MyMedR

Fulltext Getting to know journal bibliographic databases

Ng KH, Peh WC

Singapore Med J, 2010 Oct;51(10):757-60; quiz 761.

A bibliographic database is an organised digital collection of references to published literature. A bibliographic database may be general in scope or may cover a specific academic discipline. There are many types of medical and general bibliographic databases. They cover biomedical and scientific literature, morbidity and mortality statistics, therapeutic regimens, medical records, images and reviews of evidence-based medicine. Getting to know these databases will help researchers and authors to enhance their writing and publishing endeavours.

Fulltext Writing a technical note

Ng KH, Peh WC

Singapore Med J, 2010 Feb;51(2):101-3; quiz 104.

PMID: 20358146

A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.

Fulltext Writing a case report

Peh WC, Ng KH

Singapore Med J, 2010 Jan;51(1):10-3; quiz 14.

PMID: 20200769

A case report is a description of a single case with unique features. This includes a previously-unreported clinical condition, previously-unreported observation of a recognised disease, unique use of imaging or diagnostic test to reveal a disease, previously-unreported treatment in a recognised disease, or previously-unreported complication of a procedure. Case reports should be short and focused, with a limited number of figures and references. The structure of a case report usually comprises a short unstructured (or no) abstract, brief (or no) introduction, succinct but comprehensive report of the case, and to-the-point discussion.

Fulltext Writing the materials and methods

Ng KH, Peh WC

Singapore Med J, 2008 Nov;49(11):856-8; quiz 859.

PMID: 19037549

When writing scientific papers to share their research findings with their peers, it is not enough for researchers to just communicate the results of their study; it is equally important to explain the process by which they arrived at their results, so that the study can be replicated to validate the observations. The materials and methods section is used to describe the experimental design and provide sufficient details so that a competent colleague can repeat the experiment. A good materials and methods section will enable readers to evaluate the research performed and replicate the study, if necessary.

Fulltext Preparing effective tables

Ng KH, Peh WC

Singapore Med J, 2009 Feb;50(2):117-8; quiz 119.

PMID: 19296024

Tables are used in scientific papers to present information in a concise and efficient manner. Tables are able to provide information at any desired level of detail and precision. Presenting data in a table rather than as part of the text is also an effective way to reduce the length of the text. This article provides some basic guidelines to assist authors in preparing clear and effective tables for their papers.

Fulltext Presenting the statistical results

Ng KH, Peh WC

Singapore Med J, 2009 Jan;50(1):11-4.

PMID: 19224078

Statistical methods are reported in a scientific paper to summarise the data that has been collected for a study and to enable its analysis. These methods should be described with enough detail to allow a knowledgeable reader who has access to the original data to verify the reported results. This article provides basic guidelines to aid authors in reporting the statistical aspects of the results of their studies clearly and accurately.

Fulltext Writing the results

Ng KH, Peh WC

Singapore Med J, 2008 Dec;49(12):967-8; quiz 969.

PMID: 19122944

The purpose of the results section is to present the main data collected and the observations made during the research. It provides interpretation of the analysed data and does not contain details on the methods, materials or discussion. The first step in writing the results section is to review the analysed data and determine which results to present. This can be done by deciding which results are relevant to the question(s) presented in the introduction, and may be supplemented by illustrative tables and figures. The results section guides the reader through the questions investigated in the study and sets the stage for the discussion in the next section.

Fulltext Moving into the digital era: a novel experience with the first full-field digital mammography system in Malaysia

Ranganathan S, Faridah Y, Ng KH

Singapore Med J, 2007 Sep;48(9):804-7.

PMID: 17728959

Breast cancer is the commonest cancer in women and represents a significant problem from the clinical and public health perspectives. The aim of this paper is to report our experience of transitioning from screen-film mammography (SFM) to computed radiography mammography (CRM), and finally to full-field digital mammography (FFDM), and to evaluate the performance of these three different types of mammographic systems.

The Effect of Prehospital Epinephrine in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

Ng KT, Teoh WY

Prehosp Disaster Med, 2019 Oct;34(5):532-539.

PMID: 31455452 DOI: 10.1017/S1049023X19004758

INTRODUCTION: Epinephrine has been recommended for out-of-hospital cardiac arrest (OHCA) resuscitation for nearly one century, but its efficacy and safety remain unclear in the literature. The primary aim of this review was to determine whether epinephrine increases the return of spontaneous circulation in OHCA patients.

METHODS: A systematic review and meta-analysis were conducted using the following databases: MEDLINE, EMBASE, and CENTRAL, from their inception until October 2018. All the randomized controlled trials (RCTs) were included. Observational studies, case reports, case series, and non-systematic reviews were excluded.

RESULTS: Two trials including 8,548 patients were eligible for inclusion in the data synthesis. In patients who received epinephrine during OHCA, the incidence of return of spontaneous circulation was increased, with an odds ratio (95%CI) of 4.25 (3.79-4.75), P

Author Reply

Teoh WY, Ng KT

Prehosp Disaster Med, 2020 Jun;35(3):352.

PMID: 32264983 DOI: 10.1017/S1049023X20000436

Writing a systematic review

Ng KH, Peh WC

Singapore Med J, 2010 May;51(5):362-6.

PMID: 20593139

Evidence-based medicine (EBM) aims to combine the best available scientific evidence with clinical experience and individual judgment of patient needs. In the hierarchy of scientific evidence, systematic reviews (along with meta-analyses) occupy the highest levels in terms of the quality of evidence. A systematic review is the process of searching, selecting, appraising, synthesising and reporting clinical evidence on a particular question or topic. It is currently considered the best, least biased and most rational way to organise, gather, evaluate and integrate scientific evidence from the rapidly-changing medical and healthcare literature. Systematic reviews could be used to present current concepts or serve as review articles and replace the traditional expert opinion or narrative review. This article explains the structure and content of a systematic review.

Optimal beam quality selection based on contrast-to-noise ratio and mean glandular dose in digital mammography

Aminah M, Ng KH, Abdullah BJ, Jamal N

Australas Phys Eng Sci Med, 2010 Dec;33(4):329-34.

PMID: 20938762 DOI: 10.1007/s13246-010-0035-3

The performance of a digital mammography system (Siemens Mammomat Novation) using different target/filter combinations and tube voltage has been assessed. The objective of this study is to optimize beam quality selection based on contrast-to-noise ratio (CNR) and mean glandular dose (MGD). Three composition of breast were studied with composition of glandular/adipose of 30/70, 50/50, and 70/30. CNR was measured using 2, 4 and 6 cm-thick simulated breast phantoms with an aluminium sheet of 0.1 mm thickness placed on top of the phantom. Three target/filter combinations, namely molybdenum/molybdenum (Mo/Mo), molybdenum/rhodium (Mo/Rh) and tungsten/rhodium (W/Rh) with various tube voltage and mAs were tested. MGD was measured for each exposure. For 50/50 breast composition, Mo/Rh combination with tube voltage 26 kVp is optimal for 2 cm-thick breast. W/Rh combination with tube voltage 27 and 28 kVp are optimal for 4 and 6 cm-thick breast, respectively. For both 30/70 and 70/30 breast composition, W/Rh combination is optimal with tube voltage 25, 26 and 27 kVp, respectively. From our study it was shown that there are potential of dose reduction up to 11% for a set CNR of 3.0 by using beam quality other than that are determined by AEC selection. Under the constraint of lowest MGD, for a particular breast composition, calcification detection is optimized by using a softer X-ray beam for thin breast and harder X-ray beam for thick breast. These experimental results also indicate that for breast with high fibroglandular tissues (70/30), the use of higher beam quality does not always increase calcification detection due to additional structured noise caused by the fibroglandular tissues itself.

The characteristics of Fuji IP Cassette Type PII and application for radiation oncology quality assurance tests and portal imaging

Soh HS, Ung NM, Ng KH

Australas Phys Eng Sci Med, 2008 Jun;31(2):146-50.

PMID: 18697706

The advancement of digital imaging has prompted more medical institutions to go filmless. The computed radiography (CR) system is becoming an important tool not only in diagnostic imaging, but also in radiation oncology. A new CR system that was specially designed for the use in radiation oncology, Fuji IP cassette type PII has been introduced to the market in the middle of year 2006. This project aimed to study some basic physical characteristics of this new type of cassette and explore its application for performing quality assurance (QA) tests and portal imaging in radiotherapy. All the images were read by FCR 5000 Plus reader. The image was found to reach its saturation value of 1023 (due to the image was stored in 10 bits data) by depending on the sensitivity value being adjusted. The uniformity test gave the result of 0.12%. The cassette was used to perform the QA tests which were previously performed using film. All the results met the specification as stated in AAPM Task Group 40. The comparison for the portal images of PortalVision contrast-detail phantom showed that the spatial resolution of the images obtained by CR system (Fujifilm Co., Ltd., Tokyo, Japan) were better than the EPID (Varian Medical Systems, Inc., Palo Alto, USA) and film system (Eastman Kodak Co., New York, USA). The IP cassette type PII was found to be suitable as an alternative QA test tool and portal imaging in radiotherapy.

Oral candidal species among smokers and non-smokers

Rasool S, Siar CH, Ng KP

J Coll Physicians Surg Pak, 2005 Nov;15(11):679-82.

PMID: 16300700

To determine the various oral Candidal species among healthy Malaysian adults.

Fulltext Phytobezoar: an unusual cause of intestinal obstruction

Teng H, Nawawi O, Ng K, Yik Y

Biomed Imaging Interv J, 2005 Jul;1(1):e4.

PMID: 21625276 MyJurnal DOI: 10.2349/biij.1.1.e4

Small bowel phytobezoars are rare and almost always obstructive. There have been previously reported cases of phytobezoars in the literature, however there are few reports on radiological findings for small bowel bezoars. Barium studies characteristically show an intraluminal filling defect of variable size that is not fixed to the bowel wall with barium filling the interstices giving a mottled appearance. On CT scan, the presence of a round or ovoid intraluminal mass with a 'mottled gas' pattern is believed to be pathognomonic. Since features on CT scans are characteristics and physical findings are of little assistance in the diagnosis of bezoar, the diagnostic value of CT needs to be emphasised.

Fulltext Reduction of intubation rate during newborn resuscitation after transition from self-inflating bag to T-piece resuscitator

Ng KF, Choo P, Paramasivam U, Soelar SA

Med J Malaysia, 2015 Aug;70(4):228-31.

PMID: 26358019

INTRODUCTION: T-piece resuscitator (TPR) has many advantages compared to self-inflating bag (SIB). Early Continuous Positive Airway Pressure (CPAP) during newborn resuscitation (NR) with TPR at delivery can reduce intubation rate.
METHODS: We speculated that the intubation rate at delivery room was high because SIB had always been used during NR and this can be improved with TPR. Intubation rate of newborn <24 hours of life was deemed high if >50%. An audit was carried out in June 2010 to verify this problem using a check sheet.
RESULTS: 25 neonates without major congenital anomalies who required NR with SIB at delivery were included. Intubation rate of babies <24 hours of life when SIB was used was 68%. Post-intervention audit (August to November 2010) on 25 newborns showed that the intubation rate within 24 hours dropped to 8% when TPR was used. Proportion of intubated babies reduced from 48.3% (2008-2009) to 35.1% (2011-2012), odds ratio 0.58 (95% CI 0.49-0.68). Proportion of neonates on CPAP increased from 63.5% (2008-2009) to 81.0% (2011-2012), odds ratio 2.44 (95% CI 2.03-2.93). Mean ventilation days fell to below 4 days after 2010. Since then, all delivery standbys were accompanied by TPR and it was used for all NR regardless of settings. There was decline in intubation rate secondary to early provision of CPAP with TPR during NR. Mean ventilation days, mortality and length of NICU stay were reduced.
CONCLUSION: This practice should be adopted by all hospitals in the country to achieve Millennium Development Goal 4 (2/3 decline of under 5 mortality rate) by 2015.
Study site: Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia

Health beliefs in oral cancer: Malaysian estate Indian scenario

Tan BS, Ng KH, Esa R

Patient Educ Couns, 2001 Mar;42(3):205-11.

PMID: 11164319

This is a study to describe the health beliefs related to oral cancer (OC) in a high-risk group in Malaysia, a predominantly Indian community living in an agricultural setting called an estate. The study population was a convenient sample of 112 adults, above 20 years of age, attending oral cancer screening in two estates. The subjects consisted of 106 (94.6%) Indians and six (5.4%) Malays. Using the Health Belief Model, the perceptions of susceptibility to OC, its severity, and the benefits of and barriers to preventive actions, as well as beliefs underlying OC aetiology were investigated. About half of the subjects (n=57, 50.9%) felt susceptible to oral cancer. A majority of subjects (n=93, 83.0%) felt that oral cancer is a severe disease. Thirty four people (30.4%) perceived OC as a preventable disease, while 56 (50%) did not, and the remaining 22 (19.6%) did not know if OC was preventable or not. The majority of subjects (84.8%) believed that modifications to the betel quid habit could be beneficial. The information solicited can be used as a starting point to design health-education activities aimed at this group in particular and the population in general.

An in vitro study comparing two different film-screen combinations in the detection of impacted fish bones

Abdullah BJ, Kaur H, Ng KH

Br J Radiol, 1998 Sep;71(849):930-3.

PMID: 10195007

Dried fish bones from eight species of Malaysian fish were placed in an animal cadaver at four sites (tonsil, valleculae, larynx and oesophagus) and radiographed using a double and a single film-screen combination. The use of the single film-screen combination resulted in visibility of all fish bones placed in the larynx, two of which were not visible on the double film-screen combination. There was a 50% increase of the visibility of the fish bones in the oesophagus using the single film-screen combination. The difference in dose and cost between the two different film-screen combinations was not significant.

Onychomycosis in Malaysia

Ng KP, Saw TL, Madasamy M, Soo Hoo T

Mycopathologia, 1999;147(1):29-32.

PMID: 10872513

The common etiological agents of onychomycosis are dermatophytes, molds and yeasts. A mycological nail investigation of onychomycosis using direct microscopy and culture was conducted by the Mycology Unit, Department of Medical Microbiology, University of Malaya from March 1996 to November 1998. The study involved 878 nail clippings or subungal scrapings from subjects with onychomycosis. On direct microscopy examination, 50% of the specimens were negative for fungal elements. On culture, 373 specimens had no growth; bacteria were isolated from 15 nail specimens. Among the 490 specimens with positive fungal cultures, 177 (36.1%) were dermatophytes, 173 (35.5%) were molds and 130 (26.5%) were Candida. There were 2% (10/490) mixed infections of molds, yeasts and dermatophytes. Trichophyton rubrum (115/177) and Trichophyton mentagrophytes (59/177) were the main dermatophytes isolated. The molds isolated were predominantly Aspergillus niger (61/173), Aspergillus nidulans (30/173), Hendersonula toruloidea (26/173) and Fusarium species (16/173). 96.9% of the Candida species identified were Candida albicans.

Fulltext Appendicitis following blunt abdominal trauma

Ramesh G, Ho PW, Ng KL, Jegan T

Med J Malaysia, 2002 Mar;57(1):123-4.

PMID: 14569731

A young boy presented with history of abdominal trauma. History and initial clinical findings suggested a soft tissue injury. Due to increasing abdominal pain and fever, we proceeded with an exploratory laparotomy with a diagnosis of intra-abdominal injury, at which we found a perforated appendix. Appendicitis following blunt abdominal trauma needs high index of suspicion.

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