SEARCH · Search PubMed
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.
Explore the source record for details and available documents.
We analyzed all penetrating keratoplasties performed in the Singapore National Eye Centre from 1 January 1991 to 31 December 1995, using records of the Singapore Eye Bank Registry, evaluating the indications, complications, causes of graft failure, visual outcome and graft survival rate. We also looked into donor cornea acquisition in the Singapore Eye Bank and its influence on the development of corneal transplantation in the Singapore National Eye Centre. A total of 327 penetrating keratoplasties were performed during the 5-year period. Bullous keratopathy was an indication in 26.3% of cases. Of these, aphakic bullous keratopathy accounted for 11.6% of all cases, while pseudophakic bullous keratopathy accounted for 11.3%. Other indications were regrafts (11.9%), corneal dystrophies (10.4%), traumatic corneal scarring (10.1%) and keratoconus (9.8%). Graft rejection was a complication in 20% of all cases. Of these, 40.9% led to graft failure. Other major complications were raised intraocular pressure (18%), epithelium-related problems (7.3%), wound dehiscence (4.3%), cataract (3.3%) and microbial keratitis (3.1%). The main causes of graft failure were graft rejection (8.2%), endothelial failure (2.4%), infection (2.4%) and glaucoma (2.1%). Of the 327 grafts, 40.3% achieved best corrected visual acuity of 6/12 or better; 70.8% achieved vision of 6/24 or better. The overall graft survival rate was 82.3% after a mean follow-up period of 2 years. Donor corneas for the penetrating keratoplasties were obtained from foreign eye banks as well as locally, with the local donation rate steadily increasing from 1991 to 1996, with the establishment of proper eye banking facilities and the Singapore Eye Bank. These results show that the indications and outcome of penetrating keratoplasty in the Singapore National Eye Centre are similar and comparable to that of other centres with established corneal grafting programmes. The establishment of the Singapore Eye Bank has ensured the proper co-ordination of acquisition of donor material which has been vital to the development of corneal transplantation in the Singapore National Eye Centre.
The prevalence of diabetes mellitus in Singapore has increased from 1.9% in 1975 to 8.6% in 1992. The prevalence among Singaporeans aged 30 to 69 is 12%. Diabetes mellitus in Singapore is mainly of the non-insulin dependent type. Diabetes mellitus has been identified as a priority health program in the Singapore Government's National Health Agenda for the 1990s. The Ministry of Health appointed the National Diabetes Commission (NDC) as an expert panel to review and provide advice on measures to prevent and control diabetes in Singapore. The NDC, in consultation with a large number of physicians and health care professionals in Singapore and in reference to established guidelines from developed centres around the world, has drawn up the Singapore Practice Guidelines. These are mainly aimed at primary health physicians and members of the Diabetes Health Care Team who manage diabetics in Singapore. Specific issues in the diagnosis and management of non-insulin dependent diabetes, pregnancy, the elderly and insulin dependent diabetes in the young are addressed. The prevention and management of the acute and chronic complications of diabetes are also included as these are important causes of morbidity among diabetics and contribute to increased health care costs. The role of the Diabetes Health Care Team comprising the physician, nurse educator and dietitian is considered to be central to good management of diabetes. Specific targets for control are set out.
The Denver Developmental Screening Test, Singapore (DDST, Singapore), a Singapore version of the Denver II Developmental Screening Test, was field-tested, using trained staff nurses as testers, on 2459 children (known cases excluded), in 5 key ages of 3 months, 9 months, 17 months, 37 months and 60 months. Only 2.6% (65) of the parents suspected developmental problems in their children before screening. Taking children with "questionable" (7.2%), "abnormal" (3.7%) and "untestable" (1.7%) scores as the screened-out cases, the DDST, Singapore had a screened-out rate of 12.6%. A total of 171 screened-out cases and 168 "normal" children were also evaluated by the Development Assessment Clinic (DAC) of the Singapore General Hospital and the results were compared in these 2 groups of children. Among the screened-out cases, 16.6% were confirmed or suspected to have neuro-developmental disorders (NDDs) by the DAC. The computed NDD rate in the study sample was 5.3%. Based on a single DDST, Singapore test result, there was a high false positive rate of 83.5% and lower false negative rate of 3.7% compared to the DAC assessment. However, the high false positive rate would be significantly reduced by doing a repeat screening test on the "questionable" cases and having the screened-out cases assessed by trained primary health care doctors. In conclusion, no major revision is needed in the scoring criteria suggested in the current version of DDST, Singapore. It is a useful tool in identifying children who will otherwise be missed without formal screening.
INTRODUCTION: This is the first prospective cohort study in Singapore to describe the incidence of ischaemic heart disease (IHD) and stroke among Chinese, Malays and Asian Indians. MATERIALS AND METHODS: The Singapore Cardiovascular Cohort Study is a longitudinal follow-up study on a general population cohort of 5920 persons drawn from 3 previous cross-sectional surveys. Morbidity and mortality from IHD and stroke were ascertained by record linkage using a unique identification number with the death registry, Singapore Myocardial Infarct Registry and in-patient discharge databases. RESULTS: There were 193 first IHD events and 97 first strokes during 52,806 person-years of observation. The overall incidence of IHD was 3.8/1000 person-years and that of stroke was 1.8/1000 person-years. In both males and females, Indians had the highest IHD incidence, followed by Malays and then Chinese. For males after adjusting for age, Indians were 2.78 times (95% CI 1.86, 4.17; P < 0.0001) and 2.28 times (95% CI 1.34, 3.88; P = 0.002) more likely to get IHD than Chinese and Malays respectively. For females after adjusting for age, Indians were 1.97 times (95% CI 1.07, 3.63; P = 0.03) and 1.37 times (95% CI 0.67, 2.80; P = 0.39) more likely to get IHD than Chinese and Malays respectively. For stroke, male Chinese and Indians had higher incidence than Malays (though not statistically significant). However, in females, Malays had the highest incidence of stroke, being 2.57 times (95% CI 1.31, 5.05; P = 0.008) more likely to get stroke than Chinese after adjustment for age. CONCLUSIONS: This prospective study of both mortality and morbidity has confirmed the higher risk of IHD in Indians. It has also found that Malay females have a higher incidence of stroke, which deserves further study because of its potential public health importance.
OBJECTIVES: To investigate the major primary and contributory causes of death among HIV patients in Singapore. DESIGN: A retrospective observational cohort study of all adult patients seen at the national referral centre for HIV in Singapore between 1985 and 2001. METHODS: Data were extracted from the patients' records by 10 trained health care workers. AIDS-defining conditions were established using predefined criteria. For each case, a single principal cause of death and up to three contributory causes were identified. RESULTS: A total of 1504 patients aged 17 years or over were seen before the end of 2001, of whom 504 have died. The most frequent principal causes of death were Mycobacterium avium (17.5%), Mycobacterium tuberculosis (9.7%), pneumonia (cause unknown) (6.5%) and Cryptococcus neoformans (6.7%). Three hundred and eighteen patients (63.1%) died from an AIDS-defining condition. CONCLUSIONS: The causes of death were similar to those found in Western cohorts, except that disseminated M. avium was a more frequent cause of death.
The Diabcare-Singapore project was carried out in 22 clinics (general hospitals, GH and primary healthcare centres, PHC) to provide an overview of diabetes management and metabolic control status. Data from 1697 diabetic patients were collected on paper forms and analysed centrally. Type 2 diabetes mellitus patients constituted 91.4% and type I patients constituted 8.1% of population. The proportion of type I patients was greater in GH (18.1%) vs PHC (3.4%). The mean age (+/- SD) was 58.1 +/- 14.4 years and mean duration of diabetes was 10.1 +/- 7.5 years. Mean body mass index (BMI) was 25.1 +/- 4.4 kg/m2 and more than half (53%) of patients were overweight (BMI >25 kg/m2). Mean HbA1c and FBG levels were 8.0 (1.9% and 9.1 +/- 3.1 mmol/l. A total of 51% of patients had HbA1c (1% above the Upper Limits of Normal (ULN). Fasting blood glucose (FBG) was >7.8 mmol/l in 61% of patients. The majority (70%) had satisfactory levels of fasting lipids (triglycerides, total cholesterol and HDL-cholesterol). Only 19.7% practised home blood glucose self-monitoring, while 99% reported receiving some diabetes education. Sixteen percent of patients had abnormal levels of protein (>500 mg/24 h) in the urine, 3% had elevated serum creatinine levels and 36% had microalbuminuria. Retinopathy (12%), cataract (16%) and neuropathy (12%) were commonly reported diabetic complications. The data revealed suboptimal glycaemic control in about half of patients studied.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The Gastroenterological Society Working Party on Helicobacter pylori (H pylori) recommends eradication of H pylori in patients with peptic ulcer, provided H pylori infection has been demonstrated. H pylori treatment is not indicated for non-ulcer dyspepsia, histological gastritis or mere demonstration of H pylori infection. H pylori infection can be demonstrated by a urease test, culture or histological assessment on gastric antral biopsy or by a 13C and 14C urea breath test: serology is acceptable if validated in the local population. There are many eradication regimens for H pylori infection and follow-up assessments to demonstrate eradication is desirable.
Non-ulcer dyspepsia (NUD) is a common symptom whose cause is currently unclear. Helicobacter pylori (H pylori) infection is found in half of all patients with NUD but other pathophysiological abnormalities eg delayed gastric emptying, have also been described. NUD patients with or without H pylori infection have identical symptom patterns and pathophysiological parameters. Studies on the efficacy of H pylori treatment in NUD give equivocal results to date. We therefore do not recommend treatment for H pylori in NUD.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.