MyMedR

Adolescents' motivation to use social network sites from a psychological needs perspective

Wong SL, McLellan R

J Adolesc, 2024 Feb;96(2):305-321.

INTRODUCTION: Adolescents' social network sites (SNS) use is prominent during the developmental period. Various adolescents' motivations for using SNS have been reported. However, there is a lack of psychological perspectives in understanding the reasons for adolescents to use SNS. This study explored adolescents' motivation to use SNS, and a comprehensive psychological framework was used to dismantle adolescents' reasons and purposes for using SNS. Adolescents' ways of using SNS were explored to contextualize teens' SNS use.

METHODS: Semistructured interviews with 18 Malaysian adolescents (Mage = 15; 50% female; 10 Malay, 5 Chinese, 1 Indian, 1 Other Bumiputera) were conducted. The qualitative data were collected in 2021 in Malaysia through online video calls. Reflexive thematic analysis was the analytic approach.

RESULTS: Six motivations for using SNS were identified: social interaction, content subscription and exploration, emotional support, participation, distraction, and self-expression. Each of the motivations was explicitly linked with different psychological needs. Adolescents were found to use SNS differently in three aspects: deliberate use (i.e., on purpose of use and time spent on SNS), content-selective, and audience-selective.

CONCLUSION: This study demonstrates that psychological needs are the psychological reasons for adolescents' motivations for using SNS. Adolescence developmental tasks like strong peer identification and identity explorations are parts of the basic and compound psychological needs. Teens are pursuing a sense of self-coherence by using SNS. Adolescents demonstrated to use SNS differently at being deliberate and selective, which is speculated to be a result of the conflict between reflexive and reflective thought processes during SNS use.

Fulltext Children with learning disabilities in the paediatric clinic, Hospital Tuanku Ja'afar Seremban: an overview

Mariana AM, Wong SL

Med J Malaysia, 2011 Dec;66(5):487-90.

PMID: 22390107 MyJurnal

The aim of the study was to document the prevalence of learning disability among the children attending the Paediatric Clinic in Hospital Tuanku Ja'afar Seremban. The demographic distribution of these patients; the age of detection of the problem; the associated medical conditions and types of intervention received by these patients were documented. Patients who were between the ages of five to twelve years were included in the study. Learning disability was divided into three categories: speech and articulation problems, academic skills disorder and other categories which included developmental delay. Children with cerebral palsy were excluded from the study. Out of 1320 patients screened, 355 were found to have learning disorders. Majority were Malays, with the male to female ratio of 1.9:1. Most of the patients stayed in Seremban. The learning problem was most commonly detected at the age of 4 years and below. The commonest type of learning disorder was developmental delay, followed by academic skills disorder, speech and academic skills problems and speech disorders. Problems that were detected early were speech problems and developmental delay. Majority of the children had associated medical conditions. Most of the patients received some form of intervention but 11.3% did not attend any intervention program at all. A strategy should be formulated and implemented to help this group of children.

Study site: Paediatric Clinic in Hospital Tuanku Ja'afar Seremban

Traditional Cardiovascular Risk Factors in Adolescents with Type 1 Diabetes Mellitus

Donaghue K, Jeanne Wong SL

Curr Diabetes Rev, 2017;13(6):533-543.

PMID: 28120713 DOI: 10.2174/1573399813666170124095113

BACKGROUND: Cardiovascular disease (CVD) as a result of macrovascular changes is the leading cause of mortality in patients with type 1 diabetes (T1DM). While CVD complications are seen predominantly in adulthood, the atherosclerotic process begins in childhood and is accelerated in patients with T1DM. This review focuses on the epidemiology of traditional CVD risk factors in adolescents with T1DM, its association with markers of CVD and an overview of studies looking into each individual risk factor.

CONCLUSION: The risk factors that are reviewed here are hypertension, dyslipidemia, smoking, obesity, lack of exercise, hyperglycemia and diabetic nephropathy. We highlight the importance of early identification, and interventions, which include optimizing glycemic control, pharmacotherapy, regular physical activity and dietary changes.

Fulltext Observation of ureteric diameter in negative intravenous urogram in hospital universiti kebangsaan malaysia

Wong SL, Abdul Hamid H

Malays J Med Sci, 2010 Apr;17(2):4-9.

PMID: 22135531

This study observed the widest ureteric diameter in negative intravenous urogram (IVU) examinations using low osmolar contrast media.

Fulltext An unexpected cause of hoarseness of voice in a healthy teenager

Wong SL, Ibrahim ZA

Malays J Med Sci, 2010 Jan;17(1):52-5.

PMID: 22135527 MyJurnal

Laryngeal amyloidosis is a rare cause of stridor in a healthy young adult. We report a case of localised laryngeal amyloidosis, including our MRI findings, which included a necrotic centre that has not previously been described. This case also highlights the need for a high index of clinical suspicion to achieve the correct histopathological interpretation.

Fulltext Endolymphatic sac tumour

Zulkarnaen M, Tang IP, Wong SL

Malays J Pathol, 2012 Jun;34(1):53-5.

PMID: 22870599 MyJurnal

We present a case of a papillary tumour at the cerebellopontine angle in a 41-year-old man. He presented with left-sided facial and ear pain associated with dizziness, nystagmus and hearing loss. CT scan of the temporal bone showed a destructive tumour at the left cerebellopontine angle. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The definitive diagnosis requires a combination of clinical features, radiological finding and pathological correlation.

Fulltext Utilisation of specialist medical manpower in Malaysia

Wong SL, Mohan AJ, Suleiman AB

Med J Malaysia, 1998 Sep;53(3):245-50.

PMID: 10968161

One hundred and twenty specialists from the Ministry of Health, the Universities and the private sector provided information on 4,802 patients seen over a total of two hundred and forty working days. This information was used to classify the patients into four categories based on a disease complexity classification. Each specialist's perception on the appropriateness of utilisation of his expertise was obtained. Complex cases requiring specialist expertise in management made up 69.8%, 73.5% and 19.1% of the cases of the Ministry of Health, University and private sector specialists respectively. Underutilisation was most marked with paediatricians and obstetricians in the private sector. The Specialist Register, the Programme for Accreditation of Hospitals and a National Health Financing Plan can be used to influence positively the case-mix of specialists.

Fulltext Computed tomographic findings of cerebral fat embolism following multiple bone fractures

Law HL, Wong SL, Tan S

Singapore Med J, 2013 Feb;54(2):e28-30.

PMID: 23462838

Fat embolism to the lungs and brain is an uncommon complication following fractures. Few reports with descriptions of computed tomographic (CT) findings of emboli to the brain or cerebral fat embolism are available. We report a case of cerebral fat embolism following multiple skeletal fractures and present its CT findings here.

Fulltext Atretic cephalocele - an uncommon cause of cystic scalp mass

Wong SL, Law HL, Tan S

Malays J Med Sci, 2010 Jul;17(3):61-3.

PMID: 22135551

A 6 year-old girl presented with a midline parietal scalp swelling that had been gradually enlarging since birth. Magnetic resonance imaging revealed communication of the cyst with the subarachnoid space through a calvarial defect, with concomitant findings of vertically positioned straight venous sinus and subependymal grey matter heterotopia. A diagnosis of atretic cephalocele was thus made based on these classical imaging findings.

Fulltext Use of Wigglesworth pathophysiological classification for perinatal mortality in Malaysia

Amar HSS, Abdul Hamid M, Wong SL

Arch. Dis. Child. Fetal Neonatal Ed., 1996 Jan;74(1):F56-9.

PMID: 8653438

A one year prospective study of perinatal deaths was conducted to test the feasibility of using the Wigglesworth pathophysiological classification in the Malaysian health service. Four regions with high perinatal mortality rates were selected. Deaths were actively identified. Nursing staff were trained to use the classification and every death was reviewed by a clinician. A total of 26,198 births and 482 perinatal deaths were reported. The perinatal mortality rate was 18.4. Only 14 (2.9%) deaths had their Wigglesworth category reclassified. Most deaths were in the normally formed macerated stillbirths (34.4%), asphyxial conditions (26.8%), and immaturity (20.1%) subgroups. The results were compared with data from other countries that used this classification. This study has shown that the Wigglesworth pathophysiological classification can be applied to perinatal deaths in the existing Malaysian health service.

Access and Affordability of Medicines in Malaysia: Need for a National Pricing Policy

Wong SL, Ibrahim S, Abdul Kadir N, Mohd Salleh S

Appl Health Econ Health Policy, 2019 10;17(5):641-654.

PMID: 31093937 DOI: 10.1007/s40258-019-00480-9

BACKGROUND: High medicines prices are a barrier to medicines access, and their impact is greater in developing countries.

OBJECTIVE: This study assessed the availability, prices and affordability of medicines in public and private sectors in Malaysia to understand the pharmaceutical environment and guide policy recommendations.

METHODS: This nationwide cross-sectional study adapted the World Health Organization/Health Action International (WHO/HAI) methodology. A total of 87 premises from both public and private sectors participated in this study. Data on 50 medicines were collected to analyze availability, prices and affordability. Medicine prices were compared against the international reference prices (IRPs), and affordability was assessed by daily income level.

RESULTS: In the public sector, the average availability of generics (74.8%) was higher than that of the originator brand name products (19.4%). However, in the private sector, the availability of originator brands was higher (52.2%) than generics (49.1%). Procurement prices in the public sector were up to 1.5 times the IRPs, but up to 8.4 times in the private sector. The study also observed large price variation across medicines in the private sector. Median retail mark-ups in private hospitals (generics 166.9%; originators 51.0%) were higher than in retail pharmacies (generics 94.7%; originators 22.4%). Generics were generally affordable, but originator brands were unaffordable.

CONCLUSION: Current policies on generic medicines need to be strengthened to improve the availability and use of generics in the country. High medicine prices and large price variation in the current free market suggest that coherent pricing policies and regulations are needed to safeguard the accessibility and affordability of medicines for the people.

Fulltext Pharmacist-structured review of proton pump inhibitor utilisation in primary care: A nonrandomised control study

Wong SL, Sulaiman N, Ng KM, Lee ZY

Malays Fam Physician, 2021 Nov 30;16(3):87-96.

PMID: 34938396 DOI: 10.51866/oa1153

Introduction: In the primary care setting, proton pump inhibitor (PPI) overutilisation often stems from the failure to discontinue prophylaxis treatment prior to tertiary care discharge and consider step-down therapy following discharge. Long-term PPI use can result in potential drug-related problems and unnecessary drug expenditure. This study aimed to evaluate the effectiveness of pharmacist-structured review in reducing inappropriate PPI prescriptions and estimate the potential cost saving.

Methods: This non-randomised controlled study was conducted for 16 weeks at 17 government health clinics in Selangor, Malaysia. Eligible patients attending the outpatient pharmacies of intervention clinics were recruited consecutively and their consent was obtained. A structured review of PPIs was performed in which pharmacists identified patient demographics, indications and the length of PPI therapy using a PPI intervention form. Recommendations were discussed with physicians before prescription changes were made and documented. Moreover, standard management was conducted in the control clinics.

Results: A total of 568 patients with prescriptions containing PPIs were sampled, with a total of 284 patients being placed into the control and intervention groups, respectively. Compared to the control group, inappropriate PPI utilisation in the intervention group significantly decreased from 79.9 to 30.4% (p<0.05). The changes to PPI prescriptions observed in the intervention group included: stop PPI therapy (30.8%), step-down therapy (22.9%), start substitution therapy (15.9%) and no change (30.4%). The physicians' acceptance rate for pharmacist intervention was 67.8%. A 66.1% reduction in monthly PPI pill count and a 72.0% reduction in monthly medication expenditure (RM44.85/patient/year) were observed.

Conclusion: The pharmacist-structured review was effective in increasing appropriate PPI utilisation and led to substantial cost savings.

Extraskeletal myxoid chondrosarcoma of the thigh in a child: a case report

Ibrahim ZA, Chan WH, Wong SL, Ong EJ, Narihan MZ

J Orthop Surg (Hong Kong), 2014 Dec;22(3):423-6.

PMID: 25550031

Extraskeletal myxoid chondrosarcoma (EMC) is aggressive in children. The condition in children differs to that in adults and to skeletal myxoid chondrosarcoma. We report on a 9-year-old girl with EMC in her left thigh. She underwent above-knee amputation. Five months later, a small mass was noted at the right lower lobe of the lung. The patient underwent one course of ifosfamide, carboplatin, and etoposide chemotherapy, followed by resection of the mass and 8 more courses of chemotherapy. At the 2-year follow-up, she was in remission radiologically.

An unusual cause of blepharospasm

Sobri Muda A, Kwah YG, Al-Edrus SA, Wong SL, Norzaini MZ, Viswanathan S

Neuroradiol J, 2010 Nov;23(4):443-6.

PMID: 24148636

We describe a rare case of multiple dilated Virchow-Robin spaces in the brainstem in a patient presenting initially with blepharospasm with subsequent spread to involve the face and neck. On magnetic resonance imaging (MRI), these lesions demonstrated an isointense signal to cerebrospinal fluid on all sequences with no mass effect or enhancement. Although rare, this condition should be considered part of the differential diagnosis when evaluating cystic abnormalities in the brainstem. This is the first reported case of blepharospasm with subsequent orofacial and neck dystonia caused by dilated Virchow-Robin spaces. The imaging findings and differential diagnoses are discussed.

Epidemiology and strain characterization of rotavirus diarrhea in Malaysia

Hung LC, Wong SL, Chan LG, Rosli R, Ng AN, Bresee JS

Int J Infect Dis, 2006 Nov;10(6):470-4.

PMID: 17046306

The objectives of the study were to describe the epidemiology and strain characterization of rotavirus (RV), to determine the proportion of hospitalizations for diarrhea attributable to RV among children under 5 years of age, and to estimate the disease burden of RV diarrhea in Malaysia.

Cost-effectiveness analysis of Malaysian neonatal intensive care units

Cheah IG, Soosai AP, Wong SL, Lim TO, Cost-Effectiveness NICU Study Group

J Perinatol, 2005 Jan;25(1):47-53.

PMID: 15372062

To perform a cost-effective analysis on the care of infants between 1000 and 1500 g birthweight (the study group), where outcomes are measured as survival to 1 year of age.

Pyrolysis of low density polyethylene waste in subcritical water optimized by response surface methodology

Wong SL, Ngadi N, Amin NA, Abdullah TA, Inuwa IM

Environ Technol, 2016;37(2):245-54.

PMID: 26150081 DOI: 10.1080/09593330.2015.1068376

Pyrolysis of low density polyethylene (LDPE) waste from local waste separation company in subcritical water was conducted to investigate the effect of reaction time, temperature, as well as the mass ratio of water to polymer on the liquid yield. The data obtained from the study were used to optimize the liquid yield using response surface methodology. The range of reaction temperature used was 162-338°C, while the reaction time ranged from 37 min to 143 min, and the ratio of water to polymer ranged from 1.9 to 7.1. It was found that pyrolysis of LDPE waste in subcritical water produced hydrogen, methane, carbon monoxide and carbon dioxide, while the liquid product contained alkanes and alkenes with 10-50 carbons atoms, as well as heptadecanone, dichloroacetic acid and heptadecyl ester. The optimized conditions were 152.3°C, reaction time of 1.2 min and ratio of water solution to polymer of 32.7, with the optimum liquid yield of 13.6 wt% and gases yield of 2.6 wt%.

Microplastics and nanoplastics in global food webs: A bibliometric analysis (2009-2019)

Wong SL, Nyakuma BB, Wong KY, Lee CT, Lee TH, Lee CH

Mar Pollut Bull, 2020 Sep;158:111432.

PMID: 32753215 DOI: 10.1016/j.marpolbul.2020.111432

This paper presents the research landscape on microplastics and nanoplastics (M/NPs) in global food webs based on a bibliometric analysis of 330 publications published in 2009-2019 extracted from Web of Science. The publications increased tremendously since 2013. Marine Pollution Bulletin is one of the top productive journals for this topic. The publication landscape related to M/NPs in global food webs, as interdisciplinary research, is highly dependent on the funding availability. The high productivities of England, China, USA and European countries are attributed to the funding from the agencies at regional or national levels. Keyword analysis reveals the shift of research hotspots from investigations on M/NPs absorbed by various organisms in the ecosystems to studies on the trophic transfer of M/NPs and sorbed contaminants in the food webs and their associated adverse impacts. Funding agencies play important roles in leading the future development of this topic.

Fulltext Cryptococcal osteomyelitis of the femur: a case report and review of literature

Zainal AI, Wong SL, Pan KL, Wong OL, Tzar MN

Trop Biomed, 2011 Aug;28(2):444-9.

PMID: 22041767 MyJurnal

Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.

Perceptions among Muslims regarding fasting, medication use and provider engagement during Ramadan in the United States

Alshehri AM, Barner JC, Wong SL, Ibrahim KR, Qureshi S

Int J Health Plann Manage, 2021 May;36(3):945-957.

PMID: 33711183 DOI: 10.1002/hpm.3147

BACKGROUND: Muslims with chronic diseases tend to fast during Ramadan, although Islam allows them not to fast. Therefore, understanding their perceptions and how they manage their health, especially as a minority population, is very important.

OBJECTIVE: To examine Muslims' (1) perceptions of fasting exemptions, (2) medication usage behaviour, (3) perceptions of relationships with healthcare providers and (4) factors impacting health management during Ramadan.

METHOD: This was a qualitative study employing four focus groups (two groups of women and two groups of men). Adult Muslims (aged 18 years or more) with chronic diseases were invited to participate. Participants were asked open-ended questions about their fasting ability, medication usage behaviours, healthcare access and collaboration with providers during Ramadan. Trained researchers conducted the focus groups interviews in both English and Arabic. Each focus group was recorded, and three investigators independently transcribed the data and extracted themes and categories. Coding terminology issues were resolved through discussion.

RESULTS: Twenty-five Muslims with chronic diseases (e.g., diabetes, hypertension, renal failure and anaemia) participated. The most prominent themes/subthemes were as follows: (1) fasting exemption (e.g., uncontrolled medical conditions), (2) fasting nonexemption (e.g., controlled medical conditions), (3) nonoral medication use during Ramadan, (4) healthcare provider involvement during Ramadan, and (5) factors impacting health management during Ramadan.

CONCLUSION: Muslim patients perceive fasting as an important religious practice, so they tend to self-modify their medication-taking behaviours. Educating pharmacists and other healthcare providers about Muslim culture, especially their strong desire to fast, may lead to Muslims better managing their medications and viewing pharmacists and other healthcare providers as knowledgeable healthcare providers.

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