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Fulltext Outpatient procedures for cervical dysplasia: a 3 year review of laser vaporisation and LEEP

Lee KE, Koh CF, Watt WF

Med J Malaysia, 1999 Mar;54(1):47-51.
PMID: 10972004

A 3 year retrospective review (1995 to 1997) of 127 patients with cervical dysplasia who underwent Laser Vaporisation of the cervix and LEEP at the Gynaecological Cancer Centre, KK Women's & Children's Hospital, Singapore, was undertaken. Amongst the patients in the Laser Vaporisation group, the mean age was 37.7 years (SD 8.8), the mean operating time was 14.8 minutes (SD 8.5), 63.6% were given prophylactic antibiotics and the mean follow up period was 15.3 months (SD 12.0), whilst in the LEEP group, mean age was 40.3 years (SD 8.4), mean operating time, 11.8 minutes (SD 4.9), prophylactic antibiotic rate, 53.8% and mean follow up period was 19.1 months (SD 9.3). Mild and moderate haemorrhage post procedure were the only complications encountered, 10.2% (5/49) in the Laser group and 3.8% (3/78) in the LEEP group. 98% (48/49) and 97.4% (76/78) of the Laser and LEEP groups, respectively, were free of disease on follow up. None of the 3 patients with persistent or recurrent disease were diagnosed as having invasive cancer. Overall, there were no significant differences in the patient characteristics, histopathology, operating times, follow up period, the use of prophylactic antibiotics, and complications in the 2 groups. The low complication rate, high disease-free rate and the relatively short operating time of Laser Vaporisation and LEEP in our study suggests that, indeed, both the procedures can be done safely and efficiently in the outpatient setting. However the discrepancy between the histology of colposcopically directed biopsy and that of LEEP specimens suggests that colposcopically directed biopsy may not be as accurate as one might believe, and further studies analysing the concordance between colposcopically directed biopsy and LEEP biopsy histologies are needed.
Community-based monitoring for environmental sustainability: A review of characteristics and the synthesis of criteria

Muhamad Khair NK, Lee KE, Mokhtar M

J Environ Manage, 2021 Jul 01;289:112491.
PMID: 33813302 DOI: 10.1016/j.jenvman.2021.112491

Community-based monitoring is increasingly recognised as one solution to sustainable environmental management. However, the development of community-based monitoring has led to confusion or misconceptions regarding other similar initiatives. Through a review of the characteristics and synthesising criteria of effective community-based monitoring, this article addresses how to distinguish community-based monitoring from other forms of community engagement research. A review of relevant community-based monitoring literature identifies the characteristics of and knowledge gaps in procedures and governance structures. Additionally, evidence of common benefits, challenges and lessons learned for successful community-based monitoring are deliberated. As an outcome of the review, the article synthesises a set of community-based monitoring criteria as follows: (1) efficacy of initiatives, (2) technicality aspects, (3) feedback mechanisms and (4) sustainability. These synthesised criteria will be instrumental in designing customised community-based monitoring initiatives for environmental sustainability.
On-site phytoremediation applicability assessment in Alur Ilmu, Universiti Kebangsaan Malaysia based on spatial and pollution removal analyses

Mahmud MH, Lee KE, Goh TL

Environ Sci Pollut Res Int, 2017 Oct;24(29):22873-22884.
PMID: 28905277 DOI: 10.1007/s11356-017-0079-y

The present paper aims to assess the phytoremediation performance based on pollution removal efficiency of the highly polluted region of Alur Ilmu urban river for its applicability of on-site treatment. Thirteen stations along Alur Ilmu were selected to produce thematic maps through spatial distribution analysis based on six water quality parameters of Malaysia's Water Quality Index (WQI) for dry and raining seasons. The maps generated were used to identify the highly polluted region for phytoremediation applicability assessment. Four free-floating plants were tested in treating water samples from the highly polluted region under three different conditions, namely controlled, aerated and normal treatments. The selected free-floating plants were water hyacinth (Eichhornia crassipes), water lettuce (Pistia stratiotes), rose water lettuce (Pistia sp.) and pennywort (Centella asiatica). The results showed that Alur Ilmu was more polluted during dry season compared to raining season based on the water quality analysis. During dry season, four parameters were marked as polluted along Alur Ilmu, namely dissolve oxygen (DO), 4.72 mg/L (class III); ammoniacal nitrogen (NH3-N), 0.85 mg/L (class IV); total suspended solid (TSS), 402 mg/L (class V) and biological oxygen demand (BOD), 3.89 mg/L (class III), whereas, two parameters were classed as polluted during raining season, namely total suspended solid (TSS), 571 mg/L (class V) and biological oxygen demand (BOD), 4.01 mg/L (class III). The thematic maps generated from spatial distribution analysis using Kriging gridding method showed that the highly polluted region was recorded at station AL 5. Hence, water samples were taken from this station for pollution removal analysis. All the free-floating plants were able to reduce TSS and COD in less than 14 days. However, water hyacinth showed the least detrimental effect from the phytoremediation process compared to other free-floating plants, thus made it a suitable free-floating plants to be used for on-site treatment.
Dietary and Lifestyle Risk Factors of Obesity Among Young Adults: A Scoping Review of Observational Studies

Lee KX, Quek KF, Ramadas A

Curr Nutr Rep, 2023 Dec;12(4):733-743.
PMID: 38038894 DOI: 10.1007/s13668-023-00513-9

PURPOSE OF REVIEW: Obesity is a growing public health concern worldwide, especially among young adults. This scoping review aims to identify and summarize the current evidence on dietary and lifestyle risk factors associated with obesity among young adults.
RECENT FINDINGS: A scoping review was performed using the PRISMA-ScR guidelines. A systematic search of five electronic databases published from inception to October 2023 was conducted. A total of 46 observational studies met the inclusion criteria and were included in the review. The findings suggest that high intake of energy-dense foods, unhealthy eating habits, poor sleep quality, and increased screen time were significant risk factors for obesity among young adults. In contrast, the association between obesity and sedentary behavior, low physical activity levels, alcohol consumption, and smoking habits was inconclusive. The reviewed evidence suggests that unhealthy dietary habits and lifestyle behaviors are associated with an increased risk of obesity among young adults. The findings highlight the need for further research on these modifiable risk factors to prevent and manage obesity among young adults.
Fulltext Community-Based Monitoring in the New Normal: A Strategy for Tackling the COVID-19 Pandemic in Malaysia

Muhamad Khair NK, Lee KE, Mokhtar M

Int J Environ Res Public Health, 2021 Jun 22;18(13).
PMID: 34206384 DOI: 10.3390/ijerph18136712

In 2020, the COVID-19 pandemic severely impacted the global public health system and led to many deaths worldwide. COVID-19 is highly contagious and can be spread by symptomatic or asymptomatic individuals. As such, determining the risk of infection within a community is difficult. To mitigate the risk of the spread of COVID-19, the government of Malaysia implemented seven phases of the movement control order (MCO) from 18 March to 31 December 2020. However, the socioeconomic cost was substantial despite the effectiveness of the MCO in bringing down cases of infection. As noted by the Prime Minister of Malaysia, the final criterion that should be met is community empowerment. In other words, community-based mitigation measures through which communities unite to contain the pandemic are essential before the completion of the vaccination program. As a measure for controlling the pandemic, mitigation strategies in the new normal should be feasible, practical, and acceptable to communities. In this paper, we present a deliberation of a set of community-based monitoring criteria to ensure health and well-being in communities, such as efficacy, technicality, feedback, and sustainability. The proposed criteria will be instrumental in developing community-based monitoring initiatives to achieve the desired goals in coping with the pandemic as well as in empowering communities to be part of the governance process.
Fulltext Landslide factors and susceptibility mapping on natural and artificial slopes in Kundasang, Sabah

Sharir K, Roslee R, Lee KE, Simon N

Sains Malaysiana, 2017;46:1521-1540.

This study was carried out on the hilly topographic area in Kundasang, Sabah. This area is known to be extremely prone to landslides that occurred either naturally or by human interference to natural slopes. Aerial photographs interpretation was conducted in order to identify landslide distributions across three assessment years (2012, 2009 and 1984). These datasets were classified into two landslides groups based on their occurrences; natural and artificial. A total of 362 naturally occurring landslides were identified and another 133 are artificial slope landslides. Physical parameters which include lithology, slope angle, slope aspect and soil series were analyzed with each landslide group to examine the different influence of these parameters on each of the group. From the analysis, the landslide density for the natural landslide group shows that more than 35° slope angle and slope aspect facing east and southwest are prone to landslides. In terms of geological materials, high landslide density is recorded in the phyllite, shale, siltstone and sandstone lithologies group and the Pinosuk, Kepayan and Trusmadi soil series. In contrast, for the artificial
slope landslide, high landslide density is observed in the 25°-35° slope angle and similar density in every slope aspect classes. The geological materials however have similar landslide density across their factors’ classes. The landslide density technique was also used to generate the landslide susceptibility maps for both landslide conditions. Validation of the maps shows acceptable accuracy of 71% and 74%, respectively, for both natural and artificial slope landslide susceptibility maps and this shows that these maps can be used for future land use planning.
Quantifying carbon pool in ex-mining lake-converted constructed wetlands of Paya Indah Wetlands, Selangor, Malaysia

Jamion NA, Lee KE, Mokhtar M, Goh TL

Environ Sci Pollut Res Int, 2024 Mar;31(11):16291-16308.
PMID: 38315340 DOI: 10.1007/s11356-024-32140-4

Ex-mining lake-converted constructed wetlands play a significant role in the carbon cycle, offering a great potential to sequester carbon and mitigate climate change and global warming. Investigating the quantity of carbon storage capacity of ex-mining lake-converted constructed wetlands provides information and justification for restoration and conservation efforts. The present study aims to quantify the carbon pool of the ex-mining lake-converted constructed wetlands and characterise the physicochemical properties of the soil and sediment. Pearson's correlation and a one-way ANOVA were performed to compare the different sampling stations at Paya Indah Wetland, Selangor, Malaysia. An analysis of 23 years of ex-mining lake-converted constructed wetlands of Paya Indah Wetlands, Selangor, Malaysia, revealed that the estimated total carbon pool in soil and sediment accumulated to 1553.11 Mg C ha-1 (equivalent to 5700 Mg CO2 ha-1), which translates to an annual carbon sink capacity of around 67.5 Mg C ha-1 year-1. The characterisation showed that the texture of all soil samples was dominated by silt, whereas sediments exhibited texture heterogeneity. Although the pH of the soil and sediment was both acidic, the bulk density was still optimal for plant growth and did not affect root growth. FT-IR and WDXRF results supported that besides the accumulation and degradation of organic substances, which increase the soil and sediment carbon content, mineral carbonation is a mechanism by which soil and sediment can store carbon. Therefore, this study indicates that the ex-mining lake-converted constructed wetlands of Paya Indah Wetlands, Selangor, Malaysia have a significant carbon storage potential.
The neurological manifestations of Nipah virus encephalitis, a novel paramyxovirus

Lee KE, Umapathi T, Tan CB, Tjia HT, Chua TS, Oh HM, et al.

Ann Neurol, 1999 Sep;46(3):428-32.
PMID: 10482278 DOI: 10.1002/1531-8249(199909)46:3<428::AID-ANA23>3.0.C

A novel Hendra-like paramyxovirus named Nipah virus (NiV) was the cause of an outbreak among workers from one abattoir who had contact with pigs. Two patients had only respiratory symptoms, while 9 patients had encephalitis, 7 of whom are described in this report. Neurological involvement was diverse and multifocal, including aseptic meningitis, diffuse encephalitis, and focal brainstem involvement. Cerebellar signs were relatively common. Magnetic resonance imaging scans of the brain showed scattered lesions. IgM antibodies against Hendra virus (HeV) were present in the serum of all patients. Two patients recovered completely. Five had residual deficits 8 weeks later.
Late clinical and magnetic resonance imaging follow up of Nipah virus infection

Lim CC, Lee WL, Leo YS, Lee KE, Chan KP, Ling AE, et al.

J Neurol Neurosurg Psychiatry, 2003 Jan;74(1):131-3.
PMID: 12486285

The Nipah virus is a newly identified paramyxovirus responsible for an outbreak of fatal encephalitis in Malaysia and Singapore. This paper reports the follow up clinical and magnetic resonance imaging findings in 22 affected subjects. Of 13 patients with encephalitis, one died, one was lost to follow up, and seven recovered. Among the four remaining patients, one had residual sixth nerve palsy, another suffered from severe clinical depression, and a third patient had evidence of retinal artery occlusion. One patient with delayed onset Horner syndrome had a single lesion in the cervical spinal cord. The brain magnetic resonance findings were stable or improved in nine patients over 18 months of follow up. Among a second group of nine asymptomatic seropositive abattoir workers, magnetic resonance examination in seven subjects revealed discrete small lesions in the brain; similar to those detected in encephalitis patients. These findings suggest that in addition to encephalitis, the newly discovered Nipah virus affects the spinal cord and the retina. Late clinical and radiological findings can occur in Nipah virus infections as with other paramyxoviruses.
Nipah viral encephalitis or Japanese encephalitis? MR findings in a new zoonotic disease

Lim CC, Sitoh YY, Hui F, Lee KE, Ang BS, Lim E, et al.

AJNR Am J Neuroradiol, 2000 Mar;21(3):455-61.
PMID: 10730635

BACKGROUND AND PURPOSE: An epidemic of suspected Japanese encephalitis occurred in Malaysia in 1998-1999 among pig farmers. In neighboring Singapore, an outbreak occurred among pig slaughterhouse workers. It was subsequently established that the causative agent in the outbreak was not the Japanese encephalitis virus but a previously unknown Hendra-like paramyxovirus named Nipah virus.
METHODS: The brain MR images of eight patients with Nipah virus infection were reviewed. All patients tested negative for acute Japanese encephalitis virus. Seven patients had contrast-enhanced studies and six had diffusion-weighted examinations.
RESULTS: All patients had multiple small bilateral foci of T2 prolongation within the subcortical and deep white matter. The periventricular region and corpus callosum were also involved. In addition to white matter disease, five patients had cortical lesions, three had brain stem involvement, and a single thalamic lesion was detected in one patient. All lesions were less than 1 cm in maximum diameter. In five patients, diffusion-weighted images showed increased signal. Four patients had leptomeningeal enhancement and four had enhancement of parenchymal lesions.
CONCLUSION: The brain MR findings in patients infected with the newly discovered Nipah paramyxovirus are different from those of patients with Japanese encephalitis. In a zoonotic epidemic, this striking difference in the appearance and distribution of lesions is useful in differentiating these diseases. Diffusion-weighted imaging was advantageous in increasing lesion conspicuity.

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