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George Town, Malaysia

Khor S.M.,Penang General Hospital | Mohd Baidi B.,Universiti Sains Malaysia
Malaysian Journal of Nutrition

Introduction: Malnutrition is common in cancer patients. Generally, it is believed that the resting energy expenditure (REE) is elevated in cancer patients and this contributes to the development of malnutrition. Thus, to be able to assess the REE is important in planning adequate nutrition support. Methods: A crosssectional study was carried out to assess the REE in patients with solid tumour (n=25), leukemia (n=25) and healthy subjects (n=50) by using the indirect calorimetry method under standard conditions. Results: There was no significant difference between the measured REE among patients with solid tumour, leukemia and the control group (p=0.534). By contrast, there was a significant difference between the REE/kg FFM in solid tumour patients compared to the leukemia group and the healthy subjects, (p=0.049 and p=0.002). The REE derived from the Harris Benedict Equation was found to be significantly higher than the measured REE. The stress factor for patients with solid tumour was 1.35 and that for leukemia patients was 1.36. Conclusion: The REE/kg FFM in the cancer patients undergoing anticancer therapy appeared to be higher than expected compared to healthy subjects. The Harris Benedict Equation (HBE) was found to over-estimate the REE of cancer patients in the study. As the total energy expenditure (TEE) is estimated by multiplying the REE with the stress factor and physical activity factor, the overestimated REE from HBE will further increase the risk of overfeeding in this population. Source

Hasan S.S.,Universiti Sains Malaysia | Bahari M.B.,Universiti Sains Malaysia | Babar Z.U.,Universiti Sains Malaysia | Ganesan V.,Penang General Hospital
Singapore Medical Journal

Introduction: The primary purpose of this study was to evaluate the utilisation pattern and seizure outcome of newer and older antiepileptic drugs in paediatric clinical practice in a Malaysian hospital setting. Methods: Over a two-month period, all paediatric epilepsy patients from Penang General Hospital, Malaysia who were diagnosed according to the classification of the International League Against Epilepsy were followed up prospectively, and the patients' information was gathered with the help of a validated data collection form. This included demographic characteristics, monotherapy and polytherapy of antiepileptic drugs, as well as the number of seizures experienced. Results: Partial seizures, including complex and simple partial seizures (47.2 percent), followed by generalised seizures (40 percent), were the most common seizure types found in this study. An average of 1.51 antiepileptic drugs per patient was prescribed, with 54.3 percent of the patients on monotherapy and 45.7 percent on polytherapy. Overall, sodium valproate was the most frequently prescribed antiepileptic drug (36.8 percent), followed by carbamazepine (30.2 percent) and lamotrigine (10.4 percent). Carbamazepine was the most frequently prescribed monotherapy (28.6 percent), followed by sodium valproate (17.1 percent). The newer antiepileptic drugs were also found to be used as monotherapy in 7.2 percent of the cases. Moreover, a significant difference was observed between the older and newer antiepileptic drugs in terms of the number of seizures experienced (p = 0.027). Most (75 percent) of the seizure-free patients were on carbamazepine monotherapy. Conclusion: Monotherapy was the most frequently used remedy in all forms of epilepsy. Overall, sodium valproate was the most commonly used drug, while carbamazepine was found to be more frequently used as monotherapy. There was a significant difference found between the older and newer antiepileptic drugs, with 87.5 percent of seizure-free patients on older antiepileptic drugs. Source

Liang S.,Universiti Sains Malaysia | Singh M.,Penang General Hospital | Dharmaraj S.,Universiti Sains Malaysia | Gam L.-H.,Universiti Sains Malaysia
Disease Markers

Breast cancer is a leading cause of mortality in women. In Malaysia, it is the most common cancer to affect women. The most common form of breast cancer is infiltrating ductal carcinoma (IDC). A proteomic approach was undertaken to identify protein profile changes between cancerous and normal breast tissues from 18 patients. Two protein extracts; aqueous soluble and membrane associated protein extracts were studied. Thirty four differentially expressed proteins were identified. The intensities of the proteins were used as variables in PCA and reduced data of six principal components (PC) were subjected to LDA in order to evaluate the potential of these proteins as collective biomarkers for breast cancer. The protein intensities of SEC13-like 1 (isoform b) and calreticulin contributed the most to the first PC while the protein intensities of fibrinogen beta chain precursor and ATP synthase D chain contributed the most to the second PC. Transthyretin precursor and apolipoprotein A-1 precursor contributed the most to the third PC. The results of LDA indicated good classification of samples into normal and cancerous types when the first 6 PCs were used as the variables. The percentage of correct classification was 91.7% for the originally grouped tissue samples and 88.9% for cross-validated samples. © 2010 - IOS Press and the authors. All rights reserved. Source

Liang S.,Universiti Sains Malaysia | Singh M.,Penang General Hospital | Gam L.-H.,Universiti Sains Malaysia
Disease Markers

Female breast cancer is one of the leading causes of female mortality worldwide. In Malaysia, breast cancer is the most commonly diagnosed cancer in women. Of the women in Malaysia, the Chinese have the highest number of breast cancer cases, followed by the Indian and the Malay. The most common type of breast cancer is infiltrating ductal carcinoma (IDC). A proteomic approach was applied in this study to identify changes in the protein profile of cancerous tissues compared with normal tissues from 18 patients; 8 Chinese, 6 Malay and 4 Indian were analysed. Twenty-four differentially expressed hydrophilic proteins were identified. We evaluated the potential of these proteins as biomarkers for infiltrating ductal carcinoma based on their ethnic-specific expressions. Three of the upregulated proteins, calreticulin, 14-3-3 protein zeta and 14-3-3 protein eta, were found to be expressed at a significantly higher level in the cancerous breast tissues when compared with the normal tissues in cases of infiltrating ductal carcinoma. The upregulation in expression was particularly dominant in the Malay cohort. © 2010 - IOS Press and the authors. All rights reserved. Source

Atif M.,Universiti Sains Malaysia | Atif M.,Islamia University of Bahawalpur | Sulaiman S.A.S.,Universiti Sains Malaysia | Shafie A.A.,Universiti Sains Malaysia | And 3 more authors.
BMC Infectious Diseases

Background: According to the World Health Organization's recent report, in Malaysia, tuberculosis (TB) treatment success rate for new smear positive pulmonary tuberculosis (PTB) patients is still below the global success target of 85%. In this study, we evaluated TB treatment outcome among new smear positive PTB patients, and identified the predictors of unsuccessful treatment outcome and longer duration of treatment (i.e., > 6 months).Methods: The population in this study consisted of all new smear positive PTB patients who were diagnosed at the chest clinic of Penang General Hospital between March 2010 and February 2011. During the study period, a standardized data collection form was used to obtain socio-demographic, clinical and treatment related data of the patients from their medical charts and TB notification forms (Tuberculosis Information System; TBIS). These data sources were reviewed at the time of the diagnosis of the patients and then at the subsequent follow-up visits until their final treatment outcomes were available. The treatment outcomes of the patients were reported in line with six outcome categories recommended by World Health Organization. Multiple logistic regression analysis was used to find the independent risk factors for unsuccessful treatment outcome and longer treatment duration. Data were analyzed using the PASW (Predictive Analysis SoftWare, version 19.0. Armonk, NY: IBM Corp).Results: Among the 336 PTB patients (236 male and 100 female) notified during the study period, the treatment success rate was 67.26% (n = 226). Out of 110 patients in unsuccessful outcome category, 30 defaulted from the treatment, 59 died and 21 were transferred to other health care facilities. The mean duration of TB treatment was 8.19 (SD 1.65) months. In multiple logistic regression analysis, risk factors for unsuccessful treatment outcome were foreign nationality, male gender and being illiterate. Similarly, risk factors for mortality due to TB included high-grade sputum and presence of lung cavities at the start of treatment, being alcoholic and elderly. Likewise, concurrent diabetes, presence of lung cavities at the start of the treatment and being a smoker were the significant predictors of longer treatment duration.Conclusion: Our findings indicated that the treatment success rate among the new smear positive PTB patients was less than the success target set by World Health Organization. The proportion of patients in the successful outcome category may be increased by closely monitoring the treatment progress of the patients with aforementioned high risk characteristics. Similarly, more aggressive follow-up of the treatment defaulters and transferred out patients could also improve the TB treatment success rate. © 2014 Atif et al.; licensee BioMed Central Ltd. Source

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