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Fulltext Juvenile recurrent respiratory papillomatosis: A rare masquerade of asthma

Boo WH, Rajan P, Ching SM, Lee PY

Malays Fam Physician, 2015;10(2):45-8.
PMID: 27099660 MyJurnal

Juvenile recurrent respiratory papillomatosis (JRRP) is a rare condition. The varied presentation of this condition predisposes to misdiagnosis and potential life-threatening airway obstruction. In this paper, we have reported a case of JRRP presenting as severe respiratory distress and consequently mistreated as asthmatic attack culminating in a near fatal acute airway obstruction.
Fulltext Development of a controlled release of salicylic acid loaded stearic acid-oleic acid nanoparticles in cream for topical delivery

Woo JO, Misran M, Lee PF, Tan LP

ScientificWorldJournal, 2014;2014:205703.
PMID: 24578624 DOI: 10.1155/2014/205703

Lipid nanoparticles are colloidal carrier systems that have extensively been investigated for controlled drug delivery, cosmetic and pharmaceutical applications. In this work, a cost effective stearic acid-oleic acid nanoparticles (SONs) with high loading of salicylic acid, was prepared by melt emulsification method combined with ultrasonication technique. The physicochemical properties, thermal analysis and encapsulation efficiency of SONs were studied. TEM micrographs revealed that incorporation of oleic acid induces the formation of elongated spherical particles. This observation is in agreement with particle size analysis which also showed that the mean particle size of SONs varied with the amount of OA in the mixture but with no effect on their zeta potential values. Differential scanning calorimetry analysis showed that the SONs prepared in this method have lower crystallinity as compared to pure stearic acid. Different amount of oleic acid incorporated gave different degree of perturbation to the crystalline matrix of SONs and hence resulted in lower degrees of crystallinity, thereby improving their encapsulation efficiencies. The optimized SON was further incorporated in cream and its in vitro release study showed a gradual release for 24 hours, denoting the incorporation of salicylic acid in solid matrix of SON and prolonging the in vitro release.
Fulltext Investigation of a PAX6 gene mutation in a Malaysian family with congenital aniridia

Lee PC, Lam HH, Ghani SA, Subrayan V, Chua KH

Genet. Mol. Res., 2014;13(2):3553-9.
PMID: 24737507 DOI: 10.4238/2014.March.24.15

Mutations in the PAX6 gene that cause aniridia have been identified in various ethnicities but not in the Malaysian population. Therefore, the objective of this study was to investigate the PAX6 mutation in a Malaysian family with congenital aniridia. In this study, a complete ophthalmic examination was performed on a Dusun ethnic family with aniridia. Genomic DNA was extracted from the peripheral blood of the subjects and screened for the PAX6 gene mutation using polymerase chain reaction amplification high-resolution melting curve analysis (PCR-HRM) followed by confirmation via direct DNA sequencing. A heterozygous G deletion (c.857delG) in exon 7 causing a frame shift in PAX6 was identified in all affected family members. Genotype-phenotype correlation analysis revealed congenital cataract and all affected family members showed a similar spectrum of aniridia with no phenotypic variability but with differences in severity that were age-dependent. In summary, by using a PCR-HRM approach, this study is the first to report a PAX6 mutation in a Malaysian family. This mutation is the cause of the aniridia spectra observed in this family and of congenital cataract.
Diversity, extinction risk and conservation of Malaysian fishes

Chong VC, Lee PK, Lau CM

J Fish Biol, 2010 Jun;76(9):2009-66.
PMID: 20557654 DOI: 10.1111/j.1095-8649.2010.02685.x

A total of 1951 species of freshwater and marine fishes belonging to 704 genera and 186 families are recorded in Malaysia. Almost half (48%) are currently threatened to some degree, while nearly one third (27%) mostly from the marine and coral habitats require urgent scientific studies to evaluate their status. Freshwater habitats encompass the highest percentage of threatened fish species (87%) followed by estuarine habitats (66%). Of the 32 species of highly threatened (HT) species, 16 are freshwater and 16 are largely marine-euryhaline species. Fish extinctions in Malaysia are confined to two freshwater species, but both freshwater and marine species are being increasingly threatened by largely habitat loss or modification (76%), overfishing (27%) and by-catch (23%). The most important threat to freshwater fishes is habitat modification and overfishing, while 35 species are threatened due to their endemism. Brackish-water, euryhaline and marine fishes are threatened mainly by overfishing, by-catch and habitat modification. Sedimentation (pollution) additionally threatens coral-reef fishes. The study provides recommendations to governments, fish managers, scientists and stakeholders to address the increasing and unabated extinction risks faced by the Malaysian fish fauna.
Treatment with olanzapine, risperidone or typical antipsychotic drugs in Asian patients with schizophrenia

Lee C, Wu KH, Habil H, Dyachkova Y, Lee P

Aust N Z J Psychiatry, 2006 May;40(5):437-45.
PMID: 16683970

To examine clinical outcomes in Asian patients with schizophrenia receiving monotherapy with olanzapine, risperidone or typical antipsychotics in naturalistic settings.
An epidemiological study of developmental dysplasia of the hip in infants in Singapore

Ang KC, Lee EH, Lee PY, Tan KL

Ann Acad Med Singap, 1997 Jul;26(4):456-8.
PMID: 9395810

The incidence of congenital dislocation of the hip (CDH) in Singapore and Malaysia has been reported as being lower than in the West. In our hospital, we have seen an increasing number of congenital hip dislocation as well as dysplastic hips. We undertook a prospective study from December 1989 to December 1994 of 20,000 live births. The neonates were all screened by a consultant neonatologist and the findings were confirmed by a consultant paediatric orthopaedic surgeon. All babies had plain X-rays at 3 months and an acetabular index (AI) of 30 degrees or more was considered dysplastic. All babies with positive signs were followed up for 1 year and again had radiographs taken at 1 year. Comparison of plain X-rays and ultrasound assessment in a subgroup of 130 neonates showed that 64% of patients with AI > 20 degrees had hip dysplasia by ultrasonographic (alpha angle < 60 degrees) The incidence of dysplastic hips was 16.8 per 1000 live births. The overall incidence of neonates with dislocated hips was 4.7 per 1000 live births. The Malays were most affected with an incidence of 5.4 per 1000 live births. The incidence of developmental dysplasia of the hip in Singapore is higher than previously reported, with the Malays having the highest incidence. A significant number of babies with clicking hips have radiological evidence of acetabular dysplasia (AI > 30 degrees). One-third of the babies' hips were still dysplastic at 1 year of age. A well-organised screening programme with experienced examiners has proved to be useful in making early and accurate clinical diagnosis.
Bodyweight status misperception among reproductive-aged women in primary care settings

Sahiran MF, Lee PY, Mawardi M, Mohd Azizi F

Malays Fam Physician, 2020;15(3):62-73.
PMID: 33329864

Introduction: It is common, and many international and local studies confirm this, that women of reproductive age misperceive their body-weight status. This phenomenon can lead to their being less likely to adopt a healthy lifestyle which later exposes them to increased health problems and risks including those of a gynecological and obstetric nature. Generally, there have been inconsistent findings concerning the association between the self-perceived weight status and sociodemographic factors, physical activities, and previous weight loss attempts of women of reproductive age in an Asian population like Malaysia.
Objective: This study aimed to determine the factors associated with body weight status misperception among reproductive-aged women at a primary care setting in Malaysia.
Methods: This is a cross-sectional study conducted at Klinik Kesihatan Durian Tunggal in 2016-2017. The questionnaire included questions on the perception of weight status, sociodemographic factors, smoking status, level of physical activity, and weight loss attempts. Logistic regressions were used for statistical analysis to examine the association between body weight status misperception and related factors.
Results: The study recruited 630 reproductive-aged women. The mean age and SD of the respondents was 32.7 + 8.9 years, and 84% of the respondents were Malays. More than three-quarters of the respondents (75.5%, n = 476) had received up to a secondary level of education. The majority of the respondents were in the overweight/obese group (59.4%, n = 374). The mean BMI of the respondents was 27.1 kg/m2 + 6.61. Approximately 65.4% (n = 412) of the respondents had an inactive lifestyle. However, 60% (n = 378) of the respondents reported that they had attempted to reduce their weight in the last year. A total of 141 respondents (22.4%) misperceived their weight status with 113 (80.1% ) of them underestimating their weight status. Women with primary-level education (OR: 3.545, 95% CI: 1.530-8.215, p = 0.003) and secondary-level education (OR: 1.933, 95% CI: 1.065-3.510, p = 0.030) had a greater likelihood of misperceiving their body weight status as compared to those who have a tertiary level of education. Women with no weight loss attempts were also at risk of body weight status misperception (OR: 1.850, 95% CI: 1.195, 2.865, p = 0.006).
Conclusion: Bodyweight status misperception among reproductive-aged women was associated with a low level of education and with those who had made no weight loss attempts. Identifying women who are at risk of misperceiving their weight status would enable early counseling on weight management.
The diagnosis of lung cancer in the era of interventional pulmonology

Liam CK, Lee P, Yu CJ, Bai C, Yasufuku K

Int J Tuberc Lung Dis, 2021 01 01;25(1):6-15.
PMID: 33384039 DOI: 10.5588/ijtld.20.0588

Advances in bronchoscopic and other interventional pulmonology technologies have expanded the sampling procedures pulmonologist can use to diagnose lung cancer and accurately stage the mediastinum. Among the modalities available to the interventional pulmonologist are endobronchial ultrasound-guided transbronchial needles aspiration (EBUS-TBNA) and transoesophageal bronchoscopic ultrasound-guided fine-needle aspiration (EUS-B-FNA) for sampling peribronchial/perioesophageal central lesions and for mediastinal lymph node staging, as well as navigational bronchoscopy and radial probe endobronchial ultrasound (RP-EBUS) for the diagnosis of peripheral lung cancer. The role of the interventional pulmonologist in this setting is to apply these procedures based on the correct interpretation of clinical and radiological findings in order to maximise the chances of achieving the diagnosis and obtaining sufficient tissue for molecular biomarker testing to guide targeted therapies for advanced non-small cell lung cancer. The safest and the highest diagnosis-yielding modality should be chosen to avoid a repeat sampling procedure if the first one is non-diagnostic. The choice of site and biopsy modality are influenced by tumour location, patient comorbidities, availability of equipment and local expertise. This review provides a concise state-of-the art account of the interventional pulmonology procedures in the diagnosis and staging of lung cancer.
Fulltext Childhood obesity, self-esteem and health-related quality of life among urban primary schools children in Kuching, Sarawak, Malaysia

Lee PY, Cheah Wl, Chang CT, Siti Raudzah G

Malays J Nutr, 2012 Aug;18(2):207-19.
PMID: 24575667 MyJurnal

There is limited data on childhood obesity and its impact on children from diverse cultural backgrounds. This study is aimed at determining the association between obesity, self-esteem and health-related quality of life (HRQOL) among Malaysian urban primary school children of different ethnicity.
Population data of six Alu insertions in indigenous groups from Sabah, Malaysia

Kee BP, Chua KH, Lee PC, Lian LH

Ann Hum Biol, 2012 Nov-Dec;39(6):505-10.
PMID: 22989108 DOI: 10.3109/03014460.2012.719548

The present study is the first to report the genetic relatedness of indigenous populations of Sabah, Malaysia, using a set of Indel markers (HS4.32, TPA25, APO, PV92, B65 and HS3.23). The primary aim was to assess the genetic relationships among these populations and with populations from other parts of the world by examining the distribution of these markers.
Fulltext Effects of vitamin E supplementation on bone metabolism in nicotine-treated rats

Norazlina M, Lee PL, Lukman HI, Nazrun AS, Ima-Nirwana S

Singapore Med J, 2007 Mar;48(3):195-9.
PMID: 17342286

Nicotine has been shown to exert negative effects on bone. This study determined whether vitamin E supplementation is able to repair the nicotine-induced adverse effects in bone.
Fulltext Clinical observations of hydatidiform moles in a Malaysian hospital

Ong HC, Lee PYA, Ng TK, Chong CH

Singapore Med J, 1978 Mar;19(1):33-6.
PMID: 663681

A retrospective analysis of 102 cases of hydatidiform moles seen in the Maternity Hospital, Kuala Lumpur, Malaysia, is presented. The incidence was 1 : 669. The tumour was more common In the Malays and in the lower social class patients. No specific age group or parity group was exempted. Vaginal bleeding and amenorrhoea were prominent features. Hyperemesis and abdominal cramps occurred less commonly. The uterine size was larger than dates in 62.7% of patients. Pre-eclampsia complicated 23.5% of the moles and Its severity was inversely related to the uterine size. Spontaneous abortion occurred In 57.8% of patients at a mean gestational period of 19 weeks.

Study site: Maternity Hospital Kuala
Lumpur, Malaysia
Biomarkers for colorectal cancer chemotherapy: Recent updates and future perspective

Lee PY, Md Azhan FS, Low TY

Malays J Pathol, 2023 Dec;45(3):317-331.
PMID: 38155375

During the last few decades, the treatment options available for patients with metastatic colorectal cancer (mCRC) have undergone continuous improvements, transitioning from conventional chemotherapy to targeted therapy. These therapeutic innovations have led to significant improvements in patient clinical outcomes. However, there remains a need to improve the outcome for many CRC patients. Chemotherapy remains a cornerstone of CRC treatment, but the wide variability in tumour response and adverse reactions to chemotherapy poses a challenge to cancer treatment management. As a result, there is an unmet need to identify predictive biomarkers of chemotherapeutic response to guide treatment decisions. In this review, we summarise the conventional biomarkers used to predict chemotherapy responses in CRC and provide an overview of emerging predictive biomarkers based on the current understanding of the molecular biology of treatment response. Finally, we explore the challenges and future prospects of biomarker discovery to improve the prediction of patient response and ensure optimal treatment management for patients with metastatic CRC.
The value of potency testing of poliomyelitis and measles vaccines as an integral part of cold chain surveillance

Saraswathy TS, Sinniah M, Lee WS, Lee PC

Southeast Asian J Trop Med Public Health, 1993 Jun;24(2):265-8.
PMID: 8266228

The Virology Division in the Institute for Medical Research, Kuala Lumpur, Malaysia performs potency tests on oral polio vaccines and live attenuated measles vaccines. Since these potency tests were introduced in 1981 a total of 752 tests have been performed on vaccine samples from peripheral immunization centers. Of 165 representative vaccine samples sent for potency evaluation after a cold chain breakdown 154 (87%) passed minimum potency requirements recommended for immunization of infants. In the absence of potency evaluation, those vaccines exposed to temperatures higher than the recommended storage range would be discarded, perhaps resulting in unnecessary wastage and economic loss. Results of the vaccine potency evaluation has enabled health authorities to indirectly monitor cold chain efficiency and ensure the high quality of viral vaccines used in our childhood immunization program.
Fulltext Lung cancer staging now and in the future

Liam CK, Andarini S, Lee P, Ho JC, Chau NQ, Tscheikuna J

Respirology, 2015 May;20(4):526-34.
PMID: 25682805 DOI: 10.1111/resp.12489

For a long time lung cancer was associated with a fatalistic approach by healthcare professionals. In recent years, advances in imaging, improved diagnostic techniques and more effective treatment modalities are reasons for optimism. Accurate lung cancer staging is vitally important because treatment options and prognosis differ significantly by stage. The staging algorithm should include a contrast computed tomography (CT) of the chest and the upper abdomen including adrenals, positron emission tomography/CT for staging the mediastinum and to rule out extrathoracic metastasis in patients considered for surgical resection, endosonography-guided needle sampling procedure replacing mediastinoscopy for near complete mediastinal staging, and brain imaging as clinically indicated. Applicability of evidence-based guidelines for staging of lung cancer depends on the available expertise and level of resources and is directly impacted by financial issues. Considering the diversity of healthcare infrastructure and economic performance of Asian countries, optimal and cost-effective use of staging methods appropriate to the available resources is prudent. The pulmonologist plays a central role in the multidisciplinary approach to lung cancer diagnosis, staging and management. Regional respiratory societies such as the Asian Pacific Society of Respirology should work with national respiratory societies to strive for uniform standards of care. For developing countries, a minimum set of care standards should be formulated. Cost-effective delivery of optimal care for lung cancer patients, including staging within the various healthcare systems, should be encouraged and most importantly, tobacco control implementation should receive an absolute priority status in all countries in Asia.
Fulltext Association between EGF and VEGF functional polymorphisms and sporadic colorectal cancer in the Malaysian population

Lau TP, Roslani AC, Lian LH, Lee PC, Hilmi I, Goh KL, et al.

Genet. Mol. Res., 2014;13(3):5555-61.
PMID: 25117311 DOI: 10.4238/2014.July.25.9

Growth factors are polypeptides that are critical for the initiation, progression, and metastasis of cancer. Most tumor cells are capable of synthesizing particular growth factors leading to constitutive pathway activation in these cells through autocrine signaling. Epidermal growth factor (EGF) is a potent mitogenic peptide that exerts direct effects on the proliferation and differentiation of tumor cells in carcinogenesis. By contrast, vascular endothelial growth factor (VEGF) is vital for the invasion and metastasis of neoplasms through the formation of new blood vessels from mature endothelial cells. In this study, we investigated the association between functional polymorphisms of both the EGF and VEGF genes and colorectal cancer (CRC) susceptibility. A total of 130 CRC patients and 212 healthy controls were recruited for this case-control study. Genotyping of genetic variants was conducted via real-time polymerase chain reaction (PCR) amplification with allele-specific TaqMan probes. None of the genotypes of the EGF +61 A>G and VEGF +936 C>T variants was significantly associated with CRC susceptibility among the Malaysian subjects evaluated (P > 0.05). The observed frequency distributions of the EGF +61 A>G polymorphism genotypes showed ethnic heterogeneity, which was not the case for the VEGF +936 C>T genotypes. In conclusion, no positive correlation between these functional polymorphisms and CRC risk was found in this Malaysian population. Studies of the EGF and VEGF genes and CRC susceptibility are scarce, and the results reported thus far differ from one population to another. Hence, more replication studies are warranted before any firm conclusions can be made.
Immunoproteomic analysis of antibody response to cell wall-associated proteins of Candida tropicalis

Lee PY, Gam LH, Yong VC, Rosli R, Ng KP, Chong PP

J Appl Microbiol, 2014 Sep;117(3):854-65.
PMID: 24909754 DOI: 10.1111/jam.12562

This study was conducted to identify antigenic proteins of Candida tropicalis that are targeted by the host immune system.
Fulltext NOD2/CARD15 variants in Malaysian patients with sporadic colorectal cancer

Lau TP, Roslani AC, Lian LH, Lee PC, Hilmi I, Goh KL, et al.

Genet. Mol. Res., 2014;13(3):7079-85.
PMID: 24682985 DOI: 10.4238/2014.March.19.3

Colorectal cancer (CRC) is one of the most common types of cancer in both developed and developing countries. This disease is triggered by and progresses via the sequential accumulation of multiple genetic alterations. In addition, the interaction between low-penetrance genes and environmental factors can also increase the risk of developing CRC. Since inflammatory bowel diseases (IBDs) are one of the predisposing factors for CRC, IBD-related genes might, to a certain extent, be associated with cancer initiation. The nucleotide oligomerization domain 2/caspase activating recruitment domain 15 gene (NOD2/CARD15) is the most well-established gene to be associated with increased susceptibility to Crohn's disease. Thus, various studies have been performed to investigate the potential contribution of this gene to CRC risk. In this study, we aimed to determine the frequency of the Arg702Trp, Gly908Arg, 3020insC, Pro268Ser, and JW1 variants of NOD2/CARD15, and to investigate their association with CRC susceptibility. A total of 130 CRC patients and 212 healthy controls were recruited for this study. Subsequently, real-time polymerase chain reaction with TaqMan was performed for the genotyping of these NOD2/ CARD15 variants. None of the NOD2/CARD15 variants was statistically associated to CRC susceptibility in our Malaysian population. Our findings were remarkably similar to those of other Asian cohorts, which indicated that these NOD2/CARD15 variants exhibit genetic heterogeneity between Caucasian and Asian populations.
Identification of immunogenic proteins of Candida parapsilosis by serological proteome analysis

Lee PY, Gam LH, Yong VC, Rosli R, Ng KP, Chong PP

J Appl Microbiol, 2014 Apr;116(4):999-1009.
PMID: 24299471 DOI: 10.1111/jam.12408

Systemic candidiasis is the leading fungal bloodstream infection, and its incidence has been on the rise. Recently, Candida parapsilosis has emerged as an increasingly prevalent fungal pathogen, but little is known about its antigenic profile. Hence, the current work was performed to discover immunogenic proteins of C. parapsilosis using serological proteome analysis.
Fulltext Diabetic retinopathy in native and non-native Sarawakians--findings from the Diabetic Eye Registry

Mallika PS, Aziz S, Goh PP, Lee PY, Cheah WL, Chong MS, et al.

Med J Malaysia, 2012 Aug;67(4):369-74.
PMID: 23082443

This study aims to determine the risk factors associated with diabetic retinopathy (DR) among natives and non-natives Sarawakians who were seen at 3 public hospitals and one health clinic in Sarawak. It is a cross sectional study where data on patients with DM were collected by staff at these healthcare facilities and entered into the web-based Diabetic Eye Registry. Univariate and multivariate analysis was used to determine the association factors for DR. DR was significantly less associated with natives (24.4%) compared to non-native Sarawakians (34.1%) (p < 0.001). The odds of getting DR was higher in patients whose duration of DM was more than 20 years (OR = 2.6), who have renal impairment (OR = 1.7) and non-natives (OR = 1.4).

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