Knowledge, attitudes and practices towards COVID-19 among multiethnic elderly Asian residents in Singapore: a mixed-methods study

INTRODUCTION@#We investigated the knowledge, attitudes and practice (KAP) towards coronavirus disease 2019 (COVID-19) and its related preventive measures in Singaporeans aged ≥60 years.@*METHODS@#This was a population-based, cross-sectional, mixed-methods study (13 May 2020-9 June 2020) of participants aged ≥ 60 years. Self-reported KAP about ten symptoms and six government-endorsed preventive measures related to COVID-19 were evaluated. Multivariable regression models were used to identify sociodemographic and health-related factors associated with KAP in our sample. Associations between knowledge/attitude scores and practice categories were determined using logistic regression. Seventy-eight participants were interviewed qualitatively about the practice of additional preventive measures and data were analysed thematically.@*RESULTS@#Mean awareness score of COVID-19 symptoms was 7.2/10. The most known symptom was fever (93.0%) and the least known was diarrhoea (33.5%). Most participants knew all six preventive measures (90.4%), perceived them as effective (78.7%) and practised 'wear a mask' (97.2%). Indians, Malays and participants living in smaller housing had poorer mean scores for knowledge of COVID-19 symptoms. Older participants had poorer attitudes towards preventive measures. Compared to Chinese, Indians had lower odds of practising three out of six recommendations. A one-point increase in score for knowledge and attitudes regarding preventive measures resulted in higher odds of always practising three of six and two of six measures, respectively. Qualitative interviews revealed use of other preventive measures, for example, maintaining a healthy lifestyle.@*CONCLUSIONS@#Elderly Singaporeans displayed high levels of KAP about COVID-19 and its related preventive measures, with a positive association between levels of knowledge/attitude and practice. However, important ethnic and socioeconomic disparities were evident, indicating that key vulnerabilities remain, which require immediate attention.

Reversible recurrent laryngeal nerve palsy in acute thyroiditis

First reported by Nager in 1927, unilateral vocal cord paralysis associated with thyroid disease suggests the malignant and irreversible nature of the thyroid lesion. This condition is rarely seen in benign thyroid diseases, and the function of the vocal cord does not usually return. We present a 54-year-old woman with a history of right hemithyroidectomy for benign thyroid nodule, who had an episode of subacute thyroiditis associated with unilateral vocal cord paralysis. The patient was treated with intravenous antibiotics and underwent a completion thyroidectomy. Post operation, her vocal cord function recovered successfully. Unilateral vocal cord paralysis can be seen in thyroiditis, and this can be reversed with steroids and antibiotics. If surgery is necessary, care must be taken to preserve the recurrent laryngeal nerve.

Outcomes of oral tongue cancer: does age matter?

<p><b>INTRODUCTION</b>This is a retrospective study aimed to analyse the outcomes of oral tongue cancer with emphasis on young people.</p><p><b>MATERIALS AND METHODS</b>Patients treated radically between 1998 and 2006 were included and categorised according to treatment modalities (Group A: Surgery, Group B: Surgery and adjuvant therapy, Group C: Definitive radiotherapy) and age groups (≤ 40 and > 40 years). Overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRS) and metastasis-free survival (MFS) were estimated using Kaplan-Meier method.</p><p><b>RESULTS</b>There were 123 patients with 32%, 53% and 15% in Group A, B and C, respectively. Of these, 17 patients (14%) were ≤40 years with 6 (15%), 8 (12%) and 3 (16%) young oral tongues in Group A, B and C, respectively. Five-year OS and DFS were 69%/72%, 41%/47% and 16%/9.5% for Group A, B and C, respectively. Young patients had similar survival as the older population with 5-year OS of 83%, 75% and 33% in Group A, B and C, as compared to the older patients (66%, 36% and 13%, respectively).</p><p><b>CONCLUSION</b>Young oral tongue patients did not have worse outcomes.</p>