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Medical Students' Column

"Research Paper? You Must Be Joking..."

I was told that I was being a trifle too idealistic. Some were concerned that I was taking on a monumental task: "A research paper? In your final year? You must be joking!" But yes, I was a crazy fool. Cliched as it may sound, I wanted to discover something - contribute to the scientific world. How in the world did those guys in SMJ and Lancet craft something out of virtually nothing? So with that cumulation of thoughts and ideals, I took on the scientific world - looking to pluck a ripe fruit from the flourishing tree of science.

I have always had a soft spot for the common person’s problems. Flu, fever, chicken pox …asthma. And so one fine May morning, I was having breakfast at KE VII Hall with A/P Ng Tze Pin when he expressed an interest in a research paper on asthma - the effects from the haze, to be more precise. I was, of course, excited. I enquired into a few topics relating to asthma - I was looking for something which would be close to everybody’s hearts; something everyone could relate to. It was the perfect study - the condition is suffered by one in five children in Singapore. I had to help these people!

I spent countless hours surfing the Internet and browsing through the library shelves; I devised a few contingencies should anything go wrong - after all, the haze may very well not come back! I, however, soon departed from the original idea of a study on the haze and decided to focus instead on the effects that gas cooking had on asthma. And so a research paper was born.

Then came the tricky part. Further research. I had to encroach into a field of which I had virtually no knowledge of; an area swarming with scientific and medical jargon. My angels of mercy came in the form of my supervisors, A/P Ng Tze Pin and Prof Tan Wan Cheng, who only so happened to be among the leading authority in the field of respiratory medicine in Singapore.

The essence of my study involved consolidating and improving on previous studies in related fields, with the aim of overcoming limitations which had hindered the success of those studies. This was accomplished by, for example, planning a prospective cohort study design rather than a cross-sectional study so as to reduce biases. I also came up with my pride and joy: a user-friendly asthma diary that would encourage participants to consistently record their asthma outcomes. This was achieved only after back-breaking hours facing the computer, learning to master the computer programme "Pagemaker".

Another obstacle I faced during the progress of my research was the difficulty in obtaining passive air samplers in Singapore. These samplers were needed to measure the exposure to gas fumes. But I was still hopeful - I sent an e-mail to 10 previous authors to find out where I could get these samplers. The response did much to encourage me. I received 8 replies, all of which by and large pointed me in the direction of a Swiss-based company. I subsequently was able to elicit details from the company itself, and managed to obtain funds to purchase them.

With the blueprint prepared, I embarked on a pilot study that was rather disheartening as the recruitment of volunteers proved difficult: few could fall within the stringent criteria that I had set out with. I processed the results I obtained from the few and made minor changes to the study design.

After having ironed out the glitches that were brought to my attention during the trial run, the rest was relatively smooth sailing. I recruited patients from the asthma clinic in NUH and, through the 3-week long fieldwork, I monitored them closely, making personal home visits to every single volunteer in order to measure their lung function before and after cooking, and to collect samples of the gas fumes to which they were exposed. These samples were then processed with the kind assistance of Mr. Khoo Ngee Yau and his staff at the Environmental Laboratory, Department of COFM.

With the results obtained, I analysed them using the SPSS statistical software. The results proved to be well worth all my efforts - they were substantive, statistically accurate and, in many respects, exciting. In a nutshell, I showed that gas cooking might worsen asthma. I accordingly submitted the results to my supervisors for their advice. And to end off my whole research escapade, I presented it during the NUH Annual Scientific Meeting. As was the trend throughout my stint, I learnt yet another new tool as a result - Microsoft Powerpoint.

I had never thought that I was wasting time on this research study, even though I was well aware of the likelihood of failure. I survived clinical tests during the period, and was even able to spend time with my girlfriend to her satisfaction. I have picked up good learning points from this venture into research. I now understand better the mechanics behind how a scientific paper was written, the demands of publishing a paper and an opportunity to test a hypothesis in a scientific manner with universal acceptance.

Now, how did I juggle all these in final year? I guess with coffee, naps in the MRT, curiosity, and I believe, some luck.



Final Year Medical Undergraduate
NUH’s Undergraduate Research Award Recepient

Title: Nitrogen Dioxide from Gas Cooking and Bronchial Airway Responsiveness in Adult Asthmatics