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Superinfection associated with prolonged antibiotic use in non-ventilator associated hospital-acquired pneumonia

Tan YX, Wong GW, Tan YH

Int J Clin Pharm, 2021 Dec;43(6):1555-1562.
PMID: 34050873 DOI: 10.1007/s11096-021-01282-7

Background Non-ventilator associated hospital-acquired pneumonia accounts for significant antibiotic use and is associated with a high rate of resistance emergence. However, the optimal duration of antibiotic treatment is uncertain, especially in cases of non-fermenting gram-negative bacilli. Objective To compare a short course (5-7 days) to a prolonged course (10-14 days) of antibiotics for non-ventilator associated hospital-acquired pneumonia. Methods Data collected retrospectively on patients completed treatment in a Malaysian tertiary hospital from January 2017 till December 2018. Regression analysis determined variables independently associated with clinical outcome. Main outcome measures Clinical resolution, superinfection, 30-day and 90-day all-cause mortality between short and prolonged courses. Results Of the 167 patients included, 112 patients were treated with a short course antibiotic, whereas 55 patients received a prolonged course of therapy. Neither short nor prolonged course group has a significantly higher rate of clinical resolution. Short course group had significantly higher mean ± SD antibiotic-free days (21.9 ± 3.5 versus 15.1 ± 6.2 days, p
Fulltext Gas-Forming Psoas Abscess Secondary to Lumbar Spondylodiscitis

Tan YX, Cheong WL, Fong TS

Cureus, 2021 Apr 09;13(4):e14388.
PMID: 33981508 DOI: 10.7759/cureus.14388

Lower back pain is a common presentation in clinical practice. Although most are musculoskeletal in nature, occult spine infection such as spondylodiscitis is commonly missed due to its insidious onset and non-specific symptoms. We report a case of a 63-year-old diabetic woman who presented to our institution's emergency department with altered mental status, nausea, and vomiting. She had a fall one month prior with persistent lower back-pain of increasing intensity. Initial laboratory data revealed an elevated leukocyte count with neutrophil predominance. Plain radiographs showed extensive gas shadows over the chest wall, abdomen, left thigh, and left knee. CT scan revealed L2 compression fracture with spondylodiscitis at L1/L2, left psoas abscess, and extensive subcutaneous emphysema. Open abscess drainage with extensive wound debridement was performed. Intra-operative pus, as well as blood cultures, yielded Escherichia coli. Unfortunately, the patient succumbed to the infection on the seventh day of admission secondary to multi-organ failure.
SCL: Self-supervised contrastive learning for few-shot image classification

Lim JY, Lim KM, Lee CP, Tan YX

Neural Netw, 2023 Aug;165:19-30.
PMID: 37263089 DOI: 10.1016/j.neunet.2023.05.037

Few-shot learning aims to train a model with a limited number of base class samples to classify the novel class samples. However, to attain generalization with a limited number of samples is not a trivial task. This paper proposed a novel few-shot learning approach named Self-supervised Contrastive Learning (SCL) that enriched the model representation with multiple self-supervision objectives. Given the base class samples, the model is trained with the base class loss. Subsequently, contrastive-based self-supervision is introduced to minimize the distance between each training sample with their augmented variants to improve the sample discrimination. To recognize the distant sample, rotation-based self-supervision is proposed to enable the model to learn to recognize the rotation degree of the samples for better sample diversity. The multitask environment is introduced where each training sample is assigned with two class labels: base class label and rotation class label. Complex augmentation is put forth to help the model learn a deeper understanding of the object. The image structure of the training samples are augmented independent of the base class information. The proposed SCL is trained to minimize the base class loss, contrastive distance loss, and rotation class loss simultaneously to learn the generic features and improve the novel class performance. With the multiple self-supervision objectives, the proposed SCL outperforms state-of-the-art few-shot approaches on few-shot image classification benchmark datasets.
Fulltext Development, validity and reproducibility of a whole grain food frequency questionnaire in Malaysian children

Koo HC, Lim GP, Kaur S, Chan KQ, Florence Tan YX, Pang XJ, et al.

Nutr J, 2020 07 16;19(1):73.
PMID: 32677967 DOI: 10.1186/s12937-020-00588-y

BACKGROUND: To date, there is no validated whole grain assessment tool for children in any Southeast Asian countries. Hence, there is a need for a valid tool to assess whole grain intake among Malaysian children. This study aimed to develop, validate and test the reproducibility of a food frequency questionnaire (FFQ) in estimating whole grain intake among Malaysian children.
METHODS: A total of 392 children participated in the FFQ development and 112 children aged 9-12 years participated in the validation phase; with a subsample of 50 children participating in the reproducibility phase. Three-day diet record (3DR) as the reference method in validation phase. Spearman correlations, mean difference, Bland-Altman plot and cross-classification analyses were used to assess validity. The reproducibility was tested through a repeat administration of the FFQ, with 1 month time interval. Reproducibility analyses involved intra-class correlation coefficient (ICC), Cronbach's alpha and cross-classification analyses.
RESULTS: The FFQ consisted of 156 whole grain food items from six food groups. Mean intake of whole grain in FFQ1 and 3DR were correlated well (r = 0.732), demonstrated good acceptance of the FFQ. Bland Altman plots showed relatively good agreement for both the dietary methods. Cross-classification of whole grain intake between the two methods showed that
Fulltext In Vitro Toxicity Evaluation of New Generic Latanost® and Latacom® as an Ophthalmic Formulation

Ng JSC, Tan YX, Alwi NAA, Yee KM, Rashid AHA, Tan KL, et al.

J Curr Glaucoma Pract, 2022 2 18;15(3):139-143.
PMID: 35173396 DOI: 10.5005/jp-journals-10078-1319

Aim and objective: To evaluate the safety of two new generic ophthalmic formulations, Latanost® (latanoprost) and Latacom® (latanoprost and timolol) by utilizing the three-dimensional reconstructed human cornea-like epithelium (RhCE) tissue constructs as an in vitro model in the assessment of ocular irritation.
Materials and methods: In vitro irritation test was conducted on Latanost® (LTN) and Latacom® (LTC) and their corresponding innovators, Xalatan® (XLT) and Xalacom® (XLC), respectively, by using RhCE. According to the OECD guidelines No. 492 on the testing of chemicals, the ophthalmic formulations were assessed via topical exposure of the formulations on in vitro RhCE tissue. Cell viability was measured by MTT assay.
Results: The mean cell viability percentage of LTN and XLT was 70.5 and 75.7%, respectively, whereas, for LTC and XLC, the percentage viability was 95.3 and 85.7%, respectively. The two new generic formulations (LTN and LTC) did not reduce the cell viability of the RhCE tissue to ≤60%. Thus, both can be considered as nonirritant.
Conclusion: Both newly developed generics are nonocular irritants.
Clinical significance: This study informs the safety assessment of new generic antiglaucoma ophthalmic solutions applicable for long-term glaucoma treatment. The formulations aim to keep eye irritation to a minimum level.
How to cite this article: Ng JSC, Tan YX, Alwi NAA, et al. In Vitro Toxicity Evaluation of New Generic Latanost® and Latacom® as an Ophthalmic Formulation. J Curr Glaucoma Pract 2021;15(3):139-143.