Displaying publications 1 - 20 of 45 in total

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  1. Tong SF, Ho C, Tan HM
    Int J Urol, 2011 Jan;18(1):32-42.
    PMID: 20969645 DOI: 10.1111/j.1442-2042.2010.02652.x
    The aging man is becoming a major burden to Asian countries because of the current poor health status of Asian men and the aging Asian population. Life expectancy at birth for men is shorter than women by an average of 4 years in Asian countries and major causes of death are cardiovascular disease, cancers, injuries and infections. However, there are considerable variations between Asian countries because of great disparity in socioeconomic status. Male-specific disorders, such as male sexual health and urological conditions, are other major health burdens because they have a great impact on men's quality of life. More importantly, many risk factors to the causes of mortality and morbidities, such as high-risk behavior and smoking, can be improved with health promotion and early intervention. The current evidence suggests that the poor health status of men is the result of their poor health care utilization, negative health-seeking behavior, the adverse social environment for men and gender-insensitive health care delivery. However, much evidence is still needed as Asian countries have great diversity in culture, societal values and men's needs. Asian time-tested wisdom on a balanced healthy lifestyle to longevity should be explored as potential men's health promotional programs. Taking into account Asian men's health-care needs, a gender-streamlined approach and man-friendly health care delivery should be on the national agenda in managing the aging man.
  2. Tong SF, Ng CJ, Lee BC, Lee VK, Khoo EM, Lee EG, et al.
    Asian J Androl, 2012 Jul;14(4):604-11.
    PMID: 22635164 DOI: 10.1038/aja.2011.178
    This study aimed to investigate the effect of intramuscular injection of testosterone undecanoate on overall quality of life (QoL) in men with testosterone deficiency syndrome (TDS). A randomized controlled trial over a 12-month period was carried out in 2009. One hundred and twenty men aged 40 years and above with a diagnosis of TDS (serum total testosterone <12 nmol l(-1) and total Aging Male Symptom (AMS) scores ≥27) were invited to participate. Interventions comprised intramuscular injection of either placebo or 1000 mg testosterone undecanoate, given at weeks 0, 6, 18, 30 and 42. This paper presents the secondary analysis of QoL changes measured in the scores of Short-Form-12 (SF-12) scale at baseline, weeks 30 and 48 after the first injection. A total of 56/60 and 58/60 men from the active treatment and placebo group, respectively, completed the study. At week 48, before adjusting for baseline differences, the QoL of men in the treatment group improved significantly in five out of the eight domains on SF-12. The physical health composite scores improved 4.0 points from a baseline of 41.9±7.0 in the treatment group compared to 0.8 point from a baseline of 43.7±7.1 in the placebo group (F=3.652, P=0.027). The mental health composite scores improved 4.4 points from a baseline of 37.1±9.0 in the treatment group compared to 1.0 points from a baseline of 37.6±7.9 in the placebo group (F=4.514, P=0.018). After adjusting for baseline differences, significant improvement was observed in mental health composite scores, but not in physical health composite scores. Long-acting testosterone undecanoate significantly improved the mental health component of QoL in men with TDS.
    Study: Subang Jaya Aging Men's Health Study
    Funding: Bayer Schering Pharma
  3. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Support Care Cancer, 2020 Apr;28(4):1703-1715.
    PMID: 31292755 DOI: 10.1007/s00520-019-04975-y
    PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated.

    METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.

    RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.

    CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.

  4. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Eur J Cancer Care (Engl), 2020 Jul;29(4):e13248.
    PMID: 32495472 DOI: 10.1111/ecc.13248
    OBJECTIVE: This study examined the prevalence of self-perceived burden (SPB) and its association with health-related quality of life (HRQoL) among urologic cancer patients.

    METHODS: This was a prospective, cross-sectional study. A total of 429 respondents diagnosed with urologic cancers (prostate, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed by using a structured questionnaire. SPB and HRQoL were measured by the Self-perceived Burden Scale and the Functional Assessment of Cancer Therapy-General 7 Item Scale respectively.

    RESULTS AND CONCLUSION: Self-perceived burden was experienced by 73.2% of the respondents. Respondents who had a lower education level, a monthly household income

  5. Teo CH, Ng CJ, Ho CC, Tan HM
    Public Health, 2015 Jan;129(1):60-7.
    PMID: 25542745 DOI: 10.1016/j.puhe.2014.11.009
    OBJECTIVE: There is currently no documentation on the availability and implementation of policies related to men's health in Asia. This Delphi study aimed to achieve an Asian consensus on men's health policy based on the opinions and recommendations from men's health key opinion leaders.
    STUDY DESIGN: A two-phase Delphi online survey was used to gather information from men's health stakeholders across Asian countries.
    METHODS: All stakeholders were invited to participate in the survey through men's health conferences, personal contacts, recommendations from international men's health organizations and snowballing method. Stakeholders were asked about their concerns on 17 men's health key issues as well as their opinion on the availability and recommendations on men's health policies and programmes in their countries.
    RESULTS: There were a total of 128 stakeholders (policy makers, clinicians, researchers and consumers), from 28 Asian countries, who responded in the survey. Up to 85% of stakeholders were concerned about various men's health issues in Asia and in their respective country, particularly in smoking, ischaemic heart disease and high blood pressure. There is a lack of men's health policies and programmes in Asia (availability = 11.6-43.5%) and up to 92.9% of stakeholders recommended that these should be developed.
    CONCLUSIONS: These findings call for policy change and development, and more importantly a concerted effort to elevate men's health status in Asia.
  6. Tan WS, Ng CJ, Khoo EM, Low WY, Tan HM
    Aging Male, 2011 Dec;14(4):231-6.
    PMID: 22115177 DOI: 10.3109/13685538.2011.597463
    The etiology of erectile dysfunction (ED) is multi-factorial. This paper examines the association between ED, testosterone deficiency syndrome (TDS) and metabolic syndrome (MS) in Malaysian men in an urban setting. One thousand and forty-six men aged ≥ 40 years from Subang Jaya, Malaysia were randomly selected from an electoral-roll list. The men completed questionnaires that included: socio-demographic data, self-reported medical problems and the International Index of erectile function (IIEF-5). Physical examination and the following biochemical tests were performed: lipid profile, fasting blood glucose (FBG) and total testosterone. The response rate was 62.8% and the mean age of men was 55.8 ± 8.4 (41-93) years. Ethnic distribution was Chinese, 48.9%; Malay, 34.5%; Indian, 14.8%. The prevalence of moderate-severe ED was 20.0%, while 16.1% of men had TDS (< 10.4 nmol/L) and 31.3% of men had MS. Indian and Malay men were significantly more likely to have ED (p  = 0.001), TDS (p  < 0.001) and MS (p < 0.001) than the Chinese. Multivariate regression analysis showed that elevated blood pressure, elevated FBG, low high-density lipoprotein and heart disease were predictors of ED while all MS components were independently associated with TDS. Malay and Indian men have a higher disease burden compared to Chinese men and were more likely to suffer with ED, TDS and MS. MS components were closely related to TDS and ED.
  7. Tan WS, Low WY, Ng CJ, Tan WK, Tong SF, Ho C, et al.
    BJU Int, 2013 Jun;111(7):1130-40.
    PMID: 23651425 DOI: 10.1111/bju.12037
    OBJECTIVE: To evaluate the efficacy and safety of long-acting i.m. testosterone undecanoate (TU) in Malaysian men with testosterone deficiency (TD).

    PATIENTS AND METHODS: A total of 120 men, aged 40-70 years, with TD (serum total testosterone [TT] ≤ 12 nmol/L) were randomised to receive either i.m. TU (1000 mg) or placebo. In all, 58 and 56 men in the placebo and treatment arm, respectively, completed the study. Participants were seen six times in the 48-week period and the following data were collected: physical examination results, haemoglobin, haematocrit, TT, lipid profile, fasting blood glucose, sex hormone-binding globulin, liver function test, prostate- specific antigen (PSA) and adverse events.

    RESULTS: The mean (sd) age of the participants was 53.4 (7.6) years. A significant increase in serum TT (P < 0.001), PSA (P = 0.010), haematocrit (P < 0.001), haemoglobin (P < 0.001) and total bilirubin (P = 0.001) were seen in the treatment arm over the 48-week period. Two men in the placebo arm and one man in the treatment arm developed myocardial infarction. Common adverse events observed in the treatment arm included itching/swelling/pain at the site of injection, flushing and acne. Overall, TU injections were well tolerated.

    CONCLUSIONS: TU significantly increases serum testosterone in men with TD. PSA, haemoglobin and haematocrit were significantly elevated but were within clinically safe limits. There was no significant adverse reaction that led to the cessation of treatment.

  8. Tan WK, Tan MY, Tan HM, Pathmanathan R, Tan WP
    Urology, 2016 Apr;90:e7-8.
    PMID: 26773348 DOI: 10.1016/j.urology.2015.12.046
    A 39-year-old man presented with painless scrotal swelling for 2 months. He denied any asbestos exposure but worked with wall and ceiling plaster. Physical exam revealed a large right scrotum which transilluminated. Scrotal ultrasonography revealed a large right hydrocele and a polypoidal mass along the anterior wall of the scrotum. Magnetic resonance imaging of the abdomen and computed tomography of the chest showed no metastases. He underwent a right inguinal scrotal exploration and wide excision of tunica vaginalis and a partial epididymectomy. Pathology revealed well-differentiated papillary mesothelioma of the tunica vaginalis. The patient had an uneventful recovery.
  9. Tan HM, Tan WP, Wong JH, Ho CC, Teo CH, Ng CJ
    Korean J Urol, 2014 Nov;55(11):710-7.
    PMID: 25405012 DOI: 10.4111/kju.2014.55.11.710
    PURPOSE: The proposed Men's Health Index (MHI) aims to provide a practical and systematic framework for comprehensively assessing and stratifying older men with the intention of optimising their health and functional status.
    MATERIALS AND METHODS: A literature search was conducted using PubMed from 1980 to 2012. We specifically looked for instruments which: assess men's health, frailty and fitness; predict life expectancy, mortality and morbidities. The instruments were assessed by the researchers who then agreed on the tools to be included in the MHI. When there was disagreements, the researchers discussed and reached a consensus guided by the principle that the MHI could be used in the primary care setting targetting men aged 55-65 years.
    RESULTS: The instruments chosen include the Charlson's Combined Comorbidity-Age Index; the International Index of Erectile Function-5; the International Prostate Symptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageing and Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the Senior Fitness Test; the Fitness Assessment Score; and the Depression Anxiety Stress Scale-21. A pilot test on eight men was carried out and showed that the men's health index is viable.
    CONCLUSIONS: The concept of assessing, stratifying, and optimizing men's health should be incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic position to engage men at the peri-retirement age in a conversation about their life goals based on their current and predicted health status.
    KEYWORDS: Health status indicators; Men; Physical fitness; Retirement
  10. Tan HM, Tong SF, Ho CC
    J Sex Med, 2012 Mar;9(3):663-71.
    PMID: 22188573 DOI: 10.1111/j.1743-6109.2011.02582.x
    INTRODUCTION: Sexual dysfunction in men, such as erectile dysfunction, hypogonadism, and premature ejaculation, generates considerable attention. Its association with physical and psychological health is an issue which should be addressed seriously.
    AIM: A review of the literature pertaining to the correlation between sexual dysfunction and physical and psychological health.
    METHODS: PubMed search for relevant publications on the association between sexual dysfunction in men and physical and psychological health.
    MAIN OUTCOME MEASURE: Clinical and epidemiological evidence that demonstrates the association between sexual dysfunction in men and physical and psychological health.
    RESULTS: Sexual dysfunction, i.e., erectile dysfunction, hypogonadism, and premature ejaculation, has been shown to be associated with physical and psychological health. There is a strong correlation between sexual dysfunction and cardiovascular disease, metabolic syndrome, quality of life, and depression.
    CONCLUSION: The association between men's sexual dysfunction and physical and psychological health is real and proven. Therefore, it should not be taken lightly but instead treated as a life-threatening medical problem.
  11. Tan HM, Marumo K, Yang DY, Hwang TI, Ong ML
    Int J Urol, 2009 May;16(5):507-14; discussion 514-5.
    PMID: 19467120 DOI: 10.1111/j.1442-2042.2009.02283.x
    OBJECTIVES:
    To explore by a pooled subanalysis of the Global Better Sex Survey sexual aspirations and unmet needs of men and women from Hong Kong, Indonesia, Japan, Malaysia, Singapore, South Korea, Taiwan, and Thailand.

    METHODS:
    To qualify, respondents must have had sexual intercourse at least once in the past 12 months. Women must have had heterosexual intercourse. Data were weighted by population size between countries.

    RESULTS:
    Of 3538 Asian respondents (1776 men and 1762 women), 52% were aged <40 years, 40% were aged 40-59 years, and 8% were aged >or=60 years. The majority were married or in a relationship. Men and women reported having sexual intercourse 5.1 and 4.0 times monthly, respectively. Attraction to partner, foreplay, intercourse, and achieving orgasm were important to most men and women. Two thirds were less than very satisfied with their sex life, and 36% of men were interested in improving sex. For a good sexual experience, the man's ability to get and maintain an erection and erection hardness were important to the majority of Asian men and women. Few respondents reported using a prescription erectile dysfunction medication, but many showed interest in using these medications to improve their sex lives. A comparison between individual countries suggests that attitudes about sex differ from country to country, and between men and women in each country.

    CONCLUSIONS:
    Sex is very important to Asian men and women, but many of them are not fully satisfied with their sex lives and want to improve them.
  12. Tan HM, Low WY, Ng CJ, Chen KK, Sugita M, Ishii N, et al.
    J Sex Med, 2007 Nov;4(6):1582-92.
    PMID: 17908233 DOI: 10.1111/j.1743-6109.2007.00602.x
    INTRODUCTION: There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED).
    AIMS: The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan).
    MAIN OUTCOME MEASURE: Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia.
    METHODS: Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209).
    RESULTS: The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P < 0.01). Men with ED reported significantly greater rates of comorbid illness (P < 0.0001) and a reduced quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia.
    CONCLUSION: The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights a substantial need for the evaluation and treatment of ED in Asian men.
  13. Tan HM, Moh CL, Mendoza JB, Gana T, Albano GJ, de la Cruz R, et al.
    Urology, 2000 Oct 1;56(4):635-40.
    PMID: 11018621 DOI: 10.1016/s0090-4295(00)00688-9
    OBJECTIVES:
    To evaluate the efficacy, safety, and tolerability of oral sildenafil in Asian men with erectile dysfunction of various causes (organic, psychogenic, or mixed) and of more than 6 months' duration.

    METHODS:
    In this double-blind, parallel-group trial conducted at eight centers in Malaysia, the Philippines, and Singapore, 254 men, 26 to 78 years old, were randomized to 12 weeks of sildenafil or placebo taken as needed 1 hour before anticipated sexual activity. Initially, the sildenafil (n = 127) or matching placebo (n = 127) dose was 50 mg but could be increased to 100 mg or decreased to 25 mg because of a lack of efficacy or intolerance, respectively. Efficacy was assessed by the 15-question International Index of Erectile Function, patients' event logs of sexual activity, and a global efficacy question about erections.

    RESULTS:
    The two primary efficacy variables relating to achievement and maintenance of an erection sufficient for sexual intercourse, as assessed by the mean scores for International Index of Erectile Function question 3 (4.22 versus 2.59) and question 4 (4.15 versus 2.41), were both significantly higher with sildenafil than with placebo (P <0.0001). In addition, the five separate International Index of Erectile Function domains of sexual function, the percentage of successful intercourse attempts, and the global efficacy assessment of erections revealed significantly greater treatment effects in favor of sildenafil (P <0.0001 versus placebo for all variables). Treatment-related adverse events occurred in 22.8% of patients who received sildenafil and in 10.2% of those who received placebo.

    CONCLUSIONS:
    Sildenafil is an effective and well-tolerated treatment for Asian men with erectile dysfunction of broad-spectrum etiology.
  14. Tan HM
    Int. J. Androl., 2000;23 Suppl 2:87-8.
    PMID: 10849506
    The quest for improving and maintaining sexual function has been going on since time immemorial. The advent of an effective oral drug, sildenafil, has brought about unprecedented open discussion on male erectile dysfunction, and gas accelerated the pace of development of new therapies for erectile dysfunction. New knowledge in the physiology of sexual function has enabled researchers to target drug treatment at the whole network of the central nervous system and the numerous cascadic enzymatic reactions leading to relaxation of the corporal smooth muscle. One of the brightest potential applications of future molecular technology in the study of erectile dysfuction is in the utilization of gene therapy.
  15. Tan HM, Liew RP, Chan CC, Wong AT, Ngun KW
    Med J Malaysia, 1995 Mar;50(1):87-92.
    PMID: 7752983
    One thousand one hundred and sixty three patients (male-852, female-311) with ureteric calculi requiring intervention were treated between April 1988 to July 1992. Four hundred and eleven cases were treated by ESWL Monotherapy, 414 by stone manipulation plus ESWL, 301 by retrograde ureteroscopic lithotripsy, 36 by percutaneous antegrade ureteroscopic lithotripsy and 1 case by open ureterolithotomy. There were 25 failures of the initial procedures. Only three cases that failed primary procedures required open surgery. Other complications include minor ureteric mucosal perforation (3%), infection (3%), transient moderate to gross haematuria (20%), loin ache (26.4%), irritative urination (34.4%) and low grade fever (30.1%). Current modalities used in the treatment of ureteric calculi produce good results and there is generally no primary role for any open surgery.
  16. Tan HM, Cheung HS
    Med J Malaysia, 1990 Jun;45(2):113-7.
    PMID: 2152014
    Three hundred and ninety five cases in 358 consecutive patients (male-232, female-126) with renal and ureteric stones were treated with extracorporeal shockwave lithotripsy (ESWL) from March to November 1988. They either had ESWL alone, or in combination with stone manipulation or debulking percutaneous nephrolithotripsy (PCNL). Seventy five percent of the stones were found in the pelvicalyceal system and 25% in the ureter. Seventy-six percent of the stones were less than 25mm size. Two hundred and ninety (79%) cases were followed up to three months. Two hundred and forty nine (85.9%) cases were stone free and 36 (12.4%) had residual sand less than 3mm size. Five (1.7%) cases failed to fragment with ESWL monotherapy and were salvaged by either percutaneous or ureteroscopic intervention. None of the cases required any open surgery intervention.
  17. Tan HM, Cheung HS
    Med J Malaysia, 1990 Jun;45(2):118-22.
    PMID: 2152015
    Sixty eight consecutive cases of percutaneous renal surgery, percutaneous nephrolithotripsy (PCNL), were performed on 64 patients (male-41, female-23) at the Subang Jaya Medical Centre from April 1988 to July 1989. All the cases were done as a one stage procedure. Fifty eight stones were large renal or staghorn and ten were ureteric. Thirty cases (41%) were stone free after PCNL alone. Thirty eight cases had residual fragments needing extracorporeal shockwave lithotripsy (ESWL). Mean operating time was 109.6 +/- 36.0 minutes. Mean hospital stay was 4.5 +/- 1.8 days. At three months follow-up, 86% of the cases were stone free. The remaining had residual sand (less than 3mm). Minor complications occurred in six patients. None required major surgical intervention post PCNL.
  18. Tan HM, Khoo J, Pang KP
    Med J Malaysia, 2003 Jun;58(2):286-9.
    PMID: 14569752
    Two patients who had acute pancreatitis subsequently developed characteristic appearance on urography of smooth extrinsic narrowing and medial deviation of the right ureter suggestive of retroperitoneal fibrosis (RPF) resulting in ureteric obstruction. Both these patients had clinical, biochemical and sonographic evidence of acute pancreatitis. CT scan of the abdomen performed on the second patient also documented acute pancreatitis. Intravenous urograms were consistent with ureteric obstruction due to retroperitoneal fibrosis. Both cases were treated conservatively. They were well after an average of 20 months. These 2 cases illustrate the uncommon association between pancreatitis and RPF.
  19. Tan HM, Low WY
    PLoS One, 2018;13(12):e0209336.
    PMID: 30586459 DOI: 10.1371/journal.pone.0209336
    Glutathione S-Transferases (GSTs) are phase II detoxification enzymes that may have evolved in response to changes of environmental substrates. GST genes formed a multigene family and in mammals, there are six classes known as Alpha, Mu, Omega, Pi, Theta, and Zeta. Recent studies in phase I detoxification system specifically the cytochrome P450s provided a general explanation on why genes from a common origin such as those in a multigene family have both phylogenetically stable and unstable genes. Genes that participate in core functions of organisms such as development and physiology are stable whereas genes that play a role in detoxification are unstable and evolve in a process known as birth-death evolution, which is characterised by frequent gene gains and losses. The generality of the birth-death model at explaining the evolution of detoxification enzymes beyond the phase I enzyme has not been comprehensively explored. This work utilized 383 Gst genes and 300 pseudogenes across 22 mammalian species to study gene gains and losses. GSTs vary greatly in their phylogenetic stability despite their overall sequence similarity. Stable Gst genes from Omega and Zeta classes do not show fluctuation in gene numbers from human to opossum. These genes play a role in biosynthesis related functions. Unstable genes that include Alpha, Mu, Pi and Theta undergo frequent gene gain and loss in a process known as birth-death evolution. Gene members of these four classes are well known for their roles in detoxification. Our positive selection screen identified five positively selected sites in mouse GSTA3. Previous studies showed two of these sites (108H and 208E) were biochemically tested as important residues that conferred catalytic activity against the toxic aflatoxin B1-8,9-epoxide. The functional significance against aflatoxin of the remaining three positively selected sites warrant further investigation.
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