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At least 1,639 records · Page 91Linked to original sources
PubMed1991

Assessment of a daily combined preparation of isoniazid, rifampin, and pyrazinamide in a controlled trial of three 6-month regimens for smear-positive pulmonary tuberculosis. Singapore Tuberculosis Service/British Medical Research Council.

In a study in Singapore 310 patients with sputum smear-positive pulmonary tuberculosis were allocated at random to daily chemotherapy with streptomycin, isoniazid, rifampin, and pyrazinamide (1) for 2 months (2SHRZ), (2) for 1 month (1SHRZ), or (3) for 2 months without streptomycin (2HRZ). This was followed for all patients by three times weekly isoniazid and rifampin to a total duration of 6 months. During the initial period of daily chemotherapy the patients were also allocated at random to be given their HRZ either as a combined formulation (Rifater), each tablet containing 50 mg isoniazid, 120 mg rifampin, and 300 mg pyrazinamide, or as three separate drugs. During the Rifater versus separate drugs comparison the most common spontaneous complaints were of nausea and vomiting, reported by 8% of 155 patients receiving Rifater and 7% of 155 separate drugs. Other adverse effects were also reported in similar proportions in the two series. Among 271 patients with drug-susceptible strains of tubercle bacilli pretreatment there were no bacteriologic failures during chemotherapy. During 18 months of subsequent follow-up bacteriologic relapse occurred in 3 (7%) of 46 2SHRZ, 2 (5%) of 42 1SHRZ, and 3 (8%) of 40 2HRZ patients allocated to Rifater and in 0 of 47 2SHRZ, 1 (2%) of 46 1SHRZ, and 1 (2%) of 44 2HRZ patients allocated to separate drugs. There was no evidence of therapeutic benefit from continuing SHRZ administration beyond 1 month or from adding streptomycin to HRZ. The relapse rates were slightly higher in the Rifater series (p = 0.04). Further follow-up and results from other studies are therefore needed fully to assess the combined preparation.

Adolescent↗
PubMed1985

Clinical trial of three 6-month regimens of chemotherapy given intermittently in the continuation phase in the treatment of pulmonary tuberculosis. Singapore Tuberculosis Service/British Medical Research Council.

In a study in Singapore, Chinese, Malay, and Indian patients with sputum-smear-positive pulmonary tuberculosis were allocated at random to daily treatment with streptomycin, isoniazid, rifampin, and pyrazinamide for 2 months (2SHRZ), 1 month (1SHRZ), or 2 months without streptomycin (2HRZ), followed, for all patients, by 3-times-weekly isoniazid and rifampin (H3R3) up to 6 months. At 2 months, the culture-negativity rate for the 2SHRZ series was statistically significantly higher than for either of the other 2 series. All 319 patients with drug-sensitive tubercle bacilli pretreatment had a favorable bacteriologic response during chemotherapy except for one 2SHRZ/H3R3 patient, and among the 300 patients assessed during 24 months of follow-up after chemotherapy there was only 1 bacteriologic relapse in each series, giving an overall therapeutic failure rate of only 1%. Thus, the 2SHRZ combination had the highest early sterilizing activity, but the potent continuation therapy compensated for the initial inferiority of the other 2 regimens. Among the 32 patients with tubercle bacilli resistant pretreatment to isoniazid, streptomycin, or both drugs, there were no failures during chemotherapy and 3 subsequent relapses among the 30 assessed during 24 months of follow-up. Eleven (3%) of the 420 patients who started chemotherapy on their allocated regimen had hepatitis with jaundice during chemotherapy. However, 2 of these had cirrhosis pretreatment and 1 was a chronic alcoholic.

Adolescent↗
PubMed1998

The Singapore operation for recurrent dislocation of peroneal tendons: long-term results.

Recurrent dislocation of peroneal tendons is uncommon and there are few reports of the long-term results after repair. The Singapore operation, first described in 1985, is an anatomical repair based on the Bankart-like lesion seen in the superior peroneal retinaculum. We reviewed 21 patients after a mean follow-up of 9.3 years, and found no recurrence. Eighteen had good functional results and had returned to their previous levels of vocational and sports activities. The three fair results were due to painful scars or neuromas.

Activities of Daily Living↗
PubMed2026

Double heterozygous germline pathogenic variants in patients referred to a tertiary cancer genetics clinic in Singapore.

BACKGROUND: The increasing use of multigene panel testing has led to a rise in the identification of double heterozygous (DH) pathogenic variants in cancer patients, although their frequency and clinical relevance remain poorly characterised, particularly in Asian populations. METHODS: We conducted a retrospective review of 5,178 patients referred to a tertiary cancer genetics clinic in Singapore. DH pathogenic variants were defined as the presence of two or more distinct pathogenic or likely pathogenic germline variants identified by multigene panel testing. Clinical, pathological, and family history data were reviewed and analysed using appropriate non-parametric and exact statistical methods. RESULTS: Among 2,802 index patients with available genetic test results, 593 (21.2%) carried at least one pathogenic/likely pathogenic variant. DH pathogenic variants were identified in 21 individuals (0.75%), of which 9 were patients with breast cancer, 10 with non-breast malignancies, and 2 were cancer-free. The frequency of multiple primary cancers was 26.3% in DH variant carriers, 23.3% in single variant carriers, and 16.5% in those with no pathogenic variants. The median ages of first cancer diagnosis were 47, 44, and 48 years. Several DH combinations involved moderate- or low-penetrance genes, and some clinically unsuspected variants were detected only through broad multigene testing. CONCLUSION: DH pathogenic variants represent a rare subgroup that is increasingly detected through multigene panel testing. Their phenotypic expression is variable, and the influence of additional pathogenic variants remains uncertain. Our findings emphasise the need for tailored genetic evaluation and further research to guide evidence-based management for this complex patient population.

Asia↗
PubMed1999

A review of 5 years' experience in the use of botulinium toxin A in the treatment of sixth cranial nerve palsy at the Singapore National Eye Centre.

INTRODUCTION: This retrospective study reports our experience on the use of botulinum toxin A (BTXA) in the treatment of sixth cranial nerve palsy at the Singapore National Eye Centre. BTXA is derived from clostridium botulinum; it causes temporary paralysis of the extraocular muscle (medial rectus) into which it is injected, thus preventing its contracture and allows the antagonist lateral rectus muscle to take up the slack and reduce or correct the ocular misalignment. METHODS: Nineteen patients had BTXA injection for estropia due to sixth cranial nerve palsy during the period September 1992 to August 1997. The sixth cranial nerve palsy was related to nasopharyngeal carcinoma in 76.7% of cases. Follow-up after the last injection ranged from zero (defaulted) to 21 months (mean 8, median 6 months). RESULTS: A total of 25 injections were given to 19 patients. Seven patients (36.8%) had final ocular alignment within 10 prism dioptres of orthotropia of which six achieved fusion at primary gaze position. There was no correlation between the number of injections per patient and the size of strabismus or grade of lateral rectus muscle function. The incidence of ptosis was 48%, subconjunctival haemorrhage 16% and hypertropia 16%. DISCUSSION: Our results suggest that those patients with smaller strabismus and a shorter time interval between onset of strabismus and botulinum injection tend to achieve better outcome in terms of fusion or ocular alignment within 10 prism dioptres of orthotropia. The treatment of strabismus with BTXA is an acceptable approach in selected patients. The procedure is simple, safe, cheap, effective, and avoids the risks of general anaesthesia. It can substitute for or eliminate the need for strabismus surgery in some cases of sixth nerve palsy.

Abducens Nerve↗
PubMed1996

The first frozen embryo donation pregnancy for hypergonadotrophic hypogonadism in Singapore--hormonal profile and obstetric outcome.

This is the first report in South East Asia of a singleton frozen embryo donation pregnancy for hypergonadotrophic hypogonadism. The hormonal profile was compared with that of a control group of normal uncomplicated singleton pregnancies in Singapore. The plasma beta hCG levels were lower compared to those of our normal uncomplicated singleton pregnancies at 2 to 3 weeks after the embryo transfer but became comparable at 4 to 5 weeks after embryo transfer. The successful vaginal delivery and the obstetric complications developed in this case are discussed.

Adult↗
PubMed2002

Microbiology of chronic suppurative otitis media in Singapore.

The objective of the study was to study the microflora and the antibiograms of patients with chronic suppurative otitis media (CSOM) in Singapore. Ninety patients with CSOM were prospectively studied. They had chronic ear discharge and had not received antibiotics for the previous five days. Swabs were taken, and cultured for bacteria. Antibiotic testing was done using modified Kirby Bauer disk diffusion method. In addition to the usual antibiotics, the three most common topically available antibiotics (chloramphenicol, gentamicin and neomycin) were tested. There were 135 positive cultures for organisms from the 90 patients. The most common causal organisms isolated were Pseudomonas aeruginosa (33.3%) and Staphylococcus aureus (33.3%) followed by coagulase negative Staphylococcus (21.1%). Fungi accounted for 8.8% of isolates while 6.6% were anaerobes. Of the three antibiotics commonly available as topical eardrops, gentamicin has the highest susceptibility rate (82.6%), followed by neomycin (67.8%) and chloramphenicol (62.8%).

Adolescent↗
PubMed2002

Efficacy and tolerability of irinotecan in patients with advanced colorectal cancer in Singapore.

INTRODUCTION: Colorectal cancer is the commonest malignancy encountered in Singapore. The long-term outcome of patients with advanced diseases is poor. For many decades, 5-fluorouracil was the only effective cytotoxic drug against colorectal cancers. Randomised trials have documented the efficacy of irinotecan in patients with metastatic colorectal cancer. We investigated the efficacy and safety profile of irinotecan (CPT-11), as a second-line treatment for an Asian population who had failed 5-fluorouracil-based chemotherapy. MATERIALS AND METHODS: A total of 33 patients were enrolled in the study between October 1996 and May 1999. This was an open label phase II study. All patients who had received at least one dose of CPT-11 were evaluated for toxicity. Thirty patients were evaluated for response. RESULTS: Six patients (20%) had partial responses and 1 (3%) experienced minor response. Fourteen patients (47%) progressed. Nine patients (30%) had stable disease. The range of time to progression was 5.8 months to 21 months. The median survival was 9.5 months. There was no treatment-related death. Seven patients (23%) who received treatment had diarrhoea. Only 2 of the 7 patients had grade 3-4 diarrhoea. Eleven patients (37%) suffered from haematological toxicity, of whom 2 patients had grade 3-4 neutropenia. CONCLUSION: We demonstrated efficacy and tolerability of CPT-11 in Singaporean patients with advanced colorectal cancer.

Adult↗
PubMed2003

Ureteroscopy as an out-patient procedure: the Singapore General Hospital Urology Centre experience.

OBJECTIVE: To study the safety and efficacy of ureteroscopy as an out-patient procedure. DESIGN: Retrospective study. SETTING: Teaching hospital, Singapore. SUBJECTS AND METHODS: Operating facilities for out-patient ureteroscopy were introduced in late 1998. A retrospective review of all patients undergoing ureteroscopy from March 1999 to December 2000 was conducted. Clinical records were reviewed for operating time, surgical outcome and complications, and length of hospital stay and re-admissions. RESULTS: Two hundred and ten patients underwent ureteroscopy for a variety of indications--115 patients were admitted to hospital as in-patients and 95 patients were treated as out-patients. Ureteroscopy and laser lithotripsy were performed using general or regional anaesthesia. Patients assessed to be American Society of Anesthesiology class I or II were eligible for an out-patient procedure. American Society of Anesthesiology class was found to be lower for those treated as out-patients compared with those undergoing in-patient procedures--63% versus 28% for class I and 36% versus 69% for class II. Mean operating time was 37 minutes for out-patient procedures and 57 minutes for in-patient procedures (P<0.01). Complications were low for out-patients, with six unplanned re-admissions, mostly for minor complications. All patients were discharged the following day. CONCLUSION: Ureteroscopy can be offered selectively as an out-patient procedure to patients with low surgical risk, especially American Society of Anesthesiology class I patients, and others expected to have an uncomplicated surgical procedure.

Adolescent↗
PubMed1992

Pasteurella multocida infection in Singapore.

A case of Pasteurella multocida infection in Singapore is presented. The patient was a 21-year-old Chinese male who developed fever and cellulitis with abscess formation of his right index finger after it was bitten by a stray cat. The organism was isolated in pure culture and identified as Pasteurella multocida subspecies septica. The patient responded to antibiotic therapy and had an uneventful recovery.

Adult↗
PubMed2003

Chest radiographic findings of a case of severe acute respiratory syndrome (SARS) in Singapore.

A new form of atypical pneumonia was reported in the East Asian region beginning from early 2003. This was later termed by the World Health Organisation as Severe Acute Respiratory Syndrome (SARS). The diagnosis of SARS relies on a combination of clinical features and chest radiographic findings. A preliminary review of SARS in Singapore shows chest radiographic findings of patchy airspace shadowing with severe cases progressing to diffuse air-space shadowing. We illustrate these findings with temporal correlation in our case report. As SARS is a contagious, rapidly progressive and potentially fatal condition, early diagnosis is crucial for prompt management and isolation of patients. Recognition of chest radiographic findings aids in the early diagnosis and containment of SARS.

Adult↗
PubMed1992

Experience with vaginal reconstruction utilizing the modified Singapore flap.

Many types of vaginal reconstruction have been described, and we have employed several with varying degrees of success. All we have used seem to have drawbacks. In April 1989 Wee and Joseph from Singapore described a technique using neurovascular pudendal-thigh flaps as islands. Initially we used the procedure as described. Later we modified the approach by releasing the labia majora, allowing them to retract somewhat anteriorly, and rotating the flap into position. This procedure has been used in eight patients, in some instances under the most adverse circumstances in patients who have undergone multiple procedures and heavy irradiation (including intraoperative radiation) besides experiencing postoperative leakage of urine. Though we have had dehiscence and problems with infection and drainage in some of our patients, no flap has failed, contour is exceptionally good, and potential for function is satisfactory. The procedure requires less time and produces better results than any other technique employed by us in the more than 30 vaginal reconstructions we have carried out. The technique will be illustrated and clinical cases will be presented.

Adolescent↗
PubMed1992

An epidemiological survey of respiratory morbidity among granite quarry workers in Singapore: chronic bronchitis and lung function impairment.

Respiratory symptoms of chronic bronchitis and measurements of lung function were studied in an epidemiological survey of the total population of workers currently employed in granite quarries in Singapore. There were 85 rock drilling and crushing workers with current exposure in high levels of silica dust. Their respiratory parameters were studied with reference to an internal comparison group of 154 quarry maintenance and transport workers with low dust exposure, and an external comparison group of 148 Telecoms postal delivery workers with no granite dust exposure. The highly exposed workers showed greater prevalences of chronic cough and phlegm, a mean reduction of 5% in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The increased respiratory morbidity were independent of other factors such as age and smoking. Similar results were also noted after excluding those with silicosis (defined radiologically as profusion greater than 1/1 as read by at least two of three readers). This study strongly indicates a demonstrable risk of "occupational" bronchitis (mucus hypersecretion) and obstructive and restrictive lung function impairment, apart from the "classical" risk of silicosis. Measures taken to protect the health of workers exposed to silica dust should also be based on considerations taken to protect against the risk of these respiratory disorders as well.

Adult↗
PubMed2005

Community psychiatry in Singapore: a pilot assertive community treatment (ACT) programme.

Severe mental illnesses cause their sufferers dismal functional impairment. The Global Burden of Disease lists schizophrenia among the top 10 contributors to health burden and disability around the world. In the Institute of Mental Health (IMH) of Singapore, 9 out of 10 Class-C beds are occupied by patients whose hospitalisation periods last 300 days on average. Whilst de-institutionalisation has not seen its expected level of success overseas, the provision of community-based psychiatric care has been shown to be more cost-effective than hospital-based inpatient care. As such, there is a need for increased emphasis on community psychiatric services, both to provide and to effectively utilise available resources to assist patients with severe mental illnesses in living and functioning within the community. In line with several other efforts, a pilot Assertive Community Treatment or ACT Programme was launched by IMH in November 2003. This article details the aims, set-up and services of this pilot project funded by the Health Service Development Programme (HSDP) for 3 years, which receives referrals from IMH psychiatrists. With the services provided by the ACT team including psychosocial rehabilitation, it is hoped that patients will continue to receive adequate psychiatric care as well as maintain sufficient skills for self-care and independent living within the community despite the well-documented deteriorating course of psychotic illnesses like schizophrenia.

Behavior Therapy↗
PubMed2005

Mesenchymal stem cells in musculoskeletal tissue engineering: a review of recent advances in National University of Singapore.

A key factor in the tissue engineering approach to tissue repair and regeneration is the use of appropriate cells. Mesenchymal stem cells (MSCs) are derived from bone marrow stroma or connective tissues and they have the potential to differentiate into various mesenchymal cell lines in vitro and in vivo. These cells hold great promise for musculoskeletal tissue engineering. This review is based mainly on the work which has been done in the National University of Singapore on the use of MSCs for engineering cartilage, growth plate, bone and tendon/ligament as well as the clinical trail of autologous chondrocyte implantation. It can help to shape future research on musculoskeletal tissue engineering.

Animals↗
PubMed2005

Preparing the biochemistry laboratory for the next outbreak: lessons from SARS in Singapore.

Severe acute respiratory syndrome (SARS) is an emerging disease characterised by fever and atypical pneumonia and caused by a novel coronavirus. Singapore was affected by the global pandemic in early 2003, with 238 cases and 33 deaths. Samples sent to the biochemistry laboratory made up the majority (69%) of all SARS samples, yet remained a minority (29%) of total biochemistry workload. This paper describes the problems encountered and solutions adopted by the biochemistry laboratory at the designated SARS hospital in coping with this epidemic. It provides practical advice for laboratories planning for the handling of samples from future outbreaks.

Journal Article↗
PubMed1991

Seroprevalence of antibodies to the hepatitis C virus in Singapore.

The prevalence of antibodies to the hepatitis C virus (anti-HCV) in Singapore was assessed using a recombinant-based enzyme linked immunoassay system. 1004 serum samples were obtained from normal subjects (463), hemodialysis patients (112), hepatitis B virus (HBV) carriers (188), patients with hepatocellular carcinoma (HCC) (58) and patients with non-hepatitis B virus related liver diseases (183). Anti-HCV was found to be positive in 1.7% of healthy subjects, and in 20% of patients on regular hemodialysis. Three percent of HBV carriers were positive for anti-HCV. Twelve percent of patients with acute hepatitis with no known causes and 20% patients with chronic hepatitis with no known causes were positive for anti-HCV. Among patients with cirrhosis for which no known causes were found 33% were positive for anti-HCV. Thirty six percent of patients with HCC not associated with the presence of HBsAg were positive of anti-HCV. None of the patients with known causes of liver disease were positive for anti-HCV.

Adolescent↗