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  1. Fulltext Engaging the ASEAN Diaspora: Type 2 Diabetes Prevalence, Pathophysiology, and Unique Risk Factors among Filipino Migrants in the United States
    Araneta MR
    J ASEAN Fed Endocr Soc, 2019;34(2):126-133.
    PMID: 33442147 DOI: 10.15605/jafes.034.02.02
    Type 2 diabetes prevalence is rising rapidly in Southeast Asia (SEA) where urbanization and adoption of 'western' behavioral lifestyles are attributed as predominant risk factors. The Southeast Asian diaspora to the United States has resulted in a sizable portion of migrant and US born SEAs, with approximately 4 million Filipino Americans, 2 million Vietnamese-Americans, Cambodians (330,000), and Thai (300,000) as the most populous. Their longer exposure to a western lifestyle and participation in clinical studies with other racial/ethnic groups, provide opportunities to evaluate etiologic factors which might inform trends and intervention opportunities among residents of Southeast Asia. Epidemiologic studies in the US have identified higher T2D prevalence among Filipinos (16.1%) compared to groups perceived to be at highest risk for T2D, namely Latinos (14.0%), Black (13.7%), and Native Americans (13.4%), while SEAs (including Burmese, Cambodian, Indonesian, Laotian, Malaysian, and Thai, 10.5%) and Vietnamese (9.9%) had higher T2D risk compared to Whites (7.7%), despite their absence of general obesity. Asian-Americans, including SEAs, East and South Asians, collectively have higher rates of undiagnosed T2D compared to other racial/ethnic groups in the US. Almost half (44%) of Filipinos with newly diagnosed T2D have isolated post-challenge hyperglycemia and will remain undiagnosed if current screening practices remain limited to measures of glycosylated hemoglobin and fasting plasma glucose. The University of California San Diego Filipino Health Study found excess visceral adipose tissue accumulation, low ratio of muscle to total abdominal mass area, low adiponectin concentration, multiparity (≥ 6 live births), and sleep insufficiency (<7 hours) to be unique T2D risk factors among Filipino-American women, even after adjusting for established T2D risk factors including hypertension and parental history of T2D. Social determinants such as low educational attainment (less than college completion), and sustained social disadvantage during childhood and adulthood were independently associated with T2D risk. Gestational diabetes is a known risk factor for future T2DM among women; Northern California data shows that following Asian Indians, gestational diabetes was highest among Filipina and SEA parturients, who had twice the GDM prevalence as Black, Hispanic, and White women. Identification of novel T2D risk factors among SEAs may guide early diagnosis, inform pathophysiology, and identify unique opportunities for T2D prevention and management.
    Matched MeSH terms: Blood Glucose
  2. Antibody prevalence of Orientia tsutsugamushi, Rickettsia typhi and TT118 spotted fever group rickettsiae among Malaysian blood donors and febrile patients in the urban areas
    Tay ST, Kamalanathan M, Rohani MY
    Southeast Asian J Trop Med Public Health, 2003 Mar;34(1):165-70.
    PMID: 12971530
    The seroprevalence of Orientia tsutsugamushi (OT), Rickettsia typhi (RT) and TT118 spotted fever group rickettsiae (SFGR) among blood donors and febrile Malaysian patients in the urban areas was determined. Of the 240 blood donors, 5.4%, 9.2% and 1.7% had either present or previous exposure to OT, RT and SFG rickettsiae, respectively. Patients admitted to an urban hospital had high seroprevalences of OT (43.5%) and RT (22.9%), as compared to SFGR (11.6%). Antibody levels suggestive of recent infections of scrub typhus, murine typhus and tick typhus were detected in 16.8%, 12.7% and 8.2% of patients respectively. No significant difference was noted in the distribution of rickettsial antibodies among urban patients from 2 geographical locations. However, the serologic patterns of rickettsial infection in the urban areas were different form those of rural areas.
    Matched MeSH terms: Blood Donors
  3. Fulltext A blood pressure profile of rural Kadazans and Bajaus in Sabah, east Malaysia
    Gan CY, Chan MK
    Southeast Asian J Trop Med Public Health, 1993 Sep;24(3):583-9.
    PMID: 8160073
    A survey was conducted to document the blood pressures of two indigenous groups (Kadazans and Bajaus) who reside in rural Sabah in East Malaysia. Their health knowledge status is also recorded. Fifty percent of those surveyed were unable to associate high blood pressure with a risk factor and as high as 38% were unaware of the consequences of high blood pressure. A total of 16.2% had blood pressures > or = 140/or 90mm Hg while 3.9% had blood pressures > or = 160/or 95mm Hg. While these figures are low compared to those of developed countries, lifestyle changes associated with rapid urbanization in Malaysia may be expected to increase hypertension prevalence. The strengthening of health education programs is timely as health knowledge is limited and many hypertensives default treatment.
    Matched MeSH terms: Blood Pressure
  4. The enzymatic activities and lethal toxins of Trimeresurus wagleri (speckled pit viper) venom
    Tan NH, Tan CS
    Toxicon, 1989;27(3):349-57.
    PMID: 2543103
    Trimeresurus wagleri (speckled pit viper) venom exhibited the usual set of enzyme activities occurring in pit viper venoms but the content of alkaline phosphomonoesterase was unusually high, whereas the proportions of protease and arginine ester hydrolase were very low. The venom also exhibited weak thrombin-like activity but did not exhibit hemorrhagic or anticoagulant activity. Analysis of the Sephadex G-200 gel filtration fractions of the venom indicated that the lethal fraction was a low mol.wt protein, and that fractions exhibiting phosphodiesterase, phosphomonoesterase, arginine ester hydrolase, thrombin-like enzyme, L-amino acid oxidase and phospholipase A activities were not lethal. Two lethal toxins, designated as wagleri toxins 1 and 2, were isolated from the venom using Sephadex G-50 gel filtration chromatography followed by SP-Sephadex C-25 ion exchange chromatography. The mol.wts of the two toxins were 8900 by gel filtration. The LD50 (i.v.) values in mice for wagleri toxins 1 and 2 are 0.17 microgram/g and 0.19 microgram/g, respectively.
    Matched MeSH terms: Whole Blood Coagulation Time
  5. Electrolyte profile of Malaysian mothers' milk
    Alaudeen S, Muslim N, Faridah K, Azman A, Arshat H
    Malays J Reprod Health, 1988 Dec;6(2):102-7.
    PMID: 12342169
    PIP: The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's).
    Matched MeSH terms: Blood
  6. Management of primary liver cell carcinoma
    Balasegaram M
    Am J Surg, 1975 Jul;130(1):33-7.
    PMID: 50750
    A review of 352 patients with primary liver cell carcinoma treated by the author is presented. The poor rate of resectability (7 per cent) has necessitated various forms of treatment over the years. These are described in detail. Based on this experience, the current form of treatment for nonresectable carcinoma is summarized. Although it is too early to assess this form of treatment, initial results appear to be promising. A second report in the near future is planned.
    Matched MeSH terms: Blood Donors
  7. Injection speed of spinal anaesthesia for Caesarean delivery in Asian women and the incidence of hypotension: A randomised controlled trial
    Chiang CF, Hasan MS, Tham SW, Sundaraj S, Faris A, Ganason N
    J Clin Anesth, 2017 Jun;39:82-86.
    PMID: 28494915 DOI: 10.1016/j.jclinane.2017.03.025
    STUDY OBJECTIVE: The purpose of this investigation was to determine if a slower speed of spinal anaesthesia injection would reduce the incidence of hypotension.

    STUDY DESIGN: Randomised controlled trial.

    SETTING: Tertiary level hospital in Malaysia.

    PATIENTS: 77 patients undergoing elective Caesarean delivery.

    INTERVENTION: Differing speeds of spinal injection.

    MEASUREMENTS: Systolic blood pressure was assessed every minute for the first 10min and incidence of hypotension (reduction in blood pressure of >30% of baseline) was recorded. The use of vasopressor and occurrence of nausea/vomiting were also recorded.

    MAIN RESULTS: 36 patients in SLOW group and 41 patients in FAST group were recruited into the study. There was no significant difference in blood pressure drop of >30% (p=0.497) between the two groups. There was no difference in the amount of vasopressor used and incidence of nausea/vomiting in both groups.

    CONCLUSION: In our study population, there was no difference in incidence of hypotension and nausea/vomiting when spinal injection time is prolonged beyond 15s to 60s.

    TRIAL REGISTRATION: ClinicalTrials.govNCT02275897. Registered on 15 October 2014.

    Matched MeSH terms: Blood Pressure
  8. Thiopurine methyltransferase polymorphisms in a multiracial asian population and children with acute lymphoblastic leukemia
    Kham SK, Tan PL, Tay AH, Heng CK, Yeoh AE, Quah TC
    J Pediatr Hematol Oncol, 2002 Jun-Jul;24(5):353-9.
    PMID: 12142782
    The purpose of this study was to determine the frequency of thiopurine methyltransferase (TPMT) polymorphisms in a multiracial Asian population and to assess its relevance in the management of childhood acute lymphoblastic leukemia (ALL). Six hundred unrelated cord blood samples from 200 Chinese, Malay, and Indian healthy newborns were collected at the National University Hospital, Singapore; an additional 100 children with ALL were analyzed for five of the commonly reported TPMT variant alleles using polymerase chain reaction/restriction fragment length polymorphism and allele-specific polymerase chain reaction-based assays. In the cord blood study, the TPMT*3C variant was detected in all three ethnic groups; Chinese, Malays, and Indians had allele frequencies of 3%, 2.3%, and 0.8%, respectively. The TPMT*3A variant was found only among the Indians at a low allele frequency of 0.5%. The TPMT*6 variant was found in one Malay sample. Among the children with ALL, two white and one Chinese were heterozygous for the TPMT*3A variant and showed intermediate sensitivity to 6-mercaptopurine during maintenance therapy. Three Chinese patients and one Malay patient were heterozygous for the TPMT*3C variant. Mercaptopurine sensitivity could be validated in only one out of four TPMT*3C heterozygous patients. The overall allele frequency of the TPMT variants in this multiracial population was 2.5%. The TPMT*3C was the most common variant allele; TPMT*3A and TPMT*6 were rare. These results support the feasibility of performing TPMT genotyping in all children diagnosed with acute leukemia to minimize toxicity from thiopurine chemotherapy.
    Matched MeSH terms: Fetal Blood
  9. Fulltext Influence of food intake and eating habits on hypertension control among outpatients at a government health clinic in the Klang Valley, Malaysia
    Suzana S, Azlinda A, Hin SL, Khor WH, Zahara Z, Sa'ida MJ, et al.
    Malays J Nutr, 2011 Aug;17(2):163-73.
    PMID: 22303571 MyJurnal
    INTRODUCTION: In Malaysia, hypertension prevalence has increased from 13% in 1996 to 43% in 2006 based on the Third National Health and Morbidity Survey.
    METHODOLOGY: Recognising the importance of hypertension control to prevent cardiovascular morbidity and mortality, a cross-sectional study was carried out to assess factors influencing blood pressure among 74 hypertensive adults (22 men, 52 women, mean age 61.1 +/- 8.8 years old) attending an outpatient clinic of a government health clinic in Klang Valley. Subjects were interviewed to obtain information on social and health, physical activity level and food intake using Diet History Questionnaire (DHQ) and Food Frequency Questionnaire (FFQ). Anthropometric measurements including weight, height, waist circumference and percentage of body fat were also conducted.
    RESULTS: The majority of the subjects (71.6%) had poor hypertension control as determined using blood pressure. Women aged 30-59 years old had a higher mean diastolic blood pressure (87.3 +/- 11.6 mmHg) than women aged 60 years old (78.5 +/- 9.5 mmHg) (p < 0.05). Most of the men (36.4%) achieved three out of six Medical Nutrition Therapy (MNT) for Hypertension Recommendations as outlined by the Malaysian Dietitians' Association. About one-third (30.8%) of the women achieved two out of six of the guidelines. High sodium intake (adjusted OR 3.501, 95% CI 1.116-10.985, p < 0.05), daily consumption of coffee (adjusted OR 0.302, 95% CI 0.093-0.983, p < 0.05) and less intake of milk (adjusted OR 3.328, 95% CI 1.055-10.493, p < 0.05) were associated with uncontrolled hypertension.
    CONCLUSION: Three quarters of the subjects had unsatisfactory hypertensive control and was related to food intake and eating habits including high salt diet, coffee consumption and inadequate milk intake were unsatisfactory. There is a need to implement a nutrition intervention programme based on MNT to achieve good hypertensive control among subjects.
    Study site: klinik kesihatan, Klang Valley, Malaysia
    Matched MeSH terms: Blood Pressure
  10. Isolation and characterization of the thrombin-like enzyme from Cryptelytrops albolabris (white-lipped tree viper) venom
    Tan NH, Fung SY, Yap YH
    Comp Biochem Physiol B Biochem Mol Biol, 2012 Jan;161(1):79-85.
    PMID: 21983189 DOI: 10.1016/j.cbpb.2011.09.009
    A thrombin-like enzyme (termed albolabrase) was isolated in purified form from the venom of Cryptelytrops albolabris (white-lipped tree viper) using high performance anion ion exchange and gel filtration chromatography. The molecular mass of albolabrase was 33.7 kDa as determined by SDS-PAGE and 35.8 kDa as determined by Superose gel filtration chromatography. The N-terminal sequence was determined to be VVGGDECNINE which is homologous to many snake venom thrombin-like enzymes. Albolabrase exhibits both arginine ester hydrolase and arginine amidase activities and the enzyme is fastidious towards tripeptide chromogenic anilide substrates. The fibrinogen clotting activity was optimum at 3mg/mL bovine fibrinogen, and showed distinct species differences in the following decreasing order: bovine fibrinogen>dog fibrinogen≈human fibrinogen>goat fibrinogen. The enzyme failed to clot both rabbit and cat fibrinogens. Reversed-phase HPLC analysis on the breakdown products of fibrinogenolytic action of albolabrase indicated that the enzyme belongs to the AB class of snake venom thrombin-like enzyme. In the indirect ELISA, IgG anti-albolabrase reacted extensively with most crotalid venoms, except with Tropidolaemus wagleri and Calloselasma rhodostoma venoms. The double sandwich ELISA, however, showed that anti-albolabrase reacted strongly only with venoms from the Trimeresurus complex, and that the results support the proposed new taxonomy changes concerning the Trimeresurus complex.
    Matched MeSH terms: Whole Blood Coagulation Time
  11. Fulltext Effectiveness of antihypertensive drugs in hypertensive patients with end stage renal failure
    Kumolosasi E, Ng WB, Abdul Aziz SA
    Med J Malaysia, 2012 Aug;67(4):379-85.
    PMID: 23082445 MyJurnal
    Hypertension has been identified as one of the causes for end stage renal failure (ESRF) and is likely to worsen kidney function. This retrospective study was carried out at a tertiary hospital in Malaysia with the objective of determining the effectiveness of combination antihypertensive drugs in hypertensive patients with ESRF admitted between 2006 and 2008. Patients with incomplete data and who were on monotherapy were excluded from this study. Although six different combinations gave significant reductions in systolic blood pressure (SBP) (13.38 +/- 9.11 mmHg, p < 0.05) and diastolic blood pressure (DBP) (6.03 +/- 11.39 mmHg, p < 0.05), 69.16% patients did not achieve target blood pressure (BP) (< or = 130/80 mmHg). Combination of beta blocker (BB) with calcium channel blocker (CCB) was the most commonly used. The CCB-diuretic regimen achieved highest percentage of BP control compared to others (40%). Comparison of blood pressure reduction between different combinations of antihypertensive drugs were not significant (p > 0.05) except for CCB-diuretics and BB-CCB-alpha blocker. The findings suggested better BP control with CCB-diuretic relative to other combinations used.
    Matched MeSH terms: Blood Pressure
  12. Interaction of Hb South Florida (codon 1; GTG-->ATG) and HbE, with beta-thalassemia (IVS1-1; G-->A): expression of different clinical phenotypes
    Tan JA, Tan KL, Omar KZ, Chan LL, Wee YC, George E
    Eur J Pediatr, 2009 Sep;168(9):1049-54.
    PMID: 19034506 DOI: 10.1007/s00431-008-0877-9
    INTRODUCTION: Interactions of different hemoglobin variants with thalassemia alleles can result in various clinical phenotypes. HbE-beta-thalassemia generally manifests with severe anemia where individuals exhibit beta-thalassemia major with regular blood transfusions or beta-thalassemia intermedia with periodic blood transfusions. This study presents a unique Malay family with three beta-globin gene defects-HbE, Hb South Florida, and IVS1-1 (G-->A).

    MATERIALS AND METHODS: HbE activates a cryptic splice site that produces non-functional mRNAs. Hb South Florida is a rare beta-hemoglobin variant, and its interactions with other beta-thalassemia alleles have not been reported. IVS1-1 is a Mediterranean mutation that affects mRNA processing giving rise to beta(o)-thalassemia.

    RESULTS AND DISCUSSION: Fifteen mutations along the beta-globin gene complex were analyzed using the amplification refractory mutation system. Hb South Florida was identified by direct sequencing using genomic DNA.

    CONCLUSION: The affected child with HbE/IVS1-1 produced a beta-thalassemia major phenotype. Compound heterozygosity for Hb South Florida/IVS1-1 produced a beta-thalassemia carrier phenotype in the mother.

    Matched MeSH terms: Blood Transfusion
  13. Sennetsu neorickettsiosis: a probable fish-borne cause of fever rediscovered in Laos
    Newton PN, Rolain JM, Rasachak B, Mayxay M, Vathanatham K, Seng P, et al.
    Am J Trop Med Hyg, 2009 Aug;81(2):190-4.
    PMID: 19635868
    Neorickettsia sennetsu has been described from Japan and Malaysia, causing a largely forgotten infectious mononucleosis-like disease. Because it is believed to be contracted from eating raw fish, frequently consumed in the Lao PDR, we looked for evidence of N. sennetsu among Lao patients and fish. A buffy coat from 1 of 91 patients with undifferentiated fever was positive by 16S rRNA amplification and sequencing and real-time polymerase chain reactions (PCR) targeting two N. sennetsu genes. Lao blood donors and patients with fever, hepatitis, or jaundice (N = 1,132) had a high prevalence (17%) of immunofluorescence assay IgG anti-N. sennetsu antibodies compared with 4% and 0% from febrile patients (N = 848) in Thailand and Malaysia, respectively. We found N. sennetsu DNA by PCR, for the first time, in a fish (Anabas testudineus). These data suggest that sennetsu may be an under-recognized cause of fever and are consistent with the hypothesis that it may be contracted from eating raw fish.
    Matched MeSH terms: Blood Donors
  14. Determinants of the optic cup to disc ratio in an Asian population: the Singapore Malay Eye Study (SiMES)
    Amerasinghe N, Wong TY, Wong WL, Mitchell P, Shen SY, Loon SC, et al.
    Arch. Ophthalmol., 2008 Aug;126(8):1101-8.
    PMID: 18695105 DOI: 10.1001/archopht.126.8.1101
    To describe the distribution and determinants of the optic cup to disc ratio (CDR) in Malay adults in Singapore.
    Matched MeSH terms: Blood Pressure
  15. Pansinusitis causing bilateral optic neuritis in a 9-year-old child
    Bashkaran K, Shatriah I, Zunaina E, Bakiah S, Sakinah Z
    Orbit, 2009;28(6):377-9.
    PMID: 19929663 DOI: 10.3109/01676830903104678
    Sinusitis is a rare cause of optic neuritis in children. This case illustrates bilateral optic neuritis in a 9-year-old child caused by pansinusitis. It demands an accurate diagnosis with a prompt management. A proper treatment of sinusitis is essential to prevent this complication.
    Matched MeSH terms: Blood Sedimentation
  16. Treatment patterns and outcomes in management of solid cancer patients suffering from thrombocytopenia in Penang hospital
    Hassan BA, Yusoff ZB, Hassali MA, Bin Othman S
    Asian Pac J Cancer Prev, 2011;12(11):2841-5.
    PMID: 22393951
    INTRODUCTION: Thrombocytopenia denotes abnormal decreases in platelet numbers and is a major detrimental side effect of the chemotherapy or cancer disease itself which cal lead to hemorrhage from vital organ. This is particularly a problem for the brain specifically within solid cancer patients and has a great negative effect on cancer patients quality of life (QOL). It ranges from mild bleeding from small blood vessels to severe bleeding from large blood vessels. The present study was conducted to evaluate the effectiveness of treatment guidelines for thrombocytopenia among solid cancer patients in Penang hospital and to find associations between these treatments and thrombocytopenia onset and severity and to suggest changes in the guidelines.

    METHODS: This retrospective observational study, conducted in a government hospital on Penang island included 341 cancer patients with thrombocytopenia who were admitted in the period between 2003 to 2009. The main statistical tests used were Chi-square test and Logistic regression test. The level of significance was set at P < 0.05.

    RESULTS: Of the total of 341, 21 (6.2%) showed thrombocytopenia before receiving chemotherapy and the remaining 320 (93.8%) after chemotherapy. The majority suffered from moderate thrombocytopenia (n=172; 53.8%), followed by mild a (n=97; 30.3%) and finally severe (n=51; 15.9%). For treatment, chemotherapy was delayed/ reduced (n=223; 65.4%) or platelets were transfused (n=51; 34.6%). However, thrombocytopenia problems were only temporarily solved.

    CONCLUSION: Effectiveness of thrombocytopenia treatment guidelines was found to be insufficient. It is advisable that thrombopoietin be used as a cornerstone even for patients who suffer from moderate thrombocytopenia and platelets transfusion should be used just for emergency cases when thrombocytopenia leads to a critical situation.

    Matched MeSH terms: Blood Platelets
  17. Ethnicity modifies the association between diabetes mellitus and ischaemic heart disease in Chinese, Malays and Asian Indians living in Singapore
    Yeo KK, Tai BC, Heng D, Lee JM, Ma S, Hughes K, et al.
    Diabetologia, 2006 Dec;49(12):2866-73.
    PMID: 17021918 DOI: 10.1007/s00125-006-0469-z
    AIMS/HYPOTHESIS: The aim of the study was to determine whether the risk of ischaemic heart disease (IHD) associated with diabetes mellitus differs between ethnic groups.

    METHODS: Registry linkage was used to identify IHD events in 5707 Chinese, Malay and Asian Indian participants from three cross-sectional studies conducted in Singapore between the years 1984 and 1995. The study provided a median of 10.2 years of follow-up with 240 IHD events experienced. We assessed the interaction between diabetes mellitus and ethnicity in relation to the risk of IHD events using Cox proportional hazards regression.

    RESULTS: Diabetes mellitus was more common in Asian Indians. Furthermore, diabetes mellitus was associated with a greater risk of IHD in Asian Indians. The hazard ratio when comparing diabetes mellitus with non-diabetes mellitus was 6.41 (95% CI 5.77-7.12) in Asian Indians and 3.07 (95% CI 1.86-5.06) in Chinese (p = 0.009 for interaction). Differences in the levels of established IHD risk factors among diabetics from the three ethnic groups did not appear to explain the differences in IHD risk.

    CONCLUSIONS/INTERPRETATION: Asian Indians are more susceptible to the development of diabetes mellitus than Chinese and Malays. When Asian Indians do develop diabetes mellitus, the risk of IHD is higher than for Chinese and Malays. Consequently, the prevention of diabetes mellitus amongst this ethnic group is particularly important for the prevention of IHD in Asia, especially given the size of the population at risk. Elucidation of the reasons for these ethnic differences may help us understand the pathogenesis of IHD in those with diabetes mellitus.
    Matched MeSH terms: Blood Pressure
  18. Fulltext Transverse myelopathy following intrathecal administration of chemotherapy
    Teh HS, Fadilah SA, Leong CF
    Singapore Med J, 2007 Feb;48(2):e46-9.
    PMID: 17304378
    Transverse myelopathy is one of the rare complications following administration of intrathecal chemotherapy. We report two cases of transverse myelopathy following administration of intrathecal methotrexate and cytarabine arabinoside. One patient was a 17-year-old Malay man who had lymphoblastic lymphoma in the leukaemic phase, while the other patient was a 40-year-old Malay man with relapsed Hodgkin's lymphoma. Both cases demonstrated variability in onset of symptoms, clinical progression and final outcome from the complication.
    Matched MeSH terms: Peripheral Blood Stem Cell Transplantation
  19. Fulltext A brief structured education programme enhances self-care practices and improves glycaemic control in Malaysians with poorly controlled diabetes
    Tan MY, Magarey JM, Chee SS, Lee LF, Tan MH
    Health Educ Res, 2011 Oct;26(5):896-907.
    PMID: 21715653 DOI: 10.1093/her/cyr047
    We assessed the effectiveness of a brief structured diabetes education programme based on the concept of self-efficacy on self-care and glycaemic control using single-blind study design. One hundred and sixty-four participants with poorly controlled diabetes from two settings were randomized using computer-generated list into control (n = 82) and intervention (n = 82) groups, of which 151 completed the study. Monthly interventions over 12 weeks addressed the self-care practices of diet, physical activity, medication adherence and self-monitoring of blood glucose (SMBG). These self-care practices were assessed at Weeks 0 and 12 using pre- and post-questionnaires in both groups together with glycated haemoglobin A1c (HbA1c) and diabetes knowledge. In the intention-to-treat analysis (n = 164), the intervention group improved their SMBG (P = <0.001), physical activity (P = 0.001), HbA1c (P = 0.03), diabetes knowledge (P = <0.001) and medication adherence. At Week 12, HbA1c difference adjusted for SMBG frequency, medication adherence and weight change remained significant (P = 0.03) compared with control group. For within group comparisons, diabetes knowledge (P = <0.001), HbA1c level (P = <0.001), SMBG (P = <0.001) and medication adherence (P = 0.008) improved from baseline in the intervention group. In the control group, only diabetes knowledge improved (P = <0.001). These findings can contribute to the development of self-management diabetes education in Malaysia.
    Matched MeSH terms: Blood Glucose Self-Monitoring
  20. Case report post-splenectomy sepsis in thalassemic patients
    Zarina AL, Hamidah A, Zulkifli SZ, Jamal R
    Southeast Asian J Trop Med Public Health, 2005 Mar;36(2):471-3.
    PMID: 15916058
    Thalassemia is the commonest hemoglobinopathy in Malaysia. Patients with thalassemia major are transfusion dependent, and a large proportion of them will require splenectomy. As this particular group of patients is immunocompromized, overwhelming sepsis is a recognized complication. We report a series of three patients who all developed intra-abdominal abscesses following splenectomy.
    Matched MeSH terms: Blood Transfusion
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