Displaying publications 21 - 40 of 43 in total

Abstract:
Sort:
  1. Tan CK, Said S, Rajandram R, Wang Z, Roslani AC, Chin KF
    World J Surg, 2016 08;40(8):1985-92.
    PMID: 27098538 DOI: 10.1007/s00268-016-3499-9
    INTRODUCTION: Disruption of normal gut function is a common side effect post abdominal surgery. It may result in reduced tolerance to oral nutrition and progress to postoperative ileus. Microbial cell preparation is beneficial as a pre-surgical nutritional supplement to aid in bowel recovery and promote the return of normal gut function following abdominal surgery. The aim of this study was to evaluate the efficacy of pre-surgical administration of microbial cell preparation in promoting the return of normal gut function.

    METHOD: The study is a randomized, double-blind, placebo-controlled trial. In total, 40 patients were recruited. Patients were randomized to receive either microbial cell preparation (n = 20) or placebo (n = 20) for 7 days prior to elective surgery. The primary end point was the time to return of normal gut function, while the secondary end point was the duration of hospital stay.

    RESULTS: The treatment group demonstrated significantly faster return of normal gut function with a median of 108.5 h (80-250 h) which was 48 h earlier than the placebo group at a median of 156.5 h (94-220 h), p = 0.022. The duration of hospital stay in the treatment group was also shorter at a median of 6.5 days (4-30 days), in comparison to the placebo group at 13 days (5-25 days), p = 0.012.

    CONCLUSION: Pre-surgical administration of microbial cell preparation promotes the return of normal gut function in patients after colorectal cancer surgery, thus associated with faster recovery and shorter duration of hospital stay.

  2. Fatin AM, Mathana Sundram TK, Tan SSE, Seghayat MS, Lee CK, Rehman N, et al.
    Skin Res Technol, 2020 Jul;26(4):564-570.
    PMID: 31916334 DOI: 10.1111/srt.12831
    INTRODUCTION: Periorbital hyperpigmentation (POH) is among the commonest esthetic and dermatological complaints. Despite its frequency, there are inadequate information detailing its incidence and prevalence. This subsequently leads to lack of comprehensive POH classification and stratification of impact on an individual's general well'being. Malaysia, a multiracial country with an expansive expatriate population, provides a unique opportunity to identify demographics of POH and subsequently attempts to group this esthetic and dermatological entity.

    OBJECTIVE: This study aims to develop a new and clinically relevant POH classification system and to measure impact on quality of life of POH individuals.

    METHODS: One hundred patients with POH were enrolled, of which all underwent clinical assessment by a clinician. Objective assessment with mexameter and digital analysis were performed. All recruited patients also completed a questionnaire based on dermatology life quality index (DLQI).

    RESULTS: Assessments noted the commonest type of POH among the subjects was vascular (51%) with the least being pigmentary (6%). The location of POH majority involved both the upper and lower eyelids (65%). DLQI scoring shows that a majority (58%) did not disrupt their quality of life.

    CONCLUSION: Vascular type POH was the frequent most form observed, and involvement tends to occur on both eyelids. A majority of noted that POH does not affect they QOL, but the due consideration must be given in those whom are moderately and minimally affected. A thorough and comprehensive holistic approach is required in managing POH despite its focal presentation as it does affect a patient's quality of life.

  3. Liew SQ, Teoh WH, Tan CK, Yusoff R, Ngoh GC
    Int J Biol Macromol, 2018 Sep;116:128-135.
    PMID: 29738869 DOI: 10.1016/j.ijbiomac.2018.05.013
    Low methoxyl (LM) pectin was extracted from pomelo peels using subcritical water in a dynamic mode. The effects of pressure and temperature were analyzed through a face-centred central composite design. Extraction yield and the rate of extraction were found to be predominantly influenced by temperature. Optimization of the subcritical water extraction (SWE) yielded an optimized operating condition of 120°C and 30bar with a predicted pectin yield of 18.8%. The corresponding experimental yield was 19.6%, which is in close agreement with the predicted data. The pectin obtained from the optimized condition was further analyzed for its physicochemical properties. The kinetics of the SWE was also evaluated whereby the one-site kinetic desorption model was found to be in good agreement with experimental data (R2>0.94).
  4. Tan CK, Beh SP, Lee RY, Pei Jye V, Damoderam S, Mohd Naseri NI, et al.
    Ann Oncol, 2018 Nov;29 Suppl 9:ix98.
    PMID: 32178214 DOI: 10.1093/annonc/mdy438.016
  5. Naidu K, Ali MS, Abu Bakar AH, Tan CK, Arof H, Mokhlis H
    PLoS One, 2020;15(1):e0227494.
    PMID: 31999711 DOI: 10.1371/journal.pone.0227494
    This paper proposes an approach to accurately estimate the impedance value of a high impedance fault (HIF) and the distance from its fault location for a distribution system. Based on the three-phase voltage and current waveforms which are monitored through a single measurement in the network, several features are extracted using discrete wavelet transform (DWT). The extracted features are then fed into the optimized artificial neural network (ANN) to estimate the HIF impedance and its distance. The particle swarm optimization (PSO) technique is employed to optimize the parameters of the ANN to enhance the performance of fault impedance and distance estimations. Based on the simulation results, the proposed method records encouraging results compared to other methods of similar complexity for both HIF impedance values and estimated distances.
  6. Tan CK, Lim KM, Chang RKY, Lee CP, Alqahtani A
    Sensors (Basel), 2023 Jun 14;23(12).
    PMID: 37420722 DOI: 10.3390/s23125555
    Hand gesture recognition (HGR) is a crucial area of research that enhances communication by overcoming language barriers and facilitating human-computer interaction. Although previous works in HGR have employed deep neural networks, they fail to encode the orientation and position of the hand in the image. To address this issue, this paper proposes HGR-ViT, a Vision Transformer (ViT) model with an attention mechanism for hand gesture recognition. Given a hand gesture image, it is first split into fixed size patches. Positional embedding is added to these embeddings to form learnable vectors that capture the positional information of the hand patches. The resulting sequence of vectors are then served as the input to a standard Transformer encoder to obtain the hand gesture representation. A multilayer perceptron head is added to the output of the encoder to classify the hand gesture to the correct class. The proposed HGR-ViT obtains an accuracy of 99.98%, 99.36% and 99.85% for the American Sign Language (ASL) dataset, ASL with Digits dataset, and National University of Singapore (NUS) hand gesture dataset, respectively.
  7. Al-Battawi S, Latif MT, How V, Thilakavathy K, Hamid HHA, Tan CK, et al.
    PLoS One, 2024;19(12):e0315439.
    PMID: 39666673 DOI: 10.1371/journal.pone.0315439
    Motor vehicles emit most Malaysian PAHs in particulate matter of 2.5 μm (PM2.5-bound PAHs). Although traffic-related air pollution harms healthy people, there is a knowledge gap regarding PAHs' effects on Malaysians. This study examines PM2.5-bound PAH concentrations, distribution, sources, and health risks in Malaysia's high and low-traffic zones. Kuala Lumpur (KL) and Hulu Langat (HL) exhibit Malaysia's high- and low-traffic areas. The high-volume air sampler collected 40 ambient PM2.5 samples at both locations. Solid-phase extraction and gas chromatography-mass spectrometry (GC-MS) assessed PAHs. The mean PM2.5-bound PAH concentrations in KL (5.85 ng m-3) were significantly higher than in HL (0.55 ng m-3) (p<0.001). KL has nine times more low-molecular-weight PAHs (LMW-PAHs) (2.63 vs. 0.27 ng m-3) and eleven times more high-molecular-weight PAHs (HMW-PAHs) (3.22 vs. 0.28 ng m-3) than HL. Over 51% of PM2.5 air samples at both sites included HMW-PAHs. Source apportionment tools (Diagnostic ratio, positive matrix factorization, and principal component analysis) showed that fossil fuel combustions (petrol and diesel) produced the greatest PAHs in both locations. Moreover, PAH exposure impinged higher carcinogenic health risks in KL than in HL. In conclusion, traffic and automobile pollution account for the short- and long-term health risks posed by PAHs in both regions.
  8. Zaman R, Tan ESS, Bustami NA, Amini F, Seghayat MS, Ho YB, et al.
    Sci Rep, 2025 Jan 28;15(1):3507.
    PMID: 39875543 DOI: 10.1038/s41598-025-87680-7
    Opuntia ficus-indica (OFi) is a major fruit source prevalent in semiarid and arid regions across various countries worldwide. It is widely recognised for its potential health benefits; however, most studies investigating its effects have been limited to pre-clinical models, highlighting the need for further validation through clinical trials. This study aimed to evaluate the effectiveness of OFi supplementation in enhancing antioxidant levels. Fifty healthy participants, aged 18 years and older, including males and females, received a daily OFi supplement of 1500 mg for 3 months. These findings revealed a significant 48.1% increase in salivary total antioxidant capacity (TAC) (P 
  9. Suppiah TSS, Sundram TKM, Tan ESS, Lee CK, Bustami NA, Tan CK
    Asia Pac J Clin Nutr, 2018 10 3;27(5):1141-1145.
    PMID: 30272862 DOI: 10.6133/apjcn.072018.01
    BACKGROUND AND OBJECTIVES: Acne vulgaris is a common skin condition among adolescents and young adults. Its relationship with the dietary intake is highly debatable and equivocal. This study aimed to identify the association between acne vulgaris and dietary intake among Malaysians.

    METHODS AND STUDY DESIGN: A case-control study was conducted involving 57 acne vulgaris patients and 57 age-, gender- and ethnicity-matched controls. All participants were aged 14 and above. The Comprehensive Acne Severity Scale (CASS) was used to categorise patients (grades 2 to 5) and controls (grades 0 to 1). Information such as the demographics, family history, smoking habits and dietary intake were collected using a self-administered questionnaire.

    RESULTS: In the patient arm, the gender ratio of male to female was 1.5:1. 43 patients (75.4%) had a family history of acne vulgaris. No significant association was found for acne in patients with a history of smoking. Milk consumption was significantly higher in patients (63.2%, n=36) versus controls (43.9%, n=25), (OR=2.19, p<0.05). In addition, chocolate consumption was also significantly higher in patients (43.9%, n=25) versus controls (24.6%, n=14), (OR=2.4, p<0.05). No significant association was found with the intakes of sweets, potatoes, chips, nuts, yoghurt, ice-cream or carbonated drinks.

    CONCLUSIONS: Dietary intake of milk and chocolate may play a role in acne vulgaris. Prospective cohort and intervention studies are recommended to explore whether a causal relationship might obtain.

  10. Goh KM, Tan ESS, Lim CSY, Tan PY, Biswas S, Lew LA, et al.
    Nutrients, 2024 Dec 18;16(24).
    PMID: 39770987 DOI: 10.3390/nu16244366
    BACKGROUND/OBJECTIVES: Dry eye disease (DED) significantly impairs quality of life, affecting physical, social, and psychological well-being, as well as reducing workplace productivity. While lutein and zeaxanthin supplements have been shown to improve ocular health, existing research often overlooks the efficacy of lower dosages and shorter durations of supplementation. This study investigated the effects of combined supplementation with lutein, zeaxanthin, and elderberries in 110 voluntary participants through a randomized controlled trial.

    METHODS: Participants took 6 mg of lutein and 1 mg of zeaxanthin, along with 100 mg elderberry extract once daily for a duration of 20 days. Ocular health was assessed using the Ocular Surface Disease Index (OSDI), while immune status was evaluated with the Immune Status Questionnaire (ISQ).

    RESULTS: Results showed that combined supplementation significantly (p < 0.05) reduced the OSDI scores in the intervention group from 38.15 ± 11.14 to 18.26 ± 5.57, reflecting a 52.2% reduction. A similar trend was observed with the Visual Analog Scale (VAS), indicating significant (p < 0.05) improvement from 5.31 ± 1.62 to 6.73 ± 1.74, equivalent to a 26.7% improvement. Although the intervention group showed a 15.9% improvement in ISQ scores by the study's end, this was not significantly different from the placebo group, suggesting that higher dosages or longer durations may be needed to observe a meaningful effect. Additionally, findings from the Food Frequency Questionnaire revealed that the average dietary intake of lutein and zeaxanthin among participants was only 663.49 µg, equating to just 5.5% of the suggested optimal daily intake. This low consumption is concerning, as it is inversely correlated with the risk of ocular diseases.

    CONCLUSIONS: Collectively, these findings support the use of combined supplementation as an adjuvant approach to improving ocular health.

  11. Boey JY, Kong U, Lee CK, Lim GK, Oo CW, Tan CK, et al.
    Int J Biol Macromol, 2024 May;266(Pt 2):131079.
    PMID: 38537860 DOI: 10.1016/j.ijbiomac.2024.131079
    This study investigates the effects of SCG embedded into biodegradable polymer blends and aimed to formulate and characterise biomass-reinforced biocomposites using spent coffee ground (SCG) as reinforcement in PHB/PLA polymer blend. The effect of SCG filler loading and varying PHB/PLA ratios on the tensile properties and morphological characteristics of the biocomposites were examined. The results indicated that tensile properties reduction could be due to its incompatibility with the PHB/PLA matrixSCG aggregation at 40 wt% content resulted in higher void formation compared to lower content at 10 wt%. A PHB/PLA ratio of 50/50 with SCG loading 20 wt% was chosen for biocomposites with treated SCG. Biological treatment of SCG using Phanerochaete chrysosporium CK01 and Aspergillus niger DWA8 indicated P. chrysosporium CK01 necessitated a higher moisture content for optimum growth and enzyme production, whereas the optimal conditions for enzyme production (50-55 %, w/w) differed from those promoting A. niger DWA8 growth (40 %, w/w). SEM micrographs highlighted uniform distribution and effective wetting of treated SCG, resulting in improvements of tensile strength and modulus of biocomposites, respectively. The study demonstrated the effectiveness of sustainable fungal treatment in enhancing the interfacial adhesion between treated SCG and the PHB/PLA matrix.
  12. Hisham MB, Hashim AM, Mohd Hanafi N, Abdul Rahman N, Abdul Mutalib NE, Tan CK, et al.
    Sci Rep, 2022 May 02;12(1):7107.
    PMID: 35501317 DOI: 10.1038/s41598-022-08819-4
    Silage produced in tropical countries is prone to spoilage because of high humidity and temperature. Therefore, determining indigenous bacteria as potential inoculants is important to improve silage quality. This study aimed to determine bacterial community and functional changes associated with ensiling using amplicon metagenomics and to predict potential bacterial additives associated with silage quality in the Malaysian climate. Silages of two forage crops (sweet corn and Napier) were prepared, and their fermentation properties and functional bacterial communities were analysed. After ensiling, both silages were predominated by lactic acid bacteria (LAB), and they exhibited good silage quality with significant increment in lactic acid, reductions in pH and water-soluble carbohydrates, low level of acetic acid and the absence of propionic and butyric acid. LAB consortia consisting of homolactic and heterolactic species were proposed to be the potential bacterial additives for sweet corn and Napier silage fermentation. Tax4fun functional prediction revealed metabolic pathways related to fermentation activities (bacterial division, carbohydrate transport and catabolism, and secondary metabolite production) were enriched in ensiled crops (p 
  13. Choo SJ, Chang CT, Lee JCY, Munisamy V, Tan CK, Raj JD, et al.
    J Infect Dev Ctries, 2018 11 30;12(11):960-969.
    PMID: 32012125 DOI: 10.3855/jidc.10723
    INTRODUCTION: Inappropriate use of antibiotics has led to antimicrobial resistance, a major public health challenge worldwide. This study aimed to explore beliefs, knowledge, and practice on antibiotic use among general public.

    METHODOLOGY: Cross-sectional study was conducted at 13 hospitals and 44 primary health clinics in Perak from May to July 2017. Adults above 18 years, literate, and had experience in antibiotics consumption were selected through sequential sampling method. Data was collected using a self-administered questionnaire which included the three study domains i.e. belief, knowledge and practice. The questionnaire was pilot on 30 subjects.

    RESULTS: Out of 2850 distributed questionnaires, 2773 returned and 2632 were included for analysis. Mean age of the respondents was 39.7 ± 14.5 years old. Most respondents were female (58.6%), Malay (74.7%) and underwent upper secondary school (45.6%). Mean score were generated for each domain with belief: 5.87 ± 3.00 (total score: 12), knowledge: 15.82 ± 3.85 (total score: 24), practice: 6.91 ± 2.07 (total score: 12). In the belief domain, 63.2% of respondents believed that antibiotics would help them to recover faster. In the knowledge domain, 52.7% of respondents inappropriately thought that antibiotics could work on viral infections. In the practice domain, 70% of respondents expected doctors to prescribe antibiotics if suffered from symptoms.

    CONCLUSION: Majority of the respondents expect doctors to prescribe antibiotics for their illness, and most believes that antibiotics can speed up recovery of illness. Lack of awareness on antibiotic resistance was found to be a significant factor associated with inappropriate antibiotic use.

  14. Tan ESS, Chin SAFX, Sathapan MSP, Dewi AD, Amini F, Bustami NA, et al.
    PMID: 36901057 DOI: 10.3390/ijerph20054046
    The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.
  15. Mohamed R, Wang W, Tanwandee T, Hasan I, Pham CP, Lim YS, et al.
    J Gastrointest Cancer, 2024 Sep;55(3):1333-1344.
    PMID: 38995318 DOI: 10.1007/s12029-024-01089-5
    PURPOSE: In several Asian countries, hepatocellular carcinoma (HCC) is a leading cause of cancer deaths. HCC risk factors in Asia differ from those elsewhere and are changing with the treatment landscape as systemic treatment options increase. This study was conducted to gain insight from physicians and patients into HCC screening, diagnosis, and treatment strategies in Indonesia, Korea, Malaysia, Singapore, Taiwan, Thailand, and Vietnam.

    METHODS: Two cross-sectional, anonymized, online surveys were completed between July and December 2022 by physicians diagnosing and treating HCC (55 questions on risk factors, surveillance, diagnosis, and treatment) and patients ≥ 18 years old diagnosed with HCC (36 questions on disease knowledge, quality of life, and experiences of diagnosis and treatment).

    RESULTS: Responses were received from 276 physicians in all 7 countries and 130 patients in Thailand, Taiwan, and Vietnam. From the physician's perspective, surveillance programs are widespread but identify insufficient HCC cases; only 18% are early-stage HCC at diagnosis. From the patient's perspective, knowledge of risk factors increases after diagnosis, but few seek support from patient associations; patients would benefit from better communication from their doctors. Treatment affordability and side effects are key issues for patients.

    CONCLUSIONS: Awareness of the risk factors for HCC should be raised in primary care and the general population, and surveillance should identify early-stage HCC. Because patients rely on their doctors for support, doctors should better understand their patients' needs, and patients could be supported by trained nurses or case managers. Programs are needed to increase patients' access to proven HCC treatments.

  16. Cheong SC, Selvam B, Ho GF, Muhamad Nor I, Tan CK, Wong YF, et al.
    BMJ Open, 2024 Dec 03;14(12):e076898.
    PMID: 39627139 DOI: 10.1136/bmjopen-2023-076898
    INTRODUCTION: Treatment combination of pembrolizumab plus platinum and 5-fluorouracil (PF) has increased the survival of recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). The combination of platinum and gemcitabine (PG) has been shown to be superior to PF in the treatment of R/M nasopharyngeal carcinoma patients. Therefore, we hypothesise that the combination of pembrolizumab with PG would be comparable to pembrolizumab with PF as a first-line treatment in R/M HNSCC.

    METHODS AND ANALYSIS: This is an open-label, multicentre, single-arm, phase 2 study of pembrolizumab plus PG for first-line treatment in subjects with R/M HNSCC in Malaysia. The study is conducted using the Optional Simon optimal 2-stage design. At the initial stage, 26 subjects will be enrolled and if seven or more patients achieve an objective response rate (ORR), then 63 patients will be enrolled. Subjects will be given pembrolizumab 200 mg3 every 3 weeks up to 35 cycles in combination with chemotherapy for up to six cycles of platinum (either cisplatin at 35 mg/m2 intravenous on day 1 and day 8 or carboplatin at area under the curve 5 intravenous on day 1 of each 3-week cycle) and gemcitabine at 1250 mg/m2 intravenous on days 1 and 8 of a 3-week cycle. The primary end point is the ORR as per Response Evaluation Criteria in Solid Tumors 1.1. Secondary end points include the overall survival, progression free survival, response duration and safety. The exploratory objectives include relationships of microbiome profiles, prognostic and predictive biomarkers with the clinical responses.

    ETHICS AND DISSEMINATION: The study was approved by the ethics committee of the University Malaya Medical Centre (202213-10884). Findings will be disseminated through conference presentations and peer review publications.

    TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (www.

    CLINICALTRIAL: gov); NCT05286619.

  17. Figueras MM, Okada N, Tan CK, Aquino MC, Tan MCJ, Lun KW, et al.
    J Glaucoma, 2025 Mar 13.
    PMID: 40071977 DOI: 10.1097/IJG.0000000000002564
    PRCIS: In this retrospective cohort study, the 1-year cumulative probability of failure was comparable, achieving 52.20% in the phacoemulsification-iStent inject W (phaco/iStent) group and 47.80% in the phacoemulsification-micropulse transscleral laser therapy (phaco/MPTLT) group (P=0.994).

    PURPOSE: To compare the 1-year efficacy and safety of phacoemulsification combined with iStent Inject W (phaco/iStent) and phacoemulsification combined with micropulse transscleral laser therapy (phaco/MPTLT).

    METHODS: Retrospective cohort study that included patients with mild-moderate open angle glaucoma (OAG) and cataract who underwent either phaco/iStent or phaco/MPTLT in a tertiary hospital in Singapore between August 1, 2016 and December 31, 2022. The primary outcome measures were cumulative probabilities of failure between the two groups with failure defined as disease progression by Ocular Coherence Tomography (OCT-RNFL) or Visual Field Test (VFT), repeat glaucoma surgery, and inability to maintain intraocular pressure (IOP) lower than pre-operative baseline or the use of glaucoma medications for 2 consecutive visits after 1 month post-operatively. Additionally, post-operative mean IOP, average number of IOP lowering medications, visual acuity, and complications were analyzed.

    RESULTS: Forty-six patients were included. 23 eyes underwent phaco/iStent and 23 had phaco/MPTLT. The two groups had comparable cumulative probabilities of failure (52.20% phaco/iStent, 47.80% phaco/MPTLT; P=0.994) and mean IOP (15.57+2.95 mmHg phaco /iStent, 14.39+2.25 mmHg phaco/MPTLT; P=0.136) after 1 year. The change in IOP before surgery to 12 months is -1.04+3.07 mmHg in the phaco/iStent group (P=0.593) and -2.43+4.12 mmHg in the phaco/MPTLT group (P=0.022). Both achieved significant medication reduction burden (P<0.05). Intra-operative and post-operative complication rates were similar.

    CONCLUSION: Both groups showed comparable surgical efficacy and safety after 1 year. The phaco/MPTLT group demonstrated sustained IOP reduction 1 year post-operatively.

  18. Lee MH, Ahn SH, Chan HLY, Choudhry A, Alvani Gani R, Mohamed R, et al.
    J Viral Hepat, 2022 02;29(2):156-170.
    PMID: 34817896 DOI: 10.1111/jvh.13636
    There are limited data to provide better understanding of the knowledge/awareness of general population towards liver health in Asia. We sought to identify the knowledge gaps and attitudes towards liver health and liver diseases as well as evaluate associated individual-level and macro-level factors based on contextual analysis. An online survey assessing knowledge, awareness and attitudes towards liver health and disease was conducted among 7500 respondents across 11 countries/territories in Asia. A liver index was created to measure the respondents' knowledge level and the degree of awareness and attitudes. Multilevel logistic regression was performed to identify individual factors and contextual effects that were associated with liver index. The overall liver index (0-100-point scale) was 62.4 with 6 countries/territories' liver indices greater than this. In the multilevel model, the inclusion of geographical information could explain for 9.6% of the variation. Residing in a country/territory with higher HBV prevalence (80% IOR: 1.20-2.79) or higher HCV death rate (80% IOR: 1.35-3.13) increased the individual probability of obtaining a high overall liver index. Individual factors like age, gender, education, household income, disease history and health screening behaviour were also associated with liver index (all p-values<0.001). The overall liver index was positively associated with the two macro-level factors viz. HBV prevalence and HCV death rate. There is a need to formulate policies especially in regions of lower HBV prevalence and HCV death rate to further improve the knowledge, awareness and attitudes of the general public towards liver diseases.
  19. Kim DY, Toan BN, Tan CK, Hasan I, Setiawan L, Yu ML, et al.
    Clin Mol Hepatol, 2023 Apr;29(2):277-292.
    PMID: 36710606 DOI: 10.3350/cmh.2022.0212
    Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.
  20. Yoshino T, Cervantes A, Bando H, Martinelli E, Oki E, Xu RH, et al.
    ESMO Open, 2023 Jun;8(3):101558.
    PMID: 37236086 DOI: 10.1016/j.esmoop.2023.101558
    The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer (mCRC), published in late 2022, were adapted in December 2022, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with mCRC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with mCRC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian countries. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with mCRC across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation, coupled with a disparity in the drug approvals and reimbursement strategies, between the different countries.
Related Terms
Filters
Contact Us

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

External Links