Displaying publications 21 - 40 of 365 in total

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  1. Sim KS, Lee JK, Lai MA, Tso CP
    J Microsc, 2009 Oct;236(1):18-34.
    PMID: 19772533 DOI: 10.1111/j.1365-2818.2009.03194.x
    A new and robust parameter estimation technique, named Gaussian-Taylor interpolation, is proposed to predict the signal-to-noise ratio (SNR) of scanning electron microscope images. The results of SNR and variance estimation values are tested and compared with piecewise cubic Hermite interpolation, quadratic spline interpolation, autoregressive moving average and moving average. Overall, the proposed estimations for noise-free peak and SNR are most consistent and accurate to within a certain acceptable degree compared with the others.
  2. Lee J, Ma S, Heng D, Chew S, Hughes K, Tai E
    J Hum Hypertens, 2008 Jul;22(7):468-74.
    PMID: 18337755 DOI: 10.1038/jhh.2008.16
    The current hypertension (HTN) guidelines recommend the assessment of other cardiovascular disease (CVD) risk factors in individuals with HTN for further management. Few studies in Asian populations have been published to identify the outcome of individuals with HTN and other CVD risk factors. This study aims to assess the effect of HTN alone, and in combination with other CVD risk factors on all-cause and CVD mortality. Three cross-sectional studies carried out in Singapore (baseline 1982--1995) consisting of 5830 persons were grouped by the absence or presence of HTN and CVD risk factors. They were followed-up (mean 14.1 years) by linkage with the National Death Register. Cox's proportional hazards model was used to obtain adjusted hazard ratios (HRs) for risk of mortality. HTN individuals with either <2 CVD risk factors (adjusted HR 1.4; 95% confidence interval (CI) 1.0-1.8) or > or =2 CVD risk factors (adjusted HR 2.3; 95% CI 1.9-3.0) were at increased risk of all-cause mortality compared to normotensive individuals. The findings were similar for CVD mortality. HTN individuals who also smoked or had diabetes were at highest risk of all-cause mortality, whereas those with elevated total cholesterol/high-density lipoprotein cholesterol, smoked or diabetes had the highest risk for CVD mortality. These findings show that in HTN individuals it is important to assess the presence of other CVD risk factors and manage accordingly.
  3. Lee J, Heng D, Chia KS, Chew SK, Tan BY, Hughes K
    Int J Epidemiol, 2001 Oct;30(5):983-8.
    PMID: 11689508
    OBJECTIVE: This prospective study in Singapore investigated the relationships of established coronary risk factors with incident coronary heart disease (CHD) for Chinese, Malay, and Asian Indian males.

    SUBJECTS: A cohort (consisting of 2879 males without diagnosed CHD) derived from three previous cross-sectional surveys.

    METHODS: Individual baseline data were linked to registry databases to obtain the first event of CHD. Hazard ratios (HR) or relative risks for risk factors were calculated using Cox's proportional hazards model with adjustment for age and ethnic group and adjustment for age, ethnic group and all other risk factors (overall adjusted).

    RESULTS: There were 24,986 person-years of follow-up. The overall adjusted HR with 95% CI are presented here. Asian Indians were at greatest risk of CHD, compared to Chinese (3.0; 2.0-4.8) and Malays (3.4; 1.9-3.3). Individuals with hypertension (2.4; 1.6-2.7) or diabetes (1.7; 1.1-2.7) showed a higher risk of CHD. High low density lipoprotein cholesterol (LDL-C) (1.5; 1.0-2.1), high fasting triglyceride (1.5; 0.9-2.6) and low high density lipoprotein cholesterol (HDL-C) (1.3; 0.9-2.0) showed a lesser but still increased risk. Alcohol intake was protective with non-drinkers having an increased risk of CHD (1.8; 1.0-3.3). Obesity (body mass index > or =30) showed an increased risk (1.8; 0.6-5.4). An increased risk of CHD was found in cigarette smokers of > or =20 pack years (1.5; 0.9-2.5) but not with lesser amounts.

    CONCLUSIONS: The increased susceptibility of Asian Indian males to CHD has been confirmed in a longitudinal study. All of the examined established risk factors for CHD were found to play important but varying roles in the ethnic groups in Singapore.

  4. Seow A, Lee J, Sng I, Fong CM, Lee HP
    Cancer, 1996 May 1;77(9):1899-904.
    PMID: 8646691
    BACKGROUND: Non-Hodgkin's lymphoma has increased in incidence in many countries, particularly in the West. Advances in diagnostic methods and the understanding of the disease over time pose a challenge to the interpretation of these trends. The aim of this study was to determine if the disease has increased in Singapore, a newly industrialized Asian country, and to examine the possible factors that may account for any observed changes.
    METHODS: Data from the population-based Singapore Cancer Registry for the period 1968 to 1992 were reviewed to determine time trends based on sex and ethnic group. The Poisson regression model was fitted to the cross-tabulated data to obtain the adjusted incidence density ratios.
    RESULTS: A total of 1988 cases of non-Hodgkin's lymphoma were included in the analysis. There was an overall increase in incidence among both Chinese and Malaysians. However, the rate of increase was greater in females (age-standardized rate from 1.8 per 100,000 in 1968-1972 to 4.5 per 100,000 in 1988-1992) than in males (3.2 per 100,000 to 5.9 per 100,000 in the same time periods). Between ethnic groups, Malay females were at higher overall risk compared with their Chinese counterparts (incidence density ratio 1.32; 95% confidence interval, 1.08-1.61). Although a substantial proportion of patients diagnosed with Hodgkin's disease between 1968 and 1972 were reclassified on review, using present criteria, as having non-Hodgkin's lymphoma, it is unlikely that this, and other recent changes in histologic interpretation, could have accounted for an increase of this magnitude.
    CONCLUSIONS: Non-Hodgkin's lymphoma has increased in incidence among the Chinese and Malay populations in Singapore. The pattern of increase differs from that of the common cancer sites, and suggests the need to look for environmental and genetic factors that have not yet been elucidated.
  5. Seow A, Duffy SW, McGee MA, Lee J, Lee HP
    Int J Epidemiol, 1996 Feb;25(1):40-5.
    PMID: 8666502
    BACKGROUND: Breast cancer is the most commonly occurring cancer among women in Singapore, a country which has experienced significant changes in lifestyle over the past three decades. The increase in incidence of the disease is a matter of some concern.

    METHODS: Data from the population-based Singapore Cancer Registry for 1968-1992 were used to determine time trends, inter-ethnic differences and the contributions of age, period and cohort effects to the incidence of the disease.

    RESULTS: Our results revealed an average annual increase of 3.6% over the 25-year period for all women, form 20.2 per 100,000 women in the period 1968-1972 to 38.8 per 100,000 in 1988-1992. There was a statistically significant difference between the three major ethnic groups, the rate of increase being highest in Malays (4.4%) and lowest in Indians (1.4%). The overall increase was attributable to a strong cohort effect that remained significant when adjusted for time period for Chinese women and for all ethnic groups combined. The risk was observed to increase in successive birth cohorts from the 1890s to 1960s.

    CONCLUSIONS: Our results suggest that breast cancer incidence rates are likely to continue to increase more sharply in the future as women born after the mid-20th century reach the high-risk age groups. They also suggest the pattern by which important aetiological factors for the disease in our population have exerted their effects, and provide support for the role of demographic and lifestyle changes as possible risk factors.

  6. Foo SC, Ngim CH, Phoon WO, Lee J
    Sci Total Environ, 1988 Jun 15;72:113-22.
    PMID: 3406725
    Two hundred and twenty-five hair samples (150 Chinese, 44 Malays and 31 Indians) from healthy residents not occupationally exposed to mercury were analyzed by cold vapour atomic absorption spectrophotometry to determine their total, inorganic and organic mercury levels. The arithmetic means of total mercury levels in hair were 6.1, 5.2 and 5.4 ppm for the Chinese, Malays and Indians, respectively. Factors contributing to the amount of mercury in hair, including consumption of fish and marine products, use of traditional ethnic medicines, artificial hair waving, age, sex and ethnicity were analyzed. Fish consumption, sex and ethnicity are factors found to contribute significantly (p less than 0.05) to mercury levels in hair.
  7. Yeap SS, Goh EML, Das Gupta E, Lee JK
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A125-A126.
    DOI: 10.1111/j.1479-8077.2006.00199_20.x
    Aims: The aim of this study was to determine the depth of knowledge about osteoporosis (OP) among the public in Malaysia. Methods: A self-administered questionnaire was distributed to attendees of selected health-related public forums in the Klang Valley and Seremban between the months of May to October 2005. Results: 483 questionnaires were returned from 600 given out (80.5%). There were 139 (28.8%) male, 338 (70%) female respondents and 6 (1.2%) not stated. 87.1% respondents had heard of OP. Significantly more women than men had heard of OP (p = 0.015). Mean age was 50.15 ± 14.6 years, 56.7% in the range of 45-64 years. There was no significant difference in the ages of those who had heard of OP and those who had not. 180/338 (53.3%) were postmenopausal females. Those with >10 years of schooling were more likely to have heard of OP (p RM 1000/month (US$270) were more likely to have heard of OP (p =0.022). 22.6% had a positive family history of OP. 63.1% exercised regularly at an average of 4.26 ± 2.78 hours/week. 4.8% were smokers with a median of 10 cigarettes/day. 24.4% drank alcohol with a median of 1 drink/week. However, 70.9% of respondents said that OP led to falls. 89.6% were concerned about osteoporosis. 90.7% agreed that osteoporosis would make daily activities more difficult. The majority obtained their information about osteoporosis from the printed word; newspapers 55.7%, magazines 46.4%, posters/brochures 30.2%, followed by public talks 30%, relatives 29.6%, television 22.8%, medical clinic 22.6% and internet 11.4%. The majority would ask for more information on osteoporosis from their general practitioner 30.6%, followed by other medical specialists such as orthopaedic surgeons 28.4%, hospital specialists 23.8%, rheumatologists 22.4%, followed by friends 15.9%, relatives 14.3% and pharmacists 11.4%. In this self-selected population, knowledge of OP was better among women, the better educated and those earning a higher level of income. Almost 90% of respondents were concerned about getting OP. Their knowledge of OP was obtained from the printed word, which is an important consideration when considering health promotion activities. General practitioners and orthopaedic surgeons need to have a good knowledge of OP.
  8. Lee JM, Yek SH, Wilson RF, Rahman S
    Acta Trop, 2020 Dec;212:105683.
    PMID: 32888935 DOI: 10.1016/j.actatropica.2020.105683
    Understanding the diversity and dynamics of the microbiota within the mosquito holobiome is of great importance to apprehend how the microbiota modulates various complex processes and interactions. This study examined the bacterial composition of Aedes albopictus across land use type and mosquito sex in the state of Selangor, Malaysia using 16S rRNA sequencing. The bacterial community structure in mosquitoes was found to be influenced by land use type and mosquito sex, with the environment and mosquito diet respectively identified to be the most likely sources of microbes. We found that approximately 70% of the microbiota samples were dominated by Wolbachia and removing Wolbachia from analyses revealed the relatively even composition of the remaining bacterial microbiota. Furthermore, microbial interaction network analysis highlighted the prevalence of co-exclusionary patterns in all networks regardless of land use and mosquito sex, with Wolbachia exhibiting co-exclusionary interactions with other residential bacteria such as Xanthomonas, Xenophilus and Zymobacter.
  9. Chu SY, Barlow SM, Lee J, Wang J
    Int J Speech Lang Pathol, 2020 04;22(2):141-151.
    PMID: 31213093 DOI: 10.1080/17549507.2019.1622781
    Purpose: To characterise labial articulatory pattern variability using the spatiotemporal index (STI) in speakers with idiopathic Parkinson's disease (PD) across different speaking rates and syllable-sentence conditions compared to age- and sex-matched healthy controls.Method: Ten speakers with mild-severe idiopathic PD and 10 controls produced "pa" and the Rainbow Passage at slow, typical and fast speech rates. Upper lip and lower lip kinematics were digitised during a motion capture system. Data were analysed using linear mixed modelling.Result: Regardless of the participant group, a high STI value was observed in the fast speech rate for the "pa" syllable condition, particularly for movements of the lower lip. As utterance rate increased, the control group showed the highest variability, followed by PD OFF and PD ON conditions. Syllable "pa" showed a greater STI value compared to both the first and second utterance of Rainbow Passage.Conclusion: PD manifests sufficient residual capacity to achieve near-normal motor compensation to preserve the consistency of lower lip movements during speech production. The lack of a significant difference in lip STI values between ON-OFF medication states suggests that dopaminergic treatment does not influence stability of speech for individuals with mild-moderate stage PD.
  10. Chu SY, Barlow SM, Lee J, Wang J
    Int J Speech Lang Pathol, 2017 12;19(6):616-627.
    PMID: 28425760 DOI: 10.1080/17549507.2016.1265587
    PURPOSE: This research characterised perioral muscle reciprocity and amplitude ratio in lower lip during bilabial syllable production [pa] at three rates to understand the neuromotor dynamics and scaling of motor speech patterns in individuals with Parkinson's disease (PD).

    METHOD: Electromyographic (EMG) signals of the orbicularis oris superior [OOS], orbicularis oris inferior [OOI] and depressor labii inferioris [DLI] were recorded during syllable production and expressed as polar-phase notations.

    RESULT: PD participants exhibited the general features of reciprocity between OOS, OOI and DLI muscles as reflected in the EMG during syllable production. The control group showed significantly higher integrated EMG amplitude ratio in the DLI:OOS muscle pairs than PD participants. No speech rate effects were found in EMG muscle reciprocity and amplitude magnitude across all muscle pairs.

    CONCLUSION: Similar patterns of muscle reciprocity in PD and controls suggest that corticomotoneuronal output to the facial nucleus and respective perioral muscles is relatively well-preserved in our cohort of mild idiopathic PD participants. Reduction of EMG amplitude ratio among PD participants is consistent with the putative reduction in the thalamocortical activation characteristic of this disease which limits motor cortex drive from generating appropriate commands which contributes to bradykinesia and hypokinesia of the orofacial mechanism.

  11. Lee CH, Sapuan SM, Lee JH, Hassan MR
    Springerplus, 2016;5(1):1680.
    PMID: 27733982
    A study of the melt volume flow rate (MVR) and the melt flow rate (MFR) of kenaf fibre (KF) reinforced Floreon (FLO) and magnesium hydroxide (MH) biocomposites under different temperatures (160-180 °C) and weight loadings (2.16, 5, 10 kg) is presented in this paper. FLO has the lowest values of MFR and MVR. The increment of the melt flow properties (MVR and MFR) has been found for KF or MH insertion due to the hydrolytic degradation of the polylactic acid in FLO. Deterioration of the entanglement density at high temperature, shear thinning and wall slip velocity were the possible causes for the higher melt flow properties. Increasing the KF loadings caused the higher melt flow properties while the higher MH contents created stronger bonding for higher macromolecular chain flow resistance, hence lower melt flow properties were recorded. However, the complicated melt flow behaviour of the KF reinforced FLO/MH biocomposites was found in this study. The high probability of KF-KF and KF-MH collisions was expected and there were more collisions for higher fibre and filler loading causing lower melt flow properties.
  12. Kho SS, Tay PS, Lee J, Tie ST
    AME Case Rep, 2017;1:4.
    PMID: 30263991 DOI: 10.21037/acr.2017.09.05
    Pleural effusion is a common encounter in renal failure patients and frequently possess a diagnostic challenge to clinician especially when it was exudative. Fortunately, transudative pleural effusion secondary to fluid overload remains the commonest cause of pleural effusion in haemodialysis patients. Frequent thoracocentesis enhance pleural inflammation and potentially complicate further this challenging clinical presentation. We report a middle-aged gentleman with advanced chronic kidney disease presented with dyspnea and new right upper lobe consolidation on chest roentograph. He had a history of recurrent bilateral pleural effusion secondary to fluid overload and hence multiple attempts of thoracocentesis were performed. Medical thoracoscopy performed previously yielded non-specific pleuritis. Flexible bronchoscopy demonstrates normal airway with negative microbiological studies. Computed tomography (CT) of the thorax shown a loculated hypodense pleural effusion at the apical region of the right upper lobe. Ultrasound guided thoracocentesis anteriorly yield 400 mL of clear straw color fluid which was transudative by Light's criteria. Post tapping chest X-ray shown complete resolution of right upper lobe consolidation and patient reports immediate relieve of dyspnea. Patient was started on regular effective haemodialysis and pleural effusion did not recur during follow up. Loculated pleural effusion masquerading as mediastinal tumour had been reported but pleural effusion that conformed to the contour of a lung lobe is rare. This case highlights the atypical but unique presentation of a transudative pleural effusion and demonstrates the risk of repeated thoracocentesis complicating a simple clinical presentation.
  13. Marjoribanks J, Farquhar C, Roberts H, Lethaby A, Lee J
    Cochrane Database Syst Rev, 2017 Jan 17;1(1):CD004143.
    PMID: 28093732 DOI: 10.1002/14651858.CD004143.pub5
    BACKGROUND: Hormone therapy (HT) is widely provided for control of menopausal symptoms and has been used for the management and prevention of cardiovascular disease, osteoporosis and dementia in older women. This is an updated version of a Cochrane review first published in 2005. OBJECTIVES: To assess effects of long-term HT (at least 1 year's duration) on mortality, cardiovascular outcomes, cancer, gallbladder disease, fracture and cognition in perimenopausal and postmenopausal women during and after cessation of treatment. SEARCH METHODS: We searched the following databases to September 2016: Cochrane Gynaecology and Fertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO. We searched the registers of ongoing trials and reference lists provided in previous studies and systematic reviews. SELECTION CRITERIA: We included randomised double-blinded studies of HT versus placebo, taken for at least 1 year by perimenopausal or postmenopausal women. HT included oestrogens, with or without progestogens, via the oral, transdermal, subcutaneous or intranasal route. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risk of bias and extracted data. We calculated risk ratios (RRs) for dichotomous data and mean differences (MDs) for continuous data, along with 95% confidence intervals (CIs). We assessed the quality of the evidence by using GRADE methods. MAIN RESULTS: We included 22 studies involving 43,637 women. We derived nearly 70% of the data from two well-conducted studies (HERS 1998; WHI 1998). Most participants were postmenopausal American women with at least some degree of comorbidity, and mean participant age in most studies was over 60 years. None of the studies focused on perimenopausal women.In relatively healthy postmenopausal women (i.e. generally fit, without overt disease), combined continuous HT increased the risk of a coronary event (after 1 year's use: from 2 per 1000 to between 3 and 7 per 1000), venous thromboembolism (after 1 year's use: from 2 per 1000 to between 4 and 11 per 1000), stroke (after 3 years' use: from 6 per 1000 to between 6 and 12 per 1000), breast cancer (after 5.6 years' use: from 19 per 1000 to between 20 and 30 per 1000), gallbladder disease (after 5.6 years' use: from 27 per 1000 to between 38 and 60 per 1000) and death from lung cancer (after 5.6 years' use plus 2.4 years' additional follow-up: from 5 per 1000 to between 6 and 13 per 1000).Oestrogen-only HT increased the risk of venous thromboembolism (after 1 to 2 years' use: from 2 per 1000 to 2 to 10 per 1000; after 7 years' use: from 16 per 1000 to 16 to 28 per 1000), stroke (after 7 years' use: from 24 per 1000 to between 25 and 40 per 1000) and gallbladder disease (after 7 years' use: from 27 per 1000 to between 38 and 60 per 1000) but reduced the risk of breast cancer (after 7 years' use: from 25 per 1000 to between 15 and 25 per 1000) and clinical fracture (after 7 years' use: from 141 per 1000 to between 92 and 113 per 1000) and did not increase the risk of coronary events at any follow-up time.Women over 65 years of age who were relatively healthy and taking continuous combined HT showed an increase in the incidence of dementia (after 4 years' use: from 9 per 1000 to 11 to 30 per 1000). Among women with cardiovascular disease, use of combined continuous HT significantly increased the risk of venous thromboembolism (at 1 year's use: from 3 per 1000 to between 3 and 29 per 1000). Women taking HT had a significantly decreased incidence of fracture with long-term use.Risk of fracture was the only outcome for which strong evidence showed clinical benefit derived from HT (after 5.6 years' use of combined HT: from 111 per 1000 to between 79 and 96 per 1000; after 7.1 years' use of oestrogen-only HT: from 141 per 1000 to between 92 and 113 per 1000). Researchers found no strong evidence that HT has a clinically meaningful impact on the incidence of colorectal cancer.One trial analysed subgroups of 2839 relatively healthy women 50 to 59 years of age who were taking combined continuous HT and 1637 who were taking oestrogen-only HT versus similar-sized placebo groups. The only significantly increased risk reported was for venous thromboembolism in women taking combined continuous HT: Their absolute risk remained low, at less than 1/500. However, other differences in risk cannot be excluded, as this study was not designed to have the power to detect differences between groups of women within 10 years of menopause.For most studies, risk of bias was low in most domains. The overall quality of evidence for the main comparisons was moderate. The main limitation in the quality of evidence was that only about 30% of women were 50 to 59 years old at baseline, which is the age at which women are most likely to consider HT for vasomotor symptoms. AUTHORS' CONCLUSIONS: Women with intolerable menopausal symptoms may wish to weigh the benefits of symptom relief against the small absolute risk of harm arising from short-term use of low-dose HT, provided they do not have specific contraindications. HT may be unsuitable for some women, including those at increased risk of cardiovascular disease, increased risk of thromboembolic disease (such as those with obesity or a history of venous thrombosis) or increased risk of some types of cancer (such as breast cancer, in women with a uterus). The risk of endometrial cancer among women with a uterus taking oestrogen-only HT is well documented.HT is not indicated for primary or secondary prevention of cardiovascular disease or dementia, nor for prevention of deterioration of cognitive function in postmenopausal women. Although HT is considered effective for the prevention of postmenopausal osteoporosis, it is generally recommended as an option only for women at significant risk for whom non-oestrogen therapies are unsuitable. Data are insufficient for assessment of the risk of long-term HT use in perimenopausal women and in postmenopausal women younger than 50 years of age.
  14. Lee J, Che Hamzah J, Mohd Khialdin S, Naffi AA
    Cureus, 2023 May;15(5):e39153.
    PMID: 37332448 DOI: 10.7759/cureus.39153
    We report a case of bilateral open globe injury that resulted from a durian fruit falling on a 62-year-old woman's unprotected face during durian picking in her orchard. On presentation, the bilateral vision was light perception. The right eye sustained a curvilinear corneal laceration with expelled intraocular content. Meanwhile, the left eye sustained a corneoscleral laceration with expelled uvea and retina. Additionally, the right upper lid margin was lacerated. Emergency wound exploration, primary toilet, and suturing were performed on bilateral eyes. Preoperatively, she received intramuscular anti-tetanus toxoid and intravenous ciprofloxacin. Intravitreal ceftazidime and vancomycin were given intraoperatively as endophthalmitis prophylaxis. Postoperatively, the vision remained as light perception. There were no signs of endophthalmitis in both eyes. Although traumatic globe injury due to durian is uncommon, individuals should wear protective gear while in a durian orchard to avoid such unprecedented accidents. Prompt yet scrupulous action should be taken to save the globe and further possible complications.
  15. Lim WX, Khor HM, Lee JK, Ong T
    Malays Orthop J, 2023 Jul;17(2):1-6.
    PMID: 37583523 DOI: 10.5704/MOJ.2307.001
    INTRODUCTION: Fragility fractures, which occur after a low-trauma injury, increases with advancing age. Such fracture doubles the life-time risk of sustaining another fracture. This risk is highest in the immediate 18 months after the index fracture. However, most patients do not receive the appropriate risk assessment and intervention to reduce this risk. A coordinated model of care termed Fracture Liaison Service (FLS) has been reported to address this treatment gap.

    MATERIALS AND METHODS: This scoping review aims to explore the potential role and delivery of FLS services in Malaysia. Scientific and non-scientific sources relevant to FLS were identified from electronic bibliographic databases, specialist journals and relevant websites. Findings were categorised into themes and presented narratively.

    RESULTS: FLS services remain concentrated in the Klang Valley. Even within FLS services, many do not have extensive coverage to risk assess all fracture patients. These services are multidisciplinary in nature where there are links between different departments, such as orthopaedics, osteoporosis expertise, bone densitometry, rehabilitation, falls services and primary care. FLS was able to increase the number of people undergoing fracture risk assessment and treatment. The importance of FLS was highlighted by local experts and stakeholders. Its implementation and delivery are supported by a number of national guidelines.

    CONCLUSION: FLS is central to our national efforts to reduce the impending fragility fracture crisis in the coming years. Continued effort is needed to increase coverage within FLS services and across the country. Training, awareness of the problem, research, and policy change will support this endeavour.

  16. Ng JC, Ahmad Zaidi AI, Lee J, Jabar MF
    Arch Plast Surg, 2023 Nov;50(6):610-614.
    PMID: 38143843 DOI: 10.1055/a-2077-5745
    Necrotizing fasciitis is an uncommon yet fatal soft tissue infection. Current recommended treatment includes antibiotics with repeat surgical exploration and wound debridement followed by reconstruction. In burn patients, the Meek micrograft has demonstrated a higher true expansion ratio, faster reepithelialization rate, more resilient toward infection, and reduced risk of graft failure as compared with meshed graft. To our best knowledge, the use of Meek micrografting technique in reconstruction of postdebridement wounds of necrotizing fasciitis has not been reported. Hereby, we present a case of a 57-year-old gentleman who was referred to us for wound reconstruction after surgical debridement of Fournier's gangrene and extensive necrotizing fasciitis involving the anterior abdomen and bilateral femoral region. Meek micrografting technique was used to reconstruct the anterior abdomen as the wound bed was large. Although the graft was complicated with a small area of localized infection, it did not spread across the entire graft and was successfully treated with topical antibiotics and regular wound dressing. In our case, wound reconstruction using Meek micrografting technique in a patient with extensive necrotizing fasciitis was successful and showed positive outcome. Therefore, we suggest further studies to be conducted to investigate the applications and outcomes of the Meek micrografting technique, especially in patients with extensive wound bed and limited donor site availability.
  17. Singam P, Wei KT, Ruffey A, Lee J, Chou TG
    Malays J Med Sci, 2012 Jul;19(3):81-4.
    PMID: 23610554
    Fournier's gangrene is a severe life-threatening infection involving the perianal area, perineum, and external genitalia. It demands prompt recognition, critical care therapy, surgical therapy, and a combination of antibiotics. The infection commonly spreads via the fascial planes and causes superficial vascular thrombosis within the Colles' fascia around the external genitalia. It can extend cephalad to involve the Scarpa's fascia and Camper's fascia in the abdominal wall. The treatment would include multiple debridements, which would result in disfiguring scars of the perineum and might lead to significant physical and psychological complications. We describe a case of a 58-years-old man presenting with Fournier's gangrene resulting from an infection of an impacted urethral stone. The patient previously had obstructive voiding symptoms for 1 month but chose to neglect them. The resultant infection was severe and caused penile and right testicular gangrene. He underwent multiple wound debridements, which included a total penectomy and right orchiectomy. Psychological and rehabilitative support was necessary for him to overcome his loss and disfigurement.
  18. Lee J, Kim YE, Kim HY, Sinniah M, Chong CK, Song HO
    Sci Rep, 2015;5:18077.
    PMID: 26655854 DOI: 10.1038/srep18077
    High levels of anti-dengue IgM or IgG can be detected using numerous rapid diagnostic tests (RDTs). However, the sensitivity and specificity of these tests are reduced by changes in envelope glycoprotein antigenicity that inevitably occur in limited expression systems. A novel RDT was designed to enhance diagnostic sensitivity. Dengue viruses cultured in animal cells were used as antigens to retain the native viral coat protein. Monoclonal antibodies (mAbs) were then developed, for the first time, against domain I of envelope glycoprotein (EDI). The anti-dengue EDI mAb was employed as a capturer, and EDII and EDIII, which are mainly involved in the induction of neutralizing antibodies in patients, were fully available to bind to anti-dengue IgM or IgG in patients. A one-way automatic blood separation device prevented reverse migration of plasma and maximize the capture of anti-dengue antibodies at the test lines. A clinical evaluation in the field proved that the novel RDT (sensitivities of 96.5% and 96.7% for anti-dengue IgM and IgG) is more effective in detecting anti-dengue antibodies than two major commercial tests (sensitivities of 54.8% and 82% for SD BIOLINE; 50.4% and 75.3% for PanBio). The innovative format of RDT can be applied to other infectious viral diseases.
  19. Wong JL, Tie ST, Lee J, Kannan SK, Rashid Ali MR, Ibrahim A, et al.
    Med J Malaysia, 2014 Aug;69(4):195-6.
    PMID: 25500852 MyJurnal
    Recurrent respiratory papillomatosis (RRP) is a benign disease caused by the human papilloma virus (HPV), characterized by the formation of recurrent, epithelial neoplastic lesions in the airways. While benign, they can cause significant airway obstruction in some cases. Difficulties in treatment arise from the recurrent nature of the lesions despite repeated procedures. Other known procedures that result in deep tissue damage also cause unacceptable collateral damage to the underlying airway mucosa. We describe a case of recurrent papillomatosis that was successfully treated with argon plasma coagulation ( APC) when laser and electrocautery ablation had failed in the past. After the papillomatasis was treated with APC, there is no recurrence on repeat scope at 4 months and 9 months after the initial procedure. The procedure was done as a day case and there is no complication from the procedure. The property of the APC that allows it to cause only superficial thermal damage to the tissue makes it a suitable adjunct therapy to the treatment of papillomas, which are usually superficial lesions.
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