MyMedR

Is HIV Screening in the General Population Cost Effective?

Tan H, Koh K

Malays Fam Physician, 2008;3(2):96-7.

Comparison between the effects of propofol and etomidate on motor and electroencephalogram seizure duration during electroconvulsive therapy

Tan HL, Lee CY

Anaesth Intensive Care, 2009 Sep;37(5):807-14.

PMID: 19775046

An ideal anaesthetic for electroconvulsive therapy (ECT) should have rapid onset and offset with no effect on seizure duration, and provide cardiovascular stability during the procedure. Propofol is commonly used, even though it has been shown to shorten seizure duration which might affect the efficacy of ECT Etomidate has been advocated as an alternative. This prospective, randomised, single-blind, crossover study was conducted to compare the effects of etomidate (Etomidate-Lipuro, B. Braun Ltd, Melsungen, Germany) and propofol (Diprivan, AstraZeneca, UK) on seizure duration as well as haemodynamic parameters in patients undergoing ECT Twenty patients aged between 18 and 70 years were recruited. Group I received etomidate 0.3 mg/kg for the first course of ECT (Group IA) and propofol 1.5 mg/kg for the second ECT (Group IB), while Group II received propofol for the first ECT (Group IIA) and etomidate for the second ECT (Group IIB). There was a washout period of two to three days in between procedures. Parameters recorded included motor seizure duration, electroencephalogram seizure duration, blood pressure and heart rate. Analysis demonstrated neither period effect nor treatment period interaction. Etomidate was associated with a significantly longer motor and electroencephalogram seizure duration compared with propofol (P < 0.01). Neither drug demonstrated consistent effects in suppressing the rise in heart rate or blood pressure during ECT Myoclonus and pain on injection were the most common adverse effects in etomidate group and propofol group respectively. Etomidate is a useful anaesthetic agent for ECT and should be considered in patients with inadequate seizure duration with propofol.

Fulltext MRSA Infection in Vascular Surgical Patients: The HKL Experience

Wong, HS, YH, William Chang, Neeta, K.B., Lum, SG, Seet, KC, Tan, HL, et al.

Medicine & Health, 2008;3(2):294-299.

MyJurnal

Methicillin-resistant Staphylococcus aureus (MRSA) infection is important among vas-cular surgical patients. Its effect can be devastating resulting in limb amputation and mortality. We performed a retrospective patients record analysis to determine the pat-tern of MRSA infection among vascular surgical patients in Hospital Kuala Lumpur from January 2005 to December 2007. We also attempted to identify the factors asso-ciated with poor clinical outcome after such infection. There were 999 patients who underwent vascular surgeries in HKL within the analysis period. Of these 24 patients (2.4%) were detected to have MRSA surgical site infection. The infection was commoner among cigarette smokers, patients with diabetes melitus and those who had previous vascular surgery. Most infections occurred in the emergency surgery category and manifested as wound breakdown. Fifty-four percent of the infected pa-tients ended with graft removal, amputations or death. MRSA infection complicating vascular surgery resulted in poor clinical outcome. This serious threat requires intensi-fied preventive measures.

Fulltext Assessment of Coolant Delivery Techniques for Irrigation During Bone Drilling: A Cadaveric Observation

Abdul-Rashid ML, Tan HL, Pancharatnam D

Malays Orthop J, 2020 Nov;14(3):206-207.

PMID: 33403090 DOI: 10.5704/MOJ.2011.037

Gastric foveolar cell hyperplasia and its role in postoperative vomiting in patients with infantile hypertrophic pyloric stenosis

Tan HL, Blythe A, Kirby CP, Gent R

Eur J Pediatr Surg, 2009 Apr;19(2):76-8.

PMID: 19242904 DOI: 10.1055/s-2008-1039199

Foveolar cell hyperplasia (FCH) has been reported as a rare cause of persistent gastric outlet obstruction in patients with infantile hypertrophic pyloric stenosis (IHPS), which, if present, requires excision of the gastric foveolar folds to resolve the persistent obstruction. This is a review of patients with IHPS diagnosed on abdominal ultrasound to determine the incidence of FCH in IHPS and to evaluate whether it has a causal role in postoperative vomiting following pyloromyotomy for IHPS.

Fulltext Quality of life and migraine disability among female migraine patients in a tertiary hospital in Malaysia

Shaik MM, Hassan NB, Tan HL, Gan SH

Biomed Res Int, 2015;2015:523717.

PMID: 25632394 DOI: 10.1155/2015/523717

Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls.

Do folate, vitamins B₆ and B₁₂ play a role in the pathogenesis of migraine? The role of pharmacoepigenomics

Shaik MM, Tan HL, Kamal MA, Gan SH

CNS Neurol Disord Drug Targets, 2014;13(5):828-35.

PMID: 24040787

Migraine is a neurovascular disease that has classically been attributed to multifactorial aetiologies, with genetic components and environmental interactions considered the main influence. Genes such as flavoenzyme 5, 10- methylenetetrahydrofolate reductase (MTHFR), especially the C677T variant, have been associated with elevated plasma homocysteine levels. This elevation in homocysteine results in an array of metabolic disorders and increased risk of complex diseases, including migraine. Catalysation of homocysteine requires the presence of vitamins B6, B12 and folate. Deficiencies in these cofactor vitamins result in hypomethylation, which triggers migraine. Because migraine predominantly affects females, it is hypothesised that fluctuating oestrogen levels, which are governed by oestrogen receptor 1 polymorphisms, are important. Another important factor is homocysteine, the production of which is dependent upon MTHFR and B vitamins. Gene expression is modulated through epigenetic mechanisms, which involve methionine. Additionally, folate plays a major role in DNA synthesis. We propose that vitamin B intake, coupled with MTHFR and oestrogen receptor 1 polymorphisms, causes differential DNA methylation and gene expression that may contribute to the occurrence of migraine.

Phosphatidylethanolamine N-methyltransferase gene rs7946 polymorphism plays a role in risk of nonalcoholic fatty liver disease: evidence from meta-analysis

Tan HL, Mohamed R, Mohamed Z, Zain SM

Pharmacogenet Genomics, 2016 Feb;26(2):88-95.

PMID: 26636496 DOI: 10.1097/FPC.0000000000000193

Phosphatidylethanolamine N-methyltransferase (PEMT) governs the secretion of hepatic triglycerides in the form of very low-density lipoprotein and has been implicated in nonalcoholic fatty liver disease (NAFLD). Studies on the role of the PEMT rs7946 polymorphism as a genetic modifier of NAFLD have reported inconsistent results. This meta-analysis was carried out to evaluate and summarize the association of PEMT rs7946 with susceptibility to NAFLD.

Effectiveness of amylmetacresol and 2,4-dichlorobenzyl alcohol throat lozenges in patients with acute sore throat due to upper respiratory tract infection: a systematic review protocol

Tan TW, Chen BC, Tan HL, Chang CM

JBI Database System Rev Implement Rep, 2017 Apr;15(4):862-872.

PMID: 28398972 DOI: 10.11124/JBISRIR-2016-003034

REVIEW QUESTION/OBJECTIVE: This review aims to determine the best available evidence related to the effectiveness of amylmetacresol and 2,4-dichlorobenzyl alcohol throat lozenges in patients with acute sore throat due to upper respiratory tract infection (URTI). The objective is to examine the analgesic properties of amylmetacresol and 2,4-dichlorobenzyl alcohol (AMC/DCBA) throat lozenge comparing with placebo for the relief of pain in patients with acute sore throat due to URTIs.The review question is:More specifically, the objectives are to.

Fulltext Quality characteristics of green Tea's infusion as influenced by brands and types of brewing water

Tan HL, Ojukwu M, Lee LX, Mat Easa A

Heliyon, 2023 Feb;9(2):e12638.

PMID: 36816296 DOI: 10.1016/j.heliyon.2022.e12638

The influences of four types of brewing waters including tap water (TAP), alkaline ionized water (ALK), magnetized water (MAG) and mineral water (MIN), and two brands of commercial green tea (L and T) on quality characteristics of tea infusions were studied. The Oxidation Reduction Potential (ORP) values of the brewing waters was TAP > MAG, MIN > ALK. After brewing, all infusions showed a significant drop (p 

Fulltext A systematic review of treatment for patients with burning mouth syndrome

Tan HL, Smith JG, Hoffmann J, Renton T

Cephalalgia, 2022 Feb;42(2):128-161.

PMID: 34404247 DOI: 10.1177/03331024211036152

BACKGROUND: Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments.

AIM: This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects.

MATERIALS AND METHODS: Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020).

RESULTS: Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment.

CONCLUSION: A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions.Registration International Prospective Register of Systematic Reviews (PROSPERO):Protocol ID - CRD42020160892.

Improvement of cooking and textural properties of rice flour-soy protein isolate noodles stabilised with microbial transglutaminase and glucono-δ-lactone and dried using superheated steam

Ojukwu M, Tan HL, Murad M, Nafchi AM, Easa AM

Food Sci Technol Int, 2023 Dec;29(8):799-808.

PMID: 36000280 DOI: 10.1177/10820132221121169

In a bid to produce rice flour noodles with improved texture and reduced cooking time, rice flour-soy protein isolate noodles (RNS) were structurally enhanced by a combined treatment (COM) of microbial transglutaminase (MTG) with glucono-δ-lactone (GDL). The RNS-COM was either dried using superheated steam (SHS) to yield RNS-COM-SHS or steamed for 10 min (S10) before air drying to produce RNS-COM-S10 noodles. Control samples were SHS-dried rice flour (RN-SHS) and air-dried RN-S10 noodles. In general, textural and microstructural properties indicated higher textural properties and a more robust network in RNS-COM-SHS and RNS-COM-S10 than in other noodles. However, optimum cooking time (P < 0.5) was in the order; RN-SHS, RNS-COM-SHS < RN-S10 < RNS-COM-S10. As a result of the COM treatment, structurally enhanced noodles were more resistant to cooking. As applied in RNS-COM-SHS noodles, SHS was able to improve cooking quality, probably through the formation of bigger and evenly spread pores that had promoted faster gelatinisation of starch, with a high order of relative starch crystallinity.

Fulltext Validity and reliability of the Bahasa Melayu version of the Migraine Disability Assessment questionnaire

Shaik MM, Hassan NB, Tan HL, Bhaskar S, Gan SH

Biomed Res Int, 2014;2014:435856.

PMID: 25121099 DOI: 10.1155/2014/435856

BACKGROUND: The study was designed to determine the validity and reliability of the Bahasa Melayu version (MIDAS-M) of the Migraine Disability Assessment (MIDAS) questionnaire.

METHODS: Patients having migraine for more than six months attending the Neurology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, were recruited. Standard forward and back translation procedures were used to translate and adapt the MIDAS questionnaire to produce the Bahasa Melayu version. The translated Malay version was tested for face and content validity. Validity and reliability testing were further conducted with 100 migraine patients (1st administration) followed by a retesting session 21 days later (2nd administration).

RESULTS: A total of 100 patients between 15 and 60 years of age were recruited. The majority of the patients were single (66%) and students (46%). Cronbach's alpha values were 0.84 (1st administration) and 0.80 (2nd administration). The test-retest reliability for the total MIDAS score was 0.73, indicating that the MIDAS-M questionnaire is stable; for the five disability questions, the test-retest values ranged from 0.77 to 0.87.

CONCLUSION: The MIDAS-M questionnaire is comparable with the original English version in terms of validity and reliability and may be used for the assessment of migraine in clinical settings.

Fulltext Microbial-catalyzed biotransformation of multifunctional triterpenoids derived from phytonutrients

Shah SA, Tan HL, Sultan S, Faridz MA, Shah MA, Nurfazilah S, et al.

Int J Mol Sci, 2014;15(7):12027-60.

PMID: 25003642 DOI: 10.3390/ijms150712027

Microbial-catalyzed biotransformations have considerable potential for the generation of an enormous variety of structurally diversified organic compounds, especially natural products with complex structures like triterpenoids. They offer efficient and economical ways to produce semi-synthetic analogues and novel lead molecules. Microorganisms such as bacteria and fungi could catalyze chemo-, regio- and stereospecific hydroxylations of diverse triterpenoid substrates that are extremely difficult to produce by chemical routes. During recent years, considerable research has been performed on the microbial transformation of bioactive triterpenoids, in order to obtain biologically active molecules with diverse structures features. This article reviews the microbial modifications of tetranortriterpenoids, tetracyclic triterpenoids and pentacyclic triterpenoids.

Fulltext Role of laparoscopy and ultrasound in the management of "impalpable testis" in children

Budianto IR, Tan HL, Kinoshita Y, Tamba RP, Leiri S, Taguchi T

Asian J Surg, 2014 Oct;37(4):200-4.

PMID: 24661449 DOI: 10.1016/j.asjsur.2014.01.013

Undescended testes is one of the most common congenital abnormalities in boys. In cases of impalpable testes, ultrasound is often used to find the testis, which frequently provides false-negative results. Recently, laparoscopy has become popular in the management of impalpable testes.

Laparoscopic localization and microlaparotomy for focal isolated perforation in necrotizing enterocolitis: an alternative approach to a challenging problem

Nah SA, Tan HL, Tamba RP, Aziz DA, Azzam N

J Pediatr Surg, 2011 Feb;46(2):424-7.

PMID: 21292104 DOI: 10.1016/j.jpedsurg.2010.11.045

Necrotizing enterocolitis has a wide clinical spectrum of manifestation. We report a novel method of managing focal isolated perforation in necrotizing enterocolitis by using diagnostic laparoscopy to localize the site of perforation and by making a microincision over the perforation to perform exteriorization or limited resection and primary anastomosis.

The use of octyl cyanoacrylate (superglue) in hypospadias repair including its use as a fixator for urethral stents

Tan HL, Nah SA, Budianto II, Sehat S, Tamba R

J Pediatr Surg, 2012 Dec;47(12):2294-7.

PMID: 23217892 DOI: 10.1016/j.jpedsurg.2012.09.022

Octyl cyanoacrylate has been used for many years for simple skin closure, but its use in hypospadias repair and as a urethral stent fixator has not been previously reported. We report our experience.

Fulltext Gynura procumbens: An Overview of the Biological Activities

Tan HL, Chan KG, Pusparajah P, Lee LH, Goh BH

Front Pharmacol, 2016;7:52.

PMID: 27014066 DOI: 10.3389/fphar.2016.00052

Gynura procumbens (Lour.) Merr. (Family Asteraceae) is a medicinal plant commonly found in tropical Asia countries such as China, Thailand, Indonesia, Malaysia, and Vietnam. Traditionally, it is widely used in many different countries for the treatment of a wide variety of health ailments such as kidney discomfort, rheumatism, diabetes mellitus, constipation, and hypertension. Based on the traditional uses of G. procumbens, it seems to possess high therapeutic potential for treatment of various diseases making it a target for pharmacological studies aiming to validate and provide scientific evidence for the traditional claims of its efficacy. Although there has been considerable progress in the research on G. procumbens, to date there is no review paper gathering the reported biological activities of G. procumbens. Hence, this review aims to provide an overview of the biological activities of G. procumbens based on reported in vitro and in vivo studies. In brief, G. procumbens has been reported to exhibit antihypertensive, cardioprotective, antihyperglycemic, fertility enhancement, anticancer, antimicrobial, antioxidant, organ protective, and antiinflammatory activity. The commercial applications of G. procumbens have also been summarized in this paper based on existing patents. The data compiled illustrate that G. procumbens is a potential natural source of compounds with various pharmacological actions which can be utilized for the development of novel therapeutic agents.

Fulltext Validity and reliability of the Malay version of the Structured Migraine Interview (SMI) Questionnaire

Shaik MM, Hassan NB, Tan HL, Bhaskar S, Gan SH

J Headache Pain, 2015 Mar 14;16:22.

PMID: 25903056 DOI: 10.1186/s10194-015-0509-5

BACKGROUND: The Structured Migraine Interview (SMI) is a valid and reliable instrument for migraine diagnosis. However, a Malay version of the SMI is not available to be applied to the local Malaysian population. This study was designed to access the validity and reliability of a new Malay version of the SMI questionnaire.
METHODS: Patients with headache attending the Neurology Clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, were screened against the inclusion/exclusion criteria before recruitment. A standard translation procedure was used to translate and adapt the questionnaire into the Malay language. The translated version was tested for face, content and construct validities. Subsequently, validity and reliability studies were conducted (1(st) compilation), followed by retesting seven days later (2(nd) compilation).
RESULTS: A total of 157 patients between 15 and 60 years of age were enrolled in this study. The kappa value was 0.70 (p

Fulltext Dental technician pneumoconiosis mimicking pulmonary tuberculosis: a case report

Tan HL, Faisal M, Soo CI, Ban AY, Manap RA, Hassan TM

BMC Pulm Med, 2016 09 07;16(1):131.

PMID: 27604085 DOI: 10.1186/s12890-016-0293-2

BACKGROUND: Dental laboratory technicians are at risk of developing occupational respiratory diseases due to exposure to various potentially toxic substances in their working environment. Since 1939, few cases of silicosis among dental technician have been reported.

CASE PRESENTATION: We illustrate a 38 year-old female, who worked in a dental laboratory for 20 years, initially treated as pulmonary tuberculosis and chronic necrotising aspergillosis without much improvement. Computed tomography guided lung biopsy and bronchoscopic transbronchial lung biopsy were performed. Lung tissue biopsies showed presence of refractile dental materials within the areas of histiocyte proliferation. The diagnosis of dental technician pneumoconiosis was obtained and our patient underwent pulmonary rehabilitation.

CONCLUSIONS: This case highlights the importance of obtaining a detailed occupational history in tuberculosis endemic area, as pulmonary tuberculosis is a great mimicker of other respiratory diseases.

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