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  1. Amin Nordin FD, Mohd Khalid MKN, Abdul Aziz SM, Mohamad Bakri NA, Ahmad Ridzuan SN, Abdul Jalil J, et al.
    J Clin Lab Anal, 2020 Jun;34(6):e23254.
    PMID: 32141626 DOI: 10.1002/jcla.23254
    BACKGROUND: Serum protein electrophoresis (SPE) is a widely used laboratory technique to diagnose patients with multiple myeloma (MM) and other disorders related to serum protein. In patients with MM, abnormal monoclonal protein can be detected by SPE and further characterized using immunofixation electrophoresis (IFE). There are several semi-automated agarose gel-based systems available commercially for SPE and IFE. In this study, we sought to evaluate the analytical performance of fully automated EasyFix G26 (EFG26) and semi-automated HYDRASYS 2 SCAN (H2SCAN) for both SPE and IFE.

    METHODS: Both instruments were operated according to manufacturer's instructions. Samples used include a commercially available normal control serum (NCS) and patients' specimens. The following were evaluated: precision and comparison studies for SPE, and reproducibility and comparison studies for IFE. Statistical analyses were performed using Microsoft Excel.

    RESULTS: For SPE repeatability study, our results showed that EFG26 has higher coefficient of variation (%CV) compared with H2SCAN for both samples except for monoclonal component with %CV of 0.97% and 1.18%, respectively. Similar results were obtained for SPE reproducibility study except for alpha-1 (4.16%) and beta (3.13%) fractions for NCS, and beta fractions (5.36%) for monoclonal sample. Subsequently, reproducibility for IFE was 100% for both instruments. Values for correlation coefficients between both instruments ranged from 0.91 to 0.98 for the five classic bands.

    CONCLUSION: Both instruments demonstrated good analytical performance characterized by high precision, reproducibility and correlation.

    Matched MeSH terms: Blood Protein Electrophoresis/instrumentation*; Blood Protein Electrophoresis/methods; Blood Proteins/analysis*; Blood Proteins/immunology
  2. Mohd Ariffin ZA, Jamaluddin FA
    Malays J Pathol, 2020 Dec;42(3):395-400.
    PMID: 33361720
    INTRODUCTION: One commonly used equation which continues to be widely mentioned in text books and hence familiar to clinical people is total calcium + 0.02 (40 - albumin). This equation was derived using cresophthalein complexone and bromocresol green (BCG) methods for measuring serum total calcium and serum albumin respectively. However this equation maybe invalid when applied to calcium and albumin results generated by alternative assays. Hence we aim to derive an albumin-adjusted calcium equation specific to our laboratory's total calcium and albumin methodologies.

    MATERIALS AND METHODS: A total of 3,175 adult University Malaya Medical Centre (UMMC) patients deemed free of any calcium metabolism disorders were selected and divided into two groups for derivation and validation. Simple linear regression associating total calcium and albumin was constructed from the data in the derivation group. The new albumin-adjusted calcium equation was validated in the validation group. Differences in calcium status classification following adjustments based on existing and new albumin-adjusted calcium equation was compared in a 469 hypoalbuminaemic patients.

    RESULT: The new albumin adjusted calcium equation was: total calcium + 0.014 x (39-albumin). Of the 469 hypoalbuminemic patients, 78 were classified differently based on new equation. Based on the new equation, 55 normocalcemic patients were classified as hypocalcemic and 22 were classified as normocalcemic instead of hyperclacaemic.

    CONCLUSION: Based on the newly derived albuminadjusted calcium equation 17% of patients had different adjusted calcium classifications. This could potentially impact in the management. It is recommended that laboratories derive equations specific to their calcium/albumin methods and analytical platforms.

    Matched MeSH terms: Blood Chemical Analysis/methods*; Calcium/blood*; Hypercalcemia/blood; Hypocalcemia/blood
  3. Zulkufli NS, Jamaluddin FA, Tengku Yazid TN
    Malays J Pathol, 2020 Dec;42(3):385-394.
    PMID: 33361719
    INTRODUCTION: Ionised calcium is a good prognostic and diagnostic tool as opposed to total calcium in critical patients but is not available in most central laboratories and non-intensive care units. To date, four equations to calculate ionised calcium in critical patients have been published.

    OBJECTIVES: (1) Evaluate the four published equations' performance in estimating ionised calcium; (2) Determine the accuracy of calculated ionised and adjusted total calcium in classifying patients according to calcium states; and (3) Identify factors associated with hypocalcaemia in the critically ill population.

    MATERIALS AND METHODS: This is a cross-sectional study involving 281 critically ill patients aged 18-80 years of both genders in a Malaysian tertiary intensive care unit. Performance of the four equations was analysed using Bland-Altman difference plot and Passing Bablok regression analysis. Crosstabulation was conducted to assess classification accuracy. Mann-Whitney U or Pearson Chi-Square tests were performed to identify variables associated with hypocalcaemia.

    RESULTS: Calculated ionised calcium using all four equations significantly overestimated ionised calcium. Calculated ionised and adjusted total calcium had poor accuracies in classifying hypocalcaemic patients. pH was significantly higher in hypocalcaemics.

    CONCLUSION: Calculated ionised and adjusted total calcium significantly overestimate ionised calcium in the critically ill. In this specific population, calcium status should only be confirmed with ionised calcium measured by direct ion-selective electrode (ISE).

    Matched MeSH terms: Blood Chemical Analysis/methods*; Calcium/blood*; Hypercalcemia/blood; Hypocalcemia/blood
  4. George E, Wong HB, George R, Ariffin WA
    Singapore Med J, 1994 Feb;35(1):62-4.
    PMID: 8009283
    Patients on a moderate red cell transfusion programme have iron overload where the concentrations of the serum ferritin were inappropriate to increases in the transfusion load as a result of limitations of apoferritin synthesis and conversion of ferritin into haemosiderin. This study confirms the limitations for the use of estimations of the serum ferritin to evaluate the iron status in patients with expected high overload as would be seen in patients on many years of maintenance red cell transfusions in the absence of iron chelation therapy. Poor compliance, inadequate dosage of Desferal (deferoxamine), and the late initiation of iron chelation therapy were factors that were considered in the patients with failure of response to iron chelation.
    Matched MeSH terms: Blood Transfusion*; Ferritins/blood*; Iron/blood; beta-Thalassemia/blood*
  5. Boo NY, Ainoon BO, Ooi LH, Cheong SK, Haliza BM
    J Paediatr Child Health, 1994 Jun;30(3):273-4.
    PMID: 8074916
    The cord blood glucose-6-phosphate dehydrogenase (G6PD) enzyme activity of 262 normal term Malaysian neonates (92 Malays, 96 Chinese and 74 Indians) was quantitatively determined by the World Health Organisation method. Analysis of variance for the levels of G6PD enzyme activity by ethnic origin and sex showed that there was a significant difference between mean levels of enzyme activity in the three ethnic groups (P = 0.03) but no difference between the sexes (P = 0.36). Multiple range analysis showed that Malays had significantly higher mean levels of G6PD enzyme activity than those of Chinese (P = 0.01). There was no significant difference between the mean levels of G6PD enzyme activity of Chinese and Indians (P = 0.52), nor was there any difference between those of Malays and Indians (P = 0.08). The difference in levels of G6PD enzyme activity among the different ethnic groups could be due to the existence of different G6PD variants.
    Matched MeSH terms: Fetal Blood/enzymology; Fetal Blood/chemistry*; Glucosephosphate Dehydrogenase/blood*; Infant, Newborn/blood*
  6. Goh KH, Ng ML, Roslan BA, Tan TT, Nasri BN, Khalid BA
    Ann Acad Med Singap, 1993 Jul;22(4):539-43.
    PMID: 8257054
    Serum concentrations of thyroid stimulating hormone (TSH) and thyroid autoantibodies in pregnant patients with thyroid disease at various stages of pregnancy were determined by in-house ELISAs. In normal pregnancy, serum TSH levels were significantly elevated (p < 0.05) from 13 weeks of gestation. The normal reference ranges for TSH for the second (0.6-5.0 mIU/l) and third trimester (0.6-5.6 mIU/l) were significantly higher (p < 0.05; p < 0.01 respectively) compared to 0.4-4.5 mIU/l for the first trimester. In pregnant thyroid patients, serum TSH levels correlated highly (p < 0.001) to T4 (r = 0.740), FT4I (r = 0.683) and MicAb (microsomal antibodies) (r = 0.825) but weaker (p < 0.01) to T3 (r = -0.512), FT3I (r = 0.520) and TgAb (thyroglobulin antibodies) (r = 0.618). Thus, measurement of TSH with the highly sensitive ELISA (enzyme linked immunosorbent assay) would form a useful first line test for thyroid dysfunction in pregnancy while measurement of thyroid autoantibodies would aid in the diagnosis of autoimmune hypothyroidism.
    Matched MeSH terms: Autoantibodies/blood*; Thyroid Hormones/blood*; Thyrotropin/blood; Thyroxine/blood; Triiodothyronine/blood
  7. Khoo KL, Tan H, Liew YM, Sambhi JS, Aljafri AM, Hatijah A
    Med J Malaysia, 2000 Dec;55(4):439-50.
    PMID: 11221155
    The paper presents the results of a health screening programme conducted in 10 major centers in Malaysia--Kuala Lumpur, Penang, Ipoh, Johor Bahru, Alor Star, Kuala Terengganu, Malacca, Kota Bahru, Kuching and Kota Kinabalu during the National Heart Weeks, 1995-1997. There were 6,858 participants of both sexes aged between 6 years to 81 years old. The parameters involved in the screening programme were body mass index, blood pressure, heart rate, cholesterol and glucose. The following are the results of the study:- 1. The mean and standard deviation for the body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), total cholesterol (TC) and non fasting (random) blood glucose (GL) of the volunteers studied were 24.3 +/- 4.0 kg/m2, 128.3 +/- 21.1 mmHg, 79.6 +/- 11.9 mmHg, 77.2 +/- 12.1 bpm, 5.33 +/- 1.37 mmol/l and 5.11 +/- 1.97 mmol/l respectively. 2. There was a rising trend for BMI, SBP, DBP, TC and GL with age. The HR was higher in the younger age group of those below 20 years. Males tended to have higher mean values than females except for HR which was similar in both sexes. 3. The Malays, Chinese and Indians seemed to have closely similar mean values for SBP, DBP and HR but the Indians possessed the highest BMI (25.62 +/- 3.90 kg/m2), TC (5.61 +/- 1.48 mmol/l) and GL (5.41 +/- 2.43 mmol/l) among the three major ethnic groups. While the Ibans had highest TC (6.07 + 1.09 mmol/l), their GL level was the lowest (4.76 +/- 1.15 mmol/l). The Kadazans had the lowest TC level (4.94 +/- 1.39 mmol/l) among all the ethnic groups. 4. Among the participants screened, 31.9% were overweight (BMI > or = 25), 7.6% were obese (BMI > or = 30); 26.8% had raised SBP (> or = 140 mmHg) and 19.3% had raised DBP (> or = 90 mmHg); 13.6% of the participants had increased HR (> or = 90 bpm), 22% had raised TC (> or = 6.20 mmol/l) and 2% had raised GL (> or = 11.00 mmol/l). There was a higher prevalence for abnormal values with increasing age until between the ages of 60 or 70 years, when the values began to fall. 5. Age was positively correlated with SBP (r = 0.41***, df = 4351), DBP (r = 0.27***, df = 4351), TC (r = 0.22***, df = 3303) and GL (r = 0.16***, df = 2442) but negatively correlated with HR (r = -0.13***, df = 4351). The BMI was positively correlated with SBP (r = 0.29***, df = 2769), DBP (r = 0.31***, df = 2769), TC (r = 0.16***, df = 2137) and GL (r = 0.11**, df = 1637) but there was no correlation with HR (r = 0.03NS, df = 2771). The SBP and DBP were highly correlated with each other (r = 0.75***, df = 4351) and they also showed highly significant positive correlation (r = 0.08***-0.13***, df = 2441-3301) with TC and GL. TC was positively correlated with GL (r = 0.05* df = 2319) but only at the 5% probability level.
    Matched MeSH terms: Blood Glucose/analysis*; Blood Pressure*; Cholesterol/blood*
  8. Nawawi H, Girgis SI
    PMID: 12755282
    Vitamin D deficiency in adults causes osteomalacia where there is a defect in bone mineralization resulting in an excess of unmineralised osteoid in the bone matrix. The aim of this study was to evaluate the markers of bone formation: total (TALP), bone-specific alkaline phosphatase (BSALP) and procollagen type I carboxyterminal peptide (PICP) in vitamin D deficiency. We studied 100 vitamin D deficient subjects and 82 gender-matched controls. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D level of less than 7 ng/ml, and greater than 10 ng/ml for normal controls. Serum TALP assay was performed by a standard automated method, BSALP and PICP were measured by enzyme immunoassays (Metra Biosystems) and vitamin D by radioimmunoassay. There was significant difference in the TALP between female vitamin D deficient and control subjects (mean +/- sem = 99.8 +/- 8.2 vs 70.5 +/- 2.8 iu/l, p<0.001). Elevated serum TALP (>130 iu/l) was found in 20% (20/100) of the vitamin D deficient patients. There were no significant differences in BSALP or PICP between vitamin D deficient patients and gender-matched control subjects. There was no correlation between vitamin D and PICP in patients but in control subjects, a significant negative correlation (r= -0.431, p<0.0001) was found. In conclusion, although elevated TALP was observed in a minority of vitamin D deficient patients, it is a better marker than PICP. The lack of PICP response in vitamin D deficient subjects suggests the possibility of vitamin D deficiency leading to a block in osteoblast differentiation.
    Matched MeSH terms: Alkaline Phosphatase/blood*; Peptide Fragments/blood*; Procollagen/blood*; Vitamin D Deficiency/blood*; Biomarkers/blood
  9. Loke DF, Viegas OA, Ratnam SS
    Gynecol. Obstet. Invest., 1993;36(2):108-13.
    PMID: 8225044
    Serum lipid profiles were studied in 167 healthy fertile Singaporean women, aged between 18 and 40 and comprising 114 Chinese, 28 Malays and 25 Indians. Parity or ethnic differences did not affect lipid concentrations. Except for triglycerides which showed a decreasing trend, there was no significant variation in lipid concentrations with age. However, all lipid concentrations except HDL cholesterol (which decreased) appeared to increase with body mass index. Compared with other populations, these Singaporean women appeared to have higher mean concentrations of total cholesterol and lower mean concentrations of HDL cholesterol. The possibility that these differences could have contributed to the increasing incidence of coronary heart disease in Singapore is discussed.
    Matched MeSH terms: Blood Pressure; Cholesterol/blood*; Cholesterol, HDL/blood; Cholesterol, LDL/blood; Triglycerides/blood*
  10. Thambiah SC, Samsudin IN, George E, Zahari Sham SY, Lee HM, Muhamad MA, et al.
    Malays J Pathol, 2016 Aug;38(2):123-30.
    PMID: 27568669 MyJurnal
    The risk of coronary heart disease (CHD) is dramatically increased in diabetic patients due to their atherogenic lipid profile. The severity of CHD in diabetic patients has been found to be directly associated with glycated haemoglobin (HbA1c). According to the Malaysian Clinical Practice Guidelines on diabetes mellitus (DM), HbA1c level less than 6.5% reduces the risk of microvascular and macrovascular complications. Hence, this study aimed to determine the relationship between dyslipidaemia and glycaemic status in patients with type 2 DM (T2DM) patients in Hospital Putrajaya, a tertiary endocrine centre in Malaysia. This was a cross sectional, retrospective study of 214 T2DM patients with dyslipidaemia who had visited the endocrine clinic between January 2009 and December 2012. Significant correlations were found between fasting blood glucose (FBG) and HbA1c with total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL), non-high density lipoprotein cholesterol (non-HDL), LDL/HDL ratio and TC/HDL ratio; greater correlation being with HbA1c than FBG. In patients with HbA1c ≥ 6.5%, TC, TG, non-HDL and TC/HDL ratio were significantly higher than in patients with HbA1c < 6.5%. Non-HDL, LDL/HDL ratio, TC/HDL ratio and HbA1c were significantly lower in patients on statin treatment than nontreated patients (p<0.05). This significant association between glycaemic status and dyslipidaemia emphasises the additional possible use of HbA1c as a biomarker for dyslipidaemia as well as a potential indirect predictor of cardiovascular disease (CVD) risk in T2DM patients.
    Matched MeSH terms: Blood Glucose/analysis*; Diabetes Mellitus, Type 2/blood*; Biomarkers/blood*; Dyslipidemias/blood*
  11. Au A, Cheng KK, Wei LK
    Adv Exp Med Biol, 2017;956:599-613.
    PMID: 27722964 DOI: 10.1007/5584_2016_79
    Hypertension is a common but complex human disease, which can lead to a heart attack, stroke, kidney disease or other complications. Since the pathogenesis of hypertension is heterogeneous and multifactorial, it is crucial to establish a comprehensive metabolomic approach to elucidate the molecular mechanism of hypertension. Although there have been limited metabolomic, lipidomic and pharmacometabolomic studies investigating this disease to date, metabolomic studies on hypertension have provided greater insights into the identification of disease-specific biomarkers, predicting treatment outcome and monitor drug safety and efficacy. Therefore, we discuss recent updates on the applications of metabolomics technology in human hypertension with a focus on metabolic biomarker discovery.
    Matched MeSH terms: Blood Pressure/drug effects*; Hypertension/blood*; Lipids/blood*; Biomarkers/blood
  12. Ch'ng SL, Cheah SH, Husain R, Duncan MT
    Ann Acad Med Singap, 1989 May;18(3):326-7.
    PMID: 2774480
    The effect of alteration of eating pattern during Ramadan on body mass index (BMI), serum fructosamine: total protein ratio (F/TP), and glucose level in 18 healthy male Asiatic Moslems were studied. The results showed a significant decrease (p less than 0.025) in F/TP at the second week of Ramadan in 11 subjects who experienced continuous decrease in BMI throughout Ramadan. The remaining 7 subjects showed no significant changes in BMI and F/TP. No evidence of hypoglycaemia was observed in the subjects during the study. Serum fructosamine: total protein ratio in subjects with altered eating pattern preferably should be interpreted along with the change in body mass index.
    Matched MeSH terms: Blood Glucose/metabolism*; Blood Proteins/metabolism*; Hexosamines/blood*
  13. George E, Ilina I, Yasmin AM, George R, Duraisamy G
    Med J Malaysia, 1988 Dec;43(4):284-7.
    PMID: 3241594
    Matched MeSH terms: Blood Transfusion/adverse effects*; Hepatitis B/blood; Hepatitis B Surface Antigens/blood; Thalassemia/blood*
  14. Chong YH, Soh CC, Ho GS, Rajaratnam R, Nonis P
    Clin Chim Acta, 1971 Aug;34(1):85-92.
    PMID: 5118731 DOI: 10.1016/0009-8981(71)90070-2
    Matched MeSH terms: Cholesterol/blood*; Coronary Disease/blood; Lipids/blood; Lipoproteins/blood*; Triglycerides/blood*
  15. THOMSON DL, RUIZ E, BAANDKAR M
    Trans R Soc Trop Med Hyg, 1964 Sep;58:425-31.
    PMID: 14206699
    Matched MeSH terms: Blood*; Blood Chemical Analysis*; Blood Proteins*
  16. Ahmad AA, Jayarajah P, Han GWY, Yin SJOW, Rasedee A
    J Vet Med Sci, 2017 Jun 29;79(6):1134-1137.
    PMID: 28484127 DOI: 10.1292/jvms.16-0082
    Currently, there are no complete parameters established for serum biochemistry and hematology for the determination of health status of rescued common palm civets (Paradoxurus hermaphroditus). In this study, blood samples were obtained from 18 adults and 15 juvenile civets caught on Singapore Main Island. Significant age-related differences (P<0.05) were noted in the hemoglobin, erythrocyte count, packed cell volume (PCV), total serum protein and globulin concentration in the adult civets showing higher values compared with the juvenile civets. The mean corpuscular volume (MCV), the alkaline phosphatase (ALP) and the phosphorus concentrations were significantly higher (P<0.05) in juveniles compared with adult civets.
    Matched MeSH terms: Alkaline Phosphatase/blood; Blood Proteins/analysis; Phosphorus/blood; Viverridae/blood*
  17. Singh HJ, Mohammad NH, Nila A
    J Matern Fetal Med, 1999 May-Jun;8(3):95-100.
    PMID: 10338062
    To ascertain the calcium status in normal pregnant Malay women.
    Matched MeSH terms: Calcium/blood*; Parathyroid Hormone/blood*; Potassium/blood; Pregnancy/blood*; Sodium/blood
  18. Lopez JB, Royan GP, Lakhwani MN, Mahadaven M, Timor J
    Int. J. Biol. Markers, 1999 Jul-Sep;14(3):172-7.
    PMID: 10569140
    The objective of this study was to compare CA 72-4 with CEA and CA 19-9 in gastrointestinal malignancies. CA 72-4 was assayed by radioimmunoassay and CEA and CA 19-9 with the Abbott IMx analyser. The study included 52 patients with gastrointestinal cancer and 20 controls with benign gastrointestinal diseases. The 52 cases showed marker sensitivities of 39%, 49% and 35% for CA 72-4, CEA and CA 19-9, respectively, and 64% when the markers were combined. Marker expression in serum was highest in colorectal carcinoma followed by gastric and esophageal carcinoma. The sensitivities of the individual markers in colorectal, gastric and esophageal carcinomas, respectively, were: CA 72-4, 56%, 32% and 18%; CEA, 83%, 33% and 18%; CA 19-9, 53%, 25% and 18%. The sensitivity of the three markers in combination was 89%, 50% and 46% in colorectal, gastric and esophageal cancer, respectively. The specificity of CA 72-4, CEA and CA 19-9 was 100%, 72% and 86%, respectively. However, CA 72-4 is not a useful a marker for gastrointestinal cancers because of its poor sensitivity. CEA, which had the best overall sensitivity and a reasonable specificity, was the most useful single marker, especially for colorectal cancer. Whereas the single markers were not useful in gastric and esophageal cancer, the combination of the three may be.
    Matched MeSH terms: Carcinoembryonic Antigen/blood*; Gastrointestinal Neoplasms/blood*; Biomarkers, Tumor/blood*; Antigens, Tumor-Associated, Carbohydrate/blood*; CA-19-9 Antigen/blood*
  19. Ng KP, Saw TL, Wong NW, Goh KL, Chuah SY, Nagaratnam M
    Med J Malaysia, 1995 Dec;50(4):302-5.
    PMID: 8668047
    Anti-HCV antibody was detected in 1.9% of the blood donors in University Hospital. Among the risk groups, 33.3% of the patients with post-transfusion hepatitis were tested positive for anti-HCV antibody. The anti-HCV antibody was detected in 30% of the IDU. Haemodialysis patients, patients with acute and chronic hepatitis and patients with liver cirrhosis appeared to have increased risk of Hepatitis C virus infection. The results indicate that the frequency of HCV infection increases with the exposure to blood or blood products.
    Matched MeSH terms: Blood Donors*; Blood Transfusion/adverse effects; Hepatitis C Antibodies/blood*
  20. Fairus S, Nor RM, Cheng HM, Sundram K
    Nutr J, 2012;11:5.
    PMID: 22252050 DOI: 10.1186/1475-2891-11-5
    Tocotrienols (T3) and tocopherols (T), both members of the natural vitamin E family have unique biological functions in humans. T3 are detected in circulating human plasma and lipoproteins, although at concentrations significantly lower than α-tocopherol (α-T). T3, especially α-T3 is known to be neuropotective at nanomolar concentrations and this study evaluated the postprandial fate of T3 and α-T in plasma and lipoproteins.
    Matched MeSH terms: Lipoproteins/blood*; Lipoproteins, HDL/blood; Vitamin E/blood; Tocopherols/blood; Tocotrienols/blood
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