MyMedR

Displaying all 9 publications

Abstract:

Sort:

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.
Broncho-pulmonary cryptococcosis

Dutt AK, Krishnan M, Lim EJ

Med J Malaya, 1969 Sep;24(1):74-8.
PMID: 4243848
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.
The investigation of media components for optimal metabolite production of Aspergillus terreus ATCC 20542

Abd Rahim MH, Lim EJ, Hasan H, Abbas A

J Microbiol Methods, 2019 09;164:105672.
PMID: 31326443 DOI: 10.1016/j.mimet.2019.105672

PURPOSE: This study aimed to assess the effect of nitrogen, salt and pre-culture conditions on the production of lovastatin in A. terreus ATCC 20542.
METHODS: Different combinations of nitrogen sources, salts and pre-culture combinations were applied in the fermentation media and lovastatin yield was analysed chromatographically.
RESULT: The exclusion of MnSO4 ·5H2O, CuSO4·5H2O and FeCl3·6H2O were shown to significantly improve lovastatin production (282%), while KH2PO4, MgSO4·7H2O, and NaCl and ZnSO4·7H2O were indispensable for good lovastatin production. Simple nitrogen source (ammonia) was unfavourable for morphology, growth and lovastatin production. In contrast, yeast extract (complex nitrogen source) produced the highest lovastatin yield (25.52 mg/L), while powdered soybean favoured the production of co-metabolites ((+)-geodin and sulochrin). Intermediate lactose: yeast extract (5:4) ratio produced the optimal lovastatin yield (12.33 mg/L) during pre-culture, while high (5:2) or low (5:6) lactose to yeast extract ratio produced significantly lower lovastatin yield (7.98 mg/L and 9.12 mg/L, respectively). High spore concentration, up to 107 spores/L was shown to be beneficial for lovastatin, but not for co-metabolite production, while higher spore age was shown to be beneficial for all of its metabolites.
CONCLUSION: The findings from these investigations could be used for future cultivation of A. terreus in the production of desired metabolites.
Psychological processes of suffering of palliative care patients in Malaysia: a thematic analysis

Tan SB, Loh EC, Lam CL, Ng CG, Lim EJ, Boey CCM

BMJ Support Palliat Care, 2019 Mar;9(1):e19.
PMID: 27098972 DOI: 10.1136/bmjspcare-2015-001064

Although suffering in palliative care has received increasing attention over the past decade, the psychological processes that underpin suffering remain relatively unexplored.
OBJECTIVE: To understand the psychological processes involved in the experiencing of suffering at the end phase of life.
METHODS: Semistructured interviews were conducted with 20 palliative care inpatients from an academic medical centre in Kuala Lumpur, Malaysia. The transcripts were thematically analysed with NVIVO9.
RESULTS: 5 themes of psychological processes of suffering were generated: (1) perceptions, (2) cognitive appraisals, (3) hope and the struggles with acceptance, (4) emotions and (5) clinging. A model of suffering formation was constructed.
CONCLUSION: The findings may inform the development of mechanism-based interventions in the palliation of suffering.
Factor V inhibitor in neonatal intracranial hemorrhage secondary to severe congenital factor V deficiency

Lee WS, Chong LA, Begum S, Abdullah WA, Koh MT, Lim EJ

J Pediatr Hematol Oncol, 2001 May;23(4):244-6.
PMID: 11846304

We report a newborn infant girl, born to consanguineous parents, with recurrent intracranial hemorrhage secondary to congenital factor V deficiency with factor V inhibitor. Repeated transfusions of fresh-frozen plasma (FFP) and platelet concentrates, administrations of immunosuppressive therapy (prednisolone and cyclophosphamide), and intravenous immunoglobulin failed to normalize the coagulation profiles. Exchange transfusion followed-up by administrations of activated prothrombin complex and transfusions of FFP and platelet concentrates caused a temporary normalization of coagulation profile, enabling an insertion of ventriculoperitoneal (VP) shunt for progressive hydrocephalus. The treatment was complicated by thrombosis of left brachial artery and ischemia of left middle finger. The child finally died from another episode of intracranial hemorrhage 10 days after insertion of the VP shunt.
Mindfulness: A New Paradigm of Psychosocial Care in the Palliative Care Setting in Southeast Asia

Tan SB, Capelle DP, Zainal NZ, Lim EJ, Loh EC, Lam CL

Ann Acad Med Singap, 2017 Sep;46(9):339-346.
PMID: 29022034

Alleviation of suffering in palliative care needs a combination of good symptom control and psychosocial care. The capacity of mindfulness to promote psychological flexibility opens up possibilities of creating a paradigm shift that can potentially change the landscape of psychosocial care. In this review, we attempt to introduce 4 methods to establish mindfulness based on 'The Discourse on the Foundations of Mindfulness', a core text of Theravada Buddhism, followed by a brief comparison of the concepts and practices of mindfulness in different cultures and religions in Southeast Asia. Next, 2 mindfulness-based interventions specifically designed for palliative psychosocial care - mindfulness-based supportive therapy (MBST) and mini-mindfulness meditation (MMM) are introduced. We hypothesise that mindful practices, tailored to the palliative setting, can promote positive psychosocial outcomes.
Fulltext The Review of Cooking, Drying, and Green Extraction Methods on General Nutritional Properties of Mealworms and Locusts

Mohd Zaini NS, Lim EJ, Ahmad NH, Gengatharan A, Wan-Mohtar WAAQI, Abd Rahim MH

Food Bioproc Tech, 2023 Feb 20.
PMID: 36844636 DOI: 10.1007/s11947-023-03020-5

The processing of edible insects as an alternative source of nutrition may be a key driver in the development of a sustainable food and feed system. This review will study two industrial types of insects-mealworms and locusts-and summarize evidence related to the impact of processing on their micro- and macronutritional characteristics. The focus will be on their potential use as food for human consumption as opposed to animal feed. Literature has indicated that these two insects have the potential to provide protein and fat qualities comparable to or better than traditional mammalian sources. For example, mealworms-the larval form of the yellow mealworm beetlepossess a higher fat content, while adult locusts are rich in fibers, especially chitin. However, due to the different matrix and nutrient compositions, the processing of mealworms or locusts at a commercial scale needs to be tailored to minimize nutritional loss and maximize cost efficiency. The stages of preprocessing, cooking, drying, and extraction are the most critical control points for nutritional preservation. Thermal cooking applications such as microwave technology have demonstrated promising results, but the generation of heat may contribute to a certain nutritional loss. In an industrial context, drying using freeze dry is the preferred choice due to its uniformity, but it can be costly while increasing lipid peroxidation. During the extraction of nutrients, the use of green emerging technologies such as high hydrostatic pressure, pulsed electric field, and ultrasound may provide an alternative method to enhance nutrient preservation.
Comparison Between Holmium:YAG Laser with MOSES Technology vs Thulium Fiber Laser Lithotripsy in Retrograde Intrarenal Surgery for Kidney Stones in Adults: A Propensity Score-matched Analysis From the FLEXible Ureteroscopy Outcomes Registry

Castellani D, Fong KY, Lim EJ, Chew BH, Tailly T, Emiliani E, et al.

J Urol, 2023 Aug;210(2):323-330.
PMID: 37126223 DOI: 10.1097/JU.0000000000003504

PURPOSE: We evaluated stone-free rate and complications after flexible ureteroscopy for renal stones, comparing thulium fiber laser and holmium:YAG laser with MOSES technology.
MATERIALS AND METHODS: Data from adults who underwent flexible ureteroscopy in 20 centers worldwide were retrospectively reviewed (January 2018-August 2021). Patients with ureteral stones, concomitant bilateral procedures, and combined procedures were excluded. One-to-one propensity score matching for age, gender, and stone characteristics was performed. Stone-free rate was defined as absence of fragments >2 mm on imaging within 3 months after surgery. Multivariable logistic regression analysis was performed to evaluate independent predictors of being stone-free.
RESULTS: Of 2,075 included patients, holmium:YAG laser with MOSES technology was used in 508 patients and thulium fiber laser in 1,567 patients. After matching, 284 patients from each group with comparable baseline characteristics were included. Pure dusting was applied in 6.0% of cases in holmium:YAG laser with MOSES technology compared with 26% in thulium fiber laser. There was a higher rate of basket extraction in holmium:YAG laser with MOSES technology (89% vs 43%, P < .001). Total operation time and lasing time were similar. Nine patients had sepsis in thulium fiber laser vs none in holmium:YAG laser with MOSES technology (P = .007). Higher stone-free rate was achieved in thulium fiber laser (85% vs 56%, P < .001). At multivariable analysis, the use of thulium fiber laser and ureteral access sheath ≥8F had significantly higher odds of being stone-free. Lasing time, multiple stones, stone diameter, and use of disposable scopes showed significantly lower odds of being stone-free.
CONCLUSIONS: This real-world study favors the use of thulium fiber laser over holmium:YAG laser with MOSES technology in flexible ureteroscopy for renal stones by way of its higher single-stage stone-free rate.