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  1. Hooi, M.H., Tiong, W. K., Tay, K. G., Chiew,K. L., Sze, S. N.
    MATEMATIKA, 2018;34(2):333-350.
    MyJurnal
    In this paper, we look at the propagation of internal solitary waves over three
    different types of slowly varying region, i.e. a slowly increasing slope, a smooth bump and
    a parabolic mound in a two-layer fluid flow. The appropriate mathematical model for this
    problem is the variable-coefficient extended Korteweg-de Vries equation. The governing
    equation is then solved numerically using the method of lines. Our numerical simulations
    show that the internal solitary waves deforms adiabatically on the slowly increasing slope.
    At the same time, a trailing shelf is generated as the internal solitary wave propagates
    over the slope, which would then decompose into secondary solitary waves or a wavetrain.
    On the other hand, when internal solitary waves propagate over a smooth bump or a
    parabolic mound, a trailing shelf of negative polarity would be generated as the results of
    the interaction of the internal solitary wave with the decreasing slope of the bump or the
    parabolic mound. The secondary solitary waves is observed to be climbing the negative
    trailing shelf.
  2. Jaradi H, Tay KH, Delilkan AE
    Med J Malaysia, 1989 Jun;44(2):143-6.
    PMID: 2626122
    The 'Priming principle' applied to non-depolarizing muscle relaxant atracurium was studied in 60 patients. This was a double blind study. The conditions observed for intubation were graded and the efficacy of priming dose of atracurium for shortening the onset time of intubation was studied. The patients were of ASA classification I and II and received standard premedication. The purpose of the study was to use the priming dose of atracurium to shorten the onset time of intubating dose of atracurium. This would be desirable in conditions requiring rapid intubation and in situations when the depolarizing muscle relaxant suxamethonium is contra-indicated. The results were statistically significant.
  3. Lai CK, Tay KT, Abdullah R
    Med J Malaysia, 2021 03;76(2):233-235.
    PMID: 33742634
    In recognising the palliative care (PC) needs globally and in Malaysia, services were developed to serve the rural area of Kuala Lipis, Pahang. This communication describes the initial a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, stages of development towards achieving a successful implementation. PC services were led by Kuala Lipis district hospital include inpatient referrals, outpatient and community care through home visits. These services involve multi-disciplinary team inclusive of representatives from health clinics and allied health. Referrals and opioid usage have demonstrated an increasing trend since its implementation in October 2018. Implementation of rural PC services is feasible; however, long-term sustainability needs to addressed.
  4. Vijayan R, Tay KH, Tan LB, Loganathan
    Singapore Med J, 1994 Oct;35(5):502-4.
    PMID: 7701371
    One hundred and eighty-three patients undergoing surgery were interviewed twenty-four hours following surgery to assess the quality of pain relief they received in the immediate postoperative period. Interviews were conducted using a standard questionnaire for all patients. They were asked to (1) rate the quality of pain relief they obtained on a Visual Pain Analogue Scale (VPAS-0 being no pain and 10 being the worst imaginable pain); (2) state whether they were happy and satisfied with the pain relief they received; (3) if dissatisfied, they were asked to give their reasons. 37.7% (69 patients) had moderate to severe pain--pain score greater than 6 on the VPAS. Most of these patients had undergone abdominal or major orthopaedic surgery. 32.7% (60 patients) were unhappy with their postoperative pain control. The main reasons for complaint from the patients were that analgesic injections were either not given promptly or were not given at all. The survey also highlighted the inadequate under-administration of narcotic injections in the postoperative period despite orders being written up. It showed there is an urgent need for setting up an Acute Pain Service for better postoperative pain control. An anaesthesiology based Acute Pain Service was started in October 1992.
  5. Khoo SP, Shanmuhasuntharam P, Mahadzir WM, Tay KK, Latif A, Nair S
    Asia Pac J Public Health, 1998;10(1):49-51.
    PMID: 10050209 DOI: 10.1177/101053959801000111
    The delay in the diagnosis of oral cancer has been variously reported as being contributed by the clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
  6. Tay K, Kamarul T, Lok WY, Mansor M, Li X, Wong J, et al.
    Malays Orthop J, 2020 Jul;14(2).
    PMID: 32313613 DOI: 10.5704/MOJ.2007.001
    With the increasing number of COVID-19 cases and related deaths worldwide, we decided to share the development of this condition in Singapore and Malaysia. First few cases were diagnosed in the two countries at the end of January 2020, and the numbers have surged to thousands by end of March 2020. We will focus on strategies adopted by the government and also the Orthopaedic community of the two countries up till the beginning of April 2020. We hope that by sharing of relevant information and knowledge on how we are managing the COVID-19 condition, we can help other communities, and health care workers to more effectively overcome this pandemic.
  7. Tay LX, Ahmad RE, Dashtdar H, Tay KW, Masjuddin T, Ab-Rahim S, et al.
    Am J Sports Med, 2012 Jan;40(1):83-90.
    PMID: 21917609 DOI: 10.1177/0363546511420819
    Mesenchymal stem cells (MSCs) represent a promising alternative form of cell-based therapy for cartilage injury. However, the capacity of MSCs for chondrogenesis has not been fully explored. In particular, there is presently a lack of studies comparing the effectiveness of MSCs to conventional autologous chondrocyte (autoC) treatment for regeneration of full-thickness cartilage defects in vivo.
  8. Lee SC, Tang IP, Avatar SP, Ahmad N, Selva KS, Tay KK, et al.
    Med J Malaysia, 2011 Jun;66(2):101-4.
    PMID: 22106686 MyJurnal
    To explore the possible causes for delay in diagnosis and treatment of head and neck cancer at Sarawak General Hospital (SGH).
  9. Lim J, Pang HN, Tay K, Chia SL, Yeo SJ, Lo NN
    Malays Orthop J, 2020 Nov;14(3):73-81.
    PMID: 33403065 DOI: 10.5704/MOJ.2011.012
    Introduction: This study aims to investigate whether patients undergoing two-stage revision total hip arthroplasty (THA) for prosthetic joint infection (PJI) and one-stage revision THA for aseptic reasons have similar clinical outcomes and patient satisfaction during their post-operative follow-up. We hypothesise that the two-stage revision THA for PJI is associated with poorer outcomes as compared to aseptic revision THA.

    Materials and Methods: We reviewed prospectively collected data in our tertiary hospital arthroplasty registry and identified patients who underwent revision THA between 2001 and 2014, with a minimum of two years follow-up. The study group (two-stage revision THA for PJI) consists of 23 patients and the control group (one-stage revision THA for aseptic reasons) consists of 231 patients. Patient demographics, Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford Hip Score (OHS), Short Form-36 (SF-36) scores and patient reported satisfaction were evaluated. Student's t-test was used to compare continuous variables between the two groups. Statistical significance was defined as p <0.05.

    Results: The pre-operative demographics and clinical scores were relatively similar between the two groups of patients. At two years, patients who underwent revision THA for PJI reported a better WOMAC Pain Score and OHS as compared to aseptic revision THA. A similar proportion of patients were satisfied with their results of surgery in both groups (p=0.093).

    Conclusions: Although patients who underwent revision THA for PJI had poorer pre-operative functional scores (WOMAC function and SF-36 PF), at two years follow-up, these two groups of patients have comparable post-operative outcomes. Interestingly, patients who had revision THA for PJI reported a better clinical outcome in terms of OHS and WOMAC Pain score as compared to the aseptic group. We conclude that the revision THA for PJI is not inferior to aseptic revision THA in terms of patient satisfaction and clinical outcomes.

  10. Tay K, Beh CLJ, Babar MG, Kweh TJ, Priya E, Pau A
    BDJ Open, 2021 Jan 19;7(1):2.
    PMID: 33469006 DOI: 10.1038/s41405-021-00058-5
    OBJECTIVE: Tooth pain among adolescents is a common event that impacts substantially on quality of life. The purpose of this paper is to explore the role of race in the tooth pain experience and associated care-seeking.

    DESIGN: A cross-sectional questionnaire survey was conducted on 14-18 years from four different public schools in Kuala Lumpur. Socio-demographic, pain symptoms, and social impacts data were collected as well as medication use and visiting a dentist for tooth pain.

    RESULTS: Of 1473 questionnaires distributed, 1452 (98.6%) completed questionnaires were returned, with 269 (18.5%) reported having experienced tooth pain in the past 1 month. Those who identified as Indian (26.1%) were more likely to report tooth pain compared to Chinese (16.5%) and Malay (20.9%). In regression analysis, no factors were identified as independently associated with medication use, but Chinese and Indians compared to Malays, and those expressing difficulty sleeping were more likely to report visiting a dentist for treatment.

    CONCLUSION: Racial variations in the tooth pain experience and care-seeking have been identified. This may be related to socio-economic status, but further research is needed on the role of culture-related care-seeking and accessibility of dental services.

  11. Tay KT, Nik Isahak NN, Kasinathan N, Yeat CL, Saad ND
    Med J Malaysia, 2024 Mar;79(2):165-169.
    PMID: 38553921
    INTRODUCTION: Chronic refractory breathlessness is a debilitating symptom which negatively affects quality of life with profound impact on physical and psychosocial functioning of patients and/or carers. Multidisciplinary based interventions which focus on non-pharmacological approach have shown to be effective. We developed a breathlessness intervention service called breathlessness supportive therapy (BST) in a palliative care unit with limited resources. The aim is to evaluate the feasibility of developing a BST service and to study the characteristics and outcome of patients with chronic refractory breathlessness.

    MATERIALS AND METHODS: This is a retrospective study of patients with chronic refractory breathlessness and Modified Medical Research Council (mMRC) dyspnoea scale grade ≥ 2 who attended the BST clinic over 1 year period. BST consists of two clinic sessions 2 weeks apart. Data was retrieved from patients' medical notes and analysis done using Microsoft Excel.

    RESULTS: A total of 21 patients were identified. Median age was 69 years with 52% of females. 72% had non-malignant diagnoses. Median Charlson's Comorbidity Index score was 6.5. Median mMRC dyspnoea scale was 3. 47.6% had long term oxygen usage. Median Australian Karnofsky Performance Scale (AKPS) was 65 and the median baseline breathlessness visual analogue scale (VAS) was 2. 62% completed two sessions, the remaining 38% completed only one session. Mean time from BST intervention to death was 18.26 weeks, median was 22 weeks. 72% died at home, whilst 28% died in the hospital. All the patients scored 4 (somewhat agree) and 5 (strongly agree) on the overall feedback score.

    CONCLUSIONS: Development of a breathlessness intervention service is feasible in a resource limited setting and generally accepted by most patients. More research and prospective studies are needed to evaluate the effectiveness of BST in the future.

  12. Wong GR, Ha KO, Himratul-Aznita WH, Yang YH, Wan Mustafa WM, Yuen KM, et al.
    Oral Dis, 2014 Nov;20(8):762-7.
    PMID: 24320099 DOI: 10.1111/odi.12218
    The objective of the study was to determine the prevalence of HPV seropositivity among patients with oral squamous cell carcinoma (OSCC) and healthy individuals and to correlate the association between HPV 16 seropositivity and risk of OSCC.
  13. Tan D, Phipps C, Hwang WY, Tan SY, Yeap CH, Chan YH, et al.
    Lancet Haematol, 2015 Aug;2(8):e326-33.
    PMID: 26688485 DOI: 10.1016/S2352-3026(15)00097-6
    BACKGROUND: Patients with relapsed or refractory peripheral T-cell lymphoma have a poor prognosis after conventional chemotherapy. Approved novel agents have only modest single-agent activity in most subtypes of peripheral T-cell lymphoma. Panobinostat is a potent oral pan-deacetylase inhibitor. Findings of many preclinical studies have shown synergistic antilymphoma activity when panobinostat is combined with the proteasome inhibitor bortezomib. We aimed to study the effect of panobinostat and bortezomib in patients with relapsed or refractory peripheral T-cell lymphoma.

    METHODS: In this open-label, multicentre phase 2 trial, we recruited patients aged 21 years or older with relapsed or refractory peripheral T-cell lymphoma who had received at least one previous line of systemic therapy from five tertiary hospitals in Singapore, Malaysia, and South Korea. Patients received 20 mg oral panobinostat three times a week and 1·3 mg/m(2) intravenous bortezomib two times a week, both for 2 of 3 weeks for up to eight cycles. The primary endpoint was the proportion of patients who achieved an objective response in accordance with the International Working Group revised response criteria; analyses were by intention to treat. The study is completed and is registered with ClinicalTrials.gov, number NCT00901147.

    FINDINGS: Between Nov 9, 2009, and Nov 26, 2013, we enrolled 25 patients with various histological subtypes of peripheral T-cell lymphoma. Of 23 patients assessable for responses, ten (43%, 95% CI 23-63) patients had an objective response, of which five were complete responses. Serious adverse events were reported in ten (40%) of 25 patients. Common treatment-related grade 3-4 adverse events included thrombocytopenia (17 [68%]), neutropenia (ten [40%]), diarrhoea (five [20%]), and asthenia or fatigue (two [8%]). We recorded peripheral neuropathy of any grade in ten (40%) patients.

    INTERPRETATION: Combined proteasome and histone deacetylase inhibition is safe and feasible and shows encouraging activity for patients with peripheral T-cell lymphoma. Our findings validate those of preclinical studies showing synergism in the combination and represent a rational way forward in harnessing the full potential of novel agents in peripheral T-cell lymphoma.

    FUNDING: Novartis Pharmaceuticals, Janssen Pharmaceuticals, and Singhealth Foundation.

  14. Vincent-Chong VK, Ismail SM, Rahman ZA, Sharifah NA, Anwar A, Pradeep PJ, et al.
    Oral Dis, 2012 Jul;18(5):469-76.
    PMID: 22251088 DOI: 10.1111/j.1601-0825.2011.01894.x
    Multistep pathways and mechanisms are involved in the development of oral cancer. Chromosomal alterations are one of such key mechanisms implicated oral carcinogenesis. Therefore, this study aims to determine the genomic copy number alterations (CNAs) in oral squamous cell carcinoma (OSCC) using array comparative genomic hybridization (aCGH) and in addition attempt to correlate CNAs with modified gene expression.
  15. Vincent-Chong VK, Karen-Ng LP, Abdul Rahman ZA, Yang YH, Anwar A, Zakaria Z, et al.
    Head Neck, 2014 Sep;36(9):1268-1278.
    PMID: 31615169 DOI: 10.1002/hed.23448
    BACKGROUND: The purpose of this study was to investigate the cause of behavioral difference between tongue and cheek squamous cell carcinomas (SCCs) by verifying the copy number alterations (CNAs).

    METHODS: Array comparative genomic hybridization (aCGH) was used to profile unique deletions and amplifications that are involved with tongue and cheek SCC, respectively. This was followed by pathway analysis relating to CNA genes from both sites.

    RESULTS: The most frequently amplified regions in tongue SCC were 4p16.3, 11q13.4, and 13q34; whereas the most frequently deleted region was 19p12. For cheek SCC, the most frequently amplified region was identified on chromosome 9p24.1-9p23; whereas the most common deleted region was located on chromosome 8p23.1. Further analysis revealed that the most significant unique pathway related to tongue and cheek SCCs was the cytoskeleton remodeling and immune response effect on the macrophage differentiation pathway.

    CONCLUSION: This study has showed the different genetic profiles and biological pathways between tongue and cheek SCCs. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1268-1278, 2014.

  16. Nairismägi ML, Tan J, Lim JQ, Nagarajan S, Ng CC, Rajasegaran V, et al.
    Leukemia, 2016 06;30(6):1311-9.
    PMID: 26854024 DOI: 10.1038/leu.2016.13
    Epitheliotropic intestinal T-cell lymphoma (EITL, also known as type II enteropathy-associated T-cell lymphoma) is an aggressive intestinal disease with poor prognosis and its molecular alterations have not been comprehensively characterized. We aimed to identify actionable easy-to-screen alterations that would allow better diagnostics and/or treatment of this deadly disease. By performing whole-exome sequencing of four EITL tumor-normal pairs, followed by amplicon deep sequencing of 42 tumor samples, frequent alterations of the JAK-STAT and G-protein-coupled receptor (GPCR) signaling pathways were discovered in a large portion of samples. Specifically, STAT5B was mutated in a remarkable 63% of cases, JAK3 in 35% and GNAI2 in 24%, with the majority occurring at known activating hotspots in key functional domains. Moreover, STAT5B locus carried copy-neutral loss of heterozygosity resulting in the duplication of the mutant copy, suggesting the importance of mutant STAT5B dosage for the development of EITL. Dysregulation of the JAK-STAT and GPCR pathways was also supported by gene expression profiling and further verified in patient tumor samples. In vitro overexpression of GNAI2 mutants led to the upregulation of pERK1/2, a member of MEK-ERK pathway. Notably, inhibitors of both JAK-STAT and MEK-ERK pathways effectively reduced viability of patient-derived primary EITL cells, indicating potential therapeutic strategies for this neoplasm with no effective treatment currently available.
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