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Keratitis nummularis (Dimmer) among rice-cultivators in North Malaya

Lam WP

Med J Malaya, 1968 Jun;23(4):313-22.
PMID: 4235596
Fulltext A survey on mosquitoes breeding in septic tanks in several residential areas around Ipoh municipality

Lam WK, Dharmaraj D

Med J Malaysia, 1982 Jun;37(2):114-23.
PMID: 6127601

A survey on mosquito breeding in septic tanks in several residential areas was carried out on 211 septic tanks in the Ipoh Municipality. The septic tanks inspected comprised two types; the contact filter-bed with pump sump and pump motor type (Type A) and the subsoil [ilter trench type (Type B). Mosquito breeding occurred in. both types of septic tanks, with Type A septic tanks showing heavier breeding, Seventy-two (55.4 percent) of the 130 Type A septic tanks inspected had Aedes albopictus breeding. Besides being a nuisance, mosquito breeding is a potential threat to public health, as Ae. albopictus is a vector of dengue fever. Prolific breeding by Ae. albopictus was encountered in areas where Type A septic tanks were used. Other mosquitoes encountered in the survey were Culex qusnquefasciatus, Armigeres subabaltus and Uranotaenia spp. Analysis of effluent samples from Type A and Type B septic tanks revealed that of the 4 parameters measured (PH, chloride, BOD5 and Free Ammonia}, only pH was not significantly different at the 95 percent level of confidence. Chloride, BOD5 and Free Ammonia levels in. the Type B septic tanks were significantly higher than that in Type A septic tanks. Turbidity of the effluent in Type B septic tanks probably deters Ae. albopictusfrom breeding. Several methods to prevent breeding of mosquitoes in septic tanks were discussed. The easiest method is to mosquito-proof the septic tanks but this has been tried not too successfully. A method using expanded polystyrene balls is suggested. Other methods include the use of parasitic nematodes and the use of insecticides but these are not favourable.
Fulltext Unusual mediastinal lymph node uptake and peritoneopleural fistula demonstrated on Technetium-99m macro-aggregated human serum albumin (Tc-99m MAA) peritoneal scintigraphy in a patient with portal hypertension

Tan CJ, Thang SP, Lam WW

Med J Malaysia, 2016 04;71(2):69-71.
PMID: 27326945

Peritoneal radionuclide scan is an established imaging modality for evaluating peritoneopleural communications. In this case report, unusual mediastinal lymph node radiotracer uptake is seen in a patient with portal hypertension on peritoneal scintigraphy. This was suspected to be due to marked lymphatic enlargement from longstanding portal hypertension since childhood, permitting passage of the large Tc-99m MAA particle. The nodes were morphologically benign on CT. Mediastinal lymph node uptake on peritoneal scintigraphy is rare but should not raise undue clinical concern, particularly in a patient with chronic portal hypertension. Anatomic correlation with SPECT-CT can provide reassurance.
Fulltext A new clinical test for radial tunnel syndrome--the Rule-of-Nine test: a cadaveric study

Loh YC, Lam WL, Stanley JK, Soames RW

J Orthop Surg (Hong Kong), 2004 Jun;12(1):83-6.
PMID: 15237127 DOI: 10.1177/230949900401200115

Radial tunnel syndrome refers to pain on the lateral aspect of the forearm as a result of compression of the posterior interosseous nerve within a tunnel with specific anatomical boundaries. Diagnosis of the condition is difficult because of its close association with lateral epicondylitis, which warrants different methods of treatment. Based on a cadaveric study, a new clinical test, the Rule-of-Nine test, is proposed to improve the diagnostic accuracy in radial tunnel syndrome. The test involves constructing 9 equal squares on the anterior aspect of the forearm and noting those squares where tenderness can be elicited.
Fulltext Insulin-like growth factor binding protein 1, Bishop score, and sonographic cervical length: tolerability and prediction of vaginal birth and vaginal birth within 24 hours following labour induction in nulliparous women

Vallikkannu N, Lam WK, Omar SZ, Tan PC

BJOG, 2017 Jul;124(8):1274-1283.
PMID: 27348806 DOI: 10.1111/1471-0528.14175

OBJECTIVE: To evaluate the tolerability of cervical insulin-like growth factor binding protein 1 (IGFBP-1) and its value as a predictor of successful labour induction, compared with Bishop score and transvaginal ultrasound (TVUS) cervical length.
DESIGN: A prospective study.
SETTING: A tertiary hospital in Malaysia.
POPULATION: A cohort of 193 term nulliparous women with intact membranes.
METHODS: Prior to labour induction, cervical fluid was obtained via a vaginal speculum and tested for IGFBP-1, followed by TVUS and finally Bishop score. After each assessment the procedure-related pain was scored from 0 to 10. Cut-off values for Bishop score and cervical length were obtained from the receiver operating characteristic (ROC) curve. Multivariable logistic regression analysis was performed.
MAIN OUTCOMES MEASURES: Vaginal delivery and vaginal delivery within 24 hours of starting induction.
RESULTS: Bedside IGFBP-1 testing is better tolerated than Bishop score, but is less well tolerated than TVUS [median (interquartile range) of pain scores: 5 (4-5) versus 6 (5-7) versus 3 (2-3), respectively; P < 0.001]. IGFBP-1 independently predicted vaginal delivery (adjusted odds ratio, AOR 5.5; 95% confidence interval, 95% CI 2.3-12.9) and vaginal delivery within 24 hours of induction (AOR 4.9; 95% CI 2.1-11.6) after controlling for Bishop score (≥4 or ≥5), cervical length (≤29 or ≤27 mm), and other significant characteristics for which the Bishop score and TVUS were not predictive of vaginal delivery after adjustment. IGFBP-1 has 81% sensitivity, 59% specificity, positive and negative predictive values of 82 and 58%, respectively, and positive and negative likelihood ratios of 2.0 and 0.3 for vaginal delivery, respectively.
CONCLUSION: IGFBP-1 better predicted vaginal delivery than BS or TVUS, and may help guide decision making regarding labour induction in nulliparous women.
TWEETABLE ABSTRACT: IGFBP-1: a stronger independent predictor of labour induction success than Bishop score or cervical sonography.
Fulltext Effect of Macrolide Prophylactic Therapy on AIDS-Defining Conditions and HIV-Associated Mortality

Pasayan MKU, S Mationg ML, Boettiger D, Lam W, Zhang F, Ku SW, et al.

J Acquir Immune Defic Syndr, 2019 04 01;80(4):436-443.
PMID: 30550488 DOI: 10.1097/QAI.0000000000001933

BACKGROUND: Mycobacterium avium complex prophylaxis is recommended for patients with advanced HIV infection. With the decrease in incidence of disseminated Mycobacterium avium complex infection and the availability of antiretroviral therapy (ART), the benefits of macrolide prophylaxis were investigated. This study examined the impact of macrolide prophylaxis on AIDS-defining conditions and HIV-associated mortality in a cohort of HIV-infected patients on ART.
METHODS: Patients from TREAT Asia HIV Observational Database (September 2015 data transfer) aged 18 years and older with a CD4 count <50 cells/mm at ART initiation were included. The effect of macrolide prophylaxis on HIV-associated mortality or AIDS-defining conditions (as a combined outcome) and HIV-associated mortality alone were evaluated using competing risk regression. Sensitivity analysis was conducted in patients with a CD4 <100 cells/mm at ART initiation.
RESULTS: Of 1345 eligible patients, 10.6% received macrolide prophylaxis. The rate of the combined outcome was 7.35 [95% confidence interval (CI): 6.04 to 8.95] per 100 patient-years, whereas the rate of HIV-associated mortality was 3.14 (95% CI: 2.35 to 4.19) per 100 patient-years. Macrolide use was associated with a significantly decreased risk of HIV-associated mortality (hazard ratio 0.10, 95% CI: 0.01 to 0.80, P = 0.031) but not with the combined outcome (hazard ratio 0.86, 95% CI: 0.32 to 2.229, P = 0.764). Sensitivity analyses showed consistent results among patients with a CD4 <100 cells/mm at ART initiation.
CONCLUSIONS: Macrolide prophylaxis is associated with improved survival among Asian HIV-infected patients with low CD4 cell counts and on ART. This study suggests the increased usage and coverage of macrolide prophylaxis among people living with HIV in Asia.
Fulltext Cardiovascular disease incidence projections in the TREAT Asia HIV Observational Database (TAHOD)

Bijker R, Kumarasamy N, Kiertiburanakul S, Pujari S, Lam W, Chaiwarith R, et al.

Antivir Ther, 2019;24(4):271-279.
PMID: 30833516 DOI: 10.3851/IMP3298

BACKGROUND: We aimed to project the 10-year future incidence of cardiovascular disease (CVD) and model several intervention scenarios based on a multi-site Asian HIV-positive cohort.
METHODS: Analyses were based on patients recruited to the TREAT Asia HIV Observational Database (TAHOD), consisting of 21 sites in 12 countries. Patients on triple antiretroviral therapy (ART) were included if they were alive, without previous CVD, and had data on CVD risk factors. Annual new CVD events for 2019-2028 were estimated with the D:A:D equation, accounting for age- and sex-adjusted mortality. Modelled intervention scenarios were treatment of high total cholesterol, low high-density lipoprotein cholesterol (HDL) or high blood pressure, abacavir or lopinavir substitution, and smoking cessation.
RESULTS: Of 3,703 included patients, 69% were male, median age was 46 (IQR 40-53) years and median time since ART initiation was 9.8 years (IQR 7.5-14.1). Cohort incidence rates of CVD were projected to increase from 730 per 100,000 person-years (pys) in 2019 to 1,432 per 100,000 pys in 2028. In the modelled intervention scenarios, most events can be avoided by smoking cessation, abacavir substitution, lopinavir substitution, decreasing total cholesterol, treating high blood pressure and increasing HDL.
CONCLUSIONS: Our projections suggest a doubling of CVD incidence rates in Asian HIV-positive adults in our cohort. An increase in CVD can be expected in any ageing population, however, according to our models, this can be close to averted by interventions. Thus, there is an urgent need for risk screening and integration of HIV and CVD programmes to reduce the future CVD burden.