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  1. Liew KB, Tan YT, Peh KK
    AAPS PharmSciTech, 2012 Mar;13(1):134-42.
    PMID: 22167416 DOI: 10.1208/s12249-011-9729-4
    The aim of this study was to develop a taste-masked oral disintegrating film (ODF) containing donepezil, with fast disintegration time and suitable mechanical strength, for the treatment of Alzheimer's disease. Hydroxypropyl methylcellulose, corn starch, polyethylene glycol, lactose monohydrate and crosspovidone served as the hydrophilic polymeric bases of the ODF. The uniformity, in vitro disintegration time, drug release and the folding endurance of the ODF were examined. The in vitro results showed that 80% of donepezil hydrochloride was released within 5 minutes with mean disintegration time of 44 seconds. The result of the film flexibility test showed that the number of folding time to crack the film was 40 times, an indication of sufficient mechanical property for patient use. A single-dose, fasting, four-period, eight-treatment, double-blind study involving 16 healthy adult volunteers was performed to evaluate the in situ disintegration time and palatability of ODF. Five parameters, namely taste, aftertaste, mouthfeel, ease of handling and acceptance were evaluated. The mean in situ disintegration time of ODF was 49 seconds. ODF containing 7 mg of sucralose were more superior than saccharin and aspartame in terms of taste, aftertaste, mouthfeel and acceptance. Furthermore, the ODF was stable for at least 6 months when stored at 40°C and 75% relative humidity.
  2. Yazdani D, Zainal Abidin MA, Tan YH, Kamaruzaman S
    Mikrobiologiia, 2011 Sep-Oct;80(5):707-13.
    PMID: 22168015
    Thirty milled rice samples were collected from retailers in 4 provinces of Malaysia. These samples were evaluated for Aspergillus spp. infection by direct plating on malt extract salt agar (MESA). All Aspergillus holomorphs were isolated and identified using nucleotide sequences of ITS 1 and ITS 2 of rDNA. Five anamorphs (Aspergillus flavus, A. oryzae, A. tamarii, A. fumigatus and A. niger) and 5 teleomorphs (Eurotium rubrum, E. amstelodami, E. chevalieri, E. cristatum and E. tonophilum) were identified. The PCR-sequencing based technique for sequences of ITS 1 and ITS 2 is a fast technique for identification of Aspergillus and Eurotium species, although it doesn't work flawlessly for differentiation of Eurotium species. All Aspergillus and Eurotium isolates were screened for their ability to produce aflatoxin and ochratoxin A (OTA) by HPLC and TLC techniques. Only A. flavus isolate UPM 89 was able to produce aflatoxins B1 and B2.
  3. 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.
  4. Iszuari M, Mazita A, Tan GC, Hayati AR, Shareena I, Cheah FC
    Med J Malaysia, 2010 Dec;65(4):317-8.
    PMID: 21901957
    Tracheal agenesis is a rare congenital airway anomaly that usually results in a fatal outcome. The diagnosis is usually made through post-mortem examination. In the current literature, there has been no reported long-term survival although a few reports claimed prolongation of life of several hours to days. This condition is commonly associated with premature birth, polyhydramnios and a male predominance. In 90% of the cases, it is associated with multiple cardiovascular, gastrointestinal and genitourinary tract anomalies which are incompatible with life. We report a case of a premature newborn with severe respiratory distress, absent cry and cyanosis soon after birth. Attempts at endotracheal intubation failed as it was no possible to negotiate the tube beyond the vocal cords. Needle cricothyrotomy and attempted tracheostomy also failed to secure the airway. The diagnosis was confirmed at post-mortem examination.
  5. Iskandar NL, Zainudin NA, Tan SG
    J Environ Sci (China), 2011;23(5):824-30.
    PMID: 21790056
    Filamentous fungi are able to accumulate significant amount of metals from their environment. The potential of fungal biomass as agents for biosorption of heavy metals from contaminated sediments is currently receiving attention. In the present study, a total of 41 isolates of filamentous fungi obtained from the sediment of the Langat River, Selangor, Malaysia were screened for their tolerance and uptake capability of copper (Cu) and lead (Pb). The isolates were identified as Aspergillus niger, A. fumigatus, Trichoderma asperellum, Penicillium simplicissimum and P. janthinellum. A. niger and P. simplicissimum, were able to survive at 1000 mg/L of Cu(II) concentration on Potato Dextrose Agar (PDA) while for Pb, only A. niger survived at 5000 mg/L concentration. The results showed that A. niger, P. simplicissimum and T. asperellum have a better uptake capacity for Pb compared to Cu and the findings indicated promising biosorption of Cu and Pb by these filamentous fungi from aqueous solution. The present study was also determined the maximum removal of Cu(II) and Pb(II) that was performed by A. niger. The metal removal which occurred at Cu(II) 200 mg/L was (20.910 +/- 0.581) mg/g and at 250 mg/L of Pb(II) was (54.046 +/- 0.328) mg/g.
  6. Tan PC, Chai JN, Ling LP, Omar SZ
    Clin Exp Obstet Gynecol, 2011;38(2):150-4.
    PMID: 21793277
    OBJECTIVE: To evaluate maternal hemoglobin levels and red cell indices as predictive factors for gestational diabetes (GDM).

    METHOD: Data from 1,538 women were analyzed. At the first visit for prenatal care, the 50-gram glucose challenge test was followed by the 75-gram glucose tolerance test in those who screened positive. GDM was diagnosed based on the WHO (1999) criteria. Maternal complete blood count was obtained at the first visit, hospitalization for birth, and after birth. Receiver operator characteristic curves were generated to establish thresholds. Multivariable logistic regression analyses were performed to establish independent predictors of GDM.

    RESULTS: GDM was diagnosed in 182/1,538 (11.8%). GDM was associated with hemoglobin level, hematocrit and erythrocyte count at the first visit for prenatal care only. Hemoglobin threshold at the first visit was established at 11.5 g/dl. After adjustment, high hemoglobin [AOR 1.5 (95% CI 1.0-2.1); p = 0.027] remained predictive of GDM.

    CONCLUSIONS: High maternal hemoglobin level at the first prenatal visit is independently predictive of GDM.

  7. Adibah AB, Ling LP, Tan SG, Faridah QZ, Christianus A
    Mol Biol Rep, 2012 Apr;39(4):3815-20.
    PMID: 21744263 DOI: 10.1007/s11033-011-1159-6
    Horseshoe crabs are said to be declining worldwide. However, there is still no published report on the status of horseshoe crabs in Malaysia. Thus, we report here eight informative microsatellite markers that were developed using the 5'-anchored ISSR-PCR enrichment procedure to diagnose the population genetic structure of the mangrove horseshoe crab, Carcinoscorpius rotundicauda from Peninsular Malaysia. This set of markers was tested on 127 samples and showed polymorphism in this species. Hence they should be useful in future essential population genetic studies of these living fossils in the Southeast Asian region.
  8. Thumboo J, Seah A, Tan CT, Singhal BS, Ong B
    Ann Acad Med Singap, 2011 Feb;40(2):67-73.
    PMID: 21468459
    INTRODUCTION: The Multiple Sclerosis International Quality of Life questionnaire (MusiQoL) is a self-administered, multi-dimensional, patient-based health-related quality of life (HRQoL) instrument. With increasing prevalence of multiple sclerosis (MS) in Asian countries, a valid tool to assess HRQoL in those patients is needed. The aim of this study was to evaluate patient acceptability, content validity and psychometric properties of an Asian version of the English MusiQoL in Singapore, Malaysia and India.

    MATERIALS AND METHODS: English speaking patients older than 18 years of age with a defi nite diagnosis of MS were included. The self-administered survey material included the adapted HRQoL questionnaire, a validated generic HRQoL questionnaire: the short-form 36 (SF-36), as well as a checklist of 14 symptoms. We assessed the internal and external validity of the adapted MusiQoL.

    RESULTS: A total of 81 patients with MS were included in the study. The questionnaire was generally well accepted. In the samples from Malaysia and Singapore, all scales exhibited good internal consistency (Cronbach's alpha >0.70). Correlation to SF-36 was generally good, demonstrating high construct validity (P <0.001) in some aspects of the MusiQoL.

    CONCLUSION: The Asian adaptation of the English version of the MusiQoL in evaluating HRQoL seems to be a valid, reliable tool with adequate patient acceptability and internal consistency.

  9. Tai ML, Lim SY, Tan CT
    J Clin Neurosci, 2010 Aug;17(8):1089-90.
    PMID: 20542699 DOI: 10.1016/j.jocn.2009.11.034
    Paroxysmal kinesigenic dyskinesia is a rare disorder, and there are few reports of Asian patients with this condition. We reviewed the clinical features of all patients with idiopathic paroxysmal kinesigenic dyskinesia (PKD) seen at a major neurological centre in Malaysia. The charts of 11 patients with idiopathic PKD seen between 1995 and 2008 were reviewed retrospectively. The male:female ratio was 9:2. Ten patients were of Chinese ethnicity, and one was Malay. Three patients (from two families) had a family history of PKD. The involuntary movement was dystonia in 73% of patients. In one patient, attacks were precipitated by vestibular stimulation. One patient had generalized epilepsy. Another patient who did not have epilepsy demonstrated epileptiform discharges. Only slightly over one-quarter of patients had a positive family history. Males, and people of Chinese ancestry, seem to be affected more frequently by PKD in certain Asian populations.
  10. Tan GH, Harunarashid H, Das S, Goh YH, Ramzisham AR
    Clin Ter, 2010;161(6):533-4.
    PMID: 21181082
    An internal hernia through the mesosalpinx is a rare condition which is often overlooked. We report the case of a 65-year-old lady who presented with features of small bowel obstruction. At laparotomy, a gangrenous ileum was found to have herniated through a defect in the right mesosalpinx. We discuss this rare cause of a small bowel obstruction and its diagnostic dilemma.
  11. Asok T, Aziz S, Faisal HA, Tan AK, Mallika PS
    Med J Malaysia, 2009 Dec;64(4):323-4.
    PMID: 20954560 MyJurnal
    A 14 year old boy underwent a 7 hour long spinal surgery for scoliosis in the prone position. In the immediate postoperative period, he developed right proptosis, periorbital swelling, chemosis and total ophthalmoplegia. The vision in his right eye was only counting fingers and the intraocular pressure was 68 mmHg. Fundus examination revealed occlusion of the right central retinal artery. A rare manifestation of both vein and artery occlusion was possible in this patient as a result of external ocular compression due to a prolonged period in the prone position. This report highlights the importance of being aware of the possible complications of external ocular compression in non-ocular surgery.
  12. Baig MR, Tan KB, Nicholls JI
    J Prosthet Dent, 2010 Oct;104(4):216-27.
    PMID: 20875526 DOI: 10.1016/S0022-3913(10)60128-X
    The marginal fit of crowns is a concern for clinicians, and there is no conclusive evidence of any one margin configuration yielding better results than others in terms of marginal fit.
  13. Phua CE, Tan BS, Yong TK, Govindasamy M
    Asian Pac J Cancer Prev, 2011;12(12):3197-200.
    PMID: 22471453
    BACKGROUND: Nasopharyngeal carcinoma (NPC) is one of the commonest cancers encountered in Malaysia. This study aimed to evaluate the treatment outcomes for patients with NPC treated in Penang General Hospital with specific analysis of prognostic clinicopathological features and treatment modalities.

    MATERIALS AND METHODS: This retrospective study examined NPC patients between 1st January 2001 and 31st December 2005 in Penang General Hospital. Survival analyses were performed using the Kaplan-Meier method and comparisons between groups were made using the log-rank test. Important prognostic factors including patient demographics, tumour and treatment factors were analysed using the Cox proportional hazard model.

    RESULTS: A total of 285 patients were identified with a median age of 51 years, 72.6% being males. The majority were Chinese (66%) followed by Malays (31.9%). Primary tumour stages (T stages) 3 and 4 were present in 18.6% and 34% of patients respectively, and nodal disease was present in 80.4%. On overall AJCC staging, 29.1% had stage III and 50.2% had stage IV disease. Some 39.6% of patients had WHO type 3 histology and 7.4% had WHO type 1-2 histology with the remainder having NPC with no subtype reported. Concurrent chemo-irradiation was the commonest treatment received by patients (51.9%) followed by radiotherapy alone (41.8%). The 5 year overall survival and cause specific survival were 33.3% and 42.7% respectively. Age group, T stage, N stage and WHO histological subtype were independent prognostic factors for overall survival on multivariate analysis. For cause specific survival they were T stage and N stage.

    CONCLUSION: The 5 years overall survival rate was 33.3%. This low figure is primarily due to late presentation. Efforts to detect NPC at earlier stages in Malaysia are urgently needed. These should include public education to increase awareness of the prevalence of this highly treatable disease.

  14. Tan F, Liew SF, Chan G, Toh V, Wong SY
    J Eval Clin Pract, 2011 Feb;17(1):40-4.
    PMID: 20807297 DOI: 10.1111/j.1365-2753.2010.01367.x
    RATIONALE, AIMS AND OBJECTIVES: To evaluate the impact of clinical audit on diabetes care provided to type 2 diabetic patients attending our hospital general medical clinics.
    METHODS: Performances on diabetes-related process measures and intermediate outcome measures were evaluated through structured review of outpatient medical records. The results were fed back to the doctors and measures were implemented to improve care. The performance indicators were re-evaluated 2 years later to complete the audit cycle.
    RESULTS: Annual testing rates improved for HbA1c (68.4% vs. 87.4%; P < 0.001) and lipid profile (91.8% vs. 97%; P = 0.027). Enquiry on smoking improved from 45.9% to 82.3% (P < 0.001), eye screening rates from 68.9% to 78.8% (P = 0.020) and foot examinations from 22.4% to 64.1% (P < 0.001). Prescription rates for insulin increased from 17.3% to 31.8% (P = 0.001) and statin from 83.2% to 94.4% (P < 0.001). The use of aspirin (80.6% vs. 83.8%; P =0.402) and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (92.3% vs. 88.9%; P = 0.239) remained high in both cycles. More patients achieved targets for HbA1c < 7% (38% vs. 26%; P = 0.006), blood pressure < 130/80 mmHg (43% vs. 32%; P = 0.071) and low-density lipoprotein cholesterol < 2.6 mmol/L (71% vs. 52%; P <0.001).
    CONCLUSION: Clinical audit is a useful tool in improving diabetes care.
    Study site: Outpatient clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia
  15. Lim LH, Tan WB, Gibson DI
    Syst Parasitol, 2010 Jun;76(2):145-57.
    PMID: 20437220 DOI: 10.1007/s11230-010-9242-2
    Monogeneans identified as Sinodiplectanotrema malayanum n. sp. were collected from the fish Pennahia anea (Sciaenidae) off the west coast of Peninsular Malaysia. The new species is recognised on the basis of morphometrical differences in the anchors, marginal hooks and eggs and apparent differences in the 28S rDNA sequence data. The new species possesses features (ovary looping the intestinal caecum, body spines, a vagina and haptoral reservoirs) not noted in the original description of the type and only other species of the genus, S. argyrosomus Zhang, 2001, necessitating the re-assignment of the genus to the Diplectanidae Monticelli, 1903, a move which is supported by 28S rDNA evidence. Sinodiplectanotrema is redefined on the basis of the observation of several features not included in the original diagnosis.
  16. Chew MM, Gan SY, Khoo AS, Tan EL
    BMC Cancer, 2010;10:574.
    PMID: 20964870 DOI: 10.1186/1471-2407-10-574
    Nasopharyngeal carcinoma (NPC) is a type of neoplasm that is highly prevalent in East Asia and Africa with Epstein-Barr virus (EBV), genetic, and dietary factors implicated as possible aetiologic factors. Previous studies suggested the association of certain cytokines with the invasion and metastatic properties of NPC. The present study examined the roles of EBV latent membrane protein-1 (LMP1), interleukin-6 (IL-6), interleukin-10 (IL-10), transforming growth factor-beta 1 (TGF-β1) and laminin in the regulation of matrix-metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) in NPC. The effects of these factors on bmi-1, an oncogene, and ngx6, a tumour suppressor gene, were also investigated.
  17. Aziz HA, Tan YT, Peh KK, Yam MF
    Obes Res Clin Pract, 2010 Oct-Dec;4(4):e247-342.
    PMID: 24345689 DOI: 10.1016/j.orcp.2010.07.001
    Khat (Catha edulis) as well as garlic (Allium sativum) has a potential effect on reducing the lipid contents of blood. However, a mechanism by which garlic or khat reduces plasma lipids has not been fully investigated. This study aimed to investigate the direct action of khat and/or garlic (in vitro). The effects of extracted khat and/or garlic on human blood constituents (cholesterol and triglycerides) and on vegetable oil were investigated. The results showed that aqueous garlic extract was able to form an emulsion with oil but not khat extract. Even though, either khat or garlic extract has slight effect on reducing lipid contents of blood; a higher reduction was obtained when the extracts were added in combination. The mechanism of garlic on reducing lipids could be explained by its emulsifying property, while the mechanism of khat is by lipolysis. In conclusion, the synergistic effect of garlic and khat extracts opened an interesting area for further investigation on their roles in combating cardiovascular and obesity disorders.:
  18. Tan AK, Dunn RA, Samad MI, Feisul MI
    Asia Pac J Public Health, 2011 Apr;23(2):192-202.
    PMID: 20460299 DOI: 10.1177/1010539509359535
    The purpose of this study was to examine the sociodemographic and health-lifestyle factors that affect the likelihood of obesity among Malaysians. Data were obtained from the Malaysian Non-Communicable Disease Surveillance-1. The cross-sectional population-based survey consisted of 2447 observations, with an obesity prevalence rate of 17.2%. Based on logit regression analysis, the results suggest that obesity risks in Malaysia are affected by gender, education level, family history, health conditions, smoking status, and ethnic backgrounds. Specifically, Malaysians more likely to be obese are females (5.3%), lower educated (0.9%), those with history of family illnesses (4.8%), and nonsmokers (6.4%). However, Chinese (9.3%) and other (5.5%) ethnic groups are less likely to be obese when compared with Malays. Based on these results, several policy implications are discussed vis-à-vis obesity risks in Malaysia.
    Study name: Malaysia Non-Communicable Disease Surveillance-1 (MyNCDS-1) survey
  19. Yap WB, Tey BT, Alitheen NB, Tan WS
    J Chromatogr A, 2010 May 21;1217(21):3473-80.
    PMID: 20388569 DOI: 10.1016/j.chroma.2010.03.012
    Hepatitis B core antigen (HBcAg) is used as a diagnostic reagent for the detection of hepatitis B virus infection. In this study, immobilized metal affinity-expanded bed adsorption chromatography (IMA-EBAC) was employed to purify N-terminally His-tagged HBcAg from unclarified bacterial homogenate. Streamline Chelating was used as the adsorbent and the batch adsorption experiment showed that the optimal binding pH of His-tagged HBcAg was 8.0 with a binding capacity of 1.8 mg per ml of adsorbent. The optimal elution condition for the elution of His-tagged HBcAg from the adsorbent was at pH 7 in the presence of 500 mM imidazole and 1.5 M NaCl. The IMA-EBAC has successfully recovered 56% of His-tagged HBcAg from the unclarified E. coli homogenate with a purification factor of 3.64. Enzyme-linked immunosorbent assay (ELISA) showed that the antigenicity of the recovered His-tagged HBcAg was not affected throughout the IMA-EBAC purification process and electron microscopy revealed that the protein assembled into virus-like particles (VLP).
  20. Tan AK, Yen ST, Feisul MI
    Int J Public Health, 2012 Apr;57(2):279-88.
    PMID: 21318327 DOI: 10.1007/s00038-011-0238-8
    OBJECTIVE: To investigate the roles of sociodemographic and health lifestyle factors in affecting body mass index (BMI) across ethnic groups in Malaysia.

    METHODS: Data are obtained from 2,436 observations from the Malaysia Non-Communicable Disease Surveillance-1. The multi-ethnic sample is segmented into Malay, Chinese, and Indian/other ethnicities. Ordered probit analysis is conducted and marginal effects of sociodemographic and health lifestyle variables on BMI calculated.

    RESULTS: Malays between 41 and 58 years are more likely to be overweight or obese than their 31-40 years counterparts, while the opposite is true among Chinese. Retirees of Chinese and Indian/other ethnicities are less likely to be obese and more likely to have normal BMI than those between 31 and 40 years. Primary educated Chinese are more likely to be overweight or obese, while tertiary-educated Malays are less likely to suffer from similar weight issues as compared to those with only junior high school education. Affluent Malays and Chinese are more likely to be overweight than their low-middle income cohorts. Family illness history is likely to cause overweightness or obesity, irrespective of ethnicity. Malay cigarette smokers have lower overweight and obesity probabilities than non-cigarette smokers.

    CONCLUSIONS: There exists a need for flexible policies to address cross-ethnic differences in the sociodemographic and health-lifestyle covariates of BMI.

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