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PubMed1987

Antitoxic immunity of the population against diphtheria in Singapore.

A serological study to evaluate the efficacy of the diphtheria immunisation programme in Singapore based on sera collected from 425 healthy persons between 6 months and 40+ years of age showed that 94.6% of the population surveyed possessed protective neutralising antitoxin (greater than or equal to 0.01 IU/ml). No sex or ethnic difference was noted. The most suspectible age-group was adults above 40 years of age in which 14.3% had no protective antitoxic immunity against diphtheria (less than 0.01 IU/ml). The geometric mean titre was generally high with sharp anamnestic type of secondary response elicited by periodic boosters administered. The survey confirmed the efficacy of the childhood immunisation programme which extended from 3 months to 15+ years of age, in maintaining a high level of herd immunity of the population right into adulthood. Further extension of the programme to include routine revaccination of adults was not considered necessary.

Adolescent↗
PubMed1987

Suicidal poisoning deaths in Singapore 1975-1984.

This study presents the pattern of suicidal poisoning deaths in Singapore for 1975 to 1984. A total of 282 suicidal poisoning deaths investigated at the Department of Pathology were retrospectively analysed. It was found that for the ten year period, death by poisoning was the third most popular method of suicide with a mean annual percentage of 10.2%. The most commonly involved suicidal poison was the herbicide, Paraquat, used in 35.1% of the cases. Organophosphate insecticides were involved in 22.3% and drugs were used in 24%. The results of the study suggest that in view of the lethality of Paraquat and its popularity as a suicidal agent, there is a need for stricter controls to restrict the availability of Paraquat to the general population.

Adolescent↗
PubMed1987

Mediastinal benign teratoma in Singapore.

The purpose of this study was to analyse the pattern of benign mediastinal teratoma, in this region. The paper is based on a retrospective analysis of 16 consecutive patients who were admitted to the Cardiothoracic Surgical unit in Singapore from 1967 through 1984. The disease pattern appears to be similar to those reported from the west. Complete surgical excision offers a cure and it can be carried out safely.

Adolescent↗
PubMed1986

Glomerulonephritis in Singapore: an overview.

The pattern of glomerulonephritis (GN) consisting of 1057 renal biopsies is presented. Primary GN accounted for 91% and secondary GN 9% of which the commonest is lupus nephritis. Asymptomatic haematuria and proteinuria was the commonest mode of presentation (41%), gross haematuria 9%, nephrotic syndrome 29% while 5.5% presented with renal impairment and 4.3% with hypertension. Mesangial proliferative GN is the commonest histopathological lesion forming 66% of all primary GN. Minimal Lesion, Focal Global Sclerosis and Focal Segmental Glomerulosclerosis accounted for 7% each. Membranous GN was uncommon (3%) while Mesangiocapillary GN, Diffuse Endocapillary GN and Crescentic GN were even rarer. If the presenting feature was asymptomatic haematuria and proteinuria the likely diagnosis was IgA nephritis, and, if nephrotic syndrome it was likely to be Idiopathic Mesangial Proliferative GN but with negative staining on immunofluorescence. The course and prognosis of the various forms of GN are next discussed. Nephrotic syndrome with Minimal Lesion has an excellent prognosis while Crescenteric GN usually carries a grim prognosis. Finally, factors affecting the progression of IgA nephritis, the commonest form of GN occurring in Singapore are examined. Patients who developed renal failure ran two different courses; one was a slowly progressive course over an average of 7.7 years before reaching end stage renal failure (ESRF), while the other was a more rapid decline to ESRF within an average of 3.3 years where severe uncontrolled hypertension seemed to be the major adverse factor. 9% had renal impairment at the end of a follow up of 50 + 1/2 - 34 months while 5% progressed to ESRF. The cumulative renal survival was 91% after 6 years with no further loss up to 14 years. Unfavourable long term prognostic indices were proteinuria of more than 2 gms, hypertension, crescents on renal biopsy, severe segmental sclerosis and medial hypertrophy of blood vessels.

Adolescent↗
PubMed1986

Subsite distribution of large bowel cancers among the ethnic and dialect groups in Singapore.

The subsite distribution of large bowel cancers among the major ethnic groups and among major Chinese dialect groups in Singapore were analysed. It was found that the overall pattern of subsite distribution of large bowel cancers was remarkably similar among the sexes, ethnic and dialect groups. There was a progressive increase in the proportion of cancers from the right to the left side of the large bowel except for a decrease in the descending colon. The similarity in the pattern of subsite distribution despite differences in risk suggested that some common pathogenetic mechanism might be operative. It is consistent with the concept of effective exposure of the intestinal mucosa to carcinogens. The finding that greater proportions of sigmoid and rectal cancers occurred among the older age groups gave further support to such a concept. The findings of this study however do not exclude the possibility of subsite differences in sensitivity and response to carcinogens.

Adolescent↗
PubMed1986

Primary scalp cancer in Singapore.

Cancers of the scalp are uncommon. Owing to their unique site they pose problems in surgical treatment. A retrospective study of all scalp cancers notified to the Singapore Cancer Registry over 17 years has shown that squamous cell carcinoma is the most common cancer followed by basal cell carcinoma. Other cancers are sweat gland carcinoma, angiosarcoma, dermatofibrosarcoma protruberans, liposarcoma, fibrosarcoma and malignant lymphoma. Scalp cancers are more common in Chinese and very rare in Indians. There is no difference in the incidence between the sexes. The surgical treatment and reconstructive techniques employed in 52 patients are described. When localised, scalp cancers are managed like other skin cancers but once they invade bone, they become aggressive and are difficult to eradicate. Wide radical excision provides cure and the skull bone if involved should be removed.

Adolescent↗
PubMed1986

Paralytic shellfish poisoning in Singapore.

Paralytic shellfish poisoning is caused by the ingestion of shellfish meat rendered toxic by exposure to a high level of toxic dinoflagellates during the phenomenon of "red tide". This paper reports the first outbreak of paralytic shellfish poisoning from green mussels in Singapore which resulted in two deaths. Analysis of the mussel meat by a standardised mouse bioassay confirmed the presence of the toxin. An attempt was also made to extend the bioassay to an analysis of the gastrointestinal contents. The clinical features of the condition are presented.

Animals↗
PubMed1986

Inhalant abuse in Singapore.

This paper examines the current situation of inhalant abuse in Singapore. Though inhalant abuse is a new youthful phenomenon, the number of abusers has rapidly increased. And it will soon become a serious problem if it goes unchecked because it is mainly a peer group activity which can involve others, especially the youngsters, very quickly. Furthermore, inhalant substances are cheap and easily available. Other points included in the discussion are the causation of inhalant abuse, the methods and locations of abuse, sources of inhalant substances, and the abusers themselves in terms of their ethnic group, educational level, family, and residential areas.

Adolescent↗
PubMed1986

Mandibular ameloblastoma in Singapore--a 10 year review.

This paper reviews 30 cases of mandibular ameloblastoma seen and managed in the Singapore General Hospital over a 10 year period from 1976 to 1985 inclusive. Data on age and sex distribution, mode of presentation, presenting symptoms, size of tumour at time of presentation, radiological features at time of diagnosis, method of treatment and post-operative complications are discussed. There was no case of local recurrence in the 28 cases that were surgically managed. The importance of adequate local excision is emphasised. This paper also compares our local data with that of equivalent studies made in Thailand (Far East), Sweden (Europe) and Nigeria (Africa). An interesting rare case of malignant mandibular ameloblastoma is included in this study.

Adolescent↗
PubMed1986

Prevalence of respiratory illnesses of school children in the industrial, urban and rural areas of Singapore.

An epidemiological survey of 3216 primary school children living in the industrial, urban and rural areas of Singapore revealed a high prevalence of various respiratory symptoms and illnesses, with 13.1% cough, 8.2% wheezy chest, 25.9% blocked/running nose, 4.3% sinusitis, 7.8% asthmatic attacks and 4.1% bronchitis/pneumonia. Differences in the prevalence of respiratory illnesses and lung function tests were observed among children in the three areas, but this could not be accounted for by the varying air pollution levels which have been maintained below the long-term standards set up by WHO. It was probably responsible for the differences noted.

Adolescent↗
PubMed1985

Peptic ulcer surgery in Singapore, 1951-80, with particular reference to racial differences in incidence.

The incidence of operations for peptic ulcer increased in Singapore during the period 1951 to 1980 (males from 12.1 to 40.0 per 100,000 per year; females from 1.1 to 13.2 per 100,000 per year). This increase is due to an increase in surgery for both perforated and non-perforated ulcers. While an increase in elective ulcer surgery may be due to a number of factors, the increase in surgery for perforated ulcers suggests that peptic ulcers have increased in frequency over this period. The incidence of peptic ulcer surgery amongst the Chinese was higher than that amongst the Malays and the Indians. For males, however, this difference between the Chinese and the Malays became less marked over the thirty years. In contrast, the difference between the Chinese and the Indians remained constant.

Adolescent↗
PubMed1985

The epidemiology of lung cancer in Singapore.

Lung cancer has reached epidemic proportions in all developed countries and many of the urban centres of the developing world. It is the most frequent cancer site in Singapore, accounting for 23.4% (623 cases) of all cancer deaths and nearly 5% of all causes in 1982. Based on incidence data for 1968-1977, among males, there was an average of about 330 cases diagnosed each year, giving an annual incidence rate of 30.7 per 100,000 and a proportion of 21% against all sites. Among females, there was an average of about 115 cases, with the incidence rate at 11.2 and the proportion 10.3% (ranking third behind breast and cervix). The risks among the Chinese were more than double those of the other ethnic groups. The Hokkien (73.2 per 100,000) and Teochew (67.0) males had one of the highest age-standardized incidence rates in the world. Most of the cases were of the epidermoid carcinoma type. Among the females, the Cantonese (28.5) had about double the risks compared to the other dialect groups, and the rate was among the highest in the world. Adenocarcinomas accounted for almost 50% of the cases. The relevant host and environmental factors associated with lung cancer are discussed. Without doubt, cigarette smoking is the most important risk factor. The ultimate solution to this problem must lie in an effective smoking control programme, besides much-needed improvements in early diagnosis and treatment of the disease.

China↗
PubMed1979

In vitro drug resistance of salmonellae in Singapore.

Strains of Salmonella typhi isolated in Singapore were susceptible to chloramphenicol (except from two imported cases) and most of them also generally susceptible to ampicillin and septrin. Drug-resistant strains of Salmonella typhimurium appeared in 1971 and caused out-breaks among young children. However, decreasing drug-resistance of S. typhimurium was recorded in recent years following a drop in the number of cases. Other Salmonella serovers were found relatively susceptible to the antibiotics tested.

Anti-Bacterial Agents↗
PubMedDate not supplied

Family size intentions and socioeconomic status in Singapore, 1974-1981.

Singapore has in recent years undergone a tremendous fertility decline that has affected couples at all socioeconomic levels. Using representative biographical sketches, this article presents the results of a panel study on family planning intentions and behavior among 45 young Chinese Singaporean couples. The couples, ranked as average or affluent working-class, or middle-class, were first interviewed in 1974-76 and were followed up in 1981. The study compares early childbearing intentions with actual childbearing behavior, examining the motivation for childbearing by socioeconomic group and highlighting the differences found. The follow-up interviews reveal that, on average, all couples in the sample bore 0.4 fewer children than originally intended. The motivation for changed childbearing intentions, however, differed according to socioeconomic status and the perceived role that children play in the family economy.

Adult↗
PubMed1985

The microbiology of non-gonococcal urethritis (NGU) in Singapore.

Ninety-six men with non-gonococcal urethritis (NGU) were studied to determine the microbiology of NGU in Singapore. Chlamydia trachomatis emerged as the most common aetiologic agent, being isolated in 29 (30.2%) of 96 patients. The recovery rate of other potential pathogens and their significance locally are discussed.

Chlamydia Infections↗
PubMed1985

The dynamics of ageing in Singapore's population.

This paper beings by explaining with the aid of the stable population theory that the ageing of a population is chiefly, if not entirely, the result of a decline in mortality. It shows that the decline in fertility is the major determinant of an ageing population. In Singapore the ageing of our population has commenced and will gather momentum in the future: there is little that can be done to arrest this trend caused by the past rapid decline in fertility and the maintenance of fertility below replacement level since 1975. Some of the more significant consequences in the areas of level of living, consumption pattern, savings, labour shortage, and ageing work force are discussed briefly.

Adolescent↗
PubMed1971

Aedes aegypti (L.) and Aedes albopictus (Skuse) in Singapore City. 1. Distribution and density.

The distribution and density of Ae. aegypti and Ae. albopictus in Singapore were assessed from extensive larval surveys carried out from 1966 to 1968 to evaluate their respective roles in the epidemiology of dengue haemorrhagic fever and to study their ecology in the urban areas. Ten urban areas where the majority of dengue haemorrhagic fever cases occurred were surveyed.The results showed that both species were common in the city, with Ae. aegypti being the dominant species. The distribution of Ae. aegypti was more uniform and related to the prevailing housing types and conditions. Its premise index was highest in slum houses, intermediate in shop houses, and lowest in multistorey flats. Ae. albopictus, on the other hand, did not seem to be related to the prevailing housing type in its distribution but tended to be more widespread in areas with open spaces.The larval density index (the average number of larvae per housing unit) was higher for Ae. aegypti than for Ae. albopictus, in agreement with the relative densities shown by their premise indices. The larval density index correlated well with the premise index and correlated best with the infested-receptacle index. For practical purposes, the most suitable, convenient, and reliable measure of density of Ae. aegypti population seems to be the infested-receptacle index.An attempt was made to estimate the rate of dispersal of Ae. aegypti from a stable population to an adjacent area of multistorey flats. The rate of dispersal, estimated from the premise index and the larval density index, was approximately 2% per year of the "donor" population.

Aedes↗
PubMed1975

Controlled trial of intermittent regimens of rifampicin plus isoniazid for pulmonary tuberculosis in Singapore.

A total of 481 adult Chinese, Malays, and Indians in Singapore with newly diagnosed smear-positive pulmonary tuberculosis were allocated at random to four regimens of intermittent rifampicin plus isoniazid. All patients received an initial 2 weeks of daily streptomycin plus isoniazid plus rifampicin. This was followed either by twice-weekly isoniazid 15 mg/kg plus rifampicin 900 mg (HR2 regimen) or 600 mg (LR2 regimen), or by once-weekly isoniazid 15 mg/kg plus rifampicin 900 mg (HR1 regimen) or 600 mg (LR1 regimen). In addition, all patients received a daily capsule containing, at random, either rifampicin 25 mg or a matched placebo to see if the rifampicin supplement would reduce the incidence of adverse reactions to the drug. At 12 months, all the patients on the two twice-weekly regimens (HR2, LR2) had a favourable bacteriological status as had 97% of 102 HR1 and 93% of 112 LR1 patients. The therapeutic response was significantly better on the twice-weekly than on the once-weekly regimens (P = 0-0005), but the dose size of rifampicin did not have a statistically significant effect. Adverse reactions to intermittent rifampicin occurred in 25% of the HR1 patients but on the other three regimens their incidence was low. The incidence of rifampicin-dependent antibodies was higher, ranging from 48% (HR1) to 24% (LR2). The effect of dose size on the incidence of the "flu" syndrome (the commonest reaction) and of antibodies was statistically significant (P less than 0-01 and less than 0-001, respectively). The interval between doses affected the incidence of the "flu" syndrome (P less than 0-001), but not of antibodies (P greater than 0-25). The rifampicin 25 mg supplement had no effect therapeutically or on the incidence of adverse reactions or of antibodies.

Adolescent↗