BAYU by Respiratory Department, Sabah

04/10/2025

A 50-year-old lady with progressive esophageal carcinoma (despite chemo-radiotherapy) developed a malignant central airway obstruction at the upper trachea.

Given the critically narrowed airway and location, a self-expanding metallic stent was deployed. This option was chosen because of its strong radial force, ease of deployment and feasibility even in severely narrowed airways.

Aftercare is just as important as the procedure itself. Patients with airway stents require close follow-up for secretion management, granulation tissue, infection, and stent patency.

For further reading on central airway obstruction , refer to
https://journal.chestnet.org/article/S0012-3692(24)04614-2/fulltext

26/09/2025

Our Respiratory Department has always been fortunate to have wonderful pharmacists on our team, and James has been nothing short of exceptional.

It’s sad to say goodbye, but we are happy that he will be back in KL, closer to his family. James has played an active role in the care of our severe asthma and MDR-TB patients, as well as contributing greatly to our research activities.

We wish him all the very best in his next chapter.

20/09/2025

Initial experience with PeriView FLEX TBNA needle in lung nodules without airway sign — enabled direct pathway creation and smooth access with 1.1 mm cryoprobe

Further reading on PeriView FLEX TBNA needle for Lung nodules biopsy
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncy.22240
https://www.sciencedirect.com/science/article/abs/pii/S2212534521000745

19/09/2025

A case of Lung Adenocarcinoma presenting with MCAO (extrinsic type). Airway dilatation followed by stent insertion was performed, successfully reopening the RML and RLL bronchus.

Further reading on MCAO
https://pubmed.ncbi.nlm.nih.gov/38812262/

15/09/2025

The MABIP 2025, 9th Annual Scientific Meeting was held in the historical city of Melaka from 12–14th September. Congratulations to Dr Ng Khai Lip, Dr Husna and team for organizing an excellent IP conference, covering topics from the basics right through to advanced techniques.

The Sabah Bayu team was proud to play an active role — contributing as speakers, workshop facilitators, and presenting in both oral and poster sessions.

Special thanks to Dr Kannan, Dr Lo Shan Min and colleagues who held the fort in Sabah while the rest of the team took part in the meeting.

26/08/2025

After the workshops, the MTS 2025 Annual Congress commenced.

Dr Lo Shan Min chaired two sessions
-APSR MTS Joint session on pulmonary function testing
-Critical care symposium

Dr Huan Nai Chien chaired a session on recent advances in pleural medicine.

Meanwhile, four posters and two oral presentations were submitted by our team this year:

-Malignant CAO stenting case series (Dr Eunice)
-CVID (Dr Sarvin)
-Bronchopulmonary sequestration (Dr Zarif)
-Invasive pulmonary aspergillosis (Dr Prisaana)
-Utility of pf LDH/ADA ratio in differentiating TB effusion and parapneumonic effusion (Dr Larry)
-Ultrasound-guided pulmonologist-led needle biopsy of peripheral pulmonary lesions (Dr Chia Yen Lik)

Hearty congratulations to Dr Chia and Dr Larry on their oral awards.

We are also proud of our ex-HQE colleagues Dr Phoebe and Dr Syuhada for their involvement in the poster presentations.

16/08/2025

The Malaysian Thoracic Society 2025 Pre-congress workshops were held on 14th August 2025 in KLCC. Three distinct workshops were offered - EBUS, Adult Bronchiectasis, and Paediatric Chronic Suppurative Lung Disease.

In the EBUS workshop, Dr Hema presented a lecture on “Introduction to EBUS”, while Dr Huan chaired a lunch symposium on bronchoscopy’s diagnostic and therapeutic role.

The participants benefited greatly from the input of invited experts like Prof Lin, Prof Terence and Prof Poletti. Kudos to the chairpersons, Dr Kho Sze Shyang and Dr Ng Khai Lip, for an informative and enlightening day.

For some selected reading of local data on EBUS, here is the list from our different Malaysian EBUS network component sites:

Bronchial branch tracing feasibility study: https://pubmed.ncbi.nlm.nih.gov/33113256/
A review on EBUS-TMC: https://pubmed.ncbi.nlm.nih.gov/38322189/
Optimal cryo-passes and freezing time for EBUS-TMC: https://pubmed.ncbi.nlm.nih.gov/39134712/
Technique of EBUS-TMC: https://pubmed.ncbi.nlm.nih.gov/39086350/
Transbronchial cryobiopsy for R-EBUS eccentric and adjacent lesions: https://pubmed.ncbi.nlm.nih.gov/31649952/

Case reports and series:
https://pubmed.ncbi.nlm.nih.gov/39654987/
https://pubmed.ncbi.nlm.nih.gov/38576853/
https://pubmed.ncbi.nlm.nih.gov/38357899/
https://pubmed.ncbi.nlm.nih.gov/31467678/

31/07/2025

"Let's build a system where every breath counts"

Our respiratory consultant, Dr Hema, delivered the keynote address for the RESPIRE Annual Scientific Meeting 2025 held in Kota Kinabalu from 29th July to 1st August.

The NIHR Global Health Research Unit on Respiratory Health (RESPIRE) aims to improve outcomes in respiratory diseases in disadvantaged populations, is co-led by the University of Edinburgh and Universiti Malaya, and is funded by the UK National Institute for Health and Care Research (NIHR), using international development funding from the UK Government to support global health research.

In her keynote address titled "Universal Health Coverage and Respiratory Care in Malaysia: Realities , Challenges and Opportunities", Dr Hema shared the following:

1. Challenges unique to the Sabahan setting (delayed access to care, compromised quality of care, increased staff burnout, widening rural-urban disparities, disruption of primary care, increased burden on hospitals)

2. Various successes such as the strong role of our primary care clinics, public funding for biologics, digital coordination between district & HQE, and our Sabah Severe Asthma Network.

3. Suggestions for the future (Strengthening workforce, improving infrastructure and equipment, reform healthcare financing, digital health expansion, research)

Sabah Respiratory strongly supports equitable, accessible quality healthcare for all, and looks forward to future collaborations with programs like RESPIRE to improve healthcare delivery for our people.

To learn more about RESPIRE, click the link: https://usher.ed.ac.uk/respire/

Press release on the event: https://www.nabalunews.com/post/world-leading-experts-convene-to-discuss-respiratory-disease-burden-2

Press conference by the committee on va**ng: https://www.nst.com.my/amp/news/nation/2025/07/1252103/expert-urges-urgent-action-teen-va**ng-rates-surge

28/07/2025

No banquet lasts forever — as some bid farewell, others make their entrance. We bid a heartfelt farewell to Dr Larry Nyanti and Dr. Lee Jiun Hang. Both have been invaluable assets to the department, contributing greatly with their dedication and expertise. We sincerely wish them all the best in their future endeavours and hope our paths will cross again someday. We are also pleased to welcome our new fellows — Dr. Leong Wan Yi, Dr. Tee Sunn-Ren, and Dr. Prissana. We hope they will have a rewarding and enjoyable experience during their time in Kota Kinabalu.

15/06/2025

This week we bid farewell to our respiratory fellow, Dr Tharma, who completed his second year of training in HQE. Dr Tharma was a valuable team-player who will be missed for his affable nature and his dedication to patient care. We wish him all the very best in his future endeavours.

12/06/2025

Case sharing

We encountered a gentleman in his 60s presenting with bilateral lower lobe collapse on pre-cardiac operative CT, with no prior history of respiratory illness. Bronchoscopy revealed occluded right bronchus intermedius and left lower lobe bronchus with endoluminal nodules. In our first-stage procedure yesterday, we performed rigid bronchoscopy, endobronchial nodule biopsy, followed by balloon dilatation at the left lower lobe. A further second-stage procedure is planned for the right side with mitomycin C application. HPE to follow...

05/06/2025

This month's theme for College of Physicians Malaysia's weekly CMEs is Respiratory Medicine. Do listen in to a variety of crucial topics delivered by esteemed respiratory physicians from around Malaysia.

COLLEGE OF PHYSICIANS WEBINAR
JUNE 2025
RESPIRATORY Medicine

Register Here: https://us02web.zoom.us/webinar/register/WN_8W9fzwuGTKqCFtpyI197mw

5TH June 2025
Topic: Lung Cancer Frontline: Getting It Right
Speaker: Dr Tan Sin Nee, Respiratory Physician,
Hospital Tengku Ampuan Afzan

Chair: Dr Huan Nai Chien, Consultant respiratory, sleep and internal medicine physician
Queen Elizabeth Hospital.

12th June 2025
Topic: Obstructive Sleep Apnea

Speaker: Dr MINALOSANI ARUMUGAM, Respiratory Physician
Hospital Pulau Pinang

Chair: Dr Ng Khai Lip
Respiratory Physicians
Hospital Melaka

19th June 2025
Topic: Biopsy Approaches in Lung Cancer
Speaker: Hema Yamini Ramarmuty, Respiratory Physician and Head of Department,
Department of Respiratory Medicine,
Queen Elizabeth Hospital

Chair: Raymund Dass s/o Maria Dass, Pulmonologist and Internal Medicine Consultant
Hospital Tuanku Ja’afar

26th June 2025
Topic: Central Airway Obstruction
Speaker: Dr Tan Hui Xin,
Respiratory Physician
Hospital Sungai Buloh

Chair: Dr. Sangeta Vadivelu
Consultant Physician & Pulmonologist
Hospital Sultan Abdul Halim, Sungai Petani