MyMedR

Displaying all 10 publications

Abstract:

Sort:

Pleuroscopic retrieval of a sewing needle from the pleural cavity under conscious sedation by a chest physician

Tie ST, Wong JL, Kannan SK, Rahman JA

J Bronchology Interv Pulmonol, 2012 Jul;19(3):246-8.
PMID: 23207471 DOI: 10.1097/LBR.0b013e31825c3228

We report a case of a young man who presented with a left-sided pneumothorax after suffering an accidental penetrating injury by a sewing needle to the anterior chest wall. Chest radiograph and the computed tomography of the thorax revealed that the needle was in the pleural cavity and there was an associated pneumothorax. An attempt at retrieval by direct incision failed. The sewing needle was successfully retrieved by a medical pleuroscopy. The patient recovered without any consequences and was discharged home after 24 hours of observation.
Fulltext A case of recurrent respiratory papillomatosis successfully removed via endoscopic argon plasma coagulation (APC) with no evidence of recurrence

Wong JL, Tie ST, Lee J, Kannan SK, Rashid Ali MR, Ibrahim A, et al.

Med J Malaysia, 2014 Aug;69(4):195-6.
PMID: 25500852 MyJurnal

Recurrent respiratory papillomatosis (RRP) is a benign disease caused by the human papilloma virus (HPV), characterized by the formation of recurrent, epithelial neoplastic lesions in the airways. While benign, they can cause significant airway obstruction in some cases. Difficulties in treatment arise from the recurrent nature of the lesions despite repeated procedures. Other known procedures that result in deep tissue damage also cause unacceptable collateral damage to the underlying airway mucosa. We describe a case of recurrent papillomatosis that was successfully treated with argon plasma coagulation ( APC) when laser and electrocautery ablation had failed in the past. After the papillomatasis was treated with APC, there is no recurrence on repeat scope at 4 months and 9 months after the initial procedure. The procedure was done as a day case and there is no complication from the procedure. The property of the APC that allows it to cause only superficial thermal damage to the tissue makes it a suitable adjunct therapy to the treatment of papillomas, which are usually superficial lesions.
Fulltext Tuberculosis in adults

Abdul Rahaman JA, Ker HB, Yusof M, Hanafi NS, Wong JL

Malays Fam Physician, 2014;9(3):34-7.
PMID: 26425303 MyJurnal

Tuberculosis (TB) in Malaysia is rising due to multiple factors and issues related to its management are addressed in the updated evidence-based clinical practice guidelines. Screening for active TB should be considered in high risk groups. Light emitting diode-based fluorescence microscopy and nucleic acid amplification tests are recommended investigations. Health education and standardised 6-month daily antituberculosis (antiTB) regimen are among important elements for successful treatment. Latent TB infection screening should only be performed on high risk individuals. AntiTB regimen offered to HIV-positive adults should be the same as for HIV-negative adults and timing to initiate highly active antiretroviral therapy in patients with TB is based on CD4 count. All patients on antiTB treatment should be monitored to assess their response to treatment and to identify problems associated with it.
Fulltext Methacholine challenge test as an adjunctive investigative tool in patients with asthma-like symptoms: the Sabah experience

Siew BTT, Wong JL, Beniyamin A, Ho A, Kannan SKK, Jamalul Azizi AR

Med J Malaysia, 2012 Apr;67(2):204-6.
PMID: 22822644 MyJurnal

INTRODUCTION: Patients with asthma-like symptoms pose a diagnostic dilemma when physical examination is normal. The usual practice in Malaysia would be to give empirical asthma treatment. Bronchial challenge test (BCT) is widely used in many countries to diagnose asthma objectively but it is not widely available in Malaysia.
OBJECTIVE: To describe our experience with BCT using methacholine at Queen Elizabeth Hospital as a supporting tool in the investigation of patients with asthma-like symptoms.
METHODOLOGY: Review of case notes of patients who underwent BCT from July 2008 till April 2009. BCT was performed via dosimeter technique. Results were classified as high hyper responsiveness if the provocative dose of methacholine required to achieve 20% fall in FEV1 (PD20) was less than or equal to 0.125 micromol, moderate hyper responsiveness if PD20 was between 0.125 to 1.99 micromol or mild hyper responsiveness if PD20 was between 2.00 to 6.6 micromol. PD20 of more than 6.6 micromol constitutes a negative MCT.
RESULTS: 29 patients had BCT during the study period. 19 cases were included in this review. The age ranged from 13 to 70 years old. There were 12 males and 7 females. Duration of symptoms ranged from 2 weeks to 23 years. BCT was positive (mild or moderate hyper responsiveness) in 10 out of 19 patients. No patient had high bronchial hyper responsiveness.
CONCLUSIONS: BCT is a useful adjunctive tool in the investigation of patients presenting with asthma-like symptoms. This test obviates empirical asthma treatment. BCT should be made available in all major hospitals in Malaysia.
Fulltext Successful treatment of tracheal stenosis by rigid bronchoscopy and topical mitomycin C: a case report

Wong JL, Tie ST, Samril B, Lum CL, Rahman MR, Rahman JA

Cases J, 2010;3:2.
PMID: 20150982 DOI: 10.1186/1757-1626-3-2

Tracheal stenosis is a known complication of prolonged intubation. It is difficult to treat and traditional surgical approach is associated with significant risk and complications. Recurrent stenosis due to granulation tissue necessitates repeated procedures. We describe a case of short web-like tracheal stenosis (concentric membranous stenosis less than 1 cm in length without associated cartilage damage) managed by a minimally invasive thoracic endoscopic approach. Topical application of Mitomycin C, a potent fibroblast inhibitor reduces granulation tissue formation and prevents recurrence.
Fulltext Back to basic: bio-burden on hands of health care personnel in tertiary teaching hospital in Malaysia

Wong JL, Siti Azrin AH, Narizan MI, Norliah Y, Noraida M, Amanina A, et al.

Trop Biomed, 2014 Sep;31(3):534-9.
PMID: 25382481 MyJurnal

Hands of Health Care Personnel (HCP) are one of the most common vehicles for the transmission of infection. Microorganisms can survive well on the hands of HCP for a certain duration. Therefore, the purpose of this study is to bring awareness to HCP that their hands can actually be contaminated with many microorganisms. These microbes on the hands of HCP can potentially infect their patients if they do not comply with the proper hand hygiene practice. This cross-sectional study was conducted at a randomly selected Intensive Care Unit (ICU) and general ward in a hospital. Twenty five HCP from each ward were randomly selected and their hands were imprinted on blood culture plates. Microorganism growth were quantified and identified. Data were analyzed and presented as descriptive analysis. One hundred blood agar plates were processed and analyzed. Majority (71%) of the samples had more than 50 colony-forming units (CFU) and only 17% of the samples had less than 25 CFU. Microorganisms identified include Staphylococcus spp., Acinetobacter spp., Enterobacteriaceae, Pseudomonas spp., Moraxella, Delftiaacidovorans and fungi. All isolated microorganisms were antibiotic sensitive strain. This study showed that the hands of HCP were contaminated with many microorganisms. Therefore, it is imperative that HCP must practice proper hand hygiene when taking care of their patients in the wards.
Fulltext Sugarcane juice derived carbon dot-graphitic carbon nitride composites for bisphenol A degradation under sunlight irradiation

Sim LC, Wong JL, Hak CH, Tai JY, Leong KH, Saravanan P

Beilstein J Nanotechnol, 2018;9:353-363.
PMID: 29515949 DOI: 10.3762/bjnano.9.35

Carbon dots (CDs) and graphitic carbon nitride (g-C3N4) composites (CD/g-C3N4) were successfully synthesized by a hydrothermal method using urea and sugarcane juice as starting materials. The chemical composition, morphological structure and optical properties of the composites and CDs were characterized using various spectroscopic techniques as well as transmission electron microscopy. X-ray photoelectron spectroscopy (XPS) results revealed new signals for carbonyl and carboxyl groups originating from the CDs in CD/g-C3N4 composites while X-ray diffraction (XRD) results showed distortion of the host matrix after incorporating CDs into g-C3N4. Both analyses signified the interaction between g-C3N4 and CDs. The photoluminescence (PL) analysis indicated that the presence of too many CDs will create trap states at the CD/g-C3N4 interface, decelerating the electron (e-) transport. However, the CD/g-C3N4(0.5) composite with the highest coverage of CDs still achieved the best bisphenol A (BPA) degradation rate at 3.87 times higher than that of g-C3N4. Hence, the charge separation efficiency should not be one of the main factors responsible for the enhancement of the photocatalytic activity of CD/g-C3N4. Instead, the light absorption capability was the dominant factor since the photoreactivity correlated well with the ultraviolet-visible diffuse reflectance spectra (UV-vis DRS) results. Although the CDs did not display upconversion photoluminescence (UCPL) properties, the π-conjugated CDs served as a photosensitizer (like organic dyes) to sensitize g-C3N4 and injected electrons to the conduction band (CB) of g-C3N4, resulting in the extended absorption spectrum from the visible to the near-infrared (NIR) region. This extended spectral absorption allows for the generation of more electrons for the enhancement of BPA degradation. It was determined that the reactive radical species responsible for the photocatalytic activity were the superoxide anion radical (O2•-) and holes (h+) after performing multiple scavenging tests.
Hospitalisation of multiethnic older patients with AECOPD: exploration of the occurrence of anxiety, depression and factors associated with short-term hospital readmission

Al Aqqad SMH, Tangiisuran B, Hyder Ali IA, Md Kassim RMN, Wong JL, Tengku Saifudin TI

Clin Respir J, 2017 Nov;11(6):960-967.
PMID: 26763195 DOI: 10.1111/crj.12448

INTRODUCTION: The elderly, with chronic obstructive pulmonary disease (COPD), are at a higher risk of hospitalisation due to acute exacerbation of COPD (AECOPD). They also often encounter multiple co-morbidities.
OBJECTIVES: This study was aimed to explore the occurrence of anxiety, depression and to identify the factors associated with hospital readmission among older patients after AECOPD discharge.
METHODS: A multicentre prospective study was conducted in Malaysia (from 1st September 2012 till 31st September 2013) among older patients (≥60 years) hospitalised for AECOPD. Anxiety and depression were assessed on discharge using previously validated questionnaires, Generalized Anxiety Disorder-7 (GAD-7 and Geriatric Depression Scale (GDS-15), respectively. Patients were followed up for a period of 3 months after discharge.
RESULTS: A total of 81 patients with a median age of 72 years (IQR 66.40-78.00) were recruited. Anxiety was observed in 34.57% while 38.27% had depression. Both anxiety and depression were detected in 25.93% of the patients. A history of frequent AECOPD admissions was found to be associated with developing depressive symptoms, while anxiety scores were associated with severe dyspnoea. Severe depression was more commonly identified among patients aged 60-75 and in those with a history of tuberculosis. A high readmission rate (40.74%) during the 3-month period was noticed. History of frequent AECOPD admissions (OR = 2.87; 95% CI 1.05-7.85, P = 0.040) and ischemic heart disease (IHD) (OR = 4.04; 95% CI 1.1-14.6, P = 0.032) were identified as the factors associated with the risk of hospital readmission.
CONCLUSIONS: Anxiety and depression were found to be relatively common among older patients with AECOPD. IHD and history of frequent COPD hospitalisation were associated with short-term readmission among the elderly.
Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention

Tan SY, Mei Wong JL, Sim YJ, Wong SS, Mohamed Elhassan SA, Tan SH, et al.

Diabetes Metab Syndr, 2018 10 10;13(1):364-372.
PMID: 30641727 DOI: 10.1016/j.dsx.2018.10.008

Type 1 and type 2 diabetes mellitus is a serious and lifelong condition commonly characterised by abnormally elevated blood glucose levels due to a failure in insulin production or a decrease in insulin sensitivity and function. Over the years, prevalence of diabetes has increased globally and it is classified as one of the leading cause of high mortality and morbidity rate. Furthermore, diabetes confers a huge economic burden due to its management costs as well as its complications are skyrocketing. The conventional medications in diabetes treatment focusing on insulin secretion and insulin sensitisation cause unwanted side effects to patients and lead to incompliance as well as treatment failure. Besides insulin and oral hypoglycaemic agents, other treatments such as gene therapy and induced β-cells regeneration have not been widely introduced to manage diabetes. Therefore, this review aims to deliver an overview of the current conventional medications in diabetes, discovery of newer pharmacological drugs and gene therapy as a potential intervention of diabetes in the future.
Fulltext Effects of qigong on systolic and diastolic blood pressure lowering: a systematic review with meta-analysis and trial sequential analysis

Ching SM, Mokshashri NR, Kannan MM, Lee KW, Sallahuddin NA, Ng JX, et al.

BMC Complement Med Ther, 2021 Jan 06;21(1):8.
PMID: 33407414 DOI: 10.1186/s12906-020-03172-3

BACKGROUND: The benefits of qigong for systolic and diastolic blood pressure (BP) reduction have been noted in previously published systematic reviews; however, the data on its effectiveness has been at best scarce. We aimed to update the evidence of qigong on blood pressure reduction after taking into consideration the risks of random error and reliability of data in the cumulative meta-analysis using trial sequential analysis (TSA).
METHODS: Included trials were assessed using Cochrane risk of bias instrument. We performed meta-analysis with random-effects model and random errors were evaluated with TSA. We performed the search for the eligible randomized controlled trial (RCT) through Medline, Cinahl, Cochrane Central Register of Controlled Trials and also PubMed.
RESULTS: A total of 370 subjects sourced from seven eligible RCTs were entered into the analysis. The pooled results demonstrated the significant reduction with the use of qigong of the systolic blood pressure [weighted mean difference (WMD), - 10.66 mmHg (95% confidence interval (CI) = - 17.69,-3.62, p