Displaying publications 81 - 100 of 141 in total

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  1. The Utility of Combined Urine Urea and Creatinine Clearance for Pretransplant Renal Function Assessment
    Thye CK, Lee YW, Jalalonmuhali M, Lim SK, Ng KP
    Transplant Proc, 2022 Feb 02.
    PMID: 35123793 DOI: 10.1016/j.transproceed.2021.12.023
    BACKGROUND: Evaluation of donor renal function as glomerular filtration rate (GFR) is a crucial part of pretransplant workup. Most guidelines recommend measured GFR (mGFR) using exogenous markers with creatinine clearance (CrCl) as an alternative. However, exogenous markers are difficult to obtain and perform, and CrCl may overestimate GFR.

    OBJECTIVE: We explore the use of CrCl and combined urea and creatinine clearance as an alternative for GFR assessment.

    METHODS: A retrospective study involving 81 kidney donors from 2007 to 2020, with mGFR collected by chromium 51-labeled ethylenediaminetetraacetic acid (51Cr-EDTA) and CrCl and combined urea and creatinine clearance. We analyzed the performance of CrCl and combined urea and creatinine clearance against 51Cr-EDTA. Adequacy of urine volume was taken into consideration.

    RESULTS: A total of 81 candidates with a mean age of 44.80 ± 10.77 years were enrolled. Mean mGFR from 51Cr-EDTA was 123.66 ± 26.91 mL/min/1.73 m2, and combined urea and creatinine clearance and CrCl were 122.13 ± 47.07 and 133.40 ± 36.32 mL/min/1.73 m2, respectively. CrCl overestimated 51Cr-EDTA. Though combined urea and creatinine clearance had minimal bias, it had a lower correlation coefficient (0.25 vs 0.43), lower precision (49.51 vs 38.10), and slightly lower accuracy within 30% of 51Cr-EDTA (74.07% vs 76.54%).

    CONCLUSIONS: Combined urea and creatinine clearance did not improve the performance of CrCl. Nevertheless, it can potentially be used as first-line GFR assessment, followed by mGFR in selected donors, to ascertain threshold of safe kidney donation. A stringent urine collection method is essential to ensure accurate measurement.

  2. Fulltext MDRD vs. CKD-EPI in comparison to 51Chromium EDTA: a cross sectional study of Malaysian CKD cohort
    Jalalonmuhali M, Lim SK, Md Shah MN, Ng KP
    BMC Nephrol, 2017 Dec 13;18(1):363.
    PMID: 29237422 DOI: 10.1186/s12882-017-0776-2
    BACKGROUND: Accurate measurement of renal function is important: however, radiolabelled gold standard measurement of GFR is highly expensive and can only be used on a very limited scale. We aim to compare the performance of Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations in the multi-ethnic population attending University Malaya Medical Centre (UMMC).
    METHODS: This is a cross-sectional study recruiting patients, who attend UMMC Nephrology clinics on voluntary basis. 51-Chromium EDTA (51Cr-EDTA) plasma level was used to measure the reference GFR. The serum creatinine was determined by IDMS reference modified Jaffe kinetic assay (CrJaffe). The predictive capabilities of MDRD and CKD-EPI based equations were calculated. Data was analysed using SPSS version 20 and correlation, bias, precision and accuracy were determined.
    RESULTS: A total of 113 subjects with mean age of 58.12 ± 14.76 years and BMI of 25.99 ± 4.29 kg/m2 were recruited. The mean reference GFR was 66.98 ± 40.65 ml/min/1.73m2, while the estimated GFR based on MDRD and CKD-EPI formula were 62.17 ± 40.40, and 60.44 ± 34.59, respectively. Both MDRD and CKD-EPI were well-correlated with reference GFR (0.806 and 0.867 respectively) and statistically significant with p 
  3. Cladosporium cladosporioides keratomycosis: a case report
    Chew FLM, Subrayan V, Chong PP, Goh MC, Ng KP
    Jpn. J. Ophthalmol., 2009 Nov;53(6):657-659.
    PMID: 20020251 DOI: 10.1007/s10384-009-0722-3
  4. Comparative Study of the Effects of Fluconazole and Voriconazole on Candida glabrata, Candida parapsilosis and Candida rugosa Biofilms
    Madhavan P, Jamal F, Pei CP, Othman F, Karunanidhi A, Ng KP
    Mycopathologia, 2018 Jun;183(3):499-511.
    PMID: 29380188 DOI: 10.1007/s11046-018-0243-z
    Infections by non-albicans Candida species are a life-threatening condition, and formation of biofilms can lead to treatment failure in a clinical setting. This study was aimed to demonstrate the in vitro antibiofilm activity of fluconazole (FLU) and voriconazole (VOR) against C. glabrata, C. parapsilosis and C. rugosa with diverse antifungal susceptibilities to FLU and VOR. The antibiofilm activities of FLU and VOR in the form of suspension as well as pre-coatings were assessed by XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] reduction assay. Morphological and intracellular changes exerted by the antifungal drugs on Candida cells were examined by scanning electron microscope (SEM) and transmission electron microscope (TEM). The results of the antibiofilm activities showed that FLU drug suspension was capable of killing C. parapsilosis and C. rugosa at minimum inhibitory concentrations (MICs) of 4× MIC FLU and 256× MIC FLU, respectively. While VOR MICs ranging from 2× to 32× were capable of killing the biofilms of all Candida spp tested. The antibiofilm activities of pre-coated FLU were able to kill the biofilms at ¼× MIC FLU and ½× MIC FLU for C. parapsilosis and C. rugosa strains, respectively. While pre-coated VOR was able to kill the biofilms, all three Candida sp at ½× MIC VOR. SEM and TEM examinations showed that FLU and VOR treatments exerted significant impact on Candida cell with various degrees of morphological changes. In conclusion, a fourfold reduction in MIC50 of FLU and VOR towards ATCC strains of C. glabrata, C. rugosa and C. rugosa clinical strain was observed in this study.
  5. A survey of regional analgesia and anaesthesia for obstetrics in selected countries in the Far East
    Chan YK, Ng KP
    Int J Obstet Anesth, 2000 Oct;9(4):225-32.
    PMID: 15321075
    A survey was conducted in several countries in the Far East in an attempt to determine the practice of obstetric analgesia and anaesthesia there. Survey forms were sent to a total of 11 countries but in the end responses from only four countries were able to provide useful information. Responses from Singapore, Hong Kong, Taiwan and Malaysia covered between 44.9% (Singapore) and 24.6% (Malaysia) of their countries' total deliveries in 1997 and were thought to be adequate to give an impression of the obstetric analgesia and anaesthesia services in their respective countries, although this would not necessarily be completely accurate. From our survey, we found that the availability of regional analgesia for labour paralleled the economic status of the country and that a significant number of caesarean sections are conducted under regional anaesthesia, mainly spinals.
  6. Fulltext Seroprevalence of anti-HCV in an urban child population: a preliminary study from Kuala Lumpur
    Lee WS, Ng KP
    Singapore Med J, 2001 Mar;42(3):100-1.
    PMID: 11405558
    A pilot study to determine the seroprevalence of anti-HCV among children from Kuala Lumpur, Malaysia, was conducted using microparticle enzyme immunoassay. Serum samples were obtained randomly from children, aged between one to 16 years of age, admitted to the paediatric unit of University of Malaya Medical Centre, Kuala Lumpur for various medical reasons. Of the 179 samples assayed, only one was positive, giving the prevalence rate of 0.6%. It is reasonable to conclude that the seroprevalence of anti-HCV among children from Kuala Lumpur is low, less than 1%.
  7. Creatinine clearance in selection of living kidney donor among the Malaysian population: is it safe?
    Thye CK, Lee YW, Jalalonmuhali M, Lim SK, Ng KP
    BMC Nephrol, 2023 Sep 11;24(1):267.
    PMID: 37691129 DOI: 10.1186/s12882-023-03057-w
    BACKGROUND: Assessment of donor renal function is made by the measurement of Glomerular Filtration Rate (GFR). Exogenous markers are preferred over creatinine clearance and are widely used for measuring GFR. However, they are difficult to obtain, costly and laborious. This is a study to look into the safety and accuracy of creatinine clearance for renal assessment among the living kidney donors in the Malaysian population.

    METHODS: This is a retrospective, single-centre study comprising 105 living kidney donor candidates from the year 2007 to 2020. By comparing against 51-Chromium ethylenediamine-tetraacetic acid (51Cr-EDTA), we analysed creatinine clearance for correlation, bias, precision and accuracy.

    RESULTS: The study group had a mean age of 45.68 ± 10.97 years with a mean serum creatinine of 64.43 ± 17.68 µmol/L and a urine volume of 2.06 ± 0.83 L. Mean measured GFR from 51Cr-EDTA was 124.37 ± 26.83 ml/min/1.73m2 whereas mean creatinine clearance was 132.35 ± 38.18 ml/min/1.73m2. Creatinine clearance overestimated 51Cr-EDTA significantly with a correlation coefficient of 0.48 (p 

  8. Fulltext Dissecting the fungal biology of Bipolaris papendorfii: from phylogenetic to comparative genomic analysis
    Kuan CS, Yew SM, Toh YF, Chan CL, Ngeow YF, Lee KW, et al.
    DNA Res, 2015 Jun;22(3):219-32.
    PMID: 25922537 DOI: 10.1093/dnares/dsv007
    Bipolaris papendorfii has been reported as a fungal plant pathogen that rarely causes opportunistic infection in humans. Secondary metabolites isolated from this fungus possess medicinal and anticancer properties. However, its genetic fundamental and basic biology are largely unknown. In this study, we report the first draft genome sequence of B. papendorfii UM 226 isolated from the skin scraping of a patient. The assembled 33.4 Mb genome encodes 11,015 putative coding DNA sequences, of which, 2.49% are predicted transposable elements. Multilocus phylogenetic and phylogenomic analyses showed B. papendorfii UM 226 clustering with Curvularia species, apart from other plant pathogenic Bipolaris species. Its genomic features suggest that it is a heterothallic fungus with a putative unique gene encoding the LysM-containing protein which might be involved in fungal virulence on host plants, as well as a wide array of enzymes involved in carbohydrate metabolism, degradation of polysaccharides and lignin in the plant cell wall, secondary metabolite biosynthesis (including dimethylallyl tryptophan synthase, non-ribosomal peptide synthetase, polyketide synthase), the terpenoid pathway and the caffeine metabolism. This first genomic characterization of B. papendorfii provides the basis for further studies on its biology, pathogenicity and medicinal potential.
  9. Fulltext Detection of Respiratory Viruses from ARTI Patients by xTAG RVP Fast v2 Assay and Conventional Methods
    Kuan CS, Yew SM, Hooi PS, Lee LM, Ng KP
    Malays J Med Sci, 2017 Oct;24(5):33-43.
    PMID: 29386970 MyJurnal DOI: 10.21315/mjms2017.24.5.4
    Introduction: Acute respiratory tract infections (ARTIs) are a major cause of morbidity and mortality in paediatric patients. Therefore, early detection of the viral aetiologies of ARTIs is essential for patient management and infection control. In this study, we evaluated the performance of a new multiplex polymerase chain reaction (PCR) assay (xTAG Respiratory Viral Panel [RVP] Fast v2) in the detection of respiratory viruses by comparing it with that of viral culture and direct immunofluorescence (IF) staining.

    Methods: Nasopharyngeal swab and aspirate samples were collected prospectively from 199 patients who presented with ARTIs at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia during a 10-month period. The PCR assay was conducted in parallel with conventional culture and direct IF staining methods.

    Results: The positive rate of the xTAG RVP Fast v2 assay (78.4%) in detecting respiratory viruses was higher than that of the viral isolation (7.5%) and direct IF (23.1%) methods. Using the xTAG RVP Fast v2 assay, human enterovirus/human rhinovirus (HEV/HRV) was the most frequently detected (46.2%). The xTAG RVP Fast v2 assay revealed mixed infection caused by two or three respiratory viruses in 40 specimens, and these were undetected by the viral isolation and direct IF methods.

    Conclusion: The xTAG RVP Fast v2 assay was superior to conventional methods in the identification of common respiratory viruses, with higher sensitivity and shorter turnaround times for laboratory results.

  10. Etiology of blood culture isolates among patients in a multidisciplinary teaching hospital in Kuala Lumpur
    Karunakaran R, Raja NS, Ng KP, Navaratnam P
    J Microbiol Immunol Infect, 2007 Oct;40(5):432-7.
    PMID: 17932604
    Bloodstream infections are an important cause of morbidity and mortality among hospitalized patients and the surveillance of etiological agents in these infections is important for their prevention and treatment. Data on common organisms isolated from blood cultures from Malaysia are limited, and our aim was to identify the common bloodstream isolates in hospitalized patients at the University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.
  11. Fulltext The prevalence of anti-HCV antibody in risk groups and blood donors
    Ng KP, Saw TL, Wong NW, Goh KL, Chuah SY, Nagaratnam M
    Med J Malaysia, 1995 Dec;50(4):302-5.
    PMID: 8668047
    Anti-HCV antibody was detected in 1.9% of the blood donors in University Hospital. Among the risk groups, 33.3% of the patients with post-transfusion hepatitis were tested positive for anti-HCV antibody. The anti-HCV antibody was detected in 30% of the IDU. Haemodialysis patients, patients with acute and chronic hepatitis and patients with liver cirrhosis appeared to have increased risk of Hepatitis C virus infection. The results indicate that the frequency of HCV infection increases with the exposure to blood or blood products.
  12. Fulltext Fusarium sp. infection in a patient with acute lymphoblastic leukaemia
    Tan R, Ng KP, Gan GG, Na SL
    Med J Malaysia, 2013 Dec;68(6):479-80.
    PMID: 24632920 MyJurnal
    In the past two decades, Fusarium species have been increasingly recognized as serious pathogens in immunocompromised patients. The outcome of fusariosis in the context of severe persistent neutropaenia has been almost universally fatal. The treatment of fusariosis in immunocompromised patients remains a challenge and the prognosis of systemic fusariosis in this population remains poor. This report presents a case of fatal fusariosis in a 37- year-old patient who was diagnosed with precursor-B cell Acute Lymphoblastic Leukaemia (ALL).
  13. Comparative analysis of viral genomes from acute and chronic hepatitis B reveals novel variants associated with a lower rate of chronicity
    Chook JB, Ngeow YF, Khang TF, Ng KP, Tiang YP, Mohamed R
    J Med Virol, 2013 Mar;85(3):419-24.
    PMID: 23297244 DOI: 10.1002/jmv.23500
    Infection with the hepatitis B virus (HBV) may lead to an acute or chronic infection. It is generally accepted that the clinical outcome of infection depends on the balance between host immunity and viral survival strategies. In order to persist, the virus needs to have a high rate of replication and some immune-escape capabilities. Hence, HBVs lacking these properties are likely to be eliminated more rapidly by the host, leading to a lower rate of chronicity. To test this hypothesis, 177 HBV genomes from acute non-fulminant cases and 1,149 from chronic cases were retrieved from GenBank for comparative analysis. Selection of candidate nucleotides associated with the disease state was done using random guess cut-off and the Bonferroni correction. Five significant nucleotides were detected using this filtering step. Their predictive values were assessed using the support vector machine classification with five-fold cross-validation. The average prediction accuracy was 61% ± 1%, with a sensitivity of 24% ± 1%, specificity of 98% ± 1%, positive predictive value of 92% ± 4% and negative predictive value of 56% ± 1%. BCP/X, enhancer I and surface/polymerase variants were found to be associated almost exclusively with acute hepatitis. These HBV variants are novel potential markers for non-progression to chronic hepatitis.
  14. Fulltext Universal Primers for Detection and Sequencing of Hepatitis B Virus Genomes across Genotypes A to G
    Chook JB, Teo WL, Ngeow YF, Tee KK, Ng KP, Mohamed R
    J Clin Microbiol, 2015 Jun;53(6):1831-5.
    PMID: 25788548 DOI: 10.1128/JCM.03449-14
    Hepatitis B virus (HBV) has been divided into 10 genotypes, A to J, based on an 8% nucleotide sequence divergence between genotypes. The conventional practice of using a single set of primers to amplify a near-complete HBV genome is hampered by its low analytical sensitivity. The current practice of using overlapping conserved primer sets to amplify a complete HBV genome in a clinical sample is limited by the lack of pan-primers to detect all HBV genotypes. In this study, we designed six highly conserved, overlapping primer sets to cover the complete HBV genome. We based our design on the sequences of 5,154 HBV genomes of genotypes A to I downloaded from the GenBank nucleotide database. These primer sets were tested on 126 plasma samples from Malaysia, containing genotypes A to D and with viral loads ranging from 20 to >79,780,000 IU/ml. The overall success rates for PCR amplification and sequencing were >96% and >94%, respectively. Similarly, there was 100% amplification and sequencing success when the primer sets were tested on an HBV reference panel of genotypes A to G. Thus, we have established primer sets that gave a high analytical sensitivity for PCR-based detection of HBV and a high rate of sequencing success for HBV genomes in most of the viral genotypes, if not all, without prior known sequence data for the particular genotype/genome.
  15. The mycological and molecular study of Hortaea werneckii isolated from blood and splenic abscess
    Ng KP, Soo-Hoo TS, Na SL, Tay ST, Hamimah H, Lim PC, et al.
    Mycopathologia, 2005 Jun;159(4):495-500.
    PMID: 15983734
    Hortaea werneckii is an environmental dematiaceous fungus found in the halophilic environment. It causes tinea nigra. We report the isolation of H. werneckii from blood and splenic abscess of two patients with acute myelomonocytic leukaemia. H. werneckii grew at room temperature but not at 37 degrees C, it was identified by biochemical tests, growth characteristics and the presence of conspicuous collarette intercalary on dividing yeast cells. The use of specific oligonucleotide primer Hor-F (5'-TGGACACCTTCA TAACTCTTG-3') and Hor-R (5'-TCACAACGCTTAGAGACGG-3') confirmed the two isolates were H. werneckii. The sequence for 281 nucleotide of HW299 and HW403 were 99% identical but differed only in one nucleotide. In vitro anti-fungal susceptibility testing showed that the isolates were resistant to amphotericin B and flucytosine.
  16. Fulltext An outbreak of acute haemorrhagic conjunctivitis in Melaka, Malaysia
    Ghazali O, Chua KB, Ng KP, Hooi PS, Pallansch MA, Oberste MS, et al.
    Singapore Med J, 2003 Oct;44(10):511-6.
    PMID: 15024454
    This paper reports a second outbreak of acute haemorrhagic conjunctivitis due to coxsackievirus A24 in peninsular Malaysia. Between June 2002 and early October 2003, 10,327 patients, comprising 3,261 children and 7,066 adults, were treated for acute conjunctivitis in 11 government health clinics in the Melaka Tengah district of the state of Melaka. The figure grossly underestimates the size of the outbreak; as no patients treated in private clinics in the same district were included. Institution and household surveillance showed that the commonest presenting clinical feature of the illness was eye-discharge (91.2%), followed by foreign body sensation (81.8%), pain (78.3%) and subconjunctival haemorrhage (74.4%). The mean duration of illness was 6.5 and five days for patients with and without subconjunctival haemorrhage respectively.
  17. Fulltext A seroprevalence study of viral hepatitis E infection in human immunodeficiency virus type 1 infected subjects in Malaysia
    Ng KP, He J, Saw TL, Lyles CM
    Med J Malaysia, 2000 Mar;55(1):58-64.
    PMID: 11072492 MyJurnal
    Hepatitis E virus (HEV) is a RNA virus transmitted enterically. A study of anti-HEV antibodies in 145 human immunodeficiency virus type 1 (HIV-1) infected subjects found that 14.4% of them were reactive to anti-HEV antibodies. Anti-HEV IgG and anti-HEV IgM was detected in 10.3% and 4.1% of the subjects respectively. Prevalence of anti-HEV (either IgG or IgM) was similar across all adult ages (p = 0.154), between the three ethnic groups (p = 0.378), and across risk groups (p = 0.120). The results showed that HEV infection in subjects recruited in this study was most likely transmitted via faecal-route.
  18. Evaluation of a rapid test for the detection of antibodies to human immunodeficiency virus type 1 and 2
    Ng KP, Saw TL, Baki A, He J, Singh N, Lyles CM
    Int J STD AIDS, 1999 Jun;10(6):401-4.
    PMID: 10414883
    Hema-Strip HIV-1/2 is a one-step rapid test for the detection of anti-HIV-1/2 antibodies in whole blood. The test requires no expensive equipment and the results are available within 10-15 min. Using 72 known HIV-1 positive samples and 780 high-risk prisoners, the sensitivity and specificity of Hema-Strip HIV-1/2 was found to be comparable to microparticle enzyme immunoassay (MEIA). The data also indicated that Hema-Strip HIV-1/2 is an effective alternate testing system to conventional ELISA where the use of ELISA is not suitable and the result of the HIV testing is needed urgently.
  19. Anesthetic management of a parturient with superior vena cava obstruction for cesarean section
    Chan YK, Ng KP, Chiu CL, Rajan G, Tan KC, Lim YC
    Anesthesiology, 2001 Jan;94(1):167-9.
    PMID: 11135739
  20. Do Family Members of Dialysis Patients Have a Positive Attitude Toward Organ Donation?
    Tumin M, Tafran K, Zakaria RH, Satar NM, Ng KP, Lim SK
    Ann. Transplant., 2015 Dec 22;20:752-6.
    PMID: 26690676 DOI: 10.12659/aot.894427
    BACKGROUND: Malaysia, which currently uses the informed consent system (ICS), is suffering from a severe shortage of organs for transplantation. Family members of dialysis patients (FMDPs) are expected to have a positive attitude toward deceased organ donation (DOD) because they have a close relative in need of a kidney donation. This study explores FMDPs' attitude toward DOD under the ICS and the presumed consent system (PCS).

    MATERIAL/METHODS: The attitude of 350 FMDPs toward DOD under the ICS and PCS were sought between June and October 2013 in 3 dialysis institutions in Kuala Lumpur, Malaysia.

    RESULTS: Under the ICS, 6.6% of respondents were registered donors, 6.6% were ready to register at the time of the survey, 38.6% were willing to donate but not ready to register at the time of the survey, and 48.2% were unwilling to donate organs upon death. If the PCS were implemented, 57.7% of respondents (28.7% of the willing donors and 88.7% of the unwilling respondents) stated that they would officially object to organ donation.

    CONCLUSIONS: FMDPs' attitude toward DOD is not more positive or significantly better than that of the general public (based on earlier studies). The PCS may increase the number of donors, but it may also worsen the attitude of FMDPs toward DOD. Strategies aiming to promote DOD in Malaysia should be revised, and should perhaps be focused on enhancing trust of the medical system.
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