Displaying publications 1 - 20 of 109 in total

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  1. Tan PC, King AS, Omar SZ
    J Obstet Gynaecol Res, 2012 Jan;38(1):145-53.
    PMID: 21955280 DOI: 10.1111/j.1447-0756.2011.01652.x
    AIM: The aim of this study was to evaluate urine microscopy, dipstick analysis and urinary symptoms in screening for urinary tract infection (UTI) in hyperemesis gravidarum (HG).
    MATERIALS AND METHODS:   A prospective cross-sectional study was performed on women at first hospitalization for HG. A clean-catch mid-stream urine sample from each recruit was sent for microscopy (for bacteria, leucocytes and erythrocytes), dipstick analysis (for leukocyte esterase, nitrites, protein and hemoglobin) and microbiological culture. The presence of current urinary symptoms was elicited by questionnaire. UTI is defined as at least 10(5) colony-forming units/mL of a single uropathogen on culture. Screening test parameters were analyzed against UTI.
    RESULTS: UTI was diagnosed in 15/292 subjects (5.1%). Receiver-operator characteristic curve analysis of microscopic urine leucocytes revealed area under the curve=0.64, 95% confidence interval (CI) 0.5-0.79, P=0.063 and erythrocytes area under the curve=0.53, 95%CI 0.39-0.67, P=0.67 for UTI indicating the limited screening utility of these parameters. Microscopic bacteriuria (likelihood ratio [LR] 1.1, 95%CI 0.7-1.5) and urine dipstick leukocyte esterase (LR 1.4, 95%CI 1.1-1.8), nitrites (LR 2.3, 95%CI 0.3-17.2), protein (LR 1.0, 95%CI 0.7-1.6) and hemoglobin (LR 0.8, 95%CI 0.4-1.5) were not useful screening tests for UTI in HG. Elicited symptoms were also not predictive of UTI.
    CONCLUSION: Urine microscopy, dipstick analysis and urinary symptoms were not useful in screening for UTI in HG. UTI should be established by urine culture in HG before starting antibiotic treatment.
  2. Ayadurai T, Muniandy S, Omar SZ
    J Obstet Gynaecol Res, 2009 Dec;35(6):1061-8.
    PMID: 20144172 DOI: 10.1111/j.1447-0756.2009.01067.x
    The status of thrombophilia in Asian women with recurrent pregnancy loss (RPL) is obscure and poorly understood. Numerous studies suggest the non-existence or extreme rarity of the two important thrombophilia markers, factor V Leiden (FVL) and prothrombin G20210A (PTG) mutations, in patients of Asian ancestries. Thus, the consensus that thrombophilia is rare among Asians and laboratory investigations is irrelevant. We therefore investigated Malaysian women with RPL for thrombophilia abnormalities.
  3. Omar SZ, Qvist R, Khaing SL, Muniandy S, Bhalla S
    J Obstet Gynaecol Res, 2008 Apr;34(2):174-8.
    PMID: 18412778 DOI: 10.1111/j.1447-0756.2008.00755.x
    The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti-thrombin in pre-eclampsia and pregnancy-induced hypertensive patients.
  4. Tan PC, Mubarak S, Omar SZ
    J Obstet Gynaecol Res, 2008 Aug;34(4):512-7.
    PMID: 18937705 DOI: 10.1111/j.1447-0756.2008.00815.x
    AIM:
    To evaluate the relationship between gamma-glutamyltransferase (GGT) level in pregnant women at oral glucose tolerance test (OGTT) and the diagnosis of gestational diabetes (GDM).

    METHODS:
    Blood was taken for analyzing GGT level from women at high risk of GDM at the time of their scheduled OGTT. GDM was diagnosed according to World Health Organization 1999 criteria.

    RESULTS:
    GGT level correlated positively with the 2-hour glucose level (Spearman's rho = 0.112: P < 0.05). GGT values that were stratified into quartiles demonstrated a significant trend with diagnosis of GDM (chi(2) for trend; P = 0.03). Multivariable logistic regression analysis taking into account maternal age, gestational age at OGTT, body mass index and a positive 50-g glucose challenge test (GCT) indicated that high GGT was an independent risk factor for GDM (adjusted odds ratio [AOR] 2.1 95% CI 1.2-3.8: P = 0.01). In the subset of women identified by a positive GCT, on multivariable logistic regression analysis, only high GGT was an independent risk factor for GDM (AOR 2.3 95% CI 1.3-4.2: P = 0.007).

    CONCLUSION:
    Raised GGT level is an independent risk factor for GDM in high risk pregnant women undergoing OGTT.
  5. Tan PC, Jacob R, Quek KF, Omar SZ
    J Obstet Gynaecol Res, 2007 Aug;33(4):457-64.
    PMID: 17688612
    To determine pregnancy outcome in hyperemesis gravidarum and the effect of metabolic, biochemical, hematological and clinical indicators of disease severity on outcome.
  6. Lim BK, Zakaria R, Hong JGS, Omar SZ, Sulaiman S, Tan PC
    J Obstet Gynaecol Res, 2022 Jan 23.
    PMID: 35068018 DOI: 10.1111/jog.15157
    AIM: To explore digital insertion in dorsal recumbent position of 16F, 22F, or 28F catheter bores on insertion failure, duration, and pain in unripe cervix labor induction.

    METHODS: A randomized trial was performed in a University hospital in Malaysia. Term women scheduled for labor induction, Bishop score ≤ 5, singleton, cephalic presentation, intact membrane, and reassuring pre-induction fetal heart rate tracing were recruited. Women with known gross fetal anomaly, allergy to latex and inability to consent or language difficulty were excluded. Participants were randomized to 16F, 22F, or 28F Foley catheter. Primary outcome was insertion failure and main secondary outcomes were insertion duration and pain (assessed by a Visual Numerical Rating Scale [VNRS] 0-10, higher score more pain). Analysis is done by analysis of variance (ANOVA), Kruskal-Wallis, and chi square test across the three arms and by t test and Mann-Whitney U test for pair wise comparisons.

    RESULTS: One hundred twenty-seven participants' data were analyzed. The insertion failure 7/43(16%) versus 4/42(10%) versus 5/42(12%), p = 0.64, insertion duration median [IQR] 2.8 [1.8-4.8] versus 2.8 [1.7-3.7] versus 2.8 [1.7-4.3] min, p = 0.68 and insertion pain VNRS mean {SD} 4.2 {2.5} versus 3.4 {2.3} versus 3.6 {2.2}, p = 0.26, insertion to delivery interval 26.0 {9.7} versus 25.6 {9.1} versus 22.8 {7.4} h, p = 0.45, and spontaneous vaginal delivery 20/43 (45%) versus 23/42(55%) versus 25/42(60%), p = 0.48 for 16F versus 22F versus 28F arms, respectively. Pairwise comparisons were not different.

    CONCLUSION: Foley catheter 16F versus 22F versus 28F resulted in similar digital insertion performance in the dorsal recumbent position for unripe cervix labor induction.

    CLINICAL TRIAL REGISTRATION: https://doi.org/10.1186/ISRCTN21224268.

  7. Langmia IM, Apalasamy YD, Omar SZ, Mohamed Z
    PMID: 26607028
    Interleukin 1 receptor type 2 (IL1R2) regulates the inflammatory pathway that results in preterm delivery. We aim to investigate the impact of IL1R2 gene polymorphisms on the risk of preterm delivery.
  8. Lim BK, Ng KY, Omar J, Omar SZ, Gunapalaiah B, Teoh YL, et al.
    Med J Malaysia, 2014 Feb;69(1):2-8.
    PMID: 24814620
    INTRODUCTION: Cervical cancer is the third most common cancer in women worldwide. The HPV-16/18 AS04- adjuvanted vaccine (Cervarix©) has previously been shown to be highly immunogenic with a clinically acceptable safety profile. This phase IIIb, double-blind, randomized (1:1) and placebo controlled trial (NCT00345878) was designed to evaluate the vaccine immunogenicity against HPV-16 and HPV-18 as well as its safety and reactogenicity in Malaysian women.

    METHODS: Healthy women aged 18-35 years received intramuscularly three doses of either the vaccine (HPV group) or aluminium hydroxide (ALU group) at 0, 1, and 6 months. Antibody titers were measured by an enzyme-linked immunosorbent assay (ELISA).

    RESULTS: A total of 271 eligible subjects were enrolled and 266 subjects completed the study. Initially seronegative subjects in the HPV group showed 100% seroconversion one month post-dose-3 for anti HPV-16 and anti-HPV-18 antibodies with geometric mean titers of 11107.5 (95% CI: 9727.3-12683.4) EL.U/mL and 4273.5 (95% CI: 3771.8-4841.9) EL.U/mL, respectively. Over 96% of subjects in both groups received all three vaccine doses. Solicited local (pain) and general symptoms (myalgia, fatigue, arthralgia and headache) were commonly reported in both HPV and ALU groups. Eight serious adverse events were reported throughout the study (five in the HPV group; three in the ALU group), all considered by investigators to be unrelated to vaccination.

    CONCLUSION: The HPV-16/18 AS04-adjuvanted vaccine was immunogenic and generally well tolerated in Malaysian women aged 18-35 years.
  9. Nadesan K, Omar SZ
    Malays J Pathol, 2002 Jun;24(1):9-14.
    PMID: 16329550
  10. Fernandez AR, Omar SZ, Husain R
    J Reprod Med, 2016 Jan-Feb;61(1-2):47-51.
    PMID: 26995888
    To examine the association between genistein intake (estimated from a food frequency questionnaire [FFQ) and incidence of preeclampsia.
  11. Indirani B, Raman R, Omar SZ
    J Laryngol Otol, 2013 Sep;127(9):876-81.
    PMID: 23954035 DOI: 10.1017/S0022215113001692
    To investigate the aetiology of rhinitis occurring in pregnancy, by (1) describing the relationship between pregnancy rhinitis and serum oestrogen, progesterone, placental growth hormone and insulin-like growth factor, and (2) assessing the prevalence of pregnancy rhinitis among Malaysian women.
  12. Lim SS, Tan PC, Sockalingam JK, Omar SZ
    Aust N Z J Obstet Gynaecol, 2008 Feb;48(1):71-7.
    PMID: 18275575 DOI: 10.1111/j.1479-828X.2007.00808.x
    To compare oral celecoxib with oral diclofenac as pain reliever after perineal repair following normal vaginal birth.
  13. Tan PC, Subramaniam RN, Omar SZ
    Aust N Z J Obstet Gynaecol, 2007 Feb;47(1):31-6.
    PMID: 17261097
    To compare the outcome in 1000 women at term with one lower transverse Caesarean that was suitable for a trial of labour.
  14. Tan PC, Jacob R, Quek KF, Omar SZ
    Aust N Z J Obstet Gynaecol, 2006 Oct;46(5):446-50.
    PMID: 16953861
    In a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self-limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.
  15. Arumugam K, Omar SZ
    Aust N Z J Obstet Gynaecol, 1992 May;32(2):154-7.
    PMID: 1520202
    The study investigates the use of the various parameters of the semen analysis in predicting the fertility outcome in 82 infertile couples. The sperm density, % progressive motility, % normal morphology were divided into 'normal' and 'abnormal' based on the criteria proposed by WHO. The subsequent cumulative pregnancy rates were then calculated according to this criteria. A life-table method of analysis was used. All female related fertility factors were excluded. With the exception of a sperm density of less than 20 x 10(6) per ml the other parameters showed no significant correlation with the cumulative pregnancy rates at 12 months or 24 months respectively. We concluded that the semen analysis does not predict the probable outcome of the subsequent rates even when female fertility related factors were excluded apart from a sperm density less than 20 x 10(6) per ml.
  16. Tan PC, Othman A, Win ST, Hong JGS, Elias N, Omar SZ
    PMID: 34089525 DOI: 10.1111/ajo.13377
    BACKGROUND: Induction of labour (IOL) in low-risk nulliparas at 39 weeks reduces caesarean delivery. Multiparas with ripe cervixes typically have vaginal delivery within eight hours. Delivery at night and weekend are associated with higher maternal and neonatal mortality.

    AIMS: To evaluate IOL in full-term multiparas with ripe cervixes to achieve delivery at normal working hours and improve maternal satisfaction.

    METHODS: A randomised trial was performed in a tertiary hospital in Malaysia. Low-risk multiparas with ripe cervixes (Bishop score ≥6) were recruited at 38+4 -40+0  weeks, then randomised to planned labour induction at 39+0  weeks or expectant care. Primary outcomes were delivery during 'normal working hours' 09:00-17:00 hours, Monday-Friday and patient satisfaction by visual numerical rating scale.

    RESULTS: For IOL (n = 80) vs expectant care (n = 80) arms respectively, primary outcomes of delivery at normal working hours was 27/80 (34%) vs 29/78 (37%), relative risk (RR) 0.9, 95% CI 0.5-1.7, P = 0.41, patient satisfaction was 8.0 ± 1.8 vs 7.8 ± 1.6, P = 0.41; presentation for spontaneous labour or rupture of membranes were 27/80 (34%) vs 70/79 (89%), RR 0.4, 95% CI 0.3-0.5, P 

  17. Tan PC, Ling LP, Omar SZ
    Aust N Z J Obstet Gynaecol, 2007 Jun;47(3):191-7.
    PMID: 17550485 DOI: 10.1111/j.1479-828X.2007.00717.x
    Background: The best method of screening for gestational diabetes (GDM) remains unsettled. The 50-g glucose challenge test (GCT) is used in a two-stage screening process but its best threshold value can vary according to population.

    Aims: To evaluate the role of risk factors in conjunction with GCT and to determine an appropriate threshold for the one-hour venous plasma glucose with the GCT.

    Method: In a prospective study, 1600 women at antenatal booking without a history of diabetes mellitus or GDM filled a form on risk factors before GCT. Women who had GCT >or= 7.2 mmol/L underwent the 75-g oral glucose tolerance test (OGTT). GDM was diagnosed according to WHO (1999) criteria.

    Result: Thirty-five per cent had GCT >or= 7.2 mmol/L, 32.6% underwent OGTT and 34.5% of OGTT confirmed GDM. The GDM rate in our population was at least 11.4%. Examination of the receiver operator characteristic curve suggested that the best threshold value for the GCT in our population was >or= 7.6 mmol/L. Multivariable logistic regression demonstrated that only GCT >or= 7.6 mmol/L was an independent predictor for GDM (adjusted odds ratio 3.7: P < 0.001). After GCT, maternal age and anthropometry, OGTT during the third trimester, family history, obstetric history and glycosuria were not independent predictors of GDM.

    Conclusions: Risk factors were not independent predictors of GDM in women with GCT >or= 7.2 mmol/L. GCT threshold value >or= 7.6 mmol is appropriate for the Malaysian population at high risk of GDM.
  18. Tan PC, Subramaniam RN, Omar SZ
    Taiwan J Obstet Gynecol, 2008 Sep;47(3):305-11.
    PMID: 18935994 DOI: 10.1016/S1028-4559(08)60129-1
    To evaluate the influences of mode of immediate preceding delivery and number of prior vaginal births on the risk of repeat cesarean and neonatal admission at attempted vaginal birth after cesarean.
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