1.Diagnostic accuracy of Serum 1,5-anhydroglucitol as a surrogate measure of Glycemic variability among adult Filipinos with Type 2 Diabetes Mellitus: A retrospective cross-sectional study
Ainee Krystelle C. Lee ; Joebeth S. Tabora ; Christian Bernard T Cheng ; Rosa Allyn Sy
Philippine Journal of Internal Medicine 2022;60(4):270-277
Background:
Among the various glycemic indices in current use, glycemic variability has the greatest contribution in the
development of microvascular and macrovascular complications in Type 2 Diabetes mellitus (T2DM). Most metrics that are currently used to measure glycemic variability are derived from continuous glucose monitoring (CGM) data. However, CGM is burdensome to the patient due to its relatively high cost as well as the need for multiple visits with the health care provider. With the use of serum 1,5-anhydroglucitol (1,5-AG) as a biomarker of glucose fluctuations, physicians and patients alike could have an easier surrogate measure of glycemic variability thus aiding in achieving target glucose control. This study
aims to determine the diagnostic accuracy of 1,5-AG as compared to the glycemic variability metrics derived from CGM as a surrogate measure of glycemic variability among adult Filipinos with T2DM.
Methods:
Retrospective analysis of data of adult patients aged 20 years old and above diagnosed with T2DM referred for CGM at the Diabetes, Endocrine, Metabolic, and Nutrition Center of Cardinal Santos Medical Center from January 2017 to October 2021 who underwent serum 1,5-AG level determination within 2 weeks of CGM were collected. Diagnostic accuracy was obtained by computing the sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and Youden index. Pearson correlation coefficient was used to determine the correlation of 1,5-AG and the different metrics. Analysis of variance (ANOVA) was used to check for statistical significance with 99% confidence interval and a p < 0.05 considered as statistically significant.
Results:
This study involving 37 subjects showed a good diagnostic accuracy of serum 1,5-AG levels with the different measures of glycemic variability derived from CGM namely mean amplitude of glycemic excursion (MAGE), continuous overlapping net glycemic action at 1-hour intervals (CONGA-1), and mean of daily differences (MODD) with significant correlation among patients with HbA1c ≤ 7%. Subjects were on CGM for approximately 6 ± 1 day with statistically significant difference between the good and poor glucose control group (p<0.05). Determination of diagnostic accuracy between 1,5- AG and MAGE showed good accuracy (Sensitivity = 95.3%, Specificity = 100%, PPV = 100%, NPV = 75.43%, Diagnostic
accuracy 96%, and a Youden Index of 92.3) with a statistically significant correlation among subjects with HbA1c level ≤ 7% (p=0.021). There is likewise good diagnostic accuracy between CONGA-1 and 1,5-AG level (Sensitivity = 99%, Specificity = 75.29%, PPV = 89.1%, NPV = 97%, Accuracy = 89.50% and Youden index of 58.41) with a statistically significant correlation among subjects with HbA1c ≤ 7% (p=0.038). Comparison with interday glycemic variability showed fair diagnostic accuracy
between MODD and 1,5-AG (Sensitivity = 79.17%, Specificity = 78%, PPV = 97%, NPV = 32%, Accuracy = 76.89%, and Youden index of 49.07) and a statistically significant correlation among subjects with HbA1c ≤ 7% (p=0.009).
Conclusion
There is good diagnostic accuracy of serum 1,5-AG levels with the different measures of glycemic variability derived from CGM namely MAGE, CONGA-1, and MODD with significant correlation among patients with HbA1c ≤ 7%. Among diabetics with HbA1c ≤7%, 1,5-AG could be used as a surrogate measure of glycemic variability and excursions.
Diabetes Mellitus, Type 2
2.Relapsing Course of Sulfasalazine-Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Complicated by Alopecia Universalis and Vitiligo.
Bertrand Sy LIAN ; Inny BUSMANIS ; Haur Yueh LEE
Annals of the Academy of Medicine, Singapore 2018;47(11):492-493
Alopecia
;
chemically induced
;
diagnosis
;
Antirheumatic Agents
;
administration & dosage
;
adverse effects
;
Arthritis, Rheumatoid
;
drug therapy
;
Biopsy
;
methods
;
Cyclosporine
;
administration & dosage
;
Dermatologic Agents
;
administration & dosage
;
Drug Hypersensitivity Syndrome
;
diagnosis
;
etiology
;
physiopathology
;
therapy
;
Humans
;
Male
;
Middle Aged
;
Prednisolone
;
administration & dosage
;
Skin
;
pathology
;
Sulfasalazine
;
administration & dosage
;
adverse effects
;
Symptom Flare Up
;
Treatment Outcome
;
Vitiligo
;
chemically induced
;
diagnosis
3.Effect of extracts from Stachys sieboldii Miq. on cellular reactive oxygen species and glutathione production and genomic DNA oxidation
Asian Pacific Journal of Tropical Biomedicine 2018;8(10):485-489
Objective: To evaluate the antioxidant activity of extracts and fractions from Stachys sieboldii Miq., and to examine its effect on the cellular reactive oxygen species (ROS) and glutathione (GSH) production and genomic DNA oxidation in HT-1080 cells.Methods: The ROS generation induced by H2O2 was measured by the dichlorofluorescein-diacetate assay. GSH levels were measured using a fluorescent method with mBBr. Genomic DNA oxidative damage was measured with levels of oxidative DNA induced by the reaction of ferritin with H2O2.Results: Then-hexane, 85% aqueous methanol andn-butanol fractions (0.05 mg/mL concentrations) inhibited H2O2-induced ROS generation by 63%, 35% and 45%, respectively. GSH levels were significantly increased in both acetone+methylene chloride and methanol extracts (P<0.05). Supplementation of cells withn-hexane significantly increased GSH levels at concentrations of 0.05 mg/mL (P<0.05). Both the acetone+methylene chloride and methanol extracts, as well as all fractions significantly inhibited oxidative DNA damage (P<0.05). Conclusions: These results indicate that cellular oxidation was inhibited by then-hexane fraction and this fraction may contain valuable active compounds.
4.Mental Health and Health Risk Behaviors of Multicultural Adolescents according to Their Mothers' Native Country: Using Data from the 11th (2015) Korea Youth Risk Behavior Web-Based Survey 2015.
Hyeon Ok JU ; So Yeon PARK ; Jaeyoung LEE
Child Health Nursing Research 2017;23(1):101-110
PURPOSE: The purpose of this study was to analyze the mental health and health risk behaviors of multicultural adolescents according to their mothers' native country. METHODS: For this study raw data from the 11th Youth Health Behavior Online Survey (2015) was examined. Mental health and health risk behaviors for 62,985 adolescents were analyzed according to their mothers' native country. Collected data were analyzed with the SPSS program using descriptive statistics and logistic regression analysis, to which the complex sample design was applied. RESULTS: The odds ratio of depression in multicultural adolescents compared to Korean adolescents was 44.92 (CI: 5.77-349.59) for adolescents whose mothers came from Cambodia and 3.00 (CI: 1.57-5.76) for adolescents whose mothers came from North Korea. The odds ratio of attempted suicide was 14.73 (CI: 3.09-70.22) for adolescents whose mothers came from Cambodia and 8.63 (CI: 3.45-21.62) for adolescents whose mothers came from North Korea. The odds ratio of problematic drinking in multicultural adolescents was 7.47 (CI: 1.71-32.67) for adolescents whose mothers came from Mongolia. CONCLUSION: Findings indicate that when planning a health promotion program for adolescents from multicultural families, a customized approach should be sought taking into account the characteristics of mothers' native country.
Adolescent*
;
Cambodia
;
Cultural Diversity
;
Democratic People's Republic of Korea
;
Depression
;
Drinking
;
Health Behavior
;
Health Promotion
;
Humans
;
Korea*
;
Logistic Models
;
Mental Health*
;
Mongolia
;
Mothers
;
Odds Ratio
;
Risk-Taking*
;
Suicide, Attempted
5.The effect of ferulic acid ethyl ester on leptin-induced proliferation and migration of aortic smooth muscle cells.
Yung Chieh TSAI ; Yen Mei LEE ; Chih Hsiung HSU ; Sy Ying LEU ; Hsiao Yen CHIANG ; Mao Hsiung YEN ; Pao Yun CHENG
Experimental & Molecular Medicine 2015;47(8):e180-
Leptin is a peptide hormone, which has a central role in the regulation of body weight; it also exerts many potentially atherogenic effects. Ferulic acid ethyl ester (FAEE) has been approved for antioxidant properties. The aim of this study was to investigate whether FAEE can inhibit the atherogenic effects of leptin and the possible molecular mechanism of its action. Both of cell proliferation and migration were measured when the aortic smooth muscle cell (A10 cell) treated with leptin and/or FAEE. Phosphorylated p44/42MAPK, cell cycle-regulatory protein (for example, cyclin D1, p21, p27), beta-catenin and matrix metalloproteinase-9 (MMP-9) proteins levels were also measured. Results demonstrated that leptin (10, 100 ng ml-1) significantly increased the proliferation of cells and the phosphorylation of p44/42MAPK in A10 cells. The proliferative effect of leptin was significantly reduced by the pretreatment of U0126 (0.5 muM), a MEK inhibitor, in A10 cells. Meanwhile, leptin significantly increased the protein expression of cyclin D1, p21, beta-catenin and decreased the expression of p27 in A10 cells. In addition, leptin (10 ng ml-1) significantly increased the migration of A10 cells and the expression of MMP-9 protein. Above effects of leptin were significantly reduced by the pretreatment of FAEE (1 and 10 muM) in A10 cells. In conclusion, FAEE exerts multiple effects on leptin-induced cell proliferation and migration, including the inhibition of p44/42MAPK phosphorylation, cell cycle-regulatory proteins and MMP-9, thereby suggesting that FAEE may be a possible therapeutic approach to the inhibition of obese vascular disease.
Animals
;
Antioxidants/*pharmacology
;
Aorta/cytology/*drug effects
;
Caffeic Acids/*pharmacology
;
Cell Line
;
Cell Movement/*drug effects
;
Cell Proliferation/*drug effects
;
Leptin/*metabolism
;
Matrix Metalloproteinase 9/metabolism
;
Muscle, Smooth, Vascular/cytology/drug effects
;
Myocytes, Smooth Muscle/cytology/*drug effects
;
Rats
;
beta Catenin/metabolism
6.A Preliminary Clinical Study Of Lesion-Free And Lesion-Active Patients With Oral Lichen Planus And/Or Oral Lichenoid Reactions
Foo SY ; Lee WY ; Goh YC ; Siar CH
Annals of Dentistry 2015;22(1):21-29
Background: Oral lichen planus (OLP) which belongs to the spectrum of LP, is a commonly encounteredoral mucosal problem among patients seeking treatment in the Oral Medicine clinic. Its counterpart, orallichenoid reaction (OLR), which resembled OLP clinically and microscopically, is often encountered inthese patients as well. Although the various clinical forms of OLP/OLR are well-recognized, the diseasepattern in regards to lesion-active and lesion-free periods in these patients remains poorly characterized.Thus the aim of this study was to determine the clinical and demographic profile of those patients withactive OLP/OLR lesions and compare them with those patients who are clinically lesion-free.Materials and methods: The study subjects comprised 20 patients who attended the Oral MedicineClinic at the Faculty of Dentistry, University of Malaya for follow-up appointments/management. Theywere interviewed according to a pre-designed questionnaire, and clinical examination was carried out. Allthese were conducted under the supervision of Oral Medicine specialists. OLP was diagnosed accordingto the internationally accepted criteria.Results: The cohort consisted of predominantly female (n=14; 70%) and Chinese (n=9; 45%) patients,with an overall age range of 26-79 years (median, 56 years). Fifteen (75%) patients presented withactive OLP/OLR lesions and the remaining 5 (25%) were lesion-free. The lesion-active group comprised3 (15%) males and 12 (60%) females whereas the lesion-free had 3 (15%) males and 2 (10%) females.Reticular LP was the most common type (n=21/35; 60%) and the gingiva was the most prevalent site(n=21/46; 45.65%). Social habits, medical histories and medications were not significantly differentbetween lesion-active and lesion-free OLP patients.Conclusions: Findings suggest that demographic parameters, lifestyle and systemic diseases do notappear to influence the disease pattern and lesion severity in OLP.
7.Result of Visual Evoked Potential, Electroretinography and Electrooculography in Normal Subjects Using MonPack 3 System.
Seong Gyu MIN ; Young Hoon LEE ; Sun Young JIN
Journal of the Korean Ophthalmological Society 2014;55(11):1693-1697
PURPOSE: We present the results of visual evoked potential (VEP), electroretinography (ERG), and electrooculography (EOG) in normal subjects using the Mon-pack 3 system (Metrovision). METHODS: VEP, ERG, and EOG were obtained in 92 normal eyes. The measurements followed the International Society for Clinical Electrophysiology of Vision (ISCEV) standardization protocol. In VEP, the standard electrode was placed on the forehead and the active electrode was attached on the occiput. In ERG, a 20-minute dark adaptation was performed after mydriasis, and an ERG-jet electrode was used. EOG was measured by attaching an electrode to each medial canthal skin. Each latent period and electric potential was measured with average, standard deviation, median, and 95% confidencenterval (95% CI). RESULTS: The mean P100 latency in pattern VEP was 104.36 ms, and P100 latency in flash VEP was 116.71 ms. For the maximal ERG response, the implicit times of a and b waves were 22.65 ms and 44.58 ms, respectively and the amplitude of a and b waves were 274.09 microv and 489.52 microv, respectively. For the ERG cone response, the implicit time of a and b waves were 18.21 ms and 33.40 ms, respectively, and the amplitude of a and b waves were 35.87 microv and 104.42 microv, respectively. The mean ERG oscillitatory potential was 285.53 microv. The average EOG Arden ratio was 2.54. CONCLUSIONS: VEP, ERG, and EOG results from normal subjects using the Mon-pack 3 system can be applied to the diagnosis of retina and optic nerve disease and basic research.
Dark Adaptation
;
Diagnosis
;
Electrodes
;
Electrooculography*
;
Electrophysiology
;
Electroretinography*
;
Evoked Potentials, Visual*
;
Forehead
;
Mydriasis
;
Optic Nerve Diseases
;
Retina
;
Skin
8.Is there a Significant Difference in Surgery and Outcomes between Unipolar and Bipolar Hip Hemiarthroplasty? A Retrospective Study of a Single Institution in Singapore
Malaysian Orthopaedic Journal 2011;5(1):3-7
Objective: The aim was to compare outcomes differences between unipolar and bipolar hip hemiarthroplasty in one institution for the local geriatric population. Methodology: A retrospective review of 291 patients aged 70 and above who underwent hip hemiarthroplasty for neck of femur fracture from February 2004 to November 2006 was performed. Results: Operative time was lower in the unipolar group. There was no statistically significant difference between the groups in terms of superficial wound infection, d
9.Non-O1, non-O139 Vibrio cholerae bacteraemia in splenectomised thalassaemic patient from Malaysia.
Deris ZZ ; Leow VM ; Wan Hassan MN ; Nik Lah AZ ; Lee SY ; Siti Hawa H ; Siti Asma H ; Ravichandran M
Tropical Biomedicine 2009;26(3):320-325
Vibrio cholerae infection is mainly caused acute diarrhoea disease. Bacteraemia due to non-O1 V. cholerae is rare and mainly reported in liver cirrhotic patients. We report one case of non-O1 V. cholerae bacteraemia in splenectomised thalassaemic patient who presented with septic shock secondary to abdominal sepsis. She had undergone emergency laporatomy and was managed in the intensive care unit for nine days. She was treated with meropenem and doxycyline and discharged well after fourteen days of admission. The V. cholerae was identified by API 20NE, serotype and polymerase chain reaction showed as non-O1, non-O139 strain. Besides known cholera-like toxin and El Tor hemolysin, with increasing reported cases of V. cholerae bacteraemia, there is possibility of other virulence factors that allow this organism to invade the bloodstream.
10.Peritoneal implantation of ureter in a cadaveric kidney transplant recipient.
Tan SY ; Lim CS ; Teo SM ; Lee SH ; Razack A ; Loh CS
The Medical Journal of Malaysia 2003;58(5):769-770
We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.
Cadaver
;
Kidney Transplantation/*methods
;
Postoperative Complications
;
Reoperation
;
Replantation
;
Ureter/*surgery


Result Analysis
Print
Save
E-mail