MyMedR

Fulltext Differences in patient profiles of abdominal and pulmonary tuberculosis: a comparative study

Chong VH

Med J Malaysia, 2011 Oct;66(4):318-21.

Objectives: Tuberculosis remains a common infection and is often associated with non-specific constitutional symptoms or laboratory investigations regardless of site of manifestations. This study compares the profiles of abdominal tuberculosis (ATB) and pulmonary tuberculosis (PTB).
Methods: Patients with ATB (n=34, male-21, mean age 43.3 ± 16.0 years) diagnosed over a nine year period were identified from the National Tuberculosis registry and retrospectively reviewed. Comparisons were made with patients treated for PTB (n=163).
Results: The most commonly affected sites were the ileocecal regions, peritoneum and hepatobiliary system. Common clinical presentations were abdominal pain (61.8%), anorexia (44.1%), weight loss (55.9%), fever (41.1%) and abdominal distension (29.4%). Four patients had concomitant active PTB. Compared to PTB, patients with ATB had significantly lower serum haemoglobin (11.6 ± 2.4 vs. 12.6 ± 2.0 gm/dL, p=0.036) and higher rate of adverse events of antituberculous treatment (50% vs. 15.4%, p<0.001). There were no difference in prevalence of constitutional symptoms (fever, weight loss and anorexia), platelet level, albumin, total protein and erythrocyte sedimentation rate. Importantly, there was no difference in the treatment
response. More patients with ATB and concomitant active PTB had reported weight loss (100% vs. 36.7%, p=0.017).
Conclusion: There are differences in the profiles of ATB and PTB. Awareness of such differences can help to improve the understanding and management of this infection.

Multispecies impingement in a tropical power plant, Straits of Malacca

Azila A, Chong VC

Mar Environ Res, 2010 Jul;70(1):13-25.

PMID: 20338631 DOI: 10.1016/j.marenvres.2010.02.004

Marine organisms comprised about 70% of the total impinged materials by weight at water intake screens in the Kapar Power Station (KPS), Malaysia. The general groupings of 'fish', 'shrimp', 'crab', 'cephalopod' and 'others' contributed 26% (87 species), 65% (29), 2% (17), 2% (3) and 5% (42) of the total number of impinged organisms, respectively. In general, higher impingement occurred during spring tide, at nighttime and in shallow water. The glass perchlet, anchovies, ponyfishes, mojarra, catfishes, hairtail, scat and young croakers were the most vulnerable fishes. Vulnerable invertebrates included cephalopods, sea urchin, rockshells and jellyfishes, but penaeid shrimps were the most susceptible in terms of both mortality and body injury. Annually, KPS is estimated to kill 8.5 x 10(6) marine organisms (42 tons) by impingement. This amount, however, is minimal compared to commercial fishery harvests. Multispecies impingement at Malaysian power plants poses the problem of finding the best mitigation options for tropical situations.

Familial Behçet's syndrome with intestinal involvement--case reports and a review of the literature

Chong VF, Pathmanathan R

Ann Acad Med Singap, 1993 Sep;22(5):807-10.

PMID: 8267366

Behçet's syndrome is a rare multisystem disorder. The occurrence in families although well recognised is uncommon. The mode of inheritance, however, has not been elucidated. Sixty-one cases of familial disease have been documented to date. There was only one previous report on familial Behçet's syndrome with gastrointestinal involvement. This paper reports two cases of Behçet's syndrome with gastrointestinal involvement in a Malaysian woman of Chinese ethnic origin and her child. The mother satisfied three major criteria (oral ulcers, genital ulcers and erythema nodosum) and one minor criterion (gastrointestinal involvement). Her son satisfied two major criteria (oral and genital ulcers) and three minor criteria (intestinal involvement, central nervous manifestation and a positive family history). The radiological and pathological features of the gastrointestinal lesions in both patients resembled those of Crohn's disease. The literature on Behçet's syndrome is reviewed.

Fulltext Massive lower gastrointestinal bleeding secondary to colonic mucormycosis

Anand J, Ghazala K, Chong VH

Med J Malaysia, 2011 Aug;66(3):266-7.

PMID: 22111457

Lower gastrointestinal bleeding is usually due to haemorrhoids, diverticular disease, or colorectal cancer. Infective causes of gastrointestinal bleeding are rare. A 70-year-old lady was admitted with septic shock secondary to community acquired pneumonia. She later developed massive lower gastrointestinal bleeding secondary to colonic mucormycosis. Her condition deteriorated rapidly and she died of septicemia. Mucormycosis of the colon is extremely rare and is still associated with a high mortality.

Fulltext MRI findings in failed back surgery syndrome

Fan YF, Chong VF

Med J Malaysia, 1995 Mar;50(1):76-81.

PMID: 7752981

The failed back surgery syndrome (FBSS) is a difficult diagnostic problem both clinically and radiologically. Forty-three patients were evaluated prospectively with magnetic resonance imaging (MRI) and forty-five scans were obtained. Fifteen patients (33%) showed recurrent disc prolapse; 15 (33%) patients postoperative epidural fibrosis; 8 (18%) both recurrent disc prolapse and epidural scarring; 4 (9%) patients spinal stenosis, 2 whom also had both epidural fibrosis and recurrent disc prolapse; 2 (4%) normal scans; 2 (4%) patients arachnoiditis and 1 (2%) patient postoperative pseudomeningocoele formation. Gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA)-enhanced MRI was particularly helpful in differentiating recurrent disc prolapse and epidural fibrosis. Surgical findings in 11 patients were available. MRI correctly predicted recurrent disc prolapse in 6 patients, epidural fibrosis in 4 patients and spinal stenosis in 1 patient illustrating the value of this modality in the evaluation of FBSS.

Fulltext Hazards of complementary and alternative medicine

Chong VH, Yaakub AB

Singapore Med J, 2007 Jun;48(6):592; author reply 593.

PMID: 17538765

Fulltext Ectopic inferior vena cava thrombus secondary to a tubo-ovarian abscess

Koh KS, Abdullah NA, Chong VH

Med J Malaysia, 2014 Dec;69(6):293-5.

PMID: 25934966

Inferior vena cava (IVC) thrombosis typically arises distally from a thrombophlebitic extension in the pelvis or the lower extremities. It may also occur from propagation of an ovarian vein thrombosis as a result of gynaecological disorders such as pelvic inflammatory disease, endometritis or from pelvic surgeries. In this report, we present an interesting case of a tubo-ovarian abscess with an ectopic IVC thrombus. The approach to management in such cases is also highlighted.

Fulltext Transarticular spread of the sacroiliac joint in a chondrosarcoma

Chong VFH, Pathmanathan R, Sambandan SS

Med J Malaysia, 1994 Sep;49(3):282-4.

PMID: 7845280

Primary bone tumours, even in very advanced stages, rarely exhibit transarticular spread. We present a case of chondrosarcoma of the ilium with destruction of the sacroiliac joint, the ipsilateral sacral ala and with sacral nerve involvement.

Fulltext Cytomegalovirus colitis in immunocompetent patients

Momin N, Telisinghe PU, Chong VH

Singapore Med J, 2011 Sep;52(9):e170-2.

PMID: 21947157

Cytomegalovirus (CMV) infection can present with severe manifestations that are associated with significant morbidity and mortality, especially in immunocompromised patients. CMV infections in immunocompetent patients are usually transient and do not exhibit many symptoms. However, in some patients, the manifestations can be severe. We report CMV colitis in two immunocompetent patients; one in a young man who was critically ill with septicaemia and significant non-bloody diarrhoea that responded to specific CMV treatment, and another in an elderly woman who presented with nonspecific abdominal pain and fever that resolved without specific CMV treatment.

Fulltext A rare case of Dysphagia secondary to a large oesophageal lipoma

Koh KS, Chong VH, Yapp SK, Chong CF

Med J Malaysia, 2012 Oct;67(5):522-3.

PMID: 23770871

Dysphagia is considered a warning symptom that requires exclusion of significant pathology such as oesophageal cancer, especially in elderly patients. Benign neoplasms of the oesophagus are rare. We report the case of a 69-year-old lady who presented with a five years history of infrequent intermittent dysphagia that had rapidly progressed over one month. This was associated with globus sensation, weight loss, intermittent episodes of stridor and aspiration pneumonia. Investigations revealed a large oesophageal lipoma in the proximal oesophagus extending down to the lower oesophagus. This was successfully resected via a left cervical approach. She remained well two years after the surgery.

Diversity, extinction risk and conservation of Malaysian fishes

Chong VC, Lee PK, Lau CM

J Fish Biol, 2010 Jun;76(9):2009-66.

PMID: 20557654 DOI: 10.1111/j.1095-8649.2010.02685.x

A total of 1951 species of freshwater and marine fishes belonging to 704 genera and 186 families are recorded in Malaysia. Almost half (48%) are currently threatened to some degree, while nearly one third (27%) mostly from the marine and coral habitats require urgent scientific studies to evaluate their status. Freshwater habitats encompass the highest percentage of threatened fish species (87%) followed by estuarine habitats (66%). Of the 32 species of highly threatened (HT) species, 16 are freshwater and 16 are largely marine-euryhaline species. Fish extinctions in Malaysia are confined to two freshwater species, but both freshwater and marine species are being increasingly threatened by largely habitat loss or modification (76%), overfishing (27%) and by-catch (23%). The most important threat to freshwater fishes is habitat modification and overfishing, while 35 species are threatened due to their endemism. Brackish-water, euryhaline and marine fishes are threatened mainly by overfishing, by-catch and habitat modification. Sedimentation (pollution) additionally threatens coral-reef fishes. The study provides recommendations to governments, fish managers, scientists and stakeholders to address the increasing and unabated extinction risks faced by the Malaysian fish fauna.

The influence of fish cage aquaculture on pelagic carbon flow and water chemistry in tidally dominated mangrove estuaries of peninsular Malaysia

Alongi DM, Chong VC, Dixon P, Sasekumar A, Tirendi F

Mar Environ Res, 2003 May;55(4):313-33.

PMID: 12517423

The impact of floating net cages culturing the seabass, Lates calcarifer, on planktonic processes and water chemistry in two heavily used mangrove estuaries in Malaysia was examined. Concentrations of dissolved inorganic and particulate nutrients were usually greater in cage vs. adjacent (approximately 100 m) non-cage waters, although most variability in water-column chemistry related to water depth and tides. There were few consistent differences in plankton abundance, production or respiration between cage and non-cage sites. Rates of primary production were low compared with rates of pelagic mineralization reflecting high suspended loads coupled with large inputs of organic matter from mangrove forests, fishing villages, fish cages, pig farms and other industries within the catchment. Our preliminary sampling did not reveal any large-scale eutrophication due to the cages. A crude estimate of the contribution of fish cage inputs to the estuaries shows that fish cages contribute only approximately 2% of C but greater percentages of N (32-36%) and P (83-99%) to these waters relative to phytoplankton and mangrove inputs. Isolating and detecting impacts of cage culture in such heavily used waterways--a situation typical of most mangrove estuaries in Southeast Asia--are constrained by a background of large, highly variable fluxes of organic material derived from extensive mangrove forests and other human activities.

Rhodovulum sulfidophilum in the treatment and utilization of sardine processing wastewater

Azad SA, Vikineswary S, Chong VC, Ramachandran KB

Lett Appl Microbiol, 2004;38(1):13-8.

PMID: 14687209

Rhodovulum sulfidophilum was grown in settled undiluted and nonsterilized sardine processing wastewater (SPW). The aims were to evaluate the effects of inoculum size and media on the biomass production with simultaneous reduction of chemical oxygen demand (COD).

Growth and production of biomass of Rhodovulum sulfidophilum in sardine processing wastewater

Azad SA, Vikineswary S, Ramachandran KB, Chong VC

Lett Appl Microbiol, 2001 Oct;33(4):264-8.

PMID: 11559398

AIMS: Rhodovulum sulfidophilum was grown in sardine processing wastewater to assess growth characteristics for the production of bacterial biomass with simultaneous reduction of chemical oxygen demand.

METHODS AND RESULTS: Growth characteristics were compared in diluted and undiluted, settled and non-settled wastewater growing in anaerobic light and aerobic dark conditions; and also at different agitation speeds. The highest biomass (8.75 g l(-1)) and a reduction in chemical oxygen demand of 71% were obtained in unsettled, undiluted wastewater after 120 h culture with 15% inoculum. In settled wastewater, highest biomass (7.64 g l(-1)) and a COD reduction of 77% was also obtained after 120 h. Total biomass was higher (4.34 g l(-1)) after 120 h culture in anaerobic light compared to (3.23 g l(-1)) in aerobic dark growth.

CONCLUSIONS, SIGNIFICANCE AND IMPACT OF THE STUDY: Better performance, mean of total biomass (6.97 g l(-1) after 96 h), total carotenoids (4.24 mg g(-1) dry cell from 24 h) and soluble protein (431 microg ml(-1) after 96 h) were obtained from aerobic dark culture at 300 rev min(-1). The COD reduction, however, was lower (69%) after 96 h culture. Thus, the benefits in the production of bacterial biomass in non-sterilized sardine processing wastewater with the reduction of chemical oxygen demand could be achieved.

Automated otolith image classification with multiple views: an evaluation on Sciaenidae

Wong JY, Chu C, Chong VC, Dhillon SK, Loh KH

J Fish Biol, 2016 Aug;89(2):1324-44.

PMID: 27364089 DOI: 10.1111/jfb.13039

Combined multiple 2D views (proximal, anterior and ventral aspects) of the sagittal otolith are proposed here as a method to capture shape information for fish classification. Classification performance of single view compared with combined 2D views show improved classification accuracy of the latter, for nine species of Sciaenidae. The effects of shape description methods (shape indices, Procrustes analysis and elliptical Fourier analysis) on classification performance were evaluated. Procrustes analysis and elliptical Fourier analysis perform better than shape indices when single view is considered, but all perform equally well with combined views. A generic content-based image retrieval (CBIR) system that ranks dissimilarity (Procrustes distance) of otolith images was built to search query images without the need for detailed information of side (left or right), aspect (proximal or distal) and direction (positive or negative) of the otolith. Methods for the development of this automated classification system are discussed.

Fulltext Choledochal cyst in pregnancy

Koh KS, Bickle I, Mathew VV, Chong VH

Malays Fam Physician, 2016;11(2-3):27-29.

PMID: 28491243

INTRODUCTION: Biliary diseases during pregnancy are not uncommon and are frequently due to cholelithiasis. Choledochal cyst during pregnancy is rare. The management of biliary pathologies during pregnancy poses a challenge as the window of opportunity to carry out any interventions with minimal risk is small.

CASE REPORT: We report the case of a lady who was diagnosed with a large type I choledochal cyst during the second trimester of pregnancy. Due to increasing symptoms and recurrent cholangitis, she was managed with antibiotics and surgical resection. She remained well and delivered a healthy baby boy.

CONCLUSION: Clinicians need to consider choledochal cyst as a differential in pregnant patients presenting with upper abdominal fullness.

Fulltext Comment on "Hyperplasia of the retinal pigment epithelium secondary to subthreshold laser treatment in chronic central serous chorioretinopathy."

Chhablani J, Filloy A, Chong V, Wu L, Fong K

Photodiagnosis Photodyn Ther, 2024 Aug;48:104217.

PMID: 38759862 DOI: 10.1016/j.pdpdt.2024.104217

Novel life-history data for threatened seahorses provide insight into fishery effects

Lawson JM, Foster SJ, Lim AC, Chong VC, Vincent AC

J Fish Biol, 2015 Jan;86(1):1-15.

PMID: 25307290 DOI: 10.1111/jfb.12527

Life-history variables for three incidentally captured species of seahorse (Kellogg's seahorse Hippocampus kelloggi, the hedgehog seahorse Hippocampus spinosissimus and the three-spot seahorse Hippocampus trimaculatus) were established using specimens obtained from 33 fisheries landing sites in Peninsular Malaysia. When samples were pooled by species across the peninsula, sex ratios were not significantly different from unity, and height and mass relationships were significant for all species. For two of these species, height at physical maturity (HM ) was smaller than the height at which reproductive activity (HR ) commenced: H. spinosissimus (HM = 99·6 mm, HR = 123·2 mm) and H. trimaculatus (HM = 90·5 mm, HR = 121·8 mm). For H. kelloggi, HM could not be estimated as all individuals were physically mature, while HR = 167·4 mm. It appears that all three Hippocampus spp. were, on average, caught before reproducing; height at 50% capture (HC ) was ≥HM but ≤HR . The results from this study probe the effectiveness of assessment techniques for data-poor fisheries that rely heavily on estimates of length at maturity, especially if maturity is poorly defined. Findings also question the sustainability of H. trimaculatus catches in the south-west region of Peninsular Malaysia, where landed specimens had a notably smaller mean height (86·2 mm) and markedly skewed sex ratio (6% males) compared with samples from the south-east and north-west of the peninsula.

Three decades of sea water abstraction by Kapar power plant (Malaysia): What impacts on tropical zooplankton community?

Chew LL, Chong VC, Wong RCS, Lehette P, Ng CC, Loh KH

Mar Pollut Bull, 2015 Dec 15;101(1):69-84.

PMID: 26581817 DOI: 10.1016/j.marpolbul.2015.11.022

Zooplankton samples collected before (1985-86) and after (2013-14) the establishment of Kapar power station (KPS) were examined to test the hypothesis that increased sea surface temperature (SST) and other water quality changes have altered the zooplankton community structure. Elevated SST and reduced pH were detected between before and after impact pairs, with the greatest impact at the station closest to KPS. Present PAHs and heavy metal concentrations are unlikely causal factors. Water parameter changes did not affect diversity but community structure of the zooplankton. Tolerant small crustaceans, salps and larvaceans likely benefited from elevated temperature, reduced pH and shift to a more significant microbial loop exacerbated by eutrophication, while large crustaceans were more vulnerable to such changes. It is predicted that any further rise in SST will remove more large-bodied crustacean zooplankton, the preferred food for fish larvae and other meroplankton, with grave consequences to fishery production.

An unusual cause of acute abdomen and acute renal failure: Djenkolism

Sumitro K, Yong CS, Tan LT, Choo S, Lim CY, Shariman H, et al.

Malays Fam Physician, 2020;15(2):50-52.

PMID: 32843946

The djenkol bean (Archidendron pauciflorum) is a native delicacy in Southeast Asia, though consumption can sometimes lead to djenkolism. Clinical features of djenkolism include acute abdominal pain, hematuria, urinary retention, and acute kidney injury (AKI). The pain can be severe, which often leads to a misdiagnosis of acute abdomen. In this paper, we report the case of an Indonesian migrant with djenkolism. Due to the short history and severity of the abdominal pain, medical professionals suspected acute abdomen and proceeded with a negative exploratory laparotomy. However, djenkolism was suspected once relatives informed the professionals that the patient had consumed djenkol beans hours earlier. The patient recovered through aggressive hydration and urine alkalinization with bicarbonate infusion. We highlight the importance of being aware of this rare cause of AKI, especially in Southeast Asia, in order to provide early diagnoses and prompt treatments.

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