Displaying publications 81 - 100 of 283 in total

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  1. Fong CY, Low P, Ng KH, Heng HS, Chong ASL, Ong LC, et al.
    Epilepsy Behav, 2023 Dec;149:109536.
    PMID: 38008017 DOI: 10.1016/j.yebeh.2023.109536
    BACKGROUND: A computer game-based epilepsy educational programme (Epigame) can potentially improve the awareness, knowledge and attitude (AKA) and quality of life (QOL) of children with epilepsy (CWE). Our study among Malaysian CWE aimed to assess the: i) baseline level of epilepsy AKA and potential characteristics associated with poor levels of AKA, ii) effectiveness of Epigame in improving AKA and QOL of CWE.

    METHOD: Prospective cohort study on CWE age 7-18 years old with no comorbidities. Epilepsy education was delivered using Epigame. CWE completed AKA questionnaire before (time point 1 [TP1]), immediately after (TP2), 3 months (TP3) after provision of Epigame. Child self-report Health-Related Quality of Life Measurement for Children with Epilepsy (CHEQOL-25) questionnaire was completed at TP1 and TP3.

    RESULTS: Total of 106 CWE participated in this study (mean age of 13.3 years). Baseline (TP1) AKA was rated "very low to moderate" for awareness domain in 95.3 %, "very low to moderate" for knowledge domain in 67 %, "negative to indifferent" for attitude domain in 54.7 %, and "very poor to moderate' for total AKA score domain in 84 %. "Positive to very positive" for child attitude domain was significantly associated with parents with "positive to very positive" for attitude domain (OR 10.6, 95 % CI 3.23-34.66). "Good to excellent" for total child AKA domain was significantly associated with parents with "Good to excellent" for total AKA domain (OR 5.2, 95 % CI 1.16-15.02) and with 

  2. Siar CH, Nakano K, Ng KH, Tomida M, Nagatsuka H, Kawakami T
    Eur J Med Res, 2010 Apr 08;15(4):180-4.
    PMID: 20554499
    BACKGROUND: Squamous odontogenic tumor (SOT) is a rare benign odontogenic epithelial neoplasm. A slow-growing painless expansive swelling is the common presenting symptom. Histopathologically, SOT can be easily misdiagnosed as an acanthomatous ameloblastoma. Although Notch receptors and ligands have been shown to play a role in cell fate decisions in ameloblastomas, the role of these cell signaling molecules in SOT is unknown.

    CASE REPORT: This paper describes a case of SOT affecting the anterior mandible of a 10-year-old Indian female. The patient was treated by local surgical excision and there has been no follow-up clinical record of recurrence 5 years after primary treatment. Histo?pathological examination revealed a solid, locally-infiltrative neoplasm composed of bland-looking squamatoid islands scattered in a mature fibrous connective tissue stroma and the diagnosis was SOT. Immunohistochemical evaluation showed positive reactivity of varying intensity in the neoplastic epithelial cells for Notch1, Notch3, Notch4, and their ligands Jagged1 and Delta1. Expression patterns showed considerable overlap. No immunoreactivity was detected for Notch2 and Jagged2.

    CONCLUSIONS: Present findings suggest that Notch receptors and their ligands play differential roles in the cytodifferentiation of SOT.

  3. Siar CH, Nakano K, Chelvanayagam PI, Ng KH, Nagatsuka H, Kawakami T
    Eur J Med Res, 2010 Mar 30;15(3):135-8.
    PMID: 20452900
    The purpose of this report is to document a case of unsuspected ameloblastoma involving the right man dibular subpontic region in a 38-year-old Cambodian female patient. This lesion was purportedly preceded by multiple radiolucencies which were diagnosed as radicular cysts and treated a few times in the past years by enucleation followed by endodontic therapy of the affected teeth. Bridgework restoration of the partially edentulous area was performed. This case report demonstrates radiographic changes that occurred in the periods before and after the diagnosis of ameloblastoma. The case may represent an example of radicular cysts and ameloblastoma occurring as a collision phenomenon, or the ameloblastoma may have arisen as a result of neoplastic transformation of the lining epithelium in an inflammatory odontogenic epithelial cyst.
  4. Siar CH, Oo VP, Nagatsuka H, Nakano K, Ng KH, Kawakami T
    Eur J Med Res, 2009 Jul 22;14(7):315-9.
    PMID: 19661015
    STATEMENT OF THE PROBLEM: Dysplasia, the morphological yardstick of epithelial precursor lesions, is the collective term for a variety of architectural and cytological changes within the altered oral epithelium. Angiogenic squamous dysplasia (ASD), a distinct morphological characteristic in pre-invasive bronchial lesions, describes the presence of capillary tufts that are closely juxtaposed to and projecting into the dysplastic bronchial epithelium.

    OBJECTIVE: To determine whether ASD-like phenomenon occurs in oral epithelial precursor lesions, and to speculate on its relevance.

    METHODS: Twenty cases each of mild, moderate and severe oral dysplasia (inclusive of carcinoma-in-situ), and 10 normal oral mucosa (normal controls) were serial sectioned for H and E staining, and for microvessel density (MVD) scoring with CD31, CD34 and CD105. Microcapillary pattern images were digitally captured for 3-D reconstruction.

    RESULTS: Oral ASD foci consisting of CD31- and CD34-positive capillary loops abutting onto the overlying dysplastic oral epithelium (and causing it to assume an irregular or papillary surface configuration) were identified in moderate (3/20; 15%) and severe dysplasia (13/20; 65%), but not in normal oral mucosa and mild dysplasia. MVD score demonstrated increasing vascularity as epithelium progressed from normal to severe dysplasia (p<0.05). CD105 demonstrated increase neovascularization in all dysplasia grades (p<0.05).

    CONCLUSIONS: These preliminary findings taken together suggest that: 1. ASD-like phenomenon may be an important intermediary biomarker in oral precursor lesions; and 2. architectural alterations of the entire disturbed mucosa may be a more useful pre-malignancy index.

  5. Siar CH, Kawakami T, Buery RR, Nakano K, Tomida M, Tsujigiwa H, et al.
    Eur J Med Res, 2011 Nov 10;16(11):501-6.
    PMID: 22027644
    Notch signaling is an evolutionarily conserved mechanism that enables adjacent cells to adopt different fates. Ghost cells (GCs) are anucleate cells with homogeneous pale eosinophilic cytoplasm and very pale to clear central areas (previous nucleus sites). Although GCs are present in a variety of odontogenic lesions notably the calcifying cystic odontogenic tumor (CCOT), their nature and process of formation remains elusive. The aim of this study was to investigate the role of Notch signaling in the cell fate specification of GCs in CCOT. Immunohistochemical staining for four Notch receptors (Notch1, Notch2, Notch3 and Notch4) and three ligands (Jagged1, Jagged2 and Delta1) was performed on archival tissues of five CCOT cases. Level of positivity was quantified as negative (0), mild (+), moderate (2+) and strong (3+). Results revealed that GCs demonstrated overexpression for Notch1 and Jagged1 suggesting that Notch1-Jagged1 signaling might serve as the main transduction mechanism in cell fate decision for GCs in CCOT. Protein localizations were largely membranous and/or cytoplasmic. Mineralized GCs also stained positive implicating that the calcification process might be associated with upregulation of these molecules. The other Notch receptors and ligands were weak to absent in GCs and tumoral epithelium. Stromal endothelium and fibroblasts were stained variably positive.
  6. Siar CH, Yeo KB, Nakano K, Nagatsuka H, Tsujigiwa H, Tomida M, et al.
    Eur J Med Res, 2011 Jul 25;16(7):331-4.
    PMID: 21813375
    Wegener's granulomatosis is a rare multi-system disease characterized by the classic triad of necrotizing granulomas affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. Oral lesions as a presenting feature are only encountered in 2% of these cases. Hyperplastic gingival lesions or strawberry gingivitis, is a characteristic sign of Wegener's granulomatosis. The latter consists of reddish-purple exophytic gingival swellings with petechial haemorrhages thus resembling strawberries. Recognition of this feature is of utmost importance for timely diagnosis and definitive management of this potentially fatal disease. A case of strawberry gingivitis as the first presenting sign of Wegener's granulomatosis affecting a 50-year-old Malay male is reported here. The differential diagnosis of red lesions that may present in the gingiva is discussed.
  7. Siar CH, Ha KO, Aung LO, Nakano K, Tsujigiwa H, Nagatsuka H, et al.
    Eur J Med Res, 2010 Oct 25;15(10):456-60.
    PMID: 21156405
    BACKGROUND: notch receptors are critical determinants of cell fate in a variety of organisms. Notch signaling is involved in the chondrogenic specification of neural crest cells. Aberrant Notch activity has been implicated in numerous human diseases including cancers; however its role in chondrogenic tumors has not been clarified.

    METHOD: tissue samples from a case of primary chondrosarcoma of the maxilla and its recurrent tumor were examined immunohistochemically for Notch1-4 and their ligands (Jagged1, Jagged2 and Delta1) expression.

    RESULTS: both primary and recurrent tumors were histopathologically diagnosed as conventional hyaline chondrosarcoma (WHO Grade I). Hypercellular tumor areas strongly expressed Notch3 and Jagged1 in spindle and pleomorphic cells suggesting up-regulation of these protein molecules at sites of tumor proliferation. Expression patterns were distinct with some overlap. Differentiated malignant and atypical chondrocytes demonstrated variable expression levels of Jagged1, and weak to absent staining for Notch1, 4 and Delta1. Protein immunolocalization was largely membranous and cytoplasmic, sometimes outlining the lacunae of malignant chondrocytes. Hyaline cartilage demonstrated a diffuse or granular precipitation of Jagged1 suggesting presence of soluble Jagged1 activity at sites of abnormal chondrogenesis. No immunoreactivity for the other Notch members was observed. Calcified cartilage was consistently Notch-negative indicating down-regulation of Notch with cartilage maturation. Stromal components namely endothelial cells and fibroblasts variably expressed Notch1, 3 and Jagged1 but were mildly or non-reactive for the other members.

    CONCLUSIONS: Results indicate that Notch signaling pathway may participate in cellular differentiation and proliferation in chondrosarcoma. Findings implicate Notch3 and Jagged1 as key molecules that influence the differentiation and maturation of cells of chondrogenic lineage.

  8. Safari MJ, Wong JH, Kadir KA, Thorpe NK, Cutajar DL, Petasecca M, et al.
    Eur Radiol, 2016 Jan;26(1):79-86.
    PMID: 26002131 DOI: 10.1007/s00330-015-3818-9
    OBJECTIVES: To develop a real-time dose-monitoring system to measure the patient's eye lens dose during neuro-interventional procedures.

    METHODS: Radiation dose received at left outer canthus (LOC) and left eyelid (LE) were measured using Metal-Oxide-Semiconductor Field-Effect Transistor dosimeters on 35 patients who underwent diagnostic or cerebral embolization procedures.

    RESULTS: The radiation dose received at the LOC region was significantly higher than the dose received by the LE. The maximum eye lens dose of 1492 mGy was measured at LOC region for an AVM case, followed by 907 mGy for an aneurysm case and 665 mGy for a diagnostic angiography procedure. Strong correlations (shown as R(2)) were observed between kerma-area-product and measured eye doses (LOC: 0.78, LE: 0.68). Lateral and frontal air-kerma showed strong correlations with measured dose at LOC (AKL: 0.93, AKF: 0.78) and a weak correlation with measured dose at LE. A moderate correlation was observed between fluoroscopic time and dose measured at LE and LOC regions.

    CONCLUSIONS: The MOSkin dose-monitoring system represents a new tool enabling real-time monitoring of eye lens dose during neuro-interventional procedures. This system can provide interventionalists with information needed to adjust the clinical procedure to control the patient's dose.

    KEY POINTS: Real-time patient dose monitoring helps interventionalists to monitor doses. Strong correlation was observed between kerma-area-product and measured eye doses. Radiation dose at left outer canthus was higher than at left eyelid.

  9. Ng KH, Lean ML
    Health Phys, 2012 Sep;103(3):307-10.
    PMID: 22850236 DOI: 10.1097/HP.0b013e318257cfcb
    The potential of social media has expanded far beyond the initial function of social communication among a network of friends. It has become an increasingly important tool in risk communication to allow the dissemination of timely and accurate information to global citizens to make more informed choices regarding a particular crisis. The Fukushima nuclear crisis is an example where the potential of social media was not fully tapped. This caused undue stress and distrust of authorities. While the use of social media in this crisis could have altered significantly the level of trust in authorities and others, two additional points should be considered. One point is the use of plain language versus scientific language in order to reach a wider audience. The other is an urgent need to improve public information especially in the event of a nuclear emergency and to enhance educational efforts and action by improving radiological protection communication from regulatory bodies and international agencies. These are points that also play a large role in the use of social media.
  10. Ng KH, Abdullah BJ, Sivalingam S
    Health Phys, 1999 Jul;77(1):33-6.
    PMID: 10376539
    The medical radiation usage for diagnostic radiology in Malaysia (a Level II country) for 1990-1994 is reported, enabling a comparison to be made for the first time with the United Nations Scientific Committee on the Effects of Atomic Radiation Report. In 1994, the number of physicians, radiologists, x-ray units, and x-ray examinations per 1,000 population was 0.45, 0.005, 0.065, and 183, respectively. (Level I countries had averages of 2.6, 0.072, 0.35, and 860, respectively). In 1994, a total of 3.6 million x-ray examinations were performed; the annual effective dose per capita to the population was 0.05 mSv, and the collective effective dose was 1,000 person-Sv. Chest examinations contributed 63% of the total. Almost all examinations experienced increasing frequency from 1990 to 1994 except for barium studies, cholecystography, and intravenous urography (-23%, -36%, -51%). These decreases are related to the increasing use of ultrasound and greater availability of fiberoptic endoscopy. Notable increases during the same period were observed in computed tomography (161%), cardiac procedures (190%), and mammography (240%). In order to progress from Level II to Level I status Malaysia needs to expand and upgrade radiological service in tandem with the health care development of the country.
  11. Fernandez PR, Ng KH, Kaur S
    Health Phys, 2019 06;116(6):835-839.
    PMID: 30844902 DOI: 10.1097/HP.0000000000001037
    There is widespread anxiety and speculation about RF-EMF emissions by telecommunication base stations and structures, as it is perceived by some to be unsafe and a threat to public health. Scientists, medical experts, politicians, journalists, and mobile telecommunication company specialists are involved in an active debate on whether people are immune to RF or if we are gambling with our future. Interviews with 31 individuals from 7 stakeholder groups in Malaysia reveal that the residents' main concerns are that the telecommunication companies do not follow guidelines and as a result the telecommunication structures are constructed close to their homes, which they perceive as a threat to public health. Some residents also do not want these structures because of cultural reasons, while some are jealous over rental income received by the landlords. Meanwhile, the authorities entrusted with safe-guarding public health are involved in a blame game as there is no agency that is clearly in charge. The interviews also highlight that the current risk communication initiatives are more reactive rather than proactive, and that the authorities do not speak in one voice. Based on the outcome of the interviews, eleven recommendations are formulated to improve risk communication initiatives in Malaysia. The recommendations stress on repairing, building, and strengthening trust, because trust in agencies, along with credibility, determines risk communication initiatives' effectiveness. These strategies can also be effectively replicated across regions to deal with contestations over RF-EMF emissions and the impact on health.
  12. Ng KH, Yoong D, Gong J
    Health Phys, 2022 Jun 01;122(6):696-704.
    PMID: 35486926 DOI: 10.1097/HP.0000000000001548
    In April 2021, the Japanese authorities' announcement of their decision to release processed wastewater from the damaged Fukushima Daiichi nuclear power plant into the Pacific Ocean over 30 y, beginning in 2023, triggered strong domestic and international opposition. Failure to handle this situation tactfully can lead to public disorder, civil disobedience, loss of trust in the authorities, and even diplomatic sanctions. In this article, we explain the underlying reasons behind this resistance, and we offer some strategic methods that the Japanese authorities can deploy to address opposing views and overcome the Fukushima wastewater crisis.
  13. Law KB, Chang KM, Hamzah NA, Ng KH, Ong TC
    Indian J Hematol Blood Transfus, 2017 Dec;33(4):483-491.
    PMID: 29075058 DOI: 10.1007/s12288-017-0790-3
    The study aimed to investigate the effect of consolidation treatment with fludarabine, high-dose cytarabine and granulocyte colony-stimulating factor or FLAG in older AML patients. The study included 41 eligible patients above 54 years old, who received both induction and consolidation chemotherapy for AML from 2008 to 2013. The study cohort had a minimum 24 months follow-up period. Survival analysis was carried out to assess patients' overall survival and disease free survival based on types of consolidation regimens. The consolidation treatment with FLAG exerted a protective effect to both overall survival and disease free survival in older patients. Patients who were consolidated with FLAG regimen had a significant longer overall survival (log-rank, p = 0.0025) and disease free survival (log-rank, p = 0.0026). The median overall survival was longer (18.70 months) with the use of FLAG when compared to non-FLAG group (8.09 months). The median disease free survival was also longer (13.84 months) with use of FLAG when compared to the non-FLAG group (4.44 months). Regression analysis with Cox model yielded hazard ratio of 0.245 (p = 0.0094) in overall survival and 0.217 (p = 0.0068) in disease free survival. The use of FLAG as consolidation treatment was associated with approximately 60-80% reduction in hazard rates. The result was adjusted for age, race and gender in regression analysis. Older AML patients had longer remission and survival when consolidated with FLAG regimen after the induction chemotherapy.
  14. Velayutham P, Govindasamy GK, Raman R, Prepageran N, Ng KH
    Indian J Otolaryngol Head Neck Surg, 2014 Jan;66(Suppl 1):169-72.
    PMID: 24533378 DOI: 10.1007/s12070-011-0406-4
    The objective of this study is to assess high frequency hearing (above 8 kHz) loss among prolonged mobile phone users is a tertiary Referral Center. Prospective single blinded study. This is the first study that used high-frequency audiometry. The wide usage of mobile phone is so profound that we were unable to find enough non-users as a control group. Therefore we compared the non-dominant ear to the dominant ear using audiometric measurements. The study was a blinded study wherein the audiologist did not know which was the dominant ear. A total of 100 subjects were studied. Of the subjects studied 53% were males and 47% females. Mean age was 27. The left ear was dominant in 63%, 22% were dominant in the right ear and 15% did not have a preference. This study showed that there is significant loss in the dominant ear compared to the non-dominant ear (P 
  15. Al-Shabi M, Lan BL, Chan WY, Ng KH, Tan M
    Int J Comput Assist Radiol Surg, 2019 Oct;14(10):1815-1819.
    PMID: 31020576 DOI: 10.1007/s11548-019-01981-7
    PURPOSE: Lung nodules have very diverse shapes and sizes, which makes classifying them as benign/malignant a challenging problem. In this paper, we propose a novel method to predict the malignancy of nodules that have the capability to analyze the shape and size of a nodule using a global feature extractor, as well as the density and structure of the nodule using a local feature extractor.

    METHODS: We propose to use Residual Blocks with a 3 × 3 kernel size for local feature extraction and Non-Local Blocks to extract the global features. The Non-Local Block has the ability to extract global features without using a huge number of parameters. The key idea behind the Non-Local Block is to apply matrix multiplications between features on the same feature maps.

    RESULTS: We trained and validated the proposed method on the LIDC-IDRI dataset which contains 1018 computed tomography scans. We followed a rigorous procedure for experimental setup, namely tenfold cross-validation, and ignored the nodules that had been annotated by

  16. Jahmunah V, Sudarshan VK, Oh SL, Gururajan R, Gururajan R, Zhou X, et al.
    Int J Imaging Syst Technol, 2021 Jun;31(2):455-471.
    PMID: 33821093 DOI: 10.1002/ima.22552
    In 2020 the world is facing unprecedented challenges due to COVID-19. To address these challenges, many digital tools are being explored and developed to contain the spread of the disease. With the lack of availability of vaccines, there is an urgent need to avert resurgence of infections by putting some measures, such as contact tracing, in place. While digital tools, such as phone applications are advantageous, they also pose challenges and have limitations (eg, wireless coverage could be an issue in some cases). On the other hand, wearable devices, when coupled with the Internet of Things (IoT), are expected to influence lifestyle and healthcare directly, and they may be useful for health monitoring during the global pandemic and beyond. In this work, we conduct a literature review of contact tracing methods and applications. Based on the literature review, we found limitations in gathering health data, such as insufficient network coverage. To address these shortcomings, we propose a novel intelligent tool that will be useful for contact tracing and prediction of COVID-19 clusters. The solution comprises a phone application combined with a wearable device, infused with unique intelligent IoT features (complex data analysis and intelligent data visualization) embedded within the system to aid in COVID-19 analysis. Contact tracing applications must establish data collection and data interpretation. Intelligent data interpretation can assist epidemiological scientists in anticipating clusters, and can enable them to take necessary action in improving public health management. Our proposed tool could also be used to curb disease incidence in future global health crises.
  17. Subramanian P, Ramasamy S, Ng KH, Chinna K, Rosli R
    Int J Nurs Pract, 2016 Jun;22(3):232-8.
    PMID: 25355297 DOI: 10.1111/ijn.12363
    Alleviating acute pain and providing pain relief are central to caring for surgical patients as pain can lead to many adverse medical consequences. This study aimed to explore patients' experience of pain and satisfaction with postoperative pain control. A cross-sectional survey was carried out among 107 respondents who had undergone abdominal surgery in the surgical ward of an urban hospital using the Revised American Pain Society's Patient Outcome and Satisfaction Survey Questionnaires (APS-POQ-R). Data were analysed using descriptive statistics and chi-square test. Chi-square test showed significant association between race (P = 0.038), education level (P ≤ 0.001), previous operation status (P = 0.032) and operation status (P ≤ 0.001). Further analysis on nominal regression, association between dissatisfaction with factors of operation status (46.09 (95% CI 7.456, 284.947)) and previous operation status (13.38 (95% CI 1.39, 128.74)) was found to be significant. Moderate to high levels of pain intensity in the last 24 h after surgery, as well as moderate to high rates of pain-related interference with care activities were most reported. Pain still remains an issue among surgical patients, and effective pain management and health education are needed to manage pain more effectively after surgery.
  18. Bradley DA, Ng KH, Aziz YB
    Int J Rad Appl Instrum A, 1988;39(5):439-40.
    PMID: 2840420
    The utility of a phantom material, based on SMR(L) [Standard Malaysian Rubber] grade natural rubber and a formulation used for the proprietary rubber phantom-material, Temex, has been examined for the 1-MeV photon-Measurement has also been performed with 60-keV photons using the radionuclide 241Am. At photon-therapy energy levels the measured response, when compared with tabulated central-axis percentage depth doses for the defined measuring conditions, produces everywhere (in the range 1-19 cm depth) better than 2% deviation. The favourable measured response characteristics combined with the ease of processing and casting the phantom material provide the basis for useful radiotherapy machine calibration and anthropomorphic dosimetry measurements. The measured mass-attenuation coefficient, at 60keV, of 0.204 cm2 g-1 (+/- 3%) is in close agreement with tabulated values for water (0.2055 cm2 g-1).
  19. Zhu CZ, Ting HN, Ng KH, Ong TA
    J Cancer, 2019;10(17):4038-4044.
    PMID: 31417648 DOI: 10.7150/jca.28989
    Background and purpose: Bladder cancer is the most common malignant tumour in the urinary system, with a high incidence and recurrence rate. While the incidence of bladder cancer has been rising in recent years, the prevalence of bladder carcinoma is showing an increasing tendency in the younger age group. There are several methods to detect bladder cancer, but different methods have varying degrees of accuracy which intrinsically depends on the method's sensitivity and specificity. Our aim was to comprehensively summarize the current detection methods for bladder cancer based on the available literature, and at the same time, to find the best combination of different effective methods which can produce a high degree of accuracy in detecting the presence of cancerous cells in the bladder. Materials and Methods: We used key word retrieval method for searching related references in English that had been indexed in PubMed and Medline. Results and Discussion: This paper discussed the different detection methods and their sensitivities/specificities as well as the advantages and disadvantages. We summarized the best identified cancer cell detection methods with higher sensitivity/specificity. Conclusion: The results of this review can positively help to identify accurate methods for detecting bladder cancer and highlight areas to be further improved for future research work.
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