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Biomedical subjects

Y C Chee

Publications and source records attributed to Y C Chee.

At least 19 recordsLinked to original sources
PubMed1992

Urinary symptoms and urodynamic diagnosis of patients in one geriatric department.

Fifty five patients between 65 and 89 years old who had their urinary problems assessed by urodynamics study were reviewed. The most common urinary symptom among males was urge incontinence, while retention and urge incontinence occurred with equal frequency among females. The commonest cause of retention in males was bladder outlet obstruction, while atonic neurogenic bladder was the most common cause in females. Urge incontinence was strongly associated with an unstable bladder, small bladder volume and Parkinson's disease. Retention of urine, and an atonic neurogenic bladder strongly correlated with diabetes mellitus. Three patients (out of 31) with unstable bladders also had detrusor external sphincter dyssynergia. Of these, two had Parkinson's disease. Although three patients were thought to have stress incontinence after history and physical examination, only two had stress incontinence with detrusor instability on urodynamic studies. The last patient had atonic bladder with overflow.

Aged↗
PubMed1992

Health is wealth.

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Health Education↗
PubMed1992

Cardiac life support training: the Ministry of Health's experience.

This study reviews the records of all cardiac life support training courses conducted at the Ministry of Health's Life Support Training Centre situated in Singapore General Hospital over a six period from 1985 to 1990. A total of 1,789 persons were trained in Basic Life Support (BCLS), 65 as BCLS Instructors, 267 in Advanced Cardiac Life Support (ACLS), 276 in Emergency Cardiac Care (ECC) and 24 in Emergency Cardiac Defibrillation (ECD). These courses have involved a total of 1111 doctors, 1248 nurses and 62 ancillary staff. At the end of the course, 90.7% of those learning BCLS agreed that they would use their CPR skills, if required. Only 60% felt they would use mouth-to-mouth ventilation. Of 415 who expressed an interest in becoming instructors, 15.7% have, to-date, been trained. While more than 80% of persons learning, ACLS were doctors, only 25% of these were willing to instruct. There are currently 14 ACLS instructors. The ECC courses were modified from the ACLS course and taught to Emergency Room doctors only. It was found to be immensely popular with 98% expressing benefit. The ECD programme trained emergency ambulance nurses in the use of semi-automatic electrical defibrillators. The marked increased in yearning for cardiac life support skills amongst medical and nursing staff has been a major factor in the proliferation of life support training programmes at the Centre. Nurturing this enthusiasm is the key to ensuring that the programmes continue to expand for the benefit of both inpatients and the out-of-hospital lay public.

Attitude of Health Personnel↗
PubMed1991

Health care services for the elderly--a Singapore perspective.

Singapore is greying at a phenomenal pace as well as in a markedly disproportionate manner. By the year 2030, the elderly will comprise around 25% of the total population; at the same time the numbers of younger and economically active persons will decline. The reasons for this process are varied and its implications disturbing. An important consequences is the urgent need for careful and comprehensive planning to meet the elderly's needs. The needs are best addressed when the elderly are looked at as either being well or frail. A guiding principle is that most of them prefer and should remain within community (and not be institutionalised). Efficient and appropriate community services must be developed so as to support the elderly's stay in the community.

Aged↗
PubMed1991

Medical audit.

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Health Services↗
PubMed1990

The mega shot.

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Cyclophosphamide↗
PubMed1990

Infection in the elderly.

One hundred and eleven patients with pyogenic infections were studied. Of these, 32 patients (28.8%) were diabetic, and 33 patients (30%) had positive cultures obtained. Fifty-eight patients (52.3%) had fever (T degrees greater than 37.2 degrees C) while 69 patients (62.2%) had leucocytosis. Forty-one patients (36.9%) had nosocomial infections. It was found that patients older than 75 years-old did not respond to infection by a febrile response as often as those younger than 75 years-old. Mortality rate was increased in those whose T degrees greater than 38.2 degrees C and in those with more than one source of infection. Age and the presence of diabetes was not found to increase the mortality rate, though diabetics tend to have more than one source of infection. A positive blood culture was also associated with a higher mortality rate. There were also more deaths among patients with nosocomial infection than the community acquired group. The three most common sources of infection were lung, urinary tract and skin respectively. The most common group of organisms cultured was gram negative bacilli, of which Klebsiella species was most frequently isolated. Of these, 57% of the Klebsiella sp cultured came from the nosocomial group. Staphylococcus aureus was the next most frequently cultured bacteria, and all these isolates (100%) came from the nosocomial group. Though antibiotics were started within 48 hours of suspicion of infection in majority of patients (101 patients or 91%), and all of these received appropriate initial antibiotics, mortality rate remained high (26 deaths or 23.4%).

Age Factors↗
PubMed1989

Severe asthma.

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Asthma↗
PubMed1986

Pulmonary lymphoma or pseudolymphoma: a diagnostic dilemma.

The clinical significance of pulmonary pseudolymphoma remains unresolved. We report a case which highlights the lymphoma versus pseudolymphoma dilemma. An elderly lady followed up for more than ten years with a slowly enlarging right lung mass had on biopsy, lymphoid hyperplasia consistent with a lymphoma or pseudolymphoma. Laboratory investigations revealed hyperglobulinemia due to a biclonal gammopathy with elevated serum immunoglobulin M and G fractions. Monoclonal production of immunoglobulin is today considered more indicative of a neoplasia than a hyperplasia.

Diagnosis, Differential↗
PubMed1985

Small cell carcinoma of lung: a prospective clinical study.

Seventeen patients with small cell carcinoma of the lung diagnosed on sputum cytology, bronchial biopsy/aspirate or lymph node biopsy, were prospectively followed up for 33 months. Four patients who had no or inadequate treatment survived an average of 10.5 months. Ten treated patients survived 10.6 months. Three patients are still alive receiving chemotherapy with no local irradiation. All patients were Chinese; all smoked cigarettes; two patients were women; all patients were older than 50 years. Four patients had no chest complaints but presented with Superior Vena Caval obstruction (two cases), dermatomyositis and the Eaton Lambert syndrome. Two patients had the syndrome of inappropriate antidiuretic hormone secretion. None was hypercalcaemic. Twelve patients had right sided lung lesions. The majority of patients underwent combined radiotherapy and chemotherapy, the latter consisting of three weekly cyclical methotrexate, adriamycin, cyclophosphamide and CCNU (MACC regime).

Aged↗
PubMed1985

Blood glucose levels in non-diabetics on intravenous dextrose infusions.

Does a 5% dextrose infusion of up to 3 litres per 24 hours in a patient cause significant hyperglycemia if the patient is not a known diabetic? This small study showed that in 15 patients on such a drip not on steroids, the blood glucose level at least two hours postprandially did not rise above 140 mg%. On the other hand, another two patients on steroids had blood glucose levels above this value but below 180 mg%.

Adolescent↗