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  1. Leong WC, Cheong BM
    Med J Malaysia, 2017 10;72(5):314-315.
    PMID: 29197890 MyJurnal
    Diesel is commonly used as fuel for engines and is distilled from petroleum. Diesel has toxic potential and can affect multiple organs. Exposure can occur after ingestion, inhalation or through the dermal route. The practice of siphoning diesel using a rubber tubing and the mouth is common in rural communities. This can lead to accidental ingestion and aspiration. Here we report a case of a patient who accidentally ingested diesel during siphoning, which caused extensive erosion of the oral cavity and oesophagus leading to pneumomediastinum and severe chemical lung injury. The patient responded well initially to steroids and supportive care but required prolonged hospitalisation. He developed complications of nosocomial infection and succumbed 23 days after admission.
  2. Leong WC, Tang JJ
    Malays Fam Physician, 2022 Nov 30;17(3):84-88.
    PMID: 36606176 DOI: 10.51866/oa.146
    INTRODUCTION: Psoriasis affects approximately 2-3% of the population worldwide, although the overall prevalence in Asia is <0.5%. Scalp psoriasis is a common initial presentation of psoriasis, which affects almost 80% of patients with psoriasis.

    METHOD: This retrospective descriptive study investigated 1,671 patients with psoriasis with scalp involvement registered with the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.

    RESULTS: A total of 21,859 patients with psoriasis were registered with the MPR during the study period; among them, scalp involvement was seen in 7.6% (n= 1,671). Female sex preponderance (61%) was observed in the majority of Malay patients (58.5%), followed by the Chinese (16.9%), Indian (17.1%) and other ethnic patients (7.5%). A positive family history of psoriasis was identified in 22.7% (n=380). Approximately 34.8% (n=581) and 11% (n=172) of the patients had nail changes and psoriatic arthropathy, respectively. The mainstay treatment modality was topical treatment (93.6%), followed by systemic therapy (10%) and phototherapy (0.5%). The comorbidities found among the patients with scalp psoriasis included hypertension (27.9%), obesity (26%), dyslipidaemia (21%), diabetes mellitus (18.4%), ischaemic heart disease (5.4%) and cerebrovascular disease (1.3%). Approximately 23% reported a Dermatology Life Quality Index (DLQI) of >10, which indicated moderate-to-severe impairment.

    CONCLUSION: The proportion of patients with psoriasis with scalp involvement in our study (7.6%) is much lower than previous reports. Scalp psoriasis markedly negatively impacts the DLQI.

  3. Peng CI, Lin CW, Repin R, Kono Y, Leong WC, Chung KF
    Bot Stud, 2015 Dec;56(1):7.
    PMID: 28510816 DOI: 10.1186/s40529-015-0087-5
    BACKGROUND: Mount Kinabalu, reknowned for its high biodiversity and endemism, is a National Park in the State of Sabah on the northern end of the island of Borneo. Every year many visit the higher part of the Kinabalu National Park, while most lowland forests in the Park are under-explored. Two unknown species of Begonia were collected from a peridotic (ultramafic) cliff in the Kinabalu National Park at ca. 400 m elevation.

    RESULTS: The two species are named B. moneta C.-I Peng, Rimi & C. W. Lin and B. peridoticola Rimi, C.-I Peng & C. W. Lin. Begonia moneta (sect. Baryandra) is similar to B. gueritziana Gibbs, a widespread species of the same section in Borneo, differing in the peltate (vs. basifixed) leaves and the smaller flower parts. Also, their chromosome numbers are different (B. moneta, 2n = 30; B. gueritziana, 2n = 28). The peltate and succulent foliage of B. moneta is also reminiscent of B. burttii Kiew & S. Julia and B. payung S. Julia & Kiew, both of sect. Reichenheimia, from Sarawak. Begonia moneta is distinct from the two species in having branched (vs. entire) placental lamellae. Additionally, B. moneta differs from B. burttii in having 4 (vs. 5) tepals in pistillate flowers and markedly unequal (vs. equal) fruit wings. Begonia moneta differs from B. payung in the smaller leaves and conspicuously winged (vs. wingless) capsules. Begonia peridoticola (sect. Petermannia) resembles B. punchak Kiew & S. Julia from limestone areas in Kuching Division, Sarawak, differing in the entire leaf margin (vs. distantly dentate), much larger capsular wings (8-11 mm vs. 2-3 mm wide) and yellow, spiral (vs. crimson, U-shaped) styles.

    CONCLUSION: A careful study of the herbarium materials and literature supports the recognition of the two new species. Detailed descriptions, line drawings, color plates, chromsome data, foliar SEM observations and comparisons with phenetically similar species are provided to aid in identification.

  4. Chung KF, Leong WC, Rubite RR, Repin R, Kiew R, Liu Y, et al.
    Bot Stud, 2014 Dec;55(1):1.
    PMID: 28510906 DOI: 10.1186/1999-3110-55-1
    BACKGROUND: The picturesque limestone karsts across the Sino-Vietnamese border are renowned biodiversity hotspot, distinguished for extremely high endemism of calciphilous plants restricted to caves and cave-like microhabitats that have functioned as biological refugia on the otherwise harsh habitats. To understand evolutionary mechanisms underlying the splendid limestone flora, dated phylogeny is reconstructed for Asian Begonia, a species-rich genus on limestone substrates represented by no less than 60 species in southern China, using DNA sequences of nrITS and chloroplast rpL16 intron. The sampling includes 94 Begonia species encompassing most major Asian clades with a special emphasized on Chinese species.

    RESULTS: Except for two tuberous deciduous species and a species with upright stems, a majority of Sino-Vietnamese limestone Begonia (SVLB), including sect. Coelocentrum (19 species sampled) and five species of sect. Diploclinium, Leprosae, and Petermannia, are rhizomatous and grouped in a strongly supported and yet internally poorly resolved clade (Clade SVLB), suggesting a single evolutionary origin of the adaptation to limestone substrates by rhizomatous species, subsequent species radiation, and a strong tendency to retain their ancestral niche. Divergence-time estimates indicate a late Miocene diversification of Clade SVLB, coinciding with the onset of the East Asian monsoon and the period of extensive karstification in the area.

    CONCLUSIONS: Based on our phylogenetic study, Begonia sect. Coelocentrum is recircumscribed and expanded to include other members of the Clade SVLB (sect. Diploclinium: B. cavaleriei, B. pulvinifera, and B. wangii; sect. Leprosae: B. cylindrica and B. leprosa; sect. Petermannia: B. sinofloribunda). Because species of Clade SVLB have strong niche conservatism to retain in their ancestral habitats in cave-like microhabitats and Begonia are generally poor dispersers prone to diversify allopatrically, we propose that extensive and continuous karstification of the Sino-Vietnamese limestone region facilitated by the onset of East Asian monsoon since the late Miocene has been the major driving force for species accumulation via geographic isolation in Clade SVLB. Morphologically species of Clade SVLB differ mainly in vegetative traits without apparent adaptive value, suggesting that limestone Begonia radiation is better characterized as non-adaptive, an underappreciated speciation mode crucial for rapid species accumulations in organisms of low vagility and strong niche conservatism.

  5. Leong WC, Azmi NA, Wee LH, Rajah HDA, Chan CMH
    PLoS One, 2021;16(9):e0256216.
    PMID: 34587199 DOI: 10.1371/journal.pone.0256216
    Cancer is a life-threatening disease, and the challenges in accepting the diagnosis can bring a devastating emotional impact on the patient's mental and psychological wellbeing. Issues related to illness acceptance among cancer patients are not well studied in Malaysia. To date, the Acceptance of Illness Scale has not been translated to the Malay language (Bahasa Malaysia) nor validated for use in the oncology setting. The objective of the study is to translate, validate and determine the reliability of the Bahasa Malaysia version of the Acceptance of Illness Scale among Malaysian patients with cancer. A total of 129 patients newly diagnosed with cancer were consecutively sampled and the scale was administered via face-to-face interviews. A pilot test (n = 30) was conducted and test-retest reliability was determined. The Bartlett Test of Sphericity was statistically significantly (p<0.001), while the Kaiser-Mayer-Olkin (KMO) measure of sampling adequacy was adequate at 0.84. Scale item mean scores ranged between 3.02 and 4.33, while the item-total correlation ranged between 0.50 to 0.66 (p<0.05). The internal reliability coefficient was 0.84. The test-retest reliability indicated a high correlation, r = 0.94 with p = 0.001. The Bahasa Malaysia version of the Acceptance of Illness Scale is a valid and reliable instrument that is appropriate for use in Malaysian patients with cancer. Use of this scale to assess illness acceptance among the Malay-speaking patients with cancer can act as a guide for delivery of psycho-oncological services to help patients have a better mental wellbeing and life adjustment in living with cancer.
  6. Rajah HDA, Chie QT, Ahmad M, Leong WC, Bhoo-Pathy N, Chan CMH
    Asian Pac J Cancer Prev, 2021 Aug 01;22(8):2487-2492.
    PMID: 34452562 DOI: 10.31557/APJCP.2021.22.8.2487
    OBJECTIVE: The main purpose of this study was to identify the psychometric properties and validate   the Bahasa Malaysia version of the Brief Illness Perception Questionnaire among patients with cancer.

    METHODS: A total of 129 newly diagnosed patients with cancer were consecutively sampled. Reliability and validity of the questionnaire were tested using translation validity, test-retest reliability, Principal Component Analysis, Cronbach's alpha coefficient for domains and item-total correlation.

    RESULTS: The questionnaire indicates excellent test-retest reliability. The Principal Component Analysis (PCA) revealed that Kaiser-Meyer-Olkin (KMO) is 0.60 for the two-factor structure of the Brief Illness Perception Questionnaire of the Bahasa Malaysia version which consists of cognitive illness representation and emotional illness representation.

    CONCLUSION: The Brief Illness Perception Questionnaire in the Bahasa Malaysia version is a useful tool to use among patients with cancer in Malaysia context despite moderate psychometric properties. This is based on the premise that the questionnaire can be used as a quick tool to assess illness perceptions among Malaysian with cancer in routine oncology practice.

  7. Leong WC, Manan HA, Hsien CCM, Wong YF, Yahya N
    Support Care Cancer, 2024 Jun 26;32(7):460.
    PMID: 38918218 DOI: 10.1007/s00520-024-08655-4
    INTRODUCTIONS: Radical radiotherapy (RT) is the cornerstone of Head and Neck (H&N) cancer treatment, but it often leads to fatigue due to irradiation of brain structures, impacting patient quality of life.

    OBJECTIVE: This study aimed to systematically investigate the dose correlates of fatigue after H&N RT in brain structures.

    METHODS: The systematic review included studies that examined the correlation between fatigue outcomes in H&N cancer patients undergoing RT at different time intervals and brain structures. PubMed, Scopus, and WOS databases were used in the systematic review. A methodological quality assessment of the included studies was conducted following the PRISMA guidelines. After RT, the cohort of H&N cancer patients was analyzed for dose correlations with brain structures and substructures, such as the posterior fossa, brainstem, cerebellum, pituitary gland, medulla, and basal ganglia.

    RESULT: Thirteen studies meeting the inclusion criteria were identified in the search. These studies evaluated the correlation between fatigue and RT dose following H&N RT. The RT dose ranged from 40 Gy to 70 Gy. Most of the studies indicated a correlation between the trajectory of fatigue and the dose effect, with higher levels of fatigue associated with increasing doses. Furthermore, five studies found that acute and late fatigue was associated with dose volume in specific brain structures, such as the brain stem, posterior fossa, cerebellum, pituitary gland, hippocampus, and basal ganglia.

    CONCLUSION: Fatigue in H&N RT patients is related to the radiation dose received in specific brain areas, particularly in the posterior fossa, brain stem, cerebellum, pituitary gland, medulla, and basal ganglia. Dose reduction in these areas may help alleviate fatigue. Monitoring fatigue in high-risk patients after radiation therapy could be beneficial, especially for those experiencing late fatigue.

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