Displaying publications 1 - 20 of 41 in total

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  1. Wong SY, Lee CC, Ashrafzadeh A, Junit SM, Abrahim N, Hashim OH
    PLoS One, 2016;11(10):e0164993.
    PMID: 27741315 DOI: 10.1371/journal.pone.0164993
    Proteome analysis of the human hair remains challenging due to the poor solubility of hair proteins and the difficulty in their extraction. In the present study, we have developed a rapid extraction protocol for hair shaft protein using alkaline-based buffer. The new protocol accelerated the procedure by reducing the extraction time from at least a day to less than two hours and showed a protein recovery of 47.3 ± 3.72%. Further analyses of the extracted protein sample through sodium dodecyl sulfate polyacrylamide gel electrophoresis and Quadrupole-time-of-flight mass spectrometry analysis unveiled a total of 60 proteins, including 25 that were not previously reported. Identification of these proteins is anticipated to be crucial in helping to understand the molecular basis of hair for potential applications in the future.
  2. Wu M, Lu Y, Yang W, Wong SY
    Front Comput Neurosci, 2020;14:564015.
    PMID: 33469423 DOI: 10.3389/fncom.2020.564015
    Cardiovascular diseases (CVDs) are the leading cause of death today. The current identification method of the diseases is analyzing the Electrocardiogram (ECG), which is a medical monitoring technology recording cardiac activity. Unfortunately, looking for experts to analyze a large amount of ECG data consumes too many medical resources. Therefore, the method of identifying ECG characteristics based on machine learning has gradually become prevalent. However, there are some drawbacks to these typical methods, requiring manual feature recognition, complex models, and long training time. This paper proposes a robust and efficient 12-layer deep one-dimensional convolutional neural network on classifying the five micro-classes of heartbeat types in the MIT- BIH Arrhythmia database. The five types of heartbeat features are classified, and wavelet self-adaptive threshold denoising method is used in the experiments. Compared with BP neural network, random forest, and other CNN networks, the results show that the model proposed in this paper has better performance in accuracy, sensitivity, robustness, and anti-noise capability. Its accurate classification effectively saves medical resources, which has a positive effect on clinical practice.
  3. Wong SC, Ooi MH, Abdullah AR, Wong SY, Krishnan S, Tio PH, et al.
    Trop Med Int Health, 2008 Jan;13(1):52-5.
    PMID: 18291002 DOI: 10.1111/j.1365-3156.2007.01967.x
    Japanese encephalitis virus (JEV) is an important encephalitis virus in Asia, but there are few data on Malaysia. A hospital-based surveillance system for Japanese encephalitis (JE) has been in operation in Sarawak, Malaysia, for the last 10 years. JEV is endemic in Sarawak, with cases occurring throughout the year and a seasonal peak in the last quarter (one-way anova, P < 0.0001). Ninety-two per cent of 133 cases were children aged 12 years or younger; the introduction of JE vaccination in July 2001 reduced the number of JE cases (84 in the four seasons prior to vs. 49 in the six seasons after, McNemar's test, P = 0.0001). After implementation of the programme, the mean age of infected children increased from 6.3 to 8.0 years (Student's t-test, P = 0.0037), suggesting the need for a catch-up programme.
  4. Wong SY, Ooi IH, Boyce PC
    Bot Stud, 2014 Dec;55(1):51.
    PMID: 28510939 DOI: 10.1186/s40529-014-0051-9
    BACKGROUND: Haniffia Holttum is a genus of three described species of terrestrial gingers hitherto restricted to Peninsular Thailand and various localities in Peninsular Malaysia.

    RESULTS: With generic placement confirmed using nrITS, trn K and mat K plastid sequence data, Haniffia santubongensis S.Y. Wong & P.C. Boyce is described as a taxonomically novel species representing a new generic record for Borneo, to where it is endemic to Mount Santubong, Kuching Division, NW Sarawak, Malaysian Borneo. An identification key to all species is given and H. santubongensis is illustrated from living plants.

    CONCLUSION: Haniffia santubongensis is the fourth species of Haniffia so far described, and the first occurring on sandstone.

  5. Simovic I, Hilmi I, Ng RT, Chew KS, Wong SY, Lee WS, et al.
    United European Gastroenterol J, 2024 Feb;12(1):103-121.
    PMID: 37837511 DOI: 10.1002/ueg2.12477
    BACKGROUND: ATG16L1 plays a fundamental role in the degradative intracellular pathway known as autophagy, being a mediator of inflammation and microbial homeostasis. The variant rs2241880 can diminish these capabilities, potentially contributing to inflammatory bowel disease (IBD) pathogenesis.

    OBJECTIVES: To perform an updated meta-analysis on the association between ATG16L1 rs2241880 and IBD susceptibility by exploring the impact of age, ethnicity, and geography. Moreover, to investigate the association between rs2241880 and clinical features.

    METHODS: Literature searches up until September 2022 across 7 electronic public databases were performed for all case-control studies on ATG16L1 rs2241880 and IBD. Pooled odds ratios (ORP ) and 95% CI were calculated under the random effects model.

    RESULTS: Our analyses included a total of 30,606 IBD patients, comprising 21,270 Crohn's disease (CD) and 9336 ulcerative colitis (UC) patients, and 33,329 controls. ATG16L1 rs2241880 was significantly associated with CD susceptibility, where the A allele was protective (ORP : 0.74, 95% CI: 0.72-0.77, p-value: <0.001), while the G allele was a risk factor (ORP : 1.23, 95% CI: 1.09-1.39, p-value: 0.001), depending on the minor allele frequencies observed in this multi-ancestry study sample. rs2241880 was predominantly relevant in Caucasians from North America and Europe, and in Latin American populations. Importantly, CD patients harbouring the G allele were significantly more predisposed to perianal disease (ORP : 1.21, 95% CI: 1.07-1.38, p-value: 0.003).

    CONCLUSIONS: ATG16L1 rs2241880 (G allele) is a consistent risk factor for IBD in Caucasian cohorts and influences clinical outcomes. As its role in non-Caucasian populations remains ambiguous, further studies in under-reported populations are necessary.

  6. Cheng KM, Koo AC, Nasir JSBM, Wong SY
    Sci Rep, 2022 Dec 12;12(1):14843.
    PMID: 36509770 DOI: 10.1038/s41598-022-15709-2
    Recycling is a process carried out by various organizations and individuals to enhance the environment's long-term sustainability. Some youth think that recycling is a monotonous action as it may seem inconvenient, less aware of the environmental issues and more time-consuming than they think and rather go for video games. Therefore, this study investigates the relationship between motivation and recycling intention in gamified learning among youth. To address the research aim, this study uses gamification as a motivational driver for a game-like learning experience to improve recycling intentions among youth. Self-determination theory (SDT) and the theory of Planned Behavior (TPB) will be this study's main motivational and behavioral theories. (n = 124) high schools and college students were invited to take part in an online gamified recycling activity, Edcraft Gamified Learning (EGL), consisting of two levels of gamified unused plastic-crafting recycling activities. After the activity, the participants will answer a post-event questionnaire and the data collected were analyzed. The result shows that controlled motivation (CM) and autonomous motivation (AM) positively influenced youth attitudes and social norms. Besides, attitude is the only psychosocial determinant that positively influences the recycling intention of the youth. Gamification only moderates positively between attitude and recycling intention. This study has clearly shown the effectiveness of gamified learning activity towards recycling intention directly and as a component that moderates the relationship between attitude and recycling intention, which shows a favorable evaluation towards recycling intention with gamified learning involved. Moreover, the findings showed that not all relationships are positive in a gamified learning environment, and it gives a good view on the weakness and strengths with the guideline of SDT and TPB.
  7. Chao TC, Maxwell SM, Wong SY
    J Pathol, 1991 Jul;164(3):225-33.
    PMID: 1890547
    An outbreak of food poisoning resulting in 13 deaths in children occurred in Malaysia during the Chinese Festival of the Nine-Emperor Gods in 1988. The offending food was a Chinese noodle called 'Loh See Fun' (LSF). The source was traced to a factory where a banned food preservative was added to make the LSF. The food poisoning was attributable to aflatoxins and boric acid. The clinical features included vomiting, pyrexia, diarrhoea, abdominal pain, anorexia, giddiness, seizures, and eventual coma. Initially, many presented with a Reye-like syndrome. Eleven post-mortem examinations were performed. The pathological findings included extensive coagulative necrosis of the liver with proliferative 'ductal/ductular metaplasia of the hepatocytes'. Giant cell formation, central vein sclerosis, bile stasis, and steatosis were also noted. There was presence of acute tubular necrosis, superficial upper gastrointestinal erosions, and ensuing encephalopathy. The eventual cause of death is acute hepatic and renal failure.
  8. Neni SW, Latif AZ, Wong SY, Lua PL
    Seizure, 2010 Jun;19(5):280-90.
    PMID: 20466567 DOI: 10.1016/j.seizure.2010.04.006
    This study was carried out to gauge the preliminary insight regarding epilepsy among the rural society. The purposes of this study were: (1) to determine general level of awareness, knowledge and attitudes (AKA) towards epilepsy among rural communities, (2) to compare the AKA level based on socio-demographic characteristics and (3) to investigate rural cohort's perception of the best epilepsy treatment, preference for epilepsy information delivery and preference for mode of transportation to seek medical treatment. This prospective, cross sectional study included a sample of 615 rural residents enrolled via cluster sampling in East Coast region of Peninsular Malaysia (mean age=41.6+/-18.02, female=56.6%, married=65.5%, Malay=94.0%, monthly income < or = RM 500=56.9%). The Total AKA level was generally low (2.66+/-0.7). Gender-wise no significant difference was shown regarding AKA level (p>0.05). However, respondents with higher education significantly possessed better attitudes and higher Total AKA level compared to those with lower education level (p<0.001). Employed respondents reported significantly more favourable attitudes than unemployed respondents (p=0.011). Additionally, higher income rural cohorts possessed both significantly better attitudes and better AKA. These rural communities perceived modern medicine as the best epilepsy treatment (56.60%), preferred to obtain direct epilepsy-related information from health personnel (60.4%) and chose to use their own car to seek medical treatment in hospital (76.30%). The outcomes of this preliminary study signified the need to devise a dedicated epilepsy education program for implementation among rural residents. Increased AKA level in the society could enhance the people's acceptance, reduce stigmatisation and improve health-related quality of life (HRQoL) for epilepsy patients and their family.
  9. Cheow YQ, Arasu K, Wong SY, Khaw KY, Chong CW, Weaver CM, et al.
    Nutr Health, 2023 Oct 06.
    PMID: 37801559 DOI: 10.1177/02601060231204634
    Background: Adequate calcium intake at an early age is crucial to achieving peak bone mass. Nevertheless, low calcium intake is common in Malaysian children. Aim: This study examined the calcium food sources and factors associated with low calcium intake among 243 children aged 9-11 years in Kuala Lumpur. Methods: Diet histories and bone density were measured. Results: The mean calcium intake was 370 ± 187 mg/day. The main contributors to calcium intake were beverages (19.2%), cereal (18.6%), milk and dairy (13.0%), meat and poultry (12.9%), and fish and seafood (10.1%). Within each food group, calcium-contributing foods tend to be from low bioavailability sources such as rice, cocoa-based and malted drinks, and chicken rather than milk. Children who practised regular meals, ate breakfast and snacks and consumed milk more than one serving daily have a higher calcium intake. Conclusion: In conclusion, public health strategies to improve the status of low calcium intake and poor choices of calcium-rich foods are needed to optimise bone health in this population.
  10. Lua PL, Wong SY
    MyJurnal
    Objective: This interventional study was aimed to investigate the effects of dark chocolate
    consumption on anxiety, depression, and stress (ADS) among trainee nurses. Methods: A
    parallel and open-label experimental study was conducted. Of the 128 nurses enrolled, only 47 participated in the intervention study (mean age = 20.32 years; ranging from 19 to 22 years old). They were randomly assigned to an intervention group (IG, n = 25) or a control group (CG, n = 22). The IG consumed dark chocolate and CG ingested mineral water for 3 consecutive days. The validated Malay Hospital Anxiety and Depression Scale (HADS) and Depression, Anxiety and Stress Scale (DASS-21) were utilised for measuring ADS levels. Data were analysed descriptively and score comparisons were conducted using non-parametric tests. Results: No significant differences between IG and CG in ADS scores were detected at baseline (all p > 0.05). At post-consumption, ADS score were significantly reduced in IG (all p < 0.01) compared with CG (all p < 0.05). Larger effect sizes among these respondents had also revealed that there were mood-elevating effects of dark chocolate consumption. Conclusion: This study has discovered that 3-day consumption of dark chocolate may alleviate ADS status among trainee nurses suggesting that dark chocolate may have a more prominent role in improving emotional and mood generally. Further investigations are however warranted to confirm this finding.
  11. Lee WS, Karthik SV, Ng RT, Ong SY, Ong C, Chiou FK, et al.
    Pediatr Neonatol, 2019 08;60(4):396-404.
    PMID: 31409456 DOI: 10.1016/j.pedneo.2018.09.007
    BACKGROUND: Current knowledge on the clinical features and natural history of childhood primary sclerosing cholangitis - inflammatory bowel disease in Asia is limited. We described the presenting features and natural history of primary sclerosing cholangitis-inflammatory bowel disease seen in a cohort of Southeast Asian children.

    METHODS: We conducted a retrospective review of childhood primary sclerosing cholangitis-inflammatory bowel disease from three tertiary centers in Singapore and Malaysia.

    RESULTS: Of 24 patients (boys, 58%; median age at diagnosis: 6.3 years) with primary sclerosing cholangitis-inflammatory bowel disease (ulcerative colitis, n = 21; Crohn's disease, n = 1; undifferentiated, n = 2), 63% (n = 15) were diagnosed during follow-up for colitis, and 21% (n = 5) presented with acute or chronic hepatitis, 17% (n = 4) presented simultaneously. Disease phenotype of liver involvement showed 79% had sclerosing cholangitis-autoimmune hepatitis overlap, 54% large duct disease, and 46% small duct disease. All patients received immunosuppression therapy. At final review after a median [±S.D.] duration follow-up of 4.7 [±3.8] years, 12.5% patients had normal liver enzymes, 75% persistent disease, and 12.5% liver failure. The proportion of patients with liver cirrhosis increased from 13% at diagnosis to 29%; 21% had portal hypertension, and 17% had liver dysfunction. One patient required liver transplant. Transplant-free survival was 95%. For colitis, 95% had pancolitis, 27% rectal sparing, and 11% backwash ileitis at initial presentation. At final review, 67% patients had quiescent bowel disease with immunosuppression. One patient who had UC with pancolitis which was diagnosed at 3 years old developed colorectal cancer at 22 years of age. All patients survived.

    CONCLUSIONS: Liver disease in primary sclerosing cholangitis-inflammatory bowel disease in Asian children has variable severity. With immunosuppression, two-thirds of patients have quiescent bowel disease but the majority have persistent cholangitis and progressive liver disease.

  12. Wong SY, Lua PL
    Malays J Nutr, 2011 Aug;17(2):259-69.
    PMID: 22303579 MyJurnal
    Chocolate is a popular food and its consumption has long been associated with enjoyment and pleasure. The effect of chocolate on mood too has long been recognised. Chocolate is thought to have interactions with neurotransmitters which contribute to mood modulation and appetite regulation. However, the evidence in chocolate and mood studies remains highly controversial. As more is known about the influence of chocolate on mood, the reasons for these effects appear increasingly complex and inter-related.
  13. Lee WS, Ong SY, Foo HW, Wong SY, Kong CX, Seah RB, et al.
    World J Gastroenterol, 2017 Nov 21;23(43):7776-7784.
    PMID: 29209118 DOI: 10.3748/wjg.v23.i43.7776
    AIM: To examine the medical status of children with biliary atresia (BA) surviving with native livers.

    METHODS: In this cross-sectional review, data collected included complications of chronic liver disease (CLD) (cholangitis in the preceding 12 mo, portal hypertension, variceal bleeding, fractures, hepatopulmonary syndrome, portopulmonary hypertension) and laboratory indices (white cell and platelet counts, total bilirubin, albumin, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase). Ideal medical outcome was defined as absence of clinical evidence of CLD or abnormal laboratory indices.

    RESULTS: Fifty-two children [females = 32, 62%; median age 7.4 years, n = 35 (67%) older than 5 years] with BA (median age at surgery 60 d, range of 30 to 148 d) survived with native liver. Common complications of CLD noted were portal hypertension (40%, n = 21; 2 younger than 5 years), cholangitis (36%) and bleeding varices (25%, n = 13; 1 younger than 5 years). Fifteen (29%) had no clinical complications of CLD and three (6%) had normal laboratory indices. Ideal medical outcome was only seen in 1 patient (2%).

    CONCLUSION: Clinical or laboratory evidence of CLD are present in 98% of children with BA living with native livers after hepatoportoenterostomy. Portal hypertension and variceal bleeding may be seen in children younger than 5 years of age, underscoring the importance of medical surveillance for complications of BA starting at a young age.

  14. Arasu K, Chang CY, Wong SY, Ong SH, Yang WY, Chong MHZ, et al.
    Contemp Clin Trials Commun, 2021 Jun;22:100801.
    PMID: 34195468 DOI: 10.1016/j.conctc.2021.100801
    Background: Recruitment and retention in longitudinal nutrition intervention studies among children is challenging and scarcely reported. This paper describes the strategies and lessons learned from a 1-year randomized double-blind placebo-controlled trial among pre-adolescent children on the effects of soluble corn fiber (SCF) on bone indices (PREBONE-Kids).

    Methods: Participants (9-11 years old) were recruited and randomized into 4 treatment groups (600 mg calcium, 12 g SCF, 12 g SCF plus 600 mg calcium and placebo). Interventions were consumed as a fruit-flavored powdered drink for 1-year. School-based recruitment was effective due to support on study benefits from parents and teachers, peer influence and a 2-weeks study run-in for participants to assess their readiness to commit to the study protocol. Retention strategies focused on building rapport through school-based fun activities, WhatsApp messaging, providing health screening and travel reimbursements for study measurements. Compliance was enhanced by providing direct on-site school feeding and monthly non-cash rewards. Choice of 2 flavors for the intervention drinks were provided to overcome taste fatigue. Satisfaction level on the manner in which the study was conducted was obtained from a voluntary sub-set of participants.

    Results: The study successfully enrolled 243 participants within 6 months and retained 82.7% of the participants at the end of 1 year, yielding a drop-out rate of 17.3%. Compliance to the intervention drink was 85% at the start and remained at 78.7% at the end of 1 year. More than 95% of the participants provided good feedback on intervention drinks, rapport building activities, communication and overall study conduct.

    Conclusion: Successful strategies focused on study benefits, rapport building, frequent communication using social media and non-cash incentives helped improved compliance and retention rate. The lessons learned to maintain a high retention and compliance rate in this study provide valuable insights for future studies in a similar population.

  15. Wong SY, Hashim OH, Hayashi N
    PLoS One, 2019;14(3):e0213947.
    PMID: 30889197 DOI: 10.1371/journal.pone.0213947
    The primary components of human hair shaft-keratin and keratin-associated proteins (KAPs), together with their cross-linked networks-are the underlying reason for its rigid structure. It is therefore requisite to overcome the obstacle of hair insolubility and establish a reliable protocol for the proteome analysis of this accessible specimen. The present study employed an alkaline-based method for the efficient isolation of hair proteins and subsequently examined them using gel-based proteomics. The introduction of two proteomic protocols, namely the conventional and modified protocol, have resulted in the detection of more than 400 protein spots on the two-dimensional gel electrophoresis (2DE). When compared, the modified protocol is deemed to improve overall reproducibility, whilst offering a quick overview of the total protein distribution of hair. The development of this high-performance protocol is hoped to provide a new approach for hair analysis, which could possibly lead to the discovery of biomarkers for hair in health and diseases in the future.
  16. Kurup A, Leo YS, Tan AL, Wong SY
    Ann Acad Med Singap, 1999 Jul;28(4):605-9.
    PMID: 10561784
    Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.
  17. Hoe YC, Gibernau M, Wong SY
    Plant Biol (Stuttg), 2018 May;20(3):563-578.
    PMID: 29316090 DOI: 10.1111/plb.12687
    Field studies integrating pollination investigations with an assessment of floral scent composition and thermogenesis in tropical aroids are rather few. Thus, this study aimed to investigate the pollination biology of nine species belonging to Schismatoglottis Calyptrata Complex Clade. The flowering mechanism, visiting insect activities, reproductive system, thermogenesis and floral scent composition were examined. Anthesis for all species started at dawn and lasted 25-29 h. Colocasiomyia (Diptera, Drosophilidae) are considered the main pollinators for all the investigated species. Cycreon (Coleoptera, Hydrophilidae) are considered secondary pollinators as they are only present in seven of the nine host plants, despite the fact that they are the most effective pollen carrier, carrying up to 15 times more pollen grains than Colocasiomyia flies. However, the number of Colocasiomyia individuals was six times higher than Cycreon beetles. Chaloenus (Chrysomelidae, Galeuricinae) appeared to be an inadvertent pollinator. Atheta (Coleoptera, Staphylinidae) is considered a floral visitor in most investigated species of the Calyptrata Complex Clade in Sarawak, but a possible pollinator in S. muluensis. Chironomidae midges and pteromalid wasps are considered visitors in S. calyptrata. Thermogenesis in a biphasic pattern was observed in inflorescences of S. adducta, S. calyptrata, S. giamensis, S. pseudoniahensis and S. roh. The first peak occurred during pistillate anthesis; the second peak during staminate anthesis. Inflorescences of all investigated species of Calyptrata Complex Clade emitted four types of ester compound, with methyl ester-3-methyl-3-butenoic acid as a single major VOC (volatile organic compound). The appendix, pistillate zone, staminate zone and spathe emitted all these compounds. A mixed fly-beetle pollination system is considered an ancestral trait in the Calyptrata Complex Clade, persisting in Sarawak taxa, whereas the marked reduction of interpistillar staminodes in taxa from Peninsular Malaysia and especially, Ambon, Indonesia, is probably linked to a shift in these taxa to a fly-pollinated system.
  18. Arasu K, Chang CY, Wong SY, Ong SH, Yang WY, Chong MHZ, et al.
    Osteoporos Int, 2023 Apr;34(4):783-792.
    PMID: 36808216 DOI: 10.1007/s00198-023-06702-0
    Soluble corn fibre (SCF) with calcium did not improve bone indices after 1 year in preadolescent children.

    INTRODUCTION: SCF has been reported to improve calcium absorption. We investigated the long-term effect of SCF and calcium on bone indices of healthy preadolescent children aged 9-11 years old.

    METHODS: In a double-blind, randomised, parallel arm study, 243 participants were randomised into four groups: placebo, 12-g SCF, 600-mg calcium lactate gluconate (Ca) and 12-g SCF + 600-mg calcium lactate gluconate (SCF + Ca). Total body bone mineral content (TBBMC) and total body bone mineral density (TBBMD) were measured using dual-energy X-ray absorptiometry at baseline, 6 and 12 months.

    RESULTS: At 6 months, SCF + Ca had a significant increase in TBBMC from baseline (27.14 ± 6.10 g, p = 0.001). At 12 months, there was a significant increase in TBBMC from baseline in the SCF + Ca (40.28 ± 9.03 g, p = 0.001) and SCF groups (27.34 ± 7.93 g, p = 0.037). At 6 months, the change in TBBMD in the SCF + Ca (0.019 ± 0.003 g/cm2) and Ca (0.014 ± 0.003 g/cm2) groups was significantly different (p 

  19. Aziz Z, Wong SY, Chong NJ
    J Ethnopharmacol, 2013 Nov 25;150(2):442-50.
    PMID: 24120746 DOI: 10.1016/j.jep.2013.09.042
    Prevention of cardiovascular disease by modifying its major risk factors, including serum cholesterol levels, is an important strategy. Hibiscus sabdariffa L. has been promoted for reducing cholesterol levels, but its reported impact on cholesterol levels has been inconsistent. The study aimed to assess systematically the evidence and quality of current research on the effect of Hibiscus sabdariffa L. on blood lipids and its adverse effects.
  20. Ng RT, Chew KS, Choong CL, Song ZL, Teh JKL, Koay ZL, et al.
    Hepatol Int, 2022 Dec;16(6):1390-1397.
    PMID: 36131224 DOI: 10.1007/s12072-022-10417-5
    OBJECTIVE: Outcome of pediatric acute liver failure (PALF) in countries with limited availability of LT is not well described. We evaluated the outcome and prognostic indicators of PALF in Malaysia where emergency LT for ALF is limited.

    METHODS: In this retrospective review on children  452 μmol/L and peak GGT 

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