Displaying publications 61 - 80 of 150 in total

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  1. Haerian BS, Roslan H, Raymond AA, Tan CT, Lim KS, Zulkifli SZ, et al.
    Seizure, 2010 Jul;19(6):339-46.
    PMID: 20605481 DOI: 10.1016/j.seizure.2010.05.004
    The C3435T, a major allelic variant of the ABCB1 gene, is proposed to play a crucial role in drug-resistance in epilepsy. The C/C genotype carriers reportedly are at higher risk of pharmacoresistance to AEDs, but only in some studies. The hypothesis of the C-variant associated risk and resistance to antiepileptic drugs (AEDs) has been hampered by conflicting results from inadequate power in case-control studies. To assess the role of C3435T polymorphism in drug-resistance in epilepsy, a systematic review and meta-analysis was conducted.
  2. Haerian BS, Lim KS, Mohamed EH, Tan HJ, Tan CT, Raymond AA, et al.
    Seizure, 2011 Jun;20(5):387-94.
    PMID: 21316268 DOI: 10.1016/j.seizure.2011.01.008
    It is proposed that overexpression of P-glycoprotein (P-gp), encoded by the ABC subfamily B member 1 (ABCB1) gene, is involved in resistance to antiepileptic drugs (AEDs) in about 30% of patients with epilepsy. Genetic variation and haplotype patterns are population specific which may cause different phenotypes such as response to AEDs. Although several studies examined the link between the common polymorphisms in the ABCB1 gene with resistance to AEDs, the results have been conflicting. This controversy may be caused by the effect of some confounders such as ethnicity and polytherapy. Moreover, expression of the ABCB1 gene is under the control of pregnane X receptor (PXR). Evidence showed that PXR gene contribute to the response to treatment. The aim of this study was to assess the association of ABCB1 and PXR genetic polymorphisms with response to the carbamazepine (CBZ) or sodium valproate (VPA) monotherapy in epilepsy. Genotypes were assessed in 685 Chinese, Indian, and Malay epilepsy patients for ABCB1 (C1236T, G2677T, C3435T) and PXR (G7635A) polymorphisms. No association between these polymorphisms and their haplotypes, and interaction between them, with response to treatment was observed in the overall group or in the Chinese, Indian, and Malay subgroups. Our data showed that these polymorphisms may not contribute to the response to CBZ or VPA monotherapy treatment in epilepsy.
  3. Letchumanan VP, Lim KF, Mohamad AB
    Med J Malaysia, 2013 Oct;68(5):405-9.
    PMID: 24632870 MyJurnal
    INTRODUCTION: Spontaneous rupture is a dramatic presentation of HCC and it carries high mortality rate. To study the outcomes of ruptured HCC patients managed at a tertiary referral centre in Malaysia.
    METHODS: A retrospective review of all ruptured HCC patients managed as inpatient at the Department of Hepatobiliary Surgery, Hospital Selayang between January 2001 and December 2010. Data was retrieved from the hospital electronic medical records, Powerchart (Cerner Corporation Inc., USA) and supplemented with registry from Interventional Radiology record of chemoembolization and registry from hepatobiliary operative surgery records.
    RESULTS: There were 22 patients admitted with confirmed diagnosis of ruptured HCC over 10 years period. The common clinical findings on presentation were abdominal pain and presence of shock (36.4%). The mortality rate was 81.8% with only four patients noted to be alive during the follow up. One year overall survival for ER and DR are 40.0% and 72.7% respectively and the median survival in patients treated with DR was 433.3 days whereas it was 212.5 days in ER group.
    CONCLUSIONS: This study supports the clinical practice of TAE should be the first line treatment followed by staged surgery in suitable candidates with ruptured HCC.
  4. 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.
  5. Tay TKY, Lim KL, Hilmy MH, Thike AA, Goh ST, Song LH, et al.
    Malays J Pathol, 2017 Dec;39(3):257-265.
    PMID: 29279588
    INTRODUCTION: Human papillomavirus (HPV) testing is used as a means of triaging cervico-vaginal smears with low grade squamous abnormalities or as part of co-testing with cytology. While HPV testing has a high sensitivity, it has a low specificity in detecting cervical intraepithelial neoplasia grade 2 and above (CIN 2+) leading to unnecessary colposcopy referrals. We investigate the accuracy of the p16/Ki-67 dual immunocytochemical stain in determining the presence of CIN 2+ lesions on histology and its potential as a superior biomarker for triage.

    METHODS: Liquid based cervico-vaginal cytology specimens with squamous abnormalities and corresponding histology from 97 women with subsequent colposcopy and biopsy were included. The specimens were then subjected to the dual stain and Roche Cobas 4800 multiplex real time PCR HPV DNA testing. The sensitivity and specificity of the dual stain and HPV testing were calculated using CIN 2+ on histology as a reference standard.

    RESULTS: The sensitivity and specificity of the dual stain in detecting histology proven CIN 2+ was 93.7% and 76.5% while HPV testing was 85.7% and 14.7% respectively. Of the 44 women with ASCUS or LSIL on cytology, the dual stain also reduced the number of unnecessary colposcopy referrals from 27 to 7 when used as a triage marker compared to HPV testing.

    CONCLUSION: p16/Ki-67 dual stain was more sensitive and specific than HPV testing in determining the presence of CIN 2+ on histology. It could triage low grade cervico-vaginal specimens more effectively and potentially help women avoid unnecessary colposcopies. Future studies are needed to further evaluate its role in cervical cancer screening programmes.

  6. Ismail ASB, Lim KG, Mahadevan DT
    Med J Malaysia, 2020 05;75(3):260-265.
    PMID: 32467542
    BACKGROUND: Malaysia continues to have a very low cadaveric organ donation rate of 0.48 per million population. The aim of this paper is to assess the attitude, beliefs and knowledge of patients and relatives at three different hospitals in Negeri Sembilan towards organ donation to increase the acceptability of organ transplant.

    METHODS: A cross-sectional descriptive study with convenient sampling was carried out Hospital Tuanku Ja'afar, Hospital Port Dickson and Hospital Tuanku Ampuan Najihah in Negeri Sembilan, Malaysia. The participants answered a questionnaire regarding the source of their information about organ donation, their knowledge about brain death and willingness to donate. The association between variables was tested using chi-squared test or Fischer's exact test as appropriate.

    RESULTS: A total of 385 individuals completed the survey of whom 134 (35%) were willing to donate their organs upon death and 25(19%) were registered donors. Higher educational level (41%), age 30 and below (42%) and people who attended organ donation awareness campaigns (60%) were more willing to donate their organs. Correct understanding of brain death was associated with willingness to be an organ donor. The commonest reason cited for unwillingness to donate was opposition from family members.

    CONCLUSION: Marital status, religion, source of knowledge and occupation are significant factors in willingness to donate organs among Malaysians. Lower age and higher educational level were positive factors towards organ donation. Direct personal contact through awareness campaigns, family and friends has a potential for greater positive impact on organ donation.

  7. Lim SW, Ting KN, Bradshaw TD, Zeenathul NA, Wiart C, Khoo TJ, et al.
    J Ethnopharmacol, 2011 Nov 18;138(2):616-23.
    PMID: 22008878 DOI: 10.1016/j.jep.2011.10.005
    The seeds of Acalypha wilkesiana have been used empirically by traditional healers in Southwest Nigeria together with other plants as a powder mixture to treat patients with breast tumours and inflammation.
  8. Wong, W. H., Lim, T. A., Lim, K. Y.
    MyJurnal
    Introduction: Giving two intravenous anaesthetic agents simultaneously generally results in an additive effect. The aim of this study was to investigate the interaction between propofol and thiopental when given to patients who have had sedative premedication. Methods: Fifty patients were admitted into the study. All patients received oral midazolam 3.75 mg and intravenous fentanyl 100 mg before induction of anaesthesia. Twenty patients received an infusion of either propofol or thiopental while 30 patients received an infusion of an admixture of both drugs. Isobolographic analysis was used to determine the interaction between the two drugs. Results: The interaction between propofol and thiopental was
    additive. The average dose at loss of the eyelash reflex for propofol and thiopental was 0.71 mg kg-1 and 1.54 mg kg-1 respectively. Premedication decreased the induction dose by 38.2%. Conclusion: Propofol and thiopental interact in an additive fashion when given at induction of anaesthesia.
  9. Lim TA, Wong WH, Lim KY
    Med J Malaysia, 2005 Oct;60(4):432-40.
    PMID: 16570704
    The objective of this survey was to obtain a self-reported assessment of the use of information technology (IT) by final year medical students. Two hundred and sixty five students responded to a questionnaire survey. 81.5% of students considered their computer skills adequate, while 87.9% had access to computers outside the campus. Most students reported adequate skills at word processing, e-mailing and surfing the Internet. Fifty three percent of students spent three hours or more each week on the computer. While students indicated a general willingness to access Internet-based materials, further steps need to be taken to increase the use of this method of instruction.
  10. Lim AK, Ulagantheran V V, Siow YC, Lim KS
    Med J Malaysia, 2008 Aug;63(3):249-50.
    PMID: 19248701 MyJurnal
    To report a case of methylene blue related endophthalmitis. Observational case report. Review of clinical record, photographs. A 60 year old man developed endophthalmitis after methylene blue was accidentally used to stain the anterior capsule during phacoemulsification of cataract. His left visual acuity deteriorated from 6/12 to 6/36 two weeks after the operation. Despite intensive treatment with topical and intravitreal antibiotics, his condition deteriorated. A vitrectomy and silicone oil injection eventually managed to control the progression of the disease and salvage the eye. However the visual outcome remained poor due to corneal decompensation and retinal ischemia. Both vitreous tap and vitreous biopsy were negative for any organism. Methylene blue is extremely toxic to ocular structures and should not be used intraocularly.
  11. Choong YY, Lim KS
    Med J Malaysia, 2001 Mar;56(1):92-4.
    PMID: 11503304
    Phenothiazines have been associated with various ocular adverse effects, in particular cataract and corneal deposits. Several effects are vision threatening. Awareness of these effects, in particular by Psychiatrists and Ophthalmologist, is essential for prompt diagnosis and appropriate treatment. We report two patients presented to us with corneal deposits and lenticular opacities following long term use of Phenothiazines.
  12. Tsai MH, Chan CK, Chang YC, Yu YT, Chuang ST, Fan WL, et al.
    Clin Genet, 2017 Oct;92(4):397-404.
    PMID: 28170089 DOI: 10.1111/cge.12992
    BACKGROUND AND AIMS: Mutations in the disheveled, Egl-10 and pleckstrin domain-containing protein 5 (DEPDC5) gene have emerged as an important cause of various familial focal epilepsy syndromes. However, the significance of DEPDC5 mutations in patients with sporadic focal epilepsy has yet to be characterized.

    MATERIALS AND METHODS: We studied a kindred of familial focal epilepsy with variable foci using whole-exome sequencing. We subsequently studied a cohort of 293 patients with focal epilepsy and sequenced all exons of DEPDC5 using targeted resequencing.

    RESULTS: We reported a Taiwanese family with a novel splice site mutation which affected mRNA splicing and activated the downstream mammalian target of rapamycin (mTOR) pathway. Among patients with focal epilepsies, the majority (220/293) of these patients had sporadic focal epilepsy without malformation of cortical development. Two (0.9%) of these patients had probably pathogenic mutations in the DEPDC5 gene.

    DISCUSSION AND CONCLUSIONS: Our finding suggests that DEPDC5 is not only the most common gene for familial focal epilepsy but also could be a significant gene for sporadic focal epilepsy. Since focal epilepsies account for more than 60% of all epilepsies, the effect of mTORC1 inhibitor on patients with focal epilepsy due to DEPDC5 mutations will be an important future direction of research.

  13. Ahmad H, Azri MFM, Ramli R, Samion MZ, Yusoff N, Lim KS
    Sci Rep, 2021 Oct 28;11(1):21278.
    PMID: 34711908 DOI: 10.1038/s41598-021-99928-z
    In this work, mode-locked thulium-doped fiber lasers operating in the 2 µm wavelength region were demonstrated using tantalum aluminum carbide (Ta2AlC)-based saturable absorbers (SAs) utilizing the evanescent wave interaction. The Ta2AlC MAX Phase was prepared by dissolving the Ta2AlC powder in isopropyl alcohol and then deposited onto three different evanescent field-based devices, which were the tapered fiber, side-polished fiber, and arc-shaped fiber. Flame-brushing and wheel-polishing techniques were used to fabricate the tapered and arc-shaped fibers, respectively, while the side-polished fiber was purchased commercially. All three SA devices generated stable mode-locked pulses at center wavelengths of 1937, 1931, and 1929 nm for the tapered, side-polished, and arc-shaped fibers. The frequency of the mode-locked pulses was 10.73 MHz for the tapered fiber, 9.58 MHz for the side-polished fiber, and 10.16 MHz for the arc-shaped fiber. The measured pulse widths were 1.678, 1.734, and 1.817 ps for each of the three SA devices. The long-term stability of the mode-locked lasers was tested for each configuration over a 2-h duration. The lasers also showed little to no fluctuations in the center wavelengths and the peak optical intensities, demonstrating a reliable, ultrafast laser system.
  14. 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.
  15. Lim KO
    Med J Malaysia, 1991 Jun;46(2):136-43.
    PMID: 1839417
    Even though artificial heart valve implants have a history of some 30 years, there is to this day no ideal valve substitute. Each of the categories of substitutes used has its own advantages as well as problems. Since my last review on the subject, that appeared in this journal, was some 13 years ago (Lim, 1977), it is perhaps appropriate to provide an update on the status of cardiac valve replacement for the general local readership.
  16. Chow SK, Yeap SS, Goh EML, Veerapen K, Lim KKT
    Med J Malaysia, 2002 Sep;57(3):283-91.
    PMID: 12440267
    This was a prospective survey using a standard questionnaire to determine the prevalence of use of oral traditional medicine and food supplements among patients with rheumatic diseases. Among the 141 patients surveyed, we found that 69% of the patients were consuming food supplements, 35% were using traditional medicine and 45% had used traditional medicine at some time or other. Females were more likely to use food supplements (P < 0017); especially among those with higher education (p < 0.036). There was no statistical difference between those who had ever consumed compared to those who never used traditional medicines. The Chinese were more likely than others to be using traditional medicine (p < 0.007). Vitamin C and B were the most commonly used food supplements. More than two thirds of the patients obtained their traditional medicine from non-medical personnel. More than half of them used 2 or more types of traditional medicine for more than two months. Spending on traditional medicine was noted to be modest with 73% spending less than one hundred ringgit a month for their traditional treatment. Doctors need to be aware of the possible interactions between these 'self-medications' and the conventionally prescribed medication.
  17. Lim KJ
    Malays J Pathol, 2003 Jun;25(1):1-13.
    PMID: 16196373
    Successful human reproduction remains an enigma, but this is slowly changing in the current era of expanding scientific knowledge. The discovery of various molecular factors such as adhesion molecules, proteases and cytokines have in recent years been at the forefront of medical research. The growing importance of immunology in particular has led to novel new immuno-modulatory therapies and increasing research into this new aspect of reproductive immunology may well prove to be the most important breakthrough in understanding the fundamentals of human reproduction. Implantation represents the first step in the complex interactions and processes involved in foetal-maternal interaction, which continues throughout pregnancy gestation and culminates in the birth of an infant. It is therefore vital that we understand the myriad processes controlling implantation in order to build a firm foundation for exploring reproductive immunology research in the new millennium. This review brings together and presents an overview of the potential roles of currently known molecular factors such as adhesion molecules, proteases, cytokines and its interaction with the maternal immune response, incorporating the findings of previous published research performed by the author on cytokines and reproductive immunology.
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