Displaying publications 1 - 20 of 238 in total

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  1. 'Combined ameloblastoma and odontogenic keratocyst' or 'keratinising ameloblastoma'
    Siar CH, Ng KH
    Br J Oral Maxillofac Surg, 1993 Jun;31(3):183-6.
    PMID: 7685634
    Four cases of either combined occurrence of ameloblastoma and odontogenic keratocyst or a rare keratinising variant of ameloblastoma are presented. The cardinal histomorphologic characteristics are simultaneous occurrence of ameloblastomatous epithelial islands with central keratinisation and multiple keratinising cysts. Immunohistochemically the tumour elements were keratin positive and occasionally S-100 protein and desmin positive. Major differential diagnosis of these neoplasms are discussed.
  2. Fulltext (GTG)5-PCR analysis and 16S rRNA sequencing of bacteria from Sarawak aquaculture environment
    Kathleen, M.M., Samuel, L., Felecia, C., Ng K. H., Lesley, M.B., Kasing, A.
    International Food Research Journal, 2014;21(3):915-920.
    MyJurnal
    (GTG)5 PCR is a type of repetitive extragenic palindromic (rep)-PCR which amplifies the (GTG)5 repetitive element that lays throughout the bacterial genome. In this study, fifty, thirty-nine and forty-nine unknown bacteria were isolated from aquaculture farms in Miri, Limbang and Lundu, respectively. (GTG)5 PCR was used to screen for clonal diversity among the isolates according to sampling sites. Banding profiles obtained from electrophoresed (GTG)5 PCR products were analyzed by RAPDistance Software to generate a dendrogram of neighbor joining tree (NJT) format. Based on the constructed dendrogram, representative isolates were selected for further identification. Conserved 16S rRNA region of the selected bacteria isolates were amplified and purified DNA products were sequenced. (GTG)5 PCR is useful in differentiation of unknown bacterial isolates and 16S rRNA analysis species identity of the bacteria in Sarawak aquaculture environment. The high diversity of bacteria in aquaculture environment may be caused by contamination from various sources.
  3. Fulltext A Transcriptome-Wide Association Study Identifies Novel Candidate Susceptibility Genes for Pancreatic Cancer
    Zhong J, Jermusyk A, Wu L, Hoskins JW, Collins I, Mocci E, et al.
    J Natl Cancer Inst, 2020 Oct 01;112(10):1003-1012.
    PMID: 31917448 DOI: 10.1093/jnci/djz246
    BACKGROUND: Although 20 pancreatic cancer susceptibility loci have been identified through genome-wide association studies in individuals of European ancestry, much of its heritability remains unexplained and the genes responsible largely unknown.

    METHODS: To discover novel pancreatic cancer risk loci and possible causal genes, we performed a pancreatic cancer transcriptome-wide association study in Europeans using three approaches: FUSION, MetaXcan, and Summary-MulTiXcan. We integrated genome-wide association studies summary statistics from 9040 pancreatic cancer cases and 12 496 controls, with gene expression prediction models built using transcriptome data from histologically normal pancreatic tissue samples (NCI Laboratory of Translational Genomics [n = 95] and Genotype-Tissue Expression v7 [n = 174] datasets) and data from 48 different tissues (Genotype-Tissue Expression v7, n = 74-421 samples).

    RESULTS: We identified 25 genes whose genetically predicted expression was statistically significantly associated with pancreatic cancer risk (false discovery rate < .05), including 14 candidate genes at 11 novel loci (1p36.12: CELA3B; 9q31.1: SMC2, SMC2-AS1; 10q23.31: RP11-80H5.9; 12q13.13: SMUG1; 14q32.33: BTBD6; 15q23: HEXA; 15q26.1: RCCD1; 17q12: PNMT, CDK12, PGAP3; 17q22: SUPT4H1; 18q11.22: RP11-888D10.3; and 19p13.11: PGPEP1) and 11 at six known risk loci (5p15.33: TERT, CLPTM1L, ZDHHC11B; 7p14.1: INHBA; 9q34.2: ABO; 13q12.2: PDX1; 13q22.1: KLF5; and 16q23.1: WDR59, CFDP1, BCAR1, TMEM170A). The association for 12 of these genes (CELA3B, SMC2, and PNMT at novel risk loci and TERT, CLPTM1L, INHBA, ABO, PDX1, KLF5, WDR59, CFDP1, and BCAR1 at known loci) remained statistically significant after Bonferroni correction.

    CONCLUSIONS: By integrating gene expression and genotype data, we identified novel pancreatic cancer risk loci and candidate functional genes that warrant further investigation.

  4. A clinicopathologic study of odontomas: Malaysian findings
    Ng KH, Siar CH
    J Nihon Univ Sch Dent, 1997 Dec;39(4):171-5.
    PMID: 9476429
    This report reviews the clinicopathologic characteristics of 104 cases of odontomas diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period (1967-1995). The results showed no real predilection in terms of sex (M:F ratio, 1:1), race (45.2% Malays, 40.4% Chinese, 10.6% Indians and 3.8% other races) or site (maxilla:mandible ratio, 1: 1.04) distribution. The mean age at presentation was 24.8 years and the age range was 3-74 years. There were 102 intraosseous and 2 extraosseous odontomas. Swelling was the most common presenting complaint. The majority of cases (81.9%) were clinically diagnosed as odontomas. The treatment of choice was surgical enucleation. Compound (43.3%) and complex (35.5%) odontomas were the two most common histological types encountered. The present findings correlate favorably with reported studies from other geographic areas.
  5. A clinicopathological and immunohistochemical study of the calcifying epithelial odontogenic tumour (Pindborg tumour) in Malaysians
    Ng KH, Siar CH
    J Laryngol Otol, 1996 Aug;110(8):757-62.
    PMID: 8869610
    We reviewed the clinicopathological characteristics of 13 cases of calcifying epithelial odontogenic tumour (CEOT) (Pindborg tumour) diagnosed in the Division on Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period. There were eight female and five male patients. These consisted of eight (61.5 per cent) Malays, three (23.1 per cent) Chinese, one (7.7 per cent) Indian and one (7.7 per cent) Melanau. Their ages at presentation ranged from 19-61 years (mean age, 31.8 years). There were 12 central and one peripheral CEOT. Of these, 76.9 per cent of cases were located in the maxilla, the remaining in the mandible. The commonest clinical diagnosis was a dentigerous cyst (66.7 per cent). Enucleation was the main mode of treatment. Histologically, sheets and strands of polyhedral epithelial cells containing eosinophilic, homogeneous globules with Liesegang rings were observed. One case also showed extensive calcification and clear cell differentiation. Immunohistochemistry revealed a variable keratin staining of the CEOT epithelium, confirming its heterogeneity.
  6. A comparative study of radiation doses between phantom and patients via CT angiography of the intra-/extra-cranial, pulmonary, and abdominal/pelvic arteries
    Karim MKA, Sabarudin A, Muhammad NA, Ng KH
    Radiol Phys Technol, 2019 Dec;12(4):374-381.
    PMID: 31468370 DOI: 10.1007/s12194-019-00532-8
    This study aimed to evaluate effective dose and size-specific dose estimate (SSDE) of computed tomography angiography (CTA) examination using an anthropomorphic phantom. We included three CTA examination protocols to evaluate the intra- and extra-cranial arteries, pulmonary artery (CTPA), and abdominal vessels. Patient SSDEs were measured retrospectively to estimate patient dose, relative to the bodyweight of the patient and volume CT dose index (CTDIvol). Our findings revealed that the highest dose was absorbed by the left lobe of the thyroid gland during intra-/extra-cranial CTA and CTPA, that is, 14.11 ± 0.24 mGy and 16.20 ± 3.95 mGy, respectively. However, the highest absorbed dose in abdominal/pelvic CTA was the gonads (8.98 ± 0.30 mGy), while other radiosensitive organs in intra- and extra-cranial CTA, CTPA, and abdominal/pelvic CTA did not demonstrate significant differences between organs/structures with p value 0.88, 0.11, and 0.54, respectively. The estimated effective dose in intra-/extra-cranial CTA was lower in patients (0.80 ± 0.60 mSv) than in the phantom (0.83 mSv), but it was the opposite for CTPA, with the effective dose being higher in patients (7.54 ± 3.09 mSv) than in the phantom (6.68 mSv). Similar to the effective dose, only CTPA SSDEs were significantly higher in men than in women (19.74 ± 4.79 mGy versus 7.9 mGy). Effective dose and SSDE are clinically relevant parameters that can help estimate a more accurate patient dose based on a patient's size.
  7. A large exposure to Brucella melitensis in a diagnostic laboratory
    Sam IC, Karunakaran R, Kamarulzaman A, Ponnampalavanar S, Syed Omar SF, Ng KP, et al.
    J Hosp Infect, 2012 Apr;80(4):321-5.
    PMID: 22237130 DOI: 10.1016/j.jhin.2011.12.004
    Brucella species are easily transmitted by aerosols and can be acquired in the laboratory.
  8. A low cost solution for post-biopsy complications using available RFA generator and coaxial core biopsy needle
    Azlan CA, Mohd Nasir NF, Saifizul AA, Faizul MS, Ng KH, Abdullah BJ
    Australas Phys Eng Sci Med, 2007 Dec;30(4):288-91.
    PMID: 18274069
    Percutaneous image-guided needle biopsy is typically performed in highly vascular organs or in tumours with rich macroscopic and microscopic blood supply. The main risks related to this procedure are haemorrhage and implantation of tumour cells in the needle tract after the biopsy needle is withdrawn. From numerous conducted studies, it was found that heating the needle tract using alternating current in radiofrequency (RF) range has a potential to minimize these effects. However, this solution requires the use of specially designed needles, which would make the procedure relatively expensive and complicated. Thus, we propose a simple solution by using readily available coaxial core biopsy needles connected to a radiofrequency ablation (RFA) generator. In order to do so, we have designed and developed an adapter to interface between these two devices. For evaluation purpose, we used a bovine liver as a sample tissue. The experimental procedure was done to study the effect of different parameter settings on the size of coagulation necrosis caused by the RF current heating on the subject. The delivery of the RF energy was varied by changing the values for delivered power, power delivery duration, and insertion depth. The results showed that the size of the coagulation necrosis is affected by all of the parameters tested. In general, the size of the region is enlarged with higher delivery of RF power, longer duration of power delivery, and shallower needle insertion and become relatively constant after a certain value. We also found that the solution proposed provides a low cost and practical way to minimizes unwanted post-biopsy effects.
  9. A low-cost phantom for simple routine testing of single photon emission computed tomography (SPECT) cameras
    Ng AH, Ng KH, Dharmendra H, Perkins AC
    Appl Radiat Isot, 2009 Oct;67(10):1864-8.
    PMID: 19049851 DOI: 10.1016/j.apradiso.2008.10.010
    A simple sphere test phantom has been developed for routine performance testing of SPECT systems in situations where expensive commercial phantoms may not be available. The phantom was based on a design with six universal syringe hubs set in the frame to support a circular array of six glass blown spheres of different sizes. The frame was then placed into a water-filled CT abdomen phantom and scanned with a triple head camera system (Philips IRIX, USA). Comparison was made with a commercially available phantom (Deluxe Jaszczak phantom). Whereas the commercial phantom demonstrates cold spot resolution, an important advantage of the sphere test phantom was that hot spot resolution could be easily measured using almost half (370MBq) of the activity recommended for use in the commercial phantom. Results showed that the contrast increased non-linearly with sphere volume and radionuclide concentration. The phantom was found to be suitable as an inexpensive option for daily performance tests.
  10. A mutation panel comprising BRAFV600E, NRASQ61R, and NRASQ61H replicated retrospective histopathological examination findings in differentiating benign goitre from malignant papillary thyroid cancer in a cohort of Malaysian patients
    Eng ZH, Ahmad Jefry MM, Ng KL, Abdul Aziz A, Mat Junit S
    Malays J Pathol, 2023 Dec;45(3):375-390.
    PMID: 38155379
    Thyroid malignancy status is usually confirmed through histopathological examination (HPE) following thyroidectomy. In Malaysia, the application of molecular markers in pre-operative diagnosis of thyroid cancer remains unexplored. In this study, BRAF and NRAS gene mutation panel was assessed, and the results were compared with retrospective HPE findings. Malaysian patients with benign goitre (BTG: n=33) and papillary thyroid cancer (PTC: n=25; PTCa: n=20, PTCb: n=5) were recruited at Universiti Malaya Medical Centre from September 2019 to December 2022. PCR-direct DNA sequencing of BRAFV600, NRASG12, NRASG13, and NRASQ61 was conducted on DNA extracted from the patients' thyroid tissue specimens following thyroidectomy and HPE. BRAFV600E and NRASQ61R mutations showed absolute PTC-specificity with PTC-sensitivity of 32% and 28%, respectively. NRASQ61H demonstrated lower PTC-specificity (94%) but higher PTC-sensitivity (72%) compared to the BRAFV600E and NRASQ61R mutations. Although the NRASG12 and NRASG13 variants were absent in this study, a novel NRASV14D mutation was detected in a PTCa patient. Unlike PTCb, coexistence of BRAFV600E and NRASQ61 variants was commonly observed among the PTCa patients. Notably, all PTCb patients had NRASQ61H mutation with one patient carried both the NRASQ61H and BRAFV600E mutations. Association analysis revealed potential link between gender, BRAFV600E mutation and lymph node metastasis. In conclusion, mutation panel comprising BRAFV600E, NRASQ61R, and NRASQ61H did not discriminate the two PTC subtypes but replicated the retrospective HPE findings in differentiating BTG from PTC. The application of this mutation panel in pre-operative diagnosis of thyroid nodules requires further validation in a larger sample size, preferably incorporating fineneedle aspirate biopsies.
  11. A nationwide survey on awareness and knowledge about Bronchial Provocation Test amongst doctors in Malaysia
    Ng KL, Huan NC, Mohammad FA, Mohd Aminudin NH, Mohammad FA, Abdul Rahaman JA
    Med J Malaysia, 2022 Jan;77(1):33-40.
    PMID: 35086992
    BACKGROUND: Bronchial provocation test (BPT) is widely used internationally not only to evaluate bronchial responsiveness in conditions especially asthma, but is also utilized as a marker of control, severity and prognosis for asthma. However, the uptake of BPT in certain countries including Malaysia remains low. We aimed to explore this lack of knowledge by assessing the current level of awareness and knowledge on BPT amongst doctors in Malaysia.

    MATERIALS AND METHODS: A nationwide web-based questionnaire targeting doctors was sent through social media (Facebook, WhatsApp and Telegram) and Malaysian Medical Association (MMA) mailing lists between 1 October 2020 - 5 February 2021.

    RESULTS: In all 415 survey responses were analysed from doctors of various grades namely medical officers to consultants. A total of 404 (97.35%) encountered patients with asthma in their daily practice. According to specialty: 169 (40.72%) were from primary care, 121 (29.16%) internal medicine, 50 (12.05%) pulmonary medicine and 75 (18.07%) others. Only 163 (39.28%) were aware of BPT as a tool to diagnose asthma. 232 (55.90%) and 124 (29.88%) regarded BPT as an important test and felt confident to refer patients for BPT respectively. Of those participants who were not confident to refer: 35.17% were unsure of BPT indications, 33.21% were unsure of centres providing BPT, 8.17% cited logistic reasons, 6.04% were concerned of possible BPT side effects. 387 (93.25%) wanted more training in BPT. The median BPT knowledge score was 20% (1 out of 5). Awareness and knowledge were affected by specialty but not by: region of practice, gender, age and grade from logistic regression analysis.

    CONCLUSION: Various national level programs and targeted local interventions are much needed to increase the awareness, knowledge and uptake of BPT in Malaysia.

  12. Fulltext A parallel spatiotemporal saliency and discriminative online learning method for visual target tracking in aerial videos
    Aghamohammadi A, Ang MC, A Sundararajan E, Weng Ng K, Mogharrebi M, Banihashem SY
    PLoS One, 2018;13(2):e0192246.
    PMID: 29438421 DOI: 10.1371/journal.pone.0192246
    Visual tracking in aerial videos is a challenging task in computer vision and remote sensing technologies due to appearance variation difficulties. Appearance variations are caused by camera and target motion, low resolution noisy images, scale changes, and pose variations. Various approaches have been proposed to deal with appearance variation difficulties in aerial videos, and amongst these methods, the spatiotemporal saliency detection approach reported promising results in the context of moving target detection. However, it is not accurate for moving target detection when visual tracking is performed under appearance variations. In this study, a visual tracking method is proposed based on spatiotemporal saliency and discriminative online learning methods to deal with appearance variations difficulties. Temporal saliency is used to represent moving target regions, and it was extracted based on the frame difference with Sauvola local adaptive thresholding algorithms. The spatial saliency is used to represent the target appearance details in candidate moving regions. SLIC superpixel segmentation, color, and moment features can be used to compute feature uniqueness and spatial compactness of saliency measurements to detect spatial saliency. It is a time consuming process, which prompted the development of a parallel algorithm to optimize and distribute the saliency detection processes that are loaded into the multi-processors. Spatiotemporal saliency is then obtained by combining the temporal and spatial saliencies to represent moving targets. Finally, a discriminative online learning algorithm was applied to generate a sample model based on spatiotemporal saliency. This sample model is then incrementally updated to detect the target in appearance variation conditions. Experiments conducted on the VIVID dataset demonstrated that the proposed visual tracking method is effective and is computationally efficient compared to state-of-the-art methods.
  13. A proposed hierarchical fuzzy inference system for the diagnosis of arthritic diseases
    Lim CK, Yew KM, Ng KH, Abdullah BJ
    Australas Phys Eng Sci Med, 2002 Sep;25(3):144-50.
    PMID: 12416592 DOI: 10.1007/BF03178776
    Development of computer-based medical inference systems is always confronted with some difficulties. In this paper, difficulties of designing an inference system for the diagnosis of arthritic diseases are described, including variations of disease manifestations under various situations and conditions. Furthermore, the need for a huge knowledge base would result in low efficiency of the inference system. We proposed a hierarchical model of the fuzzy inference system as a possible solution. With such a model, the diagnostic process is divided into two levels. The first level of the diagnosis reduces the scope of diagnosis to be processed by the second level. This will reduce the amount of input and mapping for the whole diagnostic process. Fuzzy relational theory is the core of this system and it is used in both levels to improve the accuracy.
  14. Fulltext A review of dengue research in Malaysia
    Cheah WK, Ng KS, Marzilawati AR, Lum LC
    Med J Malaysia, 2014 Aug;69 Suppl A:59-67.
    PMID: 25417953 MyJurnal
    Dengue infection is a major cause of morbidity and mortality in Malaysia. To date, much research on dengue infection conducted in Malaysia have been published. One hundred and sixty six articles related to dengue in Malaysia were found from a search through a database dedicated to indexing all original data relevant to medicine published between the years 2000-2013. Ninety articles with clinical relevance and future research implications were selected and reviewed. These papers showed evidence of an exponential increase in the disease epidemic and a varying pattern of prevalent dengue serotypes at different times. The early febrile phase of dengue infection consist of an undifferentiated fever. Clinical suspicion and ability to identify patients at risk of severe dengue infection is important. Treatment of dengue infection involves judicious use of volume expander and supportive care. Potential future research areas are discussed to narrow our current knowledge gaps on dengue infection.
  15. Fulltext A seroprevalence study of viral hepatitis E infection in human immunodeficiency virus type 1 infected subjects in Malaysia
    Ng KP, He J, Saw TL, Lyles CM
    Med J Malaysia, 2000 Mar;55(1):58-64.
    PMID: 11072492 MyJurnal
    Hepatitis E virus (HEV) is a RNA virus transmitted enterically. A study of anti-HEV antibodies in 145 human immunodeficiency virus type 1 (HIV-1) infected subjects found that 14.4% of them were reactive to anti-HEV antibodies. Anti-HEV IgG and anti-HEV IgM was detected in 10.3% and 4.1% of the subjects respectively. Prevalence of anti-HEV (either IgG or IgM) was similar across all adult ages (p = 0.154), between the three ethnic groups (p = 0.378), and across risk groups (p = 0.120). The results showed that HEV infection in subjects recruited in this study was most likely transmitted via faecal-route.
  16. A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country
    Ooi SH, Ng KP, Sthaneshwar P, Lim SK, Khor PY, Lim JY, et al.
    BMC Nephrol, 2024 Apr 05;25(1):122.
    PMID: 38580977 DOI: 10.1186/s12882-024-03498-x
    BACKGROUND: The commonest indication for hospitalization in COVID-19 patients is hypoxemia or severe respiratory symptoms. However, COVID-19 disease may result in extrapulmonary complications including kidney-related pathology. The reported incidence of renal involvement related to COVID infection varies based on geographical location.

    OBJECTIVE: This study aimed to assess the incidence rate of AKI in hospitalized COVID-19 patients and identify risk factors and prognostic predictors.

    METHOD: In this retrospective study, we recruited hospitalized COVID-19 patients from January 2021 until June 2021 at the University Malaya Medical Center. The inclusion criteria were hospitalized for ≥ 48 h with confirmed COVID-19 infection and at least 18 years old. Patient demographic and clinical data were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines.

    RESULTS: One thousand five hundred twenty-nine COVID patients fulfilled the inclusion criteria with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36-66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n = 85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n = 323). The percentage of COVID patients in different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. Fifteen hospitalized patients (0.98%) required renal replacement therapy. 58.8% (n = 190) of AKI group had complete recovery of kidney function. Demographic factors included age (p 

  17. A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it
    Jamal N, Ng KH, McLean D
    Br J Radiol, 2003 Apr;76(904):238-45.
    PMID: 12711643
    The primary objective of this study was to determine the mean glandular dose (MGD) during diagnostic mammography in Malaysia. The secondary objective was to evaluate some of the factors affecting MGD. A survey of standard MGD was performed, based upon quality control records for the period October 1999 to August 2001. This covered 30 mammography units from 9 manufacturers. MGD was also measured for a series of patients attending mammography examinations at three other mammography units. MGD per film was estimated from recorded radiographic factors, the compressed breast thickness (CBT) and X-ray unit calibration data. MGD per woman was calculated by summing the MGDs for all films, and averaging it over both breasts. 300 women drawn equally from three major ethnic groups, namely Malay, Chinese and Indian, took part in the study. The difference of MGD per woman between ethnic groups was tested for significance using non-parametric Kruskal-Wallis and median tests. The factors affecting MGD per woman were tested for significance using a multivariate analysis of variance. The MGD for the phantom was 1.23 mGy (range 0.22-2.39 mGy) while the mean patient based MGD per film was 1.54 mGy and 1.82 mGy for the craniocaudal and mediolateral oblique views, respectively. The mean MGD per woman was 3.37 mGy. It was also found that there is no significant difference in MGD per woman among the ethnic groups (p>0.05, Kruskal-Wallis test). However, on the multivariate test two factors, namely half value layer of the X-ray beam and (CBT), had a significant effect on MGD per woman (p<0.05). No significant relationships were seen between MGD per woman with respect to ethnicity, body mass index or age.
  18. A study on the prevalence of oral habits in 100 cases of squamous cell carcinoma in Malaysia
    Ng KH, Siar CH, Ramanathan K, Murugasu P
    Ann Dent, 1986;45(2):7-10.
    PMID: 3468879
  19. Fulltext A survey of hysterectomy patterns in Malaysia (letter)
    Soh EB, Ng KB
    Med J Malaysia, 1999 Mar;54(1):152-4.
    PMID: 10972022
    Comment on: Ravindran J, Kumaraguruparan M. A survey of hysterectomy patterns in Malaysia. Med J Malaysia. 1998 Sep;53(3):263-71
  20. A survey of regional analgesia and anaesthesia for obstetrics in selected countries in the Far East
    Chan YK, Ng KP
    Int J Obstet Anesth, 2000 Oct;9(4):225-32.
    PMID: 15321075
    A survey was conducted in several countries in the Far East in an attempt to determine the practice of obstetric analgesia and anaesthesia there. Survey forms were sent to a total of 11 countries but in the end responses from only four countries were able to provide useful information. Responses from Singapore, Hong Kong, Taiwan and Malaysia covered between 44.9% (Singapore) and 24.6% (Malaysia) of their countries' total deliveries in 1997 and were thought to be adequate to give an impression of the obstetric analgesia and anaesthesia services in their respective countries, although this would not necessarily be completely accurate. From our survey, we found that the availability of regional analgesia for labour paralleled the economic status of the country and that a significant number of caesarean sections are conducted under regional anaesthesia, mainly spinals.
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