate in 14 (22.9%) and severe in 11 (18.1%) patients. Fifty-two (85.2%) patients had symptoms of at least one month's duration before presentation. The 3 commonest symptoms were haematochezia (95.1%), diarrhoea (95.1%) and mucoid stools (83.6%). Extraintestinal manifestations of disease such as backache (8.2%), peripheral arthritis (6.5%), iritis (6.5%) and liver disease (1.6%) were uncommon. Severe intestinal complications include toxic megacolon (1.6%), colonic perforation (1.6%) and massive gastrointestinal haemorrhage (1.6%). Haematological and biochemical indices at presentation generally reflected the activity and severity of disease. The disease was limited to the rectum and sigmoid colon in 12 (19.7%) patients, extended up to the splenic flexure in 16 (26.2%), up to the hepatic flexure in another 16 (26.2%) and involved the whole colon in 17 (27.9%). Pseudopolyposis was present in 13 (21.3%) patients. Of 49 patients: (a) 18 (36.7%) had remission and were relapse free subsequently (b) 14 (28.6%) had infrequent relapses (less than 3 x/year) (c) 3 (6.1%) had frequent relapses (greater than 3 x/year) (d) 10 (20.4%) had chronically active disease (e) 4 (8.2%) had a short fulminant course terminating in death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Occupational skin disease in Singapore: epidemiology & causative agents.

Of 557 patients with occupational dermatoses seen at the Middle Road Hospital, Singapore, 55.7% (310) were irritant contact dermatitis, 38.6% (215) were allergic contact dermatitis and 5.7% (32) were non contact dermatitis. More than half of the patients were below 30 years old and most were from the construction (29.5%), metal/engineering (20.6%), electrical/electronic (16.4%), transport (5.5%) and food catering (3.8%) industries. Common occupational irritants included coolants, oils, cement, solvents, detergents and soldering flux. Chromates in cement was the most common occupational allergen. Other occupational allergens included rubber chemicals from rubber apparels. Thiurammix followed by carba-mix, and PPD-mix were common rubber allergens. Resins including epoxy, acrylate and paratertiary butyl phenol resins and other metals (nickel and cobalt) were less common occupational allergens. 5 workers had contact urticaria to proteinaceous food. Non dermatitic occupational dermatoses included fibreglass dermatoses, miliaria and oil folliculitis.

Adolescent↗
PubMed1988

Immunology of renal transplantation in Singapore.

Renal transplantation is the best form of renal replacement therapy for patients suffering from endstage renal failure. While correcting the metabolic consequences of uremia, it is the only form of replacement therapy which permits full rehabilitation of the patient. However, the successful engraftment of a renal allograft is frequently limited by immunologically mediated graft loss which can be as high as 50% in the first year in cadaveric transplants. Since the beginning of the history of transplantation, various methods of modifying allograft rejection, both pretransplantation and posttransplantation have been studied. In this paper, we report the pretransplantation immunological factors that appear to modulate graft survival in renal transplantation in Singapore.

Blood Transfusion↗
PubMed1986

Sclerosing haemangioma in Singapore.

The Singapore experience with 11 cases of sclerosing haemangioma of lung seen from 1970-1984 is analysed. There is female preponderance (9/11) and the majority (8/11) were asymptomatic. Seven patients were treated by wedge resection and 4 had lobectomies. Microscopically, the lesion had variegated growth pattern with characteristic polygonal cells present in the stroma. All patients were well after surgery. The longest follow-up period is 7 years with no recurrence seen. This is an unusual, distinctive and benign entity which should be distinguished from other inflammatory conditions in the lung.

Adolescent↗
PubMed1987

Immune status of the population to poliovirus infection in Singapore.

A seroepidemiological survey conducted after two decades of mass immunization against poliomyelitis in Singapore showed a high level of herd immunity in the population to all three types of human poliovirus. Neutralizing antibodies to poliovirus 1, 2 and 3 were detected in 93.9-96.7% of the population between 6 months and over 40 years old. Adults above 30 years of age had a relatively high level of susceptibility to poliovirus infection, with 10.2-12% in the over-30-year age group possessing no neutralizing antibody against poliovirus 1, 14.3% in the 40+ age group against poliovirus 2, and 14% in the 30-39-year age group against poliovirus 3. The geometric mean titres showed a general decline among the older age groups. There were no statistically significant differences in the immune status by sex and by ethnic groups (Chinese, Malays and Indians). The importance of maintaining a high coverage of immunization, monitoring the herd immunity of the population to identify high-risk groups, and advising adults travelling to the endemic areas to be immunized against poliomyelitis was stressed.

Adolescent↗
PubMed1987

Disability, rehabilitation and after-care of stroke patients after discharge from hospital, Singapore 1983-84.

135 new onset stroke patients admitted over a nine-month period to a medical unit in Singapore were studied with emphasis on their rehabilitation and community care after discharge. Follow-up visits were made to 79 survivors at third month after onset. 16.7% of the patients made apparently complete recoveries, 20.3% remained slightly disabled, 21.5% moderately disabled, and the remaining 41.8% severely disabled. Sixty-five patients were staying in private households at third month follow-up. The main care-givers were usually female relatives. These informal carers assisted a large proportion of patients in various activities of living: 62.0% in dressing, 54.4% in walking and toileting, 30.4% in feeding, and 22.8% in turning in bed. The study establishes the need to develop and strengthen supportive services to enable disabled stroke patients to be cared for in their own homes. These include the home nursing service, elderly day care service, home help service, and meals-on-wheel service.

Aftercare↗
PubMed1988

The Republic of Singapore Navy's Scopoderm TTS study: results after 2,200 man-days at sea.

Most clinical trials investigating prevention of seasickness with transdermal scopolamine have been short-term, and little information regarding long-term use is available. We report here a double-blind trial conducted on board a flat-bottomed Republic of Singapore Navy vessel of 2,490 tons, sailing in the South China Sea. The trip lasted 26 d, but self-assessment by the 122 adult male participants (using a simplified scale quantifying the level of seasickness) was confined to the 18 d spent at sea. We found that the protection rate with transdermal scopolamine was 46-57%, with maximum benefits to inexperienced participants, during the early preadaptation phase, or in rough seas even after adaptation. Unwanted effects were few and generally minor. We concluded that the benefits of Scopoderm were worth exploiting even for long trips in moderate-to-rough seas.

Administration, Cutaneous↗
PubMed1988

Sterilisation patterns in dental practices in Singapore.

A survey to find out the standard of sterilisation of dental equipment was conducted via a questionnaire sent out to all Division I dental surgeons in Singapore. Questions asked determined the main methods of sterilisation/disinfection of hand instruments, air rotor and air motor handpieces, burs, salivary ejectors, ultrasonic scaling tips, and the use of disposable needles, local anesthetic, carpules, and gloves. Results indicated that while most respondents sterilised or disinfected various instruments, there was an apparent misconception that sterilisation and disinfection were the same thing. The majority used boiling with water or cold chemical disinfection. Most respondents were willing to treat patients with known histories of hepatitis B but would refer patients with histories of Acquired Immune Deficiency Syndrome (AIDS).

Acquired Immunodeficiency Syndrome↗
PubMed1988

Radiotherapy of early glottic cancer Singapore, 1978-1981.

This study analyses the results of primary radiotherapy for 44 patients with early glottic cancer (Tis, T1 stage) given at the Therapeutic Radiology Department, Singapore General Hospital during the 4-year period from 1978 to 1981. Irradiation was delivered using cobalt teletherapy with free set-ups, and without "air-gap" compensation. Total doses of 55Gy to 64Gy were given in daily fractions of 1.8Gy, treating five times a week. The crude 5-year survival rate for Tis/T1a tumours was 88.9% and for T1b lesions, 81%. On correcting for deaths from intercurrent disease, the survival rates improved to 95.5% and 92.6% respectively. In 33 cases where the quality of voice after radiation was assessed, 15 patients (45.4%) retained good voice quality with an additional 11 patients (33.3%) having acceptable voice quality. In seven cases the voice after radiation was rated as poor. Nine patients had local recurrence, giving a rate of 20.4%. One other patient had cervical node metastasis and subsequently developed lung secondaries. Surgery, solely or with re-irradiation, was an effective treatment for local recurrence. Re-irradiation alone failed to control any case with recurrence.

Carcinoma, Squamous Cell↗
PubMed1988

The fourth dimension of the face: a preliminary report of growth potential in the face of the Chinese population of Singapore.

Age-related changes were studied in 32 linear measurements from the faces of 180 healthy Chinese subjects of Singapore, aged 6, 12 and 18 years, with equal representation of the sexes. In addition, the differences in 10 inclinations and 6 angles of the facial profile between thirty 6-year-olds and thirty 18-year-olds of each sex were determined. The total absolute and relative growth between 6 and 18 years was established and, in the linear measurements, the relative increments were separately calculated for the 6- to 12-year-old and 12- to 18-year-old periods.

Adolescent↗
PubMed1988

Ventilatory function in Malay female workers in Singapore.

Results of the ventilatory function measurements, consisting of Forced Expiratory Volume in the first second (FEV) and Forced Vital Capacity (FVC), in a study of 195 Malay female telephonists in Singapore are reported here. The analysis of the data confirmed that FEV1 and FVC are related to age and height but not weight. The predicted normal values of the Malay female could be obtained from the derived regression equations for FEV1 and FVC. Significant differences in the FEV1 and FVC were observed in the Chinese, Indian, African, British, White and Black American women when compared with the study's Malay female population. These findings are in agreement with many of the previous studies which reported differences in ventilatory function in various racial groups.

Adult↗
PubMed1988

Skin diseases in children in Singapore.

Singapore has developed over the past 3 decades with improvement in housing, nutrition and general health. The pattern of skin diseases has changed from conditions like pyodermas and malnutrition to predominantly eczemas. The paediatric cases seen at Middle Road Hospital consist of 13% of general dermatology cases (509 of 37,964 total new cases in 1986). About 2.7% (138) of the children were below 1 year, 32.5% (1630) were below 1-4 years and 64.5% (3251) were below 14 years of age. The ten most common dermatoses (1986) follow a similar trend in most of the developed towns of Asia. This includes eczemas 32.0% (1603 cases); 14.5% (730) of atopics, non-specified eczemas 9.6% (481), hand eczema 4.1% (209), contact dermatitis 1.7% (90), discoid eczema 1.15% (57), seborrhoeic 0.7% (36). The remaining are viral warts 6.8% (342), scabies 3.2% (302), acne 3.7% (180), pyoderma 3.5% (175), dermatophytes 3.3% (169), urticaria 2.6% (134), pityriasis rosea 0.1% (51) and vitiligo 0.09% (46).

Adolescent↗
PubMed1988

Influenza surveillance in Singapore: 1972-86.

Prospective laboratory surveillance of influenza viruses has been carried out since 1973 in Singapore. The results indicate that antigenic shift variants caused epidemics at various times of the year over this period, whereas drift variants were associated with a regular increase in incidence during the second and fourth calendar quarters. Outbreaks due to influenza A virus occurred every year and to influenza B virus at intervals of 16-24 months. Between outbreaks, viruses belonging to either of the two types could be detected during most months, and certain variants appeared several months before the outbreaks they subsequently caused. The factors that contribute to the seasonal pattern are at present unknown.

Adolescent↗
PubMed1988

Incidence and epidemiology of cleft lip/palate in Singapore.

This is an on-going study monitoring congenital malformations in all babies delivered in the Kandang Kerbau Hospital, Singapore. Cleft lip and cleft palate as well as a combination of both are among those conditions closely monitored. Up till December 1987, 24 months after the study commenced, a total of 30,411 newborn infants have been screened, out of which 53 infants presented with one of these conditions, an incidence of 0.17% (one per 574 births). There were 26 males and 27 females. During this period, 15,564 males and 14,847 females were delivered; incidence in males was 0.17% and females 0.18%. The incidence in Chinese was 0.20%, Malays 0.14% and Indians 0.09%. Of the 53 cases, 11 (20.7%) have isolated cleft lip, 18 (34.0%) isolated cleft palate and 24 (45.3%) both cleft lip and palate combined. Comparison with a set of controls matched with regards to place and time of delivery, maternal age, maternal parity and ethnic group was made. Analysis of the study and control groups demonstrated that early menarche, regular menstrual periods, and ingestion of traditional medicine were significantly associated with facial clefts.

Cleft Lip↗
PubMed1987

Leprosy in Singapore.

The incidence of leprosy in Singapore is declining over the past 20 years. More than one third of new cases are now over 50 years while no child under 5 years has been affected since 1970. Male to female ratio is 2:1. Indians are more significantly affected compared to the other races and a higher proportion has tuberculoid leprosy. Tuberculoid leprosy accounts for 50.4% of cases seen during the past decade. Case detections from household contacts is still worthwhile as it accounts for 3% to 13.5% of the yearly incidence of the disease. The first four cases of dapsone resistance was confirmed in 1969. Since then the yearly incidence of clinically diagnosed dapsone resistant cases averaged 2.9 per thousand. Hence, various regimens of multiple drug therapy have been instituted.

Adolescent↗
PubMed1987

Parasitic infections in Singapore.

This paper describes various parasitic infections which are encountered in Singapore. These include the soil transmitted helminths, pinworms, Clonorchis/Opisthorchis, Hymenolepis, filariae, malarial parasites, Toxoplasma and other protozoal infections. The reasons for the transmission of these parasites in the republic are discussed. Some of the problems associated with their diagnosis are highlighted.

Cestode Infections↗