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Usefulness of stable microbubble test of tracheal aspirate for the diagnosis of neonatal respiratory distress syndrome

Boo NY, Cheong KB, Cheong SK, Lye MS, Zulfiqar MA

J Paediatr Child Health, 1997 Aug;33(4):329-34.
PMID: 9323622

OBJECTIVES: To compare the overall accuracy of the stable microbubble test (SM test) with measurement of level of surfactant protein A (SP-A) of tracheal aspirate for the diagnosis of respiratory distress syndrome (RDS).
METHODOLOGY: Tracheal aspirates were obtained from neonates on ventilatory support. The SM test was carried out on specimens of tracheal aspirate immediately after collection. Levels of SP-A in tracheal aspirates were determined by enzyme-linked immunosorbent assay (ELISA) method. The results of the SM test and SP-A level of the tracheal aspirates were compared against the clinical diagnosis of RDS based on clinical, radiological and bacteriological findings.
RESULTS: Both the median microbubble counts (6 microbubbles/mm2, range = 0-90) and median SP-A levels (100 micrograms/L, range = 0-67447) of infants with RDS were significantly lower than those of infants with no obvious lung pathology (P < 0.0001), and pneumonia (P < 0.0001). The SM test of tracheal aspirates had higher overall accuracy for the diagnosis of RDS than measurement of SP-A levels (94.6% vs 82.4%). When the receiver operating characteristic (ROC) curves of both tests for RDS were compared, the area under the ROC curve of the SM test was larger (0.9689) than that of the SP-A method (0.8965).
CONCLUSIONS: This study showed that the SM test of tracheal aspirate was a useful bedside diagnostic test for RDS. It could be carried out at any time after birth on infants requiring ventilatory support.
Transmission dynamics and estimates of malaria vectorial capacity for Anopheles balabacensis and An. flavirostris (Diptera: Culicidae) on Banggi island, Sabah, Malaysia

Hii JL, Kan S, Vun YS, Chin KF, Tambakau S, Chan MK, et al.

Ann Trop Med Parasitol, 1988 Feb;82(1):91-101.
PMID: 3041932

Holoendemic malaria transmission in two small isolated forest communities and a coastal village was studied by (1) all night human bait collections of Anopheles species from inside and outside houses and (2) buffalo-biting and CDC light-trapping catches during March and November 1984. During the same period thick and thin blood films were collected from the human population, and spleen rates were determined in children from two to nine years of age. Using both the immunoradiometric assay (IRMA) and the dissection technique, more sporozoite-positive infections were detected in An. balabacensis and An. flavirostris in November than in March. IRMA confirmed the presence of Plasmodium falciparum sporozoites. An average of 76.2% of the An. balabacensis population lived long enough to have reached a point where infectivity with P. falciparum was possible in November. Although fewer than five adult females bit humans per night at any time, a resident could theoretically have received more than 160 infective bites in one year. A high frequency of feeding on humans, coupled with increased anopheline life expectancy, contributed to high estimates of falciparum malaria vectorial capacity (number of infections distributed per case per day); for An. balabacensis (1.44-7.44 in March and 9.97-19.7 in November) and for An. flavirostris (0.19-5.14 in March and 6.27-15.8 in November). These high values may explain the increased malaria parasite rates obtained from at least two forest communities. Correlation between actual and calculated rates of gametocytaemia was poorest in Kapitangan due to inadequate sampling of the human population. In Banggi island, malaria is stable and holoendemic, and the population enjoys a high degree of immunity.
The role of expressed breastmilk and continuous positive airway pressure as predictors of survival in extremely low birthweight infants

Boo NY, Puah CH, Lye MS

J Trop Pediatr, 2000 Feb;46(1):15-20.
PMID: 10730035

A case-control study was carried out on 152 extremely low birthweight (ELBW, < 1000 g) infants born consecutively in a large Malaysian maternity hospital during a 21-month period to determine the significant predictors associated with survival at discharge. Forty-nine (32.2 per cent) of these infants survived and 103 (67.8 per cent) died. The survivors weighed significantly heavier (mean = 888 g, SD = 99) than infants who died (mean = 763 g, SD = 131; p < 0.0001). They were also of higher gestational age (mean = 28.7 weeks, SD = 2.2) than those who died (mean = 26.7 weeks, SD = 2.5; p < 0.0001). Logistic regression analysis showed that, after controlling for various confounders, only three factors were significantly associated with the survival of these infants. These were: (1) increasing birthweight of the infants (with every gram increase in birthweight, adjusted odds ratio of survival was: 1.009; 95 per cent CI 1.004, 1.015; p = 0.0006); (2) given nasal continuous positive airway pressure for treatment of respiratory distress syndrome (adjusted odds ratio of survival: 4.2; 95 per cent CI 1.2, 14.0; p = 0.02); and (3) given expressed breastmilk (adjusted odds ratio of survival: 57.5; 95 per cent CI: 7, 474; p = 0.0002). Maternal illness, intrapartum problems, ethnicity, gestational age, use of antenatal steroid, modes of delivery, Apgar scores, congenital anomalies, respiratory distress syndrome, persistent ductus arteriosus, septicemia, necrotising enterocolitis, chronic lung disease, oxygen therapy, intermittent positive pressure ventilation, surfactant therapy, and blood transfusion were not significant factors associated with increased survival.
The prognostic value of the Glasgow Coma Scale, hypoxia and computerised tomography in outcome prediction of pediatric head injury

Ong L, Selladurai BM, Dhillon MK, Atan M, Lye MS

Pediatr Neurosurg, 1996 Jun;24(6):285-91.
PMID: 8988493

The outcome of 151 children less than 15 years of age and admitted within 24 h of head injury was studied in relation to clinical and computed tomography (CT) scan features. Thirty one (20.5%) had a poor outcome (24 died, 6 were severely disabled at 6 months after injury and 1 was in a persistent vegetative state) while 120 (79.5%) had a good outcome (89 recovered well and 31 were moderately disabled). Factors associated with a poor outcome were Glasgow Coma Scale (GCS) score 24 h following injury, presence of hypoxia on admission and CT scan features of subarachnoid haemorrhage, diffuse axonal injury and brain swelling. GCS scores alone, in the absence of other factors, had limited predictive value. The prognostic value of GCS scores < 8 was enhanced two-to fourfold by the presence of hypoxia. The additional presence of the CT scan features mentioned above markedly increased the probability of a poor outcome to > 0.8, modified only by the presence of GCS scores > 12. Correct predictions were made in 90.1% of patients, indicating that it is possible to estimate the severity of a patient's injury based on a small subset of clinical and radiological criteria that are readily available.
Fulltext The World Health Organization Body Mass Index Curves for Iranian Children

Lye MS, Zarghami M, Abdollahi F

Oman Med J, 2023 Sep;38(5):e563.
PMID: 38192362 DOI: 10.5001/omj.2023.130
Temporal and spatial mapping of hand, foot and mouth disease in Sarawak, Malaysia

Sham NM, Krishnarajah I, Ibrahim NA, Lye MS

Geospat Health, 2014 May;8(2):503-7.
PMID: 24893027

Hand, foot and mouth disease (HFMD) is endemic in Sarawak, Malaysia. In this study, a geographical information system (GIS) was used to investigate the relationship between the reported HFMD cases and the spatial patterns in 11 districts of Sarawak from 2006 to 2012. Within this 7-years period, the highest number of reported HFMD cases occurred in 2006, followed by 2012, 2008, 2009, 2007, 2010 and 2011, in descending order. However, while there was no significant distribution pattern or clustering in the first part of the study period (2006 to 2011) based on Moran's I statistic, spatial autocorrelation (P = 0.068) was observed in 2012.
Stability of depressive symptoms over 3 months post-partum

Abdollahi F, Zarghami M, Sazlina SG, Lye MS

Early intervention in psychiatry, 2017 Feb;11(1):57-62.
PMID: 25582677 DOI: 10.1111/eip.12215

AIM: Prolonged depression during the post-partum period is associated with maternal and infant mortality and morbidity. Less attention has been given to factors that predict the persistence of depression beyond the first 3 months post-partum.
METHODS: From a longitudinal cohort of 2279 women who attended Mazandaran's primary health centres in 2009, 478 women with an Edinburgh Postnatal Depression Scale (EPDS) score of 12 or greater in the third trimester of pregnancy were recruited. Persistently depressed women (depressed at all three occasions: during pregnancy, and at 2 and 12 weeks post-partum) were compared with those without depression to determine demographic, cultural, obstetric and biopsychosocial predictors for persistence of depression. Data were analysed using chi-square test, t-test and logistic regression models.
RESULTS: The stability of depression was found in 193 (46.2 %) of 418 depressed cases who were followed up over the study period. Of those mothers who scored more than the threshold of 12 during the third trimester of pregnancy, 277 (66.3%) and 221 (52.9%) had high EPDS at 2 and 12 weeks post-partum. Psychological distress (based upon the General Health Questionnaire), low maternal parental self-efficacy (based upon the Parental Expectation Survey) and perceived social isolation (based upon the Network Orientation Scale) were independent predictors of persistent depression.
CONCLUSION: Fewer depressed mothers in this study were found to recover during the first 3 months after giving birth. Psychosocial factors predicted sustained depression from pregnancy to 3 months post-partum. The findings highlight the significance of support in enhancing maternal mental health.
Fulltext Social impact of nasopharyngeal carcinoma on Chinese households in Selangor, Malaysia

Armstrong RW, Armstrong MJ, Lye MS

Singapore Med J, 2000 Dec;41(12):582-7.
PMID: 11296783

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.
Fulltext Side effects of short course tuberculosis chemotherapy

Simon GK, Lye MS, Ahmad N

Med J Malaysia, 1991 Mar;46(1):88-94.
PMID: 1836044

A retrospective study of 300 tuberculosis patients on short course chemotherapy registered in 1985 at the Chest Clinic, General Hospital Alor Setar, Kedah was carried out with the purpose of identifying patient characteristics, determining incidence of side-effects and modifying treatment regimens in order to minimise these side-effects. One hundred and sixteen (38.7%) patients developed side effects. Twenty seven (9%) had side effects severe enough to warrant a change in treatment regimen. Treatment modifications and ways to minimise or control side effects are discussed.
Study site: Chest clinic, Hospital Alor Setar, Kedah, Malaysia
Serotonergic receptor gene polymorphism and response to selective serotonin reuptake inhibitors in ethnic Malay patients with first episode of major depressive disorder

Badamasi IM, Lye MS, Ibrahim N, Abdul Razaq NA, Ling KH, Stanslas J

Pharmacogenomics J, 2021 Aug;21(4):498-509.
PMID: 33731884 DOI: 10.1038/s41397-021-00228-6

The polymorphisms of the 5HTR1A and 5HTR2A receptor genes (rs6295C/G and rs6311G/A) have been evaluated for association with SSRI treatment outcome in various populations with different results. The present study was carried out to determine the association between genotypes of HTR1A-rs6295 and HTR2A-rs6311 with SSRI treatment outcome among the ethnic Malay patients diagnosed with first-episode major depressive disorder (MDD). The patients were recruited from four tertiary hospitals in the Klang Valley region of Malaysia. Predefined efficacy phenotypes based on 25% (partial early response) and 50% (clinical efficacy response) reduction in Montgomery Asberg Depression Rating Scale-self Rated score (MADRS-S) were adopted for assessment of treatment efficacy in this study. Self-reporting for adverse effects (AE) was documented using the Patient Rated Inventory of Side Effect (PRISE) after treatment with SSRI for up to 6 weeks. Adjusted binary logistic regression between genotypes of the polymorphism obtained using sequencing technique with the treatment outcome phenotypes was performed. The 142 patients recruited were made up of 96 females (67.6%) and 46 males (32.4%). Clinical efficacy and Partial early response phenotypes were not significantly associated with genotypes of HTR1A and HTR2A polymorphism. The GG genotype of HTR2A polymorphism has decreased odds for dizziness (CNS) and increased odds for poor concentration. The GA genotype increases the odd for excessive sweating, diarrhoea, constipation and blurred vision. The CC genotype of HTR1A-rs6295 decreases the odd for nausea/vomiting and increases the odd for anxiety. Thus, some genotypes of HTR1A and HTR2A polymorphism were associated with SSRI treatment outcomes in ethnic Malay MDD patients.
Fulltext Screening of brain-derived neurotrophic factor (BDNF) single nucleotide polymorphisms and plasma BDNF levels among Malaysian major depressive disorder patients

Aldoghachi AF, Tor YS, Redzun SZ, Lokman KAB, Razaq NAA, Shahbudin AF, et al.

PLoS One, 2019;14(1):e0211241.
PMID: 30677092 DOI: 10.1371/journal.pone.0211241

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is a neurotrophin found in abundance in brain regions such as the hippocampus, cortex, cerebellum and basal forebrain. It has been associated with the risk of susceptibility to major depressive disorder (MDD). This study aimed to determine the association of three BDNF variants (rs6265, rs1048218 and rs1048220) with Malaysian MDD patients.
METHODS: The correlation of these variants to the plasma BDNF level among Malaysian MDD patients was assessed. A total of 300 cases and 300 matched controls recruited from four public hospitals within the Klang Valley of Selangor State, Malaysia and matched for age, sex and ethnicity were screened for BDNF rs6265, rs1048218 and rs1048220 using high resolution melting (HRM).
FINDINGS: BDNF rs1048218 and BDNF rs1048220 were monomorphic and were excluded from further analysis. The distribution of the alleles and genotypes for BDNF rs6265 was in Hardy-Weinberg equilibrium for the controls (p = 0.13) but was in Hardy Weinberg disequilibrium for the cases (p = 0.011). Findings from this study indicated that having BDNF rs6265 in the Malaysian population increase the odds of developing MDD by 2.05 folds (95% CI = 1.48-3.65). Plasma from 206 cases and 206 controls were randomly selected to measure the BDNF level using enzyme-linked immunosorbent assay (ELISA). A significant decrease in the plasma BDNF level of the cases as compared to controls (p<0.0001) was observed. However, there was no evidence of the effect of the rs6265 genotypes on the BDNF level indicating a possible role of other factors in modulating the BDNF level that warrants further investigation.
CONCLUSION: The study indicated that having the BDNF rs6265 allele (A) increase the risk of developing MDD in the Malaysian population suggesting a possible role of BDNF in the etiology of the disorder.
Risk factors for Nipah virus transmission, Port Dickson, Negeri Sembilan, Malaysia: results from a hospital-based case-control study

Amal NM, Lye MS, Ksiazek TG, Kitsutani PD, Hanjeet KS, Kamaluddin MA, et al.

Southeast Asian J. Trop. Med. Public Health, 2000 Jun;31(2):301-6.
PMID: 11127330

A hospital-based case-control study of viral encephalitis was carried out at Port Dickson Hospital, in the state of Negeri Sembilan, Malaysia. Between March and May 1999, 69 clinically diagnosed viral encephalitis cases and 31 controls were interviewed. Job histories on pig farming activities were assessed by a group of epidemiologists and veterinary surgeons. Results show that among clinical cases of viral encephalitis, 52 (75.4%) cases were diagnosed to have Nipah virus infection based on positive serology for antibodies to the cross-reacting Hendra virus antigen. The Nipah virus encephalitis was significantly associated with a history of working in pig farms (p < 0.001, OR = 196.0, 95% CI = 20.4-4741.6), history of contact with animals (p < 0.001, OR = 38.3, 95% CI = 8.2-209.0) and with history of direct contact with pigs (p = 0.002, OR = 34.4, 95% CI = 2.6-1,024.4). The Nipah virus infection was also significantly associated with history of feeding/cleaning pigs (p < 0.001, OR = 102, 95% CI = 11.9-2,271.5). These results provide evidence that involvement in pig farming activities is significantly associated with the risk of getting Nipah virus infection. They are potential risk factors for Nipah virus transmission in the major pig-producing area of Bukit Pelandok, Port Dickson Negeri Sembilan.
Risk factors associated with umbilical vascular catheter-associated thrombosis in newborn infants

Boo NY, Wong NC, Zulkifli SS, Lye MS

J Paediatr Child Health, 1999 Oct;35(5):460-5.
PMID: 10571759

OBJECTIVE: To determine the risk factors associated with umbilical vascular catheter-associated thrombosis.
METHODS: All consecutive inborn infants with umbilical arterial (UAC) and/or umbilical venous catheters (UVC) inserted for more than 6 h duration were included in the study. Each infant was screened for thrombosis in the abdominal aorta and inferior vena cava by 2-D abdominal ultrasonography within 48-72 h of insertion of umbilical vascular catheters. Subsequent serial scanning was performed at intervals of every 5-7 days, and within 48 h after removal of catheters.
RESULTS: Upon removal of umbilical catheters, abdominal aortic thrombi were detected in 32/99 (32.3%) infants with UAC. Small thrombi were detected in the inferior vena cava of 2/49 (4.1%) infants with UVC (one of whom had both UAC and UVC). When compared with those who received only UVC (n = 18), infants who received either UAC alone (n = 68) or both UAC and UVC (n = 31) had significantly higher risk of developing thrombosis (odds ratio (OR): 7.6, 95% confidence interval (CI): 1.1, 325.5)). Logistic regression analysis of various potential risk factors showed that the only significant risk factor associated with the development of abdominal aortic thrombosis following insertion of UAC was longer duration of UAC in situ (for every additional day of UAC in situ, adjusted OR of developing thrombosis was: 1.2, 95% CI: 1.1, 1.3; P = 0.002).
CONCLUSION: Umbilical arterial catheter-associated thrombosis was common. Umbilical arterial catheter should be removed as soon as possible when not needed. Upon removal of UAC, all infants should be screened for abdominal aortic thrombus by 2-D ultrasonography.
Risk factors associated with hearing loss in term neonates with hyperbilirubinaemia

Boo NY, Oakes M, Lye MS, Said H

J Trop Pediatr, 1994 Aug;40(4):194-7.
PMID: 7932930

A study of 128 jaundiced term neonates showed that 28 (22 per cent) had hearing loss based on brain stem-evoked response. There was no significant difference in the percentage of neonates with hearing loss between those with peak serum bilirubin levels of less than 340 mumol/l (16 per cent) and those with hyperbilirubinaemia > 339 mumol/l (33 per cent) (P = 0.11). Logistic regression analysis showed that severe jaundice which required exchange transfusion and earlier age of onset of hyperbilirubinaemia were statistically significant risk factors associated with hearing loss (P = 0.038 and P = 0.012, respectively).
Risk factors associated with feed intolerance in very low birthweight infants following initiation of enteral feeds during the first 72 hours of life

Boo NY, Soon CC, Lye MS

J Trop Pediatr, 2000 Oct;46(5):272-7.
PMID: 11077935 DOI: 10.1093/tropej/46.5.272

An observational study was carried out in the Kuala Lumpur Maternity Hospital to determine the risk factors associated with feed intolerance in very low birthweight (VLBW, <1501 g) infants given intermittent 3-hourly enteral feeds within 72h after birth. Feed intolerance developed in 85 (64.4 per cent) of 132 infants. Logistic regression analysis showed that the only significant risk factor associated with feed intolerance was the age when the first feed was commenced. For each hour delay in the age of the infants when the first feed was given, the adjusted odds ratios of feed intolerance was 1.03 (95 per cent confidence intervals: 1.01-1.05; p = 0.01). Other factors (modes of delivery, Apgar score at 1 min, sex, ethnicity, history of resuscitation at birth, birthweight, gestation, multiple pregnancy, perinatal asphyxia, types of milk, hypothermia before first feed, hypotension before first feed, respiratory distress syndrome, patent ductus arteriosus, septicaemia, theophylline therapy, indomethacin therapy, ventilatory support, continuous positive airway pressure, umbilical catheterization, and surfactant therapy) were not significantly associated with feed intolerance. Our study suggests that to promote tolerance of enteral feeds in VLBW infants, intermittent orogastric feeds should be commenced as soon as possible during the first 72 h of life.
Fulltext Respiratory microorganisms in acute pharyngitis patients: Identification, antibiotic prescription patterns and appropriateness, and antibiotic resistance in private primary care, central Malaysia

Bo ZM, Tan WK, Chong CSC, Lye MS, Parmasivam S, Pang ST, et al.

PLoS One, 2022;17(11):e0277802.
PMID: 36395327 DOI: 10.1371/journal.pone.0277802

Acute pharyngitis (AP) is a common reason for private primary care consultations, thus providing an avenue for widespread antibiotic intake among the community. However, there is limited data on the antibiotic prescription appropriateness and resistance information in the Malaysian private primary care setting, therefore, this study aimed to investigate the prevalence of isolated viruses and bacteria, antibiotic resistance patterns, antibiotic prescription patterns and appropriateness by general practitioners (GPs) and factors affecting antibiotic resistance and antibiotic prescription patterns. To investigate, a cross-sectional study was conducted among 205 patients presenting with AP symptoms at private primary care clinics in central Malaysia from 3rd January 2016 to 30th November 2016. Throat swabs were collected from 205 AP patients for two purposes: (i) the detection of four common respiratory viruses associated with AP via reverse-transcription real-time PCR (qRT-PCR); and (ii) bacterial identification using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Bacterial isolates were then subjected to antibiotic susceptibility screening and McIsaac scoring was calculated post-prescription based on GP selection of criteria. Generalized estimating equations analysis with multiple logistic regression was conducted to identify factors associated with presence of virus and antibiotic prescription. The results showed that 95.1% (195/205) of patients had at least one of the four viruses, with rhinovirus (88.5%) being the most prevalent, followed by adenovirus (74.9%), influenza A virus (4.6%) and enterovirus (2.1%). A total of 862 non-repetitive colonies were isolated from the culture of throat swabs from 205 patients who were positive for bacteria. From a total of 22 genera, Streptococcus constitutes the most prevalent bacteria genus (40.9%), followed by Neisseria (20%), Rothia (13.0%), Staphylococcus (11%) and Klebsiella (4.9%). Only 5 patients carried group A beta-hemolytic streptococci (GABHS). We also report the presence of vancomycin-resistant S. aureus or VRSA (n = 9, 10.1%) among which one isolate is a multidrug-resistant methicillin-resistant S. aureus (MDR-MRSA), while 54.1% (n = 111) were found to carry at least one antibiotic-resistant bacteria species. Application of the McIsaac scoring system indicated that 87.8% (n = 180) of patients should not be prescribed antibiotics as the majority of AP patients in this study had viral pharyngitis. The antibiotic prescription appropriateness by applying post-prescription McIsaac scoring was able to rule out GABHS pharyngitis in this sample with a GABHS culture-positive sensitivity of 40% (n = 2/5) and specificity of 90% (180/200). In conclusion, antibiotic-resistant throat isolates and over-prescription of antibiotics were observed and McIsaac scoring system is effective in guiding GPs to determine occurrences of viral pharyngitis to reduce unnecessary antibiotic prescription.
Fulltext Relationships among perceived quality of healthcare services, satisfaction and behavioural intentions of international students in Kuala Lumpur, Malaysia: a cross-sectional study

Aljaberi MA, Juni MH, Al-Maqtari RA, Lye MS, Saeed MA, Al-Dubai SAR, et al.

BMJ Open, 2018 09 12;8(9):e021180.
PMID: 30209153 DOI: 10.1136/bmjopen-2017-021180

OBJECTIVE: The current study aimed to investigate the relationships among the perceived quality of healthcare services, satisfaction and behavioural intentions among international students in Kuala Lumpur, Malaysia.
SETTING: A cross-sectional study on public universities in Kuala Lumpur, Malaysia.
PARTICIPANTS: All participants in this study were international students joining public universities in Kuala Lumpur, Malaysia.
PRIMARY INDEPENDENT VARIABLE: Perceived quality of healthcare services measured on a SERVQUAL scale.
PRIMARY DEPENDENT VARIABLE: Participants' satisfaction of healthcare services assessed using five items.
SECONDARY DEPENDENT VARIABLE: Behavioural intentions measured on six items.
RESULTS: Of the 556 international students, 500 (90%) completed the survey. The study used structural equation modelling (SEM) through the AMOS (Analysis of Moment Structures) software to analyse the data. SEM analyses showed that the perceived quality of healthcare services significantly and directly affected satisfaction, with a value of 89% and an effect size of 0.78. It also had a significant indirect impact on the behavioural intentions (0.78) of international students. The results indicated that participants' satisfaction had a statistically significant impact on their behavioural intentions (0.77).
CONCLUSION: Perceived quality of care is an important driver of international students' satisfaction and their behavioural intention with healthcare services. Such relations of effects among the three investigated factors were also positive and significant.
Relationship between head growth and neurodevelopmental outcome of Malaysian very low birthweight infants during the 1st year of life

Ong LC, Boo NY, Chandran V, Zamratol SM, Allison L, Teoh SL, et al.

Ann Trop Paediatr, 1997 Sep;17(3):209-16.
PMID: 9425375

A prospective study was carried out to (i) compare head growth patterns of 103 very low birthweight (VLBW, < 1500 g) Malaysian infants and 98 normal birthweight (NBW, 2500- < 4500 g) controls during the 1st year of life; and (ii) examine the relationship between neurodevelopmental outcome at 1 year of age and occipito-frontal head circumferences (OFC) at birth and at 1 year of age in VLBW babies. When compared with those of NBW infants at birth, mid-infancy and 1 year of age, the mean OFC ratios (observed/expected OFC at 50th percentile) of VLBW infants were significantly lower (p < 0.001). Small-for-gestational-age (SGA) VLBW babies had significantly lower mean OFC ratios than their appropriate-for-gestational-age (AGA) VLBW counterparts at birth (p < 0.001), but this difference was no longer seen at mid-infancy or at 1 year of age. Logistic regression analysis showed that abnormal late neonatal cranial ultrasound findings (odds ratio 8.5, 95% confidence interval 4.12-22.07; p < 0.001) and each additional day of oxygen therapy (odds ratio 1.15, 95% confidence interval 1.00-4.45; p = 0.045) were significant risk factors associated with neurodevelopmental disability at 1 year of age, while mean OFC ratios at birth or at 1 year of age were not. Poor postnatal head growth per se did not predict disability, but probably reflected the consequences of "brain injury" as evidenced by abnormal brain scans.
Quality of Life among Breast Cancer Patients In Malaysia

Ganesh S, Lye MS, Lau FN

Asian Pac J Cancer Prev, 2016;17(4):1677-84.
PMID: 27221837

BACKGROUND: Among the factors reported to determine the quality of life of breast cancer patients are socio- demographic background, clinical stage, type of treatment received, and the duration since diagnosis.
OBJECTIVE: The objective of this study was to determine the quality of life (QOL) scores among breast cancer patients at a Malaysian public hospital.
MATERIALS AND METHODS: This cross-sectional study of breast cancer patients was conducted between March to June 2013. QOL scores were determined using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23). Both the QLQ-C30 and QLQ-BR23 assess items from functional and symptom scales. The QLQ-C30 in addition also measures the Global Health Status (GHS). Systematic random sampling was used to recruit patients.
RESULTS: 223 breast cancer patients were recruited with a response rate of 92.1%. The mean age of the patients was 52.4 years (95% CI = 51.0, 53.7, SD=10.3). Majority of respondents are Malays (60.5%), followed by Chinese (19.3%), Indians (18.4%), and others (1.8%). More than 50% of respondents are at stage III and stage IV of malignancy. The mean Global Health Status was 65.7 (SD = 21.4). From the QLQ-C30, the mean score in the functioning scale was highest for 'cognitive functioning' (84.1, SD=18.0), while the mean score in the symptom scale was highest for 'financial difficulties' (40.1, SD=31.6). From the QLQ-BR23, the mean score for functioning scale was highest for 'body image' (80.0, SD=24.6) while the mean score in the symptom scale was highest for 'upset by hair loss' (36.2, SD=29.4). Two significant predictors for Global Health Status were age and employment. The predictors explained 10.6% of the variation of global health status (R2=0.106).
CONCLUSIONS: Age and employment were found to be significant predictors for Global Health Status (GHS). The Quality of Life among breast cancer patients reflected by the GHS improves as age and employment increases.
Fulltext Profiling lysophosphatidic acid levels in plasma from head and neck cancer patients

Abdul Rahman M, Mohamad Haron DE, Hollows RJ, Abdul Ghani ZDF, Ali Mohd M, Chai WL, et al.

PeerJ, 2020;8:e9304.
PMID: 32547888 DOI: 10.7717/peerj.9304

Head and neck squamous cell carcinoma (HNSCC) represents a significant world health problem, with approximately 600,000 new cases being diagnosed annually. The prognosis for patients with HNSCC is poor and, therefore, the identification of biomarkers for screening, diagnosis and prognostication would be clinically beneficial. A limited number of studies have used lipidomics to profile lipid species in the plasma of cancer patients. However, the profile and levels of lysophosphatidic acid (LPA) species have not been examined in HNSCC. In this study, a targeted lipidomics approach using liquid chromatography triple quadrupole mass spectrometry (LCMS/MS) was used to analyse the concentration of LPA (16:0 LPA, 18:0 LPA, 18:1 LPA, 18:2 LPA and 20:4 LPA) in the plasma of patients with oral squamous cell carcinoma (OSCC) and nasopharyngeal carcinoma (NPC), together with healthy controls. The levels of three LPA species (18:1 LPA, 18:2 LPA and 20:4 LPA) were significantly lower in the plasma of OSCC patients, whilst the concentrations of all five LPA species tested were significantly lower in plasma from NPC patients. Furthermore, the order of abundance of LPA species in plasma was different between the control and cancer groups, with 16:0 LPA, 18:0 LPA levels being more abundant in OSCC and NPC patients. Medium to strong correlations were observed using all pairs of LPA species and a clear separation of the normal and tumour groups was observed using PCA analysis. In summary, the results of this study showed that the levels of several LPA species in the plasma of patients with OSCC and NPC were lower than those from healthy individuals. Understanding these variations may provide novel insights into the role of LPA in these cancers.

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