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Pre-admission therapy for childhood acute diarrhoea--a hospital-based study

Ng YJ, Lo YL, Lee WS

J Clin Pharm Ther, 2009 Feb;34(1):55-60.
PMID: 19125903 DOI: 10.1111/j.1365-2710.2008.00985.x

Acute gastroenteritis (AGE) is a common illness among infants and children contributing to significant mortality and morbidity. As such, appropriate treatment received prior to hospital admission is of utmost importance. This retrospective observational study aimed to determine preadmission management in paediatric patients prior to hospital admission. Two hundred and twenty-two case notes of paediatric AGE patients were reviewed over a 12-month period. One hundred and fifty-four patients received medications prior to admission with 143 (92.9%) patients received known classes of medications. Antipyretic agents were the most commonly prescribed (69.2%), followed by antibiotics (38.5%), anti-emetics (35.7%), oral rehydration salts (29.4%) and antidiarrhoeals (28.0%). The mean duration of stay in hospital was slightly shorter in patients, who received prior medications than those who did not (2.22 vs. 2.32 days respectively). Seventy per cent of children admitted for AGE were treated suboptimally prior to hospital admission with oral rehydration salts being largely under-utilized, despite their proven efficacy and safety. Sex, race and age had no influence on the type of preadmission treatment. A greater effort should be made to educate the general public in the appropriate treatment of AGE.
Fulltext A case of intussusception secondary to a metastatic malignant melanoma from the nasal cavity

Ng YJ, Loc LJ, Bun KS, Mushtaq S

J Surg Case Rep, 2023 Oct;2023(10):rjad572.
PMID: 37854518 DOI: 10.1093/jscr/rjad572

About 5% of all intussusception are found in adults, up to 90% of these have an anatomical lesion with ~50% of them are malignant. Malignant melanoma commonly metastasizes to the small bowel; however, melanoma causing intussusception is rare. We describe a 57-year-old lady with a history of surgically treated malignant melanoma in her nasal cavity who came with an ambiguous intestinal obstruction. Computed tomography reported ileal-ileal intussusception, which was surgically removed via emergency open laparotomy and bowel resection. Intraoperatively the intussusception was 110 cm from the ileo-cecal valve with multiple palpable lymph nodes. Histopathology confirmed the origin as malignant melanoma with lymphovascular invasion. Our literature review found the mean prevalence of intussusception secondary to melanoma was 6.924% (SD ± 5.155). Minimally invasive techniques are reported non-inferior to open laparotomy. We argue that the open technique can provide informed decisions for adequate resection of affected bowel and lymphatic drainage.
Fulltext A comprehensive review on the techniques for coconut oil extraction and its application

Ng YJ, Tham PE, Khoo KS, Cheng CK, Chew KW, Show PL

Bioprocess Biosyst Eng, 2021 Sep;44(9):1807-1818.
PMID: 34009462 DOI: 10.1007/s00449-021-02577-9

Virgin coconut oil is a useful substance in our daily life. It contains a high percentage of lauric acid which has many health benefits. The current industry has developed several methods to extract the oil out from the coconut fruit. This review paper aims to highlight several common extraction processes used in modern industries that includes cold extraction, hot extraction, low-pressure extraction, chilling, freezing and thawing method, fermentation, centrifugation, enzymatic extraction and supercritical fluid carbon dioxide. Different extraction methods will produce coconut oil with different yields and purities of lauric acid, thus having different uses and applications. Challenges that are faced by the industries in extracting the coconut oil using different methods of extraction are important to be explored so that advancement in the oil extraction technology can be done for efficient downstream processing. This study is vital as it provides insights that could enhance the production of coconut oil.
Sustainable smart photobioreactor for continuous cultivation of microalgae embedded with Internet of Things

Tham PE, Ng YJ, Vadivelu N, Lim HR, Khoo KS, Chew KW, et al.

Bioresour Technol, 2022 Feb;346:126558.
PMID: 34906702 DOI: 10.1016/j.biortech.2021.126558

This research work aims to fabricate an optimized up-scaled photobioreactor and extraction tank which incorporates the Internet of Things (IoT) for remote monitoring of selected parameters without being present in the lab as the industry is gradually moving towards the direction of remote operation. Several design factors were considered where modelling using ANSYS was carried out before the finalised design is drawn using AutoCAD. To monitor critical parameters that include liquid level, temperature, and pH condition during the operation of the tanks, water-proof sensors are implemented with the aid of Arduino NodeMCU board and the sensors are linked with Blynk, a smartphone application that allows remote monitoring via Wi-Fi connection. The sensors' results obtained using the Blynk application show high accuracy as compared with manual data except for photobioreactor liquid level. This shows that IoT and remote monitoring can be integrated successfully.
Fulltext The Conceptual Development of a Multifunctional Stepladder for Older People and Caregivers

Gan KW, Ng PK, Liew KW, Ng YJ, Yeow JA

Int J Environ Res Public Health, 2022 Nov 03;19(21).
PMID: 36361278 DOI: 10.3390/ijerph192114399

Stepladders are compact, foldable ladders with flat steps and a platform. Despite all the research and design efforts, there are still limitations in terms of the multifunctionality, usability and simplicity of stepladders and related variants. By combining ideas, features and functions from patent literature, existing products and scientific journals, this study aims to conceptualise a multifunctional stepladder for improved usability. Five concepts are created, which are screened and evaluated against a set of criteria to select the best concept for improved usability, divided into three categories: simplicity, effectiveness and efficiency. The result is a versatile invention that functions as a stepladder, walker, wheelchair and Pilates chair, suitable for older people and caregivers in nursing homes. It allows medical records or supplies to be retrieved from high places without the need for inappropriate aids. The invention can replace wheelchairs and walkers and converts into a Pilates chair to provide a mobile exercise option for older people. The concept offers older people flexibility and independence in terms of mobility and healthcare, while saving space in the nursing home. Further design studies, prototyping and testing are needed before this idea can go into production.
Fulltext A case of acute motor sensory axonal neuropathy variant of Guillain Barre syndrome and anaphylaxis reaction as a complication from hyaluronic acid breast enhancement from an unlicensed beautician

Ng YJ, Ling A, Nam LJ, Tylors PS, Bin Maliki AH, Wan Ali SA

J Surg Case Rep, 2023 May;2023(5):rjad254.
PMID: 37215624 DOI: 10.1093/jscr/rjad254

Guillain Barre syndrome (GBS) as a complication of hyaluronic acid (HA) exposure is an extremely rare occurrence. We report a case of GBS, acute motor sensory axonal neuropathy (AMSAN) variant, after a HA breast enhancement procedure. A 41-year-old lady underwent a HA breast enhancement procedure from an unlicensed beautician and developed anaphylaxis followed by bilateral breast abscess and neurological deficits involving both motor and sensory components. The AMSAN variant of GBS was diagnosed from the cytoalbuminologic dissociation and nerve conduction study. Her GBS and breast abscess were managed with plasmapheresis and bilateral mastectomy. In this case, GBS was highly suspected to be caused by HA with possible impurities. To the author's knowledge, the association between HA and GBS has not been reported or known, and further studies are required to establish this association. To prevent mortality and morbidity, breast enhancement procedures should be performed by trained professionals with properly vetted products.
Fulltext Floods Amidst COVID-19 in Malaysia: Implications on the Pandemic Responses

Ng YJ, Samy AL, Tan SL, Ramesh P, Hung WP, Ahmadi A, et al.

Disaster Med Public Health Prep, 2021 Dec 23.
PMID: 34937606 DOI: 10.1017/dmp.2021.371
The etiology of pediatric hydrocephalus across Asia: a systematic review and meta-analysis

Ferris E, Kynaston J, Dalle DU, Ng YJ, Leahy P, Hassan U, et al.

J Neurosurg Pediatr, 2024 Apr 01;33(4):323-333.
PMID: 38181497 DOI: 10.3171/2023.11.PEDS23389

OBJECTIVE: Despite the high prevalence and significant implications of pediatric hydrocephalus, the etiological distribution of pediatric hydrocephalus across the diverse Asian demographic is poorly understood. This study aimed to inform clinical guidelines and public health decisions by identifying the etiological distribution of pediatric hydrocephalus across Asia.
METHODS: In this systematic review and meta-analysis, the authors searched EMBASE, MEDLINE, CENTRAL, Global Health, Global Index Medicus, and Scopus, with no language restriction, from inception to January 27, 2023. Observational or experimental studies with pediatric data on the causes of hydrocephalus in a country within Asia were included. Pooled proportions of postinfectious hydrocephalus, nonpostinfectious hydrocephalus, and hydrocephalus related to spinal dysraphism were calculated using a random-effects model. Subgroup analyses were performed on prespecified moderators. Methodological study quality was assessed using the modified Newcastle-Ottawa Score and Cochrane's risk-of-bias tool as per the registered protocol on PROSPERO.
RESULTS: The search yielded 5110 results, for which 79 articles were included, with data on 11,529 children from 18 Asian countries. The pooled proportion of nonpostinfectious hydrocephalus was 29.0% (95% CI 22.9-35.5); postinfectious hydrocephalus was 10.7% (95% CI 7.7-14.1); and hydrocephalus secondary to dysraphism was 7.6% (95% CI 5.1-10.5). The pooled proportion of postinfectious hydrocephalus was greatest in lower-middle-income countries (19.2% [95% CI 12.8-26.3]). There was a negative association between the proportion of postinfectious hydrocephalus and Human Development Index (-1.45 [95% CI -2.21 to -0.69]; p < 0.001); urbanization of the country (-0.008 [95% CI -0.012 to -0.004]; p < 0.001); and increasing distance from the equator (-0.016 [95% CI -0.026 to -0.006]; p = 0.002). The pooled proportion of nonpostinfectious hydrocephalus was greatest in high-income countries (36.7% [95% CI 27.6-46.3]). Certain etiologies of pediatric hydrocephalus were more common in different cultural regions, with postinfectious hydrocephalus most common in South Asia (23.2% [95% CI 15.8-31.5]); nonpostinfectious in East Asia (38.3% [95% CI 26.6-50.7]); and dysraphism in West Asia (11.9% [95% CI 6.4-18.8]).
CONCLUSIONS: Geographic and economic characteristics are associated with the etiological distribution of pediatric hydrocephalus in Asia, with implications for prevention and management strategies. The large proportion of hydrocephalus cases in which the etiology was unclear highlights the need for both improved diagnostics as well as clear and strict universal guidelines on the etiological classification of hydrocephalus.
Recent advances and discoveries of microbial-based glycolipids: Prospective alternative for remediation activities

Ng YJ, Chan SS, Khoo KS, Munawaroh HSH, Lim HR, Chew KW, et al.

Biotechnol Adv, 2023 Nov;68:108198.
PMID: 37330152 DOI: 10.1016/j.biotechadv.2023.108198

Surfactants have always been a prominent chemical that is useful in various sectors (e.g., cleaning agent production industry, textile industry and painting industry). This is due to the special ability of surfactants to reduce surface tension between two fluid surfaces (e.g., water and oil). However, the current society has long omitted the harmful effects of petroleum-based surfactants (e.g., health issues towards humans and reducing cleaning ability of water bodies) due to their usefulness in reducing surface tension. These harmful effects will significantly damage the environment and negatively affect human health. As such, there is an urgency to secure environmentally friendly alternatives such as glycolipids to reduce the effects of these synthetic surfactants. Glycolipids is a biomolecule that shares similar properties with surfactants that are naturally synthesized in the cell of living organisms, glycolipids are amphiphilic in nature and can form micelles when glycolipid molecules clump together, reducing surface tension between two surfaces as how a surfactant molecule is able to achieve. This review paper aims to provide a comprehensive study on the recent advances in bacteria cultivation for glycolipids production and current lab scale applications of glycolipids (e.g., medical and waste bioremediation). Studies have proven that glycolipids are effective anti-microbial agents, subsequently leading to an excellent anti-biofilm forming agent. Heavy metal and hydrocarbon contaminated soil can also be bioremediated via the use of glycolipids. The major hurdle in the commercialization of glycolipid production is that the cultivation stage and downstream extraction stage of the glycolipid production process induces a very high operating cost. This review provides several solutions to overcome this issue for glycolipid production for the commercialization of glycolipids (e.g., developing new cultivating and extraction techniques, using waste as cultivation medium for microbes and identifying new strains for glycolipid production). The contribution of this review aims to serve as a future guideline for researchers that are dealing with glycolipid biosurfactants by providing an in-depth review on the recent advances of glycolipid biosurfactants. By summarizing the points discussed as above, it is recommended that glycolipids can substitute synthetic surfactants as an environmentally friendly alternative.