Displaying publications 1 - 20 of 31 in total

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  1. Sim S, Wong NK
    Biomed Rep, 2021 May;14(5):42.
    PMID: 33728048 DOI: 10.3892/br.2021.1418
    Nanotechnology is the exploitation of the unique properties of materials at the nanoscale. Nanotechnology has gained popularity in several industries, as it offers better built and smarter products. The application of nanotechnology in medicine and healthcare is referred to as nanomedicine, and it has been used to combat some of the most common diseases, including cardiovascular diseases and cancer. The present review provides an overview of the recent advances of nanotechnology in the aspects of imaging and drug delivery.
  2. Sim SK, Myo N, Sohail M
    Med J Malaysia, 2023 Jan;78(1):61-67.
    PMID: 36715193
    INTRODUCTION: To evaluate the effectiveness of team-based self-directed learning (SDL) in the teaching of the undergraduate Year 5 surgical posting.

    MATERIALS AND METHODS: A quasi-experimental study was conducted to develop and administer a team-based SDL versus a conventional SDL to teach undergraduate surgical topics. One hundred and seventy-four medical students who underwent the Year 5 surgical posting were recruited. They were assigned to two groups receiving either the teambased SDL or the conventional SDL. Pre- and post-SDL assessments were conducted to determine students' understanding of selected surgical topics. A selfadministered questionnaire was used to collect student feedback on the team-based SDL.

    RESULTS: The team-based SDL group scored significantly higher than the conventional SDL group in the post-SDL assessment (74.70 ± 6.81 vs. 63.77 ± 4.18, t = -12.72, p < 0.01). The students agreed that the team-based SDL method facilitated their learning process.

    CONCLUSION: The study demonstrated that the use of a teambased SDL is an effective learning strategy for teaching the Year 5 surgical posting. This method encouraged peer discussion and promoted teamwork in completing task assignments to achieve the learning objectives.

  3. Sim SM, Achike FI, Geh SL
    Med J Malaysia, 2005 Aug;60 Suppl D:41-7.
    PMID: 16315623
    In Malaysia many new medical schools (both public and private) have been set up in the last 12 years. As a result of global changes and local adjustments made in medical training, cross-breeds of different medical curricula have produced a wide spectrum of teaching-learning methods in these medical schools. In this paper, we have selected three medical schools--two public (Universiti Malaya and Universiti Putra Malaysia) and one private (International Medical University) to illustrate different approaches in the teaching-learning of pharmacology that exist in Malaysia. How do these different teaching-learning approaches affect the students' interest and ability to "master" pharmacology and in turn to develop a good prescribing practice?
  4. Azila NM, Sim SM, Atiya AS
    Ann Acad Med Singap, 2001 Jul;30(4):375-8.
    PMID: 11503543
    INTRODUCTION: Encouraging teaching practices such as problem-based learning (PBL) amongst undergraduate students within a lecture-based, system-based integrated curriculum is a challenge. Students are apprehensive about developing an organised framework for acquiring knowledge while lecturers are required to reframe their views on the educational process and their role as educators.

    MATERIALS AND METHODS: Lecturers and students in the Phase (Year) II programme were asked to fill questionnaires following the second and fourth PBL cases. The two sets of survey responses were compared to see whether the students' and teachers' perceptions had changed over the 5-month period.

    RESULTS: Students' responses from both surveys (1 and 2) were similar in that a majority agreed that the PBL tutorials had encouraged the seeking of information (66% and 67%, respectively), had improved understanding (57% and 56%), integration (65% and 70%) and application (50% and 64%) of knowledge. However, the views given in the form of written comments, following their positive responses, were somewhat contradictory. A large number of students (38% and 40%) faced difficulties in getting involved in discussions during the PBL tutorial and a majority (73% and 82%) preferred the normal subject-based tutorials. The reasons given by approximately 20% of the students were that the subject-based tutorials were more efficient for obtaining information and/or that the information had been pre-selected by the lecturers. More than 80% of the lecturers (in both surveys) perceived that the students had identified the appropriate learning objectives and covered the subject matter. The percentage of lecturers who agreed that PBL tutorials encouraged rapport and teamwork amongst students had increased in the second survey, from 70% to 92% and 55% to 83% respectively.

    CONCLUSION: Implementing PBL is not simply a matter of developing new teaching materials and new effective ways of presenting them. It requires a paradigm shift, a change in the roles of students and teachers, and time.

  5. Sim SK, Khairul Aizad A, Lim SS, Wong A
    Med J Malaysia, 2019 02;74(1):87-89.
    PMID: 30846670
    Large intracranial tumour may present only with psychiatric symptoms without any neurological deficits. Delay in surgical treatment may significantly affect the quality of life in these patients. We report a case of a young engineering student who was diagnosed as treatment-resistant depression without initial neuroimaging study. Further neuroimaging studies revealed he has a large falcine meningioma. His psychiatric symptoms resolved following surgical resection of the tumour. We emphasized the importance of initial neuroimaging study in young patients presenting with psychiatric symptoms.
  6. Fung SY, Tan NH, Sim SM
    Trop Biomed, 2010 Dec;27(3):366-72.
    PMID: 21399576 MyJurnal
    The protective effects of Mucuna pruriens seed extract (MPE) against the cardio-respiratory depressant and neuromuscular paralytic effects induced by injection of Calloselasma rhodostoma (Malayan pit viper) venom in anaesthetized rats were investigated. While MPE pretreatment did not reverse the inhibitory effect of the venom on the gastrocnemius muscle excitability, it significantly attenuated the venom-induced cardio-respiratory depressant effects (p < 0.05). The protection effects may have an immunological mechanism, as indicated by the presence of several proteins in the venom that are immunoreactive against anti-MPE. However, we cannot rule out the possibility that the pretreatment may exert a direct, non-immunological protective action against the venom.
  7. Sim SM, Back DJ, Breckenridge AM
    Br J Clin Pharmacol, 1991 Jul;32(1):17-21.
    PMID: 1909542
    1. Zidovudine (3'-azido-3'-deoxythymidine; AZT) is the drug of proven efficacy available for the treatment of patients with AIDS or ARC. It is eliminated mainly by hepatic glucuronidation. Therefore, interference with this metabolic pathway may lead to enhancement of AZT effect or to increased toxicity of the drug. We have examined the effect of a number of drugs which themselves undergo glucuronidation on AZT conjugation by human liver microsomes in vitro. 2. AZT glucuronidation followed Michaelis-Menten kinetics. The apparent Km and Vmax values (mean +/- s.d., n = 5), were 2.60 +/- 0.52 mM and 68.0 +/- 23.4 nmol h-1 mg-1, respectively, as determined from Eadie-Hofstee plots. 3. Dideoxyinosine, sulphanilamide and paracetamol were essentially non-inhibitory at concentrations up to 10 mM (4 times the concentration of AZT in the incubation). The most marked inhibitory effects were seen with indomethacin, naproxen, chloramphenicol, probenecid and ethinyloestradiol, with enzyme activity decreased by 97.7, 94.9, 88.7, 83.4% and 79.0%, respectively, at a concentration of 10 mM. Other compounds producing some inhibition of AZT conjugation were oxazepam, salicylic acid and acetylsalicylic acid. 4. Further studies are necessary to characterise the inhibition observed but the method described enables a screen of potentially important drug interactions to be carried out.
  8. Devi RC, Sim SM, Ismail R
    PMID: 22675383 DOI: 10.1155/2012/539475
    Cymbopogon citratus has been shown to have antioxidant, antimicrobial, antispasmodic and chemo-protective properties. Citral, is the major constituent of C. citratus. This study investigated the effects of methanolic extracts of leaves (LE), stems (SE), and roots (RE) of C. citratus and citral on vascular smooth muscle and explored their possible mechanisms of action. The experiment was conducted using isolated tissue preparations, where citral, LE, SE, and RE were added separately into a tissue bath that contained aortic rings, which were pre-contracted with phenylephrine (PE). Citral, LE, and RE exhibited a dose-dependent relaxant effect on the PE-induced contractions. Citral appeared to partially act via NO as its vasorelaxant effect was attenuated by L-NAME. However, the effect of LE may involve prostacyclin as indomethacin reversed the relaxant effect of LE on the PE-induced contraction. Furthermore, citral, LE, and RE abolished the restoration of PE-induced contraction caused by the addition of increasing doses of calcium in both endothelium intact and denuded rings. These findings suggest that the relaxation effect of citral, LE, and RE is endothelium-independent and may be mainly by affecting the intracellular concentration of calcium. Citral may partially act through the NO pathway while a vasodilator prostaglandin may mediate the effect of LE.
  9. Sim SK, Ch'ng CH, Tan YC, Kandasamy R, Abdullah JM
    Med J Malaysia, 2014 Apr;69(2):86-8.
    PMID: 25241818 MyJurnal
    Subtentorial subdural empyema is a rare and life threatening intracranial suppuration. It is usually an intracranial complication of otogenic infections. Early diagnosis and surgical drainage are the most important factors determining prognosis. The high mortality reported in the literature reflects the severity of subtentorial subdural empyema if proper management is delayed. Intracranial infections usually require between 4 to 6 weeks of intravenous antibiotics therapy. However, the prolonged duration of hospitalization as well as requirement for neurosurgically inserted indwelling devices may predispose these patients to new nosocomial infections.
  10. Sim SK, Lim SL, Lee HK, Liew D, Wong A
    Med J Malaysia, 2011 Jun;66(2):138-41.
    PMID: 22106695 MyJurnal
    Intensive care for severe head injury patients is very important in the prevention and treatment of secondary brain injury. However, in a resources constraint environment and limited availability of Intensive Care Unit (ICU) beds in the hospitals, not all severe head injury patients will receive ICU care. This prospective study is aimed to evaluate the outcome of severe head injured patients who received ICU and general ward care in Sarawak General Hospital (SGH) over a 6-month period. A total of thirty five severe head injury patients were admitted. Twenty three patients (65.7%) were ventilated in general ward whereas twelve patients (34.3%) were ventilated in ICU. Overall one month mortality in this study was 25.7%. Patients who received ICU care had a lower one month mortality than those who received general ward care (16.7% vs 30.4%), although it was not statistically different. Multivariate analysis revealed only GCS on admission (OR 0.731; 95% CI 0.460 to 0.877; P=0.042) as the independent predictive factor for one month mortality in this study.
  11. Sim SK, Tan YC, Ghani ARI
    Med J Malaysia, 2020 01;75(1):38-42.
    PMID: 32008018
    INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a potentially fatal neurological condition. However, due to the non-specific clinical and radiological features of CVST, it can sometimes result in a delay in the diagnosis and subsequent management. The aim of this study was to evaluate the demography, risk factors and one-year outcome of CVST patients treated in Hospital Universiti Sains Malaysia.

    METHODS: In this retrospective study, we reviewed the cases diagnosed with CVST admitted to our centre from January 2011 until November 2015.

    RESULTS: A total of 15 patients were included in this review. The patterns of imaging findings as well as risk factors for CVST is discussed with a review of the literature and current management practices. One year followed-up showed full recovery (Glasgow Outcome Scale (GOS) of 5) in 10 cases (66.7%), whereas 4 cases (26.7%) with GOS of 4 (three cases with neurological deficits, and 1 case with mild symptom. There was one case of mortality in this study secondary to sepsis during hospitalisation. The presenting symptoms were mainly headache, focal neurology deficits, seizure and altered sensorium. Risk factors identified were oral contraceptive pills usage, chronic sinuses or ear infections, and obesity. Initial computed tomography (CT) scan showed various findings and haemorrhagic infarct was one of the common findings. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) revealed majority of the patients had occlusion at two or more venous sinus sites. No patients had new or recurrent intracranial haemorrhage following initiation of anticoagulation therapy.

    CONCLUSION: Thus it is considerable safe to start anticoagulation therapy in CVST patients including those with intracranial haemorrhage. We propose further neuroimaging to avoid missed diagnosis of CVST in patient presented with recent onset headache and CT evidence of unusual cerebral infarction.

  12. Sohail M, Alyson T, Sim SK, Nik Azim NA
    Med J Malaysia, 2020 09;75(5):606-608.
    PMID: 32918439
    Ileo-ileal knotting is a rare cause of intestinal obstruction. In this condition, one bowel loop makes a knot with an adjacent bowel loop, resulting in mechanical obstruction and even gangrene of the bowel. We present a case of a young girl with ileo-ileal knotting resulting in a closed-loop obstruction and gangrene of the small bowel loop. This is a difficult condition to diagnose; a high index of suspicion and early surgical intervention are essential to reduce morbidity and mortality.
  13. Sohail M, Loke SN, Sim SK, Nik Azim NA
    Med J Malaysia, 2021 05;76(3):432-435.
    PMID: 34031348
    We present here a case of a 66-year-old lady who was diagnosed with right iliac fossa retroperitoneal leiomyosarcoma at Hospital Umum Sarawak. The challenge in this case was the extension of tumour with the involvement of her right ureter causing proximal hydroureter and hydronephrosis. After resection of tumour en-block with the involved segment of ureter, it was not possible to repair the ureteric defect directly. We used interpositional vascularized appendix graft to repair this large (7 cm) ureteric defect. We describe here this uncommon technique of ureter reconstruction.
  14. Soundirarajan M, Pakniyat N, Sim S, Nathan V, Namazi H
    Technol Health Care, 2021;29(1):99-109.
    PMID: 32568131 DOI: 10.3233/THC-192085
    BACKGROUND: Human facial muscles react differently to different visual stimuli. It is known that the human brain controls and regulates the activity of the muscles.

    OBJECTIVE: In this research, for the first time, we investigate how facial muscle reaction is related to the reaction of the human brain.

    METHODS: Since both electromyography (EMG) and electroencephalography (EEG) signals, as the features of muscle and brain activities, contain information, we benefited from the information theory and computed the Shannon entropy of EMG and EEG signals when subjects were exposed to different static visual stimuli with different Shannon entropies (information content).

    RESULTS: Based on the obtained results, the variations of the information content of the EMG signal are related to the variations of the information content of the EEG signal and the visual stimuli. Statistical analysis also supported the results indicating that the visual stimuli with greater information content have a greater effect on the variation of the information content of both EEG and EMG signals.

    CONCLUSION: This investigation can be further continued to analyze the relationship between facial muscle and brain reactions in case of other types of stimuli.

  15. Sohail M, Chua RHB, Sim SK, Nik Azim NA
    Med J Malaysia, 2022 Jan;77(1):125-127.
    PMID: 35087013
    A 60-year-old lady presented with lower abdominal discomfort and a huge palpable intra-abdominal mass for 4 months, with significant weight loss over half a year. Transvaginal ultrasonography and computed tomography (CT) abdomen showed a large right solid cystic mass likely ovarian in origin. The CA-125 was raised. With the provisional diagnosis of ovarian cancer patient underwent laparotomy at Hospital Umum Sarawak, Malaysia. However intraoperative findings showed that uterus and both ovaries were normal. The tumour was arising from the jejunum and adherent to the dome of the urinary bladder and right broad ligament. The tumour was resected and final diagnosis was jejunal gastrointestinal stromal tumour (GIST). We described this case which was misinterpreted as an ovarian cancer.
  16. Ting SL, Jobli AT, Sim SK, Norlida Awang Ojep DK
    Med J Malaysia, 2019 08;74(4):338-340.
    PMID: 31424046
    We reported a case of cauda equina myxopapillary ependymoma in a patient who presented with atypical history of progressive blurring of vision. Ophthalmology examination revealed relative afferent pupillary defect, binasal hemianopia and papilloedema. This case report serves as a reminder that the intraspinal tumour could be a cause of papilloedema, despite rare, should be considered in a hydrocephalus patient who presented with no intracranial pathology and minimal spinal symptoms.
  17. Sim SK, Lau BL, Zaila SR, Hazira N, Aniqah NM, Panicker J, et al.
    Med J Malaysia, 2021 03;76(2):138-144.
    PMID: 33742619
    INTRODUCTION: Healthcare workers serve as the frontliners against the coronavirus 2019 disease (COVID-19) and this puts them most at risk of infection as they attend to numerous patients with unknown status. This study aimed to examine stress, anxiety, and depression among healthcare workers caring for COVID-19 patients in Sarawak General Hospital (SGH), Malaysia.

    MATERIALS AND METHODS: This cross-sectional observational study conducted in SGH during the pandemic with an online self-administered questionnaire composed of two parts, the socio-demographic characteristics, and the Depression Anxiety Stress Scale (DASS).

    RESULTS: A total of 105 healthcare workers responded to this study. A questionnaire in both Bahasa Melayu and English was used. The findings showed that all healthcare workers had mild anxiety, with the majority experiencing mild stress (57.1%), and almost half of the respondents experiencing mild depression (41%). Female subjects had a significant higher mean score in anxiety level and stress level compared to male subjects (10.0±3.20 vs. 8.6±2.93, p<0.05; 14.1±4.76 vs. 10.7±3.70, p<0.05, respectively). Staff who were transferred from other units to handle COVID-19 cases experienced more psychological symptoms. There were significant correlations between the depression, anxiety and stress levels among the healthcare workers and the number of children they had (r=0.739, p=0.001; r=0.642, p=0.001; r=1, p =0.001 respectively). However, the stress level among the healthcare workers was reversely correlated with their years of working experience (r=-0.199, p=0.042).

    CONCLUSION: This study identified some socio-demographic factors associated with increased levels of stress, anxiety and depression among the healthcare workers during pandemic, which may lay ground for future interventions.

  18. Sim SM, Hoggard PG, Sales SD, Phiboonbanakit D, Hart CA, Back DJ
    AIDS Res Hum Retroviruses, 1998 Dec 20;14(18):1661-7.
    PMID: 9870320
    Zidovudine (ZDV) is converted to its active triphosphate (ZDVTP) by intracellular kinases. The intermediate ZDV monophosphate (ZDVMP) is believed to play a major role in ZDV toxicity. Manipulation of ZDV phosphorylation is a possible therapeutic strategy for altering the risk-benefit ratio. Here we investigate whether combining RBV with ZDV is able to modulate efficacy and toxicity of ZDV. We have measured the intracellular activation of ZDV (0.3 microM) in the absence and presence of ribavirin (RBV; 2 and 20 microM) in Molt 4 and U937 cells. MTT cytotoxicity of ZDV (10-1000 microM) was also measured with and without RBV (2 microM) in Molt 4 and U937 cells. Measurement of endogenous deoxythymidine triphosphate (dTTP) allowed investigation of the dTTP/ZDVTP ratio. The antiviral efficacy of ZDV in combination with RBV (2 microM) was assessed by HIV p24 antigen measurements. In the presence of RBV (2 and 20 microM) a decrease in total ZDV phosphates was observed, owing mainly to an effect primarily on ZDVMP rather than the active ZDVTP. RBV also increased endogenous dTTP pools in both cell types, resulting in an increase in the dTTP/ZDVTP ratio. ZDV alone significantly reduced p24 antigen production, with an IC50 of 0.34 microM. Addition of RBV increased the IC50 approximately fivefold (1.52 microM). However, at higher concentrations of ZDV (10 and 100 microM) the antagonistic effect of RBV (2 microM) on ZDV was lost. The RBV-mediated decrease in ZDVMP may explain the reduction in ZDV toxicity when combined with RBV (2 microM). Cytotoxicity of ZDV was reduced in the presence of RBV (2 microM) at all concentrations in both cell lines, probably owing to saturation of ZDVTP formation. The interaction of ZDV and RBV is concentration dependent.
  19. Kamal SM, Dawi NBM, Sim S, Tee R, Nathan V, Aghasian E, et al.
    Technol Health Care, 2020;28(6):675-684.
    PMID: 32200366 DOI: 10.3233/THC-192034
    BACKGROUND: Walking is one of the important actions of the human body. For this purpose, the human brain communicates with leg muscles through the nervous system. Based on the walking path, leg muscles act differently. Therefore, there should be a relation between the activity of leg muscles and the path of movement.

    OBJECTIVE: In order to address this issue, we analyzed how leg muscle activity is related to the variations of the path of movement.

    METHOD: Since the electromyography (EMG) signal is a feature of muscle activity and the movement path has complex structures, we used entropy analysis in order to link their structures. The Shannon entropy of EMG signal and walking path are computed to relate their information content.

    RESULTS: Based on the obtained results, walking on a path with greater information content causes greater information content in the EMG signal which is supported by statistical analysis results. This allowed us to analyze the relation between muscle activity and walking path.

    CONCLUSION: The method of analysis employed in this research can be applied to investigate the relation between brain or heart reactions and walking path.

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