1.Impact of cerebral palsy on the quality of life in patients and their families
Melisa Seer Yee Lim ; Chee Piau Wong
Neurology Asia 2009;14(1):27-33
Measuring QOL is a field that is gaining interest among researchers worldwide. This is a prospective,
descriptive study that aimed to look at the impact of health-related quality of life (HRQL) of cerebral
palsy in the lives of patients and their families. Methods: Patients attending the Paediatric Rehabilitation
Clinic at University of Malaya Medical Centre were interviewed prospectively using the Lifestyle
Assessment Questionnaire – Cerebral Palsy. Results: A total of 27 patients were interviewed. Three
(11.1%) patients reported severely affected quality of life. Seven (25.9%) patients reported moderately
affected quality of life and 10 (37%) reported mildly affected quality of life. The worst score of 76
were reported in 2 patients. The best score of 11 was reported in one patient.
Conclusion: The impairment and disability due to cerebral palsy is likely to be similar in both
developing and developed countries. However, the quality and type of care received by patients are
likely to determine the resultant handicap and the implication on the quality of life
2.Management and Outcomes of Fetal Hydrops in a Tertiary Care Centre in Singapore.
Xin Yi THONG ; Le Ye LEE ; Dawn Ak CHIA ; Yee Chee WONG ; Arijit BISWAS
Annals of the Academy of Medicine, Singapore 2017;46(1):4-10
: Fetal hydrops is a serious condition which can be caused by immune and non-immune aetiologies. We aimed to review the management of fetal hydrops at our hospital.: A retrospective review of all cases of fetal hydrops diagnosed in our institution from 2006 to 2013 was carried out.: Out of the 30 cases of fetal hydrops diagnosed antenatally, 17 were cases of Bart's hydrops which were all terminated in-utero. Of the remaining 13 cases, 11 cases consisted of non-immune causes of hydrops. Planned antenatal interventions including in-utero blood transfusions (n = 4) and thoracentesis (n = 5) as well as planned caesarean deliveries (n = 11) were performed in the majority of cases. Postnatal neonatal intensive care with interventions including chest drainage and transfusions were also performed. A majority, 92%, of the cases survived the perinatal period following a variable length of hospital stay ranging from a week to 3 months.: Management of fetal hydrops is complex. Close coordination between the obstetric and neonatal teams was the key to good short-term survival of neonates with antenatally diagnosed hydrops, as it allows timely antenatal intervention and anticipation of potential perinatal complications.
Abortion, Induced
;
Blood Transfusion
;
Cesarean Section
;
Disease Management
;
Drainage
;
Female
;
Fetal Therapies
;
Hemoglobins, Abnormal
;
Humans
;
Hydrops Fetalis
;
blood
;
etiology
;
therapy
;
Infant, Newborn
;
Intensive Care Units, Neonatal
;
Pregnancy
;
Prenatal Diagnosis
;
Retrospective Studies
;
Singapore
;
Survival Rate
;
Tertiary Care Centers
;
Thoracentesis
;
alpha-Thalassemia
;
blood
;
complications
3.Coronary Intravascular Lithotripsy Versus Rotational Atherectomy in an Asian Population: Clinical Outcomes in Real-World Patients
Jie Jun WONG ; Sridharan UMAPATHY ; Yann Shan KEH ; Yee How LAU ; Jonathan YAP ; Muhammad IDU ; Chee Yang CHIN ; Jiang Ming FAM ; Boon Wah LIEW ; Chee Tang CHIN ; Philip En Hou WONG ; Tian Hai KOH ; Khung Keong YEO
Korean Circulation Journal 2022;52(4):288-300
Background and Objectives:
We compared real-world clinical outcomes of patients receiving intravascular lithotripsy (IVL) versus rotational atherectomy (RA) for heavily calcified coronary lesions.
Methods:
Fifty-three patients who received IVL from January 2017 to July 2020 were retrospectively compared to 271 patients who received RA from January 2017 to December 2018.Primary endpoints were in-hospital and 30-day major adverse cardiovascular events (MACE).
Results:
IVL patients had a higher prevalence of acute coronary syndrome (56.6% vs 24.4, p<0.001), multivessel disease (96.2% vs 73.3%, p<0.001) and emergency procedures (17.0% vs 2.2%, p<0.001) compared to RA. In-hospital MACE (11.3% vs 5.9%, p=0.152), MI (7.5% vs 3.3%, p=0.152), and mortality (5.7% vs 3.0%, p=0.319) were not statistically significant. 30-day MACE was higher in the IVL cohort vs RA (17.0% vs 7.4%, p=0.035). Propensity score adjusted regression using IVL was also performed on in-hospital MACE (odds ratio [OR], 1.677; 95% confidence interval [CI], 0.588–4.779) and 30-day MACE (OR, 1.910; 95% CI, 0.774–4.718).
Conclusions
These findings represent our initial IVL experience in a high-risk, real-world cohort. Although the event rate in the IVL arm was numerically higher compared to RA, the small numbers and retrospective nature of this study preclude definitive conclusions. Theseclinical outcomes are likely to improve with greater experience and better case selection, allowing IVL to effectively treat complex calcified coronary lesions.
4.Hip fracture is associated with a reduced risk of type 2 diabetes: A retrospective cohort study
Suhas KRISHNAMOORTHY ; Casey Tze-Lam TANG ; Warrington Wen-Qiang HSU ; Gloria Hoi-Yee LI ; Chor-Wing SING ; Xiaowen ZHANG ; Kathryn Choon-Beng TAN ; Bernard Man-Yung CHEUNG ; Ian Chi-Kei WONG ; Annie Wai-Chee KUNG ; Ching-Lung CHEUNG
Osteoporosis and Sarcopenia 2024;10(2):60-65
Objectives:
Type 2 diabetes mellitus (T2DM) shares a complex relationship with bone metabolism and few studies investigated the effect of impaired bone health on the risk of T2DM. This study was conducted to investigate the association between hip fractures and the risk of incident T2DM.
Methods:
This is a retrospective cohort study using data from the real-world hip fracture cohort. Hong Kong Chinese patients aged ≥ 65 years without T2DM who were admitted to public hospitals due to a fall between 2008 and 2015 were included in the study. Patients who sustained falls with and without hip fractures were matched by propensity score (PS) at a 1:1 ratio. Competing risk regression was used to evaluate the association between hip fracture and incident T2DM, with death being the competing event.
Results:
A total of 23,314 hip fracture cases were matched to 23,314 controls. The median follow-up time was 5.09 years. The incidence rate of T2DM was 11.947 and 14.505 per 1000 person-years for the hip fracture and control group respectively. After accounting for the competing risk of death, the hip fracture group had a significantly lower risk of developing T2DM (HR: 0.771, 95% CI: 0.719–0.827). Similar results were observed in all subgroups after stratification by age and sex.
Conclusions
Hip fracture was found to be associated with a reduced risk of T2DM. These findings provide insight into the topic of bone and glucose metabolism and prompt further research in evaluating the role of bone health in the management of T2DM.
5.Short-term outcomes of patients with Type 2 diabetes mellitus treated with canagliflozin compared with sitagliptin in a real-world setting.
Yan Li SHAO ; Kuan Hao YEE ; Seow Ken KOH ; Yip Fong WONG ; Lee Ying YEOH ; Serena LOW ; Chee Fang SUM
Singapore medical journal 2018;59(5):251-256
INTRODUCTIONWe aimed to evaluate the effectiveness and safety of canagliflozin as compared to sitagliptin in a real-world setting among multiethnic patients with Type 2 diabetes mellitus (T2DM) in Singapore.
METHODSThis was a new-user, active-comparator, single-centre retrospective cohort study. Patients aged 18-69 years with T2DM and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m were eligible for inclusion if they were initiated and maintained on a steady daily dose of canagliflozin 300 mg or sitagliptin 100 mg between 1 May and 31 December 2014, and followed up for 24 weeks.
RESULTSIn total, 57 patients (canagliflozin 300 mg, n = 22; sitagliptin 100 mg, n = 35) were included. The baseline patient characteristics in the two groups were similar, with overall mean glycated haemoglobin (HbA1c) of 9.4% ± 1.4%. The use of canagliflozin 300 mg was associated with greater reductions in HbA1c (least squares [LS] mean change -1.6% vs. -0.4%; p < 0.001), body weight (LS mean change -3.0 kg vs. 0.2 kg; p < 0.001) and systolic blood pressure (LS mean change: -9.7 mmHg vs. 0.4 mmHg; p < 0.001), as compared with sitagliptin 100 mg. About half of the patients on canagliflozin 300 mg reported mild osmotic diuresis-related side effects that did not lead to drug discontinuation.
CONCLUSIONOur findings suggest that canagliflozin was more effective than sitagliptin in reducing HbA1c, body weight and systolic blood pressure in patients with T2DM, although its use was associated with an increased incidence of mild osmotic diuresis-related side effects.
Adolescent ; Adult ; Aged ; Blood Glucose ; drug effects ; Blood Pressure ; Body Mass Index ; Body Weight ; Canagliflozin ; administration & dosage ; Diabetes Mellitus, Type 2 ; drug therapy ; Female ; Glomerular Filtration Rate ; Hemoglobins ; analysis ; Humans ; Hypoglycemic Agents ; administration & dosage ; Least-Squares Analysis ; Male ; Middle Aged ; Osmosis ; Retrospective Studies ; Singapore ; Sitagliptin Phosphate ; administration & dosage ; Systole ; Treatment Outcome ; Young Adult
6.Comparing the outcome of monitored anaesthesia care and local anaesthesia for carpal tunnel syndrome surgery by neurosurgeons
Goh Chin Hwee ; Lau Bik Liang ; Teong Sook Yee ; Law Wan Chung ; Tan Peter Chee Seong ; Ravindran Vashu ; Liew Donald Ngian San ; Wong Albert Sii Hieng
The Medical Journal of Malaysia 2019;74(6):499-503
Introduction: Carpal tunnel syndrome (CTS) is the
commonest median nerve entrapment neuropathy of the
hand, up to 90% of all nerve compression syndromes. The
disease is often treated with conservative measures or
surgery. The senior author initially intended to treat his own
neurosurgical patients concurrently diagnosed with carpal
tunnel syndrome in 2014, subsequently, he began to pick up
more referrals from the primary healthcare group over the
years. This has led to the setup of a peripheral and spine
clinic to act as a hub of referrals. Objective: Department of
Neurosurgery Sarawak aimed to evaluate the surgical
outcome of carpal tunnel release done over five years.
Methods: The carpal tunnel surgeries were done under local
anaesthesia (LA) given by neurosurgeons (Bupivacaine
0.5% or Lignocaine 2%). Monitored anaesthesia care (MAC)
was later introduced by our hospital neuroanaesthetist in
the beginning of 2018 (Target-controlled infusion propofol
and boluses of fentanyl). We looked into our first 17 cases
and compared these to the two anaesthesia techniques (LA
versus MAC + LA) in terms of patient’s pain score based on
visual analogue scale (VAS).
Results: Result showed MAC provided excellent pain control
during and immediately after the surgery. None experienced
anaesthesia complications. There was no difference in pain
control at post-operation one month. Both techniques had
equal good clinical outcome during patients’ clinic follow
up.
Conclusion: Neurosurgeons provide alternative route for
CTS patients to receive surgical treatment. Being a
designated pain free hospital, anaesthetist collaboration in
carpal tunnel surgery is an added value and improves
patients overall experience and satisfaction.
7.Characteristics of dietary intakes including NOVA foods among pre-adolescents living in urban Kuala Lumpur – Findings from the PREBONE-Kids study
Wai Yew Yang ; Soon Yee Wong ; Shu Hwa Ong ; Kanimolli Arasu ; Chung Yuan Chang ; Megan Hueh Zan Chong ; Meenal Mavinkurve ; Erwin Jiayuan Khoo ; Karuthan Chinna ; Connie M. Weaver ; Winnie Siew Swee Chee
Malaysian Journal of Nutrition 2023;29(No.3):401-414
Introduction: Evidence showed considerable variability of health risk factors within different socioeconomic groups. This study aimed to characterise dietary intakes by total household income among a sample of Malaysian pre-adolescents in urban Kuala Lumpur. Methods: Baseline data of 243 healthy, pre-adolescent children between 9 and 11 years old including socio-demographic background (gender, ethnicity, and total household monthly income), anthropometry (body weight and height), and
7-day diet histories were collected. Secondary analysis was performed on dietary intakes to quantify food groups based on the Malaysian Dietary Guidelines and NOVA classification systems besides nutrients. Differences and associations between total monthly household income categories with anthropometry and dietary intakes were tested using independent t-test/Mann-Whitney U (depending on normality) and chi-square tests, respectively. Results: Most children in this study population
had dietary intakes below the recommended serving sizes for five food groups, except meat/poultry (195.2±107.2%) and fish (110.1±106.3%) and consumed about 32% of energy from ultra-processed foods (NOVA food group 4). While there was no difference in dietary intake between the bottom 40% with the middle 40% and high 20% household income groups, the percentage of energy contributed by NOVA food group 4 (processed fats/oils, condiments, and sauces) was higher in the bottom 40% households (p=0.024). Conclusion: Most pre-adolescent children in this study, regardless of household income, did not meet dietary recommendations and ate diets comprised of less nutritious foods. Comprehensive approaches that aim to improve dietary patterns and reduce the risk of diet-related chronic diseases are warranted.