MyMedR

Intraoperative ultrasound with palpation is still superior to intra-arterial calcium stimulation test in localising insulinoma

Wong M, Isa SH, Zahiah M, Azmi KN

World J Surg, 2007 Mar;31(3):586-92.

PMID: 17322973

This study assessed the sensitivities of preoperative localisation modalities such as computed tomography (CT), magnetic resonance imaging (MRI), arteriography and arterial stimulation venous sampling (ASVS) using serum insulin and C-peptide gradients to intraoperative techniques in localising insulin-secreting tumours in our institution.

A Novel Recombinant Canine Adenovirus Type 1 Detected from Acute Lethal Cases of Infectious Canine Hepatitis

Wong M, Woolford L, Hasan NH, Hemmatzadeh F

Viral Immunol, 2017 05;30(4):258-263.

PMID: 28426340 DOI: 10.1089/vim.2016.0041

In this study, canine adenoviruses (CAdVs) from two acute fatal cases of infectious canine hepatitis (ICH) were analyzed using molecular detection and sequencing of the pVIII, E3, and fiber protein genes. Pathological findings in affected dogs were typical for CAdV-1 associated disease, characterized by severe centrilobular to panlobular necrohemorrhagic hepatitis and the development of disseminated intravascular coagulation in the terminal stages of disease. Comparison of partial genome sequences revealed that although these newly detected viruses mainly had CAdV-1 genome characteristics, their pVIII gene was more similar to that of CAdV-2. This likely suggests that a recombination has occurred between CAdV-1 and CAdV-2, which possibly explains the cause of vaccine failure or increased virulence of the virus in the observed ICH cases.

Outbreaks of trypanosomiasis and the seroprevalence of T. evansi in a deer breeding centre in Perak, Malaysia

Adrian MS, Sani RA, Hassan L, Wong MT

Trop Anim Health Prod, 2010 Feb;42(2):145-50.

PMID: 19642008 DOI: 10.1007/s11250-009-9406-8

Filarial antibodies and eosinophilia in human subjects in an endemic area

Wong MM, Guest MF

Trans R Soc Trop Med Hyg, 1969;63(6):796-800.

PMID: 5368008

Lung function reference values in Singaporean children aged 6-18 years

Connett GJ, Quak SH, Wong ML, Teo J, Lee BW

Thorax, 1994 Sep;49(9):901-5.

PMID: 7940431

A study was undertaken to produce reference values of lung function in Chinese children and a means of calculating adjusted standard deviation scores of lung function for Malay and Indian ethnic groups.

Fulltext Neofusicoccum ribis Associated with Leaf Blight on Rubber (Hevea brasiliensis) in Peninsular Malaysia

Nyaka Ngobisa AI, Zainal Abidin MA, Wong MY, Wan Noordin MW

Plant Pathol J, 2013 Mar;29(1):10-6.

PMID: 25288924 DOI: 10.5423/PPJ.OA.07.2012.0110

Hevea brasiliensis is a natural source of rubber and an important plantation tree species in Malaysia. Leaf blight disease caused by Fusicoccum substantially reduces the growth and performance of H. brasiliensis. The aim of this study was to use a combination of both morphological characteristics and molecular data to clarify the taxonomic position of the fungus associated with leaf blight disease. Fusicoccum species were isolated from infected leaves collected from plantations at 3 widely separated locations - Selangor, Perak, and Johor states - in Peninsular Malaysia in 2010. All the isolates were identified according to their conidial patterns and DNA sequences generated from internal transcribed spacers (ITS1 and ITS2), the 5.8S rRNA, and an unknown locus (BotF15) containing microsatellite repeats. Based on taxonomic and sequence data, Neofusicoccum ribis was identified as the main cause of leaf blight disease in H. brasiliensis in commercial plantations in Malaysia. A pathogenicity trial on detached leaves further confirmed that N. ribis causes leaf blight disease. N. ribis is an important leaf pathogen, and its detection in Malaysia has important implications for future planting of H. brasiliensis.

Addressing unmet needs for patients with previous upper gastrointestinal bleed requiring concomitant aspirin and non-steroidal anti-inflammatory drugs

Jayaraman T, Wong MS, Mustaffa N, Lee YY

J R Coll Physicians Edinb, 2017 12;47(4):356-358.

PMID: 29537408 DOI: 10.4997/JRCPE.2017.411

α-thalassemia-associated hydrops fetalis: A rare cause of thyrotoxic cardiomyopathy

Tumian NR, Wong M, Wong CL

J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.

PMID: 25510540 DOI: 10.1111/jog.12648

α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.

Fulltext Emergency stenting of vertical vein in a neonate with obstructed supracardiac total anomalous pulmonary venous drainage

Lim WK, Wong MN, Tan SK

Med J Malaysia, 2014 Jun;69(3):138-9.

PMID: 25326356 MyJurnal

A late preterm newborn baby presented with respiratory distress and increasing cyanosis within 2 hours of birth. Bedside transthroracic echocardiography showed a critically obstructed vertical vein in a supracardiac total anomalous pulmonary venous drainage (TAPVd). Emergency stenting of the vertical vein was successfully performed at 24 hours of life.

Fulltext ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association?

Wong M, Isa SH, Kamaruddin NA, Khalid BA

Med J Malaysia, 2007 Jun;62(2):168-70.

PMID: 18705457

We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma. A routine chest radiography done preoperatively revealed a right lung nodule which was confirmed by computed tomography (CT) of the thorax. Transfrontal hypophysectomy was performed while a conservative approach was taken for the lung nodule. Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy. Histological examination revealed an atypical carcinoid. To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.

Fulltext Masking of central diabetes insipidus and hypogonadotrophic hypogonadism by germ cell tumour in suprasellar--pineal region

Isa SH, Wong M, Khalid BA

Med J Malaysia, 2006 Dec;61(5):630-2.

PMID: 17623967

A patient with beta hCG-secreting germ cell carcinoma of the pineal and suprasellar regions presented with hydrocephalus, Parinaud's syndrome, hypopituitarism and polyuria. Central diabetes insipidus was strongly suspected although the water deprivation test was not diagnostic. The polyuria however, responded to ADH analogue when the hypothyroidism and hypocortisolism were treated. Pubertal development was evident and serum testosterone was normal despite the low FSH/LH, suggesting hCG stimulation of Leydig cells. This case illustrates that a beta hCG-germ cell tumour of the suprasellar region causing hypopituitarism can mask the presence of central diabetes insipidus and hypogonadotrophic hypogonadism.

Fulltext Recent advances in the diagnosis and treatment of lung cancer

Liam CK, Lim KH, Wong MM

Med J Malaysia, 2001 Dec;56(4):514-31; quiz 532.

PMID: 12014776

Fulltext Smoking behaviour, knowledge and opinion of medical students

Wong ML, Chen PC

Med J Malaysia, 1989 Dec;44(4):317-23.

PMID: 2520041

On the basis of a questionnaire on smoking behaviour, knowledge and attitudes administered to medical students in the University of Malaya in July 1987, the prevalence of smoking was found to be low (10%) among medical students. Smokers and non-smokers were equally well informed about common smoking complications. Most students, irrespective of smoking status, felt that they would as future doctors, often advise sick smokers against smoking. In contrast, less than half would do so for healthy smokers who do not themselves raise the question of smoking. The students' personal smoking behaviour also influenced their view of their professional role. Appropriate values, attitudes and a preventive approach towards smoking need to be further developed in the medical students' thinking and behaviour.

Chronic granulomatous mastitis with axillary lymphadenopathy in a nulliparous woman

Rajendran D, Chew BS, Wong MW, Cheong YT

Med J Malaysia, 2019 12;74(6):564-565.

PMID: 31929493

Chronic Granulomatous Mastitis (CGM) is a rare disorder and this generally occurs in young women with a recent history of lactation. Development of this disease in nulliparous women are rare with an incidence of 10%. Axillary lymphadenopathy is seen in 15% of cases diagnosed with CGM. We present a case of CGM in a 23- year-old nulliparous woman presenting with a breast mass and multiple axillary lymphadenopathy. To the best of our knowledge there are no documented cases of both these rare clinical features occurring simultaneously. The use of oral steroids prevented surgery and effectively induced remission.

Anti-hypertensive prescription practices in private hospitals in Malaysia: a prospective, non-interventional, observational study

Ng WK, Philip AZ, Lim TT, Wong M, Goh EL, Tengku Ismail TS, et al.

Med J Malaysia, 2023 May;78(3):350-356.

PMID: 37271845

INTRODUCTION: In managing hypertension, monotherapy and sometimes a combination of more than one agent are used to achieve blood pressure (BP) control. The objective of this prospective, observational, multi-centre study was to assess the level of BP control in patients receiving one or more anti-hypertensive drugs in private medical centres in Malaysia according to the treatment regimens (monotherapy, free drug combinations and single pill combinations).

MATERIALS AND METHODS: Data were collected through medical records and interview sessions with patients on current pharmacotherapy for hypertension management at baseline and 2-3 months later. Results are expressed as mean ± SD for continuous data and as frequencies and percentages for categorical data.

RESULTS: Among 182 recruited patients, 89 (49%) achieved BP control by the end of the study. Majority (62/89) patients were on single-pill (monotherapy or SPC) antihypertensives. Majority (63/89) required more than two antihypertensives to achieve BP control.

CONCLUSION: Both SPC and free drug combination antihypertensives reduced BPs, but physicians preferred SPC to improve BP control and increase treatment compliance.

Hepatocellular damage due to methyldopa

Wong ML

Med J Malaya, 1971 Mar;25(3):218-9.

PMID: 4253251

Schultz-Dale reaction with sera of eosinophilic lung patients--a preliminary report

Guest MF, Wong MM

Med J Malaya, 1965 Dec;20(2):146-8.

PMID: 4159506

A demonstration of the use of the polygraph to record Schultz-Dale reactions utilizing sera of monkeys infected with Brugia malayi as sources of both antibody and antigen

Guest MF, Kek CL, Wong MM, Cheong LK

Med J Malaya, 1966 Jun;20(4):325-6.

PMID: 4224346

The effects of ethnicity on disease patterns in 472 Orientals with systemic lupus erythematosus

Thumboo J, Fong KY, Chng HH, Koh ET, Chia HP, Leong KH, et al.

J Rheumatol, 1998 Jul;25(7):1299-304.

PMID: 9676760

OBJECTIVE: To determine the effects of ethnicity on disease manifestations in Oriental patients with systemic lupus erythematosus (SLE) and to describe the risk of developing renal or central nervous system (CNS) involvement with time.
METHODS: A retrospective study of 472 patients with SLE seen at the only Rheumatology Unit in Singapore. The effect of ethnicity on selected disease manifestations at diagnosis was assessed after adjusting for demographic variables using multiple logistic regression. The probability of developing selected disease manifestations with time was determined using the Kaplan-Meier product limit method.
RESULTS: At diagnosis, Malays had a higher risk of renal or CNS involvement than Chinese (OR 2.26, 95% CI 1.21 to 4.21, and OR 3.07, 95% CI 1.01 to 9.34, respectively), and Indians a lower risk of malar rash and a higher risk of oral ulcers than Chinese (OR 0.30, 95% CI 0.13 to 0.68, and OR 2.90, 95% CI 1.45 to 7.34, respectively). The prevalence of renal or CNS involvement in the entire cohort increased with time, reaching 75.6% (95% CI 66.1% to 85.0%) and 16.7% (95% CI 11.7% to 21.6%), respectively, after 18 years of disease.
CONCLUSION: Ethnicity influenced disease manifestations at diagnosis in this cohort of Oriental patients with SLE. Renal or CNS involvement developed in previously unaffected patients up to 18 years after diagnosis, highlighting the need for continued vigilance in patients with lupus.

Preliminary results of a pilot study on the safety and efficacy of balloon dilatation of the Eustachian tube for nasopharyngeal cancer patients with chronic Eustachian tube dysfunction post irradiation

Wong MSL, Prepageran N

J Laryngol Otol, 2021 Aug;135(8):691-694.

PMID: 34342558 DOI: 10.1017/S0022215121001560

OBJECTIVE: Eustachian tube dysfunction is a known complication following radiotherapy to the head and neck region. Unfortunately, treatment options are limited, with significant associated morbidity. Balloon Eustachian tube dilatation has been used successfully to treat Eustachian tube dysfunction; hence, this study aimed to determine the safety and efficacy of this method in treating Eustachian tube dysfunction in post-radiotherapy patients with nasopharyngeal carcinoma.

METHOD: This interventional cohort pilot study on patients with Eustachian tube dysfunction compared those with nasopharyngeal carcinoma to patients without. Outcome assessment was based on tympanometry type and Eustachian Tube Dysfunction Questionnaire score.

RESULTS: A total of 14 ears (12 patients) were tested. Only 14 per cent of the nasopharyngeal carcinoma cohort showed improvement, while 71 per cent of the non-nasopharyngeal carcinoma group were successfully treated. No significant adverse effect was reported in any patient during this study.

CONCLUSION: Balloon Eustachian tube dilatation was not shown to be beneficial for post-radiotherapy Eustachian tube dysfunction in nasopharyngeal carcinoma patients in the preliminary stages of this pilot study.

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