MyMedR

Wong WK

Med J Malaysia, 1975 Dec;30(2):139-48.

Fulltext Isobolographic analysis of the hypnotic interaction between propofol and thiopental

Wong, W. H., Lim, T. A., Lim, K. Y.

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):83-89.

MyJurnal

Introduction: Giving two intravenous anaesthetic agents simultaneously generally results in an additive effect. The aim of this study was to investigate the interaction between propofol and thiopental when given to patients who have had sedative premedication. Methods: Fifty patients were admitted into the study. All patients received oral midazolam 3.75 mg and intravenous fentanyl 100 mg before induction of anaesthesia. Twenty patients received an infusion of either propofol or thiopental while 30 patients received an infusion of an admixture of both drugs. Isobolographic analysis was used to determine the interaction between the two drugs. Results: The interaction between propofol and thiopental was
additive. The average dose at loss of the eyelash reflex for propofol and thiopental was 0.71 mg kg-1 and 1.54 mg kg-1 respectively. Premedication decreased the induction dose by 38.2%. Conclusion: Propofol and thiopental interact in an additive fashion when given at induction of anaesthesia.

A survey of fractures in the dog and cat in Malaysia

Wong WT

Vet Rec, 1984 Sep 15;115(11):273-4.

PMID: 6495579

A survey of 61 canine and 26 feline fractures diagnosed between January 1980 and June 1983 at a veterinary teaching hospital was conducted. More than 80 per cent of the fractures occurred in animals less than two years old. Male animals were more frequently involved. In the dog, the femur, tibia, pelvis, radius and ulna were most often affected while in the cat, the femur, mandible, pelvis and spine were more often involved. All the findings were consistent with other reports in the literature.

Characterization and solubility study of norfloxacin-polyethylene glycol, polyvinylpyrrolidone and carbopol 974p solid dispersions

Gorajana A, Kit WW, Dua K

Recent Pat Drug Deliv Formul, 2015;9(2):167-82.

PMID: 25714525

OBJECTIVE: Norfloxacin has a low aqueous solubility which leads to poor dissolution. Keeping this fact in mind the purpose of the present study is to formulate and evaluate norfloxacin solid dispersion.

METHODS: Solid dispersions were prepared using hydrophilic carriers like polyethylene glycol (PEG) 4000, polyvinylpyrrolidone (PVP) k30 and carbopol 974pNF (CP) in various ratios using solvent evaporation technique. These formulations were evaluated using solubility studies, dissolution studies; Fourier transmitted infrared spectroscopy (FTIR), X-ray diffraction (XRD), and differential scanning calorimetery (DSC). The influence of polymer type and drug to polymer ratio on the solubility and dissolution rate of norfloxacin was also evaluated.

RESULTS: FTIR analysis showed no interaction of all three polymers with norfloxacin. The results from XRD and DSC analyses of the solid dispersion preparations showed that norfloxacin existsin its amorphous form. Among the Norfloxacin: PEG solid dispersions, Norfloxacin: PEG 1:14 ratio showed the highest dissolution rate at pH 6.8. For norfloxacin: PVP solid dispersions, norfloxacin: PVP 1:10 ratio showed the highest dissolution rate at pH 6.8. For Norfloxacin: CP solid dispersions, norfloxacin: P 1:2 ratio showed the highest dissolution rate at pH 6.8.

CONCLUSION: The solid dispersion of norfloxacin with polyethylene glycol (PEG) 4000, polyvinylpyrrolidone (PVP) k30 and carbopol 974p NF (CP), lends an ample credence for better therapeutic efficacy.

Fulltext The role of Hedgehog signalling pathway in human cancers development

Loh C. Y., Tang, T. F., Wong, W. F., Looi, Chung Yeng

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):22-22.

MyJurnal

Introduction: The Hedgehog (Hh) pathway serves as a major regulator in organ development, stem cell maintenance, cell proliferation, and cell differentiation. This pathway is highly regulated and aberrant activation will promote tumorigenesis. Hh pathway notably Sonic Hedgehog pathway was reported to be upregulated and promote tumorigenesis in various human malignancies including colorectal, gastric, lung, prostate, and breast. This review was aimed to discuss the current understanding of Hh pathway activation in different types of human cancers and discuss the development of the therapeutic applications targeting Hh pathway. Methods: A systematic review was conducted using the electronic research database PubMed Central (PMC) from 2014-2019. The search was limited to studies that are relevant to both Hh signalling pathway and human cancers. A total of 50 articles were selected and their references cited were searched and reviewed. Results: The results regarding the role of Hh signalling in pancreatic cancer and colorectal cancer are controversial with some reporting tumor promoting activities whereas others tumor suppressive activity. Besides, results from other studies suggesting that Hh signalling pathway plays an oncogenic role by inducing tumor cells proliferation, promoting metastasis and maintaining cancer stem cells in human cancers such as lung, stomach, and breast. To date, Glasdegib (PF-04449913) is the only Hh targeting small molecule inhibitor being studied at FDA Phase 3 clinical trial. Identification of the right tumors and minimization of the side effects remain as the main obstacles in the development of Hh signalling inhibitors. Conclusion: In conclusion, advancement in our understanding of Hh pathway has provided us opportunity to develop novel therapeutic strategies to fight human cancers with activated Hh pathway but more studies need to be conducted to solve the controversial regarding the role of Hh pathway in certain cancers.

Fulltext 1,1'-Diphenyl-3,3'-(p-phenyl-enedicarbon-yl)dithio-urea

Hung WW, Hassan IN, Yamin BM, Kassim MB

Acta Crystallogr Sect E Struct Rep Online, 2010;66(Pt 2):o314.

PMID: 21579744 DOI: 10.1107/S1600536809055834

The mol-ecule of the title compound, C(22)H(18)N(4)O(2)S(2), lies across a crystallographic inversion centre. The central benzene ring forms dihedral angles of 29.39 (9) and 79.11 (12)°, respectively, with the thio-urea unit and the terminal phenyl ring. Intra-molecular N-H⋯O hydrogen bonds generate two S(6) ring motifs. In the crystal, mol-ecules are linked into chains along [10] by inter-molecular N-H⋯S hydrogen bonds.

Fulltext The metaphyseal sleeve: an unexplored option in the treatment of complex primary knee osteoarthritis

Wong WK, Chua HS

Knee Surg Relat Res, 2020 Apr 16;32(1):20.

PMID: 32660589 DOI: 10.1186/s43019-020-00032-9

BACKGROUND: In an ever-aging society that as a whole has become more affluent, significant emphasis has been accorded to an improved quality of life. Knee osteoarthritis is ever-increasingly treated with total knee arthroplasty. The benefits and satisfaction experienced by those who have undergone total knee replacements (TKR) are well documented in the literature. The issue arises when osteoarthritis of the affected knee is more complex than simple osteoarthritis, i.e. the patient has complex primary osteoarthritis. This collective term encompasses conditions such as massive bone loss, ligamentous laxity, coronal defects and those with contractures. There are various classifications to describe massive bone loss but we utilized the Anderson Orthopaedic Research Institute (AORI) classification. Numerous treatment options are available and we report the use of metaphyseal sleeves as a highly successful treatment option.

METHODS: We retrospectively reviewed all the patients at our centre who underwent primary TKR using the metaphyseal sleeves. Patients were assessed on symptoms and functional status, and radiographs were also taken to assess for osseointegration. Only patients who completed 2 years of follow up were included in our study.

RESULTS: The updated (2011) Knee Society Score (KSS) was used in conjunction with radiological assessments at each follow up. Mean KSS scores improved from 53.83 preoperatively to 193.39 postoperatively. All patients demonstrated increasing osseointegration throughout follow up.

CONCLUSION: The metaphyseal sleeve is an excellent treatment option for complex primary osteoarthritic knees with good results objectively, functionally and radiologically and would be a great choice for all orthopaedic surgeons to include in their armamentarium.

Twin pregnancy -- a study of the local pattern

Teoh SK, Wong WP

Med J Malaysia, 1977 Sep;32(1):90-5.

PMID: 609353

Physiological weight changes in pregnancy in Malaysian women

Sinnathuray TA, Wong WP

Aust N Z J Obstet Gynaecol, 1972 May;12(2):122-5.

PMID: 4509097

The pattern of physiological changes in pregnancy in Malaysian women

Sinnathuray TA, Wong WP

Med J Malaya, 1971 Mar;25(3):182-6.

PMID: 4253244

Fulltext Anaesthesia for a patient with long QT syndrome undergoing renal transplantation

Lim KY, Lim TA, Wong WH

Med J Malaysia, 2005 Dec;60(5):647-9.

PMID: 16515119

Anaesthetizing patients with Long QT Syndrome is a major challenge, as the potential for sudden catastrophic cardiovascular collapse is well known. We present a 15-year-old boy with Long QT Syndrome who presented for an elective renal transplant. All electrolyte concentration abnormalities were corrected preoperative and adequate beta-blockade was maintained. The patient was given a target controlled infusion of propofol, together with opioids and atracurium. Anaesthesia was uneventful and the patient was extubated at the end of the surgical procedure.

Fulltext Perceived skill and utilisation of information technology in medical education among final year medical students, Universiti Putra Malaysia

Lim TA, Wong WH, Lim KY

Med J Malaysia, 2005 Oct;60(4):432-40.

PMID: 16570704

The objective of this survey was to obtain a self-reported assessment of the use of information technology (IT) by final year medical students. Two hundred and sixty five students responded to a questionnaire survey. 81.5% of students considered their computer skills adequate, while 87.9% had access to computers outside the campus. Most students reported adequate skills at word processing, e-mailing and surfing the Internet. Fifty three percent of students spent three hours or more each week on the computer. While students indicated a general willingness to access Internet-based materials, further steps need to be taken to increase the use of this method of instruction.

Fulltext Clomid induced combined extrauterine and intrauterine pregnancy--a case report

Ng YT, Wong WP, Puraviappan AP

Med J Malaysia, 1983 Jun;38(2):150-2.

PMID: 6621446

A 23 year old Indian lady, gravida 1 para 0, with Clomid induced pregnancy was admitted to the University Hospital on 29 August 1981 with signs and symptoms of pregnancy and intraperitoneal bleed. Period ofamenorrhoea at time of admission was eight weeks. Emergency laparotomy revealed a right leaking ectopic pregnancy and an enlarged gravid uterus. Ultrasound done on the 7th post operative day confirmed concurrent intrauterine pregnancy which progressed normally to term, ending with a normal healthy baby at 39 weeks through an assisted breech delivery.

Eclampsia - a review of 48 cases

Ong SK, Foo J, Wong WP, Yusof K

Med J Malaysia, 1978 Mar;32(3):206-11.

PMID: 683043

Characteristics of normal labour among different racial groups in Malaysia

Lim MA, Wong WP, Sinnathuray TA

Br J Obstet Gynaecol, 1977 Aug;84(8):600-4.

PMID: 889748

The characteristics of normal labour in 977 Malay, Chinese and Indian parturients were established from a retrospective study. Indian babies were found to be significantly smaller than Malay babies which were significantly smaller than Chinese babies (P less than 0-05, P less than 0-05). The mean duration of the first stage of labour taken from the time of admission to the labour ward was 3-4 hours in primiparae and 2-7 hours in multiparae. The mean durations of the second stage of labour were 23-7 minutes and 13-1 minutes respectively. Curves of mean dilatation of cervix and probit analysis at 80% revealed significant differences in the progress of normal labour in primiparae among the three racial groups. The Indian primiparae not only had a slower rate of cervical dilatation but seemed to reach the accelerated phase of dilatation later. No significant differences were noticed in the labours of multiparae.

Fulltext The Prevalence of Anti-Aquaporin 4 Antibody in Patients with Idiopathic Inflammatory Demyelinating Diseases Presented to a Tertiary Hospital in Malaysia: Presentation and Prognosis

Abdullah S, Wong WF, Tan CT

Mult Scler Int, 2017;2017:1359761.

PMID: 28203460 DOI: 10.1155/2017/1359761

Background. There have been inconsistent reports on the prevalence and pathogenicity of anti-Aquaporin 4 (AQP4) in patients presented with idiopathic inflammatory demyelinating diseases (IIDDs). Objective. To estimate the prevalence of anti-AQP4 antibody in patients with IIDDs presented to University Malaya Medical Centre in terms of patients' clinical and radiological presentations and prognoses. Methods. Retrospective data review of IIDDs patients presented from 2005 to 2015. Patients were classified into classical multiple sclerosis (CMS), opticospinal (OS) presentation, optic neuritis (ON), transverse myelitis (TM), brainstem syndrome (BS), and tumefactive MS. Anti-Aquaporin 4 antibody was tested using the Indirect Immunofluorescence Test (IIFT) cell-based assay. Statistical analysis was done using the SPSS version 20. Results. Anti-AQP4 antibody was detected in 53% of patients presented with IIDDs. CMS was more common in the seronegative group, 27/47 (57.45%; p < 0.001). Conversely, OS involvement was more common in the seropositive group, 26/53 (49.06%; p < 0.001). Longitudinally extensive spinal cord lesions (LESCLs) on MRI were also more common in the seropositive group, 29/40 (72.50%; p = 0.004). Only 2/40 (5.00%) had MRI evidence of patchy or multiple short-segment spinal cord lesions in the AQP4-positive group (p = 0.003). The relapse rate and Expanded Disability Status Scale (EDSS) were also higher in the seropositive group (5.43 versus 3.17, p = 0.005; 4.07 versus 2.51, p = 0.006, resp.). Typical clinical presentations that defined NMO were also seen in the seronegative patients, but in a lower frequency. Conclusion. Our cohort of patients had a higher prevalence of seropositivity of anti-AQP4 antibody as compared to those in Western countries. This was also associated with a more typical presentation of opticospinal involvement with LESCLs on MRI, a higher rate of relapse, and EDSS.

Fulltext Atypical pneumonia due to Chlamydia pneumoniae: a case report

Cheong YM, Wong WK, Ngeow YF

Singapore Med J, 1993 Aug;34(4):352-3.

PMID: 8266214

A first case of Chlamydia pneumoniae pneumonia in Malaysia is reported. The diagnosis was made by a significant change in C. pneumoniae antibody titre. The infection responded well to a course of erythromycin.

Fine structure of the anterior adhesive apparatus (head organs) of Bravohollisia gussevi Lim, 1995 (Monogenea: Ancyrocephalidae)

Wong WL, Brennan GP, Halton DW, Lim LH

Parasitology, 2006 Mar;132(Pt 3):427-38.

PMID: 16309563

A study of the anterior adhesive apparatus (head organs) of Bravohollisia gussevi Lim, 1995 was carried out using light and electron microscopy. The anterior adhesive apparatus or head organs in B. gussevi comprise 6 circular openings or apertures in the antero-lateral region, associated pits lined with specialized microvillous tegument that differ from the general body tegument, a bundle of ducts, and uninucleate gland cells located lateral to the pharynx. The uninucleate glands of the anterior adhesive apparatus (head organs) comprise 2 types of cells, one kind of cell producing rod-like bodies (S1) and the other oval bodies (S2). The S1 bodies are filled with numerous, less electron-dense vesicles in an electron-dense matrix, while S2 bodies have no vesicles but contain a more homogeneous electron-dense matrix. Interlinking band-like structures were observed between S1 bodies. Similar band-like structures were found between S2 bodies. The formation of S1 bodies was followed by transmission electron microscopy. However, the formation of S2 bodies was unclear and could not be resolved. Uniciliated structures were also observed around the openings of the anterior adhesive apparatus. Each uniciliated structure is usually associated with an opening of a gland cell producing granular, electron-dense, secretory bodies, which differ from the secretions produced by the lateral gland cells of the anterior adhesive apparatus.

Fulltext A case of human enteric myiasis due to larvae of Hermetia illucens (Family: Stratiomyiadae): first report in Malaysia

Lee HL, Chandrawathani P, Wong WY, Tharam S, Lim WY

Malays J Pathol, 1995 Dec;17(2):109-11.

PMID: 8935136

A case of true enteric myiasis in a 7-year-old girl is reported. Two larvae were obtained from the vomitus of the patient. After processing and identification, the larvae were found to be those of Hermetia illucens (Soldier Fly). This is the first case of true enteric myiasis due to these larvae in Malaysia.

A study of menstrual patterns following laparoscopic sterilization with silastic rings

Goh TH, Puvan IS, Wong WP, Sivanesaratnam V, Sinnathuray TA

Int. J. Fertil., 1981;26(2):116-9.

PMID: 6114062

The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.

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