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  1. Fulltext Sodium-glucose co-transporter-2 inhibitors: know the patient and the drugs
    Lim LL, Chan JCN
    Hong Kong Med J, 2019 08;25(4):268-270.
    PMID: 31416989 DOI: 10.12809/hkmj195089
  2. National dental health survey of school population in Singapore dental caries
    Goh SW, Wong MQ, Chan J
    Dent J Malaysia Singapore, 1972 May;12(1):15-21.
    PMID: 4507354
  3. Resistance and empowerment against racism: A preregistered study of associations with body appreciation and body acceptance by others in racialised minority adults in the United Kingdom
    Chan J, Craddock N, Swami V
    Body Image, 2023 Sep;46:1-8.
    PMID: 37149923 DOI: 10.1016/j.bodyim.2023.04.010
    Research on body image and racism has largely focused on how individual experiences of racism are associated with detrimental body image outcomes. However, research has not yet examined how resistance and empowerment against racism (REAR) - a repertoire of proactive strategies aimed at preventing or challenging racism both at the individual and collective levels - shape positive body image outcomes. Here, 236 women and 233 men who identified as belonging to racialised minority groups in the United Kingdom completed the REAR Scale - which measures REAR along four dimensions - as well as measures of body appreciation and body acceptance by others. Correlational analyses indicated significant inter-correlations between nearly all REAR domains and body image-related variables in men, whereas relationships in women were largely non-significant. Linear model analyses indicated that greater leadership for resistance against racism was significantly associated with higher body appreciation in women and men. Greater interpersonal confrontation of racism was significantly associated with both body appreciation and body acceptance by others in men, but not in women. These results suggest that REAR may play a role in shaping body image-related outcomes in people of colour, but that these effects are also be shaped by the intersection of gender and race.
  4. Fulltext Botulinum toxin type A for rehabilitation after a spinal cord injury: a case report
    Naicker AS, Roohi SA, Chan JL
    J Orthop Surg (Hong Kong), 2009 Apr;17(1):96-9.
    PMID: 19398803 DOI: 10.1177/230949900901700121
    A 56-year-old man became quadriplegic, bed bound, and carer-dependent secondary to cervical osteomyelitis. Three years later, he presented with generalised spasticity, crouched posture, and a large sacral pressure sore. The severe spasticity in his hips and knees prevented ischial sitting. Injections of botulinum toxin type A to both hamstrings and gastrosoleuii controlled the flexor spasticity of his lower limbs and facilitated rehabilitation and wound healing through proper positioning, wound care, stretching, and weight-bearing exercises. A few weeks later, the patient could better position himself in bed (prone lying) and on his wheelchair (ischial sitting). His spasm-related pain lessened and his mobility and activities of daily living improved. The sacral pressure sore healed completely a few months later. The patient could sleep better, feed with set-up and adaptive aids, groom, dress, and transfer himself with minimal assistance. The effects of botulinum toxin extended beyond just spasticity reduction. His upper extremity function, mobility, and social well-being were all improved through better positioning.
  5. Fulltext Carica papaya L. Leaf: A Systematic Scoping Review on Biological Safety and Herb-Drug Interactions
    Lim XY, Chan JSW, Japri N, Lee JC, Tan TYC
    Evid Based Complement Alternat Med, 2021;2021:5511221.
    PMID: 34040647 DOI: 10.1155/2021/5511221
    INTRODUCTION: The Carica papaya L. leaf is gaining interest as a potential therapeutic agent for alleviating dengue- and non-dengue-associated thrombocytopaenia. In that regard, safety considerations are as important as efficacy potential. The safety evaluation of botanical products for human use is complicated by variable formulations, complex phytochemical composition, and extrinsic toxicants. This review aimed to systematically collate related safety clinical and preclinical data, as well as reports on herb-drug interactions of C. papaya leaf consumption.

    METHODS: A systematic search using predetermined keywords on electronic databases (MEDLINE, Cochrane Library Central, LILACS, and Web of Science) and grey literature was conducted. Relevant clinical and preclinical studies were identified, screened, and analysed to present an overall safety profile of C. papaya leaf consumption.

    RESULTS: A total of 41 articles were included (23 clinical, 5 ongoing trials, and 13 preclinical) for descriptive analysis on study characteristics, adverse reactions, toxicity findings, and herb-drug interactions, from which 13 randomised controlled and quasiexperimental trials were further assessed for risk of bias and reporting quality. Overall, C. papaya leaf consumption (in the form of juice and standardised aqueous extract) was well tolerated by adult humans for short durations (

  6. Fulltext Are Indians and females less tolerant to pain? An observational study using a laboratory pain model
    Das Gupta E, Zailinawati AH, Lim AW, Chan JB, Yap SH, Hla YY, et al.
    Med J Malaysia, 2009 Jun;64(2):111-3.
    PMID: 20058568 MyJurnal
    In Malaysia, it is a common belief among health care workers that females and Indians have lower pain threshold. This experience, although based on anecdotal experience in the healthcare setting, does not allow differentiation between pain tolerance, and pain expression. To determine whether there is a difference in the tolerance to pain between the three main ethnic groups, namely the Malays, Chinese and Indians as well as between males and females. This was a prospective study, using a laboratory pain model (ischaemic pain tolerance) to determine the pain tolerance of 152 IMU medical students. The mean age of the students was 21.8 years (range 18-29 years). All of them were unmarried. The median of ischaemic pain tolerance for Malays, Chinese and Indians were 639s, 695s and 613s respectively (p = 0.779). However, statistically significant difference in ischaemic pain tolerance for males and females Indian students were observed. Possible ethnic difference in pain tolerance in casual observation is not verified by this laboratory pain model. Difference in pain tolerance between genders is shown only for Indians.
  7. Losartan reduces the costs of diabetic end-stage renal disease: an Asian perspective
    Seng WK, Hwang SJ, Han DC, Teong CC, Chan J, Burke TA, et al.
    Nephrology (Carlton), 2005 Oct;10(5):520-4.
    PMID: 16221106
    To evaluate losartan and conventional antihypertensive therapy (CT) compared with CT alone on the cost associated with end-stage renal disease (ESRD) in Hong Kong, Japan, Korea, Malaysia, Singapore and Taiwan.
  8. Newly formulated 5% 5-aminolevulinic acid photodynamic therapy on Candida albicans
    Greco G, Di Piazza S, Chan J, Zotti M, Hanna R, Gheno E, et al.
    Photodiagnosis Photodyn Ther, 2020 Mar;29:101575.
    PMID: 31614222 DOI: 10.1016/j.pdpdt.2019.10.010
    BACKGROUND: A large number of systemic diseases can be linked to oral candida pathogenicity. The global trend of invasive candidiasis has increased progressively and is often accentuated by increasing Candida albicans resistance to the most common antifungal medications. Photodynamic therapy (PDT) is a promising therapeutic approach for oral microbial infections. A new formulation of 5-aminolevulinic acid (5%ALA) in a thermosetting gel (t) (5%ALA-PTt) was patented and recently has become available on the market. However, its antimicrobial properties, whether mediated or not by PDT, are not yet known. In this work we characterised them.

    METHODS: We isolated a strain of C. albicans from plaques on the oral mucus membrane of an infected patient. Colonies of this strain were exposed for 1 24 h, to 5%ALA-PTt, 5%ALA-PTt buffered to pH 6.5 (the pH of the oral mucosa) (5%ALA-PTtb) or not exposed (control). The 1 h-exposed samples were also irradiated at a wavelength of 630 nm with 0.14 watts (W) and 0.37 W/cm2 for 7 min at a distance of <1 mm.

    RESULTS AND CONCLUSION: The 5% ALA-PTt preparation was shown to be effective in reducing the growth of biofilm and inoculum of C. albicans. This effect seems to be linked to the intrinsic characteristics of 5%ALA-TPt, such acidic pH and the induction of free radical production. This outcome was significantly enhanced by the effect of PDT at relatively short incubation and irradiation times, which resulted in growth inhibition of both treated biofilm and inoculum by ∼80% and ∼95%, respectively.

  9. Fulltext Real-world evidence on health-related quality of life in patients with type 2 diabetes mellitus using sulphonylureas: An analysis of the Joint Asia Diabetes Evaluation (JADE) Register
    Lim LL, S H Lau E, Pheng Chan S, Ji L, Lim S, Sirinvaravong S, et al.
    Diabetes Res Clin Pract, 2023 Sep;203:110855.
    PMID: 37517776 DOI: 10.1016/j.diabres.2023.110855
    AIMS: To describe health-related quality of life (HRQoL) and identify associated factors in patients with type 2 diabetes mellitus (T2DM) treated with oral glucose-lowering drugs (OGLDs).

    METHODS: This retrospective, cross-sectional analysis included adults with T2DM from 11 Asian countries/regions prospectively enrolled in the Joint Asian Diabetes Evaluation (JADE) Register (2007-2019) with available EuroQol-5D (EQ-5D-3L) data.

    RESULTS: Of 47,895 included patients, 42,813 were treated with OGLDs + lifestyle modifications (LSM) and 5,082 with LSM only. Among those treated with OGLDs, 60% received sulphonylureas (SUs), of whom 47% received gliclazide. The OGLD + LSM group had a lower mean EQ-5D-3L index score than the LSM-only group (p 

  10. Fulltext Use of sodium-glucose co-transporter-2 inhibitors in patients with type 2 diabetes mellitus and multiple cardiovascular risk factors: An Asian perspective and expert recommendations
    Deerochanawong C, Chan SP, Matawaran BJ, Sheu WH, Chan J, Man NH, et al.
    Diabetes Obes Metab, 2019 Nov;21(11):2354-2367.
    PMID: 31264765 DOI: 10.1111/dom.13819
    Diabetes mellitus in Asia accounts for more than half of the global prevalence. There is a high prevalence of cardiovascular disease (CVD) in the region among people with type 2 diabetes mellitus (T2DM) and it is often associated with multiple risk factors including hypertension, renal disease and obesity. The early onset of T2DM and the eventual long disease duration portends an increasing proportion of the population to premature CVD. In addition to lowering blood glucose, sodium-glucose co-transporter-2 (SGLT-2) inhibitors exert favourable effects on multiple risk factors (including blood pressure, body weight and renal function) and provide an opportunity to reduce the risk of CVD in patients with T2DM. In this article, we consolidated the existing literature on SGLT-2 inhibitor use in Asian patients with T2DM and established contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, published data from clinical trials in the Asian population (dapagliflozin, canagliflozin, empagliflozin, ipragliflozin, luseogliflozin and tofogliflozin), CVD outcomes trials (EMPAREG-OUTCOME, CANVAS and DECLARE-TIMI 58) and real-world evidence studies (CVD-REAL, EASEL, CVD-REAL 2 and OBSERVE-4D). A series of clinical recommendations on the use of SGLT-2 inhibitors in Asian patients with T2DM was deliberated among experts with multiple rounds of review and voting. Based on the available evidence, we conclude that SGLT-2 inhibitors represent an evidence-based therapeutic option for the primary prevention of heart failure hospitalization and secondary prevention of CVD in patients with T2DM, and should be considered early on in the treatment algorithm for patients with multiple risk factors, or those with established CVD.
  11. Fulltext Use of sodium-glucose co-transporter-2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
    Khoo CM, Deerochanawong C, Chan SP, Matawaran B, Sheu WH, Chan J, et al.
    Diabetes Obes Metab, 2021 Feb;23(2):299-317.
    PMID: 33155749 DOI: 10.1111/dom.14251
    Early onset of type 2 diabetes and a high prevalence of co-morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin-angiotensin system inhibitors, sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT-2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA-CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT-2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end-stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose-lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT-2 inhibitors represent an evidence-based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease.
  12. Fulltext Use of SGLT-2 Inhibitors in Patients with Type 2 Diabetes Mellitus and Abdominal Obesity: An Asian Perspective and Expert Recommendations
    Sheu WHH, Chan SP, Matawaran BJ, Deerochanawong C, Mithal A, Chan J, et al.
    Diabetes Metab J, 2020 02;44(1):11-32.
    PMID: 32097996 DOI: 10.4093/dmj.2019.0208
    The prevalence of obesity in Asia is of epidemic proportions, with an estimated 1 billion overweight/obese individuals in the region. The majority of patients with type 2 diabetes mellitus (T2DM) are overweight/obese, which increases the risk of cardiorenal outcomes in these patients; hence, sustained reductions in body weight and visceral adiposity are important management goals. However, most of the glucose-lowering therapies such as insulin, sulfonylureas, glinides, and thiazolidinediones induce weight gain, which makes the management of overweight/obese T2DM patients challenging. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are the only oral glucose-lowering agents that have been shown to reduce body weight and visceral adiposity. In addition, SGLT-2 inhibitors therapy reduces ectopic fat deposition and improves adipose tissue function and weight-related quality of life. In this article, we aim to consolidate the existing literature on the effects of SGLT-2 inhibitors in Asian patients with T2DM and to produce clinical recommendations on their use in overweight or obese patients with T2DM. Recommendations from international and regional guidelines, as well as published data from clinical trials in Asian populations and cardiovascular outcomes trials are reviewed. Based on the available data, SGLT-2 inhibitors represent an evidence-based therapeutic option for the management of overweight/obese patients with T2DM.
  13. The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice
    Landor AM, Ramseyer Winter VL, Thurston IB, Chan J, Craddock N, Ladd BA, et al.
    Body Image, 2024 Mar;48:101674.
    PMID: 38154289 DOI: 10.1016/j.bodyim.2023.101674
    White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.
  14. Fulltext IgM in human immunity to Plasmodium falciparum malaria
    Boyle MJ, Chan JA, Handayuni I, Reiling L, Feng G, Hilton A, et al.
    Sci Adv, 2019 09;5(9):eaax4489.
    PMID: 31579826 DOI: 10.1126/sciadv.aax4489
    Most studies on human immunity to malaria have focused on the roles of immunoglobulin G (IgG), whereas the roles of IgM remain undefined. Analyzing multiple human cohorts to assess the dynamics of malaria-specific IgM during experimentally induced and naturally acquired malaria, we identified IgM activity against blood-stage parasites. We found that merozoite-specific IgM appears rapidly in Plasmodium falciparum infection and is prominent during malaria in children and adults with lifetime exposure, together with IgG. Unexpectedly, IgM persisted for extended periods of time; we found no difference in decay of merozoite-specific IgM over time compared to that of IgG. IgM blocked merozoite invasion of red blood cells in a complement-dependent manner. IgM was also associated with significantly reduced risk of clinical malaria in a longitudinal cohort of children. These findings suggest that merozoite-specific IgM is an important functional and long-lived antibody response targeting blood-stage malaria parasites that contributes to malaria immunity.
  15. Opportunities and threats to contact lens practice: A global survey perspective
    Thite N, Desiato A, Shinde L, Wolffsohn JS, Naroo SA, Santodomingo-Rubido J, et al.
    Cont Lens Anterior Eye, 2021 12;44(6):101496.
    PMID: 34426063 DOI: 10.1016/j.clae.2021.101496
    AIM: To understand the views of contact lens (CL) practitioners across the globe regarding what they perceive as opportunities and threats in CL practice.

    METHODS: A self-administered anonymised questionnaire, constructed in English and translated in six more languages, was distributed through reputed international professional bodies and academic institutions worldwide. The questionnaire included items on demographic characteristics, type of practice, and questions designed to explore practitioners' perspective on the future of their CL practice over the next five years.

    RESULTS: A total of 2408 valid responses were analysed. Multifocal CLs for presbyopia, CLs for myopia control, use of daily disposable (DD) CLs for occasional wear, and biocompatible materials to improve comfort were identified as promising areas of opportunities by practitioners (all 8/10). Respondents from North America, and Europe valued DDCLs for occasional wear moderately more favourable (Median: 9/10 for all) as compared to colleagues in Asia (Median: 8/10, p 

  16. Fulltext Genome-wide association study in a Chinese population identifies a susceptibility locus for type 2 diabetes at 7q32 near PAX4
    Ma RC, Hu C, Tam CH, Zhang R, Kwan P, Leung TF, et al.
    Diabetologia, 2013 Jun;56(6):1291-305.
    PMID: 23532257 DOI: 10.1007/s00125-013-2874-4
    AIMS/HYPOTHESIS: Most genetic variants identified for type 2 diabetes have been discovered in European populations. We performed genome-wide association studies (GWAS) in a Chinese population with the aim of identifying novel variants for type 2 diabetes in Asians.

    METHODS: We performed a meta-analysis of three GWAS comprising 684 patients with type 2 diabetes and 955 controls of Southern Han Chinese descent. We followed up the top signals in two independent Southern Han Chinese cohorts (totalling 10,383 cases and 6,974 controls), and performed in silico replication in multiple populations.

    RESULTS: We identified CDKN2A/B and four novel type 2 diabetes association signals with p 

  17. A global-scale screening of non-native aquatic organisms to identify potentially invasive species under current and future climate conditions
    Vilizzi L, Copp GH, Hill JE, Adamovich B, Aislabie L, Akin D, et al.
    Sci Total Environ, 2021 Sep 20;788:147868.
    PMID: 34134389 DOI: 10.1016/j.scitotenv.2021.147868
    The threat posed by invasive non-native species worldwide requires a global approach to identify which introduced species are likely to pose an elevated risk of impact to native species and ecosystems. To inform policy, stakeholders and management decisions on global threats to aquatic ecosystems, 195 assessors representing 120 risk assessment areas across all six inhabited continents screened 819 non-native species from 15 groups of aquatic organisms (freshwater, brackish, marine plants and animals) using the Aquatic Species Invasiveness Screening Kit. This multi-lingual decision-support tool for the risk screening of aquatic organisms provides assessors with risk scores for a species under current and future climate change conditions that, following a statistically based calibration, permits the accurate classification of species into high-, medium- and low-risk categories under current and predicted climate conditions. The 1730 screenings undertaken encompassed wide geographical areas (regions, political entities, parts thereof, water bodies, river basins, lake drainage basins, and marine regions), which permitted thresholds to be identified for almost all aquatic organismal groups screened as well as for tropical, temperate and continental climate classes, and for tropical and temperate marine ecoregions. In total, 33 species were identified as posing a 'very high risk' of being or becoming invasive, and the scores of several of these species under current climate increased under future climate conditions, primarily due to their wide thermal tolerances. The risk thresholds determined for taxonomic groups and climate zones provide a basis against which area-specific or climate-based calibrated thresholds may be interpreted. In turn, the risk rankings help decision-makers identify which species require an immediate 'rapid' management action (e.g. eradication, control) to avoid or mitigate adverse impacts, which require a full risk assessment, and which are to be restricted or banned with regard to importation and/or sale as ornamental or aquarium/fishery enhancement.
  18. Evidence for the Higgs Boson Decay to a Z Boson and a Photon at the LHC
    Aad G, Abbott B, Abeling K, Abicht NJ, Abidi SH, Aboulhorma A, et al.
    Phys Rev Lett, 2024 Jan 12;132(2):021803.
    PMID: 38277607 DOI: 10.1103/PhysRevLett.132.021803
    The first evidence for the Higgs boson decay to a Z boson and a photon is presented, with a statistical significance of 3.4 standard deviations. The result is derived from a combined analysis of the searches performed by the ATLAS and CMS Collaborations with proton-proton collision datasets collected at the CERN Large Hadron Collider (LHC) from 2015 to 2018. These correspond to integrated luminosities of around 140  fb^{-1} for each experiment, at a center-of-mass energy of 13 TeV. The measured signal yield is 2.2±0.7 times the standard model prediction, and agrees with the theoretical expectation within 1.9 standard deviations.
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