Displaying publications 21 - 40 of 64 in total

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  1. Backhaus I, Fitri M, Esfahani M, Ngo HT, Lin LJ, Yamanaka A, et al.
    Asia Pac J Public Health, 2023 May;35(4):244-250.
    PMID: 37226778 DOI: 10.1177/10105395231172311
    In this study, we aimed to investigate the prevalence of poor mental health and its association with loneliness and social support among 3531 undergraduate students in nine Asian countries. Mental health was assessed using the Self-Reporting Questionnaire, which was developed by the World Health Organization. Across the entire sample, we detected that nearly half of the students reported poor mental health according to the Self-Reporting Questionnaire and nearly one out of seven students felt lonely. While feeling lonely increased the odds of experiencing poor mental health (odds ratio [OR]), moderate (OR: 0.35) and strong social support (OR: 0.18) decreases the odds of experiencing poor mental health. The high prevalence of poor mental health calls for further in-depth investigations and implementation of mental health support interventions.
  2. Krishnan G, Mohd Makhatar NH, Ching TH, Khoo S
    PMID: 38290212 DOI: 10.1530/EDM-23-0092
    SUMMARY: Pituitary tuberculoma is extremely rare and may pose as a diagnostic challenge especially when encountered as an isolated lesion without other systemic manifestation of tuberculosis. A 21-year-old female was admitted for diabetic ketoacidosis. On the third day of admission following the resolution of diabetic ketoacidosis she developed a sudden onset of headache and blurring of vision suggestive of pituitary apoplexy. An urgent MRI brain revealed a large sellar mass with erosion into the sphenoid sinus and intracranial vasculitis. Transphenoidal surgery was done for tumour debulking which allowed histopathological examination of the sellar mass. Immunohistochemical examination of the sellar mass was positive for Gene Xpert MTB/Rif suggesting a tuberculoma. Anti-tuberculous therapy was commenced with full recovery of pituitary hormonal profile seen 7 months post-treatment. In regions with a high incidence of tuberculosis, a tuberculoma should be a considered in a diagnostic evaluation of a sellar lesion.

    LEARNING POINTS: In an endemic area of tuberculosis, tuberculoma should be considered as a differential diagnosis when evaluating sellar lesions. Pituitary tuberculoma can present with pituitary apoplexy-like symptoms. Prompt diagnosis and treatment may lead to recovery of pituitary function.

  3. Khoo SB
    Med J Malaysia, 2002 Dec;57(4):408-17.
    PMID: 12733165
    The concept of Palliative Care is still quite new in Malaysia and there is a need to promote the awareness of its importance for patients with incurable and advanced illnesses, not only to the public but also to the nursing and medical professionals. These patients especially the poor ones very often have no one to turn to; they cannot afford to seek treatment from the private hospitals, they are turned away from acute General Hospitals and are told that there is nothing more to be done because their illnesses are no longer curable, they cannot pay for GPs to come to their homes, and there is difficulty in purchasing opiate drugs for pain relief. This is a retrospective observational study of the palliative care services we try to provide to those few patients referred to us. This study showed that out of the total of 156 patients, majority were Chinese, peak age between 50-59 years, referrals were mainly from the community and the Obstetrics + Gynaecology department, patients were referred rather late, 60% of patients died at home, most common malignancies being those of the breast, colorectal and cervix, common sites of metastases being the lungs, liver, bones, peritoneum and local infiltration, 87% of patients experienced pain, about 40% of patients were not fully aware of both diagnosis and prognosis, common drugs used being opiate analgesics followed by dexamethasone, H2 antagonist, antiemetics and NSAID.
  4. Tan SC, Matzen P, Khoo SP
    Value Health, 2014 Nov;17(7):A743.
    PMID: 27202681 DOI: 10.1016/j.jval.2014.08.153
    Objectives
    Economic evaluations of BIAsp have been published in the context of different countries. This study aimed to evaluate the financial impact from a perspective of patients treated by public providers of different adoption rates of Biphasic Insulin Aspart (BIAsp; NovoMix 30 FlexPen®) versus Biphasic Human Insulin (BHI; Mixtard Penfill®) in treating T2DM.
    Methods
    An Excel based 5-year budget impact model was built to estimate insulin treated patients by public providers using the local prevalence data. The published demographic, efficacy and adverse event data for ASEAN subgroup analyses of A1chieve study was applied. Both insulin acquisition costs and medical costs for major hypoglycaemia and other complications were applied with a 3% discount rate to the estimated corresponding incidence rates derived from the UKPDS equations. The projected adoption rates were based on the 2013 utilisation volume data. Other local specific considerations e.g. subsidized selling prices and co-payments were included in the analyses for an assumed size of eligible patients. Sensitivity analyses were conducted.
    Results
    The adoption rates of BIAsp were assumed to increase from 23.6% in 2013 to 30% or 36.5% in 2018 for base case and upside scenario, respectively. In comparison to base case scenario, increases in adoption rate of BIAsp were associated with a cumulative increase up to slightly greater than S$ 2.02M in insulin acquisition cost but a potential cumulative net saving up to approximately S$0.92M in overall total costs over 5 years, attributing to subsidized selling price of BIAsp assuming it is included standard drug list and its significantly lower major hypoglycaemia risk, respectively. Cost savings were predicted for other complications.
    Conclusions
    The wider adoption of BIAsp was predicted to result in net cost savings from patient perspective in Singapore. More cost saving would be estimated in analyses with reduced productivity loss from a societal perspective.
  5. Loh HS, Ling SY, Shanmuhasuntharam P, Zain R, Yeo JF, Khoo SP
    Aust Dent J, 1998 Jun;43(3):188-91.
    PMID: 9707784
    This survey was undertaken to study the clinical features of trigeminal neuralgia in an Asian population. Demographic data of 44 patients treated at the Dental Faculty of the National University of Singapore and at the University of Malaya were reviewed. The results of the survey were analysed and comparisons made with those of Caucasian patients as reported in other studies where there was a general similarity in the clinical findings. Trigeminal neuralgia presented predominantly in females. Right-sided involvement occurred at a greater frequency, and the peak age at onset was between the sixth and seventh decades of life. The only significant variant in the present sample was the greater involvement of the mandibular branch of the trigeminal nerve rather than the maxillary division. In addition, there was a much greater representation from Chinese patients over Malays as compared with their ratios in the general population.
  6. Yusof WZ, Khoo SP
    Singapore Dent J, 1988 Dec;13(1):39-40.
    PMID: 3155002
    Mucosal sensitivity to chlorhexidine mouthwash is a rare occurrence and very few cases have been reported in the literature. The authors report 2 cases of oral sensitivity to chlorhexidine and discuss the side-effects, possible causes of sensitivity and the management of the cases.
  7. Khoo, S,M.
    Malays Orthop J, 2007;1(2):17-20.
    MyJurnal
    Traumatic hip dislocation in children is uncommon; when this condition is diagnosed in paediatric patients, it is most frequently seen as a unilateral posterior dislocation and is rarely associated with fracture. We report here a case involving a young girl who dislocated both hips in two separate incidents.
  8. Chiew TK, Khoo S, Ansari P, Kiruthika U
    Disabil Rehabil Assist Technol, 2024 Apr;19(3):994-1002.
    PMID: 36306172 DOI: 10.1080/17483107.2022.2138996
    PURPOSE: This study uses a bibliometric approach to analyse the patterns in research related to mobile and wearable technologies for persons with disabilities to evaluate the current state of relevant research.

    MATERIALS AND METHODS: A systematic search was done using two strings covering "disability" and "mobile and wearable technologies" in the titles of publications in the Web of Science database. Two researchers independently screened the results for relevant publications. During this process, the inclusion and exclusion criteria were deliberated and refined. An independent researcher checked the screening results against the finalized inclusion and exclusion criteria to ensure that the screening was done consistently.

    RESULTS: A total of 2012 out of the 5990 retrieved publications from 2000 to 2022 were included for further analysis. We observed that publications in this area grew exponentially since 2011, almost doubling every 2 years between 2011 and 2015. Universities in the USA were the most active and prominent in relevant publications. Autism is the most researched disability in relation to mobile and wearable technologies. The publications cover both hardware (engineering, electrical and electronic) and software (computer science, theory and methods) technologies used for improving quality of life for persons with disabilities (rehabilitation).

    CONCLUSIONS: The majority of publications were from high income countries, indicating the need to study the digital divide among high-, low- and middle-income countries in adopting mobile and wearable technologies for persons with disabilities, especially ways of making these technologies more affordable and accessible to the under-privileged members of the community.

  9. Khoo S, Do NDT, Kongkam P
    Endosc Ultrasound, 2020 12 16;9(6):369-379.
    PMID: 33318375 DOI: 10.4103/eus.eus_59_20
    Malignant biliary obstruction (MBO) encompasses a variety of malignancies arising from the pancreaticobiliary system. This can be divided into malignant hilar biliary obstruction (MHBO) or malignant distal biliary obstruction (MDBO) biliary obstruction to which clinical outcomes and technical considerations of various biliary drainage methods may differ. EUS biliary drainage (EUS-BD) has been increasingly influential in the management of MBO together with other familiar biliary drainage methods such as ERCP and percutaneous transhepatic biliary drainage (PTBD). Conventionally, ERCP has always been the primary choice of endoscopic biliary drainage in both MHBO and MDBO and that PTBD or EUS-BD is used as a salvage method when ERCP fails for which current guidelines recommends PTBD, especially for MHBO. This review was able to show that with today's evidence, EUS-BD is equally efficacious and possesses a better safety profile in the management of MBO and should be on the forefront of endoscopic biliary drainage. Therefore, EUS-BD could be used either as a primary or preferred salvage biliary drainage method in these cases.
  10. Luangsukrerk T, Harinwan K, Khoo S, Kongkam P
    Can J Gastroenterol Hepatol, 2022;2022:9250370.
    PMID: 36345379 DOI: 10.1155/2022/9250370
    BACKGROUND: The lumen-apposing metal stent (LAMS) has been increasingly used for EUS-guided drainage of symptomatic walled-off pancreatic fluid collection (WOPFC) in recent years. Nevertheless, some WOPFCs may require additional drainage methods including another LAMS as a result of complexity of the lesions. This current study aimed to compare clinical parameters of patients with complex WOPFC requiring LAMS with additional methods (complex WOPFC: group A) versus single LAMS alone (noncomplex WOPFC; group B).

    METHOD: Medical records of patients with complex (group A) versus noncomplex WOPFCs (group B) were reviewed and compared in three centers in Thailand and Malaysia, between January 2016 to December 2020.

    RESULT: 31 patients with WOPFCs were recruited. 6 of 31 (19%) patients were in group A. Multivariate analysis showed that the maximal diameter of WOPFCs in group A was significantly larger than that of group B (18 ± 6 versus 13 ± 3 cm in diameter, respectively, p = 0.021). Solid component proportion was higher in group A versus B (35.8% versus 17.8%, respectively, p = 0.025). The prevalence of pancreatic duct leakage was significantly higher in group A (67% versus 20%, p = 0.23). The need of direct endoscopic necrosectomy (DEN) and the number of DEN sessions were higher in group A versus B (100% vs. 48%, p = 0.020 and 3.5 vs 0 p = 0.031, respectively).

    CONCLUSIONS: Complex WOPFC had larger diameter of lesions, higher proportion of solid component, higher prevalence of pancreatic duct leakage, and higher number of DEN is required than group noncomplex lesions. Trial Registration. This trial is registered with TCTR20180223004.

  11. Khoo SP, Lian CB
    Ann Dent, 1995 Summer;54(1-2):53-5.
    PMID: 8572549
    Spindle-cell lipoma (SCL) of the oral cavity is very rare. There are only four such reported cases in the literature. A concise literature review of SCL and a case report of a SCL affecting the cheek and lip of a 23-year-old man is presented.
  12. Chin NS, Khoo S, Low WY
    J Hum Kinet, 2012 Jun;33:151-61.
    PMID: 23486244 DOI: 10.2478/v10078-012-0054-0
    This study investigated gender, age group and locality differences in adolescent athletes' self-determination motivation and goal orientations in track and field. It also examined the relationship between the self-determination theory and achievement goal theory. A total of 632 (349 boys, 283 girls) adolescent athletes (aged 13-18 years) completed the Sports Motivation Scale and Task and Ego Orientation in Sport Questionnaire. Results indicated significant differences between gender on intrinsic motivation, extrinsic motivation, amotivation (t(630) = 4.10, p < 0.05) and ego orientation (t(630) = 2.48, p < 0.05). Male students reported higher intrinsic motivation, extrinsic motivation, amotivation and ego orientation. A significant difference was found between age groups on task orientation (t(630) = 1.94, p < 0.05) and locality on ego orientation (t(630) = 1.94, p < 0.05). Older athletes showed significantly higher task orientation. Rural athletes had higher ego orientation whereas urban athletes have higher intrinsic motivation. Task orientation was related to intrinsic motivation (r = 0.55, p < 0.01), extrinsic motivation (r = 0.55, p < 0.01), but weakly related to amotivation (r = 0.10, p < 0.01). Ego orientation was related to intrinsic motivation (r = 0.30, p < 0.01), extrinsic motivation (r = 0.36, p < 0.01) and amotivaion (r = 0.36, p < 0.01). Task orientation was related to ego orientation (r = 0.29, p < 0.01). Multiple regression analysis showed intrinsic motivation, extrinsic motivation and amotivation accounted for 30.5% of the variances in task orientation.
  13. Kamarajah SK, Khoo S, Chan WK, Sthaneshwar P, Nik Mustapha NR, Mahadeva S
    JGH Open, 2019 Oct;3(5):417-424.
    PMID: 31633048 DOI: 10.1002/jgh3.12178
    Background and Aim: To date, there are limited data on the applicability of cathepsin D for the diagnosis and monitoring of non-alcoholic steatohepatitis (NASH).

    Methods: This study included patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD) diagnosed between November 2012 and October 2015. Serum cathepsin D levels were measured using the CatD enzyme-linked immunosorbent assay (USCN Life Science, Wuhan, China) using stored samples collected on the same day of the liver biopsy procedure. The performance of cathepsin D in the diagnosis and monitoring of NASH was evaluated using receiver operating characteristic analysis.

    Results: Data for 216 liver biopsies and 34 healthy controls were analyzed. The mean cathepsin D level was not significantly different between NAFLD patients and controls; between NASH and non-NASH patients; and across the different steatosis, lobular inflammation, and hepatocyte ballooning grades. The area under receiver operating characteristic curve (AUROC) of cathepsin D for the diagnosis of NAFLD and NASH was 0.62 and 0.52, respectively. The AUROC of cathepsin D for the diagnosis of the different steatosis, lobular inflammation, and hepatocyte ballooning grades ranged from 0.51 to 0.58. Of the 216 liver biopsies, 152 were paired liver biopsies from 76 patients who had a repeat liver biopsy after 48 weeks. There was no significant change in the cathepsin D level at follow-up compared to baseline in patients who had histological improvement or worsening for steatosis, lobular inflammation, and hepatocyte ballooning grades. Cathepsin D was poor for predicting improvement or worsening of steatosis and hepatocyte ballooning, with AUROC ranging from 0.47 to 0.54. It was fair for predicting worsening (AUROC 0.73) but poor for predicting improvement (AUROC 0.54) of lobular inflammation.

    Conclusion: Cathepsin D was a poor biomarker for the diagnosis and monitoring of NASH in our cohort of Asian patients, somewhat inconsistent with previous observations in Caucasian patients. Further studies in different cohorts are needed to verify our observation.

  14. Shahrani S, Gill SS, Sooi CY, Skantha R, Kumar CVC, Limun MF, et al.
    J Gastroenterol Hepatol, 2023 Oct;38(10):1818-1822.
    PMID: 37587719 DOI: 10.1111/jgh.16313
    BACKGROUND: With changes in the epidemiology and treatment of chronic liver disease (CLD), the impact of various etiologies of liver disease on steatosis and advanced fibrosis are uncertain.

    METHODS: A retrospective study was conducted among liver disease patients of various etiologies undergoing transient elastography (TE) over a 9-year duration.

    RESULTS: Data for 2886 patients were analyzed and had the following demographics: The median age was 60 (IQR: 45-69) years, 51% were males, and ethnicity was predominantly Chinese (52.5%), followed by Malays (34%) and Indians (12.3%). The median CAP score was 272 (IQR: 219-319) dB/m and the median liver stiffness measurement (LSM) score was 6.5 (IQR: 4.9-9.7) kPa. Hepatic steatosis occurred across the spectrum of etiologies of CLD. Among patients with steatosis, the most common etiologies were nonalcoholic fatty liver disease (NAFLD) at 62% and chronic hepatitis B (CHB) at 26.3%. TE findings suggestive of cACLD (10.1-15 kPa) and highly suggestive of cACLD (>15 kPa) were observed in 11.3% and 12.4% of patients, respectively. NAFLD was found to be the most common etiology for cases with suggestive of cACLD (47.2%) and highly suggestive of cACLD (41.5%).

    CONCLUSION: Hepatic steatosis is common in CLD, regardless of etiology. Compared with other etiologies, NAFLD is now the leading cause of cACLD.

  15. Molanorouzi K, Khoo S, Morris T
    BMC Public Health, 2014;14:909.
    PMID: 25182130 DOI: 10.1186/1471-2458-14-909
    Although there is abundant evidence to recommend a physically active lifestyle, adult physical activity (PA) levels have declined over the past two decades. In order to understand why this happens, numerous studies have been conducted to uncover the reasons for people's participation in PA. Often, the measures used were not broad enough to reflect all the reasons for participation in PA. The Physical Activity and Leisure Motivation Scale (PALMS) was created to be a comprehensive tool measuring motives for participating in PA. This 40-item scale related to participation in sport and PA is designed for adolescents and adults. Five items constitute each of the eight sub-scales (mastery, enjoyment, psychological condition, physical condition, appearance, other's expectations, affiliation, competition/ego) reflecting motives for participation in PA that can be categorized as features of intrinsic and extrinsic motivation based on self-determination theory. The aim of the current study was to validate the PALMS in the cultural context of Malaysia, including to assess how well the PALMS captures the same information as the Recreational Exercise Motivation Measure (REMM).
  16. Khoo S, Morris T
    Asia Pac J Public Health, 2012 May;24(3):435-49.
    PMID: 22593220 DOI: 10.1177/1010539512446368
    Obesity is a global health concern and has a great impact on countries in the Asia-Pacific region. Physical inactivity is a major risk factor for obesity, but physical activity levels are declining in much of this region. Increasing physical activity is a priority in many countries. Considerable research has been conducted on physical activity related to obesity in Western countries, but populations in the Asia-Pacific region differ in physical, psychological, social, and cultural ways that warrant local and regional research. The authors reviewed research conducted in the Asia-Pacific region that examined either the impact of physical activity interventions on obesity-related outcomes or the effect of behavior-change interventions on physical activity participation. The number of studies found was limited, and their samples and methods varied too much to draw conclusions. The authors recommend further research in the Asia-Pacific region using systematic protocols to permit sound conclusions to be drawn and promote informed action at local levels.
  17. Müller AM, Khoo S, Morris T
    J Med Internet Res, 2016 Jan 07;18(1):e5.
    PMID: 26742999 DOI: 10.2196/jmir.5235
    BACKGROUND: Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones.

    OBJECTIVE: The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants' exercise frequency and the effects of the intervention on secondary outcomes.

    METHODS: The Malaysian Physical Activity for Health Study (myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity-related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24.

    RESULTS: In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study-unrelated injuries forced 4 participants to discontinue after a few weeks (they were not included in any analyses). Overall retention was 86% (37/43). After 12 weeks, SMS texting arm participants exercised significantly more than non-SMS texting arm participants (mean difference 1.21 times, bias-corrected and accelerated bootstrap [BCa] 95% CI 0.18-2.24). Interview analysis revealed that the SMS text messages positively influenced SMS texting arm participants who experienced exercise barriers. They described the SMS text messages as being encouraging, a push, and a reminder. After 24 weeks, there was no significant difference between the research arms (mean difference 0.74, BCa 95% CI -0.30 to 1.76). There were no significant effects for secondary outcomes.

    CONCLUSIONS: This study provides evidence that SMS text messaging is effective in promoting exercise in older adults from an upper-middle-income country. Although the effects were not maintained when SMS text messaging ceased, the results are promising and warrant more research on behavioral mobile health interventions in other regions.

    TRIAL REGISTRATION: Clinicaltrials.gov NCT02123342; http://clinicaltrials.gov/ct2/show/NCT02123342 (Archived by WebCite at http://www.webcitation.org/6eGSsu2EI).

  18. Molanorouzi K, Khoo S, Morris T
    BMC Public Health, 2015;15:66.
    PMID: 25637384 DOI: 10.1186/s12889-015-1429-7
    Background: In recent years, there has been a decline in physical activity among adults. Motivation has been shown to be a crucial factor in maintaining physical activity. The purpose of this study was to examine whether motives for participation could accurately discriminate gender, age, and type of physical activity.
    Methods: A quantitative, cross-sectional descriptive research design was employed. The Physical Activity and Leisure Motivation Scale (PALMS) was used to assess motives for physical activity in 1,360 adults (703 males, 657 females) who had been exercising regularly for at least six months. The PALMS consists of 40 items that constitute eight sub-scales (mastery, enjoyment, psychological condition, physical condition, appearance, others' expectations, affiliation, competition/ego). Respondents were divided into two age groups (young adults aged 20 to 40 years and middle-aged adults 41 to 64 years) and five types of activity (individual racing sports plus bowls, team sports, racquet sports, martial arts, and exercise).
    Results: The group discriminant function analyses revealed significant canonical functions correctly classifying the cases into gender (82%), age group (83%), team sport players 76%, individual racing sport plus bowls players 91%, racquet sport players 90%, exercisers 84%, and martial art players 91%. The competition/ego, appearance, physical condition, and mastery sub-scales contributed most to gender differences. Five sub-scales (mastery, psychological condition, others' expectations, affiliation, and enjoyment) contributed most to the discriminant function for age. For type of activity, different sub-scales were the strongest contributors to the discriminant function for each type of PA.
    Conclusion: The findings in this study suggest that strong and important motives for participation in physical activity are different across type of activity, age, and gender in adults. Understanding the motives that influence physical activity participation is critical for developing interventions to promote higher levels of involvement.
  19. Zarei S, Memari AH, Moshayedi P, Mosayebi F, Mansournia MA, Khoo S, et al.
    Arch Iran Med, 2016 Oct;19(10):704-711.
    PMID: 27743435
    BACKGROUND: Given the importance of regular physical activity, it is crucial to evaluate the factors favoring participation in physical activity. We aimed to report the psychometric analysis of the Farsi version of the Physical Activity and Leisure Motivation Scale (PALMS).

    METHODS: The Farsi version of PALMS was completed by 406 healthy adult individuals to test its factor structure and concurrent validity and reliability.

    RESULTS: Conducting the exploratory factor analysis revealed nine factors that accounted for 64.6% of the variances. The PALMS reliability was supported with a high internal consistency of 0.91 and a high test-retest reliability of 0.97 (95% CI: 0.97-0.98). The association between the PALMS and its previous version Recreational Exercise Motivation Measure scores was strongly significant (r= 0.86, P < 0.001).

    CONCLUSION: We have shown that the Farsi version of the PALMS appears to be a valuable instrument to measure motivation for physical activity and leisure.

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