Displaying publications 21 - 40 of 82 in total

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  1. Loh SY, Yip CH, Packer T, Quek KF
    Asian Pac J Cancer Prev, 2010;11(5):1293-9.
    PMID: 21198280
    OBJECTIVE: With increasing survival rates, breast cancer is now considered a chronic condition necessitating innovative care to meet the long-term needs of survivors. This paper presents the findings of a pilot study on self-management for women diagnosed with breast cancer and their implications for Asian health care providers.

    METHODS: A pre-test/ post-test pilot study was conducted to gain preliminary insights into program feasibility and barriers to participation, and to provide justification for a larger trial.

    RESULTS: The study found the 4 week self-management program feasible and acceptable, with a favourable trend in quality of life. The recruitment barriers ranged from competing medical appointments, uncollaborative health providers, linguistic barriers and social-household concerns. Supporting facilitators identified were family, health professionals and fellow participants ("buddies"). Lessons from the study are discussed with regard to Asian health providers.

    CONCLUSION: There is preliminary evidence that self management is a workable and potentially useful model even in an Asians entrenched-hierarchical medical model of care. The initial challenge was breaking down barriers in acceptancee of a collaborative stance. A clinical trial is now warranted to gather more evidence.
  2. Kuppusamy S, Faizal N, Quek KF, Razack AH, Dublin N
    World J Urol, 2010 Dec;28(6):673-6.
    PMID: 20623289 DOI: 10.1007/s00345-010-0578-7
    It is still uncertain as to which form of anaesthesia is the optimum. We conducted a study to identify the best location and optimum volume of anaesthetic agent in order to achieve best pain relief and cooperation from our patients. We also assessed the need for local anaesthetic gel for probe lubrication and if the number of cores during biopsy makes a difference in the pain score.
  3. Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J
    Clin Exp Obstet Gynecol, 2009;36(1):35-9.
    PMID: 19400416
    OBJECTIVE: To evaluate the predictive value for successful labor induction of transvaginal ultrasound (TVS) of cervical length according to parity.

    METHOD: TVS of the cervix was performed before term labor induction. Induction was considered successful if vaginal delivery was achieved within 24 hours; 231 women were available for final analysis.

    RESULTS: Analysis of the receiver operator characteristics curve showed an optimal cut-off for cervical length of < or = 20 mm for successful induction. Following multivariate logistic regression analysis, a sonographic short cervix (AOR 5.6; p < 0.001) was an independent predictor of successful induction but not a favorable Bishop score (p = 0.47). Among multiparas with a short cervix, positive and negative predictive values for successful induction were 98% (95% CI 90-100%) and 21% (95% CI 13%-32%) and among nulliparas, predictive values were 69% (95% CI 53%-82%) and 77% (95% CI 64%-87%) respectively.

    CONCLUSION: In nulliparas, cervical length can usefully predict labor induction outcome.

  4. Ma WT, Mahadeva S, Quek KF, Goh KL
    Med J Malaysia, 2007 Oct;62(4):313-8.
    PMID: 18551936 MyJurnal
    Tolerance to colonoscopy varies between populations and data from the South East Asian region is lacking. We aimed to determine tolerance and safety with to colonoscopy; conscious sedation and identify risk factors for complications in Malaysian adults. Consecutive outpatients undergoing colonoscopy were enrolled prospectively. A combination of pethidine and midazolam were used and tolerance to colonoscopy assessed three hours post-procedure using a validated scale. All patients were monitored for cardiorespiratory depression and risk factors for complications were identified. Two hundred and eight patients (mean age 57.2 +/- 14.8 years, 48% female) were enrolled. The population ethnicity consisted of 45 (21.63%) Malays, 101 (48.56%) Chinese and 56 (26.92%) Indians. Conscious sedation was achieved with 5.0 +/- 1.1 mg of midazolam and 43.3 +/- 14.0 mg of pethidine. Thirty (14.4%) patients tolerated the procedure poorly and independent predictors included female gender (OR 2.93, 95% CI = 1.22 to 7.01) and a prolonged duration of procedure (OR 2.85, 95% CI = 1.08 to 7.48). Hypotension occurred in 13 (6.25%) patients, with age > 65 years as the only risk factor (OR 13.17, 95% CI = 1.28 to 137.92). A prolonged duration was the main cause of hypoxia (OR 5.49, 95% CI = 1.54 to 19.49), which occurred in 6 (2.88%) patients. No major complications occurred during the study period. The current practice of conscious sedation is safe and tolerated well by most adults in our population. However, poor tolerance in a notable minority may have significant clinical implications.

    Study site: Division of Gastroenterology, Department of Medicine, University Malaya Medical Centre (UMMC)
  5. Quek KF, Sallam AA, Ng CH, Chua CB
    J Sex Med, 2008 Jan;5(1):70-6.
    PMID: 17362280 DOI: 10.1111/j.1743-6109.2006.00423.x
    INTRODUCTION: Sexual problems are common in the general population. Studies have shown that most of these sexual problems are related to their social lives, medical illnesses, and psychological status. Among the sexual problems in men, premature ejaculation (PE) is one of the most frequent, yet it is the least well-understood of the sexual dysfunctions of men.
    AIM: To determine the prevalence of sexual problem particularly PE and erectile dysfunction (ED) among people living in urban areas and to investigate the characteristics associated with these sexual problems in a Malaysian population.
    MAIN OUTCOME MEASURE: The PE which is defined as an intravaginal ejaculation latency time less than 2 minutes was assessed in the ED and non-ED group.
    METHODS: The Hospital Anxiety and Depression scale is used as a measure of the psychological status [30]. The ED status was assessed using the International Index of Erectile Function questionnaire.
    RESULTS: The prevalence of self-reported sexual problems for ED and PE were 41.6% and 22.3%, respectively. In those subjects with ED, 33.5% reported to have PE. Of the total of 430 subjects, anxiety was present in 8.1%, while depression was 5.3%. The prevalence of PE accounted for 25% anxiety and 14.6% for depression respectively in the population. EDs were associated with diabetes and hypertension (OR [95% CI]: 5.33 [2.33, 10.16], 3.40 [1.76, 6.57], P < 0.05), respectively, while factors associated with PE were anxiety and depression (OR [95% CI]: 1.29 [0.68, 2.45], 1.39 [0.69, 2.78]), respectively.
    CONCLUSION: Prevalence of ED is associated with medical symptoms such as diabetes and hypertension and a rise in the prevalence of age while psychological distress such as anxiety and depression also contribute to a higher PE rate.
  6. Tan PC, Jacob R, Quek KF, Omar SZ
    J Obstet Gynaecol Res, 2007 Aug;33(4):457-64.
    PMID: 17688612
    To determine pregnancy outcome in hyperemesis gravidarum and the effect of metabolic, biochemical, hematological and clinical indicators of disease severity on outcome.
  7. Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J
    Ultrasound Obstet Gynecol, 2007 May;29(5):568-73.
    PMID: 17444553
    To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term, to assess their tolerability (in terms of pain) and ability to predict need for Cesarean delivery.
  8. Tan PC, Jacob R, Quek KF, Omar SZ
    Aust N Z J Obstet Gynaecol, 2006 Oct;46(5):446-50.
    PMID: 16953861
    In a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self-limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.
  9. Tan PC, Jacob R, Quek KF, Omar SZ
    BJOG, 2006 Jun;113(6):733-7.
    PMID: 16709219
    The association between female fetal sex and hyperemesis gravidarum is well established in European and North American populations. The association between female fetuses and severity of hyperemesis remains uncertain. A retrospective study based on case notes review of 166 Asian women hospitalised for hyperemesis was performed. Female fetuses were significantly associated with hyperemesis in our population (P= 0.004, OR 1.6, 95% CI 1.2-2.2) as well as associated with severe ketonuria and high urea. When both severe ketonuria and high urea were present at initial hospital admission for hyperemesis, 83% (95% CI 66-93) of the fetuses were female.
  10. Amin NA, Quek KF, Oxley JA, Noah RM, Nordin R
    Int J Occup Environ Med, 2015 10;6(4):232-42.
    PMID: 26498051 DOI: 10.15171/ijoem.2015.632
    BACKGROUND: The Job Content Questionnaire (M-JCQ) is an established self-reported instrument used across the world to measure the work dimensions based on the Karasek's demand-control-support model.

    OBJECTIVE: To evaluate the psychometrics properties of the Malay version of M-JCQ among nurses in Malaysia.

    METHODS: This cross-sectional study was carried out on nurses working in 4 public hospitals in Klang Valley area, Malaysia. M-JCQ was used to assess the perceived psychosocial stressors and physical demands of nurses at their workplaces. Construct validity of the questionnaire was examined using exploratory factor analysis (EFA). Cronbach's α values were used to estimate the reliability (internal consistency) of the M-JCQ.

    RESULTS: EFA showed that 34 selected items were loaded in 4 factors. Except for psychological job demand (Cronbach's α 0.51), the remaining 3 α values for 3 subscales (job control, social support, and physical demand) were greater than 0.70, indicating acceptable internal consistency. However, an item was excluded due to poor item-total correlation (r<0.3). The final M-JCQ was consisted of 33 items.

    CONCLUSION: The M-JCQ is a reliable and valid instrument to measure psychosocial and physical stressors in the workplace of public hospital nurses in Malaysia.

  11. Quek KF, Low WY, Razack AH, Loh CS
    BJU Int, 2001 Jul;88(1):21-5.
    PMID: 11446839
    OBJECTIVE: To validate the English version of the International Prostate Symptom Score (IPSS) in patients with and without urinary symptoms in a Malaysian population.

    PATIENTS AND METHODS: Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test-retest method and internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate (TURP).

    RESULTS: Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's alpha > or = 0.60 and > or = 0.79, respectively) in the populations studied. The test-retest correlation coefficient for the seven domain scores was highly significant. The intra-class correlation coefficient was high (> or = 0.59). There was a high level of sensitivity and specificity for the effects of treatment, with a very significant change between the seven scores domains in the treated group but not in the control group.

    CONCLUSIONS: The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

  12. Quek KF, Low WY, Razack AH, Loh CS
    Med J Malaysia, 2001 Sep;56(3):293-301.
    PMID: 11732073
    Main objective of this study is to validate the Health-Related Quality of Life (HRQOL-20) in the Malaysian population. Reliability and internal consistency were evaluated using the test-retest method and Cronbach's alpha. Responsiveness was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.68 to 0.87). Test-retest correlation coefficients and intraclass correlation coefficient were significant (ICC = 0.58 and 0.91) as well as the high degree of sensitivity and specificity. The HRQOL-20 is a reliable, valid and sensitive to clinical changes in the Malaysian urological population.
  13. Quek KF, Low WY, Razack AH, Loh CS
    Med J Malaysia, 2001 Sep;56(3):285-92.
    PMID: 11732072
    This study aimed to validate the Beck Depression Inventory (BDI) in the Malaysian urological population. Reliability and internal consistency were evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Responsiveness was expressed as the effect size. Internal consistency was high (Cronbach's alpha value = 0.56 to 0.87). Test-retest correlation coefficient and intraclass correlation coefficient were significant (ICC = 0.56 to 0.87) and a high degree of sensitivity and specificity. The BDI is thus a reliable and a valid instrument to be used in Malaysia.
  14. Quek KF, Loh CS, Low WY, Razack AH, Dublin N
    J Sex Marital Ther, 2003 Mar-Apr;29(2):173-6.
    PMID: 12623769
  15. Quek KF, Low WY, Razack AH, Loh CS
    BJU Int, 2000 Oct;86(6):630-3.
    PMID: 11069367
    OBJECTIVE: To assess and evaluate the level of depression, anxiety and psychiatric status in patients with lower urinary tract symptoms (LUTS) before and after treatment by surgery or drugs.

    PATIENTS AND METHODS: The study included 123 patients (mean age 64.6 years, SD 7. 95) with LUTS who were treated medically (with alpha-blockers, i.e. terazosin, prazosin, doxazosin and alfuzosin), and 52 patients (mean age 69.6 years, SD 7.94) with LUTS and confirmed to have benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Both groups were assessed at baseline and 3 months after treatment using standardized questionnaires (the Beck Depression Inventory, the State-Trait Anxiety Inventory and the General Health Questionnaire-12).

    RESULTS: Patients before TURP were significantly more depressed, worried and psychiatrically morbid than were those before medical treatment. Three months after medical and surgical treatment, there was significantly less depression, anxiety and psychiatric morbidity in the TURP than in the medication group.

    CONCLUSIONS: TURP is a better treatment than medication for minimising anxiety, depression and psychiatric morbidity after treatment in patients with LUTS, but causes greater psychological stress before treatment.

  16. Quek KF, Loh CS, Low WY, Razack AH
    World J Urol, 2001 Nov;19(5):358-64.
    PMID: 11760785
    The aim of this study was to determine the effects of surgical treatment of lower urinary tract symptoms (LUTS) in a Malaysian population by evaluating the quality of life before and after treatment.
  17. Quek KF, Loh CS, Low WY, Razack AH
    Med J Malaysia, 2001 Jun;56(2):158-66.
    PMID: 11771075
    We prospectively evaluated the effect of the treatment of lower urinary tract symptoms (LUTS) on sexual function. The patients were assessed by using the International Index of Erectile Function (IIEF-15) inventory at baseline and three months after medical (alpha-blockers) or surgical treatment (transurethral resection of the prostate, TURP). Following treatment, there were improvement in erectile function and intercourse satisfaction while orgasmic, overall satisfaction and sexual drive were relatively unchanged in the medication group. Patients who had surgical treatment suffered retrograde ejaculation, dissatisfaction in sexual intercourse and overall sexual satisfaction compared to patients who were on alpha-blockers.
    Study site: Urology ward and clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  18. Hussein H, Mustafa R, Quek KF, Hassanudin NS, Shahid S
    Int J Rheum Dis, 2008;11(3):237-240.
    DOI: 10.1111/j.1756-185X.2008.00384.x
    Objective: To validate the Malay version of the Health Assessment Questionnaire (Malay-HAQ) for use in Malay-speaking rheumatoid arthritis (RA) patients in the Malaysian setting. The HAQ - Disability Index has been validated in several languages, but not in Malay.Methods: The original HAQ was modified and translated into Malay by two translators, one of whom was aware of the objectives of the Questionnaire and the other as a lay translator. Two sets of Malay-HAQ were distributed to RA patients during their routine follow-up visits; one set to be completed immediately and another set to be completed 2 weeks later. A total of 61 patients completed the two sets of Malay-HAQ. The data collected was analysed using SPSS V. 11.0. Reliability of the data was evaluated using the test-retest method and internal consistency was assessed by Cronbach's alpha.Results: The study showed that the Malay-HAQ is feasible and reliable. The Spearman's correlation coefficient ranged from 0.65 to 0.82, while the internal consistency was 0.88-0.92.Conclusion: The Malay-HAQ is a sensitive, reliable and valid instrument for the measurement of functional status in RA patients in a Malay setting. © 2008 Asia Pacific League of Associations for Rheumatology.
  19. Nissapatorn V, Lee C, Quek KF, Abdullah KA
    Jpn J Infect Dis, 2003 Oct-Dec;56(5-6):187-92.
    PMID: 14695428
    We retrospectively reviewed 419 HIV/AIDS patients in Hospital Kuala Lumpur from 1994 to 2001. In the male group, the age range was 20-74, with a mean age 37 years, while in the female group it was 17-63, with a mean age of 33 years. With regard to age group, it was found that the preponderant age group was 25-34 years. The majority of male subjects were Chinese (52.5%), single (56.3%), and unemployed (55.1%), whereas the females were Malay (42.3%), married (79.5%), and non-laborer (64.1%). Also, both groups resided in Kuala Lumpur and had heterosexual contact as the leading cause of HIV transmission. More than half of the patients had CD4 cell counts of <200 cells/cumm. We found that the acquisition of HIV infection via intravenous drug use (IDU) was directly related to the incidence of tuberculosis infection (P < 0.05). Further analysis showed HIV-related tuberculosis with IDU was also dependently correlated with occupational status (unemployed) (P < 0.05). The four main AIDS-defining diseases include tuberculosis (48%), Pneumocystis carinii pneumonia (13%), toxoplasmic encephalitis (11%), and cryptococcal meningitis (7%); in addition, 53% of these patients were found to have CD4 cell counts of less than 200 cells/cumm at the time of diagnosis.
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