Displaying publications 21 - 40 of 79 in total

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  1. Lin HP, Chan LL, Tan A, Ariffin WA, Lam SK
    Bone Marrow Transplant, 1994 Jun;13(6):725-9.
    PMID: 7920303
    The sole BMT centre in Malaysia caters only for children. Since 1987, 89 transplants have been performed using reverse barrier nursing techniques. The overall survival rate is 73% with the majority of survivors leading normal lives. The early and late infection rates of 46% and 13%, respectively, are comparable to those of other centres. Although the early septicaemia rate is 36% the immediate mortality rate is < 10%. GVHD is less frequent and severe and the interstitial pneumonitis rate lower than that in the West. The average cost of US $8000 per transplant is much lower than the cost of a transplant performed overseas. Thus we believe that our paediatric BMT programme is simple and cost-effective.
  2. Sarji SA, Abdullah BJ, Kumar G, Tan AH, Narayanan P
    Australas Radiol, 1998 Nov;42(4):293-5.
    PMID: 9833363
    A recognized cause of incomplete or cancelled MRI examinations is anxiety and claustrophobic symptoms in patients undergoing MR scanning. This appears to be a problem in many MRI centres in Western Europe and North America, where it is said to be costly in terms of loss of valuable scan time, and has led to researchers suggesting several anxiety-reducing approaches for MRI. To determine the incidence of failed MRI examination among our patients and if there are any associations with a patient's sex, age and education level, we studied claustrophobia that led to premature termination of the MRI examination in the University Malaya Medical Centre (UMMC) in 3324 patients over 28 months. The incidence of failed MRI examinations due to claustrophobia in the UMMC was found to be only 0.54%. There are associations between claustrophobia in MRI with the patients' sex, age and level of education. The majority of those affected were male patients and young patients in the 25-45-years age group. The patients' education level appears to be the strongest association with failed MRI examinations due to claustrophobia, where the majority of the affected were highly educated individuals. Claustrophobia in MRI is more of a problem among the educated individuals or patients from a higher socio-economic group, which may explain the higher incidence in Western European and North American patients.
  3. Qairul IH, Kareem BA, Tan AB, Harwant S
    Med J Malaysia, 2001 Dec;56 Suppl D:34-7.
    PMID: 14569764
    The forearm fracture is a fracture of the upper limb between the elbow and the wrist. It is a common injury in children, accounting for more than half of all children's fractures, and mostly occur when a child falls on the outstretched arm. A difficult clinical problem that often arises is how much angulation can be accepted in the child and how much remodeling will occur. One hundred consecutive cases of forearm fractures that were admitted at Childrens Orthopaedic Ward, Institute of Paediatrics at Hospital Kuala Lumpur between 1st January 1997 to 31st December 1998 were studied. We found that all fractures united 3 to 6 weeks, with a remodeling rate of about 2.5 degrees/month: the proximal fractures having the most potential to remodel. We conclude that the early remodeling potential of forearm fractures in children is 1.5 degrees/month in midshaft fractures and 2.5 degrees/month in distal and proximal fractures. We recommend accepting a 10-20 degree angulation in midshaft fractures, and a 20-30 degree angulation in metaphyseal fractures; based on our study of early remodeling potential.
  4. Kurup A, Leo YS, Tan AL, Wong SY
    Ann Acad Med Singap, 1999 Jul;28(4):605-9.
    PMID: 10561784
    Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.
  5. Tan ACC, Kumar HK, Lokeman Hazli FL, Chin L
    Med J Malaysia, 2021 09;76(5):624-629.
    PMID: 34508366
    INTRODUCTION: The use of intramuscular (IM) dexamethasone injections before an elective caesarean delivery at term has been shown in multiple randomized controlled trials to reduce the rates of transient tachypnoea of the newborn, and admission to neonatal care. Recent studies have suggested that a complete course of IM steroids can be associated with long term harmful consequences to the infants born, and there have been studies suggesting that a lower dose of IM corticosteroids can be beneficial. Therefore, we aim to establish if halving the dose of dexamethasone to 12mg can demonstrate any benefit for term elective caesarean section deliveries whilst minimizing foetal exposure.

    METHODS: An observational controlled study comparing neonatal respiratory morbidities before and after the single dose 12mg dexamethasone was implemented in our obstetrics and gynaecology centre for term elective caesarean section deliveries. We included singleton pregnancies from 37+0 to 38+6 weeks undergoing elective caesarean section into our study. A total of 674 patients fulfilled the inclusion criteria and were recruited. We compared the rates and duration of admission to neonatal intensive care unit, the need for mechanical ventilation and the rate of transient tachypnoea of the newborn in the first half of 2019 without IM dexamethasone injections against the second half of the year when a single dose IM dexamethasone was given.

    RESULTS: IM dexamethasone injection did not show any significant benefit with regards to reducing the admission to neonatal care (OR 0.97, p- value 0.69), admission to neonatal intensive care unit (OR 0.91, p- value 0.80), the need for mechanical ventilation (OR 0.98, p- value 0.95), and the incidence of transient tachypnoea of the newborn (OR1.01, p- value 0.96). There was also no significant difference for the duration of admission in the neonatal intensive care unit for both groups (p- value 0.17).

    CONCLUSIONS: This study showed that there was no significant benefit gained from the lower dose antenatal corticosteroids for term elective caesarean section deliveries and considering that there have been long term harmful consequences demonstrated from the higher dose of antenatal corticosteroids at term, this practice should therefore be discontinued until a larger study is done to refute these findings. The use of such dexamethasone should only be a viable option in a research setting.

  6. Mallika P, Tan A, Asok T, Faisal H, Aziz S, Intan G
    Malays Fam Physician, 2008;3(3):140-5.
    PMID: 25606139 MyJurnal
    OBJECTIVES: To analyze the causes and characteristics of ocular injuries presenting to Sarawak General Hospital (SGH), Kuching.

    DESIGN: It is a prospective hospital-based study done for a period of 1 year.

    SETTING: Department of Ophthalmology, Sarawak General Hospital, Malaysia.

    PARTICIPANTS: All ocular injury patients seen for the first time in the Eye Department during the period January 2006 to December 2006 were included in the study. Eye injury patients on follow-up and treated elsewhere were excluded.

    RESULTS: A total of 233 patients, and 257 eyes, were studied. Men had six-fold higher rates of injury than women. The average age of presentation was 30 years. The predominant age group was between 21-30 years, 26.2 % (n=61). Eye injuries related to work were seen in 36.9% of patients. There was a gross negligence in the use of personal protective devices in the work-related group. The common settings in which the injuries occurred included home 34.3% (n=80) and industrial premises 31.8% (n=74). Assault-related injuries 7.7% (n=18) were seen mostly among young men in the age between 20-30 years. The initial presenting visual acuity of the patients with blunt ocular trauma was better than penetrating injury.

    CONCLUSION: Ocular injuries were common in young males. Work related eye injuries were noted in a significant number of cases. Health education and preventive strategies both in the working place and at home will help to decrease the occurrence of ocular injuries.

  7. 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.
  8. Armutcu B, Tan A, Amponsah M, Parida S, Ramkissoon H
    Acta Psychol (Amst), 2023 Oct;240:104025.
    PMID: 37741033 DOI: 10.1016/j.actpsy.2023.104025
    Social media and its applications are a part of daily life in Turkey and the rest of the world. In 2022, about 80.7 % of Turkey's population (69.9 million people) spent an average of 8 h daily using the Internet, providing a significant opportunity to encourage and influence tourists' purchase intentions through social media. This study aims to determine the effects of digital marketing and social media on tourist behaviours in Turkey. This study proposes a comprehensive model for the antecedents of tourists' behavioural intentions in their destination selection that can be found in the tourist destination online content (TDOC). The quality and user-friendly accessibility of the online information provides essential clues that influence tourists' behavioural intentions (intention to visit the destination and eWOM). Tourists' level of satisfaction with their first destination visits and the digital marketing interaction channels through which they share their experiences may positively affect their repeat visits/other tourists' behavioural intentions. Therefore, this study investigates the mediator effect of satisfaction and digital marketing interactions on the behavioural intentions of tourists of Eastern origin during their destination selection. Data was collected from 264 structured questionnaires and analyzed using partial least squares structural equation (PLS-SEM) modelling. Findings show that tourists' TDOC perceptions directly affect their behavioural intentions and that tourist satisfaction has a mediator role in the relationship between tourists' TDOC perceptions and behavioural intentions. Also, the results show that satisfaction and digital marketing interactions are important determinants of the intention to visit a tourist destination and eWOM intentions. Understanding tourists' perspectives on destination choice is crucial for policy makers, businesses and marketers as it will help formulate appropriate strategies to increase destination visits. In this respect, it is recommended to develop strategies to encourage tourists to share their experiences and satisfaction levels through digital marketing channels by improving the quality of products and services. Finally, the population of this study is limited to Turkey, and future research can extend this study to countries with different cultures and make new contributions to the related literature.
  9. Jiang L, Bin Abd Razak HR, Chong HC, Tan A
    J Arthroplasty, 2014 Feb;29(2):304-7.
    PMID: 23891052 DOI: 10.1016/j.arth.2013.06.002
    We aim to compare the patient profile and outcomes after TKA between the different racial groups in Singapore. Prospective data were collected from 364 patients who underwent TKA in Singapore General Hospital from January 2006 to May 2010. Patients were stratified according to ethnicity and we compared their preoperative demographic data, Short-Form 36 (SF-36), Oxford Knee (OKS) as well as Knee Society Scores (KSS). Malays were younger (62.0 ± 5.3) at time of surgery (p=0.05) and the body mass index of Chinese (27.9 ± 4.7) was lower than Malay (30.4 ± 5.0) and Indian (31.5 ± 4.5) patients (P<0.005). Malay (40.3 ± 11.0) and Indian (39.2 ± 9.3) patients had less favourable preoperative OKS than Chinese (35.9 ± 7.8) patients (P<0.05). All 3 ethnic groups achieved statistically significant improvements in outcome measures but did not differ significantly between the ethnicities.
  10. Müller M, Spiers AJ, Tan A, Mujahid A
    Sci Rep, 2023 Mar 12;13(1):4095.
    PMID: 36907954 DOI: 10.1038/s41598-023-31197-4
    Early Mortality Syndrome (EMS) has been a major problem for shrimp aquaculture in Southeast Asia due to its epizootic prevalence within the region since the first reported case in 2009. This study explores the application of halophilic marine bacilli isolated from coral mucus and their quorum-quenching abilities as potential biocontrol agents in aquaculture systems to combat the causative agent of EMS, Vibrio parahaemolyticus. N-acylhomoserine lactone (AHL)-degrading (AiiA) activity was first screened by PCR then confirmed by bio-reporter assay, and a combination of 16S rDNA sequence analysis and quantitative phenotype assays including biofilm-formation and temperature-growth responses were used to demonstrate diversity amongst these quorum-quenching isolates. Three phenotypically distinct strains showing notable potential were chosen to undergo co-cultivation as a method for strain improvement via long term exposure to the pathogenic V. parahaemolyticus. The novel approach taken led to significant improvements in antagonism and quorum quenching activities as compared to the ancestral wild-type strains and offers a potential solution as well as pathway to improve existing beneficial microbes for one of the most pressing issues in shrimp aquacultures worldwide.
  11. Ratnasingam J, Chooi KC, Samsuddin S, Paramasivam S, Ibrahim L, Lim LL, et al.
    Endocr Pract, 2017 Jun;23(6):752.
    PMID: 27967223 DOI: 10.4158/EP161568.VV
  12. Rama Chandran S, A Vigersky R, Thomas A, Lim LL, Ratnasingam J, Tan A, et al.
    Diabetes Technol Ther, 2020 02;22(2):103-111.
    PMID: 31502876 DOI: 10.1089/dia.2019.0277
    Background:
    Complex changes of glycemia that occur in diabetes are not fully captured by any single measure. The Comprehensive Glucose Pentagon (CGP) measures multiple aspects of glycemia to generate the prognostic glycemic risk (PGR), which constitutes the relative risk of hypoglycemia combined with long-term complications. We compare the components of CGP and PGR across type 1 and type 2 diabetes.
    Methods:
    Participants: n = 60 type 1 and n = 100 type 2 who underwent continuous glucose monitoring (CGM). Mean glucose, coefficient of variation (%CV), intensity of hypoglycemia (INThypo), intensity of hyperglycemia (INThyper), time out-of-range (TOR <3.9 and >10 mmol/L), and PGR were calculated. PGR (median, interquartile ranges [IQR]) for diabetes types, and HbA1c classes were compared.
    Results:
    While HbA1c was lower in type 1 (type 1 vs. type 2: 8.0 ± 1.6 vs. 8.6 ± 1.7, P = 0.02), CGM-derived mean glucoses were similar across both groups (P > 0.05). TOR, %CV, INThypo, and INThyper were all higher in type 1 [type 1 vs. type 2: 665 (500, 863) vs. 535 (284, 823) min/day; 39% (33, 46) vs. 29% (24, 34); 905 (205, 2951) vs. 18 (0, 349) mg/dL × min2; 42,906 (23,482, 82,120) vs. 30,166 (10,276, 57,183) mg/dL × min2, respectively, all P 
  13. Leong E, Ong SK, Madli F, Tan A, Lai D, Basir N, et al.
    Asian Pac J Cancer Prev, 2020 Jan 01;21(1):259-265.
    PMID: 31983194 DOI: 10.31557/APJCP.2020.21.1.259
    BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in both men and women. In most Asian countries, both the incidence and mortality rates of CRC are gradually increasing. In Brunei Darussalam, CRC ranks first and second in lifetime risk among men and women respectively. This study aims to report the overall survival rates and associated factors of CRC in Brunei Darussalam.

    METHODS: This is a retrospective study examining CRC data for the period 2007 to 2017 retrieved from a population based cancer registry in Brunei Darussalam. A total of 728 patients were included in the analysis. Kaplan Meier method was used to estimate survival rates. Univariate analysis using log-rank test was used to examine the differences in survival between groups. Multivariate analysis using Cox PH regression was used to estimate hazard of death and obtain significant predictors that influence CRC patients' survival.

    RESULTS: The median survival time for colorectal, colon and rectal cancer patients were 57.0, 85.8 and 40.0 months respectively. The overall 1-, 3- and 5- year survival rates for CRC patients were 78.0%, 57.7% and 49.6% respectively. In univariate analysis, age at diagnosis, ethnicity, cancer stage, tumour location and histology were found to have significant difference in CRC patients' survival. In the Cox PH analysis, older age (≥70 years), cancer stage, ethnicity and other histological type were determined as associated factors of CRC patients' survival.

    CONCLUSION: This study found the overall 5-year survival rate of CRC in Brunei Darussalam is similar to that in some Asian countries such as Singapore and Malaysia. However, more efforts need to be carried out in order to raise awareness of CRC and improve the survival of CRC patients.

  14. Chuah SL, Kareem BA, Selvakumar K, Oh KS, Borhan Tan A, Harwant S
    Med J Malaysia, 2001 Jun;56 Suppl C:37-40.
    PMID: 11814247
    We studied the curve progression of untreated curves presenting to the Scoliosis Service of Hospital Kuala Lumpur. One hundred and fifty-two (152) patients were included in this study. The median rate of curve progression of idiopathic scoliosis curves was 7.03 degrees per year, for neuromuscular scoliosis curves was 17.39 degrees per year; and congenital scoliosis curves were 3.67 degrees per year. These rates are similar to the reported rates in the literature. Data for sixty-one (61) surgically treated patients were reviewed to determine the early curve correction of the curves of different aetiology. The mean age of surgery was 14.15 years old, the mean preoperative curve size was 71.61 degrees; and the mean postoperative curve size was 43.78 degrees. The mean duration of follow up after surgery was 2.44 years. The revision and removal of instrumentation rate was 8.3%.
  15. Chuah SL, Kareem BA, Selvakumar K, Oh KS, Borhan Tan A, Harwant S
    Med J Malaysia, 2001 Jun;56 Suppl C:31-6.
    PMID: 11814246 MyJurnal
    This is a study of patients referred to the Scoliosis Service of Hospital Kuala Lumpur. Three hundred and thirty five (335) consecutive patients who were seen between 1985 and 2000 were reviewed to determine the presentation of scoliosis, the treatment received and the compliance to follow up. Data were determined by measuring the frontal spinal radiographs. Two hundred and ninety eight (298) patients met inclusion criteria. Idiopathic scoliosis accounted for 203 patients (68.1%), 31 (10.4%) were neuromuscular scoliosis; and 44 (14.8%) had congenital scoliosis. Twenty-five point five percent of patients had surgery, 10.4% were treated with brace, while the remaining 69.1% of patients were observed, or had no treatment at all. Congenital scoliosis patients had better compliance compared to idiopathic or neuromuscular scoliosis patients.
  16. Vijay AP, Lim SS, Tan ATB, Rokiah P, Chan SP
    JUMMEC, 2009;12(2):92-95.
    MyJurnal
    Antithyroid drugs have been used for more than 50 years for the management of hyperthyroidism. Most patients tolerate treatment well, but some may develop rare life threatening side effects such as agranulocytosis and aplastic anaemia. Clinical experience with the latter condition is extremely limited. We report on a case of carbimazole-induced aplastic anaemia caused by hypocellular bone marrow and associated plasmacytosis in a thyrotoxic patient chronically treated with carbimazole. This resolved after substitution with propylthiouracil. The clinical course was complicated by neutropaenic septicaemia and atrial fibrillation.
    Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  17. Mallika P.S., Asokumaran T, Faisal H. A., Aziz S, Tan A. K., Intan G
    Malays Fam Physician, 2008;3(2):77-81.
    MyJurnal
    Ophthalmia neonatorum remains a significant cause of ocular morbidity, blindness and even death in underdeveloped countries. The organisms causing ophthalmia neonatorum are acquired mainly from the mother's birth canal during delivery and a small percentage of cases are acquired by other ways. Chlamydia and Neisseria are the most common pathogens responsible for the perinatal infection. Fortunately in most cases, laboratory studies can identify the causative organism and unlike other form of conjunctivitis, this perinatal ocular infection has to be treated with systemic antibiotics to prevent systemic colonization of the organism. Routine prophylaxis with 1% silver nitrate solution (credes method) has been discontinued in many developed nations for the fear of development of chemical conjunctivitis.
  18. Che HL, Kanthimathi MS, Loganathan R, Yuen KH, Tan AT, Selvaduray KR, et al.
    Eur J Clin Nutr, 2017 01;71(1):107-114.
    PMID: 27759074 DOI: 10.1038/ejcn.2016.200
    BACKGROUND/OBJECTIVES: Evidence shows that tocotrienols potentially reverse various chronic disease progressions caused by the metabolic syndrome. We aimed to investigate the acute effects of a single-dose supplementation of gamma and delta tocotrienols (γδ-T3, 1:4 ratio) compared with those in placebo on the insulinemic, anti-inflammatory and anti-thrombogenic responses in metabolic syndrome subjects.

    SUBJECTS/METHODS: Thirty metabolic syndrome subjects (15 men and 15 women) were recruited to a randomized, double-blinded and crossover study. The subjects were administered a single dose of 200 mg or 400 mg γδ-T3 emulsions or placebo incorporated into a glass of strawberry-flavored milkshake, consumed together with a high-fat muffin. Blood samples were collected at 0, 5, 15, 30, 60, 90, 120, 180, 240, 300 and 360 min after meal intake.

    RESULTS: Plasma vitamin E levels reflected the absorption of γδ-T3 after treatments. Postprandial changes in serum C-peptide, serum insulin, plasma glucose, triacylglycerol, non-esterified fatty acid and adiponectin did not differ between treatments, with women displaying delayed increase in the aforementioned markers. No significant difference between treatments was observed for plasma cytokines (interleukin-1 beta, interleukin-6 and tumor necrosis factor alpha) and thrombogenic markers (plasminogen activator inhibitor type 1 and D-dimer).

    CONCLUSIONS: Supplementation of a single dose of γδ-T3 did not change the insulinemic, anti-inflammatory and anti-thrombogenic responses in metabolic syndrome subjects.

  19. Tan AT, Emmanuel SC, Tan BY, Teo WS, Chua TS, Tan BH
    Ann Acad Med Singap, 2002 Jul;31(4):479-86.
    PMID: 12161884
    INTRODUCTION AND METHODS: Cardiovascular diseases have progressively increased in importance as a major contributor of morbidity and mortality in Asia. However, many countries in Asia do not have nationwide systematically-collected and standardised data on myocardial infarction (MI). To accurately document the extent of atherosclerotic coronary heart disease in Singapore, a nationwide myocardial infarct registry was established in the mid-1986. Possible myocardial infarct events were identified through daily national lists of cardiac enzymes, hospital discharge codes, mortuary records and the national death registry. Data obtained from clinical history, cardiac enzymes and 12-lead electrocardiogram Minnesota codes were entered into an algorithm based on the WHO MONICA study. Cases identified as "definite" MI were included in the decade's review for this study.

    RESULTS: From 1988 to 1997, 13,048 myocardial infarct events were diagnosed with 3367 deaths. There was a 39.1% decline in mortality, with an average decline of 6.5% per year [95% confidence intervals (CI), -3.9% to -9.1%]. However, the decline in incidence was only 20.8% with an average decline of 2.4% per year (95% CI, -6.6% to -1.2%). The highest incidence and mortality rates for both genders were seen in the Indians, followed by the Malays and the Chinese.

    CONCLUSION: Over 10 years, from 1988 to 1997, we documented a significant fall in mortality from MI in Singapore. There was a smaller decline in the incidence of infarction. Singapore implemented a National Healthy Lifestyle Programme in 1992 as a 10-year effort. The disparity in the incidence and mortality may suggest that a more dramatic and immediate impact has taken place in mortality through therapeutic programmes; primary preventive programmes would be more difficult to evaluate and have a more gradual impact. Only with continual accurate data collection through the whole country, over a much longer period, can the relative value of preventive and therapeutic programmes in coronary heart disease be assessed.

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