MyMedR

Medical physics in 2020: will we still be relevant?

Ng KH

Australas Phys Eng Sci Med, 2008 Jun;31(2):85-9.

From the time when Roentgen and other physicists made the discoveries which led to the development of radiology, radiotherapy and nuclear medicine, medical physicists have played a pivotal role in the development of new technologies that have revolutionized the way medicine is practiced today. Medical physicists have been transforming scientific advances in the research laboratories to improving the quality of life for patients; indeed innovations such as computed tomography, positron emission tomography and linear accelerators which collectively have improved the medical outcomes for millions of people. In order for radiation-delivery techniques to improve in targeting accuracy, optimal dose distribution and clinical outcome, convergence of imaging and therapy is the key. It is timely for these two specialties to work closer again. This can be achieved by means of cross-disciplinary research, common conferences and workshops, and collaboration in education and training for all. The current emphasis is on enhancing the specific skill development and competency of a medical physicist at the expense of their future roles and opportunities. This emphasis is largely driven by financial and political pressures for optimizing limited resources in health care. This has raised serious concern on the ability of the next generation of medical physicists to respond to new technologies. In addition in the background loom changes of tsunami proportion. The clearly defined boundaries between the different disciplines in medicine are increasingly blurred and those between diagnosis, therapy and management are also following suit. The use of radioactive particles to treat tumours using catheters, high-intensity focused ultrasound, electromagnetic wave ablation and photodynamic therapy are just some areas challenging the old paradigm. The uncertainty and turf battles will only explode further and medical physicists will not be spared. How would medical physicists fit into this changing scenario? We are in the midst of molecular revolution. Are we prepared to explore the newer technologies such as nanotechnology, drug discovery, pre-clinical imaging, optical imaging and biomedical informatics? How are our curricula adapting to the changing needs? We should remember the late Professor John Cameron who advocated imagination and creativity - these important attributes will make us still relevant in 2020 and beyond. To me the future is clear: "To achieve more, we should imagine together."

Fulltext Lingual haematoma: yet another unusual cause of upper airway obstruction

Ng KP

Med J Malaysia, 1998 Mar;53(1):112-4.

PMID: 10968150

An episode of acute upper airway obstruction was caused by a lingual haematoma, when a patient with end stage renal failure suffered a hypocalcaemic fit and bit his tongue. The large haematoma and profuse bleeding caused the patient to obstruct and become hypoxic, and rendered laryngoscopy and intubation impossible, requiring an urgent tracheostomy to secure the airway.

Fulltext Day surgery: a post operative audit

Ng KP

Med J Malaysia, 1997 Sep;52(3):269-73.

PMID: 10968097

Fifty-five patients were followed up after day surgery for breast lumpectomy. It was found that local infiltration with bupivacaine significantly decreased analgesic requirement in recovery. Almost half of the patients could not be contacted during the 24 hour post-operative follow-up by telephone. 7.1% complained of severe pain despite oral analgesics. 14.3% of patients had queries regarding wound care and 78.6% of the patients were willing to undergo day surgery again. Ongoing patient education and good post operative analgesia are crucial to enable successful establishment of ambulatory surgery. Post-operative follow-up is encouraged to audit clinical and social outcomes of day surgery.

Fulltext Peptide regulatory factors. Intercellular signalling molecules regulating tissue (re) modelling

Ng KW

Med J Malaysia, 1992 Mar;47(1):3-10.

PMID: 1387446

Microwave ovens: mapping the electrical field distribution

Ng KH

Med Lab Sci, 1991 Jul;48(3):189-92.

PMID: 1787775

Uniformity of electric field intensity of microwaves within the microwave oven cavity is necessary to ensure even load-heating, and is particularly important in pathology procedures where small volume irradiation is carried out. A simple and rapid method for mapping electric field distribution, using reversible thermographic paint, is described. Spatial heating patterns for various positions, and the effects of introducing dummy loads to modify heating distributions, have been obtained for a dedicated microwave processor, and comparison made with a domestic microwave oven.

Amnioscopy in patients with bad obstetric history and high risk pregnancies

Ng KH

Med J Malaya, 1971 Sep;26(1):59-61.

PMID: 4258578

The modern treatment of Bartholin cyst and abscess

Ng KH

Med J Malaya, 1970 Dec;25(2):120-2.

PMID: 4251132

Simple instrument for ascending urethrography in males

Ng KK

Med J Malaysia, 1972 Jun;26(4):291-292.

PMID: 35158510

No abstract available.

Fulltext Exploring new frontiers of electronic publishing in biomedical science

Ng KH

Singapore Med J, 2009 Mar;50(3):230-4.

PMID: 19352562

Publishing is a hallmark of good scientific research. The aim of publishing is to disseminate new research knowledge and findings as widely as possible in a timely and efficient manner. Scientific publishing has evolved over the years with the advent of new technologies and demands. This paper presents a brief discussion on the history and status of electronic publishing. The Open Access Initiative was created with the aim of overcoming various limitations faced by traditional publishing access models. Innovations have opened up possibilities for electronic publishing to increase the accessibility, visibility, interactivity and usability of research. A glimpse of the future publishing landscape has revealed that scientific communication and research will not remain the same. The internet and advances in information technology will have an impact on the research landscape, scholarly publishing, research policy and funding, dissemination of knowledge, and the progress of science as a whole.

Medical physics is alive and well and growing in South East Asia

Ng K, Pirabul R, Peralta A, Soejoko D

Australas Phys Eng Sci Med, 1997 Mar;20(1):27-32.

PMID: 9141310

In recent years there has been a significant economic growth in South East Asia, along with it a concurrent development of medical physics. The status of four countries--Malaysia, Thailand, the Philippines and Indonesia are presented. Medical physicists in these countries have been experiencing the usual problems of lack of recognition, low salaries, and insufficient facilities for education and training opportunities. However the situation has improved recently through the initiative of local enthusiastic medical physicists who have started MS graduate programs in medical physics and begun organizing professional activities to raise the profile of medical physics. The tremendous support and catalytic roles of the American Association of Physicists in Medicine (AAPM) and international organizations such as International Organization for Medical Physics (IOMP), International Atomic Energy Agency (IAEA), World Health Organization (WHO), and International Center for Theoretical Physics (ICTP) have been instrumental in achieving progress. Contributions by these organizations include co-sponsorship of workshops and conferences, travel grants, medical physics libraries programs, and providing experts and educators. The demand for medical physicists is expected to rise in tandem with the increased emphasis on innovative technology for health care, stringent governmental regulation, and acceptance by the medical community of the important role of medical physicists.

Dystocia caused by congenital hydronephrosis

Ng KH, Sivanesan S

Med J Malaysia, 1973 Dec;28(2):118-9.

PMID: 4276267

Fulltext Anthropometry, dietary patterns and nutrient intakes of Malaysian estate workers

Chee S, Zawiah H, Ismail M, Ng K

Malays J Nutr, 1996 Sep;2(2):112-26.

PMID: 22692134 MyJurnal

Studies were carried out in two estates in Kedah and Johor to characterize the anthropometry and dietary patterns of 334 (169 females, 165 males) Malaysian estate workers. Subjects were Malay and Indian adults (aged 18 to 60 years) engaged in various work activities including rubber tappers, palm fruit harvesters, field supervisors and workers in the estate factories. Anthropometric results showed that the prevalence of overweight (26% in men, 25% in women) and obesity (5% in men, 11% in women) were higher compared to prevalence of underweight (11% in men, 9% in women) in these workers despite being engaged in moderate to heavy activities. The dietary intake pattern revealed that the main sources of calories in the diet were rice, cooking oil and sugar. Major sources of protein in the Malay diet were anchovies and fish whilst in the Indian diet protein was provided by salted fish, anchovies, eggs, fish, and pulses. The consumption of poultry, meat and dairy products were low for both ethnic groups. The dietary intakes of a subsampel of 108 normal weight subjects (56 females, 52 males) were recorded for 3 days. The results showed that the mean energy intake was 8.44 ± 2.12 MJ in males and 6.48 ± 1.29 MJ in females. The contribution of calories from protein, fat and carbohydrate were 13%, 22% and 60% in males and 12%, 23% and 65% in females, respectively. Alcohol intake was found to contribute five percent of energy in the diet of the Indian male subjects. Calcium, iron, vitamin A, thiamin, riboflavin and niacin intake were below 66% of the Malaysian RDA, particularly amongst the women. Income appeared to have a significant correlation with energy and iron intakes of the female workers as well as thiamin, niacin and riboflavin intakes of the male workers. There is a need for improving the quality of the dietary intakes of these workers as well as nutrition education on the prevention of obesity and its consequences.

Fulltext DietPLUS- a User-friendly '2 in 1' Food Composition Database and Calculator of Nutrient Intakes

Tony Ng KW

Malays J Nutr, 2010 Apr;16(1):125-30.

PMID: 22691859 MyJurnal

The teaching and research tool called 'DietPLUS', developed by the present author at an institution of higher learning in 2007, contains nutrient information of 840 food items in Excel format. DietPLUS functions as a '2-in-1' food composition database plus a rapid calculator of nutrient intakes, with the option of 'collapsing' the food composition face leaving only the nutrient calculator face. The macronutrients featured in the programme are energy, protein, fat, carbohydrates, dietary fibre, sugars (intrinsic + added), polyunsatuared omega-6 fatty acids (mainly linoleic acid, LA) and polyunsaturated omega-3 fatty acids [alphalinolenic acid (ALA) or eicosapentaenic acid (EPA) + docosahexaenolic acid (DHA)]. The micronutrients in the programme are vitamin A (as retinol equivalents, RE), vitamin C, thiamin (vitamin B1), riboflavin (vitamin B2), and niacin. Cholesterol content was included to complete the list of food components tabled. Food items consumed are converted into gram quantities (edible portion) and are entered in one column in the Excel programme which emphasises the simplicity and user-friendliness of the present nutrient calculator. DietPLUS instantaneously sums up the macronutrients and micronutrients consumed with each subsequent entry. Macronutrients (protein, fat, carbohydrate, sugars and dietary fibre) consumed are presented as gram quantities and a percentage of the Recommended Nutrient Intakes for Malaysia 2005. An approximate number of servings are also provided for vegetables, fruits, legumes, fish and meat, which may be useful in meal planning and nutrition/dietetic counselling.

Fulltext Physicochemical, pasting and gel textural properties of wheat-ripe Cavendish banana composite flours

Ng, K. F., Abbas, F. M. A., Tan, T. C., Azhar, M. E.

International Food Research Journal, 2014;21(2):655-662.

MyJurnal

Proximate composition, pH and amylose content of ripe Cavendish banana flour (RBF) prepared in this study were compared with all-purpose wheat flour (WF). RBF was found to be significantly (P < 0.05) higher in total carbohydrates and minerals content, while significantly (P < 0.05) lower in protein and fat contents compared with those of WF. Wheat-ripe banana composite flours (W-RBF) prepared by partial substitution of WF with RBF were assessed for swelling power, solubility, pasting properties and gel textural properties. Granular swelling of RBF occurred at a higher temperature compared to that of WF, suggesting that more energy and water were required to cook WF-RBF as the presence of soluble carbohydrates would compete for water and this would eventually delay starch hydration and granular expansion during cooking. Higher substitution with RBF led to higher soluble carbohydrates content, and increase in solubility index of WF-RBF. Partial substitution with RBF also resulted in significant (P < 0.05) decrease in pasting properties. A higher substitution of WF with RBF could reduce starch gelatinisation during cooking and retrogradation owing to the reduction of available starch in WF-RBF. All WF-RBF gels were significantly (P < 0.05) firmer and less sticky compared to WF gels.

Prophylaxis against choriocarcinoma

Sivanesaratnam V, Ng KH

Med J Malaysia, 1977 Mar;31(3):229-31.

PMID: 904517

Fulltext (GTG)5-PCR analysis and 16S rRNA sequencing of bacteria from Sarawak aquaculture environment

Kathleen, M.M., Samuel, L., Felecia, C., Ng K. H., Lesley, M.B., Kasing, A.

International Food Research Journal, 2014;21(3):915-920.

MyJurnal

(GTG)5 PCR is a type of repetitive extragenic palindromic (rep)-PCR which amplifies the (GTG)5 repetitive element that lays throughout the bacterial genome. In this study, fifty, thirty-nine and forty-nine unknown bacteria were isolated from aquaculture farms in Miri, Limbang and Lundu, respectively. (GTG)5 PCR was used to screen for clonal diversity among the isolates according to sampling sites. Banding profiles obtained from electrophoresed (GTG)5 PCR products were analyzed by RAPDistance Software to generate a dendrogram of neighbor joining tree (NJT) format. Based on the constructed dendrogram, representative isolates were selected for further identification. Conserved 16S rRNA region of the selected bacteria isolates were amplified and purified DNA products were sequenced. (GTG)5 PCR is useful in differentiation of unknown bacterial isolates and 16S rRNA analysis species identity of the bacteria in Sarawak aquaculture environment. The high diversity of bacteria in aquaculture environment may be caused by contamination from various sources.

Fulltext Hepatitis B surface antigen subtypes in hepatitis B seropositive subjects in University Hospital, Kuala Lumpur

Ng KP, Saw TL

Med J Malaysia, 1999 Sep;54(3):352-7.

PMID: 11045062

Hepatitis B surface antigen can be serologically defined as ayw1, ayw2, ayw3, ayw4, ayr, adw2, adw4 and adrq+ or adrq-. A study of common HBsAg subtypes in 44 HBsAg reactive sera in University Hospital was conducted using a solid-phase sandwich EIA. Eleven samples were found not typable and among the 33 typable HBsAg reactive sera, 3 HBsAg subtypes: adw, adr and ayw were identified. Subtype adw was found in 66.7% (22/33) of the typable HBsAg reactive sera; 24.2% (8/33) was of subtype adr and 6.0% (2/33) of subtype ayw. One sample was found to be reactive to both adw and adr. HBsAg subtype adw was found more commonly in Chinese but among the Malays, HBsAg subtype adr appeared to predominate. However, the small sample size precludes firm conclusions on the predominant subtype among the Malays.

A survey of the current practice of obstetric anaesthesia and analgesia in Malaysia [correction of Malaysis]

Chan YK, Ng KP

J Obstet Gynaecol Res, 2000 Apr;26(2):137-40.

PMID: 10870307

OBJECTIVE: A survey covering 30% of the deliveries in Malaysia was done to determine the practice of obstetric anaesthesia and analgesia for 1996.

RESULTS: From the survey, it was found that the regional anaesthesia rate for caesarean section was 46% in the government hospitals compared to 29.2% in the private hospitals, with spinal anaesthesia being the most common regional anaesthetic technique used in both types of hospitals. The epidural rate for labour analgesia was only 1.5% overall for the country. Epidural analgesia services were available in all private hospitals whereas 17.6% of government hospitals surveyed did not offer this service at all.

CONCLUSIONS: Although the use of epidural analgesia for labour was low in Malaysia, the overall rate of regional anaesthesia for caesarean section (41.9%) is very much in keeping with the standards of safe practice recommended by the United Kingdom.

In the eyes of the beholder: what we see is not what we get

Abdullah BJ, Ng KH

Br J Radiol, 2001 Aug;74(884):675-6.

PMID: 11511489

A study of mean glandular dose during diagnostic mammography in Malaysia and some of the factors affecting it

Jamal N, Ng KH, McLean D

Br J Radiol, 2003 Apr;76(904):238-45.

PMID: 12711643

The primary objective of this study was to determine the mean glandular dose (MGD) during diagnostic mammography in Malaysia. The secondary objective was to evaluate some of the factors affecting MGD. A survey of standard MGD was performed, based upon quality control records for the period October 1999 to August 2001. This covered 30 mammography units from 9 manufacturers. MGD was also measured for a series of patients attending mammography examinations at three other mammography units. MGD per film was estimated from recorded radiographic factors, the compressed breast thickness (CBT) and X-ray unit calibration data. MGD per woman was calculated by summing the MGDs for all films, and averaging it over both breasts. 300 women drawn equally from three major ethnic groups, namely Malay, Chinese and Indian, took part in the study. The difference of MGD per woman between ethnic groups was tested for significance using non-parametric Kruskal-Wallis and median tests. The factors affecting MGD per woman were tested for significance using a multivariate analysis of variance. The MGD for the phantom was 1.23 mGy (range 0.22-2.39 mGy) while the mean patient based MGD per film was 1.54 mGy and 1.82 mGy for the craniocaudal and mediolateral oblique views, respectively. The mean MGD per woman was 3.37 mGy. It was also found that there is no significant difference in MGD per woman among the ethnic groups (p>0.05, Kruskal-Wallis test). However, on the multivariate test two factors, namely half value layer of the X-ray beam and (CBT), had a significant effect on MGD per woman (p<0.05). No significant relationships were seen between MGD per woman with respect to ethnicity, body mass index or age.

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