Publications by authors named "Jo Anne Lim"

10 Publications

  • Page 1 of 1

Reuse of dialysis reverse osmosis reject water for aquaponics and horticulture.

J Nephrol 2021 02 4;34(1):97-104. Epub 2021 Jan 4.

Department of Medicine, Hospital Sultan Abdul Halim, Sungai Petani, Kedah, Malaysia.

Background: Water crisis is becoming a threat to the well-being of the human population worldwide and use of water for healthcare contributes substantially to this resource depletion. Hemodialysis consumes large quantities of water. A huge volume of high purity dialysis water is required to safely perform dialysis treatment. In this process, up to 60-70% of source water is discarded. Many strategies have been suggested to promote green dialysis, and these include reuse of water, however, very few dialysis facilities have taken the preliminary steps to employ it.

Methods: We share our experience in a developing country on an innovative reject-water reuse program combining aquaculture, hydroponic and horticulture activities. This is by far the first report on a "green dialysis" project involving aquaponics that reuse dialysis reverse osmosis (RO) reject water.

Results: Our expereince suggests that reject water can be reused to promote water conservation with encouraging results. It provides a good and biosecure environment for fish breeding and vegetable farming . This project promotes a reduction in carbon footprint, a reduction in water waste, a sustainable organic food source, may lead to income generation, and provides a shared purpose and sense of pride among staff and dialysis patients.

Conclusions: Encompassing "environmental protection" practices into a hemodialysis unit can be done with relatively simple and practical steps.
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http://dx.doi.org/10.1007/s40620-020-00903-0DOI Listing
February 2021

A Malaysian ex-smoker with cough, breathlessness and nonresolving bronchospasm.

Breathe (Sheff) 2019 Dec;15(4):324-329

Dept of Medicine, Hospital Sultan Abdul Halim, Ministry of Health Malaysia, Sungai Petani, Malaysia.

http://bit.ly/2lQwe5y.
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http://dx.doi.org/10.1183/20734735.0224-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885342PMC
December 2019

Early Onset of Squamous Cell Carcinoma Arising From Tuberculosis Verrucosa Cutis.

J Am Coll Clin Wound Spec 2017 21;9(1-3):35-38. Epub 2018 Jun 21.

Department of Medicine, Hospital Sultan Abdul Halim, 08000 Sungai Petani, Kedah, Malaysia.

A 72-year-old man presented with a chronic scaly verrucous plaque over his right knee for nine months. The lesion was preceded by a well healed scar sustained five years back from a road traffic accident. He was given multiple courses of systemic antibiotic and antifungal medications but to no avail. A skin biopsy confirmed cutaneous tuberculosis. The area of plaque subsided significantly with antituberculosis treatment. However, during the second month of treatment, a new onset of a red fleshy granulating growth developed on the pre-existing site. A repeat skin biopsy revealed squamous cell carcinoma (SCC). He was subsequently referred for surgical excision. This is presumably the first reported case of SCC arising from tuberculosis verrucosa cutis. While most malignant transformations from tuberculosis has been thought to develop after a long period of time (usually more than twenty-five years), this case report showed that it may also occur within a short period of time. Awareness on this condition is important because any delay in diagnosis and treatment may have detrimental consequences.
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http://dx.doi.org/10.1016/j.jccw.2018.06.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304292PMC
June 2018

A Narrow Escape From Methotrexate: The Importance of Correlating Ultrasound Findings With Discriminatory Level of β-hCG and the β-hCG Ratio.

J Ultrasound Med 2019 08 11;38(8):2237-2238. Epub 2018 Dec 11.

Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.

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http://dx.doi.org/10.1002/jum.14899DOI Listing
August 2019

Recombinant activated factor VII (rFVIIa) in refractory haemorrhage for non-haemophiliacs: an eleven-year single-centre experience.

BMC Hematol 2018 23;18:34. Epub 2018 Nov 23.

1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia.

Background: Massive bleeding is one of the commonest salvageable causes of death. The search for an ideal haemostatic agent during massive bleeding is still ongoing. One of the novel haemostatic medications is recombinant activated factor VII (rFVIIa). To date, the usage of rFVIIa during massive haemorrhage among non-haemophiliac patients remains off-label. The aim of this study is to report our experience in using rFVIIa to treat refractory bleeding.

Methods: Medical records of all patients treated with rFVIIa for massive bleeding over an eleven-year period in a single institution were recorded. Treatment indications, 24-h and 30-day mortality, changes in transfusion needs and coagulation profiles after rFVIIa administration were analysed.

Results: rFVIIa were administered in 76 patients. Of these, 41 (53.9%) were non-surgical bleeding, followed by 22 patients (28.9%) with trauma, other surgery bleedings in 9 patients (11.8%) and 4 patients (5.4%) with peripartum haemorrhage. Total survival rate was 78.9% within 24 h and 44.7% over 30 days. Among all these patients who had received rFVIIa due to life-threatening haemorrhage, blood and blood product requirements were significantly reduced ( < 0.001), and the coagulation profiles improved significantly ( < 0.05). Two patients with preexisting thromboembolism were given rFVIIa due to intractable bleeding, both survived. No thromboembolic events were reported after the administration of rFVIIa.

Conclusions: rFVIIa significantly improved coagulation parameters and reduced blood product requirements during refractory haemorrhage. Additionally, usage of rFVIIa in trauma and peripartum haemorrhage patients yield better outcomes than other groups of patients. However, the overall mortality rate remained high.
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http://dx.doi.org/10.1186/s12878-018-0126-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251212PMC
November 2018

Masking and misleading: concomitant actinomycosis and B-cell lymphoma - a case report and review of literature.

Scott Med J 2018 Aug 30:36933018789312. Epub 2018 Aug 30.

2 Consultant Infectious Diseases Physician, Infectious Diseases Unit, Penang General Hospital, Penang, Malaysia.

We report a 72-year-old patient who presented with an ulcerated palatal mass, weight loss and adrenal insufficiency. Repeated biopsies from the mass revealed actinomycosis with no features of malignancy, while computed tomography scanning revealed a left maxillary sinus mass with invasive features and bilateral large adrenal masses. Blood and urine investigations showed adrenal insufficiency. The patient was treated as actinomycosis with adrenal involvement and was given intravenous penicillin and intravenous hydrocortisone. However, his condition did not improve and new signs appeared, that of left facial swelling and lymphadenopathy. A repeat biopsy of the palatal and adrenal masses revealed B-cell lymphoma. This case highlights the possibility that actinomycosis and lymphoma may share similar clinical presentations and may coexist. Either may mask and/or mimic the other, thus causing a delay in diagnosis. We describe the clinical progress and review the related literature. Interestingly, 9 out of the 12 reported cases of concomitant actinomycosis and malignancy (including this case) involve haematological malignancy. A high index of suspicion and treatment response reassessment is important in the management of either rare clinical entity.
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http://dx.doi.org/10.1177/0036933018789312DOI Listing
August 2018

A deadly hidden nodule.

Authors:
Jo Anne Lim

Am J Obstet Gynecol 2018 11 17;219(5):502. Epub 2018 Apr 17.

Department of Internal Medicine, Hospital Sultan Abdul Halim, Kedah, Malaysia. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2018.04.021DOI Listing
November 2018

A misdiagnosed infection mimicking "tree man disease".

PLoS Negl Trop Dis 2017 06 15;11(6):e0005543. Epub 2017 Jun 15.

Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia.

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http://dx.doi.org/10.1371/journal.pntd.0005543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472256PMC
June 2017

The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection.

Malar J 2017 01 3;16(1). Epub 2017 Jan 3.

Hospital Raja Perempuan Zainab II, 15000, Kota Bharu, Kelantan, Malaysia.

Background: Dengue and malaria are two common, mosquito-borne infections, which may lead to mortality if not managed properly. Concurrent infections of dengue and malaria are rare due to the different habitats of its vectors and activities of different carrier mosquitoes. The first case reported was in 2005. Since then, several concurrent infections have been reported between the dengue virus (DENV) and the malaria protozoans, Plasmodium falciparum and Plasmodium vivax. Symptoms of each infection may be masked by a simultaneous second infection, resulting in late treatment and severe complications. Plasmodium knowlesi is also a common cause of malaria in Malaysia with one of the highest rates of mortality. This report is one of the earliest in literature of concomitant infection between DENV and P. knowlesi in which a delay in diagnosis had placed a patient in a life-threatening situation.

Case Presentation: A 59-year old man staying near the Belum-Temengor rainforest at the Malaysia-Thailand border was admitted with fever for 6 days, with respiratory distress. His non-structural protein 1 antigen and Anti-DENV Immunoglobulin M tests were positive. He was treated for severe dengue with compensated shock. Treating the dengue had so distracted the clinicians that a blood film for the malaria parasite was not done. Despite aggressive supportive treatment in the intensive care unit (ICU), the patient had unresolved acidosis as well as multi-organ failure involving respiratory, renal, liver, and haematological systems. It was due to the presentation of shivering in the ICU, that a blood film was done on the second day that revealed the presence of P. knowlesi with a parasite count of 520,000/μL. The patient was subsequently treated with artesunate-doxycycline and made a good recovery after nine days in ICU.

Conclusions: This case contributes to the body of literature on co-infection between DENV and P. knowlesi and highlights the clinical consequences, which can be severe. Awareness should be raised among health-care workers on the possibility of dengue-malaria co-infection in this region. Further research is required to determine the real incidence and risk of co-infection in order to improve the management of acute febrile illness.
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http://dx.doi.org/10.1186/s12936-016-1666-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210313PMC
January 2017

Difficult mask ventilation: simple step to make the impossible, possible!

J Clin Anesth 2016 Nov 20;34:612-4. Epub 2016 Jul 20.

Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. Electronic address:

Mask ventilation is one of the most important skills in airway management. Difficulty in mask ventilation can become life threatening if it is associated with difficulty in intubation during general anesthesia. We report a potential impossible ventilation condition which was safely and easily overcome with appropriate innovative modification of an Opsite adhesive film.
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http://dx.doi.org/10.1016/j.jclinane.2016.06.035DOI Listing
November 2016