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Stroke - time for greater efforts and enthusiasm

Tan CT

JUMMEC, 1998;3:1-2.
Multivariate areal analysis of the impact and efficiency of the family planning programme in peninsular Malaysia

Tan Boon Ann

Asia Pac Popul J, 1987 Jun;2(2):45-66.
PMID: 12341280
Fulltext Dietary fiber and total phenolic content of selected raw and cooked beans and its combinations

Tan, C.X., Azrina, A.

International Food Research Journal, 2017;24(5):1863-1868.
MyJurnal

Beans are distinctive among a diverse and broad class of legumes. Certain health products claimed their products are high in dietary fibers and total phenolic content (TPC) because they applied bean combinations. This study aimed to determine the dietary fibers and TPC of raw and cooked beans and its combinations. Individual beans studied were kidney bean, mung bean and chickpea. Bean combinations were done by mixing each of the homogenized beans flour in the ratio of 1:1 (w/w) and 1:1:1 (w/w/w). Dietary fibers were determined using enzymaticgravimetrical method whereas TPC was determined spectrophotometrically. Results showed the insoluble dietary fiber (IDF), soluble dietary fiber (SDF), total dietary fiber (TDF) and TPC for individual raw beans varied from 20.52 to 26.61 g/100 g, 1.20 to 2.45 g/100 g, 22.08 to 27.81 g/100 g and 0.48 to 1.04 mg GAE/g, respectively. For raw bean combinations, the IDF, SDF, TDF and TPC varied from 20.74 to 23.96 g/100 g, 2.3 to 2.50 g/100 g, 23.05 to 26.46 g/100 g and 0.80 to 0.85 mg GAE/g, respectively. No significant different (p > 0.05) in IDF and SDF for raw bean combinations and individual raw beans. Meanwhile, certain raw bean combinations contained significant higher (p < 0.05) TDF and TPC than individual raw beans. The IDF, SDF, TDF and TPC for individual cooked beans varied from 14.49 to 26.30 g/100 g, 1.40 to 2.02 g/100 g, 15.88 to 28.31 g/100 g and 0.57 to 1.20 mg GAE/g, respectively. For cooked bean combinations, the IDF, SDF, TDF and TPC varied from 15.73 to 23.03 g/100 g, 1.73 to 2.36 g/100 g, 17.46 to 24.95 g/100 g and 0.61 to 1.08 mg GAE/g, respectively. After cooking, the IDF, SDF, TDF and TPC of certain beans combinations were significantly higher (p < 0.05) than individual beans. This study supports the proposal that bean combinations can possibly be used as a method to increase the amount of dietary fibers and TPC.
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.
Revisiting Notechis scutatus venom: on shotgun proteomics and neutralization by the "bivalent" Sea Snake Antivenom

Tan CH, Tan KY, Tan NH

J Proteomics, 2016 07 20;144:33-8.
PMID: 27282922 DOI: 10.1016/j.jprot.2016.06.004

Recent advances in proteomics enable deep profiling of the compositional details of snake venoms for improved understanding on envenomation pathophysiology and immunological neutralization. In this study, the venom of Australian tiger snake (Notechis scutatus) was trypsin-digested in solution and subjected to nano-ESI-LCMS/MS. Applying a relative quantitative proteomic approach, the findings revealed a proteome comprising 42 toxin subtypes clustered into 12 protein families. Phospholipases A2 constitute the most abundant toxins (74.5% of total venom proteins) followed by Kunitz serine protease inhibitors (6.9%), snake venom serine proteases (5.9%), alpha-neurotoxins (5.6%) and several toxins of lower abundance. The proteome correlates with N. scutatus envenoming effects including pre-synaptic and post-synaptic neurotoxicity and consumptive coagulopathy. The venom is highly lethal in mice (intravenous median lethal dose=0.09μg/g). BioCSL Sea Snake Antivenom, raised against the venoms of beaked sea snake (Hydrophis schistosus) and N. scutatus (added for enhanced immunogenicity), neutralized the lethal effect of N. scutatus venom (potency=2.95mg/ml) much more effectively than the targeted H.schistosus venom (potency=0.48mg/ml). The combined venom immunogen may have improved the neutralization against phospholipases A2 which are abundant in both venoms, but not short-neurotoxins which are predominant only in H. schistosus venom.
SIGNIFICANCE: A shotgun proteomic approach adopted in this study revealed the compositional details of the venom of common tiger snake from Australia, Notechis scutatus. The proteomic findings provided additional information on the relative abundances of toxins and the detection of proteins of minor expression unreported previously. The potent lethal effect of the venom was neutralized by bioCSL Sea Snake Antivenom, an anticipated finding due to the fact that the Sea Snake Antivenom is actually bivalent in nature, being raised against a mix of venoms of the beaked sea snake (Hydrophis schistosus) and N. scutatus. However, it is surprising to note that bioCSL Sea Snake Antivenom neutralized N. scutatus venom much more effectively compared to the targeted sea snake venom by a marked difference in potency of approximately 6-fold. This phenomenon may be explained by the main difference in the proteomes of the two venoms, where H. schistosus venom is dominated by short-neurotoxins in high abundance - this is a poorly immunogenic toxin group that has been increasingly recognized in the venoms of a few cobras. Further investigations should be directed toward strategies to improve the neutralization of short-neurotoxins, in line with the envisioned production of an effective pan-regional elapid antivenom.
Fulltext Physical Activity, Sedentary Behavior, and Weight Status of University Students during the COVID-19 Lockdown: A Cross-National Comparative Study

Tan ST, Tan CX, Tan SS

Int J Environ Res Public Health, 2021 07 03;18(13).
PMID: 34281062 DOI: 10.3390/ijerph18137125

The temporary closure of learning institutions during the COVID-19 pandemic has dramatically reduced the physical activity of students across all ages. Therefore, this study aimed to investigate the prevalence of physical inactivity and the patterns of physical activity among university students in confinement. This cross-sectional study involved 147 Malaysian students and 107 Indonesian students. Body weight before the pandemic and during the pandemic was self-reported by the respondents, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess the physical activity and sedentary behavior of the respondents. The findings revealed that 79.6% of Malaysians and 77.6% of Indonesians were physically active during the confinement. There was no significant difference (p < 0.05) in the duration devoted to vigorous-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 480.00 MET minutes/week) and moderate-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 0.00 MET minutes/week) among the studied population. During the pandemic, Malaysian students (M = 1386.00 MET minutes/week) devoted a significantly higher duration to walking (M = 1386.00 MET minutes/week) and sedentary behavior (9.16 ± 4.47 h/day) than Indonesian students (M = 990.00 MET minutes/week and sedentary behavior = 7.85 ± 4.27 h/day). Overall, no significant difference was noted in the total physical activity of Malaysian and Indonesian students during the pandemic (MMalaysian = 2826.00 MET minutes/week and MIndonesian = 1782.00 MET minutes/week). Findings from Spearman's rank correlation test suggested that there was a weak inverse correlation between the duration engaged in vigorous-intensity activity and weight change among the Malaysian students (rs = -0.199, p = 0.016), after adjusting for gender and age. Overall, the closure of learning institutions and exercise facilities has further prevented individuals from complying with the WHO recommendation of moderate-to-vigorous physical activity during the period of home confinement.
Fulltext Venom proteomics and antivenom neutralization for the Chinese eastern Russell's viper, Daboia siamensis from Guangxi and Taiwan

Tan KY, Tan NH, Tan CH

Sci Rep, 2018 06 04;8(1):8545.
PMID: 29867131 DOI: 10.1038/s41598-018-25955-y

The eastern Russell's viper (Daboia siamensis) causes primarily hemotoxic envenomation. Applying shotgun proteomic approach, the present study unveiled the protein complexity and geographical variation of eastern D. siamensis venoms originated from Guangxi and Taiwan. The snake venoms from the two geographical locales shared comparable expression of major proteins notwithstanding variability in their toxin proteoforms. More than 90% of total venom proteins belong to the toxin families of Kunitz-type serine protease inhibitor, phospholipase A2, C-type lectin/lectin-like protein, serine protease and metalloproteinase. Daboia siamensis Monovalent Antivenom produced in Taiwan (DsMAV-Taiwan) was immunoreactive toward the Guangxi D. siamensis venom, and effectively neutralized the venom lethality at a potency of 1.41 mg venom per ml antivenom. This was corroborated by the antivenom effective neutralization against the venom procoagulant (ED = 0.044 ± 0.002 µl, 2.03 ± 0.12 mg/ml) and hemorrhagic (ED50 = 0.871 ± 0.159 µl, 7.85 ± 3.70 mg/ml) effects. The hetero-specific Chinese pit viper antivenoms i.e. Deinagkistrodon acutus Monovalent Antivenom and Gloydius brevicaudus Monovalent Antivenom showed negligible immunoreactivity and poor neutralization against the Guangxi D. siamensis venom. The findings suggest the need for improving treatment of D. siamensis envenomation in the region through the production and the use of appropriate antivenom.
A Protein Decomplexation Strategy in Snake Venom Proteomics

Tan CH, Tan KY, Tan NH

Methods Mol Biol, 2019;1871:83-92.
PMID: 30276733 DOI: 10.1007/978-1-4939-8814-3_5

Snake venoms are complex mixtures of proteins and peptides that play vital roles in the survival of venomous snakes. As with their diverse pharmacological activities, snake venoms can be highly variable, hence the importance of understanding the compositional details of different snake venoms. However, profiling venom protein mixtures is challenging, in particular when dealing with the diversity of protein subtypes and their abundances. Here we described an optimized strategy combining a protein decomplexation method with in-solution trypsin digestion and mass spectrometry of snake venom proteins. The approach involves the integrated use of C18 reverse-phase high-performance liquid chromatography (RP-HPLC), sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and nano-electrospray ionization tandem mass spectrometry (nano-ESI-LC-MS/MS).
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
Fulltext Trajectories of Food Choice Motives and Weight Status of Malaysian Youths during the COVID-19 Pandemic

Tan ST, Tan CX, Tan SS

Nutrients, 2021 Oct 23;13(11).
PMID: 34836008 DOI: 10.3390/nu13113752

Stay-at-home orders have abruptly altered food purchasing behaviour, dietary habits, and food choice motives. Therefore, this study aims to investigate the trajectory of food choice motives and their associations with the weight status of Malaysian youths in the time of COVID-19. Socio-demographic information and anthropometric measurements were self-reported by the respondents, while the food choice motives were assessed using a validated 38-item food choice questionnaire (FCQ). Of the 1013 Malaysian youths, 48.6% gained weight due to the confinement, with an average weight gain of 3.90 ± 2.92 kg. On the other hand, 47.0% to 73.0% of the youths changed their food choice motives in the time of COVID-19. Of the 10 motives, convenience (48.5%) had the largest percentage increase, followed by weight control (47.0%) and health (45.3%). Moreover, the mean scores of health (t = -3.324, p = 0.001), convenience (t = -5.869, p < 0.001), weight control (t = -7.532, p < 0.001), natural content (t = -5.957, p < 0.001), ethical concern (t = -4.419, p < 0.001) and price (t = -3.737, p < 0.001) were significantly higher during the pandemic compared to pre-pandemic. Findings from the multinomial regression model revealed that youths highly concerned for weight control were more likely to be in the weight loss category (Adjusted odds ratio (AOR) = 1.633, Confidence Interval (CI) = 1.230-2.168, p = 0.001). Conversely, those who gained weight due to the pandemic confinement highly valued natural content in foods (AOR = 0.653, CI = 0.481-0.886, p = 0.006) when making their food choices in this unprecedented pandemic. In conclusion, Malaysian youths made healthier food choices to mitigate the risk of COVID-19 infection.
Food insecurity, eating behaviour, and relative weight change among young adults in the aftermath of the COVID-19 lockdown

Tan ST, Tan CX, Tan SS

Psychol Health Med, 2024 Aug;29(7):1362-1374.
PMID: 38200665 DOI: 10.1080/13548506.2023.2301226

This study aims to investigate the association between food insecurity, eating behaviour and relative weight change among Malaysian young adults in the aftermath of the pandemic-led lockdown. Socio-demographics, body height, and body weight were self-reported by the young adults. Food security was assessed using the 8-item validated Food Insecurity Experience Scale (FIES), while the Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18) was adopted to evaluate the eating behaviour of young adults. Of the 447, 45.9% maintained the same body weight as before the pandemic-led lockdown. While almost half of the young adults (47.2%) were food secure, about one-fourth (24.8%) suffered moderate-to-severe food insecurity. Meanwhile, the standardised raw scores for all the eating behaviour subscales were in the ascending order of cognitive restraint (49.37 ± 18.60) 0.05), suggesting that eating behaviour (cognitive restraint, uncontrolled eating and emotional eating) did not mediate the relationship between moderate-to-severe food insecurity and relative weight change. Health promotion interventions such as introducing food assistance programs, offering incentives for nutritious food purchases, and re-emphasising healthy eating are essential to rectify food insecurity and disordered eating among Malaysians.
Fulltext Food security during the COVID-19 home confinement: A cross-sectional study focusing on adults in Malaysia

Tan ST, Tan CX, Tan SS

Hum Nutr Metab, 2022 Mar;27:200142.
PMID: 38620934 DOI: 10.1016/j.hnm.2022.200142

The surge in coronavirus disease 2019 (COVID-19) transmission cases has led to the decision to execute the Movement Control Order (MCO) by the Federal Government of MalaysiaEconomic activities, psychological wellbeing, and food security may be negatively affected by the implementation of MCO. Therefore, this study aims to assess the prevalence of food insecurity and its associated factors during the enforcement of MCO 1.0. A total of 162 respondents were enrolled in this study using convenience and snowball sampling approaches. Socio-demographic information was self-reported by the respondents. Food security and the presence of depressive symptoms during the MCO 1.0 were assessed with Food Insecurity Experience Scale (FIES) and Patient Health Questionnaire-2 (PHQ-2), respectively. Current findings demonstrated that the prevalence of food insecurity was 43.2%. Ethnicity, marital status, employment status, monthly earned income and being the head of a household were significantly associated (p
A comparative study of cobra (Naja) venom enzymes

Tan NH, Tan CS

Comp. Biochem. Physiol., B, 1988;90(4):745-50.
PMID: 2854766

1. The L-amino acid oxidase, hyaluronidase, alkaline phosphomonoesterase, protease, phosphodiesterase, acetylcholinesterase, phospholipase A and 5'-nucleotidase activities of 47 samples of venoms from all the six species of cobra (Naja), including five subspecies of Naja naja, were examined. 2. The results demonstrated interspecific differences in the venom contents of phospholipase A, acetylcholinesterase, hyaluronidase and phosphodiesterase. These differences in venom enzyme contents can be used for the differentiation of species of the genus Naja. 3. Thus, our results revealed a correlation between the enzyme composition of venom and the taxonomic status of the snake at the species level for the genus Naja.
Fulltext Treatment failure of falciparum malaria with Fansidar in Tawau Sabah. January-June, 1982

Tan HS, Tan PE

Med J Malaysia, 1983 Sep;38(3):217-23.
PMID: 6369092

One hundred and ten consecutive patients with falciparum malaria were treated with Fansidar and primaquine. Of the 61 patients who were followed up at one week, 4 (6.5%) failed to clear their parasitemia (1 R III and 3 R Il treatment failures). Of the subsequent 40 patients who were seen again at one month, another 3 (7.5%) had recrudesced (R 1 treatment failure). A total of 7 patients thus experienced some form of treatment failure in the cohort of 40 who completed the one month follow up. Only 1 of these 7patients (with R III treatment) failure) failed to respond to repeat Fansidar treatment, and may be the only one with true Fansidar resistance. The overall treatment failure rate of 17.5% (95% confidence interval: 6-29%) in the cohort who completed the study is consistent with the known clinical efficacy of Fansidar. These results suggest no significant Fansidar resistance in falciparum malaria found in Sabah.
Acidimetric assay for phospholipase A using egg yolk suspension as substrate

Tan NH, Tan CS

Anal Biochem, 1988 May 1;170(2):282-8.
PMID: 3394929

A convenient acidimetric assay for phospholipase A using egg yolk suspension as substrate has been developed. The substrate mixture consists of 1 part egg yolk, 1 part 8.1 mM sodium deoxycholate, and 1 part 18 mM calcium chloride. Phospholipase A activity is measured by following the initial rate of pH change, which is linear between pH 8.0 and 7.75 and is proportional to enzyme concentration over a wide range. The assay is highly reproducible, with a coefficient of variation of 3%, and as sensitive as most established assays for phospholipase A. The assay uses inexpensive and easily available substrate and is simple to perform. It is particularly useful for monitoring phospholipase A activity in chromatography fractions.
Clinical efficacy of sulfadoxine-pyrimethamine in the treatment of falciparum malaria in Sabah, Malaysia

Tan HS, Tan PE

Ann Acad Med Singap, 1984 Apr;13(2):170-4.
PMID: 6388486

One hundred and ten consecutive patients with falciparum malaria were treated with Fansidar and primaquine. Of the 61 patients who were followed up at one week, 4 (6.6%) failed to clear their parasitaemia (1 R III and 3 R II treatment failures). Of the subsequent 40 patients who were seen again at one month, another 3 (7.5%) had recrudesced (R I treatment failure). A total of 7 patients thus experienced some form of treatment failure in the cohort of 40 who completed the one month follow up. Only 1 of these 7 patients (with R III treatment failure) failed to respond to repeat Fansidar treatment, and may be the only one with true Fansidar resistance. The overall treatment failure rate of 17.5% (95% confidence interval: 6-29%) in the cohort who completed the study is consistent with the known clinical efficacy of Fansidar. These results suggest no significant Fansidar resistance in falciparum malaria found in Sabah.
A rare case of paediatric meningioma masquerading as intra-axial lesion

Tan LY, Tan AP

Med J Malaysia, 2018 12;73(6):439-440.
PMID: 30647227

Meningiomas are neoplasm arising from meningoepithelial cells, most commonly in the fifth to sixth decade of life. Meningiomas are rare in paediatric population, accounting for 0.4-4.1% of all paediatric tumours and less than 3% of paediatric brain tumours. However, meningiomas represent the most common dural based tumours in children. We describe a rare case of paediatric fibroblastic meningioma within the left middle cranial fossa masquerading as an intra-axial mass lesion. Our discussion will be centred on atypical features of paediatric meningiomas and differential diagnosis of extra-axial mass lesion in the paediatric population.
Fulltext De Novo Venom-Gland Transcriptomics of Spine-Bellied Sea Snake (Hydrophis curtus) from Penang, Malaysia-Next-Generation Sequencing, Functional Annotation and Toxinological Correlation

Tan CH, Tan KY

Toxins (Basel), 2021 02 09;13(2).
PMID: 33572266 DOI: 10.3390/toxins13020127

Envenomation resulted from sea snake bite is a highly lethal health hazard in Southeast Asia. Although commonly caused by sea snakes of Hydrophiinae, each species is evolutionarily distinct and thus, unveiling the toxin gene diversity within individual species is important. Applying next-generation sequencing, this study investigated the venom-gland transcriptome of Hydrophis curtus (spine-bellied sea snake) from Penang, West Malaysia. The transcriptome was de novo assembled, followed by gene annotation and sequence analyses. Transcripts with toxin annotation were only 96 in number but highly expressed, constituting 48.18% of total FPKM in the overall transcriptome. Of the 21 toxin families, three-finger toxins (3FTX) were the most abundantly expressed and functionally diverse, followed by phospholipases A2. Lh_FTX001 (short neurotoxin) and Lh_FTX013 (long neurotoxin) were the most dominant 3FTXs expressed, consistent with the pathophysiology of envenomation. Lh_FTX001 and Lh_FTX013 were variable in amino acid compositions and predicted epitopes, while Lh_FTX001 showed high sequence similarity with the short neurotoxin from Hydrophis schistosus, supporting cross-neutralization effect of Sea Snake Antivenom. Other toxins of low gene expression, for example, snake venom metalloproteinases and L-amino acid oxidases not commonly studied in sea snake venom were also identified, enriching the knowledgebase of sea snake toxins for future study.
The enzymatic activities and lethal toxins of Trimeresurus wagleri (speckled pit viper) venom

Tan NH, Tan CS

Toxicon, 1989;27(3):349-57.
PMID: 2543103

Trimeresurus wagleri (speckled pit viper) venom exhibited the usual set of enzyme activities occurring in pit viper venoms but the content of alkaline phosphomonoesterase was unusually high, whereas the proportions of protease and arginine ester hydrolase were very low. The venom also exhibited weak thrombin-like activity but did not exhibit hemorrhagic or anticoagulant activity. Analysis of the Sephadex G-200 gel filtration fractions of the venom indicated that the lethal fraction was a low mol.wt protein, and that fractions exhibiting phosphodiesterase, phosphomonoesterase, arginine ester hydrolase, thrombin-like enzyme, L-amino acid oxidase and phospholipase A activities were not lethal. Two lethal toxins, designated as wagleri toxins 1 and 2, were isolated from the venom using Sephadex G-50 gel filtration chromatography followed by SP-Sephadex C-25 ion exchange chromatography. The mol.wts of the two toxins were 8900 by gel filtration. The LD50 (i.v.) values in mice for wagleri toxins 1 and 2 are 0.17 microgram/g and 0.19 microgram/g, respectively.
Partial purification of acetylcholinesterase from the venom of the shore pit viper (Trimeresurus purpureomaculatus)

Tan NH, Tan CS

Toxicon, 1988;26(5):505-8.
PMID: 3188057

Trimeresurus purpureomaculatus venom acetylcholinesterase has been partially purified by Sephadex G-200 gel filtration chromatography and DEAE Sephacel ion exchange chromatography. The enzyme has a mol. wt of 58,600. It was strongly inhibited by physostigmine salicylate and edrophonium chloride and exhibited substrate inhibition at high substrate concentration. The content of acetylcholinesterase in Trimeresurus purpureomaculatus venom was estimated to be much less than 0.3%.

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