Original Article

KC Teh, AR Aziz
Correspondence: Dr K C Teh

ABSTRACT
Objective The purpose of this study was to develop a stair-climb test of cardiorespiratory fitness for adult Singaporeans, particularly those staying in Singapore Housing and Development Board (HDB) flats.
Method 103 subjects [56 males, of mean (SD) age 44.8 (13.9) years and Body Mass Index, or BMI, 23.3 (3.2); and 47 females, of age 43.2 (12.9) years and BMI 21.9 (2.8)] were first assessed for their cardiorespiratory fitness, measured using maximal oxygen uptake (or VO2max) on a treadmill, before undergoing a stair-climb test up to the 12th storey (11 floors) of a typical HDB flat (180 steps, vertical height 27.0 metres).
Results The mean (SD) time taken for the climb (CT) and heart rate at the end of the climb (HRend) averaged 111.3 (16) seconds and 154.4 (13.4) beats.min-1 respectively for males, and 121.0 (18.1) seconds and 164.6 (15.7) beats.min-1 respectively for females. Regression equations were developed to predict VO2max from age (years), BMI, CT (seconds), HRend (beats.min-1): For males: VO2max (ml.kg-1.min-1) = 133 - 0.273 (Age) - 0.672 (BMI) - 0.236 (CT) - 0.232 (HRend). For females: VO2max (ml.kg-1.min-1) = 66.69 - 0.135 (Age) - 0.249 (BMI) - 0.128 (CT) - 0.021 (HRend). Validation of the regression equations conducted on a different sample consisting of 18 subjects (11 male and 7 female) showed significant correlations between the predicted and directly measured VO2max (males, r = 0.81 and females, r = 0.90; p < 0.01). There were no significant differences between the means of predicted and directly measured VO2max.
Conclusion A stair-climb test using HDB stairs was developed which was able to estimate cardiorespiratory fitness with reasonable accuracy.

Keywords: stair-climb test, cardiorespiratory fitness, VO2max, Singapore
Singapore Med J 2000; 41(12): 588-594

RW Armstrong, MJ Armstrong, MS Lye
Correspondence: Prof R W Armstrong

ABSTRACT
Aim of Study With a five-year survival rate of 20% in 1970 and 40-45% in 1990, and highest incidence and mortality in early and middle adult years, nasopharyngeal carcinoma (NPC) may have a severe social impact on families and households. The aim of this study was to measure the social impact of NPC in the Chinese population of Selangor, Malaysia.
Method Cases were pooled from three epidemiological case-control studies conducted in 1973-74, 1980, and 1990-92 for a total of 442. They lived in households with a grand total of 2,598 persons. Interviewers collected data on household composition: number of residents; each resident's age, sex, occupation, and relationship to the head of the household; and position of the NPC case in the household.
Results Ninety-four percent of cases supported 93% of household members in some way. Most cases were employed as income earners or homemakers and 80% had a key role as head of household and/or parent of dependent children.
Conclusion The illness and death caused by NPC had a major social impact on immediate families and on extended family and non-kin households as well.

Keywords: nasopharyngeal cancer, Malaysian Chinese, social impact, household organisation
Singapore Med J 2000; 41(12): 582-587

KH Lee, NK Chin, TK Lim
Correspondence: Dr T K Lim, mdclimtk@nus.sg

ABSTRACT
Objective To determine the severity of asthma in the elderly compared to the younger asthmatics.
Design Cross-sectional study.
Setting University outpatient asthma clinic.
Subjects Asthmatics seen over a 6 month period in 1997.
Results There were 154 patients and 16% were elderly (> 65 years) asthmatics. The elderly asthmatics were on significantly more anti-asthmatic medications (2.3 +/- 1.1 vs. 1.6 +/- 0.9, p < 0.001), and their clinical severity was significantly worse than their younger counterparts (Step 2.2 +/- 1.2 vs. 1.7 +/- 1.0, p < 0.001). Near-fatal asthma episodes were also more common in the elderly asthmatics (39% vs 13%, chi 2 test p < 0.01).
Conclusion Elderly asthmatics appear to have more severe asthma as evidenced by the increase in near-fatal episodes, and their increased clinical severity.

Keywords: asthma, elderly, near fatal
Singapore Med J 2000; 41(12): 579-581

LH Song, EST Goh, LC Phang, WT Poh, SK Tay
Correspondence: Dr Poh Wee Teng

ABSTRACT
Aim of Study To analyze the common technical problems encountered in ThinPrep preparations.
Method A prospective and retrospective study of eight hundred and fifty (n = 850) conventional cervical smears with its corresponding paired ThinPrep specimens from July 1998 to December 1998.
Results 139 ThinPreps were found to be technically suboptimal. Of these, 81 showed "patchy cells lost"; 18 showed "thick preparations"; 24 demonstrated "halo effect'" where the cellular material collected at the periphery of the cell circle, and 16 had "obscuring blood and amorphous debris", rendering the preparations "satisfactory for evaluation but limited" by the presence of the above artifacts.
Conclusion Despite its many advantages in providing standardization of specimen preparation, superb cellular presentation, reduction in the number of unsatisfactory reports and increased lesion detection rate, ThinPrep has its own limitations in terms of technical problems, ease of operation and cost effectiveness.

Keywords: cervical smears, ThinPrep, technical problems, suboptimal
Singapore Med J 2000; 41(12): 575-578