MyMedR

Late Presentation of Paediatric Pink Pulseless Supracondylar Fracture of Humerus: A Case Report

Wong M

Malays Orthop J, 2020 Mar;14(1):100-101.

PMID: 32296493 DOI: 10.5704/MOJ.2003.019

Wong ML

Med J Malaya, 1971 Mar;25(3):218-9.

Preliminary results of a pilot study on the safety and efficacy of balloon dilatation of the Eustachian tube for nasopharyngeal cancer patients with chronic Eustachian tube dysfunction post irradiation

Wong MSL, Prepageran N

J Laryngol Otol, 2021 Aug;135(8):691-694.

PMID: 34342558 DOI: 10.1017/S0022215121001560

OBJECTIVE: Eustachian tube dysfunction is a known complication following radiotherapy to the head and neck region. Unfortunately, treatment options are limited, with significant associated morbidity. Balloon Eustachian tube dilatation has been used successfully to treat Eustachian tube dysfunction; hence, this study aimed to determine the safety and efficacy of this method in treating Eustachian tube dysfunction in post-radiotherapy patients with nasopharyngeal carcinoma.

METHOD: This interventional cohort pilot study on patients with Eustachian tube dysfunction compared those with nasopharyngeal carcinoma to patients without. Outcome assessment was based on tympanometry type and Eustachian Tube Dysfunction Questionnaire score.

RESULTS: A total of 14 ears (12 patients) were tested. Only 14 per cent of the nasopharyngeal carcinoma cohort showed improvement, while 71 per cent of the non-nasopharyngeal carcinoma group were successfully treated. No significant adverse effect was reported in any patient during this study.

CONCLUSION: Balloon Eustachian tube dilatation was not shown to be beneficial for post-radiotherapy Eustachian tube dysfunction in nasopharyngeal carcinoma patients in the preliminary stages of this pilot study.

Fulltext Smoking behaviour, knowledge and opinion of medical students

Wong ML, Chen PC

Med J Malaysia, 1989 Dec;44(4):317-23.

PMID: 2520041

On the basis of a questionnaire on smoking behaviour, knowledge and attitudes administered to medical students in the University of Malaya in July 1987, the prevalence of smoking was found to be low (10%) among medical students. Smokers and non-smokers were equally well informed about common smoking complications. Most students, irrespective of smoking status, felt that they would as future doctors, often advise sick smokers against smoking. In contrast, less than half would do so for healthy smokers who do not themselves raise the question of smoking. The students' personal smoking behaviour also influenced their view of their professional role. Appropriate values, attitudes and a preventive approach towards smoking need to be further developed in the medical students' thinking and behaviour.

Mercury, lead, and other heavy metals in Chinese medicines

Wong MK, Koh LL

Biol Trace Elem Res, 1986 Aug;10(2):91-7.

PMID: 24254355 DOI: 10.1007/BF02795561

Ninety-nine samples of common Chinese medicines were purchased from Chinese medical shops in Singapore and Malaysia and analyzed for mercury, lead, copper, cadmium, cobalt, iron, and nickel. The majority of these medicines were manufactured in China, Hong Kong, and Malaysia. A few of them were of Singapore and Taiwan origin. Atomic absorption method (both flame and flameless) was used for the analyses. Mercury was found to be present in high concentrations in several of the medicines that were for oral consumption.

Filarial antibodies and eosinophilia in human subjects in an endemic area

Wong MM, Guest MF

Trans R Soc Trop Med Hyg, 1969;63(6):796-800.

PMID: 5368008

Schultz-Dale reaction with sera of eosinophilic lung patients--a preliminary report

Guest MF, Wong MM

Med J Malaya, 1965 Dec;20(2):146-8.

PMID: 4159506

α-thalassemia-associated hydrops fetalis: A rare cause of thyrotoxic cardiomyopathy

Tumian NR, Wong M, Wong CL

J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.

PMID: 25510540 DOI: 10.1111/jog.12648

α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.

Spot urine potassium as a potential screening test for aldosterone breakthrough

Sakthiswary R, Wong M, Isa ZM, Nor Azmi K

Clin Ter, 2012;163(3):195-8.

PMID: 22964690

Treatment with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) may suppress aldosterone production only in the initial phase of treatment and subsequently lead to a rising level of aldosterone to baseline or higher. This phenomenon is described as aldosterone breakthrough. Apart from serial plasma aldosterone levels, there are no other test to identify this condition. The purpose of this study was to evaluate the role of spot urine potassium as a potential screening test for aldosterone breakthrough.

Fulltext Masking of central diabetes insipidus and hypogonadotrophic hypogonadism by germ cell tumour in suprasellar--pineal region

Isa SH, Wong M, Khalid BA

Med J Malaysia, 2006 Dec;61(5):630-2.

PMID: 17623967

A patient with beta hCG-secreting germ cell carcinoma of the pineal and suprasellar regions presented with hydrocephalus, Parinaud's syndrome, hypopituitarism and polyuria. Central diabetes insipidus was strongly suspected although the water deprivation test was not diagnostic. The polyuria however, responded to ADH analogue when the hypothyroidism and hypocortisolism were treated. Pubertal development was evident and serum testosterone was normal despite the low FSH/LH, suggesting hCG stimulation of Leydig cells. This case illustrates that a beta hCG-germ cell tumour of the suprasellar region causing hypopituitarism can mask the presence of central diabetes insipidus and hypogonadotrophic hypogonadism.

The results of a worksite health promotion programme in Kuala Lumpur, Malaysia

Moy F, Sallam AA, Wong M

Health Promot Int, 2006 Dec;21(4):301-10.

PMID: 16963785

The worksite is one of the key channels for the delivery of interventions to reduce chronic diseases among adult populations. It provides easy and regular access to a relatively stable population and it encourages sustained peer support. This paper reports a 2-year follow-up of the impact of a worksite health promotion programme on serum cholesterol and dietary changes among employees in a city in Malaysia. A quasi-experimental study was conducted among Malay-Muslim male security guards, with those working in a public university in Kuala Lumpur comprising the intervention group, and those working in the teaching hospital of the same university as the comparison group. They were comparable in socio-demographic characteristics. The intervention group received intensive individual and group counselling on diet, physical activity and quitting smoking. The comparison group was given minimal education on the same lifestyle changes through mail and group counselling. The intervention group showed a statistically significant reduction in their mean total cholesterol levels as compared with the comparison group, with an intervention effect of -0.38 (95% CI = -0.63, -0.14) mmol/l. The intervention group also reported a reduction in the amount of cigarettes smoked. The worksite was shown to be an effective channel for health promotion. The adoption of the new lifestyle behaviours should be supported and sustained through modification of work policies.

Current status of Plasmodium knowlesi vectors: a public health concern?

Vythilingam I, Wong ML, Wan-Yussof WS

Parasitology, 2018 01;145(1):32-40.

PMID: 27222102 DOI: 10.1017/S0031182016000901

Plasmodium knowlesi a simian malaria parasite is currently affecting humans in Southeast Asia. Malaysia has reported the most number of cases and P. knowlesi is the predominant species occurring in humans. The vectors of P. knowlesi belong to the Leucosphyrus group of Anopheles mosquitoes. These are generally described as forest-dwelling mosquitoes. With deforestation and changes in land-use, some species have become predominant in farms and villages. However, knowledge on the distribution of these vectors in the country is sparse. From a public health point of view it is important to know the vectors, so that risk factors towards knowlesi malaria can be identified and control measures instituted where possible. Here, we review what is known about the knowlesi malaria vectors and ascertain the gaps in knowledge, so that future studies could concentrate on this paucity of data in-order to address this zoonotic problem.

DNA barcoding implicates 23 species and four orders as potential pollinators of Chinese knotweed (Persicaria chinensis) in Peninsular Malaysia

Wong MM, Lim CL, Wilson JJ

Bull. Entomol. Res., 2015 Aug;105(4):515-20.

PMID: 25913190 DOI: 10.1017/S0007485315000358

Chinese knotweed (Persicaria chinensis) is of ecological and economic importance as a high-risk invasive species and a traditional medicinal herb. However, the insects associated with P. chinensis pollination have received scant attention. As a widespread invasive plant we would expect P. chinensis to be associated with a diverse group of insect pollinators, but lack of taxonomic identification capacity is an impediment to confirm this expectation. In the present study we aimed to elucidate the insect pollinators of P. chinensis in peninsular Malaysia using DNA barcoding. Forty flower visitors, representing the range of morphological diversity observed, were captured at flowers at Ulu Kali, Pahang, Malaysia. Using Automated Barcode Gap Discovery, 17 morphospecies were assigned to 23 species representing at least ten families and four orders. Using the DNA barcode library (BOLD) 30% of the species could be assigned a species name, and 70% could be assigned a genus name. The insects visiting P. chinensis were broadly similar to those previously reported as visiting Persicaria japonica, including honey bees (Apis), droneflies (Eristalis), blowflies (Lucilia) and potter wasps (Eumedes), but also included thrips and ants.

Fulltext Recent advances in the diagnosis and treatment of lung cancer

Liam CK, Lim KH, Wong MM

Med J Malaysia, 2001 Dec;56(4):514-31; quiz 532.

PMID: 12014776

Fulltext The prevalence of endemic goitre in the Keningau Division of Sabah

Chen PC, Wong ML, Ong FP

Asia Pac J Public Health, 1989;3(1):78-81.

PMID: 2719877 DOI: 10.1177/101053958900300111

Four areas of differing remoteness were studied to determine the prevalence of goitre in the Keningau Division of Sabah. These areas were Keningau town, the Biah Resettlement Scheme, the Dalit subdistrict and the Pagalunggan subdistrict. The predominant ethnic group in these areas is the Murut. The overall endemicity of goitre for the study population was 76.5% for females aged 15 years and above. There was a significant correlation between the incidence of goitre and the remoteness of an area. The Dalit subdistrict has the highest incidence of goitre (82.6%) followed by the Pagalunggan subdistrict (77.8%), the majority of these goitre cases being classified as grade 2 (visible goitres). These were the two most remote areas in the study. In contrast, Keningau town, the least remote area has the lowest incidence of goitre (62.5%) with most of the goitres being relatively small. With regards to salt usage in the Dalit subdistrict, only 3.0% used iodised salt; 28.0% used fine salt; 3.6% used coarse salt and 65.5% used both fine and coarse salt. In the Pagalunggan subdistrict, all females used uniodised salt with 17.6% using fine salt, 20% using coarse salt and the remainder using both fine and coarse salt. As yet, there is no legislation for the iodisation of salt in Sabah. It is clear that all types of salt need to be iodised and adequately distributed to deprived areas, particularly inland areas.

Intraoperative ultrasound with palpation is still superior to intra-arterial calcium stimulation test in localising insulinoma

Wong M, Isa SH, Zahiah M, Azmi KN

World J Surg, 2007 Mar;31(3):586-92.

PMID: 17322973

This study assessed the sensitivities of preoperative localisation modalities such as computed tomography (CT), magnetic resonance imaging (MRI), arteriography and arterial stimulation venous sampling (ASVS) using serum insulin and C-peptide gradients to intraoperative techniques in localising insulin-secreting tumours in our institution.

Serum lipoprotein(A) profiles in a Singaporean population

Wong MS, Chew WL, Aw TC

Pathology, 1999 Aug;31(3):225-9.

PMID: 10503268

Lipoprotein(a) [Lp(a)] is formed when apolipoprotein(a) is linked to low density lipoprotein (LDL)-cholesterol via a single disulfide bond. It is an independent risk factor for myocardial infarction and raised concentrations are associated with an increased risk of developing coronary artery disease. Singapore has a multi-racial population of 77% Chinese, 14% Malays and 7% Indians. Studies have shown that the Indians have significantly higher standardised mortality ratios (SMR) compared to the Chinese and the Malays. We measured serum Lp(a) concentrations in 803 healthy individuals recruited from the Multiphasic Health Screening Programme, using the Macra Lp(a) sandwich enzyme immunoassay kit (Strategics Diagnostics, Delaware, USA). Lp(a) concentrations were skewed in all three groups. Our population mean was 9.0 mg/dl, with 50th, 75th and 95th percentile values of 10.2, 19.8 and 43.1 mg/dl, respectively, which are lower than values reported from Caucasian populations (15.0, 29.0 and 60.0 mg/dl, respectively). Males had lower Lp(a) concentrations than females (P < 0.05). The Indian group had significantly higher concentrations (median 12.3 mg/dl) compared to their Chinese (median 9.6 mg/dl) and Malay (median 8.4 mg/dl) counterparts (P < 0.05). This could partly account for the higher SMR seen in the Indian population in Singapore. As serum Lp(a) concentrations are method- and population-dependent, we recommend that laboratories determine their own reference ranges by their method to avoid misclassification of the coronary heart disease (CHD) risk of patients.

Fulltext Framingham Risk Scores and Anthropometric Measurements in Predicting Cardiovascular Risks among Malay Men

Moy FM, Atiya AS, Wong ML

Malays J Nutr, 2008 Mar;14(1):57-63.

PMID: 22691764 MyJurnal

Framingham Risk Scores is an established method to predict an individual's 10-year risk for coronary heart disease (CHD). It provides a more precise delineation of risk which might lead to appropriate selection of therapy and opportunities for patient education and motivation. A Healthy Lifestyle Project was initiated to decrease the modifiable risk factors for CHD in a worksite in Kuala Lumpur. The participants were Malay men (n=186) working as security guards in a public university. Their mean age was 46.6 + 6.6 years. The majority had secondary education and were married. The participants' 10-year risks based on the Framingham Risk Scores were 55.4%, 39.8% and 4.8% respectively for categories of low (< 10%), intermediate (10 to 20%) and high (>20%) risk. Their Framingham Risk Scores were then correlated with anthropometric measurements such as the Body Mass Index (BMI), waist circumference and waist-hip-ratio (WHR). All the anthropometric measurements had weak but significant correlation with the Framingham Risk Scores (WHR: r=0.26; waist circumference: r=0.23; BMI: r=0.16). In conclusion, 44.6% of our participants had more than 10% risk in developing CHD in the coming ten years. Hence, they are suitable target candidates for the promotion of a healthy lifestyle such as smoking cessation, weight control, healthy dietary patterns and increased physical activities. Indicators of abdominal obesity like WHR or waist circumference may be used to complement the Framingham Risk Scores for the prediction of CHD risk in this population.

National dental health survey of school population in Singapore dental caries

Goh SW, Wong MQ, Chan J

Dent J Malaysia Singapore, 1972 May;12(1):15-21.

PMID: 4507354

First Report of Pseudoperonospora cubensis Causing Downy Mildew of Trichosanthes cucumerina in Malaysia

Salati M, Wong MY, Sariah M, Nik Masdek H

Plant Dis, 2010 May;94(5):642.

PMID: 30754434 DOI: 10.1094/PDIS-94-5-0642A

In December 2008, infected leaves of Trichosanthes cucumerina were observed on commercial cucurbit farms located in Pontian, Johor (south of West Malaysia). Bright yellow and small necrotic lesions were observed on the adaxial surface of the leaves, whereas sporangiophores were observed on pale yellowish brown-to-brown lesions on the abaxial surface. The length and width of the sporangia ranged from 19 to 36 μm (28.6) and 11 to 23 μm (17.6), respectively. The length of the sporangiophores ranged from 310 to 450 μm, with an average length of 380 μm. The pathogen was identified as Pseudoperonospora cubensis on the basis of the morphological criteria described by Palti and Cohen (2). To confirm the morphological findings, DNA was extracted from symptomatic tissue and the internal transcribed spacer (ITS) region was PCR amplified using primers ITS5-P2 and ITS4 (3). The appropriate-sized amplicon was gel excised and column purified and then submitted for direct sequencing. The resulting 802 bp amplified ITS region was 100% identical to published P. cubensis sequences (GenBank Accession Nos. EU876603, EU876584, and AY198306). This sequence was deposited with NCBI GenBank under the Accession No. GU233293. In this study, pathogenicity tests were conducted using detached leaf disc assays (1) and a P. cubensis isolate obtained from T. cucumerina. For this purpose, leaf discs were excised from 6- to 8-week-old leaves of T. cucumerina using a 20-mm cork borer. Five leaf discs were placed with their abaxial surface facing upward on moist filter paper in petri dishes. Each of four leaf discs was inoculated with four 10-μl droplets of a 1 × 105 per ml sporangial suspension, whereas the fifth disc was inoculated with water droplets and served as a control. Three replications were completed. The leaf discs were placed in darkness at 14 ± 2°C for 24 h and subsequently incubated with a 12-h photoperiod. After 10 days, sporulation was observed on the sporangia-inoculated leaf discs with similar morphological features to the initial field samples. To our knowledge, this is the first report of P. cubensis causing downy mildew of T. cucumerina in Malaysia. References: (1) A. Lebeda and M. P. Widrlechner. J. Plant Dis. Prot. 110:337, 2003. (2) J. Palti and Y. Cohen. Phytoparasitica 8:109, 1980. (3) H. Voglmayr and O. Constantinescu. Mycol. Res. 112:487, 2008.

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