Displaying publications 41 - 60 of 96 in total

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  1. Wong MY, Croarkin PE, Lee CK, Lee PF
    Community Ment Health J, 2021 04;57(3):529-539.
    PMID: 32661820 DOI: 10.1007/s10597-020-00679-4
    Pictorial mood assessments reduce the barriers of age, culture, gender and language fluency in the course of psychiatric assessments. This study sought to validate the Ottawa Mood Scales, a pictorial form of mood assessment questionnaire among non-native English speaking young adults in Malaysia. Since the Ottawa Mood Scales has not been previously validated, the convergent validity of the Ottawa Mood Scales was measured against the Positive and Negative Affect Scale (PANAS), an established mood assessment instrument. A total of 129 young adults (aged 18-34) were recruited and completed an online survey with the Ottawa Mood Scales and PANAS questionnaires. Exploratory factor analysis indicated that the Ottawa Mood Scales has a one-dimensional structure and that a four-item model demonstrated higher reliability than the original 5-item model. Scores on the Ottawa Mood Scales items positively and significantly correlated with scores on the negative PANAS subscale, which supports the validity of the Ottawa Mood Scales in measuring the negative effect. The Cronbach's α was .793 for the four-item model of the Ottawa Mood Scales indicating acceptable reliability in this Malaysian young adult sample. It was concluded that the Ottawa Mood Scales could have utility in assessing mood disorder symptoms in young adults.
  2. Low KS, Lee CK, Lee CY
    Appl Biochem Biotechnol, 2001 Jan;90(1):75-87.
    PMID: 11257809
    The potential of quaternized wood (QW) chips in removing hexavalent chromium from synthetic solution and chrome waste under both batch and continuous-flow conditions was investigated. Sorption was found to be dependent on pH, metal concentration, and temperature. QW chips provide higher sorption capacity and wider pH range compared with untreated wood chips. The equilibrium data could be fitted into the Langmuir isotherm model, and maximum sorption capacities were calculated to be 27.03 and 25.77 mg/g in synthetic chromate solution and chrome waste, respectively. The presence of sulfate in high concentration appeared to suppress the uptake of chromium by QW chips. Column studies showed that bed depth influenced the breakthrough time greatly whereas flow rate of influent had little effect on its sorption on the column.
  3. Syed IA, Syed Sulaiman SA, Hassali MA, Thiruchelvum K, Lee CK
    Health Expect, 2015 Dec;18(6):2841-52.
    PMID: 25228140 DOI: 10.1111/hex.12268
    BACKGROUND: Understanding patients' knowledge and belief towards disease could play a vital role from an outcome perspective of disease management and HIV/AIDS patients are not exception to that.

    METHODS: Qualitative methodology was used to explore Malaysian HIV/AIDS patients' perspectives on disease and status disclosure. A semi structured interview guide was used to interview the patients and a saturation point was reached after the 13th interview. All interviews were audio-recorded and subjected to a standard content analysis framework.

    RESULTS: Understandings and beliefs towards HIV/AIDS and Perspective on disease disclosures were two main themes derived from patients' data. Beliefs towards causes and cure emerged as sub-themes under disease understandings while reasons for disclosure and non-disclosure were resulted as main sub-themes under disease disclosure. Majority of patients apprehended HIV/AIDS and its causes to acceptable extent, there were elements of spirituality and lack of education involved with such understandings. Though beliefs existed that knowing status is better than being ignorant, fear of stigma and discrimination, social consequences and family emotions were found important elements linked to disease non-disclosure.

    CONCLUSIONS: The outcomes provided basic information about patients' perceptions towards disease and status disclosure among HIV/AIDS patients which can help in the designing and improvising existing strategies to enhance disease awareness and acceptance and will also serve as baseline data for future research further focusing on this subject.
  4. Syed IA, Syed Sulaiman SA, Hassali MA, Lee CK
    Health Expect, 2015 Oct;18(5):1363-70.
    PMID: 24010818 DOI: 10.1111/hex.12116
    BACKGROUND: Health-related quality of life (HRQoL) is increasingly recognized as an important outcome and as a complement to traditional biological end points of diseases such as mortality. Unless there is a complete cure available for HIV/AIDS, development and implementation of a reliable and valid cross cultural quality of life measure is necessary to assess not only the physical and medical needs of HIV/AIDS people, but their psychological, social, environmental, and spiritual areas of life.
    METHODS: A qualitative exploration of HIV/AIDS patients' understanding, perceptions and expectations will be carried out with the help of semi structured interview guide by in depth interviews, while quantitative assessment of patient reported adverse drug reactions and their impact on health related quality of life will be carried out by using data collection tool comprising patient demographics, SF-12, Naranjo scale, and a clinical data sheet.
    RESULTS/OUTCOMES: The findings may serve as baseline QOL data of people living with HIV/AIDS in Malaysia and also a source data to aid construction of management plan to improve HIV/AIDS patients' QOL. It will also provide basic information about HIV/AIDS patients' perceptions, expectations and believes towards HIV/AIDS and its treatment which may help in designing strategies to enhance patients' awareness which in turn can help in addressing issues related to compliance and adherence.
    KEYWORDS: HIV/AIDS; adverse drug reactions; patients' perspective; quality of life
  5. Lee CK
    Med J Malaysia, 2010 Mar;65(1):1-2.
    PMID: 21265237
    In a short period of two months, the novel influenza A/H1N1 virus has circumnavigated the entire planet leaving behind in its wake approximately 3000 reported deaths worldwide. Fortunately, in many areas around the world, September 2009 brought a lull in the number of new H1N1 infections. This brought welcomed relief in many countries that had earlier experienced high respiratory disease activity in their communities. However, based on previous influenza pandemics, this reprieve may well be short-lived. As the Northern hemisphere approaches its winter months, many experts are now predicting a second wave of influenza A/H1N1 infections. This prediction maybe well placed as all 3 influenza pandemics in the last century reported second or even subsequent waves of new infections, all of which appeared to be more severe than the primary event (ref). The timing of these second waves have varied from 6 months to 3 years and invariably seemed to be linked to the winter months. It is unclear precisely what changes caused the increased severity seen during the second waves; one possibility is the progressive adaptation of the novel influenza virus to its new human host . Molecular analysis, for example, suggests that the 1918 Spanish influenza virus that emerged during the second wave had undergone changes in the hemagglutinin binding site that increased the binding specificity for human receptors. This is thought to have increased the replicative capacity and hence, the pathogenicity of the virus. It is also evident that as the H1N1 2009 pandemic virus continues to spread, opportunities for adaptation that increases virulence will also increase. Nonetheless, the changes needed for such adaptation and for increased virulence are unpredictable and by no means inevitable
  6. Lee CK
    Med J Malaysia, 2007 Mar;62(1):1-2.
    PMID: 17682559 MyJurnal
    In 1985, when HIV testing first became available, the main goal of such testing was to ensure blood safety. Hemophiliacs and other patients who were transfusion-dependent were the initial patients that needed to be protected as they were exposed to iatrogenic risk. It dawned very quickly to health authorities even then that alternative testing sites had to be quickly established to deter persons from using blood bank facilities for HIV testing purposes. At that time, professional opinion was divided regarding the value of HIV testing and whether HIV testing should be encouraged because no consensus existed regarding whether a positive test predicted transmission to sex partners or from mother to infant. No effective treatment existed then and stigma and discrimination faced by those who were found positive was rampant in many parts of the world. Counseling was designed, in part, to ensure that persons tested were aware of the implications of a positive result and in part, to address the person’s risk behavior to reduce transmission to others.
  7. Foong AL, Ng SF, Lee CK
    J Adv Nurs, 2005 Apr;50(2):134-42.
    PMID: 15788077 DOI: 10.1111/j.1365-2648.2005.03372.x
    AIM: This paper reports a study aimed at identifying the primary health care experiences of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Malaysia. The rationale behind the study was to enable informed action for developing more responsive and effective primary care.
    BACKGROUND: Reports such as from the World Health Organisation forecast sharp escalations in the incidence of HIV/AIDS in Malaysia and the Asia-Pacific region within the next few years. With sparse information on the course of infection on the local population and an understanding of health care needs of those afflicted, health services would be ill-prepared for projected increases.
    METHOD: Semi-structured interviews were conducted with a convenience sample of 99 patients attending two major HIV/AIDS clinics in Malaysia.
    FINDINGS: Several gaps in care provision were highlighted, such as with treatment/consultation facilities and availability and accessibility of information. What is also evident is that there are a number of good support services available but not well publicized to those in need of them. That includes health professionals who could be making appropriate referrals. The lack of communications and inter-professional working appears to be part of the problem.
    CONCLUSION: The findings provide baseline data and preliminary insights to government and other service providers towards advancing, optimizing and refining existing policies and infrastructure. Although the availability of a number of primary care facilities have been identified, the study indicates the need for more effective co-ordinated efforts with clear leadership to pull together scarce resources towards the aim of some degree of seamless primary care provision. It is suggested that nurses would be well placed for such a role in view of the nature of their education and training that helps prepare them for the multi-faceted role.

    Study site: One is located
    in the main general hospital in the capital city of Kuala
    Lumpur, and the other in an outpatient clinic on the outskirts
    of the city
  8. Tan SS, Leong CL, Lee CK
    Med J Malaysia, 2015 Oct;70(5):281-7.
    PMID: 26556116
    BACKGROUND: Co-infection by human immunodeficiency and hepatitis C viruses (HIV/HCV) is common and results in significant morbidity and mortality despite effective antiretroviral therapies (ART).
    METHOD: A retrospective and prospective evaluation of the efficacy and safety of pegylated interferon alfa 2a/2b plus ribavirin (PEG-IFN/RBV) in consecutive HIV/HCV co-infected patients treated in real life clinical practice in Malaysia.
    RESULTS: Forty-five HIV/HCV co-infected patients with a median age (interquartile range, IQR) of 41 years (37; 47) were assessed for treatment with PEG-IFN/RBV. All except one are of male gender and the most common risk behaviour was injecting drug use. At baseline 75.5% was on ART and the median (IQR) CD4 count was 492 cells/μl (376; 621). The HCV genotypes (GT) were 73 % GT3 and 27% GT1. Liver biopsies in forty patients showed 10% had liver cirrhosis and another 50% had significant liver fibrosis. The treatment completion rate was 79.5% with 15.9% dropped out of treatment due to adverse effects (AE) or default and 4.6% due to lack of early virological response. The AE causing premature discontinuations were neuropsychiatric and haematological. The overall sustained virological response (SVR) was 63.6% with a trend towards higher SVR in GT3 compared with GT1 (71.9% vs. 41.7%; p=0.064). In patients with bridging fibrosis plus occasional nodules or cirrhosis on liver biopsy, the SVR was significantly lower at 20% (p=0.030) compared to those with milder fibrosis.
    CONCLUSION: HIV/HCV co-infected patients can be successfully and safely treated with PEG-IFN/RBV achieving high rates of SVR except in cirrhotic patients.

    Study site: co-infection clinics at Sungai Buloh Hospita
  9. Syed IA, Sulaiman SA, Hassali MA, Syed SH, Shan LH, Lee CK
    J Med Virol, 2016 May;88(5):790-7.
    PMID: 26399724 DOI: 10.1002/jmv.24389
    Suboptimal viral suppression and CD4 response to antiretroviral treatment (HAART) is known to cause poor outcomes with the increase cost of treatment. We aimed to assess factors associated with such control among HIV/AIDS patients in Malaysia. Four hundred and six HIV/AIDS patients, using Antiretroviral Therapy (ART) for at least the past three months, treated as outpatients at medication therapy adherence clinics (MTAC) were recruited. CD4 cell counts, viral load readings along with co-variants such as socio-demographic factors, adverse drug reactions, comorbidities, and medication record were obtained. Statistical Package for Social Sciences (SPSS(®) ) version 18 and STATA IC(®) version 12 were used for data analysis. CD4 counts were found highest among those within the age category 41-50 years (390.43 ± 272.28), female (402.64 ± 276.14), other ethnicities (400.20 ± 278.04), and participants with no formal education (414.87 ± 290.90). Patients experiencing adverse effects had a 2.28 (95%CI:1.25-4.18) fold greater risk of poor CD4 control, while patients with comorbidities had 2.46 (95%CI:1.02-5.91) fold greater risk of mild viral suppression. Adverse drug reactions, co-morbidities were found to be significantly associated with poor immunological and virological outcomes in HIV/AIDS patients. However, a comprehensive evaluation is needed to better understand other confounders.
    Study site: Medication therapy adherence clinic, Hospital Sungai Buloh, Selangor, Malaysia
  10. Ling BC, Nambiar P, Low KS, Lee CK
    J Forensic Odontostomatol, 2003 Jun;21(1):17-22.
    PMID: 12793127
    Denture marking is accepted as a means of identifying dentures and persons in geriatric institutions, or post-mortem during war, crimes, civil unrest, natural and mass disasters. Labelling on the acrylic resin component of the denture can easily be damaged or destroyed by fire but on cobalt-chromium components it would be more resistant. A copper vapour laser (CVL) can be used to label the cobalt-chromium components of dentures and metal restorations easily, and legibly, and miniaturised for the incorporation of more personal particulars necessary for the identification of the deceased person. The CVL beam is focussed by its optics and delivered to the material surface by the two-axis scanner mounted with mirrors. A personal computer controls the movement of the scanner and the firing of the CVL. The high peak power of the pulsed CVL is focussed to very high energy density producing plasma ablation of the alloy surface. Very fine markings of a few microns width can be produced enabling the storage of detailed information of the deceased person on a metal surface for the purpose of rapid identification.
  11. Tan JS, Abbasiliasi S, Lalung J, Tam YJ, Murugan P, Lee CK
    Prep Biochem Biotechnol, 2021;51(3):260-266.
    PMID: 32876520 DOI: 10.1080/10826068.2020.1808793
    This study aimed at purification of phycocyanin (PC) from Phormidium tergestinum using an aqueous two-phase system (ATPS) comprised of polyethylene glycol (PEG) and salts. The partitioning efficiency of PC in ATPS and the effect of phase composition, pH, crude loading, and neutral salts on purification factor and yield were investigated. Results showed that PC was selectively partitioned toward bottom phase of the system containing potassium phosphate. Under optimum conditions of 20% (w/w) PEG 4000, 10% (w/w) potassium phosphate, 20% (v/v) crude load at pH 7, with addition of 0.5% (w/w) NaCl, PC from P. tergestinum was partially purified up to 5.34-fold with a yield of 87.8%. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that the molecular weight of PC was ∼19 kDa. Results from this study demonstrated ATPS could be used as a potential approach for the purification of PC from P. tergestinum.
  12. Lai YH, Puspanadan S, Lee CK
    Biotechnol Prog, 2019 05;35(3):e2798.
    PMID: 30828976 DOI: 10.1002/btpr.2798
    Present study aims to optimize the production of starch and total carbohydrates from Arthrospira platensis. Growing concerns toward unprecedented environmental issues associated with plastic pollution has created a tremendous impetus to develop new biomaterials for the production of bioplastic. Starch-based biopolymers from algae serve as sustainable feedstock for thermoplastic starch production due to their abundant availability and low cost. A. platensis was cultivated in Zarrouk's medium at 32 ± 1°C and exposed to red light with a photoperiod of 12:12 hr light/dark. Growth kinetics studies showed that the maximum specific growth rate (μmax ) obtained was 0.059 day-1 with the doubling time (td ) of 11.748 days. Subsequently, Zarrouk's medium with different concentrations of sulfur, phosphorus and nitrogen was prepared to establish the nutrient-limiting conditions to enhance the accumulation of starch and total carbohydrates. In this study, the highest starch accumulated was 6.406 ± 0.622 mg L-1 under optimized phosphorus limitation (0.025 g L-1 ) conditions. Nitrogen limitation (0.250 g L-1 ) results demonstrated significant influenced (p 
  13. Tai WY, Tan JS, Lim V, Lee CK
    Biotechnol Prog, 2019 05;35(3):e2781.
    PMID: 30701709 DOI: 10.1002/btpr.2781
    The high cost of cellulases remains the most significant barrier to the economical production of bio-ethanol from lignocellulosic biomass. The goal of this study was to optimize cellulases and xylanase production by a local indigenous fungus strain (Aspergillus niger DWA8) using agricultural waste (oil palm frond [OPF]) as substrate. The enzyme production profile before optimization indicated that the highest carboxymethyl cellulose (CMCase), filter paper (FPase), and xylanase activities of 1.06 U/g, 2.55 U/g, and 2.93 U/g were obtained on day 5, day 4, and day 5 of fermentation, respectively. Response surface methodology was used to study the effects of several key process parameters in order to optimize cellulase production. Of the five physical and two chemical factors tested, only moisture content of 75% (w/w) and substrate amount of 2.5 g had statistically significant effect on enzymes production. Under optimized conditions of 2.5 g of substrate, 75% (w/w) moisture content, initial medium of pH 4.5, 1 × 106 spores/mL of inoculum, and incubation at ambient temperature (±30°C) without additional carbon and nitrogen, the highest CMCase, FPase, and xylanase activities obtained were 2.38 U/g, 2.47 U/g, and 5.23 U/g, respectively. Thus, the optimization process increased CMCase and xylanase production by 124.5 and 78.5%, respectively. Moreover, A. niger DWA8 produced reasonably good cellulase and xylanase titers using OPF as the substrate when compared with previous researcher finding. The enzymes produced by this process could be further use to hydrolyze biomass to generate reducing sugars, which are the feedstock for bioethanol production.
  14. Mohd Zain NF, Paramasivam M, Tan JS, Lim V, Lee CK
    Biotechnol Prog, 2021 01;37(1):e3077.
    PMID: 32894656 DOI: 10.1002/btpr.3077
    The feasibility of using waste glycerol from the biodiesel industry for biosynthesis of polyhydroxyalkanoate (PHA) by Burkholderia cepacia BPT1213 was evaluated. Culture conditions were optimized by growing B. cepacia BPT1213 in mineral salt medium supplemented with 2% waste glycerol in a 2.5 L bioreactor. Response surface methodology was used to determine the influence of aeration rate (0.6-1.8 vvm), agitation speed (100-300 rpm), and cultivation period (48-72 hr) on PHA production. The optimum conditions for the growth and PHA accumulation were 1.5 vvm, 300 rpm, and 72 hr, with predicted values of 5.08 g/L cell dry weight (CDW), 66.07% PHA content, and 3.35 g/L total PHA concentration. Using these conditions, the experimental system produced 5.63 g/L of CDW with 64.00% wt/wt PHA content, which is threefold higher PHA concentration (3.60 g/L) compared to the non-optimized conditions. The melting temperature (Tm ) of purified PHA was 173.45 ± 1.05°C. In conclusion, the statistical approach was significantly increased the PHA production using waste glycerol as the sole carbon source.
  15. Ahmed SI, Syed Sulaiman SA, Hassali MA, Thiruchelvam K, Hasan SS, Lee CK
    J Infect Prev, 2017 Sep;18(5):242-247.
    PMID: 29317901 DOI: 10.1177/1757177416689723
    Background: Understanding patients' perspective towards HIV screening in Malaysia is pivotal to explore challenges faced by these individuals. This would be beneficial for developing local plans to improve the health-seeking behaviours among population at risk of HIV/AIDS.

    Methods: A qualitative research methodology was adopted to explore HIV/AIDS patients' views about disease screening. A semi-structured interview guide was used for in-depth patient interviews. All interviews were audio-recorded and were subjected to a standard content analysis framework for data analysis.

    Results: Most patients were positive about screening and the value of knowing about their status early. However, fear of social stigma, discrimination, lack of support system and lack of public understanding were identified as major concerns affecting their willingness to be screened. They were concerned about mandatory screening being implemented without improvement in support system and public education.

    Conclusions: Reluctance to seek HIV screening is an important factor contributing to transmission in developing countries. In the Malaysian context, efforts should be made to strengthen screening strategies especially in the most-at-risk populations to monitor the epidemic and target prevention strategies.

    Practice implications: In a multicultural context, HIV preventive strategies must include disease awareness, including measure to tackle barriers towards screening.

  16. Rahardiyan D, Moko EM, Tan JS, Lee CK
    Enzyme Microb Technol, 2023 Aug;168:110260.
    PMID: 37224591 DOI: 10.1016/j.enzmictec.2023.110260
    Plastic throughout the years is now one of the biggest world commodities and also the largest pollution to have an environmental impact, accumulating in landfills and also leaching into water systems and oceans. Especially with the shift to single-use disposable plastic, evermore positions plastics as the number one novel entity that pollutes the earth. This shift is also consistent in the food packaging industry. Managing plastic waste is still an issue at large, while the process of pyrolysis incineration still requires an obscene amount of energy that also does not resolve the problems with its environmental impact, the cost of mechanical-chemical degradation even outweighs the cost of producing the materials, and biodegradation process is a very slow and long process. Converting to bioplastics is one of the potential solutions to the global plastic issue. This review covers the potentials, limitations, challenges, progress and advancements of bioplastics, especially thermoplastic starch (starch-based bioplastic) in their efforts to replace petroleum plastics in food packaging and smart food packaging, especially for single-use (disposable) food packaging.
  17. Ahmad MF, Fauzi MA, Ahmad MH, Wider W, Lee CK
    PMID: 38593234 DOI: 10.1002/ieam.4930
    This study evaluates the knowledge structure of microplastic pollution and its effects on the aquatic food chain. The presence of microplastics has seriously harmed the ecosystem. Through bibliometric analysis, 216 journal publications were retrieved from the Web of Science (WoS) from 2008 to 2023 (April), with no restriction in the time frame. Applying bibliographic coupling and co-word analysis, the emerging, current, and future themes of microplastic pollution are presented. Three research streams are derived from bibliographic coupling, centralized on the source of microplastic pollution and its impact. At the same time, research streams from co-word analysis are associated with overcoming the issue of microplastics in the ecosystem. This study's implications suggest three main principles to mitigate microplastic issues: (1) educating the public on the impact of microplastic pollution, (2) implementing holistic regulations and policies, and (3) developing treatment strategies through conventional, innovative, and hybrid approaches. Microplastic pollution is a global concern, requiring a holistic and comprehensive approach to overcome it. This review is the first to present a scientific mapping of the microplastics literature, which is a fundamental basis for future research on microplastic pollution and its impact on the ecosystem. Integr Environ Assess Manag 2024;00:1-12. © 2024 SETAC.
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