Displaying all 17 publications

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  1. Kaushik SP, Vu C
    Aust N Z J Med, 2000 Apr;30(2):231-5.
    PMID: 10833116
    BACKGROUND: From European and North American data, it is recommended in the Asia Pacific consensus statement, that one week therapy with a proton pump inhibitor, amoxycillin and clarithromycin be used for Helicobacter pylori eradication, in areas of high metronidazole resistance. The efficacy of this regimen is unknown in Singapore.

    AIM: To assess the efficacy, safety and compliance of an H. pylori eradication regimen and examine clinical factors that potentially determine eradication.

    METHODS: Consecutive outpatients from a multicultural, south east Asian, population with H. pylori infection, with or without peptic ulcer, were treated with lansoprazole 30 mg, amoxycillin 1 gm, clarithromycin 500 mg, twice a day for seven days. Eradication was assessed by either rapid urease, histology or urea breath test. Compliance and side effects were recorded. The eradication rate and effect of ethnicity, age, sex, usage of alcohol, smoking and non-steroidal anti-inflammatory drugs, history of ulcer and endoscopic diagnosis on eradication were examined by univariate and multivariate analysis.

    RESULTS: Of 113 patients, the eradication rate by intention to treat was 98/113 (87%) (95% confidence interval [CI] 80-93%) and per protocol was 98/106 (92%) (95% CI 87-97%). Using Fisher's exact test, eradication was more successful in Chinese (intention to treat and per protocol respectively p=0.02 and p<0.001) compared to non-Chinese. By logistic regression analysis ethnicity was an independent factor associated with eradication success (p=0.0025). Side effects occurred in five (4.4%), resulting in cessation of treatment.

    CONCLUSIONS: This one week eradication regimen is safe and effective in south east Asians. Chinese ethnicity may be associated with a higher likelihood of eradication success.

  2. Huang X, Butow P, Meiser B, Goldstein D
    Aust N Z J Med, 1999 Apr;29(2):207-13.
    PMID: 10342019
    BACKGROUND: The information needs of ethnic minorities often differ from that of the dominant culture, leading to dissatisfaction among both patients and health professionals.

    AIMS: This research project aims to identify attitudes towards cancer and associated information and communication needs of Chinese patients and their relatives in Sydney, thereby providing a framework for the provision of culturally appropriate cancer care for Chinese-Australians.

    METHODS: A qualitative data collection strategy was selected as the most appropriate method, because no validated measures are available and no previous research has examined attitudes and needs of Chinese-Australian cancer patients. Patients were recruited from three major teaching hospitals in Sydney and from a Chinese cancer support organisation. Sampling was discontinued when informational redundancy was achieved. Four focus groups and 26 individual telephone interviews were conducted with a total of 36 cancer patients and 12 relatives born in China, Singapore and Malaysia.

    RESULTS: While individual differences were observed, a majority view was expressed on a range of issues. Non-disclosure of a poor prognosis was favoured, and the role of the family in liaising between health professionals and the patient was emphasised. Patients preferred a confident and clear diagnosis and treatment recommendation. Most patients wished to incorporate Chinese culture-specific treatments into their care. The need for interpreters and psychological and spiritual support was emphasised.

    CONCLUSIONS: Providing information in a culturally sensitive manner will assist doctors in providing optimum care and support for ethnic minority groups in this country.

  3. Rajadurai J, Arokiasamy J, Pasamanickam K, Shatar A, Mei Lin O
    Aust N Z J Med, 1992 Aug;22(4):345-8.
    PMID: 1445022
    From available studies, there appears to be a racial preponderance of coronary artery disease (CAD) among Indians when compared to other ethnic groups. We found that this racial difference exists even in a young Asian population with premature atherosclerosis. In this small series, these racial differences could not be explained by the commonly known risk factors for coronary artery disease--smoking, hypertension, diabetes and hypercholesterolaemia, findings similar to those found in older patients elsewhere. Only fasting triglyceride levels were significantly higher among young Indians compared to non Indians (p less than 0.02) although the importance of this finding as a risk factor for CAD remains controversial. The majority of these young patients were treated medically and their one year survival was good.
  4. Segasothy M, Tong BK, Kamal A, Murad Z, Suleiman AB
    Aust N Z J Med, 1984 Feb;14(1):23-6.
    PMID: 6590001
    Seven cases of analgesic nephropathy due to excessive ingestion of paracetamol are reported. None of these patients had been taking any other analgesic. All had radiological features of papillary necrosis. With the increasing use of paracetamol as a mild analgesic it is necessary to be aware of the possibility that paracetamol may induce analgesic nephropathy.
  5. Jayalakshmi P, Goh KL, Soo-Hoo TS, Daud A
    Aust N Z J Med, 1990 Apr;20(2):175-6.
    PMID: 2344324
    A 59-year-old Chinese man presented with a three month history of penile ulcers and abdominal pain. Syphilis and a gastric malignancy were diagnosed clinically. Biopsy of the genital and stomach ulcers revealed histiocytic granulomata containing numerous intracellular fungal bodies. Histoplasma capsulatum was subsequently cultured from the penile ulcer. Antifungal therapy was instituted. However the patient's general condition deteriorated rapidly and he died within two weeks of admission. A post-mortem liver biopsy showed numerous intracellular fungi.
  6. Kang JY
    Aust N Z J Med, 1988 Aug;18(5):661-4.
    PMID: 3072950
    The incidence of surgery for gastric cancer in Singapore increased during the period 1951 to 1980 (males from 3.5 to 8.7 per 100,000 per year: females from 0.5 to 4.2 per 100,000 per year). This increase occurred mainly during the first decade of the study and was confined to persons aged 55 and above. Chinese had the highest incidence, followed by Indians and then Malays. These racial differences remained unchanged over the period of study.
  7. Bosco J, Pathmanathan R
    Aust N Z J Med, 1991 Aug;21(4):454-6.
    PMID: 1953537
    Peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes are often the presenting features of the POEMS syndrome. Approximately 50% of these are associated with osteosclerotic myeloma, a rare variant of multiple myeloma and some with Castleman's disease, an unusual lympho-proliferative disorder. The underlying pathogenetic mechanisms have not been elucidated but amelioration of symptoms with the disappearance of the M-component suggests possible etiopathogenic mechanisms. We present a 40-year-old woman with manifestations of all three disorders.
  8. Tan CT
    Aust N Z J Med, 1989 Aug;19(4):297-302.
    PMID: 2783084
    Fifty-four per cent of 52 patients presenting to the University of Malaya Medical Centre with a myelopathy for which appropriate investigations uncovered no definite etiology, subsequently developed clinically definite or probable multiple sclerosis. In the subgroup of patients with a presentation indicative of acute/subacute transverse myelopathy, 14 or 52% also went on to develop clinically definite or probable multiple sclerosis, a far higher proportion than previously recorded in the literature. This finding is probably a further manifestation of racial difference in the behaviour of multiple sclerosis. For the group as a whole, the only factor which appeared to be associated with an increased risk of developing multiple sclerosis was female sex; 67% of 33 female patients went on to develop multiple sclerosis after a mean follow-up period of 5.5 years. Other factors such as age of onset, racial composition, level of spinal cord involvement, presence of fever and CSF finding were found not to be important.
  9. Kong NC, Shaariah W, Morad Z, Suleiman AB, Wong YH
    Aust N Z J Med, 1990 Oct;20(5):645-9.
    PMID: 2285381
    Cryptococcosis is a known opportunistic infection in immunosuppressed hosts. We report our experience of all cases presenting to our Department between December 1975 and September 1988. Eight post-renal transplant patients and three systemic lupus erythematosus (SLE) patients were affected. All were receiving treatment with steroids, in association with either azathioprine or cyclosporin. The diagnosis of cryptococcal meningitis was initially based on a positive cerebrospinal fluid (CSF) cryptococcal antigen, by latex agglutination test, and subsequently confirmed by cultures. Common clinical presentations, in descending order of frequency, included headaches, fever, mental confusion, epilepsy and papilloedema. Meningism was not a prominent feature. CT brain scans were obtained in eight patients and one showed a focal lesion and one showed cerebral atrophy. Four patients also had an abnormal chest X-ray (CXR) and one had disseminated cryptococcosis. Amphotericin and 5-fluorocytosine were the mainstay of therapy, although ketoconazole alone was subsequently used in three selected patients with cure. Four early deaths occurred in patients with delayed diagnosis and treatment, usually in association with other severe concurrent infections. We conclude that awareness of cryptococcosis is essential in immunocompromised hosts presenting with headache with, or without, mental confusion or fever.
  10. Yusof ZB, Pratap RC
    Aust N Z J Med, 1990 Oct;20(5):697-8, 700.
    PMID: 2126728
    We describe a case of cervical cord compression due to ossified posterior longitudinal ligament in association with diffuse idiopathic skeletal hyperostosis, in a young female. Characteristic CT findings are described.
  11. Chin K, Singham KT, Anuar M
    Aust N Z J Med, 1983 Aug;13(4):374-5.
    PMID: 6580862
    Acute nonspecific carditis with advanced heart block is rare. We observed nine cases with complete heart block and one with Mobitz type II block over an eight and a half year period. Temporary cardiac pacing was instituted in all while permanent pacing was required in six patients. No death was recorded.
  12. Singham KT, Wong HO
    Aust N Z J Med, 1979 Apr;9(2):174-6.
    PMID: 287460 DOI: 10.1111/j.1445-5994.1979.tb04323.x
    Findings are reviewed of isolated Patent Ductus Arteriosus after infancy as seen in 181 patients studied at the University Hospital, Kuala Lumpur, during the period 1967 to 1975. The ages of patients ranged from nine months to 54 years. Eighty-two patients underwent cardiac catheterization. More than 50% of patients were above ten years of age; the sex ratio was 1 male: 2.93 females. Thirty-two per cent of the patients had significant effort dyspnoea or were in heart failure. The complications noted were elevated pulmonary vascular resistance, Eisenmenger syndrome, bacterial endocarditis and cardiac failure.
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