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Clinicopathological correlation of oral candidiasis - Our experience in a tertiary centre over two decades

Tan CC, Lim D, Mohd Hisham NQ, Elias NA, Azli AS, Goh YC

Malays J Pathol, 2023 Aug;45(2):237-246.
PMID: 37658533

INTRODUCTION: Oral candidiasis is one of the most common fungal infections that has been widely reported around the world. In Malaysia, the available studies for this infection are scarce.
MATERIALS AND METHODS: This is a 20-year retrospective study aimed to investigate the prevalence, demographic characteristics, clinical presentations, and the association of oral candidiasis with clinical parameters in oral candidiasis cases reported in the Faculty of Dentistry, Universiti Malaya from 1999 until 2019. A total of 12,964 histopathological records from the Oral Pathology Diagnostic and Research Laboratory (OPDRL) between 1999 to 2019 were retrieved. Oral candidiasis cases were selected according to the inclusion and exclusion criteria. Information of interest was obtained and analysed.
RESULTS: From the total records retrieved, 378 oral candidiasis cases were recorded and 82.8% were diagnosed from smear test. This study showed that oral candidiasis was predominantly reported in female (64.2%) and Indian population (64.2%). The peak incidence was in the sixth decades of life (27.0%). The most commonly affected site was tongue and coated tongue was the most common clinical presentation. More than 50% of the cases had comorbidity and 10.6% were associated with dentures. Ethnicity and site of occurrence were significantly associated (p<0.05) with oral candidiasis.
CONCLUSION: This is the first large-scale study of oral candidiasis cases in Malaysia. The findings of this study are useful for clinical assessment of patients suspected of oral candidiasis.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Time and place in the prehistory of the Aslian languages

Dunn M, Kruspe N, Burenhult N

Hum Biol, 2013 Feb-Jun;85(1-3):383-400.
PMID: 24297234

The Aslian language family, located in the Malay Peninsula and southern Thai Isthmus, consists of four distinct branches comprising some 18 languages. These languages predate the now dominant Malay and Thai. The speakers of Aslian languages exhibit some of the highest degree of phylogenetic and societal diversity present in Mainland Southeast Asia today, among them a foraging tradition particularly associated with locally ancient, Pleistocene genetic lineages. Little advance has been made in our understanding of the linguistic prehistory of this region or how such complexity arose. In this article we present a Bayesian phylogeographic analysis of a large sample of Aslian languages. An explicit geographic model of diffusion is combined with a cognate birth-word death model of lexical evolution to infer the location of the major events of Aslian cladogenesis. The resultant phylogenetic trees are calibrated against dates in the historical and archaeological record to infer a detailed picture of Aslian language history, addressing a number of outstanding questions, including (1) whether the root ancestor of Aslian was spoken in the Malay Peninsula, or whether the family had already divided before entry, and (2) the dynamics of the movement of Aslian languages across the peninsula, with a particular focus on its spread to the indigenous foragers.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Fulltext Ethnic differences in mammographic densities: an Asian cross-sectional study

Mariapun S, Li J, Yip CH, Taib NA, Teo SH

PLoS One, 2015;10(2):e0117568.
PMID: 25659139 DOI: 10.1371/journal.pone.0117568

BACKGROUND: Mammographic density is a strong risk factor for breast cancer and is highly variable, but, to date, few studies have examined density in Asian women, particularly those in low and middle-income Asian countries where genetic and lifestyle determinants may be significantly different.
METHODS: A total of 1,240 women who attended an opportunistic mammogram screening programme were eligible for analysis. Mammographic density was estimated using a fully-automated thresholding method and differences across ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women.
RESULTS: Percent density was significantly higher in Chinese women (28.5%; 95% CI 27.0%, 30.0%) compared to Malay (24.2%; 95% CI 22.5%, 26.0%) and Indian (24.3%; 95% CI 22.8%, 25.7%) women (p<0.001), after adjustment for age, BMI, menopausal status, parity and age at first full term pregnancy. Correspondingly, adjusted nondense area was significantly lower in Chinese (72.2cm2; 95% CI 67.9cm2, 76.5cm2) women compared to Malay (92.1cm2; 95% CI 86.9cm2, 97.2cm2) and Indian (97.7cm2; 95% CI 93.4cm2, 101.9cm2) women (p<0.001), but dense area did not differ across the three ethnic groups.
CONCLUSIONS: Our study shows that higher percent density and lower nondense area reflect the higher incidence of breast cancer in Chinese compared to Malay and Indian women in Malaysia. Known lifestyle determinants of mammographic density do not fully account for the ethnic variations observed in mammographic density in this Asian cohort.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Fulltext Population genetic structure of peninsular Malaysia Malay sub-ethnic groups

Hatin WI, Nur-Shafawati AR, Zahri MK, Xu S, Jin L, Tan SG, et al.

PLoS One, 2011;6(4):e18312.
PMID: 21483678 DOI: 10.1371/journal.pone.0018312

Patterns of modern human population structure are helpful in understanding the history of human migration and admixture. We conducted a study on genetic structure of the Malay population in Malaysia, using 54,794 genome-wide single nucleotide polymorphism genotype data generated in four Malay sub-ethnic groups in peninsular Malaysia (Melayu Kelantan, Melayu Minang, Melayu Jawa and Melayu Bugis). To the best of our knowledge this is the first study conducted on these four Malay sub-ethnic groups and the analysis of genotype data of these four groups were compiled together with 11 other populations' genotype data from Indonesia, China, India, Africa and indigenous populations in Peninsular Malaysia obtained from the Pan-Asian SNP database. The phylogeny of populations showed that all of the four Malay sub-ethnic groups are separated into at least three different clusters. The Melayu Jawa, Melayu Bugis and Melayu Minang have a very close genetic relationship with Indonesian populations indicating a common ancestral history, while the Melayu Kelantan formed a distinct group on the tree indicating that they are genetically different from the other Malay sub-ethnic groups. We have detected genetic structuring among the Malay populations and this could possibly be accounted for by their different historical origins. Our results provide information of the genetic differentiation between these populations and a valuable insight into the origins of the Malay sub-ethnic groups in Peninsular Malaysia.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Fulltext Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia

Mahadeva S, Yadav H, Rampal S, Everett SM, Goh KL

Aliment Pharmacol Ther, 2010 May;31(10):1141-51.
PMID: 20175766 DOI: 10.1111/j.1365-2036.2010.04270.x

The role of ethnicity in the development of dyspepsia remains uncertain.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Ethnic differences in higher-order aberrations: Spherical aberration in the South East Asian Chinese eye

Lim KL, Fam HB

J Cataract Refract Surg, 2009 Dec;35(12):2144-8.
PMID: 19969221 DOI: 10.1016/j.jcrs.2009.06.031

PURPOSE: To determine the distribution of higher-order corneal and ocular aberrations in a healthy refractive surgery population.
SETTING: Island Hospital, Penang, Malaysia.
METHODS: In this prospective observational study, 1 eye of ethnic Chinese refractive surgery patients was evaluated with an Orbscan II corneal topographer and a Zywave Hartmann-Shack aberrometer with a 6.0 mm pupil. Height data were analyzed to derive the higher-order aberrations (HOAs) from the 3rd to 5th Zernike order.
RESULTS: The mean spherical equivalent in the 70 eyes evaluated was -6.46 diopters +/- 3.10 (SD). The mean total corneal HOA was 0.574 +/- 0.218 microm (range 0.269 to 1.249 microm) and the mean total ocular HOA, 0.525 +/- 0.354 microm (range 0.138 to 2.145 microm). There was no statistically significant correlation with age. The mean 3rd-order ocular aberration was 0.399 +/- 0.287 microm; the mean 4th-order, 0.297 +/- 0.223 microm; and the mean 5th-order, 0.108 +/- 0.101 microm. Corneal spherical aberration was greater than ocular spherical aberration (mean 0.312 +/- 0.114 microm versus 0.200 +/- 0.170 microm). Multilinear regression showed that the only dependent that predicted ocular spherical aberration was anterior corneal asphericity (r(2) = 0.227, F = 17.95, PAsian Chinese eyes were significantly greater than that reported in other populations. Population differences in wavefront errors were significant, and this should be noted in patient management.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Relationship between the corneal surface and the anterior segment of the cornea: An Asian perspective

Lim KL, Fam HB

J Cataract Refract Surg, 2006 Nov;32(11):1814-9.
PMID: 17081863

To determine the values for the anterior best-fit sphere (BFS) and posterior BFS in an Asian population using the Orbscan II (Bausch & Lomb) slit-scanning Placido disk corneal topographer.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Aggression in Asian patients with first-episode psychosis

Verma S, Poon LY, Subramaniam M, Chong SA

Int J Soc Psychiatry, 2005 Dec;51(4):365-71.
PMID: 16400911

The aims of this study were to examine the prevalence and severity of aggression in patients with first-episode psychosis and to identify the association between aggression and sociodemographic and clinical factors.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Fulltext Total 25-OH vitamin D concentrations in Chinese, Malays and Indians

Hawkins R

Ann Lab Med, 2013 Mar;33(2):156-8.
PMID: 23479565 DOI: 10.3343/alm.2013.33.2.156
Matched MeSH terms: Asian Continental Ancestry Group/ethnology
The sequelae of barium aspiration

Gendeh HS, Hashim ND, Mohammad Yunus MR, Gendeh BS, Kosai NR

ANZ J Surg, 2018 09;88(9):937-938.
PMID: 27122196 DOI: 10.1111/ans.13624
Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Antithrombotic treatment for stroke prevention in atrial fibrillation: The Asian agenda

Chen CH, Chen MC, Gibbs H, Kwon SU, Lo S, On YK, et al.

Int J Cardiol, 2015 Jul 15;191:244-53.
PMID: 25978611 DOI: 10.1016/j.ijcard.2015.03.369

Atrial fibrillation (AF) is the most common heart arrhythmia. Untreated AF incurs a considerable burden of stroke and associated healthcare costs. Asians have AF risk factors similar to Caucasians and a similarly increased risk of AF-related stroke; however, with a vast and rapidly ageing population, Asia bears a disproportionately large disease burden. Urgent action is warranted to avert this potential health crisis. Antithrombotic therapy with oral anticoagulants is the most effective means of preventing stroke in AF and is a particular priority in Asia given the increasing disease burden. However, AF in Asia remains undertreated. Conventional oral anticoagulation with warfarin is problematic in Asia due to suboptimal control and a propensity among Asians to warfarin-induced intracranial haemorrhage. Partly due to concerns about intracranial haemorrhage, there are considerable gaps between AF treatment guidelines and clinical practice in Asia, in particular overuse of antiplatelet agents and underuse of anticoagulants. Compared with warfarin, new direct thrombin inhibitors and Factor Xa inhibitors are non-inferior in preventing stroke and significantly reduce the risk of life-threatening bleeding, particularly intracranial bleeding. These agents may therefore provide an appropriate alternative to warfarin in Asian patients. There is considerable scope to improve stroke prevention in AF in Asia. Key priorities include: early detection of AF and identification of asymptomatic patients; assessment of stroke and bleeding risk for all AF patients; evidence-based pharmacotherapy with direct-acting oral anticoagulant agents or vitamin K antagonists for AF patients at risk of stroke; controlling hypertension; and awareness-raising, education and outreach among both physicians and patients.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Genetic polymorphism of CYP2D6 in Chinese subjects in Malaysia

Ismail R, Teh LK, Amir J, Alwi Z, Lopez CG

J Clin Pharm Ther, 2003 Aug;28(4):279-84.
PMID: 12911679

Although Malaysian Chinese share an origin with the mainland Chinese, their evolution has been influenced by intermarriages. With a gene such as CYP2D6, which is highly polymorphic, it is expected that the Malaysian Chinese would exhibit a polymorphism profile different from those of the Chinese populations in other geographical locations.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
The 27-bp VNTR polymorphism in intron 4 of the human eNOS gene in healthy Singaporean Chinese, Indians, and Malays

Gan YY, Chen CF

Biochem Genet, 2012 Feb;50(1-2):52-62.
PMID: 21927815 DOI: 10.1007/s10528-011-9458-0

Human endothelial nitric oxide synthase (eNOS) is one isoform of the nitric oxide synthases that are responsible for nitric oxide synthesis from L-arginine. The gene encoding eNOS contains a 27-bp VNTR polymorphism in intron 4. We report here for the first time the presence of a novel allele 3, which was absent in all other populations studied to date, in 1.7% each of Singaporean Indians and Malays. We also detected the presence of a novel genotype 3/5 in 3.4% each of Singaporean Indians and Malays. Allele 6, which was absent in Han Chinese from northern China and Taiwan and was also absent in Indians from the Indian subcontinent, was found in 2.1% of Singaporean Chinese and in 0.3% of Singaporean Indians.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Differences in serum potassium concentrations between Chinese, Indians and Malays

Hawkins RC

Clin Chem Lab Med, 2010;48(1):105-8.
PMID: 19929751 DOI: 10.1515/CCLM.2010.010

It has been suggested that potassium concentrations may vary between different geographical regions, possibly reflecting ethnic differences in potassium status. This study compared the serum potassium concentrations of three Asian ethnicities in a single geographical location.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Fulltext Correlation of serum cartilage oligomeric matrix protein (COMP) and interleukin-16 (IL-16) levels with disease severity in primary knee osteoarthritis: A pilot study in a Malaysian population

Das Gupta E, Ng WR, Wong SF, Bhurhanudeen AK, Yeap SS

PLoS One, 2017;12(9):e0184802.
PMID: 28910372 DOI: 10.1371/journal.pone.0184802

OBJECTIVE: The aim of this study was to investigate the correlations between serum cartilage oligomeric matrix protein (COMP), interleukin-16 (IL-16) and different grades of knee osteoarthritis (KOA) in Malaysian subjects.

METHODS: Ninety subjects were recruited comprising 30 with Kellgren-Lawrence (K-L) grade 2 KOA, 27 with K-L grade 3 KOA, 7 with grade 4 KOA, and 30 healthy controls. All subjects completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Serum COMP and IL-16 levels were measured using ELISA and their values log transformed to ensure a normal distribution.

RESULTS: There was no significant differences in levels of log serum COMP and IL-16 between healthy controls and KOA patients. There were no significant differences in the log serum COMP and IL-16 levels within the different K-L grades in the KOA patients. In KOA patients, log serum IL-16 levels significantly correlated with the WOMAC score (p = 0.001) and its subscales, pain (p = 0.005), stiffness (p = 0.019) and physical function (p<0.0001). Serum IL-16 levels were significantly higher in Malaysian Indians compared to Malays and Chinese (p = 0.024).

CONCLUSIONS: In this multi-ethnic Malaysian population, there was no difference in serum COMP and IL-16 levels between healthy controls and patients with KOA, nor was there any difference in serum COMP or IL-16 levels across the various K-L grades of KOA. However, there were significant inter-racial differences in serum IL-16 levels.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Fulltext Forensic characterization of 15 autosomal STRs in four populations from Xinjiang, China, and genetic relationships with neighboring populations

Zhan X, Adnan A, Zhou Y, Khan A, Kasim K, McNevin D

Sci Rep, 2018 03 16;8(1):4673.
PMID: 29549272 DOI: 10.1038/s41598-018-22975-6

The Xinjiang Uyghur Autonomous Region of China (XUARC) harbors 47 ethnic groups including the Manchu (MCH: 0.11%), Mongols (MGL: 0.81%), Kyrgyz (KGZ: 0.86%) and Uzbek (UZK: 0.066%). To establish DNA databases for these populations, allele frequency distributions for 15 autosomal short tandem repeat (STR) loci were determined using the AmpFlSTR Identifiler PCR amplification kit. There was no evidence of departures from Hardy-Weinberg equilibrium (HWE) in any of the four populations and minimal departure from linkage equilibrium (LE) for a very small number of pairwise combinations of loci. The probabilities of identity for the different populations ranged from 1 in 1.51 × 1017 (MCH) to 1 in 9.94 × 1018 (MGL), the combined powers of discrimination ranged from 0.99999999999999999824 (UZK) to 0.9999999999999999848 (MCH) and the combined probabilities of paternal exclusion ranged from 0.9999979323 (UZK) to 0.9999994839 (MCH). Genetic distances, a phylogenetic tree and principal component analysis (PCA) revealed that the MCH, KGZ and UZK are genetically closer to the Han population of Liaoning and the Mongol population of Mongolia while the MGL are closer to Han, Japanese, Korean, Malaysian, Hong Kong Han and Russians living in China.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Fulltext Accuracy of self-reported height, weight and BMI in a multiethnic Asian population

Roystonn K, Abdin E, Sambasivam R, Zhang Y, Chang S, Shafie S, et al.

Ann Acad Med Singap, 2021 04;50(4):306-314.
PMID: 33990818 DOI: 10.47102/annals-acadmedsg.2020183

INTRODUCTION: The study assessed whether self-reported height, weight and derived body mass index (BMI) can provide an accurate measure of anthropometric data in a multiethnic adult population in Singapore.
METHODS: Standardised anthropometric measurements were compared against the self-reported values from 5,132 adult residents in a cross-sectional, epidemiological survey. Discrepancies in self-reports from measurements were examined by comparing overall mean differences. Intraclass correlations, Cohen's kappa and Bland-Altman plots with limits of agreement, and sub-analysis by sex and ethnicity were also explored.
RESULTS: Data were obtained from 5,132 respondents. The mean age of respondents was 43.9 years. Overall, the height was overestimated (0.2cm), while there was an underestimation of weight (0.8kg) and derived BMI (0.4kg/m2). Women had a larger discrepancy in height (0.35cm, 95% confidence interval [CI] 0.22 to 0.49), weight (-0.95kg, 95% CI -1.11 to -0.79) and BMI (-0.49kg/m2, 95% CI -0.57 to -0.41) compared with men. Height reporting bias was highest among Indians (0.28cm, 95% CI 0.12 to 0.44) compared with Chinese and Malays, while weight (-1.32kg, 95% CI -1.53 to -1.11) and derived BMI (-0.57kg/m2, 95% CI -0.67 to -0.47) showed higher degrees of underreporting among Malays compared with Chinese and Indians. Substantially high self-reported versus measured values were obtained for intraclass correlations (0.96-0.99, P<0.001) and kappa (0.74). For BMI categories, good to excellent kappa agreement was observed (0.68-0.81, P<0.0001).
CONCLUSION: Self-reported anthropometric estimates can be used, particularly in large epidemiological studies. However, sufficient care is needed when evaluating data from Indians, Malays and women as there is likely an underestimation of obesity prevalence.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Why have the peninsular "negritos" remained distinct?

Benjamin G

Hum Biol, 2013 Feb-Jun;85(1-3):445-84.
PMID: 24297237

The primary focus of this article is on the so-called negritos of Peninsular Malaysia and southern Thailand, but attention is also paid to other parts of Southeast Asia. I present a survey of current views on the "negrito" phenotype--is it single or many? If the phenotype is many (as now seems likely), it must have resulted from parallel evolution in the several different regions where it has been claimed to exist. This would suggest (contrary to certain views that have been expressed on the basis of very partial genetic data) that the phenotype originated recently and by biologically well-authenticated processes from within the neighboring populations. Whole-genome and physical-anthropological research currently support this view. Regardless of whether the negrito phenotype is ancient or recent-and to the extent that it retains any valid biological reality (which is worth questioning)-explanations are still needed for its continued distinctiveness. In the Malay Peninsula, a distinctive "Semang" societal pattern followed by most, but not all, so-called negritos may have been responsible for this by shaping familial, breeding, and demographic patterns to suit the two main modes of environmental appropriation that they have followed, probably for some millennia: nomadic foraging in the forest, and facultative dependence on exchange or labor relations with neighboring populations. The known distribution of "negritos" in the Malay Peninsula is limited to areas within relatively easy reach of archaeologically authenticated premodern transpeninsular trading and portage routes, as well as of other non-negrito, Aslian-speaking populations engaged in swidden farming. This suggests that their continued distinctiveness has resulted from a wish to maintain a complementary advantage vis-à-vis other, less specialized populations. Nevertheless, a significant degree of discordance exists between the associated linguistic, societal-tradition, and biological patterns which suggests that other factors have also been at play.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology*
Admixture patterns and genetic differentiation in negrito groups from West Malaysia estimated from genome-wide SNP data

Jinam TA, Phipps ME, Saitou N, Hugo Pan-Asian SNP Consortium

Hum Biol, 2013 Feb-Jun;85(1-3):173-88.
PMID: 24297225

Southeast Asia houses various culturally and linguistically diverse ethnic groups. In Malaysia, where the Malay, Chinese, and Indian ethnic groups form the majority, there exist minority groups such as the "negritos" who are believed to be descendants of the earliest settlers of Southeast Asia. Here we report patterns of genetic substructure and admixture in two Malaysian negrito populations (Jehai and Kensiu), using ~50,000 genome-wide single-nucleotide polymorphism (SNP) data. We found traces of recent admixture in both the negrito populations, particularly in the Jehai, with the Malay through principal component analysis and STRUCTURE analysis software, which suggested that the admixture was as recent as one generation ago. We also identified significantly differentiated nonsynonymous SNPs and haplotype blocks related to intracellular transport, metabolic processes, and detection of stimulus. These results highlight the different levels of admixture experienced by the two Malaysian negritos. Delineating admixture and differentiated genomic regions should be of importance in designing and interpretation of molecular anthropology and disease association studies.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology
Hunter-gatherers in southeast Asia: from prehistory to the present

Higham C

Hum Biol, 2013 Feb-Jun;85(1-3):21-43.
PMID: 24297219

Anatomically modern hunter-gatherers expanded from Africa into Southeast Asia at least 50,000 years ago, where they probably encountered and interacted with populations of Homo erectus and Homo floresiensis and the recently discovered Denisovans. Simulation studies suggest that these hunter-gatherers may well have followed a coastal route that ultimately led to the settlement of Sahul, while archaeology confirms that they also crossed significant seas and explored well into the interior. They also adapted to marked environmental changes that alternated between relatively cool and dry conditions and warmer, wetter interludes. During the former, the sea fell by up to 120 m below its present level, which opened up a vast low-lying area known as Sundaland. Three principal alignments can be identified: the first involved the occupation of rock shelters in upland regions, the second has identified settlement on broad riverine floodplains, and the last concentrated on the raised beaches formed from about five millennia ago when the sea level was elevated above its present position. This cultural sequence was dislocated about 4 kya when rice and millet farmers infiltrated the lowlands of Southeast Asia ultimately from the Yangtze River valley. It is suggested that this led to two forms of interaction. In the first, the indigenous hunter-gatherers integrated with intrusive Neolithic communities and, while losing their cultural identity, contributed their genes to the present population of Southeast Asia. In the second, hunter-gatherers withdrew to rainforest refugia and, through selective pressures inherent in such an environment, survived as the small-bodied, dark-skinned humans found to this day in the Philippines, Peninsular Malaysia and Thailand, and the Andaman Islands. Beyond the impact of expansive rice farmers in Melanesia and Australia, hunter-gatherers continued to dominate until they encountered European settlement.

Matched MeSH terms: Asian Continental Ancestry Group/ethnology

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