Displaying publications 1 - 20 of 160 in total

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  1. Application of biochemical products as a bioremediation technique for domestic sewage treatment plants
    Salmiati, Salim MR, Hassan RM, Tan KY
    Water Sci Technol, 2007;56(7):33-40.
    PMID: 17951865
    Biochemical products have been widely used for treatment of various types of wastewater. The treatment processes with the addition of biochemical products are quite attractive because of their simplicity, minimal use of equipment, they are environmentally friendly and are suitable for the removal of organic pollutants. The purpose of these products is to enhance the activities of beneficial microbes in order to improve treatment performance. This study was carried out to determine the potential of applying biochemical products in assisting and improving the performance of sewage treatment plants. In this study, four biochemical products, namely: Zeolite, Bio-C, Eco-B and Was-D, were applied to the sewage treatment plant. Analyses were carried out on several water quality parameters such as biochemical oxygen demand (BOD), chemical oxygen demand (COD), suspended solids (SS), oil & grease (O&G), phosphorus (P), ammoniacal nitrogen (AN) and sludge thickness (ST). From the results obtained, it can be seen that the overall performance of the treatment plant improved with most of the parameters studied were found to fulfill the DOE Standard B requirements. The performance of Bio-C was found to give better results than other products.
  2. Fulltext Novel technique using amplatzer AVP I stent in management for giant renal artery pseudoaneurysm
    Sarmukh S, Putera MP, Tan KL, Chew LG
    Urol Case Rep, 2021 Mar;35:101515.
    PMID: 33318942 DOI: 10.1016/j.eucr.2020.101515
    Renal artery pseudoaneurysm (RAP) is an uncommon vascular lesion. Early detection and treatment of renal artery pseudoaneurysm is important because it can rupture and lead to life-threatening hemorrhage. Recent advances in endovascular interventions can prevent potentially challenging open surgery. We describe a case 66 year old patient who presented with a painful abdominal lumbar mass. CT scan show a giant renal artery pseudoaneurysm. We discuss management of giant renal artery pseudoaneurysm, both open surgery and endovascular surgery. Endovascular arterial embolization and stent techniques is feasible. However, open surgical treatment remains to be most effective and radical method in emergency setting.
  3. Fulltext Seroprevalence of anti-Toxoplasma gondii IgG antibody in patients with schizophrenia
    Emelia O, Amal RN, Ruzanna ZZ, Shahida H, Azzubair Z, Tan KS, et al.
    Trop Biomed, 2012 Mar;29(1):151-9.
    PMID: 22543615 MyJurnal
    Schizophrenia is a pervasive neuropsychiatric disease of unknown cause. Previous studies have reported that toxoplasmosis may be a possible cause of schizophrenia. To ascertain possible relationship between Toxoplasma gondii and schizophrenia, a cross sectional study, employing an enzyme-linked immunosorbent assay (ELISA) was performed to study the seroprevalence of anti-T. gondii IgG antibody in schizophrenic patients. Furthermore, demographic data analysis from schizophrenic patients were analysed to associate toxoplasmosis with schizophrenia. A total of 288 serum samples from schizophrenic patients (n=144) and psychiatrically healthy volunteers (n=144) were recruited in this study. Interestingly, a significant result in the serointensity rate of anti-T. gondii IgG antibody (> 60 IU/mL) in schizophrenic patients (61.1%) was demonstrated as compared to psychiatrically healthy volunteers (40.8%) (X² = 4.236, p < 0.050). However, there was no significant difference between the seropositivity rate of anti-T. gondii IgG antibody between the two groups. Analysis from demographic data revealed that the seropositivity rate of anti-T. gondii IgG antibody in schizophrenic patients was significantly associated with age group of more than 40 years old (p=0.007) and between ethnic (p=0.046). Nevertheless, no significant association between seropositivity rate of anti-T. gondii IgG antibody with gender (p=0.897), duration of illness (p=0.344) and family history of schizophrenia (p=0.282) in these patients. Thus, this finding is essential as a preliminary data in Malaysia to establish the association between T. gondii and schizophrenia.
  4. Multiplex sequencing of SARS-Cov-2 genome directly from clinical samples using the Ion Personal Genome Machine (PGM)
    Tan KK, Tiong V, Tan JY, Wong JE, Teoh BT, Abd-Jamil J, et al.
    Trop Biomed, 2021 Sep 01;38(3):283-288.
    PMID: 34362871 DOI: 10.47665/tb.38.3.069
    Various methods have been developed for rapid and high throughput full genome sequencing of SARS-CoV-2. Here, we described a protocol for targeted multiplex full genome sequencing of SARS-CoV-2 genomic RNA directly extracted from human nasopharyngeal swabs using the Ion Personal Genome Machine (PGM). This protocol involves concomitant amplification of 237 gene fragments encompassing the SARS-CoV-2 genome to increase the abundance and yield of viral specific sequencing reads. Five complete and one near-complete genome sequences of SARS-CoV-2 were generated with a single Ion PGM sequencing run. The sequence coverage analysis revealed two amplicons (positions 13 751-13 965 and 23 941-24 106), which consistently gave low sequencing read coverage in all isolates except 4Apr20-64- Hu. We analyzed the potential primer binding sites within these low covered regions and noted that the 4Apr20-64-Hu possess C at positions 13 730 and 23 929, whereas the other isolates possess T at these positions. The genome nucleotide variations observed suggest that the naturally occurring variations present in the actively circulating SARS-CoV-2 strains affected the performance of the target enrichment panel of the Ion AmpliSeq™ SARS CoV 2 Research Panel. The possible impact of other genome nucleotide variations warrants further investigation, and an improved version of the Ion AmpliSeq™ SARS CoV 2 Research Panel, hence, should be considered.
  5. Evaluation of commercial serological assays in Malaysia for detection of anti-Zika virus antibodies
    Khoo HY, Lee HY, Khor CS, Tan KK, AbuBakar S
    Trop Biomed, 2021 Dec 01;38(4):613-621.
    PMID: 35001928 DOI: 10.47665/tb.38.4.105
    The recommended test guidelines for Zika virus (ZIKV) include using both molecular and serological tools. While the molecular tools are useful for detecting acute infection, the serological tools are useful for the detection of previous infections. Nevertheless, detection of ZIKV-specific antibodies remains a challenge due to the high cross-reactivity between ZIKV and other flaviviruses such as dengue virus (DENV) and Japanese encephalitis virus (JEV). The objective of this study is to evaluate the commercially available enzyme-linked immunosorbent assay (ELISA) for the detection of ZIKV IgG. In this study, we evaluated 6 commercially available anti-ZIKV IgG ELISA kits. Pre-characterized serum panels consisting of 70 sera were selected for the evaluation. The diagnostic accuracy of each ELISA kits was determined and compared to the gold standard, Foci Reduction Neutralization Test (FRNT). The present study established that the performance of the NS1-based anti-ZIKV IgG ELISA kit was superior to that which uses of the E protein as antigen. Overall, commercial ZIKV IgG ELISA showed varying test performances, with some achieving moderate to high test sensitivities and specificities. When compared against the FRNT, the test sensitivities ranged from 7.1% to 78.6%, whereas, the test specificities ranged from 40.0% to 100%. Limitation to the study includes the cross reactivity between flavivirus and specificity of the kit in addressing the cross reactivity.
  6. Development of a TaqMan minor groove binding probe-based quantitative reverse transcription polymerase chain reaction for the detection and quantification of Zika virus
    Chin KL, Teoh BT, Sam SS, Loong SK, Tan KK, Azizan NS, et al.
    Trop Biomed, 2022 Dec 01;39(4):518-523.
    PMID: 36602210 DOI: 10.47665/tb.39.4.005
    Zika virus (ZIKV) infection has emerged as a global health concern following epidemic outbreaks of severe neurological disorders reported in Pacific and Americas since 2016. Therefore, a rapid, sensitive and specific diagnostic test for ZIKV infection is critical for the appropriate patient management and the control of disease spread. A TaqMan minor groove binding (MGB) probe-based quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay was developed based on the conserved sequence regions of 463 ZIKV NS2B genes. The designed ZIKV qRT-PCR assay was evaluated for its detection limit, strain coverage and cross-reactivity. We further assessed the clinical applicability of qRT-PCR assay for ZIKV RNA detection using a total 18 simulated clinical specimens. The detection limit of the qRT-PCR assay was 11.276 ZIKV RNA copies at the 95% probability level (probit analysis, p<= 0.05). Both Asian and African ZIKV strains were detected by the qRT-PCR assay without cross-reacting with DENV-1, DENV-2, DENV-3, DENV-4, CHIKV, JEV, LGTV, GETV and SINV. The qRT-PCR assay demonstrated a perfect agreement (k = 1.000, P < 0.001) with the reference assay; the sensitivity and specificity of the qRT-PCR assay were 100% (95% CI= 79.6-100) and 100% (95% CI= 43.9-100) respectively. The qRT-PCR assay developed in this study is a useful diagnostic tool for the broad coverage detection and quantification of both the Asian and African ZIKV strains.
  7. Fulltext Withdrawal and withholding of life sustaining treatment (WWLST): an under recognised factor in the morbidity or mortality of periviable infants?-a narrative review
    Galloway I, Roehr CC, Tan K
    Transl Pediatr, 2024 Mar 27;13(3):459-473.
    PMID: 38590374 DOI: 10.21037/tp-23-468
    BACKGROUND AND OBJECTIVE: The morbidity and mortality of infants born extremely preterm varies substantially across networks, within countries and throughout the globe. Most of the literature tends to focus on the management at birth and choices around active resuscitation of extremely preterm infants. Withdrawal and withholding of life sustaining treatment (WWLST) is an important and central process in the neonatal intensive care unit (NICU) and practices vary substantially. As such, our objective in this review was to explore whether end of life decisions also contribute to variations in the morbidity and mortality of periviable infants.

    METHODS: This narrative literature review is based on studies from the last 15 years found using several searches of medical databases (OVID Medline, Scopus and Cochrane Systematic Reviews) performed between March 2021 and December 2023.

    KEY CONTENT AND FINDINGS: Just as outcomes in periviable infants vary, the rates of and processes behind WWLST differ in the periviable population. Variation increases as gestational age decreases. Parental involvement is crucial to share decision making but the circumstances and rates of parental involvement differ. Strict guidelines in end-of-life care may not be appropriate, however there is a need for more targeted guidance for periviable infants as a specific population. The current literature available relating to periviable infants or WWLST is minimal, with many datasets rapidly becoming outdated.

    CONCLUSIONS: Further research is needed to establish the role of WWLST in variation of periviable infants' outcomes. The unification of data, acquisition of more recent datasets and inclusion of variables relating to end-of-life decisions in data collection will aid in this process.

  8. Epidemiology of adenovirus respiratory infections among hospitalized children in Seremban, Malaysia
    Foong Ng K, Kee Tan K, Hong Ng B, Nair P, Ying Gan W
    Trans R Soc Trop Med Hyg, 2015 Jul;109(7):433-9.
    PMID: 26038572 DOI: 10.1093/trstmh/trv042
    There is scarcity of data regarding epidemiology and clinical aspects of human adenovirus acute respiratory infection (ARI) among children in developing countries.
  9. Snake bite in Kelantanese children: a five year experience
    Tan KK, Choo KE, Ariffin WA
    Toxicon, 1990;28(2):225-30.
    PMID: 2339437
    The records associated with 83 children from 16 months to 12 years of age who were admitted with snake bite to Kota Bharu General Hospital and University Hospital, Universiti Sains Malaysia over a 5 year period were reviewed. Elapid bites were more common than viper bites while sea-snake bites were not recorded. Symptoms were relatively mild, the common clinical features being pain and local swelling. Antivenom therapy was required in 11 children. Only three of the 11 children developed minor adverse reactions to antivenom. Four of the 83 required ventilatory support for respiratory failure and two children died.
  10. Posterolateral spinal fusion with ostegenesis induced BMSC seeded TCP/HA in a sheep model
    Shamsul BS, Tan KK, Chen HC, Aminuddin BS, Ruszymah BH
    Tissue Cell, 2014 Apr;46(2):152-8.
    PMID: 24630213 DOI: 10.1016/j.tice.2014.02.001
    Autogenous bone graft is the gold standard for fusion procedure. However, pain at donor site and inconsistent outcome have left a surgeon to venture into some other technique for spinal fusion. The objective of this study was to determine whether osteogenesis induced bone marrow stem cells with the combination of ceramics granules (HA or TCP/HA), and fibrin could serve as an alternative to generate spinal fusion. The sheep's bone marrow mesenchymal stem cells (BMSCs) were aspirated form iliac crest and cultured for several passages until confluence. BMSCs were trypsinized and seeded on hydroxyapatite scaffold (HA) and tricalcium phosphate/hydroxyapatite (TCP/HA) for further osteogenic differentiation in the osteogenic medium one week before implantation. Six adult sheep underwent three-level, bilateral, posterolateral intertransverse process fusions at L1-L6. Three fusion sites in each animal were assigned to three treatments: (a) HA constructs group/L1-L2, (b) TCP/HA constructs group/L2-L3, and (c) autogenous bone graft group/L5-L6. The spinal fusion segments were evaluated using radiography, manual palpation, histological analysis and scanning electron microscopy (SEM) 12 weeks post implantation. The TCP/HA constructs achieved superior lumbar intertransverse fusion compared to HA construct but autogenous bone graft still produced the best fusion among all.
  11. Proceedings of the Inaugural Strategy Meeting for the Establishment of a Southeast Asia Regional Therapeutic Plasma Exchange Consortium for Neurological Disorders
    Viswanathan S, Appiwatanakul M, Nayak A, Islam B, Khatri B, Pangeran D, et al.
    Ther Apher Dial, 2019 Jun;23(3):289-297.
    PMID: 30927331 DOI: 10.1111/1744-9987.12806
    In conjunction with the third regional Southeast Asian (SEA) therapeutic plasma exchange (TPE) conference in Kuala Lumpur, Malaysia, 25 clinicians and researchers from SEA and South Asian countries attended the inaugural strategy meeting for the establishment of a regional TPE consortium for neurological disorders. The primary objective was to establish regional collaboration to improve delivery of TPE services in SEA. A pre-meeting survey was conducted to gather insights on disease spectrum, contextual practice challenges, and the need for a regional TPE consensus. Challenges identified include limited healthcare funding in support of diagnostic workup, TPE therapy, as well as development of clinical infrastructure and expertise capacity building. There was favorable interest in developing a working plan contextualized to this region. Strategies to overcome challenges were discussed. This included the need for a comprehensive referral system and network of regional TPE centers suited to local needs, supported by innovative TPE delivery programs.
  12. Long-term nasogastric tube feeding in elderly stroke patients--an assessment of nutritional adequacy and attitudes to gastrostomy feeding in Asians
    Zaherah Mohamed Shah F, Suraiya HS, Poi PJ, Tan KS, Lai PS, Ramakrishnan K, et al.
    J Nutr Health Aging, 2012 Aug;16(8):701-6.
    PMID: 23076512 DOI: 10.1007/s12603-012-0027-y
    BACKGROUND: Gastrostomy feeding is superior to long-term nasogastric (NG) feeding in patients with dysphagic stroke, but this practice remains uncommon in Asia. We sought to examine the nutritional adequacy of patients on long term NG feeding and identify barriers to gastrostomy feeding in these patients.

    METHODOLOGY: A prospective comparison of subjective global assessment (SGA), and anthropometry (mid-arm muscle circumference, MAMC; triceps skinfold thickness, TST) between elderly stroke patients on long-term NG feeding and matched controls was performed. Selected clinicians and carers of patients were interviewed to assess their knowledge and attitudes to gastrostomy feeding.

    RESULTS: 140 patients (70 NG, 70 oral) were recruited between September 2010 and February 2011. Nutritional status was poorer in the NG compared to the oral group (SGA grade C 38.6% NG vs 0% oral, p<0.001; TST males 10.7 + 3.7 mm NG vs 15.4 + 4.6 mm oral, p<0.001; MAMCmales 187.9 + 40.4 mm NG vs 228.7 + 31.8 mm oral, p<0.001). 45 (64.3%) patients on long-term NG feeding reported complications, mainly consisting of dislodgement (50.5%), aspiration of feed content (8.6%) and trauma from insertion (4.3%). Among 20 clinicians from relevant speciliaties who were interviewed, only 11 (55%) clinicians would routinely recommend a PEG. All neurologists (100%) would recommend a PEG, whilst the response was mixed among non-neurologists. Among carers, lack of information (47.1%) was the commonest reason stated for not choosing a PEG.

    CONCLUSION: Elderly patients with stroke on long term NG feeding have a poor nutritional status. Lack of recommendation by clinicians appears to be a major barrier to PEG feeding in these patients.

  13. An insight into nanocellulose as soft condensed matter: Challenge and future prospective toward environmental sustainability
    Tan K, Heo S, Foo M, Chew IM, Yoo C
    Sci Total Environ, 2019 Feb 10;650(Pt 1):1309-1326.
    PMID: 30308818 DOI: 10.1016/j.scitotenv.2018.08.402
    Nanocellulose, a structural polysaccharide that has caught tremendous interests nowadays due to its renewability, inherent biocompatibility and biodegradability, abundance in resource, and environmental friendly nature. They are promising green nanomaterials derived from cellulosic biomass that can be disintegrated into cellulose nanofibrils (CNF) or cellulose nanocrystals (CNC), relying on their sensitivity to hydrolysis at the axial spacing of disordered domains. Owing to their unique mesoscopic characteristics at nanoscale, nanocellulose has been widely researched and incorporated as a reinforcement material in composite materials. The world has been consuming the natural resources at a much higher speed than the environment could regenerate. Today, as an uprising candidate in soft condensed matter physics, a growing interest was received owing to its unique self-assembly behaviour and quantum size effect in the formation of three-dimensional nanostructured material, could be utilised to address an increasing concern over global warming and environmental conservation. In spite of an emerging pool of knowledge on the nanocellulose downstream application, that was lacking of cross-disciplinary study of its role as a soft condensed matter for food, water and energy applications toward environmental sustainability. Here we aim to provide an insight for the latest development of cellulose nanotechnology arises from its fascinating physical and chemical characteristic for the interest of different technology holders.
  14. Effects of bivalve aquaculture on plankton and benthic community
    Tan K, Xu P, Huang L, Luo C, Huang J, Fazhan H, et al.
    Sci Total Environ, 2024 Mar 01;914:169892.
    PMID: 38211869 DOI: 10.1016/j.scitotenv.2024.169892
    Global human population has increased dramatically over the past 50 years. As a result, marine fisheries and finfish aquaculture have become increasingly unsustainable, driving bivalve aquaculture to become an important food industry for the production of marine animal protein to support the growing market demand for animal protein. It is projected that the rate of bivalve aquaculture expansion will be greatly accelerated in the near future as the human population continues to increase. Although it is generally believed that unfed bivalve aquaculture has less impact on the environment than finfish aquaculture, the rapid expansion of bivalve aquaculture has raised concerns about its potential negative impact, especially on plankton and benthic community. Therefore, there is an urgent need to update the potential effects of bivalve aquaculture on plankton and benthic community. This article reviews the present state of knowledge on environmental issues related to bivalve aquaculture, and discusses potential mitigation measures for the environmental impacts induced by expansion of bivalve aquaculture. This review provides guidance for scientists and farm managers to clarify the current state of research and identify priority research needs for future bivalve aquaculture research. Therefore, specific management strategies can be formulated for the sustainable development and expansion of bivalve aquaculture.
  15. Impact of anthropogenic global hypoxia on the physiological response of bivalves
    Song J, Farhadi A, Tan K, Lim L, Tan K
    Sci Total Environ, 2024 May 20;926:172056.
    PMID: 38552980 DOI: 10.1016/j.scitotenv.2024.172056
    Dissolved oxygen (DO) is an important parameter that affects the biology, physiology, and immunology of aquatic animals. In recent decades, DO levels in the global oceans have sharply decreased, partly due to an increase in atmospheric carbon dioxide, temperature, and anthropogenic nutrient loads. Although there have been many reports on the effects of hypoxia on the survival, growth, behavior, and immunity of bivalves, this information has not been well organized. Therefore, this article provides a comprehensive review of the effects of hypoxia on bivalves. In general, hypoxia negatively impacts the food consumption rate and assimilation efficiency, as well as increasing respiration rates in many bivalves. As a result, it reduces the energy allocation for bivalve growth, shell formation, and reproduction. In severe cases, prolonged exposure to hypoxia can result in mass mortality in bivalves. Moreover, hypoxia also has adverse effects on the immunity and response of bivalves to predators, including decreased burial depths, sensitivity to predators, impairment of byssus production, and negatively impacts on the integrity, strength, and composition of bivalve shells. The tolerance of bivalves to hypoxia largely depends on size and species, with larger bivalves being more susceptible to hypoxia and intertidal species being relatively more tolerant to hypoxia. The information in this article is very useful for elucidating the current research status of hypoxia on bivalves and determining future research directions.
  16. Fulltext Impact of atrial fibrillation among stroke patients in a Malaysian teaching hospital
    Chee KH, Tan KS
    Med J Malaysia, 2014 Jun;69(3):119-23.
    PMID: 25326351 MyJurnal
    OBJECTIVES: Atrial fibrillation (AF) is a well-recognised, major risk factor for ischaemic stroke. The presence of atrial fibrillation in a stroke patient translates into higher mortality rates and significant disability. There is lack of data on the impact of atrial fibrillation on stroke patients in Malaysia. The aim of this study was to determine the prevalence of AF in a hospital setting and determine the risk factors, clinical profile and discharge outcomes in ischaemic stroke patients with and without atrial fibrillation from a tertiary centre in Malaysia.
    METHODS: This was a retrospective review of patients admitted consecutively to the University Malaya Medical Centre, Kuala Lumpur with the diagnosis of stroke during the first six months of 2009. The presence of AF was confirmed with a 12- lead ECG. All patients had neuroimaging with either cranial computed tomography (CT) or magnetic resonance imaging (MRI). Other variables such as clinical features, risk factors, stroke subtypes, length of acute ward stay, complications and evaluation at discharge (mortality) with modified Rankin scale (mRS) were also recorded.
    RESULTS: A total of 207 patients were admitted with stroke during the study duration. Twenty two patients (10.6%) were found to have non valvular AF. Patients with AF were found to be older with a mean age of 71.0 ± 2.2 than those without AF with a mean age of 63.6 ± 0.89 (p<0.05). Risk factors for stroke such as diabetes mellitus and hypertension were equally common between the two groups while the proportion of patients with ischaemic heart disease was higher among patients with AF (p<0.005). Most of the stroke subtypes among patients with AF were of ischaemic type (n=192; 92.8%) while haemorrhagic stroke was uncommon (n=15; 6.2%). Patients with AF had a longer median hospital stay, higher mortality rate and greater functional disability on hospital discharge compared to non AF patients.
    CONCLUSION: The prevalence of AF among stroke patients in a tertiary centre in Malaysia was 10.6%. Stroke patients with AF were observed to have a higher mortality rate and disability on hospital discharge.
    Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  17. Fulltext The comparative accuracy of ultrasound and mammography in the detection of breast cancer
    Tan KP, Mohamad Azlan Z, Rumaisa MP, Siti Aisyah Murni MR, Radhika S, Nurismah MI, et al.
    Med J Malaysia, 2014 Apr;69(2):79-85.
    PMID: 25241817 MyJurnal
    AIM: This study was performed to determine the accuracy of ultrasound (USG) as compared to mammography (MMG) in detecting breast cancer.

    METHODS: This was a review of patients who had breast imaging and biopsy during an 18-month period. Details of patients who underwent breast biopsy were obtained from the department biopsy record books and imaging request forms. Details of breast imaging findings and histology of lesions biopsied were obtained from the hospital Integrated Radiology Information System (IRIS). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of USG and MMG were calculated with histology as the gold standard.

    RESULTS: A total of 326 breast lesions were biopsied. Histology results revealed the presence of 74 breast cancers and 252 benign lesions. USG had a sensitivity of 82%, specificity of 84%, PPV = 60%, NPV = 94% and an accuracy of 84%. MMG had a sensitivity of 49%, specificity of 89%, PPV = 53%, NPV = 88% and an accuracy of 81%. A total of 161 lesions which were imaged with both modalities were analyzed to determine the significance in the differences in sensitivity and specificity between USG and MMG. Sensitivity of USG (75%) was significantly higher than sensitivity of MMG (44%) (X(2)1=6.905, p=0.014). Specificity of MMG (91%) was significantly higher than specificity of USG (79%) (X(2)1=27.114, p<0.001). Compared with MMG, the sensitivity of USG was 50% (95% CI 10%-90%) higher in women aged less than 50 years (X(2)1=0.000, p=1.000) and 27% (95% CI 19%-36%) higher in women aged 50 years and above (X(2)1=5.866, p=0.015). Compared with MMG, the sensitivity of USG was 40% (95% CI 10%-70%) higher in women with dense breasts (X(2)1=0.234, p=0.628) and 27% (95% CI 9%-46%) higher in women with non-dense breasts (X(2)1=4.585, p=0.032).

    CONCLUSION: Accuracy of USG was higher compared with MMG. USG was more sensitive than MMG regardless of age group. However, MMG was more specific in those aged 50 years and older. USG was more sensitive and MMG was more specific regardless of breast density. In this study, 20% of breast cancers detected were occult on MMG and seen only on USG.
  18. Fulltext Prevention is better than cure
    Andrew Tan KK
    Med J Malaysia, 2014 Feb;69(1):1.
    PMID: 24814619
    No abstract available.
  19. Fulltext Management of isolated splenic injuries after blunt trauma: an institution's experience over 6 years
    Tan KK, Chiu MT, Vijayan A
    Med J Malaysia, 2010 Dec;65(4):304-6.
    PMID: 21901951
    Forty-two patients with traumatic blunt splenic injuries were admitted over a six year period. Vehicular-related collisions and fall from height accounted for the injuries in 38 (90.5%) of them. Eleven (26.2%) underwent immediate surgery (7 splenectomy and 4 splenorrhaphy), while the remaining 31 patients were treated nonoperatively of which 3 underwent angio-embolisation. Twenty seven patients had either grade III or IV splenic injuries. Operative management was more likely in patients with lower haemoglobin or with more severe splenic injury. Nonoperative management can be adopted in patients with blunt isolated splenic injuries but operative management is still indispensable in certain instances.
  20. Fulltext Prevalence of onodi cells in Hospital Raja Permaisuri Bainun, Ipoh, Malaysia
    Tan KL, Harvinder S
    Med J Malaysia, 2010 Jun;65(2):101-2.
    PMID: 23756790 MyJurnal
    Onodi cell is a posterior ethmoid air cell that pneumatizes into the sphenoid sinus, It is an important entity for clinicians when performing endoscopic sinus surgery (EES) because it encroaches into the optic nerve and internal carotid artery. CT-scans are the road map for ESS to prevent damage to structures mentioned above. Its prevalence in Malaysia is unknown.
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