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Fulltext Bilateral traumatic hip dislocation in a child: a case report

Khoo, S,M.

Malays Orthop J, 2007;1(2):17-20.
MyJurnal

Traumatic hip dislocation in children is uncommon; when this condition is diagnosed in paediatric patients, it is most frequently seen as a unilateral posterior dislocation and is rarely associated with fracture. We report here a case involving a young girl who dislocated both hips in two separate incidents.
Fulltext Notes for the primary care teachers: giving feedback

Khoo S

Malays Fam Physician, 2007;2(1):27-8.
PMID: 25606074
Fulltext Palliative care: experience with 156 cases in a general hospital

Khoo SB

Med J Malaysia, 2002 Dec;57(4):408-17.
PMID: 12733165

The concept of Palliative Care is still quite new in Malaysia and there is a need to promote the awareness of its importance for patients with incurable and advanced illnesses, not only to the public but also to the nursing and medical professionals. These patients especially the poor ones very often have no one to turn to; they cannot afford to seek treatment from the private hospitals, they are turned away from acute General Hospitals and are told that there is nothing more to be done because their illnesses are no longer curable, they cannot pay for GPs to come to their homes, and there is difficulty in purchasing opiate drugs for pain relief. This is a retrospective observational study of the palliative care services we try to provide to those few patients referred to us. This study showed that out of the total of 156 patients, majority were Chinese, peak age between 50-59 years, referrals were mainly from the community and the Obstetrics + Gynaecology department, patients were referred rather late, 60% of patients died at home, most common malignancies being those of the breast, colorectal and cervix, common sites of metastases being the lungs, liver, bones, peritoneum and local infiltration, 87% of patients experienced pain, about 40% of patients were not fully aware of both diagnosis and prognosis, common drugs used being opiate analgesics followed by dexamethasone, H2 antagonist, antiemetics and NSAID.
Interdisciplinary, child-centred collaboration could increase the success of potentially successful Internet-based physical activity interventions

Müller AM, Khoo S

Acta Paediatr, 2016 Mar;105(3):234-43.
PMID: 26663504 DOI: 10.1111/apa.13307

Physical activity promotes health in children and adolescents, but activity levels are low. The Internet offers opportunities for physical activity interventions because children and adolescents are widely exposed to the web and enjoy being online. This review investigated the success of Internet-based interventions designed to increase physical activity in children and adolescents. Of the 13 studies we included, five reported that Internet-based interventions had significant effects on most physical activities.
Fulltext Non-face-to-face physical activity interventions in older adults: a systematic review

Müller AM, Khoo S

Int J Behav Nutr Phys Act, 2014;11(1):35.
PMID: 24612748 DOI: 10.1186/1479-5868-11-35

Physical activity is effective in preventing chronic diseases, increasing quality of life and promoting general health in older adults, but most older adults are not sufficiently active to gain those benefits. A novel and economically viable way to promote physical activity in older adults is through non-face-to-face interventions. These are conducted with reduced or no in-person interaction between intervention provider and program participants. The aim of this review was to summarize the scientific literature on non-face-to-face physical activity interventions targeting healthy, community dwelling older adults (≥ 50 years). A systematic search in six databases was conducted by combining multiple key words of the three main search categories "physical activity", "media" and "older adults". The search was restricted to English language articles published between 1st January 2000 and 31st May 2013. Reference lists of relevant articles were screened for additional publications. Seventeen articles describing sixteen non-face-to-face physical activity interventions were included in the review. All studies were conducted in developed countries, and eleven were randomized controlled trials. Sample size ranged from 31 to 2503 participants, and 13 studies included 60% or more women. Interventions were most frequently delivered via print materials and phone (n=11), compared to internet (n=3) and other media (n=2). Every intervention was theoretically framed with the Social Cognitive Theory (n=10) and the Transtheoretical Model of Behavior Change (n=6) applied mostly. Individual tailoring was reported in 15 studies. Physical activity levels were self-assessed in all studies. Fourteen studies reported significant increase in physical activity. Eight out of nine studies conducted post-intervention follow-up analysis found that physical activity was maintained over a longer time. In the six studies where intervention dose was assessed the results varied considerably. One study reported that 98% of the sample read the respective intervention newsletters, whereas another study found that only 4% of its participants visited the intervention website more than once. From this review, non-face-to-face physical activity interventions effectively promote physical activity in older adults. Future research should target diverse older adult populations in multiple regions while also exploring the potential of emerging technologies.
Physical activity and obesity research in the Asia-Pacific: a review

Khoo S, Morris T

Asia Pac J Public Health, 2012 May;24(3):435-49.
PMID: 22593220 DOI: 10.1177/1010539512446368

Obesity is a global health concern and has a great impact on countries in the Asia-Pacific region. Physical inactivity is a major risk factor for obesity, but physical activity levels are declining in much of this region. Increasing physical activity is a priority in many countries. Considerable research has been conducted on physical activity related to obesity in Western countries, but populations in the Asia-Pacific region differ in physical, psychological, social, and cultural ways that warrant local and regional research. The authors reviewed research conducted in the Asia-Pacific region that examined either the impact of physical activity interventions on obesity-related outcomes or the effect of behavior-change interventions on physical activity participation. The number of studies found was limited, and their samples and methods varied too much to draw conclusions. The authors recommend further research in the Asia-Pacific region using systematic protocols to permit sound conclusions to be drawn and promote informed action at local levels.
Volunteer motivations at a National Special Olympics event

Khoo S, Engelhorn R

Adapt Phys Activ Q, 2011 Jan;28(1):27-39.
PMID: 21282846

Understanding the motivations for people to volunteer with the management and execution of major sporting events is important for the recruitment and retention of the volunteers. This research investigated volunteer motivations at the first National Special Olympics held in Ames, Iowa, USA in July 2006. A total of 289 participants completed the 28 item Special Event Volunteer Motivation Scale. The top motivations related to the purposive incentives of wanting to help make the event a success and to do something good for the community. Factor analysis revealed a five-factor model, with the altruistic factor (purposive) being the most important. A MANCOVA was also used to compare subjects using both gender and experience as independent variables. Small but significant differences in motivation were observed.
Endoscopic ultrasound training in Asia: Taking a step further in the right direction

Khoo S, Kongkam P

JGH Open, 2021 Oct;5(10):1111-1113.
PMID: 34621994 DOI: 10.1002/jgh3.12661
Factors influencing women in physical activity programs in Malaysia

Hanlon C, Khoo S, Morris T, Eime R

Health Promot Int, 2019 Jun 01;34(3):389-399.
PMID: 29240897 DOI: 10.1093/heapro/dax093

The majority of research on factors associated with women participation in physical activity (PA) has been in developed countries with limited research in developing countries. Few women in Malaysia are active at the recommended levels for health, and activity rates are less than developed countries. Little research has focused specially on physically active Malaysian women and the factors that contribute to them becoming and staying active in PA programs. This lack of knowledge hinders the tailored development and implementation of PA programs to meet their needs. The aim of this study was to identify the factors of participation in PA programs for Malaysian women. The social-ecological model was used to investigate and theme the factors. Focus group discussion was conducted with participants in six PA programs targeted specifically to women. Thirty-seven women were involved in the focus group discussion, with ages ranging from 19 to 82 years. Inductive and deductive content analysis was conducted from verbatim transcripts using NVivo. Inductive content analysis allowed raw data and second-order themes to emerge. Findings revealed social support structures, tailored programs for women, and location were key contributors that encouraged women to participate in these programs. The similarity in contributors between women in non-western and western countries signifies a prime opportunity for bi-lateral relationships to be formed to enable the enhancement of program development relevant to different ethnicities and cultures within or across countries.
Leisure-time physical activity and physical fitness of male adolescents in Oman

Khoo S, Al-Shamli AK

Asia Pac J Public Health, 2012 Jan;24(1):128-35.
PMID: 20460285 DOI: 10.1177/1010539510366178

This study investigated the relationship between leisure-time physical activity and physical fitness (cardiovascular fitness, body fat percentage, flexibility, muscle strength, and endurance) of 10th-grade male students in Oman. Data were collected from 330 students. All participants completed a descriptive questionnaire, a 1 mile walk/run test; a skinfold analysis of the chest, abdomen, and thigh; a sit and reach test; a hand grip test; and a 1-minute sit-up test. Students spent an average of 19.20 ± 6.77 hours on sedentary activities, 3.46 ± 2.11 hours on sports activities, and 11.22 ± 9.24 hours working per week. The students had an average body fat percentage of 6.38% ± 4.67%, muscle strength 38.04 ± 7.55 kg, flexibility 38.01 ± 7.41 cm, abdominal muscle endurance 38.85 ± 8.15 times/min, and cardiovascular endurance 8.10 ± 1.65 minutes.
Nuclear and cellular volumetric alterations in oral lichen planus and lichenoid lesions: a histomorphometric study

Khoo SP, Primasari A, Saub R

J Oral Sci, 2001 Sep;43(3):151-7.
PMID: 11732734

There is presently no line of distinction between oral lichen planus and other oral lichenoid lesions. The aim of this study is to determine using histomorphometry, the differences between these lesions. Paraffin sections from 7 normal buccal epithelium, 19 oral lichen planus (LP), 14 oral lichenoid lesions (LL) and 7 discoid lupus erythematosus-like lesions (DLE-ll) were selected. The nuclear volume (V(N)) and cellular-volume (V(CELL)) of the epithelium were assessed using an image analyser. The V(N) and V(CELL), derived for both basal and spinal strata in LP and DLE-ll were 2.3 times more than that of normal tissues. There was a significant difference between LP and LL (P < 0.005) and between LL and DLE-ll (P < 0.001), but not between LP and DLE-ll. In conclusion, there appears to be a difference between LP, LL and DLE-ll and V(N) and V(CELL) may serve as potential discriminators between these groups of lesions.
Intraoral spindle-cell lipoma: report of a case and literature review

Khoo SP, Lian CB

Ann Dent, 1995 Summer;54(1-2):53-5.
PMID: 8572549

Spindle-cell lipoma (SCL) of the oral cavity is very rare. There are only four such reported cases in the literature. A concise literature review of SCL and a case report of a SCL affecting the cheek and lip of a 23-year-old man is presented.
Mucosal sensitivity to chlorhexidine mouthwash

Yusof WZ, Khoo SP

Singapore Dent J, 1988 Dec;13(1):39-40.
PMID: 3155002

Mucosal sensitivity to chlorhexidine mouthwash is a rare occurrence and very few cases have been reported in the literature. The authors report 2 cases of oral sensitivity to chlorhexidine and discuss the side-effects, possible causes of sensitivity and the management of the cases.
Fulltext Budget impact analysis of wider adoption of biphasic insulin Aspart (Biasp) in the treatment of type 2 diabetes mellitus (T2DM): a perspective of patients treated by public providers in Singapore. [Abstract]

Tan SC, Matzen P, Khoo SP

Value Health, 2014 Nov;17(7):A743.
PMID: 27202681 DOI: 10.1016/j.jval.2014.08.153

Objectives
Economic evaluations of BIAsp have been published in the context of different countries. This study aimed to evaluate the financial impact from a perspective of patients treated by public providers of different adoption rates of Biphasic Insulin Aspart (BIAsp; NovoMix 30 FlexPen®) versus Biphasic Human Insulin (BHI; Mixtard Penfill®) in treating T2DM.
Methods
An Excel based 5-year budget impact model was built to estimate insulin treated patients by public providers using the local prevalence data. The published demographic, efficacy and adverse event data for ASEAN subgroup analyses of A1chieve study was applied. Both insulin acquisition costs and medical costs for major hypoglycaemia and other complications were applied with a 3% discount rate to the estimated corresponding incidence rates derived from the UKPDS equations. The projected adoption rates were based on the 2013 utilisation volume data. Other local specific considerations e.g. subsidized selling prices and co-payments were included in the analyses for an assumed size of eligible patients. Sensitivity analyses were conducted.
Results
The adoption rates of BIAsp were assumed to increase from 23.6% in 2013 to 30% or 36.5% in 2018 for base case and upside scenario, respectively. In comparison to base case scenario, increases in adoption rate of BIAsp were associated with a cumulative increase up to slightly greater than S$ 2.02M in insulin acquisition cost but a potential cumulative net saving up to approximately S$0.92M in overall total costs over 5 years, attributing to subsidized selling price of BIAsp assuming it is included standard drug list and its significantly lower major hypoglycaemia risk, respectively. Cost savings were predicted for other complications.
Conclusions
The wider adoption of BIAsp was predicted to result in net cost savings from patient perspective in Singapore. More cost saving would be estimated in analyses with reduced productivity loss from a societal perspective.
Fulltext Validating the Physical Activity and Leisure Motivation Scale (PALMS)

Molanorouzi K, Khoo S, Morris T

BMC Public Health, 2014;14:909.
PMID: 25182130 DOI: 10.1186/1471-2458-14-909

Although there is abundant evidence to recommend a physically active lifestyle, adult physical activity (PA) levels have declined over the past two decades. In order to understand why this happens, numerous studies have been conducted to uncover the reasons for people's participation in PA. Often, the measures used were not broad enough to reflect all the reasons for participation in PA. The Physical Activity and Leisure Motivation Scale (PALMS) was created to be a comprehensive tool measuring motives for participating in PA. This 40-item scale related to participation in sport and PA is designed for adolescents and adults. Five items constitute each of the eight sub-scales (mastery, enjoyment, psychological condition, physical condition, appearance, other's expectations, affiliation, competition/ego) reflecting motives for participation in PA that can be categorized as features of intrinsic and extrinsic motivation based on self-determination theory. The aim of the current study was to validate the PALMS in the cultural context of Malaysia, including to assess how well the PALMS captures the same information as the Recreational Exercise Motivation Measure (REMM).
Fulltext A rare case of heterotopic ossification in a newborn: a case report

Khoo S, Felix L, Azura L, Manmohan S, Jeffry A

Malays Orthop J, 2012 Nov;6(3):48-50.
PMID: 25279058 MyJurnal DOI: 10.5704/MOJ.1207.006

Heterotopic ossification (HO) is the growth of bone in soft tissue, and can be broadly classified into neurogenic, genetic and traumatic causes. The pathophysiology of HO remains unknown. This disorder is extremely rare in infants and can mimic or coexist with thrombophlebitis, cellulitis or osteomyelitis. Most importantly, HO has to be differentiated from bone-forming tumours such as osteosarcoma and osteochondroma. We report a case of traumatic HO in a fiveday- old newborn following intravenous cannulation of the right wrist and left ankle, with the latter complicated with osteomyelitis. We highlight the clinical and radiological features of HO and differential diagnoses of soft tissue ossification in early childhood.
Spotlight on Athletes With a Disability: Malaysian Newspaper Coverage of the 2012 London Paralympic Games

Cheong JP, Khoo S, Razman R

Adapt Phys Activ Q, 2016 Jan;33(1):15-32.
PMID: 26785497 DOI: 10.1123/APAQ.2015-0021

This study analyzed newspaper coverage of the 2012 London Paralympic Games by 8 Malaysian newspapers. Articles and photographs from 4 English-language and 4 Malay-language newspapers were examined from August 28 (1 day before the Games) to September 10, 2012 (1 day after the Games closing). Tables, graphs, letters, fact boxes, and lists of events were excluded from analysis. A total of 132 articles and 131 photographs were analyzed. Content analysis of the newspaper articles revealed that most (62.8%) of the articles contained positive reference to the athletes with a disability. There were equal numbers (39.1%) of action and static shots of athletes. More articles and photographs of Malaysian (58%) than non-Malaysian (42%) athletes with a disability were identified. Only 14.9% of the articles and photographs were related to female athletes with a disability.
Fulltext Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial

Müller AM, Khoo S, Morris T

J Med Internet Res, 2016 Jan 07;18(1):e5.
PMID: 26742999 DOI: 10.2196/jmir.5235

BACKGROUND: Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones.
OBJECTIVE: The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants' exercise frequency and the effects of the intervention on secondary outcomes.
METHODS: The Malaysian Physical Activity for Health Study (myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity-related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24.
RESULTS: In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study-unrelated injuries forced 4 participants to discontinue after a few weeks (they were not included in any analyses). Overall retention was 86% (37/43). After 12 weeks, SMS texting arm participants exercised significantly more than non-SMS texting arm participants (mean difference 1.21 times, bias-corrected and accelerated bootstrap [BCa] 95% CI 0.18-2.24). Interview analysis revealed that the SMS text messages positively influenced SMS texting arm participants who experienced exercise barriers. They described the SMS text messages as being encouraging, a push, and a reminder. After 24 weeks, there was no significant difference between the research arms (mean difference 0.74, BCa 95% CI -0.30 to 1.76). There were no significant effects for secondary outcomes.
CONCLUSIONS: This study provides evidence that SMS text messaging is effective in promoting exercise in older adults from an upper-middle-income country. Although the effects were not maintained when SMS text messaging ceased, the results are promising and warrant more research on behavioral mobile health interventions in other regions.
TRIAL REGISTRATION: Clinicaltrials.gov NCT02123342; http://clinicaltrials.gov/ct2/show/NCT02123342 (Archived by WebCite at http://www.webcitation.org/6eGSsu2EI).
Fulltext Superior masenteric vein thrombosis

Ho CK, Khoo ST, Saw MH

Med J Malaysia, 2002 Jun;57(2):229-32.
PMID: 24326659

A 43 year-old woman presented with severe non-specific abdominal pain of 1-week duration. She was on oral contraceptive pills for the past 6 years. Clinically patient appeared ill with no specific abnormal physical sign. Moderate amount of free fluid in the peritoneal cavity on ultrasound prompted an urgent abdominal computed tomography (CT) scan, which revealed thrombosis of the superior mesenteric vein. Further investigations revealed a hypercoagulable state with protein C deficiency. Patient responded well to anticoagulation and supportive therapy. One month later patient readmitted with vomiting and signs of intestinal obstruction. Barium study revealed a moderately long tight stricture at mid jejunum with proximal dilation. A by-pass surgery was carried out. She was well at 3 months follow-up.
Detection of human herpesvirus 7 in salivary glands

Yadav M, Nambiar S, Khoo SP, Yaacob HB

Arch Oral Biol, 1997 Aug;42(8):559-67.
PMID: 9347118

The prevalence and cellular distribution of human herpesvirus 7 (HHV-7) in archival labial salivary glands was analysed for virus-specific DNA sequences by polymerase chain reaction (PCR) and in situ hybridization signals. In addition, the cellular expression of HHV-7-encoded protein was detected by immunohistochemical staining with a virus-specific monoclonal antibody. Eleven of 20 samples were positive for the HHV-7 DNA sequence by PCR. Eighteen of 20 tissues analysed by in situ hybridization showed signals in ductal, serous and mucous cells. Some nuclei of these cells and also the myoepithelial population were positive. In immunolocalization studies, all 20 salivary glands consistently showed HHV-7-expressed protein in the cytoplasm of ductal cuboidal and columnar cells. The protein was also found in the cytoplasm of mucous and serous acinar cells that were immunopositive for HHV-7. The observations are consistent with the suggestion that the labial salivary gland is a site for virus replication, potential persistence and a source of infective HHV-7 in saliva.

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