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Fulltext A "good enough" remote psychodynamic psychotherapy - A psychiatry trainee's novice experience during Coronavirus pandemic

Chong SC, Ang JK, Tan KP

Asian J Psychiatr, 2021 Nov;65:102835.
PMID: 34534918 DOI: 10.1016/j.ajp.2021.102835

Covid-19 pandemic and the public health measure have forced an en masse transition to remote therapy from physical sessions. Remote psychodynamic psychotherapy is not a new treatment modality, but its effectiveness in holding the analytic frame has been concerned by some therapists. We would like to highlight some of the therapeutic processes involved with remote psychodynamic psychotherapy, via the help of a narrative experience of a psychiatry trainee who was novice to this delivery method of therapy. Reflections on these concerns have been made in line with the experiences highlighted.
Fulltext Comparative effects of plant growth regulators on leaf and stem explants of Labisia pumila var. alata

Ling AP, Tan KP, Hussein S

J Zhejiang Univ Sci B, 2013 Jul;14(7):621-31.
PMID: 23825148 DOI: 10.1631/jzus.B1200135

OBJECTIVE: Labisia pumila var. alata, commonly known as 'Kacip Fatimah' or 'Selusuh Fatimah' in Southeast Asia, is traditionally used by members of the Malay community because of its post-partum medicinal properties. Its various pharmaceutical applications cause an excessive harvesting and lead to serious shortage in natural habitat. Thus, this in vitro propagation study investigated the effects of different plant growth regulators (PGRs) on in vitro leaf and stem explants of L. pumila.
METHODS: The capabilities of callus, shoot, and root formation were evaluated by culturing both explants on Murashige and Skoog (MS) medium supplemented with various PGRs at the concentrations of 0, 1, 3, 5, and 7 mg/L.
RESULTS: Medium supplemented with 3 mg/L indole-3-butyric acid (IBA) showed the optimal callogenesis from both leaf and stem explants with (72.34 ± 19.55)% and (70.40 ± 14.14)% efficacy, respectively. IBA was also found to be the most efficient PGR for root induction. A total of (50.00 ± 7.07)% and (77.78 ± 16.47)% of root formation were obtained from the in vitro stem and leaf explants after being cultured for (26.5 ± 5.0) and (30.0 ± 8.5) d in the medium supplemented with 1 and 3 mg/L of IBA, respectively. Shoot formation was only observed in stem explant, with the maximum percentage of formation ((100.00 ± 0.00)%) that was obtained in 1 mg/L zeatin after (11.0 ± 2.8) d of culture.
CONCLUSIONS: Callus, roots, and shoots can be induced from in vitro leaf and stem explants of L. pumila through the manipulation of types and concentrations of PGRs.
Fulltext Hypertension in a residential home for the elderly in Penang, Malaysia

Ong HT, Oung LS, Ong LM, Tan KP

Med J Malaysia, 2010 Mar;65(1):18-20.
PMID: 21265241 MyJurnal

A study of residents at the Silver Jubilee Home for the Aged was conducted to determine the prevalence, awareness and control of hypertension in this elderly community in Penang, Malaysia. Prevalence of hypertension was 36%, with 81% of patients being initially aware of this diagnosis. This relatively low hypertension prevalence rate may be because residents have a fairly sheltered lifestyle with less social stress and a daily routine that incorporates adequate exercise. Similarly, the high hypertension awareness rate compared to reported figures in the community may be because residents are more regularly monitored by the attending medical care-givers. At the beginning of the study, only 34% of hypertensive patients were well controlled with a blood pressure less than 140/90 mm Hg. This proportion rose to 53% at the end of study period. Compliance is better at a residential home because medication is served by their care-givers and cost is absorbed in this charitable organization. Our study suggests that hypertension awareness and control can be reasonable for the elderly in a residential home.
Investigation of class characteristics in English handwriting of the three main racial groups: Chinese, Malay and Indian in Singapore

Cheng N, Lee GK, Yap BS, Lee LT, Tan SK, Tan KP

J Forensic Sci, 2005 Jan;50(1):177-84.
PMID: 15831016

This paper investigated the class characteristics in English handwriting of the Chinese, Malays and Indians in Singapore, many of whom learned their native language as a second language. One hundred and fifty-four handwriting exemplars were collected and features such as letter designs, pen-lifts, letter spacing and embellishments were studied. A number of characteristic features peculiar to the individual racial group were identified, which confirmed the impact of their native language writing systems on English handwriting.
Fulltext Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia

Tan KP, Ang JK, Koh EBY, Pang NTP, Mat Saher Z

Int J Environ Res Public Health, 2023 Feb 27;20(5).
PMID: 36901243 DOI: 10.3390/ijerph20054232

Caregivers of People with dementia (PwD) commonly experience burdens and other mental health issues, e.g., depression and anxiety. At present, there are limited studies that examine the relationships between caregiver psychological factors and caregiver burden, and depressive and anxiety symptoms. Therefore, this study's objectives were to examine the relationships between psychological flexibility and mindfulness in caregivers of PwD, and to determine the predictors of these three outcomes. This was a cross-sectional study conducted in the geriatric psychiatry clinic of Kuala Lumpur Hospital, Malaysia, and the sample (n = 82) was recruited via a universal sampling method over three months. The participants completed a questionnaire that consisted of the sociodemographics of the PwD and caregivers, illness characteristics of the PwD, Acceptance and Action Questionnaire-II (AAQ-II), Mindful Attention Awareness Scale (MAAS), Zarit Burden Interview Scale (ZBI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The results show that despite significant relationships between psychological flexibility and mindfulness and lower levels of caregiver burden, and depressive and anxiety symptoms (p < 0.01), only psychological inflexibility (p < 0.01) remained as a significant predictor of the three outcomes. Therefore, in conclusion, intervention programs that target the awareness of the caregiver's psychological inflexibility should be implemented to alleviate these adverse outcomes in dementia caregivers.
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.