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Article: The effects of N-acetylcysteine on lung alveolar epithelial cells infected with respiratory syncytial virus.

Wong, K K / Kua, K P / Ooi, K S / Cheah, F C

2023 Volume 45, Issue 1, Page(s) 43–50

Abstract: Introduction: Respiratory syncytial virus (RSV) is one of the most common causes of acute lower respiratory infection in infants and young children. Mucolytic agents, such as acetylcysteine and carbocysteine have reported benefits in alleviating acute ... ...

Abstract	Introduction: Respiratory syncytial virus (RSV) is one of the most common causes of acute lower respiratory infection in infants and young children. Mucolytic agents, such as acetylcysteine and carbocysteine have reported benefits in alleviating acute upper or lower respiratory infections. Among these, N-acetylcysteine (NAC) has cyto-protective effects when cells are infected with the RSV. Materials and methods: Our study investigated primarily the dose-dependent effects of NAC on respiratory alveolar epithelial (A549) cells when co-cultured with RSV in vitro. Three different concentrations of NAC were used, 0.1 mM, 1 mM, and 10 mM. The cytotoxicity of RSV-infected cells was measured by lactate dehydrogenase and antiviral activity of NAC on cell cultures was evaluated by immunofluorescence. Results: Pre-treatment with the highest dose, 10 mM NAC, resulted in features of cell injury even without RSV infection. The proportion of cells infected by RSV and RSV-induced cell death decreased by more than 3-fold when cells were pre-treated with 1 mM NAC. Pre-treatment at the lowest dose, 0.1 mM, did not show any significant changes. Conclusion: A moderate dose of NAC (1 mM) appeared protective of RSV infection to lung alveolar epithelial cells. However, a higher dose of NAC (10 mM) may be relatively toxic and injurious to these cells.
MeSH term(s)	Child ; Infant ; Humans ; Child, Preschool ; Acetylcysteine/pharmacology ; Acetylcysteine/metabolism ; Alveolar Epithelial Cells/metabolism ; Epithelial Cells/metabolism ; Respiratory Syncytial Virus, Human/metabolism ; Lung ; Respiratory Syncytial Virus Infections/drug therapy ; Respiratory Syncytial Virus Infections/metabolism
Chemical Substances	Acetylcysteine (WYQ7N0BPYC)
Language	English
Publishing date	2023-04-29
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	604751-8
ISSN	0126-8635
ISSN	0126-8635
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Article: Traumatic abdominal wall hernia - a case of handlebar hernia.

Vincent, K / Cheah, S D

The Medical journal of Malaysia

2019 Volume 73, Issue 6, Page(s) 425–426

Abstract: Traumatic abdominal wall hernia (TAWH) after blunt injury is uncommon. Diagnosis requires careful examination and high index of suspicion. We report a case of a 12-year-old boy who complained of painful abdominal swelling over the left iliac fossa after ... ...

Abstract	Traumatic abdominal wall hernia (TAWH) after blunt injury is uncommon. Diagnosis requires careful examination and high index of suspicion. We report a case of a 12-year-old boy who complained of painful abdominal swelling over the left iliac fossa after a bicycle-handlebar hit his abdomen. TAWH was diagnosed clinically and confirmed with ultrasound and computed tomography (CT) scan. He developed incarceration after 12 hours of admission and subsequently underwent primary repair without mesh. As TAWH is usually associated with other concomitant injuries, it is important that we are meticulous to rule out other serious concomitant injuries.
MeSH term(s)	Abdominal Injuries/complications ; Abdominal Injuries/diagnosis ; Abdominal Injuries/diagnostic imaging ; Bicycling/injuries ; Child ; Hernia, Abdominal/diagnosis ; Hernia, Abdominal/diagnostic imaging ; Hernia, Abdominal/etiology ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/diagnosis ; Wounds, Nonpenetrating/diagnostic imaging
Language	English
Publishing date	2019-01-15
Publishing country	Malaysia
Document type	Case Reports ; Journal Article
ZDB-ID	604286-7
ISSN	0300-5283
ISSN	0300-5283
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Article: Exploring measurement tools to optimise hospital physician distribution.

Suan, N A M / Soelar, S A / Rani, R A / Anuar, N A / Aziz, K A A / Chan, H K / Cheah, W K / Sani, S S M / Said, R M / Hassan, M R A

The Medical journal of Malaysia

2024 Volume 79, Issue 2, Page(s) 222–233

Abstract: Introduction: Equitable healthcare delivery is essential and requires resources to be distributed, which include assets and healthcare workers. To date, there is no gold standard for measuring the correct number of physicians to meet healthcare needs. ... ...

Abstract	Introduction: Equitable healthcare delivery is essential and requires resources to be distributed, which include assets and healthcare workers. To date, there is no gold standard for measuring the correct number of physicians to meet healthcare needs. This rapid review aims to explore measurement tools employed to optimise the distribution of hospital physicians, with a focus on ensuring fair resource allocation for equitable healthcare delivery. Materials and methods: A literature search was performed across PubMed, EMBASE, Emerald Insight and grey literature sources. The key terms used in the search include 'distribution', 'method', and 'physician', focusing on research articles published in English from 2002 to 2022 that described methods or tools to measure hospital-based physicians' distribution. Relevant articles were selected through a two-level screening process and critically appraised. The primary outcome is the measurement tools used to assess the distribution of hospital-based physicians. Study characteristics, tool advantages and limitations were also extracted. The extracted data were synthesised narratively. Results: Out of 7,199 identified articles, 13 met the inclusion criteria. Among the selected articles, 12 were from Asia and one from Africa. The review identified eight measurement tools: Gini coefficients and Lorenz curve, Robin Hood index, Theil index, concentration index, Workload Indicator of Staffing Need method, spatial autocorrelation analysis, mixed integer linear programming model and cohortcomponent model. These tools rely on fundamental data concerning population and physician numbers to generate outputs. Additionally, five studies employed a combination of these tools to gain a comprehensive understanding of physician distribution dynamics. Conclusion: Measurement tools can be used to assess physician distribution according to population needs. Nevertheless, each tool has its own merits and limitations, underscoring the importance of employing a combination of tools. The choice of measuring tool should be tailored to the specific context and research objectives.
MeSH term(s)	Humans ; Delivery of Health Care ; Hospitals ; Physicians ; Health Personnel
Language	English
Publishing date	2024-03-30
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	604286-7
ISSN	0300-5283
ISSN	0300-5283
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Article ; Online: Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis.

Tsan, S E H / Viknaswaran, N L / Cheong, C C / Cheah, S / Ng, K T / Mong, S X Y / Wang, C Y

Anaesthesia

2023 Volume 78, Issue 9, Page(s) 1153–1161

Abstract: Tranexamic acid is an antifibrinolytic drug that is widely used during surgery, but there are concerns about its thromboembolic effects. We aimed to investigate the effect of prophylactic intravenous tranexamic acid on thromboembolic outcomes in patients ...

Abstract	Tranexamic acid is an antifibrinolytic drug that is widely used during surgery, but there are concerns about its thromboembolic effects. We aimed to investigate the effect of prophylactic intravenous tranexamic acid on thromboembolic outcomes in patients undergoing non-cardiac surgery. The MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials comparing intravenous tranexamic acid with placebo or no treatment in patients undergoing non-cardiac surgery were included. The primary outcome was a composite of peri-operative cardiovascular thromboembolic events, defined as any deep vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or cerebral ischaemia/infarction. A total of 191 randomised controlled trials (40,621 patients) were included in the review. The primary outcome occurred in 4.5% of patients receiving intravenous tranexamic acid compared with 4.9% of patients in the control group. Our analysis showed that there was no difference between groups for composite cardiovascular thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65, I
MeSH term(s)	Humans ; Tranexamic Acid/adverse effects ; Antifibrinolytic Agents/adverse effects ; Thromboembolism/prevention & control ; Blood Transfusion ; Myocardial Infarction ; Blood Loss, Surgical/prevention & control
Chemical Substances	Tranexamic Acid (6T84R30KC1) ; Antifibrinolytic Agents
Language	English
Publishing date	2023-06-14
Publishing country	England
Document type	Systematic Review ; Meta-Analysis ; Journal Article ; Review
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/anae.16058
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Article: Epithelial-mesenchymal transition profiles in triple negative breast carcinoma may explain its aggressive nature.

Chiew, S F / Looi, L M / Cheah, P L / Teoh, K H / Chang, S W / Abdul Sani, S F

The Malaysian journal of pathology

2023 Volume 45, Issue 3, Page(s) 363–374

Abstract: Epithelial-mesenchymal transition (EMT) is increasingly explored in cancer progression. Considering that triple negative (TN) breast cancer has the poorest survival among molecular subtypes, we investigated 49 TN, 45 luminal and 25 HER2-enriched female ... ...

Abstract	Epithelial-mesenchymal transition (EMT) is increasingly explored in cancer progression. Considering that triple negative (TN) breast cancer has the poorest survival among molecular subtypes, we investigated 49 TN, 45 luminal and 25 HER2-enriched female breast carcinomas for EMT expression (using E-cadherin and vimentin immunohistochemistry) against lymphovascular and/or lymph node invasion. E-cadherin and vimentin expressions were semi-quantitated for positive- cancer cells (0=0-<1%, 1=1-10%, 2 =11-50%, 3=>50%) and staining intensity (0=negative, 1=weak, 2=moderate, 3=strong), with final score (low=0-4 and high=6-9) derived by multiplying percentage and intensity scores for each marker. Low E-cadherin and/or high vimentin scores defined EMT positivity. Low E-cadherin co-existing with high vimentin defined "complete" (EMT-CV), while low E-cadherin (EMT-C) or high vimentin (EMT-V) occurring independently defined "partial" subsets. 38 (31.9%) cancers expressed EMT, while 59.2 % TN, 13.3% luminal and 12% HER2-enriched cancers expressed EMT (p<0.05). Among the cancers with lymphovascular and/or lymph node invasion, EMT positivity by molecular types were 66.7% TN, 7.4% luminal and 11.8% HER2-enriched (p<0.05). Although EMT-V, associated with stem-cell properties was the dominant TN EMT profile, EMT-CV, a profile linked to vascular metastases, was encountered only in TN. EMT appears important in TN cancer and different EMT profiles may be associated with its aggressive nature.
MeSH term(s)	Humans ; Female ; Vimentin/metabolism ; Triple Negative Breast Neoplasms/pathology ; Cadherins/metabolism ; Carcinoma ; Epithelial-Mesenchymal Transition ; Biomarkers, Tumor
Chemical Substances	Vimentin ; Cadherins ; Biomarkers, Tumor
Language	English
Publishing date	2023-12-29
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	604751-8
ISSN	0126-8635
ISSN	0126-8635
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Article ; Online: The proxy dilemma: Informed consent in paediatric clinical research - a case study of Thailand.

Varadan, Sheila / Sirinam, Salin / Limkittikul, Kriengsak / Cheah, Phaik Yeong

Developing world bioethics

2022 Volume 22, Issue 4, Page(s) 288–297

Abstract: Informed consent is an essential requirement for the ethical conduct of research. It is also a necessary requirement for the lawful conduct of research. Informed consent provides a legal basis to enrol human subjects in clinical research. In paediatric ... ...

Abstract	Informed consent is an essential requirement for the ethical conduct of research. It is also a necessary requirement for the lawful conduct of research. Informed consent provides a legal basis to enrol human subjects in clinical research. In paediatric research, where children do not generally enjoy a presumption of competence, a legal representative must authorise a child's enrolment. Determining who should act on behalf of the child is a matter of law, rather than ethical principle. But, if national laws are lacking or do not reflect socio-cultural realities, legal uncertainty can arise, which can have implications for children's enrolment in clinical research. Using Thailand as its case study, this paper contemplates how international legal frameworks, such as the UN Convention on the Rights of the Child, could be leveraged to navigate legal uncertainty in the informed consent process, enabling more children to access and participate in paediatric clinical research.
MeSH term(s)	Child ; Humans ; Thailand ; Informed Consent ; Advance Directives
Language	English
Publishing date	2022-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2049034-3
ISSN	1471-8847 ; 1471-8731
ISSN (online)	1471-8847
ISSN	1471-8731
DOI	10.1111/dewb.12341
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Zs.A 5461: Show issues

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Article ; Online: Experiences of preceptorship in Singapore: A qualitative exploratory study of preceptors' experience in precepting nursing students during pre-registration of clinical placement in an acute hospital.

Yeng Lau, Keat / Keng Chan, Sook / Le Cheah, Le / Abdul Jabbar, Azkiah Binte / Hoon Lim, Siew

Nurse education in practice

2024 Volume 75, Page(s) 103875

Abstract: Background: Preceptors play an important role in teaching and guiding nursing students to transit to the role of registered nurses. Nursing students are trained to acquire the skills and knowledge in providing good quality care to patients. However, the ...

Abstract	Background: Preceptors play an important role in teaching and guiding nursing students to transit to the role of registered nurses. Nursing students are trained to acquire the skills and knowledge in providing good quality care to patients. However, the preceptors in the clinical area may face challenges in providing care to their patients in addition to their preceptor role. It is vital to explore and gain insights on the preceptorship experience to better understand their challenges and facilitate their preceptorships and the learning experience of the nursing students. Aims: This study explored the preceptors' experience to understand their challenges and support received in the facilitation of the preceptorship and learning experience of the nursing students in an acute care hospital in Singapore. Methods: Semi-structured interviews were conducted from June to October 2021 with ten registered nurses working in an acute hospital. Thematic analysis was conducted. Results: Three main themes emerged from the thematic analysis: (1) preceptor-student relationship; (2) barriers and challenges to successful preceptorship; and (3) outcomes of successful preceptorship. Conclusions: This study provided valuable insights in the experience of the preceptors in Singapore. Recommendation for nursing management and leaders to establish support system in promoting recognition of preceptors, establish dialog sessions between stakeholders. Nursing education to provide support and to review the efficacy of the current preceptorship program to identify correlation with successful precepting experience for both preceptors and nursing students. Despite challenges faced by the preceptors, their experience had been positive and they are committed in precepting the nursing students.
MeSH term(s)	Humans ; Students, Nursing ; Preceptorship ; Singapore ; Education, Nursing ; Clinical Competence ; Hospitals
Language	English
Publishing date	2024-01-15
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2058575-5
ISSN	1873-5223 ; 1471-5953
ISSN (online)	1873-5223
ISSN	1471-5953
DOI	10.1016/j.nepr.2024.103875
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Article ; Online: Blood-based biomarkers of cerebral small vessel disease.

Wu, Liu-Yun / Chai, Yuek Ling / Cheah, Irwin K / Chia, Rachel S L / Hilal, Saima / Arumugam, Thiruma V / Chen, Christopher P / Lai, Mitchell K P

Ageing research reviews

2024 Volume 95, Page(s) 102247

Abstract: Age-associated cerebral small vessel disease (CSVD) represents a clinically heterogenous condition, arising from diverse microvascular mechanisms. These lead to chronic cerebrovascular dysfunction and carry a substantial risk of subsequent stroke and ... ...

Abstract	Age-associated cerebral small vessel disease (CSVD) represents a clinically heterogenous condition, arising from diverse microvascular mechanisms. These lead to chronic cerebrovascular dysfunction and carry a substantial risk of subsequent stroke and vascular cognitive impairment in aging populations. Owing to advances in neuroimaging, in vivo visualization of cerebral vasculature abnormities and detection of CSVD, including lacunes, microinfarcts, microbleeds and white matter lesions, is now possible, but remains a resource-, skills- and time-intensive approach. As a result, there has been a recent proliferation of blood-based biomarker studies for CSVD aimed at developing accessible screening tools for early detection and risk stratification. However, a good understanding of the pathophysiological processes underpinning CSVD is needed to identify and assess clinically useful biomarkers. Here, we provide an overview of processes associated with CSVD pathogenesis, including endothelial injury and dysfunction, neuroinflammation, oxidative stress, perivascular neuronal damage as well as cardiovascular dysfunction. Then, we review clinical studies of the key biomolecules involved in the aforementioned processes. Lastly, we outline future trends and directions for CSVD biomarker discovery and clinical validation.
MeSH term(s)	Humans ; Stroke/complications ; Neuroimaging/adverse effects ; Cognitive Dysfunction ; Biomarkers ; Cerebral Small Vessel Diseases/diagnostic imaging ; Magnetic Resonance Imaging
Chemical Substances	Biomarkers
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2075672-0
ISSN	1872-9649 ; 1568-1637
ISSN (online)	1872-9649
ISSN	1568-1637
DOI	10.1016/j.arr.2024.102247
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Zs.A 5579: Show issues

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Article: Clinical outcomes of acute stroke thrombolysis in neurologist and non-neurologist centres - A comparative study in Malaysia.

Chew, S H / Looi, I / Neoh, K K / Ooi, J / Cheah, W K / Zariah, A A

The Medical journal of Malaysia

2021 Volume 76, Issue 1, Page(s) 12–16

Abstract: Background: Thrombolytic therapy with intravenous alteplase is a well-established treatment for acute ischaemic stroke (AIS). However, in Malaysia, treatment prescription is often limited by the availability of neurologists. The objective was to compare ...

Abstract	Background: Thrombolytic therapy with intravenous alteplase is a well-established treatment for acute ischaemic stroke (AIS). However, in Malaysia, treatment prescription is often limited by the availability of neurologists. The objective was to compare the outcomes of acute stroke thrombolysis therapy prescribed by neurologists in the Seberang Jaya Hospital (SJH) and non-neurologists in the Taiping Hospital (TH). Methods: In this cross-sectional study, all AIS patients who received thrombolytic therapy in SJH and TH between January 2012 and September 2019 were included. Clinical data was extracted from admission records. The outcomes assessed were the percentage of patients who achieved excellent functional outcome at 3 months (modified Rankin scale of 0 to 1), rates of symptomatic intracranial haemorrhage (SICH), and mortality. Results: A total of 63 AIS patients who received thrombolytic therapy were included, of which 37 patients (58.7%) were treated in SJH. The median NIHSS on admission was 12 in SJH and 11.5 in TH. In all 21.6% of patients from SJH and 30.7% of patients from TH achieved favourable functional outcome at 3 months (p=0.412). There were no significant differences between the two centres in terms of the rates of SICH (10.8% in SJH and 3.8% in TH, p=0.314) and 3-month mortality (24.3% versus 12.5%, p=0.203). Conclusion: The 3-month functional outcomes and complication rates of stroke thrombolysis in hospitals with or without neurologists are not significantly different. Thus non-neurologist hospitals may be able to provide thrombolysis service to AIS patients safely and effectively.
MeSH term(s)	Brain Ischemia/drug therapy ; Brain Ischemia/epidemiology ; Cross-Sectional Studies ; Humans ; Malaysia/epidemiology ; Neurologists ; Stroke/drug therapy ; Stroke/epidemiology ; Thrombolytic Therapy ; Treatment Outcome
Language	English
Publishing date	2021-01-25
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	604286-7
ISSN	0300-5283
ISSN	0300-5283
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Article ; Online: Nonoperative treatment of distal radius fractures and forearm rotation in elderly patients: a retrospective study.

Liao, Janice C Y / Cheah, Andre E J / Chong, Alphonsus K S

The Journal of hand surgery, European volume

2020 Volume 45, Issue 7, Page(s) 761–763

MeSH term(s)	Aged ; Forearm ; Humans ; Radius ; Radius Fractures/diagnostic imaging ; Radius Fractures/therapy ; Retrospective Studies ; Rotation ; Ulna Fractures ; Wrist Joint
Language	English
Publishing date	2020-04-28
Publishing country	England
Document type	Letter
ZDB-ID	2272801-6
ISSN	2043-6289 ; 1753-1934
ISSN (online)	2043-6289
ISSN	1753-1934
DOI	10.1177/1753193420918235
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