MyMedR

Yin TP

Family Practitioner, 1986;9:48-52.

Is there a need for a national medical ethics committee

Devaraj TP

Med J Malaysia, 2000 Aug;55 Suppl B:38-42.

To answer the question posed the terms of reference of local ethical committees as well as a few from overseas were reviewed. It was noted that these committees were established by various professional bodies and functioned independently. Guidelines for ethical practice and conduct were made available to the profession with compliance left to the individual doctor. Amongst the many ethical issues of concern both to the public and the profession was that of self regulation. It is being suggested that these concerns be addressed rather then set up a national body.

Japanese encephalitis vaccines: current vaccines and future prospects

Monath TP

Curr. Top. Microbiol. Immunol., 2002;267:105-38.

PMID: 12082985

Vaccination against JE ideally should be practiced in all areas of Asia where the virus is responsible for human disease. The WHO has placed a high priority on the development of a new vaccine for prevention of JE. Some countries in Asia (Japan, South Korea, North Korea, Taiwan, Vietnam, Thailand, and the PRC) manufacture JE vaccines and practice childhood immunization, while other countries suffering endemic or epidemic disease (India, Nepal, Laos, Cambodia, Bangladesh, Myanmar, Malaysia, Indonesia and the Philippines) have no JE vaccine manufacturing or policy for use. With the exception of the PRC, all countries practicing JE vaccination use formalin inactivated mouse brain vaccines, which are relatively expensive and are associated with rare but clinically significant allergic and neurological adverse events. New inactivated JE vaccines manufactured in Vero cells are in advanced preclinical or early clinical development in Japan, South Korea, Taiwan, and the PRC. An empirically derived, live attenuated vaccine (SA14-14-2) is widely used in the PRC. Trials in the PRC have shown SA14-14-2 to be safe and effective when administered in a two-dose regimen, but regulatory concerns over manufacturing and control have restricted international distribution. The genetic basis of attenuation of SA14-14-2 has been partially defined. A new live attenuated vaccine (ChimeriVax-JE) that uses a reliable flavivirus vaccine--yellow fever 17D--as a live vector for the envelope genes of SA14-14-2 virus is in early clinical trials and appears to be well tolerated and immunogenic after a single dose. Vaccinia and avipox vectored vaccines have also been tested clinically, but are no longer being pursued due to restricted effectiveness mediated by anti-vector immunity. Other approaches to JE vaccines--including naked DNA, oral vaccination, and recombinant subunit vaccines--have been reviewed.

Fulltext Palliative care--a beginning

Devaraj TP

Med J Malaysia, 2002 Dec;57(4):384-9.

PMID: 12733161

Fulltext A review on the prevalence of depression in Malaysia

Mukhtar F, Oei TPS

Current Psychiatry Reviews, 2011;7:234-238.

DOI: 10.2174/157340011797183201

Transforming western technology to Eastern populations, including Malaysia, presents important implications in understanding the development, maintenance, and treatment of depression. The present paper aims to review the literature on the prevalence of depression studies in Malaysia. PsycINFO, Medline databases, local journals, and 13 published articles, were included in the current review. Findings were presented in three categories i.e., 'prevalence of depression in primary care', 'general community', and 'among clinical population'. Major limitations of previous studies were noted, and thus, problems associated with the implementation and future direction of clinical and research on depression in Malaysia, was provided. In short, the contribution of empirical research on the prevalence of depression has remained inconsistent and fragmented and it is therefore, a time to venture modification. © 2011 Bentham Science Publishers.

Trends and ethnic differences in hospital admissions and mortality for congestive heart failure in the elderly in Singapore, 1991 to 1998

Ng TP, Niti M

Heart, 2003 Aug;89(8):865-70.

PMID: 12860859

To describe trends in hospital admissions and mortality from congestive heart failure in the elderly population aged 65 years and over in Singapore, 1991 to 1998.

Fulltext Avoidable hospitalisation rates in Singapore, 1991-1998: assessing trends and inequities of quality in primary care

Niti M, Ng TP

J Epidemiol Community Health, 2003 Jan;57(1):17-22.

PMID: 12490643

STUDY OBJECTIVES: To assess avoidable hospitalisation as an indicator of quality of primary care by examining trends and gender and ethnic variations.
DESIGN AND SETTING: Aggregated nationwide data in Singapore from 1991 to1998 were analysed for hospitalisations for chronic diseases that are avoidable by timely, appropriate, and effective primary care: asthma, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension (avoidable hospitalisations).
MAIN RESULTS: Of a total of 1 479 494 hospitalisations, 6.7% were for ambulatory care sensitive conditions (ACSC). The annual rate of avoidable hospitalisation was 29.4 per 10 000 population. Women had lower rates of avoidable hospitalisations than men (22.4 versus 29.5 per 10 000), as well as for total hospitalisations (496.2 versus 515.5 per 10 000). Adjusted for total hospitalisation, men were 1.3 times more likely than women to be hospitalised for ACSC. With similar adjustments for baseline utilisation, Indian and Malays had 1.7 and 1.8 times higher rates of avoidable hospitalisations than Chinese. Avoidable hospitalisation decline was -9.1% overall; greater in men (-11.8%) than in women (-5.3%); greater for Chinese (-15.8%), than Malays (-1.1%) and Indians (increase of +4.3%).
CONCLUSION: Gender and ethnic differences and declining trends in avoidable hospitalisation demonstrated in this study suggest that avoidable hospitalisation rates are a sensitive indicator for assessing quality of primary ambulatory care.

Temporal trends and ethnic variations in amenable mortality in Singapore 1965-1994: the impact of health care in transition

Niti M, Ng TP

Int J Epidemiol, 2001 Oct;30(5):966-73.

PMID: 11689505

BACKGROUND: Amenable mortality is used to assess the effects of health care services on gains in mortality outcomes. Possibly differing patterns of trends in amenable mortality may be expected in economically less developed countries, which have undergone rapid epidemiological transition and recent reforms in health care systems, but such studies are scarce. This study was set up to examine the trends in amenable mortality in Singapore from 1965 to 1994; to estimate the relative impact of medical care and primary preventive policy measures in terms of gains in mortality outcomes; to examine ethnic differences in amenable mortality among Chinese, Malays and Indians.

METHODS: Age-standardized mortality rates were calculated for 16 amenable causes of death in Singapore for six 5-year periods (1965-1969,..., 1990-1994), and for each of the three main ethnic groups for three periods (1989-1991, 1992-1994, 1995- 1997). Amenable mortality rates were divided into those which can be reduced by timely therapeutic care for 'treatable' conditions (e.g. asthma and appendicitis), or by primary preventive measures for 'preventable' conditions (e.g. lung cancer and motor vehicle injury).

RESULTS: Amenable mortality was higher in males (age-standardized rate 109.7 per 100 000 population) than in females (age-standardized rate 60.7 per 100 000 population). Amenable mortality declined by 1.77% a year in males and 1.72% a year in females. By comparison, the average yearly decline in non-amenable mortality was 0.91% in males and 1.17% in females. The decline in amenable mortality was largely due to 'treatable' causes rather than a decline in mortality due to 'preventable' causes of death. Amenable mortality was lowest for Chinese and highest for Malays. Over the recent 9-year period from 1989 to 1997, amenable mortality declined more in Chinese than in Malays and Indians. However, Indian females showed by far the sharpest decline, whereas Indian males, by contrast, showed an increase in amenable mortality, due to both treatable and preventable causes.

CONCLUSIONS: In line with findings from European countries, amenable mortality in Singapore declined more than non-amenable mortality. There were more significant gains in mortality outcomes from medical care interventions than from primary preventive policy measures. Gender and ethnic differences in amenable mortality were also observed, highlighting issues of socioeconomic equities to be addressed in the financing and delivery of health care.

A study of the Nematode parasites of cockroaches in Singapore

Leong L, Paran TP

Med J Malaya, 1966 Jun;20(4):349.

PMID: 4224359

Meeting Report: 4(th) Biennial meeting of the Society for Free Radical Research - Asia, held during July 9-12, 2009 at Langkawi, Malaysia

Devasagayam TP

Free Radic Res, 2009 Sep 11.

PMID: 19750403

Fulltext Temporal trends and ethnic variations in asthma mortality in Singapore, 1976-1995

Ng TP, Tan WC

Thorax, 1999 Nov;54(11):990-4.

PMID: 10525557

BACKGROUND: A study was undertaken to examine temporal trends and ethnic differences in the asthma mortality rate in Singapore.
METHODS: Asthma mortality rates in Singapore were estimated from vital data for the years from 1976 to 1995. Trends in sex and age specific (5-14, 15-34, 35-59, 60+ years) rates were obtained for four periods (1976-80, 1981-85, 1986-90, 1991-95) and for Chinese, Malay, and Indian subjects for the years when these data were available (1989-95).
RESULTS: An increase in asthma mortality was observed in children aged 5-14 years from 0.21 per 100,000 person years in 1976-80 to 0.72 per 100,000 person years in 1991-95. No increases were noted in the other age groups but a small decrease was observed in the 1991-95 period for the 35-59 year age group. Marked ethnic differences in mortality rates were observed. In the group aged 5-34 years the asthma mortality rates were 0.5 per 100,000 in Chinese subjects, 1.3 per 100,000 in Indians, and 2.5 per 100,000 in Malay subjects. Similar 2-4 fold differences were observed in all other age groups.
CONCLUSIONS: Apart from genetic factors, environmental exposures and medical care factors which influence asthma prevalence and severity are most likely to be the causes of the observed temporal trends and ethnic differences in the asthma mortality rate in Singapore, but further studies are needed to elucidate these more fully.

A case of glomus jugulare tumour

Ghee LT, Devaraj TP

Med J Malaya, 1972 Sep;27(1):69-72.

PMID: 4345647

Clomiphene citrate in Asian women

Ken TP, Khin TS

Med J Malaya, 1970 Jun;24(4):297-9.

PMID: 4248351

A case of glomus jugulare tumour

Loh TG, Devaraj TP

Med J Malaysia, 1972 Sep;27(1):69-72.

PMID: 35158540

No abstract available.

Periplaneta americana (L.) as intermediate host of Moniliformis moniliformis (Bremser) in Penang, Malaysia

Anuar AK, Paran TP

Southeast Asian J Trop Med Public Health, 1976 Sep;7(3):415-6.

PMID: 1025741

Epidemiology of chronic (perennial) rhinitis in Singapore: prevalence estimates, demographic variation and clinical allergic presentation

Ng TP, Tan WC

Ann Acad Med Singap, 1994 Jan;23(1):83-8.

PMID: 8185279

We conducted a population-based study involving a stratified cluster disproportionate random sample of 2868 adults aged 20 to 74 years selected from five housing estates (Yishun, Toa Payoh, Jurong East, Geylang/Eunos and Bukit Merah). Chronic rhinitis was defined as the usual presence of symptoms of blocked or running nose, apart from colds or the flu, lasting for more than a year. Allergic rhinitis was considered to be present if these symptoms were associated with conjunctivitis or recognisable provocation by commonly known allergens, namely house dust, dogs, cats, birds, pollen, or medicines. The estimated general population prevalence of chronic rhinitis was 10.8% (95% confidence interval (CI) 8.8-12.7). Higher prevalences were noted in males, in younger adults, in Indians and Chinese, in those with higher socio-economic status, and in Toa Payoh, Jurong East and Geylang/Eunos. The prevalence of allergic rhinitis was 5.5% (95% CI 4.5-6.5). The most common 'allergenic' factor in allergic rhinitis was house dust (73%); provocation by birds, cats or dogs (5%), grass or tree pollens (5%), and medicine (5%) was less common but likely to have been under-recognised. Provocation by change in temperature (54%) and early in the morning (64%) was equally frequent in both 'allergic' and 'non-allergic' rhinitis; cigarette smoke, petrol and diesel fumes, food and work environment were less common (4-12%). Allergic rhinitis was highly significantly associated with asthma (13.9% in allergic rhinitis, 4.4% in non-allergic rhinitis, and 2.2% in non-rhinitic subjects).

Clinical manifestations in trisomy 9

Kannan TP, Hemlatha S, Ankathil R, Zilfalil BA

Indian J Pediatr, 2009 Jul;76(7):745-6.

PMID: 19475342 DOI: 10.1007/s12098-009-0158-2

Complete trisomy 9 is a lethal diagnosis and most fetuses diagnosed thus die prenatally or during the early postnatal period and majority of such cases have been known to end in spontaneous abortion in the first trimester itself. One such rare survival of fetus ending in normal delivery and surviving until 20 days is reported here detailing the clinical manifestations of the child during the period of survival. The salient clinical features observed were small face, wide fontanel, prominent occiput, micrognathia, low set ears, upslanting palpebral fissures, high arched palate, short sternum, overlapping fingers, limited hip abduction, rocker bottom feet, heart murmurs and also webbed neck, characteristic of this trisomy 9 syndrome.

Exploring SOD1 Gene for the Detection of Fetal Down Syndrome

Thilakavathy K, Rozita R, Baskaran TP

J Prenat Med, 2008 Jul;2(3):36-9.

PMID: 22439026

Fetal cells and circulating cellfree fetal DNA increases in the maternal circulation in women carrying trisomy 21 fetus.

Suicide ideation and intent in Malaysia: a review of the literature

Aishvarya S, Maniam T, Sidi H, Oei TP

Compr Psychiatry, 2014 Jan;55 Suppl 1:S95-100.

PMID: 23433220 DOI: 10.1016/j.comppsych.2013.01.005

The aim of this paper was to review the literature on suicide ideation and intent in Malaysia. PsyINFO, PubMed, Medline databases from 1845 to 2012 and detailed manual search of local official reports from Ministry of Health, Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training, were included in the current review. A total of 13 studies on suicide ideation and intent in Malaysia were found and reviewed. The review showed that research on suicide ideation and intent in Malaysia was fragmented and limited, at best. Approximately 50% of existing research on suicide ideation and intent simply focused on sociodemographic data. Fifty-four percent of the data were obtained from hospitals. No study has been conducted on treatment and interventions for suicide ideation and intent. None of the studies used validated suicide scales. The impact of culture was rarely considered. It was clear from the review that for researchers, clinicians and public health policy makers to gain a better understanding of suicide behavior especially suicide ideation and intent in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.

Influence of palm oil or its tocotrienol-rich fraction on the lipid peroxidation potential of rat liver mitochondria and microsomes

Nesaretnam K, Devasagayam TP, Singh BB, Basiron Y

Biochem. Mol. Biol. Int., 1993 May;30(1):159-67.

PMID: 8358328

The effect of palm oil, a widely used vegetable oil, rich in tocotrienols, on peroxidation potential of rat liver was examined. Long-term feeding of rats with palm oil as one of the dietary components significantly reduced the peroxidation potential of hepatic mitochondria and microsomes. As compared to hepatic mitochondria isolated from rats fed control or corn oil-rich diet, those from palm oil-fed group showed significantly less susceptibility to peroxidation induced by ascorbate and NADPH. However, in microsomes, only NADPH-induced lipid peroxidation was significantly reduced in rats fed palm oil rich-diet. Though the accumulation of thiobarbituric acid reactive substances during ascorbate-induced lipid peroxidation in mitochondria from rats fed corn oil-rich diet supplemented with tocotrienol-rich fraction (TRF) of palm oil was similar to that of control rats, the initial rate of peroxidation was much slower than those from control or corn oil fed diets. Our in vitro studies as well as analyses of co-factors related to peroxidation potential indicated that the observed decrease in palm oil-fed rats may be due to increased amount of antioxidants in terms of tocotrienol as well as decrease in the availability of substrates for peroxidation.

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