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Effect of Eurycoma longifolia Jack on orientation activities in middle-aged male rats

Ang HH, Lee KL

Fundam Clin Pharmacol, 2002 Dec;16(6):479-83.
PMID: 12685506 DOI: 10.1046/j.1472-8206.2002.00106.x

The effects of various fractions of Eurycoma longifolia Jack were studied on the orientation activities of the inbred, adult middle-aged Sprague-Dawley rats, 9 months old and retired breeders towards the receptive females (anogenital sniffing, licking, mounting), the environment (climbing, raring, exploration), themselves (nongenital grooming, genital grooming) and mobility (restricted, unrestricted) after treating these subjects twice daily for 10 days. Results showed that subjects treated with 800 mg/kg of E. longifolia Jack increased orientation activities towards the receptive females (anogenital sniffing, licking and mounting), increased genital grooming towards themselves and restricted movements to a particular area of the cage but decreased interest in the external environment (climbing, raring, exploration) as compared with the controls during the investigation period. In conclusion, this study gives further evidences that different fractions of E. longifolia Jack modified the orientation activities of the middle-aged male rats.
Selection of best impregnated palm shell activated carbon (PSAC) for simultaneous removal of SO2 and NOx

Sumathi S, Bhatia S, Lee KT, Mohamed AR

J Hazard Mater, 2010 Apr 15;176(1-3):1093-6.
PMID: 20018447 DOI: 10.1016/j.jhazmat.2009.11.037

This work examines the impregnated carbon-based sorbents for simultaneous removal of SO(2) and NOx from simulated flue gas. The carbon-based sorbents were prepared using palm shell activated carbon (PSAC) impregnated with several metal oxides (Ni, V, Fe and Ce). The removal of SO(2) and NOx from the simulated flue gas was investigated in a fixed-bed reactor. The results showed that PSAC impregnated with CeO(2) (PSAC-Ce) reported the highest sorption capacity among other impregnated metal oxides for the simultaneous removal of SO(2) and NOx. PSAC-Ce showed the longest breakthrough time of 165 and 115 min for SO(2) and NOx, respectively. The properties of the pure and impregnated PSAC were analyzed by BET, FTIR and XRF. The physical-chemical features of the PSAC-Ce sorbent indicated a catalytic activity in both the sorption of SO(2) and NOx. The formation of both sulfate (SO(4)(2-)) and nitrate (NO(3-)) species on spent PSAC-Ce further prove the catalytic role played by CeO(2).
Optimization of microporous palm shell activated carbon production for flue gas desulphurization: experimental and statistical studies

Sumathi S, Bhatia S, Lee KT, Mohamed AR

Bioresour Technol, 2009 Feb;100(4):1614-21.
PMID: 18952414 DOI: 10.1016/j.biortech.2008.09.020

Optimizing the production of microporous activated carbon from waste palm shell was done by applying experimental design methodology. The product, palm shell activated carbon was tested for removal of SO2 gas from flue gas. The activated carbon production was mathematically described as a function of parameters such as flow rate, activation time and activation temperature of carbonization. These parameters were modeled using response surface methodology. The experiments were carried out as a central composite design consisting of 32 experiments. Quadratic models were developed for surface area, total pore volume, and microporosity in term of micropore fraction. The models were used to obtain the optimum process condition for the production of microporous palm shell activated carbon useful for SO2 removal. The optimized palm shell activated carbon with surface area of 973 m(2)/g, total pore volume of 0.78 cc/g and micropore fraction of 70.5% showed an excellent agreement with the amount predicted by the statistical analysis. Palm shell activated carbon with higher surface area and microporosity fraction showed good adsorption affinity for SO2 removal.
The effect of nitrogen supplementation on the efficiency of colour and COD removal by Malaysian white-rot fungi in textile dyeing effluent

Lee KK, Kassim AM, Lee HK

Water Sci Technol, 2004;50(5):73-7.
PMID: 15497832

White-rot fungi, namely Coriolus versicolor and Schizophyllum commune, were studied for the biodecolorization of textile dyeing effluent in shaker-flask experiments. The results showed that C. versicolor was able to achieve 68% color removal after 5 days of treatment while that of S. commune was 88% in 9 days. Both fungi achieved the above results in non-sterile condition with diammonium hydrogen phosphate as the nutrient supplement. On the other hand, the best COD removal of 80% was obtained with C. versicolor in 9 days in sterile effluent with yeast extract as nutrient supplement, while S. commune was able to remove 85% COD within 8 days in non-sterile textile effluent supplemented with diammonium hydrogen phosphate.
Determination of lead in Smilax myosotiflora herbal preparations obtained in Malaysia

Ang HH, Lee KL, Kiyoshi M

Int J Environ Health Res, 2004 Aug;14(4):261-72.
PMID: 15369991

The DCA (Drug Control Authority), Malaysia implemented the phase 3 registration of traditional medicines on 1 January 1992 with special emphasis on the quality, efficacy and safety (including the presence of heavy metals) in all pharmaceutical dosage forms of traditional medicinal preparations. As such, a total of 100 traditional medicinal preparations, containing Smilax myosotiflora, in various pharmaceutical dosage forms, which were bought in the Malaysian market, were analysed for lead content using atomic absorption spectrophotometry. Results showed that 15% of the products analysed possessed 10.23-23.05 ppm of lead, and therefore, do not comply with the quality requirement for traditional medicines in Malaysia. The quality requirement for traditional medicines in Malaysia is that they should not exceed 10 ppm of lead. Out of these 15 products, five products exhibited 10.23-23.05 ppm of lead, in fact they have already been registered with the DCA Malaysia. However, the rest of the products, which possessed 12.24-20.72 ppm of lead, have still not been registered with the DCA Malaysia. Although this study successfully showed that only 85% of the products complied with the quality requirement for traditional medicines in Malaysia pertaining to lead, they cannot, however, be assumed to be safe from lead contamination because of batch-to-batch inconsistency.
Fulltext Outpatient procedures for cervical dysplasia: a 3 year review of laser vaporisation and LEEP

Lee KE, Koh CF, Watt WF

Med J Malaysia, 1999 Mar;54(1):47-51.
PMID: 10972004

A 3 year retrospective review (1995 to 1997) of 127 patients with cervical dysplasia who underwent Laser Vaporisation of the cervix and LEEP at the Gynaecological Cancer Centre, KK Women's & Children's Hospital, Singapore, was undertaken. Amongst the patients in the Laser Vaporisation group, the mean age was 37.7 years (SD 8.8), the mean operating time was 14.8 minutes (SD 8.5), 63.6% were given prophylactic antibiotics and the mean follow up period was 15.3 months (SD 12.0), whilst in the LEEP group, mean age was 40.3 years (SD 8.4), mean operating time, 11.8 minutes (SD 4.9), prophylactic antibiotic rate, 53.8% and mean follow up period was 19.1 months (SD 9.3). Mild and moderate haemorrhage post procedure were the only complications encountered, 10.2% (5/49) in the Laser group and 3.8% (3/78) in the LEEP group. 98% (48/49) and 97.4% (76/78) of the Laser and LEEP groups, respectively, were free of disease on follow up. None of the 3 patients with persistent or recurrent disease were diagnosed as having invasive cancer. Overall, there were no significant differences in the patient characteristics, histopathology, operating times, follow up period, the use of prophylactic antibiotics, and complications in the 2 groups. The low complication rate, high disease-free rate and the relatively short operating time of Laser Vaporisation and LEEP in our study suggests that, indeed, both the procedures can be done safely and efficiently in the outpatient setting. However the discrepancy between the histology of colposcopically directed biopsy and that of LEEP specimens suggests that colposcopically directed biopsy may not be as accurate as one might believe, and further studies analysing the concordance between colposcopically directed biopsy and LEEP biopsy histologies are needed.
Covalent immobilization of aminoacylase to alginate for L-phenylalanine production

Lee PM, Lee KH, Siaw YS

J Chem Technol Biotechnol, 1993;58(1):65-70.
PMID: 7763937

Aminoacylase I (EC. 3.5.1.14) was immobilized by covalent crosslinking to alginate molecules with 1-ethyl-3-(3-dimethyl-aminopropyl)-carbodiimide HCl followed by calcium alginate bead formation for the production of L-phenylalanine from the racemic mixtures of N-acetyl-DL-phenylalanine. Different concentrations of the coupling reagent were tested and the coupling process was optimized. The immobilized and the partially purified aminoacylase were characterized in terms of the activity, operational stability, thermal stability, pH and temperature optima and kinetic constants, Km and Vmax. The activity of the enzyme covalently immobilized in calcium alginate beads was enhanced by about 75% compared to that of free enzyme. The beads showed stable activity under operational conditions, they lost about 40% of their activity after four reaction cycles. The immobilized aminoacylase was more stable over a broader pH range. Thus this simple method provides irreversible immobilization of aminoacylase to give a biocatalyst with good operational stability and enhanced activity.
Immobilization of aminoacylase by encapsulation in poly-L-lysine-stabilized calcium alginate beads

Lee KH, Lee PM, Siaw YS

J Chem Technol Biotechnol, 1993;57(1):27-32.
PMID: 7763683

Aminoacylase I (EC 3.5.1.14) encapsulated in calcium alginate beads stabilized with poly-L-lysine was used for the production of L-phenylalanine by the hydrolysis of a racemic mixture of N-acetyl-DL-phenylalanine. The immobilized aminoacylase was studied with respect to operational stability, thermal stability, effects of pH and temperature and kinetic constants. The leakage of enzyme from the stabilized beads was eliminated. The immobilized enzyme retained high biological activity. The Km and Vmax values for the stabilized beads were 11.11 mmol dm-3 and 0.076 mumol min-1 respectively. The optimum pH and temperature for the hydrolysis were 6.5 and 55 degrees C respectively. Scanning electron micrographs revealed crosslinked structures on the surface of the beads. The operational performances of the beads in a batch reaction and a packed-bed bioreactor for continuous reaction were investigated. With batch reaction, only about 5% of enzyme activity was lost within ten reaction cycles and there was no significant loss of activity over 600 h of continuous operation after equilibrium was reached, and a conversion yield of about 80% was obtained.
Immobilization of aminoacylase in polyethyleneimine stabilized calcium alginate beads for L-phenylalanine production

Lee PM, Lee KH, Siaw YS

Biomater Artif Cells Immobilization Biotechnol, 1993;21(4):563-70.
PMID: 8260581

Aminoacylase I (E.C.3.5.1.14) was immobilized by entrapment in calcium alginate beads coated with polyethyleneimine for the production of L-phenylalanine by the hydrolysis of a racemic mixture of N-acetyl-DL-phenylalanine. The operational stability in terms of batch operation and continuous reaction in packed-bed bioreactor were studied. Kinetic constants, Km and Vmax values of free and immobilized enzymes were studied. Polyethyleneimine treatment was found to enhance the operational stability of the enzyme though its activity was substantially reduced. When polyethyleneimine-coated calcium alginate beads were packed into packed bed bioreactor, it was stable for at least 25 days under continuous operation without appreciable loss of activity.
Prevalence of endocrine complications in transfusion dependent thalassemia in Hospital Pulau Pinang: A pilot study

Lee KT, Lim SL, Goh AS

Med J Malaysia, 2020 01;75(1):33-37.
PMID: 32008017

INTRODUCTION: Frequent blood transfusions results in iron overload and lead to multiple endocrine complications. In spite of improvements in iron chelation therapy, a significant number of transfusion dependent thalassaemia (TDT) patients still develop endocrine complications. The aim of this study is to evaluate the prevalence of various endocrine complications in our adult TDT patients and to study the correlation with serum ferritin and liver iron concentration (LIC).
METHODS: A retrospective review of all TDT patients treated in Haematology Unit, Hospital Pulau Pinang (HPP) was conducted.
RESULTS: Of the 45 adult TDT patients, 22 were males and 23 were females with mean age of 28.8±6.9 years old. Majority of TDT in HPP were beta thalassemia major (71.1%), followed by E-Beta thalassemia (24.4%) and HbH-Constant Spring (4.4%). Frequency of transfusion was 3-4 weekly. 40.0% of adult TDT suffered from at least one endocrine complication. Among the adult TDT patients with endocrine complication, 50% have one endocrinopathy, 38.9% with two types of endocrinopathies and 11.1% of them have three or more types of endocrinopathies. Hypogonadism (22.2%) was the commonest endocrine complication, followed by osteoporosis (20%), hypothyroidism (13.3%), diabetes mellitus (6.7%) and hypocortisolism (4.4%). Patients with endocrine complications were significantly older. Mean serum ferritin level and LIC was higher among patients with endocrine complications but both were not statistically significant.
CONCLUSION: Endocrinopathy is still prevalent in 40% of adult TDT patients. This leads to higher health-care resource utilization, cost and significant morbidities among patients with TDT. Therefore, regular monitoring and early detection with intensification of chelation therapy is essential.
A recommended diet for West Malaysian pregnant women

Chan LK, Lee KL, Tan SE

Med J Malaya, 1967 Dec;22(2):94-8.
PMID: 4231985
Phenotypic and genotypic characteristics of Mycobacterium isolates from fighting fish Betta spp. in Malaysia

Najiah M, Lee KL, Noorasikin H, Nadirah M, Lee SW

Res Vet Sci, 2011 Dec;91(3):342-5.
PMID: 20971487 DOI: 10.1016/j.rvsc.2010.09.010

Mycobacteriosis due to mycobacteria is one of the most common bacterial diseases in ornamental fish. We describe here the phenotypic and genotypic characteristics of Mycobacterium isolates from fighting fish Betta spp. using ATCC Mycobacterium marinum, Mycobacterium fortuitum and Mycobacterium chelonae as references. A total of four isolates (M1, M2, M3, M4) were obtained from four out of 106 fish samples using selective agar, and identified to Mycobacterium genus using acid-fast staining and 16s rRNA gene-based genus specific polymerase chain reaction. DNA sequencing and NCBI-BLAST analysis further identified isolate M1 as M. marinum and isolates M2, M3, M4 as M. fortuitum. Morphological, physiological and biochemical tests were carried out for phenotypic characterizations. Universal M13 and wild-type phage M13 RAPD dendogram was generated to illustrate the genetic relationship of the isolates and reference strains.
Conducting qualitative research in the new norms: Are we ready?

Abdul Rashid N, Lee K, Jamil NA

Nurs Health Sci, 2021 Dec;23(4):967-973.
PMID: 34370379 DOI: 10.1111/nhs.12872

The COVID-19 pandemic has considerably hampered research practices, putting many research activities on hold. Researchers may experience difficulties arising from the unprecedented challenge, specifically during the data collection process. The main difficulties include delayed projects due to the movement control order imposed by the government. However, the advancement of information technology and the broad use of smartphones have favorable implications on qualitative research during the pandemic. This article is based on two qualitative researchers' experience doing fieldwork, specifically the difficulties encountered by the research teams and the strategies adopted to ensure the success of the projects. Both research projects used in-depth interviews as the main method for data collection. Reflective journals and field notes were used to enhance the quality of information obtained in both studies. It is hoped that this article may benefit other qualitative researchers by facilitating a successful data collection process during the COVID-19 pandemic.
The role of carbon chain length in the attachment between microbubbles and aqueous solutions of ionic liquid

Chew EK, Lee KY, Lau EV

J Colloid Interface Sci, 2017 Nov 15;506:452-459.
PMID: 28755640 DOI: 10.1016/j.jcis.2017.07.078

HYPOTHESIS: The effects of varying carbon chain lengths (CCLs) and concentrations of aqueous solutions of imidazolium based ionic liquids on bubble particle attachment (BPA) will provide a better understanding in catering for the varying degrees of surface activities in the application of the flotation technology. The general trends of this study should also be applicable to homologous series of other cationic surfactants and ionic liquids.
EXPERIMENTS: Zeta potentials of small air bubbles and bunker oil drops dispersed in aqueous solutions of n-methylimidazolium chloride ionic liquids (n=0, 2, 3, 6, 8, 10, 12) of concentrations ranging from 1000PPM to 8000PPM, as were interfacial tensions of these solutions with bunker oil (180cst) and contact angles made by air bubbles at interfaces between these solutions and thin layers of bunker oil on flat solid surfaces were investigated. Finally, interparticle forces analysis using the Derjaguin-Landau, Verwey-Overbeek (DLVO) theory is also included.
FINDINGS: Analysis using the DLVO theory showed attractive forces between the oil particles and micro-bubbles are significantly more prevalent in short CCLs solutions of imidazolium-based ILs in low concentrations, namely [C0mim][Cl] and [C2mim][Cl] at a maximum zeta potential difference of 75.3mV. The results from CA measurements follows similarly whereby low concentrations of ILs with short CCLs were in favor for the bubble-particle attachment process with angles ranging between 93.95° for [C0mim][Cl] and 97.28° for [C2mim][Cl]. IFT which is important in reducing coalescence for the preferential BPA process to occur in flotation decreases with an increase of CCL and concentration of IL.
Clinical characteristic and management of haemophilia patients in Malaysia: A single centre experience

Lee KT, Tan SK, Goh AS

Med J Malaysia, 2024 Mar;79(2):170-175.
PMID: 38553922

INTRODUCTION: Haemophilia is one of the commonest inherited bleeding disorders which may lead to long term disabilities if not treated properly. Our aim of study is to understand the clinical characteristic, treatment and complications of adult haemophilia patients in our centre.
MATERIALS AND METHODS: A retrospective cross-sectional review of all adult haemophilia A (HA) or haemophilia B (HB) patients who received treatment in Hospital Pulau Pinang from January 2021 to December 2022 was conducted. Data was retrieved from patients' medical records.
RESULTS: A total of 75 haemophilia patients (64 HA and 11 HB) were included in this study with median age of 37 years (range 19 70). 42 of them had severe haemophilia (50% of HA, 91% of HB). All HB and 93.8% of severe HA patients were on prophylaxis. Six severe and one mild HA patients developed inhibitor with four of them currently on non-factor prophylaxis. 24 patients (32%) had prior hepatitis C infection and all of them have been successfully treated. The mean annual bleeding rate for severe haemophilia patients were 1.77 (SD ±3.6). Target joints were observed in 9.3% of patients with ankle joint (71.4%) being the most affected joint. More than one quarter (26.7%) of our patients have comorbidities with majority of them having hypertension (17/20), followed by diabetes mellitus (5/20) and ischemic heart disease (5/20).
CONCLUSION: Our study showed that a significant number of adult patients with haemophilia have comorbidities. Apart from optimising factor replacement therapy, future planning should include improvement in screening, risk modification and prevention of cardiovascular disease.
Fulltext Knowledge and beliefs about breastfeeding are not determinants for successful breastfeeding

Ishak S, Adzan NA, Quan LK, Shafie MH, Rani NA, Ramli KG

Breastfeed Med, 2014;9(6):308-12.
PMID: 24893127 DOI: 10.1089/bfm.2013.0124

A cross-sectional prospective study was performed to assess knowledge and attitude toward breastfeeding among mothers in a tertiary hospital in Malaysia and its influence on their breastfeeding practices. Two hundred thirteen women who had delivered healthy babies at term were enrolled. A structured questionnaire containing demographic data and the Iowa Infant Feeding Attitude Score were used, followed by a telephone interview after 8 weeks to determine the feeding outcome. Women of Malay ethnicity with higher education level who had received breastfeeding counseling had a significantly more favorable attitude toward breastfeeding. Ethnicity was found to be a significant determinant in the success of breastfeeding, whereas returning to work was a major reason for discontinuing breastfeeding. In ensuring a successful breastfeeding practice, apart from knowledge and attitude, issues surrounding culture and traditions as well as improving deliverance of readily available support should be addressed.
Fulltext Cost-Effectiveness Analysis Of Ticagrelor In Treating Patients With Acute Coronary Syndrome In Hong Kong

Wu DB, Lee BS, Lee KK

Value Health, 2014 Nov;17(7):A487.
PMID: 27201437 DOI: 10.1016/j.jval.2014.08.1430
Fulltext Cost-effectiveness analysis of strontium ranelate verse alendronate for management of osteoporosis among post-menopausal women in Malaysia using a Markov modelling approach. [Abstract]

Wu DB, Hussain S, Mak V, Lee KK

Value Health, 2014 Nov;17(7):A382.
PMID: 27200852 DOI: 10.1016/j.jval.2014.08.2625

OBJECTIVES. Osteoporotic fractures are common in older adults and are often associated with high morbidity and mortality. As the incidence increases with age, it is natural that osteoporotic fractures have become a major health problem worldwide. Increasing number of patients with osteoporotic fracture will have a serious economic impact on the patient themselves and the society. The objective of this study is to study the cost-effectiveness of strontium ranelate compared to alendronate for patients with post-menopausal osteoporotic fractures in Malaysia.
METHODS. A Markov model was developed to project clinical and economic benefits of strontium in a hypothetical cohort of patients (N=1,000) over a 5-year time horizon. This study was conducted from a payer perspective. Model parameters including transition probabilities and costs of treating fracture at various sites were Malaysia-specific. Drug costs were obtained from a public teaching hospital in Kuala Lumpur. Utilities were derived from previous literatures and efficacy data were derived from two pivotal trials, i. e. SOTI and TROPOS trials. Outcomes were presented as cost per quality-adjusted life year (QALY) gained. A discount rate of 3% was applied. Both 1-way and multivariate probabilistic sensitivity analyses were undertaken to evaluate robustness of results.
RESULTS. Compared to alendronate, strontium could prevent 328 wrist, 192 hip, 7 vertebra and 115 multiple fractures respectively over 5 years, which was translated into 27.9 QALYs gained. Using strontium can lead to cost reduction of MYR1,416,595 (USD442,685), MYR478,257 (USD149,455), MYR22,784 (USD7,120) and MYR61,883 (USD113,088) due to reduced episodes of fractures at wrist/hip/vertebra/multiple sites respectively. The total reduction of direct medical costs of MYR2,279,519 (USD712,349) was larger than the extra drug cost, hence making strontium a cost-saving therapy.
CONCLUSIONS. It was shown that strontium appeared to be more cost-effective compared to alendronate and hence should be recommended in the public sector in Malaysia.
Hypertensive patients' preferences for complementary and alternative medicine and the influence of these preferences on the adherence to prescribed medication

Lee K, Mokhtar HH, Krauss SE, Ong BK

Complement Ther Clin Pract, 2014 May;20(2):99-105.
PMID: 24767954 DOI: 10.1016/j.ctcp.2014.03.001

PURPOSE: This study aimed to understand hypertensive patients' perceptions of and adherence to prescribed medication.
METHODS: A qualitative research study based on 23 purposely selected participants from a community health clinic in Malaysia. The participants underwent in-depth semi-structured interviews, and the data were analyzed using qualitative content analysis method.
RESULTS: The participants were presented with six types of perceptions of medication. The majority of the participants had negative perceptions of Western medicine (WM), self-adjusted their prescribed medication with complementary and alternative medicine (CAM) and concealed their self-adjusting habits from their doctors. Participants who thought positively of WM took their prescribed medication regularly. Most of the participants perceived the nature of WM as not being curative because of its side effects. Patients have the right to choose their preferred medication when they understand their illness.
CONCLUSION: Local health care systems should provide patients with alternative health services that suit their requests.
KEYWORDS: Adherence; Complementary and alternative medicine; Hypertension; Qualitative research
Study site: Klinik kesihatan, Selangor, Malaysia
Fulltext A retrospective review on successful management of Penicillium marneffei infections in patients with advanced HIV in Hospital Sungai Buloh

Nor-Hayati S, Sahlawati M, Suresh-Kumar C, Lee KC

Med J Malaysia, 2012 Feb;67(1):66-70.
PMID: 22582551 MyJurnal

Penicillium marneffei is a dimorphic fungus which commonly causes a life threatening systemic fungal infection in an immunocompromised host. It has been recognized as an AIDS defining illness in Malaysia since the beginning of the HIV pandemic. The presence of various non specific clinical presentations, especially the characteristic umbilicated papular rashes with central necrosis which lead to significant ill health in immunocompromised patients should alarm clinicians to the possibility of Penicillium marneffei infection and prompt investigations accordingly. Simple investigations like blood culture and fungal staining of the skin scrapping can confirm the diagnosis in the majority of cases. Early treatment with appropriate systemic antifungal for a definite duration will significantly decrease the mortality rate from penicilliosis.

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