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Fulltext Phialophora richardsiae isolated from a cutaneous lesion

Suppiah M, Chin CS, Keah KC

Med J Malaysia, 1987 Dec;42(4):306-8.
PMID: 3454404

Human infections due to Phialophora richardsiae, first described in 1968, is usually associated with subcutaneous cysts, although there have been reported cases of ulcerative lesions with discharging sinuses as well as infection of bones and tendon sheaths.1,2,3 Because infections by P.richardsiae are rare and the fungus relatively unknown in Malaysia, it was thought worthwhile to report the isolation of this fungus from a cutaneous lesion.
Battered child syndrome in a malaysian hospital

Hwang WT, Leng LK, Chin C

Med J Malaysia, 1974 Jun;28(4):239-43.
PMID: 4278650
Lupus nephritis in children in Malaysia

Khoo JJ, Pee S, Thevarajah B, Yap YC, Chin CK

J Paediatr Child Health, 2005 Jan-Feb;41(1-2):31-5.
PMID: 15670221 DOI: 10.1111/j.1440-1754.2005.00532.x

OBJECTIVES: To determine the pattern of renal histology, clinical outcome of children with lupus nephritis and to identify any associated risk factors predicting renal failure in these children.
METHODS: Retrospectively, 27 children under 16 years of age with lupus nephritis who had renal biopsies done at Sultanah Aminah Hospital Johor, Malaysia from 1994 to 2002 were studied. The renal histology was graded according to WHO classification system (1982). The medical records, laboratory data and the clinical outcome of the patients were studied.
RESULTS: There were 24 cases of WHO Class IV, two cases of WHO Class II and a case of WHO Class V. Twenty children were in the good renal outcome group while six children progressed into the poor renal outcome group and required renal replacement. One child was lost to follow-up. All six children in the poor renal outcome group had WHO Class IV histology. The 5-year patient and renal survival rates were 84% and 75%, respectively. Age, sex, activity and chronicity indices in the renal histology, anaemia, elevated serum creatinine, depressed levels of C3 and C4, heavy proteinuria or presence of urinary active sediments were not associated with progression to renal failure.
CONCLUSIONS: Presently, children with lupus nephritis appeared to have better patient and renal survival rates. Assessment of renal histology in these children was important for diagnosis, treatment and probably prognosis. In this study, there was a 25% incidence of loss of renal function over 5 years in children with WHO Class IV renal histology.
Fulltext Biopsy-proven childhood glomerulonephritis in Johor

Khoo JJ, Pee S, Thevarajah B, Yap YC, Chin CK

Med J Malaysia, 2004 Jun;59(2):218-25.
PMID: 15559173 MyJurnal

Background: There has been no published study of biopsy proven childhood glomerulonephritis in Malaysia.
Objectives: To determine the pattern of childhood glomerulonephritis in Johor, Malaysia from a histopathological perspective and the various indications used for renal biopsy in children.
Materials and methods: Retrospective study was done of all renal biopsies from children under 16 years of age, received in Sultanah Aminah Hospital, Johor between 1994 and 2001. The histopathological findings were reviewed to determine the pattern of biopsy proven glomerulonephritis. The indications of biopsy, mode of therapy given after biopsy and the clinical outcome were studied.
Results: 123 adequate biopsies were received, 9 children had repeated biopsies. Of the 113 biopsies, minimal change disease formed the most common histopathological diagnosis (40.7%) while lupus nephritis formed the most common secondary glomerulonephritis (23.0%). The main indications for biopsy were nephrotic syndrome (50.8%), lupus nephritis (25.4%) and renal impairment (13.1%). The mode of therapy was changed in 59.8% of the children. Of 106 patients followed up, 84 children were found to have normal renal function in remission or on treatment. 4 patients developed chronic renal impairment and 16 reached end stage renal disease. Five of the 16 children with end stage disease had since died while 11 were on renal replacement therapy. another 2 patients died of other complications.
Conclusions: The pattern of childhood GN in our study tended to reflect the more severe renal parenchymal diseases in children and those requiring more aggressive treatment. This was because of our criteria of selection (indication) for renal biopsy. Renal biopsy where performed appropriately in selected children may not only be a useful investigative tool for histological diagnosis and prognosis but may help clinicians plan the optimal therapy for these children.
A novel complex mutation of the OTC (ornithine transcarbamylase) gene in a Malaysian pedigree

Khoo AS, Balraj P, Rachedi A, Chin CN, Volpi L

Hum Mutat, 1999 Nov;14(5):448.
PMID: 10533073
Fulltext A microbiological study of vaginal discharge in women attending a Malaysian gynaecological clinic

Cheong YM, Ng YP, Chin CS, Thambu J

Med J Malaysia, 1992 Mar;47(1):44-50.
PMID: 1387449

Vaginal discharge is a common complaint of women attending gynaecological clinics. The purpose of this study was to compare the occurrence of commonly implicated microorganisms in vaginal discharge amongst women with or without the complaint, attending a gynaecological and family planning clinic. The association of Gardnerella vaginalis with bacterial vaginosis was also studied. It was found that there were no significant differences between the cases and controls in the isolation rate of Gardnerella vaginalis, Torulopsis glabrata, Ureaplasma urealyticum, Mycoplasma ssp and Group B streptococcus (p greater than 0.05). Only the isolation rate of Candida albicans was significantly higher in the cases than controls (p less than 0.01). However, there was a significant association of G. vaginalis with bacterial vaginosis.
Fulltext Psychiatric presentation of Huntington's disease in a Malaysian family

Chin CN, S'ng KH, Philip G, Rosdinom R, Wahidah A

Med J Malaysia, 1996 Mar;51(1):153-6.
PMID: 10968000

A 32-year-old Chinese lady presented to the Psychiatric Clinic with a history of change in personality for 2 years and abnormal movements for a year. After thorough investigations and observation a diagnosis of Huntington's Disease was made. Her elder brother was traced and found to have Huntington's Disease as well. He had a long standing history of antisocial behaviour and substance abuse long before the onset of the choreiform movements. Her younger brother also has choreiform movements for the last 2 years and had recent change in personality. Their mother also had abnormal movements and was recorded to be depressed and attempted suicide. The maternal grandfather had a mental illness and was warded at a mental institution till his death in 1942. Psychiatric presentation of Huntington's Disease in this Malaysian family is prominent and preceded the characteristic movements in the present generation.
Fulltext Conservative surgical management of ameloblastoma of the mandible--report on three cases

Foo GC, Siar CH, Ling KC, Chin CT

Med J Malaysia, 1983 Dec;38(4):334-8.
PMID: 6599995

Features of the typical ameloblastoma of the mandible are outlined. Three cases managed by conservative surgical treatment maintaining the continuity of the mandible are described. The factors taken into consideration when instituting this method of treatment are discussed. Results obtained are encouraging.
Concomitant cerebral and breast cryptococcosis

Arumugasamy N, Chin CS, Wong YH, Chew PH

Aust N Z J Surg, 1985 Oct;55(5):517-8.
PMID: 3868419

A patient with a solitary intracranial cryptococcoma of the occipital lobe of the brain and a concomitant granuloma of similar aetiology in the breast is reported. Despite resistance of the causative fungus to 5-fluorocytosine in vitro, the patient responded well to radical excisional surgery and therapy with 5-fluorocytosine.
Prevalence and risk factors of genitourinary Chlamydia trachomatis infection among patients attending sexually transmitted disease clinics in northern Malaysia

Yeoh CA, Chan CL, Chin CC, Tan WC

Med J Malaysia, 2020 03;75(2):103-109.
PMID: 32281589

INTRODUCTION: Chlamydia trachomatis is one of the most common sexually transmitted diseases (STDs) globally. However, data on its prevalence and risk factors in Malaysia is still scarce.
OBJECTIVE: We aimed to identify the prevalence and risk factors of genitourinary C.trachomatis infection among patients attending STD clinics in northern Peninsular Malaysia.
METHODS: A hospital-based cross-sectional study was conducted in STD clinics of Hospital Pulau Pinang and Hospital Sultanah Bahiyah, Kedah from January to November 2014. Participants were individually interviewed using a structured data collection form followed by a physical examination and laboratory tests. Nucleic Acid Amplification Test (NAAT) was used to detect C.trachomatis infection. Analysis was carried out using SPSS Version 15.
RESULTS: Eighty-three sexually active patients were enrolled, consisting of 51 males and 32 females. The median age was 28.0 years. In general, 32.5% patients were asymptomatic, the remaining presented with genital discharge (41.0%), genital warty lesion (25.3%), genital ulcer (13.3%), dysuria (13.3%), dyspareunia (2.4%), urine hesistancy (1.2%) and genital swelling (1.2%). The prevalence of genitourinary C.trachomatis infection was 21.7% in the study population; 17.6% in males and 28.1% in females. Among the infected females, 44.4% were pregnant. Of those infected 56.6% did not show any symptoms of genital infection, and 77.8% were aged between 18 and 30 years, of which most were females. Among newly diagnosed HIV patients, the prevalence was 14.3%. From multivariable logistic regression analysis, age under 28 years, being married and engagement in oral sex had significantly increased odds of C.trachomatis infection.
CONCLUSIONS: C.trachomatis infection was common among patients attending STD clinics in northern Penisular Malaysia especially in the younger age groups. Majority of the infected patients were asymptomatic.
Polyphasic approach to the identification and characterization of aflatoxigenic strains of Aspergillus section Flavi isolated from peanuts and peanut-based products marketed in Malaysia

Norlia M, Jinap S, Nor-Khaizura MAR, Son R, Chin CK, Sardjono

Int J Food Microbiol, 2018 Oct 03;282:9-15.
PMID: 29885975 DOI: 10.1016/j.ijfoodmicro.2018.05.030

Peanuts are widely consumed as the main ingredient in many local dishes in Malaysia. However, the tropical climate in Malaysia (high temperature and humidity) favours the growth of fungi from Aspergillus section Flavi, especially during storage. Most of the species from this section, such as A. flavus, A. parasiticus and A. nomius, are natural producers of aflatoxins. Precise identification of local isolates and information regarding their ability to produce aflatoxins are very important to evaluate the safety of food marketed in Malaysia. Therefore, this study aimed to identify and characterize the aflatoxigenic and non-aflatoxigenic strains of Aspergillus section Flavi in peanuts and peanut-based products. A polyphasic approach, consisting of morphological and chemical characterizations was applied to 128 isolates originating from raw peanuts and peanut-based products. On the basis of morphological characters, 127 positively identified as Aspergillus flavus, and the other as A. nomius. Chemical characterization revealed six chemotype profiles which indicates diversity of toxigenic potential. About 58.6%, 68.5%, and 100% of the isolates are positive for aflatoxins, cyclopiazonic acid and aspergillic acid productions respectively. The majority of the isolates originating from raw peanut samples (64.8%) were aflatoxigenic, while those from peanut-based products were less toxigenic (39.1%). The precise identification of these species may help in developing control strategies for aflatoxigenic fungi and aflatoxin contamination in peanuts, especially during storage. These findings also highlight the possibility of the co-occurrence of other toxins, which could increase the potential toxic effects of peanuts.
Survival advantage of initiating dialysis in elderly and non-elderly incident end-stage kidney disease patients

Ch'ng CC, Ong LM, Beh KKM, Md Yusuf WS, Chew TF, Lee ML, et al.

Nephrology (Carlton), 2020 Aug;25(8):644-651.
PMID: 31900988 DOI: 10.1111/nep.13689

AIM: Many patients, especially the elderly, who require renal replacement therapies (RRT) have delayed or rejected dialysis for various reasons. Current dialysis guidelines may not be relevant for the elderly or frail patients. We aim to determine survival advantage of initiating dialysis in patients deemed to require RRT.
METHODS: This was an observational cohort on incident end-stage kidney disease (ESKD) patients from January 1, 2007 to December 31, 2008. The primary outcome was all-cause mortality. Patients contributed person-time from the date of ESKD diagnosis until death, transplant or end of study on December 31, 2014, whichever occurred first. An extended Cox regression model with time-varying exposure to dialysis was used to account for immortal time bias.
RESULTS: Of 3990 incident ESKD patients included, 70.2% patients initiated dialysis; 78.8% with haemodialysis (HD) while the remaining 21.2% with peritoneal dialysis (PD). Dialysis reduced hazard of death in both elderly and non-elderly patients even after controlling for comorbidities (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.50, 0.68 and HR 0.76, 95% CI 0.69, 0.85, respectively). HD was protective in both the elderly and non-elderly (HR 0.53, 95% CI 0.45, 0.63 and HR 0.71, 95% CI 0.64, 0.80, respectively). PD significantly reduced risk of death compared to no dialysis in the elderly but not in the non-elderly.
CONCLUSION: Dialysis improved survival in all incident ESKD patients. The findings suggested a larger protection offered by HD. Although improvement in survival from initiating dialysis was large, its true benefit should take overall quality of life into account. SUMMARY AT A GLANCE This observational study showed that initiation of dialysis improves the survival of end-stage kidney disease (ESKD) patients of all age groups, but the quality of life is an important aspect that has not been explored.
Brain calcification in patients with cerebral lupus

Raymond AA, Zariah AA, Samad SA, Chin CN, Kong NC

Lupus, 1996 Apr;5(2):123-8.
PMID: 8743125 DOI: 10.1177/096120339600500207

Cerebral lupus (CL) is a common cause of morbidity and mortality in patients with SLE. The brain CTs of 27 consecutive adult patients with SLE and various neurological presentations were reviewed. The median age and duration of neurological symptoms at the time of the brain CT were 30 years (range = 14-51 years) and six days (range = 1 day-22 years), respectively. Eleven patients (41%) had normal CTs. The abnormalities in the remaining patients could be divided into six categories: (a) cerebral atrophy alone (two patients); (b) calcification alone (three patients); (c) infarct(s) alone (five patients); (d) cerebral atrophy and calcification (three patients); (e) cerebral atrophy and infarct(s) (one patient) and (f) cerebral atrophy, calcification and infarct(s) (two patients). Altogether eight patients (30%) (age range = 17-47 years) had intracerebral calcification: the globus pallidus was involved in all, putamen in two, head of the caudate nucleus in one, thalamus in one, centrum semiovale in two and cerebellum in three patients. Two patients had extensive calcifications of most of the basal ganglia, centrum semiovale and cerebellum. There was no relationship between the presence/degree of calcification and age of patients/duration or type of neurological presentation. The pathogenesis of cerebral calcification in CL is unknown. Cerebral lupus must now be included in the differential diagnosis of intracerebral calcification.
Nasofacial zygomycosis

Ng KH, Chin CS, Jalleh RD, Siar CH, Ngui CH, Singaram SP

Oral Surg. Oral Med. Oral Pathol., 1991 Dec;72(6):685-8.
PMID: 1812451

Zygomycosis is an uncommon polymorphic fungal disease. One clinical subtype, nasofacial zygomycosis, is caused by infectious exposure to the organism Conidiobolus coronatus. A case affecting the nose and lips of a 42-year-old Malay man is reported here. The clinicopathologic features and management of this disease are described, and its differential diagnosis is discussed.
Fulltext Evaluating the Performance of Proposed Switched Beam Antenna Systems in Dynamic V2V Communication Networks

Ahmed TH, Tiang JJ, Mahmud A, Gwo-Chin C, Do DT

Sensors (Basel), 2023 Jul 29;23(15).
PMID: 37571565 DOI: 10.3390/s23156782

This paper develops a novel approach for reliable vehicle-to-vehicle (V2V) communication in various environments. A switched beam antenna is deployed at the transmitting and receiving points, with a beam management system that concentrates the power in each beam using a low-computation algorithm and a potential mathematical model. The algorithm is designed to be flexible for various environments faced by vehicles. Additionally, an anti-failure system is proposed in case the intelligent transportation system (ITS) system fails to retrieve real-time Packet Delivery Ratio (PDR) values related to traffic density. Performance metrics include the time to collision in seconds, the bit error rate (BER), the packet error rate (PER), the average throughput (Mbps), the beam selection probability, and computational complexity factors. The proposed system is compared with traditional systems. Extensive experiments, simulations, and comparisons show that the proposed approach is excellent and reliable for vehicular systems. The proposed study demonstrates an average throughput of 1.7 Mbps, surpassing conventional methods' typical throughput of 1.35 Mbps. Moreover, the bit error rate (BER) of the proposed study is reduced by a factor of 0.1. Additionally, the proposed framework achieves a beam power efficiency of touching to 100% at computational factor of 34. These metrics indicate that the proposed method is both efficient and sufficiently robust.
Promising applications of cold plasma for microbial safety, chemical decontamination and quality enhancement in fruits

Mir SA, Siddiqui MW, Dar BN, Shah MA, Wani MH, Roohinejad S, et al.

J Appl Microbiol, 2020 Sep;129(3):474-485.
PMID: 31800143 DOI: 10.1111/jam.14541

Consumers' demand is increasing for safe foods without impairing the phytochemical and sensory quality. In turn, it has increased research interest in the exploration of innovative food processing technologies. Cold plasma technology is getting popularity now days owing to its high efficacy in decontamination of microbes in fruit and fruit-based products. As a on-thermal approach, plasma processing maintains the quality of fruits and minimizes the thermal effects on nutritional properties. Cold plasma is also exploited for inactivating enzymes and degrading pesticides as both are directly related with quality loss and presently are most important concerns in fresh produce industry. The present review covers the influence of cold plasma technology on reducing microbial risks and enhancing the quality attributes in fruits.
Fulltext Parasitic infections among Orang Asli (aborigine) in the Cameron Highlands, Malaysia

Hakim SL, Gan CC, Malkit K, Azian MN, Chong CK, Shaari N, et al.

Southeast Asian J Trop Med Public Health, 2007 May;38(3):415-9.
PMID: 17877212

In April 2004, an outbreak of acute diarrheal illness occurred among the Orang Asli (aborigine) in the Cameron Highlands, Pahang State, Peninsular Malaysia, where rotavirus was later implicated as the cause. In the course of the epidemic investigation, stool samples were collected and examined for infectious agents including parasites. Soil transmitted helminthes (STH), namely Ascaris lumbricoides (25.7%), Trichuris trichiura (31.1%) and hookworm (8.1%), and intestinal protozoa, which included Giardia lamblia (17.6%), Entamoeba histolytica/E. dispar (9.4%), Blastocystis hominis (8.1%) and Cryptosporidium parvum (2.7%), were detected. Forty-four (59.5%) were infected with at least one parasite, 24 (32.4%), 12 (16.2%) and 8 (10.8%) had single, double and triple parasitic infections, respectively. STH were prevalent with infections occurring as early as in infancy. Giardia lamblia, though the most commonly found parasite in samples from symptomatic subjects, was within the normally reported rate of giardiasis among the various communities in Malaysia, and was an unlikely cause of the outbreak. However, heavy pre-existing parasitic infections could have contributed to the severity of the rotavirus diarrheal outbreak.
Fulltext A double blind comparison of zuclopenthixol acetate with haloperidol in the management of acutely disturbed schizophrenics

Chin CN, Hamid AR, Philip G, Ramlee T, Mahmud M, Zulkifli G, et al.

Med J Malaysia, 1998 Dec;53(4):365-71.
PMID: 10971979

The aim of this study was to evaluate the efficacy and side effects of zuclopenthixol acetate compared with haloperidol in the management of the acutely disturbed schizophrenic patient. Suitable subjects diagnosed as having schizophreniform disorder or acute exacerbation of schizophrenia admitted to the psychiatric wards Hospital Kuala Lumpur were randomised to receive either zuclopenthixol acetate or haloperidol. They were rated blind for three consecutive days using the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and UKU Side Effects Scale. Apart from repeat injections of the same medication, no other anti-psychotic was given for the duration of the study. 50 subjects entered the study of which 44 completed. 23 were given zuclopenthixol acetate and 21 haloperidol. Both groups significantly reduced BPRS and CGI scores on all 3 days compared to the initial rating (p < 0.001). There was however no difference between the zuclopenthixol acetate and haloperidol group scores on all days (p > 0.05). More subjects on haloperidol than zuclopenthixol required more than 1 injection during the study. Both groups had minimal side effects. Zuclopenthixol acetate was effective in the management of the acutely disturbed schizophrenic.
Key Stakeholders' Views on Salt Intake Reduction and Barriers and Facilitators to Reducing Salt Intake in Malaysian Schools: A Qualitative Study

Mohd Isa D, Majid HA, Hairi FM, Harun Z, You YX, Abdul Manaf Z, et al.

Asia Pac J Public Health, 2024 Dec 13.
PMID: 39668727 DOI: 10.1177/10105395241304069

Excessive salt or sodium intake is strongly linked to increased blood pressure, which is a major risk factor for cardiovascular diseases. This study aimed to qualitatively explore the views of key stakeholders on salt intake reduction and barriers and facilitators to reducing salt intake in Malaysian schools. The stakeholders in this study were school administrators, food operators, and consumers. Their views were determined using in-depth interviews and focus group discussions, and data collected were analyzed using inductive thematic analysis. Salient barriers identified in this study were a lack of knowledge pertaining to salt intake reduction and foods sold outside the school. Meanwhile, key facilitators of salt reduction included few strategies such as public health campaigns, priority toward salt reduction policies, and school-based education programs, alongside support from other relevant stakeholders. Overall, the barriers and facilitators signal the need for implementing salt reduction programs and the collaborative efforts of different stakeholders.
Fulltext Low miR-19b-1-5p Expression Is Related to Aspirin Resistance and Major Adverse Cardio- Cerebrovascular Events in Patients With Acute Coronary Syndrome

Singh S, de Ronde MWJ, Creemers EE, Van der Made I, Meijering R, Chan MY, et al.

J Am Heart Assoc, 2021 01 19;10(2):e017120.
PMID: 33441016 DOI: 10.1161/JAHA.120.017120

Background Because of a nonresponse to aspirin (aspirin resistance), patients with acute coronary syndrome (ACS) are at increased risk of developing recurrent event. The in vitro platelet function tests have potential limitations, making them unsuitable for the detection of aspirin resistance. We investigated whether miR-19b-1-5p could be utilized as a biomarker for aspirin resistance and future major adverse cardio-cerebrovascular (MACCE) events in patients with ACS. Methods and Results In this cohort study, patients with ACS were enrolled from multiple tertiary hospitals in Christchurch, Hong Kong, Sarawak, and Singapore between 2011 and 2015. MiR-19b-1-5p expression was measured from buffy coat of patients with ACS (n=945) by reverse transcription quantitative polymerase chain reaction. Platelet function was determined by Multiplate aggregometry testing. MACCE was collected over a mean follow-up time of 1.01±0.43 years. Low miR-19b-1-5p expression was found to be related to aspirin resistance as could be observed from sustained platelet aggregation in the presence of aspirin (-Log-miR-19b-1-5p, [unstandardized beta, 44.50; 95% CI, 2.20-86.80; P<0.05]), even after adjusting for age, sex, ethnicity, and prior history of stroke. Lower miR-19b-1-5p expression was independently associated with a higher risk of MACCE (-Log-miR-19b-1-5p, [hazard ratio, 1.85; 95% CI, 1.23-2.80; P<0.05]). Furthermore, a significant interaction was noted between the inverse miR-19b-1-5p expression and family history of premature coronary artery disease (P=0.01) on the risk of MACCE. Conclusions Lower miR-19b-1-5p expression was found to be associated with sustained platelet aggregation on aspirin, and a higher risk of MACCE in patients with ACS. Therefore, miR-19b-1-5p could be a suitable marker for aspirin resistance and might predict recurrence of MACCE in patients with ACS.

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