Displaying publications 1 - 20 of 37 in total

  1. Lim BK, Thong KL
    J Infect Dev Ctries, 2009 Jul 01;3(6):420-8.
    PMID: 19762954
    BACKGROUND: Differentiation of Salmonella enterica into its serogroups is important for epidemiological study. The objective of the study was to apply a multiplex PCR targeting serogroups A, B, C1, D, E and Vi-positive strains of Salmonella enterica commonly found in Malaysia. A separate H-typing multiplex PCR which identified flagellar antigen "a", "b" or "d" was also optimized to confirm clinical serotypes, S. Paratyphi A and S. Typhi.

    METHODOLOGY: Sixty-seven laboratory Salmonella enterica strains were tested. Six sets of primers targeting defined regions of the O antigen synthesis genes (rfb gene cluster) and Vi antigen gene (viaB) were selected and combined into a multiplex PCR for O-grouping. Four primers (H-for, Ha-rev, Hb-rev and Hd-rev) were used in the second step multiplex PCR for H-typing. The optimized mPCR assays were further evaluated with 58 blind-coded Salmonella strains.

    RESULTS: The multiplex PCR results obtained showed 100% concordance to the conventionally typed serogroups. Validation with 58 blind coded Salmonella strains yield 100% accuracy and specificity.

    CONCLUSION: Based on this study, PCR serogrouping proved to be a rapid, alternative method for further differentiation of Salmonella enterica.

  2. Lim BK, Collaris RR
    J Obstet Gynaecol Res, 2008 Jun;34(3):436-8.
    PMID: 18588622 DOI: 10.1111/j.1447-0756.2008.00786.x
    A 62-year old para 4 with a history of a radical hysterectomy followed by radiotherapy for endometrial carcinoma was seen shortly after insertion of a pessary for a total vault prolapse. On follow-up the pessary couldn't be retrieved. An abdominal X-ray revealed the pessary in the abdominal cavity and it had to be removed by means of a laparotomy. Fistula and defects have been reported both in longstanding pessary use and as long-term complication in radical surgery with radiotherapy. In view of potential - though rare - serious complications, adequate follow-up in pessary use is therefore mandatory. Adequate diagnostic investigations are essential in deciding on an appropriate approach for rare cases like these.
  3. Loh LC, Lim BK, Wan Yusuf S
    J R Coll Physicians Edinb, 2010 Jun;40(2):100-4.
    PMID: 21125048 DOI: 10.4997/JRCPE.2010.202
    As a standard, significant pleural effusion, whether tuberculous (TB) or not, requires therapeutic thoracocentesis. We tested the hypothesis that standard anti-TB chemotherapy alone can resolve significant pleural effusion.
  4. Chen Y, Lim BK, Hashim OH
    J Hematol Oncol, 2009;2:37.
    PMID: 19709441 DOI: 10.1186/1756-8722-2-37
    The general enhanced expression of alpha1-antichymotrypsin (ACT), clusterin (CLU), alpha1-antitrypsin (AAT), haptoglobin beta-chain (HAP), and leucine rich glycoprotein (LRG) in the sera of patients with epithelial ovarian carcinoma (EOCa) was recently reported. In the present study, we compared the expression of the serum acute-phase proteins (APPs) in the patients according to their stages of cancer.
  5. Tok Ch, Bux S, Mohamed S, Lim B
    Biomed Imaging Interv J, 2006 Oct;2(4):e42.
    PMID: 21614328 MyJurnal DOI: 10.2349/biij.2.4.e42
    Fibroids are the commonest uterine neoplasms, occurring in 20% - 30% of women of reproductive age. In women who have pelvic masses of unknown cause, unusual manifestations of fibroids such as necrosis or degeneration may simulate a carcinoma or hydrometra resulting in problems with image interpretation. We report a case of an unsuspected large degenerated uterine fibroid in a lady mistakenly diagnosed as hydrometra on computed tomography scanning.
  6. Chow TW, Lim BK, Vallipuram S
    J Obstet Gynaecol Res, 2002 Aug;28(4):203-10.
    PMID: 12452262
    In this review, tuberculosis of the genital tract was diagnosed retrospectively in 11 females over 15 years. The presentations of nine cases are described. Seven of the nine cases presented with ascites, vague abdominal distension, weight loss and were misdiagnosed as ovarian carcinoma. Eight women had no relevant past history. A review on clinical presentations and diagnosis of pelvic tuberculosis is presented. We conclude that although the incidence of tuberculosis is uncommon in developed countries, its prevalence appears to be increasing worldwide. Therefore, clinicians should consider tuberculosis as a differential diagnosis when encountering clinical presentations of pelvic mass and ascites.
  7. Mu AK, Lim BK, Hashim OH, Shuib AS
    Int J Mol Sci, 2012;13(8):9489-501.
    PMID: 22949810 DOI: 10.3390/ijms13089489
    Cancers can cause some proteins to be aberrantly excreted or released in the urine, which can be used as biomarkers. To screen for potential biomarkers for endometrial cancer (ECa), the urinary proteins from patients who were newly diagnosed with early stage ECa and untreated controls were separated using two-dimensional gel electrophoresis (2-DE) and followed by image analysis. The altered levels of zinc alpha-2 glycoprotein, alpha 1-acid glycoprotein, and CD59 were detected in the patients compared to the controls. In addition, the urine of the ECa patients was also found to contain relatively lower levels of a fragment of nebulin when the 2-DE separated urinary proteins were probed using champedak galactose binding (CGB) lectin. The different levels of the nebulin fragment were further validated by subjecting the urinary protein samples to CGB lectin affinity chromatography and analysis of the bound fractions by LC-MS/MS. Our data is suggestive of the potential use of the differentially expressed urinary proteins as biomarkers for ECa although this requires further extensive validation on clinically representative populations.
  8. Abdullah-Soheimi SS, Lim BK, Hashim OH, Shuib AS
    Proteome Sci, 2010;8:58.
    PMID: 21083881 DOI: 10.1186/1477-5956-8-58
    Diagnosis of ovarian carcinoma is in urgent need for new complementary biomarkers for early stage detection. Proteins that are aberrantly excreted in the urine of cancer patients are excellent biomarker candidates for development of new noninvasive protocol for early diagnosis and screening purposes. In the present study, urine samples from patients with ovarian carcinoma were analysed by two-dimensional gel electrophoresis and the profiles generated were compared to those similarly obtained from age-matched cancer negative women.
  9. Tan PC, Vani S, Lim BK, Omar SZ
    Eur J Obstet Gynecol Reprod Biol, 2010 Apr;149(2):153-8.
    PMID: 20097465 DOI: 10.1016/j.ejogrb.2009.12.031
    To evaluate prevalence, risk factors and clinical severity correlates of anxiety and depression caseness in hyperemesis gravidarum (HG).
  10. Loh LC, Lim BK, Raman S, Vijayasingham P, Mohd Yusuf S
    Med J Malaysia, 2008 Aug;63(3):188-92.
    PMID: 19248687
    Budesonide/Formoterol (Symbicort) combination therapy as both maintenance and reliever treatment (SMART) is a novel approach in asthma management. We examined its 'real-life effectiveness' in treating Malaysian patients with moderate-to-severe asthma in whom despite on combined inhaled corticosteroids and long-acting beta2-agonist, were still inadequately controlled. In a retrospective study, 22 eligible adult patients on SMART [mean (range) age: 49 (36-65) years; FEV1: 41 (21-74)% predicted] were identified from medical records of an urban-based university hospital chest clinic, and their clinical outcomes studied at three months. Another 16 patients [50 (14-66) years; 48 (20-91)% predicted] of similar severity and treatment (i.e. Symbicort maintenance treatment plus short-acting beta2-agonist as reliever), but not on SMART, were used as comparator over the same assessment period. In addition, the patients were separately interviewed with standard questionnaire on their satisfaction and compliance to the SMART approach. In SMART group, rescue treatment requirement (p<0.001) and FEV1 [median difference = 2.5%, p=0.015; mean difference: 90 ml, p=0.013] showed significant improvement while in comparator, there was significant improvement only in the requirement for rescue treatment (p=0.023). Hospital admission rates were significantly reduced in SMART group compared to the other (p=0.039), but not in emergency treatment. Five patients asked to discontinue SMART while all others were satisfied, compliant and perceived improvement of their asthma with SMART. The maximum daily doses of inhaled budesonide and formoterol were 1400 microg and 31.5 microg respectively. Our preliminary findings suggest that SMART approach can be attempted as an effective and safe treatment option for patients with inadequately controlled moderate-to-severe asthma in Malaysian setting.
    Study site: Chest clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
  11. Abdul-Rahman PS, Lim BK, Hashim OH
    Electrophoresis, 2007 Jun;28(12):1989-96.
    PMID: 17503403
    The expression of high-abundance serum proteins in newly diagnosed patients with endometrial adenocarcinoma (EACa), squamous cell cervical carcinoma (SCCa) and cervical adenocarcinoma (ACCa), relative to control female subjects, was analyzed by subjecting serum samples to 2-DE followed by image analysis of the silver-stained protein profiles. The three cohorts of cancer patients demonstrated different altered expression of serum high-abundance proteins compared to negative control women. The expression of alpha1-antitrypsin, alpha1-B glycoprotein, cleaved high-molecular-weight kininogen (light chain) and antithrombin III were consistently altered in all the patients. However, clusterin was upregulated only in the patients with EACa, while those with SCCa and ACCa were typically characterized by the upregulated expression of zinc alpha-2-glycoprotein. The aberrant expression of selective serum proteins in the various cohorts of cancer patients was validated by competitive ELISA as well as by lectin detection. Analysis by using the champedak galactose binding lectin further highlighted an unidentified protein that may be differently glycosylated in the sera of the EACa patients that were studied.
  12. Mu AK, Lim BK, Hashim OH, Shuib AS
    Int J Mol Sci, 2013 Apr 11;14(4):7923-31.
    PMID: 23579955 DOI: 10.3390/ijms14047923
    Cancer is known to induce or alter the O-glycosylation of selective proteins that may eventually be excreted in the patients' urine. The present study was performed to identify O-glycosylated proteins that are aberrantly excreted in the urine of patients with early stage ovarian cancer (OCa). These urinary glycoproteins are potential biomarkers for early detection of OCa. In this study, urinary proteins of patients with early stage OCa and age-matched OCa negative women were subjected to two-dimensional gel electrophoresis and detection using a lectin that binds to the O-glycosylated proteins. Our analysis demonstrated significant enhanced expression of clusterin and leucine-rich alpha-2-glycoprotein, but lower levels of kininogen in the urine of the OCa patients compared to the controls. The different altered levels of these urinary glycoproteins were further confirmed using competitive ELISA. Our data are suggestive of the potential use of the aberrantly excreted urinary O-glycosylated proteins as biomarkers for the early detection of OCa, although this requires further validation in a large clinically representative population.
  13. Tan JT, Letchuman Ramanathan G, Choy MP, Leela R, Lim BK
    Med J Malaysia, 2013 Oct;68(5):384-8.
    PMID: 24632866 MyJurnal
    INTRODUCTION: Paraquat is a quaternary nitrogen herbicide which is highly toxic to human. Death is usually from respiratory failure and may occur within days up to a month after exposure. It is easily available and commonly abused to commit suicide.

    METHODOLOGY: This is a retrospective study describing the demographic characteristics, clinical features and outcomes of paraquat poisoning cases admitted to Hospital Taiping from 1st January 2008 to 30th October 2011. Medical records of 79 patients were reviewed.

    RESULT: Majority were of the Indian ethnicity (72.2%) followed by Chinese (13.9%) and Malay (10.1%). Majority was male (73.4%) and between 20 to 29 years old (34.2%). The median age of the patients was 30 years old. The mean length of stay was 6.2 days. Most exposures were intentional (69.6%) and presented to the hospital early at less than 6 hours after exposure (72.2%). Patients with positive urine paraquat result had significantly higher mortality rate compared to patients with negative results (47.4% vs 15.2% respectively). We found that neither hemofiltration nor immunosuppressive therapies help to improve survival.

    CONCLUSION: The non-survivor characteristics of patients with paraquat poisoning are intentional exposure, delay from exposure to hospital admission, urine paraquat positivity and manifestation of respiratory failure. The demographic characteristics, reasons for exposure and mortality rate are similar to previous reports. Urine paraquat may be used to assess severity of the exposure as well as prognosis. Hemofiltration and immunosuppression therapy do not improve patients' survival and paraquat remains a lethal killer.
  14. Lim BK, Ng KY, Omar J, Omar SZ, Gunapalaiah B, Teoh YL, et al.
    Med J Malaysia, 2014 Feb;69(1):2-8.
    PMID: 24814620
    INTRODUCTION: Cervical cancer is the third most common cancer in women worldwide. The HPV-16/18 AS04- adjuvanted vaccine (Cervarix©) has previously been shown to be highly immunogenic with a clinically acceptable safety profile. This phase IIIb, double-blind, randomized (1:1) and placebo controlled trial (NCT00345878) was designed to evaluate the vaccine immunogenicity against HPV-16 and HPV-18 as well as its safety and reactogenicity in Malaysian women.

    METHODS: Healthy women aged 18-35 years received intramuscularly three doses of either the vaccine (HPV group) or aluminium hydroxide (ALU group) at 0, 1, and 6 months. Antibody titers were measured by an enzyme-linked immunosorbent assay (ELISA).

    RESULTS: A total of 271 eligible subjects were enrolled and 266 subjects completed the study. Initially seronegative subjects in the HPV group showed 100% seroconversion one month post-dose-3 for anti HPV-16 and anti-HPV-18 antibodies with geometric mean titers of 11107.5 (95% CI: 9727.3-12683.4) EL.U/mL and 4273.5 (95% CI: 3771.8-4841.9) EL.U/mL, respectively. Over 96% of subjects in both groups received all three vaccine doses. Solicited local (pain) and general symptoms (myalgia, fatigue, arthralgia and headache) were commonly reported in both HPV and ALU groups. Eight serious adverse events were reported throughout the study (five in the HPV group; three in the ALU group), all considered by investigators to be unrelated to vaccination.

    CONCLUSION: The HPV-16/18 AS04-adjuvanted vaccine was immunogenic and generally well tolerated in Malaysian women aged 18-35 years.
  15. Singh DK, Mohd Nordin NA, Abd Aziz NA, Lim BK, Soh LC
    BMC Neurol, 2013;13:199.
    PMID: 24330250 DOI: 10.1186/1471-2377-13-199
    Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.
  16. Ng KL, Nawawi O, Lim BK, Htun TH, Dublin N, Razack AH
    Asian J Surg, 2017 Apr;40(2):171-174.
    PMID: 24210538 DOI: 10.1016/j.asjsur.2013.09.012
    Ureteric strictures are common and can be due to benign or malignant causes. Various surgical treatments can be used from minimally invasive endoscopic retrograde JJ stent insertion, balloon dilatation, ureterolithotomy, to open surgical exploration and repair. Memokath 051 stent is a metallic stent designed for long-term ureteral stenting in the management of ureteral strictures. The insertion of this device is usually a straightforward procedure performed endoscopically in a retrograde fashion via cystoscopy. However, this procedure can be difficult in complicated scenarios when the bladder has been removed with neoureteral reimplantations or high-grade strictures. Here, we report a case of Memokath stent insertion complicated by placement difficulties in a lady with ileal conduit due to previous ovarian cancer complicated by vesicovaginal fistula, who presented with malignant stricture of the ureteroileal anastomosis. We describe a simple yet effective antegrade technique to precisely reposition the malpositioned Memokath stent, along with illustrations.
  17. Liam CK, Ruthranesan M, Lee CH, Pang YK, Chua KT, Lim BK
    Asia Pac J Clin Oncol, 2012 Sep;8(3):267-74.
    PMID: 22897510 DOI: 10.1111/j.1743-7563.2011.01509.x
    To evaluate the response and progression-free survival (PFS) of Malaysian patients with advanced lung adenocarcinoma and unknown epidermal growth factor receptor (EGFR) mutation status treated with gefitinib.
  18. Lee CH, Liam CK, Pang YK, Chua KT, Lim BK, Lai NL
    Lung Cancer, 2011 Nov;74(2):349-51.
    PMID: 21920622 DOI: 10.1016/j.lungcan.2011.08.008
    We report a woman presenting with respiratory failure due to a right-sided pleural effusion, lung metastases and lymphangitis carcinomatosis from advanced lung adenocarcinoma in the third trimester of pregnancy, who showed good response to EGFR tyrosine kinase inhibitor.
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