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Petaling Jaya, Malaysia

Ho C.C.K.,National University of Malaysia | Tan W.P.,Thomas Jefferson University | Pathmanathan R.,Sime Darby Medical Center Subang Jaya | Tan W.K.,University of Bristol | Tan H.M.,University of Malaya
Asian Pacific Journal of Cancer Prevention

Background: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia. Materials and Methods: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results. Results: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%. Conclusions: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination. Source

Ho E.L.M.,Sime Darby Specialist Center Megah | Tong S.F.,National University of Malaysia | Tan H.M.,Sime Darby Medical Center Subang Jaya
Journal of Men's Health

Prostate-related problems now seem to stand between the aging male and good quality of life. Males of all age groups may also be affected by similar symptoms. Aging males may suffer "silently" because of their beliefs that symptoms are inevitable and normal with aging. Lower urinary tract symptoms have preceded "prostatism" as a more apt term to describe the symptoms which was previously associated with an enlarged prostate and benign prostatic hyperplasia (BPH). Size is not all that matters, yet it has important roles including prediction of the progression of BPH, serious obstructive symptoms and response to medical therapy. The size is correlated with urine flow and rising serum prostate specific antigen levels. The size also influences the treatment for prostate cancer. Data indicate that there is weak relationship between prostate size and the International Prostate Symptom Score. © 2011 WPMH GmbH. Source

Norhafizah M.,University Putra Malaysia | Mustafa W.M.B.W.,Hospital Kuala Lumpur | Sabariah A.R.,University Putra Malaysia | Shiran M.S.,University Putra Malaysia | Pathmanathan R.,Sime Darby Medical Center Subang Jaya
Medical Journal of Malaysia

Mucosal malignant melanoma (MMM) is an aggressive tumour occurring in the upper respiratory tract. It is rare compared to malignant melanoma of the skin. We report a case of a 53-year-old man with left paranasal swelling. A biopsy showed high-grade spindle cell tumour. Subsequently a subtotal maxillectomy was performed. Histopathological examination revealed a hypercellular tumour composed of mixed spindle and epitheloid cells with very occasional intracytoplasmic melanin pigment. The malignant cells were immunopositive for vimentin, S-100 protein and HMB-45. It was diagnosed as mucosal malignant melanoma (MMM). This article illustrates a rare case of MMM where the diagnosis may be missed or delayed without proper histopathological examination that include meticulous search for melanin pigment and appropriate immunohistochemical stains to confirm the diagnosis. Malignant melanoma can mimic many other types of highgrade malignancy and should be considered as a differential diagnosis in many of these instances. Source

Yeap S.S.,Sime Darby Medical Center Subang Jaya | Goh E.M.L.,Gleneagles Intan Medical Center | Das Gupta E.,International Medical University
Asia-Pacific Journal of Public Health

To determine the depth and sources of knowledge about osteoporosis (OP) among the public in Malaysia. A self-administered questionnaire was distributed to attendees of health-related public forums. A total of 87.1% of the attendees had heard of OP. Of these, 89.5% were concerned about getting OP. Significantly more women than men (P =.015), those with more than 10 years of schooling (P <.001), and those earning more than $US285 per month (P =.022) had heard of OP. Knowledge of OP risk factors was good: 97.1% identified low calcium intake, 87.8% lack of exercise, 80.0% family history of OP, and 75.8% postmenopausal status. A total of 38.7% of the attendees thought that OP was more serious than cancer and 35.1% more serious than heart disease; 55.7% obtained information about OP from newspapers and 46.4% from magazines. In this self-selected population, women, the better educated, and those earning higher incomes were more aware of OP. Knowledge of OP was obtained mainly from printed materials. © 2010 APJPH. Source

Kim D.-W.,Catholic University of Korea | Banavali S.D.,Tata Memorial Hospital | Bunworasate U.,King Chulalongkorn Memorial Hospital | Goh Y.-T.,Singapore General Hospital | And 16 more authors.
Leukemia Research

Chronic myeloid leukemia (CML) management varies across Asia due to disparities in affluence and healthcare provision. We surveyed CML management practice at 33 hospitals in 14 countries/regions to identify treatment challenges and opportunities for harmonization.Patients were generally treated according to international guidelines; however, tyrosine kinase inhibitors (TKIs) and molecular monitoring are inaccessible to many patients not covered by national insurance or eligible for subsidized treatment. Late diagnosis and suboptimal monitoring, often due to cost and accessibility issues, are challenges. Priorities for Asia include: extending accessibility to TKIs; specialist laboratory monitoring; and enriching data to support regional CML management guidelines. © 2010 Elsevier Ltd. Source

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