Displaying publications 21 - 40 of 47 in total

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  1. Lim CH, Rasti B, Sulistyo J, Hamid MA
    Heliyon, 2021 Feb;7(2):e06305.
    PMID: 33665455 DOI: 10.1016/j.heliyon.2021.e06305
    Transglycosylation is the in-vivo or in-vitro process of transferring glycosyl groups from a donor to an acceptor, which is usually performed by enzymatic reactions because of their simplicity, low steric hindrance, high region-specificity, low production cost, and mild processing conditions. One of the enzymes commonly used in the transglycosylation reaction is cyclodextrin glucanotransferase (CGTase). The transglycosylated products, catalyzed by CGTase, are widely used in food additives, supplements, and personal care and cosmetic products. This is due to improvements in the solubility, stability, bioactivity and length of the synthesized products. This paper's focus is on the importance of enzymes used in the transglycosylation reaction, their characteristics and mechanism of action, sources and production yield, and donor and acceptor specificities. Moreover, the influence of intrinsic and extrinsic factors on the enzymatic reaction, catalysis of glycosidic linkages, and advantages of CGTase transglycosylation reactions are discussed in detail.
  2. Looi I, Bakar AAA, Lim CH, Khoo TH, Samuel PE
    Med J Malaysia, 2008 Dec;63(5):423-5.
    PMID: 19803309
    We report an undiagnosed case of myotonia congenita in a 24-year-old previously healthy primigravida, who developed life threatening masseter spasm following a standard dose of intravenous suxamethonium for induction of anaesthesia. Neither the patient nor the anaesthetist was aware of the diagnosis before this potentially lethal complication occurred.
  3. Lim KS, Yang HZ, Chong WY, Cheong YK, Lim CH, Ali NM, et al.
    Opt Express, 2013 Feb 11;21(3):2551-62.
    PMID: 23481713 DOI: 10.1364/OE.21.002551
    When an optical fiber is dipped in an etching solution, the internal stress profile in the fiber varies with the fiber diameter. We observed a physical contraction as much as 0.2% in the fiber axial dimension when the fiber was reduced from its original diameter to ~6 µm through analysis using high resolution microscope images of the grating period of an etched FBG at different fiber diameters. This axial contraction is related to the varying axial stress profile in the fiber when the fiber diameter is reduced. On top of that, the refractive index of fiber core increases with reducing fiber diameter due to stress-optic effect. The calculated index increment is as much as 1.8 × 10(-3) at the center of fiber core after the diameter is reduced down to ~6 µm. In comparison with the conventional model that assumes constant grating period and neglects the variation in stress-induced index change in fiber core, our proposed model indicates a discrepancy as much as 3nm in Bragg wavelength at a fiber diameter of ~6 µm.
  4. Maniam T, Chinna K, Lim CH, Kadir AB, Nurashikin I, Salina AA, et al.
    Prev Med, 2013;57 Suppl:S45-6.
    PMID: 23454536 DOI: 10.1016/j.ypmed.2013.02.022
    The aim of this paper is to identify at-risk groups for a focused suicide prevention program for Malaysia.
  5. Cheng ML, Ling DY, Nanu P KP, Nording H, Lim CH
    Med J Malaysia, 2015 Jun;70(3):148-52.
    PMID: 26248776 MyJurnal
    INTRODUCTION: In Malaysia, late stage presentation of breast cancer (stage III or IV) has been a healthcare problem that varies geographically throughout the country. This study aims to understand the factors influencing late stage of breast cancer at presentation among Malaysian women in Segamat Hospital, Johor, which is a district hospital.

    METHODS: A retrospective descriptive study was conducted on secondary data of all newly diagnosed breast cancer women from 1st August 2011 to 28th February 2014. Secondary data includes age, ethnicity, marital status, family history, education level, occupation, presenting symptom, duration of symptom, tumour size, tumour pathology, tumour grading, oestrogen, progesterone and HER-2 receptor status were collected and analysed using SPSS version 20.0.0.

    RESULT: In total, data from 52 women was analysed and two women were excluded for incompleteness as these women defaulted. Late stage at presentation was 59.6% of all new cases (17.3% stage III and 42.3% stage IV). The commonest age group of all women diagnosed with breast cancer was in the 5th decade. Majority of them were Malay, married and housewives with no family history of breast cancer. The statistically significant factors associated with late stage at presentation include Malay ethnicity (p=0.019), presenting symptoms other than breast lump (p=0.047), and duration of breast lump more than 3 months (p=0.009).

    DISCUSSION/CONCLUSION: The study demonstrated presentation at late stage of breast cancer is a major health concern among Malaysian women in district hospital. This may be attributed to different sociocultural beliefs, strong belief in complementary and alternative medicine, lack of awareness, and difficult accessibility to healthcare services.

  6. Chin DWK, Lim S, Pang YL, Lim CH, Lee KM
    Bioresour Technol, 2019 Nov;292:121967.
    PMID: 31450064 DOI: 10.1016/j.biortech.2019.121967
    Ethylene glycol in the presence of sodium hydroxide was utilised as pretreatment for effective delignification and reduced the recalcitrance of lignocellulosic biomass which ramified the exposure of cellulose. Two-staged acid hydrolysis was also investigated which demonstrated its synergistic efficiency by minimising the deficiency of single stage acid hydrolysis. The operating parameters including acid concentration, temperature, residence time and cellulose loading for two-staged acid hydrolysis were studied by using ethylene glycol delignified degraded oil palm empty fruit bunch (DEFB) to recover the sugar based substrates for potential biofuels and other bio-chemicals production. In this study, stage I 45 wt% acid at 65 °C for 30 min coupled with high cellulose loading 21.25 w/v% and 12 wt% acid at 100 °C for 120 min was able to release a total of 89.8% optimum sugar yield with minimal formation of degradation products including 0.058 g/L furfural, 0.0251 g/L hydroxymethylfurfural and 0.200 g/L phenolic compounds.
  7. Ng BH, Tan YS, Pavitratha P, A Hing C, Zainul NH, Lim CH
    Med J Malaysia, 2020 11;75(6):759-761.
    PMID: 33219196
    A 40-year-old man presented to the Hospital Sultanah Bahiyah, Alor Setar, Kedah, with constitutional and respiratory symptoms. Physical examination and echocardiogram demonstrated massive pericardial effusion. Patient required multiple attempts of pericardiocentesis due to recurrent pericardial effusion. Initial workup including pericardial fluids examination and computed tomography imaging did not reveal any apparent cause. Magnetic resonance imaging showed a suspicious mass infiltrating into the right atrium. Autoimmune screening was negative. Patient was subsequently treated as having tuberculous pericarditis. However, his disease progressed rapidly and he eventually passed away due to right atrial rupture. Postmortem revealed a ruptured right atrial tumour leading to massive haemothorax. Histopathological examination confirmed the diagnosis of primary pericardial angiosarcoma.
  8. Ramli N, Lim CH, Rajagopal R, Tan LK, Seow P, Ariffin H
    Pediatr Radiol, 2020 08;50(9):1277-1283.
    PMID: 32591982 DOI: 10.1007/s00247-020-04717-x
    BACKGROUND: Intrathecal and intravenous chemotherapy, specifically methotrexate, might contribute to neural microstructural damage.

    OBJECTIVE: To assess, by diffusion tensor imaging, microstructural integrity of white matter in paediatric patients with acute lymphoblastic leukaemia (ALL) following intrathecal and intravenous chemotherapy.

    MATERIALS AND METHODS: Eleven children diagnosed with de novo ALL underwent MRI scans of the brain with diffusion tensor imaging (DTI) prior to commencement of chemotherapy and at 12 months after diagnosis, using a 3-tesla (T) MRI scanner. We investigated the changes in DTI parameters in white matter tracts before and after chemotherapy using tract-based spatial statistics overlaid on the International Consortium of Brain Mapping DTI-81 atlas. All of the children underwent formal neurodevelopmental assessment at the two study time points.

    RESULTS: Whole-brain DTI analysis showed significant changes between the two time points, affecting several white matter tracts. The tracts demonstrated longitudinal changes of decreasing mean and radial diffusivity. The neurodevelopment of the children was near compatible for age at the end of ALL treatment.

    CONCLUSION: The quantification of white matter tracts changes in children undergoing chemotherapy showed improving longitudinal values in DTI metrics (stable fractional anisotropy, decreasing mean and radial diffusivity), which are incompatible with deterioration of microstructural integrity in these children.

  9. Lim CH, Zainal NZ, Kanagasundram S, Zain SM, Mohamed Z
    PMID: 27177356 DOI: 10.1002/ajmg.b.32457
    Although major progress has been achieved in research and development of antipsychotic medications for bipolar disorder (BPD), knowledge of the molecular mechanisms underlying this disorder and the action of atypical antipsychotics remains incomplete. The levels of microRNAs (miRNAs)-small non-coding RNA molecules that regulate gene expression, including genes involved in neuronal function and plasticity-are frequently altered in psychiatric disorders. This study aimed to examine changes in miRNA expression in bipolar mania patients after treatment with asenapine and risperidone. Using a miRNA microarray, we analyzed miRNA expression in the blood of 10 bipolar mania patients following 12 weeks of treatment with asenapine or risperidone. Selected miRNAs were validated by using real-time PCR. A total of 16 miRNAs were differentially expressed after treatment in the asenapine group, 14 of which were significantly upregulated and the other two significantly downregulated. However, all three differentially expressed miRNAs in the risperidone group were downregulated. MiRNA target gene prediction and gene ontology analysis revealed significant enrichment for pathways associated with immune system response and regulation of programmed cell death and transcription. Our results suggest that candidate miRNAs may be involved in the mechanism of action of both antipsychotics in bipolar mania. © 2016 Wiley Periodicals, Inc.
  10. Lim CH, Lin CH, Chen DY, Chen YM, Chao WC, Liao TL, et al.
    PLoS One, 2016;11(11):e0166339.
    PMID: 27832150 DOI: 10.1371/journal.pone.0166339
    OBJECTIVE: To investigate the risk of tuberculosis (TB) among rheumatoid arthritis (RA) patients within 1 year after initiation of tumor necrosis factor inhibitor (TNFi) therapy from 2008 to 2012.

    METHODS: We used the 2003-2013 Taiwanese National Health Insurance Research Database to identify RA patients who started any RA-related medical therapy from 2008 to 2012. Those who initiated etanercept or adalimumab therapy during 2008-2012 were selected as the TNFi group and those who never received biologic disease-modifying anti-rheumatic drug therapy were identified as the comparison group after excluding the patients who had a history of TB or human immunodeficiency virus infection/acquired immune deficiency syndrome. We used propensity score matching (1:6) for age, sex, and the year of the drug index date to re-select the TNFi group and the non-TNFi controls. After adjusting for potential confounders, hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to examine the 1-year TB risk in the TNFi group compared with the non-TNFi controls. Subgroup analyses according to the year of treatment initiation and specific TNFi therapy were conducted to assess the trend of 1-year TB risk in TNFi users from 2008 to 2012.

    RESULTS: This study identified 5,349 TNFi-treated RA patients and 32,064 matched non-TNFi-treated controls. The 1-year incidence rates of TB were 1,513 per 105 years among the TNFi group and 235 per 105 years among the non-TNFi controls (incidence rate ratio, 6.44; 95% CI, 4.69-8.33). After adjusting for age, gender, disease duration, comoridities, history of TB, and concomitant medications, TNFi users had an increased 1-year TB risk (HR, 7.19; 95% CI, 4.18-12.34) compared with the non-TNFi-treated controls. The 1-year TB risk in TNFi users increased from 2008 to 2011 and deceased in 2012 when the Food and Drug Administration in Taiwan announced the Risk Management Plan for patients scheduled to receive TNFi therapy.

    CONCLUSION: This study showed that the 1-year TB risk in RA patients starting TNFi therapy was significantly higher than that in non-TNFi controls in Taiwan from 2008 to 2012.

  11. Lim CH, Tseng CW, Lin CT, Huang WN, Chen YH, Chen YM, et al.
    SAGE Open Med, 2018;6:2050312118781895.
    PMID: 29977547 DOI: 10.1177/2050312118781895
    Objective: To examine the clinical utility of tumor markers in dermatomyositis/polymyositis patients in Taiwan.

    Method: Data were collected retrospectively from the database of Taichung Veterans General Hospital in Taiwan from 1998 to 2014. Patients who fulfilled Bohan and Peter criteria of dermatomyositis/polymyositis were recruited. Serum level of tumor markers including carcinoembryonic antigen, alpha-fetoprotein, carbohydrate antigen 125, carbohydrate antigen 19-9 and carbohydrate antigen 15-3 were measured. The occurrence of malignancies and interstitial lung disease was identified. The association of tumor markers with malignancies and interstitial lung disease was examined using Chi-square test or Fisher's exact test.

    Results: Among the enrolled 151 patients, 98 (64.9%) dermatomyositis and 53 (35.1%) polymyositis, a total of 15 malignancies were detected: breast ductal carcinoma (n = 4), bladder transitional cell carcinoma (n = 2), lung adenocarcinoma (n = 2), cervical intraepithelial neoplasia 3 and papillary squamous cell carcinoma (n = 2), colorectal (colon and rectal adenocarcinoma) (n = 2), uterine adenocarcinoma (n = 1), nasopharyngeal carcinoma (n = 1) and hematological malignancy (myelodysplastic with excess blast cells) (n = 1). Among the patients with malignancies, 13 (86.7%) had dermatomyositis, 2 (13.3%) polymyositis and 3 (20%) interstitial lung disease. The mean duration from dermatomyositis/polymyositis diagnosis to the occurrence of malignancies was 6.05 ± 5.69 years. There was no significant association of raised tumor markers with the occurrence of malignancies (p > 0.085), while a significant association was observed between the elevated levels of carbohydrate antigen 15-3 and the presence of interstitial lung disease (p = 0.006).

    Conclusion: Tumor markers were not useful in malignancy screening or dermatomyositis/polymyositis patients in this tertiary center. The evaluation of the occurrence of malignancy in dermatomyositis/polymyositis patient should include a multidimensional approach. A raised level of carbohydrate antigen 15-3 may be a potential indicator of the presence of interstitial lung disease in dermatomyositis/polymyositis patients.
  12. Lim CH, Mohamed-Haflah NH, Abdullah-Sani MH, Loh CK, Abdul-Rahman MR
    Malays Orthop J, 2023 Mar;17(1):188-192.
    PMID: 37064628 DOI: 10.5704/MOJ.2303.023
    Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell tumours themselves account for 16-36% of the extragonadal germ cell tumours. Along the spectrum of osteosarcoma, parosteal osteosarcoma is a well-differentiated surface osteosarcoma with a prevalence of 4% of all osteosarcoma. As such synchronous primary parosteal osteosarcoma and primary mediastinal germ cell tumour are exceedingly rare. This leads to complexity in determining the most appropriate chemotherapy for two different types of tumours and its potential side effects of reduced immunity leading to potential secondary infection. Here we report a case of a 16-year-old boy who presented with synchronous primary osteosarcoma and primary mediastinal germ cell tumour, complicated with atypical mycobacterial infection post-operatively. Additionally, we discuss our choice of chemotherapy and the management of the atypical mycobacterial infection.
  13. Lai YY, Lim CH, Nazli MS, Samsudin IN, Thambiah SC
    Clin Chem, 2023 Nov 02;69(11):1220-1225.
    PMID: 37932109 DOI: 10.1093/clinchem/hvad158
  14. Lakhiar MT, Sanmargaraja S, Olanrewaju A, Lim CH, Ponniah V, Mathalamuthu AD
    Environ Sci Pollut Res Int, 2024 Feb;31(9):12780-12814.
    PMID: 38270761 DOI: 10.1007/s11356-024-32020-x
    This paper comprehensively examines passive and active energy retrofit strategies as a highly effective approach for reducing building energy consumption and mitigating CO2 emissions while enhancing comfort and sustainability. The paper further examines energy simulation software and assesses the integration of renewable energy systems in building to improve energy efficiency. The review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, ensuring a rigorous and comprehensive analysis. In addition, the study utilized bibliometric analysis with VOSviewer to provide valuable insights into the research trends and influential publications in building energy retrofits. Bibliometric analysis reveals strong collaboration among 17 authors, emphasizing their significant contributions. Keywords like energy retrofitting and efficiency are prominent, indicating their importance in academic literature. Findings show passive strategies are more effective in reducing energy consumption, though a combined approach with active strategies can yield optimal results. Retrofitting presents challenges, such as substantial initial costs and regulatory barriers. User acceptance is crucial, considering potential disruptions. The review highlights the importance of energy simulation software, with tools like EnergyPlus, eQUEST, and IES VE identified for evaluating and identifying cost-effective retrofit measures in building performance. By providing comprehensive insights into the various strategies and tools available for retrofitting buildings to achieve energy efficiency and sustainability goals, this review serves as an authoritative resource for building owners, managers, and professionals in the building industry. It offers invaluable guidance for informed decision-making and facilitates implementing effective, energy-efficient, and sustainable building retrofitting practices.
  15. Abdullah S, Ghazali KAB, Soh EZF, Sapuan J, Gill PS, Lim CH
    J Hand Surg Glob Online, 2024 Nov;6(6):814-817.
    PMID: 39703592 DOI: 10.1016/j.jhsg.2024.06.008
    PURPOSE: Fixation of metacarpal or phalanx bone fractures is usually performed under general anesthesia (GA) or regional anesthesia and with the use of a tourniquet to minimize bleeding. However, the use of tourniquet causes pain and discomfort after surgery. Wide-awake local anesthesia no tourniquet (WALANT) enables the surgery to be performed with the patient fully awake and without a tourniquet, which allows intraoperative assessment of function during surgery. This study aims to compare the perioperative parameters and clinical outcomes between GA versus WALANT in hand fracture fixations.

    METHODS: Forty-eight patients with hand fractures were recruited over a period of 15 months. Twenty-one patients had undergone fracture fixation under GA, whereas another 27 patients had the surgery under WALANT. Parameters including vital signs (heart rate and systolic blood pressure), surgery duration, estimated blood loss, visual analog scale, and quick disabilities of the arm, shoulder, and hand (QuickDASH) questionnaire were evaluated.

    RESULTS: Wide-awake local anesthesia no tourniquet group had significantly higher systolic blood pressure values and higher estimated blood less than GA group. Wide-awake local anesthesia no tourniquet group also documented shorter surgical time compared with GA group, but the difference was not significant. In terms of clinical outcomes, WALANT group recorded significantly lower visual analog scale score at 2 hours and 2 weeks postsurgery. However, WALANT has a comparable QuickDASH score with GA group except at 3 months postsurgery.

    CONCLUSIONS: Wide-awake local anesthesia no tourniquet surgery for hand fracture fixation provides a similar analgesic effect and comparable QuickDASH score except at 3 months postsurgery compared with GA.

    TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IIb.

  16. Kwan MK, Saw A, Chee EK, Lee CS, Lim CH, Zulkifle NA, et al.
    Med J Malaysia, 2006 Feb;61 Suppl A:17-20.
    PMID: 17042223
    Necrotizing fasciitis is a limb- and life-threatening rapidly spreading infection affecting the deep fascia with secondary necrosis of the subcutaneous tissue. It requires immediate medical attention and emergency surgery to prevent morbidity and death. This study was undertaken to determine its co-morbidity and risk factors affecting the outcome of its surgical treatment. This is a retrospective review of 36 cases of necrotizing fasciitis of the lower limb treated in our center between 1998 and 2002. Only 19% of the cases were correctly diagnosed upon admission and 48.6% were initially diagnosed as 'cellulitis'. Diabetes mellitus was the most common co-morbid. Pseudomonas, Staphylococcus, Streptococcus and Enterobactericae were the common pathogens isolated. Ten patients (27.8%) had major amputation as part of radical debridement. The overall mortality rate was 36% with laboratory parameters: high serum urea and creatinine, and low haemoglobin levels were predictors for higher mortality. Poor white cell response which is common in diabetic patients and a delay in surgical debridement were. notable attributes to a higher mortality. Necrotizing fasciitis is a serious infection associated with significant morbidity and mortality. A poor white blood cell response, high serum urea and creatinine, and low haemoglobin level were the predictors for mortality. Early diagnosis and prompt treatment are of paramount importance in the treatment of this infection.
  17. Lim CH, Zain SM, Reynolds GP, Zain MA, Roffeei SN, Zainal NZ, et al.
    PMID: 24914473 DOI: 10.1016/j.pnpbp.2014.05.017
    Recent studies have shown that bipolar disorder (BPD) and schizophrenia (SZ) share some common genetic risk factors. This study aimed to examine the association between candidate single nucleotide polymorphisms (SNPs) identified from genome-wide association studies (GWAS) and risk of BPD and SZ. A total of 715 patients (244 BPD and 471 SZ) and 593 controls were genotyped using the Sequenom MassARRAY platform. We showed a positive association between LMAN2L (rs6746896) and risk of both BPD and SZ in a pooled population (P-value=0.001 and 0.009, respectively). Following stratification by ethnicity, variants of the ANK3 gene (rs1938516 and rs10994336) were found to be associated with BPD in Malays (P-value=0.001 and 0.006, respectively). Furthermore, an association exists between another variant of LMAN2L (rs2271893) and SZ in the Malay and Indian ethnic groups (P-value=0.003 and 0.002, respectively). Gene-gene interaction analysis revealed a significant interaction between the ANK3 and LMAN2L genes (empirical P=0.0107). Significant differences were shown between patients and controls for two haplotype frequencies of LMAN2L: GA (P=0.015 and P=0.010, for BPD and SZ, respectively) and GG (P=0.013 for BPD). Our study showed a significant association between LMAN2L and risk of both BPD and SZ.
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