Displaying publications 1 - 20 of 31 in total

Abstract:
Sort:
  1. Lee JY, Wong CP, Lee SWH
    Mhealth, 2020;6:6.
    PMID: 32190617 DOI: 10.21037/mhealth.2019.09.16
    Background: Information and communication technology can be a useful tool to improve population health especially in low-middle income countries. However, the full potential of m-health may be limited by the users' health and technology literacy. This study aims to explore the m-health and technology literacy among Malaysians, and factors that may promote the use of m-health.

    Methods: A cross-sectional study was performed among residents residing around Klang and Petaling district in Selangor, Malaysia from November 2015 to January 2017. Multivariable logistic regression models were used to assess the predictors of mobile device and health apps usage and examine the association between apps use and intention to change behavior with sociodemographic predictors.

    Results: A total of 4,504 respondents participated in our survey. Most respondents reported that they owned a mobile or smartphone, which was commonly used to make calls and deliver text messages. However, only one-fifth (20.4%) of respondents were familiar with the term m-health or had used a health related application, with millennial (individuals aged ≤39 years) generally more aware of the term m-health and were more likely to use m-health as a tool for health management. The most commonly used application were for promoting adherence as well as self-efficacy (e.g., lifestyle advice). Other factors associated with higher levels of m-health use were individuals with higher level of education and individuals taking multiple medications.

    Conclusions: While most Malaysian were not familiar with m-health, they reported to have a positive attitude towards m-health. Malaysians were willing to use m-health to manage their health conditions but expressed that they required further education and training. As m-health is still at its infancy in Malaysia, there is potential to further develop m-health as an innovative solution to manage the population health.

  2. Orimaye SO, Wong JS, Wong CP
    PLoS One, 2018;13(11):e0205636.
    PMID: 30403676 DOI: 10.1371/journal.pone.0205636
    It has been quite a challenge to diagnose Mild Cognitive Impairment due to Alzheimer's disease (MCI) and Alzheimer-type dementia (AD-type dementia) using the currently available clinical diagnostic criteria and neuropsychological examinations. As such we propose an automated diagnostic technique using a variant of deep neural networks language models (DNNLM) on the verbal utterances of affected individuals. Motivated by the success of DNNLM on natural language tasks, we propose a combination of deep neural network and deep language models (D2NNLM) for classifying the disease. Results on the DementiaBank language transcript clinical dataset show that D2NNLM sufficiently learned several linguistic biomarkers in the form of higher order n-grams to distinguish the affected group from the healthy group with reasonable accuracy on very sparse clinical datasets.
  3. Tam CL, Bonn G, Yeoh SH, Wong CP
    Front Psychol, 2014;5:1328.
    PMID: 25520676 DOI: 10.3389/fpsyg.2014.01328
    The National Health and Morbidity Survey (NHMS, 2011), estimates that the number of Malaysian adults suffering from type 2 diabetes has increased from 8.3 to 31.2% since 1996. This study is a preliminary investigation of possible factors contributing to this epidemic. Knowledge of diabetes, health locus of control, diet and exercise habits, as well as family history, education level and other demographic factors to better understand the correlates of risky and healthy behaviors. This was done as part of a larger initiative to improve prevention efforts. Questionnaires were completed by 770 individuals from three Malaysian states: Selangor, Penang, and Terengganu. Findings showed that people with better health knowledge and those who have a family history of type 2 diabetes were more likely to have healthy diets. Also, health knowledge related to lower alcohol consumption. Participants with diabetic family members, however, also reported higher levels of stress. Counterintuitively, higher educational levels, higher internal locus of control, better health knowledge, as well as a family history of diabetes all correlated with lower levels of physical activity. Thus, it is suggested that, while increasing health knowledge will be important in addressing the type 2 diabetes epidemic in Malaysia, especially in relation to diet, other cultural factors, specifically norms related to exercise and physical activity, also need to be addressed if the spread of type 2 diabetes is to be addressed over the long term.
  4. Lee SW, Lee JY, Tan CS, Wong CP
    Medicine (Baltimore), 2016 Jan;95(2):e2457.
    PMID: 26765440 DOI: 10.1097/MD.0000000000002457
    Ramadan is the holy month for Muslims whereby they fast from predawn to after sunset and is observed by all healthy Muslim adults as well as a large population of type 2 diabetic Muslims.To determine the comparative effectiveness of various strategies that have been used for type 2 diabetic Muslim who fast during Ramadan.A systematic review and network meta-analysis of randomized controlled studies (RCT) as well as observational studies for patients with type 2 diabetes who fasted during Ramadan was conducted. Eight databases were searched from January 1980 through October 2015 for relevant studies. Two reviewers independently screened and assessed study for eligibility, assessed the risk of bias, and extracted relevant data. A network meta-analysis for each outcome was fitted separately, combining direct and indirect evidence for each comparison.Twenty-nine studies, 16 RCTs and 13 observational studies each met the inclusion criteria. The most common strategy used was drug changes during the Ramadan period, which found that the use of DPP-4 (Dipeptidyl peptidase inhibitor -4) inhibitors were associated with a reduction in incidence of experiencing hypoglycemia during Ramadan in both RCTs (pooled relative risk: 0.56; 95% confidence interval: 0.44-0.72) as well as in observational studies (pooled relative risk: 0.27; 0.09-0.75). Ramadan-focused education was shown to be beneficial in reducing hypoglycemia in observational studies but not RCTs (0.25 versus 1.00). Network meta-analyses suggest that incretin mimetics can reduce the risk of hypoglycemia by nearly 1.5 times.The newer antidiabetic agents appear to lower the risk of hypoglycemia and improved glycemic control when compared with sulfonylureas. Ramadan-focused education shows to be a promising strategy but more rigorous examination from RCTs are required.
  5. Yeoh SH, Tam CL, Wong CP, Bonn G
    Front Psychol, 2017;8:1411.
    PMID: 28878710 DOI: 10.3389/fpsyg.2017.01411
    The 2015 National Health and Morbidity Survey estimated that over 29% of the adult population of Malaysia suffers from mental distress, a nearly 3-fold increase from the 10.7% estimated by the NHMS in 1996 pointing to the potential beginnings of a public health crisis. This study aimed to better understand this trend by assessing depressive symptoms and their correlates in a cross-section of Malaysians. Specifically, it assesses stress, perceived locus of control, and various socio-demographic variables as possible predictors of depressive symptoms in the Malaysian context. A total of 728 adults from three Malaysian states (Selangor, Penang, Terengganu) completed Beck's depression inventory as well as several other measures: 10% of respondents reported experiencing severe levels of depressive symptoms, 11% reported moderate and 15% reported mild depressive symptoms indicating that Malaysians are experiencing high levels of emotional distress. When controlling for the influence of other variables, depressive symptoms were predictably related to higher levels of stress and lower levels of internal locus of control. Ethnic Chinese Malaysians, housewives and those engaged in professional-type occupations reported less depressive symptoms. Business owners reported more depressive symptoms. Further research should look more into Malaysians' subjective experience of stress and depression as well as explore environmental factors that may be contributing to mental health issues. It is argued that future policies can be designed to better balance individual mental health needs with economic growth.
  6. Wong KP, Bonn G, Tam CL, Wong CP
    Front Psychol, 2018;9:64.
    PMID: 29445352 DOI: 10.3389/fpsyg.2018.00064
    Increasingly, online counseling is considered to be a cost-effective and highly accessible method of providing basic counseling and mental health services. To examine the potential of online delivery as a way of increasing overall usage of services, this study looked at students' attitudes toward and likelihood of using both online and/or face-to-face counseling. A survey was conducted with 409 students from six universities in Malaysia participating. Approximately 35% of participants reported that they would be likely to utilize online counseling services but would be unlikely to participate in face-to-face counseling. Based on these results, it is suggested that offering online counseling, in addition to face-to-face services, could be an effective way for many university counseling centers to increase the utilization of their services and thus better serve their communities.
  7. Tay EL, Lee SWH, Jamaluddin SF, Tam CL, Wong CP
    BMC Pediatr, 2016 04 27;16:56.
    PMID: 27122016 DOI: 10.1186/s12887-016-0590-1
    BACKGROUND: There are limited studies describing the epidemiology of childhood brain injury, especially in developing countries. This study analyses data from the Malaysian National Trauma Database (NTrD) registry to estimate the incidence of childhood brain injury among various demographic groups within the state of Selangor and Federal Territory of Kuala Lumpur.

    METHODS: This study analysed all traumatic brain injury cases for children ages 0-19 included in the 2010 NTrD report.

    RESULTS: A total of 5,836 paediatric patients were admitted to emergency departments (ED) of reporting hospitals for trauma. Of these, 742 patients (12.7 %) suffered from brain injuries. Among those with brain injuries, the mortality rate was 11.9 and 71.2 % were aged between 15 and 19. Traffic accidents were the most common mode of injury (95.4 %). Out of the total for traffic accidents, 80.2 % of brain injuries were incurred in motorcycle accidents. Severity of injury was higher among males and patients who were transferred or referred to the reporting centres from other clinics. Glasgow Coma Scale (GCS) total score and type of admission were found to be statistically significant, χ (2) (5, N = 178) = 66.53, p 

  8. Chie QT, Tam CL, Bonn G, Wong CP, Dang HM, Khairuddin R
    Front Psychiatry, 2015;6:65.
    PMID: 25999867 DOI: 10.3389/fpsyt.2015.00065
    In recent years, there have been increasing accounts of illegal substance abuse among university students and professional groups in Malaysia. This study looks at university students' perceptions about this phenomenon. Students from Malaysian universities were asked for their impressions about drug availability and abuse, as well as factors contributing to drug abuse and relapse. The questionnaire also inquired into their knowledge and views regarding government versus private rehabilitation centers, as well as their exposure to, and views about, school-based drug-prevention education. Participants were 460 university students from five Malaysian states: Penang, Selangor, Kuala Lumpur, Sabah, and Sarawak. Results showed gender differences in perceptions of relapse prevention strategies, as well as factors leading to drug abuse and relapse. Students also believed that drug education would be more effective if initiated between the ages of 11 and 12 years, which is slightly older than the common age of first exposure, and provided suggestions for improving existing programs. Implications of student perceptions for the improvement of current interventions and educational programs are discussed.
  9. Lee JY, Lee SW, Nasir NH, How S, Tan CS, Wong CP
    Diabet Med, 2015 Dec;32(12):1658-61.
    PMID: 26103794 DOI: 10.1111/dme.12836
    AIM: This pilot study evaluated the short-term benefits of a telemonitoring-supplemented focused diabetic education compared with education alone in participants with Type 2 diabetes who were fasting during Ramadan.
    METHODS: In this pilot mixed-method study, we identified 37 participants and randomly allocated them to either a telemonitoring group (n = 18) or a group receiving Ramadan-focused pre-education only (usual care; n = 19). The telemonitoring group received goal-setting and personalized feedback.
    RESULTS: The telemonitoring group was less likely to experience hypoglycaemia than the usual care group (odds ratio: 0.1273; 95% confidence interval: 0.0267-0.6059). No significant differences were noted in glycaemic control at the end of study. Participants viewed telemedicine as a more convenient alternative although technological barriers remain a concern.
    CONCLUSIONS: The results of this study reinforce the need for monitoring as well as educational initiatives for Muslims with diabetes who fast during Ramadan. Telemonitoring offers an attractive option requiring further research. (Clinical Trial Registry No. NCT02189135).
  10. Nugroho AE, Inoue D, Wong CP, Hirasawa Y, Kaneda T, Shirota O, et al.
    J Nat Med, 2018 Mar;72(2):588-592.
    PMID: 29453649 DOI: 10.1007/s11418-018-1188-8
    Bioactivity guided separation of Reinwardtiodendron cinereum barks methanol extract led to the isolation of two new onocerane triterpenoids, reinereins A and B (1 and 2), together with three known onocerane triterpenoids. Their structures were elucidated on the basis of NMR spectroscopic data. In vitro cytotoxic activities of the isolated compounds against several type of cancer cells were evaluated.
  11. Nugroho AE, Hashimoto A, Wong CP, Yokoe H, Tsubuki M, Kaneda T, et al.
    J Nat Med, 2019 Jun;73(3):682.
    PMID: 30945063 DOI: 10.1007/s11418-019-01301-y
    The article Ceramicines M-P from Chisocheton ceramicus: isolation and structure-activity relationship study.
  12. Lee JY, Wong CP, Tan CSS, Nasir NH, Lee SWH
    BMJ Open Diabetes Res Care, 2017;5(1):e000365.
    PMID: 28761651 DOI: 10.1136/bmjdrc-2016-000365
    OBJECTIVE: We evaluated the beliefs, experience and diabetes management strategies of type 2 diabetes mellitus (T2DM) Muslim patients that chose to fast during Ramadan.
    RESEARCH DESIGN AND METHODS: A semistructured focus group interview was conducted with 53 participants with T2DM. Participants were purposefully sampled and asked to share their perspective on Ramadan fasting. All interviews were audio recorded, transcribed verbatim and analyzed thematically.
    RESULTS: Participants reported optimism towards fasting during Ramadan, as they believed that fasting was beneficial to their overall well-being, and a time for family bonding. Most participants made limited attempts to discuss with their doctors on the decision to fast and self-adjusted their medication based on experience and symptoms during this period. They also reported difficulty in managing their diet, due to fear of hypoglycemia and the collective social aspect of fasting.
    CONCLUSION: Muslims are optimistic about their well-being when fasting during Ramadan. Many choose to fulfill their religious obligation despite being discouraged by their doctors. Collaboration with religious authorities should be explored to ensure patients receive adequate education before fasting during Ramadan.
    TRIAL REGISTRATION NUMBER: NCT02189135; Results.
  13. Nugroho AE, Zhang W, Hirasawa Y, Tang Y, Wong CP, Kaneda T, et al.
    J Nat Prod, 2018 11 26;81(11):2600-2604.
    PMID: 30362746 DOI: 10.1021/acs.jnatprod.8b00749
    Three new bisindole alkaloids, bisleuconothines B-D (1-3), were isolated from the bark of Leuconotis griffithii. Their structures were elucidated by 1D and 2D NMR spectroscopy and DFT calculations. Bisleuconothine B (1) is the first monoterpene indole alkaloid dimer featuring bridges between both C-16-C-10' and C-2-O-C-9'. All compounds were deemed noncytotoxic (IC50 > 10 μM) when tested against A549 human lung adenocarcinoma cells.
  14. Yap YY, Wong CP, Lee KS, Ming LC, Khan TM
    Ther Innov Regul Sci, 2017 Jul;51(4):446-459.
    PMID: 30227055 DOI: 10.1177/2168479017697253
    This article aims to discuss the main consequences of the implementation of the Trans-Pacific Partnership Agreement (TTPA) in the pharmaceutical sector in regard to public health, focusing on the accessibility and affordability of medicines. This paper also looks at the likely impact of the TPP agreement on access to affordable medicines. The potential effects of provisions in the final text are explored based on the context of developed and developing countries. A meta-synthesis study design was used. The thematic analysis technique was used to generate themes and a decision tree of the TTPA meta-synthesis. PubMed, EBSCOhost, Ovid, and Scopus databases from inception until the first week of January 2016 were used. Only peer-reviewed journals that discussed TPPA's impact on the pharmaceutical sector were included. Data were extracted by 2 reviewers and then verified by 3 senior researchers. The extracted data were imported into Excel spreadsheets and coded line by line. Codes were organized into descriptive themes. The identified themes were cross-checked against original articles to ensure consistency. A total of 85 full articles and reports were reviewed and, finally, 32 of them were used in the meta-synthesis. Two central themes to the TTPA emerged: intellectual property rights and transparency. Five subthemes were identified under intellectual property rights: patent subject matter (representing scope of patentability), patent term adjustment for patent office delays (representing patent term extension), protection of undisclosed test or other data (representing data exclusivity), protection of undisclosed test or other data (representing patent linkage), and compulsory licensing. Meanwhile, transparency and anti-corruption-procedural fairness, which presents restriction of coverage program and reimbursement, were identified as the subthemes of transparency. Findings indicate that the TPPA could potentially hinder the affordability and accessibility of medicine, which could increase risks to public health.
  15. Nugroho AE, Hashimoto A, Wong CP, Yokoe H, Tsubuki M, Kaneda T, et al.
    J Nat Med, 2018 Jan;72(1):64-72.
    PMID: 28822030 DOI: 10.1007/s11418-017-1109-2
    Ceramicines are a series of limonoids which were isolated from the bark of Malaysian Chisocheton ceramicus (Meliaceae) and show various biological activities. Ceramicine B, in particular, has been reported to show a strong lipid droplet accumulation (LDA) inhibitory activity on a mouse pre-adipocyte cell line (MC3T3-G2/PA6). With the purpose of discovering compounds with stronger activity than ceramicine B, we further investigated the constituents of C. ceramicus. As a result, from the bark of C. ceramicus four new ceramicines (ceramicines M-P, 1-4) were isolated, and their structures were determined on the basis of NMR and mass spectroscopic analyses in combination with NMR chemical shift calculations. LDA inhibitory activity of 1-4 was evaluated. Compounds 1-3 showed LDA inhibitory activity, and 3 showed better selectivity than ceramicine B while showing activity at the same order of magnitude as ceramicine B. Since 3, which possess a carbonyl group at C-7, showed better selectivity than 5, which possess a 7α-OH group, while showing activity at the same order of magnitude as 5, we also investigated the effect of the substituent at C-7 by synthesizing several derivatives and evaluating their LDA inhibitory activity. Accordingly, we confirmed the importance of the presence of a 7α-OH group to the LDA inhibitory activity.
  16. Lee JY, Wong CP, Tan CSS, Nasir NH, Lee SWH
    Sci Rep, 2017 08 31;7(1):10119.
    PMID: 28860546 DOI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55790
    We determined the impact of a remote blood glucose telemonitoring program with feedback in type 2 diabetes mellitus patients fasting during Ramadan compared to conventional self-monitoring method. A twelve-week cluster randomised study, with 85 participants who wish to fast for at least 15 days during Ramadan was conducted. Self-measurement and transmission of blood glucose results were performed six times daily during Ramadan. Results were transmitted to a secure website for review with feedback from case manager if necessary. The control group received usual care. The main outcome was the number of participants experiencing hypoglycaemia during Ramadan and at the end of the study. During Ramadan, the number of participants reporting hypoglycaemia was significantly lower in the telemonitoring group [Odds ratio (OR): 0.186, 95% confidence interval: 0.04-0.936; p = 0.04]. Similarly, the proportion of participants reporting symptomatic hypoglycaemia at the end of the study was significantly lower in the telemonitoring group (OR: 0.257, 95% CI: 0.07-0.89; p = 0.03). A reduction of 1.07% in glycated haemoglobin levels was observed in the telemonitoring group compared to 0.24% in the control group (p 
  17. Nugroho AE, Wong CP, Hirasawa Y, Kaneda T, Tougan T, Horii T, et al.
    J Nat Med, 2023 Jun;77(3):596-603.
    PMID: 37162697 DOI: 10.1007/s11418-023-01706-w
    Ceramicines are a series of limonoids that were isolated from the bark of Malaysian Chisocheton ceramicus (Meliaceae) and were known to show various biological activity. Four new limonoids, ceramicines Q-T (1-4) were isolated from the barks of C. ceramicus, and their structures were determined on the basis of the 1D and 2D NMR analyses in combination with calculated 13C chemical shift data. Ceramicines Q-T (1-4) were established to be new limonoids with a cyclopentanone[α]phenanthren ring system with a β-furyl ring at C-17, and without a tetrahydrofuran ring like ceramicine B, which is characteristic of known ceramicines. Ceramicine R (2) exhibited potent antimalarial activity against Plasmodium falciparum 3D7 strain with IC50 value of 2.8 µM.
  18. Santhanes D, Wong CP, Yap YY, San SP, Chaiyakunapruk N, Khan TM
    Hum Vaccin Immunother, 2018 Jan 02;14(1):124-133.
    PMID: 28933635 DOI: 10.1080/21645515.2017.1381811
    A scoping review was performed to identify factors that may lead to human papillomavirus (HPV) vaccine hesitancy among women in low- and middle-income countries in South East Asian Region (SEAR) and Western Pacific Region (WPR). A systematic search of English and non-English articles using Pubmed, EMBASE, PsycINFO, Cochrane, MEDLINE, and CINAHL plus was conducted. Only 63 studies conducted in SEAR and WPR were included from inception until December 2016. Results of these studies have shown that poor awareness and knowledge of practices on cervical cancer prevention was evident in both SEAR and WPR. Concerns on safety and efficacy of the vaccine, and costs in getting vaccinated were significant barriers. Most women stated that they needed more information, and strongly welcomed a physician's recommendation in both geographical regions. Women also felt they have a low risk of acquiring HPV infection and cervical cancer. Most women in SEAR and WPR were unable to decide on whether to accept HPV vaccination.
  19. Orimaye SO, Wong JS, Golden KJ, Wong CP, Soyiri IN
    BMC Bioinformatics, 2017 Jan 14;18(1):34.
    PMID: 28088191 DOI: 10.1186/s12859-016-1456-0
    BACKGROUND: The manual diagnosis of neurodegenerative disorders such as Alzheimer's disease (AD) and related Dementias has been a challenge. Currently, these disorders are diagnosed using specific clinical diagnostic criteria and neuropsychological examinations. The use of several Machine Learning algorithms to build automated diagnostic models using low-level linguistic features resulting from verbal utterances could aid diagnosis of patients with probable AD from a large population. For this purpose, we developed different Machine Learning models on the DementiaBank language transcript clinical dataset, consisting of 99 patients with probable AD and 99 healthy controls.

    RESULTS: Our models learned several syntactic, lexical, and n-gram linguistic biomarkers to distinguish the probable AD group from the healthy group. In contrast to the healthy group, we found that the probable AD patients had significantly less usage of syntactic components and significantly higher usage of lexical components in their language. Also, we observed a significant difference in the use of n-grams as the healthy group were able to identify and make sense of more objects in their n-grams than the probable AD group. As such, our best diagnostic model significantly distinguished the probable AD group from the healthy elderly group with a better Area Under the Receiving Operating Characteristics Curve (AUC) using the Support Vector Machines (SVM).

    CONCLUSIONS: Experimental and statistical evaluations suggest that using ML algorithms for learning linguistic biomarkers from the verbal utterances of elderly individuals could help the clinical diagnosis of probable AD. We emphasise that the best ML model for predicting the disease group combines significant syntactic, lexical and top n-gram features. However, there is a need to train the diagnostic models on larger datasets, which could lead to a better AUC and clinical diagnosis of probable AD.

  20. Chia PL, Earnest A, Lee R, Lim J, Wong CP, Chia YW, et al.
    Ann Acad Med Singap, 2013 Sep;42(9):432-6.
    PMID: 24162317
    INTRODUCTION: In Singapore, the age-standardised event rates of myocardial infarction (MI) are 2- and 3-fold higher for Malays and Indians respectively compared to the Chinese. The objectives of this study were to determine the prevalence and quantity of coronary artery calcification (CAC) and non-calcified plaques across these 3 ethnic groups.

    MATERIALS AND METHODS: This was a retrospective descriptive study. We identified 1041 patients (810 Chinese, 139 Malays, 92 Indians) without previous history of cardiovascular disease who underwent cardiac computed tomography for atypical chest pain evaluation. A cardiologist, who was blinded to the patients' clinical demographics, reviewed all scans. We retrospectively analysed all their case records.

    RESULTS: Overall, Malays were most likely to be active smokers (P = 0.02), Indians had the highest prevalence of diabetes mellitus (P = 0.01) and Chinese had the highest mean age (P <0.0001). The overall prevalence of patients with non-calcified plaques as the only manifestation of sub-clinical coronary artery disease was 2.1%. There was no significant difference in the prevalence of CAC, mean CAC score or prevalence of non-calcified plaques among the 3 ethnic groups. Active smoking, age and hypertension were independent predictors of CAC. Non-calcified plaques were positively associated with male gender, age, dyslipidaemia and diabetes mellitus.

    CONCLUSION: The higher MI rates in Malays and Indians in Singapore cannot be explained by any difference in CAC or non-calcified plaque. More research with prospective follow-up of larger patient populations is necessary to establish if ethnic-specific calibration of CAC measures is needed to adjust for differences among ethnic groups.

Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links