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The effect of spent coffee ground (SCG) loading, matrix ratio and biological treatment of SCG on poly(hydroxybutyrate) (PHB)/poly(lactic acid) (PLA) polymer blend

Boey JY, Kong U, Lee CK, Lim GK, Oo CW, Tan CK, et al.

Int J Biol Macromol, 2024 May;266(Pt 2):131079.
PMID: 38537860 DOI: 10.1016/j.ijbiomac.2024.131079

This study investigates the effects of SCG embedded into biodegradable polymer blends and aimed to formulate and characterise biomass-reinforced biocomposites using spent coffee ground (SCG) as reinforcement in PHB/PLA polymer blend. The effect of SCG filler loading and varying PHB/PLA ratios on the tensile properties and morphological characteristics of the biocomposites were examined. The results indicated that tensile properties reduction could be due to its incompatibility with the PHB/PLA matrixSCG aggregation at 40 wt% content resulted in higher void formation compared to lower content at 10 wt%. A PHB/PLA ratio of 50/50 with SCG loading 20 wt% was chosen for biocomposites with treated SCG. Biological treatment of SCG using Phanerochaete chrysosporium CK01 and Aspergillus niger DWA8 indicated P. chrysosporium CK01 necessitated a higher moisture content for optimum growth and enzyme production, whereas the optimal conditions for enzyme production (50-55 %, w/w) differed from those promoting A. niger DWA8 growth (40 %, w/w). SEM micrographs highlighted uniform distribution and effective wetting of treated SCG, resulting in improvements of tensile strength and modulus of biocomposites, respectively. The study demonstrated the effectiveness of sustainable fungal treatment in enhancing the interfacial adhesion between treated SCG and the PHB/PLA matrix.
Assessment of Evaporative Demand Drought Index for drought analysis in Peninsular Malaysia

Ng CY, Wan Jaafar WZ, Othman F, Lai SH, Mei Y, Juneng L

Sci Total Environ, 2024 Mar 20;917:170249.
PMID: 38278251 DOI: 10.1016/j.scitotenv.2024.170249

An effective drought monitoring tool is essential for the development of timely drought early warning system. This study evaluates Evaporative Demand Drought Index (EDDI) as a drought indicator in measuring spatiotemporal evolution of droughts over Peninsular Malaysia during 1989-2018. The modified Mann-Kendall and Sen's slope tests were performed to detect the presence of monotonic trends in EDDI, Standardized Precipitation Index (SPI), Standardized Precipitation Evapotranspiration Index (SPEI) and their related climate variables. The performance of EDDI in capturing the drought onset, evolutions and demise of historical severe droughts was also compared with SPI and SPEI at multiple timescales. EDDI demonstrates strong spatiotemporal correlations with SPI and SPEI and comparable performance in historical drought events identification. At sub-monthly timescale, 2-week EDDI displays equivalent drought severities and durations for all historical severe droughts corresponding to the monthly EDDI. In the case when rainfall deficits are normalized in an otherwise warm and dry month, EDDI may serve as a great alternative to SPI and SPEI due to it being sensitive to the changes in prevalent atmospheric conditions. Collectively, the results fill in the knowledge gaps on drought evolutions from the evaporative perspective and highlight the efficacy of EDDI as a valuable drought early warning tool for Peninsular Malaysia. Future study should explore the physical mechanisms behind the development of flash drought and the role of evaporation in the drought propagation processes.
Fulltext Computational, optical and feasibility studies of organic luminescence TMB-PPT blend for photovoltaic application

Sharma T, Nguyen TTH, Nguyen NH, Ngo HL, Soo YH, Ng CY, et al.

Heliyon, 2024 Feb 29;10(4):e26048.
PMID: 38370184 DOI: 10.1016/j.heliyon.2024.e26048

For enhanced applications of solar cells, organic luminescence materials like long persistent luminescence (LPL) present one of the promising avenues for light enhancement. Currently, most existing luminescent materials are based on an inorganic system that requires rare elements such as europium and dysprosium, with a very high processing temperature. Adopting organic luminescence materials that are free from rare elements is necessary, considering the low-temperature fabrication and low material cost. In this work, we investigate the optical properties of an organic luminescence blend consisting of 2,8-bis(diphenylphosphoryl)dibenzo [b,d]thiophene (PPT) and N,N,N',N'-tetramethylbenzidine (TMB) through computational studies and experimental validations. Optical characteristics of the luminescence materials like optical absorption, photoluminescence, and time-resolved photoluminescence spectroscopy are characterized. To validate the functionality of the organic luminescence blend, the material is incorporated into the perovskite solar cell structure. Unfortunately, the blend is unable to emit sufficient illumination over extended periods due to its low intersystem crossing efficiency and weak spin-orbit coupling. Although the power conversion efficiency of the Luminescence/FTO/TiO2/Perovskite/Carbon structure is observed to be small under dark conditions, the application of organic luminescence materials can be further enhanced and explored.
Fulltext A Rare Case of Ectopic Adrenocorticotropic Hormone Secretion from Pancreatic Neuroendocrine Tumour Presenting with Cushing Syndrome

Lee SL, Ng CY, Sidhu J, Awang A

GE Port J Gastroenterol, 2023 Jun;30(3):239-242.
PMID: 37387716 DOI: 10.1159/000521518

Ectopic adrenocorticotropic hormone secretion (EAS) from the pancreatic neuroendocrine tumour (PNET) is rare, aggressive, and challenging to treat. We hereby present a rare case of EAS from PNET presenting with Cushing syndrome diagnosed with endoscopic ultrasound-guided fine-needle aspiration cytology. This case highlights the advanced presentation of EAS from PNET with poor clinical correlation of hypercortisolism and the grade of PNET.
Sustained clinical knowledge improvements from simulation experiences with Simulation via Instant Messaging-Birmingham Advance

Zhou D, Davitadze M, Ooi E, Ng CY, Allison I, Thomas L, et al.

Postgrad Med J, 2023 Mar 22;99(1167):25-31.
PMID: 36947426 DOI: 10.1093/postmj/qgac008

BACKGROUND: Simulation via Instant Messaging-Birmingham Advance (SIMBA) delivers simulation-based learning through WhatsApp and Zoom, helping to sustain continuing medical education (CME) for postgraduate healthcare professionals otherwise disrupted by the coronavirus (COVID-19) pandemic. This study aimed to assess whether SIMBA helped to improve clinical knowledge and if this improvement in knowledge was sustained over time.
METHODS: Two SIMBA sessions-thyroid and pituitary-were conducted in July-August 2020. Each session included simulation of various real-life cases and interactive discussion. Participants' self-reported confidence, acceptance, and knowledge were measured using surveys and multiple-choice questions pre- and post-simulation and in a 6- to 12-week follow-up period. The evaluation surveys were designed using Moore's 7 Levels of CME Outcomes Framework.
RESULTS: A total of 116 participants were included in the analysis. Significant improvement was observed in participants' self-reported confidence in approach to simulated cases (thyroid, n = 37, P
Fulltext Metastatic Biliary Stricture with "Beaded" Appearance from Cervical Adenocarcinoma

Lee SL, Sidhu J, Ng CY

Euroasian J Hepatogastroenterol, 2021 11 18;11(2):97-99.
PMID: 34786364 DOI: 10.5005/jp-journals-10018-1350

Cervical adenocarcinoma accounts for 25% of invasive cervical cancer which frequently metastasize distantly to the lungs, liver, bone, and brain. Metastases to the common bile duct from cervical cancer are exceedingly rare with few reported cases in the literature. Diagnosis of bile duct metastases from cervical cancer can be established with endoscopic ultrasound-guided fine-needle aspiration cytology, biliary cytobrushing, or direct cholangioscopy with biopsy, and this would guide further therapies such as endoscopic biliary drainage and systemic chemotherapy. We hereby present a rare case of obstructive jaundice from metastatic biliary stricture with "beaded" appearance in a patient with cervical adenocarcinoma. How to cite this article: Lee SL, Sidhu J, Ng CY. Metastatic Biliary Stricture with "Beaded" Appearance from Cervical Adenocarcinoma. Euroasian J Hepato-Gastroenterol 2021;11(2):97-99.
Fulltext Congenital colorectal tubular duplication in an infant: A tale of radiological diagnostic challenges

Ahmed S, Saifuddin MS, Ng CY, Salwati NF, Hayati F, Ismail S

Radiol Case Rep, 2021 Nov;16(11):3289-3294.
PMID: 34484533 DOI: 10.1016/j.radcr.2021.07.081

Enteric duplications (EDs) are rare congenital anomalies that result from defect during embryonic development of the gut. Although EDs can literally occur at any part of the gastrointestinal tract, ileocecal duplication is the commonest type followed by colorectal type. Morphologically, EDs are mostly cystic in nature; tubular duplications are uncommon. We report radiological diagnostic challenges encountered in dealing with a 10 month-old infant who presented with chronic constipation, progressive abdominal distension, and voiding difficulty for several weeks followed by colicky abdominal pain for three days. After a series of radiological procedures, a diagnosis of tubular colorectal duplication was made. The duplicated segment was loaded with impacted feces which exerted pressure effect on the rectum and urinary bladder. The case was treated surgically through laparoscopic procedure that included fenestration and stapling of the duplicated bowel followed by irrigation. Postoperatively, the child was followed up half-yearly for three years and was found to remain symptom-free. This case exemplifies the challenges a radiologist may experience while dealing with a case presenting with features of as acute-on-chronic intestinal obstruction and voiding difficulty.
Infected pancreatic pseudocyst following severe dengue infection

Lee SL, Ng CY, Sidhu J

Med J Malaysia, 2021 Nov;76(6):927-929.
PMID: 34806688

Severe dengue infection is life threatening as it can result in fatal complications such as intractable bleeding from coagulopathy, multiorgan failure from shock and haemophagocytic syndrome. There have been case reports of atypical manifestation of severe dengue infection such as pancreatitis, Guillian-Barre's syndrome, perforated viscus and myocarditis. However, to our knowledge, pancreatic pseudocyst from dengue-related pancreatitis has never been reported in the literature. We hereby report a case of infected pancreatic pseudocyst in a patient with persistent pyrexia, abdominal pain and raised inflammatory markers 10 weeks from the onset of severe dengue infection. Endoscopic ultrasound (EUS) guided transluminal drainage of the infected pancreatic pseudocyst with lumen-apposing metallic stent (LAMS) was performed with good clinical and radiological outcome.
Fulltext Wilms tumor presenting as small bowel obstruction in a neonate: A diagnostic challenge

Ahmed S, Nadarajan C, Ng CY, Teh YG, Abdul Muien MZ, Liew CSL

Radiol Case Rep, 2021 Oct;16(10):2908-2912.
PMID: 34401023 DOI: 10.1016/j.radcr.2021.06.058

Wilms tumor is the most common primary malignant renal tumor of childhood which usually presents between 2 and 6 years of age. Its presentation in the neonatal period is extremely rare and presenting with intestinal obstruction is perhaps unknown. We report a 2-day-old baby girl who manifested features of acute upper gastrointestinal obstruction with frequent post-feeding vomiting and abdominal distension. The initial abdominal radiograph showed abnormally displayed small bowel loops to the right hemiabdomen. Subsequent ultrasound and computed tomography scan of the abdomen detected a massive left renal mass. Left-sided nephrectomy was performed, and histopathology demonstrated left-sided Wilms tumor with favorable histology. Post-treatment yearly follow-up for 5 years recorded a disease-free, normally thriving child.
Re: benign free air under the diaphragm: a case of pneumatosis cystoides coli

Hayati F, Wong MJJ, Jailani RF, Ng CY

ANZ J Surg, 2021 10;91(10):2226.
PMID: 34665495 DOI: 10.1111/ans.17088
Fulltext Rare late-presentation congenital diaphragmatic hernia mimicking a tension pneumothorax

Muien MZA, Jeyaprahasam K, Krisnan T, Ng CY, Teh YG

Radiol Case Rep, 2021 Sep;16(9):2542-2545.
PMID: 34276850 DOI: 10.1016/j.radcr.2021.06.024

Congenital Diaphragmatic Hernia (CDH) is due to a defect in the diaphragm and is usually detected soon after birth. However, in rare cases, asymptomatic CDHs can be missed and present later in life. Late-presentation CDH can be misdiagnosed as tension pneumothorax leading to iatrogenic complications. We report a case of a 10-year-old boy who presented with non-specific symptoms of vomiting and occasional breathlessness, but was subsequently diagnosed as late-presentation CDH. This case highlights the role of imaging in the diagnosis and management of late-presenting CDH. The role of CT imaging as an invaluable tool to further evaluate equivocal radiographic findings in CDH is discussed.
Fulltext MR imaging of hypothalamic hamartoma in a patient with gelastic seizures

Wan Chek WAF, Teh YG, Eddy Suryono DN, Ng CY, Ahmed S

Radiol Case Rep, 2021 Sep;16(9):2706-2709.
PMID: 34345334 DOI: 10.1016/j.radcr.2021.06.061

Hypothalamic hamartomas (HHs) are non-neoplastic malformations that occur in the region of the hypothalamus. HH is the leading cause of gelastic seizures in children and adolescents, where laughing is characteristically manifested. However, these patients can also experience different forms of complex or generalized tonic-clonic seizures that can obscure the diagnosis of HHs. We present a case of a 10 year-old boy that experienced several seizure types, but was subsequently diagnosed with HH after MR imaging was performed. This case highlights the complementary role of MR imaging in ascertaining seizure etiololgy when the clinical history and EEG findings are non-specific. The importance of early diagnosis with MR imaging is further underscored by the fact that patients diagnosed with HH usually develop drug resistance towards antiepileptic drugs, mandating neurosurgical assessment and intervention.
Fulltext Asymptomatic complete distal abdominal aortic occlusion with initial presentation of ruptured intracranial aneurysm

Nadarajan C, Wahid AA, Ng CY, Haron J, Peter JS, Mohd Yusof MF

Radiol Case Rep, 2021 Aug;16(8):1993-1998.
PMID: 34158880 DOI: 10.1016/j.radcr.2021.05.016

Aortoilliac occlusive disease is occlusive atherosclerosis disease involving the distal aorta and bifurcation of iliac arteries and it is a subtype of peripheral arterial disease. Total occlusion of the abdominal aorta is a rare occurrence with an incidence of 3% -8.5% among the aortoiliac occlusive disease patients. We present a case of a 53 years old patient with a background history of hypertension and ex intravenous drug abuser with negative retroviral screening status, with no previous complaints who was brought to the Emergency Department with sudden onset of altered sensorium and 1 episode of seizure. Computed tomography angiogram of the brain showed a ruptured anterior communicating artery aneurysm. Diagnostic conventional angiogram of the brain was planned; however, difficulty was encountered during bilateral femoral artery cannulation with the abrupt termination of bilateral common iliac arteries. Computed tomography angiogram of the abdomen showed incidental finding of total occlusion of the abdominal aorta. As a conclusion, total occlusion of abdominal aorta secondary to aortoiliac occlusive disease with an associated intracranial aneurysm is never reported in the literature to date. This case highlights the possibility of association in between these two conditions which may benefit from further research.
Skull Base Primary Ewing Sarcoma: A Radiological Experience of a Rare Disease in an Atypical Location

Saifuddin MSAH, Ng CY, Abdullah MS

Am J Case Rep, 2021 Jun 05;22:e930384.
PMID: 34089579 DOI: 10.12659/AJCR.930384

BACKGROUND Ewing sarcoma and primitive neuroectodermal tumor are rare tumors grouped under the spectrum of the Ewing sarcoma family of tumors. These highly malignant tumors involve the bones and commonly occur in children. Ewing sarcoma of the skull bone accounts for only 1% of all Ewing sarcomas, with primary skull base Ewing sarcoma occurring in less than 1% of cases. We present a case of skull base Ewing sarcoma with complete symptom recovery and near-total radiological resolution. CASE REPORT A 4-year-old girl initially presented with a 2-month history of vomiting, poor oral intake, weight loss, and gradual visual deterioration followed by acute symptoms of fever, breathing difficulties, and seizure. Initial computed tomography and magnetic resonance imaging of the brain displayed a large sinonasal mass with extensive regional infiltration and bony destruction and no evidence of distant metastasis. A transnasal biopsy was taken. The histopathology result revealed features of skull base Ewing sarcoma. The child was given a combination of radiotherapy and chemotherapy, to which she responded well, with a minimal residual tumor. CONCLUSIONS Skull base Ewing sarcoma is a rare entity, presenting a challenge to the reporting radiologists. Differential diagnoses of esthesioneuroblastoma, olfactory neuroepithelioma, and, more commonly, sinonasal carcinoma can be misleading since they have similar radiological appearances to skull base Ewing sarcoma, which differs in treatment regimen and prognosis. Therefore, a combination of histopathological appearance, radiographic findings, and clinical correlation is important to determine the correct diagnosis, establish the appropriate treatment regime, and improve the patient's survival.
Utility of Simulation via Instant Messaging - Birmingham Advance (SIMBA) in medical education during COVID-19 pandemic

Morgan G, Melson E, Davitadze M, Ooi E, Zhou D, Hanania T, et al.

J R Coll Physicians Edinb, 2021 06;51(2):168-172.
PMID: 34131679 DOI: 10.4997/JRCPE.2021.218

BACKGROUND: Simulation via Instant Messaging - Birmingham Advance (SIMBA) aimed to improve clinicians' confidence in managing various clinical scenarios during the COVID-19 pandemic.
METHODS: Five SIMBA sessions were conducted between May and August 2020. Each session included simulation of scenarios and interactive discussion. Participants' self-reported confidence, acceptance, and relevance of the simulated cases were measured.
RESULTS: Significant improvement was observed in participants' self-reported confidence (overall n = 204, p<0.001; adrenal n = 33, p<0.001; thyroid n = 37, p<0.001; pituitary n = 79, p<0.001; inflammatory bowel disease n = 17, p<0.001; acute medicine n = 38, p<0.001). Participants reported improvements in clinical competencies: patient care 52.0% (n = 106/204), professionalism 30.9% (n = 63/204), knowledge on patient management 84.8% (n = 173/204), systems-based practice 48.0% (n = 98/204), practice-based learning 69.6% (n = 142/204) and communication skills 25.5% (n = 52/204).
CONCLUSION: SIMBA is a novel pedagogical virtual simulation-based learning model that improves clinicians' confidence in managing conditions across various specialties.
Fulltext Empyema thoracis presented as giant back abscess

Abd Karim SH, Wan Zain WZ, Mohd Hashim MN, Zakaria AD, Hayati F, Ng CY

Radiol Case Rep, 2021 May;16(5):1061-1064.
PMID: 33680277 DOI: 10.1016/j.radcr.2021.02.030

Empyema thoracis (ET) is defined as pus in the pleural space, either localized or involving the entire pleural cavity, due to diverse etiologies. In severe form, it may infiltrate the extrapulmonary region. Clinical guideline describes 3 stages of parapneumonic effusion before developing into an ET, namely the exudative stage, the fibrinopurulent stage, and the organizing/late stage. We highlight a 59-year-old gentleman who presented a back swelling masquerading as a deep-seated abscess, in which the diagnosis of ET had not been established early. The principles of treatment are treating the underlying condition such as pneumonia, pleural drainage and debridement, full re-expansion of the collapsed lung by performing chest physiotherapy, and improving nutrition. ET is a condition with a dynamic process due to diverse etiologies, either localized or involving the entire pleural cavity. The gold standard in diagnosing ET is the pleural aspiration of fluid from the pleural space, whereas the management of ET may include non-surgical and/or surgical treatments based on the basic principles of ET treatment.
Fulltext Simulation via instant messaging - Birmingham advance (SIMBA): an innovative simulation-based learning model that helped to keep medical education continue during the COVID-19 pandemic

Morgan G, Ooi E, Hanania T, Davitadze M, Zhou D, Blaggan P, et al.

Clin Med (Lond), 2021 Mar;21(Suppl 2):34-35.
PMID: 34078689 DOI: 10.7861/clinmed.21-2-s34
Accessory flexor carpi ulnaris: a rare cause of distal ulnar nerve compression

Wang CK, Ng CY

J Hand Surg Eur Vol, 2021 Feb;46(2):197-199.
PMID: 32700616 DOI: 10.1177/1753193420943050
Fulltext Case report: Ballotable abdominal mass in a child - Definitely renal in origin?

Lim GT, Teh YG, Ng CY, Mohd Khalid H, Hayati F

Ann Med Surg (Lond), 2021 Feb;62:84-87.
PMID: 33505677 DOI: 10.1016/j.amsu.2021.01.003

Introduction and importance: The differential diagnosis of a paediatric abdominal mass can be extensive, as it potentially involves multiple organs including gastrointestinal, genitourinary, endocrine, and gynaecological systems. Hence, a systematic approach to history taking and physical examination is needed to clinch the diagnosis. Specifically, the approach for assessing, investigating, and managing a ballotable left hypochondrial mass in a child can be challenging.
Case presentation: We report a 10-year-old Dusun girl presenting with left hypochondrial pain and noted a left hypochondrial mass on examination. This report highlights the role of clinical imaging during the pre-operative and post-operative phases.
Clinical discussion: Ultrasound and CT imaging was useful in determining that the tumor originated from the tail of the pancreas. The presence of a definite capsule with internal solid-cystic components helped narrowed the differential diagnosis to solid pseudopapillary neoplasm (SPN) of the pancreas. MR liver was useful to rule out liver metastasis in this child.
Intervention and outcome: The patient was scheduled for laparotomy and tumour excision at a regional paediatric centre. Successful excision of the tumor en-mass was performed and the child's subsequent recovery was uneventful.
Conclusion: Clinical imaging plays a critical role in the diagnosis and management of paediatric solid organ tumours. Other than renal origin, suspicion of pancreatic tail origin should be considered by clinicians when encountering a ballotable left abdominal mass.
Fulltext Purulent Discharge on the Pharyngeal Wall

Sefein M, Mohamad I, Hayati F, Ng CY

Oman Med J, 2021 Jan;36(1):e228.
PMID: 33628463 DOI: 10.5001/omj.2021.24

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