1.Newly diagnosed end stage kidney disease in a single centre in Sabah
Koh Wei Wong ; Sharon Lojikip ; Fei Sia Chan ; Kheng Wee Goh ; Hoong Chee Pang
The Medical Journal of Malaysia 2017;72(3):179-185
Aim: To study the epidemiology, clinical characteristics,
vascular access, and the short term survival of ESRD
patients initiated on dialysis from Hospital Queen Elizabeth
(HQE).
Background: The number of patients with ESRD is
increasing in Sabah, Malaysia. Most patients present late
and some live in remote areas with difficult access to
healthcare services. Many therefore present with potentially
fatal complications.
Methods: All the newly confirmed ESRD patients who were
initiated on renal replacement therapy (RRT) from 1 January
to 31 December 2014 were included. The basic
epidemiological and clinical data were collected. They were
divided into three groups: Group 1 - those known to the
medical service and had been prepared properly for the
initiation of RRT; Group 2 - those known to the medical
service, but were not prepared for the RRT; Group 3 - those
with undiagnosed CKD. Outcome is mainly survival at 3rd,
6th, 9th and 12th month.
Results: There were 249 ESRD patients. 153 (61.4%) were
male. The average age was 53.3 (range 12 - 83). The main
cause of ESRD was diabetic nephropathy (128 patients,
51.4%). Most patients were started on RRT with a catheter
(74.3%), 47 patients (18.9%) with a fistula, and 17 patients
(6.8%) with a Tenckhoff catheter. 185 (74.3%) patients were
not prepared properly (Group 2 – 66.3%, and Group 3 –
8.0%). The survival for 249 patients were 86.3% at 6 months,
77.9% at 12 months. Group 2 has the worst survival (81.9%
at 6 months, 71.1% at 12 months).
Conclusions: Our data showed that most patients (74.3%)
were started on dialysis in an unplanned manner with poor
survival. A comprehensive and well-supported predialysis
programme is needed.
2.In vitro growth of Ganoderma boninense isolates on novel palm extract medium and virulence on oil palm (Elaeis guineensis) seedlings
Siang Ming Kok ; Yit Kheng Goh ; Hun Jiat Tung ; Kah Joo Goh ; Wei Chee Wong ; You Keng Goh
Malaysian Journal of Microbiology 2013;9(1):33-42
Aims: Basal stem rot (BSR) disease caused by Ganoderma pathogenic fungi, especially Ganoderma boninense is
thriving rapidly in both areas with coastal and inland soils. The objectives of this study were to isolate and characterize Ganoderma isolates collected from various locations in Peninsular Malaysia through the comparison of their growth rate in vitroly on conventional and novel palm extract media, and to determine the degree of virulence caused by the isolates in oil palm seedlings.
Methodology and results: In this study, 12 Ganoderma isolates were collected from infected oil palm trees, from
various locations – Johor, Negeri Sembilan, Kedah, Perak, Pahang, and Kelantan, in Malaysia in year 2011. Twelve
Ganoderma isolates were identified using molecular method with primer set that targeted at small-subunit 18S rDNA
fragment, and characterized by determining the in vitro growth rate, and degree of virulence in 2-month-old oil palm seedlings in the nursery using both disease incidence (DI) and disease severity index (DSI) as the measurements to quantify the infection. All the Ganoderma isolates were identified as G. boninense and sequences of the respective
isolates were deposited in GenBank. In general, all the isolates proliferated faster on oil palm extract medium (OPEM) compared to malt extract agar (MEA). Twelve G. boninense isolates were observed to illustrate different degree of virulence ranging from highly pathogenic to least pathogenic.
Conclusion, significance and impact of study: Cultures of 12 G. boninense isolates were observed to show faster
growth rate (P < 0.014) on OPEM under in vitro conditions compared to conventional MEA medium, except Bt Lintang
G10 and GBA G12 isolates. OPEM medium could provide a better alternative for maintaining and culturing Ganoderma
strains. In the current study, both DI and DSI were highly correlated. However, there were low linear relationships (R2 < 0.423) between mycelia growth rate (on MEA and OPEM) and degree of virulence (DI and DSI) at 12-, 14- and 16-
weeks after treatments among the G. boninense isolates tested. Furthermore, different degrees of virulence in twelve separate Ganoderma isolates were reported. Therefore, it is crucial to incorporate more than one isolate into any researches on screening for Ganoderma resistance or tolerance planting materials, searching for potential biological control agents, and studying bitrophic or tri-trophic interactions. In addition, this study was aimed to isolate G. boninense
strains with various virulence levels for future studies.
3.Men's Health Index: A Pragmatic Approach to Stratifying and Optimizing Men's Health.
Hui Meng TAN ; Wei Phin TAN ; Jun Hoe WONG ; Christopher Chee Kong HO ; Chin Hai TEO ; Chirk Jenn NG
Korean Journal of Urology 2014;55(11):710-717
PURPOSE: The proposed Men's Health Index (MHI) aims to provide a practical and systematic framework for comprehensively assessing and stratifying older men with the intention of optimising their health and functional status. MATERIALS AND METHODS: A literature search was conducted using PubMed from 1980 to 2012. We specifically looked for instruments which: assess men's health, frailty and fitness; predict life expectancy, mortality and morbidities. The instruments were assessed by the researchers who then agreed on the tools to be included in the MHI. When there was disagreements, the researchers discussed and reached a consensus guided by the principle that the MHI could be used in the primary care setting targetting men aged 55-65 years. RESULTS: The instruments chosen include the Charlson's Combined Comorbidity-Age Index; the International Index of Erectile Function-5; the International Prostate Symptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageing and Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the Senior Fitness Test; the Fitness Assessment Score; and the Depression Anxiety Stress Scale-21. A pilot test on eight men was carried out and showed that the men's health index is viable. CONCLUSIONS: The concept of assessing, stratifying, and optimizing men's health should be incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic position to engage men at the peri-retirement age in a conversation about their life goals based on their current and predicted health status.
Aging/*physiology
;
*Health Status
;
Humans
;
Life Expectancy/*trends
;
Male
;
Men's Health/*standards/*trends
4.Lack of meaningful genotype-phenotype association in SCN1A-related infantile-onset epileptic encephalopathies
Siti Aishah Abdul Wahab ; Yusnita Yakob ; Teik-Beng Khoo ; Sangita Dharshini Terumalay ; Vigneswari Ganesan ; Chee-Ming The ; Nor Azni bin Yahaya ; Hock-Sin Heng ; Manonmani Vaithialingam ; Sau-Wei Wong
Neurology Asia 2017;22(2):99-111
Background & Objective: SCN1A gene which encodes for sodium channel alpha 1 subunit has been
found to be the most common mutated gene in patients with epilepsy. This study aims to characterize the
SCN1A mutations as well as to describe genotype and phenotype association in children with SCN1Arelated
infantile-onset epileptic encephalopathies in Malaysia. Methods: Children with infantile-onset
epileptic encephalopathy mostly suspected to have Dravet syndrome who had mutational analysis for
SCN1A gene from hospitals all over Malaysia were included in the study. Their epilepsy syndrome
diagnosis was classified into severe myoclonic epilepsy in infancy and its variants. Polymerase chain
reaction and bidirectional sequencing were used to identify SCN1A mutations. Results: A total of 38
children with heterozygous mutations were analysed, 22 (57.9%) of which were novel mutations.
Truncated mutations were the most common mutation type (19, 50%). Other mutation types were
missense mutations (14, 36.8%), splice site mutations (4, 10.5%) and in-frame deletion (1, 2.6%). The
mean age of seizure onset was 4.7 months. Seizure following vaccination was observed in 26.3% of
the children. All of them had drug resistant epilepsy. There was no significant association between
the type of mutation with the syndromic diagnosis, age of seizure onset, tendency of the seizures to
cluster or having status epilepticus, mean age when developmental delay was observed and response
to various antiepileptic drugs.
Conclusion: This study expands the spectrum of SCN1A mutations and proves the importance of
SCN1A gene testing in diagnosing infantile-onset epileptic encephalopathies patients. Although, our
study does not support any clinically meaningful genotype-phenotype association for SCN1A-related
infantile-onset epileptic encephalopathies, the clinical characteristics of our cohort are similar to those
that have been described in previous studies.
5.A survey of young ophthalmologists' perception of training in Asia during COVID-19.
Wei Wei Dayna YONG ; Teck Chang Victor KOH ; Liang SHEN ; Diva Kant MISRA ; Wing Yun Joy LEUNG ; Sudhashini CHANDRASEKARAN ; Hung Da CHOU ; Han Nian Marcus ANG ; Chee Wai WONG
Annals of the Academy of Medicine, Singapore 2021;50(9):729-732
Asia
;
COVID-19
;
Humans
;
Ophthalmologists
;
Perception
;
SARS-CoV-2
6.Perioperative Outcomes of Therapeutic Breast Surgery in the Elderly.
Chee Meng LEE ; Veronique Km TAN ; Benita Kt TAN ; Preetha MADHUKUMAR ; Wei Sean YONG ; Chow Yin WONG ; Kong Wee ONG
Annals of the Academy of Medicine, Singapore 2016;45(6):261-263
Aged, 80 and over
;
Axilla
;
Breast Neoplasms
;
epidemiology
;
surgery
;
Comorbidity
;
Diabetes Mellitus
;
epidemiology
;
Dyslipidemias
;
epidemiology
;
Female
;
Humans
;
Hypertension
;
epidemiology
;
Length of Stay
;
Lymph Node Excision
;
Mastectomy
;
Myocardial Infarction
;
epidemiology
;
Myocardial Ischemia
;
epidemiology
;
Operative Time
;
Postoperative Complications
;
epidemiology
;
Postoperative Hemorrhage
;
epidemiology
;
Seroma
;
epidemiology
;
Singapore
;
epidemiology
;
Surgical Wound Dehiscence
;
epidemiology
;
Surgical Wound Infection
;
epidemiology
;
Venous Thrombosis
;
epidemiology
7.Rapid training of non-intensivists using an online critical care course during COVID-19.
Hui Zhong CHAI ; Constance Wei Shan TEO ; Lit Soo NG ; Sandra Li Yan HUI ; Duu Wen SEWA ; Ghee Chee PHUA ; Jolin WONG ; Carrie Kah Lai LEONG ; Ken Junyang GOH
Annals of the Academy of Medicine, Singapore 2021;50(6):503-507
8.Managing tooth pain in general practice.
Sky Wei Chee KOH ; Chun Fai LI ; John Ser Pheng LOH ; Mun Loke WONG ; Victor Weng Keong LOH
Singapore medical journal 2019;60(5):224-228
Tooth pain is a common presentation in primary care, with 32.4% of Singaporeans experiencing pain from dental caries in their lifetime. Some systemic conditions can have oral presentations, and oral conditions may be associated with chronic disease. A good history and examination is key in delineating odontogenic from non-odontogenic causes of tooth pain. Primary care physicians should accurately diagnose and assess common dental conditions and make appropriate referrals to the dentist. Common non-odontogenic causes of orofacial pain can be mostly managed in primary care, but important diagnoses such as acute coronary syndrome, peritonsillar abscess and temporal arteritis must not be missed. Ibuprofen has been shown to be effacious, safe and cost-effective in managing odontogenic pain. Antibiotics are indicated when there is systemic or local spread of dental infection. Without evidence of spread, antibiotics have not been shown to reduce pain or prevent subsequent dental infections.
9.Authors' reply.
Sky Wei Chee KOH ; Chun Fai LI ; John Ser Pheng LOH ; Mun Loke WONG ; Victor Weng Keong LOH
Singapore medical journal 2019;60(7):384-384
10.Traditional Chinese medicine: herb-drug interactions with aspirin.
Jia Wei LIM ; Siow Xian CHEE ; Wen Jun WONG ; Qiu Ling HE ; Tang Ching LAU
Singapore medical journal 2018;59(5):230-239
Traditional Chinese medicine (TCM)-based herbal therapies have gained increasing popularity worldwide, raising concerns of its efficacy, safety profile and potential interactions with Western medications. Antithrombotic agents are among the most common prescription drugs involved in herb-drug interactions, and this article focused on aspirin, one of the most widely used antiplatelet agents worldwide. We discussed herbs that have potential interactions by exploring Western and TCM approaches to thrombotic events. Common TCM indications for these herbs were also highlighted, including possible scenarios of their concurrent usage with aspirin. With greater awareness and understanding of potential herb-drug interactions, TCM and Western physicians may collaborate more closely to identify, treat and, most importantly, prevent adverse drug events.
Aspirin
;
therapeutic use
;
Carthamus
;
Drug-Related Side Effects and Adverse Reactions
;
Drugs, Chinese Herbal
;
therapeutic use
;
Herb-Drug Interactions
;
Humans
;
Medicine, Chinese Traditional
;
Panax
;
Physicians
;
Platelet Aggregation Inhibitors
;
therapeutic use
;
Salvia
;
Thrombosis
;
drug therapy