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Fulltext What future for traditional Chinese medicine outside China?

Ooi GL

World Health Forum, 1993;14(1):79-85.
PMID: 8439383

In certain countries of east and south-east Asia, traditional Chinese medicine continues to be used by many people. However, the pattern of use favours the advance of the drug-retailing side of this sector rather than medical care, and there is consequently some concern about the professional status of practitioners in the long term.
Chinese medicine in Malaysia and Singapore: the business of healing

Ooi GL

Am J Chin Med, 1993;21(3-4):197-212.
PMID: 8135163 DOI: 10.1142/S0192415X93000236

Traditional Chinese medicine as it persists in several East and Southeast Asian countries, has undergone major changes. Such changes have reinforced the trading aspects of traditional Chinese medical practice with relatively little advantage for the medical care component. This paper examines the nature of changes in contemporary ethnic Chinese medical practice in Malaysia and Singapore with the aim of understanding their implications for the persistence of this medical tradition.
Fulltext Unusual Presentation of Giant Upper Limb Malignant Melanoma

Khim OG, Leong JF, Sani MH, Mohamed Haflah NH

Cureus, 2021 Aug;13(8):e16996.
PMID: 34540398 DOI: 10.7759/cureus.16996

Melanoma is rare among the Asian population. In Malaysia, there is little public awareness of melanoma compared to other types of cancer. Giant melanomas measuring more than 10 cm are rarely encountered and there are limited data available regarding this disease. We would like to report an unusual presentation of giant malignant melanoma of upper limb in a 62-year-old patient who presented with a five-month history of a progressively enlarging, painless mass on his left arm. This mass which measures 10 x 15 cm turned out to be a giant malignant melanoma of the left arm. To our knowledge, this is the largest melanoma of arm reported in Malaysia. Radiological findings were suggestive of soft tissue sarcoma with lung metastasis. Patient underwent wide local excision of left-arm mass and upper limb reconstruction. The diagnosis of malignant melanoma was made based on the final histopathology report. Despite aggressive treatment involving multidisciplinary units, it did not prevent the disease progression and patient succumbed five months after his presentation. Here, we present our experience in the management of this large malignant melanoma of the arm and to stress the sinister nature of melanoma.
Factors predicting clinical outcomes of continuous ambulatory peritoneal dialysis associated peritonitis - A single centre study

Tan YL, Ooi GS, Vaithilingam I

Med J Malaysia, 2021 05;76(3):382-389.
PMID: 34031338

BACKGROUND: Peritonitis is the common complication among Continuous Ambulatory Peritoneal Dialysis (CAPD) patients. This study is aimed to identify the factors predicting clinical outcomes of peritonitis in patients undergoing CAPD and the demographic, clinical and microbiological features of CAPD patients who were diagnosed with peritonitis.
MATERIALS AND METHODS: This is a retrospective observational study conducted to identify factors predicting clinical outcomes of CAPD associated peritonitis over a four-year period in Taiping Hospital, Malaysia.
RESULTS: A total of 109 episodes of CAPD associated peritonitis in 54 patients was enrolled with a median age being 56.5 years. In all 43.1% of these were complicated peritonitis. About half (n=54, 49.5%) of the peritonitis was caused by a single gram-positive organism. Coagulase negative Staphylococcus (CoNS) and Escherichia coli was the most often isolated gram-positive and gram-negative microorganism, respectively. We observed that less likelihood of developing complicated peritonitis in presence of abdominal pain (Odd ratio, OR 0.25, 95% confidence interval, 95%CI: 0.10, 0.63). In contrast, presence of more than one previous episode of peritonitis (OR 2.79, 95%CI: 1.11, 7.04) and previous migration and readjustment of Tenkchoff catheter (OR 7.48, 95%CI: 1.39, 40.41), were factors significantly associated with complicated peritonitis.
CONCLUSION: Presence of abdominal pain, more than one previous episode of peritonitis, and previous migration and readjustment of Tenkchoff catheter, were found as significant factors in predicting clinical outcomes of CAPD associated peritonitis.
Child care services in Malaysia: an overview

Yusof K, Wong YL, Ooi GL, Hamid-Don P

Asia Pac J Public Health, 1987;1(3):11-6.
PMID: 3452401
Comparison of the efficacy and level of adherence for morning versus evening versus before bedtime administration of simvastatin in hypercholesterolemic patients

Heng WK, Ng YP, Ooi GS, Habshoh J, Nurazlin J, Nor Azah MN, et al.

Med J Malaysia, 2019 12;74(6):477-482.
PMID: 31929472

BACKGROUND: Simvastatin is usually taken in the evening due to the circadian rhythm of hepatic cholesterol biosynthesis. The degree of reduction of low-density lipoprotein cholesterol (LDL-C) and the level of adherence to different administration time remained unknown in the Malaysian population. This study aims to investigate the effect of simvastatin on the percentage changes of lipid profile and the level of adherence to when simvastatin was instructed to be taken at different timing.
METHODS: Nine primary care health clinics across Malaysia participated in this study. 147 statin-naive subjects were selected through convenient sampling and randomised into one of the three arms (after breakfast, after dinner or before bedtime). Differences on percentage reduction of LDL-C from baseline and level of adherence among the three groups at week-16 were compared. The main outcomes measured in this study were the percentage change of lipid parameters and the percentage of high-adherence (MMAS=8) at week-16.
RESULTS: 59.2% of the patients were male. The mean age of the study population was 53.93± 10.85 years. Most of the patients were Malays (69.4%); followed by Indians (22.4%) and Chinese (8.2%). LDL-C decreased from 4.26 (Standard Deviation, SD1.01) to 2.36 (SD0.69)mmol/L at week-16 for patients taking simvastatin before bedtime; an absolute reduction of 44.95%.The differences of LDL-C percentage reduction between three arms were significantly different (p<0.001). The greatest LDL-C reduction was observed when simvastatin was taken before bedtime and revealed 56.2% patients with high-adherence at week-16.
CONCLUSION: Simvastatin showed superior LDL-reduction and higher level of adherence when being instructed to be taken before bedtime.
acFibroMASH Index for the Diagnosis of Fibrotic MASH and Prediction of Liver-related Events: An International Multicenter Study

Feng G, Mózes FE, Ji D, Treeprasertsuk S, Okanoue T, Shima T, et al.

Clin Gastroenterol Hepatol, 2024 Oct 02.
PMID: 39362618 DOI: 10.1016/j.cgh.2024.07.045

BACKGROUND & AIMS: Metabolic dysfunction-associated steatohepatitis (MASH) and fibrotic MASH are significant health challenges. This multi-national study aimed to validate the acMASH index (including serum creatinine and aspartate aminotransferase concentrations) for MASH diagnosis and develop a new index (acFibroMASH) for non-invasively identifying fibrotic MASH and exploring its predictive value for liver-related events (LREs).
METHODS: We analyzed data from 3004 individuals with biopsy-proven metabolic dysfunction-associated steatotic liver disease (MASLD) across 29 Chinese and 9 international cohorts to validate the acMASH index and develop the acFibroMASH index. Additionally, we utilized the independent external data from a multi-national cohort of 9034 patients with MASLD to examine associations between the acFibroMASH index and the risk of LREs.
RESULTS: In the pooled global cohort, the acMASH index identified MASH with an area under the receiver operating characteristic curve (AUROC) of 0.802 (95% confidence interval [CI], 0.786-0.818). The acFibroMASH index (including the acMASH index plus liver stiffness measurement) accurately identified fibrotic MASH with an AUROC of 0.808 in the derivation cohort and 0.800 in the validation cohort. Notably, the AUROC for the acFibroMASH index was 0.835 (95% CI, 0.786-0.882), superior to that of the FAST score at 0.750 (95% CI, 0.693-0.800; P < .01) in predicting the 5-year risk of LREs. Patients with acFibroMASH >0.39 had a higher risk of LREs than those with acFibroMASH <0.15 (adjusted hazard ratio, 11.23; 95% CI, 3.98-31.66).
CONCLUSIONS: This multi-ethnic study validates the acMASH index as a reliable, noninvasive test for identifying MASH. The newly proposed acFibroMASH index is a reliable test for identifying fibrotic MASH and predicting the risk of LREs.