The prevalence of obesity in singapore primary school children

The purpose of this study is to survey the prevalence of obesity in Singapore primary school children from 1976 to 1980. The number of children screened comprised of 221,988 in primary I and 218,104 in primary VI. The male to female ratio was 1.04:1. Obesity is defined as body weight above 120% of Harvard standard weight for height. The overall prevalence rate was 3.51% with a significantly higher rate in boys (3.95%) than in girls (3.06%), p less than 0.0001. This sex difference prevailed in both the primary I and primary VI group. Furthermore, primary VI students had a higher prevalence rate (4.29%) compared to the primary I students (2.75%) p less than 0.0001. The prevalence rates were rising over the years with a rate of 5.33% in 1980 compared to that in 1976 (1.80%). Our observations suggest that the problem of obesity is an increasing one. The tendency to become obese increases with age and boys are more prone to obesity.

The incidence of atopy in steroid-responsive nephrotic syndrome: clinical and immunological parameters

Fifty-nine children with steroid-responsive nephrotic syndrome (SRNS), ages ranging from two to 18 years, were studied to determine the incidence of atopy, using both clinical and immunological parameters. Children with SRNS were found to have a significantly higher incidence of atopy both in themselves (z = 2.51, p less than 0.05) and their first-degree relatives (z = 2.34, p less than 0.05). The proportion of children with raised serum IgE levels (60%) and the geometric mean (631 U/ml) in SRNS children were significantly higher than control values, 14.5% and 136 U/ml, respectively (p less than 0.0001). Intra-group comparison showed that children with multiple relapses (more than two relapses) had higher incidence of skin test positivity to house dust mite (p less than 0.01) and to two or more antigens (p less than 0.05). Our data would suggest that atopy may be a predisposing factor in local children with SRNS.

Automated blood pressure reading--its claims and its reliability

Advances in technology have made available automated devices for rapid and easy measurements of arterial blood pressure. This study evaluates the performance of one such device, the Hitachi Digital Blood Pressure and Pulse Monitor, Model HME-20, against a standard mercury sphygmomanometer, the Accoson . Fifty four sets of systolic and diastolic readings were simultaneously obtained using the two instruments. The readings obtained by both methods correlated significantly with each other (p less than 0.001). However, the mean diastolic pressure obtained by HME-20 is significantly lower than that obtained by the Accoson (p less than 0.05). There is also a consistent underestimation of systolic and diastolic pressures of 8 mm Hg by HME-20. Moreover, linear correlation studies between HME-20 and Accoson readings reveal that the 95% confidence limits are fairly wide, which limit, therefore, the value of a single reading by HME-20. Our preliminary evaluation suggests that HME-20 is more suited to monitor the trend of blood pressure changes rather than to provide precise determination of arterial blood pressures.

Doppler ultrasonic brachial blood pressure measurements in normal Chinese neonates: a preliminary report

The purpose of this study was to determine brachial blood pressures in normal Chinese neonates using a Doppler ultrasonic blood pressure monitor (Roche Arteriosonde 1020). The systolic (SP) and diastolic (DP) pressures of 100 healthy, full-term Chinese neonates were determined in triplicate under resting conditions. The pulse pressures (PP) were derived from the SP and DP. Correlation studies reveal significant positive correlation between age and PP (r = 0.34, P less than 0.0002), between weight and SP (r = 0.23, P less than 0.02) and between weight and PP (r = 0.40, P less than 0.02). No significant difference exists between blood pressures of males and females (P greater than 0.05). Comparison with three Western studies reveals that our mean SP is the lowest (1-3). This may be due to technical factors, e.g. different Doppler ultrasonic device, anthropometric factors or true genetic or environmental differences.

Seasonal variations in admissions to a tropical paediatric unit

The monthly admissions over the last 10 years (1972-1981) of children with common illnesses to the Department of Paediatrics, National University of Singapore, were analyzed to ascertain if there were any significant seasonal patterns. The method used (developed by Walter and Elwood) consists of estimating the amplitude of seasonal variations and the time at which the maximum occurs in a postulated simple harmonic fluctuation. Six out of the 9 diagnostic groups studied were found to have significant seasonal variations in at least 5 out of 10 years or 3 out of the last 5 years: pharyngitis, bronchitis, broncho-pneumonia, bronchial asthma, gastro-enteritis, and febrile convulsions. Febrile convulsions showed the best correlation (in terms of the number of monthly admissions) with the other illnesses showing seasonal fluctuations. Admissions for bronchial asthma were negatively correlated with the others. No consistent pattern in the time of peak number of admissions was discernable. The seasonal variations demonstrated are probably related to outbreaks of viral infections which tend to occur round the year in the tropics.

Reliability of transcutaneous oxygen monitoring of critically ill children in a general pediatric unit

While transcutaneous continuous monitoring of partial pressure of oxygen (TcPO2) is a proven valuable diagnostic tool in intensive care of sick neonates, its use in older children is less well defined. The purpose of this study is to establish the accuracy and reliability of TcPO2 as a reflection of arterial partial pressure of oxygen (PaO2) in critically ill pediatric patients. Twenty-six children, age ranging from 4 days to 13 years, were studied. The main diagnostic categories were cardiac 54 per cent, respiratory 27 per cent, gastrointestinal 15 per cent, and neurologic 4 per cent. Forty three estimations of PaO2 (by radial arterial sampling) and TcPO2 (by cutaneous monitor) were obtained simultaneously. Their correlation coefficient, regression equation, and confidence limits were calculated by standard statistical methods with the aid of a microcomputer. Our data show that the high degree of correlation between TcPO2 and PaO2 is highly significant (r = 0.90, p less than 0.001) for the full range of PaO2 between 0 to 200 mm Hg. At the lower range of PaO2 (0-79 mm Hg), the degree of correlation (r = 0.91, p less than 0.001) is better than that (r = 0.77, p less than 0.001) at the higher range (80-200 mm Hg), although the difference between the two correlation coefficients is not significant (p greater than 0.05). It is important to note that TcPO2 consistently underestimates the PaO2 and the 95% confidence limits are rather wide. We conclude that TcPO2 is a reasonably accurate reflection of PaO2 in critically ill pediatric patients. Its main advantage is in predicting and showing trends in tissue oxygenation by noninvasive means. However, when critical assessment of the degree of hypoxemia is required, TcPO2 is no substitute for PaO2.

Chediak-Higashi syndrome in a Chinese infant

Chediak-Higashi syndrome in Chinese has not been previously reported in the English literature. A 14-month Chinese girl who presented with partial oculocutaneous albinism and Pseudomonas infection was found to have the classical intracytoplasmic inclusion bodies in the leucocytes by light and electron microscopy. Other characteristic features typical of this syndrome included hepatosplenomegaly, defective chemotaxis, and coarse but sparse melanin granules in hair shaft. She was also found to have hypertriglyceridaemia, a rare lipid abnormality occasionally reported in children suffering from this syndrome. Despite vigorous therapy with high dose ascorbate, corticosteroid and intravenous antibiotics, she died in the accelerated phase of Pseudomonas septicaemia.

Parental age and birth order in Chinese children with congenital heart disease

Parental age and birth order were studied in 100 Chinese children with congenital heart disease (proven by cardiac catheterisation) and in 100 controls. A higher incidence of congenital heart disease was present in the children with higher birth orders. No relationship was found between the incidence and the paternal or maternal ages. Using the method of multiple regression analysis this birth order effect was significant (p less than 0.01) and independent of parental age. This finding provides indirect evidence of environmental influence in the causation of congenital heart disease, which is known to be inherited in a multifactorial manner. Family planning to limit the size of the family may possibly contribute to the reduction of the incidence of congenital heart disease.

New prognostic criteria for children with cyanotic congenital heart disease

Available oxygen and oxygen unloading capacity were determined at the time of cardiac catheterisation, from blood gas analysis, p 50 in vivo, and haemoglobin, in 79 children with cyanotic congenital heart disease, their age ranging from 2 weeks to 14 years. The patients were followed up for six months to find out how many of those without surgical intervention survived. Actuarial analysis showed that the six month survival rate among the patients with low available oxygen or oxygen unloading capacity was significantly lower (24% and 49%, respectively) compared with those with normal indices (90% and 96%, respectively). Both available oxygen and oxygen unloading capacity were superior to arterial oxygen saturation and arterial oxygen content as prognostic criteria. Haemoglobin and haematocrit were of little value in prognosis. Available oxygen appeared to be the best prognostic criterion for survival at six months. It is concluded that available oxygen and oxygen unloading capacity are useful prognostic criteria in children with cyanotic congenital heart disease. These new criteria, when used in conjunction with the conventional methods of assessing the cardiac lesion, may be of considerable help to the physician in evaluating the prognosis of the patient.