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Fulltext Priority in special care nurseries in Malaysia

Lam KL

Med J Malaysia, 1983 Mar;38(1):1-3.
PMID: 6633326
Preliminary investigations of the bonding strength between irreversible alginate impression material & brass surfaces

Lam KS

Dent J Malaysia Singapore, 1968 Feb;8(1):19-23.
PMID: 4882516
Prevention of hospital infection

Lam KL

Med J Malaysia, 1978 Dec;33(2):133-6.
PMID: 755163
Fulltext Molecular docking analysis of Carica papaya Linn constituents as antiviral agent

Radhakrishnan, N., Lam, K. W., Norhaizan, M. E.

International Food Research Journal, 2017;24(4):1819-1825.
MyJurnal

Carica papaya (papaya) fruits are available throughout the world and it is well accepted as food or as a quasi-drug. Aqueous papaya leaves extract have been used as treatment for dengue fever. This prompted us to carry out the docking study on these nine selected ligands (phyto-constituents of papaya) which are carpaine, dehydrocarpaine I and II, cardenolide, p-coumaric acid, chlorogenic acid, caricaxanthin, violaxanthin and zeaxanthin. These phytoconstituents were evaluated on the docking behaviour of dengue serotype 3 RNA-dependent RNA polymerase (RdRp); influenza A (H1N9) virus neuraminidase (NA); chikungunya virus glycoprotein (E3-E2-E1) and chikungunya virus non-structural protein2 (nsP2) protease using Discovery Studio Version 3.1. In addition, molecular physicochemical, drug-likeness, ADMET (Absorption, Distribution, Metabolism, Excretion and Toxicity) and TOPKAT (Toxicity Prediction by Komputer Assisted Technology) analyses were done. The molecular physicochemical analysis revealed that cardenolide and p-coumaric acid (2 ligands) complied with Lipinski’s rule of five. Dehydrocarpaine II, cardenolide, caricaxanthin, violaxanthin and zeaxanthin all the five ligands were predicted to have plasma protein binding (PPB) effect. Docking studies and binding free energy calculations revealed that p-coumaric acid exhibited very least binding energy irrespective of its target protein. Hence, the results of this present study exhibited the potential of these nine ligands as antiviral agent.
The immunopathogenesis of dengue haemorrhagic fever

Pang T, Lam KS

Immunol. Today, 1983 Feb;4(2):46-9.
PMID: 25291069 DOI: 10.1016/0167-5699(83)90110-X

Over the past 20 years, dengue haemorrhagic fever (DHF) has been the subject of intensive epidemiological, clinical, virological and immunological investigations. Considerable debate and controversy have surrounded its causation and the probable role of immunological mechanisms in its pathogenesis. The exact cause of DHF is still uncertain and this article reviews current thinking about the problem.
Fulltext Transradial coronary angioplasty and stenting--immediate results and 3-month clinical follow-up in the first 50 patients performed at the National Heart Institute

Pillay D, Lam KH, Muda MN, Hamid Z

Med J Malaysia, 2000 Dec;55(4):467-72.
PMID: 11221159

Aim: To explore the safety and feasibility of coronary angioplasty and stenting via the radial artery in a heterogenous group of patients and to report the immediate and 3-month clinical follow-up.
Background: The use of the transradial approach for coronary angiography was first described by Lucien Campeau in 1989. Based on the favorable initial results, this technique has gained widespread acceptance worldwide. Ferdinand Kiemeneij’s work in transradial angioplasty and stenting has taken invasive cardiology into the exciting new era of “minimally invasive coronary intervention”.
Methods and results: Fifty consecutive patients underwent Transradial Percutaneous Transluminal Coronary Angioplasty (PTCA) with or without stenting from mid March 98 – December 98. The right radial approach was utilized in 41 patients (80%) while the left in 9 patients. Ninety percent of the procedures was done on an adhoc basis. Diabetes mellitus was present in 38% of patients. Eighty percent of the patients had unstable angina pectoris and 60% had a prior history of acute myocardial infarction. The commonest vessel involved was the LAD (41%) and type B lesions predominated (54%). PTCA was successful in 96%. One patient had a total LAD occlusion, which could not be wired, and another developed severe spasm during catheter manipulation. The latter ad successful PTCA via the right femoral route Stents were utilized in 57% of patients. The commonest indication for stenting was suboptimal PTCA results (89%) and dissection (14%). There was no stent embolization and all stents were successfully deployed (100%). One patient developed acute stent thrombosis necessitating repeat PTCA and another patient sustained an acute anteroseptal myocardial infarction 5 days post procedure as a result of subacute stent thrombosis and died. Two patients had successful primary PTCA. There was no bleeding or vascular complications. 60% of patients were treated on an outpatient basis. At 3-months follow up 1 patient required CABG’s for disease progression. Three patients had absent radial pulses without adverse consequence. No patient required repeat PTCA at follow up.
Conclusion: In summary, adhoc PTCA and stenting is safe and feasible in our patient population. A study on the cost effectiveness of the procedure compared to conventional femoral PTCA is warranted.
Effect of continued feeding of cows' milk on asymptomatic infants with milk protein sensitive enteropathy

Iyngkaran N, Yadav M, Boey CG, Lam KL

Arch Dis Child, 1988 Aug;63(8):911-5.
PMID: 3415326

The clinical response and the histological changes in the mucosa of the small bowel in response to continued feeding with cows' milk protein were assessed over a period of 2-6 weeks in 24 infants who had shown histological changes without immediate clinical symptoms after challenge with a diet containing cows' milk protein. Twenty of the 24 infants (83%) thrived well on cows' milk protein. Jejunal biopsy specimens taken six to eight weeks after the initial biopsy showed histological improvement in all 20 infants compared with biopsy specimens taken soon after the challenge, which had shown mucosal damage. The mucosa had returned to normal in 12, was mildly abnormal in seven, and moderately abnormal in one. Corresponding improvements in the activities of mucosal enzymes were seen. In four of the 24 infants (17%) symptoms developed between three and six weeks. Histological examination of the jejunal biopsy specimens showed that mucosal damage had progressed in two, and remained the same in two; moreover, the disaccharidase activities remained depressed. The present study shows that most infants with enteropathy caused by sensitivity to cows' milk protein but without clinical symptoms develop tolerance to the protein and the mucosa returns to normal despite continued feeding with cows' milk protein.
The management of neonatal tetanus

Lee EL, Khoo BH, Lam KL

Med J Malaysia, 1978 Mar;32(3):220-4.
PMID: 683047
Accidental vaccinia infection - a case report

Lam KL, How VJ, Lam SK

Med J Malaysia, 1975 Mar;30(3):227-30.
PMID: 1160684
Fulltext Latex C-serum from Hevea brasiliensis induces non-apoptotic cell death in hepatocellular carcinoma cell line (HepG2)

Lam KL, Yang KL, Sunderasan E, Ong MT

Cell Prolif, 2012 Dec;45(6):577-85.
PMID: 23046445 DOI: 10.1111/j.1365-2184.2012.00841.x

OBJECTIVES: Latex from Hevea brasiliensis (natural rubber tree primarily cultivated for its rubber particles) has no known primary metabolic function, although its biological role is as a plant defence system. The present study has evaluated specific anti-proliferative effects of latex whole C-serum and its subfractions, on human cancer cell lines.
MATERIALS AND METHODS: Cell viability assay using MTT, DNA fragmentation assay and real-time PCR were used to evaluate the cytotoxic effects of latex whole C-serum and its subfractions on the cell lines.
RESULTS: MTT assay revealed very low LC(50) values, 2.0 and 280 ng/ml, for DCS and DCP treatments, respectively. DCS was proven to be more potent compared to DCP, in conferring specific anti-proliferative effects on the cancer cell lines. The study also indicated that anti-proliferative activity of pre-heated C-serum fractions diminished significantly.
CONCLUSION: Although noteworthy cell death was reported, DNA fragmentation assay and real-time PCR confirmed that that induced by latex C-serum subfractions was not promoted via the classical apoptotic signalling pathway.
Severity and extent of upper small bowel mucosal damage in cow's milk protein-sensitive enteropathy

Iyngkaran N, Yadav M, Boey CG, Lam KL

J Pediatr Gastroenterol Nutr, 1988 Sep-Oct;7(5):667-74.
PMID: 3183870

A series of 31 infants, 28 with cow's milk protein sensitive enteropathy (CMPSE) and 3 controls, was studied for severity and extent of mucosal damage of the upper small bowel in relation to the development of clinical symptoms. Following challenge with the offending cow's milk, 18 infants (Group 1) developed severe mucosal changes at both the proximal and distal small bowel mucosa and all of these infants presented with clinical symptoms. The other 10 infants (Group 2) who did not develop clinical symptoms following the challenge had less severe damage to the distal small bowel mucosa as compared to the proximal region. The histological score of both the proximal and distal postchallenge biopsies were significantly lower in Group 2 as compared to Group 1 infants. The mucosal disaccharidase and alkaline phosphatase levels were depleted in both the proximal and distal biopsies following challenge but the depletion was greater in the proximal than the distal biopsies. It is suggested that the extent and severity of mucosal damage to the proximal duodenum and jejunum have a critical bearing on the development of clinical symptoms.
Fulltext Dystrophic Scoliosis in Neurofibromatosis and Rib-head Resection: A Case Report

Chong KL, Lam KS, Zuki Z

Malays Orthop J, 2017 Nov;11(3):59-62.
PMID: 29326771 MyJurnal DOI: 10.5704/MOJ.1711.007

Surgical management of scoliosis in Neurofibromatosis type I may be challenging at times especially when dealing with dystrophic curves. We highlight the importance of meticulous study of the radiological imaging and careful pre-operative planning in a patient with dystrophic scoliosis.
Fulltext Viral agents of acute respiratory infections in young children in Kuala Lumpur

Ong SB, Lam KL, Lam SK

Bull World Health Organ, 1982;60(1):137-40.
PMID: 6282479

The results of this study indicate that the important viral agents associated with lower respiratory tract infections in young children are respiratory syncytial virus, rhinovirus, and parainfluenza virus, particularly in those under 2 years of age. This is in close agreement with studies done in temperate climates. Influenza A virus is seasonal and plays an important role in upper respiratory tract infections in older children.
Study site: Inpatients and outpatients, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Fulltext Respiratory virus disease in Malaysian children: a serological study

Ong SB, Lam KL, Lam SK

Bull World Health Organ, 1975;52(3):376-8.
PMID: 1084808

Paired sera from 101 Malaysian children aged up to 10 years and suffering from respiratory illnesses were examined serologically for evidence of respiratory viral infections. Of these children, 32.6% showed rising antibody titres for one or more of the test agents. Respiratory syncytial virus appeared to be the main respiratory pathogen involved, followed by Mycoplasma pneumoniae, parainfluenza viruses, adenoviruses, and influenza A virus. These findings are generally similar to those reported by others in temperate and tropical countries.
Fulltext Lupus nephritis in childhood

Peh SC, Looi LM, Lam KL, Teh BH

Malays J Pathol, 1987 Aug;9:73-8.
PMID: 3452712

In the 12-year period between 1974 and 1985, 19 children aged between 8 and 12 years with systemic lupus erythematosus (SLE) were seen in the Department of Paediatrics, University Hospital, Kuala Lumpur. A preponderance of females (M:F = 1:2.8) and ethnic Chinese was evident. Renal biopsies revealed a wide Iange of renal morphology, including minimal change glomerulonephritis, focal proliferative glomerulonephritis, diffuse proliferative glomerulonephritis with varying degrees of severity and membranous glomerulonephritis. The majority (15) of patients had clinical SLE at the time of renal biopsy, of whom 4 were also grossly nephrotic. In the remaining 4 patients a diagnosis of SLE was made after further investigation for nephrotic syndrome (2) and acute nephritis (2). The pattern of renal pathology in childhood lupus nephritis appears not to differ significantly from adults.
Key words: Systemic lupus erythematosus, glomerulonephritis
Testicular relapse in childhood acute lymphoblastic leukaemia in Malaysia, 1967-82

Lin HP, Taib NM, Singh P, Sinniah D, Lam KL

Aust Paediatr J, 1984 Mar;20(1):53-6.
PMID: 6590027

From 1967-82, 9 children with testicular relapse (TR) of acute lymphoblastic leukaemia (ALL) were diagnosed out of 99 boys treated, an incidence of 9.1%. The median time from the onset of ALL until diagnosis was 28 months (range 3-41 months). All were asymptomatic; six were detected on routine examination while three were diagnosed only on biopsy. Routine biopsy prior to stopping chemotherapy is useful in detecting occult TR. Biopsies should be done on both the testes regardless of the clinical findings. The age, leucocyte count and hepatosplenomegaly at diagnosis of ALL were not found to be significant factors in influencing relapse. Eight children were in bone marrow remission at the time of TR, but three had preceding or concurrent meningeal leukaemia while in the other five the testis was the first and only site of relapse. Radiotherapy was effective in local disease control but failed to prevent bone marrow relapse in all except two patients despite continuation of chemotherapy. The median time from onset of TR until bone marrow relapse was 7 months (range 3-13 months) and the median time until death, was 11 months (range 6-18 months). The frequency of testicular relapse may be related to the intensity of either the initial induction therapy or the consolidation chemotherapy. Further studies are required to determine whether the incidence of testicular relapse will decline with more intensive early treatment.
The pathology of the nephrotic syndrome in Malaysians

Prathap K, Looi LM, Lam KL, Wang F, Chua CT

Malays J Pathol, 1983 Aug;6:39-49.
PMID: 6599867
Causative effect of cow's milk protein and soy protein on progressive small bowel mucosal damage

Iyngkaran N, Yadav M, Boey CG, Kamath KR, Lam KL

J Gastroenterol Hepatol, 1989 3 1;4(2):127-36.
PMID: 2490907

Some infants intolerant to cow's milk protein (CMP) are often also intolerant to other food proteins including soy protein (SP). The effect of CMP and SP in infants recovering from diarrhoeal disease was studied in 22 infants who were maintained on an hypo-allergenic formula for 4-6 weeks. The infants were then challenged successively, initially with SP, followed 24 h later with CMP and then rechallenged with SP 24 h after CMP provocation. Three groups were recognized on the basis of clinical symptoms and mucosal changes following SP challenge. Group 1 comprised four infants who developed clinical and histological reactions on SP challenge. The subsequent CMP challenge, 24 h after the initial SP challenge, resulted in clinical symptoms in three of the four infants, and they developed increased mucosal injury. Rechallenge with SP in the three infants caused development of severe clinical symptoms. Group 2 comprised 12 infants who developed histological reaction but had no clinical symptoms to initial SP challenge. The subsequent CMP challenge caused further progression in mucosal pathology in 11 of the 12 infants and six also had associated clinical symptoms. Rechallenge with SP in the latter six infants resulted in development of clinical symptoms in three and tolerance to SP in three infants. Group 3 comprised six infants who tolerated SP and CMP but one of these infants developed mild histological changes to CMP. The progression of mucosal injury following SP and CMP challenge was associated with a significant decrease in mucosal disaccharidases, alkaline phosphatase levels and presence of reducing sugar in the stools. The 1 h blood xylose level continued to decrease significantly following the pre-SP, post-SP, and post-CMP challenge. It appears that the small bowel mucosa of young infants recovering from diarrhoeal disease remains sensitive not only to CMP but also to SP. The feeding of these proteins in rapid successive sequence to infants with mucosal damage might result in further progression of the mucosal injury. Thus, the exclusion for a variable period of time of antigenic food proteins like CMP and SP from the diet of young infants recovering from diarrhoea might reduce the risk of inducing mucosal sensitivity to these proteins in susceptible infants.
Fulltext Estimating sediment yield at Kaduna watershed, Nigeria using soil and water assessment tool (SWAT) model

Daramola J, Ekhwan TM, Mokhtar J, Lam KC, Adeogun GA

Heliyon, 2019 Jul;5(7):e02106.
PMID: 31372557 DOI: 10.1016/j.heliyon.2019.e02106

Over the years, sedimentation has posed a great danger to the storage capacity of hydropower reservoirs. Good understanding of the transport system and hydrological processes in the dam is very crucial to its sustainability. Under optimal functionality, the Shiroro dam in Northern Nigeria can generate ∼600 MW, which is ideally sufficient to power about 404,000 household. Unfortunately, there have not been reliable monitoring measures to assess yield in the upstream, where sediments are sourced into the dam. In this study, we applied the Soil and Water Assessment Tool (SWAT) to predict the hydrological processes, the sediment transport mechanism and sediment yield between 1990 and 2018 in Kaduna watershed (32,124 km2) located upstream of the dam. The model was calibrated and validated using observed flow and suspended sediment concentration (SSC) data. Performance evaluation of the model was achieved statistically using Nash-Sutcliffe (NS), coefficient of determination (r2) and percentage of observed data (p-factor). SWAT model evaluation using NS (0.71), r2 (0.80) and p-factors of 0.86 suggests that the model performed satisfactorily for streamflow and sediment yield predictions. The model identified the threshold depth of water (GWQMN.gw) and base flow (ALPHA_BF.gw) as the most sensitive parameters for streamflow and sediment yield estimation in the watershed. Our finding showed that an estimated suspended sediment yield of about 84.1 t/ha/yr was deposited within the period under study. Basins 67, 71 and 62 have erosion prone area with the highest sediment values of 79.4, 75.1 and 73.8 t/h respectively. Best management practice is highly recommended for the dam sustainability, because of the proximity of erosion-prone basins to the dam.
Mesangial IGM in minimal change glomerular disease: a clinicopathological study in a Malaysian population

Looi LM, Wang F, Lam KL, Chua CT

Pathology, 1985 Jan;17(1):41-4.
PMID: 3889788

During a 6 yr period, 105 (69%) of 153 patients in whom a histological diagnosis of minimal change glomerular disease was made had renal biopsy tissue suitable for immunofluorescence examination. Thirty seven (35%) patients showed glomerular mesangial deposits of IgM. All the patients presented with the nephrotic syndrome. We found no significant difference in age and sex prevalence, presentation, response to therapy and glomerular morphology between IgM positive and IgM negative groups. This study suggests that there is no necessity to categorize IgM positive minimal change glomerular disease as a separate entity.

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