MyMedR

Extragastrointestinal manifestations of Helicobacter pylori infection: facts or myth? A critical review

Tan HJ, Goh KL

J Dig Dis, 2012 Jul;13(7):342-9.

PMID: 22713083 DOI: 10.1111/j.1751-2980.2012.00599.x

Helicobacter pylori (H. pylori) infection is reported to be associated with many extragastrointestinal manifestations, such as hematological diseases [idiopathic thrombocytopenic purpura (ITP) and unexplained iron deficiency anemia (IDA)], cardiovascular diseases (ischemic heart diseases), neurological disorders (stroke, Parkinson's disease, Alzheimer's disease), obesity and skin disorders. Among these, the best evidence so far is in ITP and unexplained IDA, with high-quality studies showing the improvement of IDA and ITP after H. pylori eradication. The evidence of its association with coronary artery disease is weak and many of the results may be erroneous. The role of H. pylori infection in affecting serum leptin and ghrelin levels has attracted a lot of attention recently and available data to date have been conflicting. There have also been many uncontrolled, small sample studies suggesting an association between H. pylori infection and neurological disorders or chronic urticaria. However, more studies are required to clarify such proposed causal links.

Fulltext Anesthesia for massive retrosternal goiter with severe intrathoracic tracheal narrowing: the challenges imposed -A case report-

Tan PC, Esa N

Korean J Anesthesiol, 2012 May;62(5):474-8.

PMID: 22679546 DOI: 10.4097/kjae.2012.62.5.474

Anesthetic management of patients with mediastinal masses remains challenging as acute cardiorespiratory decompensation may follow induction of anesthesia. We describe a 57 year old lady with massive retrosternal goiter and severe intrathoracic tracheal compression who had a total thyroidectomy. Comprehensive contingency plans were an essential prerequisite for successful management of difficult airway, including multidisciplinary involvement of otorhinolaryngologic and cardiothoracic surgeons preparing for rigid bronchoscopy and cardiopulmonary bypass. Awake oral fiberoptic intubation was performed under dexmedetomidine sedation. Severe tracheal narrowing necessitated usage of a 5.0 mm uncuffed flexometallic endotracheal tube. Anesthesia was maintained with sevoflurane and dexmedetomidine infusion with target controlled infusion of remifentanil as analgesia. No muscle relaxant was given. Surgical manipulation led to intermittent total tracheal compression and inadequate ventilation. The tumor was successfully removed via the cervical approach. A close working relationship between anesthesiologists and surgeons was the key to the safe use of anesthesia and uneventful recovery of this patient.

Optimization of neural networks using variable structure systems

Mohseni SA, Tan AH

IEEE Trans Syst Man Cybern B Cybern, 2012 Dec;42(6):1645-53.

PMID: 22665508 DOI: 10.1109/TSMCB.2012.2197610

This paper proposes a new mixed training algorithm consisting of error backpropagation (EBP) and variable structure systems (VSSs) to optimize parameter updating of neural networks. For the optimization of the number of neurons in the hidden layer, a new term based on the output of the hidden layer is added to the cost function as a penalty term to make optimal use of hidden units related to weights corresponding to each unit in the hidden layer. VSS is used to control the dynamic model of the training process, whereas EBP attempts to minimize the cost function. In addition to the analysis of the imposed dynamics of the EBP technique, the global stability of the mixed training methodology and constraints on the design parameters are considered. The advantages of the proposed technique are guaranteed convergence, improved robustness, and lower sensitivity to initial weights of the neural network.

Who are eating and not eating fruits and vegetables in Malaysia?

Yen ST, Tan AK

Int J Public Health, 2012 Dec;57(6):945-51.

PMID: 22331314 DOI: 10.1007/s00038-012-0343-3

OBJECTIVE: To investigate the roles of sociodemographic factors in fruit and vegetable (FV) consumption in Malaysia.

METHODS: Data are obtained from the Malaysia Non-Communicable Disease Surveillance-1. Logistic regressions are conducted using a multiracial (Malay, Chinese, Indian and other ethnic groups) sample of 2,447 observations to examine the factors affecting individual decisions to consume FV on a daily basis.

RESULTS: Based on the binary outcomes of whether individuals consumed FV daily, results indicate that work hours, education, age ethnicity, income, gender, smoking status, and location of residence are significantly correlated with daily fruit consumption. Daily vegetable consumption is significantly correlated with income, gender, health condition, and location of residence.

CONCLUSIONS: Our results imply the need for programs to educate and motivate consumers to make healthier dietary choices. Interventions to increase FV consumption by changing behaviors should be considered, as should those that increase public awareness of the dietary benefits of FV. These intervention programs should be targeted at and tailored toward individuals who are less educated, younger, less affluent, males, smokers, and metropolitan dwellers.

Fulltext Acute renal failure and posterior reversible encephalopathy syndrome following multiple wasp stings: a case report

Loh HH, Tan CHH

Med J Malaysia, 2012 Feb;67(1):133-5.

PMID: 22582570 MyJurnal

Wasp stings can present in various ways, ranging from mild self-limiting illness to severe multi organ failure with a potentially fatal outcome. We report a case of multiple wasp stings leading to acute renal failure needing prolonged dialysis support and posterior reversible encephalopathy syndrome.

Fulltext Gangrenous small bowel obstruction secondary to congenital internal herniation: a case report

Tan YL, Alhagi MV

Med J Malaysia, 2012 Feb;67(1):118-20.

PMID: 22582563 MyJurnal

Congenital internal herniation is a rare condition presenting as recurrent abdominal pain or acute intestinal obstruction. In cases in which bowel incarceration or strangulation develop, rapid progression to bowel ischemia, necrosis or perforation is inevitable. Mortality in such cases has been reported to be as high as 50%. Despite advances in imaging modalities, arriving at a pre-operative diagnosis of a congenital internal herniation remains a challenge. We report such a case where imaging was unsuccessful in determining the cause of intestinal obstruction in a 3 year old child. Congenital internal herniation may result in disastrous consequences if not addressed in a timely fashion due to its rarity. Hence a high index of clinical suspicion is needed to avoid missing this diagnosis in a child presenting with recurrent abdominal pain or acute intestinal obstruction.

Fulltext Kaposi's sarcoma: case report and treatment options

Tan WC, Chan LC

Med J Malaysia, 2011 Oct;66(4):383-4.

PMID: 22299569

Kaposi's sarcoma (KS) is strongly associated with Human Herpes Virus 8 (HHV8) and Human Immunodeficiency Virus infection (HIV). It was the first malignancy to be linked with Acquired Immunodeficiency Syndrome (AIDS). We report a case of Kaposi's sarcoma in a newly diagnosed retroviral homosexual patient with CD4 count of 21. He had multiple firm discrete violaceous plaques and nodules scattered over the face, scalp, hard palate, trunk and genitalia. Biopsy of a skin nodule over the trunk and a biopsy of a lesion from the gastric mucosa confirmed Kaposi's sarcoma. He was started on Highly Active Antiretroviral Therapy (HAART) and cryotherapy (liquid nitrogen) was given for the lesions over the skin. He responded well to treatment. Liquid nitrogen is a useful adjuvant treatment for Kaposi's sarcoma.

Efficacy and reusability of alginate-immobilized live and heat-inactivated Trichoderma asperellum cells for Cu (II) removal from aqueous solution

Tan WS, Ting AS

Bioresour Technol, 2012 Nov;123:290-5.

PMID: 22940332 DOI: 10.1016/j.biortech.2012.07.082

Cu(II) removal efficacies of alginate-immobilized Trichoderma asperellum using viable and non-viable forms were investigated with respect to time, pH, and initial Cu(II) concentrations. The reusability potential of the biomass was determined based on sorption/desorption tests. Cu(II) biosorption by immobilized heat-inactivated T. asperellum cells was the most efficient, with 134.22mg Cu(II) removed g(-1) adsorbent, compared to immobilized viable cells and plain alginate beads (control) with 105.96 and 94.04mg Cu(II) adsorbed g(-1) adsorbent, respectively. Immobilized non-viable cells achieved equilibrium more rapidly within 4h. For all biosorbents, optimum pH for Cu(II) removal was between pH 4 and 5. Reusability of all biosorbents were similar, with more than 90% Cu(II) desorbed with HCl. These alginate-immobilized cells can be applied to reduce clogging and post-separation process incurred from use of suspended biomass.

Fulltext Dietary compliance and its association with glycemic control among poorly controlled type 2 diabetic outpatients in Hospital Universiti Sains Malaysia

Tan SL, Juliana S, Sakinah H

Malays J Nutr, 2011 Dec;17(3):287-99.

PMID: 22655451 MyJurnal

Introduction: Compliance with medical nutrition therapy is important to improve patient outcomes. The purpose of this study was to determine dietary compliance and its association with glycemic control among outpatients with poorly controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia (HUSM).
Methods: In this cross-sectional study, patients who had a glycosylated hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women) agreed to participate in this study. A questionnaire-based interview was used to collect socio-demographic, clinical and diabetes self-care data. The patient’s dietary compliance rate was determined by the Summary of Diabetes Self-Care Activities (SDSCA) measure. Anthropometric and biological measurements were also taken.
Results: Only 16.4% of the respondents adhered to the dietary regimen provided by dietitians. Among the 7 dietary self-care behaviours, item number 6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest compliant rate (54.1%); whereas item number 3 (eat five or more servings of
fruits and vegetables per day) had the lowest compliant rate (23.0%). There was a significant association between gender (p=0.037) and fasting blood sugar (FBS) (p=0.007) with the compliance status. Conclusion: Dietary non-compliance is still common among T2DM patients. Dietitians need to improve their skills and use more effective intervention approaches in providing dietary counseling to patients.
Keywords: Dietary compliance, diet counseling, type 2 diabetes mellitus

Rise of herbal and traditional medicine in erectile dysfunction management

Ho CC, Tan HM

Curr Urol Rep, 2011 Dec;12(6):470-8.

PMID: 21948222 DOI: 10.1007/s11934-011-0217-x

Herbal medicine long has been used in the management of sexual dysfunction, including erectile dysfunction. Many patients have attested to the efficacy of this treatment. However, is it evidence-based medicine? Studies have been done on animal models, mainly in the laboratory. However, randomized controlled trials on humans are scarce. The only herbal medications that have been studied for erectile dysfunction are Panax ginseng, Butea superba, Epimedium herbs (icariin), Tribulus terrestris, Securidaca longipedunculata, Piper guineense, and yohimbine. Of these, only Panax ginseng, B. superb, and yohimbine have published studies done on humans. Unfortunately, these published trials on humans were not robust. Many herbal therapies appear to have potential benefits, and similarly, the health risks of various phytotherapeutic compounds need to be elucidated. Properly designed human trials should be worked out and encouraged to determine the efficacy and safety of potential phytotherapies.

Species of the subgenus Cantotrella (Orthoptera: Gryllidae: Podoscirtinae: Varitrella) from Singapore, Malaysia and Indonesia

Gorochov AV, Tan MK

Zootaxa, 2014;3774:535-51.

PMID: 24871520 DOI: 10.11646/zootaxa.3774.6.3

Ten species of the subgenus Cantotrella Gorochov, 2006 belonging to the genus Varitrella Gorochov, 2003 of the tribe Podoscirtini are recorded from Singapore, Malaysia and Indonesia. Eight of them are new and described here: V. (C.) orion sp. nov.; V. (C.) trusmadi sp. nov.; V. (C.) striata sp. nov.; V. (C.) robusta sp. nov., V. (C.) sukau sp. nov., V. (C.) tawau sp. nov., V. (C.) amoena sp. nov., V. (C.) manukan sp. nov.

Fulltext The clinical features and outcomes of acute liver failure associated with dengue infection in adults: a case series

Tan SS, Bujang MA

Braz J Infect Dis, 2013 Mar-Apr;17(2):164-9.

PMID: 23453417 DOI: 10.1016/j.bjid.2012.09.007

OBJECTIVE: To describe the clinical manifestations and outcome of acute liver failure (ALF) associated with dengue viral infection, a rare but severe complication.
METHODS: One hundred and fifty five consecutive patients with ALF admitted to the national liver centre from 2001 to 2009 were reviewed retrospectively. Eight cases due to dengue infection were identified and their clinical characteristics are described.
RESULTS: All patients had severe dengue with one dengue shock syndrome. The median (minimum, maximum) age was 33.5 (17, 47) years with 50% female. The median (minimum, maximum) duration from the onset of fever to development of ALF was 7.5 (5, 13) days and the maximum hepatic encephalopathy (HE) grade were III in five patients and II in three patients. Three patients had systemic inflammatory responses (SIRS) on admission and were in grade III HE. The presence of SIRS on admission was associated with higher grade of HE and its development during the course of hospitalization was associated with worsening HE grade. The hepatitis was characterized by marked elevations in: alanine transaminase [median admission 1140.5 u/L (639, 4161); median peak 2487 u/L (998, 5181)], serum bilirubin [median admission 29 μmol/L (23, 291); median peak 127 μmol/L (72, 592)], and prothrombin time [median admission 16.8s (15.3, 26.2); median peak 22s (15.3, 40.7)]. The survival rate with standard medical therapy alone was 100%.
CONCLUSIONS: Dengue associated ALF manifest about one week after the onset of fever with severe hepatitis and encephalopathy. In our experience, the outcome with standard medical therapy alone is excellent.

Taxonomic notes on two species of bush katydids (Orthoptera: Tettigoniidae: Phaneropterinae) from Bukit Fraser, Malay Peninsula

Tan MK, Kamaruddin KN

Zootaxa, 2013;3710:389-94.

PMID: 26106700

Material based on a taxonomic collection in Bukit Fraser, Pahang of Malay Peninsula enables the review of two genera of bush katydid (Phaneropterinae). The female of Elimaea (Rhaebelimaea) pseudochloris Ingrisch, 1998 is described and recorded for the first time outside its type locality, Thailand. One new species of Pseudopsyra from Bukit Fraser is described: Pseudopsyra bispina sp. n.

A new species of mole cricket (Orthoptera: Gryllotalpidae: Gryllotalpinae) from Bukit Fraser, Malay Peninsula, with taxa notes on another similar mole cricket

Tan MK, Kamaruddin KN

Zootaxa, 2013;3691:324-32.

PMID: 26167588

One new species of Gryllotalpa from Bukit Fraser, Pahang of Malay Peninsula is described: Gryllotalpafraser sp. n. Pho tographs of Gryllotalpa hirsuta Burmeister, 1838 were examined and some remarks are made here, including a compari son with Gryllotalpafraser sp. n. and Gyllotalpa nymphicus Tan, 2012.

New species of scaly crickets (Orthoptera: Mogoplistinae) from Bukit Fraser, Malay Peninsula

Tan MK, Kamaruddin KN

Zootaxa, 2013;3721:258-64.

PMID: 26120671

Two new species of Mogoplistinae from Bukit Fraser, Pahang of Malay Peninsula are described: Micrornebius malaya sp. n. and Ornebius albalatus sp. n.

Fulltext Alternanthera sessilis Red Ethyl Acetate Fraction Exhibits Antidiabetic Potential on Obese Type 2 Diabetic Rats

Tan KK, Kim KH

Evid Based Complement Alternat Med, 2013;2013:845172.

PMID: 23606892 DOI: 10.1155/2013/845172

The antidiabetic potential of Alternanthera sessilis Red was investigated using the obese type 2 diabetic rats induced by high fat diet and streptozotocin. Three fractions (hexane, ethyl acetate, and water) were obtained from the crude ethanol extract of Alternanthera sessilis Red. Alternanthera sessilis Red ethyl acetate fraction (ASEAF) was found to possess the most potent antihyperglycemic effect through oral glucose tolerance test. The ASEAF was subsequently given to the diabetic rats for two weeks. It was found that two-week administration of ASEAF reduces the fasting blood glucose level, triglyceride level, and free fatty acid level of the rats. ASEAF-treated diabetic rats showed higher pancreatic insulin content and pancreatic total superoxide dismutase activity compared to the untreated diabetic rats. Also, the insulin sensitivity indexes suggested that ASEAF ameliorates the insulin resistant state of the diabetic rats. In conclusion, ASEAF could be developed into a potential antidiabetic agent for the management of type 2 diabetes.

Fulltext Riding on the crest of electronic publishing wave

Kadri N, Tan L, Ng Kh

Biomed Imaging Interv J, 2009 Jan;5(1):e1.

PMID: 21611022 MyJurnal DOI: 10.2349/biij.5.1.e1

Recombinant hepatitis B virus core particles: association, dissociation and encapsidation of green fluorescent protein

Lee KW, Tan WS

J Virol Methods, 2008 Aug;151(2):172-180.

PMID: 18584885 DOI: 10.1016/j.jviromet.2008.05.025

The recombinant hepatitis B virus (HBV) core antigen (HBcAg) expressed in Escherichia coli self-assembles into icosahedral capsids of about 35 nm which can be exploited as gene or drug delivery vehicles. The association and dissociation properties of the C-terminally truncated HBcAg with urea and guanidine hydrochloride (GdnHCl) were studied. Transmission electron microscopy (TEM) revealed that the dissociated HBcAg was able to re-associate into particles when the applied denaturing agents were physically removed. In order to evaluate the potential of the particles in capturing molecules, purified green fluorescent protein (GFP) was applied to the dissociated HBcAg for encapsidation. The HBcAg particles harbouring the GFP molecules were purified using sucrose density gradient ultracentrifugation and analysed using native agarose gel electrophoresis and TEM. A method for the encapsidation of GFP in HBcAg particles which has the potential to capture drugs or nucleic acids was established.

Changing epidemiology of Helicobacter pylori in Asia

Tan HJ, Goh KL

J Dig Dis, 2008 Nov;9(4):186-9.

PMID: 18959588 DOI: 10.1111/j.1751-2980.2008.00344.x

As in developed societies, the prevalence of Helicobacter pylori has declined rapidly in Asia. This has been shown in both seroprevalence-based and endoscopy-based studies. While the decline in the incidence of gastric cancer has now been observed, a decrease in peptic ulcer disease has not been so clearly evident. This apparent paradox can be explained by an increase in non-H. pylori associated ulcers - such as those related to non-steroidal anti-inflammatory drugs or idiopathic ulcers. The increase of gastroesophageal reflux disease in Asia has been widely observed and commented on and its relationship to the decline in H. pylori speculated upon. However there have been few conclusive studies from Asia on this subject. While the improved diagnosis and elimination of H. pylori has contributed to its decline, a more basic change involving large segments of the Asian population must be responsible. An improvement in hygiene and living conditions that results from more affluent Asian societies is thought to be a possible cause.

Importance of a thorough examination

Pau WS, Tan KK

Pediatr Infect Dis J, 2008 Jun;27(6):569-70.

PMID: 18449061 DOI: 10.1097/INF.0b013e318168db08

Scrub typhus is a common cause of febrile illness among children from rural regions in tropical countries. We described 2 cases of scrub typhus with an eschar localized in the genitalia that was missed during the routine medical examination of a febrile child.

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