MyMedR

A preliminary survey of drug dependence in the state of Penang, West Malaysia

Tan E

Med J Malaysia, 1973 Sep;28(1):23-8.

A simple adherence test for detection of IgM antibodies in typhoid

Ong LY, Pang T, Lim SH, Tan EL, Puthucheary SD

J Med Microbiol, 1989 Jul;29(3):195-8.

A simple adherence test to detect IgM antibodies in patients with typhoid is described. The test utilises the IgM-"capture" approach, in which the test serum is applied to microtitration plate wells previously coated with anti-human IgM, followed by application of a stained Salmonella typhi antigen suspension which shows adherence in positive cases. By this test, 58 (95%) of 61 sera from confirmed cases of typhoid possessed IgM antibodies to the H or O or both antigens of S. typhi. In patients for whom a diagnosis of typhoid was based only on a significant Widal-test titre, 31 (41%) of 76 sera had IgM antibodies to the H or O or both antigens of S. typhi. Some cross-reactivity of the IgM antibodies was detected, especially with the O antigens of S. paratyphi A and B. A total of 82 sera from non-typhoidal fevers (leptospirosis, typhus, dengue fever) showed no reactivity in this test. In normal sera there was no detectable IgM to the O antigen of S. typhi and only a small number (3.9%) had low levels of IgM to the H antigen. The significance and potential importance of this simple, sensitive, specific and economical test is discussed.

A systematic review of occupational therapy intervention for handwriting skills in 4-6 year old children

Kadar M, Wan Yunus F, Tan E, Chai SC, Razaob Razab NA, Mohamat Kasim DH

Aust Occup Ther J, 2020 02;67(1):3-12.

PMID: 31799722 DOI: 10.1111/1440-1630.12626

INTRODUCTION: Handwriting skills play a significant role in all stages of an individual's life. Writing interventions should be considered at a younger age to ensure proper development of writing skills. Hence, the aims of this study is to evaluate the current evidence of occupational therapy interventions in handwriting skills for 4-6 year old children.

METHODS: Published literature was systematically searched according to PRISMA guidelines using specific key terms. Initial search identified 785 studies; however only seven met the inclusion criteria and were assessed for final review. Studies were methodologically appraised using the McMaster Critical Review Form-Quantitative Studies.

RESULTS: The review found no randomised control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4-6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost.

CONCLUSION: The long-term benefit from these interventions and the effects of these interventions on a broader spectrum of fine motor abilities need to be explored further with stronger research designs. However, the lack of studies adopting high level study designs, i.e., RCT designs means, results need to be approached with caution by occupational therapists when implementing handwriting skills intervention in practice.

Fulltext Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines

Coccolini F, Improta M, Sartelli M, Rasa K, Sawyer R, Coimbra R, et al.

World J Emerg Surg, 2021 08 09;16(1):40.

PMID: 34372902 DOI: 10.1186/s13017-021-00380-1

Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.

Fulltext Acute stroke patients with high BMI are less likely to have severe disability at initial presentation

Choo WS, Foo S, Tan E, Thayaparan FS, Chung YY, Raman S, et al.

Med J Malaysia, 2009 Mar;64(1):34-6.

PMID: 19852318 MyJurnal

This is a prospective study to determine the severity of disability and prognosis of acute stroke patients related to their Body Mass index (BMI). A total of 79 consecutive CT-scan-proven acute stroke patients who were admitted to Hospital Tuanku Ja'afar, Seremban between November 2006 and April 2007 were recruited (male:female 49:30; mean age 62.7 years; ischemic stroke 70, intracerebral bleed 9). The patients were divided according to BMI less than 25 (Group A) and equal or greater than 25 (Group B). Severity of disability was measured between 24-48 hours by modified Rankin's score. Patients were followed up after one month. Thirty-seven patients had severe disability (Rankin Score 5). Twenty-nine patients had adverse outcomes including 11 deaths and 18 rehospitalizations or prolonged hospital/nursing home stay. 34.3% of Group B had severe disability compared to 56.8% of Group A (chi2 P = 0.046). Conversely 42.9% of Group B had adverse events at one month compared to 31.8% of Group A (chi2 P = 0.312). There were no statistical differences between high- and low-BMI groups for gender ratio, smoking, hypertension, diabetes, prior cardiovascular disease, mean age, mean lipid profile and blood pressure. When comparing patients with Rankin Score 1-4 versus 5, age and BMI were statistically significant between the two groups. By multivariate analysis only age is independent predictor for severe disability (P < 0.05). The results of this pilot study should be confirmed in larger prospective multicentre trial.

An appraisal of the role of the intra-uterine contraceptive device for family planning in Malaysia

Frank Tan EH

Med J Malaysia, 1976 Dec;31(2):123-127.

PMID: 35008156

No abstract available.

Fulltext An epidemiological investigation of an outbreak of leptospirosis associated with swimming, Beaufort, Sabah

Koay TK, Nirmal S, Noitie L, Tan E

Med J Malaysia, 2004 Oct;59(4):455-9.

PMID: 15779577

From October 13 to October 21, 1999, a total of 46 males, aged 8 to 19 years, were admitted to Beaufort Hospital after swimming in the creek near an oil palm plantation in Kampung (Kg) Kebatu, Beaufort. Thirty (30) presented with symptoms including fever, vomiting, bodyache, giddiness, headache, chest pain and cough, while 16 others, were asymptomatic. One, a 15 year old boy, died from haemorrhagic shock secondary to pulmonary haemorrhage. The onset of the illness was from 11 October to 19 October 1999. A case-control study found that the outbreak was associated with swimming in the creek (p<0.0001). A total of 44 paired sera samples were sent for microscopic agglutination test (MAT), 5 pairs showed sero-conversion, 3 pairs had 4 fold rise in titre and 18 pairs were positive at >320. The findings indicated that Leptospirosis was the cause of the outbreak of this illness and the contaminated creek water was the source of the infection. The occurrence of flooding and stagnation in the creek following the heavy rainfall during the first week of October 1999 could have contributed to the timing of the outbreak.

Fulltext An evaluation of dietary adequacy among patients with constipation-predominant irritable bowel syndrome in Malaysia

Shafiee NH, Razalli NH, Mokhtar NM, Tan E, Ali RAR

Intest Res, 2022 Jan;20(1):124-133.

PMID: 33472341 DOI: 10.5217/ir.2020.00050

BACKGROUND/AIMS: Substantial proportions of patients with constipation-predominant irritable bowel syndrome (IBS-C) linked their symptoms with particular intake of foods. However, there is lack of current data regarding the intake among IBS-C patients before any dietary interventions. Thus, this study aimed to evaluate the dietary adequacy among IBS-C against the standard recommended nutrient intake (RNI) and healthy controls.

METHODS: A retrospective case-control study was conducted involving IBS-C patients and healthy control subjects. A validated 126-food items frequency questionnaire was administered to all the subjects to assess their dietary intake, guided by dietitians. The calculated nutrients intake for IBS-C patients was then compared against the standard RNI and healthy controls.

RESULTS: A total of 306 subjects were recruited, among which 218 were diagnosed with IBS-C and 88 were included as healthy controls. IBS-C patients had significantly lower intake of wholegrain products, fried foods, dairy products, fruits, and vegetables compared to healthy controls. The daily intake of energy, certain macronutrients, and micronutrients among IBS-C patients was significantly lower than the healthy subjects. Less than 5% of IBS-C patients and healthy subjects achieved the standard recommendation for dietary fiber. Also, various vitamin intake (B1, B2, B6, folate, B12, E, K, and potassium) among IBS-C patients did not meet the standard RNI.

CONCLUSIONS: Dietary intakes of IBS-C patients did not meet the recommended intake for Malaysian and showed the nutritional inadequacies compared to the control subjects. Our study highlighted the importance of dietary evaluation prior to planning strategies for dietary intervention targeting IBS-C patients.

Fulltext Application of ATR-FTIR Incorporated with Multivariate Data Analysis for Discrimination and Quantification of Urea as an Adulterant in UHT Milk

Tan E, Binti Julmohammad N, Koh WY, Abdullah Sani MS, Rasti B

Foods, 2023 Jul 27;12(15).

PMID: 37569123 DOI: 10.3390/foods12152855

Urea is naturally present in milk, yet urea is added intentionally to increase milk's nitrogen content and shelf life. In this study, a total of 50 Ultra heat treatment (UHT) milk samples were spiked with known urea concentrations (0-5 w/v%). Attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy with principal component analysis (PCA), discriminant analysis (DA), and multiple linear regression (MLR) were used for the discrimination and quantification of urea. The PCA was built using 387 variables with higher FL > 0.75 from the first PCA with cumulative variability (90.036%). Subsequently, the DA model was built using the same variables from PCA and demonstrated the good distinction between unadulterated and adulterated milk, with a correct classification rate of 98% for cross-validation. The MLR model used 48 variables with p-value < 0.05 from the DA model and gave R2 values greater than 0.90, with RMSE and MSE below 1 for cross-validation and prediction. The DA and MLR models were then validated externally using a test dataset, which shows 100% correct classification, and the t-test result (p > 0.05) indicated that the MLR could determine the percentage of urea in UHT milk within the permission limit (70 mg/mL). In short, the wavenumbers 1626.63, 1601.98, and 1585.5534 cm-1 are suitable as fingerprint regions for detecting urea in UHT milk.

Fulltext Asperuloside Enhances Taste Perception and Prevents Weight Gain in High-Fat Fed Mice

Ishaq M, Tran D, Wu Y, Nowak K, Deans BJ, Xin JTZ, et al.

Front Endocrinol (Lausanne), 2021;12:615446.

PMID: 33927690 DOI: 10.3389/fendo.2021.615446

Asperuloside is an iridoid glycoside found in many medicinal plants that has produced promising anti-obesity results in animal models. In previous studies, three months of asperuloside administration reduced food intake, body weight, and adipose masses in rats consuming a high fat diet (HFD). However, the mechanisms by which asperuloside exerts its anti-obesity properties were not clarified. Here, we investigated homeostatic and nutrient-sensing mechanisms regulating food intake in mice consuming HFD. We confirmed the anti-obesity properties of asperuloside and, importantly, we identified some mechanisms that could be responsible for its therapeutic effect. Asperuloside reduced body weight and food intake in mice consuming HFD by 10.5 and 12.8% respectively, with no effect on mice eating a standard chow diet. Fasting glucose and plasma insulin were also significantly reduced. Mechanistically, asperuloside significantly reduced hypothalamic mRNA ghrelin, leptin, and pro-opiomelanocortin in mice consuming HFD. The expression of fat lingual receptors (CD36, FFAR1-4), CB1R and sweet lingual receptors (TAS1R2-3) was increased almost 2-fold by the administration of asperuloside. Our findings suggest that asperuloside might exert its therapeutic effects by altering nutrient-sensing receptors in the oral cavity as well as hypothalamic receptors involved in food intake when mice are exposed to obesogenic diets. This signaling pathway is known to influence the subtle hypothalamic equilibrium between energy homeostasis and reward-induced overeating responses. The present pre-clinical study demonstrated that targeting the gustatory system through asperuloside administration could represent a promising and effective new anti-obesity strategy.

Asthma and TNF variants in Chinese and Malays

Tan EC, Lee BW, Tay AW, Chew FT, Tay AH

Allergy, 1999 Apr;54(4):402-3.

PMID: 10371104

Behavioural self-analysis in the medical curriculum: a comparison of Malaysian and American experiences

Armstrong HE, Tan ES

Med Educ, 1979 Mar;13(2):99-102.

PMID: 431423 DOI: 10.1111/j.1365-2923.1979.tb00930.x

Behavioural self-analysis projects were introduced into the second year medical curriculum in behavioural sciences at the University of Malaya. Students performance and evaluation of the experience were compared with those of American medical students. It was concluded that receptivity of medical students to principles of behaviour therapy is relatively similar in the two societies.

Biological properties of TW01 cells expressing latent membrane protein-1 gene of EBV-derived from nasopharyngeal carcinoma cells at different stages of malignancy

Tan EL, Sam CK

Exp Oncol, 2007 Sep;29(3):166-74.

PMID: 18004239

Epstein-Barr virus (EBV), a human gammaherpesvirus is intimately associated with nasopharyngeal carcinoma (NPC), with the incidence of the virus detected in malignant tissues being close to 100% in NPC endemic areas. The viral latent gene, latent membrane protein 1 (LMP1), has all the typical characteristics of an oncogene and extensive studies have shown beyond doubt its abilities in cellular transformation giving rise to malignant phenotypes. The present study compares the gene sequence and biological properties of LMP1 gene derived from two patients with different stages of NPC--one presented with dysplastic, pre-malignant lesion and the other with malignant lesion.

Body-image barrier perception as a function of assimilation within the Malaysian aborigines

Armstrong HE, Tan EK

J Soc Psychol, 1978 Aug;105(Second Half):165-73.

PMID: 692090

Fulltext Breast-conserving surgery versus mastectomy in young women with breast cancer in Asian settings

Sinnadurai S, Kwong A, Hartman M, Tan EY, Bhoo-Pathy NT, Dahlui M, et al.

BJS Open, 2019 02;3(1):48-55.

PMID: 30734015 DOI: 10.1002/bjs5.50111

Background: Mastectomy rates among women with early breast cancer in Asia have traditionally been high. This study assessed trends in the surgical management of young women with early-stage breast cancer in Asian settings. Survival in women treated with breast-conserving surgery (BCS; lumpectomy with adjuvant radiotherapy) and those undergoing mastectomy was compared.

Methods: Young women (aged less than 50 years) newly diagnosed with stage I or II (T1-2 N0-1 M0) breast cancer in four hospitals in Malaysia, Singapore and Hong Kong in 1990-2012 were included. Overall survival (OS) was compared for patients treated by BCS and those who had a mastectomy. Propensity score analysis was used to account for differences in demographic, tumour and treatment characteristics between the groups.

Results: Some 63·5 per cent of 3536 women underwent mastectomy. Over a 15-year period, only a modest increase in rates of BCS was observed. Although BCS was significantly associated with favourable prognostic features, OS was not significantly different for BCS and mastectomy; the 5-year OS rate was 94·9 (95 per cent c.i. 93·5 to 96·3) and 92·9 (91·7 to 94·1) per cent respectively. Inferences remained unchanged following propensity score analysis (hazard ratio for BCS versus mastectomy: 0·81, 95 per cent c.i. 0·64 to 1·03).

Conclusion: The prevalence of young women with breast cancer treated by mastectomy remains high in Asian countries. Patients treated with BCS appear to survive as well as those undergoing mastectomy.

CHARACTERISTICS OF PATIENTS AND ILLNESSES SEEN AT TAMPOI MENTAL HOSPITAL; (A PRELIMINARY REPORT)

TAN ES

Med J Malaysia, 1964 Sep;19:3-7.

PMID: 14240061

Chronic haemolytic anaemia; a report of three cases of Cooley's anaemia and five cases of acholuric jaundice seen in Malaya with a discussion on the differential diagnosis

FIELD CE, TAN EE

Med J Malaya, 1955 Sep;10(1):60-82.

PMID: 13287496

Clinical observations on nail changes in psoriasis

Tham SN, Lim JJ, Tay SH, Chiew YF, Chua TN, Tan E, et al.

Ann Acad Med Singap, 1988 Oct;17(4):482-5.

PMID: 3265604

410 cases of psoriasis [282 males (68%) and 127 females (31%)] were interviewed and examined to study the nail changes. The prevalence of nail changes was 78.0% (males = females). Common changes were pitting (67.5%) and onycholysis (67.2%). Dystrophy of varying degrees occurred in 35.0%, subungual hyperkeratosis in 24.7%, discoloration in 18.4%, loss of nails in 2.8% and pustulation in 1.3%. Pitting and onycholysis was the most common combination (45.6%). Nail changes were significantly more common in patients who have moderate to severe psoriasis as compared with patients with mild psoriasis; in patients who have psoriasis for greater than 5 years as compared with patients who have psoriasis for less than 5 years; and in patients older than age 50 as compared with those aged less than 50. A definite correlation was found between the prevalence of nail changes and the presence of scalp and periungual psoriasis, and the presence of joint involvement.

Correction: ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Frassini S, Cobianchi L, Fugazzola P, Biffl WL, Coccolini F, Damaskos D, et al.

World J Emerg Surg, 2023 Nov 27;18(1):52.

PMID: 38012756 DOI: 10.1186/s13017-023-00522-7

Fulltext Dysphagia as a side effect of botulinum toxin injection

Kwek ABE, Tan EK, Luman W

Med J Malaysia, 2004 Oct;59(4):544-6.

PMID: 15779592

Dysphagia is a known adverse effect of botulinum toxin injection into the cervical region for dystonia. We present an unusual case of dysphagia arising from injection into the orbicularis oculi muscle, which has hitherto not been described. We postulate that her dysphagia was caused by distant side effects of botulinum toxin due to repeated injections. We recommend that clinicians should restrict the frequency of injections to as few life-time doses of the toxin as possible for adequate management of spasm. The practice of re-injecting patients routinely every three months, or at the first return of mild spasms should be discouraged.

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