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Biomedical subjects

H M Oh

Publications and source records attributed to H M Oh.

33 records · Page 2Linked to original sources
PubMed1997

Clinical presentation of herpes zoster in a Singapore hospital.

BACKGROUND: There is a direct correlation between increasing age and incidence of herpes zoster. There is an increased risk of complications in the elderly and the immunocompromised. OBJECTIVE: To study the clinical epidemiology of hospitalised patients with herpes zoster. METHODS: Medical records of all patients hospitalised with zoster were respectively analysed. RESULTS: Sixty-seven patients (3% of total admissions) were studied. There were 35 males and 32 females with a mean age of 50.35 +/- 21.71. There was an increased proportion of older patients in the study cohort. Nineteen patients (28.4%) were immunocompromised with malignancy occurring in 9 patients. Thirteen had been on cytotoxic and/or steroid therapy. The commonest symptoms were rash, pain and fever. Eighty-five percent of the patients had complications (bacterial super-infection in (61%), dissemination (31%), ocular involvement (5%) and post-herpetic neuralgia (13.4%). There was an increasing frequency of duration of pain with increasing age in the patients with post-herpetic neuralgia. Forty-three patients were treated with acyclovir. The median time to healing of lesions was 11 days. The 41 patients with bacterial super-infection received antibiotics with median time to healing of 12 days. CONCLUSION: Increasing age and immunocompromised state appear to be risk factors for developing herpes zoster in hospitalised patients.

Female↗
PubMed1996

Cefuroxime compared to amoxicillin-clavulanic acid in the treatment of community-acquired pneumonia.

The study compared the efficacy and safety of cefuroxime (CFX) versus amoxicillin-clavulanic acid (AC) in the treatment of community-acquired pneumonia. A total of 48 patients (mean age 44 years; 32 males and 16 females) were randomised to receive sequential intravenous/oral CFX (750 mg i.v. 8H for 48 H/500 mg p.o bid) and sequential intravenous/oral AC (1.2 g i.v. 8 H for 48 H/ 750 mg p.o. tid) for 7-14 days. The two groups were well matched for age, sex and treatment duration (median 7 days). The most frequent causative organisms were Mycoplasma (3), Klebsiella species (2), Pseudomonas aeruginosa (2) and hemolytic streptococcus (2). clinical cure was obtained in 20 patients (83.3%) and 18 patients (75%) of CFX and AC group respectively. Clinical improvement was observed in one patient of the CFX group. There were 3 failures in the CFX group and 4 failures in the AC group. Two patients in the AC group developed adverse drug reactions (namely vomiting and rash) and were withdrawn from the study. In conclusion, cefuroxime and amoxicillin-clavulanic acid have comparable efficacy and safety in the treatment of community-acquired pneumonia.

Administration, Oral↗
PubMed1996

Varicella pneumonia in adults--clinical spectrum.

Varicella pneumonia is the most common complication of chickenpox and it also has the highest mortality. A retrospective study was carried out on 10 patients with varicella pneumonia over a period of one year. Seven of the 10 patients with varicella pneumonia had a history of smoking. The majority of the patients with varicella pneumonia presented with cough, dyspnoea, hypoxia and a compatible chest radiograph. All the patients with varicella pneumonia were treated with intravenous acyclovir. Four patients required mechanical ventilation. Nine out of the 10 patients were cured with only one death. It may be reasonable to select adults with varicella and who smoke, for early treatment with acyclovir.

Acyclovir↗
PubMed1995

A descriptive profile and the immune status of some hospitalised patients with measles.

The incidence of measles in Singapore has declined with the introduction of measles vaccination in 1976. However, a progressive increase in notified measles cases has occurred since 1990. To characterise the current profile of hospitalised patients with measles, particularly their measles immunity status, we analysed 46 cases over a period of 3 months. The majority (69.6%) were school-going children (aged 5-19 years). Of the 25 patients (54.3%) classified as preventable by immunisation according to the current strategy, 68% were school-age persons. Five previously vaccinated patients had measles enzyme immunoassay immunoglobulin M and immunoglobulin G antibodies present. The occurrence of preventable cases among school-age children indicates that the implementation of the current immunisation programme should be improved.

Adolescent↗
PubMed1995

Upper respiratory tract infections - otitis media, sinusitis and pharyngitis.

Management of the patient with otitis media, sinusitis or pharyngotonsillitis is based on information about the host, the organism and the antimicrobial agent. Otitis media (OM) is a common infection in children but selected children have recurrent and chronic OM. The predominant organisms responsible for OM are Streptococcus pneumonia, Haemophilus influenzae and Moraxella catarrhalis. Changes in the antimicrobial susceptibility govern the choice of antimicrobial agents. Surgical treatment should be considered if the child has persistent hearing loss in both ears. Sinusitis shares with OM similar pathogenesis, microbiology and choices of antimicrobial therapy. Endoscopic surgery is the treatment of choice for chronic sinusitis. Pharyngitis may be either viral or bacterial in origin. Penicillin remains the treatment of choice for bacterial pharyngotonsillitis. In patients with recurrent infection, the emergence of B-lactamase producing strains has to be considered and erythromycin or oral cephalosporins might be indicated.

Anti-Bacterial Agents↗
PubMed1994

Advice for the international traveller.

International travel has increased in recent years. The spectrum of disease associated with travel is wide. All travellers should be encouraged to seek pre-travel medical advice which include the need for vaccination and malaria prophylaxis and advice on preventive health measures during travel. The returning traveller with an illness should be advised to seek post-travel treatment.

Antimalarials↗
PubMed1994

Multidrug-resistant typhoid fever in Singapore.

A study was conducted to determine the clinical and epidemiological characteristics of multidrug-resistant (MDR) typhoid fever in Singapore. Twenty-one of 121 patients with typhoid fever had MDR typhoid fever after recent travel to the Indian subcontinent. Fifty patients with drug susceptible typhoid fever were also analysed for comparison. Nineteen of the MDR S. typhi isolates had resistance to ampicillin, chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) while the remainder had resistance to ampicillin and TMP-SMX. The predominant presenting symptoms were fever and diarrhoea. Eleven patients with MDR typhoid fever were treated with oral ciprofloxacin and nine with intravenous ceftriaxone. The patients with MDR typhoid fever had a longer duration of fever defervescence (8 +/- 5 days) compared to those with drug-susceptible typhoid fever (5.7 +/- 4.16 days) (p < 0.01). Eighteen patients were cured and one patient defaulted treatment. Two patients relapsed within two months of treatment. The study showed that 17.4% of patients with typhoid fever had imported MDR S. typhi after recent travel to the Indian subcontinent where MDR typhoid fever is prevalent.

Adult↗
PubMed1994

Acquired immunodeficiency syndrome and Cryptosporidium infection.

A child suffering from the acquired immunodeficiency syndrome (AIDS) with intestinal cryptosporidiosis is reported. The child presented with profuse diarrhoea up to 15 episodes a day over a period of one week. Management was with intravenous rehydration and oral spiramycin. Diagnosis of intestinal cryptosporidiosis requires examination of multiple stool specimens by several concentration and staining procedures which aid in the visualisation of the oocysts. In the absence of an effective treatment for cryptosporidiosis, the cornerstone of management is mainly supportive therapy.

AIDS-Related Opportunistic Infections↗
PubMed1993

Infections in systemic lupus erythematosus.

A prospective study was carried out on the occurrence of infections in 28 hospitalised systemic lupus erythematosus (SLE) patients. In 38 episodes of infections, 23 were bacterial (60.5%), 4 were viral (10.6%) and culture negative infections were present in 10 (26.3%). The most common isolated organisms were Staphylococcus aureus (30.4%), Salmonella species (21.7%), Pseudomonas species (13.0%), and Klebsiella species (13.0%). The care rate was 94.7%. Death occurred in 2 patients. Lupus activity, impaired renal function, and cytotoxic therapy did not predispose to infection.

Adolescent↗
PubMed1991

Actinomycosis of the brain.

Actinomyces species are rare but treatable causes of central nervous system infection. A case of actinomycotic cerebral abscess is reported. The primary source of infection was probably the lung based on radiological findings although culture of the bronchial brushings was negative. The patient had surgical excision and repeated drainage with two prolonged causes of antibiotic therapy. At follow-up examination 36 months later, the patient was well except for a residual left hemiplegia. Diagnosis of cerebral actinomycosis can be made by anaerobic culture of the appropriate specimens or on histologic grounds. Optimal management combines adequate surgical drainage and prolonged antibiotic therapy.

Actinomycosis↗