Displaying publications 1 - 20 of 26 in total

  1. Lim WK, Wong MN, Tan SK
    Med. J. Malaysia, 2014 Jun;69(3):138-9.
    PMID: 25326356 MyJurnal
    A late preterm newborn baby presented with respiratory distress and increasing cyanosis within 2 hours of birth. Bedside transthroracic echocardiography showed a critically obstructed vertical vein in a supracardiac total anomalous pulmonary venous drainage (TAPVd). Emergency stenting of the vertical vein was successfully performed at 24 hours of life.
  2. Tan BY, Cheah JS, Tan SK, Chew BK
    Med J Malaya, 1970 Jun;24(4):308-10.
    PMID: 4248355
  3. Tan SK, Leung WK, Tang ATH, Zwahlen RA
    PLoS ONE, 2017;12(10):e0185951.
    PMID: 29016682 DOI: 10.1371/journal.pone.0185951
    BACKGROUND: Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA).

    OBJECTIVE: To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.

    METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.

    RESULTS: Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.

    CONCLUSION: Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.

    STUDY REGISTRATION: PROSPERO (registration number: CRD42016046484).

  4. Tan SK, Leung WK, Tang ATH, Zwahlen RA
    PLoS ONE, 2017;12(7):e0181146.
    PMID: 28749983 DOI: 10.1371/journal.pone.0181146
    BACKGROUND: Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).

    OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.

    METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.

    RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.

    CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

  5. Tan SK, Tang ATH, Leung WK, Zwahlen RA
    J Craniofac Surg, 2019 Mar 28.
    PMID: 30946225 DOI: 10.1097/SCS.0000000000005351
    PURPOSE: To investigate short- and long-term three-dimensional changes of pharyngeal airway morphology and hyoid bone position in dento-skeletal class III deformity patients after 2-jaw orthognathic surgery with segmentation.

    METHODS: A retrospective analysis has been performed on patients with dento-skeletal class III deformity who had undergone orthognathic 2-jaw surgery with segmentations, presenting both pre- and post-surgical cone-beam computed tomographys. Three-dimensional skeletal movements, pharyngeal airway changes and hyoid bone position were measured and correlated.

    RESULTS: The mean short term postsurgical review period for all included 47 patients was 5.8 ± 2.2 months. Thirteen patients among them provided a mean long term period of 26.4 ± 3.4 months. The mean postsurgical maxillary movement was 2.29 ± 2.49 mm in vertical, 2.02 ± 3.45 mm in horizontal direction, respectively, while the mandibular movement was 6.49 ± 4.58 mm in vertical, and -5.85 ± 6.13 mm in horizontal direction. In short-term, the vertical length of nasopharynx was found to be reduced (P = 0.005) but increased for the oropharynx (P  0.05) detected between patients with and without genioplasty advancement.

    CONCLUSION: Two-jaw orthognathic surgery in dento-skeletal class III patients led to a statistically non-significant reduction of the post-surgical airway volume in both short- and long-term. Although the post-surgical oropharyneal minimum cross-sectional area was decreased significantly in the short term, this finding did not persist in the long term.

  6. Tan HH, Tan SK, Shunmugan R, Zakaria R, Zahari Z
    Sultan Qaboos Univ Med J, 2017 Nov;17(4):e455-e459.
    PMID: 29372089 DOI: 10.18295/squmj.2017.17.04.013
    Persistent urogenital sinus (PUGS) is a rare anomaly whereby the urinary and genital tracts fail to separate during embryonic development. We report a three-year-old female child who was referred to the Sabah Women & Children Hospital, Sabah, Malaysia, in 2016 with a pelvic mass. She had been born prematurely at 36 gestational weeks via spontaneous vaginal delivery in 2013 and initially misdiagnosed with neurogenic bladder dysfunction. The external genitalia appeared normal and an initial sonogram and repeat micturating cystourethrograms did not indicate any urogenital anomalies. She therefore underwent clean intermittent catheterisation. Three years later, the diagnosis was corrected following the investigation of a persistent cystic mass posterior to the bladder. At this time, a clinical examination of the perineum showed a single opening into the introitus. Magnetic resonance imaging of the pelvis revealed gross hydrocolpos and a genitogram confirmed a diagnosis of PUGS, for which the patient underwent surgical separation of the urinary and genital tracts.
  7. Tan SH, Habibullah MS, Tan SK, Choon SW
    J. Environ. Manage., 2017 Dec 01;203(Pt 1):603-611.
    PMID: 28285804 DOI: 10.1016/j.jenvman.2017.02.029
    This study investigates the impact of the aggregate and individual dimensions of environmental performance (EP) on financial performance (FP), based on a dataset covering the travel and tourism industry (airlines, casinos, hotels, and restaurants) across different economic regions over the period 2003-2014. The results reveal that EP positively affects the FP in the hotel industry when aggregate EP is used. When individual dimensions of EP are considered, resource reduction is found to positively (negatively) affect the performance in the hotel (airline) industry, while product innovation positively affects the performance in the restaurant industry. Hence, the trade-off effect seems to be dominant in the airline industry, and the 'heterogeneous resources and reputation-building' hypothesis is evident in both the hotel and restaurant industries. In addition, in general, the findings support the positive moderating effect of slack resources on the relationship between the individual dimensions of EP and FP in the travel and tourism industry, and, hence, are supportive of the slack resources hypothesis. These effects, however, vary depending on the travel and tourism industry under investigation.
  8. Tan SK, Tang ATH, Leung WK, Zwahlen RA
    J Stomatol Oral Maxillofac Surg, 2018 Dec;119(6):461-468.
    PMID: 30099221 DOI: 10.1016/j.jormas.2018.07.004
    PURPOSE: To investigate short- and long-term post-surgical three-dimensional changes of pharyngeal airway morphology and hyoid bone position in dento-skeletal class II deformity patients after two-jaw surgery with segmentation.

    METHODS: Relations between skeletal movement, hyoid bone position and three-dimensional pharyngeal airway changes were retrospectively analyzed on pre- and post-surgical CBCTs in dento-skeletal class II patients who underwent orthognathic two-jaw surgery with segmentation.

    RESULTS: While long-term significant reductions in length (P= 0.003), surface area (P= 0.042) and volume (P= 0.004) were found in the nasopharynx, the highly significant increases in oropharyngeal airway length, surface area, volume and the minimal cross-sectional area (P 

  9. Tan BC, Tan SK, Wong SM, Ata N, Rahman NA, Khalid N
    PMID: 25883671 DOI: 10.1155/2015/451870
    The distribution patterns of flavonoids and cyclohexenyl chalcone derivatives in conventional propagated (CP) and in vitro-derived (CPA) field-grown plants of an important medicinal ginger, Boesenbergia rotunda, are described. A total of eight compounds were extracted from six organs (rootlet, rhizome, shoot base, maroon stem, stalk, and leaf) of the CP and CPA plants. Five major chromatographic peaks, namely, alpinetin, pinocembrin, pinostrobin, 4-hydroxypanduratin A, and panduratin A, were consistently observed by high performance liquid chromatography. Nonaerial organs had higher levels of flavonoids than the aerial ones for all types of samples. Among the compounds detected, pinostrobin and 4-hydroxypanduratin A were the most abundant flavonoid and cyclohexenyl chalcone derivative, respectively. The distribution and abundance of the bioactive compounds suggested that the shoot base could be more potentially useful for medicinal application than other organs of the plant and may be the site of storage or occurrence of biosynthetic enzymatic activities.
  10. Cheng N, Lee GK, Yap BS, Lee LT, Tan SK, Tan KP
    J. Forensic Sci., 2005 Jan;50(1):177-84.
    PMID: 15831016
    This paper investigated the class characteristics in English handwriting of the Chinese, Malays and Indians in Singapore, many of whom learned their native language as a second language. One hundred and fifty-four handwriting exemplars were collected and features such as letter designs, pen-lifts, letter spacing and embellishments were studied. A number of characteristic features peculiar to the individual racial group were identified, which confirmed the impact of their native language writing systems on English handwriting.
  11. Chow VT, Tham KM, Lim-Tan SK, Sng IT, Bernard HU
    Asia Oceania J Obstet Gynaecol, 1990 Dec;16(4):373-7.
    PMID: 1966000
    The close epidemiological relationships between specific genital human papillomavirus (HPV) types and neoplasia of the cervix uteri have been extensively documented worldwide, including Singapore. Cervical cancer incidence rates in Singapore show variations between the major ethnic groups. To ascertain the corresponding HPV infection rates among the various races in Singapore, we analysed the cervical smears of 225 women by filter in situ DNA hybridization, and compared the data with a previous similar study. Fourteen (6.2%) individuals were HPV-positive, with HPV 16 and HPV 31 being the commonest types. No significant difference between HPV positivity rates in Chinese (5.0%) and in Malays (6.7%) was found, even though Chinese have a higher cervical cancer incidence than Malays. Furthermore, the cervical HPV carriage rate among women with normal cytology was 5.9%. In the light of reports of high genital HPV prevalence rates detected by DNA amplification, these data support the notion that HPV infection is commonly latent and requires the cooperation of other factors for cervical carcinogenesis.
  12. Tan SK, Yeong CH, Ng KH, Abdul Aziz YF, Sun Z
    PLoS ONE, 2016;11(8):e0161543.
    PMID: 27552224 DOI: 10.1371/journal.pone.0161543
    OBJECTIVES: This study aimed to measure the absorbed doses in selected organs for prospectively ECG-triggered coronary computed tomography angiography (CCTA) using five different generations CT scanners in a female adult anthropomorphic phantom and to estimate the effective dose (HE).

    MATERIALS AND METHODS: Prospectively ECG-triggered CCTA was performed using five commercially available CT scanners: 64-detector-row single source CT (SSCT), 2 × 32-detector-row-dual source CT (DSCT), 2 × 64-detector-row DSCT and 320-detector-row SSCT scanners. Absorbed doses were measured in 34 organs using pre-calibrated optically stimulated luminescence dosimeters (OSLDs) placed inside a standard female adult anthropomorphic phantom. HE was calculated from the measured organ doses and compared to the HE derived from the air kerma-length product (PKL) using the conversion coefficient of 0.014 mSv∙mGy-1∙cm-1 for the chest region.

    RESULTS: Both breasts and lungs received the highest radiation dose during CCTA examination. The highest HE was received from 2 × 32-detector-row DSCT scanner (6.06 ± 0.72 mSv), followed by 64-detector-row SSCT (5.60 ± 0.68 and 5.02 ± 0.73 mSv), 2 × 64-detector-row DSCT (1.88 ± 0.25 mSv) and 320-detector-row SSCT (1.34 ± 0.48 mSv) scanners. HE calculated from the measured organ doses were about 38 to 53% higher than the HE derived from the PKL-to-HE conversion factor.

    CONCLUSION: The radiation doses received from a prospectively ECG-triggered CCTA are relatively small and are depending on the scanner technology and imaging protocols. HE as low as 1.34 and 1.88 mSv can be achieved in prospectively ECG-triggered CCTA using 320-detector-row SSCT and 2 × 64-detector-row DSCT scanners.

  13. Tan SK, Leung WK, Tang ATH, Tse ECM, Zwahlen RA
    Plast Reconstr Surg Glob Open, 2017 Dec;5(12):e1608.
    PMID: 29610716 DOI: 10.1097/GOX.0000000000001608
    Background: A validated questionnaire is needed to study a more holistic outcome assessment including postsurgical aesthetic satisfaction and psychosocial changes in orthognathic patients. The aim of this study was to determine the reliability and validity of 9 orthognathically relevant translated FACE-Q scales among Hong Kong Chinese orthognathic patients.

    Methods: Two hundred fifty adult Cantonese-speaking patients of 18 years or older who underwent orthognathic treatment were recruited in the Prince Philip Dental Hospital of Hong Kong. Nine of an overall of 40 independent FACE-Q scales were selected and translated into Hong Kong Chinese. The reliability, validity, and test-retest reliability were examined using Cronbach's alpha, paired t test and Pearson's correlation coefficients.

    Results: The Hong Kong Chinese version of the 9 FACE-Q scales was obtained by forward-backward translation. One hundred eight male (mean age, 25.57 ± 4.49) and 142 female (mean age, 24.61 ± 4.54) patients were recruited for the reliability and validation process. The internal consistency (0.89-0.97) and the test-retest reliability (0.73-0.90) were found to be high. The validity of the translated questionnaires was comparable with that of the original FACE-Q.

    Conclusion: The results presented here prove that the 9 translated FACE-Q scales are reliable and valid instruments for research and clinical purposes in Hong Kong Chinese orthognathic patients.

  14. Wong JHD, Anem LEA, Tan S, Tan SK, Ng KH
    Phys Med, 2019 Dec;68:47-51.
    PMID: 31739145 DOI: 10.1016/j.ejmp.2019.11.007
    OBJECTIVE: This study measured the radiation exposure of the eye lens of medical personnel performing fluoroscopy and interventional procedures at the Sarawak General Hospital in Kuching, Sarawak, Malaysia. This study was the first in Malaysia to utilise in vivo radiation measurement relatively near the eye lens.

    METHODS: 41 medical personnel performing 79 procedures were monitored for their eye lens exposure using the NanoDot™ optically-stimulated luminescence dosimeters (OSLD) taped to the outer canthus of their eyes. The air-kerma area product (KAP), fluoroscopy time (FT) and number of procedure runs were also recorded.

    RESULTS: KAP, FT and number of runs were strongly correlated. However, only weak to moderate correlations were observed between these parameters with the measured eye lens doses. The average median equivalent eye lens dose was 0.052 mSv (ranging from 0.0155 to 0.672 mSv). The eye lens doses of primary operators were found to be significantly higher than their assistants due to the closer proximity to the patient and X-ray tube. The left eye lens of the operators received the highest amount of radiation due to their habitual positioning towards the radiation source.

    CONCLUSION: KAP and FT were not useful in predicting the equivalent eye lens dose exposure in interventional radiological procedures. Direct in vivo measurements were needed to provide a better estimate of the eye lens doses received by medical personnel during these procedures. This study highlights the importance of using direct measurement, such as OSLDs, instead of just indirect factors to monitor dose in the eye lens in radiological procedures.

  15. Dayrat B, Goulding TC, Khalil M, Comendador J, Xuân QN, Tan SK, et al.
    Zookeys, 2019;877:31-80.
    PMID: 31592220 DOI: 10.3897/zookeys.877.36698
    As part of an ongoing effort to revise the taxonomy of air-breathing, marine, onchidiid slugs, a new genus, Laspionchis Dayrat & Goulding, gen. nov., is described from the mangroves of South-East Asia. It includes two new species, Laspionchis boucheti Dayrat & Goulding, sp. nov., and Laspionchis bourkei Dayrat & Goulding, sp. nov., both distributed from the Malacca Strait to the Philippines and Australia. This study is based on extensive field work in South-East Asia, comparative anatomy, and both mitochondrial (COI and 16S) and nuclear (ITS2 and 28S) DNA sequences. The two new species are found in the same habitat (mud surface in mangrove forests) and are externally cryptic but are distinct anatomically. Both species are also strongly supported by DNA sequences. Three cryptic, least-inclusive, reciprocally-monophyletic units within Laspionchis bourkei are regarded as subspecies: L. bourkei bourkei Dayrat & Goulding, ssp. nov., L. bourkei lateriensis Dayrat & Goulding, ssp. nov., and L. bourkei matangensis Dayrat & Goulding, ssp. nov. The present contribution shows again that species delineation is greatly enhanced by considering comparative anatomy and nuclear DNA sequences in addition to mitochondrial DNA sequences, and that thorough taxonomic revisions are the best and most efficient path to accurate biodiversity knowledge.
  16. Tan SK, Sanmugam A, Danaee M, Ramanujam TM, Nallusamy MA, Zahari Z, et al.
    Sultan Qaboos Univ Med J, 2019 Nov;19(4):e352-e358.
    PMID: 31897319 DOI: 10.18295/squmj.2019.19.04.011
    Objectives: Transition of care (TOC) from paediatric to adult care is still at an early stage in Malaysia. This study aimed to explore current practices and perspectives regarding TOC among paediatric surgeons in Malaysia.

    Methods: This study was carried out between June and December 2017. All 48 paediatric surgeons currently working in Malaysia were invited to participate in a questionnaire-based survey to assess demographic characteristics and practices and perspectives regarding TOC.

    Results: A total of 38 paediatric surgeons participated in the survey (response rate: 79.2%). Overall, 97.4% did not have an organised TOC model in their institution, with most (65.8%) caring for paediatric patients with complex surgical conditions until adulthood. Although the majority (86.8%) felt that care should be transitioned to adult surgeons with appropriate credentials, most surgeons (84.2%) nevertheless preferred to be involved in the management of adolescent patients after transition. However, there was no consensus regarding the most suitable age to begin the transition. Years of experience as a paediatric surgeon and place of practice did not affect overall TOC practice scores (P >0.050 each). The presence of adult comorbidities was considered the most common reason to initiate TOC (81.6%), while the lack of TOC guidelines was perceived to be the greatest barrier (84.2%).

    Conclusion: This study provides a better understanding of TOC from the point of view of paediatric surgeons in Malaysia. However, further studies involving other stakeholders (i.e. patients and adult surgeons) are needed to help formulate a suitable and successful TOC model in this setting.

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