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  1. Fulltext Smokeless tobacco use among rural Kadazan women in Sabah, Malaysia
    Gan CY
    Southeast Asian J Trop Med Public Health, 1995 Jun;26(2):291-6.
    PMID: 8629063
    A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. Women with low education were more likely to be chewers. The chewing habit was usually acquired during the teenage years and the practice was perceived mainly as a cultural norm. 73.3% of these smokeless tobacco users were unaware of any adverse health effect of this type of tobacco use as compared to 53.9% of the non-tobacco users. The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.
  2. Fulltext Tobacco usage among rural Bajaus in Sabah, Malaysia
    Gan CY
    Southeast Asian J Trop Med Public Health, 1998 Sep;29(3):643-8.
    PMID: 10437972
    As part of a larger study to bring attention to smoking and smokeless tobacco use among the indigenous people of Sabah State in Malaysia, the Bajaus were interviewed in a cross-sectional survey. 74.4% of the men smoked compared to 3.3% of the women and 77% of women used smokeless tobacco compared to 4.3% of men. Local handrolled cigarettes called kirais were popular and smokeless tobacco was used as an ingredient in the ritual of betel-quid chewing. Tobacco was also used because it was thought to have medicinal effects. The prevalence of smokeless tobacco use was significantly lower among the better educated women but for smoking, education had no relation with prevalence. Both habits could be easily maintained as they were cheap practices which were socially and culturally accepted. Awareness of the adverse effects of such tobacco habits was poor and intervention programs to curb tobacco use is required.
  3. Reliability Assessment and Activation Energy Study of Au and Pd-Coated Cu Wires Post High Temperature Aging in Nanoscale Semiconductor Packaging
    Gan CL, Hashim U
    Journal of electronic packaging, 2013 Jun;135(2):0210101-210107.
    PMID: 24891811
    Wearout reliability and high temperature storage life (HTSL) activation energy of Au and Pd-coated Cu (PdCu) ball bonds are useful technical information for Cu wire deployment in nanoscale semiconductor device packaging. This paper discusses the influence of wire type on the wearout reliability performance of Au and PdCu wire used in fine pitch BGA package after HTSL stress at various aging temperatures. Failure analysis has been conducted to identify the failure mechanism after HTSL wearout conditions for Au and PdCu ball bonds. Apparent activation energies (Eaa) of both wire types are investigated after HTSL test at 150 °C, 175 °C and 200 °C aging temperatures. Arrhenius plot has been plotted for each ball bond types and the calculated Eaa of PdCu ball bond is 0.85 eV and 1.10 eV for Au ball bond in 110 nm semiconductor device. Obviously Au ball bond is identified with faster IMC formation rate with IMC Kirkendall voiding while PdCu wire exhibits equivalent wearout and or better wearout reliability margin compare to conventional Au wirebond. Lognormal plots have been established and its mean to failure (t50) have been discussed in this paper.
  4. Fulltext Extraction and characterization of pepsin-solubilized collagen from the body wall of crown-of-thorns Starfish (Acanthaster planci)
    Tan, C. C., Karim, A. A., Latiff, A. A., Gan, C. Y., Ghazali, F. C.
    International Food Research Journal, 2013;20(6):3013-3020.
    MyJurnal
    Pepsin-solubilized collagen (PSC) was extracted from the body wall of crown-of-thorns starfish (COTS) (Acanthaster planci) using pepsin digestion in 0.5 M acetic acid. The electrophoretic pattern of PSC showed that it consisted of two α chains (α1 and α2 chains). In addition, the peptide mapping showed that there were some differences in peptide patterns among PSC, calf skin collagen and salmon skin collagen. This suggested that the primary structure of the PSC was different from calf skin collagen and salmon skin collagen. Furthermore, Fourier transform infrared spectroscopy (FTIR) investigation showed the existence of triple helical structure in PSC, suggesting that the triple helical structure was well preserved during the extraction of collagen from COTS. The denaturation temperature of PSC was 33.0°C, which was comparable with mammalian collagen. In addition, the amino acid composition analysis showed that the imino acid content of PSC was similar to mammalian collagen but it was higher than other marine collagen. This suggested that the imino acid content might contributed the denaturation temperature of collagen. The results in this study suggest that PSC from the underutilized COTS has potential to be exploited in various commercial applications.
  5. Utilization of maternal and child health facilities by the urban poor of Kuala Lumpur
    Gan CY, Yusof K
    Southeast Asian J Trop Med Public Health, 1993 Jun;24(2):302-6.
    PMID: 8266233
    A survey conducted to assess the extent which the urban poor in rapidly expanding Kuala Lumpur utilize maternal and child health services available to them. The sample consisted of 1,380 households with children below 6 years and yielded 1,233 children below 6 years of age. 74% of the children had been delivered in government hospitals and 86% of the pregnancies had antenatal care in governmental establishments. 89.2% had BCG immunization before they were 1 year old but 13.3% had not received DPT by that age. Immunization was mainly done in government clinics. The overall immunization coverage for the whole of Kuala Lumpur is expected to be higher than these figures limited to the urban poor. Health planners should increase health facilities in the city to accommodate the expanding population. There is a need to continually campaign for immunization to improve coverage among the urban poor.
  6. The role of acute internal medicine service in handling burden of medical access block in a tertiary hospital, Hospital Melaka experience
    Adznan NUH, Gan CL
    Med J Malaysia, 2021 Jan;76(1):68-72.
    PMID: 33510112
    INTRODUCTION: Access block is a major problem faced by most hospitals. It has led to congestions in emergency departments (ED) leading to sub-optimal or delayed treatment. Inevitably the spotlight falls on medical department, being accountable for the highest proportion of access block in ED.

    MATERIALS AND METHODS: This is a retrospective study looking at data collected during office hours on 79 working days, excluding weekends and public holidays in Hospital Melaka, Malaysia. Details on all medical access block cases that were reviewed were recorded including their locations, diagnosis, disposition decisions and if they received specialist input at the time of their initial assessment by the medical team in ED. The aim is to revolutionise patient admission flow by offering early specialist care with rapid assessment, investigation and treatment. Hence, improving the overall treatment efficiency and reduce medical access block.

    RESULTS: There were 1321 admissions. A total of 82% of the patients were admitted to the medical wards while 13% of them were given acute treatment in ED and discharged home with appropriate follow ups. We managed to resolve 18% of medical access block by re-triaging our cases and offering timely acute medical treatment. Nearly 90% of patients received first hand medical specialist input during the initial assessment by the Acute Internal Medicine (AIM) team in ED.

    CONCLUSION: The significant resolution in medical access block with active screening, re-triaging and management of patients by the AIM team allows a more optimal hospital bed management. Patients also receive timely access to medical intervention with specialist care and stable patients can benefit from early supported discharge.

  7. Fulltext A blood pressure profile of rural Kadazans and Bajaus in Sabah, east Malaysia
    Gan CY, Chan MK
    Southeast Asian J Trop Med Public Health, 1993 Sep;24(3):583-9.
    PMID: 8160073
    A survey was conducted to document the blood pressures of two indigenous groups (Kadazans and Bajaus) who reside in rural Sabah in East Malaysia. Their health knowledge status is also recorded. Fifty percent of those surveyed were unable to associate high blood pressure with a risk factor and as high as 38% were unaware of the consequences of high blood pressure. A total of 16.2% had blood pressures > or = 140/or 90mm Hg while 3.9% had blood pressures > or = 160/or 95mm Hg. While these figures are low compared to those of developed countries, lifestyle changes associated with rapid urbanization in Malaysia may be expected to increase hypertension prevalence. The strengthening of health education programs is timely as health knowledge is limited and many hypertensives default treatment.
  8. Fulltext Trends and dietary implications of some chronic non-communicable diseases in peninsular Malaysia
    Khor GL, Gan CY
    Asia Pac J Clin Nutr, 1992 Sep;1(3):159-68.
    PMID: 24323170
    Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
  9. Fulltext Circulatory microRNA-145 expression is increased in cerebral ischemia
    Gan CS, Wang CW, Tan KS
    Genet. Mol. Res., 2012;11(1):147-52.
    PMID: 22370881 DOI: 10.4238/2012.January.27.1
    Cerebral ischemia or ischemic stroke is mainly attributed to vascular and circulation disorders. Among protein biomarkers, RNA profiles have also been identified as markers of ischemic stroke. MicroRNA-145 expression is ostensibly recognized as marker and modulator of vascular smooth muscle cell phenotype; however, expression levels in ischemic stroke had not been investigated. Employing real-time quantitative PCR, we examined the expression profile of circulatory microRNA-145 in healthy control subjects (N = 14) and ischemic stroke patients (N = 32). Circulatory microRNA-145 expression was significantly higher in ischemic stroke patients than in control subjects. This demonstrates that hemostatic mechanisms are affected by ischemic stroke. We conclude that circulating microRNA-145 has potential as a biomarker for ischemic stroke.
  10. Fulltext Growth optimization of Lactobacillus rhamnosus FTDC 8313 and the production of putative dermal bioactives in the presence of manganese and magnesium ions
    Lew LC, Liong MT, Gan CY
    J Appl Microbiol, 2013 Feb;114(2):526-35.
    PMID: 23082775 DOI: 10.1111/jam.12044
    AIMS: The study aimed to optimize the growth and evaluate the production of putative dermal bioactives from Lactobacillus rhamnosus FTDC 8313 using response surface methodology, in the presence of divalent metal ions, namely manganese and magnesium.
    METHODS AND RESULTS: A central composite design matrix (alpha value of ± 1.414) was generated with two independent factors, namely manganese sulphate (MnSO(4) ) and magnesium sulphate (MgSO(4) ). The second-order regression model indicated that the quadratic model was significant (P < 0.01), suggesting that the model accurately represented the data in the experimental region. Three-dimensional response surfaces predicted an optimum point with maximum growth of 10.59 log(10) CFU ml(-1) . The combination that produced the optimum point was 0.80 mg ml(-1) MnSO(4) and 1.09 mg ml(-1) MgSO(4) . A validation experiment was performed, and data obtained showed a deviation of 0.30% from the predicted value, ascertaining the predictions and the reliability of the regression model used. Effects of divalent metal ions on the production of putative dermal bioactives, namely hyaluronic acid, diacetyl, peptidoglycan, lipoteichoic acid and organic acids in the region of optimized growth, were evaluated using 3D response surfaces generated. Evaluation based on the individual and interaction effects showed that both manganese and magnesium played an important role in the production of these putative bioactives.
    CONCLUSIONS: Optimum growth of Lact. rhamnosus FTDC 8313 in reconstituted skimmed milk was achieved at 10.59 log(10) CFU ml(-1) in the presence of MnSO(4) (0.80 mg ml(-1) ) and MgSO(4) (1.09 mg ml(-1) ). Production of putative dermal bioactive and inhibitory compounds including hyaluronic acid, diacetyl, peptidoglycan, lipoteichoic acid and organic acids at the regions of optimized growth showed potential dermal applications.
    SIGNIFICANT AND IMPACT OF THE STUDY: This research can serve as a fundamental study to further evaluate the potential of Lactobacillus strains in non-gut-related roles such as dermal applications.
  11. Assessment of cross-linking in combined cross-linked soy protein isolate gels by microbial transglutaminase and Maillard reaction
    Gan CY, Cheng LH, Easa AM
    J Food Sci, 2009 Mar;74(2):C141-6.
    PMID: 19323728 DOI: 10.1111/j.1750-3841.2009.01053.x
    Soy protein isolate (SPI) gels were produced using single cross-linking agents (SCLA) of microbial transglutaminase (MTG) via incubation for 5 or 24 h (SCLA-MTG). When powdered SCLA-MTG gels were heated for 2 h with ribose (R2) (2 g/100 mL), dark brown gels were formed, and these were designated as combined cross-linking agent (CCLA) gels: MTG5(R2) and MTG24(R2). The results showed that the levels of Maillard-derived browning and cross-links of MTG5(R2) and MTG24(R2) gels were significantly (P < 0.05) lower than a control gel produced without MTG (SCLA-R2) even though the percentage of ribose remaining after heating of these gels was similar, indicating that a similar amount of ribose was consumed during heating. epsilon-(gamma-glutamyl)lysine bonds formed during incubation of SPI with MTG may have reduced the free amino group of SPI to take part in the Maillard reaction; nevertheless, ribose took part in the Maillard reaction and initiated the Maillard cross-linkings within the CCLA gels.
  12. Fulltext Pandoraea sp. RB-44, a novel quorum sensing soil bacterium
    Han-Jen RE, Wai-Fong Y, Kok-Gan C
    Sensors (Basel), 2013 Oct 18;13(10):14121-32.
    PMID: 24145919 DOI: 10.3390/s131014121
    Proteobacteria are known to communicate via signaling molecules and this process is known as quorum sensing. The most commonly studied quorum sensing molecules are N-acylhomoserine lactones (AHLs) that consists of a homoserine lactone moiety and an N-acyl side chain with various chain lengths and degrees of saturation at the C-3 position. We have isolated a bacterium, RB-44, from a site which was formally a landfill dumping ground. Using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry analysis, this isolate was identified as a Pandoraea sp.which was then screened for AHL production using biosensors which indicated its quorum sensing properties. To identify the AHL profile of Pandoraea sp. RB-44, we used high resolution tandem mass spectrometry confirming that this isolate produced N-octanoylhomoserine lactone (C8-HSL). To the best of our knowledge, this is the first report that showed quorum sensing activity exhibited by Pandoraea sp. Our data add Pandoraea sp. to the growing number of bacteria that possess QS systems.
  13. Fulltext Outcome of moderate to severe malnutrition following persistent diarrhoea--a hospital-based retrospective study
    Lee WS, Gan CS, Chai PF, Harun F
    Med J Malaysia, 2008 Aug;63(3):229-36.
    PMID: 19248696
    We aimed to determine the outcome of nutritional intervention in children with moderate to severe malnutrition following persistent diarrhoea (PD), referred to a tertiary referral unit in Malaysia. Thirty-one (44%) of the 71 children (median age 19 months) with PD had moderate to severe malnutrition on admission. Fifty-three (75%) required dietary modification and 15 (21%) needed parenteral nutrition (PN, median duration 96 days). Of the 70 patients in whom remission of diarrhoea could be ascertained, 64 (91%) achieved remission. Three required home PN. At three months after discharge, there was a significant improvement in the mean weight-for-height z-score as compared to the original score at initial presentation (from -1.83 +/- -1.77 to -0.80 +/- -1.17; p < 0.001), although 12 (22%) of the 55 patients in whom nutritional status could be ascertained still had moderate to severe malnutrition. In conclusion, moderate to severe malnutrition was a common complication following PD resulting from diverse causes. With appropriate therapy, remission can be achieved in majority of patients, although a small number of patients needed home PN because of persistence of diarrhoea.
  14. Nipah virus infection of pigs in peninsular Malaysia
    Mohd Nor MN, Gan CH, Ong BL
    Rev. - Off. Int. Epizoot., 2000 Apr;19(1):160-5.
    PMID: 11189713
    Between late 1998 and 1999, the spread of a new disease of pigs, characterized by a pronounced respiratory and neurological syndrome, sometimes accompanied by the sudden death of sows and boars, was recorded in pig farms in peninsular Malaysia. The disease appeared to have a close association with an epidemic of viral encephalitis among workers on pig farms. A previously unrecognised paramyxovirus was later identified from this outbreak; this virus was related to, but distinct from, the Hendra virus discovered in Australia in 1994. The new virus was named 'Nipah' and was confirmed by molecular characterization to be the agent responsible for the disease in both humans and pigs. The name proposed for the new pig disease was 'porcine respiratory and neurological syndrome' (also known as 'porcine respiratory and encephalitis syndrome'), or, in peninsular Malaysia, 'barking pig syndrome'. The authors describe the new disease and provide the epidemiological findings recorded among infected pigs. In addition, the control programmes which were instituted to contain the virus in the national swine herd are outlined.
  15. Fulltext The prevalence, nature and severity of disabilities in a Malaysian community
    Chen PCY, Arokiasamy JT, Gan CY
    Med J Malaysia, 1983 Sep;38(3):206-11.
    PMID: 6231457
  16. Hepatitis B infection among Chinese STD patients in Kuala Lumpur, Malaysia
    Gan CY, Yap SF, Ngeow YF, Wong HC
    Sex Transm Dis, 1991 4 1;18(2):84-8.
    PMID: 1862464 DOI: 10.1097/00007435-199118020-00006
    This study documents the prevalence of Hepatitis B serological markers among STD patients who have had multiple sexual partners in Kuala Lumpur, Malaysia, and compares the rates with those of a sample of the population with single or no sexual partners. A total of 336 Chinese STD patients (multiple partners group) and 234 Chinese control subjects (non-multiple partner group) were screened. Those with a history of blood transfusion or parenteral drug abuse had been excluded from the study, and all study subjects were heterosexuals. The overall carrier rate was 9.2% for the multiple partner group (MP group) and 6.8% for the non-multiple partner group (NMP group). Infection rates were 64.3% for the MP-group and 38.9% for the NMP group. After adjustments for age and sex, there was no significant difference in carrier rates between the two groups, but infection rates were significantly different with the MP group, being 3.2 times more likely to acquire infection than the NMP group. The study concludes that in heterosexuals, those with multiple sexual partners have increased chances of acquiring HBV infection.
  17. Nutritional status of Kadazan children in a rural district in Sabah, Malaysia
    Gan CY, Chin B, Teoh ST, Chan MK
    Southeast Asian J Trop Med Public Health, 1993 Jun;24(2):293-301.
    PMID: 8266232
    The nutritional status of 896 Kadazan children below 6 years of age from 23 villages of Tambunan District were studied. When stunting and wasting were defined as those who were below two standard deviations of height-for-age and weight-for-height (Waterlow et al, 1977) and based on the National Center for Health Statistics reference population, 67.6% of boys and 66.8% of girls were stunted while 12.3% of boys and 8.3% of girls were wasted. Weaning foods and toddler feeding practices were unsatisfactory. The role of health education on child care and feeding practices is emphasized.
  18. Fulltext Malaysian mothers' knowledge & practices on care of neonatal jaundice
    Boo NY, Gan CY, Gian YW, Lim KS, Lim MW, Krishna-Kumar H
    Med J Malaysia, 2011 Aug;66(3):239-43.
    PMID: 22111448
    This study aimed to determine the gaps of knowledge and practices of care of neonatal jaundice among Malaysian mothers. It was a cross sectional study of 400 mothers who attended the obstetric clinics or were admitted to the obstetric wards of a general hospital. They were surveyed with a structured set of questionnaire. The results showed that a majority (93.8%) of them knew about neonatal jaundice, and 71.7% knew that jaundice lasting more than 2 weeks was abnormal. However, only 34.3% of them were aware that jaundice appearing during the first 36 hours of life was abnormal. Less than 20% knew about glucose-6-phosphate dehydrogenase deficiency and that fetal-maternal blood group differences could cause jaundice. Although 71.7% and 69.7%, respectively, of the mothers knew that severe jaundice could cause death and brain damage, only 38.4% of them were aware that severe jaundice could result in hearing impairment. A very low proportion (27.1%) of them was aware that putting jaundiced infants under the direct sun could result in dehydration and worsening of jaundice. Out of a maximum score of 15, the mean maternal knowledge score was 7.4 (95% confidence intervals: 7.1, 7.7). Majority (83.1%) of the multiparous mothers with a past history of having children developing neonatal jaundice (n = 154) practiced placing their infants under the direct sun. This study revealed that there was a wide knowledge gap among Malaysian mothers on care of neonatal jaundice. Placing infants under the direct sun was still a common practice.
    Study site: Obstetric clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
  19. Optimising prostate biopsies and imaging for the future-a review
    Chan K, Ghani DAM, Teoh J, Brodie A, Gan C, Foley C, et al.
    Urol Oncol, 2024 Dec;42(12):421-428.
    PMID: 39299895 DOI: 10.1016/j.urolonc.2024.08.019
    Conventionally, transrectal ultrasound guided prostate biopsy (TRUS-Bx) was the main technique used for the diagnosis of prostate cancer since it was first described in 1989 [1]. However, the PROMIS trial showed that this random, nontargeted approach could miss up to 18% of clinically significant cancer (csPCa) [2]. Furthermore, risk of sepsis post TRUS-Bx can be as high as 2.4% [3]. Understanding the demerits of TR-biopsy have led to the introduction of transperineal prostate biopsy (TP-Bx). The incorporation of mpMRI revolutionized prostate cancer diagnostics, allowing visualization of areas likely to harbor csPCa whilst permitting some men to avoid an immediate biopsy. Furthermore, the advent of prostate specific membrane antigen-positron emission tomography (PSMA-PET) is highly promising, because of its role in primary diagnosis of prostate cancer and its higher diagnostic accuracy over conventional imaging in detecting nodal and metastatic lesions. Our narrative review provides an overview on prostate biopsy techniques and an update on prostate imaging, with particular focus on PSMA-PET.
  20. Financial planning
    Ngeow WC, Choong KF, Ong TK, Shim CN, Wee JM, Lee MY, et al.
    Br Dent J, 2008 Dec 13;205(11):583.
    PMID: 19079084 DOI: 10.1038/sj.bdj.2008.1034
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