1.Food allergy and allergic rhinitis in 435 asian patients – A descriptive review
Kathleen A Pang ; Kenny P Pang ; Edward B Pang ; Tan Yuk Ngi Cherilynn ; Yiong Huak Chan ; Jin Keat Siow
The Medical Journal of Malaysia 2017;72(4):215-220
Objective: To describe the prevalence of food allergy in
Asian patients with allergic rhinitis.
Study Design: A non-randomized prospectively collected
patients over a three year period, with complaints of nose
congestion, rhinorrhea and/or nasal discharge.
Results: There were 435 patients enrolled, 213 children and
222 adults. The children group had a high prevalence of
allergen specific IgE to Dermatophagoides pteryonysinus
(70%), Dermatophagoides farina (69%), and Blomia
tropicalis (55%); followed by dogs (32%), cats (19%) and
cockroaches (19%). In the children food allergy category, the
top three allergens were egg white (54%), milk (31%) and
soya bean (13%). The adult group had results of
Dermatophagoides pteryonysinus (71%), Dermatophagoides
farina (72%), and Blomia tropicalis (59%); the adult food
allergy category, the top 3 allergens were egg white (13%),
milk (6%) and soya bean (5%). There was a statistically
significant difference in the child and adult group for Dust,
D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat,
gluten and soya bean. In the age specific child groups, there
was an increased in egg food allergy levels, with a peak at
the age of five-nine years old and decreasing thereafter
(p=0.04). In the children group, the mean Total Nasal
Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult
group was similar, with a mean TNSS of 9.8 (range 5 to 12).
Conclusion: The prevalence of food allergy in paediatric
patients with allergic rhinitis is fairly high and should be
considered when treating these children.
2.Predictors of difficulty in intubation in patients with obstructive sleep apnoea
Cybil Mei Zhi Wang ; Kenny Peter Pang ; Tan Soo Guan ; Kathleen Ann Pang ; Edward Benjamin Pang ; Tan Yuk Ngi Cherilynn ; Yiong Huak Chan ; Brian W. Rotenberg
The Medical Journal of Malaysia 2019;74(2):133-137
Objective: To evaluate predictors of difficult intubation in
patients with obstructive sleep apnoea (OSA).
Methodology: Prospective series of 405 OSA patients (350
males/55 females) who had upper airway surgery.
Procedures included functional endoscopic sinus surgery,
septoplasty, turbinate reduction, palate/tonsil surgery,
and/or tongue base surgery. Intubation difficulty (ID) was
assessed using Mallampati grade, Laryngoscopic grade
(Cormack and Lehane), and clinical parameters including
BMI, neck circumference, thyromental distance, jaw
adequacy, neck movements and glidescope grading.
Results: Mean age was 41.6 years old; mean BMI 26.6; mean
neck circumference 44.5cm; mean Apnea Hypopnea Index
(AHI) was 25.0; and mean LSAT 82%. The various laryngeal
grades (based on Cormack and Lehane), grade 1 - 53
patients (12.9%), grade 2A - 127 patients (31.0%), grade 2B -
125 patients (30.5%), grade 3 - 93 patients (22.7%) and grade
4 - seven patients (1.7%); hence, 24.4% had difficulties in
intubation. Parameters that adversely affected intubation
were, age of the patient, opening of mouth, retrognathia,
overbite, overjet, limited neck extension, thyromental
distance, Mallampati grade, and macroglossia (p<0.001).
Body mass index (BMI) (p=0.087), neck circumference
(p=0.645), neck aches (p=0.728), jaw aches (p=0.417), tonsil
size (p=0.048), and AHI (p=0.047) had poor correlation with
intubation. BMI-adjusted for Asians and Caucasians,
showed that Asians were more likely to have difficulties in
intubation (adjusted OR = 4.6 (95%Confidence Interval: 1.05
to 20.06) (p=0.043), compared to the Caucasian group.