Displaying publications 1 - 20 of 27 in total

Abstract:
Sort:
  1. Tan PC, King AS, Omar SZ
    J Obstet Gynaecol Res, 2012 Jan;38(1):145-53.
    PMID: 21955280 DOI: 10.1111/j.1447-0756.2011.01652.x
    AIM: The aim of this study was to evaluate urine microscopy, dipstick analysis and urinary symptoms in screening for urinary tract infection (UTI) in hyperemesis gravidarum (HG).
    MATERIALS AND METHODS:   A prospective cross-sectional study was performed on women at first hospitalization for HG. A clean-catch mid-stream urine sample from each recruit was sent for microscopy (for bacteria, leucocytes and erythrocytes), dipstick analysis (for leukocyte esterase, nitrites, protein and hemoglobin) and microbiological culture. The presence of current urinary symptoms was elicited by questionnaire. UTI is defined as at least 10(5) colony-forming units/mL of a single uropathogen on culture. Screening test parameters were analyzed against UTI.
    RESULTS: UTI was diagnosed in 15/292 subjects (5.1%). Receiver-operator characteristic curve analysis of microscopic urine leucocytes revealed area under the curve=0.64, 95% confidence interval (CI) 0.5-0.79, P=0.063 and erythrocytes area under the curve=0.53, 95%CI 0.39-0.67, P=0.67 for UTI indicating the limited screening utility of these parameters. Microscopic bacteriuria (likelihood ratio [LR] 1.1, 95%CI 0.7-1.5) and urine dipstick leukocyte esterase (LR 1.4, 95%CI 1.1-1.8), nitrites (LR 2.3, 95%CI 0.3-17.2), protein (LR 1.0, 95%CI 0.7-1.6) and hemoglobin (LR 0.8, 95%CI 0.4-1.5) were not useful screening tests for UTI in HG. Elicited symptoms were also not predictive of UTI.
    CONCLUSION: Urine microscopy, dipstick analysis and urinary symptoms were not useful in screening for UTI in HG. UTI should be established by urine culture in HG before starting antibiotic treatment.
    Matched MeSH terms: Hyperemesis Gravidarum/complications*; Hyperemesis Gravidarum/urine
  2. Tan PC, Jacob R, Quek KF, Omar SZ
    J Obstet Gynaecol Res, 2007 Aug;33(4):457-64.
    PMID: 17688612
    To determine pregnancy outcome in hyperemesis gravidarum and the effect of metabolic, biochemical, hematological and clinical indicators of disease severity on outcome.
    Matched MeSH terms: Hyperemesis Gravidarum/blood; Hyperemesis Gravidarum/pathology*; Hyperemesis Gravidarum/urine
  3. MUN CT
    Med J Malaysia, 1964 Jun;18:223-5.
    PMID: 14199437
    Matched MeSH terms: Hyperemesis Gravidarum*
  4. Sulaiman W, Othman A, Mohamad M, Salleh HR, Mushahar L
    Malays J Med Sci, 2002 Jul;9(2):43-6.
    PMID: 22844223 MyJurnal
    Two cases of Wernicke's encephalopathy due to hyperemesis gravidarum are described. The first patient presented with bilateral papilloedema, altered sensorium and the second with bilateral retinal haemorrhages, ophthalmoplegia and nystagmus. Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase and thiamine pyrophosphate levels. This is a rare but treatable complication of hyperemesis gravidarum (HG) and due to lack of diagnostic tools, there is often diagnostic uncertainty, delay in commencing appropriate treatment, as well as irreversible damage to the upper brain stem and death.
    Matched MeSH terms: Hyperemesis Gravidarum
  5. Tan PC, Jacob R, Quek KF, Omar SZ
    Aust N Z J Obstet Gynaecol, 2006 Oct;46(5):446-50.
    PMID: 16953861
    In a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self-limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.
    Matched MeSH terms: Hyperemesis Gravidarum/blood; Hyperemesis Gravidarum/classification*; Hyperemesis Gravidarum/epidemiology
  6. Subramaniam R, Soh EB, Dhillon HK, Abidin HZ
    Aust N Z J Obstet Gynaecol, 1998 Aug;38(3):339-41.
    PMID: 9761170
    Matched MeSH terms: Hyperemesis Gravidarum/therapy*
  7. Beevi Z, Low WY, Hassan J
    Am J Clin Hypn, 2015 Oct;58(2):215-23.
    PMID: 26264544 DOI: 10.1080/00029157.2015.1013186
    Ptyalism gravidarum, or sialorrhea, is the excessive secretion of saliva during pregnancy. Treatment of ptyalism gravidarum is often challenging due to its unknown etiologies. This article discusses a case of ptyalism gravidarum with concomitant hyperemesis in which the condition was successfully treated with hypnosis. A 28-year-old woman presented with ptyalism 2 months into her pregnancy and hyperemesis 3 months into pregnancy with associated vomiting that occurred following every meal. Hypnosis was administered at week 16 of pregnancy to eliminate ptyalism and hyperemesis, to prepare for childbirth, and to increase overall psychological well-being. Ptyalism resolved by week 36, concurrent with the final hypnosis session.
    Matched MeSH terms: Hyperemesis Gravidarum/therapy*
  8. Tan PC, Kartik B, Thanendran P, Zakaria R, Win ST, Omar SZ
    Sci Rep, 2020 03 10;10(1):4445.
    PMID: 32157169 DOI: 10.1038/s41598-020-61114-y
    A case-controlled study was performed to evaluate taste and smell impairment, nausea or vomiting (NV) response to taste and smell and toleration to food texture, item and cooking method in hyperemesis gravidarum patients (HG) compared to gestation-matched controls from a university hospital and primary care clinic in Malaysia. Taste strips (4 base tastes), sniff sticks (16 selected smells) and a food-related questionnaire were used. 124 participants were recruited. Taste impairment was found in 13%(8/62) vs. 0%(0/62) P = 0.003 and the median for correct smell identification was 5[4-6] vs. 9[7-9] P 
    Matched MeSH terms: Hyperemesis Gravidarum/complications*; Hyperemesis Gravidarum/physiopathology*
  9. Tan PC, Zaidi SN, Azmi N, Omar SZ, Khong SY
    PLoS One, 2014;9(3):e92036.
    PMID: 24637791 DOI: 10.1371/journal.pone.0092036
    To evaluate the temporal and case-controlled correlations of anxiety, depression and stress with hyperemesis gravidarum.
    Matched MeSH terms: Hyperemesis Gravidarum/complications*; Hyperemesis Gravidarum/psychology*
  10. Abas MN, Tan PC, Azmi N, Omar SZ
    Obstet Gynecol, 2014 Jun;123(6):1272-1279.
    PMID: 24807340 DOI: 10.1097/AOG.0000000000000242
    OBJECTIVE: To compare ondansetron with metoclopramide in the treatment of hyperemesis gravidarum.

    METHODS: We enrolled 160 women with hyperemesis gravidarum in a double-blind randomized trial. Participants were randomized to intravenous 4 mg ondansetron or 10 mg metoclopramide every 8 hours for 24 hours. Participants kept an emesis diary for 24 hours; at 24 hours, they expressed their well-being using a 10-point visual numeric rating scale and answered an adverse effects questionnaire. Nausea intensity was evaluated using a 10-point visual numeric rating scale at enrollment and at 8, 16, and 24 hours. Primary analysis was on an intention-to-treat basis.

    RESULTS: Eighty women each were randomized to ondansetron or metoclopramide. Median well-being visual numeric rating scale scores were 9 (range, 5-10) compared with 9 (range, 4-10) (P=.33) and vomiting episodes in the first 24 hours were 1 (range, 0-9) compared with 2 (range, 0-23) (P=.38) for ondansetron compared with metoclopramide, respectively. Repeat-measures analysis of variance of nausea visual numeric rating scale showed no difference between study drugs (P=.22). Reported rates of drowsiness (12.5% compared with 30%; P=.01; number needed to treat to benefit, 6), xerostomia (10.0% compared with 23.8%; Pgravidarum. However, the overall profile, particularly regarding adverse effects, was better with ondansetron. In our setting, metoclopramide was significantly less expensive than ondansetron and remained a reasonable antiemetic choice.

    CLINICAL TRIAL REGISTRATION: ISRCN Register, www.isrctn.org, ISRCTN00592566.

    LEVEL OF EVIDENCE: I.

    Matched MeSH terms: Hyperemesis Gravidarum/drug therapy*
  11. Tan PC, Khine PP, Vallikkannu N, Omar SZ
    Obstet Gynecol, 2010 May;115(5):975-981.
    PMID: 20410771 DOI: 10.1097/AOG.0b013e3181d99290
    OBJECTIVE: To compare the effects of promethazine with those of metoclopramide for hyperemesis gravidarum.

    METHODS: Women at their first hospitalization for hyperemesis gravidarum were approached when intravenous antiemetic therapy was needed. They were randomly assigned to receive 25 mg promethazine or 10 mg metoclopramide every 8 hours for 24 hours in a double-blind study. Primary outcomes were vomiting episodes by diary and well-being visual numerical rating scale score (10-point scale) in the 24-hour main study period. Participants also filled out an adverse-effects questionnaire at 24 hours and a nausea visual numerical rating scale score at recruitment and at 8, 16, and 24 hours.

    RESULTS: A total of 73 and 76 women, randomized to metoclopramide and promethazine, respectively, were analyzed. Median vomiting episodes were one (range 0-26) compared with two (range 0-26) (P=.81), and well-being visual numerical rating scale scores were 8 (range 1-10) compared with 7 (range 2-10) (P=.24) for metoclopramide and promethazine, respectively. Repeat-measures analysis of variance of the nausea visual numerical rating scale scores showed no significant difference between study drugs (F score=0.842, P=.47). Reported drowsiness (58.6% compared with 83.6%, P=.001, number needed to treat to benefit [NNTb] 5), dizziness (34.3% compared with 71.2%, Pgravidarum. The adverse effects profile was better with metoclopramide.

    Matched MeSH terms: Hyperemesis Gravidarum/drug therapy*
  12. Tan PC, Norazilah MJ, Omar SZ
    Obstet Gynecol, 2013 Feb;121(2 Pt 1):291-298.
    PMID: 23232754 DOI: 10.1097/AOG.0b013e31827c5e99
    OBJECTIVE: To compare 5% dextrose-0.9% saline against 0.9% saline solution in the intravenous rehydration of hyperemesis gravidarum.

    METHODS: Women at their first hospitalization for hyperemesis gravidarum were enrolled on admission to the ward and randomly assigned to receive either 5% dextrose-0.9% saline or 0.9% saline by intravenous infusion at a rate 125 mL/h over 24 hours in a double-blind trial. All participants also received thiamine and an antiemetic intravenously. Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being (by 10-point visual numerical rating scale) at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours.

    RESULTS: Persistent ketonuria rates after the 24-hour study period were 10 of 101 (9.9%) compared with 11 of 101 (10.9%) (P>.99; relative risk 0.9, 95% confidence interval 0.4-2.2) and median (interquartile range) well-being scores at 24 hours were 9 (8-10) compared with 9 (8-9.5) (P=.73) in the 5% dextrose-0.9% saline and 0.9% saline arms, respectively. Repeated measures analysis of variance of the nausea visual numerical rating scale score as assessed every 8 hours during the 24-hour study period showed a significant difference in favor of the 5% dextrose-0.9% saline arm (P=.046) with the superiority apparent at 8 and 16 hours, but the advantage had dissipated by 24 hours. Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different.

    CONCLUSIONS: Intravenous rehydration with 5% dextrose-0.9% saline or 0.9% saline solution in women hospitalized for hyperemesis gravidarum produced similar outcomes.

    CLINICAL TRIAL REGISTRATION: ISRCTN Register, www.controlled-trials.com/isrctn, ISRCTN65014409.

    LEVEL OF EVIDENCE: I.

    Matched MeSH terms: Hyperemesis Gravidarum/therapy*
  13. Tan PC, Norazilah MJ, Omar SZ
    Obstet Gynecol, 2013 Jun;121(6):1360.
    PMID: 23812475 DOI: 10.1097/AOG.0b013e31829395ef
    Matched MeSH terms: Hyperemesis Gravidarum/therapy*
  14. Sim Mervyn Ian, Nor Zuraida Zainal, Aili Hanim
    MyJurnal
    Osmotic demyelination syndrome (ODS) may occur as a consequence of a
    rapid change in serum osmolality. We report a case of a 32-year-old woman
    who presented to the hospital with symptoms suggestive of severe
    hyperemesis gravidarum. Blood investigation results showed that patient had
    severe hyponatraemia (serum sodium 109 mmol/L) and hypokalaemia
    (serum potassium 1.7 mmol/L). Active and vigorous corrections to these
    electrolyte imbalances had led to an overly increased of serum sodium levels
    within a short duration of time. Four days after the rapid correction, patient
    started exhibiting neuropsychiatric manifestations. Radiological findings
    were consistent with the diagnosis of ODS. The neuropsychiatric symptoms
    experienced by patient gradually worsened with time. Subsequently,
    intravenous methylprednisolone was administered to patient. Patient showed
    marked response to the steroid given. At the time of discharge, twenty-seven
    days later, patient had recovered from most of the neuropsychiatric sequelae;
    but still required assistance during ambulation. In conclusion, correction of
    electrolyte imbalances should be done in a more judicious manner. Prudent
    corrections of electrolyte alterations could have possibly prevented the onset
    of ODS and its’ devastating neuropsychiatric sequelae in this patient.
    Matched MeSH terms: Hyperemesis Gravidarum
  15. Tan PC, Jacob R, Quek KF, Omar SZ
    Int J Gynaecol Obstet, 2006 Jun;93(3):246-7.
    PMID: 16682037
    Matched MeSH terms: Hyperemesis Gravidarum/pathology*; Hyperemesis Gravidarum/physiopathology*; Hyperemesis Gravidarum/ultrasonography
  16. Zulkifli SN, Paine LL, Greener DL, Subramaniam R
    Int J Gynaecol Obstet, 1991 May;35(1):29-36.
    PMID: 1680072
    Trends in selected pregnancy complications from 1969 to 1987 in a tertiary hospital in Malaysia are presented. Complications reviewed were abortion, ectopic pregnancy, anemia, hypertension, hyperemesis, antepartum and postpartum hemorrhage. Possible explanations for the observed trends were discussed, including the role of improved obstetric care and changes in the characteristics of the childbearing population. The data presented give some indication of maternal morbidity in the childbearing population served by this tertiary center and should lead to improvements in provision of services as well as in health data collection in the future.
    Matched MeSH terms: Hyperemesis Gravidarum/epidemiology
  17. Sheila Rani Kovil George, Sivalingam Nalliah
    MyJurnal
    The purpose of this prospective longitudinal study was to investigate the maternal cardiac haemodynamic and structural changes that occur
    in pregnancies with uncomplicated hyperemesis gravidarum in a selected Malaysian population. Nine women underwent serial echocardiography beginning at 12 weeks of gestation and throughout pregnancy at monthly intervals. Their echocardiograms were repeated at 6 and 12 weeks following delivery to reflect the pre-pregnancy haemodynamic state. Cardiac output was measured by continuous wave Doppler at the aortic valve. Interventricular septum thickness was determined by M- mode echocardiography and ventricular diastolic function by assessing flow at the mitral valve with Doppler recording. Cardiac output showed an increase of 32.9% at 36 weeks and maintained till 40 weeks of gestation. Heart rate increased from 79 ± 6 to 96 ± 8 beats/min at 36 weeks. Stroke volume increased by 16.4 % at 40 weeks of gestation when compared to the baseline
    value. Systolic and diastolic blood pressure did not appreciably change but showed a lower reading during the mid-trimester period. Early inflow velocity of left ventricle did not show a rise while peak atrial velocity showed an increasing trend; thus the ratio of early inflow to peak atrial transport showed a declining trend from early pregnancy to term. End diastolic dimension of left ventricle and interventricular septum thickness showed an increased value at term. Uncomplicated hyperemesis gravidarum did not alter the haemodynamic changes throughout pregnancy and concur with established data for normal pregnancy.
    Matched MeSH terms: Hyperemesis Gravidarum
  18. Adibah, I., Khursiah, D., Ahmad, A.I., Zaki, N.N.M.
    MyJurnal
    Introduction: The aim of treatment for hyperemesis gravidarum is to stop vomiting, correction of dehydration, starvation and electrolytes imbalance. The common types of fluid used for fluid replacement are isotonic solutions like normal saline and hartman's solutions. The absence of potassium in normal saline makes hartman's solution superior but there is a possibility that the lactate component in hartman's solution could worsen the starvation state of the patients. This study is to evaluate which of these two solutions is more effective for fluid replacement in hyperemesis gravidarum. The objectives are to compare which solution corrects dehydration, hypokalaemia and acetonuria faster and to evaluate whether the ketosis state is aggravated by lactate component in hartman's solution. Materials and Methods: Patients with hyperemesis gravidarum were randomised to receive either Hartman's solution or normal saline at the rate of 125mls/hour. Blood urea and serum electrolytes, haematocrit, lactate and urine acetone were taken during admission and repeated every 12 hours. The volume of fluid required to correct dehydration, hypokalaemia and acetonuria were compared. Comparison of the pre and post treatment level of serum lactate were also done. Results: Both hartman's solution and normal saline are both effective in correcting dehydration (11.52±3.28 pints versus 11.94 ± 2.30pints respectively) and acetonuria (11.64 ± 2.75 pints versus 11.64 ± 2.54 pints respectively).
    A lower volume of hartman's solution was needed to correct hypokalaemia (8.34 ± 2.44 pints versus 8.88 ± 2.63 pints) but was not statistically significant. Ketonaemia was not made worse after treatment with hartman's solution. Conclusion: Normal saline and hartman's solution are equally effective in treating complications of hyperemesis gravidarum.
    Matched MeSH terms: Hyperemesis Gravidarum
  19. 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).
    Matched MeSH terms: Hyperemesis Gravidarum/drug therapy*
  20. Tan PC, Vani S, Lim BK, Omar SZ
    Eur J Obstet Gynecol Reprod Biol, 2010 Apr;149(2):153-8.
    PMID: 20097465 DOI: 10.1016/j.ejogrb.2009.12.031
    To evaluate prevalence, risk factors and clinical severity correlates of anxiety and depression caseness in hyperemesis gravidarum (HG).
    Matched MeSH terms: Hyperemesis Gravidarum/etiology; Hyperemesis Gravidarum/epidemiology*; Hyperemesis Gravidarum/psychology
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links