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Intention to seek professional help for depression and its associated factors among elderly patients in Tenkera Health Clinic, Melaka, Malaysia

Chai YH, Tong SF, Khairuddin W

Med J Malaysia, 2021 Jan;76(1):61-67.
PMID: 33510111

BACKGROUND: Prevalence of mental disorders such as depression in the elderly is rising with the ageing population. This study is aimed to determine the prevalence of depression, their intention to seek help and the factors associated to seek professional help among elderly patients in a primary care clinic.
METHODS: This was a cross-sectional with systematic sampling conducted from June to December 2019 in Tengkera Health Clinic (THC). Patient Health Questionnaire- 9 (PHQ-9), socioeconomic data and a dichotomous yes-no response for intention to seek help was collected from 273 elderly patients attending the outpatient clinic.
RESULTS: The prevalence of elderly depression at THC was 10.3% and the prevalence of intention to seek professional help for depression among elderly patients at Tengkera Health Clinic was 27.5%. Factors that were associated with intention to seek professional help for depression were prior experience of seeking professional help, adjusted OR 3.45[95%CI (1.41-8.48)] and education level of the respondents- secondary education, adjusted OR 3.10 [95%CI (1.01-9.53)] comparing with no formal education; tertiary education, adjusted OR 4.66 [95%CI (1.08-20.04)] comparing with no formal education.
CONCLUSION: The prevalence of elderly depression was high while the prevalence of intention to seek professional help for depression in the sample population was low. Primary care physicians play a vital role in identifying elderly patients with low education level for screening and treatment as well as promoting awareness and breaking down barriers and stigma towards mental illness.
Fulltext Mercury release from a Sn-Cu-Zn free amalgam

Lui JL, Tong SL, Teh SK

Ann Dent, 1994;1(1):1-4.
MyJurnal

The mercury controversy related to dental amalgam is still continuing. In Malaysia, part of, this controversy has been attributed to a recently - introduced dental amalgam claimed to be non-mercury releasing and causing no mercury toxicity. The purpose of this study was to investigate whether this amalgam, Composil, was indeed non-mercury releasing. Six specimens each of Composil and a control (GS-80) were incubated at 3TC in deionised-distilled water. The daily mercury release was determined over a four-week study period using the stationary cold-vapour atomic absorption spectrometric method. The mean mercury release of Composil was 30.9 Ilg/cm2/ 24hr whilst that of GS-80 was 0.9 Ilg/cm2124hr and the difference was found to be highly significant (P < 0.00l). Results of this study therefore did not substantiate the manufacturer's claim. The release of mercury from amalgam restorations and their implications in clinical practice were also discussed.
Fulltext Dynamic spatiotemporal trends of dengue transmission in the Asia-Pacific region, 1955-2004

Banu S, Hu W, Guo Y, Naish S, Tong S

PLoS One, 2014;9(2):e89440.
PMID: 24586780 DOI: 10.1371/journal.pone.0089440

BACKGROUND: Dengue fever (DF) is one of the most important emerging arboviral human diseases. Globally, DF incidence has increased by 30-fold over the last fifty years, and the geographic range of the virus and its vectors has expanded. The disease is now endemic in more than 120 countries in tropical and subtropical parts of the world. This study examines the spatiotemporal trends of DF transmission in the Asia-Pacific region over a 50-year period, and identified the disease's cluster areas.
METHODOLOGY AND FINDINGS: The World Health Organization's DengueNet provided the annual number of DF cases in 16 countries in the Asia-Pacific region for the period 1955 to 2004. This fifty-year dataset was divided into five ten-year periods as the basis for the investigation of DF transmission trends. Space-time cluster analyses were conducted using scan statistics to detect the disease clusters. This study shows an increasing trend in the spatiotemporal distribution of DF in the Asia-Pacific region over the study period. Thailand, Vietnam, Laos, Singapore and Malaysia are identified as the most likely clusters (relative risk = 13.02) of DF transmission in this region in the period studied (1995 to 2004). The study also indicates that, for the most part, DF transmission has expanded southwards in the region.
CONCLUSIONS: This information will lead to the improvement of DF prevention and control strategies in the Asia-Pacific region by prioritizing control efforts and directing them where they are most needed.
Fulltext The yield for colorectal cancer and adenoma by indication at colonoscopy

Cheong KL, Roohi S, Jarmin R, Sagap I, Tong SHY, Qureshi A

Med J Malaysia, 2000 Dec;55(4):464-6.
PMID: 11221158

Colonoscopy is an integral part of the clinician armamentarium in the diagnosis of colorectal cancer and its precursor, the adenoma. Polypoid lesions when identified can be excised at colonoscopy and in turn reduce the risk of colorectal cancer. We prospectively evaluated the yield of colorectal cancer and adenomatous polyps by indication for colonoscopy over a one-year period. A total of 375 colonoscopies were carried out. The more common indications of colonoscopy were rectal bleeding, abdominal pain, surveillance of colorectal cancer and altered bowel habit. The highest yield for cancer was for rectal bleeding with 12.5% while surveillance of patients with a history of polyps yielded the highest percentage of new polyps. We conclude that rectal bleeding as an indication for colonoscopy yielded the highest number of cancers.
Tributyltin distribution in the coastal environment of Peninsular Malaysia

Tong SL, Pang FY, Phang SM, Lai HC

Environ Pollut, 1996;91(2):209-16.
PMID: 15091442

The occurrence of tributyltin (TBT) is reported in the coastal waters of a few selected sites in Peninsular Malaysia. Water, bivalves and sediment samples collected were analysed specifically for TBT using sensitive analytical methods which involved a solvent extraction procedure with appropriate clean-up followed by graphite furnace atomic absorption spectrometric measurements. The levels of TBT in the seawater in unexposed areas were found in the range from <3.4 to 20 ng litre(-1) as compared to coastal areas with high boat and ship activities where TBT levels in seawater were generally above 30 ng litre(-1), with the highest level found at 281.8 ng litre(-1). TBT levels in the tissues of random cockle and soft-shell clam samples from local markets were found in the range from <0.5 to 3.7 ng g(-1) wet weight. The levels of TBT found in green mussel samples both from the market (23.5 ng g(-1) wet weight) and those from a mussel farm (14.2 ng g(-1) wet weight) indicate slight accumulation of TBT. In sediments, TBT levels were found ranging from <0.7 ng g(-1) dry weight in unexposed coastal sites to as high as 216.5 ng g(-1) dry weight for a site within a port area.
Plant-based milk: unravel the changes of the antioxidant index during processing and storage - a review

Tong SC, Siow LF, Tang TK, Lee YY

Crit Rev Food Sci Nutr, 2024;64(14):4603-4621.
PMID: 36377721 DOI: 10.1080/10408398.2022.2143477

As a nutrient rich emulsion extracted from plant materials, plant-based milk (PBM) has been the latest trend and hot topic in the food industry due to the growing awareness of consumers toward plant-based products in managing the environmental (carbon footprint and land utility), ethical (animal well-fare) and societal (health-conscious) issues. There have been extensive studies and reviews done to discuss the distinct perspective of PBM including its production, health effects and market acceptance. However, not much has been emphasized on the valuable antioxidants present in PBM which is one of the attributes making them stand apart from dairy milk. The amounts of antioxidants in PBM are important. They offered tremendous health benefits in maintaining optimum health and reducing the risk of various health disorders. Therefore, enhancing the extraction of antioxidants and preserving their activity during production and storage is important. However, there is a lack of a comprehensive review of how these antioxidants changes in response to different processing steps involved in PBM production. Presumably, antioxidants in PBM could be potentially lost due to thermal degradation, oxidation or leaching into processing water. Hence, this paper aims to fill the gaps by addressing an extensive review of how different production steps (germination, roasting, soaking, blanching, grinding and filtration, and microbial inactivation) affect the antioxidant content in PBM. In addition, the effect of different microbial inactivation treatments (thermal or non-thermal processing) on the alteration of antioxidant in PBM was also highlighted. This paper can provide useful insight for the industry that aims in selecting suitable processing steps to produce PBM products that carry with them a health declaration.
Fulltext Feasibility of implementing chronic care model in the Malaysian public primary care setting

Ariffin F, Ramli AS, Daud MH, Haniff J, Abdul-Razak S, Selvarajah S, et al.

Med J Malaysia, 2017 04;72(2):106-112.
PMID: 28473673 MyJurnal

INTRODUCTION: Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM.

METHODOLOGY: A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM. All public PHC with Family Medicine Specialist in Selangor and Kuala Lumpur were invited to participate. A site feasibility questionnaire was distributed to collect site investigator and clinic information as well as delivery of care for diabetes and hypertension.

RESULTS: there were a total of 34 public PHC invited to participate with a response rate of 100%. there were 20 urban and 14 suburban clinics. the average number of patients seen per day ranged between 250-1000 patients. the clinic has a good mix of multidisciplinary team members. All clinics had a diabetic registry and 73.5% had a hypertensive registry. 23.5% had a dedicated diabetes and 26.5% had a dedicated hypertension clinic with most clinic implementing integrated care of acute and NCD cases.

DISCUSSION: the implementation of the essential components of CCM is feasible in public PHCs, despite various constraints. Although variations in delivery of care exists, majority of the clinics have adequate staff that were willing to be trained and are committed to improving patient care.
Coordination polymer-derived cobalt-embedded and N/S-doped carbon nanosheet with a hexagonal core-shell nanostructure as an efficient catalyst for activation of oxone in water

Tuan DD, Oh WD, Ghanbari F, Lisak G, Tong S, Andrew Lin KY

J Colloid Interface Sci, 2020 Nov 01;579:109-118.
PMID: 32574728 DOI: 10.1016/j.jcis.2020.05.033

As sulfate-radical (SR)-based advanced oxidation processes are increasingly implemented, Oxone has been frequently-used for generation of SR. While Co3O4 nanoparticle (NP) has been widely-accepted as a promising catalyst for activating Oxone, Co3O4 NPs tend to aggregate in water, losing their reactivity. Thus, many attempts have immobilized Co3O4 NPs on supports, especially carbonaceous substrates, because combination of Co NPs with carbon substrates offers synergistic effects for boosting catalytic activities. Moreover, carbon substrates doped with hetero-atoms (N and S) further increase electron transfer and reactivity. Therefore, it is even promising to immobilize Co NPs onto N/S-doped carbon (NSC) to form Co-embedded NSC (denoted as CoNSC) for enhancing Oxone activation. In this study, a convenient and facile technique is proposed to prepare such a CoNSC via a simple carbonization treatment of a coordination polymer of Co and trithiocyanuric acid (TTCA). The resulting CoNSC exhibits the sheet-like hexagonal morphology with the core-shell configuration, and Co NPs are well-embedded into the N/S-doped carbonaceous matrix, making it an advantageous heterogeneous catalyst for Oxone activation. As Azorubine S (ARS) decolorization is employed as a model reaction of Oxone activation, CoNSC exhibits a higher catalytic activity than pristine Co3O4 and NSC for Oxone activation to decolorize ARS. In comparison to the other reported catalysts, CoNSC also possesses a much lower Ea for ARS decolorization. CoNSC can be also reusable and stable for Oxone activation over multiple cycles without loss of catalytic activity. These features validate that CoNSC is a promising and useful Co-based catalyst for Oxone activation.
Fulltext The men's health gap: men must be included in the global health equity agenda

Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G

Bull World Health Organ, 2014 Aug 01;92(8):618-20.
PMID: 25197149 DOI: 10.2471/BLT.13.132795
Designing Calcium Silicate Cements with On-Demand Properties for Precision Endodontics

Cahyanto A, Rath P, Teo TX, Tong SS, Malhotra R, Cavalcanti BN, et al.

J Dent Res, 2023 Dec;102(13):1425-1433.
PMID: 37861249 DOI: 10.1177/00220345231198185

Calcium silicate (C3S) cements are available in kits that do not account for patients' specific needs or clinicians' preferences regarding setting time, radiopacity, mechanical, and handling properties. Moreover, slight variations in powder components and liquid content affect cement's properties and bioactivity. Unfortunately, it is virtually impossible to optimize several cement properties simultaneously via the traditional "one variable at a time" strategy, as inputs often induce trade-offs in properties (e.g., a higher water-to-powder ratio [W/P] increases flowability but decreases mechanical properties). Herein, we used Taguchi's methods and genetic algorithms (GAs) to simultaneously analyze the effect of multiple inputs (e.g., powder composition, radiopacifier concentration, and W/P) on setting time, pH, flowability, diametral tensile strength, and radiopacity, as well as prescribe recipes to produce cements with predicted properties. The properties of cements designed with GAs were experimentally tested, and the results matched the predictions. Finally, we show that the cements increased the genetic expression of odonto/osteogenic genes, alkaline phosphatase activity, and mineralization potential of dental pulp stem cells. Hence, GAs can produce cements with tailor-made properties and differentiation potential for personalized endodontic treatment.
Echocardiographic agreement in the diagnostic evaluation for infective endocarditis

Lauridsen TK, Selton-Suty C, Tong S, Afonso L, Cecchi E, Park L, et al.

Int J Cardiovasc Imaging, 2016 Jul;32(7):1041-51.
PMID: 27100526 DOI: 10.1007/s10554-016-0873-5

Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reproducibility for IE echocardiographic variables and (2) to describe a methodology for assessing quality in an observational cohort containing site-interpreted data. IE reproducibility was assessed on a subset of echocardiograms from subjects enrolled in the International Collaboration on Endocarditis registry. Specific echocardiographic case report forms were used. Intra-observer agreement was assessed from six site readers on ten randomly selected echocardiograms. Inter-observer agreement between sites and an echocardiography core laboratory was assessed on a separate random sample of 110 echocardiograms. Agreement was determined using intraclass correlation (ICC), coverage probability (CP), and limits of agreement for continuous variables and kappa statistics (κweighted) and CP for categorical variables. Intra-observer agreement for LVEF was excellent [ICC = 0.93 ± 0.1 and all pairwise differences for LVEF (CP) were within 10 %]. For IE categorical echocardiographic variables, intra-observer agreement was best for aortic abscess (κweighted = 1.0, CP = 1.0 for all readers). Highest inter-observer agreement for IE categorical echocardiographic variables was obtained for vegetation location (κweighted = 0.95; 95 % CI 0.92-0.99) and lowest agreement was found for vegetation mobility (κweighted = 0.69; 95 % CI 0.62-0.86). Moderate to excellent intra- and inter-observer agreement is observed for echocardiographic variables in the diagnostic assessment of IE. A pragmatic approach for determining echocardiographic data reproducibility in a large, multicentre, site interpreted observational cohort is feasible.

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