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Displaying publications 21 - 25 of 25 in total

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Fulltext Myocardial infarction, circadian rhythm and delay in hospital admission

Quek DK, Ong SB, Lim LY

Med J Malaysia, 1989 Mar;44(1):14-22.
PMID: 2626108

Circadian variations have been observed in the onset of acute coronary syndromes including acute myocardial infarction. We studied 422 acute myocardial infarction patients who presented to the coronary care unit of General Hospital Kuala Lumpur. Of the 318 (75.4%) patients whose data was complete, a circadian rhythm with bimodal peak was demonstrated. The second quarter of the day i.e. 6.00 a.m. to 12 noon was shown to have a significantly increased frequency of onset of acute myocardial infarction (p less than 0.05). Time delay in presenting to the hospital was also determined. This showed that 56.8% of acute myocardial infarction patients presented early, within four hours of the onset of symptoms. By six hours, more than 71% had sought hospital care. This early presentation to the hospital may offer a realistic opportunity for optimal thrombolytic therapy should this treatment modality be offered as routine to infarct patients.
Fulltext Cigarette smoking and the risk of myocardial infarction, and acute non-infarct coronary events among Malaysian women

Quek DK, Lim LY, Ong SB

Med J Malaysia, 1989 Sep;44(3):210-23.
PMID: 2626136

In a prospective case-control study over a two-year period involving 1006 women, 264 women with acute myocardial infarction (AMI), 305 with non-infarct acute coronary syndromes (CAD) were compared with 437 women with no coronary heart disease (Controls), to determine the relationship between cigarette smoking and other risks factors with coronary heart disease. A history of current cigarette smoking was strongly associated with the risk of coronary events for both AMI And CAD (p less than 0.001). 23.9% of patients with acute coronary syndromes were current smokers, compared with only 12.8% among controls. Overall, women smokers had about a two-fold increase in risk for all coronary events. Younger women smokers (less than 40 years) and those between 61-70 years had particularly higher risks (10.3 and 2.7 times respectively (p less than 0.01, p less than 0.02). A dose-response pattern of increased AMI risks (from 2.0 to 2.9 times) among women smokers was also found, corresponding to the number of cigarettes smoked per day (p less than 0.05). Other significant coronary risk factors established were: postmenopausal status (OR 6.5), diabetes mellitus (OR 5.1), hypertension (OR 1.6), family history of premature coronary heart disease less than 50 years (OR 1.3) and use of oral contraceptive pills (OR 1.4). Our results thus emphasize that cigarette smoking is an important determinant of acute coronary events even among Malaysian women.
Initial experience of laparoscopic retroperitoneal partial nephrectomy in an academic hospital in Malaysia

Khoo HC, Lim LY, Shukor S, Zainal Adwin ZA, Zulkifli MZ, Fam XI

Med J Malaysia, 2022 Nov;77(6):764-767.
PMID: 36448397

Laparoscopic retroperitoneal partial nephrectomy (LRPN) is a technically demanding kidney surgery due to the limited space and unfamiliar approach in the retroperitoneal space. The aim of this study is to review the outcome of our initial experience in performing this procedure. All patients who underwent LRPN between 2019 to 2022 were included in this retrospective review. A total of 23 patients underwent LRPN. The mean operating time was 178±43 minutes and mean warm ischemia time was 20±5 minutes. The average estimated blood lost was 89±68ml and the mean postoperative hospital stay was 3.6±0.8 days. Two patients (11.1%) had positive margin and no local recurrence was seen after mean follow up of 15.8±12.0 months. Our initial experience on LRPN showed promising results to perform partial nephrectomy safely and effectively.
A computational and experimental study on acoustic pressure for ultrasonically formed oil-in-water emulsion

Tiong TJ, Chu JK, Lim LY, Tan KW, Hong Yap Y, Asli UA

Ultrason Sonochem, 2019 Sep;56:46-54.
PMID: 31101285 DOI: 10.1016/j.ultsonch.2019.03.026

In the field of ultrasonic emulsification, the formation and cavitation collapse is one major factor contributing to the formation of micro- and nano-sized emulsion droplets. In this work, a series of experiments were conducted to examine the effects of varying the ultrasonic horn's position to the sizes of emulsion droplets formed, in an attempt to compare the influence of the simulated acoustic pressure fields to the experimental results. Results showed that the intensity of the acoustic pressure played a vital role in the formation of smaller emulsion droplets. Larger areas with acoustic pressure above the cavitation threshold in the water phase have resulted in the formation of smaller emulsion droplets ca. 250 nm and with polydispersity index of 0.2-0.3. Placing the ultrasonic horn at the oil-water interface has hindered the formation of small emulsion droplets, due to the transfer of energy to overcome the interfacial surface tension of oil and water, resulting in a slight reduction in the maximum acoustic pressure, as well as the total area with acoustic pressures above the cavitation threshold. This work has demonstrated the influence of the position of the ultrasonic horn in the oil and water system on the final emulsion droplets formed and can conclude the importance of generating acoustic pressure above the cavitation threshold to achieve small and stable oil-in-water emulsion.
Fulltext Prospective evaluation of using multiparametric magnetic resonance imaging in cognitive fusion prostate biopsy compared to the standard systematic 12-core biopsy in the detection of prostate cancer

Lim LY, Tan GH, Zainuddin ZM, Fam XI, Goh EH, Syaris OS, et al.

Urol Ann, 2020 07 17;12(3):276-282.
PMID: 33100755 DOI: 10.4103/UA.UA_98_19

Purpose: There is mounting evidence to suggest that multiparametric magnetic resonance imaging (mpMRI)-guided biopsy is better than systematic biopsy for the diagnosis of prostate cancer (PCa). Cognitive fusion biopsy (CFB) involves targeted biopsies of areas of suspicious lesions noted on the mpMRI by transrectal ultrasound (TRUS) operator. This study was undertaken to determine the accuracy of mpMRI of the prostate with Prostate Imaging-Reporting and Data System (PI-RADS) version 2 in detecting PCa. We also compare the cancer detection rates between systematic 12-core TRUS biopsy and CFB.
Materials and Methods: Sixty-nine men underwent mpMRI of the prostate followed by TRUS biopsy. In addition to 12-core biopsy, CFB was performed on abnormal lesions detected on MRI.
Results: Abnormal lesions were identified in 98.6% of the patients, and 59.4% had the highest PI-RADS score of 3 or more. With the use of PI-RADS 3 as cutoff, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI for the detection of PCa were 91.7%, 57.8%, 53.7%, and 92.8%, respectively. With the use of PI-RADS 4 as cutoff, the sensitivity, specificity, PPV, and NPV of mpMRI were 66.7%, 91.1%, 80%, and 83.7%, respectively. Systematic biopsy detected more PCa compared to CFB (29% vs. 26.1%), but CFB detected more significant (Gleason grade ≥7) PCa (17.4% vs. 14.5%) (P < 0.01). CFB cores have a higher PCa detection rate as compared to systematic cores (P < 0.01).
Conclusions: mpMRI has a good predictive ability for PCa. CFB is superior to systematic biopsy in the detection of the significant PCa.