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Fulltext The Use of the Self-Standing Turning Transfer Device to Perform Bed-To-Chair Transfers Reduces Physical Stress among Caregivers of Older Patients in a Middle-Income Developing Country

Goh CH, Muslimah Y, Ng SC, Subramanian P, Tan MP

Front Med (Lausanne), 2014;1:32.
PMID: 25593906 DOI: 10.3389/fmed.2014.00032

Manual transfer of elderly patients remains commonplace in many developing countries because the use of lifting equipment, such as hoists, is often considered unaffordable luxuries. The aim of this study was, therefore, to evaluate the usage and potential benefits of a low-cost, mechanical turning transfer device among elderly patients and their caregivers on a geriatric ward in a developing country in South East Asia. Fifty-six inpatients, aged 66-92 years, on a geriatric ward, and their caregivers were recruited. Participants were asked to transfer from bed-to-chair transfer with manual assistance, and the task was repeated using the Self-standing Turning Transfer Device (STurDi). The time taken to perform manual transfers and STurDi-assisted transfers was recorded. Physical strain was assessed using the perceived physical stress-rating tool for caregivers with and without the use of the device. User satisfaction was evaluated using the usefulness, satisfaction, and ease of use questionnaire. There was a significant reduction in transfer-time with manual transfers compared to STurDi-assisted transfers [mean (SD) = 48.39 (13.98) vs. 36.23 (10.96); p ≤ 0.001]. The physical stress rating was significantly lower in STurDi-aided transfers compared to manual transfers, shoulder [median (interquartile range) = 0 (1) vs. 4 (3); p = 0.001], upper back [0 (0) vs. 5 (4); p = 0.001], lower back [0 (1) vs. 5 (3), p = 0.001], whole body [1 (2) vs. 4 (3), p = 0.001], and knee [0 (1) vs. 1 (4), p = 0.001]. In addition, majority of patients and caregivers definitely or strongly agreed that the device was useful, saved time, and was easy to use. We have therefore demonstrated in a setting where manual handling was commonly performed that a low-cost mechanical transfer device reduced caregiver strain and was well received by older patients and caregivers.
The use of magnetic resonance phase-contrast cine in Chiari malformation with syringomyelia

Goh CH, Hamzah MR, Kandasamy R, Ghani ARI, Wong SH, Idris Z, et al.

Med J Malaysia, 2020 11;75(6):666-671.
PMID: 33219175

INTRODUCTION: Chiari malformation (CM) is a disorder of mesodermal origin and is commonly associated with syringomyelia. Foramen magnum decompression is the first-line of standard treatment in symptomatic patients with a confirmed radiographic diagnosis. Magnetic resonance (MR) cine allows accurate evaluation of cerebrospinal fluid (CSF) physiology at the craniovertebral junction but often this is under-utilised in Malaysia.
METHODS: In this series, we looked into nine cases of CM with syringomyelia from clinical and radiological perspective before and after surgery. The radiological parameters were herniated tonsillar length, syrinx: cord ratio, syrinx length and diameter. Flow velocity and morphologic changes in Chiari were illustrated.
RESULTS: Seven patients showed either reduction in syrinx length, syrinx: cord ratio or both postoperatively. Clinical recovery somewhat varied in motor and sensory symptoms. Four patients gained better functional grade in modified Rankin scale (MRS) while the rest remained similar. The study highlighted the advantage of CSF flow dynamics information over MR anatomical radiographic improvement in addressing the neurologic and functional recovery. We also discussed the practicality of cine sequence in preoperative patient selection, syrinx analysis and postoperative flow evaluation in anticipation of clinical outcome.
CONCLUSION: Phase-contrast cine MRI is a useful tool dictated by resource availability. We recommend its routine use in preoperative analysis and subsequent observational follow-up after surgery.
Using SERS-based microfluidic paper-based device (μPAD) for calibration-free quantitative measurement of AMI cardiac biomarkers

Lim WY, Goh CH, Thevarajah TM, Goh BT, Khor SM

Biosens Bioelectron, 2020 Jan 01;147:111792.
PMID: 31678828 DOI: 10.1016/j.bios.2019.111792

Recently, surface enhanced Raman scattering (SERS) has attracted much attention in medical diagnosis applications owing to better detection sensitivity and lower limit of detection (LOD) than colorimetric detection. In this paper, a novel calibration-free SERS-based μPAD with multi-reaction zones for simultaneous quantitative detection of multiple cardiac biomarkers - GPBB, CK-MB and cTnT for early diagnosis and prognosis of acute myocardial infarction (AMI) are presented. Three distinct Raman probes were synthesised, subsequently conjugated with respective detecting antibodies and used as SERS nanotags for cardiac biomarker detection. Using a conventional calibration curve, quantitative simultaneous measurement of multiple cardiac biomarkers on SERS-based μPAD was performed based on the characteristic Raman spectral features of each reporter used in different nanotags. However, a calibration free point-of-care testing device is required for fast screening to rule-in and rule-out AMI patients. Partial least squares predictive models were developed and incorporated into the immunosensing system, to accurately quantify the three unknown cardiac biomarkers levels in serum based on the previously obtained Raman spectral data. This method allows absolute quantitative measurement when conventional calibration curve fails to provide accurate estimation of cardiac biomarkers, especially at low and high concentration ranges. Under an optimised condition, the LOD of our SERS-based μPAD was identified at 8, 10, and 1 pg mL-1, for GPBB, CK-MB and cTnT, respectively, which is well below the clinical cutoff values. Therefore, this proof-of-concept technique shows significant potential for highly sensitive quantitative detection of multiplex cardiac biomarkers in human serum to expedite medical decisions for enhanced patient care.
Water quality variation during a strong El Niño event in 2016: a case study in Kampar River, Malaysia

Ng CK, Goh CH, Lin JC, Tan MS, Bong W, Yong CS, et al.

Environ Monit Assess, 2018 Jun 15;190(7):402.
PMID: 29904816 DOI: 10.1007/s10661-018-6784-2

El Niño and Southern Oscillation (ENSO) is a natural forcing that affects global climate patterns, thereon influencing freshwater quality and security. In the advent of a strong El Niño warming event in 2016 which induced an extreme dry weather in Malaysia, water quality variation was investigated in Kampar River which supplies potable water to a population of 92,850. Sampling points were stratified into four ecohydrological units and 144 water samples were examined from October 2015 to March 2017. The Malaysian Water Quality Index (WQI) and some supplementary parameters were analysed in the context of reduced precipitation. Data shows that prolonged dry weather, episodic and sporadic pollution incidents have caused some anomalies in dissolved oxygen (DO), total suspended solids (TSS), turbidity and ammoniacal nitrogen (AN) values recorded and the possible factors are discussed. The month of March and August 2016 recorded the lowest precipitation, but the overall resultant WQI remained acceptable. Since the occurrence of a strong El Niño event is infrequent and far between in decadal time scale, this paper gives some rare insights that may be central to monitoring and managing freshwater resource that has a crucial impact to the mass population in the region of Southeast Asia.