MyMedR

Fulltext Pilomatrixoma of left shoulder in an elderly female: a case report

Tan L, Ooi C, Chua H, Zulkiflee O

Malays Orthop J, 2013 Jul;7(2):48-50.

PMID: 25722828 MyJurnal DOI: 10.5704/MOJ.1307.005

We report a huge pilomatrixoma of the left shoulder in an elderly female, raising fear of malignancy. Magnetic Resonance Imaging delineated the swelling and wide surgical excision was performed. Post operative recovery was uneventful. Long term follow up is necessary in view of the possibility of recurrence and malignant transformation.

KEY WORDS: Pilomatrixoma, Pilomatricoma, Calcifying Epithelioma of Malherbe, Shoulder, Upper Limb, Elderly, Female.

Fulltext Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

Klionsky DJ, Abdelmohsen K, Abe A, Abedin MJ, Abeliovich H, Acevedo Arozena A, et al.

Autophagy, 2016;12(1):1-222.

PMID: 26799652 DOI: 10.1080/15548627.2015.1100356

Genotyping and characterization of Toxoplasma gondii strain isolated from pigs in Hubei province, central China

Xia NB, Lu Y, Zhao PF, Wang CF, Li YY, Tan L, et al.

Trop Biomed, 2020 Jun 01;37(2):489-498.

PMID: 33612818

Toxoplasma gondii, a ubiquitous pathogen that infects nearly all warm-blooded animals and humans, can cause severe complications to the infected people and animals as well as serious economic losses and social problems. Here, one local strain (TgPIG-WH1) was isolated from an aborted pig fetus, and the genotype of this strain was identified as ToxoDB #3 by the PCR RFLP typing method using 10 molecular markers (SAG1, SAG2, alternative SAG2, SAG3, BTUB, GRA6, L358, PK1, C22-8, C29-2 and Apico). A comparison of the virulence of this isolate with other strains in both mice and piglets showed that TgPIG-WH1 was less virulent than type 1 strain RH and type 2 strain ME49 in mice, and caused similar symptoms to those of ME49 such as fever in piglets. Additionally, in piglet infection with both strains, the TgPIG-WH1 caused a higher IgG response and more severe pathological damages than ME49. Furthermore, TgPIG-WH1 caused one death in the 5 infected piglets, whereas ME49 did not, suggesting the higher virulence of TgPIG-WH1 than ME49 during piglet infection. Experimental infections indicate that the virulence of TgPIG-WH1 relative to ME49 is weaker in mice, but higher in pigs. This is probably the first report regarding a ToxoDB #3 strain from pigs in Hubei, China. These data will facilitate the understanding of genetic diversity of Toxoplasma strains in China as well as the prevention and control of porcine toxoplasmosis in the local region.

A colonic amoebic abscess mimicking colonic carcinoma

Tan LP, Foong KK, Yvonne Ai LL

Med J Malaysia, 2018 10;73(5):334-335.

PMID: 30350818 MyJurnal

Amebiasis is one of the major causes of diarrhea in the developing countries and it can present with a wide range of gastrointestinal symptoms depending on the phase of infection. We described a case of 50 year-old male patient who presented with abdominal pain, diarrhea and vomiting. After right hemicolectomy for appendicular abscess with tumour over the ileum, histopathological examinations revealed numerous trophozoites of Entamoeba histolytica in a background of inflammations (Figure 1). Following resection of the ameboma, he received intravenous metronidazole treatment for total of two weeks duration.

Fulltext Socio-demographic factors and healthy lifestyle behaviours among Malaysian adults: National Health and Morbidity Survey 2019

Khaw WF, Nasaruddin NH, Alias N, Chan YM, Tan L, Cheong SM, et al.

Sci Rep, 2022 Oct 04;12(1):16569.

PMID: 36195767 DOI: 10.1038/s41598-022-20511-1

This study aimed to investigate the association between socio-demographic factors and designated healthy lifestyle behaviours in a nationally-representative sample of Malaysian adults aged 18 years and above. Secondary data involving 7388 participants aged 18-96 years from the National Health and Morbidity Survey 2019, a national cross-sectional survey, was used in this study. A healthy lifestyle score (0-5 points) was calculated based on five modifiable lifestyle factors: non-smoker, body mass index

Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI

Suppiah S, Rahmat K, Mohd-Shah MN, Azlan CA, Tan LK, Aziz YF, et al.

Clin Radiol, 2013 Sep;68(9):e502-10.

PMID: 23706826 DOI: 10.1016/j.crad.2013.04.002

To investigate the diagnostic accuracy of single-voxel proton magnetic resonance spectroscopy (SV (1)H MRS) by quantifying total choline-containing compounds (tCho) in differentiating malignant from benign lesions, and subsequently, to analyse the relationship of tCho levels in malignant breast lesions with their histopathological subtypes.

An unusual cause of secondary spontaneous pneumothorax in a 27-year-old man

Lim KH, Tan LH, Liam CK, Wong CM

Chest, 2001 Nov;120(5):1728-31.

PMID: 11713160

First molecular detection of Tritrichomonas foetus in domestic cats in Klang Valley, Malaysia

Tan LP, Megat Abd Rani PA, Sharma RSK, Syed Hussain SS, Watanabe M

Trop Biomed, 2020 Sep 01;37(3):756-762.

PMID: 33612788 DOI: 10.47665/tb.37.3.756

Tritrichomonas foetus is known to cause chronic diarrhea in the feline species in many different regions of the world. However, there is a paucity of information on T. foetus among cats in Malaysia. This study was conducted to determine the prevalence of Tritrichomonas foetus in the pet and stray cat population in Klang Valley, Malaysia. A total of 201 pet and stray cats' fecal samples were collected in Klang Valley. 24 samples were cultured in the InPouch® TF Feline to observe for motile trophozoites. A nested PCR protocol was used to screen for T. foetus in the collected samples. The prevalence of T. foetus in the cat population in Klang Valley was 33%. There was no association between Tritrichomonas infection and age, sex, breed or management of the cats. However, statistical analysis revealed that stray cats were more likely to be infected with T. foetus compared to pet cats. This study confirmed for the first time the presence of T. foetus among the cat population in Klang Valley, Malaysia.

Prevalence of Toxoplasma gondii in pet and stray cats in Klang Valley, Malaysia

Tan LP, Megat Abd Rani PA, Sharma RSK, Syed Hussain SS, Watanabe M

Trop Biomed, 2020 Sep 01;37(3):542-550.

PMID: 33612769 DOI: 10.47665/tb.37.3.542

Toxoplasma gondii, a zoonotic protozoan that has a worldwide distribution, is known to infect many warm-blooded vertebrates. The feline species including domestic cats are the definitive hosts for Toxoplama gondii and shed the infective oocyst. There is lack of information on the prevalence of Toxoplasma gondii in cats in Malaysia. The objective of this study was to determine both the seroprevalence of T. gondii and the prevalence of T. gondii DNA in cats' feces in Klang Valley, Malaysia. 198 blood and 201 fecal samples were collected from pet and stray cats from the local council, Dewan Bandaraya Kuala Lumpur (DBKL) and University Veterinary Hospital, Universiti Putra Malaysia respectively. The overall seroprevalence of Toxoplasma gondii in cats in the Klang Valley was found to be 5.5%. There was a high prevalence (10.5%) of T. gondii DNA detected in the cat fecal samples in both pet and stray cats suggestive of T. gondii oocyst shedding. Stray cats showed a higher seroprevalence and molecular prevalence of T. gondii than the pet cats. However, comparative analysis using Chi-square test showed no significant difference between both groups (P>0.05). Higher prevalence (10.5%) of cats shedding T. gondii DNA as compared to the seroprevalence (5.5%) was found in the cat population in the Klang Valley. The high prevalence of cats shedding T. gondii DNA is alarming as this may directly reflect the number of oocysts excreted into the environment posing a significant public health hazard.

Clinical algorithms for the management of intrapartum maternal urine abnormalities

Cheung KW, Tan LN, Meher S, WHO Intrapartum Care Algorithms Working Group

BJOG, 2022 Apr 12.

PMID: 35415941 DOI: 10.1111/1471-0528.16726

AIM: To develop evidence-based clinical algorithms for management of common intrapartum urinary abnormalities.

POPULATION: Women with singleton, term pregnancies in active labour and immediate postnatal period, at low risk of complications.

SETTING: Healthcare facilities in low- and middle-income countries.

SEARCH STRATEGY: A systematic search and review were conducted on the current guidelines from WHO, NICE, ACOG and RCOG. Additional search was done on PubMed and The Cochrane Database of Systematic Reviews up to May 2020.

CASE SCENARIOS: Four common intrapartum urinary abnormalities were selected: proteinuria, ketonuria, glycosuria and oliguria. Using reagent strip testing, glycosuria was defined as ≥2+ on one occasion or of ≥1+ on two or more occasions. Proteinuria was defined as ≥2+ and presence of ketone indicated ketonuria. Oliguria was defined as hourly urine output ≤30 ml. Thorough initial assessment using history, physical examination and basic investigations helped differentiate most of the underlying causes, which include diabetes mellitus, dehydration, sepsis, pre-eclampsia, shock, anaemia, obstructed labour, underlying cardiac or renal problems. A clinical algorithm was developed for each urinary abnormality to facilitate intrapartum management and referral of complicated cases for specialised care.

CONCLUSIONS: Four simple, user-friendly and evidence-based clinical algorithms were developed to enhance intrapartum care of commonly encountered maternal urine abnormalities. These algorithms may be used to support healthcare professionals in clinical decision-making when handling normal and potentially complicated labour, especially in low resource countries.

TWEETABLE ABSTRACT: Evidence-based clinical algorithms developed to guide intrapartum management of commonly encountered urinary abnormalities.

Fulltext Validation and utilization of an internally controlled multiplex Real-time RT-PCR assay for simultaneous detection of enteroviruses and enterovirus A71 associated with hand foot and mouth disease

Thanh TT, Anh NT, Tham NT, Van HM, Sabanathan S, Qui PT, et al.

Virol J, 2015 Jun 09;12:85.

PMID: 26050791 DOI: 10.1186/s12985-015-0316-2

BACKGROUND: Hand foot and mouth disease (HFMD) is a disease of public health importance across the Asia-Pacific region. The disease is caused by enteroviruses (EVs), in particular enterovirus A71 (EV-A71). In EV-A71-associated HFMD, the infection is sometimes associated with severe manifestations including neurological involvement and fatal outcome. The availability of a robust diagnostic assay to distinguish EV-A71 from other EVs is important for patient management and outbreak response.

METHODS: We developed and validated an internally controlled one-step single-tube real-time RT-PCR in terms of sensitivity, linearity, precision, and specificity for simultaneous detection of EVs and EV-A71. Subsequently, the assay was then applied on throat and rectal swabs sampled from 434 HFMD patients.

RESULTS: The assay was evaluated using both plasmid DNA and viral RNA and has shown to be reproducible with a maximum assay variation of 4.41 % and sensitive with a limit of detection less than 10 copies of target template per reaction, while cross-reactivity with other EV serotypes was not observed. When compared against a published VP1 nested RT-PCR using 112 diagnostic throat and rectal swabs from 112 children with a clinical diagnosis of HFMD during 2014, the multiplex assay had a higher sensitivity and 100 % concordance with sequencing results which showed EVs in 77/112 (68.8 %) and EV-A71 in 7/112 (6.3 %). When applied to clinical diagnostics for 322 children, the assay detected EVs in throat swabs of 257/322 (79.8 %) of which EV-A71 was detected in 36/322 (11.2 %) children. The detection rate increased to 93.5 % (301/322) and 13.4 % (43/322) for EVs and EV-A71, respectively, when rectal swabs from 65 throat-negative children were further analyzed.

CONCLUSION: We have successfully developed and validated a sensitive internally controlled multiplex assay for rapid detection of EVs and EV-A71, which is useful for clinical management and outbreak control of HFMD.

Fulltext Influence of co-morbidity in the interpretation of tuberculin skin reactivity in multi-ethnic adult patients with tuberculosis

Loh LC, Chan SK, Ch'ng KI, Tan LZ, Vijayasingham P, Thayaparan T

Med J Malaysia, 2005 Oct;60(4):426-31.

PMID: 16570703

In the Malaysian setting of multi-ethnicity and high BCG coverage, interpretation of Tuberculin Skin Testing (TST) may be difficult. Between January 2001 and December 2003, a retrospective study on all adult patients with documented TST results treated for tuberculosis (TB) in chest clinics of two government hospitals was conducted to determine the reliability of TST and factors affecting its interpretation. One hundred and three patients [mean age (SD): 43 (17); male: 67%] were eligible for data collection: 72% and 57% of patients had positive TST results based on cut-off points of 10mm and 15mm respectively. The only significant univariate association with TST results was the severity of co-morbidity. A patient with co-morbidity score of 3 defined as those with any cancer, end-stage renal or liver disease, or HIV disease, was more likely to have a negative TST results [10mm cut-off point: Odd Ratio (95% CI) 6.6 (1.82 to 24.35), p = 0.003; 15mm cut-off point: 4.8 (1.21 to 18.95), p = 0.012]. A TST reading of 10mm had a higher sensitivity than 15mm as the cut-off point in diagnosing TB infection. Considering all possible confounding factors like ethnicity, prior BCG vaccination and TB burden in the population, severity of co-morbidity remains strongly predictive of a negative TST. Caution should be exercised in interpreting TST in these patients.
Study site: Chest clinic, Hospital Seremban, Hospital Kuala Pilah, Negeri Sembilan, Malaysia

Diagnostic accuracy and ability to reduce unnecessary FNAC: A comparison between four Thyroid Imaging Reporting Data System (TI-RADS) versions

Tan L, Tan YS, Tan S

Clin Imaging, 2020 Sep;65:133-137.

PMID: 32470834 DOI: 10.1016/j.clinimag.2020.04.029

BACKGROUND: Thyroid Imaging Reporting Data System (TI-RADS) is used to characterize thyroid nodules while reducing unnecessary FNAC. Over the years, several versions of TI-RADS have been developed but there is no consensus on which TI-RADS is the best system. This study aimed to compare the diagnostic accuracy and ability of ACR TI-RADS, EU TI-RADS, K TI-RADS, AI TI-RADS to eliminate unnecessary FNAC.

METHODS: In this prospective study, thyroid nodules were characterized by using the four TI-RADS systems and US-guided FNAC was done for nodule with the highest ACR TI-RADS score. Correlation between TI-RADS and FNAC results were analyzed.

RESULTS: Out of 244 thyroid nodules, 100 nodules with either size <1 cm (43 nodules) non-diagnostic or inconclusive FNAC results (57 nodules) were excluded. Seven nodules (4.9%) were confirmed to be malignant on FNAC. K TI-RADS showed 100% sensitivity and NPV but the lowest specificity (40.2%). EU TI-RADS had the highest specificity (83.2%) but the lowest sensitivity (57.1%) and NPV (97.4%). ACR TI-RADS had an average sensitivity (85.7%) and NPV (98.6%). The specificity of ACR TI-RADS (51.1%) was lower than EU TI-RADS but higher than K TI-RADS. AI TI-RADS showed higher specificity (61.8% vs 51.1%, p

Acquired lung cysts in post primary tuberculosis: An uncommon radiological finding in a common disease

Tan LS, Tan S

Med J Malaysia, 2018 02;73(1):54-56.

PMID: 29531206 MyJurnal

Tuberculosis (TB) is still an endemic disease in Malaysia. Cystic lung disease in post primary tuberculosis is not common. It can occur before, during or after completion of anti-TB treatment. Clinical history and review of serial chest radiograph is paramount to make the diagnosis. This case report highlights an interesting case of a young female patient who developed extensive cystic lung disease during the course of anti-TB treatment and the importance of recognizing this unusual manifestation.

Influence of sodium chloride treatment and polysaccharides as debittering agent on the physicochemical properties, antioxidant capacity and sensory characteristics of bitter gourd (Momordica charantia) juice

Siti Rashima R, Maizura M, Kang WM, Fazilah A, Tan LX

J Food Sci Technol, 2017 Jan;54(1):228-235.

PMID: 28242920 DOI: 10.1007/s13197-016-2454-y

The effects of sodium chloride (NaCl) (3.5%) solution and polysaccharides, such as carboxymethyl cellulose (CMC) (0.1, 0.3 and 0.5%) and gum arabic (5, 10 and 15%), on the physicochemical properties, antioxidant capacity and sensory characteristics of bitter gourd juice were investigated. An increase in the concentration of CMC and gum arabic significantly was observed to increase the lightness (L value) and the viscosity (mPas) of bitter gourd juice at all levels. Increased concentrations of gum arabic significantly increased the total soluble solids. The bitter gourd fruit treated with NaCl solution produced the highest lightness (L value) and scavenging activity of free radical 2,2-diphenyl-1-picrylhydrazyl of bitter gourd juice. Increased concentration of gum arabic up to 15% significantly increased the total phenolic content. The addition of 5% gum arabic effectively reduced the bitterness of the bitter gourd juice. Viscosity of the juice resulted in negative correlation for bitterness.

Fulltext Development of a controlled release of salicylic acid loaded stearic acid-oleic acid nanoparticles in cream for topical delivery

Woo JO, Misran M, Lee PF, Tan LP

ScientificWorldJournal, 2014;2014:205703.

PMID: 24578624 DOI: 10.1155/2014/205703

Lipid nanoparticles are colloidal carrier systems that have extensively been investigated for controlled drug delivery, cosmetic and pharmaceutical applications. In this work, a cost effective stearic acid-oleic acid nanoparticles (SONs) with high loading of salicylic acid, was prepared by melt emulsification method combined with ultrasonication technique. The physicochemical properties, thermal analysis and encapsulation efficiency of SONs were studied. TEM micrographs revealed that incorporation of oleic acid induces the formation of elongated spherical particles. This observation is in agreement with particle size analysis which also showed that the mean particle size of SONs varied with the amount of OA in the mixture but with no effect on their zeta potential values. Differential scanning calorimetry analysis showed that the SONs prepared in this method have lower crystallinity as compared to pure stearic acid. Different amount of oleic acid incorporated gave different degree of perturbation to the crystalline matrix of SONs and hence resulted in lower degrees of crystallinity, thereby improving their encapsulation efficiencies. The optimized SON was further incorporated in cream and its in vitro release study showed a gradual release for 24 hours, denoting the incorporation of salicylic acid in solid matrix of SON and prolonging the in vitro release.

Fulltext Syringocystadenoma papilliferum arising in a naevus sebaceous

Faheem NAA, Kwan Z, Yong ASW, Ch'ng CC, Tan KK, Naicker M, et al.

Malays J Pathol, 2019 Apr;41(1):47-49.

PMID: 31025637

Naevus sebaceus is a cutaneous hamartoma with the potential of developing into benign or malignant neoplasms. Syringocystadenoma papilliferum (SCAP) have been reported to originate from naevus sebaceus. SCAP is a rare, benign adnexal skin tumour of apocrine or eccrine type of differentiation which typically presents as a nodule or a plaque on the scalp or face. We report a case of syringocystadenoma papilliferum arising in an undiagnosed pre-existing naevus sebaceus in a 56-year-old female.

Apical hypertrophic cardiomyopathy

Chia BL, Tan LK

Am J Cardiol, 1984 May 01;53(9):1413.

PMID: 6538741

Glaucoma severity affects diffusion tensor imaging (DTI) parameters of the optic nerve and optic radiation

Sidek S, Ramli N, Rahmat K, Ramli NM, Abdulrahman F, Tan LK

Eur J Radiol, 2014 Aug;83(8):1437-41.

PMID: 24908588 DOI: 10.1016/j.ejrad.2014.05.014

To evaluate whether MR diffusion tensor imaging (DTI) of the optic nerve and optic radiation in glaucoma patients provides parameters to discriminate between mild and severe glaucoma and to determine whether DTI derived indices correlate with retinal nerve fibre layer (RNFL) thickness.

WITHDRAWN: Preliminary investigation on Mycoplasma maculosum isolated from chickens

Mohd-Zain Z, Tan LJ

Res Vet Sci, 2010 Nov 09.

PMID: 21067786

This article has been withdrawn at the request of the authors. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

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