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Fulltext Sodium and potassium contents in selected salts and sauces

Tan, W. L., Azlan, A., Noh, M.F.M.

International Food Research Journal, 2016;23(5):2181-2186.
MyJurnal

The study was undertaken to determine and compare the sodium and potassium contents in
selected salts (table salt, coarse salt, French sea salt, Himalayan pink salt and bamboo salt)
and sauces (light soy sauce, sweet soy sauce, chili sauce, tomato sauce and mayonnaise).
Findings of the present study showed that the sodium content of salts was highest in table salt
(35870.0 mg/100 g) and lowest in French sea salt (31235.0 mg/100 g), whereas the potassium
content was highest in bamboo salt (399.4 mg/100 g) and lowest in table salt (43.7 mg/100
g). There was no significant difference between sodium amounts of the salts. Bamboo salt
was significantly higher in potassium than other salts. The ranking of sodium and potassium
in sauces was similar, where light soy sauce contained the highest amount (4402.0 and 395.4
mg/100 g) and mayonnaise contained the least (231.3 and 63.6 mg/100 g). Both sodium and
potassium contents of light soy sauce were significantly higher than other sauces. Bamboo salt
is a better choice instead of other salts in terms of the potassium level. Among sauces, although
light soy sauce is high in potassium; however, its high sodium has offset the beneficial effect
of potassium.
Is the Singapore-Malaysia Congress of Medicine relevant in an age of specialisation?

Tan WC

Ann Acad Med Singap, 1999 May;28(3):315.
PMID: 10575512
Fulltext Abdominal stab wound with inferior vena cava injury: a case report

Narasimman S, Tan WJ

Med J Malaysia, 2014 Dec;69(6):291-2.
PMID: 25934965 MyJurnal
Fulltext Assessing oral cancer knowledge and awareness among Malaysian dental and medical students

Awan KH, Khang TW, Yee TK, Zain RB

J Cancer Res Ther, 2014 Oct-Dec;10(4):903-7.
PMID: 25579526 DOI: 10.4103/0973-1482.138011

BACKGROUND:
Oral cancer is a foremost health dilemma in several regions of the world. General dental practitioners and general medical practitioners play a major role in recognition of oral mucosal changes that may lead to malignancy. Their knowledge in oral cancer itself and the risk factors associated with the disease need to be sufficient.

OBJECTIVE:
The objective of the present study was to investigate awareness and knowledge of undergraduate dental and medical students in early detection and prevention of oral cancer.

MATERIALS AND METHODS:
Dental and medical students were invited to participate by answering a questionnaire on their habits of the oral mucosa examination and history taking, knowledge on risk factors and changes related with oral cancer, referral of patients as well as their desire to receive further information on oral cancer. Chi-square test was carried out to analyze knowledge and awareness between undergraduate dental and medical students.

RESULTS:
Undergraduate dental students were more likely to examine oral mucosa (96.7%) and advice risk habits to patients (93.9%) compared to medical students (60.6% and 79.8% respectively). Significantly more dental students considered smoking (84.4%), betel quid chewing (76.1%), and alcohol drinking (35%) as risk factors. Clinical changes of oral cancer were better identified by dental students (leukoplakia-52.8%, erythroplakia-45%, and non-healing ulcer-40%) compared to medical students (leukoplakia-12.9%, erythroplakia-4.6%, and non-healing ulcer-10.3%). Both dental and medicals students reported the desire to receive further information in relation to oral cancer.

CONCLUSION:
Dental students have better knowledge and awareness in prevention and early detection of oral cancer compared to medical students.
Sweet's syndrome: A review from two tertiary hospitals in Malaysia

Tan WF, Voo SYM, Tan WC, Sandhya R

Med J Malaysia, 2022 Nov;77(6):669-675.
PMID: 36448383

INTRODUCTION: Sweet's syndrome (SS) also known as acute febrile neutrophilic dermatosis, is an uncommon disease characterised by acute onset of tender, violaceous or erythematous, oedematous papules, nodules or plaques, with fever. It is classified into classic, malignancyassociated, and drug-induced subtypes.The aims of this study is to evaluate the subtypes, clinical features, laboratory profiles, and treatment of patients with SS.
MATERIALS AND METHODS: We did a retrospective medical record review of all patients with SS from July 2014 to July 2018 at Hospital Queen Elizabeth and Hospital Pulau Pinang, both tertiary hospitals in Malaysia.
RESULTS: Twenty-nine patients were included. Approximately half of the patients (15) were females with a mean age of onset of 50.93 (± 11.52) years. The most common subtype was classic (62.0%) followed by malignancy-associated (31.0%) and drug-induced (6.9%). Among the patients with the classic subtype, infective-related causes (50.0%) were the most common. Among the patients with malignancy, eight had haematological malignancy and one had a solid tumour. Two-third of the malignancies were diagnosed within a year after the diagnosis of SS. Eight of our patients in Sabah had mycobacterial infections with three having concomitant haematological malignancies. Patients with malignancy-associated SS had lower mean haemoglobin (p=0.018) and mean platelet count (p=0.031). Itch was associated with the presence of pustules (p=0.038). Histopathological examination of all skin lesions showed dermal neutrophilic infiltrates and 25 (86.2%) of them had papillary dermal oedema. The study was limited by its retrospective design. The sample size was small likely due to the uncommon occurrence of this condition.
CONCLUSION: SS is an uncommon dermatosis with distinctive clinical and histopathological features. Screening for underlying malignancy is essential especially for those who present with anaemia, thrombocytopenia, and pathergy phenomenon. Mycobacterial infection should be considered in this region due to high tuberculosis burden.
Fulltext Kaposi's sarcoma: case report and treatment options

Tan WC, Chan LC

Med J Malaysia, 2011 Oct;66(4):383-4.
PMID: 22299569

Kaposi's sarcoma (KS) is strongly associated with Human Herpes Virus 8 (HHV8) and Human Immunodeficiency Virus infection (HIV). It was the first malignancy to be linked with Acquired Immunodeficiency Syndrome (AIDS). We report a case of Kaposi's sarcoma in a newly diagnosed retroviral homosexual patient with CD4 count of 21. He had multiple firm discrete violaceous plaques and nodules scattered over the face, scalp, hard palate, trunk and genitalia. Biopsy of a skin nodule over the trunk and a biopsy of a lesion from the gastric mucosa confirmed Kaposi's sarcoma. He was started on Highly Active Antiretroviral Therapy (HAART) and cryotherapy (liquid nitrogen) was given for the lesions over the skin. He responded well to treatment. Liquid nitrogen is a useful adjuvant treatment for Kaposi's sarcoma.
Trianchoratus longianchoratus sp. n. (Monogenea: Ancyrocephalidae: Heteronchocleidinae) from Channa lucius (Osteichthyes: Channidae) in Peninsular Malaysia

Tan WB, Lim LH

Folia Parasitol., 2009 Sep;56(3):180-4.
PMID: 19827361

One new and three previously described species of Trianchoratus Price et Berry, 1966 were collected from the gills of Channa lucius (Cuvier) and Channa striata (Bloch) from the Bukit Merah Reservoir, Perak and Endau-Rompin, Pahang, Peninsular Malaysia. They are Trianchoratus longianchoratus sp.n., T. malayensis Lim, 1986 and T. pahangensis Lim, 1986 from C. lucius, and T. ophicephali Lim, 1986 from C. striata. The new species differs from the Trianchoratus species hitherto described from channids and anabantoids in having two ventral anchors with a long curved inner root and one dorsal anchor with a curved inner root and lacking an outer root. A table summarizing the known species of heteronchocleidins (Trianchoratus, Eutrianchoratus and Heteronchocleidus) and Sundanonchus reported from fish hosts of different families (Channidae, Helostomatidae, Anabantidae and Osphronemidae) is provided.
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.
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).
Fulltext Gastric cancer in Malaysia: the need for early diagnosis

Kandasami P, Tan WJ, Norain K

Med J Malaysia, 2003 Dec;58(5):758-62.
PMID: 15190664 MyJurnal

Gastric cancer is an important cause of death among patients with malignancies in Malaysia. Survival of patients with gastric cancer is dependent on the stage at which diagnosis is made. We report our experience in dealing with gastric cancer in a major Ministry of Health Hospitals in Malaysia. A retrospective review of two hundred and fifty consecutive histologically proven gastric adenocarcinoma at Hospital Ipoh for the period January 1988 to 1998 was performed. The study confirms that gastric cancer is a disease of the elderly and has a male preponderance. It is also identifies the Chinese and Indians to be at increased risk of gastric cancer when compared to the Malays. The most striking finding in this study was the very late stage of disease at time of presentation. Eighty-two percent of the patients presented with stage IV disease and curative surgery was offered only to a 16% of them. In a substantial number of patients not even a palliative procedure was offered. Early detection is the key to improving survival in gastric cancer patients. There is an urgent need for clinicians to change their approach to the management of the disease. Patients with dyspeptic symptoms should be investigated early rather then wait for classical symptoms of gastric cancer.
Fulltext Dengue-related Longitudinally Extensive Transverse Myelitis

Tan W, Lim CTS

Neurol India, 2019 9 13;67(4):1116-1117.
PMID: 31512649 DOI: 10.4103/0028-3886.266296
A sinister rash in a lady with breast malignancy

Tan WF, Voo SYM

Med J Malaysia, 2021 03;76(2):275-277.
PMID: 33742647

Cutaneous metastasis may be the first presentation of an undiagnosed malignancy or a relapse of a previously treated malignancy. We describe a case of a 64-year-old lady with cutaneous metastases from breast carcinoma, who presented with two uncommon rash morphology-carcinoma erysipeloides (CE) and annular erythema. Histopathological examination showed infiltration of neoplastic cells in the dermal lymphatics and staging CT showed distant metastases. She is currently on palliative chemotherapy. A high index of suspicion and early referral to a dermatologist is crucial for early diagnosis for a patient who presents with an inflammatory skin lesion that is refractory to treatment, particularly if the patient has a previous history of malignancy.
Fulltext Concurrent Influenza A and Pulmonary Melioidosis in pregnancy

Tan WF, Lee HG

Med J Malaysia, 2021 03;76(2):245-247.
PMID: 33742637

Melioidosis is endemic in Sabah. It causes significant morbidity and mortality if diagnosis and treatment is delayed. Important risk factors include diabetes, chronic kidney diseases, chronic lung diseases, thalassaemia, immunosuppressive therapy, and hazardous alcohol consumption. Influenza A is usually a self-limiting disease but is associated with high morbidity and mortality in highrisk populations especially during pregnancy. Both melioidosis and influenza A commonly present in patients with pneumonia. Secondary bacterial pneumonia is a known complication in approximately one third of patients with severe pneumonia due to influenza A, resulting in intensive care unit admissions. However, melioidosis is not commonly recognized as an aetiology in secondary bacterial pneumonia complicating influenza A infection. This is important as empirical antibiotics that are used to treat secondary bacterial pneumonia due to influenza A often do not cover melioidosis. Here we report a rare case of concurrent pulmonary melioidosis and influenza A in a 30- year-old primigravida at 27 weeks of pregnancy in the Queen Elizabeth Hospital, Sabah, Malaysia to highlight the challenge in the recognition and management of both infections in a melioidosis endemic area.
Hamatopeduncularia Yamaguti, 1953 (Monogenea: Ancylodiscoididae) from catfish off Peninsular Malaysia: Description of two new species and insights on the genus

Soo OYM, Tan WB

Parasitol Int, 2021 Apr;81:102282.
PMID: 33444771 DOI: 10.1016/j.parint.2021.102282

Hamatopeduncularia longiangusticirrata sp. nov. and H. petalumvaginata sp. nov. were collected from Arius maculatus and Nemapteryx caelata, respectively from Tanjung Karang, Peninsular Malaysia. Morphological and molecular investigations were carried out to ascertain the identity of the new species. The two new species differ from previously described Hamatopeduncularia species in the morphology of the male and female reproductive organs. Hamatopeduncularia longiangusticirrata sp. nov. possesses a long penis similar to H. elongata, H. longicopulatrix, H. brisbanensis, H. major and H. petalumvaginata sp. nov., but differs in having a thread-like tapering distal end and can be distinguished from H. brisbanensis and H. major in not having an accessory piece. Hamatopeduncularia longiangusticirrata sp. nov. is also unique in having an ornamented penis initial and a vaginal tube surrounded by fine hair-like structures. Hamatopeduncularia petalumvaginata sp. nov. possesses a simple penis without an accessory piece and a petaloid vaginal opening that resembles the arrangement of petals on a flower. Maximum likelihood trees were constructed from partial 28S and 18S rDNA sequences of the two new species and other ancylodiscoidids to reveal a strongly supported monophyletic branch consisting of the two new species for both markers. According to Lim's classification in 1996 of Hamatopeduncularia species penis type, H. petalumvaginata sp. nov. has been classified within the elegans-type and H. longiangusticirrata sp. nov. is proposed as the longiangusticirrata-type.
The current state of understanding of oncology expanded access programs in Malaysia

Yong FL, Tan WC

Med J Malaysia, 2024 Mar;79(2):191-195.
PMID: 38553925

INTRODUCTION: An expanded access program (EAP) is a regulatory mechanism that provides access to an investigational drug, which is not approved for use, in treating life-threatening conditions when all the standard-ofcare treatments are exhausted.
MATERIALS AND METHODS: An online, anonymous, voluntary survey was conducted to assess the level of knowledge and understanding about EAPs among Malaysian oncologists using SurveyMonkey® between April 2020 and June 2020. Oncologists who had enquired about EAP in the past, were invited at random to participate in the survey. Participants who did not provide consent or failed to complete the survey were excluded.
RESULTS: A total of 15 oncologists participated in the survey, from both public (46.6%) and private (46.6%) practices. Most respondents (80%) had filed between 1 to 10 EAP applications in the past 12 months. For 73.3% respondents, resources or training were not provided for EAPs from institutions. Around 53% of the respondents reported that their knowledge of EAPs and application processes including country regulations is 'good'. The majority of respondents (73.3%) reported that the educational modules on an overview of EAPs, country regulations and the EAP application process will be beneficial. Most participants received information about the existing EAPs either by reaching out to a pharmaceutical sponsor or through another health care provider and some received information about the existing EAPs through their institutions or patients/caregivers. Most of the respondents recommended that pharmaceutical companies should have readily available information related to the availability and application of EAPs for all pipeline products on their websites.
DISCUSSION: EAPs are crucial treatment access pathways to provide investigational drugs to patients who have exhausted their treatment options and are not eligible for participation in clinical trials. Malaysian oncologists have a fair understanding about the EAPs and the application processes.
CONCLUSION: Additional training and awareness are needed for Malaysian oncologists to upscale the utilisation of EAPs.
Fulltext Microbial and heavy metal contamination in commonly consumed traditional Chinese herbal medicines

Ting A, Chow Y, Tan W

J Tradit Chin Med, 2013 Feb;33(1):119-24.
PMID: 23596824

The increasing popularity and widespread use of traditional Chinese herbs as alternative medicine have sparked an interest in understanding their biosafety, especially in decoctions that are consumed. This study aimed to assess the level of microbial and heavy metal contamination in commonly consumed herbal medicine in Malaysia and the effects of boiling on these contamination levels.
Fulltext Chronic osteomyelitis secondary to human bite: a case report

Tan W, Wazir N, Chiu C, Ko M

Malays Orthop J, 2012 Nov;6(3):40-1.
PMID: 25279055 MyJurnal DOI: 10.5704/MOJ.1207.003

We report a case of a human bite that was initially inadequately treated and progressed to chronic osteomyelitis, finally resulting in digital amputation. Human bites are seemingly innocuous, but if neglected, may lead to subsequent infection and morbidity. Persistence of symptoms should alert the practitioner to the possibility of infection extending to the soft tissue or bone. Bacteriological studies commonly yield mixed aerobic and anaerobic flora. Early debridement and antibiotic treatment may prevent development of severe soft tissue or bone infection.
Existence of two forms of L protein of Newcastle disease virus isolates due to a compensatory mutation in Domain V

Kusumaningtyas E, Tan WS, Zamrod Z, Eshaghi M, Yusoff K

Arch Virol, 2004 Sep;149(9):1859-65.
PMID: 15593426

Nucleotide sequence comparison of the L gene of the Malaysian neurotropic-viscerotropic velogenic NDV strain AF2240 with other NDV strains revealed a single nucleotide insertion at position 3870. This mutation is compensated by a nucleotide deletion downstream at position 3958 which results in two forms of the L proteins containing a 30-amino acid substitution in Domain V. This compensatory mutation does not correlate with the pathogenicity of the viral strains but it may affect the viral replication as Domain V is believed to play an important role in the replication of paramyxoviruses.
Fulltext Knowledge, attitude and practice of antibiotics prescribing among medical officers of public health care facilities in the state of Kedah, Malaysia

Tan WL, Siti R, Shahfini I, Zuraidah A

Med J Malaysia, 2015 Oct;70(5):307-11.
PMID: 26556121 MyJurnal

BACKGROUND: Antibiotic resistance is a rising problem in Malaysia. For instance, high antibiotic prescribing rate for upper respiratory tract infection and inappropriate choice of antibiotic is a significant healthcare concern in Malaysia. Our main objective was to study knowledge, attitude and practice of antibiotic prescribing among medical officers in Kedah, Malaysia.
METHODS: A cross sectional study was conducted in outpatient departments of health clinics and hospitals in Kedah from June 2013 until December 2013. Sample size was 118 and systematic sampling was conducted. Research tool used was a validated questionnaire from studies conducted in Congo and Peru.
RESULTS: Response rate was 84.8%. Majority of our respondents were female doctors (71.0%), local graduates (63.0%), and practiced for 4 years or less (61.0%). 52.0% of the respondents prescribed antibiotics more than once daily. Mean knowledge score on antibiotics was 5.31 ±1.19 (95% CI: 5.06; 5.54). More than half (62.0%) of our respondents were confident in antibiotic prescribing and there were merely 18.0% of them consulted any colleagues prior to prescription. There was a significant difference in frequency of antibiotic prescribing between junior doctors and senior doctors (P-value: 0.036). In addition, there was also a significant association between frequency of antibiotic prescribing and awareness of antibiotic resistance in their daily practice. (P-value: 0.002).
CONCLUSION: Knowledge on antibiotic was moderate among our medical officers and antibiotic prescribing was frequent. Training and courses on appropriate antibiotic prescribing should be emphasized to ensure the best practice in antibiotic prescription.
Study site: Klinik Kesihatan, outpatient clinics, district hospital, general hospital, Kedah, Malaysia
Novel peptides that inhibit the propagation of Newcastle disease virus

Ramanujam P, Tan WS, Nathan S, Yusoff K

Arch Virol, 2002 May;147(5):981-93.
PMID: 12021868

A disulfide constrained random heptapeptide library displayed on filamentous bacteriophage M13 was applied to select specific ligands that interact with Newcastle disease virus (NDV). A fusion phage carrying the amino acid sequence TLTTKLY was selected from the panning procedure. An antibody competition assay showed that the selected phage was capable of competing with the polyclonal antibodies raised against NDV for binding sites on the virus. Determination of the binding affinity of this phage with NDV by an equilibrium binding assay in solution revealed two different dissociation constants, suggesting that there could be two distinct binding sites for the phage on NDV. Synthetic peptides with the sequence CTLTTKLYC, either in linear or cyclic conformations inhibited the binding of phage bearing the same sequence to NDV. These peptides also inhibited the hemolytic activity of the virus as well as its propagation in embryonated chicken eggs.

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