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Bleeding characteristics and mortality outcomes following ST-elevation myocardial infarction thrombolysis:a 5-year analysis in an Asian population

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World Journal of Emergency Medicine 2024年第6期15卷 433-440页

作者： hock peng koh Jivanraj RNagarajah Hasnita Hassan Noel Thomas Ross Pharmacy Department Hospital Kuala LumpurMinistry of Health MalaysiaKuala Lumpur 50586Malaysia Emergency and Trauma Department Hospital Kuala LumpurMinistry of Health MalaysiaKuala Lumpur 50586Malaysia Medical Department Hospital Kuala LumpurMinistry of Health MalaysiaKuala Lumpur 50586Malaysia

BACKGROUND:Bleeding outcomes are crucial primary safety endpoints in studies involving thrombolytic *** study aimed to determine the incidence,characteristics and mortality outcomes of bleeding following ST-elevation myocardial infarction(STEMI)thrombolysis in an Asian ***:This single-centre retrospective study included all STEMI patients who received thrombolytic therapy from 2016 to 2020 in a Malaysian tertiary *** population sampling was used in this *** primary outcome was bleeding events post-thrombolysis,categorised using the Thrombolysis in Myocardial Infarction(TIMI)bleeding *** statistics were used to determine the associations between relevant ***:Data from 941 patients were analysed.A total of 156(16.6%)STEMI patients bled ***,minor,and minimal TIMI occurred in 7(0.7%),17(1.8%),and 132(14.0%)patients,*** 65 years(P=0.031)and Malaysian Chinese(P=0.008)were associated with a higher incidence of bleeding ***,foreigners(P=0.032)and current smoker(P=0.007)were associated with a lower incidence of *** TIMI major(P<0.001)and TIMI minor(P<0.001)were associated with a higher incidence of all-cause in-hospital mortality among STEMI *** minor bleeding was significantly higher in the streptokinase *** bleeding sites were comparable between streptokinase and tenecteplase recipients,except for a significantly higher incidence of gastrointestinal bleeding in the streptokinase recipients(P=0.027).CONCLUSION:In our Asian population,the incidence of total bleeding events following STEMI thrombolysis is comparable to that previously *** development of TIMI major and minor bleeding complications is associated with higher mortality.

关键词： Bleeding ST-elevation myocardial infarction thrombolysis Asian Tenecteplase Streptokinase

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Chromaticity of Complete 6-Partite Graphs with Certain Star or Matching Deleted Ⅱ

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Acta Mathematicae Applicatae Sinica 2013年第1期29卷 35-42页

作者： Roslan Hasni Ameen Shaman Ameen Yee-hock peng Hai-xing Zhao School of Mathematical Sciences Universiti Sains Malaysia Department of Mathematics and Institute for Mathematical Research University Putra Malaysia Department of Mathematics Qinghai Normal University

Let P（G, λ） be the chromatic polynomial of a graph G. Two graphs G and H are said to be chromatically equivalent, denoted G N H, if P（G, λ） = P（H, λ）. We write [G] = {HIH - G}. If [G] = {G}, then G is said to be chromatically unique. In this paper, we first characterize certain complete 6-partite graphs with 6rid＋1 vertices according to the number of 7-independent partitions of G. Using these results, we investigate the chromaticity of G with certain star or matching deleted. As a by-product, many new families of chromatically unique complete 6-partite graphs with certain star or matching deleted are obtained.

关键词： chromatic polynomial chromatically closed chromatic uniqueness

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Can we omit systematic biopsies in patients undergoing MRI fusion-targeted prostate biopsies?

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Asian Journal of Andrology 2023年第1期25卷 43-49页

作者： Jeffrey J Leow Soon hock koh Marcus WL Chow Wayren Loke Rolando Salada Seok Kwan Hong Yuyi Yeow Chau Hung Lee Cher Heng Tan Teck Wei Tan Department of Urology Tan Tock Seng HospitalSingapore 308433Singapore Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of Diagnostic Radiology Tan Tock Seng HospitalSingapore 308433Singapore

Magnetic resonance imaging(MRI)-targeted prostate biopsy is the recommended investigation in men with suspicious lesion(s)on *** role of concurrent systematic in addition to targeted biopsies is currently *** our prospectively maintained database,we identified men with at least one Prostate Imaging-Reporting and Data System(PI-RADS)≥3 lesion who underwent targeted and/or systematic biopsies from May 2016 to May *** significant prostate cancer(csPCa)was defined as any Gleason grade group≥2 *** 545 patients who underwent MRI fusion-targeted biopsy,222(40.7%)were biopsy naïve,247(45.3%)had previous prostate biopsy(s),and 76(13.9%)had known prostate cancer undergoing active *** cancer was more commonly found in biopsy-naïve men(63.5%)and those on active surveillance(68.4%)compared to those who had previous biopsies(35.2%;both P<0.001).Systematic biopsies provided an incremental 10.4%detection of csPCa among biopsy-naïve patients,versus an incremental 2.4%among those who had prior negative *** regression found age(odds ratio[OR]=1.03,P=0.03),prostate-specific antigen(PSA)density≥0.15 ng ml^(−2)(OR=3.24,P<0.001),prostate health index(PHI)≥35(OR=2.43,P=0.006),higher PI-RADS score(vs PI-RADS 3;OR=4.59 for PI-RADS 4,and OR=9.91 for PI-RADS 5;both P<0.001)and target lesion volume-to-prostate volume ratio≥0.10(OR=5.26,P=0.013)were significantly associated with csPCa detection on targeted *** conclusion,for men undergoing MRI fusion-targeted prostate biopsies,systematic biopsies should not be omitted given its incremental value to targeted biopsies *** factors such as PSA density≥0.15 ng ml^(−2),PHI≥35,higher PI-RADS score,and target lesion volume-to-prostate volume ratio≥0.10 can help identify men at higher risk of csPCa.

关键词： prostate biopsy prostate cancer prostate health index prostate-specific antigen software fusion Uronav

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Development of a heart rate variability and complexity model in predicting the need for life-saving interventions amongst trauma patients

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Burns & Trauma 2019年第1期7卷 107-117页

作者： Aravin Kumar Nan Liu Zhi Xiong koh Jayne Jie Yi Chiang Yuda Soh Ting Hway Wong Andrew Fu Wah Ho Takashi Tagami Stephanie Fook-Chong Marcus Eng hock Ong Yong Loo Lin School of Medicine National University of SingaporeSingaporeSingapore Health Services Research Centre Singapore Health ServicesAcademia20 College RoadSingapore 169856Singapore Duke-NUS Medical School National University of SingaporeSingaporeSingapore Department of Emergency Medicine Singapore General HospitalSingaporeSingapore Department of General Surgery Singapore General HospitalSingaporeSingapore Department of Emergency and Critical Care Medicine Nippon Medical SchoolTokyoJapan Health Services Research Unit Singapore General HospitalSingaporeSingapore

Background:Triage trauma scores are utilised to determine patient disposition,interventions and prognostication in the care of trauma *** rate variability(HRV)and heart rate complexity(HRC)reflect the autonomic nervous system and are derived from electrocardiogram(ECG)*** this study,we aimed to develop a model incorporating HRV and HRC,to predict the need for life-saving interventions(LSI)in trauma patients,within 24 h of emergency department ***:We included adult trauma patients(≥18 years of age)presenting at the emergency department of Singapore General Hospital between October 2014 and October *** excluded patients who had non-sinus rhythms and larger proportions of artefacts and/or ectopics in ECG *** obtained patient demographics,laboratory results,vital signs and outcomes from electronic health *** conducted univariate and multivariate analyses for predictive model ***:Two hundred and twenty-five patients met inclusion criteria,in which 49 patients required *** LSI group had a higher proportion of deaths(10,20.41%vs 1,0.57%,p<0.001).In the LSI group,the mean of detrended fluctuation analysis(DFA)-α1(1.24 vs 1.12,p=0.045)and the median of DFA-α2(1.09 vs 1.00,p=0.027)were significantly *** stepwise logistic regression analysis determined that a lower Glasgow Coma Scale,a higher DFA-α1 and higher DFA-α2 were independent predictors of requiring *** area under the curve(AUC)for our model(0.75,95%confidence interval,0.66–0.83)was higher than other scoring systems and selected vital ***:An HRV/HRC model outperforms other triage trauma scores and selected vital signs in predicting the need for LSIs but needs to be validated in larger patient populations.

关键词： Triage trauma score Hear trate variability Heart rate complexity Life-saving interventions

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Interaction between salinity intrusion and vegetation succession:A modeling approach

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Theoretical & Applied Mechanics Letters 2013年第3期3卷 1-8页

作者： Su Yean Teh hock Lye koh Donald L.DeAngelis Mike Turtora School of Mathematical Sciences Universiti Sains MalaysiaPenang 11800Malaysia UCSI University No.1UCSI HeightsJalan Menara GadingTaman ConnaughtKuala Lumpur 56000Federal Territory of Kuala Lumpur U.S.Geological Survey and University of Miami Coral GablesFlorida 33124USA U.S.Geological Survey GainesvilleFlorida 32605USA

Predicting potential changes in groundwater salinity in low-lying coastal regions due to climate change is important, where coastal vegetation is abundant, succession competition between halophytes and glycophytes plays a significant role in the salinity budget. Sea level rise enhances salinity intrusion, contributing an additional dimension to vegetation competition. A new simulation model known as mangrove-hardwood hammock model coupled with saturated-unsaturated transport （MANTRA） has recently been developed by the authors to simulate groundwater salinity regimes in the presence of vegetation competition, subject to climate change. MANTRA is based upon linking two existing Unites States geological survey （USGS） simulation models known as mangrove-hardwood hammock model （MANHAM） and saturated-unsaturated transport （SUTRA）. MANHAM simulates the evolution of vegetation succession subject to changing groundwater salinity. SUTRA simulates saturated and unsaturated transport of solutes and salinity in groundwater given sea salinity. MANTRA improves the simulation robustness to simultaneously simulate groundwater hydrology, salinity and coastal vegetation succession subject to sea level rise. Some simulation results will be presented to demonstrate the impact of sea level rise on coastal vegetation succession and groundwater salinity.

关键词： salinity intrusion groundwater vegetation succession MANTRA climate change

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Emergency medical services use and its association with acute ischaemic stroke evaluation and treatment in Singapore

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Stroke & Vascular Neurology 2020年第2期5卷 121-127页

作者： Hanzhang Xu Ying Xian Fung peng Woon Janet Prvu Bettger Daniel T Laskowitz Yih Yng Ng Marcus Eng hock Ong David Bruce Matchar Deidre Anne De Silva Department of Family Medicine and Community Health Duke University School of MedicineDurhamNorth CarolinaUnited States Duke University School of Nursing DurhamNorth CarolinaUnited States Duke Clinical Research Institute DurhamNorth CarolinaUnited States Department of Neurology Duke University School of MedicineDurhamNorth CarolinaUnited States Department of Neurology National Neuroscience Institute-Singapore General Hospital CampusSingapore Department of Orthopaedic Surgery Duke University School of MedicineDurhamNorth CarolinaUnited States HomeTeam Government of Singapore Ministry of Home AffairsSingapore Department of Emergency Medicine Singapore General HospitalSingapore Program in Health Services and Systems Research Duke-NUS Graduate Medical SchoolSingapore Department of Medicine(General Internal Medicine) Duke University School of MedicineDurhamNorth CarolinaUnited States

Background Emergency medical services(EMS)is a critical link in the chain of stroke *** aimed to assess EMS use for stroke in Singapore,identify characteristics associated with EMS use and the association of EMS use with stroke evaluation and *** The Singapore Stroke Registry combines nationwide EMS and public hospital data for stroke cases in *** regressions with the generalised estimating equations were performed to examine the association between EMS use and timely stroke evaluation and *** Of 3555 acute ischaemic patients with symptom onset within 24 hours admitted to all five public hospitals between 2015 and 2016,68%arrived via *** who used EMS were older,were less likely to be female,had higher stroke severity by National Institute of Health Stroke Scale and had a higher prevalence of atrial fibrillation or peripheral arterial *** transported by EMS were more likely to receive rapid evaluation(door-to imaging time≤25 min 34.3%vs 11.1%,OR=2.74(95%CI 1.40 to 5.38))and were more likely to receive intravenous tissue plasminogen activator(tPA,22.8%vs 4.6%,OR=4.61(95%CI 3.52 to 6.03)).Among patients treated with tPA,patients who arrived via EMS were more likely to receive timely treatment than self-transported patients(door-to needle time≤60 min 52.6%vs 29.4%,OR=2.58(95%CI 1.35 to 4.92)).Conclusions EMS use is associated with timely stroke evaluation and treatment in *** EMS-Hospital stroke pathways and targeted public campaigns to advocate for appropriate EMS use have the potential to improve acute stroke care.

关键词： needle treatment likely

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New mesogenic Schiff base esters comprising benzothiazole moiety:Synthesis and mesomorphic properties

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Chinese Chemical Letters 2009年第9期20卷 1081-1084页

作者： Sie Tiong Ha Teck Ming koh Guan Yeow Yeap Hong Cheu Lin Jun Kit Beh Yip Foo Win peng Lim Boey Faculty of Engineering & Science Universiti Tunku Abdul RahmanJln Genting KlangSetapak 53300 Kuala LumpurMalaysia Liquid Crystal Research Laboratory School of Chemical SciencesUniversiti Sains Malaysia 11800 MindenPenangMalaysia Department of Materials Science & Engineering National Chiao Tung University1001 Ta-Hsueh RoadHsinchu 300Taiwan Faculty of Science Engineering & TechnologyUniversiti Tunku Abdul RahmanJln UniversitiBandar Barat 31900 KamparPerakMalaysia

A homologous series of Schiff base esters, 6-methoxy-2-（2-hydroxy-4-alkanoyloxybenzylidenamino）benzothiazoles, compris- ing a benzothiazole moiety as the core was synthesized. All the members of this series exhibited an enantiotropic nematic phase. The azomethine linkage along with the lateral hydroxyl and terminal methoxyl groups were found to exert an effect on the mesomorphic properties. 2009 Sie Tiong Ha. Published by Elsevier B.V. on behalf of Chinese Chemical Society. All rights reserved.

关键词： Schiff bases Benzothiazoles Mesomorphic Nematic Structure-liquid crystal property relationship

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Poor performance of the modified early warning score for predicting mortality in critically ill patients presenting to an emergency department

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World Journal of Emergency Medicine 2013年第4期4卷 273-277页

作者： Le Onn Ho Huihua Li Nur Shahidah Zhi Xiong koh Papia Sultana Marcus Eng hock Ong Department of Emergency Medicine Singapore General HospitalSingapore Department of Clinical Research Singapore General HospitalSingapore Office of Clinical Science Duke-NUS Graduate Medical SchoolSingapore

BACKGROUND:This study was undertaken to validate the use of the modified early warning score(MEWS) as a predictor of patient mortality and intensive care unit(ICU)/ high dependency(HD)admission in an Asian ***:The MEWS was applied to a retrospective cohort of 1 024 critically ill patients presenting to a large Asian tertiary emergency department(ED) between November 2006 and *** MEWS was calculated based on vital signs parameters on arrival at *** of mortality and ICU/HD admission were obtained from hospital *** ability of the composite MEWS and its individual components to predict mortality within 30 days from ED visit was ***,specificity,positive and negative predictive values were derived and compared with values from other cohorts.A MEWS of ≥4 was chosen as the cut-off value for poor prognosis based on previous ***:A total of 311(30.4%) critically ill patients were presented with a MEWS ≥*** mean age was 61.4 years(SD 18.1) with a male to female ratio of *** the 311 patients,53(17%)died within 30 days,64(20.6%) were admitted to ICU and 86(27.7%) were admitted to *** area under the receiver operating characteristic curve was 0.71 with a sensitivity of 53.0%and a specificity of 72.1%in addition to a positive predictive value(PPV) of 17.0%and a negative predictive value(NPV)of 93.4%(MEWS cut-off of ≥4) for predicting ***:The composite MEWS did not perform well in predicting poor patient outcomes for critically ill patients presenting to an ED.

关键词： Modified early warning score Emergency department Outcomes Triage

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Concurrent amoebic and histoplasma colitis:A rare cause of massive lower gastrointestinal bleeding

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World Journal of Gastroenterology 2010年第10期16卷 1296-1298页

作者： peng Soon koh April Camilla Roslani Kumar Vasudeavan Vimal Mohd Shariman Ramasamy Umasangar Rajkumar Lewellyn Department of Surgery Faculty of MedicineUniversity Malaya Department of Surgery Taiping Hospital Department of Pathology Raja Permaisuri Bainun Hospital

Infective colitis can be a cause of massive lower gastrointestinal bleeding requiring acute surgical intervention. Causative organisms include entamoeba and histoplasma species. However, concurrent colonic infection with both these organisms is very rare, and the in vivo consequences are not known. A 58-year-old male presented initially to the physicians with pyrexia of unknown origin and bloody diarrhea. Amoebic colitis was diagnosed based on biopsies, and he was treated with metronidazole. Five days later, the patient developed massive lower gastrointestinal bleeding with hemorrhagic shock. Emergency total colectomy with end-ileostomy was performed. However, he deteriorated and died on the second postoperative day. Histopathological examination revealed multiple deep ulcers at the hepatic flexure where fungal bodies of mycelial and yeast forms were noted. Isolated lymph nodes showed abscess formation with fungal bodies. Infective fungal colitis with Histoplasma capsilatum was diagnosed. In vitro, amoebic parasites can increase virulence and pathogenicity of histoplasma which may account for the fulminant presentation in this patient. Although rare, this unusual dual infection should be considered in the differential diagnosis of infective colitis, as appropriate antimicrobial treatment may prevent progression to massive lower gastrointestinal bleeding, obviating the need for urgent surgical intervention.

关键词： Gastrointestinal hemorrhage Histoplasma Amoebic colitis Colectomy Infective colitis

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经气管灌注血管紧张素Ⅱ导致凋亡性急性肺损伤(英文)

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生理学报 2008年第6期60卷 715-722页

作者：庄甲举李小鹏 Bruce David Uhal koh Rhun Yian 白求恩军医学院生理教研室石家庄050081 美国密歇根州立大学生理学系密歇根州东兰辛市48824

为研究外源性血管紧张素Ⅱ(angiotensinⅡ,ANG)在急性肺损伤和肺泡上皮细胞凋亡中的作用,经气管分别给雄性Wistar大鼠(175～200g)灌注ANG、ANG加caspase抑制剂ZVAD-fmk、ANG加ANG受体1阻断剂losartan和仅灌注磷酸盐缓冲溶液(PBS)。6或20... 详细信息

为研究外源性血管紧张素Ⅱ(angiotensinⅡ,ANG)在急性肺损伤和肺泡上皮细胞凋亡中的作用,经气管分别给雄性Wistar大鼠(175～200g)灌注ANG、ANG加caspase抑制剂ZVAD-fmk、ANG加ANG受体1阻断剂losartan和仅灌注磷酸盐缓冲溶液(PBS)。6或20h后在体灌洗动物肺脏,测定灌洗液中血红蛋白(hemoglobin,Hb)和荧光物质(BODIPY)标定的白蛋白含量(在灌洗前15min静脉注入BODIPY-白蛋白)。TUNEL测定显示,灌注ANG6h后,支气管和肺泡上皮细胞内标定的DNA片断显著增加(P<0.05);ANG所致的DNA片断增加可被同时灌注ZVAD-fmk或losartan阻断。灌注ANG后免疫标定caspase3阳性细胞数量显著增多(P<0.01),ZVAD-fmk或losartan同样显著减少caspase3阳性细胞的数量。灌注ANG显著增加肺泡灌洗液中荧光标定的白蛋白(P<0.01)和Hb的含量(P<0.05);ZVAD-fmk或losartan亦显著抑制荧光白蛋白和Hb含量的变化。结果表明,肺泡上皮细胞在体暴露于外源性ANG足以引起ANG受体1介导的上皮细胞凋亡和肺泡屏障损伤。

关键词：凋亡肺泡上皮细胞急性肺损伤 Ⅱ型肺泡细胞

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