Displaying publications 61 - 80 of 414 in total

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  1. Tan ST, Sherina MS, Rampal L, Normala I
    Med J Malaysia, 2015 Feb;70(1):1-5.
    PMID: 26032521 MyJurnal
    BACKGROUND: Undergraduate medical students have been the most distressed group among the student population. Depression and anxiety have been found to be more prevalent in this group of students compared to others.

    OBJECTIVE: This study was conducted to determine the prevalence and predictors of suicidality among undergraduate medical students in a public university.

    METHODS: This was an analytical cross-sectional study, conducted in a public university in Selangor, Malaysia. Data were collected using self-administered questionnaires from January to February 2013, and analysed using the Statistical Package for Social Sciences Software (version 21).

    RESULTS: Out of 625 undergraduate medical students, 537 (85.9%) participated in the study. The prevalence of the suicidality among undergraduate medical students was 7.0%. The significant predictors of suicidality based on multiple logistic regression were the respondent's lifetime suicide attempts (Adjusted Odds Ratio, AOR 10.4, 95% CI 2.7 to 40.9); depression (AOR 5.9, 95% CI 1.5 to 23.0); breaking off a steady love relationship (AOR 5.4, 95% CI 1.3 to 22.4); hopelessness (AOR 4.9, 95% CI 1.1 to 21.6); and something valued being lost or stolen (AOR 4.4, 95% CI 1.2 to 15.9).

    CONCLUSION: These findings indicate that mental health care services should be strengthened at university level. The results show a need for an intervention programme to reduce suicidality among the undergraduate medical students.
  2. Tan ST, Yoong BK
    Med J Malaysia, 2020 11;75(6):734-735.
    PMID: 33219186
    Tacrolimus, which bonds to an immunophilin, FK506 binding protein (FKBP) has emerged as one of the most widely used immunosuppressant post solid organ transplantation. It offers excellent patient survival rates post-transplantation and a lesser number of acute rejections as compared to cyclosporine. Tacrolimus has a narrow therapeutic window with overexposure leading to acute and chronic forms of nephrotoxicity. Remarkably few data have been published on the overexposure to tacrolimus following mild diarrhoea in post-transplant patients who received treatment with tacrolimus. We observed a post-liver transplant patient with increased trough level of tacrolimus during severe diarrhoea with no complications following a timely adjustment on the dose of tacrolimus.
  3. Tan ST, Shahril PIA
    Ethics Med Public Health, 2023 Apr;27:100874.
    PMID: 36776244 DOI: 10.1016/j.jemep.2023.100874
    BACKGROUND: The COVID-19 pandemic may have worsened food insecurity and altered the eating behaviour of young adults. Therefore, this cross-sectional study aims to investigate the correlation between moderate-to-severe food insecurity and the risk of eating disorders among young urbanists in Malaysia after the pandemic-led lockdown.

    METHODS: The food security status and the risk of eating disorders were assessed using the validated Food Insecurity Experience Scale (FIES) and Eating Attitude Test (EAT-26), respectively.

    RESULTS: Among the 208 young urbanists, approximately one-third (30.8%) were moderate-to-severe food insecure and about one-fifth (18.8%) were at risk of eating disorders after the nationwide lockdown. With the adjustment of gender, the binary logistic regression analysis revealed that moderate-to-severe food insecure individuals were 2.279 times (P = 0.030, 95% CI = 1.084-4.791) more likely to engage in disordered eating in the aftermath of the COVID-19 pandemic. The findings of partial correlation further indicated that moderate-to-severe food insecurity was positively correlated (rpartial = 0.156, P = 0.024) with bulimia and food preoccupation after the outbreak.

    CONCLUSIONS: Governments and non-governmental organizations must work closely to develop effective policies to address food insecurity and disordered eating behaviour among young urbanists - after the pandemic.

  4. Tan SS, Abu Hassan MR, Abdullah A, Ooi BP, Korompis T, Merican MI
    J Viral Hepat, 2010 Jun;17(6):410-8.
    PMID: 19758272 DOI: 10.1111/j.1365-2893.2009.01191.x
    Chronic hepatitis C is associated with increased morbidity and mortality in persons undergoing haemodialysis. This single-arm, open-label clinical trial investigated the safety and efficacy of an escalating dosage regimen of pegylated interferon (PEG-IFN) alpha-2b in this patient population. Patients with chronic hepatitis C who were undergoing haemodialysis began treatment with PEG-IFN alpha-2b at a dose of 0.5 microg/kg/week, which was increased every 4 weeks to a maximum of 1 microg/kg/week. Treatment duration was 24 weeks for patients with genotype (G) 2 or 3 infection and 48 weeks for patients with G1 infection. The primary end point was sustained virological response (SVR). Of 46 patients screened, 34 (G1: 70.6%; G3: 29.4%) were treated and 23 (67.6%) completed treatment. Overall, 85.3% of patients experienced early virological response, 52.9% experienced end-of-treatment response, and 50% attained SVR, with a trend toward higher SVR rates in G3 compared with G1 patients (80%vs 37.5%; P = 0.06). Anaemia was the main reason for discontinuation of treatment. Patients with chronic hepatitis C who are undergoing haemodialysis can be successfully treated with an escalating dosage regimen of PEG-IFN alpha-2b monotherapy. G3-infected patients can attain high rates of SVR with only 24 weeks of therapy.
  5. Tan SS, Leong CL, Lee CK
    Med J Malaysia, 2015 Oct;70(5):281-7.
    PMID: 26556116
    BACKGROUND: Co-infection by human immunodeficiency and hepatitis C viruses (HIV/HCV) is common and results in significant morbidity and mortality despite effective antiretroviral therapies (ART).
    METHOD: A retrospective and prospective evaluation of the efficacy and safety of pegylated interferon alfa 2a/2b plus ribavirin (PEG-IFN/RBV) in consecutive HIV/HCV co-infected patients treated in real life clinical practice in Malaysia.
    RESULTS: Forty-five HIV/HCV co-infected patients with a median age (interquartile range, IQR) of 41 years (37; 47) were assessed for treatment with PEG-IFN/RBV. All except one are of male gender and the most common risk behaviour was injecting drug use. At baseline 75.5% was on ART and the median (IQR) CD4 count was 492 cells/μl (376; 621). The HCV genotypes (GT) were 73 % GT3 and 27% GT1. Liver biopsies in forty patients showed 10% had liver cirrhosis and another 50% had significant liver fibrosis. The treatment completion rate was 79.5% with 15.9% dropped out of treatment due to adverse effects (AE) or default and 4.6% due to lack of early virological response. The AE causing premature discontinuations were neuropsychiatric and haematological. The overall sustained virological response (SVR) was 63.6% with a trend towards higher SVR in GT3 compared with GT1 (71.9% vs. 41.7%; p=0.064). In patients with bridging fibrosis plus occasional nodules or cirrhosis on liver biopsy, the SVR was significantly lower at 20% (p=0.030) compared to those with milder fibrosis.
    CONCLUSION: HIV/HCV co-infected patients can be successfully and safely treated with PEG-IFN/RBV achieving high rates of SVR except in cirrhotic patients.

    Study site: co-infection clinics at Sungai Buloh Hospita
  6. Tan SS, Aminah A, Mohd Suria Affandi Y, Atil O, Babji AS
    Int J Food Sci Nutr, 2001 Jan;52(1):91-8.
    PMID: 11225183
    Physico-chemical and sensory characteristics of frankfurters prepared with three types of palm fats (PF60: 40, PF70: 30 and PF80: 20) and palm olein (POo) at 20 and 25% of fat levels were studied. Incorporation of different fats at 20 and 25% did not affect the cooking yields of the frankfurters. Frankfurters incorporated with 25% POo showed the highest value of water-holding capacity (WHC) among eight formulations. The frankfurters containing POo showed the least cooking loss compared to those with palm fats. The incorporation of different type and level of fats resulted in significant changes in the colour (lightness, redness, yellowness) of frankfurters. Texture profiles of both raw and cooked frankfurters were found to be altered by the blending of different type and level of fats. In raw frankfurters, hardness for frankfurters mixed with palm fats were significantly higher than the one with POo but greater values for cohesiveness was observed in raw frankfurters blended with POo. Lowest chewiness was demonstrated by frankfurters mixed with 20% POo. Grilling increased the hardness values of all frankfurters. Contrary to the raw counterparts, cooked frankfurter with POo was the hardest among all formulations. Cohesiveness and chewiness was also found to be significantly higher for cooked frankfurters mixed with POo. Raw frankfurters with fat content of 25% showed greater value in hardness than those of 20%. However, there were no significant differences (P > 0.05) observed for all the texture profile attributes in cooked frankfurters due to fat levels. In sensory evaluation, frankfurters prepared with POo were found to be most acceptable by consumer panels as they scored the highest for hardness rating, chicken flavour, oiliness and overall acceptance attributes.
  7. Tan SS, Aminah A, Zhang XG, Abdul SB
    Meat Sci, 2006 Mar;72(3):387-97.
    PMID: 22061722 DOI: 10.1016/j.meatsci.2005.07.012
    This study was designed to explore the potential of refined, bleached and deodorized (RBD) palm oil (PO) and palm stearin (POs) utilization in chicken frankfurters. A 10 points augmented simplex-centroid design was used to study the effect of chicken fat (CF), PO and POs as well as the interaction of these fats on the emulsion, textural and sensory properties of chicken frankfurters. All frankfurters were formulated to contain approx 25% fat, 52% moisture and 10% protein. No significant difference was found in end chopping temperatures of all meat batters even though the temperature of PO and POs upon incorporation into meat batters was 50°C higher than CF. Strong emulsions were formed as no fluid losses were observed in all the meat batters tested after heating. Texture profiles of the frankfurters containing PO and/or CF were quite similar, but increment of POs raised hardness, chewiness, and shear hardness of the frankfurters. Acceptability of the frankfurters was evaluated using hedonic test. Panelists found no difference in hardness preference between frankfurters made from totally CF and PO, while frankfurters made from POs were rated as hard and brittle. CF was important in determining acceptability of the frankfurters, as reduction of CF in formulation resulted in lower scores in chicken flavor, juiciness, oiliness and overall acceptance of the frankfurters. Frankfurters with sensory acceptability comparable to a commercial one were found to comprise of more than 17% CF, and less than 67% PO and 17% POs of the fat blend.
  8. Tan SS, Adlin Nadia Z
    Med J Malaysia, 2017 06;72(3):165-174.
    PMID: 28733564 MyJurnal
    AIM: To describe the clinical characteristic of hepatitis C (HCV) patients and the results of pegylated interferon and ribavirin (PegIFN/RBV) therapy in a routine clinical practice.

    METHODS: A retrospective review of consecutive HCV patients treated with PegIFN/RBV in 2004 to 2012.

    RESULTS: A total of 273 patients received treatment. The mean age was 44.16 ± 10.5 years and 76% were male. The top 2 self-reported risks were blood or blood product transfusion before 1994 and injection drug use, found in 57.1% of patients. The predominant HCV genotype (GT) was 3 at 60.6%, second was GT1 at 36.1% and other GTs were uncommon at about 1% or less. About half of our patients have high baseline viral load (>800,000 iu/ml), 18.3% had liver cirrhosis and 22.3% had HIV co-infection. Co-morbid illness was found in 42.9%, hypertension and type 2 diabetes were the two most common. The overall sustained virological response (SVR) by intention-to-treat analysis were 54.9% (n=150/273), 41.2% (40/97) for GT1, 100% (5/5) for GT2 and 62% (101/163) for GT3. Subgroup analysis for HCV monoinfected, treatment naïve showed SVR of 49.2% (31/63) for GT1, 100% (5/5) for GT2 and 67% (69/103) for GT3. In HCV mono-infected and treatment experienced (n=29), the SVR was 28.6% (4/14) for GT1, 21.4% (69/103) for GT3. In the HIV/HCV co-infected, treatment naïve (n=56), the SVR was 28.6% (4/14) for GT1 and 64.3% (27/42) for GT3. Treatment naïve GT3 mono-infected patients had a statistically significant higher SVR compared to treatment experienced patients (P=0.001). In GT3 patients who achieved rapid virological response, the SVR was significantly higher at 85.2% (P< 0.001). The SVR for cirrhotics were low especially for GT1 at 21% (4/19) and 31% (4/13) based on all patients and treatment naïve HCV monoinfected respectively. In GT3 cirrhotics the corresponding SVR were 57.1% (16/28) and 60.9% (14/23). Premature discontinuation rate was 21.2% with the majority due to intolerable adverse events at 12.1%.

    CONCLUSIONS: In our routine clinical practice, the HCV patients we treated were young, predominantly of GT3 and many had difficult-to-treat clinical characteristics. The SVR of our patients were below those reported in Asian clinical trials but in keeping with some "real world" data.

  9. Tan SP, Bux SI, Kumar G, Razack AH, Chua CB, Lee SH, et al.
    Transplant Proc, 2004 Sep;36(7):1914-6.
    PMID: 15518697
    Catheter angiography is traditionally used to determine renal arterial anatomy in live renal donors. Three-dimensional (3D) contrast-enhanced magnetic resonance imaging (MRA) has been suggested as a noninvasive replacement. We assessed the possibility of using MRA in live renal donors in Malaysia.
  10. Tan SP, Abdullah BJ, Waran V, Liew WF
    Neuroradiology, 2003 Jan;45(1):53-5.
    PMID: 12525956
    We present a rare indirect nontraumatic cerebrospinal fluid (CSF) fistula secondary to a fourth ventricle ependymoma. The fistula resulted from rupture of the left temporal horn, distant from the tumour. The fistula was well demonstrated by MRI. High-resolution CT demonstrated a defect in the roof of the sphenoid sinus, but no leakage of CSF was seen on CT cisternography.
  11. Tan SN, Gendeh HS, Sani A, Mat-Baki M
    Int J Surg Case Rep, 2016;21:99-103.
    PMID: 26957189 DOI: 10.1016/j.ijscr.2016.02.012
    Myeloid Sarcoma (MS) or Granulocytic Sarcoma is an uncommon laryngeal malignancy. It may arise from myelodysplastic syndromes, malignancy or de novo. Presentation in the larynx is rare and some may present with Acute Myeloid Leukaemia (AML) whereby the later may be asymptomatic.
  12. Tan SMK, Azmi MT, Reddy JP, Shaharom MH, Rosdinom R, Maniam T, et al.
    Med J Malaysia, 2005 Aug;60(3):328-37.
    PMID: 16379188
    Stigmatising attitudes towards mental illness may improve with clinical exposure during medical school training. Attitudes of 48 fourth year medical students in Universiti Kebangsaan Malaysia were assessed before and after their compulsory attachment in Psychiatry, using the Attitude Towards Psychiatry-30 (ATP) and the Attitude towards Mental Illness (AMI) questionnaires. ATP scores improved significantly with training (104.8 and 114.4, pre- and post-attachment respectively) as did AMI scores (63.4 and 68.1 respectively). Both improvements were statistically significant. (ATP: z = 4.55, p < 0.0005) (AMI: z = 3.75, p < 0.0005). Attitudes towards mental illness appeared to have become more favourable with clinical training in psychiatry.
  13. Tan SM, Shafiee Z, Wu LL, Rizal AM, Rey JM
    Int J Psychiatry Med, 2005;35(2):123-36.
    PMID: 16240970 DOI: 10.2190/EQ71-RMWV-6CEJ-1DGM
    Objectives: To examine the association between ethnicity, depression, quality of life, and diabetic control in Malaysian adolescents and young adults with type I diabetes mellitus.

    Methods: Fifty-two outpatients with type I diabetes (mean age 15.5 years) who attended a Diabetes Clinic were included. The level of HbA1c was the measure of diabetes control used (better control defined as HbA1c < 10%). Other variables were measured through questionnaires (e.g., depressive symptoms, quality of life), computerized diagnostic interviews (major depression), and medical records (e.g., demographic, family circumstances, compliance with treatment).

    Results: Ethnic Chinese youth showed better diabetic control than Malays and Indians (mean HbA1c 9.1%, 10.3%, and 11.0% respectively). Young people with better diabetic control (HbA1c < 10%) were more likely to have better quality of life and less likely to live in problematic families. When the cut-off for diabetic control was stricter (HbA1c < or = 8%), the young person's compliance was the main predictor of poor control. Family problems were also associated with poor control but to a lesser extent. The initial association between poorer diabetes control and depression became non-significant when quality of life was taken into account.

    Conclusions: There are ethnic differences in juvenile diabetic control in this Malaysian sample which need to be understood further. Previous findings of an association between quality of life and glycemic control were verified but different definitions of good control showed different associations with individual and environmental variables. Clinicians' awareness and early intervention for psychosocial problems (for example, inadequate family support) could improve diabetes control.
  14. Tan SL, Rahmat K, Rozalli FI, Mohd-Shah MN, Aziz YF, Yip CH, et al.
    Clin Radiol, 2014 Jan;69(1):63-71.
    PMID: 24156797 DOI: 10.1016/j.crad.2013.08.007
    To investigate the capability and diagnostic accuracy of diffusion-weighted imaging (DWI) in differentiating benign from malignant breast lesions using 3 T magnetic resonance imaging (MRI).
  15. 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
  16. Tan SL, Neoh CY, Tan HH
    Singapore Med J, 2012 Feb;53(2):e24-7.
    PMID: 22337196
    Rhinoscleroma is a chronic, slowly progressive, inflammatory disease of the upper respiratory tract. It is associated with Klebsiella rhinoscleromatis infection. We present the clinical and pathological features of four patients diagnosed with rhinoscleroma at the National Skin Centre, Singapore between 1997 and 2010. All four patients presented with only cutaneous involvement, and the diagnosis was clinched via histological examination. The patients were treated with a combination of antibiotics. Two patients who were on follow-up at the time of this writing responded positively to the antibiotic treatment, while two were lost to follow-up. Rhinoscleroma is a diagnostic challenge, as it is an uncommon disease in Singapore and Malaysia. We highlight this condition to raise awareness of the disease in order to aid in early diagnosis of patients. Without treatment, this condition can result in significant complications, including involvement of the lower airways. Early diagnosis and appropriate treatment help to reduce morbidity.
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