MyMedR

The place of Bactrim and Vibramycin in acute salpingitis

Ng A

Med J Malaysia, 1975 Dec;30(2):133-4.

Immersion pulmonary oedema and Takotsubo cardiomyopathy

Ng A, Edmonds C

Diving Hyperb Med, 2015 Dec;45(4):255-7.

A 67-year-old female scuba diver developed a typical immersion pulmonary oedema (IPE), but investigations strongly indicated Takotsubo cardiomyopathy (TC). The cardiac abnormalities included increased cardiac enzymes, electrocardiographic anomalies and echocardiographic changes, all reverting to normal within days. This case demonstrates a similarity and association between IPE and TC, and the importance of prompt cardiac investigations both in the investigation of IPE and in making the diagnosis of TC.

Fulltext A study on community acquired pneumonia in adults requiring hospital admission in Penang

Hooi LN, Looi I, Ng AJ

Med J Malaysia, 2001 Sep;56(3):275-84.

PMID: 11732071

A study was carried out to determine the pattern of microbiological organisms causing community acquired pneumonia in adult patients admitted to Penang Hospital between November 1999 and August 2000. Altogether, 98 patients (64 males, 34 females) with a mean age (+/- S.D.) of 55.9 (+/- 19.0) (range 15 to 87) years were included in the study. Causative organisms were identified in 42 patients (42.9%). Mycobacterium tuberculosis was the commonest pathogen being identified in 15.3% of cases, followed by Klebsiella pneumoniae (7.2%), Pseudomonas aeruginosa (6.1%) and Staphylococcus aureus (5.1%). Streptococcus pneumoniae and Acinetobacter spp accounted for 3 cases each (3.1%) and Haemophilus influenzae, non-haemolytic Streptococcus, Mycoplasma pneumoniae, Salmonella typhi, Escherichia coli, Klebsiella spp and Pseudomonas spp for 1 case each (1.0%). Four patients (4.1%) had dual infections and no case of legionella pneumonia was found in this series.

Termination of pregnancy by single large dose injection of prostaglandins E2 and F2 transcervically into the extra-amniotic space

Ng AY, Cheng M, Ratnam SS

Med J Malaysia, 1973 Dec;28(2):120-2.

PMID: 4276228

Approaches to deriving Schwann cells from human bone marrow for neural tube regeneration in a clinical setting

Hidayah HN, Mazzre M, Ng AM, Ruszymah BH, Shalimar A

Med J Malaysia, 2008 Jul;63 Suppl A:39-40.

PMID: 19024973

Bone marrow derived Mesenchymal stem cells (MSCs) were evaluated as an alternative source for tissue engineering of peripheral nerves. Human MSCs were subjected to a series of treatment with a reducing agent, retinoic acid and a combination of trophic factors. This treated MSCs differentiated into Schwann cells were characterized in vitro via flow cytometry analysis and immunocytochemically. In contrast to untreated MSCs, differentiated MSCs expressed Schwann cell markers in vitro, as we confirmed by flow cytometry analysis and immunocytochemically. These results suggest that human MSCs can be induced to be a substitute for Schwann cells that may be applied for nerve regeneration since it is difficult to grow Schwann cells in vitro.

A low-cost phantom for simple routine testing of single photon emission computed tomography (SPECT) cameras

Ng AH, Ng KH, Dharmendra H, Perkins AC

Appl Radiat Isot, 2009 Oct;67(10):1864-8.

PMID: 19049851 DOI: 10.1016/j.apradiso.2008.10.010

A simple sphere test phantom has been developed for routine performance testing of SPECT systems in situations where expensive commercial phantoms may not be available. The phantom was based on a design with six universal syringe hubs set in the frame to support a circular array of six glass blown spheres of different sizes. The frame was then placed into a water-filled CT abdomen phantom and scanned with a triple head camera system (Philips IRIX, USA). Comparison was made with a commercially available phantom (Deluxe Jaszczak phantom). Whereas the commercial phantom demonstrates cold spot resolution, an important advantage of the sphere test phantom was that hot spot resolution could be easily measured using almost half (370MBq) of the activity recommended for use in the commercial phantom. Results showed that the contrast increased non-linearly with sphere volume and radionuclide concentration. The phantom was found to be suitable as an inexpensive option for daily performance tests.

Antibiotic susceptibility and serotype distribution of Streptococcus pneumoniae in Malaysian children

Cheong YM, Jegathesan M, Henrichsen J, Wong YH, Ng AJ, Louis A

J Trop Pediatr, 1988 08;34(4):182-5.

PMID: 3172328 DOI: 10.1093/tropej/34.4.182

Fulltext A ten-year review of ruptured sinus of valsalva: clinico-pathological and echo-Doppler features

Shah RP, Ding ZP, Ng AS, Quek SS

Singapore Med J, 2001 Oct;42(10):473-6.

PMID: 11874151

Rupture of the sinus of valsalva (RSOV) is an uncommon condition with a variety of manifestations ranging from an asymptomatic murmur to cardiogenic shock. This retrospective 10-year review (1985-1995) of 18 patients from a single institution revealed that 6 (33%) were female and 12 (67%) were male with a mean age of 37.6 +/- 13.4 years and that 72% were Chinese by ethnic descent with the remaining 28% being Malay. Eight patients (44.4%) presented with an asymptomatic murmur, 4 (22.2%) with acute chest pain, 4 (22.2%) with mild heart failure, 2 (11.1%) with severe heart failure, and 2 (11.1%) with cardiogenic shock. Rupture of the right aneurysmal coronary cusp (RCC) made up 15 (83.3%) while those of the non-coronary cusp (NCC) made up the remaining. Most of the RCC ruptures were directed into the right ventricle and all of the NCC ruptures were into the right atrium. Ventricular septal defects (VSDs) were found in 9 (50%) of the patients, (although detected by echocardiography in only one third of those patients), aortic regurgitation in 6 (33.3%) and aortic valve vegetations in 2 (11.1%). Echocardiography was found to be accurate in diagnosing RSOVs with 100% diagnostic accuracy after 1990 with four misdiagnoses before 1990. Of these four patients, two were misdiagnosed as having VSDs, one as having a coronary arteriovenous fistula and one as having a patent ductus arteriosus. The anatomical structure of the "windsock" was seen in 64% of the patients who were correctly diagnosed. The pattern of colour flow and spectral Doppler was seen in all patients and helped to localise the site of rupture and the direction of flow. In summary, echocardiography is a simple and accurate way of diagnosing and defining RSOVs and is the imaging modality of choice.

Fulltext Non-O1 Vibrio cholerae septicaemia: a case report

Tan KK, Sin KS, Ng AJ, Yahya H, Kaur P

Singapore Med J, 1994 Dec;35(6):648-9.

PMID: 7761898

Non-O1 vibrio cholerae infections are associated with sporadic cases of gastroenteritis and extraintestinal infections. Septicaemia due to non-O1 vibrio cholerae is rare and are mainly reported in adults, particularly in immunocompromised patients. We report a case of non-O1 vibrio cholerae septicaemia and gastroenteritis in an 8-year-old child. The patient presented with bloody diarrhoea, fever and severe dehydration. Non-O1 vibrio cholerae were isolated from blood and stool cultures. The clinical course was uneventful after starting appropriate rehydration and supportive therapy.

Fulltext Health and economic impact of combination therapy vs. Monotherapy for treatment of benign prostatic hyperplasia in hong kong

Wu DB, Yee CH, Ng AC, Chaiyakunapruk N, Lee KK

Value Health, 2014 Nov;17(7):A812.

PMID: 27203071 DOI: 10.1016/j.jval.2014.08.558

Sourcing different neuro-progenitor cell for the use of nerve construct

Yazid AG, Anuar A, Onhmar HT, Ng AM, Ruszymah BH, Amaramalar SN

Med J Malaysia, 2008 Jul;63 Suppl A:113-4.

PMID: 19025011

Spinal cord, sciatic nerve, olfactory ensheathing cell and bone marrow derived mesenchymal stem cells were evaluated as an alternative source for tissue engineering of nerve conduit. All cell sources were cultured in alpha-MEM medium. Olfactory Ensheathing Cell (OEC) showed the best result with higher growth kinetic compared to the others. Spinal cord and sciatic nerve were positive for GFAP, OEC were positive for GFAP, S100b and anti-cytokeratin 18 but negative for anti-Human Fibroblast.

Isolation techniques of murine bone marrow progenitor cells and their adipogenic, neurogenic and osteogenic differentiation capacity

Ng AM, Kojima K, Kodoma S, Ruszymah BH, Aminuddin BS, Vacanti AC

Med J Malaysia, 2008 Jul;63 Suppl A:121-2.

PMID: 19025015

Bone marrow derived progenitor cells have been widely studied for its multipotent property and have proofed to be an important resource in regenerative medicine. However, the propagation of murine bone marrow appeared to be a great challenge as compared to other mammalian species. In this study, various isolation techniques and the plasticity of the isolated cells were evaluated. Our result shows that magnetic sorting technique yielded the most viable cells and displayed wider differentiation capacity.

Derivation of neurospheres from bone marrow stromal cells

Ng AM, Westerman K, Kojima K, Kodoma S, Aminuddin BS, Ruszymah BH, et al.

Med J Malaysia, 2008 Jul;63 Suppl A:7-8.

PMID: 19024958

Nerve stem cells have a unique characteristic in that they form spherical aggregates, also termed neurospheres, in vitro. The study demonstrated the successful derivation of these neurospheres from bone marrow culture. Their plasticity as nerve stem cells was confirmed. The findings further strengthens the pluripotency of cell populations within the bone marrow.

Epidemiology and strain characterization of rotavirus diarrhea in Malaysia

Hung LC, Wong SL, Chan LG, Rosli R, Ng AN, Bresee JS

Int J Infect Dis, 2006 Nov;10(6):470-4.

PMID: 17046306

The objectives of the study were to describe the epidemiology and strain characterization of rotavirus (RV), to determine the proportion of hospitalizations for diarrhea attributable to RV among children under 5 years of age, and to estimate the disease burden of RV diarrhea in Malaysia.

Pharmacokinetics of propofol infusion in Asian patients undergoing coronary artery bypass grafting

Lee HS, Khoo YM, Chua BC, Ng AS, Tan SS, Chew SL

Ther Drug Monit, 1995 Aug;17(4):336-41.

PMID: 7482686

The pharmacokinetics of propofol was studied in 11 Asian patients with fentanyl-isoflurane anaesthesia during cardiopulmonary bypass (CPB) and undergoing elective coronary artery bypass grafting (CABG). Instead of the usual increments of morphine and a benzodiazepine, propofol (4 mg/kg/h) was initiated at the start of CPB and ceased at CPB separation. Whole blood propofol concentrations were determined during and postinfusion using high-performance liquid chromatography with fluorescence detection. Data from four patients seemed to fit a two-compartment model, whereas those from seven patients were significantly (F test, p < 0.05) better fitted to a three-compartment model. The pharmacokinetic parameters were as follows: The mean (SD) of the initial distribution phase t1/2 pi, intermediate distribution phase t1/2 alpha, and elimination phase t1/2 beta were 2.22 (1.04) min, 42.9 (16.4) min, and 370 (138) min, respectively. The mean clearance of 1.31 (0.50) L/min was lower than those reported from other studies, whereas the mean blood concentration of 2.2 (1.0) mg/L at the 1-h infusion period was higher. The mean calculated apparent Css was 3.9 (1.5) mg/L. The low clearance is likely to be due to hemodynamic changes during CPB and CABG, thereby affecting drug distribution and blood flow to the liver.

Fulltext The past and current updates on diagnostic aspects of osteoarthritis

Tan WM, Lau SF, Ajat M, Mansor R, Abd-Rani PAM, Ng AMH, et al.

Jurnal Veterinar Malaysia, 2017;29(1):7-12.

MyJurnal

Osteoarthritis (OA) is a progressive joint disease leading to the destruction of joint structures, which in turn causes severe and chronic pain to the patient. Since OA is a troubling and disruptive disease, numerous researches have been done into diagnosing this disease, both in the early and the late stages of the disease. Diagnostic modalities such as radiography, computed-tomography (CT), micro-computed tomography (µ-CT), and magnetic resonance imaging (MRI) have been used in OA research. Not only that, more advance measurements and criteria have been established to standardize OA research. Currently, the OA research has been delving into proteomic studies to search for potential disease biomarkers. Biomarkers such as urinary C-terminal telopeptide of collagen type 2 (uCTX-II) and cartilage oligometric protein (COMP) have shown potential to be both diagnostic and prognostic biomarkers. For this review paper, the developments in diagnostic modalities are discussed focusing more on proteomic and biomarker studies.

Fulltext A novel language-neutral Visual Cognitive Assessment Test (VCAT): validation in four Southeast Asian countries

Lim L, Ng TP, Ong AP, Tan MP, Cenina AR, Gao Q, et al.

Alzheimers Res Ther, 2018 01 22;10(1):6.

PMID: 29370825 DOI: 10.1186/s13195-017-0333-z

BACKGROUND: Cognitive screeners are imperative for early diagnosis of dementia. The Visual Cognitive Assessment Test (VCAT) is a language-neutral, visual-based test which has proven useful for a multilingual population in a single-center study. However, its performance utility is unknown in a wider and more diverse Southeast Asian cohort.

METHODS: We recruited 164 healthy controls (HC) and 120 cognitively impaired (CI) subjects- 47 mild cognitive impairment (MCI) and 73 mild Alzheimer's disease (AD) dementia participants, from four countries between January 2015 and August 2016 to determine the usefulness of a single version of the VCAT, without translation or adaptation, in a multinational, multilingual population. The VCAT was administered along with established cognitive evaluation.

RESULTS: The VCAT, without local translation or adaptation, was effective in discriminating between HC and CI subjects (MCI and mild AD dementia). Mean (SD) VCAT scores for HC and CI subjects were 22.48 (3.50) and 14.17 (5.05) respectively. Areas under the curve for Montreal Cognitive Assessment (0.916, 95% CI 0.884-0.948) and the VCAT (0.905, 95% CI 0.870-0.940) in discriminating between HCs and CIs were comparable. The multiple languages used to administer VCAT in four countries did not significantly influence test scores.

CONCLUSIONS: The VCAT without the need for language translation or cultural adaptation showed satisfactory discriminative ability and was effective in a multinational, multilingual Southeast Asian population.

Epidemiology of Streptococcus pneumoniae infection in Malaysia

Rohani MY, Raudzah A, Ng AJ, Ng PP, Zaidatul AA, Asmah I, et al.

Epidemiol Infect, 1999 Feb;122(1):77-82.

PMID: 10098788

During a 1-year period from October 1995 to September 1996, 273 isolations of Streptococcus pneumoniae were made from various types of clinical specimens. The majority of the isolates (39.2%) were from sputum whilst 27.5% were from blood, CSF and other body fluids. The organism was isolated from patients of all age groups, 31.1% from children aged 10 years and below, 64.7% of which come from children aged 2 years or below. The majority of the isolates belong to serotypes 1, 6B, 19B, 19F and 23F. Serotypes 1 and 19B were the most common serotypes associated with invasive infection. About 71.9% of the invasive infections were due to serotypes included in the available 23 valent polysaccharide vaccine. The rates of resistance to penicillin and erythromycin were 7.0 and 1.1% respectively. Our findings show that the serotypes of S. pneumoniae causing most invasive infections in Malaysia are similar to those in other parts of the world and the available vaccine may have a useful role in this population.

Leadership and mentoring in medical physics: The experience of a medical physics international mentoring program

Santos JC, Goulart LF, Giansante L, Lin YH, Sirico ACA, Ng AH, et al.

Phys Med, 2020 Aug;76:337-344.

PMID: 32759035 DOI: 10.1016/j.ejmp.2020.07.023

Mentoring aims to improve careers and create benefits for the participants' personal and professional lives. Mentoring can be an individual or a shared experience for a group, while the mentor's role remains the same in both models. Mentors should increase confidence, teach, inspire, and set examples, helping the mentees to mould their path, contributing to the pursuit of their personal and professional goals. This study aims to report on the experience of early-career medical physics professionals and postgraduate students participating in a global mentoring program and to assess the impact of this activity on their professional development. The objectives of this mentoring program are to develop leadership roles among young medical physicists and to provide guidance and support. An online questionnaire was administered to the mentee participants. The analysis of their responses is reported in this work and the current status of the programme was examined using a SWOT analysis. In general, the mentoring experience had a positive impact on the mentees. The mentors were found especially helpful in the decision-making situations and in other conflicts that may arise with career development. Additionally, the mentees felt that mentoring contributed to the development of leadership skills required for the job market and assist in personal development. This paper concludes that participation of young medical physicists in a mentoring group program is beneficial to their career and therefore should be encouraged.

Fulltext Audit on cardiovascular disease preventive care in general practice

Chan SC, Lee TW, Teoh LC, Abdullah ZC, Xavier G, Sim CK, et al.

Singapore Med J, 2008 Apr;49(4):311-5.

PMID: 18418523

INTRODUCTION: Cardiovascular disease is a major cause of morbidity and mortality. Primary care doctors as general practitioners (GPs) play a central role in prevention, as they are in contact with a large number of patients in the community through provision of first contact, comprehensive and continuing care. This study aims to assess the adequacy of cardiovascular disease preventive care in general practice through a medical audit.
METHODS: Nine GPs in Malaysia did a retrospective audit on the records of patients, aged 45 years and above, who attended the clinics in June 2005. The adequacy of cardiovascular disease preventive care was assessed using agreed criteria and standards.
RESULTS: Standards achieved included blood pressure recording (92.4 percent), blood sugar screening (72.7 percent) and attaining the latest blood pressure of equal or less than 140/90 mmHg in hypertensive patients (71.3 percent). Achieved standards ranged from 11.1 percent to 66.7 percent in the maintenance of hypertension and diabetic registries, recording of smoking status, height and weight, screening of lipid profile and attaining target blood sugar levels in diabetics.
CONCLUSIONS: In the nine general practice clinics audited, targets were achieved in three out of ten indicators of cardiovascular preventive care. There were vast differences among individual clinics.

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