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  1. Faust O, Acharya UR, Sudarshan VK, Tan RS, Yeong CH, Molinari F, et al.
    Phys Med, 2017 Jan;33:1-15.
    PMID: 28010920 DOI: 10.1016/j.ejmp.2016.12.005
    The diagnosis of Coronary Artery Disease (CAD), Myocardial Infarction (MI) and carotid atherosclerosis is of paramount importance, as these cardiovascular diseases may cause medical complications and large number of death. Ultrasound (US) is a widely used imaging modality, as it captures moving images and image features correlate well with results obtained from other imaging methods. Furthermore, US does not use ionizing radiation and it is economical when compared to other imaging modalities. However, reading US images takes time and the relationship between image and tissue composition is complex. Therefore, the diagnostic accuracy depends on both time taken to read the images and experience of the screening practitioner. Computer support tools can reduce the inter-operator variability with lower subject specific expertise, when appropriate processing methods are used. In the current review, we analysed automatic detection methods for the diagnosis of CAD, MI and carotid atherosclerosis based on thoracic and Intravascular Ultrasound (IVUS). We found that IVUS is more often used than thoracic US for CAD. But for MI and carotid atherosclerosis IVUS is still in the experimental stage. Furthermore, thoracic US is more often used than IVUS for computer aided diagnosis systems.
  2. Fu JY, Htar TT, De Silva L, Tan DM, Chuah LH
    Molecules, 2017 Feb 04;22(2).
    PMID: 28165404 DOI: 10.3390/molecules22020233
    Vitamin E is recognized as an essential vitamin since its discovery in 1922. Most vegetable oils contain a mixture of tocopherols and tocotrienols in the vitamin E composition. Structurally, tocopherols and tocotrienols share a similar chromanol ring and a side chain at the C-2 position. Owing to the three chiral centers in tocopherols, they can appear as eight different stereoisomers. Plant sources of tocopherol are naturally occurring in the form of RRR while synthetic tocopherols are usually in the form of all-racemic mixture. Similarly, with only one chiral center, natural tocotrienols occur as the R-isoform. In this review, we aim to discuss a few chromatographic methods that had been used to separate the stereoisomers of tocopherols and tocotrienols. These methods include high performance liquid chromatography, gas chromatography and combination of both. The review will focus on method development including selection of chiral columns, detection method and choice of elution solvent in the context of separation efficiency, resolution and chiral purity. The applications for separation of enantiomers in vitamin E will also be discussed especially in terms of the distinctive biological potency among the stereoisoforms.
  3. Lim KS, Ng CC, Chan CK, Foo WS, Low JS, Tan CT
    Seizure, 2017 Feb;45:24-27.
    PMID: 27912112 DOI: 10.1016/j.seizure.2016.11.011
    PURPOSE: Ethnic variation in epilepsy classification was reported in the Epilepsy Phenome/Genome Project. This study aimed to determine the ethnic variation in the prevalence of genetic (idiopathic) generalized epilepsy (GGE) and GGE with family history in a multi-ethnic Asian population in Malaysia.

    METHOD: In this cross-sectional study, 392 patients with a clinical diagnosis of GGE were recruited in the neurology outpatient clinic, University of Malaya Medical Centre (UMMC), from January 2011 till April 2016.

    RESULTS: In our epilepsy cohort (n=2100), 18.7% were diagnosed to have GGE. Of those, 28.6% >(N=112) had family history of epilepsy with a mean age of seizure onset of 16.5 years old, and 42.0% had myoclonic seizures (N=47). The lifetime prevalence of epilepsy among first-degree relative of those with GGE and positive family history was 15.0%. Analysis according to ethnicity showed that Malaysian Chinese had the lowest percentage of GGE among those with epilepsy (12.3%), as compared with Indian and Malay (25.3% and 21.3%, p<0.001). In addition, 32.1% of these Indian patients with GGE had positive family history, which is more than the Malay (26.4%) and Chinese (27.5%) ethnic groups. Consanguineous marriage was noted in 5 Indian families with positive family history (9.6%).

    CONCLUSION: There was ethnic variation in the prevalence of GGE, whereby the Malaysian Chinese had the lowest percentage of GGE as compared with Indian and Malay. A substantial proportion of GGE had positive family history among the three ethnics groups.

    Study site: neurology outpatient clinic, University of Malaya Medical Centre (UMMC)
  4. Lay KK, Cheong BM, Tong WL, Tan MK, Hung YM
    Nanotechnology, 2017 Apr 21;28(16):164003.
    PMID: 28244882 DOI: 10.1088/1361-6528/aa6385
    A graphene nanoplatelet (GNP) coating is utilized as a functionalized surface in enhancing the evaporation rate of micro-spray cooling for light-emitting diodes (LEDs). In micro-spray cooling, water is atomized into micro-sized droplets to reduce the surface energy and to increase the surface area for evaporation. The GNP coating facilitates the effective filmwise evaporation through the attribute of fast water permeation. The oxygenated functional groups of GNPs provide the driving force that initiates the intercalation of water molecules through the carbon nanostructure. The water molecules slip through the frictionless passages between the hydrophobic carbon walls, resulting an effective filmwise evaporation. The enhancement of evaporation leads to an enormous temperature reduction of 61.3 °C. The performance of the LED is greatly enhanced: a maximum increase in illuminance of 25% and an extension of power rating from 9 W to 12 W can be achieved. With the application of GNP coating, the high-temperature region is eliminated while maintaining the LED surface temperature for optimal operation. This study paves the way for employing the effective hybrid spray-evaporation-nanostructure technique in the development of a compact, low-power-consumption cooling system.
  5. Kaliya-Perumal AK, Yeh YC, Luo CA, Joey-Tan KY
    Clin Orthop Surg, 2017 Mar;9(1):71-76.
    PMID: 28261430 DOI: 10.4055/cios.2017.9.1.71
    BACKGROUND: The technique used to administer a selective nerve root block (SNRB) varies depending on individual expertise. Both the anteroposterior (AP) subpedicular approach and oblique Scotty dog subpedicular approach are widely practiced. However, the literature does not provide a clear consensus regarding which approach is more suitable. Hence, we decided to analyse the procedural parameters and clinical outcomes following SNRBs using these two approaches.

    METHODS: Patients diagnosed with a single lumbar herniated intervertebral disc (HIVD) refractory to conservative management but not willing for immediate surgery were selected for a prospective nonrandomized comparative study. An SNRB was administered as a therapeutic alternative using the AP subpedicular approach in one group (n = 25; mean age, 45 ± 5.4 years) and the oblique Scotty dog subpedicular approach in the other group (n = 22; mean age, 43.8 ± 4.7 years). Results were compared in terms of the duration of the procedure, the number of C-arm exposures, accuracy, pain relief, functional outcome and the duration of relief.

    RESULTS: Our results suggest that the oblique Scotty dog subpedicular approach took a significantly longer duration (p = 0.02) and a greater number of C-arm exposures (p = 0.001). But, its accuracy of needle placement was 95.5% compared to only 72% using the AP subpedicular approach (p = 0.03). There was no significant difference in terms of clinical outcomes between these approaches.

    CONCLUSIONS: The AP subpedicular approach was simple and facile, but the oblique Scotty dog subpedicular approach was more accurate. However, a brief window period of pain relief was achieved irrespective of the approaching technique used.

  6. Tee PF, Abdullah MO, Tan IAW, Amin MAM, Nolasco-Hipolito C, Bujang K
    Environ Technol, 2018 Apr;39(8):1081-1088.
    PMID: 28417676 DOI: 10.1080/09593330.2017.1320433
    A microbial fuel cell (MFC) integrated with adsorption system (MFC-AHS) is tested under various operating temperatures with palm oil mill effluent as the substrate. The optimum operating temperature for such system is found to be at ∼35°C with current, power density, internal resistance (Rin), Coulombic efficiency (CE) and maximum chemical oxygen demand (COD) removal of 2.51 ± 0.2 mA, 74 ± 6 mW m-3, 25.4 Ω, 10.65 ± 0.5% and 93.57 ± 1.2%, respectively. Maximum current density increases linearly with temperature at a rate of 0.1772 mA m-2 °C-1, whereas maximum power density was in a polynomial function. The temperature coefficient (Q10) is found to be 1.20 between 15°C and 35°C. Present studies have demonstrated better CE performance when compared to other MFC-AHSs. Generally, MFC-AHS has demonstrated higher COD removals when compared to standalone MFC regardless of operating temperatures.

    ABBREVIATIONS: ACFF: activated carbon fiber felt; APHA: American Public Health Association; CE: Coulombic efficiency; COD: chemical oxygen demand; ECG: electrocardiogram; GAC: granular activated carbon; GFB: graphite fiber brush; MFC: microbial fuel cell; MFC-AHS: microbial fuel cell integrated with adsorption hybrid system; MFC-GG: microbial fuel cell integrated with graphite granules; POME: palm oil mill effluent; PTFE: polytetrafluoroethylene; SEM: scanning electron microscope.

  7. Khoo TB, Tan JW, Ng HP, Choo CM, Bt Abdul Shukor INC, Teh SH
    Int J Clin Pharm, 2017 Jun;39(3):551-559.
    PMID: 28417303 DOI: 10.1007/s11096-017-0463-1
    Background There is a lack of large comprehensive studies in developing countries on paediatric in-patient prescribing errors in different settings. Objectives To determine the characteristics of in-patient prescribing errors among paediatric patients. Setting General paediatric wards, neonatal intensive care units and paediatric intensive care units in government hospitals in Malaysia. Methods This is a cross-sectional multicentre study involving 17 participating hospitals. Drug charts were reviewed in each ward to identify the prescribing errors. All prescribing errors identified were further assessed for their potential clinical consequences, likely causes and contributing factors. Main outcome measures Incidence, types, potential clinical consequences, causes and contributing factors of the prescribing errors. Results The overall prescribing error rate was 9.2% out of 17,889 prescribed medications. There was no significant difference in the prescribing error rates between different types of hospitals or wards. The use of electronic prescribing had a higher prescribing error rate than manual prescribing (16.9 vs 8.2%, p 
  8. Arulselvan P, Tan WS, Gothai S, Muniandy K, Fakurazi S, Esa NM, et al.
    Molecules, 2016 Oct 31;21(11).
    PMID: 27809259
    In the present investigation, we prepared four different solvent fractions (chloroform, hexane, butanol, and ethyl acetate) of Moringa oleifera extract to evaluate its anti-inflammatory potential and cellular mechanism of action in lipopolysaccharide (LPS)-induced RAW264.7 cells. Cell cytotoxicity assay suggested that the solvent fractions were not cytotoxic to macrophages at concentrations up to 200 µg/mL. The ethyl acetate fraction suppressed LPS-induced production of nitric oxide and proinflammatory cytokines in macrophages in a concentration-dependent manner and was more effective than the other fractions. Immunoblot observations revealed that the ethyl acetate fraction effectively inhibited the expression of inflammatory mediators including cyclooxygenase-2, inducible nitric oxide synthase, and nuclear factor (NF)-κB p65 through suppression of the NF-κB signaling pathway. Furthermore, it upregulated the expression of the inhibitor of κB (IκBα) and blocked the nuclear translocation of NF-κB. These findings indicated that the ethyl acetate fraction of M. oleifera exhibited potent anti-inflammatory activity in LPS-stimulated macrophages via suppression of the NF-κB signaling pathway.
  9. Tan GH, Shah SA, Ali NM, Goh EH, Singam P, Ho CCK, et al.
    Investig Clin Urol, 2017 05;58(3):186-191.
    PMID: 28480344 DOI: 10.4111/icu.2017.58.3.186
    PURPOSE: This study aimed to determine the urethral stricture (US) rate and identify clinical and surgical risk factors associated with US occurrence after transurethral resection of the prostate using the bipolar Gyrus PlasmaKinetic Tissue Management System (PK-TURP).

    MATERIALS AND METHODS: This was an age-matched case-control study of US occurrence after PK-TURP. Retrospective data were collected from the hospital records of patients who had a minimum of 36 months of follow-up information. Among the data collected for analysis were prostate-specific antigen level, estimated prostate weight, the amount of prostate resected, operative time, history of urinary tract infection, previous transurethral resection of the prostate, and whether the PK-TURP was combined with other endourological procedures. The resection rate was calculated from the collected data. Univariate and multivariate analyses were performed to identify clinical and surgical risk factors related to US formation.

    RESULTS: A total of 373 patients underwent PK-TURP between 2003 and 2009. There were 13 cases of US (3.5%), and most of them (10 of 13, 76.9%) presented within 24 months of surgery. Most of the US cases (11 of 13, 84.6%) occurred at the bulbar urethra. Multivariable logistic regression analyses identified slow resection rate as the only risk factor significantly associated with US occurrence.

    CONCLUSIONS: The US rate of 3.5% after PK-TURP in this study is comparable to contemporary series. A slow resection rate seems to be related to US occurrence. This should be confirmed by further studies; meanwhile, we must be mindful of this possibility when operating with the PK-TURP system.

  10. Tan CW, Sam IC, Chong WL, Lee VS, Chan YF
    Antiviral Res, 2017 07;143:186-194.
    PMID: 28457855 DOI: 10.1016/j.antiviral.2017.04.017
    Zika virus (ZIKV) is an arthropod-borne flavivirus that causes newborn microcephaly and Guillian-Barré syndrome in adults. No therapeutics are available to treat ZIKV infection or other flaviviruses. In this study, we explored the inhibitory effect of glycosaminoglycans and analogues against ZIKV infection. Highly sulfated heparin, dextran sulfate and suramin significantly inhibited ZIKV infection in Vero cells. De-sulfated heparin analogues lose inhibitory effect, implying that sulfonate groups are critical for viral inhibition. Suramin, an FDA-approved anti-parasitic drug, inhibits ZIKV infection with 3-5 log10 PFU viral reduction with IC50value of ∼2.5-5 μg/ml (1.93 μM-3.85 μM). A time-of-drug-addition study revealed that suramin remains potent even when administrated at 1-24 hpi. Suramin inhibits ZIKV infection by preventing viral adsorption, entry and replication. Molecular dynamics simulation revealed stronger interaction of suramin with ZIKV NS3 helicase than with the envelope protein. Suramin warrants further investigation as a potential antiviral candidate for ZIKV infection. Heparan sulfate (HS) is a cellular attachment receptor for multiple flaviviruses. However, no direct ZIKV-heparin interaction was observed in heparin-binding analysis, and downregulate or removal of cellular HS with sodium chlorate or heparinase I/III did not inhibit ZIKV infection. This indicates that cell surface HS is not utilized by ZIKV as an attachment receptor.
  11. Leong BDK, Govindarajanthran N, Hafizan TM, Tan KL, Hanif H, Zainal AA
    Med J Malaysia, 2017 04;72(2):91-93.
    PMID: 28473670 MyJurnal
    INTRODUCTION: There has been a paradigm shift in the treatment of AAA with the advent of endovascular aneurysm repair (EVAR). Rapid progress and evolution of endovascular technology has brought forth smaller profile devices and closure devices. Total percutaneous endovascular aneurysm repair (pEVAR) involves the usage of suture-mediated closure devices (SMCDs) at vascular access sites to avoid a traditional surgical cutdown.

    MATERIALS AND METHODS: We retrospectively reviewed our experience of pEVAR between April 2013 and July 2014. Primary success of the procedure was defined as closure of a common femoral artery (CFA) arteriotomy without the need for any secondary surgical or endovascular procedure within 30 days.

    RESULTS: In total there were 10 pEVAR cases performed in the study period, one case in Queen Elizabeth Hospital during visiting vascular service. Patients have a mean age of 73.4 year old (66-77 year old) The mean abdominal aortic size was 7.2 cm (5.6-10.0cm). Mean femoral artery diameter was 9.0 mm on the right and 8.9 mm on the left. Mean duration of surgery was 119 minutes (98- 153 minutes). 50% of patients were discharged at post-operative day one, 30%- day two and 20%- day three. Primary success was achieved in 9 patients (90%) or in 19 CFA closures (95%). No major complication was reported.

    DISCUSSION: We believe that with proper selection of patients undergoing EVAR, pEVAR offers a better option of vascular access with shorter operative time, less post- operative pain, shorter hospital stay and minimises the potential complications of a conventional femoral cutdown.

  12. Yusof ENM, Tahir MIM, Ravoof TBSA, Tan SL, Tiekink ERT
    Acta Crystallogr E Crystallogr Commun, 2017 Apr 01;73(Pt 4):543-549.
    PMID: 28435717 DOI: 10.1107/S2056989017003991
    The title di-thio-carbazate ester (I), C18H18N2S2 [systematic name: (E)-4-methyl-benzyl 2-[(E)-3-phenyl-allyl-idene]hydrazinecarbodi-thio-ate, comprises an almost planar central CN2S2 residue [r.m.s. deviation = 0.0131 Å]. The methyl-ene(tolyl-4) group forms a dihedral angle of 72.25 (4)° with the best plane through the remaining non-hydrogen atoms [r.m.s. deviation = 0.0586 Å] so the mol-ecule approximates mirror symmetry with the 4-tolyl group bis-ected by the plane. The configuration about both double bonds in the N-N=C-C=C chain is E; the chain has an all trans conformation. In the crystal, eight-membered centrosymmetric thio-amide synthons, {⋯HNCS}2, are formed via N-H⋯S(thione) hydrogen bonds. Connections between the dimers via C-H⋯π inter-actions lead to a three-dimensional architecture. A Hirshfeld surface analysis shows that (I) possesses an inter-action profile similar to that of a closely related analogue with an S-bound benzyl substituent, (II). Computational chemistry indicates the dimeric species of (II) connected via N-H⋯S hydrogen bonds is about 0.94 kcal mol(-1) more stable than that in (I).
  13. Tan YJ, Yeo CI, Halcovitch NR, Jotani MM, Tiekink ERT
    Acta Crystallogr E Crystallogr Commun, 2017 Apr 01;73(Pt 4):493-499.
    PMID: 28435705 DOI: 10.1107/S205698901700353X
    The title compound, (C6H11)3PS (systematic name: tri-cyclo-hexyl-λ(5)-phosphane-thione), is a triclinic (P-1, Z' = 1) polymorph of the previously reported ortho-rhom-bic form (Pnma, Z' = 1/2) [Kerr et al. (1977 ▸). Can. J. Chem. 55, 3081-3085; Reibenspies et al. (1996 ▸). Z. Kristallogr. 211, 400]. While conformational differences exist between the non-symmetric mol-ecule in the triclinic polymorph, cf. the mirror-symmetric mol-ecule in the ortho-rhom-bic form, these differences are not chemically significant. The major feature of the mol-ecular packing in the triclinic polymorph is the formation of linear chains along the a axis sustained by methine-C-H⋯S(thione) inter-actions. The chains pack with no directional inter-actions between them. The analysis of the Hirshfeld surface for both polymorphs indicates a high degree of similarity, being dominated by H⋯H (ca 90%) and S⋯H/H⋯S contacts.
  14. Rosli R, Tan MP, Gray WK, Subramanian P, Mohd Hairi NN, Chin AV
    Clin Gerontol, 2017 03 29;40(4):249-257.
    PMID: 28459304 DOI: 10.1080/07317115.2017.1311978
    OBJECTIVES: To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE).

    METHODS: The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience sample of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. The MMSE performance was used as a reference.

    RESULTS: The study enrolled 66 participants, with a median age of 78.5 years (interquartile range [IQR], 72.5-83.0) years and 11.0 median years of education (IQR, 9.0-13.0). Forty-three (65.2%) were female, and 32 (48.4%) were Chinese. The area under the receiver operating characteristic (AUROC) curve values were .962 (IDEA cognitive screen), .970 (PMIS), and .935 (MMSE). The optimal cutoff values for sensitivity and specificity were: IDEA cognitive screen: ≤ 11, 90.9% and 89.7%; PMIS: ≤ 6, 97.3% and 69.0%; and MMSE: ≤ 23, 84.6% and 76.0%. Although the sample size was small, multivariable logistic regression modelling suggested that all three screen scores did not appear to be educationally biased.

    CONCLUSION: The IDEA and PMIS tools are potentially valid screening tools for dementia in urban Malaysia, and perform at least as well as the MMSE. Further work on larger representative, cohorts is needed to further assess the psychometric properties.

    CLINICAL IMPLICATIONS: Study provides alternative screening tools for dementia for both non-specialists and specialists.
  15. Nissapatorn V, Kamarulzaman A, Init I, Tan LH, Rohela M, Norliza A, et al.
    Med J Malaysia, 2002 Sep;57(3):304-10.
    PMID: 12440270 MyJurnal
    A cross-sectional study was carried out in University of Malaya Medical Centre, Kuala Lumpur. Blood samples from 100 HIV-infected patients and 203 Healthy Blood Donors (HBD) were collected and anti-Toxoplasma antibodies were detected by using conventional ELISA. The seroprevalence of toxoplasmosis in HIV/AIDS and Healthy Blood Donors were found to be 21% and 28.1% respectively. There was no significant association between the seroprevalence of toxoplasmosis and various possible risk factors i.e. contact with cat, consumption of undercooked meat and history of blood transfusion in both groups. No significant differences between Toxoplasma seroprevalence in HIV/AIDS and Healthy Blood Donors in association with presence of single or multiple risk factors were found. The mean CD4 count among HIV/AIDS patients in this study was 202.23 cell/cumm. There was no significant association between CD4 count and seropositivity for Toxoplasma antibodies in HIV/AIDS patients.
  16. Tseng WS, Ebata K, Kim KI, Krahl W, Kua EH, Lu Q, et al.
    Int J Soc Psychiatry, 2001;47(1):8-23.
    PMID: 11322408
    Remarkable improvements in economic conditions and a considerable upgrade in the quality of life have been observed in many parts of Asia during the past several decades. At the same time, many mental health challenges face the people of Asia. Various social mental health indexes are reviewed here, with available data from China, Japan, Korea, Singapore, Malaysia, and other Asian societies. The data are compared with data from the United States, Australia in the Pacific Rim, and some other Western countries to examine patterns of similarity or difference between East and West in the process of modernization. Common trends in mental health issues associated with rapid sociocultural change observed in different Asian societies are discussed, as well as the relative shortage of mental health personnel available in many Asian societies. It is emphasized that, in addition to expanding psychiatric services, there is an even more urgent need to promote mental health knowledge and concern through education in the general population. Mental health needs to be cultivated and maintained by social forces and cultural strengths. It is stressed that there is a challenge for Asian people to advance mental health beyond economic development in the 21st century.
  17. Liam CK, Lim KH, Wong CMM, Lau WM, Tan CT
    Med J Malaysia, 2001 Mar;56(1):10-7.
    PMID: 11503285
    Introduction: The flow-volume curves of patients with obstructive sleep apnoea (OSA) obtained during the awake state are frequently abnormal.
    Objective: To determine 1) the relationship between the awake respiratory function and the severity of sleep-disordered breathing in a group of Malaysian patients with the OSA syndrome and 2) the frequency of flow-volume curve abnormality in these patients.
    Materials and methods: A retrospective analysis of the data from respiratory function tests during wakefulness and nocturnal polysomnography was performed on 48 patients with OSA. The severity of OSA was defined by the apnoea-hypopnoea index (AHI) and the lowest oxygen saturation during sleep (SPO2nadir).
    Results: AHI had a significant relationship with alveolar-arterial oxygen gradient (r=0.34, p=0.046) and SPO2nadir (r=0.049, p<0.001) but not with any anthropometric parameter or the other awake respiratory function variables measured SPO2nadir, has a significant relationship with body mass index (r=0.54, P<0.001), neck circumference (r=-0.39, p=0.013), awake room air PaO2 (r=0.61, p<0.001), alveolar-arterial oxygen gradient (r=-0.41, p=0.015) and baseline supine SpO2 (r=0.53, p<0.001). there was no correlation between SPO2nadir and any spirometric or static lung volume parameters. The maximum inspiratory and maximum expiratory flow volume curves of 26 patients (54%) showed a ratio of forced expiratory flow to forced inspiratory flow at mid-vital capacity (FEF50/FIF50) greater than one. In addition, flow oscillations (the ‘sawtooth’ sign) were noted in the inspiratory and/or expiratory flow-volume curves of 21 patients (44%), 9 of who did not have an FEF50/FIF50>1. Altogether, the maximum flow-volume curves during wakefulness of 35 (&3%) of the 48 patients showed variable upper airway obstruction and/or flow oscillations. However, the presence of these two upper airway abnormalities, either occurring alone or together did not have an effect on the severity of OSA as measured by the AHI or SPO2nadir.
    Conclusions: Abnormalities of the flow-volume loop consistent with inspiratory flow limitation and/or upper airway instability during wakefulness are common in patients with the OSA syndrome. The degree of oxygen desaturation during sleep in these patients as related to their awake oxygenation status.
  18. Chew NK, Sim BF, Tan CT, Goh KJ, Ramli N, Umapathi P
    Neurology, 2001 Aug 14;57(3):529-31.
    PMID: 11502928
    In a hospital series of 70 patients on follow-up after radiotherapy for nasopharyngeal carcinoma, 14 patients (20%) developed delayed post-irradiation bulbar palsy 1 to 18 years after radiotherapy (mean 5.5 years). Functional disability was moderate to severe. Three patients had aspiration pneumonia with one mortality. Post-irradiation bulbar palsy was a common complication and probably resulted from direct neuronal damage.
  19. Tan EC, Lee BW, Tay AW, Chew FT, Tay AH
    Allergy, 1999 Apr;54(4):402-3.
    PMID: 10371104
  20. Lim LC, Tan HH, Lee LH, Tien SL, Abdul Ghafar A
    Ann Acad Med Singap, 1999 Mar;28(2):252-5.
    PMID: 10497677
    Resistance to activated protein C (APC-R) is the commonest inherited cause of thrombosis among Caucasians. Few studies have been carried out on its prevalence in Asians. We conducted a prospective study on 60 patients with thromboembolism to determine its prevalence in our local population. The Factor V Leiden (VaQ506) mutation associated with this condition was detected by amplification of the Factor V gene by polymerase chain reaction (PCR) and digestion of the fragment with Mnl I. Three patients were found to be heterozygous for this mutation. None of the 3 patients had other concomitant hypercoagulable states. In addition, we studied the prevalence of this condition in Malays which was found to be 0.5%. Our study suggests that the incidence of APC-R is much lower here compared to the West.
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