Displaying publications 21 - 40 of 57 in total

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  1. Azhar T, Kamada T, Lopez F, Harun R, Nor I, Lim A
    Med J Malaysia, 1991 Jun;46(2):123-8.
    PMID: 1839415
    One hundred patients with carcinoma of the cervix stages 1B to 4A were treated with intracavitary high dose rate radiation using a linear cobalt source. All cases have received external beam pelvic irradiation to 4500cGy mid plane in twenty fractions over four weeks. The results in terms of patient compliance and convenience were good while acute and late morbidities were comparable to standard Manchester technique of low dose rate intracavitary therapy as practised in the Institute of Radiotherapy and Oncology General Hospital Kuala Lumpur. The four year actuarial survival rate is 76% for stage II and 48% for stage III. All three stage IV patients died within 1 year. Four out of seven stage I patients are alive (minimum follow-up 18 months, longest 43 months). One died of systemic spread at 33 months while one is lost to follow up.
  2. Asma I, Sim BL, Brent RD, Johari S, Yvonne Lim AL
    Trop Biomed, 2015 Jun;32(2):310-22.
    PMID: 26691260 MyJurnal
    Cryptosporidiosis is a particular concern in immunocompromised individuals where symptoms may be severe. The aim of this study was to examine the epidemiological and molecular characteristics of Cryptosporidium infections in HIV/AIDS patients in Malaysia in order to identify risk factors and facilitate control measures. A modified Ziehl-Neelsen acid fast staining method was used to test for the presence of Cryptosporidium oocysts in the stools of 346 HIV/AIDS patients in Malaysia. Standard coproscopical methods were used to identify infections with other protozoan or helminths parasites. To identify the species of Cryptosporidium, DNA was extracted and nested-PCR was used to amplify a portion of the SSU rRNA gene. A total of 43 (12.4%) HIV-infected patients were found to be infected with Cryptosporidium spp. Of the 43 Cryptosporidium-positive HIV patients, 10 (23.3%) also harboured other protozoa, and 15 (34.9%) had both protozoa and helminths. The highest rates of cryptosporidiosis were found in adult males of Malay background, intravenous drug users, and those with low CD4 T cell counts (i.e., < 200 cells/mm3). Most were asymptomatic and had concurrent opportunistic infections mainly with Mycobacterium tuberculosis. DNA sequence analysis of 32 Cryptosporidium isolates identified C. parvum (84.3%), C. hominis (6.3%), C. meleagridis (6.3%), and C. felis (3.1%). The results of the present study revealed a high prevalence of Cryptosporidium infection in hospitalized HIV/AIDS patients. The results also confirmed the potential significance of zoonotic transmission of C. parvum in HIV infected patients, as it was the predominant species found in this study. However, these patients were found to be susceptible to a wide range of Cryptosporidium species. Epidemiological and molecular characterization of Cryptosporidium isolates provides clinicians and researchers with further information regarding the origin of the infection, and may enhance treatment and control strategies.
  3. Wameadesa N, Sae-lim A, Hayeebilan F, Rattanachuay P, Sukhumungoon P
    PMID: 29642296
    Local Thai and imported Malaysian beef in southern Thailand area carry
    several Shiga toxin-producing Escherichia coli (STEC) serotypes. STEC O104 is an
    important pathogen capable of causing outbreaks with considerable morbidity
    and mortality. This study investigated the presence of E. coli O104 from local Thai
    and imported Malaysian beef obtained from markets in Hat Yai City, Songkhla
    Province during August 2015 - February 2016. Thirty-one E. coli O104 strains
    were isolated from 12 beef samples (16% and 23% Thai and imported Malaysian,
    respectively). Thirty strains possessed aggA (coding for a major component of
    AAF/I fimbriae), a gene associated with enteroaggregative E. coli (EAEC) pathotype,
    and all strains carried fimH (encoding Type 1 fimbriae). Thirty strains
    belonged to phylogenetic group B1 and one strain (from Malaysian beef) to group
    A. Agglutination of yeast cells was observed among 29 E. coli O104 strains. Investigation
    of stx2 phage occupancy loci demonstrated that sbcB was occupied in 12
    strains. Antimicrobial susceptibility assay revealed that 7 strains were resistant
    to at least one antimicrobial agent and two were multi-drug resistant. One strain
    carried extended spectrum β-lactamase gene blaCTX-M and three carried blaTEM. PFGE-generated DNA profiling showed identical DNA pattern between that of
    one EAEC O104 strain from Thai beef and another from Malaysian beef, indicating
    that these two strains originated from the same clone. This is the first report
    in Thailand describing the presence of EAEC O104 from both Thai and imported
    Malaysian beef and their transfer between both countries. Thorough surveillance
    of this pathogen in fresh meats and vegetables should help to prevent any possible
    outbreak of E. coli O104.
  4. Zhao Z, Takano A, Lim AST, Lim TH, Selvarajan S
    Malays J Pathol, 2020 Apr;42(1):115-119.
    PMID: 32342940
    INTRODUCTION: Alveolar rhabdomyosarcoma (RMS) usually occurs in adolescents and young adults, and most frequently arises in the extremities.

    CASE REPORT: We present a rare case of metastatic alveolar RMS from a nasal primary to cervical lymph nodes (LNs) in an elderly patient, diagnosed on the fine-needle aspiration (FNA) biopsy. Smears showed malignant round cells featuring focal rhabdoid appearance, with rhabdomyoblastic differentiation further supported by immunocytochemical stains. Diagnosis of alveolar RMS was confirmed by fluorescence in situ hybridization (FISH) identifying FOXO1 gene involvement with dual colour break-apart probes at locus 13q14.

    DISCUSSION: The differential diagnosis for a small round blue cell tumour in the elderly generally includes metastatic small cell carcinoma, lymphoma, malignant melanoma, RMS, desmoplastic small round cell tumour and Ewing's sarcoma/primitive neuroectodermal tumour. Subtle morphological analysis and expression pattern of immunostaining for skeletal muscle differentiation led to the diagnosis of RMS. Cytogenetic testing on the FOXO1 gene rearrangement helps definite subtyping of alveolar RMS.

  5. Janssen SMJ, Foo A, Johnson SN, Lim A, Satel J
    Conscious Cogn, 2021 03;89:103089.
    PMID: 33607423 DOI: 10.1016/j.concog.2021.103089
    To examine the relationship between visual imagery and autobiographical memory, eye position and pupil size were recorded while participants first searched for memories and then reconstructed the retrieved memories (Experiment 1), or only searched for memories (Experiment 2). In Experiment 1, we observed that, although recollective experience was not associated with the number of fixations per minute, memories that took longer to retrieve were linked to increased pupil size. In Experiment 2, we observed that directly retrieved memories were recalled more quickly and were accompanied by smaller pupils than generatively retrieved memories. After correcting for response time, retrieval mode also produced an effect, showing that decreased pupil size is not simply due to directly retrieved memories being recalled more quickly. These findings provide compelling evidence that objective measures, such as pupil size, can be used alongside subjective measures, such as self-reports, to distinguish between directly retrieved and generatively retrieved memories.
  6. Eng V, Lim A, Janssen SMJ, Satel J
    Acta Psychol (Amst), 2018 Feb;183:51-57.
    PMID: 29328938 DOI: 10.1016/j.actpsy.2017.12.011
    Studies of endogenous and exogenous attentional orienting in spatial cueing paradigms have been used to investigate inhibition of return, a behavioral phenomenon characterized by delayed reaction time in response to recently attended locations. When eye movements are suppressed, attention is covertly oriented to central or peripheral stimuli. Overt orienting, on the other hand, requires explicit eye movements to the stimuli. The present study examined the time course of slowed reaction times to previously attended locations when distractors are introduced into overt and covert orienting tasks. In a series of experiments, manual responses were required to targets following central and peripheral cues at three different cue-target intervals, with and without activated oculomotor systems. The results demonstrate that, when eye movements are suppressed, behavioral inhibition is reduced or delayed in magnitude by the presence of a distractor relative to conditions without distractors. However, the time course of behavioral inhibition when eye movements are required remains similar with or without distractors.
  7. Lim A, Eng V, Janssen SMJ, Satel J
    Exp Brain Res, 2018 05;236(5):1369-1382.
    PMID: 29520444 DOI: 10.1007/s00221-018-5225-3
    Inhibition of return (IOR) refers to an increase in reaction times to targets that appeared at a previously cued location relative to an uncued location, often investigated using a spatial cueing paradigm. Despite numerous studies that have examined many aspects of IOR, the neurophysiological mechanisms underlying IOR are still in dispute. The objective of the current research is to investigate the plausible mechanisms by manipulating the cue and target types between central and peripheral stimuli in a traditional cue-target paradigm with saccadic responses to targets. In peripheral-cueing conditions, we observed inhibitory cueing effects across all cue-target onset asynchronies (CTOAs) with peripheral targets, but IOR was smaller and arose later with central targets. No inhibition was observed in central-cueing conditions at any CTOAs. Empirical data were simulated using a two-dimensional dynamic neural field model. Our results and simulations support previous work demonstrating that, at short CTOAs, behavioral inhibition is only observed with repeated stimulation-an effect of sensory adaptation. With longer CTOAs, IOR is observed regardless of target type when peripheral cueing is used. Our findings suggest that behaviorally exhibited inhibitory cueing effects can be attributed to multiple mechanisms, including both attenuation of visual stimulation and local inhibition in the superior colliculus.
  8. Krishnan S, Blebil AQ, Dujaili JA, Chuang S, Lim A
    PMID: 37361790 DOI: 10.1007/s10639-023-11745-1
    As we enter a world of blended learning in higher education, an increased need for adaptation of teaching strategies to enhance engagement has been recognised to amplify learning outcomes online. Gamification has been identified as a creative tool to engage the current cohort of learners who are also characteristically tech-savvy. To this end, escape room games have gained considerable traction in medical and pharmacy education to promote learning, critical thinking and teamwork. In this pilot study we describe the implementation of a 60-minute, web-based hepatitis-themed escape room game within a Year 3 Pharmacotherapy unit at Monash University. A total of 418 students participated in this activity. Students' knowledge gain on the topic was assessed through a pre- and post-intervention assessment, whereby a statistically significant improvement was seen in the knowledge score following implementation of the gaming activity (58.66% pre-intervention vs. 72.05% post-intervention, p 
  9. Lim A, Krishnan SS, Blebil AQ, Malone D
    Int J Pharm Pract, 2023 Dec 19;31(6):646-649.
    PMID: 37410964 DOI: 10.1093/ijpp/riad048
    OBJECTIVES: To describe the implementation and assess whether an objective structured clinical examination (OSCE) is a viable assessment tool for testing Antimicrobial Stewardship (AMS) principles.

    METHODS: A three-station OSCE set in a hospital and community pharmacy was designed and mapped to the World Health Organisation's AMS intervention practical guide. This OSCE comprised 39 unique cases and was implemented across two campuses (Malaysia and Australia) at one institute. Stations were 8 min long and consisted of problem-solving and applying AMS principles to drug therapy management (Station 1), counselling on key antimicrobials (Station 2) or managing infectious diseases in primary care (Station 3). Primary outcome measure to assess viability was the proportion of students who were able to pass each case.

    KEY FINDINGS: Other than three cases with pass rates of 50, 52.8 and 66. 7%, all cases had pass rates of 75% or more. Students were most confident with referral to medical practitioner cases and switching from intravenous to oral or empirical to directed therapy.

    CONCLUSIONS: An AMS-based OSCE is a viable assessment tool in pharmacy education. Further research should explore whether similar assessments can help improve students' confidence at recognising opportunities for AMS intervention in the workplace.

  10. Anthony K, Wong HK, Lim A, Sow F, Janssen SM
    Q J Exp Psychol (Hove), 2024 Mar;77(3):447-460.
    PMID: 37649149 DOI: 10.1177/17470218231200724
    The retrieval of autobiographical memories involves the construction of mental representations of past personal events. Many researchers examining the processes underlying memory retrieval argue that visual imagery plays a fundamental role. Other researchers, however, have argued that working memory is an integral component involved in memory retrieval. The goal of this study was to resolve these conflicting arguments by comparing the relative contributions of visual imagery and working memory during the retrieval of autobiographical memories in a dual-task paradigm. While following a moving dot, viewing a dynamic visual noise (DVN), or viewing a blank screen, 95 participants recalled their memories and subsequently rated them on different memory characteristics. The results suggest that inhibiting visual imagery by having participants view DVN merely delayed memory retrieval but did not affect the phenomenological quality of the memories retrieved. Taxations to the working memory by having participants follow a moving dot, on the contrary, resulted in only longer retrieval latencies and no reductions in the specificity, vividness, or the emotional intensity of the memories retrieved. Whereas the role of visual imagery during retrieval is clear, future studies could further examine the role of working memory during retrieval by administering a task that is less difficult or by recruiting a larger sample than this study. The results of this study seem to suggest that both visual imagery and working memory play a role during the retrieval of autobiographical memory, but more research needs to be conducted to determine their exact roles.
  11. Lawson JM, Foster SJ, Lim AC, Chong VC, Vincent AC
    J Fish Biol, 2015 Jan;86(1):1-15.
    PMID: 25307290 DOI: 10.1111/jfb.12527
    Life-history variables for three incidentally captured species of seahorse (Kellogg's seahorse Hippocampus kelloggi, the hedgehog seahorse Hippocampus spinosissimus and the three-spot seahorse Hippocampus trimaculatus) were established using specimens obtained from 33 fisheries landing sites in Peninsular Malaysia. When samples were pooled by species across the peninsula, sex ratios were not significantly different from unity, and height and mass relationships were significant for all species. For two of these species, height at physical maturity (HM ) was smaller than the height at which reproductive activity (HR ) commenced: H. spinosissimus (HM = 99·6 mm, HR = 123·2 mm) and H. trimaculatus (HM = 90·5 mm, HR = 121·8 mm). For H. kelloggi, HM could not be estimated as all individuals were physically mature, while HR = 167·4 mm. It appears that all three Hippocampus spp. were, on average, caught before reproducing; height at 50% capture (HC ) was ≥HM but ≤HR . The results from this study probe the effectiveness of assessment techniques for data-poor fisheries that rely heavily on estimates of length at maturity, especially if maturity is poorly defined. Findings also question the sustainability of H. trimaculatus catches in the south-west region of Peninsular Malaysia, where landed specimens had a notably smaller mean height (86·2 mm) and markedly skewed sex ratio (6% males) compared with samples from the south-east and north-west of the peninsula.
  12. Tan DB, Yong YK, Tan HY, Kamarulzaman A, Tan LH, Lim A, et al.
    HIV Med, 2008 May;9(5):307-16.
    PMID: 18400078 DOI: 10.1111/j.1468-1293.2008.00565.x
    A proportion of HIV patients beginning antiretroviral therapy (ART) develop immune restoration disease (IRD). Immunological characteristics of IRD were investigated in a cohort of HIV patients beginning therapy in Kuala Lumpur, Malaysia.
  13. Lim A, Tan D, Price P, Kamarulzaman A, Tan HY, James I, et al.
    AIDS, 2007 Jul 31;21(12):1525-34.
    PMID: 17630546
    To examine the relationships between blood CD4 natural regulatory T (Treg) cells, plasma HIV RNA level, CD4 T-cell count and immune activation in untreated HIV-infected patients and immunodeficient patients beginning antiretroviral therapy (ART), using a novel phenotype to define Treg cells (CD25CD127CD4). Data were compared with established Treg cell markers (FoxP3, CTLA-4 and GITR).
  14. Sam CK, Kesavan-Padmaja, Liam CK, Soon SC, Lim AL, Ong EK
    Asian Pac J Allergy Immunol, 1998 Mar;16(1):1-4.
    PMID: 9681122
    In this paper we report results of skin prick tests (SPT) using pollen extracts on 200 patients with clinical symptoms of asthma, and results of a parallel study in which pollen was collected and classified over a period of 18 months. The patients were outpatients from the University Hospital in Kuala Lumpur, Malaysia, while the pollen grains were collected with a spore trap placed in the campus of the University of Malaya, approximately one kilometer from the University Hospital. Pollen extracts of 3 grasses (Bahia, Bermuda, rough pigweed) and 2 flowering trees, Acacia and Melaleuca, were used in the SPT. Of the 29.5% asthmatics with positive SPT reactions, 21.5% were to one or more of the grass pollens, 21.5% to Acacia and 7.5% to Melaleuca pollen. Acacia and Bermuda grass extracts were the most allergenic, which agreed with results of the pollen collection which showed grass and Acacia pollen grains to be the two most commonly found pollens.

    Study site: University Malaya Medical Centre (UMMC)
  15. Lim AS, Ang BC, Heng LK, Hart PM, Ngui MS, Chew P, et al.
    Ann Acad Med Singap, 1989 Mar;18(2):174-7.
    PMID: 2751233
    This is a retrospective study of 525 posterior chamber implants in diabetics performed by A S M Lim and B C Ang of Singapore. The patients were reviewed by visiting ophthalmologists--J E Kennedy (Sydney), M Ngui (East Malaysia) and P M Hart (Belfast). This study did not show any significant difference in the complication of post-operative visual acuity between diabetics and non-diabetics. 95% obtained 6/12 vision or better when pre-existing disease was excluded. It also showed that posterior chamber implants can be inserted in eyes with maculopathy or proliferative retinopathy if laser treatment was effectively done before or after surgery.
  16. Janssen SMJ, Anthony K, Chang CYM, Choong EL, Neoh JY, Lim A
    Memory, 2020 Dec 31.
    PMID: 33382346 DOI: 10.1080/09658211.2020.1868525
    When examining spontaneously recovered memories of childhood sexual abuse, victims report that there had been periods in which they had forgotten the abuse. However, there are sometimes people with whom the victim had spoken about the abuse during the period in which the victim had supposedly forgotten the abuse, suggesting the victim had not forgotten the abuse but the prior recall of the abuse. The underestimation of previous knowledge is termed the forgot-it-all-along effect. The goal of the present study was replicating the results of a laboratory study that had provided a theoretical understanding for the forgot-it-all-along effect by showing that people have difficulties remembering "remembering" when the memory had previously been recalled in a different context. The effect was replicated by using the same neutral context sentences, suggesting the finding was robust. We also extended the experimental design by using positive and negative context sentences, but it did not become smaller when the positive sentences provided the different context or larger when the negative sentences provided the different context. Although the sample sizes were sufficiently large to provide statistical power for the forgot-it-all-along effect, they may not have been sufficiently large to observe the moderation effects of emotional context.
  17. Bermeitinger C, Kalbfleisch L, Schäfer K, Lim A, Goymann H, Reuter L, et al.
    Adv Cogn Psychol, 2020;16(2):131-149.
    PMID: 32665804 DOI: 10.5709/acp-0291-y
    Response priming refers to the finding that a prime preceding a target influences the response to the target. With German subjects, horizontally moving dots as primes, and static arrows as targets, there are typically faster responses to compatible (i.e., prime and target are associated with the same response) as compared to incompatible targets (i.e., positive compatibility effect, PCE) with short stimulus onset asynchronies (SOAs). In contrast, with longer SOAs, subjects respond faster to incompatible as compared to compatible targets (i.e., negative compatibility effect, NCE). In the present study, we extended the evidence by adding vertically oriented materials. Furthermore, we tested subjects from Malaysia and Japan, where the vertical orientation is more present in daily life, and compared them to German subjects to investigate whether the amount of experience with one orientation influences the compatibility effects on this orientation. Overall, we found pronounced PCEs in the short SOA (i.e., 150 ms) but only reduced PCEs in the longer SOAs (i.e., 350, 550, and 750 ms) across all countries and orientations. There were no differences between the German and Malaysian samples, but the Japanese sample showed larger PCEs in the longer SOAs compared to both other samples. Furthermore, we found larger PCEs for horizontal than vertical materials in the short SOA and larger PCEs for vertical than horizontal materials in the longer SOAs. We discuss our findings in light of theories and findings on compatibility effects as well as attentional mechanisms.
  18. Tsuboi M, Lim AC, Ooi BL, Yip MY, Chong VC, Ahnesjö I, et al.
    J Evol Biol, 2017 Jan;30(1):150-160.
    PMID: 27748990 DOI: 10.1111/jeb.12995
    Brain size varies greatly at all taxonomic levels. Feeding ecology, life history and sexual selection have been proposed as key components in generating contemporary diversity in brain size across vertebrates. Analyses of brain size evolution have, however, been limited to lineages where males predominantly compete for mating and females choose mates. Here, we present the first original data set of brain sizes in pipefishes and seahorses (Syngnathidae) a group in which intense female mating competition occurs in many species. After controlling for the effect of shared ancestry and overall body size, brain size was positively correlated with relative snout length. Moreover, we found that females, on average, had 4.3% heavier brains than males and that polyandrous species demonstrated more pronounced (11.7%) female-biased brain size dimorphism. Our results suggest that adaptations for feeding on mobile prey items and sexual selection in females are important factors in brain size evolution of pipefishes and seahorses. Most importantly, our study supports the idea that sexual selection plays a major role in brain size evolution, regardless of on which sex sexual selection acts stronger.
  19. Lim AC, Chong VC, Chew WX, Muniandy SV, Wong CS, Ong ZC
    J Acoust Soc Am, 2015 Jul;138(1):404-12.
    PMID: 26233039 DOI: 10.1121/1.4923153
    Acoustic signals of the tiger-tail seahorse (Hippocampus comes) during feeding were studied using wavelet transform analysis. The seahorse "click" appears to be a compounded sound, comprising three acoustic components that likely come from two sound producing mechanisms. The click sound begins with a low-frequency precursor signal, followed by a sudden high-frequency spike that decays quickly, and a final, low-frequency sinusoidal component. The first two components can, respectively, be traced to the sliding movement and forceful knock between the supraorbital bone and coronet bone of the cranium, while the third one (purr) although appearing to be initiated here is produced elsewhere. The seahorse also produces a growling sound when under duress. Growling is accompanied by the highest recorded vibration at the cheek indicating another sound producing mechanism here. The purr has the same low frequency as the growl; both are likely produced by the same structural mechanism. However, growl and purr are triggered and produced under different conditions, suggesting that such "vocalization" may have significance in communication between seahorses.
  20. Sahimin N, Yunus MH, Douadi B, Yvonne Lim AL, Noordin R, Behnke JM, et al.
    Trop Biomed, 2019 Dec 01;36(4):1014-1026.
    PMID: 33597471
    The influx of low skilled migrant workers to Malaysia from low socio-economic countries where gastrointestinal parasitic infections are prevalent has raised concerns about transmission to the local population. Three methods for detection (serology, microscopy and molecular techniques) were utilized to identify Entamoeba infections amongst the targeted cohort and determine risk factors associated with infection. Serological screening of 484 migrant workers from five working sectors in Peninsular Malaysia using IgG4 ELISA based on the rPPDK antigen showed an overall seroprevalence of 7.4% (n = 36; CL95 = 5.3-10.1%) with only one factor statistically associated with seropositivity of anti-amoebic antibodies, i.e. years of residence in Malaysia (χ2 1 = 4.007, p = 0.045). Microscopic examination of 388 faecal samples for protozoan cysts and trophozoites showed a slightly higher prevalence (11.6%; n=45; CL95: 8.4-14.8%). Meanwhile, amplification of the 16S rDNA gene detected two species i.e. Entamoeba dispar (23/388; 5.9%; CL95: 3.6-8.3%) and E. histolytica (11/388; 2.8%; CL95: 1.2-4.5%) and mixed infections with both parasites in only three samples (3/388; 0.8%; CL95: 0.2-2.2%). Entamoeba dispar infection was significantly associated with those employed in food and domestic services (χ2 4 = 12.879, p = 0.012). However, none of the factors affected the prevalence of E. histolytica infection. Despite the low prevalence of E. histolytica in faecal samples of the study cohort, the presence of this pathogenic parasite still poses potential public health risks and calls for tighter control strategies based on better availability of chemotherapeutic treatment and accessibility to appropriate health education.
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