Displaying publications 141 - 160 of 652 in total

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  1. Saw JT, Bahari MB, Ang HH, Lim YH
    Complement Ther Clin Pract, 2006 Nov;12(4):236-41.
    PMID: 17030294
    This is a cross-sectional survey evaluating the use of herbal medicines in medical wards patients that may interfere with the effect of antiplatelet or anticoagulant therapy. Among the 250 patients participated, 42.4% (n=106) were taking herbs with 76 patients (71.7%) using herbs for the past 12 months. Overall, almost 31% (n=23, N=76) of patients were taking one or more of the specified herbal medicines [ginseng (Panax ginseng), garlic (Allium sativum), ginkgo (Gingko biloba) thought to interact with antiplatelet or anticoagulant therapy. The study showed that 21% (n=16, N=76) of patients co-ingested specified herbs with antiplatelet or anticoagulant therapy, of which half of them were at risk of potential drug-herb interactions. A large proportion of respondents involved in potential drug-herb interaction were elderly people (62.5%, n=5). However, more than 90% of herbal users did not disclose the use of herbal medicine to their health professionals. It is thus prudent for all care givers to be aware of the possibility of drug-herb interaction and inquire about herbal use from patients.
  2. Ang CY, Samsudin AR, Karima AM, Nizam A
    Med J Malaysia, 2004 May;59 Suppl B:149-50.
    PMID: 15468862
    The aim of this study was to evaluate the morphological and biological properties of a locally produced "Bovine Bone Sponge" for use in dentistry. Bovine bone sponge was prepared from local calf bone. Endotoxin level and surface properties were investigated. The pore size and water uptake ability were measured and results were compared with the commercial haemostatic agent. The material was tested for its haemostatic property and its inhibition of alveolar bone resorption in a sheep model following dental extraction. Results revealed a significant difference in haemostatic effect, and a shorter bleeding time and a lower rate of alveolar bone resorption in bovine bone sponge compare to a commercial haemostatic agent.
  3. Omar S, Bhutani MS, Yasuda K, Ang TL
    Gastroenterol Res Pract, 2013;2013:508082.
    PMID: 23365564 DOI: 10.1155/2013/508082
  4. Loh LC, Chelliah A, Ang TH, Ali AM
    Med J Malaysia, 2004 Dec;59(5):659-64.
    PMID: 15889569 MyJurnal
    Severe Acute Respiratory Syndrome (SARS) epidemic illustrated the crucial role of infection surveillance and control measures in the combat of any highly transmissible disease. We conducted an interview survey of 121 medical staff 145 doctors, 46 staff nurses and 30 medical assistants) in a state hospital in Malaysia three months after the end of SARS epidemic (from October to December 2003). Staff was grouped according to those directly involved in the care of suspected SARS patients [S+ group n=41] and those who were not [S- group; n=80]. On hand washing following sneezing, coughing and touching patients, the proportions of medical staff that reported an increase after the SARS crisis were 22.3%, 16.5% and 45.5% respectively. On wearing masks, gloves, and aprons when meeting potentially infectious patients, the proportions that reported an increase were 39.7%, 47.1% and 32.2% respectively. Significantly more staff in S+ than S- group reported these increases. Sixty percent of staff was aware of changes in hospital infection control policies after SARS; 93.4% was aware of notifying procedures, and 81.8% was aware of whom to notify in the hospital. Regarding infection isolation ward, Infectious Control Nurse and Infection Control Committee Chairman in the hospital, the proportions of staff that could correctly name them were 39.7%, 38.3% and 15.7% respectively. Significantly more in S+ than S- group could do so. However, more than half the staff claimed ignorance on the knowledge of infection isolation ward (56.2%), Infection Control Nurse (57.9%) and Chairman (65.3%). Our findings demonstrated that SARS crisis had some positive impact on the infection control practices and awareness of medical staff especially on those with direct SARS involvement. Implications for future control of infectious diseases are obvious.
  5. Loh LC, Ali AM, Ang TH, Chelliah A
    Med J Malaysia, 2004 Aug;59(3):431-2.
    PMID: 15727395
  6. Jawin V, Ang HL, Omar A, Thong MK
    PLoS One, 2015;10(9):e0137580.
    PMID: 26360420 DOI: 10.1371/journal.pone.0137580
    Studies on pulse oximetry screening for neonatal sepsis and respiratory disease in a middle-income country are lacking. Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is an effective and life-saving strategy in developed countries. While most studies have reported false-positive results during CCHD screening, they have not elaborated on the detected disease types. We studied the effectiveness and outcomes of pulse oximetry newborn screening for non-cardiac hypoxemic diseases such as neonatal sepsis, respiratory diseases, and CCHD in a middle-income country.
  7. Ng KP, Soo-Hoo TS, Na SL, Ang LS
    Mycopathologia, 2002;155(4):203-6.
    PMID: 12650596
    A total of 576 dermatophytes were isolated from patients with a variety of skin infections from January 1993 to May 2000. Ten species of dermatophytes were identified: Epidermophyton floccosum (0.7%), Microsporum audouinii (1.1%), M. canis (3.1%), M. gypseum (0.3%), Trichophyton concentricum (3.5%), T. equinum (0.2%), T. mentagrophytes (36.1%), T. rubrum (53.8%), T. verrucosum (0.2) and T. violaceum (1.0%). The body sites most frequently affected by dermatophytes were the buttocks, nails and trunk. Anthropophilic dermatophytes made up 60.1% of the isolates; the most common species was T. rubrum, T. mentagrophytes and M. canis were the two main zoophilic dermatophytes. T. mentagrophytes was isolated from all body sites except the scalp. M. canis was found to be associated with domestic dogs and was not isolated from ethnic Malays. The only geophilic dermatophyte was M. gypseum, an uncommon dermatophyte associated with tinea pedis.
  8. Pang KP, Ang AHC, Tan HKK
    Med J Malaysia, 2002 Sep;57(3):376-82; quiz 383.
    PMID: 12440282
    Otitis media with effusion (OME) is a very common condition seen in children, and is the commonest cause of hearing loss in an infant. It is also a fairly common condition encountered by the family practitioner, and often the family practitioner is the first doctor the parents bring the child to. Otitis media with effusion is a simple condition but, if left undiagnosed or untreated, can lead to preventable long-term consequences. Hence, a high index of suspicion is necessary, early and accurate diagnosis, prompt treatment, with close follow-up is of essence. The epidemiology, aetiological factors, clinical presentations, diagnosis, various medical and surgical options, cost-effectiveness of therapy and the impact of OME on the child's development are discussed.
  9. Ang KC, Lee EH, Lee PY, Tan KL
    Ann Acad Med Singap, 1997 Jul;26(4):456-8.
    PMID: 9395810
    The incidence of congenital dislocation of the hip (CDH) in Singapore and Malaysia has been reported as being lower than in the West. In our hospital, we have seen an increasing number of congenital hip dislocation as well as dysplastic hips. We undertook a prospective study from December 1989 to December 1994 of 20,000 live births. The neonates were all screened by a consultant neonatologist and the findings were confirmed by a consultant paediatric orthopaedic surgeon. All babies had plain X-rays at 3 months and an acetabular index (AI) of 30 degrees or more was considered dysplastic. All babies with positive signs were followed up for 1 year and again had radiographs taken at 1 year. Comparison of plain X-rays and ultrasound assessment in a subgroup of 130 neonates showed that 64% of patients with AI > 20 degrees had hip dysplasia by ultrasonographic (alpha angle < 60 degrees) The incidence of dysplastic hips was 16.8 per 1000 live births. The overall incidence of neonates with dislocated hips was 4.7 per 1000 live births. The Malays were most affected with an incidence of 5.4 per 1000 live births. The incidence of developmental dysplasia of the hip in Singapore is higher than previously reported, with the Malays having the highest incidence. A significant number of babies with clicking hips have radiological evidence of acetabular dysplasia (AI > 30 degrees). One-third of the babies' hips were still dysplastic at 1 year of age. A well-organised screening programme with experienced examiners has proved to be useful in making early and accurate clinical diagnosis.
  10. Ang PP, Tan GC, Karim N, Wong YP
    Acta Cytol., 2020;64(3):248-255.
    PMID: 31352449 DOI: 10.1159/000501406
    BACKGROUND: Differentiating reactive mesothelial cells from metastatic carcinoma in effusion cytology is a challenging task. The application of at least 4 monoclonal antibodies including 2 epithelial markers (Ber-EP4, MOC-31, CEA, or B72.3) and 2 mesothelial markers (calretinin, WT-1, CK5/6, or HBME-1) are often useful in this distinction; however, it is not readily available in many resource-limited developing countries. Aberrant immunoexpression of enhancer of zeste homolog 2 (EZH2), a transcriptional repressor involved in cancer progression, is observed widely in various malignancy. In this study, we evaluate the diagnostic value of EZH2 as a single reliable immunomarker for malignancy in effusion samples.

    METHODS: A total of 108 pleural, peritoneal, and pericardial effusions/washings diagnosed as unequivocally reactive (n = 41) and metastatic carcinoma (n = 67) by cytomorphology over 18 months were reviewed. Among the metastatic carcinoma cases, 54 were adenocarcinoma and others were squamous cell carcinoma (n = 1), carcinosarcoma (n = 1), and carcinoma of undefined histological subtypes (n = 11). Cell block sections were immunostained by EZH2 (Cell Marque, USA). The percentages of EZH2-immunolabeled cells over the total cells of interest were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off score to define EZH2 immunopositivity.

    RESULTS: A threshold of 8% EZH2-immunolabeled cells allows distinction between malignant and reactive mesothelial cells, with 95.5% sensitivity, 100% specificity, 100% positive predictive value, and 93.2% negative predictive value (p < 0.0001). The area under the curve was 0.988.

    CONCLUSION: EZH2 is a promising diagnostic biomarker for malignancy in effusion cytology which is inexpensive yet trustworthy and could potentially be used routinely in countries under considerable economic constraints.

  11. Ang CS, Teo KM, Ong YL, Siak SL
    Addict Health, 2019 Jan;11(1):1-10.
    PMID: 31308904 DOI: 10.22122/ahj.v11i1.539
    Background: The exponential growth of smartphones has afforded many users with ubiquitous access to socialization as seen in the various mobile apps used to communicate and connect with others. The present study employed mixed-method approaches to analyse the impact of phubbing on social connectedness among adolescents in Malaysia.

    Methods: A total of 568 adolescents were participated in quantitative surveys, and of these participating adolescents, 6 were further invited to join focus group interviews.

    Findings: Quantitative findings supported the mediating role of communication disturbance in the relationships between phone obsession and familial connectedness, school connectedness, and self-connectedness, but not for friendship connectedness. Qualitative findings further elucidated the detrimental effect of phone obsession on their sense of belonging from the perspectives of adolescents.

    Conclusion: This study reaffirms that phubbing behaviour is predictive of social disconnectedness. Therefore, preventive and treatment interventions should be developed to avoid and control a potential risk of social disconnectedness epidemics attribute to phubbing.

  12. Ang JY, Bhojwani K, Chan HK, Chan AC
    Acupunct Med, 2021 02;39(1):64-68.
    PMID: 32539426 DOI: 10.1177/0964528420920307
    INTRODUCTION: The objective of this retrospective study was to evaluate the effectiveness and safety of acupuncture-assisted anesthesia (AAA) in breast lump excision.

    METHODS: The medical records of all patients who underwent breast lump excision under AAA in combination with electrical stimulation at traditional acupuncture points in 2016 were examined. All of them (n = 17) received electrostimulation (2-4 Hz) using single needles inserted at bilateral LI4 and PC6. They also underwent insertion of four acupuncture needles at the lump site, which were electrically stimulated at 30 Hz frequency.

    RESULTS: All surgical procedures were successful with minimal use of analgesics and local anesthetic. The median pain score reported was 1/10 (interquartile range (IQR) = 2/10) at the first hour, and slightly increased to 2/10 (IQR = 2/10) between 24 and 48 h of the surgery. No major postoperative adverse events were documented, except for drowsiness in one case.

    CONCLUSION: AAA was found to be generally safe and effective for anaesthesia and analgesia in breast lump excision. However, a large-scale randomized controlled study is required to verify the findings.

  13. Yu CY, Chan KG, Yean CY, Ang GY
    Diagnostics (Basel), 2021 Jan 01;11(1).
    PMID: 33401392 DOI: 10.3390/diagnostics11010053
    The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began as a cluster of pneumonia cases in Wuhan, China before spreading to over 200 countries and territories on six continents in less than six months. Despite rigorous global containment and quarantine efforts to limit the transmission of the virus, COVID-19 cases and deaths have continued to increase, leaving devastating impacts on the lives of many with far-reaching effects on the global society, economy and healthcare system. With over 43 million cases and 1.1 million deaths recorded worldwide, accurate and rapid diagnosis continues to be a cornerstone of pandemic control. In this review, we aim to present an objective overview of the latest nucleic acid-based diagnostic tests for the detection of SARS-CoV-2 that have been authorized by the Food and Drug Administration (FDA) under emergency use authorization (EUA) as of 31 October 2020. We systematically summarize and compare the principles, technologies, protocols and performance characteristics of amplification- and sequencing-based tests that have become alternatives to the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel. We highlight the notable features of the tests including authorized settings, along with the advantages and disadvantages of the tests. We conclude with a brief discussion on the current challenges and future perspectives of COVID-19 diagnostics.
  14. Ali A, Andriyana A, Hassan SBA, Ang BC
    Polymers (Basel), 2021 Apr 29;13(9).
    PMID: 33947012 DOI: 10.3390/polym13091437
    The development of advanced composite materials has taken center stage because of its advantages over traditional materials. Recently, carbon-based advanced additives have shown promising results in the development of advanced polymer composites. The inter- and intra-laminar fracture toughness in modes I and II, along with the thermal and electrical conductivities, were investigated. The HMWCNTs/epoxy composite was prepared using a multi-dispersion method, followed by uniform coating at the mid-layers of the CF/E prepregs interface using the spray coating technique. Analysis methods, such as double cantilever beam (DCB) and end notched flexure (ENF) tests, were carried out to study the mode I and II fracture toughness. The surface morphology of the composite was analyzed using field emission scanning electron microscopy (FESEM). The DCB test showed that the fracture toughness of the 0.2 wt.% and 0.4 wt.% HMWCNT composite laminates was improved by 39.15% and 115.05%, respectively, compared with the control sample. Furthermore, the ENF test showed that the mode II interlaminar fracture toughness for the composite laminate increased by 50.88% and 190%, respectively. The FESEM morphology results confirmed the HMWCNTs bridging at the fracture zones of the CF/E composite and the improved interlaminar fracture toughness. The thermogravimetric analysis (TGA) results demonstrated a strong intermolecular bonding between the epoxy and HMWCNTs, resulting in an improved thermal stability. Moreover, the differential scanning calorimetry (DSC) results confirmed that the addition of HMWCNT shifted the Tg to a higher temperature. An electrical conductivity study demonstrated that a higher CNT concentration in the composite laminate resulted in a higher conductivity improvement. This study confirmed that the demonstrated dispersion technique could create composite laminates with a strong interfacial bond interaction between the epoxy and HMWCNT, and thus improve their properties.
  15. Low A, Singh S, Ang EL, Kadir AJ, Samsudin A
    Malays Fam Physician, 2021 Jul 22;16(2):45-49.
    PMID: 34386163 DOI: 10.51866/oa1147
    Purpose: A clinical audit to establish whether eye doctors achieve the benchmark in reminding glaucoma patients about the dangers of driving. After introducing two simple interventions, a follow-up audit was performed.

    Methodology: Initially, we interviewed 85 patients with established glaucoma who underwent Humphrey visual field (HVF) testing and also reviewed their medical notes. We looked for documentation of their driving status, specifically whether those with bilateral visual field (VF) defects recalled being given advice about the dangers of driving and whether this was documented in the notes. After this initial audit, doctors were educated on the availability of guidelines on visual requirements for driving, and reminder adhesive labels were put on the front of medical notes of driving glaucoma patients. A follow-up audit was then performed on 95 different patients.

    Results: In the initial audit, none of the patients had their driving status recorded. Only 36% of drivers with bilateral VF defects recalled being advised of the dangers of driving, with no documentation of whether the advice was given to them. Following the interventions, documentation of driving status became 86%. All drivers with bilateral VF defects recalled being advised regarding the dangers of driving, with documentation of the advice being given recorded in 73% of the medical notes.

    Conclusion: Eye doctors are inadequately identifying, advising, and documenting the dangers of driving in the medical notes of glaucoma patients with bilateral VF defects. This can be improved with simple interventions, such as the education of doctors and creating reminder labels, for the benefit of our glaucoma patients.

  16. Ang KM, Yeo LY, Hung YM, Tan MK
    Lab Chip, 2016 09 21;16(18):3503-14.
    PMID: 27502324 DOI: 10.1039/c6lc00780e
    The deposition of a thin graphene film atop a chip scale piezoelectric substrate on which surface acoustic waves are excited is observed to enhance its performance for fluid transport and manipulation considerably, which can be exploited to achieve further efficiency gains in these devices. Such gains can then enable complete integration and miniaturization for true portability for a variety of microfluidic applications across drug delivery, biosensing and point-of-care diagnostics, among others, where field-use, point-of-collection or point-of-care functionality is desired. In addition to a first demonstration of vibration-induced molecular transport in graphene films, we show that the coupling of the surface acoustic wave gives rise to antisymmetric Lamb waves in the film which enhance molecular diffusion and hence the flow through the interstitial layers that make up the film. Above a critical input power, the strong substrate vibration displacement can also force the molecules out of the graphene film to form a thin fluid layer, which subsequently destabilizes and breaks up to form a mist of micron dimension aerosol droplets. We provide physical insight into this coupling through a simple numerical model, verified through experiments, and show several-fold improvement in the rate of fluid transport through the film, and up to 55% enhancement in the rate of fluid atomization from the film using this simple method.
  17. Habiba U, Afifi AM, Salleh A, Ang BC
    J Hazard Mater, 2017 Jan 15;322(Pt A):182-194.
    PMID: 27436300 DOI: 10.1016/j.jhazmat.2016.06.028
    In this study, chitosan/polyvinyl alcohol (PVA)/zeolite nanofibrous composite membrane was fabricated via electrospinning. First, crude chitosan was hydrolyzed with NaOH for 24h. Afterward, hydrolyzed chitosan solution was blended with aqueous PVA solution in different weight ratios. Morphological analysis of chitosan/PVA electrospun nanofiber showed a defect-free nanofiber material with 50:50 weight ratio of chitosan/PVA. Subsequently, 1wt.% of zeolite was added to this blended solution of 50:50 chitosan/PVA. The resulting nanofiber was characterized with field emission scanning electron microscopy, X-Ray diffraction, Fourier transform infrared spectroscopy, swelling test, and adsorption test. Fine, bead-free nanofiber with homogeneous nanofiber was electrospun. The resulting membrane was stable in distilled water, acidic, and basic media in 20 days. Moreover, the adsorption ability of nanofibrous membrane was studied over Cr (VI), Fe (III), and Ni (II) ions using Langmuir isotherm. Kinetic parameters were estimated using the Lagergren first-order, pseudo-second-order, and intraparticle diffusion kinetic models. Kinetic study showed that adsorption rate was high. However, the resulting nanofiber membrane showed less adsorption capacity at high concentration. The adsorption capacity of nanofiber was unaltered after five recycling runs, which indicated the reusability of chitosan/PVA/zeolite nanofibrous membrane. Therefore, chitosan/PVA/zeolite nanofiber can be a useful material for water treatment at moderate concentration of heavy metals.
  18. Ang KM, Yeo LY, Hung YM, Tan MK
    Biomicrofluidics, 2016 Sep;10(5):054106.
    PMID: 27703592
    The ability to drive microcentrifugation for efficient micromixing and particle concentration and separation on a microfluidic platform is critical for a wide range of lab-on-a-chip applications. In this work, we investigate the use of amplitude modulation to enhance the efficiency of the microcentrifugal recirculation flows in surface acoustic wave microfluidic systems, thus concomitantly reducing the power consumption in these devices for a given performance requirement-a crucial step in the development of miniaturized, integrated circuits for true portable functionality. In particular, we show that it is possible to obtain an increase of up to 60% in the acoustic streaming velocity in a microdroplet with kHz order modulation frequencies due to the intensification in Eckart streaming; the streaming velocity is increasing as the modulation index is increased. Additionally, we show that it is possible to exploit this streaming enhancement to effect improvements in the speed of particle concentration by up to 70% and the efficiency of micromixing by 50%, together with a modest decrease in the droplet temperature.
  19. Ang KM, Yeo LY, Hung YM, Tan MK
    Nanoscale, 2017 May 18;9(19):6497-6508.
    PMID: 28466906 DOI: 10.1039/c7nr01690e
    We exploit the possibility of enhancing the molecular transport of liquids through graphene films using amplitude modulated surface acoustic waves (SAWs) to demonstrate effective and efficient nanoparticle filtration. The use of the SAW, which is an extremely efficient means for driving microfluidic transport, overcomes the need for the large mechanical pumps required to circumvent the large pressure drops encountered in conventional membranes for nanoparticle filtration. 100% filtration efficiency was obtained for micron-dimension particulates, decreasing to only 95% for the filtration of particles of tens of nanometers in dimension, which is comparable to that achieved with other methods. To circumvent clogging of the film, which is typical with all membrane filters, a backwash operation to flush the nanoparticles is incorporated simply by reversing the SAW-induced flow such that 98% recovery of the initial filtration rate is recovered. Given these efficiencies, together with the low cost and compact size of the chipscale SAW devices, we envisage the possibility of scaling out the process by operating a large number of devices in parallel to achieve typical industrial-scale throughputs with potential benefits in terms of substantially lower capital, operating and maintenance costs.
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