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Wai YZ, Pee XK, Lai YP, Alias R. Descemet stripping endothelial keratoplasty versus penetrating keratoplasty in bullous keratopathy: A 2-year analysis of graft survival and outcomes in a tertiary eye centre in Kuala Lumpur. Med J Malaysia 2023; 78:74-78. [PMID: 36715195] [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: 06/18/2023]
Abstract
INTRODUCTION This study aims to compare the 2-year graft survival and outcomes of descemet stripping endothelial keratoplasty (DSEK) and penetrating keratoplasty (PK) for the treatment of bullous keratopathy (BK) among multiethnic Malaysia populations treated at a Tertiary Eye Centre in Kuala Lumpur, Malaysia. MATERIALS AND METHODS This was a retrospective study of BK or Fuchs endothelial dystrophy (FED) patients who underwent DSEK or PK from 2015 to 2019 in Kuala Lumpur Hospital with a minimal post-operative follow-up of 2 years. Outcome measures included best-corrected visual acuity (BCVA), graft survival and complications. A total of 26 DSEK cases and 32 PK cases were included. RESULTS At 2 years, graft survival rates were quite similar in two groups (DSEK 80.8% vs PK 75%, p=0.765). The mean follow-up period was 35.2 months in DSEK and 31.4 months for PK (p=0.465). The cumulative survival rates were slightly higher in the DSEK group (DSEK 73.1% vs PK 53.1%, p=0.119), but the result was not statistically significant. Postoperative complications were associated with higher graft failure in both groups (p=0.019). DSEK group has better post-operative BCVA (LogMAR DSEK 0.42 vs PK 0.83, p=0.003). CONCLUSION Similar graft survival rates were observed with both corneal transplant techniques for 2 years among Malaysian patients with BK. Post-operative complications can cause a higher risk of graft failure. DSEK produced better post-operative BCVA compared to PK.
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Affiliation(s)
- Y Z Wai
- Kuala Lumpur Hospital, Department of Ophthalmology, Kuala Lumpur, Malaysia.
| | - X K Pee
- Sarawak General Hospital, Department of Ophthalmology, Sarawak, Malaysia
| | - Y P Lai
- Kuala Lumpur Hospital, Department of Ophthalmology, Kuala Lumpur, Malaysia
| | - R Alias
- Kuala Lumpur Hospital, Department of Ophthalmology, Kuala Lumpur, Malaysia
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Tong J, Liang CM, Huang K, Xiang HY, Qi J, Feng LL, Lai YP, Shao SS, Wu XY, Tao FB. Prenatal serum thallium exposure and 36-month-old children's attention-deficit/hyperactivity disorder symptoms: Ma'anshan birth cohort study. Chemosphere 2020; 244:125499. [PMID: 32050328 DOI: 10.1016/j.chemosphere.2019.125499] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
Thallium (Tl) is a highly toxic heavy metal that has been suggested to be responsible for oxidative stress and mitochondrial dysfunction. However, few studies have focused on the relationship of prenatal Tl exposure with children's neurobehavioural development. The purpose of our study was to investigate the association between prenatal Tl exposure and attention-deficit/hyperactivity disorder (ADHD) symptoms in 36-month-old children. We used data from 2851 mother-newborn pairs from the Ma'anshan Birth Cohort Study (MABC); serum Tl concentration was assessed in the first, second and third trimesters of pregnancy as well as in the umbilical cord blood. We assessed ADHD symptoms in the children using the Chinese version of the Conners abbreviated symptom questionnaire (C-ASQ). The adjusted odds ratio (OR) for the risk of ADHD symptoms was 2.00 [95% confidence interval (CI): 1.20, 3.32] and 2.08 (95% CI: 1.26, 3.43) for the third (60.25-75.21 ng/L) and fourth quartiles of serum Tl (>75.21 ng/L), respectively, in the second trimester of pregnancy, in comparison with the first quartile of serum Tl (<50.86 ng/L). The risk of ADHD symptoms was elevated among boys exposed to the fourth quartile of serum Tl in the second trimester of pregnancy (adjusted OR 2.08, 95% CI: 1.13, 3.83). Our results demonstrated that high levels of Tl exposure in the second trimester of pregnancy were related to a higher risk of ADHD symptoms in 36-month-old children, and the association of higher serum Tl exposure in the second trimester with ADHD symptoms was only found in boys.
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Affiliation(s)
- Juan Tong
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Chun-Mei Liang
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, People's Republic of China
| | - Kung Huang
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, People's Republic of China
| | - Hai-Yun Xiang
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Juan Qi
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Lan-Lan Feng
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Ya-Ping Lai
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Shan-Shan Shao
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, People's Republic of China
| | - Xiao-Yan Wu
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, People's Republic of China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui, People's Republic of China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, People's Republic of China.
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Sun Y, Fang J, Yang R, Lai YP, Hu JJ, Duan XN, Su PY, Wan YH, Tao FB. [Prospective association between early adiposity rebound and adolescent development in girls]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 51:796-800. [PMID: 28881544 DOI: 10.3760/cma.j.issn.0253-9624.2017.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To determine possible relations between early adiposity rebound and adolescent development. Methods: Prospective children cohort from 2 kindergartens selected through clustering convenience sampling method in Anhui Province was established since Sep. 2010. Participants were classified as Cohort 1 (2010), Cohort 2 (2011) and Cohort 3 (2012) according to the recruiting year. Till Sep. 2015, a toal of 802 girls were included in this study, and received follow-up till primary school. During kindergarten period, physical examination was carried out every 3 months, 8 times in total. In primary school, physical examination was carried out annually; till Sep.2015, the cohort 1, 2, 3 took physical examination for 12, 11, 10 times, respectively. Information on household economic status and child physical activity was acquired through parents questionnaire survey, and breast development were assessed through visual inspection and palpation. Adiposity rebound was determined according to Rolland-Cachera's method for each girl. Differences between early adiposity rebound and normal adiposity rebound groups were compared by using t test and χ(2) test. Multivariate regression analysis was applied to explore the association between early adiposity rebound and breast development. Results: The average age of participants was (8.90±0.87) years old and the BMI was (17.48±2.70) kg/m(2). The average age at adiposity rebound was (6.16±0.90) years old and the BMI was (15.33±1.82) kg/m(2). Premature breast development was found significantly higher in girls in early adiposity rebound group (27.8%, 54/802) than it in normal adiposity rebound group (13.7%) (P<0.001). After current adiposity, age, household economic status, childhood physical activity adjusted, the OR of premature beast development in early adiposity rebound group was 2.41(95%CI: 1.41-4.12). Conclusion: Early adiposity rebound increases the risk of premature puberty in girls.
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Affiliation(s)
- Y Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei 230032, China
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Liu F, Liu Y, Lai YP, Gu XN, Liu DM, Yang M. Fetal Hemodynamics and Fetal Growth Indices by Ultrasound in Late Pregnancy and Birth Weight in Gestational Diabetes Mellitus. Chin Med J (Engl) 2017; 129:2109-14. [PMID: 27569240 PMCID: PMC5009597 DOI: 10.4103/0366-6999.189057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: The offspring of women with gestational diabetes mellitus (GDM) are prone to macrosomia. However, birth weight is difficult to be correctly estimated by ultrasound because of fetal asymmetric growth characteristics. This study aimed to investigate the correlations between fetal hemodynamics, fetal growth indices in late pregnancy, and birth weight in GDM. Methods: A total of 147 women with GDM and 124 normal controls (NC) were enrolled in this study. Fetal hemodynamic indices, including the systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of umbilical artery (UA), middle cerebral artery (MCA), and renal artery (RA), were collected. Fetal growth indices, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length, were also measured by ultrasound. Birth weight, newborn gender, and maternal clinical data were collected. Results: The independent samples t-test showed that BPD, HC, and AC were larger in GDM than in NC (P < 0.05). Fetal hemodynamic indices of the UA and MCA were lower (P < 0.05), but those of the RA were higher (P < 0.001) in GDM than in NC. Birth weight was higher in GDM than in NC (P < 0.001). Pearson's correlation analysis showed that hemodynamic indices of the UA were negatively correlated with birth weight, BPD, HC, and AC in both groups (P < 0.05). MCA (S/D, PI, and RI) was negatively correlated with birth weight, HC, and AC in GDM (r = −0.164, −0.206, −0.200, −0.226, −0.189, −0.179, −0.196, −0.177, and − 0.172, respectively, P < 0.05), but there were no correlations in NC (P > 0.05). RA (S/D, PI, and RI) was positively correlated with birth weight in GDM (r = 0.168, 0.207, and 0.184, respectively, P < 0.05), but there were no correlations in NC (P > 0.05). Conclusion: Fetal hemodynamic indices in late pregnancy might be helpful for estimating newborn birth weight in women with GDM.
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Affiliation(s)
- Fang Liu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Yong Liu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Ya-Ping Lai
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Xiao-Ning Gu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Dong-Mei Liu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Min Yang
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
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Abstract
Invasive amebiasis rarely occurs in homosexual men and human immunodeficiency virus (HIV)-infected individuals and has not been regarded as a beacon for concomitant HIV infection. We encountered a bisexual man with a protracted course of amebic liver abscess and amebic colitis. In the presence of fever, generalized lymphadenopathy, and elevated serum aminotransferase levels, HIV infection was suspected and then confirmed by a de novo seroconversion of HIV antibody. Subsequently, we noted two consecutive patients with amebic liver abscess, also later found to be infected with HIV. The ameba obtained from these three cases was identified as Entamoeba histolytica by amplification of 16S ribosomal RNA by polymerase chain reaction and direct sequencing. This observation suggests that amebic liver abscess and colitis can be presentations for HIV infection in the Far East. Thus, the local patients with invasive amebiasis, especially those with a protracted course or with risk factors of HIV infection, should be tested for HIV.
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Affiliation(s)
- C J Liu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Yuen MF, Hui CK, Cheng CC, Wu CH, Lai YP, Lai CL. Long-term follow-up of interferon alfa treatment in Chinese patients with chronic hepatitis B infection: The effect on hepatitis B e antigen seroconversion and the development of cirrhosis-related complications. Hepatology 2001; 34:139-45. [PMID: 11431745 DOI: 10.1053/jhep.2001.25273] [Citation(s) in RCA: 181] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The long-term effect of interferon alfa (IFN-alpha) in Chinese patients with chronic hepatitis B infection is unknown. A total of 411 chronic hepatitis B patients (208 treated with IFN-alpha and 203 as control) were followed up for hepatitis B serology and the development of hepatoma and other cirrhosis-related complications. The hepatitis B e antigen (HBeAg) seroconversion rate in the IFN-alpha-treated group, though significantly greater at 6 and 24 months, was comparable with the control group on subsequent follow-up, irrespective of pretreatment alanine transaminase (ALT) levels. HBeAg seroreversion rate was higher in the IFN-alpha group compared with the control group (21.1% vs. 2.2%; P =.001). Loss of hepatitis B surface antigen (HBsAg) occurred in 2.4% of the IFN-alpha-treated patients and 0.49% of the control patients (P = NS). Around 90% of the anti-HBe-positive patients in both groups were still hepatitis B virus (HBV)-DNA-positive by polymerase chain reaction (PCR) assay. Two patients suffered from hepatic reactivation during the course of treatment. Nine (4.3%) patients in the IFN-alpha group and 2 (1.0%) in the control group developed complications of cirrhosis and hepatoma (P =.062). In Chinese HBsAg carriers, IFN-alpha was of no long-term benefit in inducing HBeAg seroconversion or in the prevention of hepatoma and other cirrhosis-related complications.
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Affiliation(s)
- M F Yuen
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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Lai YP, Wu MS, Chen MY, Chuang CY, Shun CT, Lin JT. Timing and necessity of endoscopy in AIDS patients with dysphagia or odynophagia. Hepatogastroenterology 1998; 45:2186-9. [PMID: 9951891] [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: 04/12/2023]
Abstract
BACKGROUND/AIMS Dysphagia and odynophagia are common problems with significant morbidity in acquired immunodeficiency syndrome (AIDS) patients. Endoscopy in AIDS patients with esophageal symptoms is valuable for diagnosis, but the timing and necessity of routine endoscopy remains controversial. METHODOLOGY We retrospectively studied 40 AIDS patients undergoing upper gastrointestinal endoscopy. Among them, 25 patients were enroled with dysphagia and/or odynophagia and were put on empirical fluconazole treatment before endoscopic evaluation. RESULTS Fourteen (56%) of 25 patients improved after fluconazole treatment, while 11 patients had persistent symptoms. Among the 14 patients with symptomatic improvement, 7 were found to have esophageal candidiasis which improved after continuation of fluconazole for 1-2 more weeks. The other 7 patients had a normal endoscopic appearance. In contrast, among 11 patients with persistent symptoms, there were 3 patients with azole-resistant candidiasis, 3 with cytomegalovirus esophagitis, 1 with herpes simplex virus esophagitis with candidiasis, 1 with Kaposi's sarcoma, and 3 with idiopathic esophageal ulcer. They were successfully treated with Amphotericin B, Ganciclovir, Acyclovior, and oral steroids, except for the patient with Kaposi's sarcoma. CONCLUSIONS Routine endoscopy may not necessarily be indicated in every AIDS patient with dysphagia or odynophagia. Empirical fluconazole treatment can improve symptoms in 50% of patients. It is only indicated when patients have persistent symptoms after empirical treatment. With endoscopic examination, etiologic agents other than common candidiasis can be determined and the patients can thus be put on specific treatment.
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Affiliation(s)
- Y P Lai
- Department of Internal Medicine, National Taiwan University, Taipei
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Affiliation(s)
- Y P Lai
- Dept of Internal Medicine, National Taiwan University Hospital, Taipei
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