MyMedR

Early (at 34-35 weeks) external cephalic version reduced the risk of non-cephalic (breech) presentation at birth but has no effect on risk of caesarean section

Tan PC

Evid Based Med, 2012 Apr;17(2):45-6.

PMID: 21949255 DOI: 10.1136/ebm.2011.100125

Review: calcium supplementation during pregnancy reduces the risk of pre-eclampsia

Tan PC

Evid Based Med, 2008 Jun;13(3):83.

PMID: 18515630 DOI: 10.1136/ebm.13.3.83

Fulltext Oral nifepidine versus subcutaneous terbutaline tocolysis for external cephalic version: a double-blind randomised trial

Collaris R, Tan PC

BJOG, 2009 Jan;116(1):74-80; discussion 80-1.

PMID: 19087079 DOI: 10.1111/j.1471-0528.2008.01991.x

To evaluate oral nifedipine versus subcutaneous terbutaline tocolysis for external cephalic version (ECV).

Training of peritoneal dialysis nurses

Tan PC, Morad Z

Perit Dial Int, 2003 Dec;23 Suppl 2:S206-9.

PMID: 17986550

Clinical disciplines in which the nurse plays as pre-eminent a role in total patient care as in peritoneal dialysis (PD) are few. The PD nurse is readily identified by the patient as the principal source of advice on day-to-day aspects of treatment, as a resource manager for supplies of PD disposables and fluids, and as a general counselor for all kinds of advice, including diet, rehabilitation, and medication, among others. The PD nurse is thus the key individual in the PD unit, and most activities involve and revolve around the nursing staff. It is therefore not surprising that most nephrologists pay considerable attention to the selection of PD nurses, particularly in long-term PD programs such as continuous ambulatory peritoneal dialysis (CAPD). The appointment of a PD nurse depends on finding an individual with the right attributes, broad general experience, and appropriate training.

Fulltext Anesthesia for massive retrosternal goiter with severe intrathoracic tracheal narrowing: the challenges imposed -A case report-

Tan PC, Esa N

Korean J Anesthesiol, 2012 May;62(5):474-8.

PMID: 22679546 DOI: 10.4097/kjae.2012.62.5.474

Anesthetic management of patients with mediastinal masses remains challenging as acute cardiorespiratory decompensation may follow induction of anesthesia. We describe a 57 year old lady with massive retrosternal goiter and severe intrathoracic tracheal compression who had a total thyroidectomy. Comprehensive contingency plans were an essential prerequisite for successful management of difficult airway, including multidisciplinary involvement of otorhinolaryngologic and cardiothoracic surgeons preparing for rigid bronchoscopy and cardiopulmonary bypass. Awake oral fiberoptic intubation was performed under dexmedetomidine sedation. Severe tracheal narrowing necessitated usage of a 5.0 mm uncuffed flexometallic endotracheal tube. Anesthesia was maintained with sevoflurane and dexmedetomidine infusion with target controlled infusion of remifentanil as analgesia. No muscle relaxant was given. Surgical manipulation led to intermittent total tracheal compression and inadequate ventilation. The tumor was successfully removed via the cervical approach. A close working relationship between anesthesiologists and surgeons was the key to the safe use of anesthesia and uneventful recovery of this patient.

Do fertility intentions predict subsequent behavior? Evidence from Peninsular Malaysia

Tan PC, Tey NP

Stud Fam Plann, 1994 Jul-Aug;25(4):222-31.

PMID: 7985216 DOI: 10.2307/2137905

Data from the 1984 Malaysian Population and Family Survey were matched with birth registration records for 1985-87 to determine the accuracy of statements regarding desired family size that were reported in a household survey in predicting subsequent reproductive behavior. The findings of this study were that stated fertility intention provides fairly accurate forecasts of fertility behavior in the subsequent period. In other words, whether a woman has another child is predicted closely by whether she wanted an additional child. Informational, educational, and motivational activities of family planning programs would, therefore, have greater success in reducing family size if fertility intentions were taken into account.

Changing patterns of marriage and household formation in Peninsular Malaysia

Tan PC, Jones GW

Sojourn, 1990;5(2):163-93.

PMID: 12283691

"Based on surveys conducted among different ethnic groups in rural and urban settings in Peninsular Malaysia in 1981-82, this paper analyses changes in patterns of marriage and household formation among Malays, Chinese, and Indians. Aspects covered include social mixing before marriage, choice of spouse, comparison of spouses' characteristics, and place of residence after marriage. There are important cultural differences between the main Malaysian ethnic groups in matters related to marriage, but in many important respects, attitudes and practice are tending to converge...."

Malay divorce in Peninsular Malaysia: the near-disappearance of an institution

Tan PC, Jones GW

Southeast Asian J Soc Sci, 1990;18(2):85-114.

PMID: 12317142

Recent and prospective population trends in Malaysia

Jones GW, Tan PC

J Southeast Asian Stud, 1985 Sep;16(2):262-80.

PMID: 12267554

Heights and weights of a sample of Malaysian children

Tan PC, Wong CL

Med J Malaya, 1969 Sep;24(1):12-7.

PMID: 4243835

Contemporary approaches to hyperemesis during pregnancy

Tan PC, Omar SZ

Curr Opin Obstet Gynecol, 2011 Apr;23(2):87-93.

PMID: 21297474 DOI: 10.1097/GCO.0b013e328342d208

PURPOSE OF REVIEW: Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years.

RECENT FINDINGS: The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy.

SUMMARY: Women with significant NVP should be identified so that they can be safely and effectively treated.

Oestrogen-soaked vaginal packing for decubitus ulcer in advanced pelvic organ prolapse: a case series

Abdullah B, Khong SY, Tan PC

Int Urogynecol J, 2016 Jul;27(7):1057-62.

PMID: 26718780 DOI: 10.1007/s00192-015-2930-3

INTRODUCTION: Cervicovaginal decubitus ulceration is a well-known complication of advanced pelvic organ prolapse (POP). There is no consensus for its management. This case series describes the outcome of using repeated vaginal packs soaked with oestrogen cream to reduce POP and promote decubitus ulcer healing. We aimed to investigate the speed of ulcer healing and endometrial safety with this regimen.

METHODS: This was a retrospective study of patients with stage 3 or 4 POP and intact uterus with decubitus ulcer who were planned for surgery that included hysterectomy after ulcer healing. Vaginal packs are replaced at least biweekly-or more frequently if extruded-until ulcer resolution.

RESULTS: Thirteen patients were studied. Mean age was 69 ± 6 years and mean duration of menopause was 19 ± 6 years. Nine patients had a single ulcer and four had multiple ulcers. Mean ulcer diameter was 2.8 ± 1.5 cm and mean duration for ulcer healing was 26 ± 14 days. Hysterectomy and pelvic floor reconstruction was performed a median of 5 (range 0-153) days after ulcer healing was first noted. Histopathological examination of the endometrium following hysterectomy showed three specimens with endocervical hyperplasia; one had concurrent proliferative endometrium, two had simple endometrial hyperplasia and another two had proliferative endometrium.

CONCLUSION: Oestrogen-soaked vaginal packing is a viable option for managing a decubitus ulcer in advanced POP. We document a measurable impact on the endometrium with this short-term preoperative regimen. Further research is needed to evaluate its efficacy in promoting ulcer healing and endometrial safety.

A placebo-controlled trial of oral pyridoxine in hyperemesis gravidarum

Tan PC, Yow CM, Omar SZ

Gynecol. Obstet. Invest., 2009;67(3):151-7.

PMID: 19077388 DOI: 10.1159/000181182

To evaluate oral pyridoxine in conjunction with standard therapy in women hospitalized for hyperemesis gravidarum (HG).

The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes

Tan PC, Ling LP, Omar SZ

Int J Gynaecol Obstet, 2009 Apr;105(1):50-5.

PMID: 19154997 DOI: 10.1016/j.ijgo.2008.11.038

OBJECTIVE:
To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).

METHODS:
GCT was positive if the 1-hour plasma glucose level was >or=7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.

RESULTS:
GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2-3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0-2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0-6.0).

CONCLUSION:
GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.

Absorbable versus nonabsorbable sutures for subcuticular skin closure of a transverse suprapubic incision

Tan PC, Mubarak S, Omar SZ

Int J Gynaecol Obstet, 2008 Nov;103(2):179-81.

PMID: 18639876 DOI: 10.1016/j.ijgo.2008.05.023

Gamma-glutamyltransferase level in pregnancy is an independent risk factor for gestational diabetes mellitus

Tan PC, Mubarak S, Omar SZ

J Obstet Gynaecol Res, 2008 Aug;34(4):512-7.

PMID: 18937705 DOI: 10.1111/j.1447-0756.2008.00815.x

AIM:
To evaluate the relationship between gamma-glutamyltransferase (GGT) level in pregnant women at oral glucose tolerance test (OGTT) and the diagnosis of gestational diabetes (GDM).

METHODS:
Blood was taken for analyzing GGT level from women at high risk of GDM at the time of their scheduled OGTT. GDM was diagnosed according to World Health Organization 1999 criteria.

RESULTS:
GGT level correlated positively with the 2-hour glucose level (Spearman's rho = 0.112: P < 0.05). GGT values that were stratified into quartiles demonstrated a significant trend with diagnosis of GDM (chi(2) for trend; P = 0.03). Multivariable logistic regression analysis taking into account maternal age, gestational age at OGTT, body mass index and a positive 50-g glucose challenge test (GCT) indicated that high GGT was an independent risk factor for GDM (adjusted odds ratio [AOR] 2.1 95% CI 1.2-3.8: P = 0.01). In the subset of women identified by a positive GCT, on multivariable logistic regression analysis, only high GGT was an independent risk factor for GDM (AOR 2.3 95% CI 1.3-4.2: P = 0.007).

CONCLUSION:
Raised GGT level is an independent risk factor for GDM in high risk pregnant women undergoing OGTT.

Fulltext Trial of labor after one cesarean: role of the order and number of prior vaginal births on the risk of emergency cesarean delivery and neonatal admission

Tan PC, Subramaniam RN, Omar SZ

Taiwan J Obstet Gynecol, 2008 Sep;47(3):305-11.

PMID: 18935994 DOI: 10.1016/S1028-4559(08)60129-1

To evaluate the influences of mode of immediate preceding delivery and number of prior vaginal births on the risk of repeat cesarean and neonatal admission at attempted vaginal birth after cesarean.

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.

Fulltext Outcome of neonates admitted to special care nursery, University Hospital, Kuala Lumpur: a comparison of two periods

Toh CK, Tan PC, Chan YK

Med J Malaysia, 1984 Mar;39(1):21-7.

PMID: 6513836

The overall mortality rate of babies delivered in the University Hospital, Kuala Lumpur has improved significantly from 18.5 in 1969-1971 to 9.9 per thousand live births in 1979-1981. This drop in mortality is also seen in those infants weighing 1001 - 2000 g at birth. Indian babies in the weight group 1001 - 1500 g at birth appear to have a significantly lower mortality than the other races. Babies referred from outside have a much higher mortality rate compared to babies delivered in University Hospital, Kuala Lumpur.

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