CRC SGH Newsletter Issue 52

CRC SGH
NEWSLETTER
ISSUE # 52
JULY 2022
Clinical Research Centre, Sarawak General Hospital
Jalan Tun Ahmad Zaidi Adruce, 93586 Kuching, Sarawak
Phone: 082-276820 / 082-276666 ext 1074 / 1075
Fax: 082-276823
E-mail: leelen.crc@gmail.com, ireneg.crc@gmail.com
To contribute (news & event, publication, article of interest, etc),
please call us or email to leelen.crc@gmail.com or ireneg.crc@gmail.com
For more information please visit our website.
http://www.crc.gov.my/crcSarawak/
You are welcome to contribute
Contact Us
CLINICAL RESEARCH CENTRE, SARAWAK GENERAL HOSPITAL

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CRC SGH NEWSLETTER
Issue # 52 July 2022
1. Overview & Current Status
Clinical Research Centre, Sarawak General Hospital (CRCSGH) started its operation in the new facility on the 1st
November 2016. This integrated clinical research facility consists its own ward, pharmacy, procedure room, sample/
specimen processing and physiological system testing equipment.
CRCSGH Physiology Laboratory is equipped to conduct human cardiology, respiratory and neurology assessments,
with the mission to improve patient health outcome through ethical and quality clinical research; and vision to become
the leading physiology laboratory in Asia.
At present capacity, CRCSGH Physiology Laboratory is involved in 7 Industry-Sponsored Researches (ISRs)
including an early phase drug trial, 8 Investigator-Initiated Researches (IIRs) and 3 local and international hybrid IIRs.
The following tests are available in our laboratory for research applications:
i. Transthoracic Echocardiogram (ECHO)
ii. 12-Lead Electrocardiogram (ECG)
iii. Ambulatory ECG monitoring
iv. Realtime Telemetry monitoring
v. Ambulatory Blood Pressure Monitoring (ABPM)
vi. Cardiopulmonary Exercise Test (CPET)
vii. Electroencephalogram (EEG)
viii. Treadmill Exercise Stress Test
CRC SGH NEWSLETTER
PHYSIOLOGY LABORATORY – CURRENT STATUS & FUTURE PERSPECTIVES
Dr. Lai Wei Hong, Dr. Diana Foo Hui Ping, Dr. John Yeo Jui Ping,
Macnicholson Igo, Mohammad Nor Azlan Sulaiman
Clinical Research Centre, Sarawak General Hospital,
Jalan Hospital, 93586, Sarawak, Malaysia
CRCSGH Physiology Laboratory
setup
SGH respiratory physician performing
biological calibration of the
Cardiopulmonary Exercise Test (CPET)
system

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CRC SGH NEWSLETTER
2. Research Collaborations & Achievements
Since the establishment of this facility, our team has been working closely with local and international clinicians,
clinician-scientists and scientists in various research projects. The success of these projects was largely attributed to
the real team effort involving multidisciplinary teams (resulting from the years of great collaborations and friendship).
Many collaborative IIRs and hybrid IIRs were selected for oral presentations in national and international conferences,
and publications in international journals.
CRC SGH NEWSLETTER
Figure 1: Publication on ASEAN Heart Journal
to read
full-text
Figure 2: Publication on EP Europace Journal
to read
full-text

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CRC SGH NEWSLETTER
CRC SGH NEWSLETTER
Figure 3: Publication on Sensor Journal
to read
full-text
Figure 4: Publication on Journal of Asia Pacific Society of Cardiology
to read
full-text

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CRC SGH NEWSLETTER
3. Future Perspectives
3.1 ISO Accreditation
At the time of writing, there are limited physiology laboratories locally, and no accredited physiology laboratory in Ma-
laysia. Quality management system (QMS) is paramount to oversee the activities and processes of an organisation;
and for CRCSGH, the implementation and accreditation of QMS is essential to achieve our mission. Currently,
CRCSGH is in the midst of establishing accreditation scope for physiology assessments/tests in Malaysia with Stand-
ard Malaysia, with the aim for CRCSGH Physiology Laboratory to be the first ISO15189 accredited facility for physiolo-
gy-related assessments in the country.
CRC SGH NEWSLETTER
Presentation of Athlete Heart Project at
Great Wall
Presentation of PROVE-AF Project at National Heart
Association of Malaysia (NHAM) Congress 2018
Presentation of Resistant Hypertension Project at NHAM Congress 2022

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CRC SGH NEWSLETTER
3.2 Strategic Linkages
CRCSGH strives to establish more local and international strategic linkages, as we believe in the core fundamental of
creating a complete/wholesome value chain for research findings to be impactful and able to be disseminated and/or
utilised efficiently.
3.3 Pioneering Care via Impactful Research
Hypertension and diabetes are very prevalent among the Malaysian population, and lead to higher risks for
cardiovascular disease. In view of the many drugs and therapies for heart failure, CRCSGH is embarking on screening
for left ventricular dysfunction (diastolic and systolic) among patients with established diabetes/hypertension (using
ECHO) to identify those whom such treatments can be prescribed to improve their cardiovascular outcomes. In
addition, the use of 24h ABPM was emphasized in our resistant hypertension study to identify patients with true
resistant hypertension, and those with non-dipper/reverse dipper hypertension to facilitate decision-making in
treatment strategies to optimize blood pressure control.
Stroke due to atrial fibrillation (AF) is common and diagnosis of AF post-stroke requires prolonged cardiac monitoring.
However, there are practical limitations with current guidelines-recommended technologies which are often associated
with limited resources and patients’ barrier to invasive monitoring procedures. Since 2017, CRCSGH Physiology
Laboratory had tested various novel digital wireless technologies (e.g. AliveCor Smartphone device, cardiac patch
devices, remote monitoring patch device) to address the need to enhance diagnostic strategy in stroke patients with
sinus rhythm and remote monitoring in the elderly community, so that therapeutic intervention can commence early for
secondary AF-related stroke prevention. Moving forward, our laboratory will continue to conduct impactful research
that will benefit patient care and improve their outcomes.
CRC SGH NEWSLETTER
CRCSGH team, Sarawak Heart Centre
Cardiologists, and representatives from IDS
Meds (supplier for ST2 biomarkers for the
BLAST-DM project). Pilot phase of the project
was presented at Joint Meeting of Coronary
Revascularization (JCR) in Busan (2015)
Meeting between CRCSGH team, SGH Sleep
Physician, representative from Symbiomed,
and representative from Sarawak Research &
Development Council (2022)

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CRC SGH NEWSLETTER
.
For any enquiries, please do not hesitate to contact us via:
Dr. Diana Foo Hui Ping
Physiology Laboratory (Head)
Clinical Research Centre, Sarawak General Hospital
Email: dianafoo.crc@gmail.com
CRC SGH NEWSLETTER
Cardiac/remote monitoring research in CRCSGH from 2017 until present

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CRC SGH NEWSLETTER
Clinical Research Centre Sarawak General Hospital (CRC SGH) Laboratory was set up in year 2016. In 2019, CRC
SGH laboratory obtained its MS ISO/IEC 17025:2017 General requirements for the competence of testing and
calibration laboratories and MS ISO 15189:2014 Medical laboratories accreditation.
As a research laboratory in healthcare setting, CRC SGH laboratory plays a significant role in producing reliable
results that can be used for diagnosis, prognosis, treatment planning and follow up of diseases. Laboratory is also
expected to provide the highest possible quality of service. Therefore, quality of the test results is always fundamental
for the laboratory. However, how to define the required level of quality is a question that has been subject to much
debate.
In CRC SGH laboratory, quality control (QC) is an essential aspect of ensuring that test results are valid and fit for the
purpose as determined by the quality objectives i.e. accuracy and precision. QC also is used to validate whether our
instrument is operating within pre-defined specifications, inferring that the test results reported are reliable. Both
Internal Quality Control (IQC) and External Quality Control (EQC) are utilized in our laboratory to increase the
reliability of the test results analytical quality. This includes proficiency testing, inter-laboratory comparisons, Levey
Jennings control chart, certified reference standards, replicate testing using the same or different methods and Sigma
Metrics. Sigma Metrics has been utilized by the laboratory as it is an optimal QC procedure that recognizes the need
for customized QC rules for assays based on their inherent variability.
Apart from IQC and EQC, permissible limit for uncertainty of measurement is also part of the quality assessment
process in our laboratory. Typically, every measurement in the laboratory has an error. Therefore, a measurement
only gives an approximation of the true value of the quantity to be measured. The possible difference to the true value,
or the measurement uncertainty, should be estimated and reported as part of any good analytical practice.
Since the laboratory practice is always at a fast pace, it is important that the improvement occurs from time to time in
CRC SGH laboratory. This includes the improvement of quality system and workflows that will help in the facilitation of
accurate and rapid diagnostics, the efficiency of treatment and the reduction of errors in the laboratory process.
Quality is not a day’s result; it is a continuous improvement process to keep the success continuing. Thus let’s build it
slowly, continuously and steadily.
CRC SGH NEWSLETTER
QUALITY CONTROL IN LABORATORY SETTING
By: CRC SGH laboratory team
The CRC SGH
laboratory team
Analyst performing
QC run before the
start of samples
analysis

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CRC SGH NEWSLETTER
Events & Updates
CRC Sarawak General Hospital
MOSTI and Malaysia Genome and Vaccine Institute (MGVI) Visit
On 17th
May 2022, the deputy secretary general (technology development) of MOSTI, YBhg. Datuk Ts. Dr. Mohd Nor
Azman Hassan made a visit to CRC SGH to discuss on vaccine development and clinical research. The visit was also
attended by Dr Mohd Ghows Mohd Azzam, the director of MGVI. It was a fruitful visit as CRC SGH and SGH can
showcase our clinical research capabilities for any future collaborations with MOSTI and MGVI.
NHAM ASM 2022
This year’s National Heart Association Malaysia Annual Scientific Meeting (NHAM ASM) was held on 3-5 June 2022 at
the KL Convention Center. CRC SGH participated in a few oral presentation sessions to share the findings of our re-
search at the scientific meeting. Congratulations to Dr Diana Foo Hui Ping from CRC SGH who won the free paper ses-
sion with her abstract “Association of resistant hypertension with cardiac and renal damage in Malaysia”.

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CRC SGH NEWSLETTER
Events & Updates
Digital Health Research and Innovation (DHRi) team and British High Commission Visit
CRC SGH is honored to be visited by the DHRi team from ICR under the leadership of Datuk Dr Kalaiarasu M.
Peariasamy as well as Mr Aaron Kual, the medical advisor to the British High Commission in Malaysia on the 19th
July
2022. The DHRi team shared on the digital research projects that their team are working on, including the project they
are collaborating with Swinburne University of Technology Sarawak. During the visit, health directions and clinical
research insights were shared among the participants.
CRC Sibu Hospital
Courses Update
Clinical Research Post-Graduate Society of Sibu Hospital (CRPS) & Clinical Research Centre Sibu successfully
organised the first Good Clinical Practice (GCP) workshop on 22-24 Jan 2022 in Agape Centre Sibu. Forty-one
participants attended the first GCP workshop.
Recently, on16-18 July 2022, the second GCP workshop was organised in Kingwood Hotel Sibu. It was attended by 54
participants (one re-sit participant) with various backgrounds, including medical officers, research officers, science
officers, optometrists, a pharmacist, specialist doctors, and a clinical psychologist. The participants come from Sibu and
also outside Sibu likes Kuching, Serian, Kapit, and Miri.

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CRC SGH NEWSLETTER
Events & Updates
CRC Sibu Hospital
1st
Good Clinical Practice (GCP) Workshop 22-24 January 2022
Participants attending the GCP workshop on
22-24 Jan 2022 in Wong Mee Sing Hall, Agape
Centre Sibu.
Participants attending the
Good Clinical Practice (GCP) certification exam
on 24 Jan 2022 in Wong Mee Sing Hall, Agape
Centre Sibu.
2nd
Good Clinical Practice (GCP) Workshop 16-18 July 2022 in Kingwood Hotel, Sibu

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CRC SGH NEWSLETTER
Events & Updates
CRC Sibu Hospital
Research Activities
Industry Sponsor Research (ISR)
As of today, Sibu Hospital has nine ongoing and five new ISRs. One of the studies is the COVID-19 vaccine clinical trial
for children using Corona-Vac Ò
(Sinovac). The principal investigator, Dr Toh Teck Hock and the research team
consisting of more than a team of 50 doctors, pharmacists and site coordinators from both CRC and CRM. We join
hands in preparing, coordinating, and roll-out the study. From early November 2021 to March 2022 the team was
occupied with the study recruitment, and managed to screen 609 children and recruited 567 children into the study;
being one of the top recruiting centres in the world. Research officers in CRC are performing the PCR COVID-19 test in
CRC-SEGi-Duke Molecular Lab for any COVID-19 suspected case among the recruited children.
Pictures showing SC doing documentation and data entries in Sinovac project room, CRC Sibu
Picture of research officer in the midst of RNA extraction for PCR analysis

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CRC SGH NEWSLETTER
Events & Updates
CRC Sibu Hospital
With the slowly returning of more “normal” but new norm life, research activities in CRC Sibu also slowly return. Our
collaboration with the University of Texas Medical Branch (previously Duke University) on identifying novel respiratory
viruses and working with Sunway University on children’s development resume our recruitment. Our prime paper1
published in early 2022 with researchers from Ohio State University, Duke University and Ethiopia on the discovery of a
novel canine coronavirus has been cited by more than 70 papers. In addition, two more papers have also been
published this year, thanks to our international collaborators who work on animal alphacoronaviruses and screening
children with autism.2,3
1. Vlasova Anastasia N, Diza Annika, Damtie Debasu, Xiu Leshan, Toh TH, Lee Jeffrey Soon-Yit, Saif Linda J, Gray C
Gregory. Novel canine coronavirus among hospitalized pneumonia patients in Malaysia. Clin Infect Dis.
2022 Feb 11; 74(3):446-54. doi: 10.1093/cid/ciab456.
2. Vlasova AN, Toh TH, Lee JSY, Davis P, Azevedo MSP, Lednicky JA, Saif LJ, Gray GC. Animal alphacoronavirus-
es found in human patients with acute respiratory illness in different countries. Emerg Microbes Infect. 2022
Feb 14;1-7. doi: 10.1080/22221751.2022.2040341. Online ahead of print
3. Stevanovic D, Robins DL, Toh TH, et al. Cross-cultural similarities and differences in reporting autistic symptoms in
toddlers: A study synthesizing M-CHAT(-R) data from ten countries. Res Autism Spectr Disord. July 2022; Vol 95.
101984. https://doi.org/10.1016/j.rasd.2022.101984
CRC Miri Hospital
Clinical Trials Day and Sponsored Research Award Presentation 2022
A heart-felt congratulations to all the members of Clinical Research
Centre (CRC), Clinical Research Malaysia (CRM) and all investigators
from Miri Hospital for receiving not one but two awards on 19th May 2022
during Clinical Trials Day and Sponsored Research Award Presentation
2022.
One of which is "Significant Advancement Award for Site", where there is
a significant increase in the number of studies that we are involved (10
studies) and being one of the top site involved in Infectious Disease
Clinical Trial. This award was proudly received by Dr Jack Wong Siew
Yu, who is our Hospital Director and also our CRC Head of Department.
Special congratulations to Dato’ Dr Fam Tem Lom from Medical
Department of Miri Hospital for receiving "Significant Investigator Award
for Investigator". Through his guidance and appropriate task
allocation, there is a significant increase in sponsored study participation
constantly exceeding sponsor's target.
Congratulations again to all everyone involved in the achievement!
From left to right: Mr Tan Sia
Hong, Dato’ Dr Fam Tem Lom, Dr
Jack Wong Siew Yu, Mr Alvin Bundoi

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CRC SGH NEWSLETTER
Events & Updates
CRC Miri Hospital
Good Clinical Practice Workshop 2022
We held our 10th
Good Clinical Practice Workshop on the 11th
– 13th
April 2022. The workshop was conducted via hybrid
manner whereby the lectures were delivered physically and also virtually. The examination was conducted physically in
accordance to SOP. Throughout the event strict SOP was being implemented. There were a total of 31 participants and
23 participants passed the examination.
Intermediate Research Methodology 2022 (1st
Session)
On the 27th
– 28th
June 2022, the above mentioned workshop was jointly organized by CRC and Pharmacy Department
of Miri Hospital. The workshop was conducted virtually and a total of 51 participants attended the workshop.
CRC Bintulu Hospital
Introduction to Clinical Research Seminar (Hybrid)
On 25th of May 2022, CRC Hospital Bintulu organised this seminar with the objective of providing an
introductory overview which covers basic concepts of clinical research aimed at clinicians and allied health professionals
involved in clinical research.
Group photo of the ICR organized by CRC Hospital Bintulu

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CRC SGH NEWSLETTER
Announcements
Introduction to Questionnaire Development Studies Workshop
Date: 6th
July 2022 (Wednesday)
Venue: Virtual (via Zoom Meeting)
Contact Person: Ms Nur Syafiqah / Mdm Zuriah
Contact Number: 082-276820; Fax: 082-276823
Email: syafiqahyusup97@gmail.com
Good Clinical Practice (GCP) Certification Workshop
Date: 27th
- 29th
August 2022 (Saturday - Monday)
Venue: Imperial Hotel, Kuching
NIH Guidelines for Conducting Research in MOH and Facilities 2021 (3rd
Edition) Roadshow
Date: 6th
September 2022 (Tuesday)
Venue: Auditorium CRC, Sarawak General Hospital
Introduction to Questionnaire Validation Studies Workshop
Date: 21st
September 2022 (Wednesday)
Research Design and Statistical Analysis for Diagnostic Studies
Date: 19th
October 2022 (Wednesday)
CRC Miri Hospital
Good Clinical Practice Workshop 2022
Date: 11th
– 13th
April 2022
Venue: Jinhold Hotel & Serviced Apartment Sdn Bhd.
Contact Person: Dr Lim Soo How
Contact Number: 085-413674 (O), 085-420033 (Ext 537), 011-27642455 (H/P)
Email:patickcow123@gmail.com/limsoohow@moh.gov.my

CRC SGH Newsletter Issue 52

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CRC SGH Newsletter Issue 52