MyMedR

Acute retinal necrosis by cytomegalovirus in an immunocompetent adult: case report and review of the literature

Tajunisah I, Reddy SC, Tan LH

Int Ophthalmol, 2009 Apr;29(2):85-90.

A rare case of acute retinal necrosis caused by cytomegalovirus in an immunocompetent adult, diagnosed by polymerase chain reaction of vitreous aspirate, with good visual outcome after intravitreal and intravenous ganciclovir and oral prednisolone therapy, is reported. A 50-year-old healthy lady presented with redness and diminution of vision in her right eye of 10 days duration. She had anterior chamber inflammation, marked vitritis, and anterior retinal necrosis in the right eye. Blood and other investigations did not reveal any infectious diseases and HIV testing was negative. The retinal lesions and panuveitis resolved with treatment. Two months later she developed retinal detachment which was treated successfully. The best-corrected vision was 6/12 in the right eye. Seven cases of cytomegalovirus ocular infection in immunocompetent healthy adults, reported in the literature, were reviewed. The different presentations of this disease and the importance of suspecting this causative agent are highlighted.

Labour and perinatal outcome in women at term with one previous lower-segment Caesarean: a review of 1000 consecutive cases

Tan PC, Subramaniam RN, Omar SZ

Aust N Z J Obstet Gynaecol, 2007 Feb;47(1):31-6.

PMID: 17261097

To compare the outcome in 1000 women at term with one lower transverse Caesarean that was suitable for a trial of labour.

Goserelin versus leuprolide before hysterectomy for uterine fibroids

Lim SS, Sockalingam JK, Tan PC

Int J Gynaecol Obstet, 2008 May;101(2):178-83.

PMID: 18164303 DOI: 10.1016/j.ijgo.2007.10.020

To compare goserelin and leuprolide given before hysterectomy for symptomatic large fibroid uteri.

Application of biochemical products as a bioremediation technique for domestic sewage treatment plants

Salmiati, Salim MR, Hassan RM, Tan KY

Water Sci Technol, 2007;56(7):33-40.

PMID: 17951865

Biochemical products have been widely used for treatment of various types of wastewater. The treatment processes with the addition of biochemical products are quite attractive because of their simplicity, minimal use of equipment, they are environmentally friendly and are suitable for the removal of organic pollutants. The purpose of these products is to enhance the activities of beneficial microbes in order to improve treatment performance. This study was carried out to determine the potential of applying biochemical products in assisting and improving the performance of sewage treatment plants. In this study, four biochemical products, namely: Zeolite, Bio-C, Eco-B and Was-D, were applied to the sewage treatment plant. Analyses were carried out on several water quality parameters such as biochemical oxygen demand (BOD), chemical oxygen demand (COD), suspended solids (SS), oil & grease (O&G), phosphorus (P), ammoniacal nitrogen (AN) and sludge thickness (ST). From the results obtained, it can be seen that the overall performance of the treatment plant improved with most of the parameters studied were found to fulfill the DOE Standard B requirements. The performance of Bio-C was found to give better results than other products.

Improving OSCE examiner skills in a Malaysian setting

Tan CP, Azila NM

Med Educ, 2007 May;41(5):517.

PMID: 17470099

A reassessment of recall frequency intervals for screening in low caries incidence populations

Tan EH, Batchelor P, Sheiham A

Int Dent J, 2006 Oct;56(5):277-82.

PMID: 17069070

OBJECTIVES: To reassess the recall frequency interval for dental examinations for children, based on annual caries increments.

METHODS: Cross sectional data collected on school children in eight rural and urban schools through the national Incremental Dental Care Programme (IDCP) for one district in Malaysia were analysed to assess their annual caries increment and trend lines. The Restorative Index was calculated to assess the success of the IDCP in rendering children dentally fit.

RESULTS: The annual caries increments were low; the current caries levels were between 0.65 and 1.50 for 12 year-old children in Kota Tinggi District. Most of the caries experience was on pits and fissures. From 7 to 12 years old, the overall annual caries increment for the total study population was 0.19. The mean annual caries increment increased slightly between the ages of 12 to 14 years and 14 to 16 years and was 0.24 and 0.25 respectively. Two distinct caries incremental trend lines were observed for children aged 7 to 16 years. One group reached a mean DMFT of about 0.75 while the other group a mean DMFT of about 1.4 at 12 years. The trend lines continued over the next 4 years until the children were 16 years old. The Restorative Index was higher in urban schools that also had low DMFT levels.

CONCLUSIONS: Based on the low annual caries increments of between 0.65 and 1.50, yearly dental examination intervals can safely be extended to 2-yearly intervals or even longer. Such a change of screening recall intervals would help improve resource allocation. Resources saved by extending recall intervals can be redirected to the small proportion of children with higher disease levels. This will help render more school children dentally fit and reduce inequalities in oral health.

Quantification of Epstein-Barr virus DNA load, interleukin-6, interleukin-10, transforming growth factor-beta1 and stem cell factor in plasma of patients with nasopharyngeal carcinoma

Tan EL, Selvaratnam G, Kananathan R, Sam CK

BMC Cancer, 2006;6:227.

PMID: 16995954

Nasopharyngeal carcinoma (NPC) is a common epithelial neoplasm among the Chinese populations in Southern China and South East Asia. Epstein-Barr virus (EBV) is known to be an important etiologic agent of NPC and the viral gene products are frequently detected in NPC tissues along with elevated antibody titres to the viral proteins (VCA and EA) in a majority of patients. Elevated plasma EBV DNA load is regarded as an important marker for the presence of the disease and for the monitoring of disease progression. However, other serum/plasma parameters such as the levels of certain interleukins and growth factors have also been implicated in NPC. The objectives of the present study are, 1) to investigate the correlations between plasma EBV DNA load and the levels of interleukin (IL)-6, IL-10, TGF-beta1 and SCF (steel factor) and 2) to relate these parameters to the stages of NPC and the effect of treatment.

Fulltext Migration of a foreign body in the maxillary sinus illustrating natural mucociliary action

Pang KP, Siow JK, Tan HM

Med J Malaysia, 2005 Oct;60(4):523-5.

PMID: 16570724

We present a case of a foreign body which migrated to the maxillary ostia by mucociliary action from its initial location on the floor of the maxillary sinus where it was traumatically introduced. This report illustrates that a powerful mechanism of mucociliary action can cause relatively heavy objects within the maxillary sinus to migrate naturally to the sinus ostia against gravitational force.

Fulltext Marjolin's ulcer--a near forgotten entity

Tan BC, Horton TC, Sara Ahmad T

Med J Malaysia, 2006 Feb;61 Suppl A:91-3.

PMID: 17042239

We report a case of a 55-year-old man who presented with a 6-month history of a fungating ulcer on the right hand at the site of a previously healed ulcer that had been present for 40 years. Histopathological examination of four-quadrant biopsy specimens showed a moderately differentiated squamous cell carcinoma (SCC). A transradiocarpal amputation with stump closure using radial flap was performed as it was not possible to achieve a functionally and cosmetically acceptable hand after a wide excision with 2 cm tumour-free margin. It is our intention to highlight this rare condition as reminder to consider this entity as a differential diagnosis of chronic non-healing skin ulcer.

Isolation of lactic acid bacteria from Malaysian foods and assessment of the isolates for industrial potential

Mohd Adnan AF, Tan IK

Bioresour Technol, 2007 May;98(7):1380-5.

PMID: 16872826

Two traditional fermented food 'tapai' (fermented tapioca) and 'tempoyak' (fermented durian flesh), chilli puree and fresh goat's milk were used as sources for the isolation of lactic acid bacteria (LAB). A total of 126 isolates were obtained and by sequential screening for catalase activity and Gram-staining, 55 were determined to be LAB out of which 16 were established to be homofermentative by the gel plug test. Seven isolates were identified by use of the API 50CHL kit and two lactobacilli strains and one lactococci strain were selected to study their growth and lactic acid production profiles in a time course experiment. The lactobacilli strains, both isolated from 'tapai', produced higher amounts of cells and lactic acid from glucose as compared to the lactococci strain isolated from fresh goat's milk.

Fulltext Shoulder ultrasound

Tan S, Fairbairn K, Kirk J, Liong W

Biomed Imaging Interv J, 2006 Oct;2(4):e58.

PMID: 21614338 DOI: 10.2349/biij.2.4.e58

Recent developments and applications of liquid phase microextraction in fruits and vegetables analysis

Abdulra'uf LB, Sirhan AY, Huat Tan G

J Sep Sci, 2012 Dec;35(24):3540-53.

PMID: 23225719 DOI: 10.1002/jssc.201200427

The sample preparation step has been identified as the bottleneck of analytical methodology in chemical analysis. Therefore, there is need for the development of cost-effective, easy to operate, and environmentally friendly miniaturized sample preparation technique. The microextraction techniques combine extraction, isolation, concentration, and introduction of analytes into analytical instrument, to a single and uninterrupted step, and improve sample throughput. The use of liquid-phase microextraction techniques for the analysis of pesticide residues in fruits and vegetables are discussed with the focus on the methodologies employed by different researchers and their analytical performances. Analytes are extracted using water-immiscible solvents and are desorbed into gas chromatography, liquid chromatography, or capillary electrophoresis for identification and quantitation.

Applications of solid-phase microextraction for the analysis of pesticide residues in fruits and vegetables: a review

Abdulra'uf LB, Chai MK, Tan GH

J AOAC Int, 2012 11 28;95(5):1272-90.

PMID: 23175958

This paper reviews the application of various modes of solid-phase microextraction (SPME) for the analysis of pesticide residues in fruits and vegetables. SPME is a simple extraction technique that eliminates the use of solvent, and it is applied for the analysis of both volatile and nonvolatile pesticides. SPME has been successfully coupled to both GC and LC. The coupling with GC has been straightforward and requires little modification of existing equipment, but interfacing with LC has proved challenging. The external standard calibration technique is widely used for quantification, while standard addition and internal or surrogate standards are mainly used to account for matrix effects. All parameters that affect the extraction of pesticide residues from fruits and vegetables, and therefore need to be optimized, are also reviewed. Details of the characteristics of analytical procedures and new trends in fiber production using sol-gel technology and molecularly imprinted polymers are discussed.

Paronychia induced by the epidermal growth factor receptor inhibitor cetuximab

Lee SL, Tan BS, Chan LC

J Oncol Pharm Pract, 2013 Sep;19(3):273-8.

PMID: 23161875 DOI: 10.1177/1078155212461289

While the development of epidermal growth factor receptor inhibitors has been hailed as a remarkable triumph in the field of oncology, it has inherited with it a host of cutaneous side-effects that have been increasingly observed in a substantial number of patients in the recent years. One cutaneous manifestation that may inflict significant pain and affect activities of daily living among some of the patients receiving epidermal growth factor receptor inhibitors is paronychia. A case of paronychia associated with the use of cetuximab in the management of KRAS wild-type midrectal adenocarcinoma along with its management has been described.

Method development for determination of fluroxypyr in soil

Halimah M, Tan YA, Ismail BS

J Environ Sci Health B, 2004;39(5-6):765-77.

PMID: 15620085

Four methods were developed for the analysis of fluroxypyr in soil samples from oil palm plantations. The first method involved the extraction of the herbicide with 0.05 M NaOH in methanol followed by purification using acid base partition. The concentrated material was subjected to derivatization and then cleaning process using a florisil column and finally analyzed by gas chromatography (GC) equipped with electron capture detector (ECD). By this method, the recovery of fluroxypyr from the spiked soil ranged from 70 to 104% with the minimum detection limit at 5 microg/kg. The second method involved solid liquid extraction of fluroxypyr using a horizontal shaker followed by quantification using high performance liquid chromatography (HPLC) equipped with UV detector. The recovery of fluroxypyr using this method, ranged from 80 to 120% when the soil was spiked with fluroxypyr at 0.1-0.2 microg/g soil. In the third method, the recovery of fluroxypyr was determined by solid liquid extraction using an ultrasonic bath. The recovery of fluroxypyr at spiking levels of 4-50 microg/L ranged from 88 to 98% with relative standard deviations of 3.0-5.8% with a minimum detection limit of 4 microg/kg. In the fourth method, fluroxypyr was extracted using the solid liquid extraction method followed by the cleaning up step with OASIS HLB (polyvinyl dibenzene). The recovery of fluroxypyr was between 91 and 95% with relative standard deviations of 4.2-6.2%, respectively. The limit of detection in method 4 was further improved to 1 pg/kg. When the weight of soil used was increased 4 fold, the recovery of fluroxypyr at spiking level of 1-50 microg/kg ranged from 82-107% with relative standard deviations of 0.5-4.7%.

Existence of two forms of L protein of Newcastle disease virus isolates due to a compensatory mutation in Domain V

Kusumaningtyas E, Tan WS, Zamrod Z, Eshaghi M, Yusoff K

Arch Virol, 2004 Sep;149(9):1859-65.

PMID: 15593426

Nucleotide sequence comparison of the L gene of the Malaysian neurotropic-viscerotropic velogenic NDV strain AF2240 with other NDV strains revealed a single nucleotide insertion at position 3870. This mutation is compensated by a nucleotide deletion downstream at position 3958 which results in two forms of the L proteins containing a 30-amino acid substitution in Domain V. This compensatory mutation does not correlate with the pathogenicity of the viral strains but it may affect the viral replication as Domain V is believed to play an important role in the replication of paramyxoviruses.

Identification of epitopes in the nucleocapsid protein of Nipah virus using a linear phage-displayed random peptide library

Eshaghi M, Tan WS, Yusoff K

J Med Virol, 2005 Jan;75(1):147-52.

PMID: 15543570

A random peptide library of heptamers displayed on the surface of M13 bacteriophage was used to identify specific epitopes of antibodies in pooled sera of swine naturally infected by Nipah virus. The selected heptapeptides were aligned with protein sequences of Nipah virus and several putative epitopes were identified within the nucleocapsid protein. A total of 41 of 60 (68%) selected phage clones had inserts resembling a region with the sequence SNRTQGE, located at the C-terminal end (amino acids 503-509) of the nucleocapsid protein. The binding of antibodies in the swine and human antisera to the phage clone was inhibited by a synthetic peptide corresponding to this region. Epitopes identified by phage display are consistent with the predicted antigenic sites for the Nipah virus nucleocapsid protein. The selected phage clone used as a coating antigen discriminated swine and human Nipah virus sera-positive from sera-negative samples exhibiting characteristics, which might be attractive for diagnostic tests.

Accreditation of medical schools: the question of purpose and outcomes

Azila NM, Tan CP

Med J Malaysia, 2005 Aug;60 Suppl D:35-40.

PMID: 16315622

Accreditation is a process by which official accrediting bodies evaluate institutions using a set of criteria and standards, following established procedures, to ensure a high quality of education needed to produce highly competent graduates. Additional objectives include (1) ensuring quality institutional functioning, (2) strengthening capabilities of educational institutions for service to the nation and (3) improving public confidence in medical schools. The accreditation process provides an opportunity for the institution to critically reflect upon all the aspects of its programme and the level of compliance or attainment of the requirements. The self-evaluation exercise, which identifies strengths and weaknesses, is perceived as formative. It is envisaged that eventually institutions will adopt a learning culture for curriculum development, implementation, monitoring and matching the outcomes. In conclusion, periodic accreditation activities can act as a "monitoring" system to ensure that the quality of medical education is maintained according to established standards.

A pilot project on hospital-based universal newborn hearing screening: lessons learned

Mukari SZ, Tan KY, Abdullah A

Int J Pediatr Otorhinolaryngol, 2006 May;70(5):843-51.

PMID: 16246430

This paper reports the performance of a newly implemented hospital-based universal newborn hearing screening programme and the challenges to the effective implementation.

Fulltext Percutaneous dilational tracheostomy--a 3 year experience in a general hospital in Malaysia

Tan CC, Lee HS, Balan S

Med J Malaysia, 2004 Dec;59(5):591-7.

PMID: 15889560

All percutaneous tracheostomies performed in the general intensive care unit (ICU), Hospital Sultanah Aminah, Johor Bahru, Malaysia, from July 1999 to June 2002 were studied. The tracheostomies were performed as an elective bedside technique in the ICU. A total of 352 percutaneous tracheostomies were performed. Eighty-eight percent of the tracheostomies were completed within 15 minutes. The most common complication was bleeding which occurred in 52 patients (14.7%). The rest of the complications encountered were:- transient hypoxia twelve (3.4%), inability/ difficulty to insert tracheostomy tube eight (2.3%), false passage four (1.1%), transient hypotension two (0.6%), pneumothorax two (0.6%), peristomal infection two (0.6%), subcutaneous emphysema one (0.3%), cuff rupture one (0.3%), oesophageal cannulation one (0.3%), and granuloma formation one (0.3%). Conversion to conventional tracheostomies were performed on 7 patients (2%). There was one unfortunate death related to percutaneous tracheostomy. In conclusion, percutaneous dilational tracheostomy can be used safely to manage the airway of critically ill patients.

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