1.Presence of pathogenic candidal hyphae in patients with palatal coverage appliances/prostheses
Archives of Orofacial Sciences 2019;14(1):30-39
Oral candidiasis is an opportunistic infection of the oral cavity. This study aimed to determine
prevalence of oral candidiasis in patients with palatal coverage orthodontic appliances and prostheses and its risk
factors. Three groups of patients were recruited after an informed consent. The two tested groups were the
denture and the upper removable orthodontic appliance (URA) groups while patients with no prosthesis/appliance
acted as control. The assessments included demographic profile, denture/URA age, night-time wearing and
duration of wearing. Signs and symptoms of candidiasis were examined intra-orally. Unstimulated salivary flow
rate test was also performed. Smears samples were taken from palatal mucosa and impression surfaces of
denture/URA and stained with Periodic Acid Schiff (PAS). The data were analysed using descriptive and chisquare tests. A total of 86 patients were recruited; denture (n=30), URA (n=22), control (n=34). Denture and URA
groups had significantly more positive cases of candidal infection (56.7 and 72.7% respectively) as compared to
control group (20.6%). Among the subjects with oral candidiasis, denture patients were detected to have more
severe amount of candidal hyphae (20%) than URA (13.6%) group. The relationships between oral candidiasis
and these risk factors i.e. age, night-time wearing, daily total hours of wearing and denture/URA hygiene were
statistically significant (p<0.05). Thus, patients who are wearing palatal coverage removable appliances or
prostheses have higher prevalence of oral candidiasis. The risk is greater with confounding factors such as age,
duration of wearing and oral hygiene
2.Incidence of phantom limb phenomena after lower limb amputations in a Singapore tertiary hospital.
Eliza I-Lin SIN ; Sze Ying THONG ; Keah-How POON
Singapore medical journal 2013;54(2):75-81
INTRODUCTIONPhantom limb sensations (PLS), phantom limb pain (PLP) and stump pain (SP) are well-recognised postamputation phenomena. However, there is a dearth of related epidemiological data in Asian populations. This study was conducted to fill the information gap.
METHODSTelephone interviews were conducted with patients who underwent lower limb amputations at a tertiary hospital in Singapore. Information was obtained on phantom limb characteristics, perioperative pain and functional assessment.
RESULTSA total of 159 patients underwent amputations over a 31-month period. At the time of the interview, 47 patients had died and 66 were contactable, of whom 49 patients were interviewed. Of these, 31 (63%) patients experienced PLS. 22 patients had postoperative pain, with 9 having both PLP and SP, 3 having PLP alone and 10 having SP alone. Among the 12 patients with PLP, at least 6 (50%) experienced constant or daily pain and 7 (58%) scored their pain as moderate-to-severe. Among those with PLP and/or SP (n = 22), 5 were distressed by the pain, 11 were on analgesics and 3 received medical follow-up. 7 (32%) patients reported functional limitations secondary to PLP or SP. Altogether, 28 (57%) patients were wheelchair or bed bound.
CONCLUSIONThe incidence of PLP was 25% in our cohort. Although this is lower than that reported in other studies, it remains significant, as some patients suffered moderate-to-severe pain. The difference in incidence may be due to differences in the ethnic composition and/or indications for amputation in our group. Follow-up and care could improve the outcomes in these patients.
Adult ; Aged ; Aged, 80 and over ; Amputation ; adverse effects ; Cohort Studies ; Disabled Persons ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pain, Postoperative ; Phantom Limb ; epidemiology ; etiology ; Risk Factors ; Singapore ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult
3.Cross-reactivity of pink peppercorn in cashew and pistachio allergic individuals
Joan Jue Ying TOO ; Lynette Pei Chi SHEK ; Mohana RAJAKULENDRAN
Asia Pacific Allergy 2019;9(3):e25-
BACKGROUND: The Pink peppercorn belongs to the same Anacardiaceae family as cashew and pistachio. However, the cross-reactivity of pink peppercorn with cashew and pistachio has yet to be studied. To date, there has been a single case report of anaphylaxis to pink peppercorn in a cashew and pistachio allergic individual. OBJECTIVE: We aim to demonstrate cross-sensitization to pink peppercorn in cashew and/or pistachio allergic children. METHODS: A small descriptive cohort study looking at cross-sensitization of pink peppercorn in cashew and/or pistachio allergic children was conducted. Children with a history of reaction to pistachio and/or cashew nut underwent skin prick tests to the pink peppercorn species Schinus terebinthifolius to determine cross-sensitization. RESULTS: Out of the 21 cashew and/or pistachio allergic subjects, 16 (76.2%) demonstrated cross-sensitization to pink peppercorn. None of the subjects had any knowledge of previous exposure or allergic reactions to pink peppercorn. DISCUSSION: This study demonstrates potential cross-reactivity between pink peppercorn and cashew and pistachio. While an oral food challenge to pink peppercorn would have been important in demonstrating clinical cross-reactivity, this was not performed due to ethical constraints. We hope to increase the awareness of pink peppercorn as a potential and hidden source of allergen and encourage further studies to demonstrate the clinical cross-reactivity and to better delineate the major allergen involved.
Anacardiaceae
;
Anacardium
;
Anaphylaxis
;
Child
;
Cohort Studies
;
Cross Reactions
;
Food Hypersensitivity
;
Hope
;
Humans
;
Hypersensitivity
;
Nuts
;
Pistacia
;
Skin
4.Child maltreatment syndrome: demographics and developmental issues of inpatient cases.
Xin Ying NGIAM ; Ying Qi KANG ; Ramkumar AISHWORIYA ; Jennifer KIING ; Evelyn Chung Ning LAW ;
Singapore medical journal 2015;56(11):612-617
INTRODUCTIONThis study aimed to describe the demographic, social, developmental and behavioural profile of children hospitalised for alleged child maltreatment syndrome (CMS).
METHODSThis study was a retrospective review of the consecutive inpatient records of children (0-16 years) admitted to the National University Hospital, Singapore, for alleged CMS over a three-year period. Descriptive data on the demographic characteristics, alleged maltreatment, medical and developmental histories, and family background of these children were collected and analysed. Chi-square statistics were used to test whether family factors were associated with the type of maltreatment and the presence of developmental disorders.
RESULTSA total of 89 children, who accounted for 90 admission cases, were studied. Physical abuse (70.0%) was the most common, followed by neglect (11.1%) and sexual abuse (7.8%). Child protection services had already been involved in 29.2% of the cases prior to the child's admission. Children who were victims of abuse were more likely to come from homes with a prior history of domestic violence (p = 0.028). Financial difficulty was found to be a risk factor for neglect (p = 0.005). Among the 89 children, 15.7% were found to have developmental disorders and 10.1% had mental health diagnoses. Children who had developmental disorders were more likely to have a parent with a mental health disorder (p = 0.002).
CONCLUSIONA sizeable proportion of the children admitted for alleged CMS had developmental or behavioural disorders. Clinicians have a role in ensuring that these children have appropriate follow-up plans. Children from high-risk families should be screened for maltreatment.
Adolescent ; Child ; Child Abuse ; statistics & numerical data ; Child, Abandoned ; statistics & numerical data ; Child, Institutionalized ; statistics & numerical data ; Child, Orphaned ; statistics & numerical data ; Child, Preschool ; Developmental Disabilities ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Inpatients ; statistics & numerical data ; Male ; Poverty ; Prevalence ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology
7.Apnoeic and Hypopnoeic Load in Obstructive Sleep Apnoea: Correlation with Epworth Sleepiness Scale.
Joel Ci GOH ; Joyce TANG ; Jie Xin CAO ; Ying HAO ; Song Tar TOH
Annals of the Academy of Medicine, Singapore 2018;47(6):216-222
INTRODUCTIONPatients with obstructive sleep apnoea (OSA) often present with excessive daytime sleepiness (EDS) as measured by the Epworth Sleepiness Scale (ESS). However, the relationship between EDS and OSA severity as measured by the apnoea-hypopnoea index (AHI) remains inconsistent. We hypothesise that this may be due to the usage and equal weightage of apnoea and hypopnoea events used in determining AHI and that apnoea and hypopnoea load as measured by their total durations may be a better metric to use. We sought to investigate if apnoea or hypopnoea load can display better correlation with ESS.
MATERIALS AND METHODSRetrospective analysis of 821 patients with AHI ≥5, who underwent in-laboratory polysomnogram for suspected OSA from January 2015-December 2015, was performed. Objective factors on polysomnogram were correlated with ESS.
RESULTSESS was correlated with age (r = -0.148, <0.001), number of apnoeas (r = 0.096, = 0.006), apnoea load (r = 0.102, = 0.003), apnoea index (r = 0.075, = 0.032), number of desaturations (r = 0.081, = 0.020), minimum SpO (r = -0.071, = 0.041), time SpO <85% (r = 0.075, = 0.031) and REM sleep duration (r = 0.099, = 0.004). Linear regression analysis found age ( <0.001), apnoea load ( = 0.005), REM ( = 0.021) and stage 1 sleep duration ( = 0.042) as independent factors correlated to ESS. The apnoea load calculated using duration in apnoea correlate with ESS in patients with severe OSA by AHI criteria compared to the mild category.
CONCLUSIONAHI does not correlate with ESS. Younger age, longer apnoea, stage 1 and REM sleep were independently related to higher ESS though the correlations were weak. Apnoea load should be taken into account when determining OSA severity.
Adult ; Age Factors ; Disorders of Excessive Somnolence ; diagnosis ; etiology ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; methods ; Retrospective Studies ; Severity of Illness Index ; Singapore ; Sleep Apnea Syndromes ; physiopathology ; Sleep Apnea, Obstructive ; complications ; diagnosis ; physiopathology ; Sleep, REM ; physiology ; Statistics as Topic
8.Specific Serum Immunoglobulin G (IgG) Levels Against Antigens Implicated in Hypersensitivity Pneumonitis in Asymptomatic Individuals.
Yi Hern TAN ; Cecilia Cl NGAN ; Shan Wei HUANG ; Chian Min LOO ; Su Ying LOW
Annals of the Academy of Medicine, Singapore 2019;48(1):36-38
Adult
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Alternaria
;
immunology
;
Alveolitis, Extrinsic Allergic
;
immunology
;
Animals
;
Antibodies
;
immunology
;
Antibodies, Bacterial
;
immunology
;
Antibodies, Fungal
;
immunology
;
Antigens
;
immunology
;
Antigens, Bacterial
;
immunology
;
Antigens, Fungal
;
immunology
;
Aspergillus fumigatus
;
immunology
;
Asymptomatic Diseases
;
Candida albicans
;
immunology
;
Cladosporium
;
immunology
;
Columbidae
;
immunology
;
Female
;
Healthy Volunteers
;
Humans
;
Immunoglobulin G
;
immunology
;
Male
;
Melopsittacus
;
immunology
;
Middle Aged
;
Mucor
;
immunology
;
Nocardia
;
immunology
;
Parrots
;
immunology
;
Penicillium chrysogenum
;
immunology
;
Stachybotrys
;
immunology
;
Thermoactinomyces
;
immunology
9.Assessment of knowledge and perceptions of medical radiation among caregivers and adolescent patients in the paediatric emergency department.
Su Yah CHEW ; Ivy Wei Ling ANG ; Desiree Xin Ying LIM ; Madeleine Qiao Si TAN ; Zi Ying WEE
Singapore medical journal 2021;62(11):582-587
INTRODUCTION:
This study aimed to assess understanding of the potential risks associated with medical imaging among caregivers and adolescent patients in a paediatric emergency department (PED) in Singapore.
METHODS:
A prospective convenience sample survey was performed involving adolescents and caregivers presenting to our PED from December 2015 to May 2016. The questionnaire examined demographic data, knowledge of imaging procedures and radiation risks, and expectations regarding information provided about medical radiation.
RESULTS:
A total of 349 questionnaires were returned (caregivers 82.5%, adolescents 17.5%). A mean of 6.2 ± 2.4 (out of 11) questions were correctly answered. Those who had tertiary education fared better than those who did not (36.4% vs. 17.2% scoring above the mean, p = 0.001). Age, gender, history of previous imaging and imaging performed during the visit did not affect the score. Two-thirds of the participants did not associate medical radiation with any negative lifetime risk of cancers or know that different scans entailed differing amounts of radiation. Most were unaware that the radiation dose in medical imaging is adjusted to a child's size. Among patients who underwent imaging, 90.1% received explanations on the need for scans, and 26.5% were informed of the risks involved. Almost all participants wished to be informed of imaging indications and risks. More preferred to learn this from physicians (75.6%) or technicians (51.6%) rather than through educational pamphlets (34.4%) or Internet resources (22.9%).
CONCLUSION
Awareness regarding medical radiation needs to be improved in our patient population. A mismatch exists between caregiver expectations and the actual procedure of disclosure of the risk associated with radiation.
10.Factors associated with mortality among patients with active pulmonary tuberculosis requiring intensive care.
Wann Jia LOH ; Yue YU ; Chian Min LOO ; Su Ying LOW
Singapore medical journal 2017;58(11):656-659
INTRODUCTIONThe aim of this study was to identify patient characteristics and risk factors associated with in-hospital mortality of patients with pulmonary tuberculosis (PTB) requiring intensive care unit (ICU) management.
METHODSA retrospective chart review was conducted of all patients with active PTB admitted to the ICU at Singapore General Hospital, Singapore, between January 2005 and December 2010.
RESULTSThere were 2,155 patients with active PTB diagnosed, of whom 83 (3.9%) patients were admitted to the ICU, but eight were excluded because their admission to the ICU was unrelated to PTB. The most common comorbidities were diabetes mellitus (n = 23, 30.7%) and immunocompromised host (n = 25, 33.3%). A few (n = 4, 5.3%) of the patients had HIV coinfection. A majority (n = 67, 89.3%) of patients required mechanical ventilation and the mean duration of mechanical ventilation was 8.05 ± 14.43 days. Mean duration of ICU stay and hospital stay were 10.23 ± 15.8 days and 33.7 ± 50.7 days, respectively. In-hospital mortality was 62.7% (n = 47), and 36 of these patients died while in the ICU (ICU mortality, 48.0%). Univariate analysis identified ischaemic heart disease, low albumin, Acute Physiology and Chronic Health Evaluation score, disseminated intravascular coagulation, shock and multiorgan failure as significantly associated with mortality. Multivariate analysis showed that low albumin on the day of ICU admission was the only significant independent predictor of death (p = 0.033).
CONCLUSIONIn-hospital mortality from active PTB requiring ICU admission was 62.7%, and low albumin was an independent predictor of mortality in this study.