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Fulltext A review of depression research in Malaysia

Ng CG

Med J Malaysia, 2014 Aug;69 Suppl A:42-5.
PMID: 25417950 MyJurnal

Depression is a debilitating illness and has become a leading cause of morbidity globally. We aim to summarise the evidence available in regard to the prevalence, type of assessment tools used and treatment options for depression in Malaysia. Two hundred and forty seven articles related to depression were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Fifty seven articles were selected and reviewed on the basis of clinical relevance and future research implications. Findings were summarised, categorised and presented according to prevalence of depression, depression in women, depression in clinical condition, assessment tools, and treatment of depression. The prevalence of depression in Malaysia was estimated to be between 8 and 12%. The figures were higher among women of low socio-economic background or those with comorbid medical condition. The common assessment tools used in Malaysia include Beck Depression Inventory (BDI), Depression, Anxiety and Stress Scale (DASS), Patient Health Questionnaire 9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS). They were translated into the Malay language and their psychometric properties were established. Both pharmacological treatment and psychotherapy were commonly used in Malaysia, and were highly recommended in local clinical practice guidelines. There are discrepancies in the reported rates of depression in Malaysia and this needs to be addressed. There were lack of studies looking into the depression among subgroups in Malaysia especially in the male population. There were several instruments available for assessment of depression in Malaysia but their suitability for the local setting need further research. Both pharmacotherapy and psychotherapy were recommended in the local treatment guideline in Malaysia. With the emergence of generic medication, we need to compare their clinical efficacy and tolerability with original products.
Fulltext Role of ampicillin-sulbactam: a district hospital’s experience in treating diabetic foot ulcers

Ng, C. S., Vadivelu, M., Chan, K. Y.

International e-Journal of Science, Medicine & Education, 2009;3(2):28-30.
MyJurnal

Abstract: Ampicillin-sulbactam combination is the most frequently prescribed antibiotic in diabetic foot ulcers. We conducted a retrospective study to evaluate the antibiotic sensitivity of bacteria isolated to this antibiotic. In 33 patients with diabetic foot ulcer (September 2008-March 2009), 67% were culture positive in which Citrobacter spp accounted for 36% of these isolates. The rest isolated included Pseudomonas aeruginosa (22%), Proteus spp (18%), Acinetobacter spp (9%), Klebsiella pneumoniae (5%), Escherichia coli (5%) and Staphylococcus aureus (5%). These isolates were more likely to be ampicillin-resistant (n=18) than were ampicillin-sensitive isolates (n=4). Ampicillin resistance has raised our concern about current practice of prescribing ampicillin/ sulbactam as monotherapy for majority of our patients with such ulcers.
A study of the effectiveness of local exhaust ventilation (LEV) using computational fluid dynamics (CFD) approach

Ng, C. S., Leman, A. M., N. Asmuin

Journal of Occupational Safety and Health, 2012;9(3):1-8.
MyJurnal

Local exhaust ventilation (LEV) is used in industries to capture contaminants such as gases, dusts, mists, vapours or fumes out of workstations to protect occupants’ exposure to contaminants. LEV is allocated and installed by employers, however it doesn’t work accordingly. LEV design is often overlooked and underappreciated. Effectiveness of LEV system can be achieved if more attention is focused to proper design of LEV system. To solve this issue, computational fluid dynamics (CFD) can be performed. CFD is a software tool to predict and simulate fluid dynamic phenomena. CFD is used to forecast or reconstruct the behaviour of an engineering product under assumed or measure boundary conditions. However, CFD is just a prediction tool, which can lead to inaccuracy of predicting airflow due to problems with pre-processing, solver and post-processing with parameter from actual experimental results. Therefore, validation is needed to help minimizing percentage error of CFD methods. In this research, measurements of airflow parameter of LEV system at National Institute of Occupational Safety and Health (NIOSH) Bangi, Selangor were conducted. Control Speed panel found at NIOSH Bangi, which is used to increase or decrease speed of fan, was performed using Control Speed of 20%, 40% 60% and 80%. Upon validation, average absolute error obtained from four different control speeds ranges from 3.372% to 4.862%. Validity of CFD modelling is acceptable, which is less than 5% and good agreement is achieved between actual experimental results and CFD simulation results. Therefore, it can be concluded that CFD software tool can be performed to simulate air velocity in LEV system. CFD methods can save labour costs and time consumption when it is used during earliest stage of LEV design, before actual construction is implemented. The outcome of this paper can be used as a baseline for factories equipped with LEV system to protect occupants’ exposure to contaminants.
Fulltext Respiratory clinics: cough and melena in a 60-year-old man

Khajotia R, Ng C

Malays Fam Physician, 2010;5(1):44-5.
PMID: 25606186
137Cs and 40K levels in marine species caught in Malaysian waters

Dougherty G, Ng CE

Health Phys, 1982 Dec;43(6):915-9.
PMID: 7152953
Practising EBM in primary care

Liew S, Ng C

Malays Fam Physician, 2013;8(2):1.
PMID: 25606273
Bacillus cereus in rice: A review on food poisoning, antimicrobial resistance, and control measures

Woh PY, Ng C

Trop Biomed, 2024 Sep 01;41(3):298-309.
PMID: 39548784 DOI: 10.47665/tb.41.3.010

Rice is often associated with Bacillus cereus (B. cereus) food poisoning. This review aims to explore the food poisoning activity, antimicrobial resistance, and control measures of B. cereus in rice from 1974 to October 2023. We searched for eligible studies from the PubMed database based on explicit criteria following the PRISMA checklist. A total of 117 articles were collected, and the final analysis included 29 studies. Quality appraisal was performed using AMSTAR 2, SANRA 2, and Critical Appraisal Tool standards. B. cereus can grow and multiply in food to cause emetic vomiting or diarrheal syndrome. The primary etiology of B. cereus contamination is improper food handling and storage temperature during the cooking, cooling, and reheating stages of rice. The alarming rise of antimicrobial resistance in B. cereus to beta-lactam antibiotics necessitates alternatives from natural antimicrobial preservatives such as carvacrol, chitosan, or trans-cinnamaldehyde to prevent microbial infestation and toxin production. Implementing food safety strategies tailored to specific food settings, such as restaurants and factorymanufactured ready-to-eat rice, is critical for preventing food contamination by B. cereus. Given the heat-resistant spores and intoxication properties of B. cereus, it is important to develop effective interventions and hygienic protocols from farm to fork.
Fulltext Identification of floral genes for sex determination in Calamus palustris Griff. by using suppression subtractive hybridization

Ng CY, Wickneswari R, Choong CY

Genet. Mol. Res., 2014;13(3):6037-49.
PMID: 25117361 DOI: 10.4238/2014.August.7.18

Calamus palustris Griff. is an economically important dioecious rattan species in Southeast Asia. However, dioecy and onset of flowering at 3-4 years old render uncertainties in desired female:male seedling ratios to establish a productive seed orchard for this rattan species. We constructed a subtractive library for male floral tissue to understand the genetic mechanism for gender determination in C. palustris. The subtractive library produced 1536 clones with 1419 clones of high quality. Reverse Northern screening showed 313 clones with differential expression, and sequence analyses clustered them into 205 unigenes, including 32 contigs and 173 singletons. The subtractive library was further validated with reverse transcription-quantitative polymerase chain reaction analysis. Homology identification classified the unigenes into 12 putative functional proteins with 83% unigenes showing significant match to proteins in databases. Functional annotations of these unigenes revealed genes involved in male flower development, including MADS-box genes, pollen-related genes, phytohormones for flower development, and male flower organ development. Our results showed that the male floral genes may play a vital role in sex determination in C. palustris. The identified genes can be exploited to understand the molecular basis of sex determination in C. palustris.
Is breast self examination (BSE) still relevant? A study on BSE performance among female staff of University of Malaya

Dahlui M, Ng C, Al-Sadat N, Ismail S, Bulgiba A

Asian Pac J Cancer Prev, 2011;12(2):369-72.
PMID: 21545196

OBJECTIVES: This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities.
METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.
RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.
CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.
Intraoperative methylene blue sentinel lymph node mapping in colorectal cancer

Chan SH, Ng C, Looi LM

ANZ J Surg, 2008 Sep;78(9):775-9.
PMID: 18844907 DOI: 10.1111/j.1445-2197.2008.04648.x

Isosulfan blue is not available for clinical use in Malaysia. This study describes the use of methylene blue as an alternative to isosulfan blue in colorectal sentinel node mapping.
Fulltext Lingual thyroid--a lesson to learn (letter)

Ng CS, Mohd Razak MS

Med J Malaysia, 2005 Mar;60(1):115.
PMID: 16250296

Comment on: Ramzisham AR, Somasundaram S, Nasir ZM. Lingual thyroid--a lesson to learn. Med J Malaysia. 2004 Oct;59(4):533-4
Fulltext Bone mineral densities and hip axis lengths of normal Singapore women

Ng CED, Sundram F, Mahbub UR, Hoon P

Med J Malaysia, 1999 Jun;54(2):180-4.
PMID: 10972027

This study aims to evaluate the bone mineral densities and hip axis lengths of women in the local population. 227 normal Singapore women of ages 20 to 70 years had evaluation of their bone mineral densities (BMDs) by means of dual X-ray absorptiometry (DXA). The trend of BMDs at the left femoral neck and the lumbar spine remains fairly constant with increasing age until the 45-49 years age-band, beyond which there is a consistent decline. The mean hip axis length is 10.3 cm with a standard deviation of 0.6 cm. In general, the bone mineral densities in the femoral neck and lumbar spine as measured by DXA and the hip axis length of the local population is lower than corresponding figures reported in the Western population.
Fulltext Giant Chondrosarcoma of Proximal Humerus in an Adult Female Patient: A Case Report

Ng CK, Azuhairy A, Tan LH, Nordin A

Malays Orthop J, 2015 Jul;9(2):51-53.
PMID: 28435611 MyJurnal DOI: 10.5704/MOJ.1507.001

Chondrosarcoma is the third most common primary tumour of the bone, after myeloma and osteosarcoma. Most of the chondrosarcoma grow slowly and rarely metastasize, and they have an excellent prognosis after adequate surgery. However most of them are chemo or radio-resistant. We report a case of primary chondrosarcoma of proximal humerus in a 36-year-old female who presented with a six years history of left shoulder swelling and restricted range of motion. Trucut biopsy showed a well-differentiated chondrosarcoma. The patient underwent forequarter amputation of left upper limb and was started on chemotherapy following operation.
Fulltext Co-morbid hypertension, diabetes mellitus or dyslipidemia among patients prescribed with second generation antipsychotic: a comparison study between aripiprazole, quetiapine and clozapine based on pharmacy prescription database

Ng CG, Chan PL, Said MA

Malaysian Journal of Psychiatry, 2015;24(2):0-0.
MyJurnal

Introduction: Second generation antipsychotic (SGA) was linked to increased risk of metabolic syndrome. The risk varies between different SGA. We aim to study this risk by examining the co-prescription of antihypertensive, antidiabetic and lipid lowering drugs in patients prescribed with either aripiprazole, quetiapine or clozapine.
Methods: This is a retrospective cohort study based on the prescription records of a teaching hospital. Prescription records between January 1, 2013 and December 31, 2014 for
psychiatric unit were extracted. Patients with at least one prescription of any antipsychotic were included. The odds of antihypertensive, antidiabetic and lipid lowering drugs co-prescription in patients with either aripiprazole, quetiapine or clozapine were calculated.
Results: Of the 1742 study subjects, 88 patients were prescribed with aripiprazole, 175 patients with clozapine and 124 patients with quetiapine. Patients prescribed with quetiapine had
higher odds of co-prescribed with antihypertensive (OR = 1.71, 95% CI = 1.11, 2.63), antidiabetic drugs (OR = 1.81, 95% CI = 1.11, 2.95) and lipid lowering drugs (OR = 1.94, 95% CI = 1.19, 3.16). There were higher odds of co-prescription of antihypertensive (OR = 1.54, 95% CI = 1.05, 2.25), antidiabetic drugs (OR = 1.69, 95% CI = 1.10, 2.59) and lipid lowering drugs
(OR = 1.90, 95% CI = 1.24, 2.91) in patients with clozapine. However, there were no increase odds of co-prescription of the three agents in patients with aripiprazole.
Conclusion: We need to monitor the risk of metabolic syndrome in patients treated with SGA. Aripiprazole has lower risk of metabolic syndrome.
Infected pancreatic pseudocyst following severe dengue infection

Lee SL, Ng CY, Sidhu J

Med J Malaysia, 2021 Nov;76(6):927-929.
PMID: 34806688

Severe dengue infection is life threatening as it can result in fatal complications such as intractable bleeding from coagulopathy, multiorgan failure from shock and haemophagocytic syndrome. There have been case reports of atypical manifestation of severe dengue infection such as pancreatitis, Guillian-Barre's syndrome, perforated viscus and myocarditis. However, to our knowledge, pancreatic pseudocyst from dengue-related pancreatitis has never been reported in the literature. We hereby report a case of infected pancreatic pseudocyst in a patient with persistent pyrexia, abdominal pain and raised inflammatory markers 10 weeks from the onset of severe dengue infection. Endoscopic ultrasound (EUS) guided transluminal drainage of the infected pancreatic pseudocyst with lumen-apposing metallic stent (LAMS) was performed with good clinical and radiological outcome.
Perforated gastric ulcer in severe dengue infection: A case report

Ng CY, Lee SL, Foo SL

Med J Malaysia, 2017 08;72(4):244-245.
PMID: 28889137 MyJurnal

Abdominal pain is one of the common presentations in severe dengue infection. We report a rare case of perforated gastric ulcer in a young man diagnosed with severe dengue infection and the challenges we faced in managing this patient. Perforated gastric ulcer need to be considered if there are signs of peritonitis and persistent abdominal pain that does not conform to the natural history of dengue. Proper imaging and early surgical intervention in perforated gastric ulcer is vital in preventing further complication and reducing the risk of mortality.
Fulltext Effective Communication at Different Phases of COVID-19 Prevention: Roles, Enablers and Barriers

Mohd Hanafiah K, Ng C, Wan AM

Viruses, 2021 Jun 03;13(6).
PMID: 34204909 DOI: 10.3390/v13061058

In an age of globalisation and hyperconnectivity, the COVID-19 pandemic has caused unprecedented and sustained impact worldwide. This article discusses issues related to (science) communication at different phases of the COVID-19 epidemic timeline. We consider the role of communication for prevention from the ecological perspective, taking into consideration that many emerging pathogens, including COVID-19, likely arise in part due to anthropogenic changes to natural environments. Communication forms part of the early response setting the scene for public buy-in of public health interventions at the start of an outbreak, as well as to maintain precautions over time. Finally, communication is a key element in increasing acceptance for new tools that require mass uptake to be effective, as seen with roll-out challenges for the COVID-19 vaccines, which faced heightened concerns of efficacy and safety while mired with rampant misinformation. Ultimately, strategies for prevention of viral epidemics such as COVID-19 must include communication strategies at the forefront to reduce the risk of the emergence of new diseases and enhance efforts to control their spread and burden. Despite key themes emerging, what constitutes effective communication strategies for different people and contexts needs to be investigated further.
Efficacy of ivermectin against Parastrongylus malaysiensis infection in rats

Ambu S, Mak JW, Ng CS

J Helminthol, 1992 Dec;66(4):293-6.
PMID: 1293196

The efficacy of ivermectin on experimental infections of P. malaysiensis in rats was determined. Ivermectin was 99.4% and 97.9% effective at a dosage of 400 meg and 800 meg respectively at seven days post-infection. The same two dosages of ivermectin when given at 14 days post infection had an efficacy of 100%. However, as an adulticide it had only 40.7% efficacy. Ivermectin may therefore be useful for the treatment of parastrongyliasis due to the larval stages of the worm which can cause significant pathology in man and animals.
Fulltext Bibliography of clinical research in Malaysia: methods and brief results

Teng CL, Zuhanariah MN, Ng CS, Goh CC

Med J Malaysia, 2014 Aug;69 Suppl A:4-7.
PMID: 25417946

This article describes the methodology of this bibliography. A search was conducted on the following: (1) bibliographic databases (PubMed, Scopus, and other databases) using search terms that maximize the retrieval of Malaysian publications; (2) Individual journal search of Malaysian healthrelated journals; (3) A targeted search of Google and Google Scholar; (4) Searching of Malaysian institutional repositories; (5) Searching of Ministry of Health and Clinical Research Centre website. The publication years were limited to 2000- 2013. The citations were imported or manually entered into bibliographic software Refworks. After removing duplicates, and correcting data entry errors, PubMed's Medical Subject Headings (MeSH terms) were added. Clinical research is coded using the definition "patient-oriented-research or research conducted with human subjects (or on material of human origin) for which the investigator directly interacts with the human subjects at some point during the study." A bibliography of citations [n=2056] that fit the criteria of clinical research in Malaysia in selected topics within five domains was generated: Cancers [589], Cardiovascular diseases [432], Infections [795], Injuries [142], and Mental Health [582]. This is done by retrieving citations with the appropriate MESH terms, as follow: For cancers (Breast Neoplasms; Colorectal Neoplasms; Uterine Cervical Neoplasms), for cardiovascular diseases (Coronary Disease; Hypertension; Stroke), for infections (Dengue; Enterovirus Infections, HIV Infections; Malaria; Nipah Virus; Tuberculosis), for injuries (Accidents, Occupational; Accidents, Traffic; Child Abuse; Occupational Injuries), for mental health (Depression; Depressive Disorder; Depressive Disorder, Major; Drug Users; Psychotic Disorders; Suicide; Suicide, Attempted; Suicidal Ideation; Substance- Related Disorders).
Anhedonia among patients with Major Depressive Disorder: A comparison between patients on escitalopram and healthy controls

Ng CG, Wong SK, Loh HS, Yee A

Clin Ter, 2014;165(6):e384-90.
PMID: 25524191 DOI: 10.7417/CT.2014.1778

BACKGROUND AND AIMS: Escitalopram has widely been recognized as one of the most frequently used antidepressants, with superior tolerability and great efficacy in preventing major depressive disorder (MDD) relapse and recurrence. However, anhedonia, which is a core symptom of MDD, remains difficult to treat. This study investigates the hedonic levels of MDD patients treated with Escitalopram.

MATERIALS AND METHODS: A total of 108 participants, 26 of whom with MDD on Escitalopram, were recruited in this cross sectional study. They were evaluated using the Snaith-Hamilton Pleasure Scale (SHAPS) and Beck Depression Inventory (BDI) questionnaires to assess their hedonic state, general mental health condition and level of depression.

RESULTS: Our study shows that most items in the SHAPS scores are significantly different between MDD patients on Escitalopram and the controls.

CONCLUSIONS: The hedonic capacity remains different between the two groups despite patients with MDD are put on Escitalopram treatment. Escitalopram fails to alleviate the hedonic state of MDD patients. Antidepressants that improve both depressive symptoms and hedonic states should be considered when treating MDD patients in clinical settings.

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