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Basri NI, Mahdy ZA, Ahmad S, Abdul Karim AK, Shan LP, Abdul Manaf MR, Ismail NAM. The World Health Organization (WHO) versus The International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes. Horm Mol Biol Clin Investig 2018; 34:hmbci-2017-0077. [PMID: 29453924 DOI: 10.1515/hmbci-2017-0077] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/08/2018] [Indexed: 11/15/2022]
Abstract
Background Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. Methods This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017. They were randomized into the WHO and the IADPSG groups. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting and 2 h post prandial glucose levels were taken. The primary outcome was the prevalence of GDM. The secondary outcomes were the incidence of primary cesarean section, gestational hypertension or preeclampsia, preterm delivery <37 weeks, fetal macrosomia, neonatal hypoglycemia and shoulder dystocia or birth injury. Results The prevalence of GDM in both groups were similar (37.9% vs. 38.6%). GDM women in the WHO group had a significantly higher incidence of gestational hypertension or preeclampsia (p = 0.004) and neonatal hypoglycemia (p = 0.042). In contrast, GDM women in the IADPSG group had a significantly higher incidence of fetal macrosomia (p = 0.027) and cesarean section (p = 0.012). Conclusion The IADPSG diagnostic criteria for GDM may not be suitable for use in our population as it resulted in women being diagnosed later and being undertreated, thus leading to adverse maternal and neonatal outcomes.
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Affiliation(s)
- Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shuhaila Ahmad
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Abdul Kadir Abdul Karim
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Lim Pei Shan
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Nor Azlin Mohd Ismail
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, Phone: 0391455555, Fax: 0391456672
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Abu MA, Abdul Ghani NA, Shan LP, Sulaiman AS, Omar MH, Ariffin MHM, Baharuddin A, Shohaimi S, Man ZC. Do exercises improve back pain in pregnancy? Horm Mol Biol Clin Investig 2017; 32:/j/hmbci.ahead-of-print/hmbci-2017-0012/hmbci-2017-0012.xml. [PMID: 28742515 DOI: 10.1515/hmbci-2017-0012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/23/2017] [Indexed: 11/15/2022]
Abstract
Objective To assess the efficacy of an exercise program towards reducing back pain in pregnant women. Methods In this prospective control study, 145 low risk pregnant women who scored more than 20 for functional limitation assessment were recruited. The severity of back pain was assessed using the visual analoque scale (VAS) and the functional limitation was assessed using the Oswestry disability questionnaire (ODQ). All participants were informed of back care measures and provided with Paracetamol as an adjunct analgesia. The intervention group will have a session with a trained physiotherapist. Subsequently, all participants will be required to fill in a similar questionnaire regarding pain intensity and functional limitation assessment after 6 weeks post-intervention. Results There was a significant reduction in the VAS score and improvement in functional ODQ score in the intervention group. The median usage of Paracetamol as an analgesia to control back pain in the control group was 500 mg higher than the intervention group. There was a weak association of age, parity, duration of back pain, and body mass index with functional ODQ score at 6 week following intervention. Conclusion The back pain exercise reducing program was effective in reducing back pain intensity and analgesia usage with a significant improvement in functional ability.
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Affiliation(s)
- Muhammad Azrai Abu
- Department of Obstetrics and Gynaecology, UKM Medical Centre Kuala Lumpur, Malaysia
| | | | - Lim Pei Shan
- Department of Obstetrics and Gynaecology, UKM Medical Centre Kuala Lumpur, Malaysia
| | | | - Mohd Hashim Omar
- Department of Obstetrics and Gynaecology, UKM Medical Centre Kuala Lumpur, Malaysia
| | | | - Azmi Baharuddin
- Department of Orthopaedic and Trauma, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Shuhaila Shohaimi
- Department of Physiotherapy and Rehabilitation, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Zuraidah Che Man
- Department of Epidemiology, UKM Medical Centre, Kuala Lumpur, Malaysia
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Ali AB, Ahmad MFB, Kwang NB, Shan LP, Shafie NM, Omar MH. Dydrogesterone support following assisted reproductive technique (ART) reduces the risk of pre-eclampsia. Horm Mol Biol Clin Investig 2017; 27:93-6. [PMID: 26910749 DOI: 10.1515/hmbci-2015-0063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 12/20/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pre-eclampsia (PE) contributes to poor maternal morbidity and mortality. Progesterone is hypothesised to reduce the risk of PE. AIM To determine the effect of progestogen supplementation during assisted reproductive technique (ART) in reducing the incidence of PE. METHOD A retrospective comparative analysis among 1140 pregnancies between January 2006 and March 2015 conducted in a tertiary centre. A total of 570 pregnancies who conceived following ART with progesterone supplementation (study group) and an age-matched spontaneous pregnancies, without progesterone supplementation (control group, n=570) were included in the analysis. The study group received progesterone support following ART or intrauterine insemination (IUI) until 14-16 weeks' gestation. RESULTS The rate of PE was significantly lower in the study group compared to control group (8.4% vs. 14.2%, p<0.05). Women supplemented with dydrogesterone only showed a lower PE incidence as compared to women received a combination of dydrogesterone and hydroxyprogesterone caproate, however, it was not statistically significant (6.9% vs. 9.9%; 6.9%; p=0.2).
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Dasrilsyah RA, Shan LP, Kwang NB, Shafiee MN, Omar MH. Spontaneous conception following GnRHa and progestogen therapy in adenomyosis. Horm Mol Biol Clin Investig 2017; 27:77-9. [PMID: 26812802 DOI: 10.1515/hmbci-2015-0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 12/17/2015] [Indexed: 12/25/2022]
Abstract
Adenomyosis is a common gynaecological disorder that is associated with infertility and miscarriage. We report a case of adenomyosis presented with urinary retention and infertility. The patient successfully conceived spontaneously following GnRHa followed by progestogen therapy. This treatment option might provide a synergistic effect in improving fertility and pregnancy outcome for women with adenomyosis. This modality has no potential surgical risk; it minimises the long-term side effects of GnRHa and also provides luteal support.
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Kwang NB, Mahayudin T, Yien HL, Abdul Karim AK, Teik CK, Shan LP. Effect of an Educational Intervention on Knowledge of Human Papillomavirus Vaccination among Pre-University Students in Malaysia. Asian Pac J Cancer Prev 2016; 17:267-74. [PMID: 26838222 DOI: 10.7314/apjcp.2016.17.1.267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical cancer is the fourth most common cancer among women worldwide. Studies evaluating the effect of health education on knowledge and perception of cervical cancer have generated conflicting results. Thus, this study aimed to evaluate the effect of educational intervention towards knowledge of HPV vacccination for cervical cancer prevention among pre-university students in Malaysia. MATERIALS AND METHODS This was an experimental before and after study performed between October 2014 and March 2015. Five hundred and eighty students were randomly assigned into intervention and control groups. All were required to complete both pre-intervention and post-intervention questionnaires. Those in the intervention group were given an information leaflet to read before answering the post-intervention questionnaire. RESULTS Almost half (48.3%) of the students had poor knowledge, with a score less than 5, and only 51 (8.8%) exhibited good knowledge, with a score of 11 and above. After educational intervention, the number of students with poor knowledge was reduced to 177 (29.3%) and the number of students who exhibited good knowledge increased to 148 (25.5%). Students from the intervention group demonstrated significant higher total scores in knowledge regarding 'HPV infection and cervical cancer' (p=0.000) and 'HPV vaccination and cervical cancer prevention' (p=0.000) during post-intervention as compared to the control group. CONCLUSIONS Knowledge on HPV infection and vaccination is low among pre-university students. Educational intervention in the form of information leaflets appears effective in creating awareness and improving knowledge.
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Affiliation(s)
- Ng Beng Kwang
- Department of Obstetrics and Gynaecology, UKM Medical Centre, Malaysia E-mail : ,
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Kwang NB, Yee CM, Shan LP, Teik CK, Chandralega KN, Abdul Kadir AK. Knowledge, perception and attitude towards human papillomavirus among pre-university students in Malaysia. Asian Pac J Cancer Prev 2014; 15:9117-23. [PMID: 25422188 DOI: 10.7314/apjcp.2014.15.21.9117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the knowledge, perception and attitudes towards human papilloma virus (HPV) among pre-university students in Malaysia. STUDY DESIGN In this cross sectional study, between November 2013 to March 2014, in a public university, a convenient sampling method was used. A total of 716 respondents were recruited and interviewed with a set of standard questionnaires for assessment of knowledge, perception and attitudes towards HPV and predictor variables associated with level of knowledge. RESULTS Almost half (48.9%) of the respondents scored less than 5 and were categorised as having poor knowledge. Three hundred and twelve (43.6%) respondents had moderate knowledge and only 54 (7.5%) respondents exhibited good knowledge with the score of 11 and above. Only 142 (20%) students perceived themselves to be vulnerable to HPV infection though 560 (78.2%) students thought that HPV infection is a serious disease. Perceived benefits and desire to be vaccinated were significantly associated with gender (p=0.000) and knowledge of HPV vaccine and cervical cancer (p=0.000). CONCLUSIONS The level of knowledge regarding HPV among the pre-university students was low. However, student intention for vaccination increased with increasing level of knowledge. Thus, efforts to improve knowledge and awareness should be prioritised to increase uptake of the HPV vaccination programme and hence reduce morbidity and mortality from consequences of HPV infection, including cervical carcinoma.
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Affiliation(s)
- Ng Beng Kwang
- Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia E-mail : ;
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Liu W, Shan LP, Dong XS, Liu XW, Ma T, Liu Z. Effect of early fluid resuscitation on the lung in a rat model of lipopolysaccharide-induced septic shock. Eur Rev Med Pharmacol Sci 2013; 17:161-169. [PMID: 23377803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Many clinical trials have showed that early fluid resuscitation can improve the prognosis and reduce the mortality rate of patients with septic shock. However, some experiments suggest that abundant fluid may injure the lung and other tissues. AIM To evaluate the protective effect of early fluid resuscitation and simultaneous norepinephrine treatment on lung function by using the rat model of lipopolysaccharide (LPS)-induced septic shock. MATERIALS AND METHODS Male Wistar rats were randomly divided into four groups: normal control group, septic shock control group, early fluid resuscitation treatment group, early fluid resuscitation and simultaneous norepinephrine treatment group. Blood gas, lactate, fluid volume, and dose of norepinephrine were recorded. Pathological change was observed by hematoxylin and eosin staining and transmission electron microscopy. The activities of hydroxyl radicals, MDA, SOD and MPO were detected by spectrophotometry. The expression of IL-6, IL-8, and TNF-alpha were determined with ELISA kits. RESULTS LPS could induce rats to suffer from acute lung injury in early stage of septic shock. Early fluid resuscitation could guarantee effective circulating blood volume and tissue perfusion pressure, improve microcirculatory derangements, increase oxygen partial pressure and oxygenation index, but have the tendency to aggravate pulmonary edema. Simultaneous norepinephrine treatment in early stage could decrease the fluid volume, alleviate the degree of pulmonary edema, reduce the expression level of pro-inflammatory mediators in the serum and BALF, and increase the oxygenation index. CONCLUSIONS Early fluid resuscitation and simultaneous norepinephrine treatment may be a superior alternative to protect lung injury secondary to septic shock.
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Affiliation(s)
- W Liu
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, P.R. China
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Othman R, Omar MH, Shan LP, Shafiee MN, Jamal R, Mokhtar NM. Microarray profiling of secretory-phase endometrium from patients with recurrent miscarriage. Reprod Biol 2012; 12:183-99. [PMID: 22850470 DOI: 10.1016/s1642-431x(12)60085-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of the present study was to identify differentially expressed genes and their related biological pathways in the secretory phase endometrium from patients with recurrent miscarriage (RM) and fertile subjects. Endometrial samples from RM and fertile patients were analyzed using the Affymetrix GeneChip® ST Array. The bioinformatic analysis using the Partek Genomic Suite revealed 346 genes (175 up-regulated and 171 down-regulated) that were differentially expressed in the endometrium of RM patients compared to the fertile subjects (fold change ≥1.5, p<0.005). Validation step using quantitative real-time polymerase chain reaction (qPCR) confirmed a similar expression pattern of four exemplary genes: one up-regulated gene (fibroblast growth factor 9, FGF9) and three down-regulated genes: integrin β3 (ITGB3), colony stimulating factor 1 (CSF1) and matrix-metalloproteinases 19 (MMP19). The Gene Set Enrichment Analysis (GSEA) and the Pathway Studio software have found 101 signaling pathways (p<0.05) associated with the affected genes including the FGFR3 /signal transducer and activator of transcription (STAT) pathway and the CSF1R/STAT pathway. Cell adhesion, cell differentiation and angiogenesis were among biological processes indicated by this system. In conclusion, microarray technique is a useful tool to study gene expression in the secretory phase-endometrium of RM patients. The differences in endometrial gene expressions between healthy and RM subjects contribute to an increase in our knowledge on molecular mechanisms of RM development and may improve the outcome of pregnancies in high-risk women with RM.
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Affiliation(s)
- Rosfayati Othman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Shafiee MN, Shan LP, Ahmad S, Idris N, Omar MH. The use of gonadotrophin-releasing hormone (GnRH) analogue in endometroid adenocarcinoma of the ovary: a case report and discussion. Eur J Obstet Gynecol Reprod Biol 2011; 161:110-1. [PMID: 22177834 DOI: 10.1016/j.ejogrb.2011.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 09/06/2011] [Accepted: 11/08/2011] [Indexed: 11/18/2022]
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Shafiee MN, Ismail NM, Shan LP, Kampan N, Omar MH, Dali HM. A case report: metastatic choriocarcinoma to the gum. Sex Reprod Healthc 2011; 2:91-2. [PMID: 21439527 DOI: 10.1016/j.srhc.2011.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 02/07/2011] [Accepted: 02/09/2011] [Indexed: 11/16/2022]
Abstract
Choriocarcinoma is a rare neoplasia with a tendency of distant metastasis although highly sensitive to chemotherapy renders a good prognosis and outcome. Lungs, liver and cerebral metastasis are commonly implicated with maxillofacial region rarely involved. We illustrate a case of overwhelming metastatic choriocarcinoma to lungs, liver, brain and to the extreme of gum metastasis. Decompressive craniectomy for intracranial bleeding, multiple transfusions to correct anaemia and coagulopathy were done before high-risk-regime chemotherapy. Despite this, due to fulminant multi-organs involvement she finally succumbed to death. In conclusion, gum bleeding in choriocarcinoma may suggest metastasis and poor prognosis.
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Affiliation(s)
- Mohamad Nasir Shafiee
- The Department of Obstetrics and Gynaecology, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia.
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Shan LP, Bee OF, Suniza SS, Adeeb N. Developing a Malaysian Osteoporosis Screening Tool (MOST) for early osteoporosis detection in Malaysian women. Sex Reprod Healthc 2010; 2:77-82. [PMID: 21439525 DOI: 10.1016/j.srhc.2010.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/25/2010] [Accepted: 11/27/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Osteoporotic fracture is a major health burden. Early diagnosis and management would improve the quality of life and reduce costs to the society. OBJECTIVE We aimed to identify risk factors associated with osteoporosis followed by development and validation of a screening tool in the hope of providing an appropriate regime to detect low bone density (BMD) in Malaysia. METHODOLOGY Between November 1999 and November 2002, 514 healthy women aged ≥ 45 with intact uterus, non-HRT users were recruited. Following BMD testing, a screening tool was developed. For validation, 72 women were recruited from June 2003 to December 2003. RESULTS Age and a longer duration postmenopause were negatively linked to BMD. Higher family income, BMI, waist and hip circumference were positively correlated. A score of ≥ 4, the screening tool had a sensitivity of 73.2%, a specificity of 61.6% for identifying women with low BMD (T score ≤ -2) plus a sensitivity of 80.2% in selecting women with osteoporosis. The tool enabled a 45.9% reduction in unnecessary DEXA testing. Validation of the screening tool showed a negative predictive value of 97.8%, sensitivity and specificity of 87.5% and 70.3%, respectively. CONCLUSION The Malaysian Osteoporosis Screening Tool (MOST) is relatively simple. Its usage may reduce unnecessary DEXA test.
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Affiliation(s)
- Lim Pei Shan
- Department of O&G, Medical Faculty, Universiti Kebangsaan Malaysia, Malaysia.
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Abstract
Embryonic antigen associated with an aminoazo dye-induced rat hepatoma was identified in the serum from rats bearing progressively growing tumours. Antigenic activity in serum samples was detected by their capacity to neutralize multiparous rat serum antibody reacting with surface embryonic antigens expressed upon viable hepatoma cells as assessed with use of the indirect membrane immunofluorescence test. Serum taken at various states of tumour growth from hepatoma-bearing rats was separated by Sephadex G-150 gel filtration column chromatography at pH 7.3 and pH 2.8 with use of procedures designed to identify free circulating antigen and antigen derived from immune complexes. Hepatoma-associated embryonic antigen was demonstrable in tumour-bearer serum in a free form most markedly in the later stages after implantation of tumour cells (from the end of the 2nd week to the 5th week of tumour growth). Antigenic activity in fractions derived from immune complexes was detected earlier during tumour development (from day 8 after tumour induction), and this was present in all serum samples taken up to the 5th week after tumour cell inoculation.
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