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  1. Loh TL, Zulkiflee AB
    AME Case Rep, 2018;2:20.
    PMID: 30264016 DOI: 10.21037/acr.2018.04.05
    Anaplastic thyroid carcinoma (ATC) is a particularly fearsome form of thyroid cancer due to its extreme aggressiveness and dismal prognosis. Patients with ATC typically present with a rapidly enlarging neck mass with compressive symptoms. We report a case of ATC, mimicking a thyroid abscess; in a 52-year-old Chinese male with one month history of enlarging neck mass. Ultrasound of the neck was suggestive of a thyroid cyst and fine needle aspiration cytology was negative for malignancy. He presented again 2 weeks later with increased swelling and pain suggestive of right neck abscess. An incision and drainage was performed and histopathology result of a proximal isolated enlarged lymph node biopsied revealed metastatic carcinoma. Subsequent right thyroid wedge biopsy finding 1 month later were confirmatory of ATC.
  2. Aylesworth L, Lawson JM, Laksanawimol P, Ferber P, Loh TL
    J Fish Biol, 2016 Apr;88(4):1620-30.
    PMID: 26840386 DOI: 10.1111/jfb.12908
    New records of the Japanese seahorse Hippocampus mohnikei from Cambodia, Malaysia, Thailand and Vietnam, along with recently published studies from India and Singapore, have greatly expanded the known range of H. mohnikei within Southeast Asia. These new records reveal novel habitat preferences and threats to H. mohnikei in the region. Although the global conservation status of H. mohnikei is classified as Data Deficient according to the IUCN Red List of Threatened Species, new sightings indicate that this species is found in similar habitats and faces similar threats as other Hippocampus species that are considered Vulnerable.
  3. Lim RCA, Loh TL, Yahaya Z, Wan Hamizan AK
    Indian J Otolaryngol Head Neck Surg, 2022 Oct;74(Suppl 2):1964-1966.
    PMID: 36452519 DOI: 10.1007/s12070-020-01941-7
    Pathologies of the branchial apparatus originate from abnormal embryological development and frequently affects the second branchial cleft. Fourth branchial cleft lesions are exceptionally few and existing literature on it is scarce. We present a case of a fourth branchial pouch sinus, masquerading as a recurrent neck abscess.
  4. Chong W, Loh ST, Kulasegarah J, Loh TL, Tengku Kamalden TMIB
    Indian J Otolaryngol Head Neck Surg, 2022 Oct;74(Suppl 2):1800-1802.
    PMID: 36452768 DOI: 10.1007/s12070-020-01809-w
    Tuberculous retropharyngeal abscess is a rare form of extrapulmonary tuberculosis. We describe an immunocompetent teenager who has her tuberculous retropharyngeal abscess ruptured and then diagnosis confirmed by the presence of acid-fast bacilli from the gastric lavage.
  5. Quek SXZ, Loo EXL, Demutska A, Chua CE, Kew GS, Wong S, et al.
    J Gastroenterol Hepatol, 2021 Aug;36(8):2187-2197.
    PMID: 33615534 DOI: 10.1111/jgh.15466
    BACKGROUND AND AIM: Gastrointestinal manifestations of the coronavirus disease 2019 (COVID-19) pandemic may mimic irritable bowel syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with self-reported IBS.

    METHODS: We conducted an anonymized survey from May to June 2020 in 33 countries. Knowledge, attitudes, and practices on personal hygiene and social distancing as well as psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine differences in well-being and compliance to social distancing measures between respondents with and without self-reported IBS. Factors associated with improvement or worsening of IBS symptoms were evaluated.

    RESULTS: Out of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had self-reported IBS, and 374 (13.8%) did not know what IBS was. Self-reported IBS respondents reported significantly worse emotional, social, and psychological well-being compared with non-IBS respondents and were less compliant to social distancing measures (28.2% vs 35.3%, P = 0.029); 61.6% reported no change, 26.6% reported improvement, and 11.8% reported worsening IBS symptoms. Higher proportion of respondents with no change in IBS symptoms were willing to practice social distancing indefinitely versus those who deteriorated (74.9% vs 51.4%, P = 0.016). In multivariate analysis, willingness to continue social distancing for another 2-3 weeks (vs longer period) was significantly associated with higher odds of worsening IBS.

    CONCLUSION: Our study showed that self-reported IBS respondents had worse well-being and compliance to social distancing measures than non-IBS respondents. Future research will focus on occupational stress and dietary changes during COVID-19 that may influence IBS.

  6. Chua CE, Kew GS, Demutska A, Quek S, Loo EXL, Gui H, et al.
    BMJ Open, 2021 08 09;11(8):e046310.
    PMID: 34373296 DOI: 10.1136/bmjopen-2020-046310
    INTRODUCTION: Regardless of having effective vaccines against COVID-19, containment measures such as enhanced physical distancing and good practice of personal hygiene remain the mainstay of controlling the COVID-19 pandemic. Countries across Asia have imposed these containment measures to varying extents. However, residents in different countries would have a differing degree of compliance to these containment measures potentially due to differences in the level of awareness and motivation in the early phase of pandemic.

    OBJECTIVES: In our study, we aimed to describe and correlate the level of knowledge and attitude with the level of compliance with personal hygiene and physical distancing practices among Asian countries in the early phase of pandemic.

    METHODS: A multinational cross-sectional study was carried out using electronic surveys between May and June 2020 across 14 geographical areas. Subjects aged 21 years and above were invited to participate through social media, word of mouth and electronic mail.

    RESULTS: Among the 2574 responses obtained, 762 (29.6%) participants were from East Asia and 1812 (70.4%) were from Southeast Asia (SEA). A greater proportion of participants from SEA will practise physical distancing as long as it takes (72.8% vs 60.6%). Having safe distancing practices such as standing more than 1 or 2 m apart (AdjOR 5.09 95% CI (1.08 to 24.01)) or more than 3 or 4 m apart (AdjOR 7.05 95% CI (1.32 to 37.67)), wearing a mask when they had influenza-like symptoms before the COVID-19 pandemic, preferring online news channels such as online news websites/applications (AdjOR 1.73 95% CI (1.21 to 2.49)) and social media (AdjOR 1.68 95% CI (1.13 to 2.50) as sources of obtaining information about COVID-19 and high psychological well-being (AdjOR 1.39 95% CI (1.04 to 1.87)) were independent factors associated with high compliance.

    CONCLUSIONS: We found factors associated with high compliance behaviour against COVID-19 in the early phase of pandemic and it will be useful to consider them in risk assessment, communication and pandemic preparedness.

  7. Shah SU, Xiu Ling Loo E, En Chua C, Sen Kew G, Demutska A, Quek S, et al.
    PLoS One, 2021;16(6):e0252835.
    PMID: 34097719 DOI: 10.1371/journal.pone.0252835
    IMPORTANCE: Knowledge and attitude influence compliance and individuals' practices. The risk and protective factors associated with high compliance to these preventive measures are critical to enhancing pandemic preparedness.

    OBJECTIVE: This survey aims to assess differences in mental health, knowledge, attitudes, and practices (KAP) of preventive measures for COVID-19 amongst healthcare professionals (HCP) and non-healthcare professionals.

    DESIGN: Multi-national cross-sectional study was carried out using electronic surveys between May-June 2020.

    SETTING: Multi-national survey was distributed across 36 countries through social media, word-of-mouth, and electronic mail.

    PARTICIPANTS: Participants ≥21 years working in healthcare and non-healthcare related professions.

    MAIN OUTCOME: Risk factors determining the difference in KAP towards personal hygiene and social distancing measures during COVID-19 amongst HCP and non-HCP.

    RESULTS: HCP were significantly more knowledgeable on personal hygiene (AdjOR 1.45, 95% CI -1.14 to 1.83) and social distancing (AdjOR 1.31, 95% CI -1.06 to 1.61) compared to non-HCP. They were more likely to have a positive attitude towards personal hygiene and 1.5 times more willing to participate in the contact tracing app. There was high compliance towards personal hygiene and social distancing measures amongst HCP. HCP with high compliance were 1.8 times more likely to flourish and more likely to have a high sense of emotional (AdjOR 1.94, 95% CI (1.44 to 2.61), social (AdjOR 2.07, 95% CI -1.55 to 2.78), and psychological (AdjOR 2.13, 95% CI (1.59-2.85) well-being.

    CONCLUSION AND RELEVANCE: While healthcare professionals were more knowledgeable, had more positive attitudes, their higher sense of total well-being was seen to be more critical to enhance compliance. Therefore, focusing on the well-being of the general population would help to enhance their compliance towards the preventive measures for COVID-19.

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