Displaying publications 1 - 20 of 78 in total

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  1. Current status of malaria in Malaysia
    Lim ES
    Southeast Asian J. Trop. Med. Public Health, 1992 Sep;23 Suppl 4:43-9.
    PMID: 1364867
    The Malaria Eradication Program was started in 1967 in Peninsular Malaysia. Since then and up to 1980, there was a reduction in the number of reported malaria cases from 160,385 in 1966 to 9,110 cases for Peninsular Malaysia. Although the concept of eradication has changed to one of control in the 1980, the anti-malaria activities have remained the same. However, additional supplementary activities such as the use of impregnated bednets, and the Primary Health Care approach, have been introduced in malarious and malaria-prone areas. Focal spraying activity is instituted in localities with outbreaks in both malaria-prone and non-malarious areas. Passive case detection has been maintained in all operational areas. In 1990, 50,500 cases of malaria were reported of which 69.7% (35,190) were from Sabah, 27.8% (14,066) from Peninsular Malaysia and 2.5% (1,244) from Sarawak. Until June 1991 a total of 18,306 cases were reported for the country. Plasmodium falciparum continues to be the predominant species, contributing to 69.6% of the parasites involved. The case fatality rate for 1990 was 0.09%. There were 43 deaths all of which were attributed to cerebral malaria. The problems faced in the prevention and control of malaria include problems associated with the opening of land for agriculture, mobility of the aborigines of Peninsular Malaysia (Orang Asli) and inaccessibility of malaria problem areas. There is need to ensure prompt investigation and complete treatment of cases especially in malarious areas. The promotion of community participation in control activities should be intensified. Primary Health Care should be continued and intensified in the malarious areas.(ABSTRACT TRUNCATED AT 250 WORDS)
  2. Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note
    Brand Y, Lim E, Waran V, Prepageran N
    J Laryngol Otol, 2015 Dec;129(12):1243-7.
    PMID: 26412297 DOI: 10.1017/S0022215115002601
    Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa.
  3. The specificity of a rapid method of assay for the presence of Legionella species in water
    Lim EW, Meers PD
    Ann Acad Med Singap, 1989 Jul;18(4):348-51.
    PMID: 2679337
    A rapid method of assay, using a monoclonal antibody linked to alkaline phosphatase, was used for the detection of the Pontiac subgroup of Legionella pneumophila serogroup 1. It was tested for its specificity against 53 strains of Legionella recently isolated from the environment in Singapore and Malaysia. The specificity and sensitivity of this method of assay was confirmed, though there is some concern that the specificity was too narrow, and there are reservations about the criteria suggested for interpreting the results.
  4. Fulltext Identification of αo-thalassaemia (–SEA) using an Enzyme- Linked Immunosorbent Assay (ELISA) for embryonic zeta-globin chain detection – a preliminary study
    Tan, J. A. M. A., George, E., Lim, E. J., Zakaria, Z., Hassan, R., Wee, Y. C., et al.
    Malaysian Journal of Medicine and Health Sciences, 2006;2(2):81-87.
    MyJurnal
    Objectives: This study aimed to evaluate the UBI MAGIWELTM ζ-GLOBIN ELISA Kit for the presumptive diagnosis of αo-thalassaemia. The ELISA results obtained were confirmed by molecular characterisation of αo-thalassaemia using a Duplex-PCR. Methods: Routine peripheral blood counts and red cell indices were determined in 94 blood samples sent for Hb analysis. Hb subtypes were quantified by high performance liquid chromatography (HPLC) and Hb electrophoresis conducted on agarose gel at pH 8.5. Zeta-globin chain levels were determined using the UBI MAGIWELTM ζ-GLOBIN ELISA Kit. Molecular analysis was performed using a duplex-PCR which simultaneously amplifies
    a normal 136 bp sequence between the ψα−α2-globin genes and a 730 bp Southeast Asian deletion-specific sequence (–SEA) between the ψα2−θ1-globin genes. Results: Using the ELISA assay kit, 20 blood samples were presumptively identified as α-thalassaemia carriers from elevated ζ-globin chains (OD>0.3) while the remaining 74 blood samples showed OD
  5. Fulltext Bone marrow and peripheral blood changes in non-Hodgkin's lymphoma
    Lim EJ, Peh SC
    Singapore Med J, 2000 Jun;41(6):279-85.
    PMID: 11109344
    47 patients with non-Hodgkin's lymphoma (NHL) were studied retrospectively to determine their marrow and blood changes at diagnosis.
  6. Influencing secondary school STUDENTS' conservation behavior intention through an interpretive education program on the malayan tapir
    Lim EA, Manohar M, Aziz A, Zakaria M
    Eval Program Plann, 2016 10;58:60-69.
    PMID: 27315301 DOI: 10.1016/j.evalprogplan.2016.05.008
  7. Trend in metals variation in Tasik Chini, Pahang, Peninsular Malaysia
    Shuhaimi-Othman M, Mushrifah I, Lim EC, Ahmad A
    Environ Monit Assess, 2008 Aug;143(1-3):345-54.
    PMID: 17987397
    Water from 15 sampling stations in Tasik Chini (Chini Lake), Peninsular Malaysia were sampled for 12 months from September 2004 until August 2005 and analyzed for 11 metals including iron (Fe), aluminum (Al), manganese (Mn), barium (Ba), zinc (Zn), lead (Pb), copper (Cu), cadmium (Cd), nickel (Ni), chromium (Cr) and cobalt (Co). Results showed that the mean (min-max) metal concentrations (in micrograms per liter) in Tasik Chini waters for the 12 months sampling based on 15 sampling stations (in descending order) for Fe, Al, Mn, Ba, Zn, Pb, Cu and Cd were 794.84 (309.33-1609.07), 194.53 (62.37-665.93), 29.16 (16.68-79.85), 22.07 (15.64-29.71), 5.12 (2.224-6.553), 2.36 (1.165-4.240), 0.832 (0.362-1.443) and 0.421 (0.254-0.696) respectively. Concentration for three metals i.e. Ni, Cr and Co were too low and not detected by the graphite furnace Atomic Absorption Spectrophotometry (AAS). Comparison with various water quality standards showed that the mean metals concentration in surface water of Tasik Chini were low and within the range of natural background except for Fe and Al. In general, metal concentrations in Tasik Chini water varied temporally and spatially. The main factors influencing these metal concentrations in the water were the raining season and mining activities. Stations located at Tanjung Jerangking and Melai areas were the most effected due to those factors.
  8. Effect of a carotene concentrate on the growth of human breast cancer cells and pS2 gene expression
    Nesaretnam K, Jin Lim E, Reimann K, Lai LC
    Toxicology, 2000 Oct 26;151(1-3):117-26.
    PMID: 11074306
    Breast cancer is the most common cancer in women worldwide. The growth of breast cancer cells is either hormone-dependent or hormone-independent. Both types are represented in vitro by the estrogen-receptor positive (ER+) MCF-7 and the estrogen-receptor negative (ER-) MDA-MB-231 cell lines, respectively. The pS2 gene is an estrogen-regulated gene and serves as a marker for the ER+ tumours. Carotenoids are pigments with anti-cancer properties besides having pro-vitamin A, antioxidant and free-radical quenching effects. This study was designed firstly, to compare the effect of palm oil carotene concentrate with retinoic acid on the growth of the ER+ MCF-7 and the ER- MDA-MB-231 cells; and secondly to evaluate the effect of the palm oil carotene concentrate on the regulation of pS2 mRNA. The growth experiments were performed with monolayer cells seeded in phenol red free RPMI 1640 culture media and subsequently treated with varying concentrations of either retinoic acid or palm oil carotenoids. The cell numbers were determined at the start of each experiment and then at successive time intervals. The results showed that the palm oil carotene concentrate caused dose-dependent inhibition of estradiol-stimulated growth of MCF-7 cells but did not affect the proliferation of MDA-MB-231 cells. Retinoic acid caused similar, albeit more potent effects, as significant inhibition was observed at lower concentrations than the palm oil carotenoids. In the pS2 gene expression experiment, cell monolayers were treated with the carotene concentrate (10(-6) M), either with or without supplemented estradiol (10(-8) M), and subsequently the RNA was extracted. Northern blotting was performed and the regulation of pS2 mRNA determined using a 32P-labelled pS2 cDNA probe. The results showed that the palm oil carotene concentrate did not affect the expression of pS2 mRNA and are therefore independent of the estrogen-regulated pathway.
  9. Broncho-pulmonary cryptococcosis
    Dutt AK, Krishnan M, Lim EJ
    Med J Malaya, 1969 Sep;24(1):74-8.
    PMID: 4243848
  10. Fulltext Editorial: Data assimilation in cardiovascular medicine: Merging experimental measurements with physics-based computational models
    Lim E, Shi Y, Leo HL, Al Abed A
    Front Physiol, 2023;14:1153861.
    PMID: 36846318 DOI: 10.3389/fphys.2023.1153861
  11. Fulltext CT angiography versus Digital Subtraction angiography for intracranial vascular pathology in a clinical setting
    Cunli Y, Khoo LS, Lim PJ, Lim EH
    Med J Malaysia, 2013 Oct;68(5):415-23.
    PMID: 24632872
    No abstract available.
  12. Effect of spatial inlet velocity profiles on the vortex formation pattern in a dilated left ventricle
    Chan BT, Lim E, Ong CW, Abu Osman NA
    Comput Methods Biomech Biomed Engin, 2015;18(1):90-6.
    PMID: 23521137 DOI: 10.1080/10255842.2013.779683
    Despite the advancement of cardiac imaging technologies, these have traditionally been limited to global geometrical measurements. Computational fluid dynamics (CFD) has emerged as a reliable tool that provides flow field information and other variables essential for the assessment of the cardiac function. Extensive studies have shown that vortex formation and propagation during the filling phase acts as a promising indicator for the diagnosis of the cardiac health condition. Proper setting of the boundary conditions is crucial in a CFD study as they are important determinants, that affect the simulation results. In this article, the effect of different transmitral velocity profiles (parabolic and uniform profile) on the vortex formation patterns during diastole was studied in a ventricle with dilated cardiomyopathy (DCM). The resulting vortex evolution pattern using the uniform inlet velocity profile agreed with that reported in the literature, which revealed an increase in thrombus risk in a ventricle with DCM. However the application of a parabolic velocity profile at the inlet yields a deviated vortical flow pattern and overestimates the propagation velocity of the vortex ring towards the apex of the ventricle. This study highlighted that uniform inlet velocity profile should be applied in the study of the filling dynamics in a left ventricle because it produces results closer to that observed experimentally.
  13. Review on CFD simulation in heart with dilated cardiomyopathy and myocardial infarction
    Chan BT, Lim E, Chee KH, Abu Osman NA
    Comput Biol Med, 2013 May;43(4):377-85.
    PMID: 23428371 DOI: 10.1016/j.compbiomed.2013.01.013
    The heart is a sophisticated functional organ that plays a crucial role in the blood circulatory system. Hemodynamics within the heart chamber can be indicative of exert cardiac health. Due to the limitations of current cardiac imaging modalities, computational fluid dynamics (CFD) have been widely used for the purposes of cardiac function assessment and heart disease diagnosis, as they provide detailed insights into the cardiac flow field. An understanding of ventricular hemodynamics and pathological severities can be gained through studies that employ the CFD method. In this research the hemodynamics of two common myocardial diseases, dilated cardiomyopathy (DCM) and myocardial infarction (MI) were investigated, during both the filling phase and the whole cardiac cycle, through a prescribed geometry and fluid structure interaction (FSI) approach. The results of the research indicated that early stage disease identification and the improvement of cardiac assisting devices and therapeutic procedures can be facilitated through the use of the CFD method.
  14. Numerical simulations of flow through the aorta using both ideal and realistic geometrical models
    Wan Ab Naim WN, Ganesan P, Al Abed A, Lim E
    Annu Int Conf IEEE Eng Med Biol Soc, 2012;2012:653-6.
    PMID: 23365977 DOI: 10.1109/EMBC.2012.6346016
    The effects of curvature and tapering on the flow progression in the aorta were studied using numerical simulations on a realistic geometrical model of the aorta and three different versions of the ideal aorta models. The results showed that tapering increases velocity magnitude and wall shear stress while local curvatures affect the skewness of the velocity profile, the thickness of the boundary layer as well as the recirculation regions. Wall shear stress distribution in the aorta serves as an important determinant in the progression of arterial disease.
  15. Fulltext Integrated Anterior, Central, and Posterior Skull Base Unit - A New Perspective
    Brand Y, Waran V, Zulkiflee AB, Lim E, Prepageran N
    Front Surg, 2015;2:32.
    PMID: 26258128 DOI: 10.3389/fsurg.2015.00032
    The skull base is one of the most complex anatomical regions and forms the floor of the cranial cavity. Skull base surgery involves open, microscopic, and endoscopic approaches to the anterior, middle, or posterior cranial fossa. A multispecialty team approach is essential in treating patients with skull base lesions. Traditionally, rhinologists are involved in providing access to anterior skull base lesions while otologists are involved in the treatment of lesions of the posterior skull base. This is the case in most skull base centers today. In this article, we share a new perspective of an integrated skull base unit where a team of otolaryngologists and neurosurgeons treat anterior, middle, and posterior skull base pathologies. The rationale for this approach is that most technical skills required in skull base surgery are interchangeable and apply whether an endoscopic or microscopic approach is used. We show how the different skills apply to the different approaches and share our experience with an integrated skull base unit.
  16. Fulltext Preload-based starling-like control for rotary blood pumps: numerical comparison with pulsatility control and constant speed operation
    Mansouri M, Salamonsen RF, Lim E, Akmeliawati R, Lovell NH
    PLoS One, 2015;10(4):e0121413.
    PMID: 25849979 DOI: 10.1371/journal.pone.0121413
    In this study, we evaluate a preload-based Starling-like controller for implantable rotary blood pumps (IRBPs) using left ventricular end-diastolic pressure (PLVED) as the feedback variable. Simulations are conducted using a validated mathematical model. The controller emulates the response of the natural left ventricle (LV) to changes in PLVED. We report the performance of the preload-based Starling-like controller in comparison with our recently designed pulsatility controller and constant speed operation. In handling the transition from a baseline state to test states, which include vigorous exercise, blood loss and a major reduction in the LV contractility (LVC), the preload controller outperformed pulsatility control and constant speed operation in all three test scenarios. In exercise, preload-control achieved an increase of 54% in mean pump flow ([Formula: see text]) with minimum loading on the LV, while pulsatility control achieved only a 5% increase in flow and a decrease in mean pump speed. In a hemorrhage scenario, the preload control maintained the greatest safety margin against LV suction. PLVED for the preload controller was 4.9 mmHg, compared with 0.4 mmHg for the pulsatility controller and 0.2 mmHg for the constant speed mode. This was associated with an adequate mean arterial pressure (MAP) of 84 mmHg. In transition to low LVC, [Formula: see text] for preload control remained constant at 5.22 L/min with a PLVED of 8.0 mmHg. With regards to pulsatility control, [Formula: see text] fell to the nonviable level of 2.4 L/min with an associated PLVED of 16 mmHg and a MAP of 55 mmHg. Consequently, pulsatility control was deemed inferior to constant speed mode with a PLVED of 11 mmHg and a [Formula: see text] of 5.13 L/min in low LVC scenario. We conclude that pulsatility control imposes a danger to the patient in the severely reduced LVC scenario, which can be overcome by using a preload-based Starling-like control approach.
  17. Efficiency of blood usage for elective surgery in the University Hospital Kuala Lumpur
    Lim EJ, Lopez CG, Veera SN, Menaka N, Aminah A
    Malays J Pathol, 1996 Dec;18(2):107-12.
    PMID: 10879231
    Provision of quality care, service and blood products to patients while containing costs and the amount of blood used should be the aim of every blood bank. Therefore a prospective audit was carried out over three months to determine how efficiently blood was being used in elective surgery in the University Hospital, Kuala Lumpur. Every case with blood crossmatched was monitored to determine the amount transfused and the posttransfusion haemoglobin level. Overcrossmatching of varying degrees was noted in almost all surgical procedures and overtransfusion in 45.5% of patients transfused. The rate of case postponement was 18.1%. These indicate inefficient utilization of blood and other resources. The transfusion index (TI) and range of units transfused were calculated for each procedure. They can be used as indicators of blood requirement and potential severity of hemorrhage. Suggestions to improve efficiency of blood utilization include the introduction and ongoing monitoring of guidelines on crossmatching and transfusion based on the data obtained here, by the hospital blood transfusion committee; the "group, screen and hold" practice for surgical procedures with high crossmatch transfusion ratios, low transfusion indices and a small range of units transfused could also be adopted.
  18. Cancers among South-East Asian Nationals in Brunei Darussalam
    Chong VH, Telisinghe PU, Lim E, Tan J, Chong CF
    Asian Pac J Cancer Prev, 2016;17(2):845-9.
    PMID: 26925690
    BACKGROUND: Worldwide, the incidence of cancers is increasing and is becoming a major public health issue, including those in the Asia Pacific region. South-East Asia is a region with diverse populations with different disease spectra. This study looked at the spectrum of cancers among South-East Asians working in Brunei Darussalam.

    MATERIALS AND METHODS: The cancer registry from 1994 to 2012 maintained by the State Laboratory was retrospectively reviewed. Crude incidence rates were calculated based on the population census of 2010.

    RESULTS: Altogether, there was a total of 418 cancer cases diagnosed among South-East Asians, giving an incidence of 5.1% (n=418/8,253). The affected nationals in decreasing frequency were Malaysians (53.1%), followed by Filipinos (25.8%), Indonesians (15.3%), Thais (3.8%), Myanmese (1.7%) and Vietnamese (0.2%) with no recorded cases for Singapore and the People's Republic of Laos. The overall mean age of diagnosis was 46.1±4.2 years old, with an increasing trend over the years (p<0.05 ANOVA). The overall gender ratio was 42.3:57.7 (male:female), more females among the Filipinos and Indonesians, more males among the Thais, and equal representation among the Malaysians and the Myanmese. The most common were cancers of the digestive system (19.9%), followed by female reproductive/gynecologic system (16.0%), breast (15.6%), hematological/lymphatic (12.0%) and head/neck (8.1%). There were differences in the prevalence of cancers among the various nationalities with highest crude incidence rate among the Myanmese (141.2/100,000), followed by the Malaysian (88.5/100,000), and the Filipinos (40.6/100,000) and the lowest among the Thais (18.4/100,000), Indonesians (10.5/100,000) and the Vietnamese (6.3/100,000).

    CONCLUSIONS: Cancers among South-East Asian residing in Brunei Darussalam accounted for 5.1% of all cancers. The most common cancers were cancers of the digestive, gynecologic/female reproductive system and breast with certain types slowly increasing in proportions. There mean age of diagnoses was increasing.

  19. Fulltext Pneumocephalus and air travel: an experimental investigation on the effects of aircraft cabin pressure on intracranial pressure
    Lim E, Lan BL, Ooi EH, Low HL
    Sci Rep, 2020 08 12;10(1):13626.
    PMID: 32788610 DOI: 10.1038/s41598-020-70614-w
    This study investigates the effects of aircraft cabin pressure on intracranial pressure (ICP) elevation of a pneumocephalus patient. We propose an experimental setup that simulates the intracranial hydrodynamics of a pneumocephalus patient during flight. It consists of an acrylic box (skull), air-filled balloon [intracranial air (ICA)], water-filled balloon (cerebrospinal fluid and blood) and agarose gel (brain). The cabin was replicated using a custom-made pressure chamber. The setup can measure the rise in ICP during depressurization to levels similar to that inside the cabin at cruising altitude. ΔICP, i.e. the difference between mean cruising ICP and initial ICP, was found to increase with ICA volume and ROC. However, ΔICP was independent of the initial ICP. The largest ΔICP was 5 mmHg; obtained when ICA volume and ROC were 20 ml and 1,600 ft/min, respectively. The postulated ICA expansion and the subsequent increase in ICP in pneumocephalus patients during flight were successfully quantified in a laboratory setting. Based on the quantitative and qualitative analyses of the results, an ICA volume of 20 ml and initial ICP of 15 mmHg were recommended as conservative thresholds that are required for safe air travel among pneumocephalus patients. This study provides laboratory data that may be used by doctors to advise post-neurosurgical patients if they can safely fly.
  20. Convolutional neural network regression for short-axis left ventricle segmentation in cardiac cine MR sequences
    Tan LK, Liew YM, Lim E, McLaughlin RA
    Med Image Anal, 2017 Apr 12;39:78-86.
    PMID: 28437634 DOI: 10.1016/j.media.2017.04.002
    Automated left ventricular (LV) segmentation is crucial for efficient quantification of cardiac function and morphology to aid subsequent management of cardiac pathologies. In this paper, we parameterize the complete (all short axis slices and phases) LV segmentation task in terms of the radial distances between the LV centerpoint and the endo- and epicardial contours in polar space. We then utilize convolutional neural network regression to infer these parameters. Utilizing parameter regression, as opposed to conventional pixel classification, allows the network to inherently reflect domain-specific physical constraints. We have benchmarked our approach primarily against the publicly-available left ventricle segmentation challenge (LVSC) dataset, which consists of 100 training and 100 validation cardiac MRI cases representing a heterogeneous mix of cardiac pathologies and imaging parameters across multiple centers. Our approach attained a .77 Jaccard index, which is the highest published overall result in comparison to other automated algorithms. To test general applicability, we also evaluated against the Kaggle Second Annual Data Science Bowl, where the evaluation metric was the indirect clinical measures of LV volume rather than direct myocardial contours. Our approach attained a Continuous Ranked Probability Score (CRPS) of .0124, which would have ranked tenth in the original challenge. With this we demonstrate the effectiveness of convolutional neural network regression paired with domain-specific features in clinical segmentation.
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