MyMedR

Rape--the Malaysian scenario

Nadesan K, Omar SZ

Malays J Pathol, 2002 Jun;24(1):9-14.

PMID: 16329550

Fulltext Endometrial carcinoma can develop in patients on tamoxifen therapy

Omar SZ, Sivanesaratnam V

Med J Malaysia, 1999 Jun;54(2):280-2.

PMID: 10972045

The use of the semen analysis in predicting fertility outcome

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.

Hormonal changes causing rhinitis in pregnancy among Malaysian women

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.

Human papillomavirus vaccination in the resourced and resource-constrained world

Woo YL, Omar SZ

Best Pract Res Clin Obstet Gynaecol, 2011 Oct;25(5):597-603.

PMID: 21684811 DOI: 10.1016/j.bpobgyn.2011.05.004

Human papillomavirus has been established as the causal agent for cervical cancer. The identification of a clear cause presents an unparalleled opportunity for cancer control. As such, the development of prophylactic human papillomavirus vaccines has been rightly hailed as one of the significant scientific triumphs of the past 20 years. This story of scientific triumph over disease, however, is not yet complete. The fruit of scientific labour must be delivered to the people in order to fulfil the underlying intent of the research (i.e. to prevent cancer and save lives). The success of a vaccination programme, however, does not depend on the biological efficacy of the vaccine alone. Various other local factors, such as poverty, gender inequality, cultural traditions, or religious beliefs, can significantly constrain the success of any vaccination programme. In this chapter, we provide an overview of how the human papillomavirus vaccine works and its global uptake, as well as, how variations in local contexts can affect the successful implementation of a vaccination programme. Other factors besides vaccine costs also need serious attention. With better understanding of such factors, policy makers and medical health professionals will be better equipped to make informed decisions to maximise the potential benefits of the human papillomavirus vaccines for the most number of people in individual countries.

Fulltext Large lower segment myoma--myomectomy at lower segment caesarean section--a report of two cases

Omar SZ, Sivanesaratnam V, Damodaran P

Singapore Med J, 1999 Feb;40(2):109-10.

PMID: 10414171

Uterine leiomyoma is found in approximately 2% of pregnant women. One in ten women will have complications related to myoma in pregnancy. Myomectomy during pregnancy especially at Caesarean section is much discouraged in the literature. We present here 2 cases of large uterine myoma, situated in the anterior aspect of the lower segment, complicating pregnancy at term. Myomectomy in both instances allowed delivery of the fetus through the lower segment, making vaginal delivery in subsequent pregnancies possible.

Contemporary approaches to hyperemesis during pregnancy

Tan PC, Omar SZ

Curr Opin Obstet Gynecol, 2011 Apr;23(2):87-93.

PMID: 21297474 DOI: 10.1097/GCO.0b013e328342d208

PURPOSE OF REVIEW: Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years.

RECENT FINDINGS: The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy.

SUMMARY: Women with significant NVP should be identified so that they can be safely and effectively treated.

Development and validation of a food frequency questionnaire to estimate the intake of genistein in Malaysia

Fernandez AR, Omar SZ, Husain R

Int J Food Sci Nutr, 2013 Nov;64(7):794-800.

PMID: 23701012 DOI: 10.3109/09637486.2013.798269

To develop and validate a food frequency questionnaire (FFQ) to estimate the genistein intake in a Malaysian population of pregnant women.

Thrombophilia investigation in Malaysian women with recurrent pregnancy loss

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.

Macrosomia is the only reliable predictor of shoulder dystocia in babies weighing 3.5 kg or more

Mansor A, Arumugam K, Omar SZ

Eur J Obstet Gynecol Reprod Biol, 2010 Mar;149(1):44-6.

PMID: 20042263 DOI: 10.1016/j.ejogrb.2009.12.003

To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more.

A placebo-controlled trial of oral pyridoxine in hyperemesis gravidarum

Tan PC, Yow CM, Omar SZ

Gynecol. Obstet. Invest., 2009;67(3):151-7.

PMID: 19077388 DOI: 10.1159/000181182

To evaluate oral pyridoxine in conjunction with standard therapy in women hospitalized for hyperemesis gravidarum (HG).

The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes

Tan PC, Ling LP, Omar SZ

Int J Gynaecol Obstet, 2009 Apr;105(1):50-5.

PMID: 19154997 DOI: 10.1016/j.ijgo.2008.11.038

OBJECTIVE:
To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).

METHODS:
GCT was positive if the 1-hour plasma glucose level was >or=7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.

RESULTS:
GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2-3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0-2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0-6.0).

CONCLUSION:
GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.

Absorbable versus nonabsorbable sutures for subcuticular skin closure of a transverse suprapubic incision

Tan PC, Mubarak S, Omar SZ

Int J Gynaecol Obstet, 2008 Nov;103(2):179-81.

PMID: 18639876 DOI: 10.1016/j.ijgo.2008.05.023

Gamma-glutamyltransferase level in pregnancy is an independent risk factor for gestational diabetes mellitus

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.

Fulltext Trial of labor after one cesarean: role of the order and number of prior vaginal births on the risk of emergency cesarean delivery and neonatal admission

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.

Labour and perinatal outcome in women at term with one previous lower-segment Caesarean: a review of 1000 consecutive cases

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.

Role of Genistein in Preeclampsia: A Case-Control Study

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.

Effect of high levels of human chorionic gonadotropin and estradiol on the severity of hyperemesis gravidarum

Tan PC, Tan NC, Omar SZ

Clin Chem Lab Med, 2009;47(2):165-71.

PMID: 19191722 DOI: 10.1515/CCLM.2009.041

Serum human chorionic gonadotropin (hCG) and estradiol levels are higher in women with hyperemesis gravidarum (HG) than in unaffected pregnant controls. We postulated that higher levels of these hormones may be associated with clinically more severe HG. The aim of this study was to evaluate the effect of maternal hCG and estradiol levels on the severity of HG.

Serum FGF-21 and FGF-23 in association with gestational diabetes: a longitudinal case-control study

Mosavat M, Omar SZ, Sthanshewar P

Horm Mol Biol Clin Investig, 2020 Mar 13;41(2).

PMID: 32167928 DOI: 10.1515/hmbci-2019-0060

Background Fibroblast growth factors (FGFs); FGF-21 and FGF-23, have been proposed to be associated with metabolic syndrome. However, data on the role of these peptides in gestational diabetes mellitus (GDM) are limited. Therefore, this study was designed to assess the association of serum FGF-21 and FGF-23 with the risk of GDM. Furthermore, we evaluated the circulation of these peptides in pregnancy and post-puerperium. Materials and methods Fifty-three pregnant subjects with GDM and 43 normal glucose tolerance (NGT) pregnant women participated in this study. Serum FGF-21 and FGF-23 were measured during pregnancy and post-puerperium. Results FGF-21 and FGF-23 were low in GDM compared to NGT during pregnancy. There were no significant differences in the level of these peptides post-puerperium. Using logistic regression, FGF-23 [odds ratio (OR) 0.70 (95% confidence interval [CI]: 0.50-0.96)] was inversely associated with GDM, so a 1-μg/mL decrease in FGF-23 levels was associated with a 1.4-fold increased risk of developing GDM and this remained statistically significant after adjustment for confounders [adjusted OR (aOR) 0.70 (95% CI: 0.50-0.98)]. There was no association of FGF-21 with the development of GDM risk. Conclusions Lower FGF-23 concentrations could be involved in the pathophysiology of GDM. FGF-21, even though associated with metabolic risk factors in pregnancy, may not be a fundamental factor in GDM.

Screening for gestational diabetes at antenatal booking in a Malaysian university hospital: the role of risk factors and threshold value for the 50-g glucose challenge test

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.

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