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Aortic arch anomalies: treatable causes of dysphagia and respiratory distress

Saw HS, Lim KH, Singh J, Singham KT

Med J Malaysia, 1979 Sep;34(1):48-51.
PMID: 542152
Fulltext Validity and reliability of the SF-36: the Malaysian context

Sararaks S, Azman AB, Low LL, Rugayah B, Aziah AM, Hooi LN, et al.

Med J Malaysia, 2005 Jun;60(2):163-79.
PMID: 16114157

Results of construct validity and reliability of the SF-36 are described, based on data from a multi-centre study on asthmatics and a population based survey. Questionnaire refinement was carried out between the two studies. Quality of data was good, with all items having less than 0.5% missing values. Floor and/or ceiling effects were observed for REE, REP, PF and SF. For scaling assumptions, correlations between each items and its hypothesized scale were all above 0.50, except for one item in PF. and for both items in SF. Item discriminant validity was an issue for items in VT, SF and MH scales. Cronbach's as for all scales exceeded the recommended 0.70 level, except for SF. Only one latent dimension was identified in principal component analysis, and only 52-53% of variance accounted for. As expected, PF shows high correlations with the physical component while MH was highly correlated with the mental component. Contrasting findings in the loadings of other scales were observed in the asthma data. Age, disease severity and presence of self-reported handicap/disability significantly affect PF, while MH demonstrates no obvious pattern with declining age. In essence, the Malay version of SF-36 could be used in Malaysia, with its generally acceptable internal consistency and validity. The caveat is in the call for additional domains of importance to Malaysians that is not covered by the instrument, and in the caution to be employed when using and construing the instrument.
Fulltext Systematic Literature Review of Herpes Zoster Disease Burden in Southeast Asia

San Martin P, Aunhachoke K, Batac MCF, Lodrono-Lim K, Kwanthitinan C, Santoso D, et al.

Infect Dis Ther, 2023 Jun;12(6):1553-1578.
PMID: 37314653 DOI: 10.1007/s40121-023-00822-0

INTRODUCTION: Herpes zoster (HZ; i.e., shingles) is caused by the reactivation of varicella zoster virus leading to a painful dermatomal rash. An increasing trend in cases of HZ is evident worldwide; however, there is a lack of comprehensive reviews for Southeast Asian countries.
METHODS: We performed a systematic literature review of articles published until May 2022 that reported HZ epidemiology, clinical management, and health economic data in six Southeast Asian countries: Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. Literature searches were conducted in Medline, Scopus, Embase, and gray literature. Articles written in English or local languages were considered for inclusion.
RESULTS: In total, 72 publications were included in the study; 22 were case studies and over 60% originated in Singapore and Thailand. Only two studies (data from Thailand) reported incidence of HZ. The proportion of patients reported with HZ was 0.68-0.7% among dermatology clinics, 0.14% at one emergency department (5.3% of dermatology cases) in Singapore, and 3% of admissions at another hospital in Singapore. Pain was the most common symptom associated with HZ, reported in 74.21-100% of patients. HZ complications were reported in 10.2-21.2% of patients, and the proportions with postherpetic neuralgia and HZ ophthalmicus were 6.3-50% and 4.98-28.57%, respectively. Additionally, there is a lack of comprehensive, up-to-date HZ economic data, with only six studies identified for the Philippines, Singapore, and Thailand.
CONCLUSIONS: Overall, there are limited data reporting incidence and prevalence of HZ in Southeast Asia at a national level. High rates of complications, symptoms, and abundance of case reports suggest substantial healthcare resource utilization for patients with HZ and highlight the need for further research in Southeast Asia assessing the societal impact.
Fulltext Serogroups and antibiotic susceptibility patterns of Neisseria meningitidis isolated from army recruits in a training camp

Rohani MY, Ahmad Afkhar F, Amir MA, Muhd Amir K, Sahura H, Fairuz A, et al.

Malays J Pathol, 2007 Dec;29(2):91-4.
PMID: 19108400 MyJurnal

Invasive Neisseria meningitidis infection is rare but carries a high mortality rate. The carriage rate in the normal population is around 10% and can be higher in confined populations. A study on the prevalence of carriage of N. meningitidis was conducted among 3195 army recruits after 2 months of intensive training in an army camp. N. meningitidis was isolated from 37.0% of these recruits. Two hundred and ten of N. meningitidis isolates were subjected to serogrouping and 100 to antibiotic sensitivity testing by the disc diffusion method and E-test for penicillin. Ten (4.8%) of 210 Neisseria meningitidis serogrouped belonged to serogroup W135, 3.33% serogroup A and 81.4% belonged to either serogroup X, Y or Z. With the agar disc diffusion method, all the N. meningitidis showed susceptiblity to chloramphenicol, rifampicin, cefotaxime and levofloxacin; 85% of the strains were resistant to cotrimoxazole and 12.5% resistant to penicillin. However, based on minimum inhibitory concentration, none of the Neisseria meningitidis tested was resistant to penicillin.
Neuroimaging in refractory epilepsy. Current practice and evolving trends

Ramli N, Rahmat K, Lim KS, Tan CT

Eur J Radiol, 2015 Sep;84(9):1791-800.
PMID: 26187861 DOI: 10.1016/j.ejrad.2015.03.024

Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.
Fulltext Steady flow visualization in a rigid model of the aortic bifurcation: application to atherosclerosis

Ramadan QM, Hamid O, Lim KO

J Biol Phys, 2001 Mar;27(1):35-57.
PMID: 23345732 DOI: 10.1023/A:1011822423672

Hemodynamics have long been implicated in atherogenesis. The studiesreported here seek to explain the mechanisms for the formation ofatherosclerotic plaque in an aortic bifurcation. Flow studies were made ina model constructed from plexiglass to represent an aortic bifurcation. Under steady flow conditions at inflow Reynolds numbers of 80-1250,the streamline flow patterns and the boundary layer separation zones wereinvestigated in relation to the location of atherosclerotic plaques clinicallyfound at regions in the human aortic bifurcation. The streamline flowswere visualized by a slow injection of dye over the cross section of the tubeentrance and along the tube walls. The studies revealed a complex flowfield where secondary flows, induced by the centrifugal and viscous forces,cause the fluid to move towards the inner walls of the aortic bifurcation. The effect was more clearly seen with increasing Reynolds number. Boundary layer separation zones were observed to occur at the outercorners of the branching. The nature of the separation zone formed wasfound to be dependent on Reynolds number. The residence time of fluidparticles within such a separation zone was estimated by measuring thewashout time of a bolus of dye injected at strategic locations along the tubewalls. The residence time was found to decrease exponentially withincreasing Reynolds number. These observations provide strong support forthe role of flow separation in the accumulation of LDL and plateletaggregation within the aortic bifurcation.
Ofloxacin, a new quinolone for the treatment of gonorrhea

Rajakumar MK, Ngeow YF, Khor BS, Lim KF

Sex Transm Dis, 1988 1 1;15(1):25-6.
PMID: 3162781

Forty-three patients with uncomplicated gonorrhea were treated with 400 mg of ofloxacin. All had cultures negative for Neisseria gonorrhoeae at follow-up within two weeks of treatment. Minimal side effects were reported. Ofloxacin appears to be satisfactory as a single-dose oral drug for the treatment of gonococcal urethritis, including those cases caused by penicillinase-producing strains of N. gonorrhoeae.
Fulltext Hepatitis B markers in heterosexuals involved in promiscuous sexual activity

Rajakumar MK, Ton SH, Lim KF, Oorloff KH

Med J Malaysia, 1984 Mar;39(1):65-8.
PMID: 6513842

179 heterosexuals, selected for VDRL testing on the basis of a history of involvement in promiscuous sexual activity, mainly prostitution, had their serum also tested for hepatitis B infection markers, HBsAg, HBeAg and anti-HBe. 51 samples (29%) were found to be positive for at least one of the three markers, at levels higher than the already high levels in voluntary random blood donors in Malaysia.
Fulltext Anti N-Methyl-D-Aspartate receptor encephalitis: An under-recognised cause of encephalitis

Rajahram GS, Nadarajah R, Lim KS, Menon J

Med J Malaysia, 2015 Dec;70(6):363-4.
PMID: 26988212 MyJurnal

Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an immune mediated condition with characteristic clinical presentation. We report the first case from Borneo, Sabah and the use of electroconvulsive therapy (ECT) in treating recalcitrant psychiatrist symptoms associated with this condition.
Fulltext Sea-snake bite; a survey of fishing villages in northwest Malaya

REID HA, LIM KJ

Br Med J, 1957 Nov 30;2(5056):1266-72.
PMID: 13479694
Fulltext Endo-parasite fauna of rodents caught in five wet markets in Kuala Lumpur and its potential zoonotic implications

Paramasvaran S, Sani RA, Hassan L, Hanjeet K, Krishnasamy M, John J, et al.

Trop Biomed, 2009 Apr;26(1):67-72.
PMID: 19696729

Rodents were collected from five wet markets (Chow Kit, Dato Keramat, Setapak, Jinjang and Kepong) in Kuala Lumpur, Federal Territory between March to April 2006. Ninety seven rats were trapped using wire traps measuring 29 x 22 x 50 cm baited with fruits, coconuts, dried fish or sweet potatoes. A total of 17 different species of parasites were identified from three species of rats out of which 11 (65%) were identified to be zoonotic. The helminths identified from the urban rats were nematodes- Capillaria hepatica, Gongylonema neoplasticum, Heterakis spumosa, Heterakis sp., Masterphorus muris, Nippostrongylus brasiliensis, Physolaptera sp., Pterogodermatis sp., Rictularia tani and Syphacia muris; cestodes- Hymenolepis nana, Hymenolepis diminuta, Hymenolepis sabnema, Hymenolepis sp., Raillietina sp. and Taenia taeniaeformis, and acanthocephalan- Moniliformis moniliformis. The following parasites are of potential medical importance: C. hepatica, G. neoplasticum, R. tani, S. muris, H. diminuta, H. nana, Raillietina sp. and T. taeniaeformis.
Fulltext Ectoparasite fauna of rodents and shrews from four habitats in Kuala Lumpur and the states of Selangor and Negeri Sembilan, Malaysia and its public health significance

Paramasvaran S, Sani RA, Hassan L, Krishnasamy M, Jeffery J, Oothuman P, et al.

Trop Biomed, 2009 Dec;26(3):303-11.
PMID: 20237444 MyJurnal

A total of 204 rodents comprising 14 host species from four different habitats were examined. Nine rodent species were trapped from the forest and another five species were trapped from the coastal, rice field and urban habitats. Rattus rattus diardii (67%) was the predominant rodent species examined. Fifty six (47.3%) rodents and shrews were found to be infested with at least one of the 20 species of ectoparasite recovered. Mites belonging to the family Trombiculidae were the predominant ectoparasite species recovered. Ticks belonging to the family Ixodidae were recovered mainly from the forest dwelling rodents. Polyplax spinulosa and Hoplopleura pacifica were the common lice species found infesting the urban rodents. Xenopsylla cheopis was the only flea species recovered. The following ecto-parasites have been incriminated as important vectors or as mechanical carriers for the transmission of zoonotic diseases: Ixodes granulatus, Dermacentor sp. Haemaphysalis sp., Amblyomma sp. Ascoschoengastia indica, Leptotrombidium deliense, Ornithonyssus bacoti, Laelaps nuttalli, H. pacifica, P. spinulosa and Xenopsylla cheopis. Urban and forest rodents were significantly higher in ecto-parasitic infestation, compared to rats from the other two habitats. However, there was no significant statistical association between male and female rodents infested with ectoparasites.
A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country

Ooi SH, Ng KP, Sthaneshwar P, Lim SK, Khor PY, Lim JY, et al.

BMC Nephrol, 2024 Apr 05;25(1):122.
PMID: 38580977 DOI: 10.1186/s12882-024-03498-x

BACKGROUND: The commonest indication for hospitalization in COVID-19 patients is hypoxemia or severe respiratory symptoms. However, COVID-19 disease may result in extrapulmonary complications including kidney-related pathology. The reported incidence of renal involvement related to COVID infection varies based on geographical location.
OBJECTIVE: This study aimed to assess the incidence rate of AKI in hospitalized COVID-19 patients and identify risk factors and prognostic predictors.
METHOD: In this retrospective study, we recruited hospitalized COVID-19 patients from January 2021 until June 2021 at the University Malaya Medical Center. The inclusion criteria were hospitalized for ≥ 48 h with confirmed COVID-19 infection and at least 18 years old. Patient demographic and clinical data were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines.
RESULTS: One thousand five hundred twenty-nine COVID patients fulfilled the inclusion criteria with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36-66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n = 85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n = 323). The percentage of COVID patients in different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. Fifteen hospitalized patients (0.98%) required renal replacement therapy. 58.8% (n = 190) of AKI group had complete recovery of kidney function. Demographic factors included age (p
Infrequent occurrence of vancomycin-resistant enterococci in poultry from Malaysian wet markets

Ong CH, Asaad M, Lim KC, Ngeow YF

Malays J Pathol, 2002 Dec;24(2):91-4.
PMID: 12887166

Fifty samples of chicken, duck and geese faeces were obtained from 13 wet markets in Kuala Lumpur to study the prevalence of vancomycin-resistant enterococci (VRE) among local market poultry. Biotyping of colonies grown on azide agar incubated at 45 degrees C yielded E. pseudoavium, E. faecalis, E. faecium and E. gallinarum from chicken faeces and E. malodoratus, E. faecalis, E. faecium, E. gallinarum, E. hirae/dispar, and E. durans from goose and duck faeces. On agar containing 6 mg/ l of vancomycin, one strain of E. flavescens was identified, giving a VRE detection rate of 2.0%. This isolate had a vancomycin M.I.C. of 8 mg/l as determined by the Etest, and the van C-3 gene that was identified by PCR followed by sequence analysis. The prevalence of VRE among poultry sold in local markets appears to be low, and may reflect the infrequent use of antimicrobials in our poultry farms. Nevertheless, the possibility of human acquisition of microbes via the food chain cautions against the use of antimicrobials in animal husbandry that may encourage the emergence and spread of multi-drug resistant organisms like the VRE among animal microbial flora.
Fulltext Ovitrap surveillance of the dengue vectors, Aedes (Stegomyia) aegypti (L.) and Aedes (Stegomyia) albopictus Skuse in selected areas in Bentong, Pahang, Malaysia

Norzahira R, Hidayatulfathi O, Wong HM, Cheryl A, Firdaus R, Chew HS, et al.

Trop Biomed, 2011 Apr;28(1):48-54.
PMID: 21602768 MyJurnal

Ovitrap surveillance was conducted in methodically selected areas in Bentong, Pahang, Malaysia from June 2008 till December 2009 in order to identify insular sites with stable Aedes aegypti population. Eleven sites were surveyed in Bentong district, Pahang, and one of these locations (N3º33' E101º54') was found to have an ovitrap index of Ae. aegypti and Aedes albopictus ranging from 8%-47% and 37%-78% respectively, indicating that this site could be a high-risk area for dengue outbreak. Ae. aegypti larvae were found in both indoor and outdoor ovitraps (p>0.05) while significant difference between the populations of Ae. albopictus larvae from indoors and outdoors was observed (p<0.01). Data collected in this study could provide important entomological information for designing an effective integrated vector control programme to combat Aedes mosquitoes in this area.
Right hydronephrosis and vesicocolic fistula complicating sigmoid colonic diverticulitis: report of a case

Ng KK, Tan KM, Lim KT

Dis Colon Rectum, 1975 Oct;18(7):623-5.
PMID: 1181168
Fulltext Low back pain and associated risk factors among health science undergraduates

Mohd Nordin NA, Ajit Singh DK, Lim K

Sains Malaysiana, 2014;43:423-428.

Identification of associated risk factors is important to enable successful implementation of low back pain prevention strategies. To date, there is limited research data on back pain among young adults in Malaysia despite an increasing incidence of this disabling condition worldwide. A cross-sectional survey was conducted to determine the incidence of low back pain (LBP) and associated factors among health science undergraduates. A self-administered questionnaire was distributed to full time students of a main public university. One hundred and forty undergraduates; mean age 21.4±1.3 years, 70% female, 60% in year 3 of study, participated in the survey. The results showed that 31% spent between 6 and 8 h and another 31% spent more than 9 h sitting in a day. Twelve percent of the undergraduates rated their fitness level as ‘poor’. The incidence of LBP was 40.3% among the undergraduates. LBP incidence was associated with age (X2=12.1, p=0.007), years of study (X2=8.7, p=0.03), self-rated physical fitness (X2=7.0, p=0.02) and hours spent sitting (X2 =8.7, p=0.03). Gender, body mass index and hours spent in sports and physical activity were not associated with LBP. The findings from this study demonstrate that physical fitness and sitting duration is associated with low back pain among health science undergraduates. Health science undergraduates should improve their physical fitness, practice frequent breaks and stretching during sitting. This will help to minimize LBP related to decreased fitness levels and prolonged sitting.
Zoonotic implications of cats and dogs in filarial transmission in Peninsular Malaysia

Mak JW, Yen PK, Lim KC, Ramiah N

Trop Geogr Med, 1980 Sep;32(3):259-64.
PMID: 7210162

Filarial infections in 447 cats and 68 dogs from six endemic areas of human filariasis in Peninsular Malaysia were studied as part of the study on the zoonotic transmission of subperiodic Brugia malayi infection. 20.6% of cats and 57.4% of dogs had filarial infections. Cats were infected with subperiodic B. malayi, B. pahangi, Dirofilaria repens and D. immitis. Dogs were infected with B. pahangi and D. immitis. 6.9% of the cats had subperiodic B. malayi infection. The zoonotic implications of these infections and their impact on the filariasis control programme in Peninsular Malaysia were discussed.
Rich antiferroelectric phase diagram of antiferroelectric-ferroelectric superlattices: internal electric field- and interface induced phase transitions

Lum CY, Lim KG, Chew KH

J Phys Condens Matter, 2020 Jun 16;32(42):425401.
PMID: 32544898 DOI: 10.1088/1361-648X/ab9d4a

We propose a thermodynamic model to the study the antiferroelectric (AFE) phase transitions in antiferroelectric-ferroelectric (AFE-FE) superlattices in which the coupling at the interface between two layers is mediated by local polarizations. Phase diagram of the AFE layer in term of the degree of interfacial effect λ and temperature T involving ferrielectric (FI) and ferroelectric (FE) phases is investigated. These two phases are stabilized by the interfacial effect and internal electric field. AFE thickness L AFE versus T phase diagram is also constructed. Intermediate regions of two-phase coexistence (IM) emerge in the λ-T and L AFE-T phase diagrams, if certain interface properties λ and layer thickness L AFE criteria are met. These IM regions are metastable states, which exist as a transition state between two phases. A tricritical point locates at the boundaries across the FI, IM and FE phases is found in the L AFE-T phase diagram. Competition among the internal electric field due to the electrostatic coupling, the FE ordering arises from the interfacial effect and the antiferroelectric ordering within the AFE layer giving rises to the rich AFE phase diagram.
Contractile function of smooth muscle retained after overnight storage

Loong BJ, Tan JH, Lim KH, Mbaki Y, Ting KN

Naunyn Schmiedebergs Arch Pharmacol, 2015 Oct;388(10):1061-7.
PMID: 26051407 DOI: 10.1007/s00210-015-1140-3

The functional responses of different overnight-stored in vitro tissues are not clearly described in any animal model. The influence of overnight storage in an animal model may vary between tissue types. We employed Sprague-Dawley rat as our animal model and investigated the functional changes of rat aorta, trachea, bronchus and bladder that were used (i) immediately after surgical removal (denoted as fresh) and (ii) after storage in aerated (95% O2, 5% CO2) Krebs-Ringer bicarbonate solution at 4 °C for 24 h (denoted as stored). The aorta ring was pre-contracted with phenylephrine, and the functional response of the tissue was investigated using isoprenaline, forskolin and carbachol. Carbachol was also used to increase the tone in trachea, bronchus rings and bladder strips. A clear reduced function of endothelium, with a minor if any effect in the smooth muscle function in rat aorta was observed after overnight storage. The contractile response of overnight-stored rat airway (trachea and bronchus) and bladder smooth muscles remained unchanged. Among all tested tissues, only bronchus showed a reduced response rate (only 40% responded) after storage. In vitro rat tissues that are stored in Krebs solution at 4 °C for 24 h can still be used to investigate smooth muscle responses, however, not endothelium-mediated responses for aorta. The influence of overnight storage on different tissues from an animal model (Sprague-Dawley rat in our study) also provides an insight in maximising the use of sacrificed animals.

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