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Focal nodular hyperplasia of the liver

Chong KC

Med J Malaysia, 1974 Jun;28(4):296-9.
PMID: 4278779
Diverticula of the vermiform appendix: a report of nine cases

Chong KC

Postgrad Med J, 1976 Aug;52(610):504-10.
PMID: 824633

The incidence, clinical features and pathology of nine cases of diverticula of the appendix in Malaysians are reported. The findings are discussed and compared with those previously reported. The pathogenesis of the lesion in eight cases is unknown. The rare association of lumenal obstruction by a carcinoid tumour and diverticulum formation in the appendix is seen in one case.
Fulltext Multiple organ failure and septic shock in disseminated tuberculosis

Lim KH, Chong KL

Singapore Med J, 1999 Mar;40(3):176-8.
PMID: 10402899

The diagnosis of disseminated tuberculosis should be entertained in all patients with unexplained fever associated with hepatomegaly and/or splenomegaly with or without anomalies in liver function tests and haemogram. It should be considered as a possible cause of septic shock especially in patients with typical risk factors such as advanced age, diabetes, alcoholism or immunosuppression. Prompt therapy could be life saving in an otherwise potentially fatal condition. It is therefore appropriate to initiate anti-tuberculosis treatment as soon as such a diagnosis is suspected and not await final confirmation.
Permanent cardiac pacing in Malaysia. An update

Saw HS, Chong KT, Singham AM

Ann Acad Med Singap, 1981 Oct;10(4 Suppl):93-8.
PMID: 7344608

Updated data on permanent cardiac pacing in Malaysia is presented. Over the past 3 1/2 years (1976-1980), 75 patients underwent insertion of pacemakers giving an annual incidence of about 20 cases as compared with a total of 21 cases in the previous 8 years (1968-1977). Many of the features reported in an earlier paper in 1977 viz mode of presentation, age and sex distribution and indications for pacing remain unchanged. Over this period only 4 patients required lead replacement. Since concentrating mainly on the use of epicardial leads implanted via a subxiphoid approach, complications have been remarkably low. The problem of availability of pacemakers has been averted. Cost remains a major consideration when recommending one pacemaker in preference over another. The details concerning clinical features, indications for pacing, complications and other problems encountered in the management of these patients are discussed.
Fulltext The external ear--the electrical aspects in relation to acupuncture--a preliminary report

Ong LS, Hamiadji T, Chong KL

Med J Malaysia, 1980 Sep;35(1):53-7.
PMID: 7253999

This study is based on measuring the d.c. (direct current) skin conductance of the acupuncture points representing the heart on the external ear. The subjects were 30 healthy volunteers and 20 cardiac patients. The results obtained showed that the skin resistance of the heart acupuncture loci on the auricle of the cardiac patients were markedly reduced when compared with that of the healthy controls. The value of this method of auricular electroacupuncture diagnosis is discussed.
Report on two cases of hyperosmolar, hyperglycaemic nonketotic diabetic coma

Gip LS, Chong KF, Omar AR

Med J Malaysia, 1978 Dec;33(2):150-3.
PMID: 755167
The empty sella syndrome

Anuar M, Ng KK, Chong KF

Med J Malaysia, 1977 Mar;31(3):244-6.
PMID: 904521
Thermosonication and optimization of stingless bee honey processing

Chong KY, Chin NL, Yusof YA

Food Sci Technol Int, 2017 Oct;23(7):608-622.
PMID: 28614964 DOI: 10.1177/1082013217713331

The effects of thermosonication on the quality of a stingless bee honey, the Kelulut, were studied using processing temperature from 45 to 90 ℃ and processing time from 30 to 120 minutes. Physicochemical properties including water activity, moisture content, color intensity, viscosity, hydroxymethylfurfural content, total phenolic content, and radical scavenging activity were determined. Thermosonication reduced the water activity and moisture content by 7.9% and 16.6%, respectively, compared to 3.5% and 6.9% for conventional heating. For thermosonicated honey, color intensity increased by 68.2%, viscosity increased by 275.0%, total phenolic content increased by 58.1%, and radical scavenging activity increased by 63.0% when compared to its raw form. The increase of hydroxymethylfurfural to 62.46 mg/kg was still within the limits of international standards. Optimized thermosonication conditions using response surface methodology were predicted at 90 ℃ for 111 minutes. Thermosonication was revealed as an effective alternative technique for honey processing.
Fulltext Dystrophic Scoliosis in Neurofibromatosis and Rib-head Resection: A Case Report

Chong KL, Lam KS, Zuki Z

Malays Orthop J, 2017 Nov;11(3):59-62.
PMID: 29326771 MyJurnal DOI: 10.5704/MOJ.1711.007

Surgical management of scoliosis in Neurofibromatosis type I may be challenging at times especially when dealing with dystrophic curves. We highlight the importance of meticulous study of the radiological imaging and careful pre-operative planning in a patient with dystrophic scoliosis.
The association between physical activity and burnout among anaesthesia postgraduate trainees in Malaysia

Jaishree S, Chong KW, Lim TA

Med J Malaysia, 2022 Nov;77(6):655-660.
PMID: 36448381

INTRODUCTION: Burnout is a psychological problem which is becoming more prevalent among medical professionals resulting in various negative outcomes. Physical activity has been found to be an effective method in alleviating burnout. The aim of this study was to determine the association between physical activity and burnout among postgraduate anaesthesia trainees in Malaysia. The study also intended to determine the level of physical activity among trainees, the factors affecting this practice, and the prevalence of burnout among anaesthesia trainees.
MATERIALS AND METHODS: An online self-administered questionnaire was sent out to all postgraduate anaesthesia trainees between August 2020 and January 2021 via email and respondents were recruited on a voluntary basis.
RESULTS: The prevalence of burnout among postgraduate anaesthesia trainees was high (54%). This prevalence was higher among trainees with low a level of physical activity. Half of the trainees (50.8%) engaged in moderate physical activity while only 12% reported a high level of physical activity. The postgraduate study year was found to be a significant factor affecting the practice of physical activity.
CONCLUSION: There is a significant association between physical activity and burnout among postgraduate anaesthesia trainees in Malaysia. Physical activity has the potential to be an essential method of reducing burnout. Hence, measures should be implemented to improve the practice of physical activity among healthcare professionals in order to reduce workplace burnout.
Fulltext Inhibition of Mild Steel Corrosion in Sulfuric Acid Solution by New Schiff Base

Al-Amiery AA, Kadhum AAH, Kadihum A, Mohamad AB, How CK, Junaedi S

Materials (Basel), 2014 Jan 28;7(2):787-804.
PMID: 28788488 DOI: 10.3390/ma7020787

The efficiency of Schiff base derived from 4-aminoantipyrine, namely 2-(1,5-dimethyl-4-(2-methylbenzylidene)amino)-2-phenyl-1H-pyrazol-3(2H)-ylidene) hydrazinecarbothioamide as a corrosion inhibitor on mild steel in 1.0 M H2SO4 was investigated using electrochemical impedance spectroscopy (EIS), potentiodynamic polarization (PD) and electrochemical frequently modulation (EFM) in addition to the adsorption isotherm, corrosion kinetic parameters and scanning electron microscopy (SEM). The results showed that this inhibitor behaved as a good corrosion inhibitor, even at low concentration, with a mean efficiency of 93% and, also, a reduction of the inhibition efficiency as the solution temperature increases. A polarization technique and EIS were tested for different concentrations and different temperatures to reveal that this compound is adsorbed on the mild steel, therefore blocking the active sites, and the adsorption follows the Langmuir adsorption isotherm model. The excellent inhibition effectiveness of 2-(1,5-dimethyl-4-(2-methylbenzylidene)amino)-2-phenyl-1H-pyrazol-3(2H)-ylidene)hydrazinecarbothioamide was also verified by scanning electron microscope (SEM).
Proteomics profiling of epidermal mucus secretion of a cichlid (Symphysodon aequifasciata) demonstrating parental care behavior

Chong K, Joshi S, Jin LT, Shu-Chien AC

Proteomics, 2006 Apr;6(7):2251-8.
PMID: 16385477

The discus fish (Symphysodon aequifasciata) is a cichlid demonstrating advanced mode of parental care towards fry. Both male and female fish utilized epidermal mucus secreted from specialized epidermal cells to feed developing fry. We utilized proteomics to compare protein profile from parental and nonparental fish. Gel analysis revealed a total of 35 spots that were up-regulated in parental mucus. In tandem, another 18 spots were uniquely expressed in parental mucus. MS analysis of these spots identified proteins such as fructose biphosphate aldolase, nucleoside diphosphate kinase, and heat shock proteins, which are essential to support energy provision, cell repair and proliferation, stress mediation, and defense mechanism in parental fish during parental-care period. Concurrently, the detection of several antioxidant-related proteins such as thioredoxin peroxidase and hemopexin suggests a need to overcome oxidative stress during hypermucosal production in parental-care behavior. A C-type lectin was also found to be uniquely expressed in parental mucus and could have important role in providing antimicrobial defense to both parental fish and fry. In summary, our study shows that discus mucus proteome undergoes changes in protein expression during parental-care period.
Fulltext A clinical appraisal of patients with psoriasis treated in Seremban General Hospital, Malaysia

Siow KY, Mohd Safdar NA, Chong KH, Chua KB

Med J Malaysia, 2004 Aug;59(3):330-4.
PMID: 15727378 MyJurnal

A prospective clinical study of 181 patients with psoriasis seen in Seremban General Hospital showed the incidence of psoriasis among dermatology outpatients was 2.15%. A significantly higher proportion of male patients were affected, with a male to female ratio of 1.7:1. Within the racial groups; 63 were Malays, 37 Chinese, and 81 Indians. There was a significantly higher proportion of Indians affected as compared with the races. The mean age of patients in this study was 43.7 years old but the mean age of onset of psoriasis in these patients was 33.1 years old. Thirty-one (17.1%) patients gave a positive family history of psoriasis and the mean age of onset of psoriasis was lower (29.3 years old) for patients with a positive family history. Plaque psoriasis was the commonest type of clinical presentation with the scalp being the commonest site affected. Psoriatic arthropathy was seen in 35 (19.3%) patients. Ninety-five (52.5%) patients gave a positive history of factors exacerbating their pre-existing disease and stress was singled out as the most common exacerbating factor.
Study site: Skin clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
A randomised comparison of simvastatin versus simvastatin and low cholesterol diet in the treatment of hypercholesterolaemia

Thuraisingham S, Tan KH, Chong KS, Yap SF, Pasamanikam K

Int J Clin Pract, 2000 Mar;54(2):78-84.
PMID: 10824361

There is little evidence to show that strict dietary modification alone confers any significant impact on cardiac events in primary and secondary prevention of coronary heart disease. Given the efficacy of the statins, the need for strict dietary modification in patients on statin therapy has been questioned. This study was performed to assess 1) the added benefit on serum lipid levels of a strict low-fat dietary regimen in patients with hypercholesterolaemia already treated with simvastatin; 2) the efficacy of simvastatin on the lipid profile of our sample Asian population; and 3) the tolerability and side-effect profile of simvastatin. This study was a prospective evaluation of 60 patients with hypercholesterolaemia treated with simvastatin who were subjected to either a normal diet or a dietitian guided low-fat diet. Assessment of the effects on serum lipid levels, side-effects, biochemical and haematological markers were performed. After 24 weeks of treatment, a strict dietitian guided low-fat diet conferred no additional benefit over and above what was achieved by simvastatin alone. Furthermore, a higher dose of simvastatin was needed in the dietitian guided diet group to achieve the target LDL-cholesterol level. Simvastatin resulted in a significant positive alteration of lipid profiles in all patients. The drug was well tolerated, with no significant change in either haematological or biochemical indices. Simvastatin is a highly effective cholesterol-lowering drug with a beneficial effect on the entire lipid spectrum in a cross-section of Asian patients, and is well tolerated. A dietitian guided dietary approach confers no additional advantage once statin therapy has been initiated.
Black piedra in west Malaysia

Adam BA, Soo-Hoo TS, Chong KC

Australas J Dermatol, 1977 Apr;18(1):45-7.
PMID: 883925
Early outcome of cardiac surgery in dialysis-dependent end-stage renal failure patients

Chong KS, Pau CP, Azmi MI, Taib ME, Dillon J

Med J Malaysia, 2020 01;75(1):43-46.
PMID: 32008019

INTRODUCTION: Preoperative dialysis-dependent renal failure is a strong independent risk factor for in-hospital mortality and morbidity after open heart surgery. This retrospective study analyses the early outcome in dialysis-dependent renal failure patients who underwent elective open-heart surgery in the Institut Jantung Negara (IJN).
METHODS: We retrospectively analyse a series of 228 consecutive postoperative patients with dialysis-dependent (end stage renal failure (ESRF)) admitted to the adult cardiothoracic ICU in IJN between January 2012 and December 2016.
RESULTS: The overall early mortality rate included 34 patients (15.8%). Patients with ESRF underwent combined procedure recorded a very high mortality rate at 56.3%. Twenty-four patients (11.2%) needed resternotomy for postoperative bleeding or cardiac temponade. Postoperative mediastinitis rate was high, involving 13 patients (6%). The neurological and gastrointestinal complications rate were recorded at 2.3% (5 patients) and 6% (13 patients) respectively. In the group of patients (n=199) with sinus rhythm during the preoperative period, 100 patients (50.3%) developed postoperative AF. 77 patients (35.8%) stayed in hospital for more than 14 days.
CONCLUSIONS: dialysis-dependent patients undergoing cardiac surgery poses higher perioperative risk of mortality and morbidity of 3-4 times higher compared to those patients with normal renal function. IJN shows acceptable perioperative risk of mortality and morbidity which is comparable to other centres.
Ganoderma boninense mycelia for phytochemicals and secondary metabolites with antibacterial activity

Abdullah S, Jang SE, Kwak MK, Chong K

J Microbiol, 2020 Dec;58(12):1054-1064.
PMID: 33263896 DOI: 10.1007/s12275-020-0208-z

Antiplasmodial nortriterpenes with 3,4-seco-27-norlanostane skeletons, almost entirely obtained from fruiting bodies, represent the main evidential source for bioactive secondary metabolites derived from a relatively unexplored phytopathogenic fungus, Ganoderma boninense. Currently lacking is convincing evidence for antimicrobial secondary metabolites in this pathogen, excluding that obtained from commonly observed phytochemicals in the plants. Herein, we aimed to demonstrate an efficient analytical approach for the production of antibacterial secondary metabolites using the mycelial extract of G. boninense. Three experimental cultures were prepared from fruiting bodies (GBFB), mycelium cultured on potato dextrose agar (PDA) media (GBMA), and liquid broth (GBMB). Through solvent extraction, culture type-dependent phytochemical distributions were diversely exhibited. Water-extracted GBMB produced the highest yield (31.21 ± 0.61%, p < 0.05), but both GBFB and GBMA elicited remarkably higher yields than GBMB when polar-organic solvent extraction was employed. Greater quantities of phytochemicals were also obtained from GBFB and GBMA, in sharp contrast to those gleaned from GBMB. However, the highest antibacterial activity was observed in chloroform-extracted GBMA against all tested bacteria. From liquid-liquid extractions (LLE), it was seen that mycelia extraction with combined chloroform-methanol-water at a ratio of 1:1:1 was superior at detecting antibacterial activities with the most significant quantities of antibacterial compounds. The data demonstrate a novel means of assessing antibacterial compounds with mycelia by LLE which avoids the shortcomings of standardized methodologies. Additionally, the antibacterial extract from the mycelia demonstrate that previously unknown bioactive secondary metabolites of the less studied subsets of Ganoderma may serve as active and potent antimicrobial compounds.
Fulltext Biophysical characterization of antibacterial compounds derived from pathogenic fungi Ganoderma boninense

Abdullah S, Oh YS, Kwak MK, Chong K

J Microbiol, 2021 Feb;59(2):164-174.
PMID: 33355891 DOI: 10.1007/s12275-021-0551-8

There have been relatively few studies which support a link between Ganoderma boninense, a phytopathogenic fungus that is particularly cytotoxic and pathogenic to plant tissues and roots, and antimicrobial compounds. We previously observed that liquid-liquid extraction (LLE) using chloroformmethanol-water at a ratio (1:1:1) was superior at detecting antibacterial activities and significant quantities of antibacterial compounds. Herein, we demonstrate that antibacterial secondary metabolites are produced from G. boninense mycelia. Antibacterial compounds were monitored in concurrent biochemical and biophysical experiments. The combined methods included high performance thin-layer chromatography (HPTLC), gas chromatography-mass spectrometry (GC-MS), high-performance liquid chromatography (HPLC), fourier transform infrared (FTIR), and nuclear magnetic resonance (NMR) spectroscopy. The antibacterial compounds derived from mycelia with chloroform-methanol extraction through LLE were isolated via a gradient solvent elution system using HPTLC. The antibacterial activity of the isolated compounds was observed to be the most potent against Staphylococcus aureus ATCC 25923 and multidrug-resistant S. aureus NCTC 11939. GC-MS, HPLC, and FTIR analysis confirmed two antibacterial compounds, which were identified as 4,4,14α-trimethylcholestane (m/z = 414.75; lanostane, C30H54) and ergosta-5,7,22-trien-3β-ol (m/z = 396.65; ergosterol, C28H44O). With the aid of spectroscopic evaluations, ganoboninketal (m/z = 498.66, C30H42O6), which belongs to the 3,4-seco-27-norlanostane triterpene family, was additionally characterized by 2D-NMR analysis. Despite the lack of antibacterial potential exhibited by lanostane; both ergosterol and ganoboninketal displayed significant antibacterial activities against bacterial pathogens. Results provide evidence for the existence of bioactive compounds in the mycelia of the relatively unexplored phytopathogenic G. boninense, together with a robust method for estimating the corresponding potent antibacterial secondary metabolites.
Fulltext Study on Welding Characteristics and Parameters of Gas Metal Arc Welding for A516 Grade 70 Steel with ER70S-6 and ER308LSi Filler Materials

Chong K, Mhd Noor EE, Amir A, Baig MF

Materials (Basel), 2024 Nov 04;17(21).
PMID: 39517665 DOI: 10.3390/ma17215391

Welding is a crucial process in joining metals, especially in the fabrication industry. Thisresearch aimed to investigate the effects of using two different filler materials, ER70S-6 and ER308LSi, with nine combinations of wire feeder speed (WFS) and shielding gas flow rate (GFR), on weld joints. The study focused on the weld quality and material properties of Gas Metal Arc Welded (GMAW) butt joints of ASTM A516 G70 plates, characterized through visual inspection, liquid penetrant testing, tensile testing, hardness testing, and optical microscopy. Results indicated that the highest ultimate tensile strength and hardness were achieved at 4 m/min WFS and 15 L/min GFR with ER70S-6, and 5 m/min WFS and 20 L/min GFR with ER308LSi. The specimens welded with ER308LSi demonstrated superior mechanical properties compared to those welded with ER70S-6. Additionally, the study revealed the influence of microstructural changes from the base metal (BM) to the heat-affected zone (HAZ) and fusion zone (FZ), with finer and more compact grain structures contributing to higher hardness values. These findings underscore the importance of selecting appropriate filler materials, WFS, and GFR to achieve the desired weld quality and material properties for A516 G70 low-carbon steel welded joints.
Fulltext Traditional and Complementary Medicine (TCM) among Study Population with Cardiovascular Risk; use and Substitution for Conventional Medicine in Pahang, Malaysia

Kew Y, Chia YL, Lai SM, Chong KY, Ho XL, Liew DW, et al.

Med J Malaysia, 2015 Apr;70(2):86-92.
PMID: 26162383 MyJurnal

INTRODUCTION: Cardiovascular diseases are the main cause of morbidity and mortality in Malaysia. There is evidence of high traditional and complementary medicine (TCM) use among population with cardiovascular risk and there have been anecdotal reports about substitution of conventional medicines with TCM. We investigated the prevalence of TCM use, treatment preference and substitution of conventional medicines in study population with cardiovascular risk factors in Pahang, Malaysia.

METHODS: A cross-sectional survey was conducted using an interviewer-administered questionnaire in five districts of Pahang. A total of 1250 households were chosen through proportionate and systematic sampling. Respondents aged 18 years and above were selected.

RESULTS: The study population with cardiovascular risk factors who used TCM was higher than the general population (31.7% versus 25.9%). There were no clear preferences in using TCM by gender, age groups, educational level and income even though other bumiputeras showed a slight inclination towards TCM use. Among the study population with cardiovascular risk factors who consumed TCM, 20-30% of them were using TCM as a substitute for their conventional medications. Respondents from the younger age group (18-40 years) (57.1%), highest educational level (43.2%), other bumiputeras (38.4%) and highest income group (31.4%) preferred the combination of both conventional and traditional medicine.

CONCLUSION: TCM use among population with cardiovascular risk factors is high. The high preference for combination therapy of TCM and conventional medications among young adults and the use of TCM to substitute conventional medications show that much research is needed to provide proven TCM therapies to avoid self-mismanagement of cardiovascular risk in Malaysia.

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