1.Cross-reaction of Sera from COVID-19 Patients with SARS-CoV Assays.
Wei Yee WAN ; Siew Hoon LIM ; Eng Hong SENG
Annals of the Academy of Medicine, Singapore 2020;49(7):523-526
Antibodies, Viral
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physiology
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Betacoronavirus
;
physiology
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Clinical Laboratory Techniques
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Coronavirus Infections
;
diagnosis
;
Cross Reactions
;
physiology
;
Enzyme-Linked Immunosorbent Assay
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Fluorescent Antibody Technique, Indirect
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Humans
;
Pandemics
;
Pneumonia, Viral
;
diagnosis
;
SARS Virus
;
physiology
2.Simple method for assessing standing height using recumbent length in bedridden patients using soft and firm mattresses
Wong Wei Yee ; Lim Su Lin ; Chan Yiong Huak
Malaysian Journal of Nutrition 2019;25(1):37-45
Introduction: The accurate measurement of the height of bedridden patients is difficult. Height assessment is required for the calculation of body mass index, which is crucial for determining the nutrition status of a patient. This study aimed to validate recumbent length measurement against the standing height measurement using soft and firm mattresses and to derive predictive equations to calculate the actual height of bedridden patients on mattresses with different firmness.
Methods: Ninety-nine hospitalised participants (mean age 48.9±13.9 years; range 21–80 years) (49 men, 50 women) and 100 healthy participants (mean age 36.8±13.6 years; range 21–77 years) (50 men, 50 women) were recruited. Standing height was measured using a stadiometer. Recumbent length was measured using a 2 metre long measuring tape. Hospitalised participants lay on soft mattress and healthy participants on firm mattress.
Results: Using Bland–Altman plot, 96% of hospitalised participants using soft mattress were within 2.5±2.7 cm (mean±2SD) whereas 97% of healthy participants using firm mattress were within 2.1±2.1 cm. The regression equation developed using firm mattress was Standing height (cm) = 0.993 x Recumbent length – 0.943; (r2=0.982). The regression equation developed using soft mattress was Standing height (cm) = 1.012 x Recumbent length – 4.477; (r2=0.981).
Conclusion: We concluded that recumbent length is a valid clinical tool to estimate standing height. Standing height can be estimated from the predictive equations developed for patients lying on soft or firm mattresses.
3.Treating acutely ill patients at home: Data from Singapore.
Stephanie Q KO ; Joel GOH ; Yee Kian TAY ; Norshima NASHI ; Benjamin M Y HOOI ; Nan LUO ; Win Sen KUAN ; John T Y SOONG ; Derek CHAN ; Yi Feng LAI ; Yee Wei LIM
Annals of the Academy of Medicine, Singapore 2022;51(7):392-399
INTRODUCTION:
Hospital-at-home programmes are well described in the literature but not in Asia. We describe a home-based inpatient substitutive care programme in Singapore, with clinical and patient-reported outcomes.
METHODS:
We conducted a retrospective cohort study of patients admitted to a hospital-at-home programme from September 2020 to September 2021. Suitable patients, who otherwise required hospitalisation, were admitted to the programme. They were from inpatient wards, emergency department and community nursing teams in the western part of Singapore, where a multidisciplinary team provided hospital-level care at home. Electronic health record data were extracted from all patients admitted to the programme. Patient satisfaction surveys were conducted post-discharge.
RESULTS:
A total of 108 patients enrolled. Mean age was 67.9 (standard deviation 16.7) years, and 46% were male. The main diagnoses were skin and soft tissue infections (35%), urinary tract infections (29%) and fluid overload (18%). Median length of stay was 4 (interquartile range 3-7) days. Seven patients were escalated back to the hospital, of whom 2 died after escalation. One patient died at home. There was 1 case of adverse drug reaction and 1 fall at home, and no cases of hospital-acquired infections. Patient satisfaction rates were high and 94% of contactable patients would choose to participate again.
CONCLUSION
Hospital-at-home programmes appear to be safe and feasible alternatives to inpatient care in Singapore. Further studies are warranted to compare clinical outcomes and cost to conventional inpatient care.
Aftercare
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Aged
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Female
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Hospitalization
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Humans
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Length of Stay
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Male
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Patient Discharge
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Retrospective Studies
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Singapore
4.Pericarditis and myocarditis after COVID-19 mRNA vaccination in a nationwide setting.
Jonathan YAP ; Mun Yee THAM ; Jalene POH ; Dorothy TOH ; Cheng Leng CHAN ; Toon Wei LIM ; Shir Lynn LIM ; Yew Woon CHIA ; Yean Teng LIM ; Jonathan CHOO ; Zee Pin DING ; Ling Li FOO ; Simin KUO ; Yee How LAU ; Annie LEE ; Khung Keong YEO
Annals of the Academy of Medicine, Singapore 2022;51(2):96-100
INTRODUCTION:
Despite reports suggesting an association between COVID-19 mRNA vaccination and pericarditis and myocarditis, detailed nationwide population-based data are sparsely available. We describe the incidence of pericarditis and myocarditis by age categories and sex after COVID-19 mRNA vaccination from a nationwide mass vaccination programme in Singapore.
METHODS:
The incidence of adjudicated cases of pericarditis and myocarditis following COVID-19 mRNA vaccination that were reported to the vaccine safety committee between January to July 2021 was compared with the background incidence of myocarditis in Singapore.
RESULTS:
As of end July 2021, a total of 34 cases were reported (9 pericarditis only, 14 myocarditis only, and 11 concomitant pericarditis and myocarditis) with 7,183,889 doses of COVID-19 mRNA vaccine administered. Of the 9 cases of pericarditis only, all were male except one. The highest incidence of pericarditis was in males aged 12-19 years with an incidence of 1.11 cases per 100,000 doses. Of the 25 cases of myocarditis, 80% (20 cases) were male and the median age was 23 years (range 12-55 years) with 16 cases after the second dose. A higher-than-expected number of cases were seen in males aged 12-19 and 20-29 years, with incidence rates of 3.72 and 0.98 case per 100,000 doses, respectively.
CONCLUSION
Data from the national registry in Singapore indicate an increased incidence of pericarditis and myocarditis in younger men after COVID-19 mRNA vaccination.
Adolescent
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Adult
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COVID-19/prevention & control*
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COVID-19 Vaccines/adverse effects*
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Child
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Female
;
Humans
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Male
;
Middle Aged
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Myocarditis/etiology*
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Pericarditis/etiology*
;
RNA, Messenger
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SARS-CoV-2
;
Vaccination/adverse effects*
;
Vaccines, Synthetic
;
Young Adult
;
mRNA Vaccines
5.Intravascular large B-cell lymphoma presenting as panniculitis clinically: a case report.
Yee Wei PHOON ; Xuling LIN ; T THIRUMOORTHY ; Soo Yong TAN ; Hwei Yee LEE ; Soon Thye LIM ; Haur Yueh LEE
Singapore medical journal 2018;59(3):163-164
Biopsy
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CD79 Antigens
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metabolism
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Central Nervous System
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Diagnosis, Differential
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Female
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Humans
;
Immunohistochemistry
;
Inflammation
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Ki-67 Antigen
;
metabolism
;
Lymphoma, Large B-Cell, Diffuse
;
diagnosis
;
Magnetic Resonance Imaging
;
Middle Aged
;
Panniculitis
;
diagnostic imaging
;
Prognosis
6.A population-based survey of mental disorders in Singapore.
Siow Ann CHONG ; Edimansyah ABDIN ; Janhavi Ajit VAINGANKAR ; Derrick HENG ; Cathy SHERBOURNE ; Mabel YAP ; Yee Wei LIM ; Hwee Bee WONG ; Bonnie GHOSH-DASTIDAR ; Kian Woon KWOK ; Mythily SUBRAMANIAM
Annals of the Academy of Medicine, Singapore 2012;41(2):49-66
INTRODUCTIONMental illnesses are not only a growing public health concern but also a major social and economic issue affecting individuals and families throughout the world. The prevalence of mental disorders, the extent of disability caused by these disorders, and services utilisation of these patients has been well studied in developed countries. The aim of this study was to establish the prevalence of select mental disorders and their associated sociodemographic correlates in the adult Singapore resident population.
MATERIALS AND METHODSThis was a cross-sectional, populationbased, epidemiological study of adult Singapore residents aged 18 years and above. The subjects were randomly selected using a disproportionate stratified sampling method. The diagnoses of selected mental disorders including major depressive disorder (MDD), dysthymia, bipolar (bipolar I & II) disorders, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), alcohol abuse and alcohol dependence were established using the Composite International Diagnostic Interview, which is a fully structured diagnostic instrument that assesses lifetime and 12-month prevalence of mental disorders.
RESULTSAmong the 6616 respondents (response rate of 75.9%), 12.0% had at least one lifetime affective, anxiety, or alcohol use disorders. The lifetime prevalence of MDD was 5.8% and that of bipolar disorder was 1.2%. The combined lifetime prevalence of the 2 anxiety disorders, GAD and OCD was 3.6%, with the latter being more common than GAD (0.9% and 3.0% respectively). The lifetime prevalence of alcohol abuse and dependence were found to be 3.1% and 0.5% respectively. Age, gender, ethnicity, marital status and chronic physical illnesses were all significant correlates of mental disorders.
CONCLUSIONThe identified associated factors would help guide resource allocation, policy formulation and programme development in Singapore.
Adolescent ; Adult ; Aged ; China ; ethnology ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Male ; Mental Disorders ; classification ; diagnosis ; epidemiology ; ethnology ; Middle Aged ; Risk Assessment ; Singapore ; epidemiology ; Young Adult
7.The efficacy of influenza vaccination in healthcare workers in a tropical setting: a prospective investigator blinded observational study.
Si Wei KHEOK ; Chia Yin CHONG ; Grace MCCARTHY ; Wai Yee LIM ; Khean Teik GOH ; Lubna RAZAK ; Nancy W S TEE ; Paul Ananth TAMBYAH
Annals of the Academy of Medicine, Singapore 2008;37(6):465-469
INTRODUCTIONInfluenza vaccine has been shown to be highly effective in temperate regions with well-defined seasonal influenza. Healthcare workers (HCWs) are advised to receive regular influenza vaccination to protect themselves and their patients. However, there are limited data on the efficacy of influenza vaccine in HCWs in the tropics.
MATERIALS AND METHODSIn this observational, investigator blinded cohort study, bi-monthly questionnaires recording influenza-like illness (ILI) episodes and medical leave were administered to 541 HCWs at the Singapore National University Hospital and KK Women's and Children's Hospital from 2004 to 2005. ILI was defined according to a standard symptom score.
RESULTSBaseline characteristics were comparable in both the vaccinated and non-vaccinated groups. Overall, the relative risk of self-reported ILI in vaccinated HCWs was 1.13 [95% confidence interval (CI), 0.98-1.13; P=0.107]; medical leave taken was lower in the vaccinated group [mean 0.26+/-0.6 days per visit, compared with 0.30+/-0.5 days in the non-vaccinated group (P=0.40)]. Because of the reported Northern Hemisphere 2003/04 vaccine mismatch, we stratified the cohort and determined that the group which received a matched vaccine had a relative risk of ILI of 0.49 (95% CI, 0.37-0.66; P<0.001), achieving a vaccine efficacy of 51%. Mean medical leave decreased significantly in HCWs who received the matched vaccine, compared with those who did not receive vaccination (0.13+/-0.3 vs 0.30+/-0.5; P<0.001) and with HCWs vaccinated with mismatched strains (0.13+/-0.3 vs 0.39+/-0.9; P=0.01).
CONCLUSIONSA well-matched influenza vaccine is effective in preventing ILI and reducing sickness absence in healthcare workers in tropical settings. Efforts need to be made to increase influenza vaccination rates and to improve the currently available vaccines.
Adult ; Attitude of Health Personnel ; Cohort Studies ; Confidence Intervals ; Female ; Health Personnel ; statistics & numerical data ; Humans ; Influenza Vaccines ; Influenza, Human ; epidemiology ; prevention & control ; Male ; Occupational Exposure ; Occupational Health ; Prospective Studies ; Risk ; Singapore ; epidemiology ; Single-Blind Method ; Surveys and Questionnaires ; Tropical Climate
8.Hypertension management and lifestyle changes following screening for hypertension in an Asian low socioeconomic status community: a prospective study.
Liang En WEE ; Jolene WONG ; Run Ting CHIN ; Zhi Yong LIN ; Daniel E Q GOH ; Kalpana VIJAKUMAR ; Kiat Yee VONG ; Wei Ling TAY ; Hui Ting LIM ; Gerald C H KOH
Annals of the Academy of Medicine, Singapore 2013;42(9):451-465
INTRODUCTIONThis study investigated the effect of an access-enhanced intervention on hypertension screening and management, as well as on health behaviours among newly diagnosed hypertensives, in a multi-ethnic low socioeconomic status (SES) community. Factors associated with hypertension screening, treatment, and control in the community were also determined.
MATERIALS AND METHODSThe study involved all residents aged ≥40 years in 2 public rental housing precincts (low SES), between 2009 and 2011, who were followed-up prospectively for 1 year after a 6-month community-based intervention comprising a 3-month access-enhanced screening component and a 3-month follow-up (outreach) component. Blood pressure was measured at baseline and follow-up. Multivariate Cox regression determined predictors of hypertension management at follow-up.
RESULTSThe follow-up rate was 80.9% (467/577). At baseline, 60.4% (282/467) were hypertensive; 53.5% (151/282) were untreated; 54.2% (71/131) uncontrolled. One year later, postintervention, 51.6% (78/151) of untreated hypertensives were treated; combined with treated hypertensives previously uncontrolled, 53.0% (79/149) achieved control. Older age independently predicted treatment (adjusted relative risk, aRR = 1.98, CI, 1.08 to 3.65); majority ethnicity (aRR = 1.76, CI, 1.05 to 2.96), employment (aRR = 1.85, CI, 1.26 to 2.80) and newly treated hypertension (aRR=1.52, CI, 1.01 to 2.32) predicted control. A total of 52.4% (97/185) were irregularly screened at baseline; at follow-up 61.9% (60/97) were regularly screened. Cost and misperceptions were common barriers to screening and treatment. Newly diagnosed hypertensives were also less likely to go for additional cardiovascular screening (aRR = 0.54, CI, 0.29 to 0.99).
CONCLUSIONAn access-enhanced intervention had some success in improving hypertension management within low SES communities; however, it was less successful in improving cardiovascular risk management, especially in encouraging lifestyle changes and additional cardiovascular screening amongst newly diagnosed hypertensives.
Adult ; Age Factors ; Aged ; Antihypertensive Agents ; therapeutic use ; Asian Continental Ancestry Group ; statistics & numerical data ; Diet, Sodium-Restricted ; methods ; Exercise Therapy ; methods ; Female ; Health Services Accessibility ; statistics & numerical data ; Humans ; Hypertension ; diagnosis ; ethnology ; therapy ; Male ; Mass Screening ; Middle Aged ; Multivariate Analysis ; Patient Compliance ; ethnology ; statistics & numerical data ; Patient Dropouts ; statistics & numerical data ; Poverty ; statistics & numerical data ; Proportional Hazards Models ; Prospective Studies ; Risk Reduction Behavior ; Singapore ; Smoking Cessation ; methods ; Social Class ; Treatment Outcome ; Weight Reduction Programs ; methods
9.Impact of Knowledge and Attitudes on Lifestyle Practices in Preventing Type 2 Diabetes Mellitus.
Benson Wg ANG ; Mui Yee TAN ; Cheryl My GOH ; Sylwan RAHARDJA ; Beatrice Y LIM ; Wenqi CHIEW ; Thurston Yj HENG ; Kuang Ian TAN ; Jenies Hx FOO ; Sarah Zl THAM ; Jason Ks CHNG ; Wei Jie SEOW ; Nan LUO
Annals of the Academy of Medicine, Singapore 2019;48(8):247-263
INTRODUCTION:
Diabetes mellitus is a major public health issue in Singapore. To shape healthcare policies for the primary prevention of diabetes, it is crucial to understand Singaporeans' knowledge, attitudes and practices related to diabetes and its prevention. This study aimed to assess the knowledge, attitudes and lifestyles of individuals without diabetes.
MATERIALS AND METHODS:
A cross-sectional household survey was performed between 31 January to 3 February 2019 to examine knowledge, attitudes and practices related to diabetes. Inclusion criteria of the participants included: 1) Singaporeans/permanent residents, 2) between 30 to 64 years old, and 3) who did not have a diagnosis of diabetes. Logistic and linear regression models were used to analyse the association of knowledge and attitudes with physical activity and diet habits, respectively.
RESULTS:
Among 806 participants, 72.2% did not meet the Health Promotion Board's physical activity recommendation. Physical activity was associated with better diabetes knowledge (odds ratio [OR] 5.38, 95% confidence interval [CI] = 1.65-17.53, = 0.049), stronger beliefs in diabetes prevention (OR 3.36, 95% CI = 1.02-11.12, = 0.047) and lower levels of worry about diabetes (OR 0.41, 95% CI 0.17-1.00, = 0.049). Neither knowledge nor beliefs or worries about diabetes was associated with diet.
CONCLUSION
There is a need to reinforce the importance of physical activity and healthy diet in preventing diabetes. Although improving the knowledge level of diabetes may increase physical activity of the population, it is unlikely to improve dietary choices without effective behavior change interventions.