Displaying all 15 publications

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  1. Lim CW, Othman A, Hashim HA
    Malays J Med Sci, 2023 Aug;30(4):102-115.
    PMID: 37655146 DOI: 10.21315/mjms2023.30.4.10
    BACKGROUND: In the context of the coronavirus (COVID-19) pandemic, effectively coping with daily stressors is crucial for children who experience restrictions on physical movement and social activities. We examined the effects of the online-delivered guided imagery relaxation (GIR) technique on the stress and well-being of primary school children.

    METHODS: Thirty-four (N = 34) 11-year-old students were randomly assigned to either intervention (n = 17) or waitlist-control (n = 17) groups. The participants from the intervention group were required to attend a 4-week online GIR session and practice the techniques daily for 5 min-10 min. The Stress in Children (SiC) questionnaire, the Strengths and Difficulties Questionnaire-Parent Reported (SDQ-PR) and tracking form were administered pre- and post-intervention.

    RESULTS: Eleven (64.7%) participants attended all sessions and eight (47.0%) completed daily practices. Mixed-model ANOVA indicated no significant difference between participants from intervention and waitlist-control groups across pre- and post-intervention time points, with P-values greater than 0.05 for stress and well-being.

    CONCLUSION: Issues regarding online intervention, including managing children's activities from a distance, Internet connectivity, and time limitations might have affected their adherence and the research outcome. Nonetheless, the online-delivered GIR technique is a promising intervention modality. However, its implementation should be improvised to be more impactful.

  2. Shatnawi H, Lim CW, Ismail FB, Aldossary A
    Heliyon, 2021 Jul;7(7):e07489.
    PMID: 34307940 DOI: 10.1016/j.heliyon.2021.e07489
    The solar receiver is considered the cornerstone of the solar tower power system. In particular, it receives high-temperature heat flux rays, and extracts the maximum heat energy to be transferred to the heat transfer fluid, while minimising any thermal and mechanical stresses. Reducing the solar receiver size helps to reduce the loss of spillage; consequently, the thermal stress increases. Using a solar receiver with inserted triangular longitudinal fins enhances the heat transfer as well as strengthens the receiver tube. This study aims to optimise the number of fins, heat flux aiming point, heat transfer fluid, nanoparticle effect with molten salt as the base fluid, and type of receiver material. Non-uniform heat flux with the cosine and Gaussian effects have been considered. When the number of fins (N) increases, the maximum temperature (Tmax) decreases and the heat transfer is enhanced. When N = 20, Tmax = 656.4 K and when N = 1, Tmax = 683.55, while the efficiency for N = 1 is greater by 3% compared to when N = 20. The cosine distribution of heat flux has a higher maximum temperature than the Gaussian distribution by 29% and is 102% higher in receiver efficiency. The thermal efficiency when the heat flux is aimed at the middle point of the receiver is higher by 10% compared with a lower or upper aiming point. Using Al2O3 nanoparticles with a concentration of 0.5 wt.% increases the thermal efficiency by 14% more than when using pure molten salt when Re = 38000. Using liquid sodium is not required to monitor the peak heat flux, and by adding triangular fins the displacement and thermal stress are 6.5 % lower compared to a smooth receiver.
  3. Mohd Hajiri M, Shaharuddin S, Long CM, Hashim R, Zulkifly HH, Kasim SS, et al.
    Value Health, 2015 Nov;18(7):A378.
    PMID: 26532133 DOI: 10.1016/j.jval.2015.09.795
    Conference abstract:
    Objectives: Warfarin has been used for more than 50 years as stroke prophylaxis in patients with atrial fibrillation. New oral anticoagulant, Dabigatran, was developed and shown to be safer and more efficacious compared to Warfarin due to its lower tendency of bleeding and in reducing stroke incidences. This study aims to compare the pattern of anticoagulants used and to assess their safety and efficacy by evaluating bleeding and stroke occurrences in both groups.
    Methods: This is a retrospective study carried out at a hospital with hematology clinic in the state of Selangor, Malaysia. The samples of the study were patients with atrial fibrillation, prescribed with warfarin or dabigatran. Data collected includes patients’ demographics, co-morbidities, and stroke and haemorrhage events.
    Results: A total of 71 patients were recruited in this study with 21, 21 and 29 patients were on Warfarin, Dabigatran 110 mg and Dabigatran 150 mg respectively. Out of 50 Dabigatran users, 36 of them are warfarin-experienced. 1 out of 21 patients on warfarin experienced stroke while none in both 110 and 150mg dabigatran group. A total of 11 (52.4%) of warfarin patients experienced bleeding with 2 of them having major bleeding whereas, only 4 (8%) out of 50 dabigatran patients experienced minor bleeding, 1 in patient who were on Dabigatran 150mg and 3 patients who were on Dabigatran 110mg.
    Conclusions: The pattern of anticoagulant used for stroke prophylaxis in atrial fibrillation is slowly changing from Warfarin to Dabigatran. Evaluation of safety and efficacy profile of Warfarin shows that Warfarin requires more extensive management and monitoring in order to achieve therapeutic goals with fewer side effects. Comparison between both anticoagulants show that Dabigatran is safer and more effective compared to warfarin
    Study site: Haematology clinic, hospital, Selangor, Malaysia
  4. Ng CH, Lim CW, Teoh SG, Fun HK, Usman A, Ng SW
    Inorg Chem, 2002 Jan 14;41(1):2-3.
    PMID: 11782136
    Treatment of vanadium(V) oxide with an ethanol-concentrated sulfuric acid mixture, followed by the addition of an equimolar amount of beta-alanine and sodium hydroxide, and finally raising the pH to 3.9 with sodium carbonate solution, under continuous heating in a water bath and in the presence of air, leads to the polyionic sodium cyclo-[mu(6)-(sulfato-O,O',O'')tris[mu-(beta-alanine-O,O')-mu-oxo]tris(mu-hydroxo-mu-oxo)hexa[oxovanadium(V)]] sulfate tridecahydrate which crystallizes in the monoclinic P2(1)/n space group [a = 9.5192(4), b = 20.1185(9), c = 22.6174(9) A, beta = 97.011(1) degrees; Z = 4]. The crown-shaped polyoxovanadium(V) cluster cation, with carboxylate-bridging amino acid ligands, has an Anderson structure with two unique capping sulfato ligands. Its structural analysis, together with IR, UV-vis, and preliminary data on its solution properties, is presented.
  5. Yong GY, Mohamed-Noor J, Ong PY, Suliman NB, Lim CW, Zahari M
    Eur J Ophthalmol, 2021 Feb 07.
    PMID: 33550831 DOI: 10.1177/1120672121992953
    PURPOSE: To report the clinical profile and effectiveness of oral doxycycline as a non-invasive treatment for glaucoma filtering surgery complications.

    METHOD: Prospective case series.

    RESULTS: Doxycycline is widely used in treating corneal melts, ocular surface diseases, meibomian gland disease, recurrent epithelial cell erosion, rosacea, and keratitis sicca. This prospective case series highlights the successful treatment of five patients with leaking blebs and conjunctiva erosion from glaucoma filtration surgery with the use of oral doxycycline. There was no adverse event reported in our cases.

    CONCLUSIONS: This study suggests that oral doxycycline may be a feasible non-surgical treatment modality due to its ability to inhibit collagenolysis, restore the Meibomian gland function, thereby stopping breakdown and promote conjunctival tissue healing.

  6. Goh LL, Lim CW, Sim WC, Toh LX, Leong KP
    PLoS One, 2017;12(1):e0169233.
    PMID: 28046094 DOI: 10.1371/journal.pone.0169233
    BACKGROUND: Genetic determinants of drug response remain stable throughout life and offer great promise to patient-tailored drug therapy. The adoption of pharmacogenetic (PGx) testing in patient care requires accurate, cost effective and rapid genotyping with clear guidance on the use of the results. Hence, we evaluated a 32 SNPs panel for implementing PGx testing in clinical laboratories.

    METHODS: We designed a 32-SNP panel for PGx testing in clinical laboratories. The variants were selected using the clinical annotations of the Pharmacogenomics Knowledgebase (PharmGKB) and include polymorphisms of CYP2C9, CYP2C19, CYP2D6, CYP3A5 and VKORC1 genes. The CYP2D6 gene allele quantification was determined simultaneously with TaqMan copy number assays targeting intron 2 and exon 9 regions. The genotyping results showed high call rate accuracy according to concordance with genotypes identified by independent analyses on Sequenome massarray and droplet digital PCR. Furthermore, 506 genomic samples across three major ethnic groups of Singapore (Malay, Indian and Chinese) were analysed on our workflow.

    RESULTS: We found that 98% of our study subjects carry one or more CPIC actionable variants. The major alleles detected include CYP2C9*3, CYP2C19*2, CYP2D6*10, CYP2D6*36, CYP2D6*41, CYP3A5*3 and VKORC1*2. These translate into a high percentage of intermediate (IM) and poor metabolizer (PM) phenotypes for these genes in our population.

    CONCLUSION: Genotyping may be useful to identify patients who are prone to drug toxicity with standard doses of drug therapy in our population. The simplicity and robustness of this PGx panel is highly suitable for use in a clinical laboratory.

  7. Tan SN, Sani D, Lim CW, Ideris A, Stanslas J, Lim CTS
    PMID: 32051689 DOI: 10.1155/2020/8068797
    Edible bird's nest (EBN) which is solidified swiftlet's saliva contains high nutritional value. It is widely consumed in countries like Malaysia, Indonesia, and Thailand. However, previous proximate analysis of Malaysia EBN was not representative of all the regions in Malaysia. In recent years, safety issues such as high nitrate and nitrite contents, presence of heavy metal, adulteration, fungal infection, and cancer cell stimulation were associated with EBN. Hence, this study aimed to determine the proximate analysis, safety profile during normal weather and hazy periods, and its effect on cancer cells stimulation in Malaysia-farmed EBN. Seven raw cleaned EBN samples were sourced from 6 different regions in Malaysia. Proximate analysis and safety profile were performed using official AOCA methods and Malaysian Standard. High protein (53.03-56.37%) and carbohydrate content (27.97-31.68%) with an acceptable level of moisture (10.8-14.04%) and ash (2.22-3.38%) were reported. A good safety profile was obtained with low nitrite and nitrate levels, with undetectable heavy metals and no significant growth of pathogenic microorganism except mould. Epidermal growth factor was detected but below the quantification level with the chicken EGF ELISA kit. The microculture tetrazolium (MTT) assay was performed for growth stimulation assessment comparing human EGF and EBN. There was no significant cell growth observed in cancer cells after EBN treatment. In conclusion, EBN Malaysia has a good nutritional profile, free of heavy metals, and an acceptable level of nitrate, nitrite, and microorganism profile except for mould contents. Furthermore, the in vitro study indicated that EBN was not associated with cancer cell growth.
  8. Kee AR, Yip VCH, Tay ELT, Lim CW, Cheng J, Teo HY, et al.
    BMC Ophthalmol, 2020 Nov 10;20(1):440.
    PMID: 33167902 DOI: 10.1186/s12886-020-01701-9
    BACKGROUND: To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability.

    METHODS: A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated.

    RESULTS: A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761-1.000) compared to Swept Source (0.113-0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source.

    CONCLUSIONS: AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.

  9. Chua NYC, Chong PF, Najme Khir R, Lim CW, Ismail JR, Mohd Arshad MK, et al.
    Atherosclerosis, 2017 Aug;263:e184.
    PMID: 29365712 DOI: 10.1016/j.atherosclerosis.2017.06.591
  10. Lee TY, Farah N, Chin VK, Lim CW, Chong PP, Basir R, et al.
    Nutr Res, 2023 Nov;119:1-20.
    PMID: 37708600 DOI: 10.1016/j.nutres.2023.08.010
    Riboflavin is a precursor of the essential coenzymes flavin mononucleotide and flavin adenine dinucleotide. Both possess antioxidant properties and are involved in oxidation-reduction reactions, which have a significant impact on energy metabolism. Also, the coenzymes participate in metabolism of pyridoxine, niacin, folate, and iron. Humans must obtain riboflavin through their daily diet because of the lack of programmed enzymatic machineries for de novo riboflavin synthesis. Because of its physiological nature and fast elimination from the human body when in excess, riboflavin consumed is unlikely to induce any negative effects or develop toxicity in humans. The use of riboflavin in pharmaceutical and clinical contexts has been previously explored, including for preventing and treating oxidative stress and reperfusion oxidative damage, creating synergistic compounds to mitigate colorectal cancer, modulating blood pressure, improving diabetes mellitus comorbidities, as well as neuroprotective agents and potent photosensitizer in killing bloodborne pathogens. Thus, the goal of this review is to provide a comprehensive understanding of riboflavin's biological applications in medicine, key considerations of riboflavin safety and toxicity, and a brief overview on the nanoencapsulation of riboflavin for various functions including the treatment of a range of diseases, photodynamic therapy, and cellular imaging.
  11. Careena S, Sani D, Tan SN, Lim CW, Hassan S, Norhafizah M, et al.
    PMID: 30186358 DOI: 10.1155/2018/9318789
    Cognitive disability is a common feature associated with a variety of neurological conditions including Alzheimer's Disease (AD), Parkinson's Disease (PD), brain injury, and stroke. Emerging evidence has demonstrated that neuroinflammation plays an important role in the development of cognitive impairment. Current available therapies are relatively ineffective in treating or preventing cognitive disabilities, thus representing an important, unfulfilled medical need. Hence, developing potential treatment is one of the major areas of research interest. Edible bird's nests (EBN) are nests formed by swiftlet's saliva containing sialic acid, which is believed to improve brain function. This present study was embarked upon to evaluate the learning and memory enhancing potential effect of EBN by using Morris water maze test in a Wistar rat model of LPS-induced neuroinflammation. LPS elicited cognitive impairment in the rats by significantly increasing the escape latency while decreasing the number of entries in the probe trial, which are coupled with increased production of proinflammatory cytokines (TNF-α, IL-1β, and IL-6) and oxidative markers (ROS and TBARS) in the hippocampus. Treatment with EBN (125 mg/kg, 250 mg/kg, and 500 mg/kg; p.o.) effectively reversed the effect of LPS on escape latency and probe trial and, in addition, inhibited the LPS-induced upregulation of proinflammatory cytokines and oxidative markers. These findings are suggestive that there is existence of neuroprotective effect contained inside the edible bird's nest.
  12. Lim CW, Cheng J, Tay ELT, Teo HY, Wong EPY, Yong VKY, et al.
    BMC Ophthalmol, 2018 Dec 10;18(1):315.
    PMID: 30526537 DOI: 10.1186/s12886-018-0976-y
    BACKGROUND: Despite the potential usefulness of optical coherence tomography angiography in retinal and optic disc conditions, the reliability of the imaging modality remains unclear. This study set out to measure the microvascular density of macula and optic disc by mean of optical coherence tomography angiography and report the repeatability of the vessel density measurements.

    METHODS: Cross sectional observational cohort study. Subjects with normal eyes were recruited. Two sets of optical coherence tomography angiography images of macula and optic nerve head were acquired during one visit. Novel in-house developed software was used to count the pixels in each images and to compute the microvessel density of the macula and optic disc. Data were analysed to determine the measurement repeatability.

    RESULTS: A total of 176 eyes from 88 consecutive normal subjects were recruited. For macular images, the mean vessel density at superficial retina, deep retina, outer retina and choriocapillaries segment was OD 0.113 and OS 0.111, OD 0.239 and OS 0.230, OD 0.179 and OS 0.164, OD 0.237 and OS 0.215 respectively. For optic disc images, mean vessel density at vitreoretinal interface, radial peripapillary capillary, superficial nerve head and disc segment at the level of choroid were OD 0.084 and OS 0.085, OD 0.140 and OS 0.138, OD 0.216 and OS 0.209, OD 0.227 and OS 0.236 respectively. The measurement repeatability tests showed that the coefficient of variation of macular scans, for right and left eyes, ranged from 6.4 to 31.1% and 5.3 to 59.4%. Likewise, the coefficient of variation of optic disc scans, for right and left eyes, ranged from 14.3 to 77.4% and 13.5 to 75.3%.

    CONCLUSIONS: Optical coherence tomography angiography is a useful modality to visualise the microvasculature plexus of macula and optic nerve head. The vessel density measurement of macular scan by mean of optical coherence tomography angiography demonstrated good repeatability. The optic disc scan, on the other hand, showed a higher coefficient of variation indicating a lower measurement repeatability than macular scan. Interpretation of optical coherence tomography angiography should take into account test-retest repeatability of the imaging system.

    TRIAL REGISTRATION: National Healthcare Group Domain Specific Review Board ( NHG DSRB ) Singapore. DSRB Reference: 2015/00301.

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