Displaying publications 1 - 20 of 27 in total

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  1. Ng SH
    Asian Bioeth Rev, 2022 Jan 15.
    PMID: 35069882 DOI: 10.1007/s41649-021-00198-8
    Malaysia hosts a significant number of refugees, asylum-seekers and migrant workers. Healthcare access for these individuals has always proved a challenge: language barriers, financial constraints and mobility restrictions are some of the frequently cited hurdles. The COVID-19 pandemic has exacerbated these existing inequalities, with migrants and refugees bearing the brunt of chronic systemic injustices. Providing equitable healthcare access for all, regardless of their citizenship and social status remains an ethical challenge for healthcare providers, particularly within the framework of a resource-limited healthcare system. Inclusive healthcare and socio-economic policies are necessary to ensure every individual's equal opportunity to attain good health. The collective experiences of refugees and migrants in the pursuit of healthcare, as highlighted by the two cases described, showcases the importance of equity in healthcare access and the detrimental implications of non-inclusive healthcare and socio-economic policies.
  2. Ng SH, Roshan S
    Med J Malaysia, 2018 12;73(6):410-412.
    PMID: 30647216
    Kawasaki disease is an autoimmune disease that commonly affects children below the age of 5 years. It is a vasculitic disease of unknown aetiology effecting the skin, eyes, lymph nodes and mucosal layer. Intravenous Immunoglobulin (IVIG) and aspirin therapy are the mainstay treatment however a number of cases have been shown to be refractory to this treatment. Evidence regarding approach and treatment for such cases is limited. This case report is to share our experience in the management of Refractive Kawasaki disease at a district level.
  3. Ng SH, Lang BH
    World J Surg Oncol, 2013;11:83.
    PMID: 23566353 DOI: 10.1186/1477-7819-11-83
    Parathyroid carcinoma is a rare endocrine malignancy, accounting for less than 1% of cases of primary hyperparathyroidism. Patient-related factors such as age and sex, as well as the biological features and management of the cancer, influence mid-term and long-term survival. We report a case of a young man with an unusual presentation of parathyroid carcinoma. The patient presented with left thigh swelling, which had been present for 6 months without other symptoms of hypercalcemia. On computed tomography scan a hypodense lesion, 30 × 20 × 20 mm in size, was seen in the posterior thyroid. There was no evidence of cervical lymphadenopathy or local infiltration. On a Sestamibi scan, a hot spot was seen in the lower pole of left thyroid lobe. Cervical neck exploration was performed. The patient subsequently underwent surgery and a parathyroid tumor was excised. The tumor was adherent to the thyroid capsule, but there was no evidence of invasion. After surgery, the patient's calcium and parathyroid hormone levels normalized, but histology confirmed parathyroid carcinoma with capsular and vascular invasion. The patient was offered reoperation, but declined, and developed recurrent parathyroid carcinoma 2 years later. In this report, we aim to present the challenges in managing parathyroid carcinoma and discuss factors that might contribute to future locoregional recurrences. This case also highlighted several issues, including the challenge of ascertaining the diagnosis before surgery and the dilemma of reoperation after simple excision.
  4. Choy YC, Lim WL, Ng SH
    Med J Malaysia, 2007 Oct;62(4):299-302.
    PMID: 18551933 MyJurnal
    The main goal of perioperative transfusion is to reduce the morbidity and mortality associated with inadequate delivery of oxygen to the tissues during surgery. In this audit, the primary trigger for transfusion was clinical anaemia assessed by examination of a patient's conjunctiva [40.7%] followed by estimation of blood loss of greater 20% of total blood volume [29.3%]. Haemoglobin estimation in the operation theater was not done in 45.9% of studied patients and only 7.8% patients had transfusion based on this criteria. A common practice is to transfuse blood for hypovolaemia. This was the indication for blood transfusion in 96 patients (7.8%). Inappropriate use of blood in this way has led to wastage of a valuable resource and exposed patients to potential risks of unwanted side effects. Analysis of haemoglobin estimation at recovery room showed 32% of patient with co-morbidities had Hb > 10 gm% while 65% and 29.5% of patients without co-morbidities had Hb > 8 gm% and 10 gm% respectively. This reflects the practice of anaesthetists in maintaining a target of Hb of 10 gm% for both groups of patients while a target of 8 gm% is still relatively safe for patients with good cardiovascular reserves. This has resulted in signifant use of homologous blood which will certainly burden the blood bank and increase the cost of healthcare.
  5. Kadirvelu A, Sadasivan S, Ng SH
    PMID: 23226028 DOI: 10.2147/DMSO.S37183
    Coping with type II diabetic patients is increasingly posing large financial burdens, sorely felt especially by growing economies. Self-management has been found to be an effective approach towards maintaining good control in diabetics. However, although efforts at implementing self-management have had initial success, there has been a lack of sustainability. This review examines the different components impinging on self-care among type II diabetic patients. These include the critical role of social support, the need for support from health care providers, the value of support from family and friends, the influence of sex and cultural factors in self-care behavior, the benefits of peer support, and the role of literacy in diabetes self-care. Despite the mounting evidence for the effectiveness of social support in diabetes care, and the various stakeholders including this in their clinical guidelines, there has only been a lukewarm response from policy-makers towards ensuring its implementation. Hence, more effort is required from health care providers in moving away from just understanding the effects of new drugs and subsequently putting their patients on these drugs, and going back to the basics of communicating with the patients, understanding their woes, and helping to motivate/empower their patients. This paper analyzes the various components of social support, their influence on diabetes self-care, and how health care providers can help in this process.
  6. Eng JB, Hooi LN, Ng SH
    Med J Malaysia, 1999 Mar;54(1):125-7.
    PMID: 10972017
    Patients with upper airway obstruction from malignant disease are difficult to manage. A 62 year old patient presented with stridor and was found to have an upper tracheal tumour. Bronchoscopy, dilatation and stenting were performed successfully. The techniques and indications for the use of dynamic airway stent are discussed.
  7. Ng SH, Tay JS, Lai EL
    BMJ Case Rep, 2021 May 24;14(5).
    PMID: 34031075 DOI: 10.1136/bcr-2020-240611
    IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterised by dense lymphoplasmacytic infiltration rich in IgG4-positive plasma cells, storiform fibrosis and obliterative phlebitis. Serum IgG4 levels are typically elevated but half of the patients had normal serum IgG4 levels. IgG4-RD represents a spectrum of diseases that involve various organs such as the pancreas, liver, kidneys, and salivary glands often manifesting as diffuse organ enlargement or a mass-like lesion mimicking cancer. An increased incidence of malignancy among patients with IgG4-RD has been reported. Thus, differentiating malignancy from IgG4-RD manifestation is important as the treatment differs. Glucocorticoids are considered first-line therapy and should be started early to prevent fibrosis. Patients usually have an excellent clinical response to steroids, and poor steroid response is indicative of an alternative diagnoses such as malignancy. This case report describes a case of IgG4-RD with renal mass in a young man that resolved with glucocorticoid therapy alone.
  8. Ng SH, Woi PM, Basri M, Ismail Z
    J Nanobiotechnology, 2013;11:27.
    PMID: 24059593 DOI: 10.1186/1477-3155-11-27
    Palm oil esters (POEs) are esters derived from palm oil and oleyl alcohol have great potential in the cosmetic and pharmaceutical industries due to the excellent wetting behavior of the esters without the oily feel. The role of oil-in-water nanoemulsions loaded with tocotrienol sedimentation behavior was studied. LUMiFuge® 116 particle separation analyzer was used to investigate the sedimentation behavior of POEs/tocotrienol/xanthan gum nanoemulsion system during centrifugation. Analyzing the sedimentation kinetics of dispersions in a centrifugal field also yields information about the rheological behavior and structural stability.
  9. Zaidi ST, Hassan Y, Postma MJ, Ng SH
    Pharm World Sci, 2003 Dec;25(6):299-302.
    PMID: 14689820
    To analyse clinical pharmacists interventions in the ICU of the Penang General Hospital (Penang, Malaysia) and to assess the pharmaco-economic impact of these interventions.
  10. Er HM, Nadarajah VD, Ng SH, Wong AN
    Korean J Med Educ, 2020 Sep;32(3):185-195.
    PMID: 32723985 DOI: 10.3946/kjme.2020.166
    PURPOSE: Direct student involvement in quality processes in education has been suggested to encourage shared responsibilities among faculty and students. The objectives of this study were to explore undergraduate health professions students' understanding of quality assurance (QA) in education, and identify the challenges and enablers for student involvement in an Asian context.

    METHODS: Twenty semi-structured interviews were conducted among medical, dentistry, and pharmacy students in a Malaysian University. The interviews were audio-recorded, transcribed verbatim, and thematically analyzed to understand the students' perspectives of QA in education.

    RESULTS: The participants recognized the importance of QA towards ensuring the quality of their training, which will consequently impact their work readiness, employability, and quality of healthcare services. Academic governance, curriculum structure, content and delivery, faculty and student quality, teaching facilities, and learning resources were indicated as the QA areas. The challenges for students' involvement included students' attitude, maturity, and cultural barrier. To enhance their buy-in, clear objectives and impact, efficient QA mechanism, and recognition of students' contribution had been suggested.

    CONCLUSION: The findings of this study support student-faculty partnership in QA processes and decision making.

  11. Tan L, Ng SH, Omar A, Karupaiah T
    Child Obes, 2018 07;14(5):280-290.
    PMID: 29985649 DOI: 10.1089/chi.2018.0037
    BACKGROUND: Unhealthy food marketing to children is a key risk factor for childhood obesity. Online video platforms have surpassed television as the primary choice for screen viewing among children but the extent of food marketing through such media is relatively unknown. We aimed to examine food and beverage advertisements (ads) encountered in YouTube videos targeting children in Malaysia.

    METHODS: The social media analytics site SocialBlade.com was used to identify the most popular YouTube videos (n = 250) targeting children. Ads encountered while viewing these videos were recorded and analyzed for type of product promoted and ad format (video vs. overlay). Food and beverage ads were further coded based on food category and persuasive marketing techniques used.

    RESULTS: In total 187 ads were encountered in sampled videos. Food and beverage ads were the most common at 38% (n=71), among which 56.3% (n = 40) promoted noncore foods. Ads for noncore foods were more commonly delivered as video rather than overlay ads. Among ads promoting noncore foods, the most commonly employed persuasive marketing techniques found were taste appeal (42.3%), uniqueness/novelty (32.4%), the use of animation (22.5%), fun appeal (22.5%), use of promotional characters (15.5%), price (12.7%), and health and nutrition benefits (8.5%).

    CONCLUSIONS: Similar to television, unhealthy food ads predominate in content aimed toward children on YouTube. Policies regulating food marketing to children need to be extended to cover online content in line with a rapidly-evolving digital media environment. Service providers of social media can play a part in limiting unhealthy food advertising to children.

  12. Sii HL, Ng SH, Wong VF, Law WC
    Acta Neurol Taiwan, 2023 Dec 30;32(4):207-211.
    PMID: 37723913
    PURPOSE: Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 vaccine administration is very rare. Early recognition of GBS at early stage could prevent extensive nerve damage with potential respiratory and autonomic failure.

    CASE REPORT: We report a case of paraparetic spectrum of GBS in a 53-year-old lady who presented with rapidly progressive acute flaccid paralysis involving both lower extremities with areflexia eight days after the first dose of Sinovac vaccine for SARS-CoV-2 in Malaysia. Cerebrospinal fluid (CSF) albuminocytological dissociation was seen and nerve conduction study (NCS) revealed sensory neuropathy. The diagnosis of GBS was made based on the Brighton criteria. Patient responded well to intravenous immunoglobulin (IVIG).

    CONCLUSION: Though there is currently no convincing evidence of any causation between GBS and SARS- CoV-2 vaccination, clinicians should remain vigilant and consider GBS in the differential diagnosis for patient who presents with weakness with reduced or absent deep tendon reflex after vaccination against SARS-CoV-2.

  13. Ng SH, Wong KP, Lang BH
    J Thyroid Res, 2012;2012:946276.
    PMID: 22970410 DOI: 10.1155/2012/946276
    An increasing elderly population, a rising incidence of differentiated thyroid carcinoma (DTC), and a rising incidence of benign nodular disease with age are all contributing to a rise in thyroid operations for the elderly. Literature review on the outcome and safety of thyroid surgery in elderly patients has been filled with conflicting results and this subject remains controversial. Although most single-institution studies conducted by high-volume surgeons did not find significant differences of complication rates in elderly when compared with younger cohorts, they often lacked the power necessary to identify subtle differences and suffered from various selection and referral biases. Recent evidence from large population-based studies concluded that thyroid surgery in the elderly was associated with higher complication rates. One of the major contributing factors for the increased complication rate was because most elderly patients suffered from many preexisting comorbidities. Therefore, elderly patients who have abnormal thyroid findings should complete a thorough preoperative workup and better postoperative care after undergoing any thyroid surgery. Furthermore, these high-risk patients would benefit if they could be referred to high-volume, specialized surgical units early. In this systemic review, we aimed to evaluate different issues and controversies in thyroidectomy for elderly patients.
  14. Ng SH, Mohd Zain MS, Zakaria F, Wan Ishak WR, Wan Ahmad WA
    Biomed Res Int, 2015;2015:214918.
    PMID: 26682215 DOI: 10.1155/2015/214918
    Pleurotus sajor-caju (PSC) is an edible oyster mushroom featuring high nutritional values and pharmacological properties. Objective. To investigate the hypoglycemic and antidiabetic effects of single and repeated oral administration of PSC aqueous extract in normal and diabetic rats.
  15. Ng SH, Kelly B, Se CH, Chinna K, Sameeha MJ, Krishnasamy S, et al.
    Glob Health Action, 2014 Dec;7(1):25169.
    PMID: 28672562 DOI: 10.3402/gha.v7.25169
    Background Food advertising on television (TV) is well known to influence children's purchasing requests and models negative food habits in Western countries. Advertising of unhealthy foods is a contributor to the obesogenic environment that is a key driver of rising rates of childhood obesity. Children in developing countries are more at risk of being targeted by such advertising, as there is a huge potential for market growth of unhealthy foods concomitant with poor regulatory infrastructure. Further, in developing countries with multi-ethnic societies, information is scarce on the nature of TV advertising targeting children. Objectives To measure exposure and power of TV food marketing to children on popular multi-ethnic TV stations in Malaysia. Design Ethnic-specific popular TV channels were identified using industry data. TV transmissions were recorded for each channel from November 2012 to August 2013 (16 hr/day) for randomly selected weekdays and weekend days during normal days and repeated during school holidays (n=88 days). Coded food/beverage advertisements were grouped into core (healthy), non-core (non-healthy), or miscellaneous (unclassified) food categories. Peak viewing time (PVT) and persuasive marketing techniques were identified. Results Non-core foods were predominant in TV food advertising, and rates were greater during school holidays compared to normal days (3.51 vs 1.93 food ads/hr/channel, p<0.001). During normal days' PVT, the ratio of non-core to core food advertising was higher (3.25 food ads/hr/channel), and this more than trebled during school holidays to 10.25 food ads/hr/channel. Popular channels for Indian children had the lowest rate of food advertising relative to other ethnic groups. However, sugary drinks remained a popular non-core product advertised across all broadcast periods and channels. Notably, promotional characters doubled for non-core foods during school holidays compared to normal days (1.91 vs 0.93 food ads/hr/channel, p<0.001). Conclusions This study highlights non-core food advertising, and predominantly sugary drinks are commonly screened on Malaysian TV channels. The majority of these sugary drinks were advertised by multinational companies, and this observation warrants regulatory attention.
  16. Ng SH, Kelly B, Se CH, Sahathevan S, Chinna K, Ismail MN, et al.
    BMC Public Health, 2015;15:1047.
    PMID: 26459341 DOI: 10.1186/s12889-015-2392-z
    Television food advertising (TVFA) is the most dominant medium in the obesogenic environment promoting unhealthy food choices in children.
  17. Hawkes F, Manin BO, Ng SH, Torr SJ, Drakeley C, Chua TH, et al.
    Parasit Vectors, 2017 Jul 18;10(1):338.
    PMID: 28720113 DOI: 10.1186/s13071-017-2277-3
    BACKGROUND: Plasmodium knowlesi is found in macaques and is the only major zoonotic malaria to affect humans. Transmission of P. knowlesi between people and macaques depends on the host species preferences and feeding behavior of mosquito vectors. However, these behaviours are difficult to measure due to the lack of standardized methods for sampling potential vectors attracted to different host species. This study evaluated electrocuting net traps as a safe, standardised method for sampling P. knowlesi vectors attracted to human and macaque hosts. Field experiments were conducted within a major focus on P. knowlesi transmission in Malaysian Borneo to compare the performance of human (HENET) or macaque (MENET) odour-baited electrocuting nets, human landing catches (HLC) and monkey-baited traps (MBT) for sampling mosquitoes. The abundance and diversity of Anopheles sampled by different methods were compared over 40 nights, with a focus on the P. knowlesi vector Anopheles balabancensis.

    RESULTS: HLC caught more An. balabacensis than any other method (3.6 per night). In contrast, no An. balabacensis were collected in MBT collections, which generally performed poorly for all mosquito taxa. Anopheles vector species including An. balabacensis were sampled in both HENET and MENET collections, but at a mean abundance of less than 1 per night. There was no difference between HENET and MENET in the overall abundance (P = 0.05) or proportion (P = 0.7) of An. balabacensis. The estimated diversity of Anopheles species was marginally higher in electrocuting net than HLC collections, and similar in collections made with humans or monkey hosts.

    CONCLUSIONS: Host-baited electrocuting nets had moderate success for sampling known zoonotic malaria vectors. The primary vector An. balabacensis was collected with electrocuting nets baited both with humans and macaques, but at a considerably lower density than the HLC standard. However, electrocuting nets were considerably more successful than monkey-baited traps and representatively characterised anopheline species diversity. Consequently, their use allows inferences about relative mosquito attraction to be meaningfully interpreted while eliminating confounding factors due to trapping method. On this basis, electrocuting net traps should be considered as a useful standardised method for investigating vector contact with humans and wildlife reservoirs.

  18. Ng SH, Robert SD, Wan Ahmad WA, Wan Ishak WR
    Food Chem, 2017 Jul 15;227:358-368.
    PMID: 28274444 DOI: 10.1016/j.foodchem.2017.01.108
    The purpose of this study was to determine the effects of Pleurotus sajor-caju (PSC) powder addition at 0, 4, 8 and 12% levels on the nutritional values, pasting properties, thermal characteristics, microstructure, in vitro starch digestibility, in vivo glycaemic index (GI) and sensorial properties of biscuits. Elevated incorporation levels of PSC powder increased the dietary fibre (DF) content and reduced the pasting viscosities and starch gelatinisation enthalpy value of biscuits. The addition of DF-rich PSC powder also interfered with the integrity of the starch granules by reducing the sizes and inducing the uneven spherical shapes of the starch granules, which, in turn, resulted in reduced starch susceptibility to digestive enzymes. The restriction starch hydrolysis rate markedly reduced the GI of biscuits. The incorporation of 8% PSC powder in biscuits (GI=49) could be an effective way of developing a nutritious and low-GI biscuit without jeopardizing its desirable sensorial properties.
  19. Ng SH, Babar MG, Ahmed SI, Hasan SS, Yang WY
    J Eval Clin Pract, 2024 Mar;30(2):153-161.
    PMID: 37641432 DOI: 10.1111/jep.13913
    AIM: Empathic behaviour has a direct link to the positive clinical outcomes. Health professionals, which include dietitians, are increasingly expected to demonstrate the impact of their care on patient outcomes. To date, there is limited research exploring the empathic behaviour of dietetics students.

    METHODS: This cross-sectional study evaluated the psychometric properties of Jefferson Scale of Empathy-Healthcare Provider Student (JSE-HPS) and empathic behaviour of dietetics students.

    RESULTS: Undergraduate dietetics students from one private and two public universities in Malaysia participated (n = 455). Item and scale psychometric properties were examined using principal component analysis and differences in mean empathy scores for students were assessed across years of study and types of universities. A 3-factor solution emerged in the results, accounting for 26.76%, 10.75% and 6.3% of the variance. The JSE-HPS demonstrated good internal consistency (α = 0.83). Despite students enroled at public universities scoring higher mean empathy scores than students enroled at the private university, the difference was not significant. The only significant difference was between the empathy level of first and third year students (p = 0.033).

    CONCLUSION: As empathy underpins patient-centred management in the nutrition care process, it should be well integrated into curriculum delivery so that appropriate levels of empathy can be developed to prepare work-ready healthcare professionals.

  20. Alenichev A, Suwalowska H, Faure MC, Ng SH, Modlin C, Ambrogi I, et al.
    Wellcome Open Res, 2023;8:191.
    PMID: 38313470 DOI: 10.12688/wellcomeopenres.19346.2
    In recent years, the global health community has increasingly reported the problem of 'invisibility': aspects of health and wellbeing, particularly amongst the world's most marginalized and impoverished people, that are systematically overlooked and ignored by people and institutions in relative positions of power. It is unclear how to realistically manage global health invisibility within bioethics and other social science disciplines and move forward. In this letter, we reflect on several case studies of invisibility experienced by people in Brazil, Malaysia, West Africa and other transnational contexts. Highlighting the complex nature of invisibility and its interconnectedness with social, political and economic issues and trends, we argue that while local and targeted interventions might provide relief and comfort locally, they will not be able to solve the underlying causes of invisibility. Building from the shared lessons of case study presentations at an Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative (GLIDE), we argue that in dealing with an intersectional issue such as invisibility, twenty-first century global health bioethics could pursue a more 'disturbing' framework, challenging the narrow comforting solutions which take as a given the sociomaterial inequalities of the status quo. We highlight that comforting and disturbing bioethical frameworks should not be considered as opposing sides, but as two approaches working in tandem in order to achieve the internationally set global health milestones of providing better health and wellbeing for everyone. Insights from sociology, anthropology, postcolonial studies, history, feminist studies and other styles of critical reasoning have long been disturbing to grand narratives of people and their conditions. To rediscover the ethos of the WHO Alma Ata Declaration-a vision of "health for all by the year 2000"-these thinking tools will be necessary aids in developing cooperation and support beyond the narrow market logic that dominates the landscape of contemporary global health.
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