Displaying publications 1 - 20 of 72 in total

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  1. Urban blue: A global analysis of the factors shaping people's perceptions of the marine environment and ecological engineering in harbours
    Strain EMA, Alexander KA, Kienker S, Morris R, Jarvis R, Coleman R, et al.
    Sci Total Environ, 2019 Mar 25;658:1293-1305.
    PMID: 30677991 DOI: 10.1016/j.scitotenv.2018.12.285
    Marine harbours are the focus of a diverse range of activities and subject to multiple anthropogenically induced pressures. Support for environmental management options aimed at improving degraded harbours depends on understanding the factors which influence people's perceptions of harbour environments. We used an online survey, across 12 harbours, to assess sources of variation people's perceptions of harbour health and ecological engineering. We tested the hypotheses: 1) people living near impacted harbours would consider their environment to be more unhealthy and degraded, be more concerned about the environment and supportive of and willing to pay for ecological engineering relative to those living by less impacted harbours, and 2) people with greater connectedness to the harbour would be more concerned about and have greater perceived knowledge of the environment, and be more supportive of, knowledgeable about and willing to pay for ecological engineering, than those with less connectedness. Across twelve locations, the levels of degradation and modification by artificial structures were lower and the concern and knowledge about the environment and ecological engineering were greater in the six Australasian and American than the six European and Asian harbours surveyed. We found that people's perception of harbours as healthy or degraded, but not their concern for the environment, reflected the degree to which harbours were impacted. There was a positive relationship between the percentage of shoreline modified and the extent of support for and people's willingness to pay indirect costs for ecological engineering. At the individual level, measures of connectedness to the harbour environment were good predictors of concern for and perceived knowledge about the environment but not support for and perceived knowledge about ecological engineering. To make informed decisions, it is important that people are empowered with sufficient knowledge of the environmental issues facing their harbour and ecological engineering options.
  2. Fulltext Tuberculosis in adults
    Abdul Rahaman JA, Ker HB, Yusof M, Hanafi NS, Wong JL
    Malays Fam Physician, 2014;9(3):34-7.
    PMID: 26425303 MyJurnal
    Tuberculosis (TB) in Malaysia is rising due to multiple factors and issues related to its management are addressed in the updated evidence-based clinical practice guidelines. Screening for active TB should be considered in high risk groups. Light emitting diode-based fluorescence microscopy and nucleic acid amplification tests are recommended investigations. Health education and standardised 6-month daily antituberculosis (antiTB) regimen are among important elements for successful treatment. Latent TB infection screening should only be performed on high risk individuals. AntiTB regimen offered to HIV-positive adults should be the same as for HIV-negative adults and timing to initiate highly active antiretroviral therapy in patients with TB is based on CD4 count. All patients on antiTB treatment should be monitored to assess their response to treatment and to identify problems associated with it.
  3. Therapeutic equivalence of a low dose artemisinin formulation in falciparum malaria patients
    Wong JW, Yuen KH, Nagappan S, Shahul WS, Ho SS, Gan EK, et al.
    J Pharm Pharmacol, 2003 Feb;55(2):193-8.
    PMID: 12631411
    We have evaluated the therapeutic equivalence of a beta-cyclodextrin-artemisinin complex at an artemisinin dose of 150 mg, with a commercial reference preparation, Artemisinin 250 at a recommended dose of 250 mg. One hundred uncomplicated falciparum malarial patients were randomly assigned to orally receive either beta-cyclodextrin-artemisinin complex (containing 150 mg artemisinin) twice daily for five days or the active comparator (containing 250 mg artemisinin) twice daily for five days. The patients were hospitalized for seven days and were required to attend follow up assessments on days 14, 21, 28 and 35. All patients in both treatment groups were cured of the infection and achieved therapeutic success. At day seven of treatment, all patient blood was clear of the parasites and the sublingual temperature of all patients was less than 37.5 degrees C. Moreover, the parasite clearance time in both treatment groups was similar, being approximately three days after initiation of treatment. Comparable plasma artemisinin concentrations were observed between patients in both treatment groups at 1.5 and 3.0 h, although slightly higher levels were obtained with patients in the beta-cyclodextrin-artemisinin complex-treated group. The beta-cyclodextrin-artemisinin complex at a dose of 150 mg artemisinin was therapeutically equivalent to 250 mg Artemisinin 250. Additionally, patients receiving beta-cyclodextrin-artemisinin complex showed less variability in their plasma artemisinin concentrations at 1.5 h post-dosing, which suggested a more consistent rate of drug absorption.
  4. Fulltext The use of radiochromic EBT2 film for the quality assurance and dosimetric verification of 3D conformal radiotherapy using Microtek ScanMaker 9800XL flatbed scanner
    Sim GS, Wong JH, Ng KH
    J Appl Clin Med Phys, 2013 Jul 08;14(4):4182.
    PMID: 23835383 DOI: 10.1120/jacmp.v14i4.4182
    Radiochromic and radiographic films are widely used for radiation dosimetry due to the advantage of high spatial resolution and two-dimensional dose measurement. Different types of scanners, including various models of flatbed scanners, have been used as part of the dosimetry readout procedure. This paper focuses on the characterization of the EBT2 film response in combination with a Microtek ScanMaker 9800XL scanner and the subsequent use in the dosimetric verification of a 3D conformal radiotherapy treatment. The film reproducibility and scanner uniformity of the Microtek ScanMaker 9800XL was studied. A three-field 3D conformal radiotherapy treatment was planned on an anthropomorphic phantom and EBT2 film measurements were carried out to verify the treatment. The interfilm reproducibility was found to be 0.25%. Over a period of three months, the films darkened by 1%. The scanner reproducibility was ± 2% and a nonuniformity was ±1.9% along the direction perpendicular to the scan direction. EBT2 measurements showed an underdose of 6.2% at high-dose region compared to TPS predicted dose. This may be due to the inability of the treatment planning system to predict the correct dose distribution in the presence of tissue inhomogeneities and the uncertainty of the scanner reproducibility and uniformity. The use of EBT2 film in conjunction with the axial CT image of the anthropomorphic phantom allows the evaluation of the anatomical location of dose discrepancies between the EBT2 measured dose distribution and TPS predicted dose distribution.
  5. The state of lipid control in patients with diabetes in a public health care centre
    Wong JS, Tan F, Lee PY
    Asia Pac J Public Health, 2007;19(3):16-21.
    PMID: 18330400 DOI: 10.1177/101053950701900304
    Achieving treatment targets has been difficult in treating diabetic patients. This cross-sectional study describes the lipid profiles of patients with diabetes mellitus at a public primary health care centre in Sarawak, Malaysia. The targets for lipid control were based on the International Diabetes Federation recommendation (2002). 1031 patients (98% Type 2 Diabetes) were studied. Fasting lipid profiles were available in 990 (96%) patients. The mean total cholesterol was 5.3 +/- 1.0 mmol/L, Triglycerides 1.90 +/- 1.26 mmol/L, HDL-C 1.28 +/- 0.33 mmol/L and LDL-C 3.2 +/- 0.9 mmol/L. Overall, 22% of patients achieved the treatment target for LDL-C level < 2.6mmol/L. 67% of patients had HDL-C > 1.1 mmol/L and 42% of patients had a target TG level below 1.5 mmol/L. Of the 40% of patients who received lipid-lowering drug, 17% achieved LDL-C target, 50% had LDL-C 2.6-4.4 mmol/ L and 33% have LDL-C > 4.0 mmol/L. For the remaining 60% not receiving any lipid lowering therapy, 68% had LDL-C between 2.6-4.0 mmol/L and 7% had LDL-C level > 4 mmol/L. Dyslipidemia is still under-treated despite the availability of effective pharmacological agents and the greatly increased risk of cardiovascular diseases in diabetic patients.
  6. Fulltext The role of CT in case ascertainment and management of COVID-19 pneumonia in the UK: insights from high-incidence regions
    Chua F, Armstrong-James D, Desai SR, Barnett J, Kouranos V, Kon OM, et al.
    Lancet Respir Med, 2020 May;8(5):438-440.
    PMID: 32220663 DOI: 10.1016/S2213-2600(20)30132-6
  7. The pattern and clinical manifestations of rheumatoid arthritis in Sarawak General Hospital
    Teh CL, Wong JS
    Clin Rheumatol, 2008 Nov;27(11):1437-40.
    PMID: 18773254 DOI: 10.1007/s10067-008-0945-6
    The aim of our study is to describe the pattern, clinical features, treatment regimes, and disease activity among the patients treated for rheumatoid arthritis (RA) in the Sarawak General Hospital. We performed a cross-sectional study of all patients with a diagnosis of RA who received treatment at the General Medical Clinic and the Rheumatology Clinic in Sarawak General Hospital over a 1-year period from 1st June 2006 to 31st May 2007. Demographic data, clinical features, and disease activity of all 154 patients were collected for statistical analysis. Rheumatoid arthritis afflicts all the major racial groups in Sarawak including the native population. Our patients have a mean disease duration of 5.4 years (SD 5.69) and a mean duration of delay in diagnosis RA and initiation of disease-modifying antirheumatic drug (DMARD) treatment of 42.9 months (SD 60.1). They have a low rate of interstitial lung disease (6.5%) and rheumatoid nodules (4.5%). Rheumatoid factor was positive in 65.5% of our patients. They have a mean Disease Activity Score (DAS) 28 score of 4.28 (SD 1.33). Only 12.5% of our patients are in remission with DAS 28 < 2.6 and 30.9% of our patients are having high disease activity with DAS 28 > 5.1. Despite the high usage of DMARDs in Sarawak (>80%), our patients have severe disease with high disease activity indices. This is most likely due to delay in diagnosis and initiating DMARDs in RA patients in Sarawak.

    Study site: General Medical Clinic and the Rheumatology Clinic in Sarawak General Hospital
  8. The effects of Euphorbia hirta on the ultrastructure of the murine liver, kidney and aorta
    Wong JY, Chen YS, Chakravarthi S, Judson JP, L SR, Er HM
    Exp Ther Med, 2013 Nov;6(5):1247-1250.
    PMID: 24223653
    Euphorbia hirta is widely used in traditional remedies and has been used cross-culturally for generations against maladies such as asthma, skin ailments and hypertension. Previous studies have demonstrated that Euphorbia hirta has antibacterial activity, and have also indicated certain antimolluscidal, antimalarial and anti-inflammatory properties, the latter of which have been suggested to be more pronounced than those of the rheumatological drug, etanercept. To date, no studies have identified the anatomical effects of this herb on the organs of test animals. This study aimed to identify the effects of Euphorbia hirta on the ultrastructure of the murine liver, kidney and aorta. A total of 32 adult male Sprague-Dawley rats were divided into four groups; three groups were fed with aqueous extracts of Euphorbia hirta at doses of 1, 10 and 50 mg/kg, respectively, every alternate day for 50 days, while one group served as a control. The animals were later sacrificed and the liver, kidney and aorta harvested for examination by electron microscopy. The aorta showed no ultrastructural changes across the groups. Renal and hepatic tissue from the treated groups demonstrated dose-dependent injuries, which showed architectural damage beginning in the nuclei and spreading outwards. Taking into consideration the properties of Euphorbia hirta that have been described in previous studies, in addition to the results from the present study, it appears that the herb may exhibit similar effects to those of the quinolone group of antibiotics. Further in-depth investigations are required into the potential effects of Euphorbia hirta, deleterious and otherwise.
  9. Fulltext The South East Asian Federation of Organizations for Medical Physics (SEAFOMP): Its history and role in the ASEAN countries
    Ng Kh, Wong J
    Biomed Imaging Interv J, 2008 Apr;4(2):e21.
    PMID: 21614324 DOI: 10.2349/biij.4.2.21
    Informal discussion started in 1996 and the South East Asian Federation of Organizations for Medical Physics (SEAFOMP) was officially accepted as a regional chapter of the IOMP at the Chicago World Congress in 2000 with five member countries, namely Indonesia, Malaysia, Philippines, Singapore and Thailand. Professor Kwan-Hoong Ng served as the founding president until 2006. Brunei (2002) and Vietnam (2005) joined subsequently. We are very grateful to the founding members of SEAFOMP: Anchali Krisanachinda, Kwan-Hoong Ng, Agnette Peralta, Ratana Pirabul, Djarwani S Soejoko and Toh-Jui Wong.The objectives of SEAFOMP are to promote (i) co-operation and communication between medical physics organizations in the region; (ii) medical physics and related activities in the region; (iii) the advancement in status and standard of practice of the medical physics profession; (iv) to organize and/or sponsor international and regional conferences, meetings or courses; (v) to collaborate or affiliate with other scientific organizations.SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) series was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004) and Jakarta (2006). The respective congress themes indicated the emphasis and status of development. The number of participants (countries in parentheses) was encouraging: 110 (17), 150 (16), 220 (23) and 126 (7).In honour of the late Professor John Cameron, an eponymous lecture was established. The inaugural John Cameron Lecture was delivered by Professor Willi Kalender in 2004. His lecture was titled "Recent Developments in Volume CT Scanning".
  10. Systemic sclerosis in Sarawak: a profile of patients treated in the Sarawak General Hospital
    Teh CL, Kuan YC, Wong JS
    Rheumatol Int, 2009 Aug;29(10):1243-5.
    PMID: 19373465 DOI: 10.1007/s00296-009-0938-z
    We performed a cross-sectional study of the demography, clinical and laboratory features of patients with systemic sclerosis patients followed up in our centre from 1984 to 2007. There were 23 cases with the majority of them (96%) being female. They have a mean age of 50.3 years and a mean disease duration of 6.02 (SD 5.82) years. Our patients comprised of multi-ethnic groups with predominantly Chinese (52%), Sarawak natives (35%) and Malays (13%). They have a mean lag time to diagnosis of 24.8 (SD 34.8) months. All the patients have sclerodermatous skin changes with 16(70%) having diffuse scleroderma and 7(30%) having limited scleroderma. The common clinical manifestations found in our patients were Raynaud's phenomenon (91%), sclerodactyly (65%), digital ulcers (52%) and pulmonary fibrosis (52%). There was low incidence of pulmonary hypertension (13%) and renal involvement (4%). The majority of our patients (67%) have positive ANA with 33% positive Scl-70. The majority received calcium channel blockers (87%), aspirin (48%) and low-dose prednisolone (48%). One patient developed adenocarcinoma of the lung on follow-up. This study demonstrated the rarity of systemic sclerosis in our centre with considerable lag time to diagnosis in our patients. Diffuse cutaneous systemic scleroderma is more common in our centre with rare pulmonary hypertension and renal involvement.
  11. Systemic lupus erythematosus pregnancies: the Sarawak experience and review of lupus pregnancies in Asia
    Teh CL, Wong JS, Ngeh NK, Loh WL
    Rheumatol Int, 2011 Sep;31(9):1153-7.
    PMID: 20349069 DOI: 10.1007/s00296-010-1435-0
    We performed a cross-sessional study of all systemic lupus erythematosus (SLE) pregnancies during a 4-year period (2006-2009) to describe the clinical features, maternal and foetal outcomes in our centre. There were 48 pregnancies in 44 women with SLE. Our patients have a mean age of 30.0 years (SD 6.36) and a mean disease duration of 40.67 months (SD 48.23). Our patients have complicated pregnancies: 32.7% have SLE flares, 17.3% have preeclampsia and 48.9% needed caesarean sections. There were 20.0% foetal losses and 17.8% preterm deliveries in our patients. SLE flares contributed to 60.0% of foetal losses in our patients. Lupus pregnancies in our centre generally have a good maternal and foetal outcome comparable to developed countries in Asia. The low incidence of APS, the high usage of hydroxychloroquine and the high SLE remission rate in our patients prior to conceptions contributed to the good outcome.
  12. Systemic lupus erythematosus pregnancies: a case series from a tertiary, East Malaysian hospital
    Teh CL, Wong JS, Ngeh NK, Loh WL
    Lupus, 2009 Mar;18(3):278-82.
    PMID: 19213870 DOI: 10.1177/0961203308096661
    We performed a retrospective study of all systemic lupus erythematosus (SLE) pregnancies during a two-year period (2006-2007) to describe the clinical features, maternal and foetal outcomes in our centre. There were 17 pregnancies in 16 women with SLE. Our patients have a mean age of 28.31 years (SD 5.24) and a mean disease duration of 38.62 months (SD 38.03). Our patients have complicated pregnancies: 35.3% have SLE flares, 21.1% have preeclampsia and 47.4% needed caesarean sections. There were 15.8% foetal losses and 12.5% preterm deliveries in our patients. All the foetal losses occurred in patients with severe SLE flares during pregnancies. Lupus pregnancies in our centre generally have a good maternal and foetal outcome comparable with developed countries. The low incidence of antiphospholipid syndrome, the high usage of hydroxychloroquine and the high SLE remission rate in our patients before conceptions are the possible factors contributing to the good outcome.
  13. Subcutaneous mycosis presenting as a non- healing left calf ulcer in an immunocompromised patient
    Tang ASO, Yong KY, Wong J, Chua HH, Chew LP
    Med J Malaysia, 2017 04;72(2):122-123.
    PMID: 28473676
    This is a case report of subcutaneous mycosis presenting as a non-healing left calf ulcer in an immunocompromised patient. Traumatic inoculation of the causative agent is the most likely route of infection. The diagnosis requires a detailed history and high clinical suspicion, confirmed by histopathological examination. The management requires a multidisciplinary team approach involving surgeon, pathologist, physician sub-specialised in infectious disease, wound care nursing team as well as social support services. The literature review recommended that the treatment of choice for such infection is surgical debridement in addition to optimal antifungal therapy.
  14. Fulltext Standard of care for type 2 diabetic patients in a public hospital general medical clinic: report of a self-audit
    Tan F, Chan G, Wong JS, Rozario F
    Med J Malaysia, 2008 Aug;63(3):224-8.
    PMID: 19248695 MyJurnal
    We audited the standard of care provided to 200 consecutive type 2 diabetic patients attending our hospital general medical clinic. Data on diabetes related processes and outcome measures were collected. Annual testing rates (blood pressure 100%, fasting lipid profile 91.8%, HbA1c 69%) were higher compared to complications screening rates (Eye 69%, albuminuria 51%, foot 22.4%). Lifestyle intervention was lacking with BMI documented in 38.3% of patients and smoking history in 46%. Fifty percent and 41% of patients with HbA1c > 7.5% were referred to diabetes educator and dietitian respectively. For outcome measures, 26% of patients achieved HbA1c < or = 7%, 33% achieved BP < or = 130/80 while 56% achieved LDL < or = 2.6 mmol/L. Aspirin was prescribed in 78% and ACE inhibitor or angiotensin receptor blocker in 91.8% of patients. Lifestyle intervention and complication screening are the two major areas of deficiencies in the care of type 2 diabetic patients in our hospital general medical clinic.
    Study site: General medical clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia
  15. Simple method to extend the range of ECO-BB for waters with high backscattering coefficient
    Wong J, Chin Liew S, Wong E
    Appl Opt, 2020 Nov 01;59(31):9690-9697.
    PMID: 33175805 DOI: 10.1364/AO.405227
    The ECO-BB (Sea Bird Scientific) is a popular instrument used by water optics researchers to measure the backscattering coefficient of waters in the visible to near-infrared wavelengths. The ECO-BB is calibrated by default for oceanic waters where the backscattering coefficient is typically low. In inland and coastal waters however, there is a tendency for the ECO-BB to reach saturation due to the high number of suspended particles. In the paper, a simple method is presented to extend the range of the ECO-BB instrument in such waters using a nephelometric turbidimeter. The method was first tested on powdered calcium carbonate in pure freshwater, followed by collected water samples from the Singapore Straits and the Lupar River in Sarawak. All three tests confirm the correlation between the ECO-BB and turbidimeter and show that the turbidimeter is a good proxy for backscattering coefficient measurements in turbid waters.
  16. Simple high-performance liquid chromatographic method for the determination of tocotrienols in human plasma
    Yap SP, Julianto T, Wong JW, Yuen KH
    J Chromatogr B Biomed Sci Appl, 1999 Dec 10;735(2):279-83.
    PMID: 10670741
    A simple high-performance liquid chromatographic method using fluorescence detection was developed for the determination of vitamin E especially delta-, gamma- and alpha-tocotrienols in human plasma. The method entailed direct injection of plasma sample after deproteinization using a 3:2 mixture of acetonitrile-tetrahydrofuran. The mobile phase comprised 0.5% (v/v) of distilled water in methanol. Analyses were run at a flow-rate of 1.5 ml/min with the detector operating at an excitation wavelength of 296 nm and emission wavelength of 330 nm. This method is specific and sensitive, with a quantification limit of approximately 40, 34 and 16 ng/ml for alpha-, gamma- and delta-tocotrienol, respectively. The mean absolute recovery values were about 98% while the within-day and between-day relative standard deviation and percent error values of the assay method were all less than 12.0% for alpha-, gamma- and delta-tocotrienol. The calibration curve was linear over a concentration range of 40-2500, 30-4000 and 16-1000 ng/ml for alpha-, gamma- and delta-tocotrienol, respectively. Application of the method in a bioavailability study for determination of the above compounds was also demonstrated.
  17. Seroprevalence of Leptospirosis in Working Dogs
    Lau SF, Wong JY, Khor KH, Roslan MA, Abdul Rahman MS, Bejo SK, et al.
    Top Companion Anim Med, 2017 Dec;32(4):121-125.
    PMID: 29525230 DOI: 10.1053/j.tcam.2017.12.001
    Working dogs are canine animals that have been trained to assist human beings in carrying out various tasks. They help in guarding property, performing rescues, assisting the visually impaired or physically handicapped, searching for drugs, explosives, and others. Leptospirosis is one of the most widespread zoonotic diseases in the world and a commonly occurring disease of the tropics and subtropics. In Malaysia, all working dogs are normally vaccinated with serovars, Pomona, Icterohaemorrhagiae, Canicola, and Grippotyphosa based on protocols recommended from other countries. The duration of immunity in vaccinated dogs for Leptospira can last up to 13 months; however, there is no full crossprotection between the different serovars. Five representative canine units from different government agencies in Malaysia (n = 96 dogs) were recruited in this study. For detection, the microscopic agglutination test was performed by incubating the serum from dogs with various serovars of leptospires, namely, Icterohaemorrhagiae, Canicola, Pomona, Grippotyphosa, Australis, Bataviae, Javanica, Tarassovi, Hebdomadis, Lai, and Pyrogenes. The plasma obtained was used for polymerase chain reaction (PCR) analysis, for the detection of 16S rRNA, and lipL 32 genes of Leptospira. Out of the 96 dogs sampled, only 3 dogs were positive toward serovars, Australis, Bataviae, and Javanica, based on the cutoff point at 1:80. The seroprevalence of canine leptospirosis in this population was 3.1% (n = 3/96). However, all 96 blood samples of working dogs tested negative for both pathogenic and nonpathogenic Leptospira genes. The results revealed that, by vaccination alone, working dogs were not fully protected against leptospirosis and could pose a risk to dog handlers. A preventative and control protocol for leptospirosis is warranted, and its implementation should be monitored and improved accordingly from time to time, in order to maintain a healthy condition in both working dogs and their handlers.
  18. Real-time eye lens dose monitoring during cerebral angiography procedures
    Safari MJ, Wong JH, Kadir KA, Thorpe NK, Cutajar DL, Petasecca M, et al.
    Eur Radiol, 2016 Jan;26(1):79-86.
    PMID: 26002131 DOI: 10.1007/s00330-015-3818-9
    OBJECTIVES: To develop a real-time dose-monitoring system to measure the patient's eye lens dose during neuro-interventional procedures.

    METHODS: Radiation dose received at left outer canthus (LOC) and left eyelid (LE) were measured using Metal-Oxide-Semiconductor Field-Effect Transistor dosimeters on 35 patients who underwent diagnostic or cerebral embolization procedures.

    RESULTS: The radiation dose received at the LOC region was significantly higher than the dose received by the LE. The maximum eye lens dose of 1492 mGy was measured at LOC region for an AVM case, followed by 907 mGy for an aneurysm case and 665 mGy for a diagnostic angiography procedure. Strong correlations (shown as R(2)) were observed between kerma-area-product and measured eye doses (LOC: 0.78, LE: 0.68). Lateral and frontal air-kerma showed strong correlations with measured dose at LOC (AKL: 0.93, AKF: 0.78) and a weak correlation with measured dose at LE. A moderate correlation was observed between fluoroscopic time and dose measured at LE and LOC regions.

    CONCLUSIONS: The MOSkin dose-monitoring system represents a new tool enabling real-time monitoring of eye lens dose during neuro-interventional procedures. This system can provide interventionalists with information needed to adjust the clinical procedure to control the patient's dose.

    KEY POINTS: Real-time patient dose monitoring helps interventionalists to monitor doses. Strong correlation was observed between kerma-area-product and measured eye doses. Radiation dose at left outer canthus was higher than at left eyelid.

  19. Fulltext Quality assurance in mammography: College of Radiology Survey in Malaysia
    Ho EL, Ng KH, Wong JH, Wang HB
    Med J Malaysia, 2006 Jun;61(2):204-8.
    PMID: 16898312
    Malaysia's mammography QA practice was surveyed based on the Malaysian Ministry of Health and the American College of Radiology (ACR) requirements. Data on mammography unit, processor, image receptor, exposure factors, mean glandular dose (MGD), sensitometry, image quality and viewbox luminance were obtained. Mean developer temperature and cycle time were 34.1 +/- 1.8degreesC and 107.7 +/- 33.2 seconds. Mean base+fog level, speed index and contrast index were 0.20+/-0.01, 1.20+/-0.01 and 1.33+/-0.26 respectively. Eighty-six percent of the fifty centres passed the image quality test while 12.5% complied with ACR recommended viewbox luminance. Average MGD was 1.0+/-0.4 mGy. Malaysia is on the right track for QA but with room for total quality improvement.
  20. Psychological and work-related factors predicting work engagement in Malaysian employees
    Chan CMH, Wong JE, Wee LH, Jamil NA, Yeap LLL, Swarna Nantha Y, et al.
    Occup Med (Lond), 2020 Sep 09;70(6):400-406.
    PMID: 32537649 DOI: 10.1093/occmed/kqaa107
    BACKGROUND: Past research on work engagement has focused almost exclusively on either psychological or work-related factors in almost wholly separate literature. There is therefore a need to examine how these factors collectively influence work engagement.

    AIMS: To determine levels of work engagement and to identify psychological and work-related characteristics predicting work engagement in employees in Malaysia.

    METHODS: We recruited 5235 employees from 47 public and private organizations in Malaysia who responded to an online health survey. We assessed work engagement with the 9-item Utrecht Work Engagement Scale (UWES-9) and psychological distress using the 6-item Kessler scale. We performed multiple linear regression to determine predictors of work engagement.

    RESULTS: Employee mean age was 33.8 years (standard deviation [SD] ± 8.8). The mean work engagement score on the UWES-9 was 3.53 (SD ± 0.94). Eleven of 18 variables on multiple regression predicted work engagement, F(18, 4925) = 69.02, P < 0.001, R2 = 0.201. Factors that predicted higher work engagement were age, marital status, education level, job type, job permanency, longer sleep duration, lower psychological distress and no history of workplace bullying.

    CONCLUSIONS: Key factors associated with poorer work engagement in Malaysian employees include inadequate sleep, psychological distress and a history of workplace bullying. These are modifiable factors that individuals and employers can target to improve work engagement, ideally tailored according to occupational type.

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