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Fulltext Placenta Praevia: Preach and Perception

Tan, KC, Chuah, CY, Fong, KY, Phang, SL, Nor Azlin, M.I.

Medicine & Health, 2007;2(2):139-145.
MyJurnal

Placenta praevia is a known obstetric condition that causes complications to mother and fetus. This study was done to evaluate the knowledge of placenta praevia amongst the obstetric patients. A cross sectional study was carried out in Hospital Ipoh, Perak among 323 antenatal and postnatal patients. Socio-demographic parameters (ie age, race, parity, occupation, educational level) and history of placenta praevia were studied in relation to level of knowledge and attitude towards placenta praevia. Twenty (6.2%) from 323 women had current or past history of placenta praevia. Three had history of placenta praevia while 17 had current placenta praevia with prevalence of 5.3%. The mean score of knowledge achieved by patients was 11.8 which indicated overall poor knowledge. Occupation, level of education and history of placenta praevia were found to have a relationship with level of knowledge regarding placenta praevia in all obstetric patients. There was a significant relationship between attitude of patients with current and history of placenta praevia to level of knowledge regarding placenta praevia. (p=0.037,
Fulltext Corrosive oesophageal stricture in Malaysian adults

Krishnan MMS, Tan KC

Med J Malaysia, 1983 Dec;38(4):325-6.
PMID: 6599992

M. M. Sudhakar Krishnan, MS, FRCS (Edin & Glasg).
Department of Surgery, University Hospital, Kuala Lumpur, Malaysia
Mullerian duct cyst (utricular cyst): treatment with the transvesical, transtrigonal approach

Goon HK, Tan KC, Sakijan AS

Aust N Z J Surg, 1987 Sep;57(9):683-6.
PMID: 3689258

The diagnosis of mullerian duct or utricular cyst should be considered in a child with urinary difficulties and a palpable midline, anterior rectal mass. Endoscopic cannulation of the cyst has been found to be the most useful diagnostic test. Infection should be treated with the appropriate antibiotics before definitive treatment. Surgical excision offers the best result. The transperitoneal and posterior parasacral approaches have been described but we favour the transvesical, transtrigonal approach which we find highly satisfactory. The risk of malignancy at a later age is an added indication for surgery.
A comparison of radiometric correction techniques in the evaluation of the relationship between LST and NDVI in Landsat imagery

Tan KC, Lim HS, Matjafri MZ, Abdullah K

Environ Monit Assess, 2012 Jun;184(6):3813-29.
PMID: 21755424 DOI: 10.1007/s10661-011-2226-0

Atmospheric corrections for multi-temporal optical satellite images are necessary, especially in change detection analyses, such as normalized difference vegetation index (NDVI) rationing. Abrupt change detection analysis using remote-sensing techniques requires radiometric congruity and atmospheric correction to monitor terrestrial surfaces over time. Two atmospheric correction methods were used for this study: relative radiometric normalization and the simplified method for atmospheric correction (SMAC) in the solar spectrum. A multi-temporal data set consisting of two sets of Landsat images from the period between 1991 and 2002 of Penang Island, Malaysia, was used to compare NDVI maps, which were generated using the proposed atmospheric correction methods. Land surface temperature (LST) was retrieved using ATCOR3_T in PCI Geomatica 10.1 image processing software. Linear regression analysis was utilized to analyze the relationship between NDVI and LST. This study reveals that both of the proposed atmospheric correction methods yielded high accuracy through examination of the linear correlation coefficients. To check for the accuracy of the equation obtained through linear regression analysis for every single satellite image, 20 points were randomly chosen. The results showed that the SMAC method yielded a constant value (in terms of error) to predict the NDVI value from linear regression analysis-derived equation. The errors (average) from both proposed atmospheric correction methods were less than 10%.
Fulltext A Comparative Study of Respiratory Quality of Life among Firefighters, Traffic Police and Other Occupations in Malaysia

Chean KY, Abdulrahman S, Chan MW, Tan KC

Int J Occup Environ Med, 2019 10;10(4):203-215.
PMID: 31586385 DOI: 10.15171/ijoem.2019.1657

BACKGROUND: Despite its excellent psychometric properties, St George's Respiratory Questionnaire (SGRQ) has not been previously used in measuring respiratory quality of life (RQoL) among traffic police and firefighters who are at risk of poor respiratory health by virtue of their occupations.
OBJECTIVE: To assess and compare the RQoL of the occupationally exposed (firefighters and traffic police) and the occupationally unexposed populations in Penang, Malaysia.
METHODS: We recruited male traffic police and firefighters from 5 districts of Penang by convenient sampling during June to September 2018. Participants completed the SGRQ. Scores (symptoms, activity, impacts, total) were derived using a scoring calculator. Higher scores indicate poorer RQoL. Univariate and multivariate linear regression models were fitted to explore the relationship of the independent predictive factors with participants' RQoL.
RESULTS: We recruited 706 participants---211 firefighters, 198 traffic police, and 297 from general population. Smokers had significantly higher scores than non-smokers in all SGRQ domains. Regardless of smoking status, the "occupationally exposed group" had higher symptoms score than the "occupationally unexposed group," who had higher activity and impact scores. Smoking status, comorbidity status and monthly income were significant independent predictors of SGRQ total score.
CONCLUSION: In comparison with the general population, firefighters and traffic police reported poorer RQoL; smoking further deteriorated their respiratory health. There is a need to strengthen preventive health measures against occupational disease and smoking cessation among firefighters and traffic police.
Multiple regression analysis in modeling of columnar ozone in Peninsular Malaysia

Tan KC, Lim HS, Mat Jafri MZ

Environ Sci Pollut Res Int, 2014 Jun;21(12):7567-77.
PMID: 24599658 DOI: 10.1007/s11356-014-2697-y

This study aimed to predict monthly columnar ozone (O3) in Peninsular Malaysia by using data on the concentration of environmental pollutants. Data (2003-2008) on five atmospheric pollutant gases (CO2, O3, CH4, NO2, and H2O vapor) retrieved from the satellite Scanning Imaging Absorption Spectrometer for Atmospheric Chartography (SCIAMACHY) were employed to develop a model that predicts columnar ozone through multiple linear regression. In the entire period, the pollutants were highly correlated (R = 0.811 for the southwest monsoon, R = 0.803 for the northeast monsoon) with predicted columnar ozone. The results of the validation of columnar ozone with column ozone from SCIAMACHY showed a high correlation coefficient (R = 0.752-0.802), indicating the model's accuracy and efficiency. Statistical analysis was utilized to determine the effects of each atmospheric pollutant on columnar ozone. A model that can retrieve columnar ozone in Peninsular Malaysia was developed to provide air quality information. These results are encouraging and accurate and can be used in early warning of the population to comply with air quality standards.
Fulltext Fostering closed-loop supply chain orientation by leveraging strategic green capabilities for circular economy performance: empirical evidence from Malaysian electrical and electronics manufacturing firms

Shaharudin MR, Zailani S, Tan KC, Cross J, Hotrawaisaya C

Environ Dev Sustain, 2023 Jan 18.
PMID: 36687740 DOI: 10.1007/s10668-022-02832-3

In recent years, the concept of a circular economy (CE) has gained importance and attracted significant attention among scholars and practitioners. Research that examines the firm's supply chain capabilities and orientation for performance is well established nonetheless still lacking in supporting the transition from a linear economy to a circular economy. The firms can foster a closed-loop supply chain orientation (CLSCO) through strategic green capabilities as an alternative obtainable to SC firms to achieve CE performance. Thus, this study is interested to examine the antecedents and outcomes of CLSCO by applying the Resource-Based View and Natural Resource-Based View theories. In total, 150 Malaysian manufacturers responded to the survey and were analysed using the SEM Lisrel method. Among the hypotheses tested, only one had no direct effect on CLSCO, and that was the recovery capacities. The remaining hypothesis indicates that CLSCO is positively affected by integration and production capabilities. In contrast, the results of CLSCO indicate that the extent of a company's CLSCO does affect its success in the circular economy. The study concludes, based on the RBV and NRBV principles, that the success of firms in optimising their resources would enable them to use the CLSCO and attain CE performance. Thus, there are numerous ways in which this study can provide practitioners with valuable research insights.
Anesthetic management of a parturient with superior vena cava obstruction for cesarean section

Chan YK, Ng KP, Chiu CL, Rajan G, Tan KC, Lim YC

Anesthesiology, 2001 Jan;94(1):167-9.
PMID: 11135739
Fulltext Pharmacological evaluation of aqueous root extract of Selayak Hitam: lack of oxytocic activity

Gan EK, Abdul Razak D, Mohamad M, Lajis R, Tan KC, Sam TW

Med J Malaysia, 1984 Mar;39(1):42-7.
PMID: 6513839

Aqueous root extract of Selayak Hitam a plant commonly found in Malaysian jungles and reported to have abortifacient property was screened for oxytocic effect. Results obtained from in vitro experiments on isolated uterus preparation from both pregnant and non pregnant rats and in vivo experiments on uterus contraction in rats in situ, showed that the extract lacks oxytocic effect. It is concluded that the alleged abortifacient property if any, is not mediated through oxytocin or oxytocic-like effect.
Fulltext Barriers to smoking cessation: a qualitative study from the perspective of primary care in Malaysia

Chean KY, Goh LG, Liew KW, Tan CC, Choi XL, Tan KC, et al.

BMJ Open, 2019 07 09;9(7):e025491.
PMID: 31289057 DOI: 10.1136/bmjopen-2018-025491

OBJECTIVES: This qualitative study aims to construct a model of the barriers to smoking cessation in the primary care setting.
DESIGN: Individual in-depth, semistructured interviews were audio-taped, then verbatim transcribed and translated when necessary. The data were first independently coded and then collectively discussed for emergent themes using the Straussian grounded theory method.
PARTICIPANTS AND SETTING: Fifty-seven current smokers were recruited from a previous smoking related study carried out in a primary care setting in Malaysia. Current smokers with at least one failed quit attempts were included.
RESULTS: A five-theme model emerged from this grounded theory method. (1) Personal and lifestyle factors: participants were unable to resist the temptation to smoke; (2) Nicotine addiction: withdrawal symptoms could not be overcome; (3) Social cultural norms: participants identified accepting cigarettes from friends as a token of friendship to be problematic; (4) Misconception: perception among smokers that ability to quit was solely based on one's ability to achieve mind control, and perception that stopping smoking will harm the body and (5) Failed assisted smoking cessation: smoking cessation services were not felt to be user-friendly and were poorly understood. The themes were organised into five concentric circles based on time frame: those actionable in the short term (themes 1 and 2) and the long term (themes 3, 4, 5).
CONCLUSIONS: Five themes of specific beliefs and practices prevented smokers from quitting. Clinicians need to work on these barriers, which can be guided by the recommended time frames to help patients to succeed in smoking cessation.
Influence of bariatric surgery on weight reduction and control of chronic disease among obese patients in Malaysia

Tan KC, Chang CT, Cheah WK, Vinayak CR, Chan HK

Med J Malaysia, 2019 Jun;74(3):215-218.
PMID: 31256176

INTRODUCTION: This study was designed to determine the influence of bariatric surgery on changes in the body mass index (BMI), and the control of diabetes, hypertension and dyslipidaemia among obese patients in Malaysia.
MATERIALS AND METHODS: This was a retrospective cohort study undertaken at a public tertiary care centre in the state of Perak, Malaysia. Information of obese patients who underwent bariatric surgery was obtained from their medical records. The changes in the BMI, HbA1C, systolic and diastolic blood pressure (SBP and DBP), and lipid levels between three months before and after the surgery were assessed.
RESULTS: The patients (n=106) were mostly Malay (66.0%), had at least one comorbidity (61.3%), and had a mean age of 40.38±11.75 years. Following surgery, the BMI of the patients was found to reduce by 9.78±5.82kg/m2. For the patients who had diabetes (n=24) and hypertension (n=47), their mean HbA1C, SBP and DBP were also shown to reduce significantly by 2.02±2.13%, 17.19±16.97mmHg, and 11.45±12.63mmHg, respectively. Meanwhile, the mean total cholesterol, triglyceride and low-density lipoprotein levels of those who had dyslipidaemia (n=21) were, respectively, lowered by 0.91±1.18mmol/L, 0.69±1.11mmol/L and 0.47±0.52mmol/L.
CONCLUSION: The findings suggest that in addition to weight reduction, bariatric surgery is helpful in improving the diabetes, hypertension and dyslipidaemia control among obese patients. However, a large-scale trial with a control group is required to verify our findings.
Fulltext Effectiveness of the use of internet search by third year medical students to establish a clinical diagnosis

Nalliah S, Chan SL, Ong CL, Suthan TH, Tan KC, She VN, et al.

Singapore Med J, 2010 Apr;51(4):332-8.
PMID: 20505913

Internet search has been the main source for information and data mining in medical research. Its use by medical students has immensely contributed to learning activities. The main aim of the study was to determine the effectiveness of internet use by medical students during their initial years of clinical instruction in order to establish a diagnosis after being provided with the history and physical findings of a clinical problem.
Fulltext Depression, anxiety and stress among patients with diabetes in primary care: A cross-sectional study

Tan KC, Chan GC, Eric H, Maria AI, Norliza MJ, Oun BH, et al.

Malays Fam Physician, 2015;10(2):9-21.
PMID: 27099657 MyJurnal

Background: The incidence of diabetes mellitus is ever increasing. Individuals with diabetes mellitus may have concurrent mental health disorders and are shown to have poorer disease outcomes. The objectives of this study were to determine the prevalence of depression, anxiety and stress (DAS) in diabetes patients aged 20 years or more in the primary care setting.
Methods: This was a cross-sectional study involving the use of self-administered questionnaire conducted in eight primary care private and government clinics in Pulau Pinang and Melaka, Malaysia. The validated DASS-21 questionnaire was used as a screening tool for the symptoms of DAS. Prior permission was obtained from the patients and, clearance from ethical committee was obtained before the start of the study. Data analysis was done using SPSS statistical software.
Results: A total of 320 patients with diabetes from eight centres were enrolled via convenience sampling. Sample size was calculated using the Kish’s formula. The prevalence of DAS among patients with diabetes from our study was 26.6%, 40% and 19.4%, respectively. Depression was found to be significantly associated with marital status and family history of DAS; anxiety was significantly
associated with monthly household income, presence of co-morbidities and family history of DAS; and stress was significantly associated with occupation and family history of DAS.
Conclusions: The prevalence of DAS was higher in patients with diabetes compared with the general community. We recommend to routinely screen all patients with diabetes using the DASS-21 questionnaire because it is easy to perform and inexpensive.
Realizing room temperature catalytic hydrogenation of sodium phenoxide by Ru/TiO2 for hydrogen storage

Tan KC, Pei Q, Yu J, Wen H, Yu Y, Wang J, et al.

Chem Commun (Camb), 2023 Apr 04;59(28):4177-4180.
PMID: 36942825 DOI: 10.1039/d3cc00068k

Sodium phenoxide is a potentially promising hydrogen storage material due to its high hydrogen capacity and enhanced thermodynamic properties. Nevertheless, efficient catalysts are still lacking due to the high kinetic barrier for the reversible hydrogen uptake and release of sodium phenoxide. In the current work, a comparative study on the catalytic hydrogenation of sodium phenoxide was conducted. To our delight, a simple yet effective ruthenium-based catalyst was identified to respond aggressively to hydrogen in the solid-state hydrogenation of sodium phenoxide even at room temperature. The activity was enhanced by 6 fold with the as-synthesized 5.0% Ru/TiO2 catalyst as compared to that with commercial 5.0% Ru/Al2O3, respectively, under the same conditions.
Sodium anilinide-cyclohexylamide pair: synthesis, characterization, and hydrogen storage properties

Jing Z, Yu Y, Chen R, Tan KC, He T, Wu A, et al.

Chem Commun (Camb), 2020 Jan 22.
PMID: 31967625 DOI: 10.1039/c9cc08593a

The lack of efficient hydrogen storage material is one of the bottlenecks for the large-scale implementation of hydrogen energy. Here, a series of new hydrogen storage materials, i.e., anilinide-cyclohexylamide pairs, are proposed via the metallation of an aniline-cyclohexylamine pair. DFT calculations show that the enthalpy change of hydrogen desorption (ΔHd) can be significantly tuned from 60.0 kJ per mol-H2 for the pristine aniline-cyclohexylamine pair to 42.2 kJ per mol-H2 for sodium anilinide-cyclohexylamide and 38.7 kJ per mol-H2 for potassium anilinide-cyclohexylamide, where an interesting correlation between the electronegativity of the metal and the ΔHd was observed. Experimentally, the sodium anilinide-cyclohexylamide pair was successfully synthesised with a theoretical hydrogen capacity of 4.9 wt%, and the hydrogenation and dehydrogenation cycle can be achieved at a relatively low temperature of 150 °C in the presence of commercial catalysts, in clear contrast to the pristine aniline-cyclohexylamine pair which undergoes dehydrogenation at elevated temperatures.
Fulltext Nanosizing Approach-A Case Study on the Thermal Decomposition of Hydrazine Borane

Abu Osman NA, Nordin NI, Tan KC, Hosri NAHA, Pei Q, Ng EP, et al.

Materials (Basel), 2023 Jan 16;16(2).
PMID: 36676604 DOI: 10.3390/ma16020867

Hydrazine borane (HB) is a chemical hydrogen storage material with high gravimetric hydrogen density of 15.4 wt%, containing both protic and hydridic hydrogen. However, its limitation is the formation of unfavorable gaseous by-products, such as hydrazine (N2H4) and ammonia (NH3), which are poisons to fuel cell catalyst, upon pyrolysis. Previous studies proved that confinement of ammonia borane (AB) greatly improved the dehydrogenation kinetics and thermodynamics. They function by reducing the particle size of AB and establishing bonds between silica functional groups and AB molecules. In current study, we employed the same strategy using MCM-41 and silica aerogel to investigate the effect of nanosizing towards the hydrogen storage properties of HB. Different loading of HB to the porous supports were investigated and optimized. The optimized loading of HB in MCM-41 and silica aerogel was 1:1 and 0.25:1, respectively. Both confined samples demonstrated great suppression of melting induced sample foaming. However, by-products formation was enhanced over dehydrogenation in an open system decomposition owing to the presence of extensive Si-O···BH3(HB) coordination that further promote the B-N bond cleavage to release N2H4. The Si-OH···N(N2H4) hydrogen bonding may further promote N-N bond cleavage in the resulting N2H4, facilitating the formation of NH3. As temperature increases, the remaining N-N-B oligomeric chains in the porous silica, which are lacking the long-range structure may further undergo intramolecular B-N or N-N cleavage to release substantial amount of N2H4 or NH3. Besides open system decomposition, we also reported a closed system decomposition where complete utilization of the N-H from the released N2H4 and NH3 in the secondary reaction can be achieved, releasing mainly hydrogen upon being heated up to high temperatures. Nanosizing of HB particles via PMMA encapsulation was also attempted. Despite the ester functional group that may favor multiple coordination with HB molecules, these interactions did not impart significant change towards the decomposition of HB selectively towards dehydrogenation.
Fulltext Assessing airflow limitation among smokers in a primary care setting

Chean KY, Rahim FF, Chin JS, Choi XL, Liew KW, Tan CC, et al.

Malays J Med Sci, 2018 May;25(3):78-87.
PMID: 30899189 MyJurnal DOI: 10.21315/mjms2018.25.3.8

Background: Many smokers have undiagnosed chronic obstructive pulmonary disease (COPD), and yet screening for COPD is not recommended. Smokers who know that they have airflow limitation are more likely to quit smoking. This study aims to identify the prevalence and predictors of airflow limitation among smokers in primary care.
Methods: Current smokers ≥ 40 years old who were asymptomatic clinic attendees in a primary care setting were recruited consecutively for two months. We used a two-step strategy. Step 1: participants filled in a questionnaire. Step 2: Assessment of airflow limitation using a pocket spirometer. Multiple logistic regression was utilised to determine the best risk predictors for airflow limitation.
Results: Three hundred participants were recruited. Mean age was 58.35 (SD 10.30) years old and mean smoking history was 34.56 pack-years (SD 25.23). One in two smokers were found to have airflow limitation; the predictors were Indian ethnicity, prolonged smoking pack-year history and Lung Function Questionnaire score ≤ 18. Readiness to quit smoking and the awareness of COPD were low.
Conclusions: The high prevalence of airflow limitation and low readiness to quit smoking imply urgency with helping smokers to quit smoking. Identifying airflow limitation as an additional motivator for smoking cessation intervention may be considered. A two-step case-finding method is potentially feasible.
Study site: primary care clinic (outpatient clinic), Pulau Pinang, Malaysia
Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study

Chang CT, Chan HK, Cheah WK, Tan MP, Ch'ng ASH, Thiam CN, et al.

J Pharm Policy Pract, 2023 Oct 19;16(1):122.
PMID: 37858273 DOI: 10.1186/s40545-023-00630-4

INTRODUCTION: Polypharmacy and potentially inappropriate medications (PIM) are common among older adults. To guide appropriate prescribing, healthcare professionals often rely on explicit criteria to identify and deprescribe inappropriate medications, or to start medications due to prescribing omission. However, most explicit PIM criteria were developed with inadequate guidance from quality metrics or integrating real-world data, which are rich and valuable data source.
AIM: To develop a list of medications to facilitate appropriate prescribing among older adults.
METHODS: A preliminary list of PIM and potential prescribing omission (PPO) were generated from systematic review, supplemented with local pharmacovigilance data of adverse reaction incidents among older people. Twenty-one experts from nine specialties participated in two Delphi to determine the list of PIM and PPO in February and March 2023. Items that did not reach consensus after the second Delphi round were adjudicated by six geriatricians.
RESULTS: The preliminary list included 406 potential candidates, categorised into three sections: PIM independent of diseases, disease dependent PIM and omitted drugs that could be restarted. At the end of Delphi, 92 items were decided as PIM, including medication classes, such as antacids, laxatives, antithrombotics, antihypertensives, hormones, analgesics, antipsychotics, antidepressants, and antihistamines. Forty-two disease-specific PIM criteria were included, covering circulatory system, nervous system, gastrointestinal system, genitourinary system, and respiratory system. Consensus to start potentially omitted treatment was achieved in 35 statements across nine domains.
CONCLUSIONS: The newly developed PIM criteria can serve as a useful tool to guide clinicians and pharmacists in identifying PIMs and PPOs during medication review and facilitating informed decision-making for appropriate prescribing.

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