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Three-layer technique to close a persistent tracheo-oesophageal fistula

Lee LM, Razi A

Asian J Surg, 2004 Oct;27(4):336-8.
PMID: 15564191

This report of a patient with a persistent tracheo-oesophageal (TE) fistula after removal of a speech valve describes a modification of the technique described by Rosen et al for closing TE. Under local anaesthesia, an incision was made above the stoma edge from 9 o'clock to 3 o'clock. The trachea was separated from the oesophagus to beyond the fistula, and the fistula tract was excised. The oesophageal opening was closed in layers and a local flap rotated from the adjacent sternocleidomastoid muscle and sutured over the oesophageal closure. The trachea was then closed separately.
Fulltext Pre and post treatment mucociliary function in allergic rhinitis in three different treatment modalities

Lee LM, Gendeh BS

Med J Malaysia, 2003 Mar;58(1):17-20.
PMID: 14556322

Allergic rhinitis causes an impairment of the mucociliary function in the nose. It is hoped that treatment of perennial allergic rhinitis would be able to revert mucociliary function to normal. This study aims to compare pre and post treatment mucociliary transport time in 3 different treatment modalities. Ninety-two newly diagnosed patients with allergic rhinitis were randomised into 3 groups and started on different treatment regimes. At the end of 8 weeks, the group treated with only intranasal beclomethasone showed some, though not significant, improvement in the mucociliary function. There were no changes in the mucociliary function in the other two groups treated with beclomethasone and loratidine or loratidine alone.

Study site: ENT clinic in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
UKM
Fulltext Cotton bud and ear cleaning--a loose tip cotton bud?

Lee LM, Govindaraju R, Hon SK

Med J Malaysia, 2005 Mar;60(1):85-8.
PMID: 16250286

Complications that arise from self-cleaning the external ear canal are common. This is a prospective study using standard questionnaire on the practice of ear cleaning in 50 subjects. A loose tip cotton bud was also shown to them to assess if it was acceptable to replace their current cotton bud. Thirty six percent of them clean their ears by introducing an object into the ear canal once or more a day. The commonest reason to clean the ears was the presence of earwax. Only 6% used a cotton bud to mop fluid from the ear canal. Almost all (92%) the subjects used a cotton bud to clean the ear. A complication rate of 2% was noted. A loose tip cotton swab was shown to the subjects. Despite explaining that it is safer and better, only 24% of the subject were willing to change to this loose tip cotton bud. Seventy four percent of the subjects cleaned their ear regularly because of earwax. The misconception of needing to clean the ear canal by introducing an object into the ear is rampant. This practice should be avoided and health care providers can play an important role in this.
Evaluation of rapid influenza diagnostic tests for influenza A and B in the tropics

Chong YM, Tan XH, Hooi PS, Lee LM, Sam IC, Chan YF

J Med Virol, 2019 08;91(8):1562-1565.
PMID: 31032971 DOI: 10.1002/jmv.25495

Rapid diagnosis of influenza is important for early treatment and institution of control measures. In developing tropical countries such as Malaysia, influenza occurs all year round, but molecular assays and conventional techniques (such as immunofluorescence and culture) for diagnosis are not widely available. Rapid influenza diagnostic tests (RIDTs) may be useful in this setting. A total of 552 fresh respiratory specimens were assessed from patients with respiratory symptoms at a teaching hospital in Kuala Lumpur, Malaysia from November 2017 to March 2018. Two digital immunoassays (DIAs), STANDARD F Influenza A/B Fluorescence Immunoassay (STANDARD F) and Sofia Influenza A + B Fluorescence Immunoassay (Sofia) and one conventional RIDT (immunochromatographic assay), SD Bioline Influenza Ag A/B/A(H1N1) Pandemic rapid test kit (SD Bioline) were evaluated in comparison with a WHO-recommended reverse transcription quantitative PCR (RT-qPCR). Of the 552 samples, influenza A virus was detected in 47 (8.5%) and influenza B virus in 7 (1.3%). The digital immunoassays STANDARD F and Sofia had significantly higher overall sensitivity rates (71.7% and 70.6%, respectively) than the conventional RIDT SD Bioline and immunofluorescence/viral culture (55.8% and 52.8%, respectively). Sensitivity rates were higher for influenza A than influenza B, and specificity rates were uniformly high, ranging from 98% to 100%. Digital readout RIDTs can be used in tropical settings with year-round influenza if PCR is unavailable.
Fulltext A simple and inexpensive physical lysis method for DNA and RNA extraction from freshwater microalgae

Yee W, Abdul-Kadir R, Lee LM, Koh B, Lee YS, Chan HY

3 Biotech, 2018 Aug;8(8):354.
PMID: 30105179 DOI: 10.1007/s13205-018-1381-1

In this work, a simple and inexpensive physical lysis method using a cordless drill fitted with a plastic pellet pestle and 150 mg of sterile sea sand was established for the extraction of DNA from six strains of freshwater microalgae. This lysis method was also tested for RNA extraction from two microalgal strains. Lysis duration between 15 and 120 s using the cetyltrimethyl ammonium bromide (CTAB) buffer significantly increased the yield of DNA from four microalgalstrains (Monoraphidium griffithii NS16, Scenedesmus sp. NS6, Scenedesmus sp. DPBC1 and Acutodesmus sp. DPBB10) compared to control. It was also found that grinding was not required to obtain DNA from two strains of microalgae (Choricystis sp. NPA14 and Chlamydomonas sp. BM3). The average DNA yield obtained using this lysis method was between 62.5 and 78.9 ng/mg for M. griffithii NS16, 42.2-247.0 ng/mg for Scenedesmus sp. NS6, 70.2-110.9 ng/mg for Scenedesmus sp. DPBC1 and 142.8-164.8 ng/mg for Acutodesmus sp. DPBB10. DNA obtained using this method was sufficiently pure for PCR amplification. Extraction of total RNA from M. griffithii NS16 and Mychonastes sp. NPD7 using this lysis method yielded high-quality RNA suitable for RT-PCR. This lysis method is simple, cheap and would enable rapid nucleic acid extraction from freshwater microalgae without requiring costly materials and equipment such as liquid nitrogen or beadbeaters, and would facilitate molecular studies on microalgae in general.
Fulltext Detection of Respiratory Viruses from ARTI Patients by xTAG RVP Fast v2 Assay and Conventional Methods

Kuan CS, Yew SM, Hooi PS, Lee LM, Ng KP

Malays J Med Sci, 2017 Oct;24(5):33-43.
PMID: 29386970 MyJurnal DOI: 10.21315/mjms2017.24.5.4

Introduction: Acute respiratory tract infections (ARTIs) are a major cause of morbidity and mortality in paediatric patients. Therefore, early detection of the viral aetiologies of ARTIs is essential for patient management and infection control. In this study, we evaluated the performance of a new multiplex polymerase chain reaction (PCR) assay (xTAG Respiratory Viral Panel [RVP] Fast v2) in the detection of respiratory viruses by comparing it with that of viral culture and direct immunofluorescence (IF) staining.
Methods: Nasopharyngeal swab and aspirate samples were collected prospectively from 199 patients who presented with ARTIs at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia during a 10-month period. The PCR assay was conducted in parallel with conventional culture and direct IF staining methods.
Results: The positive rate of the xTAG RVP Fast v2 assay (78.4%) in detecting respiratory viruses was higher than that of the viral isolation (7.5%) and direct IF (23.1%) methods. Using the xTAG RVP Fast v2 assay, human enterovirus/human rhinovirus (HEV/HRV) was the most frequently detected (46.2%). The xTAG RVP Fast v2 assay revealed mixed infection caused by two or three respiratory viruses in 40 specimens, and these were undetected by the viral isolation and direct IF methods.
Conclusion: The xTAG RVP Fast v2 assay was superior to conventional methods in the identification of common respiratory viruses, with higher sensitivity and shorter turnaround times for laboratory results.
Fulltext Providing a laboratory diagnostic service for pandemic SARS-CoV-2 in a developing country

Sam IC, Chong J, Kamarudin R, Jafar FL, Lee LM, Bador MK, et al.

Trans R Soc Trop Med Hyg, 2020 08 01;114(8):553-555.
PMID: 32497211 DOI: 10.1093/trstmh/traa037