MyMedR

Fulltext Results of 50 consecutive aneurysmectomies for abdominal aortic aneurysms at a private specialist centre

Leong YP, Sappany A

Med J Malaysia, 1995 Dec;50(4):330-3.

The management of abdominal aortic aneurysms (AAA) at a private medical centre was reviewed. The criteria for surgery were AAA more than or equal to five centimeters in diameter, symptomatic AAA even if less than five centimeters and ruptured AAA. A total of 67 patients were seen between October 1991 to September 1994. The age range was 48 to 94 years, mean = 69.8. There were 58 males to nine females. Twelve patients presented with ruptured AAA. There were three suprarenal AAA and three mycotic AAA. Aneurysmectomies were performed on 50 patients. This include all patients with ruptured AAA. There was no mortality in the elective cases. One patient with ruptured AAA died, ie. an operative mortality of eight per cent. It was concluded that a very low operative mortality can be achieved in this group of high risk patients. Our results were comparable to those reported by other centres in the developed countries. Important factors contributing to these results include a team approach in a unit interested in this disease, careful pre-operative preparation and a rigid post-operative regime. For ruptured AAA, survival of the patient depended on a successful and timely operation. It was also concluded that no patient should be deemed unfit for surgery or denied an operation if they needed to have one and it was safe to transport patients with ruptured AAA to a centre where the operation can be performed.

Experimental group A rotaviral infection in cynomolgus monkeys raised on formula diet

Leong YK, Awang A

Microbiol. Immunol., 1990;34(2):153-62.

PMID: 2161071

Rotaviral infections in cynomolgus monkeys (Macaca fasicularis) were studied to ascertain its suitability as a model of infection and diarrhea caused by group A human rotaviruses. Formula-fed monkeys were used as they could be observed closely. Experimental rotaviral infection of cynomolgus monkeys was age-dependent; only young monkeys were readily infected. Formula-fed newborns were readily infected with cell-culture-adapted human (WA) and simian (SA11) viruses and with a rotavirus from a human fecal specimen. However, diarrhea was detected only in very young animals. A number of rotaviral shedding patterns as a function of time were observed. Although there was no typical viral shedding pattern which represented exclusive association of viral infection with diarrhea, the initial level of viral excretion and the maximum level of viral shedding attained were much higher in animals with diarrhea. Seroconversion occurred in less than half of the inoculated animals. The presence of maternal rotaviral antibodies did not prevent infection or diarrhea.

Internal iliac artery graft in the management of ruptured mycotic aneurysm of the femoral artery

Leong YP, Lokman S

J Cardiovasc Surg (Torino), 1989 Nov-Dec;30(6):955-6.

PMID: 2600128

The use of an autologous ipsilateral internal iliac artery to restore circulation after excision of a ruptured femoral aneurysm in a patient addicted to drugs is described. Autogenous vein graft was not available. The advantages of using the internal iliac artery in this situation are discussed. The use of internal iliac artery graft in this situation has not been previously described in the literature.

Graft and Button Modification of Technique of Coracoclavicular Joint Reconstruction in Treatment of Chronic Type V Acromioclavicular Joint Dislocation: A Case Report

Leong YC, Muhammad-Suhairi J

Malays Orthop J, 2019 Jul;13(2):45-48.

PMID: 31467652 DOI: 10.5704/MOJ.1907.009

Treatment of chronic Rockwood's type V Acromioclavicular (AC) joint dislocation remains controversial. We describe a surgical technique to reduce and maintain AC joint using a combination of gracilis autograft with GraftMax™ button (Conmed Inc, Utica, NY). Graft was prepared using running whip stitch technique with No. 5 Hi-Fi high strength suture (ConMed Linvatec, Largo, FL). Our technique reduces intraoperative clavicular and coracoid tunnel fracture and restores anatomical coracoclavicular ligament. At sixth week and third month postoperatively, the patient demonstrated good clinical and radiographic outcome.

Fulltext Ruptured abdominal aortic aneurysm treated by endovascular aneurysm repair under local anaesthesia

Tay JWT, Leong YP

Med J Malaysia, 2012 Feb;67(1):111-2.

PMID: 22582560 MyJurnal

A 68 year old man with significant cardiorespiratory risks factors presented with a ruptured thoracic aortic aneurysm (TAA). This was treated by emergency thoracic endovascular aneurysm repair (TEVAR) under general anaesthesia (GA). An incidental abdominal aortic aneurysm (AAA) was not treated. Eight months later, he presented with ruptured AAA. Due to the patient's compromised respiratory system, he underwent endovascular aneurysm repair (EVAR) under local anaesthesia (LA). He had a smoother post-operation recovery compared to the first repair under GA.

Fulltext Primary mesenteric venous thrombosis--a case report

Tay SK, Leong YP

Med J Malaysia, 1989 Jun;44(2):171-3.

PMID: 2626127

Mesenteric venous thrombosis has been described to occur in cases where there has been no apparent cause. The diagnosis is usually delayed because the signs and symptoms are non-specific. A case of primary mesenteric venous thrombosis is reported below. Its presentation and pathology are discussed. Treatment is surgery with resection of gangrenous bowel and primary anastomosis. Post-operative anticoagulation is advocated.

Gangrene of the foot following peripheral phlebography

Leong YP, Jasmi AY

J R Coll Surg Edinb, 1991 Jun;36(3):180-1.

PMID: 1920234

Fulltext Jugular venous aneurysm--a rare cause of neck swelling

Dhillon MK, Leong YP

Singapore Med J, 1991 Apr;32(2):177-8.

PMID: 2042085

An 8-year old boy presented with a right neck swelling which appeared only intermittently. The swelling was well demonstrated by the Valsalva manoeuvre. The differential diagnosis include a laryngocele, a superior mediastinum tumour or cyst and a venous aneurysm. Plain radiography, computerized tomography, ultrasonography and venography were performed. A diagnosis of venous aneurysm was confirmed. Ultrasonography was the best modality for imaging of this rare condition. It is non-invasive and it will also delineate the extent of the lesion. The treatment is expectant. Surgery is reserved for cosmesis and symptomatic aneurysms.

Laceration of the common hepatic duct bifurcation by blunt abdominal trauma

Muin A, Leong YP, Tay SK

Injury, 1992;23(6):422-3.

PMID: 1428177

Laboratory and field tests of temephos (AbateR) on mosquito larvae and non-target organisms in rice fields in Malaysia

Yap HH, Lau BL, Leong YP

Southeast Asian J. Trop. Med. Public Health, 1982 Dec;13(4):646-53.

PMID: 6189198

The toxic effects of Abate (temephos) on mosquito larvae and non-target organisms were studied in the rice-field and in the laboratory. In the laboratory tests, Culex tritaeniorhychus larvae and cladoceran zooplanktons (predominantly Diaphanosoma and Moinodaphnia species) were found to be highly susceptible to Abate with LC50 values of 0.27 and less than 0.10 parts per billion respectively. Other non-target species in decreasing degree of susceptibility to Abate were copepods (Tropodiaptomus spp.), Aplocheilus panchax and Tubifex worms. In field study, Abate at concentrations 60, 100 and 200 gm hectare-1 is effective in maintaining the rice-fields free of Anopheles and Culex mosquitoes for at least 2 days. No mortality was observed for Aplocheilus panchax and Tubifex worms at the above concentrations; nevertheless, populations of cladoceran zooplanktons and copepods were reduced up to seven days posttreatment.

Fulltext Treatment of bleeding gastroesophageal varices: a report of forty-four cases

Tay SK, Leong YP, Meah FA, Abdullah T, Zain AR

Med J Malaysia, 1992 Dec;47(4):267-72.

PMID: 1303478

Bleeding gastroesophageal varices is associated with a high morbidity and mortality. Forty-four cases of bleeding gastroesophageal varices were treated at the Department of Surgery, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur over four and a half years. Thirty-two of them had liver cirrhosis. Hepatitis B infection was noted in 13 and alcoholic abuse was present in 14 patients. Five patients had associated hepatoma. Thirty-four percent had gastric fundal varices and a third of these bled from them. A total of 179 endoscopic injection sclerotherapy sessions were performed averaging 4 per person. Rebleeding rate was 4% and mortality was high (50%) in these cases. It was concluded that injection sclerotherapy is a safe and effective means of controlling bleeding oesophageal varices. Operative surgery was employed in those who rebled after injection and would be considered in those in Child's A.

Quality of life amongst lymphoma survivors in a developing country

Ng DL, Leong YC, Gan GG

Support Care Cancer, 2016 12;24(12):5015-5023.

PMID: 27460016

PURPOSE: The survival for patients with lymphoma has improved over the past decades with the introduction of novel agents. Quality of life of these survivors is now being studied with focus on minimising the late effects of chemotherapy and improving psychosocial support. This study aims to determine the prevalence of anxiety and depression of lymphoma survivors and to investigate the possible association between these disorders and quality of life.

METHODS: Patients with previous diagnosis of lymphoma who remained in remission were recruited from a major hospital in Malaysia. Quality of life of these patients was measured using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30). Anxiety and depression symptoms were assessed using Hospital Anxiety and Depression scale (HADS).

RESULTS: A total of 156 patients participated in this study. Eighteen percent (18 %) of patients had symptoms of anxiety, and 10 % had symptoms of depression. Patients who had higher depression scores were older, of lower education level and had more than one comorbidity illness. Patients with anxiety were associated with lower overall quality of life (QOL) score, lower emotional and cognitive functioning and complained more of fatigue and insomnia (p

Erectile dysfunction among male lymphoma survivors in a developing country

Gan GG, Ng DLC, Leong YC

Ann Oncol, 2018 Nov;29 Suppl 9:ix90.

PMID: 32178189 DOI: 10.1093/annonc/mdy437.011

Fulltext Duodenal leiomyosarcoma: a report of a rare and aggressive tumour

Ho YN, Leong YP, Sakijan AS, Swaminathan M, Sarvananthan K

Singapore Med J, 1992 Jun;33(3):297-8.

PMID: 1631594

A 45-year-old Malay lady who presented with intermittent abdominal pain and a left hypochondrial mass was found to have a 10 x 8 x 5 cm duodenal tumour without local invasion at laparotomy. En bloc resection of the tumour with adequate margin of clearance was done and histopathological diagnosis of low grade leiomyosarcoma was made. Fourteen months later, she returned with multiple metastases in the liver and needed palliative chemotherapy for pain relief. Duodenal leiomyosarcomata are very rare tumour. Their prognostic indicators include biological grading, tumour size and presence of metastases. Recognition of its high malignant potential calls for close surveillance calls even after apparent curative surgery.

Influence of genetic polymorphisms of cytokine genes in the outcome of HLA-matched allogeneic stem cell transplantation in a South East Asian population

Gan GG, Leong YC, Bee PC, Chin EF, Abdul Halim H, Nadarajan VS, et al.

Cytokine, 2016 Feb;78:55-61.

PMID: 26638029 DOI: 10.1016/j.cyto.2015.11.022

Non-HLA gene polymorphisms have been shown to be associated with the risk of graft-versus-host disease (GVHD) and outcome of allogeneic haematopoietic stem cell transplantation (AHSCT). This study aims to investigate the role of IL6, TNFα, IL10, IL2 and IL12 gene polymorphisms in the outcome of AHSCT in a South East Asian population. A total of 67 patients and 59 donors who underwent HLA-identical matched sibling AHSCT were available for analysis. There was no significant association between the different cytokine genotypes of patients with the incidence and severity of acute GVHD. Patients with IL2 166∗T allele and patients who received donor stem cells who had IL2 166∗G allele appeared to have reduced incidence of cGVHD. Patients who received donor stem cells with IL12 1188∗C allele are found to be associated with better disease free survival. These results suggest a possible role of IL2 and IL12 gene polymorphisms in the outcome of AHSCT in a South East Asian population.

In situ determination of the static inductance and resistance of a plasma focus capacitor bank

Saw SH, Lee S, Roy F, Chong PL, Vengadeswaran V, Sidik AS, et al.

Rev Sci Instrum, 2010 May;81(5):053505.

PMID: 20515137 DOI: 10.1063/1.3429207

The static (unloaded) electrical parameters of a capacitor bank are of utmost importance for the purpose of modeling the system as a whole when the capacitor bank is discharged into its dynamic electromagnetic load. Using a physical short circuit across the electromagnetic load is usually technically difficult and is unnecessary. The discharge can be operated at the highest pressure permissible in order to minimize current sheet motion, thus simulating zero dynamic load, to enable bank parameters, static inductance L(0), and resistance r(0) to be obtained using lightly damped sinusoid equations given the bank capacitance C(0). However, for a plasma focus, even at the highest permissible pressure it is found that there is significant residual motion, so that the assumption of a zero dynamic load introduces unacceptable errors into the determination of the circuit parameters. To overcome this problem, the Lee model code is used to fit the computed current trace to the measured current waveform. Hence the dynamics is incorporated into the solution and the capacitor bank parameters are computed using the Lee model code, and more accurate static bank parameters are obtained.

Complementary and alternative medicine use in patients with hematological cancers in Malaysia

Gan GG, Leong YC, Bee PC, Chin E, Teh AK

Support Care Cancer, 2015 Aug;23(8):2399-406.

PMID: 25876158 DOI: 10.1007/s00520-015-2614-z

BACKGROUND: Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country.

PATIENTS AND METHODS: This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale.

RESULTS: A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage.

CONCLUSION: In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.

Sonographic nomogram of paediatric renal size in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Leong YY, Kanaheswari Y, Faizah MZ, Hing EY, Nik Ismail NA, Nik Fuad NF, et al.

Med J Malaysia, 2020 03;75(2):130-135.

PMID: 32281593

INTRODUCTION: A person's childhood is an important period of growth, and also one's most vulnerable, as one can be exposed to various pathologies, for example those that could affect the growth of one's kidney. Asians are physiologically different from Caucasians, and the nomogram renal size obtained from a Western population (mostly of Caucasians) is not be suitable for representing Asian children. As such a nomogram on paediatric renal size derived from Malaysia is needed.

METHODS: A total of 109 (64 males and 45 females) aged 0-12 in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) took part in this study. They underwent ultrasonography of both kidneys, and their demographic and anthropometric data were collected. The mean and standard deviations of the renal length and renal volume according to their age groups was calculated, and the final data was compared to the ones reported by Rosenbaum et al. (1984).

RESULT: Body weight and Body Surface Area (BSA) of the children reported the strongest correlation with renal size. Significant differences were found between local and the data from Rosenbaum et al (1984). A nomogram on paediatric renal size based on children in PPUKM was then created.

DISCUSSION: Ultrasonography is regarded as the standard method for determining renal size. Body weight and BSA were both strongly correlated with renal size. It was shown that the widely used nomograms derived from data obtained from Caucasian was not suitable to represent the population of Malaysian children.

Fulltext Acromion Morphology of Patients with Rotator Cuff Disease in Standard AP Shoulder Radiograph in Hospital Sultanah Bahiyah and Hospital Kuala Lumpur

Leong YC, Yeoh CW, Azman MI, Juhari MS, Siti HT

Malays Orthop J, 2022 Nov;16(3):50-54.

PMID: 36589379 DOI: 10.5704/MOJ.2211.009

INTRODUCTION: Rotator cuff pathology is commonly attributed to acromion morphology that is demonstrable in standard AP shoulder radiographs by measuring the critical shoulder angle (CSA), the lateral acromial angle (LAA), and the acromial index (AI). However, these parameters vary among races and countries. Therefore, our study aimed to get the local data on acromion morphology in patients with rotator cuff disease.

MATERIALS AND METHODS: MRI shoulder reports between January 2012 and June 2018 were reviewed. The study group consisted of 47 patients with rotator cuff injury with a partial or complete tear, and a control group of 37 patients with tendinitis or osteoarthritis and intact rotator cuffs. The CSA, LAA, and AI of both groups were measured on the anteroposterior shoulder radiograph. The risk factors for both groups and the acromion morphology were recorded.

RESULTS: The CSA for the rotator cuff tear and the control group was 39.08° and 38.28°, LAA was 72.57 ° and 73.51°, and AI was 0.79 and 0.75. The acromion morphology differed in terms of gender, and only LAA was different among the different ethnic groups. There was a negative correlation between age and CSA, age and AI, LAA and CSA, LAA and AI, but a positive correlation between AI and CSA.

CONCLUSION: The CSA for rotator cuff tear patients in our population was 39.08°, LAA was 72.57°, and AI was 0.79. The acromion morphology was significantly influenced by age and gender.

Omeprazole compared with ranitidine once daily in the treatment of duodenal ulcer

Chelvam P, Goh KL, Leong YP, Leela MP, Yin TP, Ahmad H, et al.

J Gastroenterol Hepatol, 1989;4 Suppl 2:53-61.

PMID: 2491362

A double-blind randomized study in 230 Malaysian patients with duodenal ulcer was conducted to compare the proton-pump inhibitor, omeprazole 20 mg, given once daily in the morning, with ranitidine 300 mg, administered once daily at night. After 2 and 4 weeks of treatment, 222 and 220 patients, respectively, were evaluable according to the study protocol. Omeprazole produced significantly higher healing rates than ranitidine at both 2 weeks (75% versus 46%, respectively, P less than 0.0001) and 4 weeks (97% versus 83%, respectively, P = 0.001). Ulcer symptoms were relieved more rapidly by omeprazole than ranitidine. After 2 weeks, daytime epigastric pain was reported by 30% of ranitidine-treated patients but only by 15% of omeprazole-treated patients, which is a statistically significant difference (P = 0.004). No major clinical or biochemical side effects were recorded for either omeprazole or ranitidine. In conclusion, omeprazole 20 mg was found to be superior to ranitidine 300 mg administered once daily for the treatment of duodenal ulcer as measured by ulcer healing and pain relief.

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