Displaying publications 81 - 100 of 148 in total

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  1. 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.

  2. Lim KY, Rajah R, Ng BH, Soo CI
    Med J Malaysia, 2020 07;75(4):430-432.
    PMID: 32724009
    Chronic obstructive pulmonary disease (COPD) is a debilitating progressive lung disease characterised by irreversible airflow obstruction. In addition to an increase in morbidity and mortality, exacerbation also results in frequent hospital visits, which place a burden on healthcare systems. Non-invasive positive pressure ventilation (NPPV) with conventional inspiratory pressures is the standard ventilatory support for patients in exacerbation. At present, the use of higher inspiratory pressures through high intensity noninvasive positive pressure ventilation (Hi-NPPV) during an exacerbation remains unknown. We describe a novel application of Hi-NPPV in a patient with acute exacerbation who was refractory to conventional NPPV.
  3. Lim KT, Hanifah YA, Mohd Yusof MY, Thong KL
    Trop Biomed, 2012 Jun;29(2):212-9.
    PMID: 22735842 MyJurnal
    Staphylococcus aureus is a persistent human pathogen responsible for a variety of infections ranging from soft-tissue infections to bacteremia. It produces a variety of virulence factors which are responsible for specific acute staphylococcal toxaemia syndromes. The objective of this study was to determine the prevalence of a repertoire of toxin genes among Malaysian MRSA strains and their genetic diversity by PCR-RFLP of coa gene. One hundred eighty-eight strains (2003, 2004, 2007 and 2008) of methicillin-resistant S. aureus (MRSA) were screened for 20 genes encoding for extracellular virulence determinant (sea, seb, sec, sed, see, seg, seh, sei, sej, tst, eta, etb, etd) and adhesins (cna, etb, fnbA, fnbB, hlg, ica, sdrE). The genetic relatedness of these strains was determined by PCR-RFLP of coa gene and agr grouping. Majority of the strains were tested positive for efb and fnbA (96% each), ica (78%) and hlg (59%) genes. A total of 101 strains were positive for at least one type of staphylococcal enterotoxin genes with sea being the predominant. Genes for seb, sed, see, seh, sej, eta and etb were not detected in any of the MRSA strains. The prevalence of sea, sec and ica among strains isolated in 2008 was increased significantly (p< 0.05) compared to 2003. Most of the strains were of agr type I (97.5%) followed by agr type II (1.2%) and agr type III (0.6%). All sea, sei and tst gene-positive strains were of agr type I. The only etd positive strain was agr type III. PCR-RFLP of coa produced 47 different patterns. The number of strains with virulence factors (sea, sec and ica) had increased over the years. No direct correlation between PCR-RFLP- coa profiles and virulotypes was observed.
  4. Lim KK, Siti Rohana D, Zawiah A, Wan Nazaimoon WM
    Trop Biomed, 2006 Dec;23(2):172-8.
    PMID: 17322819 MyJurnal
    This is a cross-sectional study conducted from January to September 2004 in a group of school children aged 8 -10 years old. The schools and study subjects were selected using stratified systematic sampling technique. A total of 44 schools and 1100 subjects were selected from schools with iodinator and schools without iodinator. Samples collected were spot urine and drinking water. Dietary and iodised water consumption data were obtained from interviews. A total of 931 subjects (84.6%) responded; 558 (50.7%) from schools with iodinator and 373 (33.9%) from schools without iodinator. Results showed that in more than half (53.8%) of the schools with iodinators, mean water iodine level was below 25 microg/L. The study population in Terengganu was found to be mildly iodine deficient with an overall median urine iodine concentration (uIC) of 74 microg/L. Based on WHO criteria, 4.1% with uIC <20 microg/L (severe), 19.5% with uIC between 20-49 microg/L (moderate), 49.2% with uIC between 50-99 microg/L (mild) and 27.2% was iodine sufficient with uIC >100 microg/L. Majority of the study subjects were found to have high seafood intake (> 90%) and low in goitrogen food intake. This study suggests water iodinator system may not be a suitable method of supplying iodine and an alternative is needed in order to eradicate the iodine deficiency problem seen in some parts of Malaysia.
  5. Isa MH, Lim K, Jaafar MJ, Mohd Saiboon I
    Front Surg, 2021;8:698774.
    PMID: 34485373 DOI: 10.3389/fsurg.2021.698774
    Background: The aim of this study was to compare the effectiveness of self-instructional-video (SIV) and classroom training method (CTM) in learning Focus-Assessment with Sonography-in-Trauma (FAST) among house officers (HO). Method: A randomized controlled study involving house officers working in the university hospital in Malaysia was conducted where participants were randomized into SIV group (intervention) and CTM group (control). Each group had to undergo a 4 h hands-on training. The intervention group has undergone self-training using the video material without any facilitation while the control group received lecture and hands-on training with facilitators. Participants' performance was assessed using a validated Objective Structured Clinical Examination checklist for landmark identification and interpretation of images generated. Learning preference and confidence level were also assessed. Result: A total of 33 HO were enrolled in this study. Marks obtained in image acquisition by the intervention and control were 25.3 (SD = 5.3) and 25.6 (SD = 2.3) p > 0.05, respectively. While in image interpretation, the mean score for the intervention and control group was 10.3 (SD 1.7) and 9.8 (SD = 1.7) p > 0.05, respectively. Overall performance assessment, showed the intervention group obtained 35.6 (SD = 5.9) compared to control 35.3 (SD = 3.4), p > 0.05. Based on pre-specified determinant these scores difference falls within the 10% of non-inferiority margin. The absolute difference between both groups was 0.3 (CI = -3.75 to 3.21, p = 0.871), which proves non-inferiority but not superiority. In terms of learning preference and confidence to perform FAST, most of the participants preferred the control group approach. Conclusion: The SIV method is as effective as the CTM for learning FAST among the house officers and served as an alternative to classroom teaching. However, this technique needs improvement in promoting their confidence and preference. Perhaps incorporating a feedback session after going through the SIV would improve the confidence.
  6. Wan Rozita WM, Kaur H, Amal NM, Lim KH
    MyJurnal
    Misuse of alcohol among adolescents, particularly schoolchildren has become one of the public health concerns in Malaysia due to its serious effects and an increased risk of alcohol related injuries, especially motor vehicle injuries. This is the most common type of youthful fatal injury in Malaysia. However the availability of data on the extent of alcohol abuse particularly among school children in this country is limited. Therefore, we conducted this study with the objectives of identifying the prevalence of alcohol drinking among school children in Kuala Lumpur, factors rekited to alcohol drinking among the adolescents and to assess health status of their parents through the presence of any related alcohol diseases and the habits of alcohol drinking among their parents.
    In this baseline study a two stage stratified sampling design was used to recruit 8532 eligible students from the selected secondary schools in Kuala Lumpur. The prevalence of alcohol drinking was 9.0% (771 / 8532) . Significant factors identihed related to alcohol consumption were akoholic father (OR=1.29), akoholic mother (1 .55) ; elder siblings consume alcohol (2 .49) and the Chinese ethnic group (1 .55) . The study revealed that factors which signihcantly contributed to the habit of alcohol drinking were related to whether their parents consumed alcohol or not or either their eMer siblings were ako taking alcohol. Therefore, the, results from this study could be used as a baseline data to describe the level of alcohol consumption among adolescents particularly school children. Ehfective public health interventions that focus on the familial context of adolescents' drinking habits may be developed.
  7. Benedict F, Lim KS, Jambunathan ST, Hashim AH
    East Asian Arch Psychiatry, 2016 Sep;26(3):109-11.
    PMID: 27703099
    We present a patient with topiramate-induced psychosis who developed alternative psychosis following temporal lobectomy. The number of surgical candidates for temporal lobectomy is increasing as is the frequency of psychiatric co-morbidities. Preoperative planning should take account of these psychiatric co-morbidities. In particular, precautions should be taken when antiepileptic drug-induced psychosis occurs, as this could predict the occurrence of alternative psychosis following lobectomy.
  8. 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.
  9. Tsai JJ, Wu T, Leung H, Desudchit T, Tiamkao S, Lim KS, et al.
    Acta Neurol. Scand., 2018 Apr;137(4):378-391.
    PMID: 29214650 DOI: 10.1111/ane.12879
    Epileptic seizures are refractory to treatment in approximately one-third of patients despite the recent introduction of many newer antiepileptic drugs (AEDs). Development of novel AEDs therefore remains a high priority. Perampanel is a first-in-class non-competitive selective AMPA receptor antagonist with a unique mechanism of action. Clinical efficacy and safety of perampanel as adjunctive treatment for focal seizures with/without secondary generalization (±SG) and primary generalized tonic-clonic (PGTC) seizures have been established in five phase 3 randomized controlled trials (RCTs), and a long-term extension study, and perampanel is approved as monotherapy for focal seizures ±SG in the USA. In patients with focal seizures ±SG, add-on perampanel resulted in median percent reduction in seizure frequency 23.3%-34.5% and ≥50% responder rate 28.5%-37.6%; in PGTC seizures, these results were 76.5% and 64.2%, respectively. Efficacy among adolescents (reduction in seizure frequency 34.8%-35.6%; ≥50% responder rate 40.9%-45.0%) and elderly people (reduction in seizure frequency 12.5%-16.9%; ≥50% responder rate 22.2%-42.9%) is similar to those in adults, and results remain comparable between Asian (reduction in seizure frequency 17.3%-38.0%) and global populations. Perampanel has been extensively studied in real-world clinical practice, with similar efficacy and safety results to the RCTs (≥50% responder rate 12.8%-75.0%; adverse events of somnolence/sedation, dizziness, ataxia, and behavioral changes). Real-world observational studies suggest that perampanel tolerability can be improved by slow titration (2 mg every 2-4 weeks), and bedtime administration can mitigate somnolence and dizziness. Counseling about the potential for behavioral changes and close monitoring are recommended.
  10. Lim KY, Khoo CS, Rajah R, Tan HJ, Tajurudin FW
    Med J Malaysia, 2023 Sep;78(5):635-638.
    PMID: 37775491
    INTRODUCTION: Epilepsy is a neurological disease with high global prevalence. Almost one-third of epilepsy patients continue having seizures despite adequate treatment. Perampanel has been widely used in the Western countries as an adjunctive therapy for both generalized and focal seizures. Owing to its high cost, the use of perampanel is limited in our country.

    MATERIALS AND METHODS: We conducted a descriptive, retrospective study among epilepsy patients treated with perampanel. We aimed to assess the efficacy and safety of perampanel as an adjunctive in our hospital.

    RESULTS AND CONCLUSIONS: From our cohort of 25 patients, most of the patients were either on one or three anti-seizure medications (ASMs) prior to initiation of perampanel. Perampanel was added in 88% of them due to persistent seizures. Twenty-two (88%) patients experienced reduction in seizure frequency. 12% experienced mild side effects, which were leg cramps, hyponatremia and drowsiness. Only 1 patient stopped perampanel due to its side effects.

    CONCLUSION: Perampanel is a well-tolerated ASM that should be widely used as an adjunctive. More studies with regards to its efficacy and safety involving more centres are encouraged in Malaysia.

  11. Lim KT, Hanifah YA, Yusof M, Thong KL
    Indian J Med Microbiol, 2012 Apr-Jun;30(2):203-7.
    PMID: 22664438 DOI: 10.4103/0255-0857.96693
    The objective of this study was to determine the expression and transferability of tetracycline and erythromycin resistance among 188 MRSA strains from a Malaysian tertiary hospital. The minimum inhibitory concentrations (MICs) for oxacillin, erythromycin, tetracycline and ciprofloxacin ranged from 4 to 512 μg/ml, 0.25 to 256 μg/ml, 0.5 to 256 μg/ml and 0.5 to 512 μg/ml, respectively. Tetracycline-resistant strains showed co-resistance towards ciprofloxacin and erythromycin. There was a significant increase (P<0.05) of high-level tetracycline (≥MIC 256 μg/ml) and erythromycin (≥MIC 128 μg/ml) resistant strains in between the years 2003 and 2008. All erythromycin-resistant strains harboured ermA or ermC gene and all tetracycline-resistant strains harboured tetM or tetK gene. The blaZ was detected in all MRSA strains, whereas ermA, tetM, ermC, tetK and msrA genes were detected in 157 (84%), 92 (49%), 40 (21%), 39 (21%) and 4 (2%) MRSA strains, respectively. The blaZ, tetM, ermC and tetK genes were plasmid-encoded, with ermC gene being easily transmissible. Tn5801-like transposon was present in 78 tetM-positive strains. ermA and tetM genes were the most prevalent erythromycin and tetracycline resistance determinants, respectively, in MRSA strains. The association of resistance genes with mobile genetic elements possibly enhances the spread of resistant traits in MRSA.
  12. Lim KH, Kee CC, Sumarni MG, Lim KK, Tee EO, Christopher VM, et al.
    MyJurnal
    Adolescents who overestimate the prevalence of smoking among their peers or other teens are at higher risk to take up smoking. The purpose of this study is to elucidate the factors which are related to adolescents’ overestimation of smoking. We surveyed form four (16 years old) students in Petaling District, Selangor. A sample was selected using two-stage stratified sampling, and data were collected using standardised, self-administered questionnaires. A response rate of 80.4% (n=1045/1298) was obtained, and a total of 943 students were included in the final analysis. About 73 percent (n=688/943) of the respondents overestimated the prevalence of smoking among their peers. The odds of overestimating increased as the number of close friends who smoke increased [Two close friends, OR=3.10(1.67-5.75), three close friends OR=10.81(4.44-26.3) and four-five close friends OR= 12.91(5.31-31.43)]. Those who had an elder brother who smoked (OR=1.95 (1.18-3.24)) and females [2.08(1.37-3.33) were more likely to overestimate peer smoking prevalence. Intervention programmes to correct the misperception of peer smoking prevalence are recommended, in addition to measures to modify the other factors that are amenable to intervention, so as to reduce the risk of smoking initiation among adolescents.
  13. Teh CH, Lim KK, Chan YY, Lim KH, Azahadi O, Hamizatul Akmar AH, et al.
    Public Health, 2014 May;128(5):416-23.
    PMID: 24726414 DOI: 10.1016/j.puhe.2013.10.008
    OBJECTIVES: Despite the health-enhancing benefits of physical activity, a large segment of the Malaysian population does not engage in regular physical activity at the recommended level. This study aimed to determine physical activity patterns and the associated sociodemographic correlates of physical activity.
    STUDY DESIGN: Data on physical activity were obtained from the National Health and Morbidity Survey (NHMS) 2011, a nationally representative, population-based cross-sectional study. A two-stage stratified sampling method was used to select a representative sample of Malaysian adults aged 16 years and above.
    METHODS: A total of 19,145 adults aged 16 years and above were recruited, and face-to-face interviews were conducted using the International Physical Activity Questionnaire (IPAQ), short version. The correlates for physical activity were identified using multivariate analysis.
    RESULTS: In this study, 64.3% (95%CI: 63.1-65.5) of Malaysian adults aged 16 and above were physically active, but overall physical activity levels decreased with advancing age. Men, rural residents, 'other' ethnic groups, and married women were more likely to demonstrate higher levels of physical activity.
    CONCLUSION: Approximately 65% of Malaysian adults were physically active. However, it is recommended that health promotions for active lifestyles should be targeted to the least active segments, which constitute more than a quarter of the Malaysian population.
    KEYWORDS: Correlates; IPAQ; Malaysian adults; Physical activity; Sociodemographic
    Study name: National Health and Morbidity Survey (NHMS-2011)
  14. Cheong KC, Ghazali SM, Hock LK, Yusoff AF, Selvarajah S, Haniff J, et al.
    Obes Res Clin Pract, 2014 Mar-Apr;8(2):e154-62.
    PMID: 24743011 DOI: 10.1016/j.orcp.2013.03.004
    INTRODUCTION: Previous studies have proposed the lower waist circumference (WC) cutoffs be used for defining abdominal obesity in Asian populations.
    OBJECTIVE: To determine the optimal cut-offs of waist circumference (WC) in predicting cardiovascular (CV) risk factors in the multi-ethnic Malaysian population.
    METHODS: We analysed data from 32,703 respondents (14,980 men and 17,723 women) aged 18 years and above who participated in the Third National Health and Morbidity Survey in 2006. Gender-specific logistic regression analyses were used to examine associations between WC and three CV risk factors (diabetes mellitus, hypertension, and hypercholesterolemia). The Receiver Operating Characteristic (ROC) curves were used to determine the cut-off values of WC with optimum sensitivity and specificity for detecting these CV risk factors.
    RESULTS: The odds ratio for having diabetes mellitus, hypertension, and hypercholesterolemia, or at least one of these risks, increased significantly as the WC cut-off point increased. Optimal WC cut-off values for predicting the presence of diabetes mellitus, hypertension, hypercholesterolemia and at least one of the three CV risk factors varied from 81.4 to 85.5 cm for men and 79.8 to 80.7 cm for women.
    CONCLUSIONS: Our findings indicate that WC cut-offs of 81 cm for men and 80 cm for women are appropriate for defining abdominal obesity and for recommendation to undergo cardiovascular risk screening and weight management in the Malaysian adult population.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  15. Ali MM, Lim KS, Yang HZ, Chong WY, Lim WS, Ahmad H
    Appl Opt, 2013 Aug 1;52(22):5393-7.
    PMID: 23913056 DOI: 10.1364/AO.52.005393
    This paper proposes an approach based on an optical imaging technique for the period measurement of fiber Bragg gratings (FBG). The simple, direct technique involves a differential interface contrast (DIC) microscope and a high-resolution CCD camera. Image processing is performed on the microscope images to obtain low-noise grating profiles and then the grating periods. Adopting a large image sample size in the image processing can reduce uncertainty. During the investigation, FBGs of different grating periods are fabricated by prestraining the photosensitive fibers during the UV-writing process. A good linearity between the measured Bragg wavelengths and grating periods is observed and the measured strain-optics coefficient was found to be in agreement with reported literature.
  16. Chong WY, Lim KS, Lim WH, Harun SW, Adikan FR, Ahmad H
    Phys Rev E Stat Nonlin Soft Matter Phys, 2012 Jan;85(1 Pt 2):016314.
    PMID: 22400665
    Spreading of evaporative liquid drops in a thin porous layer has been studied. The entire spreading process can be divided into three distinct phases according to the change of the wetted porous region size. The first phase is characterized by the expansion of the wetted porous region and shrinking of the liquid drop. Contact line pinning is observed in the wetted porous region in the second phase even with the liquid drop totally absorbed into the porous layer. The third phase sees the shrinkage of the wetted porous region until it is not observable. Based on these observations, a model is devised to simulate the spreading of a liquid drop under the studied conditions. Partial differential equations are used to describe the relation between liquid drop volume and other important parameters of a fluid flow, including maximum wetted region diameter achieved, time taken to reach each spreading process phase, and evaporation rate. Calculated results are in good agreement with the experimental data.
  17. Cheong YK, Lim KS, Lim WH, Chong WY, Zakaria R, Ahmad H
    Rev Sci Instrum, 2011 Aug;82(8):086115.
    PMID: 21895293 DOI: 10.1063/1.3627374
    Tapered fibre tips fabricated using mechanical polishing method is studied. The fibre tips are formed by sequential polishing flat-ended single mode fibres with decreasing aluminium oxide polishing film grit size. Based on the proposed technique, tapered fibre tips with cone angle ranging from 30° to 130° are fabricated by controlling the polishing angle. Besides the variety of cone angle, considerable smoothness of the fibre tip surface may assist in good metal coating and hence a well-defined aperture can be obtained. In addition, this paper presents a two-step hybrid fabrication method combining the proposed polishing method with chemical etching method to increase the possible fibre tip cone angles achievable by chemical etching method.
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