Displaying publications 81 - 100 of 157 in total

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  1. Cheah PK, Steven EM, Ng KK, Hashim MI, Abdul Kadir MH, Roder NP
    Int J Emerg Med, 2021 May 07;14(1):30.
    PMID: 33962581 DOI: 10.1186/s12245-021-00354-9
    Sabah in Malaysian Borneo is among the Malaysian states which reported a high number of detected COVID-19 cases during the current pandemic. Due to geographical challenges and limited resources, clinicians developed novel strategies for managing patients. The use of a dual oxygen concentrator system for mechanical ventilation is one of the innovations developed by retrieval team members from the Emergency Department (ED) of the Sabah Women and Children's Hospital. Due to conditions requiring isolation of patients suspected of or positive for COVID-19, high-risk patients were treated in an ED extension area that lacked central wall oxygen. Direct access to oxygen tanks became the only viable option, but ensuring a continuous supply was laborious. The novel setup described within this paper has been used on intubated patients in the ED extension area with moderate to high ventilator settings successfully. This simple setup, designed to meet the limited resources within a pandemic environment, needed only a turbine-driven ventilator, two oxygen concentrators, a 3-way connector, and three oxygen tubing. The application of this setup could potentially save more critically ill patients who are being managed in resource-limited conditions such as in smaller district hospitals or out in the field.
  2. Lim ZD, Pheng E, Min ETL, Van Rostenberghe H, Shatriah I
    PMID: 33916368 DOI: 10.3390/ijerph18073783
    Platelets are a primary source of pro- and anti-angiogenic cytokines. However, the evidence of their role in retinopathy of prematurity (ROP) is controversial. This retrospective study aimed to compare mean weekly platelet counts between infants with and without ROP over the first 6 weeks of life. A total of 93 infants matched by gestational age and birth weight were recruited (31 with ROP, 62 without ROP). Weekly mean platelet counts and other related risk factors were documented. The repeated measure analysis of variance (ANOVA) and the repeated measure analysis of covariance (ANCOVA) were used to compare mean platelet counts over time between the two groups, with and without adjusting for confounders. We found significant differences in the weekly mean platelet counts of infants with and without ROP over the first 6 weeks of life (p = 0.002). These differences disappeared after adjusting for covariates (p = 0.489). Lower mean platelet counts in ROP infants are not directly related to ROP, but rather to the presence of other risk factors for ROP, such as culture-proven sepsis, blood transfusion and bronchopulmonary dysplasia.
  3. Low QJ, Lim TH, Hon SA, Cheo SW, Wagino N, Yap EWL
    Malays Fam Physician, 2021 Nov 30;16(3):101-103.
    PMID: 34938398 DOI: 10.51866/cr1276
    Skin conditions are a common reason for consulting primary health care. The public frequently expects their primary health care providers to be able to recognise and treat common skin conditions with confidence. Primary care providers must be able to identify 'red flag' skin conditions that require dermatology referral. However, diagnosis is often delayed due to the non-specific clinical presentation, low incidence, slow evolution and long-term history of such lesions. We report the case of a patient with extramammary Paget's disease that presented to her primary care provider and subsequently underwent a wide local excision.
  4. Rohaizam J, Tang IP, Jong DE, Tan TY, Narihan MZ
    Med J Malaysia, 2012 Jun;67(3):345-8.
    PMID: 23082435 MyJurnal
    Extracranial schwannomas in the head and neck region are rare neoplasms. The tumours often present as asymptomatic, slowly enlarging lateral neck masses and determination of the nerve origin is not often made until the time of surgery. Preoperative diagnosis maybe aided by imaging studies such as magnetic resonance imaging or computed tomography, while open biopsy is no longer recommended. The accepted treatment for these tumors is surgical resection with preservation of the neural pathway. We report four cases of cervical schwannomas that we encountered at our center during four years of period. The clinical features, diagnosis and origin, management and pathological findings of these benign tumors are discussed.
  5. Chee EL, Lim AY, Modamio P, Fernandez-Lastra C, Segarra I
    Eur J Drug Metab Pharmacokinet, 2016 Jun;41(3):309-19.
    PMID: 25656737 DOI: 10.1007/s13318-015-0264-7
    Sunitinib is a multitargeted tyrosine kinase inhibitor approved for gastrointestinal stromal tumor (GIST), advanced renal cell carcinoma (RCC) and pancreatic neuroendocrine tumors. It is metabolized via CYP3A4 and has low brain penetration due to efflux transporters ABCB1B and ABCG2. We studied the interaction with ketoconazole (50 mg/kg), antifungal drug which shares metabolic pathways and efflux transporters, in ICR female mice after oral coadministration (30 min apart) of 60 mg/kg sunitinib (study group) versus sunitinib alone (control group). Plasma, liver, kidney and brain sunitinib concentrations were measured by HPLC at 2, 5, 10, 20, 40 min, 1, 2, 4, 6, 12 h post-sunitinib administration, and non-compartmental pharmacokinetic parameters estimated. In plasma, ketoconazole coadministration increased plasma maximum concentration (C MAX) 60 %, delayed time to C MAX (T MAX); 1.6-fold greater area under the curve AUC0→∞ (p  0.05) and decreased in brain (1.70 ± 0.23, p > 0.05). The results showed a significant ketoconazole-sunitinib interaction that affected plasma, tissue pharmacokinetics and tissue uptake mechanisms. The study portrays the risk to increase toxicity and potential clinical translatability to treat tumors in tissues.
  6. Hamid AA, Dek MS, Tan CP, Zainudin MA, Fang EK
    Antioxidants (Basel), 2014;3(3):502-15.
    PMID: 26785067 DOI: 10.3390/antiox3030502
    Changes in antioxidant properties and degradation of bioactives in palm oil (PO) and rice bran oil (RBO) during deep-frying were investigated. The alpha (α)-tocopherol, gamma (γ)-tocotrienol and γ-oryzanol contents of the deep-fried oils were monitored using high performance liquid chromatography, and antioxidant activity was determined using 2-diphenyl-1-picryl hydrazyl (DPPH) radical scavenging activity. Results revealed that the antioxidant activity of PO decreased significantly (p < 0.05), while that of RBO was preserved after deep-frying of fries. As expected, the concentration of α-tocopherol in PO and γ-tocotrienol in both PO and RBO decreased significantly (p < 0.05) with increased frying. Results also showed that γ-tocotrienol was found to be more susceptible to degradation compared to that of α-tocopherol in both PO and RBO. Interestingly, no significant degradation of α-tocopherol was observed in RBO. It is suggested that the presence of γ-oryzanol and γ-tocotrienol in RBO may have a protective effect on α-tocopherol during deep-frying.
  7. Thalayasingam M, Loo EX, Tan MM, Bever HV, Shek LP
    Singapore Med J, 2015 Nov;56(11):622-5.
    PMID: 26668407 DOI: 10.11622/smedj.2015171
    The prevalence of perceived food allergies exceeds that of true food allergies. Unnecessary food avoidance may increase parental and patient anxiety, reduce quality of life and increase the risk of nutritional deficiency. An oral food challenge (OFC) can provide an objective measure regarding the presence or absence of food allergies in a child. This study reviews the indications for and outcomes of OFCs performed on children.
  8. Mun-Wei L, Aiman-Mardhiyyah MY, Hayati AA, Ikram IM, Tai ELM, Shatriah I
    Korean J Ophthalmol, 2023 Feb;37(1):42-48.
    PMID: 36549302 DOI: 10.3341/kjo.2021.0131
    PURPOSE: Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patients with nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control group and to correlate it with visual acuity and level of proteinuria.

    METHODS: The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome and healthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria, and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus optical coherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map.

    RESULTS: The mean foveal thickness was 238.15 ± 22.98 µm for children with nephrotic syndrome and 237.01 ± 22.60 µm for the control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significant correlation with visual acuity was observed in the superior outer macula (r = -0.41, p = 0.019), the nasal outer macula (r = -0.41, p = 0.019), and the inferior outer macula (r = -0.40, p = 0.021). There was no significant correlation between the mean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated a trend towards increased macular thickness.

    CONCLUSIONS: The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significant correlation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.

  9. Chau EYW, Bakar AA, Zamhot AB, Zaini IZ, Binti Adanan SN, Sabardin DMB
    BMC Emerg Med, 2024 Apr 12;24(1):58.
    PMID: 38609924 DOI: 10.1186/s12873-024-00973-4
    BACKGROUND: The latest Surviving Sepsis Campaign 2021 recommends early antibiotics administration. However, Emergency Department (ED) overcrowding can delay sepsis management. This study aimed to determine the effect of ED overcrowding towards the management and outcome of sepsis patients presented to ED.

    METHODS: This was an observational study conducted among sepsis patients presented to ED of a tertiary university hospital from 18th January 2021 until 28th February 2021. ED overcrowding status was determined using the National Emergency Department Overcrowding Score (NEDOCS) scoring system. Sepsis patients were identified using Sequential Organ Failure Assessment (SOFA) scores and their door-to-antibiotic time (DTA) were recorded. Patient outcomes were hospital length of stay (LOS) and in-hospital mortality. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 26. P-value of less than 0.05 for a two-sided test was considered statistically significant.

    RESULTS: Total of 170 patients were recruited. Among them, 33 patients presented with septic shock and only 15% (n = 5) received antibiotics within one hour. Of 137 sepsis patients without shock, 58.4% (n = 80) received antibiotics within three hours. We found no significant association between ED overcrowding with DTA time (p = 0.989) and LOS (p = 0.403). However, in-hospital mortality increased two times during overcrowded ED (95% CI 1-4; p = 0.041).

    CONCLUSION: ED overcrowding has no significant impact on DTA and LOS which are crucial indicators of sepsis care quality but it increases overall mortality outcome. Further research is needed to explore other factors such as lack of resources, delay in initiating fluid resuscitation or vasopressor so as to improve sepsis patient care during ED overcrowding.

  10. Hasbi A, Shatriah I, Tai ELM, Rahim HA, Zamli AH
    Korean J Ophthalmol, 2024 Dec;38(6):450-460.
    PMID: 39434580 DOI: 10.3341/kjo.2024.0102
    PURPOSE: Worldwide, limited information is available on the psychosocial function and health-related quality of life (HRQoL) in children with congenital ptosis, nor the effect of corrective surgery on these parameters. This study aimed to evaluate the social anxiety and HRQoL of Malaysian children with primary simple unilateral congenital ptosis following ptosis surgery.

    METHODS: A prospective cohort study was conducted among children with primary simple unilateral congenital ptosis and their parent/guardian who attended three tertiary hospitals from 2022 to 2024. The patients and their parents/guardians answered Spence Children's Anxiety Scale-Social Anxiety and the PedsQL 4.0 Generic Core Scale, at the time of recruitment and 3 months after ptosis surgery.

    RESULTS: This study involved 45 children, of which 26 (57.8%) were female. At enrollment, 18 (40.0%) had severe ptosis, and 15 (33.3%) had amblyopia. All surgeries were successful, with a mean margin to reflex distance (MRD) 1 and mean intereye MRD1 difference of 4.07 ± 0.62 and 0.29 ± 0.46 mm, respectively. Significant improvements in both social anxiety and HRQoL of children and parent were observed following surgery (p < 0.001). A decrease in intereye MRD1 difference postoperatively was the only significant factor affecting social anxiety of children with ptosis following surgery (p < 0.001). Together with the presence of amblyopia (p < 0.001), the intereye MRD1 difference was found to have a significant impact on the improvement in HRQoL (p = 0.021). Age, sex, and education level of parent/guardians were found to significantly affect the change in social anxiety following ptosis surgery (p < 0.05), while the factor most associated with improvement of parental HRQoL was an improvement in the MRD1 of the ptotic eye (p < 0.001).

    CONCLUSIONS: Ptosis surgery significantly improved social anxiety and HRQoL in children with congenital ptosis and their parents/guardians. Psychosocial function should be a consideration when identifying indications for surgery in children with congenital ptosis.

  11. Lau EXX, Farrukh MJ, Keshavarzi F, Ming LC, Paneerselvam GS, Suleiman AK
    BMC Complement Med Ther, 2025 Mar 08;25(1):97.
    PMID: 40057740 DOI: 10.1186/s12906-025-04816-y
    BACKGROUND: The use of traditional and complementary medicines (T&CM) among menopausal women has become prevalent due to the concerns on the adverse effects and differing opinions regarding hormone replacement therapy's (HRT) suitability for long-term following the release of Women's Health Initiative (WHI) results in 2002. To date, there have been no studies conducted on knowledge, attitude and practice towards T&CM among menopausal women in Malaysia. In addition, many women seek relief from menopausal symptoms by using T&CM despite questionable safety and efficacy. The objective of this study was to determine the knowledge, attitude and practice of menopausal women towards T&CM and its correlation with sociodemographic data in Kuala Lumpur and to assess the prevalence, types and perceived effectiveness of T&CM used by menopausal women in Kuala Lumpur.

    METHODS: A cross-sectional study was conducted among menopausal women (n = 390) in Kuala Lumpur in the form of self-administered questionnaire. Data was collected using convenience sampling. The questionnaire was adopted from previous studies and some literature reviews with modifications. It was composed of 4 sections. Statistical analyses were performed using the IBM SPSS Statistics Version 26. Data obtained was analysed using descriptive and inferential analysis such as independent t test, one way ANOVA and chi square test.

    RESULTS: The prevalence of T&CM used among menopausal women was found to be 27.2%. Evening primrose oil (53.2%), vitamins and minerals (53.2%) and black cohosh (48%) were most frequently used. Black cohosh and phytoestrogens were perceived as effective in relieving menopausal symptoms by 36.6% and 43.4% of respondents, respectively. Over half of the respondents had poor knowledge (51.3%), negative attitude (56.9%) and poor practice (55.7%) regarding the utilization of T&CM in menopause. There was a significant association between knowledge and attitude (p value  RM10,1000) showed higher knowledge and positive attitude.

    CONCLUSIONS: Menopausal women in Kuala Lumpur were found to have a low prevalence rate of T&CM utilization. Respondents' low understanding and unfavourable views might significantly impact the inadequate usage of T&CM.

  12. Yap JY, Tai ELM, Kueh YC, Salleh S, Ibrahim M
    Int Ophthalmol, 2025 Jan 20;45(1):29.
    PMID: 39832029 DOI: 10.1007/s10792-024-03390-5
    PURPOSE: To evaluate the effects of pre-operative ranibizumab injection on microvascular density (MVD), 8-hydroxyguanosine (8-OHdG) and recurrence after surgical excision of primary pterygium.

    METHOD: This was a prospective cohort interventional study involving 52 patients with primary pterygium divided equally into control and intervention groups. The intervention group received 0.5 mg ranibizumab two weeks prior to pterygium excision surgery. All participants had pterygium excision with autologous conjunctival graft under local anaesthesia. Excised pterygium tissues were evaluated for MVD and 8-OHdG. Each participant was monitored for recurrence up to 2 years after intervention. Pearson chi-square and Fisher exact tests were used to examine the differences between both groups.

    RESULTS: The intervention group demonstrated significantly lower MVD (p 

  13. Xi Loh EY, Fauzi MB, Ng MH, Ng PY, Ng SF, Ariffin H, et al.
    ACS Appl Mater Interfaces, 2018 Nov 21;10(46):39532-39543.
    PMID: 30372014 DOI: 10.1021/acsami.8b16645
    The evaluation of the interaction of cells with biomaterials is fundamental to establish the suitability of the biomaterial for a specific application. In this study, the properties of bacterial nanocellulose/acrylic acid (BNC/AA) hydrogels fabricated with varying BNC to AA ratios and electron-beam irradiation doses were determined. The manner these hydrogel properties influence the behavior of human dermal fibroblasts (HDFs) at the cellular and molecular levels was also investigated, relating it to its application both as a cell carrier and wound dressing material. Swelling, hardness, adhesive force (wet), porosity, and hydrophilicity (dry) of the hydrogels were dependent on the degree of cross-linking and the amount of AA incorporated in the hydrogels. However, water vapor transmission rate, pore size, hydrophilicity (semidry), and topography were similar between all formulations, leading to a similar cell attachment and proliferation profile. At the cellular level, the hydrogel demonstrated rapid cell adhesion, maintained HDFs viability and morphology, restricted cellular migration, and facilitated fast transfer of cells. At the molecular level, the hydrogel affected nine wound-healing genes (IL6, IL10, MMP2, CTSK, FGF7, GM-CSF, TGFB1, COX2, and F3). The findings indicate that the BNC/AA hydrogel is a potential biomaterial that can be employed as a wound-dressing material to incorporate HDFs for the acceleration of wound healing.
  14. Lee YY, Saba E, Irfan M, Kim M, Chan JY, Jeon BS, et al.
    Phytomedicine, 2019 Feb 15;54:169-181.
    PMID: 30668366 DOI: 10.1016/j.phymed.2018.09.186
    BACKGROUND: Different processing conditions alter the ginseng bioactive compounds, promoting or reducing its anti-inflammatory effects. We compared black ginseng (BG) - that have been steamed 5 times - with red ginseng (RG).

    HYPOTHESIS/ PURPOSE: To compare the anti-inflammatory activities and the anti-nociceptive properties of RG and BG.

    METHODS: Nitric Oxide (NO) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay, quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR), western blot, xylene-induced ear edema, carrageenan-induced paw edema RESULTS: The ginsenoside contents were confirmed using high-performance liquid chromatography (HPLC) and has been altered through increased processing. The highest concentration of these extracts inhibited NO production to near-basal levels in lipopolysaccharide (LPS)-stimulated RAW 264.7 without exhibiting cytotoxicity. Pro-inflammatory cytokine expression at the mRNA level was investigated using qRT-PCR. Comparatively, BG exhibited better inhibition of pro-inflammatory mediators, iNOS and COX-2 and pro-inflammatory cytokines, IL-1β, IL-6 and TNF-α. Protein expression was determined using western blot analysis and BG exhibited stronger inhibition. Xylene-induced ear edema model in mice and carrageenan-induced paw edema in rats were carried out and tested with the effects of ginseng as well as dexamethasone and indomethacin - commonly used drugs. BG is a more potent anti-inflammatory agent, possesses anti-nociceptive properties, and has a strong potency comparable to the NSAIDs.

    CONCLUSION: BG has more potent anti-inflammatory and anti-nociceptive effects due to the change in ginsenoside component with increased processing.

  15. Tevaraj JM, Tai Li Min E, Mohd-Noor RA, Thavaratnam LK, Salmah WM, Wan Hitam WH
    Case Rep Ophthalmol Med, 2016;2016:6741925.
    PMID: 28078151 DOI: 10.1155/2016/6741925
    A previously healthy 27-year-old Malay male presented with acute onset of painless, severe blurring of vision in his right eye. It was associated with headache and vomiting for the past week. Relative afferent pupillary defect was present in the right eye, with reduced optic nerve function. Patient also had bilateral generalised optic disc swelling, splinter haemorrhages, and tortuous vessels. Initial examination was suggestive of either optic neuritis or raised intracranial pressure. Typical features of bilateral optic perineuritis (OPN) such as tram track and doughnut sign were observed on magnetic resonance imaging. Connective tissue and infective screening were negative. He was diagnosed with bilateral optic perineuritis and treated with high dose intravenous corticosteroids followed by a three-month course of oral steroids. His vision and optic nerve function recovered to baseline levels.
  16. Liaw YY, Loong FS, Tan S, On SY, Khaw E, Chiew Y, et al.
    Breast J, 2020 Mar;26(3):469-473.
    PMID: 31486157 DOI: 10.1111/tbj.13520
    Women with a positive family history of breast cancer are greatly predisposed to breast cancer development. From January 2007 to December 2016, 1101 patients with a histologically confirmed breast cancer were divided into two groups: patients with and without a positive family history of breast cancer. Variables including age at presentation, ethnicity, tumor size, age at menarche, age at menopause, oral contraceptive pill (OCP) use, hormone replacement therapy (HRT), alcohol intake, smoking, body mass index (BMI), diabetes mellitus, parity, and breastfeeding were recorded. One hundred and fifty-nine out of 1101 (14.4%) of the patients had a family history of breast cancer. There was no significant difference in the incidence of breast cancer among Malays, Chinese, and Indians. Both patient groups presented at a mean age of about 60 years (+FH 60; -FH 61.2 P-value = .218). Significantly higher prevalence of history of benign breast disease (11.3%, P .018), nulliparity (13.2%, P .014), tumor size at presentation of more than 5 cm (47.3%, P 0.001), and bilateral site presentation (3.1%, P 0.029) were noted among respondents with a positive family history of breast cancer compared to those with a negative family history of breast cancer. The odds of having a tumor size larger than 5cm at presentation were almost two times higher in patients with a positive family history as compared to those without a family history (adjusted OR = 1.786, 95% CI 1.211-2.484) (P-value .003). Women in Malaysia, despite having a positive family history of breast cancer, still present late at a mean age of 60 with a large tumor size of more than 5 cm, reflecting a lack of awareness. Breastfeeding does not protect women with a family history from developing breast cancer.
  17. Todd J, Aspell JE, Barron D, Toh EKL, Zahari HS, Mohd Khatib NA, et al.
    Body Image, 2020 Sep;34:101-111.
    PMID: 32512525 DOI: 10.1016/j.bodyim.2020.05.011
    Gastric interoception refers to the processing of sensory stimuli originating in the gut. Previous research has found that gastric interoception (measured using a water load task) is associated with drive for thinness in young Western women. However, associations with broader facets of body image and in diverse national groups have not been previously investigated. To address these issues, we asked samples of adults in the United Kingdom (UK; N = 91, women n = 54) and Malaysia (N = 100, women n = 50) to complete a 2-stage water load task (WLT) and measures of positive body image (i.e., body appreciation, functionality appreciation). The results indicated that a greater change in the intensity of self-reported WLT-related sensations was associated with significantly higher body appreciation and functionality appreciation after accounting for gender identity, body mass index, and national group. Behavioural performance on the WLT was significantly associated with body appreciation and functionality appreciation for the Malaysian sample, but not the UK adults, after accounting for gender identity and body mass index. These findings extend previous research by demonstrating that there are significant associations between facets of gastric interoception and previously unexplored facets of body image in both Western and non-Western settings.
  18. Chew CC, Ng S, Chee YL, Koo TW, Liew MH, Chee EL, et al.
    Invest New Drugs, 2017 08;35(4):399-411.
    PMID: 28285369 DOI: 10.1007/s10637-017-0447-y
    Coadministration of diclofenac and sunitinib, tyrosine kinase inhibitor, led to sex-divergent pharmacokinetic drug-drug interaction outcomes. Male and female mice were administered 60 mg/kg PO sunitinib alone (control groups) or with 30 mg/kg PO diclofenac. Sunitinib concentration in plasma, brain, kidney and liver were determined by HPLC and non-compartmental pharmacokinetic parameters calculated. In male mice, diclofenac decreased AUC0→∞ 38% in plasma (p 
  19. Liew MH, Ng S, Chew CC, Koo TW, Chee YL, Chee EL, et al.
    Invest New Drugs, 2017 04;35(2):145-157.
    PMID: 28070719 DOI: 10.1007/s10637-016-0415-y
    The sex-divergent pharmacokinetics and interaction of tyrosine kinase inhibitor sunitinib with paracetamol was evaluated in male and female mice. Mice (control groups) were administered 60 mg/kg PO sunitinib alone or with 200 mg/kg PO paracetamol (study groups). Sunitinib concentration in plasma, brain, kidney and liver were determined and non-compartmental pharmacokinetic analysis performed. Female control mice showed 36% higher plasma sunitinib AUC0→∞, 31% and 27% lower liver and kidney AUC0→∞ and 2.2-fold higher AUC0→∞ in brain (all p 
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