Displaying publications 1 - 20 of 60 in total

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  1. Ong TK
    Eur Endod J, 2017;2(1):1-6.
    PMID: 33403352 DOI: 10.14744/eej.2017.17035
    Objective: The purpose of this article was to report the finding of the disappearance of intracanal medication as a supporting evidence of vertical root fracture (VRF) through non-surgical intervention.

    Methods: A retrospective review of the dental records of patients seen by an endodontist in a private endodontic office from September 2013 to September 2016 was conducted by the same endodontist. Cases that met the inclusion and exclusion criteria were assigned as the subjects of this study, and data were extracted from their clinical and radiographic records. Patient's demographic features, pre-operative signs and symptoms, details of rendered clinical procedures, follow-up visits, clinical and radiographic findings were recorded. Seventeen teeth for which non-surgical exploratory re-treatment was initiated were included in this study. Calcium hydroxide-based intracanal medication was placed for 2-4 weeks. Obturation of the root canals was performed if the tooth showed improvement of clinical signs and symptoms. If not, a cone-beam computed tomography (CBCT) scan was proposed to the patient to rule out VRF.

    Results: After the non-surgical re-treatment was initiated, 13 teeth showed improvement of clinical symptoms and the re-treatment was therefore completed. The remaining 4 teeth presented with unresolved clinical presentations (deep pocket, presence of sinus tract and/or tender to percussion and palpation). Four teeth showed partial disappearance of intracanal medication where VRF was confirmed using CBCT in 3 teeth and with a conventional periapical (PA) radiograph in 1 tooth.

    Conclusion: The disappearance of intracanal medication during non-surgical intervention was often associated with VRF. Thus, this feature may serve as an aid in diagnosing VRF.

  2. Ong TK
    Eur Endod J, 2019;4(3):145-149.
    PMID: 32161902 DOI: 10.14744/eej.2019.03016
    A 27-year-old male patient complained of dental pain on previously root-treated tooth #17. Intentional replantation (IR) was performed. However, the symptoms returned at 10 months of follow-up, and a sinus tract was detected on the buccal gingiva of tooth #17. The patient refused extraction of the tooth and tooth was scheduled for non-surgical retreatment. Root canal retreatment was initiated with the removal of the previous root filling material while leaving the retrograde filling in situ. After 1 month of intracanal medication, the tooth became asymptomatic with complete healing of the sinus tract and the root canal filling was completed. Clinical and radiographic examination at 1 year follow-up revealed endodontic success with complete resolution of periapical radiolucency. This case report shows that non-surgical retreatment could be a viable alternative for failed IR.
  3. Ong TK, Harun N, Lim TW
    Eur Endod J, 2019;4(2):90-95.
    PMID: 32161894 DOI: 10.14744/eej.2019.13007
    In this case report, three teeth with complete or incomplete cemental tear in two patients were presented. Even though periapical radiograph could detect cemental tear in these three teeth, the cone-beam computed tomography scanning clearly revealed the pattern of the cemental tear, which was later confirmed by histopathological examination. Therefore, this case report shows the benefits of incorporating both cone-beam computed tomography and histopathological examination to diagnose cemental tear.
  4. Khoo A, Ho CK, Ong TK, Khairul A
    Singapore Med J, 1994 Dec;35(6):595-8.
    PMID: 7761883
    A descriptive study of 143 cases of clinically diagnosed measles in patients under the age of 12 years admitted to the Duchess of Kent Hospital, Sandakan, Sabah, during the year 1990 was carried out. The median age of the patients was one year and 13.3% of the cases were between the ages of 6 and 9 months. The male to female ratio was 1.3:1. The majority of the cases (85.3%) were not immunised against measles while 60.0% of the cases were malnourished. Most of the cases (86.0%) had at least one complication with 32.9% of the cases having more than one complications. The main complications were pneumonia (74.1%) and diarrhea (38.5%). Other complications were convulsions, otitis media and corneal ulceration/scarring. A case of pneumonia with mediastinal emphysema and subcutaneous emphysema was noted. The case fatality rate was 1.4% while blindness was the long term morbidity in 1.4% of the cases. Measles remains an important cause of morbidity in children in Sabah.
  5. Sim KH, Ong TK, Chin SP, Wong M
    Indian Heart J, 2007 Mar-Apr;59(2 Suppl B):B25-32.
    PMID: 19153433
  6. Ong TK, Lim GS, Singh M, Fial AV
    J Endod, 2020 Dec;46(12):1856-1866.e2.
    PMID: 32827507 DOI: 10.1016/j.joen.2020.08.016
    INTRODUCTION: The purposes of this review were to appraise the level of evidence of the existing regenerative endodontic therapy (RET) publications, perform a meta-analysis on the survival and healing rates of necrotic immature permanent teeth treated with RET, and run a meta-analysis on the quantitative assessment of the root development of those teeth.

    METHODS: Electronic searches were performed in Web of Science, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Library databases. Two authors independently screened the titles and abstracts for eligibility. The analyses were performed on the clinical outcomes (ie, survival, healing, and root development) of the procedure.

    RESULTS: Eleven articles were included in the qualitative and quantitative syntheses. Three studies were randomized controlled trials, 6 were prospective cohort studies, and 2 were retrospective cohort studies. The pooled survival and healing rates were 97.3% and 93.0%, respectively. The pooled rates of root lengthening, root thickening, and apical closure were 77.3%, 90.6%, and 79.1%, respectively. However, if 20% radiographic changes were used as a cutoff point, there were only 16.1% root lengthening and 39.8% root thickening.

    CONCLUSIONS: Within the limitations of the present study, it can be concluded that RET yielded high survival and healing rates with a good root development rate. However, clinical meaningful root development after RET was unpredictable.

  7. Tan CSY, Fong AYY, Jong YH, Ong TK
    Glob Heart, 2018 12;13(4):241-244.
    PMID: 30213574 DOI: 10.1016/j.gheart.2018.08.003
    BACKGROUND: Warfarin is an anticoagulant indicated for patients who had undergone mechanical heart valve(s) replacement (MHVR). In these patients, time in therapeutic range (TTR) is important in predicting the bleeding and thrombotic risks.
    OBJECTIVE: This study aimed to describe the anticoagulation control of warfarin using TTR in patients with MHVR in a tertiary health care referral Center.
    METHODS: Data were collected retrospectively by reviewing clinical notes of outpatients who attended international normalized ratio (INR) clinics in November 2015. Patients who had MHVR and who took warfarin were included. The data collected were demographics, relevant laboratory investigations, and patients' prior medical history. TTR was calculated using Rosendaal and traditional methods.
    RESULTS: A total of 103 patients with MHVR were recruited. The mean age was 51.72 ± 13.97 years and 46.6% were male. A total of 54.4% had mitral valve replacement (MVR), whereas 26.2% had aortic valve replacement (AVR). The mean TTR calculated using the Rosendaal method was 57.1%. There was no significant difference among patients with AVR, MVR, and both valves (AMVR) in terms of TTR (AVR vs. MVR vs. AMVR, 62.94 ± 23.08, 54.12 ± 21.62, 57.63 ± 17.47; p = 0.213). The average dose of warfarin for all groups was approximately 3 mg/day. Moreover, MVR, AVR, and AMVR patients who had TTR (Rosendaal method) ≤60% were 58.9%, 37.0%, and 45.0%, respectively. Only 4.8% had minor bleeding, whereas none had stroke in the period of TTR determination.
    CONCLUSIONS: Despite a majority of patients having <60% TTR, there were low incidences of bleeding and stroke events in this center. There were no factors found to be associated with INR control in this study.
    Study site: INR clinic, Sarawak Heart Centre, Sarawak General Hospital, Malaysia
  8. Or SY, Khaw YC, Hwang PX, Ong TK
    Malays Orthop J, 2017 Jul;11(2):60-63.
    PMID: 29021881 MyJurnal DOI: 10.5704/MOJ.1707.007
    Chronic sagittal band injury with tendon dislocation of the extensor digitorum communis in the hand often requires operative stabilization. Various surgical techniques have been reported to repair and reconstruct the sagittal band. Nonetheless, most of the techniques are technically demanding and require donor graft. In this case report, we report a novel surgical technique to centralize and stabilize the tendon by reattaching the radial sagittal band with anchor sutures. The advantages of this new technique are simple, no donor morbidity and stable repair to restore the normal biomechanics of the tendon. The patient was able to return to work in three months and no recurrent dislocation was noted at review two years after surgery.
  9. Ong TK, Lim D, Singh M, Fial AV
    J Evid Based Dent Pract, 2022 Dec;22(4):101722.
    PMID: 36494117 DOI: 10.1016/j.jebdp.2022.101722
    OBJECTIVES: The purpose of this review was to appraise the quality of evidence of the existing publications on IR, and to perform a meta-analysis on the treatment outcomes of IR.

    METHODS: The specific PIO questions were as follows: Population: Patients with periapical periodontitis either before or after non-surgical endodontic therapy.

    INTERVENTION: IR performed with retrograde preparation and retrograde filling.

    OUTCOMES: the healing, treatment complications, and the factors influencing these outcomes after IR. Electronic and hand searches were performed in the Web of Science, PubMed, CINAHL, and Cochrane Library databases. Two authors independently screened the titles and abstracts for eligibility. The risk of bias was performed using the NIH Quality Assessment Tool, and each study was rated as "Good", "Fair" or "Poor". The analyses were performed on the treatment outcome (healing and complications), and the factors influencing the outcome of the procedure.

    RESULTS: Fourteen articles were included in the qualitative and quantitative syntheses. One was a prospective cohort study, and the other 13 were retrospective cohort studies. Overall, the evidence of this review was of poor-to-fair quality. The pooled healing rate was 80.2%, and there was a 21.7% of complication rate. Longer follow-up period, the presence of perio-endo disease, the use of non-bioceramic material as retrograde filling, longer extraoral time, and maxillary molar were found to be associated with lower healing rates. However, the differences between the subgroups were not statistically significant.

    CONCLUSIONS: The present review showed IR yielded a good overall healing rate with a low complication rate. Taking the quality of evidence into account, more high-quality studies are required to evaluate the validity of the factors that may influence the treatment outcome of IR.

  10. Tiong WN, Sim EU, Fong AY, Ong TK
    J Cardiovasc Dis Res, 2013 Mar;4(1):3-6.
    PMID: 24023462 DOI: 10.1016/j.jcdr.2012.08.004
    BACKGROUND: Diagnosing acute coronary syndrome (ACS) remains a challenge in patients presenting at early phase of hospitalization. We hypothesized that inflammatory markers of plaque rupture could accurately identifying ACS patients from stable coronary artery diseases (CAD).

    MATERIALS AND METHODS: The serum and peripheral blood gene expression levels of C-reactive protein (CRP) and von Willebrand factor (vWF) in multiethnic Malaysian patients (n = 7) admitted with early hospitalization of ACS was evaluated. Nine patients with stable coronary artery disease without previous history of ACS were enrolled as controls.

    RESULTS: Serum and peripheral blood mRNA levels of CRP and vWF were significantly higher in ACS compared to control groups (P 

  11. Koh KH, Tan C, Hii L, Ong TK, Jong YH
    Med J Malaysia, 2012 Apr;67(2):173-6.
    PMID: 22822638 MyJurnal
    End stage renal disease (ESRD) patients have a much higher rate of cardiac disease and cardiac mortality as compared with the general population. Revascularisation such as coronary artery bypass grafting (CABG) may also carry a higher rate of complications and morbidity. We compared our ESRD patients who underwent CABG with the general population and ESRD population.
  12. Ong TK, Chin SP, Chan WL, Liew CK, Seyfarth MT, Liew HB, et al.
    Med J Malaysia, 2005 Dec;60(5):629-36.
    PMID: 16515115
    The accuracy of multi-detector computed tomographic (MDCI) coronary angiography (CTA) is dependant on image quality as well as the experience of the operator. Established centers have reported negative predictive values of over 95%. The aim of our study was to investigate the accuracy and feasibility of CTA for the assessment of haemodynamically significant coronary stenosis in a center with very early experience (<6 months) utilizing the improved spatial and temporal resolutions of the latest generation 64-row MDCI scanner. One hundred and twenty eight patients (93 male, 35 female; mean age 56.2 +/- 9.5 years) with suspected or known coronary artery disease underwent both CIA and conventional coronary angiographv (CCA). The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values for stenoses > or =50% by CIA compared to CCA were 70%, 97%, 70% and 97% respectively. Evaluation of main and proximal segments in patients with good quality images (78% of patients) produced values of 94%, 95%, 74% and 99% respectively. The improved spatial and temporal resolutions of 64-row MJ) CT provided a high negative predictive value in assessing significant coronary artery stenosis even in a centre with very early experience. However, new centers embarking on CTA might not be able to reproduce the results reported by more experienced centers.
  13. Oon YY, Koh KT, Khaw CS, Mohd Amin NH, Ong TK
    Med J Malaysia, 2019 08;74(4):328-330.
    PMID: 31424042
    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is primarily a familial disease with autosomal dominant inheritance. Incomplete penetrance and variable expression are common, resulting in broad disease spectrum. Three patterns of phenotypic expression have been described: (1) "classic" subtype, with predominant right ventricle involvement, (2) "left dominant" subtype, with early and dominant left ventricle involvement, and (3) "biventricular" subtype, with both ventricles equally affected. Genotypephenotype associations have been described, but there are other genetic and non-genetic factors that can affect disease expression. We describe two different phenotypic expressions of ARVC in a family.
  14. Yingchoncharoen T, Wu TC, Choi DJ, Ong TK, Liew HB, Cho MC
    Korean Circ J, 2021 Aug;51(8):681-693.
    PMID: 34227265 DOI: 10.4070/kcj.2021.0029
    BACKGROUND AND OBJECTIVES: Heart failure (HF) poses substantial economic burden, primarily driven by high hospitalization and mortality rates. This study aimed to understand the economic burden of HF in 4 Asian countries under varying healthcare systems.

    METHODS: This was a non-interventional, retrospective study conducted in South Korea, Taiwan, Thailand and Malaysia through medical chart review. Eligible patients included those who had either ≥1 hospitalization or ≥2 outpatient visits from January 1st to December 31st, 2014, and at least one year of follow-up. Resource use and direct healthcare costs (adjusted to 2015 USD) of HF were assessed. HF costs for subgroups stratified by age and sex were assessed.

    RESULTS: A total of 568 patients were recruited from South Korea (n=200), Taiwan (n=200), Thailand (n=100) and Malaysia (n=68). The proportion of patients hospitalized ranged from 20.0% to 93.5% (South Korea 20.0%, Thailand 49.0%, Malaysia 70.6%, and Taiwan 93.5%). The overall annual HF cost per patient was $2,357, $4,513, $3,513 and $1,443 in South Korea, Taiwan, Thailand, and Malaysia, respectively; hospitalized HF care costs were $10,714, $4,790, $7,181 and $1,776, respectively. The length of stay was more than 12.2 days except in Malaysia. No specific trend was observed in subgroup analysis.

    CONCLUSIONS: In Asia, HF poses significant economic burden and hospitalization has emerged as the major cost driver among healthcare costs. A streamlined treatment strategy reducing hospitalization rate can minimize the economic burden.

  15. Anchah L, Hassali MA, Lim MS, Ibrahim MI, Sim KH, Ong TK
    Health Qual Life Outcomes, 2017 Jan 13;15(1):10.
    PMID: 28086784 DOI: 10.1186/s12955-016-0583-7
    BACKGROUND: Acute Coronary Syndrome (ACS) is one of the most burdensome cardiovascular diseases in terms of the cost of interventions. The Cardiac Rehabilitation Programme (CRP) is well-established in improving clinical outcomes but the assessment of actual clinical improvement is challenging, especially when considering pharmaceutical care (PC) values in phase I CRP during admission and upon discharge from hospital and phase II outpatient interventions. This study explores the impact of pharmacists' interventions in the early stages of CRP on humanistic outcomes and follow-up at a referral hospital in Malaysia.

    METHODS: We recruited 112 patients who were newly diagnosed with ACS and treated at the referral hospital, Sarawak General Hospital, Malaysia. In the intervention group (modified CRP), all medication was reviewed by the clinical pharmacists, focusing on drug indication; understanding of secondary prevention therapy and adherence to treatment strategy. We compared the "pre-post" quality of life (QoL) of three groups (intervention, conventional and control) at baseline, 6 months and 12 months post-discharge with Malaysian norms. QoL data was obtained using a validated version of Short-Form 36 Questionnaire (SF-36). Analysis of variance (ANOVA) with repeated measure tests was used to compare the mean differences of scores over time.

    RESULTS: A pre-post quasi-experimental non-equivalent group comparison design was applied to 112 patients who were followed up for one year. At baseline, the physical and mental health summaries reported poor outcomes in all three groups. However, these improved gradually but significantly over time. After the 6-month follow-up, the physical component summary reported in the modified CRP (MCRP) participants was higher, with a mean difference of 8.02 (p = 0.015) but worse in the mental component summary, with a mean difference of -4.13. At the 12-month follow-up, the MCRP participants performed better in their physical component (PCS) than those in the CCRP and control groups, with a mean difference of 11.46 (p = 0.008), 10.96 (p = 0.002) and 6.41 (p = 0.006) respectively. Comparing the changes over time for minimal important differences (MICD), the MCRP group showed better social functioning than the CCRP and control groups with mean differences of 20.53 (p = 0.03), 14.47 and 8.8, respectively. In role emotional subscales all three groups showed significant improvement in MCID with mean differences of 30.96 (p = 0.048), 31.58 (p = 0.022) and 37.04 (p 

  16. Tan SSN, Koh KT, Tiong LL, Ong TK, Fong AYY
    Pharmacogenomics, 2018 10;19(15):1151-1157.
    PMID: 30191759 DOI: 10.2217/pgs-2018-0082
    AIM: Recurrent thrombotic events still occur despite dual antiplatelet therapy in patient's post percutaneous coronary intervention (PCI) could be attributed to high on-treatment platelet reactivity.

    METHODS: A 44-year-old male, who had staged PCI to left anterior descending (LAD) 2 weeks after an anterior MI, with a drug-coated stent was readmitted with new anterior STEMI 35 days later. Coronary angiogram revealed mid-stent thrombus in situ. He had further uncomplicated PCI. Platelet function testing and genotyping showed clopidogrel high on-treatment platelet reactivity and CYP2C19*3/*17 genotype. Ticagrelor was commenced.

    RESULTS & CONCLUSION: This case study is the first reported in Malaysia to document a patient with a CYP2C19*3/*17 genotype presenting with a stent thrombosis after an uncomplicated index PCI procedure.

  17. Chow HB, Lim CT, Ho YH, Cham YL, Fong AYY, Said A, et al.
    Clin Case Rep, 2023 Jun;11(6):e7580.
    PMID: 37351358 DOI: 10.1002/ccr3.7580
    KEY CLINICAL MESSAGE: The high-risk "Shark Fin" electrocardiogram (ECG) pattern has been associated with transmural ischemia but can also result from electrolyte anomalies. Therefore, the decision for invasive coronary catheterization requires a detailed history and dedicated biochemical tests.

    ABSTRACT: Pseudo-infarction ECG pattern resembling "Shark Fin" was demonstrated in a 76-year-old lady with a previous total thyroidectomy who presented with unspecific symptoms. An incidental finding of hypokalemia and hypocalcemia was thought to be related to delayed onset hypoparathyroidism. Potential etiologies like coronary vasospasm and catecholamine-associated myocardial injury were suggested.

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