Summary Cervix cancer is about twice as common in Asia as in the Western world and its incidence varies among different Asian ethnic groups. A study based in Singapore, the population of which comprises Chinese, Indians and Malaysians, offers the opportunity to evaluate whether the same risk factors are important in this part of the world as in the West.A total of 135 cases and an equal number of controls were interviewed and details concerning reproductive and sexual history, smoking, hygiene, socio-economic status and education were collected. Seventy-three cases had invasive cancer while 62 had micro-invasive disease or CIN III. The most important risk factors were parity and number of sexual partners. Smoking was rare in cases and controls and did not appear to be an important determinant of risk. Of the socio-economic factors, education appeared most predictive and lowered the risk. Age at first intercourse was strongly correlated with education (positively) and parity (negatively), but not with number of sexual partners. Biopsies were available for HPV DNA analysis in 38 cases and 37% were positive, mostly for HPV type 16. All these factors gave similar risks in invasive and preinvasive disease.A fairly consistent picture of risk factors for cervical cancer is now emerging from studies in Western Countries (Cramer, 1982). The most important of these are factors related to sexual behaviour and elevated risks have been associated with multiple sexual partners and having been divorced

Ahstruct.During the years 1960 to I970 inclusive, six conjoined twins were delivered out of a total of 403 441 deliveries including 3 276 twins and 37 triplet deliveries, an incidence of 1 in 67241 deliveries and 1 in 655 twin deliveries. A seventh cilnjained twin was delivered in late January 1971: inclusion of this case as well as the deliveries in January 1971 would lead to an incidence of I in 57 975 deliveries and I in 546 twin deliveries. Four of the twins were thoracopagus. one craniopagus, one dicephalus tripus tetrabrachius and one syncephalus. One of thc thoracopagus twins occurred in a triplet pregnancy. All except two were delivered alive; four died within a few hours to a few days. One t h x u p a g u s survived till 3 months of age; surgical separation was then attempted resulting on one survival whr, has developed normally and is now 7 years old. Antenatal diagnosis is necessary if the siirvival rate is to be improved.Conjoined twins have fascinated both physician and layman over the centuries and many excellent papers have been written about them. In 1952. Sebastian Munster (12) reported on a case of craniopagus alive a t the age of 6 years. About 400 to 500 cases of conjoined twins have been reported (3). Because of its extreme rarity. many papers have been in the form of case reports a n d / o r reviews of the subject. From available literature. only one series of conjoined twins has been reported from a single hospital ( I I); this is because the condition is so rare that a single case may not occur for many years. As a result, the incidences reported are a t best very approximate (8).I t is the purpose of this paper to present a n analysis of the cases which occurred in the Kandang Kerbau Hospital, Singapore during the last 11 years. MATERIALFrom 1960 to 1970, six cases of conjoined twins were encountered out of 403 441 deliveries giving an incidence of I in 67 241 deliveries. One of the twins was delivered before arrival at the hospital, but as the total deliveries in the hmpital include all such cases (born before arrival), this does not affect th-calculation of the incidence. This is compared with an incidence of 4 in 25 OOO (11).3 in X.5000 (10) and 2 in 100000 (18). More recently.Compton (2) reviewed five cases (from 2 h3spitals) OCcurring in a period of 20 years, during which t h m were about 250000 deliveries. an incidence of I in 50000. During this same period. 3 276 twins and 37 triplets were delivered: the incidence of conjoined twins c>mplicating twin gestations is therefore I in 655 and that for conjoined twins complicating triplet pregnancies is I in 37. Compton (1971) found an incidcncc of I conjoined twin in 900 twin deliveries but as the incidence of twin pregnancies for a single year was projected over 20 years to arrive at the total number of twins delivered during this period. the incidence must be considered to be only approximate. In the present paper. thc total number of twins delivered were actually taken frdm th-records. The incidence with regard to triplet pregnancies ...

Objective To determine the normal response to a 75 g glucose challenge in the context of an oral glucose tolerance test in the third trimester of pregnancy. Design Prospective observational study. Setting Antenatal clinic, Kandang Kerbau Hospital, Singapore. Subjects Sixty‐four normal pregnant women with a low risk for diabetes. Interventions Glucose (75 g) challenge following an overnight fast after 28 weeks of gestation. Main outcome measure Venous plasma glucose levels taken before and 2 h after the glucose challenge. Results Upper limits of normality were found to be fasting glucose 4·9 mmol/l and 2 h glucose 9·2 mmol/l. Conclusion The WHO (1980) criteria should not be used in pregnancy.

Summary An investigation was made into the onset and severity of neonatal jaundice in 114 patients following spontaneous labour and labour induced by (a) amniotomy, (b) amniotomy and simultaneous infusion of oxytocin, (c) amniotomy and simultaneous administration of oral prostaglandin E2, (PGE2,). No significant difference in serum bilirubin levels in the first five days of life was found in the four groups.

No abstract