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Fulltext Ocular biometric measurements in emmetropic and myopic Malaysian children - a population-based study

Goh PP, Azura R

Med J Malaysia, 2012 Oct;67(5):497-502.
PMID: 23770867 MyJurnal

This is the first population based study on ocular biometric measurements (OBMs) conducted in Malaysia. Its objective is to measure and compare among children of different ethnicity who have myopia and emmetropia. Subsets of children aged between 7 and 8 years old who participated in a larger population based refractive error study had their axial length, anterior chamber depth, lens thickness and vitreous depth measured using A scan and vertical and horizontal corneal curvature measured using an autokeratorefractometer. Eighty eight of the 870 children (10.1%) examined had myopia. Boys, Chinese and children with myopia had significantly longer axial length and vitreous depth compared to girls, Malay and Indian and children who were emmetropic respectively. Girls and children with myopia had steeper corneal curvature. The baseline OBMs in Malaysian children of different ethnicity are valuable for studies in myopia progression. Like other studies, children with myopia have longer axial length (P <0.001). and vitreous depth (P <0.001) compared to children who are emmetropia (without myopia).
Fulltext Status of diabetic retinopathy among diabetics registered to the Diabetic Eye Registry, National Eye Database, 2007

Goh PP, National Eye Database Study Group

Med J Malaysia, 2008 Sep;63 Suppl C:24-8.
PMID: 19230243

Diabetic Eye Registry, a web based registry hosted at the National Eye Database (www.acrm.org.my/end) collects data in a systematic and prospective nature on status of diabetic retinopathy (DR) among diabetics seen for the first time at Ministry of Health ophthalmology clinics. The 2007 report on 10,586 diabetics revealed that 63.3% of eyes examined had no DR, 36.8% had any form of DR, of which 7.1% had proliferative diabetic retinopathy. Up to 15.0% of eyes had vision threatening DR requiring laser or surgery at their first visit. Data on diabetic eye registry is useful in monitoring the quality of diabetic management, particularly in eye screening as reflected by the proportion of patients with severe DR needing intervention at the first visit to Ophthalmology clinics.
Fulltext A study of perforating eye injuries at the Ophthalmology Department, National University of Malaysia

Zainal M, Goh PP

Med J Malaysia, 1997 Mar;52(1):12-6.
PMID: 10968048

One hundred and sixty seven (167) perforating eye injuries involving 159 patients were analyzed in a retrospective study over a three-year period. The degree of blindness and their associated factors were determined. Most patients were in the first three decades of life and were males. One hundred and seven (64%) eyes had vision of 3/60 or worse at initial assessment. Of these only 45% of eyes had improved vision to 6/36 or better at six months of follow-up. Fifty-five per cent of eyes were blind. The only significant associated factor identified was the extent of injury. Age, time interval and mechanism of injury were not significant factors.
Fulltext Retinoblastoma Registry report--Hospital Kuala Lumpur experience

Jamalia R, Sunder R, Alagaratnam J, Goh PP

Med J Malaysia, 2010 Jun;65 Suppl A:128-30.
PMID: 21488473

Retinoblastoma is a childhood ocular cancer. The aim of this paper is to describe the clinical and epidemiological characteristics of patients with retinoblastoma in a major paediatric ophthalmology center in the country. Retrospective information was collected through the retinoblastoma registry. Late presentation with advanced staging is a major problem.
Fulltext Introducing a collection of reviews on major diseases in Malaysia

Lim KG, Lim AW, Goh PP

Med J Malaysia, 2014 Aug;69 Suppl A:1-3.
PMID: 25417945

No abstract available.
Fulltext National Eye Database--a web based surveillance system

Goh PP, Elias H, Norfariza N, Mariam I, National Eye Database Steering Committee

Med J Malaysia, 2008 Sep;63 Suppl C:20-3.
PMID: 19227672

National Eye Database (www.acrm.org.my/ned) is a web based surveillance system which collects data on eye diseases and clinical performance in ophthalmology service. It is a prospective study with online data collection, concurrent descriptive data analysis and real time report. It includes cataract surgery registry, diabetic eye registry, glaucoma registry, contact lens related corneal ulcer surveillance and monthly ophthalmology service census. This article presents the methodology and some registries reports. The web based surveillance system has made dissemination of report prompt, easy and without barrier.
Fulltext Self-Adaptive Filtering Approach for Improved Indoor Localization of a Mobile Node with Zigbee-Based RSSI and Odometry

Loganathan A, Ahmad NS, Goh P

Sensors (Basel), 2019 Nov 01;19(21).
PMID: 31683837 DOI: 10.3390/s19214748

This study presents a new technique to improve the indoor localization of a mobile node by utilizing a Zigbee-based received-signal-strength indicator (RSSI) and odometry. As both methods suffer from their own limitations, this work contributes to a novel methodological framework in which coordinates of the mobile node can more accurately be predicted by improving the path-loss propagation model and optimizing the weighting parameter for each localization technique via a convex search. A self-adaptive filtering approach is also proposed which autonomously optimizes the weighting parameter during the target node's translational and rotational motions, thus resulting in an efficient localization scheme with less computational effort. Several real-time experiments consisting of four different trajectories with different number of straight paths and curves were carried out to validate the proposed methods. Both temporal and spatial analyses demonstrate that when odometry data and RSSI values are available, the proposed methods provide significant improvements on localization performance over existing approaches.
Novel synergistic hydrous iron-nickel-manganese (HINM) trimetal oxide for hazardous arsenite removal

Nasir AM, Goh PS, Ismail AF

Chemosphere, 2018 Jun;200:504-512.
PMID: 29501887 DOI: 10.1016/j.chemosphere.2018.02.126

A novel hydrous iron-nickel-manganese (HINM) trimetal oxide was successfully fabricated using oxidation and coprecipitation method for metalloid arsenite removal. The atomic ratio of Fe:Ni:Mn for this adsorbent is 3:2:1. HINM adsorbent was identified as an amorphous nanosized adsorbent with particle size ranged from 30 nm to 60 nm meanwhile the total active surface area and pore diameter of HINM area of 195.78 m2/g and 2.43 nm, respectively. Experimental data of arsenite adsorption is best fitted into pseudo-second order and Freundlich isotherm model. The maximum adsorption capacity of arsenite onto HINM was 81.9 mg/g. Thermodynamic study showed that the adsorption of arsenite was a spontaneous and endothermic reaction with enthalpy change of 14.04 kJ/mol and Gibbs energy of -12 to -14 kJ/mol. Zeta potential, thermal gravimetric (TGA) and Fourier transform infrared (FTIR) analysis were applied to elucidate the mechanism of arsenite adsorption by HINM. Mechanism of arsenite adsorption by HINM involved both chemisorption and physisorption based on the electrostatic attraction between arsenite ions and surface charge of HINM. It also involved the hydroxyl substitution by arsenite ions through the formation of inner-sphere complex. Reusability of HINM trimetal oxide was up to 89% after three cycles of testing implied that HINM trimetal oxide is a promising and practical adsorbent for arsenite.
Fulltext Diabetic eye screening in Malaysia: findings from the National Health and Morbidity Survey 2006

Goh PP, Omar MA, Yusoff AF

Singapore Med J, 2010 Aug;51(8):631-4.
PMID: 20848059

INTRODUCTION: Diabetic retinopathy (DR) is the commonest complication of diabetes mellitus (DM), and is the leading cause of blindness among working adults. Modification of the associated risk factors as well as early detection and treatment of sight-threatening DR can prevent blindness. Clinical practice guidelines recommend annual eye screening for patients with DM. The proportion of patients in Malaysia who adhere to this recommendation was initially unknown.
METHODS: The Malaysian National Health and Morbidity Survey is a population-based survey conducted once every decade on the various aspects of health, behaviour and diseases. The DM questionnaire on eye screening was administered as face-to-face interviews with 2,373 patients with known DM who were aged 18 years and older.
RESULTS: In all, 55 percent of patients with known DM had never undergone an eye examination. Among patients who had undergone eye examinations, 32.8 percent had the last examination within the last one year, 49.8 percent within the last one to two years, and 17.4 percent more than two years ago. A significantly lower proportion of younger patients and patients who received treatment for DM from non-government facilities had previously undergone eye examinations.
CONCLUSION: The prevalence of DM observed among Malaysians aged 30 and above is 14.9 percent; thus, there is a significant number of people with potential blinding DR. Adherence to eye screening guidelines and the prompt referral of sight-threatening DR are essential in order to reduce the incidence of blindness among patients with DM.
Study name: National Health and Morbidity Survey (NHMS-2006)
Pre-treatment of multi-walled carbon nanotubes for polyetherimide mixed matrix hollow fiber membranes

Goh PS, Ng BC, Ismail AF, Aziz M, Hayashi Y

J Colloid Interface Sci, 2012 Nov 15;386(1):80-7.
PMID: 22909959 DOI: 10.1016/j.jcis.2012.07.033

Mixed matrix hollow fibers composed of multi-walled carbon nanotubes (MWCNTs) and polyetherimide (PEI) were fabricated. Pre-treatment of MWCNTs was carried out prior to the incorporation into the polymer matrix using a simple and feasible two stages approach that involved dry air oxidation and surfactant dispersion. The characterizations of the surface treated MWCNTs using TEM and Raman spectroscopy have evidenced the effectiveness of dry air oxidation in eliminating undesired amorphous carbon and metal catalyst while surfactant dispersion using Triton X100 has suppressed the agglomeration of MWCNTs. The resultant mixed matrix hollow fibers were applied for O(2)/N(2) pure gas separation. Interestingly, it was found that removal of disordered amorphous carbons and metal particles has allowed the hollow structures to be more accessible for the fast and smooth transport of gas molecules, hence resulted in noticeable improvement in the gas separation properties. The composite hollow fibers embedded with the surface modified MWCNTs showed increase in permeability as much as 60% while maintaining the selectivity of the O(2)/N(2) gas pair. This study highlights the necessity to establish an appropriate pre-treatment approach for MWCNTs in order to fully utilize the beneficial transport properties of this material in mixed matrix polymer nanocomposite for gas separation.
Fulltext Contact lens--related corneal ulcer: a two-year review

Goh PP, Shamala R, Chandamalar S, Tai XY, National Eye Database Study Group

Med J Malaysia, 2010 Jun;65 Suppl A:120-3.
PMID: 21488471

To create a national registry of contact-lens related corneal ulcers (CLRCU) patients in Malaysia with the aim of detecting outbreaks, identifying pattern of causative organisms, determining patient demography, risk factors, wearing patterns and monitoring outcome of treatment. The CLRCU registry is an ongoing patient registry established in 2007 as a surveillance tool used by Malaysian Ministry of Health ophthalmology departments. Notification of patients clinically suspected of CLRCU was performed online through the National Eye Database (NED). Data collected included patient demography, contact lens type, causative organism and treatment outcome. During 2007-2008, a total of 202 patients were notified to the CLRCU registry with a mean age of 26.7 years (71.8% female). All registered patients wore soft contact lens and monthly disposable lenses were the most popular (83.5%). The majority of patients had bacterial CLRCU and the most common causative organism was Pseudomonas (79.7% of bacterial cases). No epidemics were identified during the period of data examination. Use of contact lenses, which is increasing during modern times, may lead to CLRCU as a severe complication. The CLRCU registry is an effective tool which uses a web-based notification system that allows quick and up to date reports of CLRCU cases. This provides the ability to monitor outbreaks of disease and identify important causative and associated factors of the disease which may be used to reduce future incidence.
Fulltext The surgical treatment of multiple small bowel strictures in Crohn's disease by combined resection and stricturoplasty

Kum CK, Sim EK, Ngoi SS, Goh P, Sinniah R

Med J Malaysia, 1992 Dec;47(4):323-7.
PMID: 1303488

Crohn's disease is extremely rare among Asians. Resection of strictures causing obstruction has traditionally been the accepted choice in surgical therapy. This may lead to problems such as iatrogenic short bowel syndrome and its sequelae. Stricturoplasty is an acceptable and safe alternative. We report a case where combined stricturoplasty and resection was performed safely and advocate its use.
Bispectral index during modified rapid sequence induction using thiopentone or propofol and rocuronium

Sie MY, Goh PK, Chan L, Ong SY

Anaesth Intensive Care, 2004 Feb;32(1):28-30.
PMID: 15058117

This randomized controlled trial compared Bispectral Index (BIS) values in 40 patients after a modified rapid sequence induction using thiopentone 4 mg/kg or propofol 2 mg/kg with rocuronium 0.6 mg/kg as muscle relaxant. Endotracheal intubation was performed at 60 seconds from induction of anaesthesia and BIS values were recorded for three minutes after induction. At the 120, 150 and 180 second measurements there was a significantly greater proportion of subjects with BIS values < or = 60 ("anaesthetized") in the propofol group compared with the thiopentone group (P values < 0.02, < 0.01 and < 0.01 respectively). All intubations were completed within two minutes. No explicit recall of intubation was detected clinically with either induction agent. The BIS scores we have measured suggest that thiopentone 4 mg/kg is more likely to be associated with lighter planes of anaesthesia and consequent risk of awareness than propofol 2 mg/kg, if intubation is delayed or prolonged.
Fulltext Flex Sensor Compensator via Hammerstein-Wiener Modeling Approach for Improved Dynamic Goniometry and Constrained Control of a Bionic Hand

Syed Mubarak Ali SAA, Ahmad NS, Goh P

Sensors (Basel), 2019 Sep 10;19(18).
PMID: 31509987 DOI: 10.3390/s19183896

In this paper, a new control-centric approach is introduced to model the characteristics of flex sensors on a goniometric glove, which is designed to capture the user hand gesture that can be used to wirelessly control a bionic hand. The main technique employs the inverse dynamic model strategy along with a black-box identification for the compensator design, which is aimed to provide an approximate linear mapping between the raw sensor output and the dynamic finger goniometry. To smoothly recover the goniometry on the bionic hand's side during the wireless transmission, the compensator is restructured into a Hammerstein-Wiener model, which consists of a linear dynamic system and two static nonlinearities. A series of real-time experiments involving several hand gestures have been conducted to analyze the performance of the proposed method. The associated temporal and spatial gesture data from both the glove and the bionic hand are recorded, and the performance is evaluated in terms of the integral of absolute error between the glove's and the bionic hand's dynamic goniometry. The proposed method is also compared with the raw sensor data, which has been preliminarily calibrated with the finger goniometry, and the Wiener model, which is based on the initial inverse dynamic design strategy. Experimental results with several trials for each gesture show that a great improvement is obtained via the Hammerstein-Wiener compensator approach where the resulting average errors are significantly smaller than the other two methods. This concludes that the proposed strategy can remarkably improve the dynamic goniometry of the glove, and thus provides a smooth human-robot collaboration with the bionic hand.
Fulltext Diabetic retinopathy in native and non-native Sarawakians--findings from the Diabetic Eye Registry

Mallika PS, Aziz S, Goh PP, Lee PY, Cheah WL, Chong MS, et al.

Med J Malaysia, 2012 Aug;67(4):369-74.
PMID: 23082443

This study aims to determine the risk factors associated with diabetic retinopathy (DR) among natives and non-natives Sarawakians who were seen at 3 public hospitals and one health clinic in Sarawak. It is a cross sectional study where data on patients with DM were collected by staff at these healthcare facilities and entered into the web-based Diabetic Eye Registry. Univariate and multivariate analysis was used to determine the association factors for DR. DR was significantly less associated with natives (24.4%) compared to non-native Sarawakians (34.1%) (p < 0.001). The odds of getting DR was higher in patients whose duration of DM was more than 20 years (OR = 2.6), who have renal impairment (OR = 1.7) and non-natives (OR = 1.4).
Fulltext Investigator-initiated clinical trials in Malaysia and the role of the Clinical Research Centre of the Ministry of Health

Sivanandam AF, Hon YK, Yuen S, Muninathan P, Goh PP, Lim TO

Med J Malaysia, 2010 Jun;65 Suppl A:138-42.
PMID: 21488475

The objective of this review is to better understand the concept of investigator-initiated trials and its benefits. While investigator-initiated trials can be an invaluable tool, there are several challenges in its initiation and management. However, it is for these reasons that Clinical Research Centre (CRC) had developed the Investigator Initiated Trial (IIT) Programme where financial support and technical assistance are provided to local investigators embarking on their own clinical trials. In the course of preparing the review, we found that the inclination of investigator-initiated trials has yet to be well established in Ministry of Health, Malaysia. Given the potential and impact of such trials, clinicians should be aware of their ability as well as the availability of a supportive network in mobilising their concerted research efforts. Greater research collaboration among investigators could foster more innovative, insightful and constructive research.
Randomized double-blind comparison of ketamine-propofol, fentanyl-propofol and propofol-saline on haemodynamics and laryngeal mask airway insertion conditions

Goh PK, Chiu CL, Wang CY, Chan YK, Loo PL

Anaesth Intensive Care, 2005 Apr;33(2):223-8.
PMID: 15960405

The aim of this prospective, double-blind, randomized, placebo-controlled clinical trial was to investigate whether the administration of ketamine before induction with propofol improves its associated haemodynamic profile and laryngeal mask airway (LMA) insertion conditions. Ninety adult patients were randomly allocated to receive either ketamine 0.5 mg x kg(-1) (n = 30), fentanyl 1 microg x kg(-1) (n = 30) or normal saline (n = 30), before induction of anaesthesia with propofol 2.5 mg x kg(-1). Insertion of the LMA was performed 60s after injection of propofol. Arterial blood pressure and heart rate were measured before induction (baseline), immediately after induction, immediately before LMA insertion, immediately after LMA insertion and every minute for three minutes after LMA insertion. Following LMA insertion, the following six subjective endpoints were graded by a blinded anaesthestist using ordinal scales graded 1 to 3: mouth opening, gagging, swallowing, movement, laryngospasm and ease of insertion. Systolic blood pressure was significantly higher following ketamine than either fentanyl (P = 0.010) or saline (P = 0.0001). The median (interquartile range) summed score describing the overall insertion conditions were similar in the ketamine [median 7.0, interquartile range (6.0-8.0)] and fentanyl groups [median 7.0, interquartile range (6.0-8.0)]. Both appeared significantly better than the saline group [median 8.0, interquartile range (6.75-9.25); P = 0.024]. The incidence of prolonged apnoea (> 120s) was higher in the fentanyl group [23.1% (7/30)] compared with the ketamine [6.3% (2/30)] and saline groups [3.3% (1/30)]. We conclude that the addition of ketamine 0.5 mg x kg(-1) improves haemodynamics when compared to fentanyl 1 microg x kg(-1), with less prolonged apnoea, and is associated with better LMA insertion conditions than placebo (saline).
Facile synthesis of GO and g-C3N4 nanosheets encapsulated magnetite ternary nanocomposite for superior photocatalytic degradation of phenol

Rehman GU, Tahir M, Goh PS, Ismail AF, Samavati A, Zulhairun AK, et al.

Environ Pollut, 2019 Oct;253:1066-1078.
PMID: 31434184 DOI: 10.1016/j.envpol.2019.07.013

In this study, the synthesis of Fe3O4@GO@g-C3N4 ternary nanocomposite for enhanced photocatalytic degradation of phenol has been investigated. The surface modification of Fe3O4 was performed through layer-by-layer electrostatic deposition meanwhile the heterojunction structure of ternary nanocomposite was obtained through sonicated assisted hydrothermal method. The photocatalysts were characterized for their crystallinity, surface morphology, chemical functionalities, and band gap energy. The Fe3O4@GO@g-C3N4 ternary nanocomposite achieved phenol degradation of ∼97%, which was significantly higher than that of Fe3O4@GO (∼75%) and Fe3O4 (∼62%). The enhanced photoactivity was due to the efficient charge carrier separation and desired band structure. The photocatalytic performance was further enhanced with the addition of hydrogen peroxide, in which phenol degradation up to 100% was achieved in 2 h irradiation time. The findings revealed that operating parameters have significant influences on the photocatalytic activities. It was found that lower phenol concentration promoted higher activity. In this study, 0.3 g of Fe3O4@GO@g-C3N4 was found to be the optimized photocatalyst for phenol degradation. At the optimized condition, the reaction rate constant was reported as 6.96 × 10-3 min-1. The ternary photocatalyst showed excellent recyclability in three consecutive cycles, which confirmed the stability of this ternary nanocomposite for degradation applications.
Interocular optical biometry differences as predictors of postoperative cataract surgery refractive outcomes: A retrospective cohort study

Wai YZ, Ng QX, Adnan TH, Chong YY, Mohamad AS, Goh PP

Med J Malaysia, 2021 Nov;76(6):884-892.
PMID: 34806678

INTRODUCTION: Few studies have reported the impact of preoperative interocular discrepancy in optical biometry (axial length, corneal power, white-to-white, central corneal thickness) on postoperative refractive outcomes. This study aims to investigate any predictive value of preoperative optical biometry differences between eyes on postoperative refractive outcomes.
MATERIALS AND METHODS: A retrospective cohort study of patients who have undergone optical biometry measurement before unilateral phacoemulsification in the Queen Elizabeth Hospital, Sabah, Malaysia from 2018 to 2020. Biometry data of interest includes axial length (AL), keratometry(K), white-to-white (WTW) and central corneal thickness (CCT). The postoperative outcomes of interest were the patient's preoperative refractive target, postoperative best-corrected visual acuity (BCVA), postoperative refractive outcomes, and optical biometry prediction error.
RESULTS: The interocular biometry discrepancies which were associated with higher odds of prediction error >0.5D from the refractive target were Interocular Corneal Power Difference (IKD)-average≥0.8 D (Odds Ratio, OR=1.97; 95% Confidence Intervals, 95%CI: 1.06, 3.67) and Interocular WTW Difference ≥1.5 mm (OR=2.77; 95%CI: 1.11, 6.92). In cases with prediction error >1.0D, the measurements were Interocular AL Difference ≥0.4 mm (OR=2.99; 95%CI: 1.11, 8.06), IKD flat≥0.4D (OR=2.76; 95%CI: 1.31, 5.82) and Interocular CCT Difference ≥15μm (OR=3.53; 95%CI: 1.29, 9.64).
CONCLUSION: Interocular axial length difference ≥0.4mm and interocular central corneal thickness difference ≥15μm are associated with refractive error >1.0D from the pre-operative target. Interocular average corneal power difference ≥0.8D and interocular white-to-white difference ≥1.5mm have higher odds of refractive drift >0.5D from the refractive aim. The above cutoff values help clinicians to identify which patients have a higher risk of refractive shift post-cataract surgery and counsel the patient before cataract operation.
Electrochemical quantification of atrazine-fulvic acid and removal through bismuth tungstate photocatalytic hybrid membranes

Krishnan SAG, Gumpu MB, Arthanareeswaran G, Goh PS, Aziz F, Ismail AF

Chemosphere, 2023 Jan;311(Pt 2):137016.
PMID: 36374783 DOI: 10.1016/j.chemosphere.2022.137016

Herbicides such as atrazine and humus substances such as fulvic acid are widely used in agricultural sector. They can be traced in surface and groundwater around the agriculture field at concentrations beyond the approved limit due to their mobility and persistence. Bismuth-based photocatalysts activated by visible light are potential materials for removing various organic pollutants from water bodies. These photocatalysts can also be suitable candidates for developing a hybrid membrane with anti-fouling properties. In this study, Bi2WO6 nanoparticles were synthesized via the hydrothermal method and integrated into the cellulose acetate (CA), polyetherimide (PEI), polysulfone (PSF) and polyvinylidene fluoride (PVDF) polymers via physical blending approach. The hybrid membranes were then characterized by FTIR, XPS and FESEM to confirm the chemical bonding, chemical composition and surface morphology of Bi2WO6. Thus, the pure water flux of CA (35.6 L m-2 h-1), PEI (46.56 L m-2 h-1), PSF (6.84 L m-2 h-1), and PVDF (68.47 L m-2 h-1) hybrid membranes has significantly enhanced than the pristine CA, PEI, PSF and PVDF membranes. The significant rejection of atrazine-fulvic acid was observed with hybrid membranes in the order of CA (84.1%) > PVDF (72.7%) > PEI (47.8%) > PSF (37.2%), and these membranes have shown an excellent flux recovery ratio than pristine membranes. Further, electrochemical quantification studies were performed to analyze the removal efficiency of atrazine-fulvic acid from water. In this present work, GO-modified SPE was employed for electrochemical sensing studies. The resultant CA hybrid membrane achieved removal efficiency of 84.08% for atrazine. It was observed that the Bi2WO6 established strong bonding with CA, and PVDF membranes, thus showing a significant removal efficiency and FRR than other hybrid and pristine membranes.

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