Displaying publications 1 - 20 of 47 in total

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  1. Nadesan K, Chan SP, Wong CM
    Malays J Pathol, 1998 Jun;20(1):49-54.
    PMID: 10879265
    Heat stroke, which is also known as "sun stroke," is a medical emergency, and fatalities can occur unless it is diagnosed early and treated efficiently. Heat stroke may manifest quite suddenly, giving little time to differentiate it from extreme physical exhaustion in collapsed subjects. It is also known to lead to serious disseminated intravascular coagulation. Sudden death in a young female is presented who collapsed after trekking in a hilly, jungle area in Malaysia on a warm, humid day. She had joined a weight reduction programme a few weeks earlier. She was found collapsed and in a semiconscious state in the jungle by her groupmates and was taken to hospital. On admission she was unconscious, hyperpyrexic, with rapid, thready pulse and a low blood pressure. Biochemical studies revealed metabolic acidosis, elevated liver and cardiac enzymes and impairment of renal function. Her coagulation profile was found to be impaired and she started bleeding through the mouth and nostrils. She also developed watery diarrhoea and initially a septicaemic condition, including acute enteritis was suspected. Despite active treatment, her condition deteriorated and she died eight hours after admission. Autopsy confirmed a generalised bleeding tendency, with pulmonary, oesophageal and gastrointestinal mucosal haemorrhages. Flame-shaped subendocardial shock haemorrhages were seen in the interventricular septum on the left side of the heart. The findings support a diagnosis of heat stroke. Various aspects related to heat stroke, the autopsy diagnosis and its prevention are discussed.
  2. Wong CM, Ganesh R, Ng KY
    Med J Malaysia, 1999 Mar;54(1):117-9.
    PMID: 10972015
    Diagnosis of ectopic pregnancy prior to rupture is an arduous task even with the availability of many new investigative methods and imaging modalities. Above all, a high index of suspicion is necessary when dealing with women who present in early pregnancy with abdominal pain and vaginal bleeding. With the increased use of ovulation induction agents, the probability of heterotropic pregnancy should be kept in mind. The use of transvaginal ultrasonography (TVS) will help in earlier diagnosis because of its advantages over transabdominal ultrasonography (TAS).
  3. Liam CK, Lim KH, Wong CM, Tang BG
    Int J Tuberc Lung Dis, 1999 Apr;3(4):300-9.
    PMID: 10206500
    SETTING: An urban university teaching hospital.
    OBJECTIVES: To determine patients' attitudes to tuberculosis and their knowledge of the disease, and factors associated with treatment compliance.
    DESIGN: All adult patients commenced on treatment for tuberculosis from September 1994 to February 1996 were interviewed on initiation of treatment. To assess patient compliance with treatment, hospital clinical records were reviewed retrospectively.
    RESULTS: A total of 135 patients with a mean age (±SD) of 41.9 (±17.4) years (range 15–84 years) were interviewed. The patients had limited understanding and knowledge about tuberculosis. There was a negative correlation between patient age and tuberculosis knowledge score (r = −0.18, P = 0.038). Patients with tertiary education had better knowledge than the others. Of 118 patients who were followed-up in our chest clinic, 80 (67.8%) completed the prescribed treatment. Compliance with treatment and follow-up was not affected by age, sex, ethnic group, educational level, occupation, extent of knowledge, tuberculosis symptoms, hospitalisation for tuberculosis or duration of the prescribed treatment regimen. There was a trend toward poorer compliance among patients who equated disappearance of tuberculosis symptoms with cure of the disease.
    CONCLUSIONS: Malaysian patients with newly diagnosed tuberculosis attending a university teaching hospital had misconceptions and limited knowledge about the disease and its treatment. Educational background was an important determinant of a patient's level of knowledge about tuberculosis. Compliance was not affected by patient characteristics. Adequate counselling and education of patients and close relatives on tuberculosis and the necessity for prolonged treatment may help to improve treatment compliance.
    Study site: Chest clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  4. Wong CM, Lim KH, Liam CK
    Postgrad Med J, 1999 May;75(883):297-8.
    PMID: 10533638
    Cryptococcal infection uncommonly presents with pulmonary manifestations and even more rarely so as massive bilateral effusions. Pleural involvement is usually associated with underlying pulmonary parenchymal lesions and is unusual while on antifungal therapy. We report a patient with cryptococcal meningitis who, while on intravenous 5-flucytosine and amphotericin B, developed life-threatening bilateral massive pleural effusions with evidence of spontaneous resolution, consistent with prior hypothesis of antigenic stimulation as the cause of pleural involvement.
  5. Lim KH, Liam CK, Vasudevan AE, Wong CM
    Respirology, 1999 Sep;4(3):299-301.
    PMID: 10489679 DOI: 10.1046/j.1440-1843.1999.00195.x
    A 62-year-old man presented with a 3-month history of chronic non-productive cough and unexplained fever. Further questioning revealed that he had headaches and myalgia. Bilateral thickened temporal arteries were noted on physical examination. The erythrocyte sedimentation rate was 96 mm in 1 h. A biopsy specimen of the left temporal artery showed inflammatory changes consistent with the diagnosis of giant cell arteritis. Commencement of prednisolone resulted in rapid and dramatic resolution of his symptoms. Physicians should be aware of respiratory symptoms in patients with giant cell arteritis in order to avoid delay in diagnosis and therapy of this condition.
  6. Liam CK, Lim KH, Wong CM
    Respirology, 2000 Mar;5(1):33-8.
    PMID: 10728729
    To define the causes of exudative pleural effusions in our region.
  7. Lim KH, Liam CK, Wong CM
    Postgrad Med J, 2000 Aug;76(898):512, 518-9.
    PMID: 10908387
  8. Liam CK, Lim KH, Wong CM
    Asian Pac J Allergy Immunol, 2000 Sep;18(3):135-40.
    PMID: 11270467
    This study aimed to evaluate dry powder inhaler naive asthmatic patients' perception and preference of the Accuhaler, a multidose dry powder inhaler and the pressurized metered dose inhaler (pMDI). After the first instruction, 66.7% of 48 patients enrolled in the study could demonstrate the correct use of the Accuhaler. When the patients were asked to compare the pMDI and the Accuhaler after using the Accuhaler to administer salmeterol for 4 weeks, the Accuhaler scored significantly better than the pMDI for the following features: knowing how many doses are left, presence of an attached cover, taste, instruction for use, attractiveness, ease of use, ease of holding, shape, and comfortable mouthpiece. The pMDI scored better to the Accuhaler in terms of size. More patients preferred the Accuhaler than the pMDI; the presence of a dose counter and perceived ease of use were the main reasons cited for their preference for the Accuhaler.
    Study site: Asthma Clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  9. Liam CK, Lim KH, Wong CM
    Respirology, 2000 Dec;5(4):355-61.
    PMID: 11192546
    This study aimed to determine whether the clinicopathological features of lung cancer in patients younger than 40 years differ from that of older patients in an Asian country.
  10. Lim KH, Lim YC, Liam CK, Wong CM
    Chest, 2001 Mar;119(3):955-7.
    PMID: 11243981
  11. Liam CK, Goh CT, Isahak M, Lim KH, Wong CM
    Asian Pac J Allergy Immunol, 2001 Jun;19(2):79-83.
    PMID: 11699724
    The objective of this study was to determine the relationship between asthma symptoms and the degree of airway obstruction as measured by the forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) in a group of 64 asthmatic patients with clinically stable disease attending a university-based urban asthma clinic. Asthma symptoms did not correlate with the degree of airway obstruction as measured by prebronchodilator PEFR (total asthma symptom score vs PEFR: r = -0.214, p = 0.104, n = 59) and only correlated poorly with prebronchodilator FEV1 (total asthma symptom score vs FEV1: r = -0.256, p = 0.041, n = 64). These results lend support to the recommendation that airway obstruction should be measured objectively when assessing patients with chronic persistent asthma.
    Study site: Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  12. Liam CK, Lim KH, Wong CM
    Respirology, 2001 Sep;6(3):259-64.
    PMID: 11555386
    This study aimed to investigate the microbial aetiology of community-acquired pneumonia (CAP) in patients requiring hospitalization.
  13. Lim KH, Tan LH, Liam CK, Wong CM
    Chest, 2001 Nov;120(5):1728-31.
    PMID: 11713160
  14. Liam CK, Loo KL, Wong CM, Lim KH, Lee TC
    Respirology, 2002 Dec;7(4):345-50.
    PMID: 12421243 DOI: 10.1046/j.1440-1843.2002.00409.x
    OBJECTIVE: The aim of this study was to investigate the prevalence of skin prick test (SPT) reactivity to common aeroallergens among Malaysian asthmatic patients with and without rhinitis.
    METHODOLOGY: An SPT using eight aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat fur, cockroach, Acacia sp., Bermuda grass, Aspergillus fumigatus and Aspergillus niger) was performed on 206 asthmatic patients.
    RESULTS: One hundred and forty patients (68%) were reactive to at least one of the aeroallergens. Among the SPT-positive patients, a positive prick test reaction to the house dust mites, D. pteronyssinus (93.6%), and D. farinae (81.4%) was most common, followed by cat fur (20.0%), cockroach (7.9%), Bermuda grass (7.9%), Acacia sp. (7.9%), A. fumigatus (0.7%) and A. niger (0.7%). A history of rhinitis was elicited in 111 (53.9%) patients and 95 (85.3%) of these patients were SPT-positive compared with only 45 (47.4%) of 95 patients with asthma symptoms alone (P < 0.001). The presence of rhinitis and a young age of onset of asthma were independent factors for positive SPT reaction to at least one of the aeroallergens.
    CONCLUSIONS: The prevalence of SPT reactivity to common aeroallergens is high among Malaysian asthmatics, particularly in those with an early age of onset and in those with coexisting rhinitis.
    Study site: Asthma Clinic, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  15. Wong CM, Lim KH, Liam CK
    Respirology, 2003 Mar;8(1):65-8.
    PMID: 12856744
    OBJECTIVE: In southeast Asia, pulmonary tuberculosis (TB) is the most frequently presumed diagnosis for haemoptysis. This study was designed to assess the causes of haemoptysis, the diagnostic yield of causes in different diagnostic modalities and the distribution of older patients.

    METHODS: All patients presenting to the University of Malaya Medical Centre, Kuala Lumpur, Malaysia with haemoptysis were recruited prospectively and evaluated.

    RESULTS: One hundred and sixty patients were evaluated for haemoptysis; 71 (44.4%) were aged 60 years or more. Significantly more patients smoked in the older age group (P = 0.002). The main causes of haemoptysis in the older patients were bronchogenic carcinoma (49.3%), pneumonia (11.3%), bronchiectasis (8.6%), cryptogenic (5.6%) and active TB (4.2%). Significantly more older patients had carcinoma (P < 0.001), while the younger patients more often had TB (P < 0.001). Chest pain was significantly more common in the older patients (P = 0.025), particularly in patients with carcinoma. Bronchoscopy alone or combined with CT of the thorax was significantly more diagnostic in the older patient (P = 0.006).

    CONCLUSION: Bronchogenic carcinoma is the commonest cause of haemoptysis in patients aged 60 years and above. Presumptive anti-TB therapy should not be encouraged despite the regional high prevalence of TB.

  16. Wong CM, Lim KH, Liam CK
    Respirology, 2003 Mar;8(1):107-9.
    PMID: 12856752
    Pregnancy complicated by lung cancer has been rarely reported. The regional incidence of this complex situation is likely to increase in the future and optimal management needs to be established to better deal with this situation. We report two patients with metastatic lung cancer complicating pregnancy to highlight the evaluation and management difficulties associated with this problem and to contribute to the limited information in the literature.
  17. Loqman MY, Wong CM, Hair-Bejo M, Zuki AB, Hafeez YM
    Med J Malaysia, 2004 May;59 Suppl B:113-4.
    PMID: 15468844
    A study was conducted to investigate the effectiveness of freeze-dried bovine pericardium (FDBP) as a biomaterial in diaphragmatic herniorrhapy in dogs. Eight adult dogs were randomly selected and divided into two equal groups. In FDBP group, a diaphragmatic defect was induced and repaired with an identical size of FDBP. In the control group, a diaphragmatic wall was incised at three-side border creating a flap and sutured. Grossly, only mild intrathoracic adhesion was observed for most of the animals, and no herniation occured. Microscopically, the biomaterial incorporated into the host's tissue by ingrowth of young muscle fiber and massive new blood vessel formation in between the fibrous tissue.
  18. Aida AA, Che Man YB, Wong CM, Raha AR, Son R
    Meat Sci, 2005 Jan;69(1):47-52.
    PMID: 22062638 DOI: 10.1016/j.meatsci.2004.06.020
    A method for species identification from pork and lard samples using polymerase chain reaction (PCR) analysis of a conserved region in the mitochondrial (mt) cytochrome b (cyt b) gene has been developed. Genomic DNA of pork and lard were extracted using Qiagen DNeasy(®) Tissue Kits and subjected to PCR amplification targeting the mt cyt b gene. The genomic DNA from lard was found to be of good quality and produced clear PCR products on the amplification of the mt cyt b gene of approximately 360 base pairs. To distinguish between species, the amplified PCR products were cut with restriction enzyme BsaJI resulting in porcine-specific restriction fragment length polymorphisms (RFLP). The cyt b PCR-RFLP species identification assay yielded excellent results for identification of pig species. It is a potentially reliable technique for detection of pig meat and fat from other animals for Halal authentication.
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