Displaying publications 1 - 20 of 43 in total

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  1. Abdullah H, Abdul Wahab N, Abu Bakar K
    BMJ Case Rep, 2017 Jun 13;2017.
    PMID: 28611167 DOI: 10.1136/bcr-2017-219793
    Matched MeSH terms: Twins, Conjoined*
  2. Baskaran A
    Med J Malaysia, 1997 Sep;52(3):291-2.
    PMID: 10968100
    Conjoined twins in a triplet pregnancy is an extremely rare occurrence. We present here, a 27-year-old multigravida with gestational diabetes and a conjoined twins in a triplet pregnancy.
    Matched MeSH terms: Twins, Conjoined*
  3. Chin YM, Wan Ariffin A, Lin HP, Chan YS
    Med J Malaysia, 1996 Mar;51(1):145-8.
    PMID: 10967997
    Two 4-year-old monozygotic Chinese, female twins developed concordant childhood acute lymphoblastic leukemia (ALL) within an interval of about 2 weeks. Based on morphology and cytochemistry findings of the bone marrow blast cells, a diagnosis of ALL, L1 was made. Immunophenotyping showed the blast cells of both twins expressed similar antigens, i.e. HLA-DR, CD10, CD13, CD19, CD22 and CD34. Identical blood group, same HLA (human leucocyte antigen) genotype, sex and similar appearance suggest that the twins are monozygotic. Since the bone marrow leukemic cells of both twins were identical in morphology and expressed the same antigens with almost similar percentages of positivity, it is likely that the blast cells were derived from the same single clone. Based on the single clone hypothesis, the leukemogenic event must have arisen in utero in one twin and the cells from the abnormal clone then spread to the other twin via shared placental anastomoses.
    Matched MeSH terms: Diseases in Twins*; Twins, Monozygotic*
  4. Yang CY, Hoong MF, Li CS, Li WF, You SH, Lee YC, et al.
    Taiwan J Obstet Gynecol, 2021 May;60(3):517-522.
    PMID: 33966739 DOI: 10.1016/j.tjog.2021.03.023
    OBJECTIVE: To evaluate the association between intrauterine growth restriction (IUGR) and the incidence of fetuses with patent ductus arteriosus (PDA) and Hemodynamically significant PDA (Hs-PDA) in dichorionic twins (DC) with selective IUGR.

    MATERIALS AND METHODS: This is an observational cohort study and retrospective case assessment, involved twins born at Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan between 2013 and 2018. DC twins with selective IUGR (sIUGR) were defined as the presence of a birth weight discordance of >25% and a smaller twin with a birth weight below the tenth percentile. PDA was diagnosed using echocardiography between postnatal day 3 and 7. Hs-PDA was defined as PDA plus increased pulmonary circulation, poor systemic perfusion, cardiomegaly, pulmonary edema, or hypotension requiring pharmacotherapeutic intervention.

    RESULT: A total of 1187 twins were delivered during the study period, and 53 DC twins with selective IUGR were included in this study. DC twins with PDA have higher rate of preterm birth, lower gestational age of delivery, and lower mean birth weight of both twins compared with DC twins without PDA. In a comparison of the sIUGR twin with the appropriate for gestational age co-twin, both the incidences of PDA (28.30% vs. 7.55%, respectively; P = 0.003) and Hs-PDA (24.53% vs. 5.66%, respectively; P = 0.002) were higher in sIUGR fetuses than in the appropriate for gestational age co-twins. Small gestational age of delivery was the only variable to predict PDA and Hs-PDA [p = 0.002, Odds ratio = 0.57 (0.39-0.82), p = 0.009, Odds ratio = 0.71 (0.55-0.92), respectively].

    CONCLUSION: An analysis of dichorionic twins with sIUGR indicated that IUGR increased the risk of PDA and hemodynamically significant PDA.

    Matched MeSH terms: Twins, Dizygotic
  5. Hung TH, Hsieh TT, Shaw SW, Kok Seong C, Chen SF
    J Diabetes Investig, 2021 Jun;12(6):1083-1091.
    PMID: 33064935 DOI: 10.1111/jdi.13441
    AIMS/INTRODUCTION: The association between gestational diabetes mellitus (GDM) and adverse maternal and perinatal outcomes in twin pregnancies remains unclear. This study was undertaken to highlight risk factors for GDM in women with dichorionic (DC) twins, and to determine the association between GDM DC twins and adverse maternal and perinatal outcomes in a large homogeneous Taiwanese population.

    MATERIALS AND METHODS: A retrospective cross-sectional study was carried out on 645 women with DC twins, excluding pregnancies complicated by one or both fetuses with demise (n = 22) or congenital anomalies (n = 9), who gave birth after 28 complete gestational weeks between 1 January 2001 and 31 December 2018. Univariable and multiple logistic regression analyses were carried out.

    RESULTS: Maternal age >34 years (adjusted odds ratio 2.52; 95% confidence interval 1.25-5.07) and pre-pregnancy body mass index >24.9 kg/m2 (adjusted odds ratio 2.83, 95% confidence interval 1.47-5.46) were independent risk factors for GDM in women with DC twins. Newborns from women with GDM DC twins were more likely to be admitted to the neonatal intensive care unit (adjusted odds ratio 1.70, 95% confidence interval 1.06-2.72) than newborns from women with non-GDM DC twins. Other pregnancy and neonatal outcomes were similar between the two groups.

    CONCLUSIONS: Advanced maternal age and pre-pregnancy overweight or obesity are risk factors for GDM in women with DC twins. Except for a nearly twofold increased risk of neonatal intensive care unit admission of newborns, the pregnancy and neonatal outcomes for women with GDM DC twins are similar to those for women with non-GDM DC twins.

    Matched MeSH terms: Twins, Dizygotic/statistics & numerical data*
  6. Krishna L, Abdul Jalil NF, Lott PW, Singh S, Choo MM
    Eur J Ophthalmol, 2021 Mar;31(2):NP119-NP122.
    PMID: 31390886 DOI: 10.1177/1120672119867605
    PURPOSE: To report three cases of juvenile myasthenia gravis aged between 18 and 24 months with ocular symptoms as their first presentation.

    METHOD: A case series.

    RESULTS: We present a case series of juvenile myasthenia gravis in a tertiary centre in Malaysia. Two of the three cases consist of a pair of twins who presented with ptosis of bilateral eyes; the first twin presented 4 months later than the second twin. These two cases were positive for anti-acetylcholine receptor antibodies and had generalized myasthenia gravis, whereas the other case was negative for receptor antibodies and was purely ocular myasthenia gravis.

    CONCLUSION: Juvenile myasthenia gravis is relatively rare in toddlers. Early diagnosis and commencement of treatment is important to slow the progression of the disease and avoiding life-threatening events.

    Matched MeSH terms: Diseases in Twins/diagnosis*; Diseases in Twins/drug therapy; Diseases in Twins/genetics; Twins, Monozygotic*
  7. Anna Liza R, Alik RZ, Ahmad Murad Z, Ghazali I
    Med J Malaysia, 2008 Aug;63(3):263-4.
    PMID: 19248707 MyJurnal
    Premature Ovarian Failure (POF) is associated with subfertility. Despite efforts to induce ovulation, success rates are low. We report a case of POF spontaneously conceiving twins while on hormone replacement therapy.
    Matched MeSH terms: Twins
  8. Shiek Ahmad B, Wark JD, Petty SJ, O'Brien TJ, Gorelik A, Sambrook PN, et al.
    Epilepsia, 2015 Nov;56(11):1714-22.
    PMID: 26513212 DOI: 10.1111/epi.13136
    To investigate cross-sectional and longitudinal differences in static and dynamic standing balance measures and lower limb muscle strength in patients who are treated chronically with antiepileptic drugs (AEDs).
    Matched MeSH terms: Diseases in Twins/drug therapy*; Diseases in Twins/genetics
  9. Yaacob R, Zainal Mokhtar A, Abang Jamari DZH, Jaafar N
    BMJ Case Rep, 2017 Sep 23;2017.
    PMID: 28942402 DOI: 10.1136/bcr-2017-220801
    Fetus-in-fetu (FIF) is a rare entity in which malformed parasitic twin grows inside the body of its twin. It is most commonly presented with mass in the abdomen. We present a case of a 15-year-old boy who presented with abdominal mass since infancy. Radiological investigations are suggestive of FIF. Intraoperatively, malformed fetus in a sac was found and excised. Postoperatively the patient recovers well and was put on follow-up.
    Matched MeSH terms: Twins, Conjoined*
  10. Jahanfar S, Jaffar SH
    Twin Res Hum Genet, 2013 Feb;16(1):246-7.
    PMID: 23110917 DOI: 10.1017/thg.2012.80
    The National Malaysian Twin Registry was established in Royal College of Medicine, Perak, University Kuala Lumpur (UniKL) in June 2008 through a grant provided by UniKL. The general objective is to facilitate scientific research involving participation of twins and their family members in order to answer questions of health and wellbeing relevant to Malaysians. Recruitment is done via mass media, poster, and pamphlets. We now have 266 adult and 204 children twins registered. Several research projects including reproductive health study of twins and the role of co-bedding on growth and development of children are carried out. Registry holds annual activities for twins and seeks to provide health-related information for twins. We seek international collaboration.
    Matched MeSH terms: Diseases in Twins/diagnosis*; Diseases in Twins/genetics; Diseases in Twins/epidemiology; Twins/genetics*
  11. Jahanfar S
    Ann Hum Biol, 2018 Aug;45(5):395-400.
    PMID: 30328724 DOI: 10.1080/03014460.2018.1526320
    BACKGROUND: Genetic and environmental influences on anthropometric measures can be investigated by comparing dizygotic (DZ) versus monozygotic (MZ) twins. Investigating cohorts living in different geographical areas across the globe can identify the variation in heritability versus environment.

    AIMS: (1) To investigate the association between birth weight and anthropometric measurements during adulthood; (2) to study the genetic and environmental influences on body measures including birth weight, weight and height among twins; and (3) to assess the variation in heritability versus environment among two cohorts of twins who lived in different geographical areas.

    SUBJECTS AND METHODS: Twins were collected from two twin registers. Data on birth weight, adult weight and height in 430 MZ and 170 DZ twins living in two geographically distinct parts of the world were collected. A genetic analysis was performed using MX software.

    RESULTS: Birth weight was associated with weight, height and BMI. Both MZ and DZ twins with low birth weight had shorter height during their adult life (p = 0.001), but only MZ twins with lower birth weight were lighter at adulthood (p = 0.001). Intra-pair differences in birth weight were not associated with differences in adult height (p = 0.366) or weight (p = 0.796). Additive genetic effects accounted for 53% of the variance in weight, 43% in height and 55% in birth weight. The remaining variance was attributed to unique environmental effects (15% for weight, 13% for height and 45% for birth weight and only 16% for BMI). Variability was found to be different in the two cohorts. The best fitting model for birth weight and BMI was additive genetic and non-shared environment and for weight and height was additive genetic, non-shared environment (plus common Environment).

    CONCLUSIONS: Data suggests that the association between weight at birth and anthropometric measures in later life is influenced by both genetic and environmental factors. Living in different environments can potentially relate to variation found in the environment.

    Matched MeSH terms: Twins, Dizygotic*; Twins, Monozygotic*
  12. Jahanfar, S.
    Malays Fam Physician, 2008;3(2):111-112.
    PMID: 25606132 MyJurnal
    A twin registry is a registry of twin pairs (monozygotic = MZ and Dizygotic = DZ) who are willing to consider participating in health-related research. Twins are able to help researchers study the impact of genetic and environmental factors on health and the treatment and prevention of disease in a special way. Throughout the world, twin registries have been established by the governments via the National Health and Medical Research in order to put researchers in touch with twins who might be willing to take part in particular projects. In Australia, for example, more than 30,000 pairs of twins have joined the registry, making it the largest volunteer registry of its kind in the world. However, in some countries such as Denmark, the first twin registry was born in a medical faculty and it was then expanded to the National Twin Registry of Denmark. (Copied from article).
    Matched MeSH terms: Twins
  13. Halim AS, Emami A, Salahshourifar I, Kannan TP
    Arch Plast Surg, 2012 May;39(3):184-9.
    PMID: 22783524 DOI: 10.5999/aps.2012.39.3.184
    Keloid disease is a fibroproliferative dermal tumor with an unknown etiology that occurs after a skin injury in genetically susceptible individuals. Increased familial aggregation, a higher prevalence in certain races, parallelism in identical twins, and alteration in gene expression all favor a remarkable genetic contribution to keloid pathology. It seems that the environment triggers the disease in genetically susceptible individuals. Several genes have been implicated in the etiology of keloid disease, but no single gene mutation has thus far been found to be responsible. Therefore, a combination of methods such as association, gene-gene interaction, epigenetics, linkage, gene expression, and protein analysis should be applied to determine keloid etiology.
    Matched MeSH terms: Twins, Monozygotic
  14. Jahanfar S, Lye MS, Krishnarajah IS
    Indian J Hum Genet, 2013 Apr;19(2):245-50.
    PMID: 24019629 DOI: 10.4103/0971-6866.116127
    INTRODUCTION: Menarche or first menstrual period is a landmark in reproductive life span and it is the most prominent change of puberty. The timing of menarche can be under the influence of genes as well as individual environmental factors interacting with genetic factors.

    OBJECTIVE: Our study objectives were (a) to investigate the heritability of age of menarche in twins, (b) to obtain the association between age of menarche and childhood factors, and reproductive events/behavior, (c) to examine whether or not having a male co-twin affects early/late menarche.

    METHODOLOGY: A group of female-female identical (n = 108, 54 pairs), non-identical twins (n = 68, 34 pairs) and 17 females from opposite-sex twin sets were identified from twin registries of Malaysia and Iran. Genetic analysis was performed via two methods of Falconers' formula and maximum likelihood.

    RESULTS: Heritability was found to be 66% using Falconers' formula and 15% using univariate twin analysis. Model analysis revealed that shared environmental factors have a major contribution in determining the age of menarche (82%) followed by non-shared environment (18%).

    DISCUSSION: Result of this study is consistent with that of the literature. Timing of menarche could be under the influence of shared and non-shared environmental effects. Hirsutism was found to have a higher frequency among subjects with late menarche. There was no significant difference in age of menarche between females of opposite-sex twins and females of same-sex twins.

    CONCLUSION: It is concluded that twin models provide a powerful means of examining the total genetic contribution to age of menarche. Longitudinal studies of twins may clarify the type of environmental effects that determine the age of menarche.

    Matched MeSH terms: Twins
  15. Wendel K, Akkök ÇA, Kutzsche S
    BMJ Case Rep, 2017 Jul 05;2017.
    PMID: 28679510 DOI: 10.1136/bcr-2016-218269
    Neonatal alloimmune thrombocytopaenia (NAIT) generally results from platelet opsonisation by maternal antibodies against fetal platelet antigens inherited from the infant's father. Newborn monochorionic twins presented with petechial haemorrhages at 10 hours of life, along with severe thrombocytopaenia. Despite the initial treatment with platelet transfusions and intravenous immunoglobulin, they both had persistent thrombocytopaenia during their first 45 days of life. Class I human leucocyte antigen (HLA) antibodies with broad specificity against several HLA-B antigens were detected in the maternal serum. Weak antibodies against HLA-B57 and HLA-B58 in sera from both twins supported NAIT as the most likely diagnosis. Platelet transfusion requirements of the twins lasted for 7 weeks. Transfusion of HLA-matched platelet concentrates was more efficacious to manage thrombocytopaenia compared with platelet concentrates from random donors. Platelet genotyping and determination of HLA antibody specificity are needed to select compatible platelet units to expedite safe recovery from thrombocytopaenia in NAIT.
    Matched MeSH terms: Twins
  16. Chan YK, Loh PS
    Med Hypotheses, 2016 Sep;94:108-11.
    PMID: 27515214 DOI: 10.1016/j.mehy.2016.06.018
    More than 90% of the human species are right handed. Although outwardly our body appears symmetrical, a 50/50% lateralization in handedness never occurs. Neither have we seen more than 50% left handedness in any subset of the human population. By 12-15weeks of intrauterine life, as many as 6 times more fetuses are noted by ultrasound studies to be sucking on their right thumbs. Distinct difference in oxygenation leading to dissimilar energy availability between right and left subclavian arteries in place by week 9 of life may hold the clue to the lateralization of hand function and eventually, the same in the brain. We know there is a higher incidence of left handedness in males, twins, premature babies and those born to mothers who smoke. They may represent a subset with less distinct difference in oxygenation between the 2 subclavian arteries during the fetal stage. This hypothesis if correct not only closes the gap in understanding human handedness and lateralization but also opens a vista for new research to focus on in utero tissue energy availability and its impact on outcome in life.
    Matched MeSH terms: Twins
  17. Lum MY
    Matched MeSH terms: Twins, Conjoined
  18. MARZUKI A
    Med J Malaysia, 1963 Jun;17:288-91.
    PMID: 14060506
    Matched MeSH terms: Twins*
  19. Menon DK
    Twin Res Hum Genet, 2005 Jun;8(3):259-61.
    PMID: 15989753
    The aim of this study was to determine the accuracy of sonographic chorionicity determination in the largest sample of twin pregnancies to date. We retrospectively analyzed 463 twin pregnancies delivered over a 6-year period to determine in each case what the antenatal sonographic prediction of chorionicity was, and then what the subsequent post partum pathological diagnosis of chorionicity was. Out of 436 twin pregnancies, 428 were correctly diagnosed for chorionicity as confirmed by pathology reports. Sonography as a screening tool for monochorionic twin pregnancies has a sensitivity of 100%, a specificity of 97.9% and a predictive value positive of 88.2%. Transvaginal scanning in the first trimester determined twin chorionicity with a sensitivity and a specificity of 100%. This study has confirmed in the largest sample to date that sonographic chorionicity determination is best done in the first trimester using vaginal scans, where it has 100% accuracy.
    Matched MeSH terms: Twins
  20. Norsidah AM, Lim SK, Ibtisan I, Misiran K
    Med J Malaysia, 1996 Dec;51(4):420-5.
    PMID: 10968028
    Anaesthesia for the separation of conjoined twins requires a well-prepared, multidisciplinary team. Each patient for surgery is different and the extent of organ sharing and coexisting anomalies must be determined before surgery so that problems can be anticipated. We report our experience of the anaesthetic management for the separation of six sets of conjoined twins. Anaesthesia and surgery were prolonged, massive blood loss and transfusion, hypothermia, electrolyte imbalance and infection being the main perioperative problems encountered.
    Matched MeSH terms: Diseases in Twins*; Twins, Conjoined/surgery*
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