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Biomedical subjects

S K Ng

Publications and source records attributed to S K Ng.

At least 37 records · Page 2Linked to original sources

Positive patch-test reactions to para-phenylenediamine, their clinical relevance and the concept of clinical tolerance.

406 patients were patch tested over an 18-month period (January 1998 to June 1999) at a dermatology referral centre. 33 patients (8.1%) had a positive reaction to para-phenylenediamine (PPD). 20 patients were experiencing PPD hair dye dermatitis (present relevance, 61%), 2 were using PPD hair dyes without developing dermatitis (clinical tolerance, 6%), 4 had previously used PPD hair dyes with dermatitis in the past (past relevance, 12%), 3 had previously used PPD hair dyes without dermatitis (past exposure, 9%) and 4 had no known exposure to PPD (unknown relevance, 12%). Of the 20 patients whose test results were of present relevance, 17 avoided PPD hair dyes, resulting in total clearance of the dermatitis in all except 3, who had concurrent endogenous eczema. 3 continued using PPD hair dyes: 2 had recurrent contact dermatitis and 1 avoided dermatitis with meticulous technique. The 2 patients with clinical tolerance continued using PPD hair dyes with no dermatitis.

Adult↗

Paradoxical enlargement of tuberculous brain abscess during drug treatment: a case report.

This is a case report of a patient suffering from tuberculous (TB) brain abscesses. Despite supervised and appropriate anti-TB chemotherapy, the size of the abscesses paradoxically increased, accompanied by clinical deterioration at 1 month. A second aspiration was performed which yielded a large amount of viable tubercle bacilli. The same drug regimen was continued. This was followed by complete resolution of the lesions in 12 months. Hence TB brain abscess which remains culture and smear positive after four weeks treatment may not represent treatment failure.

Antitubercular Agents↗

Falls amongst institutionalised psycho-geriatric patients.

Falls are common among the elderly patients in the psycho-geriatric wards and yet they have been understudied. A fall is a multi-factorial syndrome involving the patient and the environment. Psycho-geriatric patients who fall may suffer serious physical injuries that result in morbidity, further institutionalisation or even mortality. This study aims to examine the contributing factors to, and morbidity and outcome of falls among institutionalised psycho-geriatric patients so that preventive strategies can be refined. Data of patients who fell over a year's period in four psycho-geriatric wards were collected retrospectively and compared with those who had not fallen within the same period. The general profile of the psycho-geriatric patient who falls is one who is: above seventy-five years old; on three or more medications; and having recent changes in medication and mental status. About one in three fallers fell repeatedly. The rate of serious injury and mortality was low. In conclusion, while many factors are attributable to the common effects of aging and physical illnesses; psychotropic medication, change in mental state and specific environmental factors also play significant contributory roles to falls in this group of patients.

Accidental Falls↗

Video-assisted thoracoscopic thymectomy for myasthenia gravis.

Thymectomy is an established therapy in the management of generalized myasthenia gravis, in addition to medical treatment. However, the optimal surgical approach to thymectomy has remained controversial. There are advocates for transternal, transcervical approaches or "maximal" thymectomy. Video-assisted thoracic surgery (VATS) presents a new approach to thymectomy and forms the basis of this article, in which we discuss patient selection, technique, and results. We believe complete thymectomy, comparable with the transternal approach, could be achieved by VATS. Our intermediate-term results compare well with other surgical techniques. By minimizing chest wall trauma, VATS not only causes less postoperative pain, shortens hospital stay, gives better cosmetic results but also leads to wider acceptance by patients (and their neurologists) for earlier surgery. However, the true role of this approach in thoracic surgery awaits long-term results.

Anesthesia, General↗

Hypergammaglobulinaemic purpura presenting as reticulate purpura.

Hypergammaglobulinaemic purpura, first described by Waldenstrom, is a rare skin disease. The essential features are the presence of purpura with polyclonal hypergammaglobulinaemia. We describe a case of hypergammaglobulinaemic purpura occurring in a Chinese man with reticulate purpura and haemorrhagic blisters.

Aged↗

A study of the sensitization rate to sesquiterpene lactone mix in Singapore.

We report a study of the sensitization rate to sesquiterpene lactone (SL) mix at the National Skin Centre, Singapore. This is a retrospective review of 1256 patients who were patch tested to SL mix (0.1%) from January 1995 to December 1997. 18 out of 1256 patients (1.43%) reacted positively to SL mix. Their ages ranged from 13 to 58 years (average 33.8 years). There were 15 Chinese, 2 Indian and 1 Malay patients. There was a female preponderance, with a female: male ratio of 3.5:1. The most common clinical presentation were dermatitis of the hands (8; 44%), face (5; 28%), and generalized involvement (5; 28%). After extensive evaluation, only 2 patients had a positive patch test reaction that was of current clinical relevance. 13 patients had concomitant sensitization to other allergens. The 3 commonest concomitant allergens were nickel, balsam of Peru and fragrance mix. In our series, SL allergy is observed to be more common in females and the mean age is lower compared to the classical Compositae dermatitis. The sensitization rate is comparable to other studies, although the clinical relevance is only 11%.

Adolescent↗

Vogt-Koyanagi-Harada disease: extensive vitiligo with prodromal generalized erythroderma.

The occurrence of vitiligo with prodromal erythema in Vogt-Koyanagi-Harada (VKH) disease is rarely observed. We describe a 68-year-old Chinese woman who developed extensive vitiligo 6 months after the onset of a generalized erythroderma and 12 months after the onset of acute bilateral uveitis. She also had a 4-year history of psoriatic plaques on the trunk which resolved completely without recurrence 15 months after the onset of erythroderma. The extensive cutaneous inflammation prior to the onset of vitiligo in our patient with VKH disease has not been reported before and strongly suggests an immunologic etiology for VKH disease.

Aged↗

Subtypes and case-fatality rates of stroke: a hospital-based stroke registry in Taiwan (SCAN-IV).

Stroke data bank can afford important information regarding risk factors, pathogenesis, prognosis, etc. By means of hospital-based stroke registry, we investigated the risk factors and case-fatality rates in different types of stroke and transient ischemic attack (TIA) patients at the National Taiwan University Hospital in 1995. After excluding ineligible patients, 995 patients aged 1-98 years (575 men and 420 women) were recruited. Men predominated in all age groups for stroke and TIA in general except for cerebral hemorrhage (CH) in patients aged < 35 years and subarachnoid hemorrhage (SAH) in patients aged > or = 45 years. Of these, 676 (67.9%), 41 (4.1%), 228 (22.9%) and 50 (5%) patients were classified in the categories of cerebral infarction (CI), TIA, CH and SAH, respectively. The CI/CH ratio was 2.96. Hypertension remained one of the most important risk factors for CI, CH and TIA patients. Severe extracranial carotid artery stenosis (> or = 50%) was found in 12% of the CI patients and 27% of the TIA patients, but not found in the CH and SAH patients. Of these patients, the 30-day case-fatality rate was 10.9%, highest in SAH (30%), followed by CH (24.1%) and CI (5.6%). There were 41 in-hospital stroke patients who had significantly higher case-fatality rates than the other stroke patients (P<0.001 for all stroke, CI and CH patients by chi2 test). As compared to the previous stroke registries in Taiwan, there is a secular trend of increasing CI/CH ratios. These findings in Taiwan were compared with those in other populations, including other Asian, Caucasian and black populations. The CI/CH ratios in Asian populations, including Chinese, Japanese and Korean, were much lower than those in Caucasian and black populations. Dietary, environmental and genetic factors probably play important roles in these differences.

Adolescent↗

Topical traditional Chinese medicine. A report from Singapore.

Topical traditional Chinese medicine is still widely used, especially by those of Chinese descent in Singapore. This practice is likely to be similar wherever there is a sizable Chinese community. In this article I discuss the types of topical traditional Chinese medicine available in Singapore--emphasizing particularly the ingredients used in the making of them--in an attempt to dispel some myths and misconceptions about traditional oils and balms.

Administration, Topical↗

Pemphigus foliaceus and oral lichen planus in a patient with systemic lupus erythematosus and thymoma.

A 49-year-old woman with systemic lupus erythematosus, and a history of thymoma and chronic white plaques of the oral mucosa, developed a blistering eruption which was diagnosed as pemphigus foliaceus based on clinical, histological and direct immunofluorescence findings. However, the white plaques had both the clinical and histological features of lichen planus, as well as intercellular antibodies suggestive of pemphigus. Such conditions in combination have been documented previously, but this is believed to be the first report of the coexistence of all four in one individual. The common mechanism underlying these four conditions may well be an immunological disturbance.

Female↗

Anaesthetic implications of Maffucci's syndrome.

Maffucci's syndrome is a rare, congenital disease due to neuro-ectodermal dysplasia and is characterized by enchondromatosis and multiple soft tissue haemangiomata. A case of Maffucci's syndrome with haemangiomata along the upper airways requiring laser surgery is described. The literature on Maffucci's syndrome is reviewed.

Adult↗