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  1. Tan LP, Ng BK, Balraj P, Lim PK, Peh SC
    Pathology, 2007 Apr;39(2):228-34.
    PMID: 17454753
    BACKGROUND AND AIMS: Colorectal cancers of different subtypes involve different pathogenic pathways like the Wnt and the mutator pathways. In this study, we screened 73 colorectal cancer cases from a multi-racial group for genetic and expression profile defects with the aim of correlating these with patients' clinicopathological characteristics.
    METHODS: Mutation screening of the entire coding region of APC and exon 3 of CTNNB1, loss of heterozygosity (LOH) of APC, and microsatellite instability (MSI) status were assessed for 44 patients with available paired frozen normal and tumour tissues. In addition, 29 cases with available paraffin embedded tumour blocks were screened for mutation in exon 3 of CTNNB1, the APC mutation cluster region (codon 1286-1513), and hMLH1, hMSH2, hMSH6 protein expressions by immunohistochemistry method.
    RESULTS: In our study, 15/73 cases showed APC mutations (20.5%), 1/73 cases had CTNNB1 mutation (1.4%), 5/32 cases had APC LOH (15.6%), and 16/70 (22.9%) cases revealed at least some form of mismatch repair (MMR) defect. Tumour grade (poor differentiation) was found to correlate significantly with right-sided tumour and mucinous histology (p = 0.01879 and 0.00320, respectively). Patients of younger age (below 45 years) more often had tumours of mucinous histology (p = 0.00014), while patients of older age (above 75 years) more often had tumours on the right side of the colon (p = 0.02448). Tumours of the mucinous histology subtype often had MMR defects (p = 0.02686). There was no difference in the occurrence of APC and CTNNB1 mutations and MMR defects found within our multi-racial colorectal cancer patient cohort.
    CONCLUSION: Our findings support the notion that racial factor may not be related to the occurrence of MMR defects and APC and CTNNB1 mutations in our multi-racial patient cohort.
  2. Azali HY, Norly S, Wong LM, Tan KS, Safian NM
    Asian J Surg, 2007 Apr;30(2):138-40.
    PMID: 17475585
    We report an unusual co-existence of Burkholderia pseudomallei and acid fast bacilli in a young Malay gentleman with liver abscess. He was treated with antibiotics and surgical drainage. This phenomenon has not been reported in previous literature and the dilemma of its management is discussed.
  3. Ibrahim NA, Wong YY, Lean QY, Ramasamy K, Lim SM, Tan MP, et al.
    Res Social Adm Pharm, 2024 Feb;20(2):172-181.
    PMID: 37980238 DOI: 10.1016/j.sapharm.2023.11.001
    BACKGROUND: Independent and safe medication self-management is essential for successful aging. Nevertheless, how older adults with cognitive frailty (CF) self-manage medications at their own homes remain elusive.

    OBJECTIVE: This study aimed at assessing the medication self-management capability of home-dwelling older adults with CF and exploring the ways, perceived challenges and barriers in medication self-management.

    METHODS: A convergent mixed-method study design was used. The medication management capability of 16 CF individuals aged ≥ 60 years on ≥ 1 long-term prescription drugs were assessed using the Drug Regimen Unassisted Grading Scale (DRUGS). Virtual in-depth interviews were also performed between July-August 2022 using a semi-structured interview guide. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analysed using a thematic analysis approach guided by Bailey and colleagues' model of medication self-management.

    RESULTS: The mean DRUGS summary score was 96.86 [standard deviation (SD) 3.74] with highest performance scores observed in medication access (100 %) and lowest performance score in medication identification (91.46 %). Informants were able to independently take their medications and they tended to organise their medication intakes according to mealtime even though some admitted missing medication doses due to forgetfulness. Informants had difficulties with recalling drug names, with little awareness of self-monitoring their own health conditions and the effects of medications. Misconceptions towards medications, difficulties in accessing medications, reduced mobility and worsening health conditions could potentially deter informants from safe and independent medication self-management. In contrast, trust in doctors and a desire to achieve treatment goal could motivate medication self-management.

    CONCLUSION: The findings revealed knowledge gaps among older adults with CF in identifying their medications and self-monitoring which warrant reinforcement by healthcare professionals to ensure chronic safe medication use. Future studies should evaluate strategies to enhance medication safety in terms of self-monitoring in individuals with CF.

  4. Ali S, Tan SC, Lee CK, Yusoff Z, Haque MR, Mylonas A, et al.
    Sensors (Basel), 2023 Nov 02;23(21).
    PMID: 37960622 DOI: 10.3390/s23218922
    Software-Defined Networking (SDN), which is used in Industrial Internet of Things, uses a controller as its "network brain" located at the control plane. This uniquely distinguishes it from the traditional networking paradigms because it provides a global view of the entire network. In SDN, the controller can become a single point of failure, which may cause the whole network service to be compromised. Also, data packet transmission between controllers and switches could be impaired by natural disasters, causing hardware malfunctioning or Distributed Denial of Service (DDoS) attacks. Thus, SDN controllers are vulnerable to both hardware and software failures. To overcome this single point of failure in SDN, this paper proposes an attack-aware logical link assignment (AALLA) mathematical model with the ultimate aim of restoring the SDN network by using logical link assignment from switches to the cluster (backup) controllers. We formulate the AALLA model in integer linear programming (ILP), which restores the disrupted SDN network availability by assigning the logical links to the cluster (backup) controllers. More precisely, given a set of switches that are managed by the controller(s), this model simultaneously determines the optimal cost for controllers, links, and switches.
  5. Mohd Sahardi NFN, Jaafar F, Tan JK, Mad Nordin MF, Makpol S
    Nutrients, 2023 Oct 25;15(21).
    PMID: 37960173 DOI: 10.3390/nu15214520
    (1) Background: Muscle loss is associated with frailty and a reduction in physical strength and performance, which is caused by increased oxidative stress. Ginger (Zingiber officinale Roscoe) is a potential herb that can be used to reduce the level of oxidative stress. This study aimed to determine the effect of ginger on the expression of metabolites and their metabolic pathways in the myoblast cells to elucidate the mechanism involved and its pharmacological properties in promoting myoblast differentiation. (2) Methods: The myoblast cells were cultured into three stages (young, pre-senescent and senescent). At each stage, the myoblasts were treated with different concentrations of ginger extract. Then, metabolomic analysis was performed using liquid chromatography-tandem mass spectrometry (LCMS/MS). (3) Results: Nine metabolites were decreased in both the pre-senescent and senescent control groups as compared to the young control group. For the young ginger-treated group, 8-shogaol and valine were upregulated, whereas adipic acid and bis (4-ethyl benzylidene) sorbitol were decreased. In the pre-senescent ginger-treated group, the niacinamide was upregulated, while carnitine and creatine were downregulated. Ginger treatment in the senescent group caused a significant upregulation in 8-shogaol, octadecanamide and uracil. (4) Conclusions: Ginger extract has the potential as a pharmacological agent to reduce muscle loss in skeletal muscle by triggering changes in some metabolites and their pathways that could promote muscle regeneration in ageing.
  6. Lim TW, Choo KY, Lim RLH, Pui LP, Tan CP, Ho CW
    Heliyon, 2023 Nov;9(11):e21940.
    PMID: 38027851 DOI: 10.1016/j.heliyon.2023.e21940
    Red dragon fruit (RDF) is well-known for its high nutritional content, especially the red pigment betacyanins that possess high antioxidant activity. Natural fermentation is an ancient yet outstanding technique that relies on the autochthonous microbiota from fruits and vegetables surfaces to preserve and improve the nutritional values and quality of the food product. The present study was to evaluate and identify the indigenous microbial community (bacteria and fungi) that are involved in the natural fermentation of RDF. Results revealed a total of twenty bacterial pure cultures and nine fungal pure cultures were successfully isolated from fermented red dragon fruit drink (FRDFD). For the first time, the PCR amplification of 16S rRNA and ITS regions and sequence analysis suggested nine genera of bacteria and three genera of fungi (Aureobasidium pullulans, Clavispora opuntiae, and Talaromyces aurantiacus) present in the FRDFD. Four dominant (≥10 % isolates) bacteria species identified from FRDFD were Klebsiella pneumonia, Brevibacillus parabrevis, Bacillus tequilensis and Bacillus subtilis. The carbohydrate fermentation test showed that all the indigenous microbes identified were able to serve as useful starter culture by fermenting sucrose and glucose, thereby producing acid to lower the pH of FRDFD to around pH 4 for better betacyanins stability. The present study provides a more comprehensive understanding of the indigenous microbial community that serves as the starter culture in the fermentation of RDF. Besides, this study provides a useful guide for future research to be conducted on studying the rare bacterial strains (such as B. tequilensis) identified from the FRDFD for their potential bioactivities and applications in medical treatment and functional foods industries.
  7. Chan JSW, Lim XY, Japri N, Ahmad IF, Tan TYC
    Planta Med, 2024 Mar;90(3):204-218.
    PMID: 38035621 DOI: 10.1055/a-2219-9801
    Zingiber zerumbet, a plant native to tropical and subtropical Asia, has a vast range of traditional uses and has been continuously studied for its medicinal properties. However, a systematic methodological approach in evidence synthesis on the plant's efficacy is lacking, and there is a need to elicit the current research status of this plant. This scoping review was conducted to systematically explore and collate the available scientific evidence on the efficacy of Z. zerumbet and its main phytoconstituents in various formulations, their biological mechanisms, and their safety. Results included 54 articles consisting of animal studies, while there were no published human studies. Only half of the included studies provided adequate reporting on the quality-related details of Z. zerumbet formulations. Identified pharmacological activities were analgesic, anti-inflammatory, anti-diabetic, anti-hyperlipidemic, anti-neoplastic, immunomodulatory, antioxidant, antipyretic, hepatoprotective, nephroprotective, gastroprotective, and locomotor-reducing activities. Notably, the ethanolic extract of Z. zerumbet was found to be well tolerated for up to 28 days. In conclusion, Z. zerumbet and zerumbone have various pharmacological effects, especially in analgesic and anti-inflammatory models. However, there is still a pressing need for comprehensive safety data to conduct clinical trials.
  8. Zhang J, Zhang Z, Peng S, Veloo A, Bailey RP, Tan WH
    Front Psychol, 2023;14:1260253.
    PMID: 38023018 DOI: 10.3389/fpsyg.2023.1260253
    INTRODUCTION: The Sport Anxiety Scale-2 (SAS-2) is a validated measure of sports trait anxiety, with promising psychometric properties. However, its cross-cultural applicability in Chinese samples remains unexplored. Thus, the primary objectives of this study were twofold: to translate the SAS-2 into Chinese and assess the psychometric properties of the Chinese version.

    METHODS: In Study 1, we initiated the translation of the SAS-2 into Chinese. This assessment involved bilingual Chinese students proficient in both English and Chinese. Additionally, we conducted a cross-linguistic measurement invariance analysis. In Study 2, we delved into the psychometric properties of the Chinese SAS-2 using a sample of Chinese student athletes. This examination encompassed an evaluation of its factor structure, convergent and discriminant validity, and measurement invariance across genders.

    RESULTS: Our findings in Study 1 indicated no significant differences in item scores between the Chinese SAS-2 and the English version, and measurement invariance across languages. In Study 2, we uncovered that the Chinese SAS-2 and its factors exhibited excellent reliability, with Cronbach's alpha values exceeding 0.80. Confirmatory factor analyses upheld the original three-factor model, demonstrating acceptable model fit indices (CFI = 0.96, TLI = 0.93, RMSEA = 0.08). Furthermore, all three factors of the Chinese SAS-2 displayed significant and positive correlations with athlete burnout and State-Trait anxiety. Additionally, this study elucidated the mediating role of Concentration Disruption (Somatic anxiety and Concentration Disruption) in the relationship between the Trait (State) anxiety, and athlete burnout. Moreover, we identified measurement invariance of the Chinese version of the SAS-2 across genders. Finally, female college athletes exhibited significantly higher scores in somatic anxiety and worry compared to their male counterparts.

    DISCUSSION: In sum, our findings affirm that the Chinese version of the SAS-2 demonstrates robust reliability and correlates effectively with related criteria, thus validating its suitability for use in a Chinese context.

  9. Tan CY, Wafiatul NMH, Chang SMW, Tee AX, Lim AW
    Med J Malaysia, 2023 Nov;78(6):793-802.
    PMID: 38031223
    INTRODUCTION: There has been an observed number of readmissions after an index COVID-19 admission, including admissions after an initial home quarantine. The purpose of this study was to identify the clinical characteristics and outcomes of COVID-19 patients who were readmitted or admitted after an initial home quarantine between 21 and 90 days of illness.

    MATERIALS AND METHODS: This was a single-centre retrospective cohort study comprising patients admitted to a state hospital in Selangor, Malaysia, between August and October 2021. The demographic data, clinical characteristics, presenting complaints, laboratory tests, organ dysfunction, use of invasive ventilation, intensive care unit (ICU) admissions, length of hospitalisation and mortality were collected and analysed.

    RESULTS: The analysis involved a total of 195 cases. More than a quarter of the cases (52 [26.7%]) were related to the initial COVID-19 infection. Nine cases (4.6%) required mechanical ventilation, while eight cases (4.1%) were admitted to the ICU. The overall mortality was 17 cases (8.7%). Surviving patients were younger (49.5 vs. 58.4 years), less likely to have diabetes mellitus (48.3% vs. 82.4%), or chronic kidney disease (12.9% vs. 41.2%); had higher levels of admission haemoglobin (12.6 vs. 9.1g/dL) and albumin (33.0 vs. 21.0g/L); lower white blood cells (10.2 vs. 13.0 × 109/L), creatinine (81.2 vs. 151.9μmol/L) and C-reactive protein (18.2 vs. 135.0mg/L) at admission; less likely to have MI (6.7% vs. 23.5%), sepsis (3.4% vs. 47.1%), or acute kidney injury (3.4% vs. 17.6%) and organ dysfunction (25.3% vs. 94.1%).

    CONCLUSION: Approximately a quarter of patients were admitted or readmitted due to direct COVID-19 complications between 21 and 90 days of illness. The baseline oxygen requirements at admission were independently associated with mortality, invasive mechanical ventilation and ICU admissions. Further research is needed to establish a risk model for patients returning to a hospital to predict their risk of post-COVID complications.

  10. Chan WK, Tan KW, Chong KP, Lim ACC, Khalid I
    Cureus, 2023 Oct;15(10):e47189.
    PMID: 38021569 DOI: 10.7759/cureus.47189
    Open pancreaticoduodenectomy, also known as Whipple surgery, is a complex and painful procedure that requires a multi-modal analgesic approach for successful post-operative rehabilitation and recovery. While thoracic epidural analgesia (TEA) remains the gold standard for pain relief after open upper abdominal surgery, it carries many risks that may outweigh the potential benefits of the technique. Furthermore, in laparoscopic converted to open pancreaticoduodenectomy cases, post-operative placement of a thoracic epidural catheter is inconvenient to the patient due to pain and positioning. The external oblique intercostal (EOI) block is a novel method that provides somatic analgesia to the upper abdomen. We present a case of bilateral EOI block with catheter insertion for post-operative analgesia in a patient who underwent laparoscopic converted to open Whipple surgery.
  11. Shi J, Zhao J, Zhang Y, Wang Y, Tan CP, Xu YJ, et al.
    Anal Chem, 2023 Dec 26;95(51):18793-18802.
    PMID: 38095040 DOI: 10.1021/acs.analchem.3c03785
    Metabolomics and proteomics offer significant advantages in understanding biological mechanisms at two hierarchical levels. However, conventional single omics analysis faces challenges due to the high demand for specimens and the complexity of intrinsic associations. To obtain comprehensive and accurate system biological information, we developed a multiomics analytical method called Windows Scanning Multiomics (WSM). In this method, we performed simultaneous extraction of metabolites and proteins from the same sample, resulting in a 10% increase in the coverage of the identified biomolecules. Both metabolomics and proteomics analyses were conducted by using ultrahigh-performance liquid chromatography mass spectrometry (UPLC-MS), eliminating the need for instrument conversions. Additionally, we designed an R-based program (WSM.R) to integrate mathematical and biological correlations between metabolites and proteins into a correlation network. The network created from simultaneously extracted biomolecules was more focused and comprehensive compared to those from separate extractions. Notably, we excluded six pairs of false-positive relationships between metabolites and proteins in the network established using simultaneously extracted biomolecules. In conclusion, this study introduces a novel approach for multiomics analysis and data processing that greatly aids in bioinformation mining from multiomics results. This method is poised to play an indispensable role in systems biology research.
  12. Liew SC, Pallath V, Rasali Y, Foong CC, Hong WH, Tan MP
    PLoS One, 2023;18(12):e0289176.
    PMID: 38117842 DOI: 10.1371/journal.pone.0289176
    INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic, the use of virtual consultations has accelerated to ensure continued access to healthcare despite lockdowns and physical distancing measures. We aimed to determine the knowledge (awareness) of, attitude (acceptability) to, and practice (exposure) [KAP] of virtual consultations (VC), the demographic factors associated with poor KAP, and the correlation between the three KAP domains.

    METHODS: A cross-sectional study, using a convenience sampling technique, was conducted from 13 September, 2021 to 28 November, 2021. We designed a 45-item VC KAP questionnaire. This was distributed to outpatient users attending cardiovascular, dermatology, geriatrics, haematology, endocrine, respiratory, gastroenterology, rheumatology, or neurology clinics at the University Malaya Medical Centre. It was completed during face-to-face, online, or telephone interviews. The data were analysed using SPSS version 24.0. Binary logistic regression was used to determine the demographic factors associated with KAP. Correlation between KAP domains was determined using Spearman's rho (r). A p-value of <0.05 was considered statistically significant.

    RESULTS: A total of 366 questionnaires were completed. Knowledge (awareness), attitude (acceptability), and practice (exposure) were considered good in 69.7%, 80.9%, and 24.6% of participants, respectively. There were no significant relationships between age, gender, ethnicity, and duration of hospital attendance (years) with knowledge (awareness), attitude (acceptability), and practice (exposure). A moderate positive correlation was seen between knowledge (awareness) and attitude (acceptability) (Attitude total [Atotal]) (r = 0.48, p<0.001), with no significant correlation between knowledge (awareness) and practice (exposure) (r = 0.04, p = 0.45), and attitude (acceptability) (Atotal) and practice (r = 0.01, p = 0.82).

    CONCLUSION: Overall, outpatient clinic users had good knowledge (awareness) of and were receptive towards VC but had poor practice (exposure). More opportunities for VC use in healthcare can increase exposure and subsequent utilisation. Interventions to increase the effectiveness of VC use should be explored in future studies.

  13. Tan LK, Chua EH, Mohd Ghazali S, Cheah YK, Jayaraj VJ, Kee CC
    Nutrients, 2023 Dec 08;15(24).
    PMID: 38140302 DOI: 10.3390/nu15245043
    The healthy eating plate concept has been introduced in many countries, including Malaysia, as a visual guide for the public to eat healthily. The relationship between Malaysian Healthy Plate (MHP) and adequate fruit and vegetable (FV) intake among morbid Malaysian adults is unknown. Hence, we investigated the relationship between awareness of the MHP and FV intake among morbid Malaysian adults. National survey data on 9760 morbid Malaysian adults aged 18 years and above were analyzed. The relationship between awareness of MHP and FV intake among Malaysian adults with obesity, diabetes mellitus, hypertension, and hypercholesterolemia were determined using multivariable logistic regression controlling for sociodemographic characteristics and lifestyle risk factors. Our data demonstrated that MHP awareness is associated with adequate FV intake among the Malaysian adults with abdominal obesity (adjusted odds ratio (aOR): 1.86, 95% confidence interval (CI): 1.05-3.29), diabetes mellitus (aOR: 4.88, 95% CI: 2.13-22.18), hypertension (aOR: 4.39, 95% CI: 1.96-9.83), and hypercholesterolemia (aOR: 4.16, 95% CI: 1.48-11.72). Our findings indicated the necessity for ongoing efforts by policymakers, healthcare professionals, and nutrition educators to promote the concept of MHP and ensure that morbid Malaysian adults consume a sufficient intake of FV or adopt a healthy eating pattern to achieve and maintain optimal health.
  14. Reyneke T, Lee B, Li H, Haque S, Abdullah SZ, Tan BKW, et al.
    Front Psychol, 2023;14:1017566.
    PMID: 38144986 DOI: 10.3389/fpsyg.2023.1017566
    BACKGROUND: Little research has considered the influence of culture on control appraisals in the context of posttraumatic stress disorder (PTSD).

    OBJECTIVES: This study aimed to investigate whether cultural group moderated the relationship between control (primary and secondary) appraisals and PTSD symptoms in trauma survivors from Western (Australian) and Asian (Malaysian) cultural contexts.

    METHODS: Trauma survivors (107 Australian with European cultural heritage; 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an online survey assessing PTSD symptoms and appraisals of control.

    RESULTS: Cultural group moderated the association between primary control and PTSD symptoms; the positive association was significant for the Australian group but not the Malaysian group. While cultural group did not moderate the association between secondary control and PTSD symptoms, there was an indirect pathway between secondary control appraisals and PTSD symptoms through interdependent self-construal for both cultural groups.

    CONCLUSION: The findings indicate that cultural group and self-construal influence the associations between different types of control appraisals and PTSD. Further research exploring the role of culture and different appraisal types in PTSD is needed.

  15. Wong LP, Alias H, Tan SL, Sia TE, Saw A
    Omega (Westport), 2025 May;91(1):62-81.
    PMID: 36217612 DOI: 10.1177/00302228221132902
    Background: This study assesses the level of death anxiety among the family members of the Silent Mentor Programme (SMP) and determines whether their participation in various ceremonies during the training session impacted their death anxiety. Methods: The revised Collett-Lester Fear of Death Scale (CL-FODS) was administered to the study participants before the opening ceremony and after the sending-off ceremony of the programme. Results: All the four subscales that measure fear of one's own death, fear of the process of one's own dying, fear of the death of others and fear of the process of others dying in the CL-FODS showed significant reduction after the sending-off ceremony compared with before the opening ceremony. Younger family members reported significantly higher mean total death anxiety scores compared to the older members. Conclusion: The SMP not only nurtures doctors with humanity but also helps the family members to cope with grief and loss.
  16. Wang M, Fu X, Zhang D, Chen F, Liu M, Zhou S, et al.
    Sci Total Environ, 2023 Jul 01;880:163470.
    PMID: 37076008 DOI: 10.1016/j.scitotenv.2023.163470
    Global climate change and rapid urbanization, mainly driven by anthropogenic activities, lead to urban flood vulnerability and uncertainty in sustainable stormwater management. This study projected the temporal and spatial variation in urban flood susceptibility during the period 2020-2050 on the basis of shared socioeconomic pathways (SSPs). A case study in Guangdong-Hong Kong-Macao Greater Bay Area (GBA) was conducted for verifying the feasibility and applicability of this approach. GBA is predicted to encounter the increase in extreme precipitation with high intensity and frequency, along with rapid expansion of constructed areas, resulting in exacerbating of urban flood susceptibility. The areas with medium and high flood susceptibility will be expected to increase continuously from 2020 to 2050, by 9.5 %, 12.0 %, and 14.4 % under SSP1-2.6, SSP2-4.5, and SSP5-8.5 scenarios, respectively. In terms of the assessment of spatial-temporal flooding pattern, the areas with high flood susceptibility are overlapped with that in the populated urban center in GBA, surrounding the existing risk areas, which is consistent with the tendency of construction land expansion. The approach in the present study will provide comprehensive insights into the reliable and accurate assessment of urban flooding susceptibility in response to climate change and urbanization.
  17. Ng LC, Lee CS, Lim BB, Mohd Tap R, Tan XT, Tang MM
    Med J Malaysia, 2023 May;78(3):364-371.
    PMID: 37271847
    INTRODUCTION: Dermatomycoses are common superficial cutaneous fungal infections which affect the skin, nails and human hairs. It affects 20 to 25% of the world population. The causative fungus varies geographically across the globe. Study on dermatomycoses is crucial to identify the aetiological fungus involved locally. The study aimed to determine the causative fungus of superficial fungal infections of the skin, nail and hair in patients presented to Hospital Melaka.

    METHODS: This was a prospective study conducted from 15th January 2022 till 15th October 2022 at Dermatology Clinic, Hospital Melaka. Subjects with clinical dermatomycoses were included in this study. The samples were collected from skin, nails and hairs clinically affected by tinea corporis/cruris/pedis, onychomycosis and tinea capitis respectively. A potassium hydroxide (KOH) study was performed on the sample in which the fungal hyphae/yeast positive subjects were sent for fungal culture and fungal PCR test.

    RESULT: A total of 222 clinical samples from skin, nails and hairs with a clinical suspicion of dermatomycoses yielded fungal hyphae/yeast in KOH. Majority of the samples were collected from skin (138, 62.2%), followed by nails (65, 29.3%) and hairs (19, 8.6%). Male to female ratio was 1.18: 1. The age ranged from 2 to 87 with the median of 55.5-yearsold. Out of 222 samples, 150 (67.6%) were fungal culture positive. From fungal culture positive samples, 87 samples were from tinea corporis, 50 samples were from onychomycoses and 13 samples were from tinea capitis. Trichophyton rubrum (39, 44.8%) was the commonest dermatophyte isolated in tinea corporis/cruris/pedis. Nondermatophyte moulds (NDM, 35, 70%) were the main fungi isolated in onychomycosis. Microsporum canis (7/53.8%) was the principal causative fungus among patients with tinea capitis. Among 150 fungal culture positive samples, 76 were fungal PCR positive. Only 38 samples consistently isolated same fungal species in both fungal culture and PCR test.

    CONCLUSION: Majority of tinea corporis and tinea capitis fungal culture isolated dermatophytes, especially Trichophyton rubrum and Microsporum canis, respectively. Non-dermatophyte moulds were mainly isolated in onychomycosis.

  18. Thye CT, Hamdan M, Sethi N, Rajaratnam RK, Hong J, Tan PC
    Int J Gynaecol Obstet, 2023 Nov;163(2):601-609.
    PMID: 37199331 DOI: 10.1002/ijgo.14861
    OBJECTIVE: To evaluate 4-point per day self-monitoring of blood glucose (SMBG) every 2 weeks compared with every week.

    METHODS: A total of 104 patients with lifestyle-controlled gestational diabetes (GDMA1) were randomized to 2-weekly or weekly 4-point per day (fasting on awakening and 2-h post-meals) SMBG. Primary outcome was the change in glycated hemoglobin (HbA1c) level from enrollment to 36 weeks of pregnancy across trial arms. The non-inferiority margin was an HbA1c increase of 0.2%.

    RESULTS: The mean difference for change in HbA1c from enrollment to 36 weeks was 0.003% (95% confidence interval [CI] -0.098% to +0.093%), within the 0.2% non-inferiority margin. The change in HbA1c level increased significantly within both trial arms-0.275% ± 0.241% (P 

  19. Khoo YW, Gao L, Khaw YS, Tan HT, Li S, Chong KP
    Plant Dis, 2023 May 25.
    PMID: 37227434 DOI: 10.1094/PDIS-01-23-0109-PDN
    Paspalum conjugatum (family Poaceae), locally known as Buffalo grass, is a perennial weed that can be found in rice field, residential lawn, and sod farm in Malaysia (Uddin et al. 2010; Hakim et al. 2013). In September 2022, Buffalo grass with rust symptoms and signs were collected from the lawn located in Universiti Malaysia Sabah in the province of Sabah (6°01'55.6"N, 116°07'15.7"E). The incidence was 90%. Yellow uredinia were observed primarily on the abaxial surface of the leaves. As the disease progressed, leaves were covered with coalescing pustules. Microscopic examination of pustules revealed the presence of urediniospores. Urediniospores were ellipsoid to obovoid in shape, contents in yellow, 16.4-28.8 x 14.0-22.4 μm and echinulate, with a prominent tonsure on most of the spores. A fine brush was used to collect yellow urediniospores, and genomic DNA was extracted based on Khoo et al. (2022a). The primers Rust28SF/LR5 (Vilgalys and Hester 1990; Aime et al. 2018) and CO3_F1/CO3_R1 (Vialle et al. 2009) were used to amplify partial 28S ribosomal RNA (28S) and cytochrome c oxidase III (COX3) gene fragments following the protocols of Khoo et al. (2022b). The sequences were deposited in GenBank under accession numbers OQ186624- OQ186626 (985/985 bp) (28S) and OQ200381-OQ200383 (556/556 bp) (COX3). They were 100% similar to Angiopsora paspalicola 28S (MW049243) and COX3 (MW036496) sequences. Phylogenetic analysis using maximum likelihood based on the combined 28S and COX3 sequences indicated that the isolate formed a supported clade to A. paspalicola. Koch's postulates were performed with spray inoculations of urediniospores suspended in water (106 spores/ml) on leaves of three healthy Buffalo grass leaves, while water was sprayed on three additional Buffalo grass leaves which served as control. The inoculated Buffalo grass were placed in the greenhouse. Symptoms and signs similar to those of the field collection occurred after 12 days post inoculation. No symptoms occurred on controls. To our knowledge, this is the first report of A. paspalicola causing leaf rust on P. conjugatum in Malaysia. Our findings expand the geographic range of A. paspalicola in Malaysia. Albeit P. conjugatum is a host of the pathogen, but the host range of the pathogen especially in Poaceae economic crops need to be studied. Weed management could be an effective way to eliminate inoculum sources of A. paspalicola.
  20. Hong JGS, Vimaladevi A, Razif NA, Omar SZ, Tan PC
    BMC Pregnancy Childbirth, 2023 May 24;23(1):378.
    PMID: 37226087 DOI: 10.1186/s12884-023-05685-4
    BACKGROUND: A majority of pregnant women experience sleep disruption during pregnancy, especially in the third trimester. Lack of sleep is associated with preterm birth, prolonged labor and higher cesarean section rate. Six or less hours of night sleep in the last month of pregnancy is associated with a higher rate of caesarean births. Eye-masks and earplugs compared to headband improve night sleep by 30 or more minutes. We sought to evaluate eye-mask and earplugs compared to sham/placebo headbands on spontaneous vaginal delivery.

    METHODS: This randomized trial was conducted from December 2019-June 2020. 234 nulliparas, 34-36 weeks' gestation with self-reported night sleep 

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