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Biomedical subjects

O M Chay

Publications and source records attributed to O M Chay.

11 recordsLinked to original sources

Mycoplasma infection in children.

One hundred and eleven children with Mycoplasma pneumonia infection were studied. Their mean age was 6.2 +/- 3.1 years. The two commonest symptoms were cough (98%) and fever (95%). Only 23% of children had cough of greater than one week's duration. Ninety one per cent had positive chest signs. Radiological abnormalities were seen in 95% of chest x-ray. Complications included dermatological (10%), pleural effusion (5%), neurological disorder (3%), septicaemia (1%), bronchiectasis (1%). Two children with Down's Syndrome died. A rare case of Mycoplasma bronchitis with Reye's Syndrome was observed.

Anti-Bacterial Agents

Complications of severe lower respiratory tract infections in Singapore children.

Over one year period, 240 children with severe lower respiratory infection was admitted to a general paediatric department. The mortality was 1.6%. Apart from pleural effusions and skin exanthems, several major complications were noted. These were septicaemia (1), apnoea (2), encephalopathy (3), meningitis (1), Stevens Johnson Syndrome (1), bronchiectasis (1) and lung abscess (1).

Child

Efficacy of Zaditen (ketotifen) in wheezy infants and young children.

This was a double-blind, randomised evaluation of the efficacy and safety of Zaditen in comparison with placebo in infants and young children (aged 6-36 months). These children either had (i) at least 2 episodes of wheezing over 8 weeks, or (ii) persistent wheeze over 4 weeks, prior to entering into the study. In the doctor's opinion, the group treated with Zaditen had more improvement in symptomatology (p < 0.05). They were more likely to have reduced or discontinued bronchodilators. They showed trends of improvement of symptom scores in night cough, wheeze and sputum production. These differences, however, did not reach statistical significance. There were no major adverse reaction of note.

Child, Preschool

Etiology of acute severe lower respiratory tract infection in hospital-based patients.

Acute respiratory infections are common childhood illnesses. Most are mild and self-limiting. Five percent are lower respiratory tract diseases and are potentially serious. A prospective study was conducted to ascertain the etiology of community-acquired severe lower respiratory tract infections (LRTI) in hospital based patients. Mycoplasma was the most frequently identified agent (33%). This was followed by viruses (28%) and bacteria (15%). Twenty-four percent of children had no identified causative agent.

Acute Disease

Severe bronchiolitis in children.

Acute viral bronchiolitis is one of the most common causes of paediatric respiratory disease, especially in the first year of life. Young infants and those with pre-existent cardiorespiratory problems are at an increased risk of acute respiratory failure necessitating mechanical ventilation. A prospective study was carried out from November 1988 to October 1989, to analyse the clinical features, aetiology and outcome of patients with severe bronchiolitis. 52 (29.9%) out of 174 cases of acute bronchiolitis admitted were found to be severe. A virus aetiology was identified in 75% of the cases, respiratory syncytial virus (RSV) being the commonest agent. 88.5% of the patients were less than 1 year of age, with a male preponderance of 1.4:1. There was a higher incidence in the Malay ethic group. Despite the viral aetiology, 88.2% were treated with a course of antibiotics. There was one death, and 2 patients had apnea requiring mechanical ventilation.

Acute Disease

Bronchial asthma in Singapore children.

The incidence of bronchial asthma admissions to Singapore's major Paediatric Units has increased over the years. The diagnosis of asthma was usually simple but patients with atypical presentations required the demonstration of bronchial lability to confirm the diagnosis. National statistics revealed a small but constant number of deaths from asthma in childhood. Underestimation of severity and delay in treatment were important contributing factors to deaths from asthma.

Adolescent

Enteroviral meningitis in neonates.

We present 4 neonates with enteroviral meningitis. The cerebrospinal fluid findings were variable and posed a diagnostic problem. Immediate outcome was excellent and 3 of the 4 infants were normal at follow-up at 6 months of age. However long-term follow-up will be necessary to to determine any long-term sequelae.

Coxsackievirus Infections

Asthma in Singapore children.

Over the last decade, admissions from respiratory infections have declined but there had been an increase in admissions from Bronchial Asthma in Singapore Government Hospitals. Better recognition by doctors and increased prevalence are important factors. However, mortality had remained low. Like other mortality studies, underestimation of the severity of asthma and undertreatment are the major contributing factors to asthma deaths in Singapore children. Therefore, better public education and continuing education of medical personnel may help to reduce deaths from asthma in children and adolescents.

Adolescent

Lung function after pertussis.

The relationship between pertussis infection and subsequent abnormalities of pulmonary function is not clear. Thirty subjects (16 male, 14 female) aged 14.3 years (s.e.m. = 1.9) were studied who had been hospitalized with culture-proven pertussis when less than 6 months of age. Details of respiratory symptoms in the subjects and their families were obtained. Standard spirometry, lung volumes by body plethysmography, maximum flows at low lung volumes and histamine challenges were performed. Nine of 30 (30%) subjects were symptomatic with a history of recurrent cough and wheeze while 11 of 30 (37%) had abnormal pulmonary function tests. Seven of nine symptomatic subjects had abnormal pulmonary function including positive histamine challenges. Twenty-one per cent had a family history of asthma. This study indicates that children hospitalized in infancy with pertussis can subsequently be shown to have recurrent lower airways symptomatology and abnormal pulmonary function, but the incidence is not significantly higher than a control group from the same socio-economic background.

Adolescent

Reproducibility of hyperventilation of cold dry air in children with cystic fibrosis.

Wheezing is a significant problem in some patients with cystic fibrosis. Currently available tests are not reliable at determining whether this wheezing is due to co-existent asthma or to the underlying pulmonary disease. The reproducibility of hyperventilation of cold dry air (HVCDA) was studied over eight days in 11 children with cystic fibrosis. A group with mild lung disease were selected to minimize the variability due to underlying pulmonary disease. Fifty-six per cent of subjects had consistent responses to HVCDA. A test of reproducibility was performed on the respiratory heat exchange, the percentage fall in FEV1 after HVCDA and the ratio of these two (R). Respiratory heat exchange was found to be highly reproducible with a reproducibility co-efficient of 0.97. The percentage fall in FEV1 after HVCDA and R were not reproducible over the eight-day period. Hyperventilation of cold dry air did not give reproducible results in children with cystic fibrosis, suggesting that a single test may not be suitable for judging bronchial liability.

Adolescent