Implementation of Child Rights in the Children’s Homes in Malaysia

Pathmanathan R. Nalasami,Siti Hajar Abu Bakar,Jal Zabdi Yusoff,Haris Abd. Wahab,Noralina Omar,M. Rezaul Islam 한국사회복지학회 2015 Asian Social Work and Policy Review Vol.9 No.3

The objective of this study was to examine the implementation of the Convention on the Rights of the Child (CRC) in the Children Homes under the Social Welfare Department (SWD) in Malaysia. Data was collected from 402 registered children who were staying in six Children Homes across the country. This study employed self-report surveys where multiple data collection methods, such as face-to-face structured interviews, key informant interviews (KIIs), and documentation survey, were used. The study found that the SWD failed to comply with most of the commitments of CRC in Children Homes at its implementation level, and it is still needs based. The findings of this study present important guidelines for government and policy makers in improving child welfare services in the Children Homes in Malaysia

Fluorescence-in-situ-hybridization in the Surveillance of Urothelial Cancers: Can Use of Cystoscopy or Ureteroscopy be Deferred?

Ho, Christopher Chee Kong,Tan, Wei Phin,Pathmanathan, Rajadurai,Tan, Wei Keith,Tan, Hui Meng Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.7

Background: Fluorescence in situ hybridization (FISH) testing may be useful to screen for bladder carcinoma or dysplasia by detecting aneuploidy chromosomes 3, 7, 17 and deletion of the chromosome 9p21 locus in urine specimens. This study aimed to assess the sensitivity, specificity, positive and negative predictive value of FISH in a multi-ethnic population in Asia. Materials and Methods: Patients with haematuria and/or past history of urothelial cancer on follow-up had their voided urine tested with FISH. Patients then underwent cystoscopy/ureteroscopy and any lesions seen were biopsied. The histopathological reports of the bladder or ureteroscopic mucosal biopsies were then compared with the FISH test results. Results: Two hundred sixty patients were recruited. The sensitivity and specificity of the FISH test was 89.2% and 83.4% respectively. The positive (PPV) and negative predictive values (NPV) were 47.1% and 97.9%. By excluding patients who had positive deletion of chromosome 9, the overall results of the screening test improved: sensitivity 84.6%; specificity 96.4%; PPV 75.9% and NPV 97.9%. Conclusions: UroVysion FISH has a high specificity of detecting urothelial cancer or dysplasia when deletion of chromosome 9 is excluded. Negative UroVysion FISH-tests may allow us to conserve health resources and minimize trauma by deferring cystoscopic or ureteroscopic examination.

Poster Session : PS 0616 ; Others ; Improving Screening and Supplementation with Vitamin B12 Among Our Older Diabetic Patients on Chronic Metformin Therapy

( G Halina Kusz ),( Michael Roxas ),( Suba Pathmanathan ),( Joseph Ramzy ),( Ahmad Al Taweel ),( Tessa Antalan ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: Dementia continues to be a growing concern that affects millions of Americans. Vitamin B12 defi ciency is one of reversible causes of cognitive impairment. Metformin is a widely used fi rst choice agent to manage diabetes. One of its side effects is vitamin B12 defi ciency. Due to a lack of awareness of this side effect, patients are often left undiagnosed and untreated. Methods: The goal of our QI project is to educate our physicians and advocate the annual screening and supplementation with vitamin B12 all IMRGP older, diabetic patients who are on metformin therapy. Our aim is that within next three months we will increase in our clinic screening for B12 defi ciency and supplementation with vitamin by 50%. We retrieved data from the clinic “Diabetic Registry”, and selected all diabetic patients 65 years and older. From an online prescribing list we selected patients who are on chronic metformin therapy and who have prescribed vitamin B12. Educational efforts such as QI Forum presentations are ongoing. Clinic posters and chart reminders are incoming. Results: In our clinic we have a total of 729 diabetic patients from ages 20-97were. 246 patients (34%) were over 65 years old. 90 patients (36.6%) were on metformin, and 41 of them (45%) were on chronic therapy. None of them has documented prescribed vitamin B12. A baseline screening rate and vitamin supplementation is currently calculated from manual chart review. The pending results will be included. Conclusions: We hope that through all educational efforts and increasing awareness, we achieve a 50% increase in screening rate and supplementation with vitamin B12 all older diabetic patients on chronic metformin therapy to prevent cognitive impairment and subsequently to improve health-related quality of life for our patients.

Differential Glycosylation of Na^+/H^+ Exchanger Isoform 1 (NHE1) in Rat Parotid and Sublingual Glands

Park, Keerang,Rechardson, Linda A.,Dharmini Pathmanathan,Lantz, Heather M.,Melvin, James E. Korean Academy of Oral Biology and the UCLA Dental 1999 International Journal of Oral Biology Vol.24 No.2

We characterized the giycosylation pattern of rat Na^+/H^+ exchanger isoform 1 (NHE1) in two distinct types of salivary glands, the serous parotid gland and the mucous sublingual gland. Northern blot analyses showed that the transcript size of NHE1 in both glands was 4.8 kb. However, affinity-purified polyclonal NHE1 antibody detected a 90-95 kDa protein in the crude membrane protein fraction from sublingual glands, whereas NHE1 from parotid gland membrane was 90-100 kDa. Treatment of NHE1proteins with n-glycosidase F, O-glycosidase. Neuraminidase and Endoglycosidase H demonstrated that NHE1 in both types of glands has N-linked, but not O-linked glycosylation. NHE1 in parotid glands was Endoglycosidase H-sensitive indicating the presence of high mannose-type or hybrid-type N-linked oligosaccharides. In contrast, NHE1 in sublingual glands was insensitive to Endoglycosidase H. These results suggest that glycosylation of NHE1 is salivary gland-specific.

EGFR Mutation Testing Practices within the Asia Pacific Region: Results of a Multicenter Diagnostic Survey

Yatabe, Yasushi,Kerr, Keith M.,Utomo, Ahmad,Rajadurai, Pathmanathan,Tran, Van Khanh,Du, Xiang,Chou, Teh-Ying,Enriquez, Ma. Luisa D.,Lee, Geon Kook,Iqbal, Jabed,Shuangshoti, Shanop,Chung, Jin-Haeng,Hag Elsevier 2015 JOURNAL OF THORACIC ONCOLOGY Vol.10 No.3

<P>The efficacy of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in EGFR mutation-positive non-small-cell lung cancer (NSCLC) patients necessitates accurate, timely testing. Although EGFR mutation testing has been adopted by many laboratories in Asia, data are lacking on the proportion of NSCLC patients tested in each country, and the most commonly used testing methods.</P>

The impact of variations in care and complications within a colorectal Enhanced Recovery After Surgery program on length of stay

James Wei Tatt Toh,Jack Cecire,Kerry Hitos,Karen Shedden,Fiona Gavegan,Nimalan Pathmanathan,Toufic El Khoury,Angelina Di Re,Annelise Cocco,Alex Limmer,Tom Liang,Kar Yin Fok,James Rogers,Edgardo Solis 대한대장항문학회 2022 Annals of Coloproctolgy Vol.38 No.1

Purpose: Enhanced Recovery After Surgery (ERAS) has become standard of care in colorectal surgery. However, there is not a universally accepted colorectal ERAS protocol and significant variations in care exist between institutions. The aim of this study was to examine the impact of variations in ERAS interventions and complications on length of stay (LOS). Methods: This study was a single-center review of the first 200 consecutive patients recruited into our prospectively collected ERAS database. The primary outcome of this study was to examine the rate of compliance to ERAS interventions and the impact of these interventions on LOS. The secondary outcome was to assess the impact of complications (anastomotic leak, ileus, and surgical site infections) on LOS. ERAS interventions, rate of adherence, LOS, readmissions, morbidity, and mortality were recorded, and statistical analysis was performed. Results: ERAS variations and complications significantly influenced patient LOS on both univariate and multivariate analysis. ERAS interventions identified as the most important strategies in reducing LOS included laparoscopic surgery, mobilization twice daily postoperative day (POD) 0 to 1, discontinuation of intravenous fluids on POD 0 to 1, upgrading to solid diet by POD 0 to 2, removal of indwelling catheter by POD 0 to 2, avoiding nasogastric tube reinsertion and removing drains early. Both major and minor complications increased LOS. Anastomotic leak and ileus were associated with the greatest increase in LOS. Conclusion: Seven high-yield ERAS interventions reduced LOS. Major and minor complications increased LOS. Reducing variations in care and complications can improve outcomes following colorectal surgery.

Roles of Ki67 in Breast Cancer - Important for Management?

Yip, CH,Bhoo-Pathy, N,Daniel, JM,Foo, YC,Mohamed, AK,Abdullah, MM,Ng, YS,Yap, BK,Pathmanathan, R Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancers in a Multiethnic Malaysian Patient Population

Liam, Chong-Kin,Leow, Hwong-Ruey,How, Soon-Hin,Pang, Yong-Kek,Chua, Keong-Tiong,Lim, Boon-Khaw,Lai, Nai-Lang,Kuan, Yeh-Chunn,Pailoor, Jayalakshmi,Rajadurai, Pathmanathan Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.1

Background: Mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) are predictive of response to EGFR-targeted therapy in advanced stages of disease. This study aimed to determine the frequency of EGFR mutations in NSCLCs and to correlate their presence with clinical characteristics in multiethnic Malaysian patients. Materials and Methods: In this prospective study, EGFR mutations in exons 18, 19, 20 and 21 in formalin-fixed paraffin-embedded biopsy specimens of consecutive NSCLC patients were asessed by real-time polymerase chain reaction. Results: EGFR mutations were detected in NSCLCs from 55 (36.4%) of a total of 151 patients, being significantly more common in females (62.5%) than in males (17.2%) [odds ratio (OR), 8.00; 95% confidence interval (CI), 3.77-16.98; p<0.001] and in never smokers (62.5%) than in ever smokers (12.7%) (OR, 11.50; 95%CI, 5.08-26.03; p<0.001). Mutations were more common in adenocarcinoma (39.4%) compared to non-adenocarcinoma NSCLCs (15.8%) (p=0.072). The mutation rates in patients of different ethnicities were not significantly different (p=0.08). Never smoking status was the only clinical feature that independently predicted the presence of EGFR mutations (adjusted OR, 5.94; 95%CI, 1.94-18.17; p=0.002). Conclusions: In Malaysian patients with NSCLC, the EGFR mutation rate was similar to that in other Asian populations. EGFR mutations were significantly more common in female patients and in never smokers. Never smoking status was the only independent predictor for the presence of EGFR mutations.