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  1. Tan, B.L., Suhaniza, H.J., Lai, C. C., Norazalina, S., Roselina, K., Norhaizan, M.E.
    MyJurnal
    Temukut, or brewers’ rice, is a mixture of broken rice, rice bran, and rice germ. Extensive studies have been conducted on rice bran, which possesses various health benefits. Temukut, however has been less well studied. The present study aimed to investigate the antioxidant and growth inhibition properties of temukut extract using colon cancer (HT-29), ovary cancer (Caov-3), and liver cancer (HepG2) cell lines. The antioxidant activity was determined by the β-carotene bleaching assay, analysis of the DPPH radical scavenging capacity, and a FRAP assay. The total phenolic compounds, oryzanol, vitamin E, and phytic acid levels in temukut were also investigated. The antiproliferative activity was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. There was a significant difference in the cytotoxicity of two types of temukut extract (water and methanol) for HT-29 and Caov-3 cells (p < 0.05) but not for HepG2 cells. The HepG2 cell line is the least sensitive to temukut, (IC50 = 55.30 μg/mL), whereas the highest sensitivity was observed in Caov-3 cells (IC50 =36.67 μg/mL). No cytotoxic effect of temukut was observed on normal cells (BalBlc3T3). Although the content of the phytochemicals studied (total phenolic compounds, vitamin E, oryzanol, and phytic acid) in temukut was lower than that in rice bran, as has been previously reported, the present study demonstrated temukut’s potential to inhibit the proliferation of HT-29, Caov-3, and HepG2 cells.
  2. Leung R, Ho P, Lam CW, Lai CK
    J Allergy Clin Immunol, 1997 May;99(5):594-9.
    PMID: 9155823
    BACKGROUND: Allergen sensitization is associated with asthma and allergic disease in children, but such a relationship has not been confirmed in Chinese populations.

    OBJECTIVES: The objective of this study was to evaluate the effects of allergen sensitization and family history of atopy on asthma and allergic disease in Chinese schoolchildren from three southeast Asian populations.

    METHODS: Written questionnaires on respiratory and allergic symptoms were completed by parents of children of secondary-school age (age range 12 to 18 years) in Hong Kong (n = 1062), Kota Kinabalu in eastern Malaysia (n = 409), and San Bu in southern China (n = 737). A subsample of school-children underwent skin prick testing to common inhalant allergens (Hong Kong 471 children, Kota Kinabalu 321, San Bu 647).

    RESULTS: The prevalence of asthma and allergic disease in schoolchildren was highest in Hong Kong, intermediate in Kota Kinabalu, and lowest in San Bu. However, the overall rate of atopic sensitization was similar in the three populations (49% to 63%). House dust mite and cockroach were the two most common allergens causing sensitization and these gave rise to more than 95% of the positive skin test results in all three populations. By regression analysis, mite allergy was associated with rhinitis and asthma in all three populations, and a family history of asthma, rhinitis, or eczema was strongly associated with respective symptoms in the subjects. After adjusting for age, sex, atopic status, and family history of allergic disease, the place of residence remained a significant independent factor for asthma (odds ratio [OR] = 1.0 for Hong Kong, 0.57 for Kota Kinabalu, 0.15 for San Bu, p < 0.001), rhinitis (OR = 1.0 for Hong Kong, 0.59 for Kota Kinabalu, 0.15 for San Bu, p < 0.001), or eczema (OR = 1.0 for Hong Kong, 0.35 for Kota Kinabalu, 1.01 for San Bu, p < 0.001).

    CONCLUSION: Sensitization to indoor allergens was a significant risk factor for asthma and allergic disease, and familial clustering of disease was common in the region. However, the marked difference in disease prevalence in the three southeast Asian populations of Chinese schoolchildren cannot be explained by atopic sensitization and family history alone, and the place of residence was an independent risk factor for asthma and allergies, which suggests an important environmental role in disease pathogenesis.

  3. Lai CK, Tay KT, Abdullah R
    Med J Malaysia, 2021 03;76(2):233-235.
    PMID: 33742634
    In recognising the palliative care (PC) needs globally and in Malaysia, services were developed to serve the rural area of Kuala Lipis, Pahang. This communication describes the initial a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, stages of development towards achieving a successful implementation. PC services were led by Kuala Lipis district hospital include inpatient referrals, outpatient and community care through home visits. These services involve multi-disciplinary team inclusive of representatives from health clinics and allied health. Referrals and opioid usage have demonstrated an increasing trend since its implementation in October 2018. Implementation of rural PC services is feasible; however, long-term sustainability needs to addressed.
  4. Ong LC, Teh CS, Darshinee J, Omar A, Ang HL
    Cardiol Young, 2017 Sep;27(7):1306-1313.
    PMID: 28260550 DOI: 10.1017/S1047951117000166
    OBJECTIVES: The objectives of this study were to compare the quality-of-life scores of Malaysian children with CHD and their healthy siblings, to determine the level of agreement between proxy-reports and child self-reports, and to examine variables that have an impact on quality of life in those with CHD.

    METHODS: Parental-proxy scores of the Pediatric Quality of Life Inventory 4.0 core scales were obtained for 179 children with CHD and 172 siblings. Intra-class coefficients were derived to determine the levels of proxy-child agreement in 66 children aged 8-18 years. Multiple regression analysis was used to determine factors that impacted Pediatric Quality of Life Inventory scores.

    RESULTS: Proxy scores were lower in children with CHD than siblings for all scales except physical health. Maximum differences were noted in children aged 5-7 years, whereas there were no significant differences in the 2-4 and 13-18 years age groups. Good levels of proxy-child agreement were found in children aged 8-12 years for total, psychosocial health, social, and school functioning scales (correlation coefficients 0.7-0.8). In children aged 13-18 years, the level of agreement was poor to fair for emotional and social functioning. The need for future surgery and severity of symptoms were associated with lower scores.

    CONCLUSION: Differences in proxy perception of quality of life appear to be age related. The level of proxy-child agreement was higher compared with other reported studies, with lower levels of agreement in teenagers. Facilitating access to surgery and optimising control of symptoms may improve quality of life in this group of children.

  5. Loh LC, Lai CH, Liew OH, Siow YY
    Med J Malaysia, 2005 Dec;60(5):570-7.
    PMID: 16515107
    Chronic Obstructive Pulmonary Disease (COPD) is a growing health problem worldwide and in Malaysia. Until recently, research on COPD has been slow and difficult, partly due to the huge heterogeneity of this disease, and its variable and imprecise definitions. To perform a descriptive study on a convenient sample of local patients with COPD treated in a state hospital in Malaysia. Fifty-two patients [mean (95% CI) age: 67 (63-70) years; 86% male: 38% Malays, 36% Chinese, 25% Indians; mean (95% CI) PEFR: 45 (40-51) % predicted normal] were interviewed. Clinico-demographic data was collected using a structured questionnaire and health-related quality of life was scored using St George's Respiratory Questionnaire (SGRQ). For analysis, patients were also divided into moderate (n=17) [PEFR 50% to 80%] and severe (n=35) [PEFR < 50%] disease groups. Except for education and total family income, demographic and comorbidity variables were comparable between the two groups of COPD severity. All except 9% of patients were current or ex-smokers. Breathlessness, not chronic bronchitis (i.e. cough and sputum), was the first ranking respiratory symptom in over 70% of the patients, whether currently or at early disease manifestation. Between 5 and 15% of the patients denied any symptom of chronic bronchitis as current or early stage symptoms. Duration of symptoms prior to the diagnosis varied considerably with about 9% having symptoms for over 10 years. Over 80% of the patients smoked for over 15 years before the onset of symptoms. Quality of life in patients with COPI) was generally poor and similar between both COPD severity groups. About one fifth of the patients had exacerbations more than 12 times a year. While many features described in our local patients are well recognized in COPD, the finding that 'chronic bronchitis' is not a prominent symptom in the current or past history may have important implications in the diagnosis of at risk individuals and patients with early disease requiring attention. More research is required to confirm and to understand this.
  6. Lai CCK, Md Nor N, Kamaruddin NA, Jamil A, Safian N
    Clin Exp Dermatol, 2021 Jan;46(1):58-64.
    PMID: 32619023 DOI: 10.1111/ced.14363
    BACKGROUND: Pruritus is common in patients with diabetes mellitus (DM), and may lead to complex dermatological conditions if left untreated. Pruritus can be caused by increased transepidermal water loss (TEWL) and reduced skin hydration.

    AIMS: To compare TEWL and skin hydration in patients with DM and controls, and to investigate associations between TEWL and skin hydration with glycated haemoglobin (HbA1c), fasting blood sugar (FBS), treatment, peripheral neuropathy (PN) and age in patients with diabetes.

    METHODS: This was a prospective, case-control study carried out at a tertiary medical centre in Kuala Lumpur, Malaysia. TEWL and skin hydration measurements were taken at six different body sites in both groups.

    RESULTS: In total, 146 patients (73 cases, 73 controls) were included (24 men and 49 women in each group). No significant difference in TEWL or skin hydration was seen between patients with DM and controls, but there were significant reductions in skin hydration in patients with DM who had FBS > 7 mmol/L (P  6.5% (P  1 U/kg/day (P  45 years old, there was a significant reduction in TEWL (P = 0.04) and hydration (P  8 mmol/L and increased in patients with higher insulin requirement.

  7. Lai C, Yee SY, Ying T, Chadban S
    Transpl Int, 2021 12;34(12):2431-2441.
    PMID: 34626503 DOI: 10.1111/tri.14132
    Delayed graft function (DGF) after kidney transplantation is associated with inferior outcomes and higher healthcare costs. DGF is currently defined as the requirement for dialysis within seven days post-transplant; however, this definition is subjective and nonspecific. Novel biomarkers have potential to improve objectivity and enable earlier diagnosis of DGF. We reviewed the literature to describe the range of novel biomarkers previously studied to predict DGF. We identified marked heterogeneity and low reporting quality of published studies. Among the novel biomarkers, serum NGAL had the greatest potential as a biomarker to predict DGF, but requires further assessment and validation through larger scale studies of diagnostic test performance. Given inadequacies in the dialysis-based definition, coupled with the high incidence and impact of DGF, such studies should be pursued.
  8. Lai C, Mohammad N, Hassan TM, Abdul Hamid MF
    BMJ Case Rep, 2017 Sep 11;2017.
    PMID: 28893806 DOI: 10.1136/bcr-2017-221239
    This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions. We made the decisions for intrapleural fibrinolytic therapy using low-dose alteplase 2.5 mg each time, in view of the elderly patient as sacrosanct for risk of bleeding. Furthermore, DNase was not used, as it is not yet available in our setting. Both of our patients had good clinical and radiological outcomes, without the need for surgical interventions.
  9. Ghadiry M, Gholami M, Lai CK, Ahmad H, Chong WY
    PLoS One, 2016;11(4):e0153949.
    PMID: 27101247 DOI: 10.1371/journal.pone.0153949
    Generally, in a waveguide-based humidity sensors, increasing the relative humidity (RH) causes the cladding refractive index (RI) to increase due to cladding water absorption. However, if graphene oxide (GO) is used, a reverse phenomenon is seen due to a gap increase in graphene layers. In this paper, this interesting property is applied in order to fabricate differential humidity sensor using the difference between RI of reduced GO (rGO) and nano-anatase TiO2 in a chip. First, a new approach is proposed to prepare high quality nano-anatase TiO2 in solution form making the fabrication process simple and straightforward. Then, the resulted solutions (TiO2 and GO) are effortlessly drop casted and reduced on SU8 two channels waveguide and extensively examined against several humid conditions. Investigating the sensitivity and performance (response time) of the device, reveals a great linearity in a wide range of RH (35% to 98%) and a variation of more than 30 dB in transmitted optical power with a response time of only ~0.7 sec. The effect of coating concentration and UV treatment are studied on the performance and repeatability of the sensor and the attributed mechanisms explained. In addition, we report that using the current approach, devices with high sensitivity and very low response time of only 0.3 sec can be fabricated. Also, the proposed device was comprehensively compared with other state of the art proposed sensors in the literature and the results were promising. Since high sensitivity ~0.47dB/%RH and high dynamic performances were demonstrated, this sensor is a proper choice for biomedical applications.
  10. Lai CCK, Yaacub YJ, Siow YC, Baharum N
    Med J Malaysia, 2023 Nov;78(6):780-786.
    PMID: 38031221
    INTRODUCTION: Prolonged grief disorder (PGD) is a diagnosis characterised by severe, persistent and disabling grief beyond 6 months post-death of a loved one. The new text revision of DSM-5 (DSM-5-TR) approved a new diagnosis PGD on March 2022. In Malaysia, PGD is not routinely screened in healthcare settings and hence goes untreated. The aim of this study is to identify prevalence and factors related to PGD among bereaved relatives whose loved ones had access to PCU services.

    MATERIALS AND METHODS: A cross-sectional study involving bereaved individuals in Palliative Care Unit Hospital Selayang. Participants (n=175) were recruited through telephone, and a validated tool Prolonged Grief Disorder Scale (PG-13) was asked to identify PGD. Further data collected were concomitant stressors in life and support system in the bereaved individual.

    RESULTS: Prevalence of PGD was 2.9% (n=5), and subthreshold PGD was 4% (n=7). A model of multiple logistic regression calculated most of the traditional risk factors were not significant except having an increased responsibility as a single parent after passing of a spouse or loved one, had 10 times increased odds of PGD (Odds Ratios: 10.93; 95% Confidence Interval: 2.937, 40.661). Otherwise, immediate family support (80%), religion (60%) and community (40%) support were the top three coping mechanisms of our PGD cohort, although they were not significant in a multiple logistic regression model.

    CONCLUSION: Our PGD percentage may not be as high as those of other countries, but nonetheless they exist and their needs are just as important. The authors hope that this paper may create an awareness among the healthcare clinicians about PGD in our society, for a greater access of service to understand them and better public awareness.

  11. Kanaheswari Y, Lai C, Raja Lope RJ, Azizi AB, Zulfiqar MA
    J Paediatr Child Health, 2015 Feb;51(2):223-5.
    PMID: 25099316 DOI: 10.1111/jpc.12707
    Congenital dermal sinus (CDS) and occult spinal dysraphism are suspected when a cutaneous marker overlies the spine of a newborn. CDS can have the appearance of a simple dimple and occur within the gluteal cleft without any skin markers. CDS are the commonest cause of intramedullary spinal cord abscess.
  12. Raymundo N, Yu-cheng B, Zi-yan H, Lai CH, Leung K, Subramaniam R, et al.
    Climacteric, 2004 Sep;7(3):312-8.
    PMID: 15669556
    We investigated the effects of 2 months of treatment with topical estrogens on atrophic vaginitis and gynecological health in Asian women.
  13. Lai CM, Mak KK, Watanabe H, Jeong J, Kim D, Bahar N, et al.
    Public Health, 2015 Sep;129(9):1224-36.
    PMID: 26343546 DOI: 10.1016/j.puhe.2015.07.031
    OBJECTIVES: This study examines the associations of Internet addiction with social anxiety, depression, and psychosocial well-being among Asian adolescents. A self-medication model conceptualizing Internet addiction as a mediating role in relating depression and social anxiety to negative psychosocial well-being was tested.
    STUDY DESIGN: A cross-sectional survey.
    METHODS: In the Asian Adolescent Risk Behavior Survey (AARBS), 5366 adolescents aged 12-18 years from six Asian countries (China, Hong Kong, Japan, South Korea, Malaysia, and Philippines) completed a questionnaire with items of the Internet Addiction Test (IAT), Social Anxiety Scale for Adolescents (SAS-A), Center for Epidemiological Studies Depression Scale (CESD), Self-Rated Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA-SR) in the 2012-2013 school year. Structural equation modelling was used to examine the mediating role of Internet addiction in depression, social anxiety, and subjective psychosocial well-being.
    RESULTS: Significant differences on the scores of IAT, SAS-A, CESD, and HoNOSCA-SR across the six countries were found. The proposed self-medication model of Internet addiction received satisfactory goodness-of-fit with data of all countries. After the path from social anxiety to Internet addiction had been discarded in the revised model, there was a significant improvement of the goodness-of-fit in the models for Japan, South Korea, and the Philippines.
    CONCLUSIONS: Depression and social anxiety reciprocally influenced, whereas depression associated with poorer psychosocial well-being directly and indirectly through Internet addiction in all six countries. Internet addiction mediated the association between social anxiety and poor psychosocial well-being in China, Hong Kong, and Malaysia.
    KEYWORDS: Adolescents; Asian; Depression; Internet addiction; Social anxiety; Structural equation modelling
  14. Chong WY, Lim WH, Yap YK, Lai CK, De La Rue RM, Ahmad H
    Sci Rep, 2016 Apr 01;6:23813.
    PMID: 27034015 DOI: 10.1038/srep23813
    Increased absorption of transverse-magnetic (TM)-polarised light by a graphene-oxide (GO) coated polymer waveguide has been observed in the presence of transverse-electric (TE)-polarised light. The GO-coated waveguide exhibits very strong photo-absorption of TE-polarised light--and acts as a TM-pass waveguide polariser. The absorbed TE-polarised light causes a significant temperature increase in the GO film and induces thermal reduction of the GO, resulting in an increase in optical-frequency conductivity and consequently increased optical propagation loss. This behaviour in a GO-coated waveguide gives the action of an inverted optical switch/modulator. By varying the incident TE-polarised light power, a maximum modulation efficiency of 72% was measured, with application of an incident optical power level of 57 mW. The GO-coated waveguide was able to respond clearly to modulated TE-polarised light with a pulse duration of as little as 100 μs. In addition, no wavelength dependence was observed in the response of either the modulation (TE-polarised light) or the signal (TM-polarised light).
  15. Babji AS, Aidilla M, Gugapreya C, Lai CJ, Nur Bazlina B, Cahyana C, et al.
    Malays J Nutr, 2007 Sep;13(2):171-7.
    PMID: 22691755 MyJurnal
    The protein nutritive value of anchovy, mackerel and canned sardine samples together with casein as a reference formulation were evaluated. Proximate composition, protein quality and protein digestibility were determined. Procedures for evaluation included Protein Efficiency Ratio (PER) using the rat bioassay and in vivo Apparent Digestibility (AD). Rats fed with canned sardine diet had the highest mean body weight (154.8±12.28g) while rats fed with anchovy diet had the lowest mean body weight (145.27±15.89g) with significant differences between all the groups. Mean body weight of rats fed with selected fish diet was higher compared to rats fed with casein diet. For PER value, canned sardine has the highest value (2.48), followed by anchovy (2.46) and mackerel (2.34). PER value for all selected fish is lower than that for casein (3.14). Mackerel had the highest value of in vivo AD (96.99%), followed by casein (96.96%), canned sardine (96.88%) and anchovy (91.29%). In conclusion, among the types of fish compared, sardine had the highest protein quality while mackerel showed the highest digestibility.
  16. Hamsah E, Robinson F, Hayati F, Arsat N, Kaur N, Sriram RK, et al.
    Med J Malaysia, 2023 Dec;78(7):876-882.
    PMID: 38159921
    INTRODUCTION: The fourth leading cause of cancer-related mortality and morbidity worldwide is colorectal cancer (CRC). Numerous reasons have contributed to the massive rise in CRC cases, for which Asian nations differ significantly in terms of risk incidence rates. The objectives of this study were to, first, identify the socio-demographic characteristics of those of North Borneo ethnicity and body mass index (BMI) and, second, determine the association of these factors with CRC. This research will contribute to preventing this form of cancer.

    MATERIALS AND METHODS: This study is an analysis of a matched case-control study with a ratio of 1:2. The case group contained 206 respondents, and the control group contained 412. All CRC cases were confirmed with the histological results. The control group was matched for links between age, sex and ethnicity with CRC. The Statistical Package for Social Sciences Statistics (SPSS) IBM version 28.0 was used to conduct descriptive analysis using chi-squared testing and simple logistic regression. The statistical significance was P < 0.05.

    RESULT: Overall, 618 respondents took part in this survey, of which 256 (41.4%) were female and 362 (58.6%) were male. The maximum age was 76, with a mean age ± SD of 53.17 ± 11.4. Those of Bajau ethnicity comprised 24.6% (152) of the population, followed by Dusun with 22.8% (141), Kadazan with 17.6% (109%), other North Borneo ethnic groups with 15.5% (96), Bugis with 9.7% (60), Brunei with 4.4% (27) and other predominant races with 5.3% (33). Regression analyses revealed that the incidence of CRC in North Borneo, Malaysia, was substantially correlated with income, occupation, other linked diseases and BMI.

    CONCLUSION: Various risk factors are linked to CRC, based on the findings related to socio-demographic characteristics and BMI. Therefore, to lower the nationwide prevalence of CRC, national public health campaigns should include collaboration with the regional authorities to highlight the incidence and risk factors of CRC based on ethnicity.

  17. Koppikar S, Oaknin A, Babu KG, Lorusso D, Gupta S, Wu LY, et al.
    ESMO Open, 2023 Feb;8(1):100774.
    PMID: 36696825 DOI: 10.1016/j.esmoop.2022.100774
    The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with endometrial cancer was published in 2022. It was therefore decided, by both the ESMO and the Indian Society of Medical and Paediatric Oncology (ISMPO), to convene a virtual meeting in July 2022 to adapt the ESMO 2022 guidelines to take into account the variations in the management of endometrial cancer in Asia. These guidelines represent the consensus opinion of a panel of Asian experts representing the oncological societies of China (CSCO), India (ISMPO), Indonesia (ISHMO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO). Voting was based on scientific evidence and was conducted independently of the current treatment practices and treatment access constraints in the different Asian countries, which were discussed when appropriate. The aim of this guideline manuscript is to provide guidance for the optimisation and harmonisation of the management of patients with endometrial cancer across the different regions of Asia, drawing on the evidence provided by Western and Asian trials whilst respecting the variations in clinical presentation, diagnostic practices including molecular profiling and disparities in access to therapeutic options, including drug approvals and reimbursement strategies.
  18. Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HL, Chen CJ, et al.
    Hepatol Int, 2016 Jan;10(1):1-98.
    PMID: 26563120 DOI: 10.1007/s12072-015-9675-4
    Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.
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