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Biomedical subjects

C L Goh

Publications and source records attributed to C L Goh.

At least 109 records · Page 6Linked to original sources
PubMed1995

Evaluation of enzyme immunoassay for the detection of anogenital infections caused by Chlamydia trachomatis.

BACKGROUND--Infection caused by Chlamydia trachomatis is now recognised as the most prevalent sexually transmitted disease in many parts of the world. Anorectal infections caused by C. trachomatis is not uncommon. Enzyme-linked immunoassay (EIA) detects an antigen lipopolysaccharide (LPS) of C. trachomatis directly in clinical specimens. OBJECTIVE--Our aim was to compare an enzyme immunoassay, Wellcozyme Chlamydia (WZ04) with cell culture for the diagnosis of chlamydial infection of the anogenital tract. METHOD--Rectal swabs were taken from 100 prostitutes (80 females and 20 males) for chlamydia culture, WZ04 and direct immunofluorescence (DIF). In addition, endocervical specimens were obtained from the females for the above three tests. MAIN FINDINGS--All the positive rectal specimens were from females. Nine patients had a positive chlamydia culture from the rectum but negative WZ04 and DIF. Two patients had false positive results by WZ04 but negative culture and DIF. For cervical specimens, WZ04 identified 43% (3/7) of the culture positive cases. Specificity was 98.6%. WZ04 identified an additional specimen as positive which was also confirmed as positive by DIF. CONCLUSION--Our study shows that in our hands enzyme-linked immunoassays such as Wellcozyme Chlamydia are neither sensitive nor specific in detecting C. trachomatis infection of the rectum. For cervical infections, the sensitivity of WZ04 was 43% and the specificity 98.6% as compared to culture, with a positive predictive value of 75% and a negative predictive value of 94.7%.

Adult↗
PubMed1995

Epidemiology of sexually transmitted diseases in Singapore, 1977 to 1993.

The pattern and prevalence of sexually transmitted diseases (STDs) have changed over the past decades. There is a decline in the prevalence of STDs in many countries. The prevalence of bacterial STDs including gonorrhoea, syphilis and chancroid have declined because of the availability of effective antibiotics whereas the prevalence of viral STDs, including herpes simplex and viral warts, have increased as no effective antiviral drugs are available for these infections at present. The highest proportion of patients with STDs are still those below 30 years old. Most of the patients acquire STDs from commercial sex workers. Health education and prevention remain the most important ways to control STDs until effective antiviral agents and vaccines against STDs become available. Constant monitoring of the trends of STDs will help the authorities to implement relevant and cost-effective preventive programmes.

Adolescent↗
PubMed1995

Prevalence of sexually transmitted diseases among commercial sex workers in Singapore from 1977 to 1993: the effects of screening measures.

This paper discusses the trend of sexually transmitted diseases (STDs) among commercial sex workers in Singapore. Various STD control measures were introduced in Singapore since 1976 to control STDs among commercial sex workers. Under a Medical Surveillance Scheme introduced in 1976, all commercial sex workers were encouraged to undergo regular STD screening and received treatment when found to be infected. As a result, the infection rates of various STDs among commercial sex workers have declined over the years. The infection rate for gonorrhoea has declined from 9% in 1977 to 1.7% in 1993. The chlamydia infection rate declined from 8% in 1992 to 4% in 1993. The human immunodeficiency virus (HIV) infection rate among commercial sex workers under the Medical Scheme was less than 0.1%. The STD infection rate of commercial sex workers who did not participate in the Medical Scheme was much higher than those enrolled in the Medical Scheme. Our findings indicated the effectiveness of the Medical Scheme in controlling STDs among commercial sex workers.

Chlamydia Infections↗
PubMed1995

Comparing the efficacy of pefloxacin and ciprofloxacin in the treatment of acute uncomplicated gonococcal urethritis in males.

The aim of this study was to compare the efficacy of single-dose pefloxacin 400 mg and ciprofloxacin 250 mg in the treatment of acute uncomplicated gonococcal urethritis in males. One hundred and twenty male patients with uncomplicated gonococcal urethritis were assigned alternately to receive single oral doses of either pefloxacin 400 mg or ciprofloxacin 250 mg. Forty-one out of 43 patients (95.3%) of the pefloxacin group and 46 of 47 (97.9%) of the ciprofloxacin group were cured of gonorrhoeae. The rates of post-gonococcal urethritis were 57.7% and 53.3% in the pefloxacin and ciprofloxacin groups respectively. There was a high incidence of penicillinase-producing gonococci (34.2%). High level resistance to pefloxacin (minimum inhibitory concentration [MIC] >1.0 mg/l) resulting in clinical failure on 400 mg stat dose was noted in 1 isolate. It also showed decreased susceptibility to ciprofloxacin (MIC 0.25 mg/l). Another isolate showed high-level resistance (MIC 0.06 mg/l) to ciprofloxacin 250 mg stat dose with concomitant decreased susceptibility to pefloxacin (MIC >1.0 mg/l). Ciprofloxacin 250 mg stat dose is still useful for the treatment of uncomplicated gonococcal urethritis in males. The cure rate of 95.3% with pefloxacin at 400 mg stat dose is acceptable, but needs to be monitored with caution. The emergence of a more resistant strain of Neisseria gonorrhoeae to fluoroquinolones calls for vigilance in the monitoring of antimicrobial susceptibility.

Acute Disease↗
PubMed1995

Dual therapy with doxycycline and ketoprofen compared to doxycycline in the treatment of uncomplicated non-gonococcal urethritis.

The aim of this study was to compare a combination of doxycyline and ketoprofen, and doxycycline alone in treating non-gonococcal urethritis (NGU), with particular emphasis on reducing recurrent or persistent disease. Sixty-five men with first episode acute NGU were enrolled between November 1992 and November 1994. The men were randomly assigned to either the doxycycline plus ketoprofen group, group A (doxycycline 100 mg twice daily for 10 days plus ketoprofen 200 mg daily for 10 days, n = 34), or the doxycycline group, group B (100 mg twice daily for 10 days, n = 31). Out of the 65 patients studied, Chlamydia trachomatis was isolated from 9 patients (13.8%), Ureaplasma urealyticum from 6 patients (9.2%) and Mycoplasma hominis from 2 patients (3.1%). At 6 weeks in group A, 16 patients (47%) were cured, one patient had a recurrence (2.9%), and 4 patients had persistent infection (11.8%). Eleven patients defaulted follow-up (32.4%) and 2 patients were dropped from the trial. In contrast, for group B, 13 patients (42%) were cured, 5 patients (16%) had a recurrence, 2 patients (6.5%) had persistent infection and 3 patients (9.7%) were reinfected. Eight patients (25.8%) defaulted follow-up. At 12 weeks, for group A, 14 patients (41.2%) remained cured, one patient (2.9%) had a recurrence, 4 patients (11.8%) had persistent infection and one patient (2.9%) was reinfected. Twelve patients (35.3%) defaulted follow-up. For group B, 8 patients (25.8%) remained cured, 6 patients (19.4%) had recurrence, 2 patients (6.5%) had persistent infection and 5 patients (16.1%) were reinfected. Ten patients (32.2%) defaulted follow-up. There were no statistically significant differences between the two groups except for patients with recurrent NGU where the difference (1 versus 6 patients) was statistically significant (P = 0.019).

Anti-Bacterial Agents↗
PubMed1995

Correlation between saliva and serum for human immunodeficiency virus 1 and 2 antibodies using a rapid test system.

Currently, human immunodeficiency virus (HIV) tests are almost totally serum based. In situations where blood is difficult or inconvenient to obtain, a substitute to venepuncture offers an attractive alternative. The prototype OraScreen saliva dipsticks were tested on 278 samples comprising 100 normals, 100 samples from persons attending a sexually transmitted disease clinic and 78 samples from persons confirmed to have HIV. The specificity and the sensitivity of the diagnostic test for saliva was 99.5% and 94.7% respectively, when compared to a routine solid-phase enzyme-linked immunosorbent assay (ELISA) test on serum samples and Western blot test when indicated. The prototype OraScreen dipstick test shows potential for saliva testing in situations where it would be inconvenient to use blood. Further evaluation of saliva testing is warranted on a large sample population with a low prevalence of HIV infection.

Adult↗
PubMed1995

Project youth inform--a school-based sexually transmitted disease/acquired immune deficiency syndrome education programme.

A pilot project, ¿Youth Inform¿ endorsed by the Ministry of Health and Ministry of Education, Singapore, was undertaken in 1992 for 2 years. It aims to enhance sexually transmitted disease (STDs)/human immunodeficiency virus (HIV) control in Singapore by providing structured information for young people between the ages of 16 to 20 years in Polytechnics, Junior Colleges, Centralised Institutes and Pre-University Centres. Project Youth Inform comprises 8 components. They include a focus group discussion, a training seminar for teachers, a lecture/slide presentation cum question-and-answer session, an educational booklet/bookmark, exhibitions, a video, provisions for anonymous questions, and an evaluation. The programme is conducted during school hours at the premises of the institutions and the attendance per session is between 150 to 350 students. A total of 152 sessions have been completed for all the schools. It is ongoing and is currently administered by the School Health Service and Training and Health Education Department. Feedback from principals, teachers and students was gathered formally through surveys and informally through interviews and observations. One thousand students were randomly selected for the survey to assess their responses towards the programme. Eighty-six percent reported that they found it educational and informative. Indicators found to have an influence on the effectiveness of the programme were timing, vocabulary used (medical terms) and integration of the programme into the school's curriculum. In conclusion, Project Youth Inform was on the whole positively received. However, it is essential to constantly accommodate and adapt to new facts and methods of teaching and maintain close coordination with the Ministries and the schools. An effective STD/acquired immune deficiency syndrome programme is an important step towards the prevention, management and control of the epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Condom use negotiation among sex workers in Singapore: findings from qualitative research.

Following an earlier study of 806 sex workers in Singapore in which they were found to succeed only half the time in getting clients to use condoms, a qualitative investigation was conducted on 40 sex workers to explore their perceived barriers and approaches in negotiating condom use with clients. Five different patterns of condom use were identified: successful, unsuccessful, misinformed, passive and uninterested. The successful negotiators used several practical approaches to secure clients' compliance. Unsuccessful negotiators experienced problems such as inability to resist clients' pressure or respond to their queries. The misinformed group believed that regular clients were safe. The passive group did not negotiate condom use due to their perceptions of lack of support from peers and brothel keepers, and the uninterested group was apathetic with fatalistic perceptions of AIDS. The in-depth interviews with successful negotiators provided relevant, specific and practical information which could be disseminated to their peers to develop their negotiation skills. This qualitative study also provided useful insights on condom use negotiation and highlighted the need for comprehensive interventions which should not only aim at developing sex workers' negotiation skills but also at gathering support from brothel keepers to facilitate behaviour change, and public education directed at clients to increase condom use.

Adult↗
PubMed1994

Isotretinoin therapy in acne vulgaris: a 10-year retrospective study in Singapore.

BACKGROUND: The use of isotretinoin, a first generation synthetic retinoid, in the treatment of patients with severe acne vulgaris was a major therapeutic advance in dermatology. This 10-year retrospective study reviews the effectiveness of isotretinoin in patients with acne vulgaris seen in a skin clinic in Singapore. METHODS: The case records of 250 cases of severe inflammatory and nodulocystic acne treated with isotretinoin were analyzed with reference to the demographic data, response to isotretinoin, dosage and cost of isotretinoin used, adverse effects, clinical follow-up, and relapse. RESULTS: Two hundred and fifty patients, 171 men (68.4%) and 79 women (31.6%), with different types and grades of acne vulgaris were studied. The dose of isotretinoin used ranged from 0.33 to 1.0 mg/kg/day (median 0.5 mg/kg/day) for a period ranging from 1 to 12 months (median 4 months). Response was excellent in 127 (50.8%) patients, good in 86 (34.4%), fair in 30 (12.0%) and poor in 7 (2.8%). Relapse occurred in 14 (5.6%) patients over a 6-month follow-up period. Adverse effects were noted in 140 (56.0%) patients and were mild in most cases. Eighteen (7.2%) patients had to discontinue the drug due to significant side effects. CONCLUSION: This study confirms that isotretinoin is very effective for severe acne, and complete remission can be induced in more than 90% of cases even with lower dosage regimens. Significant clinical improvement can be achieved with the use of lower doses (mean 0.5 mg/kg/day) for an average of 4 months of treatment with lower risk of adverse effects.

Acne Vulgaris↗
PubMed1994

In vitro evaluation of griseofulvin, ketoconazole, and itraconazole against various dermatophytes in Singapore.

BACKGROUND: Superficial cutaneous fungal infection, principally dermatophytosis, is an extremely common skin disease. Various in vitro test systems have been developed in recent years to determine the antifungal activity of various drugs. The minimum inhibitory concentration (MIC) obtained may give an indication of the in vivo potency of the drugs. METHODS: One hundred patients (69 men and 31 women) with a clinical diagnosis of dermatophytosis were entered into the study. Direct microscopy and culture were done on all patients. The MICS were determined using the broth dilution method. RESULTS: The age range was 1-76 years. The most common diagnosis was tinea corporis (36%), followed by tinea cruris (22%), and tinea pedis (19%). The most common fungus isolated was T. rubrum (58%), followed by E. floccosum (14%), and T. mentagrophytes (10%). The majority of the isolates was sensitive to the three drugs tested (griseofulvin, ketoconazole, and itraconazole). Of the isolates, 82% were sensitive to griseofulvin, 78% to ketoconazole, and 81% to itraconazole, all at a concentration of < 0.25 micrograms/mL. For T. rubrum, there were four isolates that had an MIC of > or = 64 micrograms/mL to griseofulvin, seven isolates and nine isolates with an MIC > or = 64 micrograms/mL to ketoconazole and itraconazole, respectively. T. interdigitale was relatively resistant to the three drugs in vitro with four of seven isolates having an MIC > or = 4 micrograms/mL with griseofulvin, one of seven isolate with an MIC > or = 64 micrograms/mL with ketoconazole, and three of seven isolates with an MIC > or = 32 micrograms/mL with itraconazole. CONCLUSIONS: The in vitro antifungal activity of griseofulvin, ketoconazole, and itraconazole are similar against dermatophytes in Singapore. Griseofulvin may be given as the first-line drug for treating such infections in Singapore.

Adolescent↗
PubMed1994

Epidemiology of skin disease among children in a referral skin clinic in Singapore.

This retrospective epidemiologic study compared data of skin disease in children less than 16 years old with those of adults attending the same tertiary referral outpatient clinic. Of the 74,589 patients seen in this clinic, 9273 (12.4%) were children. There were significant differences in the types of skin disease between children and adults. In children, eczema was the most common (50%), followed by viral infection (7%), bacterial infection (5%), and insect bite reaction (5%), significantly higher proportions than in adults. In contrast, acne vulgaris (3%), fungal infection (3%), and psoriasis (1.1%) rates were significantly lower in children than in adults. Atopic eczema (51%), followed by endogenous handfoot eczema (9.6%) was the most common type of eczema in children. The number of children with atopic (including asteatotic eczema) and seborrhoeic eczema decreased with age, suggesting that these conditions tend to clear with age, whereas other endogenous eczemas, including hand-foot eczema, nummular eczema, and lichen simplex chronicus, tend to increase with age. Epidemiologic data are useful in monitoring changes in disease trends in children and planning health care programs for them.

Adolescent↗
PubMed1994

The incidence of cutting fluid dermatitis among metalworkers in a metal fabrication factory: a prospective study.

We compared the incidence of occupational dermatitis and transepidermal water vapour loss (TEWL) changes from cutting fluids (neat mineral oils) in 24 new machinists with 27 armed forces paramedics (controls) over a 6-month period. The cumulative incidence of occupational dermatitis in positive controls increased from 38% at week 3 to 77% at week 6. It then decreased to 50% at week 9 and thereafter remained constant at about 50% throughout the remaining study period. 2 workers sought medical treatment for their dermatitis. Only 1 worker had a job transfer because of his dermatitis. None of the paramedics developed dermatitis during the study period. The mean basal TEWL values on the hands of machinists and controls were 17.6 and 14.5 g/m2/h (n.s.) respectively. The mean TEWL values of machinists increased to 22 g/m2/h by week 3 and then remained fairly constant throughout the remaining study period. The mean TEWL of negative controls remained fairly constant (at about 14 g/m2/h) from the beginning to the end of the study period. The mean TEWL value of machinists was significantly higher than that of negative controls throughout the study period. There was no significant difference in the prevalence of cutting fluid dermatitis between machinists with high basal TEWL values (> or = 17 g/m2/h) and those with low basal TEWL values (< 17 g/m2/h).

Adolescent↗
PubMed1994

Efficacies of a barrier cream and an afterwork emollient cream against cutting fluid dermatitis in metalworkers: a prospective study.

We compared the point prevalence of cutting fluid dermatitis and transepidermal water vapour loss (TEWL) changes in groups of new machinists who (a) used a barrier cream; (b) used an afterwork emollient cream; and (c) did not use any cream (controls) over a 6-month period. All machinists handled cutting fluid (neat mineral oil) during their work. There was no significant difference in the prevalence of cutting fluid dermatitis in the 3 groups throughout the study period. The prevalence of cutting fluid dermatitis in all groups increased rapidly during the first 6 weeks and thereafter remained steady throughout the remainder of the study period. The prevalence of cutting fluid dermatitis was slightly lower in machinists using afterwork emollient cream compared to those using barrier cream and controls (not significant). The differences in the mean TEWL changes during the study period among the 3 groups were also not statistically significant. The mean TEWL values in the 3 groups increased rapidly during the first 6 weeks of exposure to cutting fluids and thereafter remained fairly constant throughout the remainder of the study period. Barrier cream and afterwork emollient cream did not appear to have any significant effect against either cutting fluid dermatitis or TEWL changes in machinists exposed to cutting fluid. However, afterwork emollient cream appeared clinically to help reduce the prevalence of cutting fluid irritation.

Adolescent↗