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  1. Rashid AA, Zuhra H, Tan CE
    Med J Malaysia, 2018 08;73(4):197-201.
    PMID: 30121681 MyJurnal
    INTRODUCTION: Social support and self-efficacy are factors that influence patients' health behaviour. However, the relationship between these two factors among patients with Type 2 Diabetes Mellitus (T2DM) has not been adequately explored. This study aims to report social support and selfefficacy of Malaysian T2DM patients, and their correlations.

    METHODS: This cross-sectional questionnaire study involved 329 patients with T2DM who received their follow up at a public primary care clinic. Patients were selected via systematic random sampling. Patients self-completed locally adapted versions of the Medical Outcomes Study (MOS) Social Support Survey and Diabetic Management Self Efficacy Scale (DMSES). The scores of both tools were analysed to determine the association and correlation between social support and self-efficacy.

    RESULTS: The mean score for overall social support was 72.7±21.40 score range (0-100). "Affectionate support" was rated the highest averaged mean score at 78.31±23.71 (score range: 0-100). The mean DMSES score was 147.6±35.5 (score range :0-200), of which "medications" subscale was rated the highest with averaged mean scores 9.07±1.67 (score range: 0-10). Overall social support and self-efficacy were found to be weakly correlated (r=0.197, p<0.001). However, all subscales of social support were moderately correlated with "medications" subscale of self-efficacy.

    CONCLUSION: Social support is significantly associated with patients' self-efficacy in handling their own medications.

  2. Lee SW, Loo CH, Tan WC
    Med J Malaysia, 2018 10;73(5):338-339.
    PMID: 30350820 MyJurnal
    Confluent and reticulated papillomatosis (CRP) was first described in 1927 by Gougerot and further characterised by Carteud.1 It is relatively rare, and the exact pathophysiology was not well known. Over the years, multiple treatment modalities were proposed. We report our experience with three cases of CRP which showed complete clearance with tetracycline group of antibiotics.
  3. Sharma M, Tan RS, Acharya UR
    Comput Biol Med, 2018 11 01;102:341-356.
    PMID: 30049414 DOI: 10.1016/j.compbiomed.2018.07.005
    Myocardial infarction (MI), also referred to as heart attack, occurs when there is an interruption of blood flow to parts of the heart, due to the acute rupture of atherosclerotic plaque, which leads to damage of heart muscle. The heart muscle damage produces changes in the recorded surface electrocardiogram (ECG). The identification of MI by visual inspection of the ECG requires expert interpretation, and is difficult as the ECG signal changes associated with MI can be short in duration and low in magnitude. Hence, errors in diagnosis can lead to delay the initiation of appropriate medical treatment. To lessen the burden on doctors, an automated ECG based system can be installed in hospitals to help identify MI changes on ECG. In the proposed study, we develop a single-channel single lead ECG based MI diagnostic system validated using noisy and clean datasets. The raw ECG signals are taken from the Physikalisch-Technische Bundesanstalt database. We design a novel two-band optimal biorthogonal filter bank (FB) for analysis of the ECG signals. We present a method to design a novel class of two-band optimal biorthogonal FB in which not only the product filter but the analysis lowpass filter is also a halfband filter. The filter design problem has been composed as a constrained convex optimization problem in which the objective function is a convex combination of multiple quadratic functions and the regularity and perfect reconstruction conditions are imposed in the form linear equalities. ECG signals are decomposed into six subbands (SBs) using the newly designed wavelet FB. Following to this, discriminating features namely, fuzzy entropy (FE), signal-fractal-dimensions (SFD), and renyi entropy (RE) are computed from all the six SBs. The features are fed to the k-nearest neighbor (KNN). The proposed system yields an accuracy of 99.62% for the noisy dataset and an accuracy of 99.74% for the clean dataset, using 10-fold cross validation (CV) technique. Our MI identification system is robust and highly accurate. It can thus be installed in clinics for detecting MI.
  4. Poh WY, Omar MS, Tan HP
    Ann Saudi Med, 2018 8 6;38(4):269-276.
    PMID: 30078025 DOI: 10.5144/0256-4947.2018.269
    BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is rec.ognized as a common complication of radiographic contrast-enhanced procedures. N-acetylcysteine (NAC) is commonly prescribed, but CI-AKI can still develop despite NAC administration as prophylaxis.

    OBJECTIVE: Identify the predictive factors for development of CI-AKI in patients prescribed NAC.

    DESIGN: Prospective, cross-sectional.

    SETTING: A tertiary hospital in Malaysia.

    PATIENTS AND METHODS: All adult patients who were prescribed NAC for prevention of CI-AKI were identified through an NAC drug us.age monitoring card maintained by the inpatient pharmacy. The study was conducted from March to July 2017.

    MAIN OUTCOME MEASURES: Statistically significant predictive fac.tors for development of CI-AKI despite NAC administration.

    SAMPLE SIZE: 152 RESULTS: The most commonly recognized risk factors for CI-AKI present in the study population were renal impairment (n=131, 86.2%), anemia (n=107, 70.4%), and diabetes mellitus (n=90, 59.2%). Hydration therapy was initiated in 128 patients (84.2%) prior to the contrast-enhanced procedure. Sixty-one (40.1%) were treated with nephrotoxic medications concomitantly with NAC. Fifteen (9.9%) patients developed AKI. Hypotension (OR: 6.02; 95% CI 1.25-28.97) and use of high contrast volume (OR: 6.56; 95% CI: 1.41-30.64) significantly increased the odds for AKI. Prior hydration therapy (OR: 0.13; 95% CI 0.03-0.59) showed protective effects.

    CONCLUSION: The risk predictors identified for CI-AKI were hypotension, high contrast volume and prior hydration therapy.

    LIMITATION: May not have identified other confounding factors for development of CI-AKI.

    CONFLICT OF INTEREST: None.

  5. Tan G, Khoo P, Chan K
    Ann R Coll Surg Engl, 2018 Oct 05;100(8):1-6.
    PMID: 30286634 DOI: 10.1308/rcsann.2018.0143
    INTRODUCTION: The development of thoracic endovascular aortic repair has altered the approach and reduced the risk of treating the majority of descending thoracic aortic conditions. Primarily developed for the exclusion of thoracic aortic aneurysms, it is now used in place of open repair surgery for most descending thoracic aortic diseases, and has also been used to treat aortic arch diseases in selected cases.

    METHODS: A literature search was conducted of Medline and Embase databases from January 2007 to February 2017, using the key words 'aortic disease', 'thoracic aorta' and 'endovascular repair'; 205 articles were identified, of which 25 studies were selected for review based on their relevance.

    FINDINGS: The key findings of the indications, techniques, outcomes, complications and comparisons with open surgical repair were extracted from the published studies and are summarised in this review. Thoracic endovascular aortic repair is the preferred choice of intervention for patients with descending thoracic aortic disease. With time, it has improved to be safer and has the potential to expand aortic treatment choices in future.

  6. Chew SC, Tan CP, Nyam KL
    Food Sci Biotechnol, 2017;26(1):63-69.
    PMID: 30263511 DOI: 10.1007/s10068-017-0009-2
    This study assessed the changes of antioxidant activity and bioactive compounds of crude and refined kenaf seed oil during accelerated storage at 65°C for 24 days. 2,2-Diphenyl-1-picrylhydrazyl and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical scavenging assays were used to determine their antioxidant activity. The changes of phenolic, tocopherol, and phytosterol contents during the storage were also studied. The phenolic content and antioxidant activity of refined oil were significantly lower than those of crude oil after the accelerated storage. There was a decrease of 72.5% tocopherol content and 31.1% phytosterol content in the crude oil and a decrease of 67% tocopherol content and 12.1% phytosterol content in the refined oil during the accelerated storage. There was no significant difference in tocopherol and phytosterol contents for crude and refined oils after the storage. The rate of degradation of tocopherol and phytosterol contents in refined oil was slower than that in crude oil during the storage.
  7. Tan JP, Tam SM, Kiew R
    PhytoKeys, 2018.
    PMID: 30416344 DOI: 10.3897/phytokeys.110.25846
    Begoniayenyeniae is a new species of horticultural value known only from the Endau Rompin National Park, Peninsular Malaysia. It is similar to Begoniarajah with which it had previously been confused in the number of tepals and leaf characters. The new species is compared with three similar species, B.foxworthyi, B.rajah and B.reginula and photographs of all four species and descriptions of B.yenyeniae and B.rajah are provided. Molecular analysis using the ndhF-rpl132 chloroplast marker confirms the four species as distinct. Amongst native species, the three variegated species, B.yenyeniae, B.rajah and B.reginula, are some of the most popular Malaysian begonias in cultivation. Based on its restricted distribution, Begoniayenyeniae, under the IUCN Red List Categories and Criteria, is assessed as Critically Endangered.
  8. Chen WS, Tan JH, Mohamad Y, Imran R
    Injury, 2019 May;50(5):1118-1124.
    PMID: 30591225 DOI: 10.1016/j.injury.2018.12.031
    BACKGROUND: The establishment of an accurate prognostic model in major trauma patients is important mainly because this group of patients will benefit the most. Clinical prediction models must be validated internally and externally on a regular basis to ensure the prediction is accurate and current. This study aims to externally validate two prediction models, the Trauma and Injury Severity Score model developed using the Major Trauma Outcome Study in North America (MTOS-TRISS model), and the NTrD-TRISS model, which is a refined MTOS-TRISS model with coefficients derived from the Malaysian National Trauma Database (NTrD), by regarding mortality as the outcome measurement.

    METHOD: This retrospective study included patients with major trauma injuries reported to a trauma centre of Hospital Sultanah Aminah over a 6-year period from 2011 and 2017. Model validation was examined using the measures of discrimination and calibration. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC) and 95% confidence interval (CI). The Hosmer-Lemeshow (H-L) goodness-of-fit test was used to examine calibration capabilities. The predictive validity of both MTOS-TRISS and NTrD-TRISS models were further evaluated by incorporating parameters such as the New Injury Severity Scale and the Injury Severity Score.

    RESULTS: Total patients of 3788 (3434 blunt and 354 penetrating injuries) with average age of 37 years (standard deviation of 16 years) were included in this study. All MTOS-TRISS and NTrD-TRISS models examined in this study showed adequate discriminative ability with AUCs ranged from 0.86 to 0.89 for patients with blunt trauma mechanism and 0.89 to 0.99 for patients with penetrating trauma mechanism. The H-L goodness-of-fit test indicated the NTrD-TRISS model calibrated as good as the MTOS-TRISS model for patients with blunt trauma mechanism.

    CONCLUSION: For patients with blunt trauma mechanism, both the MTOS-TRISS and NTrD-TRISS models showed good discrimination and calibration performances. Discrimination performance for the NTrD-TRISS model was revealed to be as good as the MTOS-TRISS model specifically for patients with penetrating trauma mechanism. Overall, this validation study has ascertained the discrimination and calibration performances of the NTrD-TRISS model to be as good as the MTOS-TRISS model particularly for patients with blunt trauma mechanism.

  9. Tan SY, Arshad H, Abdullah A
    PLoS One, 2019;14(1):e0207191.
    PMID: 30605474 DOI: 10.1371/journal.pone.0207191
    Mobile Augmented Reality (MAR) requires a descriptor that is robust to changes in viewing conditions in real time application. Many different descriptors had been proposed in the literature for example floating-point descriptors (SIFT and SURF) and binary descriptors (BRIEF, ORB, BRISK and FREAK). According to literature, floating-point descriptors are not suitable for real-time application because its operating speed does not satisfy real-time constraints. Binary descriptors have been developed with compact sizes and lower computation requirements. However, it is unclear which binary descriptors are more appropriate for MAR. Hence, a distinctive and efficient accuracy measurement of four state-of-the-art binary descriptors, namely, BRIEF, ORB, BRISK and FREAK were performed using the Mikolajczyk dataset and ALOI dataset to identify the most appropriate descriptor for MAR in terms of computation time and robustness to brightness, scale and rotation changes. The obtained results showed that FREAK is the most appropriate descriptor for MAR application as it able to produce an application that are efficient (shortest computation time) and robust towards scale, rotation and brightness changes.
  10. Tan BL, Norhaizan ME, Chan LC
    PMID: 30519270 DOI: 10.1155/2018/7826576
    Manilkara zapota (L.) P. Royen, called sapodilla, or locally known as ciku, belongs to the family Sapotaceae. We found that Manilkara zapota leaf water extract has cytotoxic effect against human hepatocellular carcinoma (HepG2) cell line in our earlier study. Therefore, this study aimed to explore the anticancer properties of Manilkara zapota leaf water extract in HepG2 cells. We also aimed to unravel yet undiscovered mechanisms and identified several expressed genes whose functions in cytotoxicity activity of Manilkara zapota leaf water extract in HepG2 cells have not been well-studied. The apoptosis and intracellular reactive oxygen species (ROS) activities were analyzed using Annexin V-propidium iodide staining and dichlorodihydrofluorescein diacetate, respectively, by NovoCyte Flow Cytometer. Bax and Bcl-2 expression were assessed using Enzyme-Linked Immunosorbent Assay. The associated molecular pathways were evaluated by quantitative real-time PCR. Overall analyses revealed that Manilkara zapota leaf water extract can increase percentage of early apoptotic cells, induce the formation of ROS, upregulate c-Jun N-terminal kinase 1 (JNK1) and inducible nitric oxide synthase (iNOS), and reduce Akt1 and vascular endothelial growth factor A (VEGFA) transcriptional activities. Our data suggest that Manilkara zapota leaf water extract can suppress the growth of HepG2 cells via modulation of ERK1/2/Akt1/JNK1 transcriptional expression.
  11. Chong YM, Kaur G, Tan ML
    J Asian Nat Prod Res, 2019 Aug;21(8):754-771.
    PMID: 30606060 DOI: 10.1080/10286020.2018.1520704
    Andrographolide, a major bioactive compound isolated from Andrographis paniculata (Burm. F.) Nees, was evaluated for its effects on the hOAT1 membrane transporter. Substrate determination and inhibition of hOAT1-mediated uptake transport assay was carried out using recombinant CHO-hOAT1 cells. The results showed that the uptake ratio of andrographolide was less than 2.0 at all concentrations tested, indicating that andrographolide is not a hOAT1 substrate. Andrographolide has no significant effects on the p-aminohippuric acid uptake and on the mRNA and protein expression of hOAT1. In conclusion, andrographolide may not pose a drug-herb interaction risk related to hOAT1.
  12. Tan JK, Jaafar F, Makpol S
    BMC Complement Altern Med, 2018 Nov 29;18(1):314.
    PMID: 30497457 DOI: 10.1186/s12906-018-2383-6
    BACKGROUND: Replicative senescence of human diploid fibroblasts (HDFs) has been used as a model to study mechanisms of cellular aging. Gamma-tocotrienol (γT3) is one of the members of vitamin E family which has been shown to increase proliferation of senescent HDFs. However, the modulation of protein expressions by γT3 in senescent HDFs remains to be elucidated. Therefore, this study aimed to determine the differentially expressed proteins (DEPs) in young and senescent HDFs; and in vehicle- and γT3-treated senescent HDFs using label-free quantitative proteomics.

    METHODS: Whole proteins were extracted and digested in-gel with trypsin. Peptides were detected by Orbitrap liquid chromatography mass spectrometry. Mass spectra were identified and quantitated by MaxQuant software. The data were further filtered and analyzed statistically using Perseus software to identify DEPs. Functional annotations of DEPs were performed using Panther Classification System.

    RESULTS: A total of 1217 proteins were identified in young and senescent cells, while 1218 proteins in vehicle- and γT3-treated senescent cells. 11 DEPs were found in young and senescent cells which included downregulation of platelet-derived growth factor (PDGF) receptor beta and upregulation of tubulin beta-2A chain protein expressions in senescent cells. 51 DEPs were identified in vehicle- and γT3-treated senescent cells which included upregulation of 70 kDa heat shock protein, triosephosphate isomerase and malate dehydrogenase protein expressions in γT3-treated senescent cells.

    CONCLUSIONS: PDGF signaling and cytoskeletal structure may be dysregulated in senescent HDFs. The pro-proliferative effect of γT3 on senescent HDFs may be mediated through the stimulation of cellular response to stress and carbohydrate metabolism. The expressions and roles of these proteins in relation to cellular senescence are worth further investigations. Data are available via ProteomeXchange with identifier PXD009933.

  13. Lee IL, Tan TC, Govind SK
    Exp Parasitol, 2019 Mar;198:105-110.
    PMID: 30695704 DOI: 10.1016/j.exppara.2019.01.007
    This study was aimed at establishing a protocol for water sample processing for the detection of Blastocystis sp. using distilled water spiked with Blastocystis sp. cysts. The study established a protocol involving eight technical aspects, namely, storage temperature, storage duration, minimum water sample volume, optimum relative centrifugal force, centrifugation duration, minimum number of cyst for inoculation in Jones' medium and turn-around-time for the detection of vacuolar forms of Blastocystis sp. Results showed a minimum of 1.0 L water sample should be collected and processed on the same day. Otherwise, it should be stored at 4 °C and processed within 3 days. Water sample should be centrifuged at 1400×g for 10 min. For the isolation of Blastocystis sp. cysts, parasite pellet could be layered on top of Ficoll-Paque™ PLUS, centrifuged at 1400×g for 20 min and washed twice using 0.9% saline with centrifugation at 1400×g for 10 min. A minimum of 1 × 105 cysts could then be inoculated in Jones' medium supplement with 10% horse serum, incubated at 37 °C and examined for any presence of vacuolar forms of Blastocystis sp. after 3 days of inoculation. A protocol for water sample processing for the detection of Blastocystis sp. has successfully been established. The protocol was validated using 106 various water samples. This protocol will be very useful in determining the extent of Blastocystis sp. contamination in water sources in order to identify the seriousness of contamination.
  14. Tan TL, Lee LY, Lim WC
    Med J Malaysia, 2018 12;73(6):427-429.
    PMID: 30647223
    The occurrence of Leptospirosis and Escherichia coli coinfection in the post-partum period is a novel case. This report illustrated a previously well woman from a suburban area presented with acute neurological deterioration following a two days history of fever during her puerperal period. Early interventions with fluids, broad spectrum antibiotics and intensive supportive care were given. Despite that, she deteriorated rapidly and developed pulmonary hemorrhage, disseminated intravascular coagulopathy, and multi-organ failure. She succumbed within 12 hours of admission. The knowledge about such fatal co-infections should be disseminated to medical practitioners encountering Leptospirosis infection and general public.
  15. Tan LS, Daud MH, Nasirudin N
    J Hand Surg Asian Pac Vol, 2018 Dec;23(4):577-580.
    PMID: 30428790 DOI: 10.1142/S2424835518720335
    Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular lesion of the skin or mucous membrane with rapid growth or repetitive trauma. Rarely seen in adult, its management varies and surgical intervention is usually common. We report a case of pyogenic granuloma of the right index finger in a 46-year-old gentleman who presented with painless swelling of the right index finger after a trivial injury. Wedge biopsy confirmed the diagnosis and excision of the granuloma measuring 3 cm × 3 cm × 2 cm was done with curettage and electrocautery over the base of granuloma. The wound subsequently healed well with good functional and aesthetic outcome.
  16. Ahmad H, Ong SQ, Tan EH
    Int J Insect Sci, 2019;11:1179543318823533.
    PMID: 30675104 DOI: 10.1177/1179543318823533
    Megaselia scalaris (Loew) is one of the best-known diets for the swiftlet. Previous studies have addressed the problem of some mass rearing conditions for this insect; unfortunately, the details of the nutritional composition of the life stages and cost of the breeding materials were insufficiently reported, even though this information is crucial for farming the edible-nest swiftlet. We aimed to investigate the nutritional composition of the life stages of M scalaris on a cost basis using 3 common commercial breeding materials: chicken pellets (CPs), fish pellets (FPs), and mouse pellets (MPs). Modified Association of Official Analytical Chemists (AOAC) proximate and mineral analyses were carried out on the insect's third instar larvae, pupal, and adult stages to determine the nutritional composition. Regardless of the breeding materials, the adult stage of M scalaris had significantly higher crude protein than the other stages; the pupae were rich in calcium, which is required for egg production; and the third instar larvae had the highest amount of crude fat compared with the other stages. Regarding the energy content, there were no significant differences among the stages according to the breeding materials. In terms of nutritional cost, CP was the most economic breeding material and generated the highest amount of nutrients per US dollar (US $). Different life stages of M scalaris were used by the swiftlets by supplying the required nutrients, and future studies should focus on effective diet feeding methods.
  17. Wendy Tan AY, Chieng JY
    Med J Malaysia, 2018 12;73(6):361-364.
    PMID: 30647204
    OBJECTIVE: Approximately one-third of patients with esophageal varices will develop bleeding which is a major cause of morbidity and mortality in patients with liver cirrhosis. Currently, the two most widely used modalities to prevent variceal bleeding are pharmacologic and oendoscopic variceal band ligation (EVL). However, EVL has been associated with significant complications. Hence we aim to evaluate and to identify the epidemiology, demography, and complications of EVL at our local Malaysian tertiary hospital.

    METHOD: This is a retrospective study of all the patients that had undergone endoscopic variceal surveillance at the Gastroenterology endoscopy unit, Serdang Hospital from 1st January 2015 to 31st March 2017. Patients' demography, aetiologies of liver cirrhosis, platelet level and international normalised ratio (INR) prior banding procedure, and the post EVL complications were recorded and further analysed with SPSS version 16.

    RESULTS: In this study, 105 patients were screened for varices. Fifty-five of them had undergone EVL, with a quarter of the patients requiring repeated ligation. There was a male preponderance with 76.4%. 56.4% of patients were in age from 40-59 years. The majority of our patients were of the Malay ethnicity. The major aetiology for liver cirrhosis in our patients was viral hepatitis with Hepatitis C (31.0%), and Hepatitis B (20.0%). Most of our patients had platelet count >50,000 and INR <1.5 prior to EVL. There was no major complication in all of our subjects.

    CONCLUSION: EVL is relatively safe and feasible treatment for prevention of oesophageal variceal bleeds with a low complication rate.

  18. Hassan RA, Heng LY, Tan LL
    Sci Rep, 2019 04 23;9(1):6379.
    PMID: 31015498 DOI: 10.1038/s41598-019-42757-y
    A novel disposable electrochemical biosensor based on immobilized calf thymus double-stranded DNA (dsDNA) on the carbon-based screen-printed electrode (SPE) is developed for rapid biorecognition of carrageenan by using methylene blue (MB) redox indicator. The biosensor protocol for the detection of carrageenan is based on the concept of competitive binding of positively charged MB to the negatively charged dsDNA and carrageenan. The decrement in the MB cathodic peak current (ipc) signal as a result of the released MB from the immobilized dsDNA, and attracted to the carrageenan can be monitored via differential pulse voltammetry (DPV). The biosensor showed high sensitivity and selectivity to carrageenan at low concentration without interference from other polyanions such as alginate, gum arabic and starch. Calibration of the biosensor with carrageenan exhibited an excellent linear dependence from 1-10 mg L-1 (R2 = 0.98) with a detection limit of 0.08 mg L-1. The DNA-based carrageenan biosensor showed satisfactory reproducibility with 5.6-6.9% (n = 3) relative standard deviations (RSD), and possessing several advantages such as simplicity, fast and direct application to real sample analysis without any prior extensive sample treatments, particularly for seaweeds and food analyses.
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