Displaying publications 1 - 20 of 89 in total

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  1. Fulltext Lethal complication of a common disease-varicella pneumonitis
    Neesha Sundramoorthy, Khaiteri R., Low J. M.
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):68-68.
    MyJurnal
    Introduction: Varicella pneumonitis is a rare but lethal complication of varicella zoster infection. Case description:We report a case of a 42 year old gentleman who presented with fever, rash, cough and worsening shortness of breath after exposure to his daughter who just recovered from varicella zoster infection. He is an active smoker with no comorbidities. He presented on day 4 of illness with generalised vesicular eruption and respiratory examination revealed reduced vesicular breath sounds bilaterally. He was intubated in view of worsening respiratory distress and was transferred to ICU. Chest X-ray and ABG was suggestive of acute respiratory distress syndrome(ARDS). He was treated with IV Acyclovir and broad spectrum antibiotics in view of subsequent hospital acquired infection. He was discharged well after 3 weeks of hospitalisation. Discussion: Varicella zoster infection is caused by Human alpha-herpesvirus 3, one of eight herpes viruses known to infect humans. Diagnosis of varicella pneumonitis with ARDS was made on the basis of rash, respiratory symptoms and contact with a child who just recovered from varicella zoster infection and rapid worsening of radiological changes. The risk factor of developing severe pneumonitis can be attributed to active smoking. Conclusion: High degree of suspicion and timely diagnosis is crucial for a favourable outcome in a patient with this rare complication.
  2. Important differential in a patient presenting with neuropsychiatric symptoms: Anti-N-Methyl-D-Aspartate receptor encephalitis
    Low JM
    Med J Malaysia, 2017 10;72(5):306-307.
    PMID: 29197887 MyJurnal
    Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an immune mediated condition, which remains relatively unknown in Malaysia outside tertiary hospitals with neurology unit. It is often misdiagnosed as a psychiatric illness before definitive treatment is instituted. We report here an 18-year-old man who initially presented to the psychiatry unit before he was subsequently diagnosed as having anti-NMDAR encephalitis. To our knowledge, this is the first reported case of anti-NMDAR encephalitis in the east coast of Peninsular Malaysia.
  3. POEMS syndrome: A rare paraneoplastic presentation of spinal plasmacytoma
    Low JM, Basiam S, Ahlam Naila K
    Med J Malaysia, 2019 08;74(4):335-337.
    PMID: 31424045
    The acronym POEMS syndrome was coined for a unique multisystem disorder characterised by peripheral neuropathy, organomegaly, endocrinopathies, monoclonal gammopathy and skin changes. We report a male patient presenting to us with spinal plasmacytoma complicated with paraplegia. He was subsequently diagnosed to have POEMS syndrome and successfully treated with thalidomide and dexamethasone. Post treatment, he is able to ambulate independently.
  4. Isoniazid-induced encephalopathy in an end-stage renal disease patient - A case report and literature review
    Low JM, Wong KW
    Med J Malaysia, 2019 12;74(6):553-554.
    PMID: 31929489
    Patients with end stage renal disease have higher risk of tuberculosis due to lower cell-mediated immunity. Standard regime of anti-tuberculosis contains isoniazid where neurological side effects such as seizure and encephalopathy have been documented. We present a case of isoniazid-induced encephalopathy in a haemodialysis patient. A literature review on isoniazid-induced encephalopathy was done. Recognition of this condition is important as it is reversible with cessation of isoniazid and institution of high dose pyridoxine.
  5. Limits on efficient human mindreading: convergence across Chinese adults and Semai children
    Wang B, Hadi NS, Low J
    Br J Psychol, 2015 Nov;106(4):724-40.
    PMID: 25631400 DOI: 10.1111/bjop.12121
    We tested Apperly and Butterfill's (2009, Psychological Review, 116, 753) theory that humans have two mindreading systems whereby the efficient-system guiding anticipatory glances displays signature limits that do not apply to the flexible system guiding verbal predictions. Experiments 1 and 2 tested urban Mainland-Chinese adults (n = 64) and Experiment 3 tested Semai children living in the rainforests of Peninsular Malaysia (3- to 4-year-olds, n = 60). Participants - across different ages, groups and methods - anticipated others' false-beliefs about object-location but not object-identity. Convergence in signature limits signalled that the early-developing efficient system involved minimal theory-of-mind. Chinese adults and older Semai children showed flexibility in their direct predictions. The flexible mindreading system in ascribing others' beliefs as such was task-sensitive and implicated maturational and cultural contributions.
  6. The microstructure of practice activities engaged in by elite and recreational youth cricket players
    Low J, Williams AM, McRobert AP, Ford PR
    J Sports Sci, 2013;31(11):1242-50.
    PMID: 23547916 DOI: 10.1080/02640414.2013.778419
    Practice plays an important role in skill acquisition, although not all practice is of equal quality. We examined the types of team practice activities in four groups of youth cricket players. The groups were recreational- and elite-children (9 to 12 years of age) and recreational- and elite-adolescent players (13 to 17 years of age). Time motion analysis recorded the duration in two types of practice activities, namely, Training Form and Playing Form. Training Form is mainly drill-type activities, whereas Playing Form is mainly games-based activities. Training Form activity is thought to contain fewer opportunities to develop the perceptual, cognitive and motor skills required for successful performance in competition when compared to Playing Form. Session duration was a mean value of 95, s = 29 min. All players combined spent 69% of session time in Training Form activity and 19% in Playing Form, with the remaining percentage of time spent in transition between activities. Recreational-children spent around half of their time in Playing Form activity, whereas both elite and adolescent groups spent little or no time in this activity. Findings from this research highlight a gap between research and practice that may not be optimal for skill acquisition.
  7. Factors affecting medical students' intention to use Rain Classroom: a cross-sectional survey
    Lv H, Low J, Tan SK, Tang L, Li X
    BMC Med Educ, 2024 Jan 24;24(1):86.
    PMID: 38267919 DOI: 10.1186/s12909-024-05037-6
    BACKGROUND: Rain Classroom was one of the most popular online learning platforms in Chinese higher education during the pandemic. However, there is little research on user intention under the guidance of technology acceptance and unified theory (UTAUT).

    OBJECTIVE: This research aims to determine factors influencing students' behavioural intention to use Rain Classroom.

    METHODS: In this cross-sectional and correlational investigation, 1138 medical students from five medical universities in Guangxi Province, China, made up the sample. This study added self-efficacy (SE), motivation (MO), stress (ST), and anxiety (AN) to the UTAUT framework. This study modified the framework by excluding actual usage variables and focusing only on intention determinants. SPSS-26 and AMOS-26 were used to analyze the data. The structural equation modelling technique was chosen to confirm the hypotheses.

    RESULTS: Except for facilitating conditions (FC), all proposed factors, including performance expectancy (PE), effort expectancy (EE), social influence (SI), self-efficacy (SE), motivation (MO), anxiety (AN), and stress (ST), had a significant effect on students' behavioural intentions to use Rain Classroom.

    CONCLUSIONS: The research revealed that the proposed model, which was based on the UTAUT, is excellent at identifying the variables that influence students' behavioural intentions in the Rain Classroom. Higher education institutions can plan and implement productive classrooms.

  8. Topotactic Transformation of Bismuth Oxybromide into Bismuth Tungstate: Bandgap Modulation of Single-Crystalline {001}-Faceted Nanosheets for Enhanced Photocatalytic CO2 Reduction
    Kong XY, Tong T, Ng BJ, Low J, Zeng TH, Mohamed AR, et al.
    ACS Appl Mater Interfaces, 2020 Jun 17;12(24):26991-27000.
    PMID: 32433865 DOI: 10.1021/acsami.9b15950
    The photocatalytic conversion of CO2 to energy-rich CH4 solar fuel is an ideal strategy for future energy generation as it can resolve global warming and the imminent energy crisis concurrently. However, the efficiency of this technology is unavoidably hampered by the ineffective generation and utilization of photoinduced charge carriers. In this contribution, we report a facile in situ topotactic transformation approach where {001}-faceted BiOBr nanosheets (BOB-NS) were employed as the starting material for the formation of single-crystalline ultrathin Bi2WO6 nanosheets (BWO-NS). The as-obtained BWO-NS not only preserved the advantageous properties of the 2D nanostructure and predominantly exposed {001} facets but also possessed enlarged specific surface areas as a result of sample thickness reduction. As opposed to the commonly observed bandgap broadening when the particle sizes decrease to an ultrathin nanoscale owing to the quantum size effect, the developed BWO-NS exhibited a fascinating bandgap narrowing compared to those of pristine Bi2WO6 nanoplates (BWO-P) synthesized from a conventional one-step hydrothermal approach. Moreover, the electronic band positions of BWO-NS were modulated as a result of ion exchange for the reconstruction of the energy bands, where BWO-NS demonstrated significant upshifting of CB and VB levels; these are beneficial for photocatalytic reduction applications. This propitious design of BWO-NS through integrating the merits of BOB-NS caused BWO-NS to exhibit substantial 2.6 and 9.3-fold enhancements of CH4 production over BOB-NS and BWO-P, respectively.
  9. Surface-active site modulation of the S-scheme heterojunction toward exceptional photocatalytic performance
    Wang J, Wang Z, Zhang J, Chai SP, Dai K, Low J
    Nanoscale, 2022 Dec 15;14(48):18087-18093.
    PMID: 36448604 DOI: 10.1039/d2nr05341a
    Heterojunction photocatalysts have shown their immense capability in enhancing photogenerated charge carrier separation. Yet, the intrinsic scarcity of active sites in semiconductor components of heterojunction photocatalysts limits their potential for photocatalysis being used in practical applications. Herein, we employ a non-noble metal cocatalyst (i.e., NiS) for modulating a S-scheme heterojunction photocatalyst consisting of Cd3(C3N3S3)2 (CdCNS) and CdS. It is revealed that the formation of the CdCNS/CdS S-scheme heterojunction can enable optimal photogenerated charge carrier utilization efficiency and optimized redox capability. More importantly, the meticulous loading of NiS can play multiple roles in enhancing the photocatalytic performance of the CdCNS/CdS photocatalyst, including endowing it with abundant surface-active sites and acting as a photogenerated electron acceptor. As a result, the optimized NiS-loaded CdCNS/CdS attains an excellent hydrogen production rate of 38.17 mmol g-1 h-1, to reach a quantum efficiency of 29.02% at 420 nm. The results reported in this work provide an interesting insight into the important roles of surface-active site modulation in optimizing photocatalytic performances.
  10. Fulltext Developing Future-Ready University Graduates: Nurturing Wellbeing and Life Skills as Well as Academic Talent
    Gan TY, Beevi Z, Low J, Lee PJ, Hall DA
    Front Psychol, 2022;13:827517.
    PMID: 35310246 DOI: 10.3389/fpsyg.2022.827517
    Higher education is starting to embrace its role in promoting student wellbeing and life skills, especially given the concerning levels of poor mental health and uncertainties in the future job market. Yet, many of the published studies evaluating positive educational teaching methods thus far are limited to interventions delivered to small student cohorts and/or imbedded within elective wellbeing courses, and are focussed on developed Western countries. This study addressed this gap by investigating the effectiveness of an institution-wide compulsory course informed by the principles of Seligman's Wellbeing Theory. The course was delivered at a British university in a developing country in Southeast Asia. It purposefully sought to nurture growth-oriented outcomes (including self-awareness, positive emotions, and personal effectiveness) and was taken by an entire cohort of year one undergraduate students. We tested the effectiveness of the curriculum content and staff coaching style in achieving life skills, and evaluated how these perceptions influenced students' subjective wellbeing. A convergent mixed-methods design was used with 350 survey respondents and 11 interviewees. Perceived life skills scores showed a 2.5% improvement at the end of the course. Partial Least Squares Structural Equation Modelling tested the predicted relationships between variables. All relationships were statistically significant, but the influence of course design and educators' style on life skills acquisition (50.8% of the variance) was moderate, while the effect on subjective happiness and life satisfaction (4-5% of the variance) was very weak. Qualitative data indicated that while quantifiable benefits to wellbeing might not be immediate, students did anticipate longer-term benefits for happiness and life satisfaction. This finding suggests that such a novel educational approach is well-received by Asian students and may sow the seeds for future benefit by positively impacting on their skills, behaviours, attitudes, and values. To achieve optimal flourishing at university, we recommend exploring teaching practises that combine positive education with coaching psychology practises.
  11. Roxithromycin potentiates the effects of chloroquine and mefloquine on multidrug-resistant Plasmodium falciparum in vitro
    Min TH, Khairul MF, Low JH, Che Nasriyyah CH, A'shikin AN, Norazmi MN, et al.
    Exp Parasitol, 2007 Apr;115(4):387-92.
    PMID: 17118354
    Chloroquine (CQ) and mefloquine (MQ) are no longer potent antimalarial drugs due to the emergence of resistant Plasmodium falciparum. Combination therapy has become the standard for many regimes in overcoming drug resistance. Roxithromycin (ROM), a known p-glycoprotein inhibitor, is reported to have antimalarial activity and it is hoped it will potentiate the effects of both CQ/MQ and reverse CQ/MQ-resistance. We assayed the effects of CQ and MQ individually and in combination with ROM on synchronized P. falciparum (Dd2 strain) cultures. The IC(50) values of CQ and MQ were 60.0+/-5.0 and 16.0+/-3.0 ng/ml; these were decreased substantially when combined with ROM. Isobolograms indicate that CQ-ROM combinations were relatively more synergistic (mean FICI 0.70) than MQ-ROM (mean FICI 0.85) with their synergistic effect at par with CQ-verapamil (VRP) (mean FICI 0.64) and MQ-VRP (mean FICI 0.60) combinations. We conclude that ROM potentiates the CQ/MQ response on multidrug-resistant P. falciparum.
  12. Tailoring the field and indication of adjuvant pelvic radiation for patients with FIGO stage Ib lymph nodes-negative cervical carcinoma following radical surgery based on the GOG score--a pilot study
    Rushdan MN, Tay EH, Khoo-Tan HS, Lee KM, Low JH, Ho TH, et al.
    Ann Acad Med Singap, 2004 Jul;33(4):467-72.
    PMID: 15329758
    INTRODUCTION: The traditional indications for adjuvant pelvic radiotherapy (RT) for International Federation of Obstetrics and Gynecology (FIGO) stage Ib1 lymph nodes-negative cervix carcinoma following radical surgery based on histopathological factors, such as deep stromal invasion and lymphovascular space invasion (LVSI), were often inconsistently applied. The perceived risk of relapse was subjectively determined. This pilot study attempts to determine if the treatment outcome will be affected when the indication for RT is based on the Gynecologic Oncology Group (GOG) Risk Score (RS) and the field of adjuvant RT is tailored to the RS.

    MATERIALS AND METHODS: From 1997 to 1999, 55 patients with FIGO stage Ib1 lymph nodes-negative cervical carcinoma limited to the cervix were prescribed RT following radical surgery, based on their RS, as follows: RS <40, RT is omitted; RS >40 to <120, modified (smaller) field RT; and RS >120, standard field pelvic RT. Their incidence and site of recurrence were compared with a similar cohort of 40 patients who were treated prior to 1997.

    RESULTS: Prior to 1997, of the 40 patients, 10 patients were given standard field RT. There were 2 (5%) recurrent diseases. The mean duration of follow-up was 61.6 months (range, 1 to 103 months). The RS of 23 of the 30 patients who were not given RT were available. The mean RS was 22 with 5 patients having a score of >40. From 1997 onwards, of the 55 patients, 28 (51%) did not require RT, 13 (23%) were treated with modified (smaller) field RT and 14 (26%) were given standard field RT. There were 2 (3.6%) cases of relapse. The mean duration of follow-up was 36.4 months (range, 5 to 60 months). All patients with a RS of <40 did not suffer any relapse. Their survival outcomes were better when compared to patients who did not have any RT in the GOG Study.

    CONCLUSIONS: The results of this study indicated that postoperative adjuvant RT given to patients with a high GOG RS of >120, significantly improved their 5-year recurrence rate and disease-free survival, as compared with the similar group of patients who were without adjuvant therapy in the GOG study. Patients with a GOG risk-score of <40 may be safely spared from adjuvant pelvic RT. The current treatment protocol did not compromise the outcome in patients, compared with the use of a less precise treatment protocol in the past.

  13. Fulltext 27 years of benthic and coral community dynamics on turbid, highly urbanised reefs off Singapore
    Guest JR, Tun K, Low J, Vergés A, Marzinelli EM, Campbell AH, et al.
    Sci Rep, 2016 11 08;6:36260.
    PMID: 27824083 DOI: 10.1038/srep36260
    Coral cover on reefs is declining globally due to coastal development, overfishing and climate change. Reefs isolated from direct human influence can recover from natural acute disturbances, but little is known about long term recovery of reefs experiencing chronic human disturbances. Here we investigate responses to acute bleaching disturbances on turbid reefs off Singapore, at two depths over a period of 27 years. Coral cover declined and there were marked changes in coral and benthic community structure during the first decade of monitoring at both depths. At shallower reef crest sites (3-4 m), benthic community structure recovered towards pre-disturbance states within a decade. In contrast, there was a net decline in coral cover and continuing shifts in community structure at deeper reef slope sites (6-7 m). There was no evidence of phase shifts to macroalgal dominance but coral habitats at deeper sites were replaced by unstable substrata such as fine sediments and rubble. The persistence of coral dominance at chronically disturbed shallow sites is likely due to an abundance of coral taxa which are tolerant to environmental stress. In addition, high turbidity may interact antagonistically with other disturbances to reduce the impact of thermal stress and limit macroalgal growth rates.
  14. Association between autophagy and KRAS mutation with clinicopathological variables in colorectal cancer patients
    Awi NJ, Yap HY, Armon S, Low JSH, Peh KB, Peh SC, et al.
    Malays J Pathol, 2021 Aug;43(2):269-279.
    PMID: 34448791
    Autophagy is a host defensive mechanism responsible for eliminating harmful cellular components through lysosomal degradation. Autophagy has been known to either promote or suppress various cancers including colorectal cancer (CRC). KRAS mutation serves as an important predictive marker for epidermal growth factor receptor (EGFR)-targeted therapies in CRC. However, the relationship between autophagy and KRAS mutation in CRC is not well-studied. In this single-centre study, 92 formalin-fixed paraffin-embedded (FFPE) tissues of CRC patients (42 Malaysian Chinese and 50 Indonesian) were collected and KRAS mutational status was determined by quantitative PCR (qPCR) (n=92) while the expression of autophagy effector (p62, LC3A and LC3B) was examined by immunohistochemistry (IHC) (n=48). The outcomes of each were then associated with the clinicopathological variables (n=48). Our findings demonstrated that the female CRC patients have a higher tendency in developing KRAS mutation in the Malaysian Chinese population (p<0.05). Expression of autophagy effector LC3A was highly associated with the tumour grade in CRC (p<0.001) but not with other clinicopathological parameters. Lastly, the survival analysis did not yield a statistically significant outcome. Overall, this small cohort study concluded that KRAS mutation and autophagy effectors are not good prognostic markers for CRC patients.
  15. Fulltext Self-activated superhydrophilic green ZnIn2S4 realizing solar-driven overall water splitting: close-to-unity stability for a full daytime
    Chong WK, Ng BJ, Lee YJ, Tan LL, Putri LK, Low J, et al.
    Nat Commun, 2023 Nov 24;14(1):7676.
    PMID: 37996415 DOI: 10.1038/s41467-023-43331-x
    Engineering an efficient semiconductor to sustainably produce green hydrogen via solar-driven water splitting is one of the cutting-edge strategies for carbon-neutral energy ecosystem. Herein, a superhydrophilic green hollow ZnIn2S4 (gZIS) was fabricated to realize unassisted photocatalytic overall water splitting. The hollow hierarchical framework benefits exposure of intrinsically active facets and activates inert basal planes. The superhydrophilic nature of gZIS promotes intense surface water molecule interactions. The presence of vacancies within gZIS facilitates photon energy utilization and charge transfer. Systematic theoretical computations signify the defect-induced charge redistribution of gZIS enhancing water activation and reducing surface kinetic barriers. Ultimately, the gZIS could drive photocatalytic pure water splitting by retaining close-to-unity stability for a full daytime reaction with performance comparable to other complex sulfide-based materials. This work reports a self-activated, single-component cocatalyst-free gZIS with great exploration value, potentially providing a state-of-the-art design and innovative aperture for efficient solar-driven hydrogen production to achieve carbon-neutrality.
  16. Fulltext Coral community response to bleaching on a highly disturbed reef
    Guest JR, Low J, Tun K, Wilson B, Ng C, Raingeard D, et al.
    Sci Rep, 2016 Feb 15;6:20717.
    PMID: 26876092 DOI: 10.1038/srep20717
    While many studies of coral bleaching report on broad, regional scale responses, fewer examine variation in susceptibility among coral taxa and changes in community structure, before, during and after bleaching on individual reefs. Here we report in detail on the response to bleaching by a coral community on a highly disturbed reef site south of mainland Singapore before, during and after a major thermal anomaly in 2010. To estimate the capacity for resistance to thermal stress, we report on: a) overall bleaching severity during and after the event, b) differences in bleaching susceptibility among taxa during the event, and c) changes in coral community structure one year before and after bleaching. Approximately two thirds of colonies bleached, however, post-bleaching recovery was quite rapid and, importantly, coral taxa that are usually highly susceptible were relatively unaffected. Although total coral cover declined, there was no significant change in coral taxonomic community structure before and after bleaching. Several factors may have contributed to the overall high resistance of corals at this site including Symbiodinium affiliation, turbidity and heterotrophy. Our results suggest that, despite experiencing chronic anthropogenic disturbances, turbid shallow reef communities may be remarkably resilient to acute thermal stress.
  17. Ethnicity, obstructive sleep apnoea and ischaemic heart disease
    Tan YK, Khoo KL, Low JA, Wong ZW, Theng CT, Ong TH, et al.
    Ann Acad Med Singap, 1999 Mar;28(2):214-6.
    PMID: 10497669
    We studied the relationship between different ethnic groups, obstructive sleep apnoea (OSA) and ischaemic heart disease. Four hundred and thirty-two inpatients from the medical wards were interviewed. Limited overnight sleep studies were done in 129 of those who had habitual snoring, daytime sleepiness based on an Epworth sleepiness scale of 8 or more, or a large neck size of 40 cm or more. There were 315 Chinese (72.9%), 67 Malays (15.5%), 43 Indians (10%) and 3 from other races (1.4%). The prevalence of OSA was 19.7%, 30% and 12% among the Chinese, Malays and Indians, respectively. The prevalence ratio for OSA was 1.52 in Malays using Chinese patients as the baseline (P = 0.07). The median neck circumference was 37 cm in both racial groups. The median body mass index was 22.7 kg/m2 in Chinese compared to 23.6 kg/m2 in Malays. The median apnoea-hypopnoea index was 22.7, 19.0 and 26.9 events/hour among the Chinese, Malays and Indians, respectively. OSA was independently associated with the prevalence of IHD (adjusted prevalence ratio 1.68; 95% CI: 1.15, 2.46; P = 0.009). The prevalence of ischaemic heart disease (IHD) was 31%, 24% and 28% in Chinese, Malays and Indians, respectively. The prevalence ratio for IHD in Malays compared to Chinese was 0.77. After adjusting for OSA, there was an even greater reduction in the risk of IHD (adjusted prevalence ratio 0.70). This suggests that OSA is a confounder in the relationship between race and ischaemic heart disease.
  18. Fulltext Carry forward advantages of traditional medicines in prevention and control of outbreak of COVID-19 pandemic
    Deng JG, Hou XT, Zhang TJ, Bai G, Hao EW, Chu JJH, et al.
    Chin Herb Med, 2020 Jul;12(3):207-213.
    PMID: 32834811 DOI: 10.1016/j.chmed.2020.05.003
    Members of the China-ASEAN Joint Laboratory for International Cooperation in Traditional Medicine Research used the video conference platform to exchange and discuss the advantages of traditional medicine through the form of score exchange and report, and research and develop the amount and issues of the therapeutic COVID-19 products of concern. This paper mainly reviews the achievements of the implementation of the epidemic prevention and control plan, advances of scientific basic studies on SARS-CoV-2, analysis and screening of potential targets and pathways of antiviral compounds based on network pharmacology and development of antiviral food dual-use products. The authors believe that the declaration of the (10 + 3) special meeting of national leaders on epidemic prevention and control should raise the medical and pharmaceutical issues of common concern. It is the responsibility of our joint laboratory members to accelerate the development of traditional medicine research and industry. Also the authors believe that this exchange will certainly promote the development of the cause of cooperation.
  19. Fulltext Ministry of health clinical practice guidelines: cancer screening
    Lee HP, Chew CT, Consigliere DT, Heng D, Huang DT, Khoo J, et al.
    Singapore Med J, 2010 Feb;51(2):170-3; quiz 174-5.
    PMID: 20358158
    The Ministry of Health publishes national clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with key recommendations from the guidelines) from the Ministry of Health clinical practice guidelines on cancer screening, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website (http://www.moh.gov. sg/mohcorp/publications.aspx?id=24018). The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
  20. Pleural fluid residue as a diagnostic tool for cytology-negative malignant pleural effusion: A proof-of-concept study
    Nyanti LE, Huan NC, Ramarmurty HY, Renganathan T, Bin Abdul Aziz MA, Low JL, et al.
    Afr J Thorac Crit Care Med, 2023;29(4):e1149.
    PMID: 38239775 DOI: 10.7196/AJTCCM.2023.v29i4.1149
    BACKGROUND: Pleural fluid residue, or macroscopic tissue, circulating freely in the pleural fluid obtained through direct filtration, may carry diagnostic histopathological information. We aimed to determine the histopathological concordance of pleural fluid residue in diagnosing TPE and MPE, compared with conventional pleural biopsy. This was a prospective cohort study of consecutive inpatients with cytology-negative exudative effusion who underwent pleuroscopy and had their initial suctioned pleural fluid filtered for residue samples. Pleural fluid residue demonstrated malignant cells in four out of seven cases of pleural biopsy-confirmed malignancy. Pleural fluid residue has comparable cytomorphology but reduced cellularity compared with pleural biopsy. No tuberculous histological features were present in the pleural fluid residue samples. In this preliminary study pleural fluid residue provided histopathological information for malignant pleural effusion, but no incremental diagnostic information for tuberculous effusion. However larger and more definitive studies are required to clarify these findings, and to explore the utility and suitability of pleural fluid residue for mutational analysis.

    WHAT THE STUDY ADDS: This study demonstrates the potential of pleural fluid residue as a non-invasive diagnostic method for confirming malignancy in cytology-negative exudative effusion.

    WHAT ARE THE IMPLICATIONS OF THE FINDINGS: In resource-limited settings or patients contraindicated for pleural biopsy, pleural fluid residue may provide a viable diagnostic alternative; however, this observation needs further validation.

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