Publications by authors named "Chee Shee Chai"

We hypothesized that persistent lifetime (PLT) images could represent tumor imaging traits, locations, and persistent contrasts of topological components (connected and hole components) corresponding to gene mutations such as epidermal growth factor receptor (EGFR) mutant signs. We aimed to develop a topological radiogenomic approach using PLT images to identify EGFR mutation-positive patients with non-small cell lung cancer (NSCLC). The PLT image was newly proposed to visualize the locations and persistent contrasts of the topological components for a sequence of binary images with consecutive thresholding of an original computed tomography (CT) image.

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Objectives: Cancer pain is a prevalent and challenging symptom affecting a significant number of patients globally, with inadequate control remaining a substantial challenge despite advancements in pain management. Non-pharmacological interventions, including mindfulness-based approaches, have shown promise in alleviating cancer-related pain. This study aimed to explore the efficacy of a single session of 20-minute mindful breathing in reducing pain among patients with cancer.

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Background: Motivational interviewing (MI) is a person-centred approach focused on empowering and motivating individuals for behavioural change. Medical students can utilize MI in patient education to engage with patients' chronic health ailments and maladaptive behaviours. A current scoping review was conducted to 1) determine the types of MI (conventional, adapted, brief and group MI) education programs in medical schools, delivery modalities and teaching methods used; 2) classify educational outcomes on the basis of Kirkpatrick's hierarchy; and 3) determine the key elements of MI education via the FRAMES (feedback, responsibility, advice, menu of options, empathy, self-efficacy) model.

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Understanding the prevalence of abnormal lung function and its associated factors among patients recovering from COVID-19 is crucial for enhancing post-COVID care strategies. This study primarily aimed to determine the prevalence and types of spirometry abnormalities among post-COVID-19 patients in Malaysia, with a secondary objective of identifying its associated factors. Conducted at the COVID-19 Research Clinic, Faculty of Medicine, University Technology MARA, from March 2021 to December 2022, this study included patients at least three months post-discharge from hospitals following moderate-to-critical COVID-19.

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Article Synopsis
  • Afatinib can be safely started at doses lower than the standard 40 mg/day for treating non-small cell lung cancer (NSCLC) with EGFR mutations, but its effectiveness in real-world settings needed examination.
  • A study involving 133 NSCLC patients in Malaysia found that lower doses (below 40 mg) had a higher objective response rate (72.3%) compared to the standard dose (54.0%).
  • Although patients on lower doses were more likely to respond to treatment, the overall median survival was similar, indicating potential benefits without compromising safety.
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Introduction: Malaysia entered the transition to the endemic phase of Coronavirus 2019 (COVID-19) on 1st April 2022. This study aims to determine the public's willingness to perform COVID-19 self-testing. Factors that influenced their willingness were also assessed.

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Objectives: To elucidate a novel radiogenomics approach using three-dimensional (3D) topologically invariant Betti numbers (BNs) for topological characterization of epidermal growth factor receptor (EGFR) Del19 and L858R mutation subtypes.

Methods: In total, 154 patients (wild-type EGFR, 72 patients; Del19 mutation, 45 patients; and L858R mutation, 37 patients) were retrospectively enrolled and randomly divided into 92 training and 62 test cases. Two support vector machine (SVM) models to distinguish between wild-type and mutant EGFR (mutation [M] classification) as well as between the Del19 and L858R subtypes (subtype [S] classification) were trained using 3DBN features.

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Article Synopsis
  • This study investigated how forced expiratory volume (FEV), exacerbations, and patient-reported outcomes (PROs) relate to each other in individuals with stable chronic obstructive pulmonary disease (COPD).
  • The analysis included data from 374 COPD patients, revealing that those with a lower FEV (less than 30%) experienced more exacerbations compared to those with higher FEV levels.
  • Although correlations were found between lower FEV and increased exacerbations, the severity of airflow limitation did not significantly increase PRO scores, suggesting that different aspects of COPD management need to be considered.
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Obstructive sleep apnea is a chronic, sleep-related breathing disorder, which is an independent risk factor for cardiovascular disease. The renin-angiotensin-aldosterone system regulates salt and water homeostasis, blood pressure, and cardiovascular remodelling. Elevated aldosterone levels are associated with excess morbidity and mortality.

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Background: The initiation of a new drug, for instance, the coronavirus disease 2019 (COVID-19) vaccine in children could be a source of major concern for parents. This study aims to determine the willingness of parents in Malaysia to vaccinate their children younger than 12 years against COVID-19.

Methods: An online cross-sectional survey was conducted nationwide in Malaysia from August 29, 2021, to October 17, 2021.

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Objectives: Suffering is common among patients with advanced cancer. The practice of mindfulness during patient care can potentially reduce suffering. We aimed to examine the efficacy of mindfulness-based supportive therapy (MBST) on reducing suffering in patients with advanced cancer.

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Article Synopsis
  • - The study focused on understanding Malaysians' knowledge, attitudes, and practices (KAP) related to mental health during the later stage of the COVID-19 pandemic, involving a nationwide survey with over 2,100 participants.
  • - Results showed that while respondents had good knowledge about COVID-19, with an average knowledge score of 10 out of 12, their attitudes and practices were less positive, indicating a disconnect between what they knew and how they acted.
  • - The study concluded that although knowledge was high, it did not lead to improved attitudes or practices, suggesting a need for targeted health education to bridge these gaps in the context of ongoing pandemic challenges.
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Background: Patients with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent. Almost 70% of haematological cancer patients reported fatigue.

Methods: We conducted a parallel-group, non-blinded, randomised control trial at the haemato-oncology unit of University Malaya Medical Centre, from 1st October 2019 to 31st May 2020.

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Context: Numerous studies have shown that gratitude can reduce stress and improve quality of life.

Objective: Our study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer.

Methods: We conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia.

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Background: There have been limited reports looking into the care of patients with asthma exacerbations admitted to tertiary hospitals in Southeast Asia. This study aims to determine the extent in which the 2019 Global Initiative for Asthma (GINA) guidelines were being met.

Methods: A retrospective study of patients with asthma exacerbations admitted to the University of Malaya Medical Centre (UMMC) and Pantai Hospital Kuala Lumpur (PHKL), Malaysia from 1 July 2019 to 31 December 2019.

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Background: Coronavirus 2019 disease (COVID-19) is a highly infectious disease prompting extreme containment measures, including lockdown, travel restrictions, social distancing, and stringent personal hygiene. This study investigates the depression level and coping responses toward the lockdown, referred as the movement control order (MCO) during COVID-19 pandemic in Malaysia and its impact on quality of life.

Method: This cross-sectional study was conducted from April to May 2020.

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Objectives: To propose a novel robust radiogenomics approach to the identification of epidermal growth factor receptor (EGFR) mutations among patients with non-small cell lung cancer (NSCLC) using Betti numbers (BNs).

Materials And Methods: Contrast enhanced computed tomography (CT) images of 194 multi-racial NSCLC patients (79 EGFR mutants and 115 wildtypes) were collected from three different countries using 5 manufacturers' scanners with a variety of scanning parameters. Ninety-nine cases obtained from the University of Malaya Medical Centre (UMMC) in Malaysia were used for training and validation procedures.

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Background: Coronavirus disease 2019 (COVID-19) is highly contagious and has claimed more than one million lives, besides causing hardship and disruptions. The Fleischner Society has recommended chest X-ray (CXR) in detecting cases at high risk of disease progression, for triaging suspected patients with moderate-to-severe illness, and for eliminating false negatives in areas with high pre-test probability or limited resources. Although CXR is less sensitive than real-- time reverse transcription-polymerase chain reaction (RT-PCR) in detecting mild COVID-19, it is nevertheless useful because of equipment portability, low cost and practicality in serial assessments of disease progression among hospitalized patients.

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Article Synopsis
  • * Involving 300 patients, the study found that only 24.3% had a good TTR (≥ 60%), with a mean score of 70.2%, while most patients had poor TTR with a mean score of 39.5%.
  • * Although TTR was significantly associated with social functioning, there was no notable difference in overall HRQoL or treatment satisfaction scores between patients with good and poor TTR.
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Article Synopsis
  • The study assessed the health-related quality of life (HRQoL) of COPD patients classified into phenotypes based on exacerbation frequency and subtypes, revealing significant differences among them.
  • Out of 185 COPD patients, 58.4% were non-exacerbators, 27.6% were frequent exacerbators, and 14.1% had asthma-COPD overlap, with the majority exposed to biomass fuel or were smokers.
  • Results showed that frequent exacerbators had worse HRQoL scores compared to the other groups across multiple assessment tools, indicating more severe symptoms and limitations in daily activities.
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Context: There has been increasing evidence of the role of mindfulness-based interventions in improving various health conditions. However, the evidence for the use of mindfulness in the palliative care setting is still lacking.

Objectives: The objective of our study was to determine the efficacy of a single session of 20 min mindful breathing in alleviating multiple symptoms in palliative care.

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Background: This study aims to determine the predictors of acquired mutation in advanced non-small cell lung cancer (NSCLC) patients harbouring sensitizing ( mutation following the failure of first- or second-generation -tyrosine kinase inhibitor (TKI).

Methods: This is a retrospective observational study of NSCLC patients with sensitising mutation experiencing disease progression (PD) whilst on first- or second-generation -TKIs with subsequent investigations to detect acquired mutation at the University of Malaya Medical Centre from 1st January 2015 to 31st December 2017.

Results: A total of 87 patients were included.

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Heart failure is the leading cause of morbidity and mortality worldwide. Standard treatment for heart failure includes pharmacotherapy and cardiac device implants. However, supportive approaches in managing dyspnea in heart failure are limited.

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Introduction And Aim: Patient quality of life (QOL) while on long-term oral anticoagulant therapy has been receiving greater attention in recent years due to the increase in life expectancy brought about by advances in medical care. This study aimed to compare the QOL, treatment satisfaction, hospitalization and bleeding rate in patients on long-term warfarin versus direct oral anticoagulants (DOAC).

Methods: This was a cross-sectional study of patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE) on long-term anticoagulant therapy attending the cardiology clinic and anticoagulation clinic of the University Malaya Medical Centre from July 1, 2016, to June 30, 2018.

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