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Fulltext Tracking Progress from Policy Development to Implementation: A Case Study on Adoption of Mandatory Regulation for Nutrition Labelling in Malaysia

Ng S, Kelly B, Yeatman H, Swinburn B, Karupaiah T

Nutrients, 2021 Jan 29;13(2).
PMID: 33573100 DOI: 10.3390/nu13020457

Mandatory nutrition labelling, introduced in Malaysia in 2003, received a "medium implementation" rating from public health experts when previously benchmarked against international best practices by our group. The rating prompted this qualitative case study to explore barriers and facilitators during the policy process. Methods incorporated semi-structured interviews supplemented with cited documents and historical mapping of local and international directions up to 2017. Case participants held senior positions in the Federal government (n = 6), food industry (n = 3) and civil society representations (n = 3). Historical mapping revealed that international directions stimulated policy processes in Malaysia but policy inertia caused implementation gaps. Barriers hindering policy processes included lack of resources, governance complexity, lack of monitoring, technical challenges, policy characteristics linked to costing, lack of sustained efforts in policy advocacy, implementer characteristics and/or industry resistance, including corporate political activities (e.g., lobbying, policy substitution). Facilitators to the policy processes were resource maximization, leadership, stakeholder partnerships or support, policy windows and industry engagement or support. Progressing policy implementation required stronger leadership, resources, inter-ministerial coordination, advocacy partnerships and an accountability monitoring system. This study provides insights for national and global policy entrepreneurs when formulating strategies towards fostering healthy food environments.
Laparoscopic management of 53 cases of cornual ectopic pregnancy

Ng S, Hamontri S, Chua I, Chern B, Siow A

Fertil Steril, 2009 Aug;92(2):448-52.
PMID: 18930204 DOI: 10.1016/j.fertnstert.2008.08.072

To present our experience of laparoscopic management of cornual ectopic pregnancy.
Two-year retrospective review of lens-induced glaucoma in Hospital Taiping, Perak, Malaysia

Zulaikha AR, Fhun LC, Ng SL, Shahidatul-Adha M

Med J Malaysia, 2024 Jul;79(4):452-456.
PMID: 39086343

INTRODUCTION: Delayed cataract surgery has long been known to cause lens-induced glaucoma (LIG). This study examined the demographic and clinical profile, ocular characteristics and outcomes of LIG in a tertiary referral centre in Malaysia.
MATERIALS AND METHODS: Data from the National Eye Database (Malaysia) for cataract surgery performed at Hospital Taiping, Perak, between January 2019 and December 2020 were reviewed. The medical records of patients with LIG were retrieved to obtain demographic data, clinical profiles and visual outcomes.
RESULTS: Of 3233 patients who underwent cataract surgery at Hospital Taiping, Perak, between 2019 and 2020, 25 underwent emergency surgery for LIG. However, only 24 patients fulfilling the diagnostic criteria for LIG were included in the study: 14 (58.33%) patients with phacomorphic and 10 (41.6%) patients with phacolytic glaucoma. The mean age of the patients was 66±12 years. Women and men were equally affected. Most patients were Malay (75%), followed by Chinese (16.67%) and Indian (8.33%). The anterior chamber depth (ACD) was significantly shallow with a mean value of 2.72 mm. Nineteen (79.1%) patients presented with visual acuity of worse than counting fingers. The mean intraocular pressure (IOP) at presentation was 47.5±13.66mmHg, which improved to 15.08±8.09mmHg postoperatively. A best-corrected visual acuity of 6/15 and better was achieved in 20 patients (83.33%) despite glaucomatous optic neuropathy being present in 41.67% of the cases. The majority (58.3%) of surgeries were performed via extracapsular cataract extraction, while six (25%) of our patients underwent successful phacoemulsification. Seven (29.17%) patients had intraocular complications: five with zonular dialysis and two with posterior capsule rupture. Of these seven cases, four ended up with intracapsular cataract extraction, leaving two of them aphakic.
CONCLUSION: Prompt cataract surgery is paramount in all LIG cases to reduce IOP and achieve better visual outcomes. Despite the promising prognosis associated with early surgical intervention, patients should be counselled about the potential for a guarded visual prognosis from complicated surgery and its long-term complications.
Perspectives of Nanoemulsion Strategies in The Improvement of Oral, Parenteral and Transdermal Chemotherapy

Pandey M, Choudhury H, Yeun OC, Yin HM, Lynn TW, Tine CLY, et al.

Curr Pharm Biotechnol, 2018;19(4):276-292.
PMID: 29874994 DOI: 10.2174/1389201019666180605125234

BACKGROUND: Targeting chemotherapeutic agents to the tumor tissues and achieving accumulation with ideal release behavior for desired therapy requires an ideal treatment strategy to inhibit division of rapid growing cancerous cells and as an outcome improve patient's quality of life. However, majority of the available anticancer therapies are well known for their systemic toxicities and multidrug resistance.
METHODS: Application of nanotechnology in medicine have perceived a great evolution during past few decades. Nanoemulsion, submicron sized thermodynamically stable distribution of two immiscible liquids, has gained extensive importance as a nanocarrier to improve chemotherapies seeking to overcome the limitations of drug solubilization, improving systemic delivery of the chemotherapeutics to the site of action to achieve a promising inhibitory in tumor growth profile with reduced systemic toxicity.
RESULTS AND CONCLUSION: This review has focused on potential application of nanoemulsion in the translational research and its role in chemotherapy using oral, parenteral and transdermal route to enhance systemic availability of poorly soluble drug. In summary, nanoemulsion is a multifunctional nanocarrier capable of enhancing drug delivery potential of cytotoxic agents, thereby, can improve the outcomes of cancer treatment by increasing the life-span of the patient and quality of life, however, further clinical research and characterization of interactive reactions should need to be explored.
13C NMR relaxation study of molecular motions in tetraphenyltin and tetra(p-tolyl)tin in solution

Ng S, Sathasivam RV, Lo KM, Xie Y, Schaefer HF

J Phys Chem A, 2005 Dec 29;109(51):12059-63.
PMID: 16366662

The Woessner approach is applied to the 13C relaxation data for tetraphenyltin (1) and tetra(p-tolyl)tin (2) in CDCl3 solution over the temperature range 5-42 degrees C to obtain correlation times for rotational motions and hence the activation barriers. Quantum mechanical computations were carried out to obtain the rotational energy barriers for comparison. For 2 the relaxation data indicate (1) slower ring rotation than in 1, (2) highly hindered internal rotation of the methyl group. IR and chemical shift data support the hypothesis of hyperconjugation of the methyl correlated with interaction between the pi-electrons and the 5d orbitals of tin in the (p-tolyl)Sn moiety to account for the hindrances to the rotations of the ring and the methyl. The activation barrier for the tolyl group rotation is found to be much higher than that for the phenyl rotation. However, the Woessner approach yields an anomalously high barrier for the methyl rotation. An explanation based on correlated rotations of the tolyl ring and the methyl is offered.
Fulltext Unbalanced chromosomal translocation: a cause of recurrent spontaneous abortion

Zarina AL, Jamil MA, Ng SP, Rohana J, Yong SC, Salwati S, et al.

Med J Malaysia, 2006 Jun;61(2):260-2.
PMID: 16898328 MyJurnal

Recurrent spontaneous abortion, defined as three consecutive abortions, occurs in approximately 1% to 2% of couples. Although the cause is unknown in up to 50% of cases, about 5% of these couples are found to be a balanced translocation carrier. We report a case in which the mother was identified to be a translocation carrier following the birth of a baby with multiple congenital abnormalities.
Nutrient composition, antioxidant properties, and anti-proliferative activity of Lignosus rhinocerus Cooke sclerotium

Yap YH, Tan N, Fung S, Aziz AA, Tan C, Ng S

J Sci Food Agric, 2013 Sep;93(12):2945-52.
PMID: 23460242 DOI: 10.1002/jsfa.6121

Lignosus rhinocerus (tiger milk mushroom) is an important medicinal mushroom used in Southeast Asia and China, and its sclerotium can be developed into functional food/nutraceuticals. The nutrient composition, antioxidant properties, and anti-proliferative activity of wild type and a cultivated strain of L. rhinocerus sclerotia were investigated.
Breastfeeding prevalence and practices among Singaporean Chinese, Malay and Indian mothers

Foo LL, Quek SJ, Ng SA, Lim MT, Deurenberg-Yap M

Health Promot Int, 2005 Sep;20(3):229-37.
PMID: 15814526

The National Breastfeeding Survey 2001 was the first comprehensive study on breastfeeding conducted on a national level in Singapore. It aimed to establish the prevalence of breastfeeding among Chinese, Malay and Indian mothers and to identify factors influencing breastfeeding. A total of 2098 mothers were interviewed in this two-phase study, with the first interview conducted 2 months after delivery and the second interview 6 months after birth among mothers who were still breastfeeding at 2 months. Frequency distributions of breastfeeding prevalence and types of breastfeeding practices at different time intervals (from birth to 6 months) were produced. Multivariate logistic regression was carried out to construct a model with predictive information on factors which influence continued breastfeeding till 2 months and 6 months after delivery respectively. The study found that about 94.5% of the mothers attempted breastfeeding. At 1 month, 71.6% were still breastfeeding, 49.6% continued to do so at 2 months, and 29.8% persisted till 4 months. By 6 months, the breastfeeding prevalence rate fell to 21.1%. The results of this study show higher breastfeeding prevalence rates compared to past studies in Singapore. Despite this, exclusive breastfeeding is still not a common practice. Various factors were found to be significant in influencing mothers' decision to breastfeed. Factors such as ethnicity, age, educational attainment, religion and baby's sex are non-modifiable in the short term or at an individual level. However, factors such as awareness of breastfeeding benefits, advice from health professionals and previous breastfeeding experience are potentially modifiable. Efforts aimed at promoting breastfeeding in Singapore need to take these modifiable factors into consideration so as to better tailor health promotion efforts on breastfeeding to women.
Fulltext New Insights on the Burstein-Moss Shift and Band Gap Narrowing in Indium-Doped Zinc Oxide Thin Films

Saw KG, Aznan NM, Yam FK, Ng SS, Pung SY

PLoS One, 2015;10(10):e0141180.
PMID: 26517364 DOI: 10.1371/journal.pone.0141180

The Burstein-Moss shift and band gap narrowing of sputtered indium-doped zinc oxide (IZO) thin films are investigated as a function of carrier concentrations. The optical band gap shifts below the carrier concentration of 5.61 × 1019 cm-3 are well-described by the Burstein-Moss model. For carrier concentrations higher than 8.71 × 1019 cm-3 the shift decreases, indicating that band gap narrowing mechanisms are increasingly significant and are competing with the Burstein-Moss effect. The incorporation of In causes the resistivity to decrease three orders of magnitude. As the mean-free path of carriers is less than the crystallite size, the resistivity is probably affected by ionized impurities as well as defect scattering mechanisms, but not grain boundary scattering. The c lattice constant as well as film stress is observed to increase in stages with increasing carrier concentration. The asymmetric XPS Zn 2p3/2 peak in the film with the highest carrier concentration of 7.02 × 1020 cm-3 suggests the presence of stacking defects in the ZnO lattice. The Raman peak at 274 cm-1 is attributed to lattice defects introduced by In dopants.
Age, sex, haemoglobin level, and white cell count at diagnosis are important prognostic factors in children with acute lymphoblastic leukemia treated with BFM-type protocol

Ng SM, Lin HP, Ariffin WA, Zainab AK, Lam SK, Chan LL

J Trop Pediatr, 2000 Dec;46(6):338-43.
PMID: 11191144

The presenting features and treatment outcome for 575 Malaysian children (< or = 12 years of age) with newly diagnosed acute lymphoblastic leukemia (ALL), admitted to the University Hospital, Kuala Lumpur, Malaysia between 1 January 1980 and 30 May 1995 were evaluated to determine their prognostic significance. Two-year overall survival was achieved in 67 per cent of all patients and 55 per cent of patients were relapse-free at 2 years. All except 10 patients, with identified French-American-British L3 morphology were treated with the modified Berlin-Frankfurt-Munster 78 treatment protocol. Univariate analyses of failure rate conferred age, sex, white cell count and hemoglobin level as potentially significant prognostic factors. All four presenting features retained their prognostic strength in a multivariate analysis. Race, platelet count, morphological subtype, liver/spleen size, lymphadenopathy, central nervous system and mediastinal mass involvement did not show any significant effect on treatment outcome. The 2-year survival rate was significantly different with regard to age, white cell count and hemoglobin level. However, sex was not significantly related to overall survival. These prognostic factors may have implications on future stratification of risk-adjusted initial treatment in the management of childhood ALL. Our analysis of Malaysian children is similar to what could be predicted based on previous studies in other populations.
Clinical features and treatment outcome of children with myeloid antigen coexpression in B-lineage acute lymphoblastic leukemia: a study of 151 Malaysian children

Ng SM, Ariffin WA, Lin HP, Chan LL, Chin YM

J Trop Pediatr, 2000 Apr;46(2):73-8.
PMID: 10822932

The purpose of the study was to evaluate the incidence of myeloid antigen coexpression and its prognostic significance in childhood acute lymphoblastic leukemia (ALL) in Malaysia. A retrospective study was conducted of all ALL cases (< or = 12 years old) diagnosed and treated in University Hospital, Kuala Lumpur, Malaysia between 1 January 1992 and 30 May 1995, with available immunophenotype data. Presenting features and treatment outcome of 39 B-lineage ALL patients with myeloid antigen coexpression (My+B) were compared with 112 B-lineage ALL patients without myeloid antigen coexpression (My-B) for similarity in demographic, clinical and laboratory features and their treatment outcome. My+B and My-B patients were treated with a uniform treatment protocol. Myeloid antigen coexpression was defined as more than 30% isolated leukemic cells positive for CD13 and/or CD33. The ages at diagnoses ranged from 2 months to 12 years. Median age was 4 years. The incidence of myeloid antigen coexpression was 23 per cent. Univariate analyses showed that presenting features were similar between My+B and My-B with regard to age, sex, race, FAB morphology, white cell count, hemoglobin level, platelet count, liver/spleen size, central nervous system or mediastinal involvement, presence of lymphadenopathy, and proportion of blast cells detected in the marrow. Treatment outcome were not significant between the two groups. The 2-year event free survival was achieved in 44 per cent of My+B and 57 per cent of My-B (p = 0.11). The 2-year overall survival rates were 62 per cent for My+B vs. 77 per cent for My-B (p = 0.08). This study demonstrates that myeloid antigen coexpression is fairly common and constitutes 23 per cent of childhood ALL within the Malaysian population and that it is not an adverse risk factor in childhood ALL.
Linear chains in polymeric dicyclohexylammonium tributyl(4-oxo-4H-pyran-2,6-dicarboxylato)stannate and methylphenylammonium tributyl(pyridine-2,6-dicarboxylato)stannate containing trigonal bipyramidal tin

Ng SW, Shanmuga Sundara Raj S, Fun HK, Razak IA, Hook JM

Acta Crystallogr C, 2000 Aug;56 ( Pt 8):966-8.
PMID: 10944291

catena-Poly[dicyclohexylammonium [tributyltin-mu-(4-oxo-4H-pyran-2,6-dicarboxylato-O(2):O( 6))]], (C(12)H(24)N)[Sn(C(7)H(2)O(6))(C(4)H(9))(3)], consists of 4-oxo-4H-pyran-2,6-dicarboxylato groups that axially link adjacent tributyltin units into a linear polyanionic chain. The ammonium counter-ions surround the chain, and each cation forms a pair of hydrogen bonds to the double-bond carbonyl O atoms of the same dianionic group. The chain propagates in a zigzag manner along the c axis of the monoclinic cell. In catena-poly[methyl(phenyl)ammonium [tributyltin-mu-(pyridine-2,6-dicarboxylato-O(2):O(6))]], (C(7)H(10)N)[Sn(C(7)H(3)NO(4))(C(4)H(9))(3)], the pyridine-2, 6-dicarboxylato groups also link the tributyltin groups into a chain, but the hydrogen-bonded chain propagates linearly on the ac face of the monoclinic cell.
Fulltext Coronary stents in the management of coronary artery disease review of first 100 stents

Ng SC, Sawatt C, Foo LK, Hitam O, Khor PG, Lee YK

Med J Malaysia, 1996 Mar;51(1):75-9.
PMID: 10967983

This is a review of the first 100 coronary stents implanted for the indications of PTCA restenosis, acute or threatened closure and De Novo lesions. The success rates were high and complications rates were low. Subacute stent thrombosis rates were low and stenting for De Novo lesions in > 3.0 mm arteries provide the best short and long term results. Six months restenosis rate was low. Stent assisted high pressure balloon angioplasty is an important advance.
Fulltext Antiphospholipid antibodies and stroke in the young--a study of three cases

Lee MK, Cheng HM, Ng SC, Menaka N, Tan CT, Wang F

Med J Malaysia, 1993 Sep;48(3):330-5.
PMID: 8183147

Cerebral infarction in the young is likely to be non-atheromatous. While in previous studies no cause has been found in 40% to 50% of patients, an increasing role for haemorheological factors is becoming apparent. Among these, an association between antiphospholipid antibodies (aPLs) and ischaemic cerebrovascular disease is now well-recognised. This entity has not been previously reported in Malaysian patients. In a study of 80 patients with stroke below the age of 50 years who were seen at the University Hospital, Kuala Lumpur, between January 1982 and May 1992, 3 patients with ischaemic cerebral infarction were found to have aPLs. aPLs was detected using ELISA method for anticardiolipin antibodies (aCLs), and presence of lupus anticoagulant (LA) was established by kaolin clotting time, thromboplastin inhibition test and platelet neutralisation procedure. Only 1 patient had active systemic lupus erythematous. Cerebrovascular events were recurrent in one of the 2 non-lupus patients. aPL-related stroke should be considered in young patients who have cerebral ischaemia occurring without obvious cause. More cases are likely to emerge in Malaysia with active screening.
Fulltext The first frozen embryo donation pregnancy for hypergonadotrophic hypogonadism in Singapore--hormonal profile and obstetric outcome

Chan CLK, Kumar J, Ong ML, Ng SC, Bongso TA, Ratnam SS

Med J Malaysia, 1996 Dec;51(4):482-4.
PMID: 10968039

This is the first report in South East Asia of a singleton frozen embryo donation pregnancy for hypergonadotrophic hypogonadism. The hormonal profile was compared with that of a control group of normal uncomplicated singleton pregnancies in Singapore. The plasma beta hCG levels were lower compared to those of our normal uncomplicated singleton pregnancies at 2 to 3 weeks after the embryo transfer but became comparable at 4 to 5 weeks after embryo transfer. The successful vaginal delivery and the obstetric complications developed in this case are discussed.
Epidemiological aspects of an outbreak of dengue fever/dengue haemorrhagic fever in Singapore

Goh KT, Ng SK, Chan YC, Lim SJ, Chua EC

Southeast Asian J. Trop. Med. Public Health, 1987 Sep;18(3):295-302.
PMID: 3433161

A nation-wide outbreak of 260 cases of DF/DHF with 1 death occurred in Singapore from Apr-Sept 1986. The outbreak originated from 3 separate foci of transmission at the western, south-eastern and north-eastern parts of the island and then spread to other dengue receptive urban and suburban areas. The morbidity rate was highest in young male Chinese adults between 15 and 24 years of age. The outbreak was rapidly brought under control through destruction of adult Aedes mosquitoes, surveys and source reduction of larval breeding habitats, health education and to a certain extent law enforcement. The Aedes population was high in the main foci of transmission although the overall house index was only 1.1. Other factors which could have precipitated the outbreak included waning herd immunity of the human population and continuous introduction of dengue virus into the country.
Bis[N,N-bis(2-hydroxyethyl)dithiocarbamato]dimethyltin(IV)

Ng SW, Yang Farina AA, Othman AH, Baba I, Sivakumar K, Fun HK

Acta Crystallogr C, 2000 Mar 15;56(Pt 3):E84-5.
PMID: 15263206

The title compound, [Sn(CH(3))(2)(C(5)H(10)NO(2)S(2))(2)], has crystallographic mirror symmetry (C-Sn-C on mirror plane) and the coordination polyhedron around the Sn atom is a tetrahedron [C-Sn-C 139.3 (2) degrees and S-Sn-S 82.3 (1) degrees ] distorted towards a skew-trapezoidal bipyramid owing to an intramolecular Sn.S contact [3.0427 (6) A]. The molecules are linked into a linear chain by intermolecular O-H.O hydrogen bonds [O.O 2.646 (3) A].
Bis(N,N-dimethylthiocarbamoylthio)acetic acid

Low KS, Muniandy S, Naumov P, Shanmuga Sundara Raj S, Fun HK, Razak IA, et al.

Acta Crystallogr C, 2000 Mar 15;56(Pt 3):E113-4.
PMID: 15263222

Bis(N,N-dimethylthiocarbamoylthio)acetic acid, [(CH(3))(2)NC(=S)S](2)CHC(=O)OH or C(8)H(14)N(2)O(2)S(4), exists as a centrosymmetric hydrogen-bonded dimer [O.O 2.661 (3) A].
A survey of genes in Eimeria tenella merozoites by EST sequencing

Wan KL, Chong SP, Ng ST, Shirley MW, Tomley FM, Jangi MS

Int J Parasitol, 1999 Dec;29(12):1885-92.
PMID: 10961844

A study of about 500 expressed sequence tags (ESTs), derived from a merozoite cDNA library, was initiated as an approach to generate a larger pool of gene information on Eimeria tenella. Of the ESTs, 47.7% had matches with entries in the databases, including ribosomal proteins, metabolic enzymes and proteins with other functions, of which 14.3% represented previously known E. tenella genes. Thus over 50% of the ESTs had no significant database matches. The E. tenella EST dataset contained a range of highly abundant genes comparable with that found in the EST dataset of T. gondii and may thus reflect the importance of such molecules in the biology of the apicomplexan organisms. However, comparison of the two datasets revealed very few homologies between sequences of apical organelle molecules, and provides evidence for sequence divergence between these closely-related parasites. The data presented underpin the potential value of the EST strategy for the discovery of novel genes and may allow for a more rapid increase in the knowledge and understanding of gene expression in the merozoite life cycle stage of Eimeria spp.
Prolonging the interval from ovarian hyperstimulation to laparoscopic ovum pick-up improves oocyte yield, quality, and developmental competence in goats

Abdullah RB, Liow SL, Rahman AN, Chan WK, Wan-Khadijah WE, Ng SC

Theriogenology, 2008 Sep 15;70(5):765-71.
PMID: 18579196 DOI: 10.1016/j.theriogenology.2008.04.052

The objective was to evaluate the effect of the interval between ovarian hyperstimulation and laparoscopic ovum pick-up (LOPU) on quality and developmental competence of goat oocytes before and after in vitro maturation (IVM) and intracytoplasmic sperm injection (ICSI). Estrus was synchronized with an intravaginal insert containing 0.3g progesterone (CIDR) for 10d, combined with a luteolytic treatment of 125 microg cloprostenol 36 h prior to CIDR removal. Ovaries were hyperstimulated with 70 mg FSH and 500 IU hCG given im 36, 60, or 72 h prior to LOPU (n=15, 16, and 7 does, respectively). For these groups, oocyte retrieval rates (mean+/-S.E.M.) were 24.7+/-2.9, 54.5+/-4.7, and 82.8+/-4.6% (P<0.001), and the proportions of cumulus-oocyte complexes (COC) with more than five layers of cumulus cells were 29.7+/-8.3, 37.6+/-6.9, and 37.3+/-7.0% (P<0.001). The proportion of IVM oocytes was highest at 72 h (82.1+/-2.8%; P<0.05), with no significant difference between 36 and 60 h (57.3+/-8.9% and 69.0+/-8.4%). Cleavage rates of ICSI embryos were 4.2+/-4.2, 70.9+/-8.4, and 78.9+/-8.2% with LOPU 36, 60, and 72 h post FSH/hCG (P<0.01), with a lower proportion of Grade-A embryos (P<0.05) following LOPU at 36 h compared to 60 and 72 h (29.7+/-8.3%, 37.6+/-6.9%, and 37.3+/-7.0%). In summary, a prolonged interval from FSH/hCG to LOPU improved oocyte retrieval rate and oocyte quality. Therefore, under the present conditions, LOPU 60 or 72 h after FSH/hCG optimized yields of good-quality oocytes for IVM and embryo production in goats.

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