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  1. Subramaniam A, Silong AD, Uli J, Ismail IA
    BMC Med Educ, 2015;15:129.
    PMID: 26268222 DOI: 10.1186/s12909-015-0407-1
    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital.
    Matched MeSH terms: Inservice Training/methods*; Teaching/methods
  2. Jiamsakul A, Chaiwarith R, Durier N, Sirivichayakul S, Kiertiburanakul S, Van Den Eede P, et al.
    J Med Virol, 2016 Feb;88(2):234-43.
    PMID: 26147742 DOI: 10.1002/jmv.24320
    HIV drug resistance assessments and interpretations can be obtained from genotyping (GT), virtual phenotyping (VP) and laboratory-based phenotyping (PT). We compared resistance calls obtained from GT and VP with those from PT (GT-PT and VP-PT) among CRF01_AE and subtype B HIV-1 infected patients. GT predictions were obtained from the Stanford HIV database. VP and PT were obtained from Janssen Diagnostics BVBA's vircoType(TM) HIV-1 and Antivirogram®, respectively. With PT assumed as the "gold standard," the area under the curve (AUC) and the Bland-Altman plot were used to assess the level of agreement in resistance interpretations. A total of 80 CRF01_AE samples from Asia and 100 subtype B from Janssen Diagnostics BVBA's database were analysed. CRF01_AE showed discordances ranging from 3 to 27 samples for GT-PT and 1 to 20 samples for VP-PT. The GT-PT and VP-PT AUCs were 0.76-0.97 and 0.81-0.99, respectively. Subtype B showed 3-61 discordances for GT-PT and 2-75 discordances for VP-PT. The AUCs ranged from 0.55 to 0.95 for GT-PT and 0.55 to 0.97 for VP-PT. Didanosine had the highest proportion of discordances and/or AUC in all comparisons. The patient with the largest didanosine FC difference in each subtype harboured Q151M mutation. Overall, GT and VP predictions for CRF01_AE performed significantly better than subtype B for three NRTIs. Although discrepancies exist, GT and VP resistance interpretations in HIV-1 CRF01_AE strains were highly robust in comparison with the gold-standard PT.
    Matched MeSH terms: Microbial Sensitivity Tests/methods; Genotyping Techniques/methods
  3. Pahl C, Zare M, Nilashi M, de Faria Borges MA, Weingaertner D, Detschew V, et al.
    J Biomed Inform, 2015 Jun;55:174-87.
    PMID: 25900270 DOI: 10.1016/j.jbi.2015.04.004
    This work investigates, whether openEHR with its reference model, archetypes and templates is suitable for the digital representation of demographic as well as clinical data. Moreover, it elaborates openEHR as a tool for modelling Hospital Information Systems on a regional level based on a national logical infrastructure. OpenEHR is a dual model approach developed for the modelling of Hospital Information Systems enabling semantic interoperability. A holistic solution to this represents the use of dual model based Electronic Healthcare Record systems. Modelling data in the field of obstetrics is a challenge, since different regions demand locally specific information for the process of treatment. Smaller health units in developing countries like Brazil or Malaysia, which until recently handled automatable processes like the storage of sensitive patient data in paper form, start organizational reconstruction processes. This archetype proof-of-concept investigation has tried out some elements of the openEHR methodology in cooperation with a health unit in Colombo, Brazil. Two legal forms provided by the Brazilian Ministry of Health have been analyzed and classified into demographic and clinical data. LinkEHR-Ed editor was used to read, edit and create archetypes. Results show that 33 clinical and demographic concepts, which are necessary to cover data demanded by the Unified National Health System, were identified. Out of the concepts 61% were reused and 39% modified to cover domain requirements. The detailed process of reuse, modification and creation of archetypes is shown. We conclude that, although a major part of demographic and clinical patient data were already represented by existing archetypes, a significant part required major modifications. In this study openEHR proved to be a highly suitable tool in the modelling of complex health data. In combination with LinkEHR-Ed software it offers user-friendly and highly applicable tools, although the complexity built by the vast specifications requires expert networks to define generally excepted clinical models. Finally, this project has pointed out main benefits enclosing high coverage of obstetrics data on the Clinical Knowledge Manager, simple modelling, and wide network and support using openEHR. Moreover, barriers described are enclosing the allocation of clinical content to respective archetypes, as well as stagnant adaption of changes on the Clinical Knowledge Manager leading to redundant efforts in data contribution that need to be addressed in future works.
    Matched MeSH terms: Medical Record Linkage/methods; Information Storage and Retrieval/methods*
  4. Yew KL, Choy CN, Kam JY, Kang Z
    Int J Cardiol, 2015;187:530-1.
    PMID: 25863294 DOI: 10.1016/j.ijcard.2015.04.013
    Matched MeSH terms: Blood Specimen Collection/methods*; Coronary Angiography/methods
  5. Woo MK, Ng KH
    J Med Internet Res, 2003 Jan-Mar;5(1):e3.
    PMID: 12746208
    Medical physics is a relatively small community but it spans great geographical distances, usually with a scarcity of experts whose expertise could greatly benefit students entering into the field. In addition there are many software systems for which an interactive education method would be most advantageous.
    Matched MeSH terms: Nuclear Physics/methods; Education, Distance/methods*
  6. Deurenberg-Yap M, Deurenberg P
    Food Nutr Bull, 2002 Sep;23(3 Suppl):34-7.
    PMID: 12362808
    Body fat percent (BF%) was measured in 108 adult Chinese, 76 Malays, and 107 Indians in Singapore by densitometry, deuterium oxide dilution (hydrometry), dual energy x-ray absorptiometry (DXA) and a chemical four-compartment model (BF%4c). The hydration of the fat-free mass (FFM) was calculated. Subjects ranged in age from 18 to 69 years and their body mass index ranged from 16 to 40 kg/m2. BF%4c for the various subgroups were: Chinese females (33.5 +/- 7.5%), Chinese males (24.4 +/- 6.1%), Malay females (37.8 +/- 6.3%), Malay males (26.0 +/- 7.6%), Indian females (38.2 +/- 7.0%) and Indian males (28.1 +/- 5.5%). Biases were found between BF%4c and BF% measured by 2-compartment models (hydrometry, densitometry, DXA), with systematic underestimation by DXA and densitometry. On a group level hydrometry had the lowest bias while DXA gave the highest bias. When validated against BF%4c, 2-compartment models were found to be unsuitable for accurate measures of body fat due to high biases at the individual level and the violation of assumptions of constant hydration of FFM and density FFM among the ethnic groups. On a group level the best 2-compartment model for measuring body fat was found to be hydrometry.
    Matched MeSH terms: Densitometry/methods; Absorptiometry, Photon/methods
  7. Rahmah N, Taniawati S, Shenoy RK, Lim BH, Kumaraswami V, Anuar AK, et al.
    Trans R Soc Trop Med Hyg, 2002 1 31;95(6):601-4.
    PMID: 11816429
    A total of 753 serum samples from 6 institutions in 3 countries (Malaysia, Indonesia and India) were used to evaluate an immunochromatographic rapid dipstick test, Brugia Rapid, for diagnosis of Brugia malayi infection. The samples comprised sera from 207 microfilaria-positive individuals and 546 individuals from filaria non-endemic areas. The latter consisted of 70 individuals with soil-transmitted helminth infections, 68 with other helminth infections, 238 with protozoan infections, 12 with bacterial and viral infections and 158 healthy individuals. The dipstick is prepared with a goat anti-mouse antibody control line and a B. malayi recombinant-antigen test line. First, the dipstick is dipped into a well containing diluted patient serum, thus allowing specific anti-filarial antibody in the serum to react with the recombinant antigen. Then the dipstick is placed into an adjacent well containing reconstituted anti-human IgG4-gold. After 10 min, development of 2 red-purplish lines denotes a positive result and one line indicates a negative reaction. The overall results of the evaluation showed 97% sensitivity, 99% specificity, 97% positive predictive value and 99% negative predictive value. Brugia Rapid is thus a promising diagnostic tool for detection of B. malayi infection, and would be especially useful for the brugian filariasis elimination programme.
    Matched MeSH terms: Chromatography/methods; Immunoassay/methods
  8. Abdullah J, Ariff AR, Ghazaime G, Naing NN
    Stereotact Funct Neurosurg, 2001;76(3-4):175-80.
    PMID: 12378096
    The beneficial effects of stereotactic third ventriculostomy versus ventriculoperitoneal shunt were evaluated in 62 paediatric patients and analysed in relation to age, sex, clinical history, presence of meningomyelocele, magnetic resonance imaging measurements of hydrocephalus and third ventricle floor size. The third ventriculostomy were done on 50 patients using the Richard-Wolf Caemaert Endoscope and the Leksell Stereotactic Frame Model G. These patients were operated using the 4-French Fogarty catheter to open the base of the third ventricle. During the same period of study 12 paediatric patients with aqueduct stenosis who were managed by ventriculoperitoneal shunt were included. Both surgical procedures were compared. Statistically univariate analysis revealed that those patient with an age group of more than six months undergoing ventriculostomy had good outcome. Multivariate analysis revealed that past history of haemorrhage and/or meningitis were predictors of poor outcome. Sex, size of lumbar meningocele at birth, abnormal ventricular anatomy or narrow third ventricular floor size were non predictors of bad outcome in these patients. There was no difference in outcome in both the shunt or ventriculostomy group.
    Matched MeSH terms: Endoscopy/methods; Ventriculostomy/methods
  9. Lee CT
    SPUMS J, 1998 Sep;28(3):125-32.
    PMID: 11542272
    The Sharpened Romberg Test (SRT) is a test of balance commonly used in Diving Medicine. Interpretation of an abnormal test can be confounded by several factors. This study was conducted to further evaluate the usefulness of the SRT. In the first part of the study, naval and civilian volunteers in a Naval Base were recruited as subjects. The SRT scores were recorded in two separate trials; once in the morning (4 attempts) and once in the evening (4 attempts) to evaluate the effect of practice on the SRT. In the second part of the study immediate pre- and post-dive scores in a group of divers were measured to evaluate: (1) the effect of decompression; (2) the effect of the normal post-dive fatigue; and (3) the vestibular effect of swaying after a boat ride. Comparisons were also made between the distributions of the SRTs of the normal subjects and those of a retrospective group of DCI patients treated at the Slark Hyperbaric Unit, Royal New Zealand Navy Hospital (RNZNH), Auckland. The SRT was found to have an early learning effect. Second attempts were significantly better than the first (p<0.001) within the same trial. However this learning effect plateaued by the third and fourth attempts. No difference was found between trials (morning and evening). There was a post-dive decline in the scores of the first attempts only (p<0.05). Subsequent second to fourth attempts were not affected by diving. The practice effect is only evident between the first and second attempts within the same trial but not between trials. The pre- and post-dive data showed that the SRT was not affected by decompression, post-dive fatigue or the vestibular sensation of swaying that is commonly experienced after a boat ride. Comparison of the distributions between controls and DCI patients showed a bimodal pattern. Fifty-four percent (54%) of the DCI patients had 'normal' scores (60 seconds), while 14% had scores between 16-35 seconds and 32% scored less than 15 seconds. In contrast, 95% of the control groups had 'normal' scores while 5% scored between 16-35 seconds. Therefore, accepting a score of less than 40 seconds as being "abnormal" will give the SRT a sensitivity of 46%, specificity of 95% and predictive value of 82%.
    Matched MeSH terms: Naval Medicine/methods; Neurologic Examination/methods*
  10. Chiu CL, Ong GS
    Ann Acad Med Singap, 2000 Mar;29(2):256-8.
    PMID: 10895351
    INTRODUCTION: We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation.

    CLINICAL PICTURE: A 51-year-old man had an uneventful anaesthesia lasting about 6.5 hours. Intubation was performed by a very junior medical officer and was considered difficult. He developed sore throat, chest pain, numbness of both hands and palpable crepitus around the neck postoperatively. Chest X-ray revealed diffuse subcutaneous emphysema, pneumomediastinum and possible pneumopericardium.

    TREATMENT: He was treated conservatively with bed rest, oxygen, analgesia, antibiotic prophylaxis, reassurance and close monitoring.

    OUTCOME: The patient made an uneventful recovery.

    CONCLUSIONS: We discussed the possible causes.

    Matched MeSH terms: Anesthesia, General/methods; Intubation, Intratracheal/methods
  11. Palaniappan R, Paramesran R, Nishida S, Saiwaki N
    IEEE Trans Neural Syst Rehabil Eng, 2002 Sep;10(3):140-8.
    PMID: 12503778
    This paper proposes a new brain-computer interface (BCI) design using fuzzy ARTMAP (FA) neural network, as well as an application of the design. The objective of this BCI-FA design is to classify the best three of the five available mental tasks for each subject using power spectral density (PSD) values of electroencephalogram (EEG) signals. These PSD values are extracted using the Wiener-Khinchine and autoregressive methods. Ten experiments employing different triplets of mental tasks are studied for each subject. The findings show that the average BCI-FA outputs for four subjects gave less than 6% of error using the best triplets of mental tasks identified from the classification performances of FA. This implies that the BCI-FA can be successfully used with a tri-state switching device. As an application, a proposed tri-state Morse code scheme could be utilized to translate the outputs of this BCI-FA design into English letters. In this scheme, the three BCI-FA outputs correspond to a dot and a dash, which are the two basic Morse code alphabets and a space to denote the end (or beginning) of a dot or a dash. The construction of English letters using this tri-state Morse code scheme is determined only by the sequence of mental tasks and is independent of the time duration of each mental task. This is especially useful for constructing letters that are represented as multiple dots or dashes. This combination of BCI-FA design and the tri-state Morse code scheme could be developed as a communication system for paralyzed patients.
    Matched MeSH terms: Brain Mapping/methods*; Electroencephalography/methods
  12. Bakeri SA, Yasin RM, Koh YT, Puthucheary SD, Thong KL
    J Appl Microbiol, 2003;95(4):773-80.
    PMID: 12969291
    The study was undertaken to determine clonal relationship and genetic diversity of the human strains of Salmonella enterica serovar Enteritidis isolated from 1995 to 2002 from different parts of Malaysia.
    Matched MeSH terms: Microbial Sensitivity Tests/methods; Electrophoresis, Gel, Pulsed-Field/methods
  13. Ainoon O, Alawiyah A, Yu YH, Cheong SK, Hamidah NH, Boo NY, et al.
    PMID: 12971572
    Neonatal screening for G6PD deficiency has long been established in many countries. The aim of the study was to determine whether the routine semiquantitative fluorescent spot test could detect all cases of G6PD deficiency, including those cases with partial deficiency (residual red cell G6PD activity between 20-60% of normal). We compared the results of G6PD screening by the semiquantitative fluorescent spot test and quantitative G6PD activity assay on a group of 976 neonates and 67 known female heterozygotes. The values for mean G6PD activity of G6PD-normal neonates and 293 healthy adult females were determined. There was no significant difference in the mean normal G6PD activity between the two racial groups in the neonates (669 Malays, 307 Chinese) and in the 293 healthy adult females (150 Malays, 143 Chinese) group. The values for the upper limits of total deficiency (20% of normal residual activity) for neonates and adult females were 2.92 U/gHb and 1.54 U/gHb, respectively. The upper limits of partial deficiency (60% of normal residual activity) were 8.7 U/gHb and 4.6 U/gHb respectively. The prevalence of G6PD deficiency among the male neonates was 5.1% (26) by both the fluorescent spot test and the enzyme assay method. The G6PD activity levels of all 26 cases of G6PD-deficient male neonates were < 20% normal (severe enzyme deficiency). In the female neonate group, the frequency of G6PD deficiency was 1.3% (6 of 472) by the fluorescent spot test and 9.35% (44 of 472) by enzyme assay. The 6 cases diagnosed as deficient by the fluorescent spot test showed severe enzyme deficiency (< 2.92 U/gHb). The remaining 38 female neonates had partial enzyme deficiency and all were misdiagnosed as normal by the fluorescent spot test. In the female heterozygote group, G6PD deficiency was diagnosed in 53% (35 of 67) by enzyme assay and in 7.5% (4 of 67) of cases by the fluorescent spot test. The 4 cases detected by fluorescent spot test had severe enzyme deficiency (<1.6 U/gHb). The remaining 31 (46.3%) cases, diagnosed as normal by fluorescent spot test, showed partial G6PD deficiency. In conclusion, we found that the semiquantitative fluorescent spot test could only diagnose cases of total G6PD deficiency and misclassified the partially-deficient cases as normal. In this study, the overall prevalence of G6PD deficiency was 3.28% by the semiquantitative fluorescent spot test and 7.17% by enzyme assay. This means that 3.9% of G6PD-deficient neonates were missed by the routine fluorescent spot test and they were found to be exclusively females. This study demonstrates a need to use a method that can correctly classify female heterozygotes with partial G6PD deficiency. The clinical implication is that these individuals may be at risk of the hemolytic complication of G6PD deficiency.
    Matched MeSH terms: Genetic Testing/methods; Neonatal Screening/methods
  14. Wong AK, Sushila S, Thomas H, Tong JMG
    Med J Malaysia, 1999 Mar;54(1):102-9.
    PMID: 10972012
    A total of 155 consecutive anaesthetics in three public Malaysian hospitals were prospectively studied to assess preoxygenation practices by their anaesthesia providers. Preoxygenation was practised in 96.1% of patients. Specialist and non-specialist anaesthesiologist did not preoxygenate 8.8% and 2.3% of their patients, respectively. Overall incidence of arterial oxygen desaturation during induction was 15.5%. Arterial oxygen desaturation occurred more frequently with emergency surgery (30.2%) in comparison to elective surgery (9.8%). Arterial oxygen desaturation occurred more frequently with non-specialist (18.9%) than specialist anaesthesia providers (3.0%).
    Matched MeSH terms: Anesthesia, General/methods; Anesthesiology/methods*
  15. Nambiar P, Yaacob H, Menon R
    J Forensic Odontostomatol, 1996 Dec;14(2):30-3.
    PMID: 9227080
    Teeth are the most durable structures in the human body. The timing and sequence of their development, as contained in dental development charts, have been used as valid criteria for age determination. The third molars however are the last teeth to erupt and are regarded as the most variable in the dentition. Age estimation in a legal context, using developing third molars must be carefully applied otherwise justice may miscarry. A case of wrongful use of the technique is presented here.
    Matched MeSH terms: Age Determination by Teeth/methods*; Forensic Dentistry/methods*
  16. Ross RS, Viazov S, Schmitt U, Schmolke S, Tacke M, Ofenloch-Haehnle B, et al.
    J Med Virol, 1998 Feb;54(2):103-6.
    PMID: 9496367
    Since the identification of the new human virus, GB virus C (GBV-C)/hepatitis G-virus (HGV), in 1995/1996, reverse transcription polymerase chain reaction remained the sole available diagnostic tool for GBV-C/HGV infection. Recently, a serologic test based on the detection of antibodies to the putative envelope protein 2 (anti-E2) has been introduced. We used this assay for a seroepidemiological survey including 3,314 healthy individuals from different parts of the world, 123 patients from Germany who were suspected to have an increased risk of acquiring GBV-C/HGV infection, 128 multiple organ donors, and 90 GBV-C/HGV RNA positive persons. In European countries, anti-E2 seropositivity ranged from 10.9% (Germany) to 15.3% (Austria). In South Africa (20.3%) and Brazil (19.5%), even higher anti-E2 prevalence rates were recorded. In Asian countries like Bhutan (3.9%), Malaysia (6.3%), and the Philippines (2.7%), anti-E2 positivity was significantly lower. GBV-C/HGV anti-E2 prevalence in potential "risk groups," i.e., patients on hemodialysis and renal transplant recipients, did not vary significantly from anti-E2 seroprevalence in German blood donors. Anti-E2 and GBV-C/HGV RNA were found to be mutually exclusive, confirming the notion that anti-E2 has to be considered as a marker of past infection.
    Matched MeSH terms: Immunoassay/methods; Polymerase Chain Reaction/methods
  17. Razak IA, Lind OP
    Singapore Dent J, 1995 Jul;20(1):11-5.
    PMID: 9582683
    A questionnaire survey on cross-infection control was conducted among 1371 professionally trained dentists whose names appeared in the Malaysian Government Gazette of 1990. A 73.1 percent response rate was obtained. About 13 percent of the dentists routinely did not wear gloves during treatment of patients as opposed to 54 percent who routinely did. About 83 percent and 52 percent of dentists wore a mask and eyewear or glasses respectively when carrying out dental procedures. About 93 percent of dentists would use a new sterile needle for each patient and about 40 percent would wipe working surfaces with disinfectant after each patient. The practice of sterilizing handpieces was found to be uncommon as opposed to the sterilization of hand instruments. Variations were observed in some of the infection control measures by gender, seniority in service and employment status. More than one-third of the respondents had experienced puncture wounds during the last month prior to the survey.
    Matched MeSH terms: Disinfection/methods; Sterilization/methods
  18. Ishak R, Zakaria Z
    PMID: 9561621
    Hemophilia B is an X-linked recessive disorder of the hemostasis involving a defective clotting factor IX. Amplification of the regions containing restriction fragment length polymorphisms (RFLP) can be achieved by the use of polymerase chain reaction (PCR). This paper describes the analysis of 2 RFLPs involving the Dde1 and Taq1 restriction sites within the factor IX gene in a family with hemophilia B. Digestion of the PCR products with Taq1 revealed a 163bp fragment in all the family members. This finding suggests the absence of restriction site for Taq1 enzyme. However, the Dde1 digest results in bands 369bp and 319bp segregated amongst the family members. The pattern of inheritance of the 369bp fragment in this family suggested that both the patient's mother and aunt are not carriers and that the patient's factor IX gene could have undergone a de novo mutation producing a defective factor IX gene responsible for the hemophilia B. This is supported by the fact that no family history of hemophilia B is indicated in the other male members within the family.
    Matched MeSH terms: Heterozygote Detection/methods*; Polymerase Chain Reaction/methods*
  19. Eamsobhana P, Yong HS, Mak JW, Wattanakulpanich D
    PMID: 9561620
    A dot-blot ELISA was compared with a previously performed sandwich ELISA for the detection of Parastrongylus cantonensis antigens in sera from patients. Using the same monoclonal antibody and the same sera, 6 of 10 sera (60%) from parastronglyiasis patients were positive in dot-blot ELISA, whereas with sandwich ELISA, 5 of the same patient sera (50%) were positive. The specificity in both assays was 100% using 50 sera from patients with other parasitic diseases; of these, 10 each were from patients with cysticercosis, filariasis, gnathostomiasis, malaria and toxocariasis. The control group consisted of 53 sera from normal health Thais and Malaysians. The sensitivity of the assays was, however, slightly better with dot-blot ELISA and because it is simple, quick and cost-effective, it may be a test of choice for specific diagnosis of human parastrongyliasis.
    Matched MeSH terms: Enzyme-Linked Immunosorbent Assay/methods*; Immunoblotting/methods*
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