Professor Danforn Lim graduated from the University of New South Wales and he is a medical practitioner, university clinical academician and a well-known media personality in the Chinese community in Sydney NSW. In 2016, Prof Lim was also awarded to be the Business Person of the Year at the Local Business Award. He is one of the very few doctors in the country to hold both registrations as a Registered Medical Practitioner (with Specialist Registration) and Registered Chinese Medicine Practitioner in Australia. With knowledge in both Western and Chinese Medicine, Prof Lim keeps an open mind in his clinical practice and aims to deliver the best possible care to his patients.
Academically, Prof Lim has completed 3 Bachelor degrees, 3 postgraduate diplomas, 3 Master degrees and 2 Doctorate degrees. He has published more than 70 journal articles in the last 7 years as well as being a reviewer/editorial board member (including Editor in chief) for more than 30 different peer reviewed journals. He received full scholarship support for his PhD(Medicine) study in Polycystic Ovarian Syndrome (PCOS) at the University of New South Wales, Australia and has also completed his second doctorate study in Business Administration through Institute of Economics, Polish Academy of Sciences.
PhD(UNSW), MBBS(UNSW), BSc(Med), ExecDrBusAdmin(INE PAN), BHltSc(CompMed)(CSU), Diploma in Child Health (Syd), ClinDipPallMed (RACP), GradDipAcup(RMIT), MMed(Repro Hlt & Hum Genetics)(Syd), MAppSc(Acupuncture)(RMIT), MAppMgt(Health)(Newcastle), Cert BSM (Cambridge UK), FRACGP, FASLM, FIML, Chartered Manager (UK/Aust), AFRACMA, AFCHSM, RCMP (Acup&CHM), FFCMASA, JP
- Registered Specialist in General Practice, Medical Board of Australia
- Registered Chinese Medicine Practitioner (Acupuncture & Chinese Herbal Medicine), Chinese Medicine Board of Australia
- Rail Industry Safety and Standards Board Authorised Medical Professional
- InjuryNet Accredited Pre-Employment Medical Assessor
- US Dept of Veteran Affairs Veterans Evaluation Services Accredited Physician Examiner
- Executive Vice President, Specialist Medical Services Group
- Family Medicine
- Palliative Medicine
- Integrative Chinese and Western Medicine
- Polycystic Ovarian Syndrome
- Integrative Medicine
- Health Care Management
- Medical Economics and Management
Chen, H & Lim, CED 2019, 'The efficacy of using acupuncture in managing polycystic ovarian syndrome', CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, vol. 31, no. 6, pp. 428-432.View/Download from: Publisher's site
Lim, CED, Ng, RWC, Cheng, NCL, Zhang, GS & Chen, H 2019, 'Acupuncture for polycystic ovarian syndrome.', The Cochrane database of systematic reviews, vol. 7, no. 7.View/Download from: Publisher's site
BACKGROUND:Polycystic ovarian syndrome (PCOS) is characterised by the clinical signs of oligo-amenorrhoea, infertility and hirsutism. Conventional treatment of PCOS includes a range of oral pharmacological agents, lifestyle changes and surgical modalities. Beta-endorphin is present in the follicular fluid of both normal and polycystic ovaries. It was demonstrated that the beta-endorphin levels in ovarian follicular fluid of otherwise healthy women who were undergoing ovulation were much higher than the levels measured in plasma. Given that acupuncture impacts on beta-endorphin production, which may affect gonadotropin-releasing hormone (GnRH) secretion, it is postulated that acupuncture may have a role in ovulation induction via increased beta-endorphin production effecting GnRH secretion. This is an update of our previous review published in 2016. OBJECTIVES:To assess the effectiveness and safety of acupuncture treatment for oligo/anovulatory women with polycystic ovarian syndrome (PCOS) for both fertility and symptom control. SEARCH METHODS:We identified relevant studies from databases including the Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, CNKI, CBM and VIP. We also searched trial registries and reference lists from relevant papers. CENTRAL, MEDLINE, Embase, PsycINFO, CNKI and VIP searches are current to May 2018. CBM database search is to November 2015. SELECTION CRITERIA:We included randomised controlled trials (RCTs) that studied the efficacy of acupuncture treatment for oligo/anovulatory women with PCOS. We excluded quasi- or pseudo-RCTs. DATA COLLECTION AND ANALYSIS:Two review authors independently selected the studies, extracted data and assessed risk of bias. We calculated risk ratios (RR), mean difference (MD), standardised mean difference (SMD) and 95% confidence intervals (CIs). Primary outcomes were live birth rate, multiple pregnancy rate and ovulation rate, and secondary outcomes were clinical pregna...
Kwok, C & Lim, D 2016, 'Evaluation of a Culturally Tailored Education to Promote Breast and Cervical Cancer Screening Among Chinese-Australian Women', Journal of Cancer Education, vol. 31, no. 3, pp. 595-601.View/Download from: Publisher's site
This paper aims to evaluate the impact of the culturally sensitive and linguistically appropriate education program on the following: (i) awareness of screening practices (breast awareness, mammogram, and Pap smear test); (ii) screening intention within the next six months; and (iii) knowledge about breast and cervical cancer among Chinese-Australian women. Titled "Happy and Healthy Life in Sydney," this was a quasi-experimental study with both pre- and post-test design. A convenience sample of 288 Chinese women was recruited through Chinese organizations such as churches and community centers. Participants completed the questionnaires before and after the educational program. The results show that the program was effective in promoting awareness of breast and cervical cancer screening and resulted in increased participative intentions in both mammogram and Pap smear testing within the next 6 months. Results also indicate that knowledge and belief scores were significantly increased. Conclusion: Our study supports that educational programs which use culturally sensitive and linguistically appropriate strategies are effective in improving both knowledge of breast and cervical cancer and awareness of their early detection practices among Chinese-Australian women.
Lim, CED, Ng, RWC, Cheng, NCL, Cigolini, M, Kwok, C & Brennan, F 2016, 'Advance care planning for haemodialysis patients', Cochrane Database of Systematic Reviews, vol. 2016, no. 7.View/Download from: Publisher's site
© 2016 The Cochrane Collaboration. Background: End-stage kidney disease (ESKD) is a chronic, debilitative and progressive illness that may need interventions such as dialysis, transplantation, dietary and fluid restrictions. Most patients with ESKD will require renal replacement therapy, such as kidney transplantation or maintenance dialysis. Advance care planning traditionally encompass instructions via living wills, and concern patient preferences about interventions such as cardiopulmonary resuscitation and feeding tubes, or circumstances around assigning surrogate decision makers. Most people undergoing haemodialysis are not aware of advance care planning and few patients formalise their wishes as advance directives and of those who do, many do not discuss their decisions with a physician. Advance care planning involves planning for future healthcare decisions and preferences of the patient in advance while comprehension is intact. It is an essential part of good palliative care that likely improves the lives and deaths of haemodialysis patients. Objectives: The objective of this review was to determine whether advance care planning in haemodialysis patients, compared with no or less structured forms of advance care planning, can result in fewer hospital admissions or less use of treatments with life-prolonging or curative intent, and if patient's wishes were followed at end-of-life. Search methods: We searched the Cochrane Kidney and Transplant Specialised Register to 27 June 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Social Work Abstracts (OvidSP). Selection criteria: All randomised controlled trials (RCTs) and quasi-RCTs (RCTs in which allocation to treatment was obtained by alternation, use of alternate medical records, date of birth or other predictable methods) looking at advance care planning versus no form o...
Lim, CED, Ng, RWC, Xu, K, Cheng, NCL, Xue, CCL, Liu, JP & Chen, N 2016, 'Acupuncture for polycystic ovarian syndrome', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, no. 5.View/Download from: Publisher's site
Yu, X, Lim, CED & Cheng, NCL 2016, 'A systematic review and meta-analysis of acupuncture and related therapies for palliative cancer care', Focus on Alternative and Complementary Therapies, vol. 21, no. 2, pp. 97-98.View/Download from: Publisher's site
Yu, X, Lim, CED & Cheng, NCL 2016, 'Meta-analysis of the Chinese herbal bath therapy for knee osteoarthritis', Focus on Alternative and Complementary Therapies, vol. 21, no. 1, pp. 36-37.View/Download from: Publisher's site
Yu, X, Lim, CED & Cheng, NCL 2016, 'Role of compound Danshen dripping pill in early diabetic retinopathy', Focus on Alternative and Complementary Therapies, vol. 21, no. 1, pp. 38-39.View/Download from: Publisher's site
Zhou, K, Zhang, J, Xu, L, Wu, T & Lim, CED 2016, 'Chinese herbal medicine for subfertile women with polycystic ovarian syndrome', Cochrane Database of Systematic Reviews, vol. 2016, no. 10.View/Download from: Publisher's site
© 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background: Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinology abnormalities, and affects 5% to 10% of women of reproductive age. Western medicines, such as oral contraceptives, insulin sensitizers and laparoscopic ovarian drilling (LOD), have been used to treat PCOS. Recently, many studies have been published that consider Chinese herbal medicine (CHM) as an alternative treatment for women with PCOS. Objectives: To assess the efficacy and safety of CHM for subfertile women with PCOS. Search methods: We searched sources, including the following databases, from inception to 9 June 2016: the Cochrane Gynaecology and Fertility Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Allied and Complementary Medicine (AMED), PsycINFO, Chinese National Knowledge Infrastructure (CNKI), VIP, Wanfang and trial registries. In addition, we searched the reference lists of included trials and contacted experts in the field to locate trials. Selection criteria: Randomized controlled trials (RCTs) that considered the use of CHM for the treatment of subfertile women with PCOS. Data collection and analysis: Two review authors independently screened appropriate trials for inclusion, assessed the risk of bias in included studies and extracted data. We contacted primary study authors for additional information. We conducted meta-analyses. We used the odds ratios (ORs) to report dichotomous data, with 95% confidence intervals (CI). We assessed the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods. Main results: We included five RCTs with 414 participants. The comparisons in the included trials were as follows: CHM versus clomiphene, CHM plus clomiphene versus clomiphene (with or without ethinyloestradiol cyproterone acetate (CEA)), CHM plus follicle aspiration...
Lim, DCE & Cheng, NCL 2015, 'Commentary', Focus on Alternative and Complementary Therapies, vol. 20, no. 3-4, pp. 155-156.View/Download from: Publisher's site
Sun, X, Luo, X, Zhao, C, Chung Ng, RW, Lim, CED, Zhang, B & Liu, T 2015, 'The association between fine particulate matter exposure during pregnancy and preterm birth: A meta-analysis', BMC Pregnancy and Childbirth, vol. 15, no. 1.View/Download from: Publisher's site
© 2015 Sun et al. Background: Although several previous studies have assessed the association of fine particulate matter (PM2.5) exposure during pregnancy with preterm birth, the results have been inconsistent and remain controversial. This meta-analysis aims to quantitatively summarize the association between maternal PM2.5 exposure and preterm birth and to further explore the sources of heterogeneity in findings on this association. Methods: We searched for all studies published before December 2014 on the association between PM2.5 exposure during pregnancy and preterm birth in the MEDLINE, PUBMED and Embase databases as well as the China Biological Medicine and Wanfang databases. A pooled OR for preterm birth in association with each 10μg/m3 increase in PM2.5 exposure was calculated by a random-effects model (for studies with significant heterogeneity) or a fixed-effects model (for studies without significant heterogeneity). Results: A total of 18 studies were included in this analysis. The pooled OR for PM2.5 exposure (per 10μg/m3 increment) during the entire pregnancy on preterm birth was 1.13 (95 % CI = 1.03-1.24) in 13 studies with a significant heterogeneity (Q = 80.51, p < 0.001). The pooled ORs of PM2.5 exposure in the first, second and third trimester were 1.08 (95 % CI = 0.92-1.26), 1.09 (95 % CI = 0.82-1.44) and 1.08 (95 % CI = 0.99-1.17), respectively. The corresponding meta-estimates of PM2.5 effects in studies assessing PM2.5 exposure at individual, semi-individual and regional level were 1.11 (95 % CI = 0.89-1.37), 1.14 (95 % CI = 0.97-1.35) and 1.07 (95 % CI = 0.94-1.23). In addition, significant meta-estimates of PM2.5 exposures were found in retrospective studies (OR = 1.10, 95 % CI = 1.01-1.21), prospective studies (OR = 1.42, 95 % CI = 1.08-1.85), and studies conducted in the USA (OR = 1.16, 95 % CI = 1.05-1.29). Conclusions: Maternal PM2.5 exposure during pregnancy may increase the risk of preterm birth,but significant heterogeneity was fou...
Lim, CED & Cheng, NCL 2014, 'Commentary', Focus on Alternative and Complementary Therapies, vol. 19, no. 1, pp. 34-35.View/Download from: Publisher's site
Lim, CED & Cheng, NCL 2014, 'Effect of mindfulness based stress reduction in stage 0-III breast cancer survivors', Focus on Alternative and Complementary Therapies, vol. 19, no. 4, pp. 219-220.View/Download from: Publisher's site
Lim, CED & Cheng, NCL 2013, 'Acupuncture for allergic rhinitis: Active and sham acupuncture both seem to work', Focus on Alternative and Complementary Therapies, vol. 18, no. 3, pp. 136-137.View/Download from: Publisher's site
Lim, CED & Cheng, NCL 2013, 'Electroacupuncture for symptom improvement in benign prostatic hyperplasia', Focus on Alternative and Complementary Therapies, vol. 18, no. 4, pp. 199-200.View/Download from: Publisher's site
Lim, CED, Ng, RWC & Xu, K 2013, 'Non-hormonal methods for induction of labour', CURRENT OPINION IN OBSTETRICS & GYNECOLOGY, vol. 25, no. 6, pp. 441-447.View/Download from: Publisher's site
Wong, FWS & Lim, DCE 2013, 'Factors influencing the choice of hysterectomy approach for the management offibroid uterus', Gynecology and Minimally Invasive Therapy, vol. 2, no. 2, pp. 61-64.View/Download from: Publisher's site
Aim: The aim of this study was to identify factors influencing the choice between different approaches in hysterectomy for uterine fibroids. Methods: A cross-sectional study was conducted involving 285 women who had undergone hysterectomy for uterine fibroids at the Liverpool Hospital, New South Wales, Australia. Results: This study shows that several factors influenced the choice of hysterectomy approach. First, concomitant adnexal surgery increased the likelihood of undergoing an abdominal hysterectomy rather than either a vaginal or a laparoscopic hysterectomy by 10- and fivefold (both p<0.01), respectively. Second, women with a larger uterus (>280g) had a 20 (. p<0.05) and 10 (. p<0.01) times greater chance of undergoing an abdominal hysterectomy than either a vaginal or a laparoscopic hysterectomy, respectively. Third, gynecologic endoscopists were more likely to perform laparoscopic hysterectomy than gynecologic generalists (. p<0.001). Conclusion: Certain clinical parameters determine the choice of hysterectomy approach. Surgeons' expertise also has significant influence over the choice between laparoscopic and traditional approaches for hysterectomy. © 2013.
Lam, CFD, Leung, KS, Heng, PA, Lim, CED & Wong, FWS 2012, 'Chinese Acupuncture Expert System (CAES)-A Useful Tool to Practice and Learn Medical Acupuncture', JOURNAL OF MEDICAL SYSTEMS, vol. 36, no. 3, pp. 1883-1890.View/Download from: Publisher's site
Lim, CED & Cheng, NCL 2012, 'Connective tissue reflex massage to improve peripheral circulation in type 2 diabetes mellitus', Focus on Alternative and Complementary Therapies, vol. 17, no. 1, pp. 69-70.View/Download from: Publisher's site
Lim, CED & Cheng, NCL 2012, 'Massage therapy to improve sleep quality post coronary artery bypass graft surgery', Focus on Alternative and Complementary Therapies, vol. 17, no. 1, pp. 67-68.View/Download from: Publisher's site
Lim, CED, Wong, WSF & Cheng, NCL 2012, 'Xiao Shan Zhu Lin Si's secret gynaecological Chinese medicinal formulae - grappling with an ancient disease in modern times', Journal of the Australian Traditional-Medicine Society, vol. 18, no. 1, pp. 27-29.
Luo, X, Hong, XS, Xiong, XD, Zeng, LQ & Lim, CED 2012, 'A single nucleotide polymorphism in EXO1 gene is associated with cervical cancer susceptibility in chinese patients', International Journal of Gynecological Cancer, vol. 22, no. 2, pp. 220-225.View/Download from: Publisher's site
Objective: The aim of this study was to investigate the association of Exonuclease1 (EXO1) genetic polymorphism and the development of cervical carcinoma. Methods: This study was conducted with 126 patients diagnosed with cervical cancer and 278 people with no cancer history. The polymerase chain reaction-based restriction fragment length polymorphism was used to evaluate the K589E and C908G gene polymorphisms. Unconditional logistic regression analysis was used to estimate the association between the genotypes and the risk for cervical cancer. Results: This is the first study on the role of EXO1 K589E (rs1047840) and EXO1 C908G (rs10802996) polymorphisms in cervical cancer in a Chinese population. Our results indicated that the EXO1 K589G polymorphism were significantly associated with the risk for cervical cancer. Compared with the G allele EXO1 K589E, the A allele increased the risk for cervical cancer (adjusted odds ratio, 1.67; 95% confidence interval, 1.13-2.45). By contrast, we have not found a significant association between the EXO1 C908G polymorphism and cervical cancer risk (P = 0.791). Conclusion: These findings indicate that the SNPs of EXO1 K589E may contribute to cervical cancer carcinogenesis in Chinese populations. A larger population study will need to be carried out to further validate the potential association of EXO1 genetic polymorphism and cervical carcinoma. Copyright © 2012 by IGCS and ESGO.
Pan, M-W, Ye, N, Chen, Z-Q, Gu, C-M & Lim, CED 2012, 'Observation of Infiltration and Activation of Dendritic Cells in Primary Foci of Prostate Cancer using Fuzhengyiliufa Integrative Treatments', JOURNAL OF THE AUSTRALIAN TRADITIONAL-MEDICINE SOCIETY, vol. 18, no. 3, pp. 151-154.
Zhang, XZ, Ye, N, Pan, MW & Lim, CED 2012, 'Preventive Treatment for Diseases: A Practice Model. A Challenge for Hospital Management in the Field of Integrative Medicine', JOURNAL OF THE AUSTRALIAN TRADITIONAL-MEDICINE SOCIETY, vol. 18, no. 4, pp. 221-223.
Chen, W, Lim, CED, Kang, H-J & Liu, J 2011, 'Chinese Herbal Medicines for the Treatment of Type A H1N1 Influenza: A Systematic Review of Randomized Controlled Trials', PLOS ONE, vol. 6, no. 12.View/Download from: Publisher's site
Lim, CED & Cheng, NCL 2011, 'Clinician's role of psychological support in helping parents and families with pregnancy loss', Journal of the Australian Traditional-Medicine Society, vol. 17, no. 4, pp. 215-217.
Pregnancy loss can be devastating for both parents and any complementary & alternative medicine (CAM) clinicians involved. In order to provide the possible best continuing care to patients, it is important for CAM clinicians to understand their roles in providing psychological support to patients and families experiencing pregnancy loss. Some approaches to discussing pregnancy loss with patients are described in this paper.
Lim, CED & Cheng, NCL 2011, 'Obesity and Reproduction', JOURNAL OF THE AUSTRALIAN TRADITIONAL-MEDICINE SOCIETY, vol. 17, no. 3, pp. 143-145.
Lim, DCE, Chen, W, Cheng, LNC, Xue, CC, Wong, FWS, O'Sullivan, AJ & Liu, JP 2011, 'Acupuncture for polycystic ovarian syndrome', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, no. 8.View/Download from: Publisher's site
Wong, WSF & Lim, CED 2011, 'Hormonal treatment for endometriosis associated pelvic pain', IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE, vol. 9, no. 3, pp. 163-170.
Wong, WSF, Lee, TCE & Lim, CED 2011, 'A retrospective study of laparoscopic-assisted vaginal hysterectomy (LAVH) in virgins and nulliparae', EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, vol. 157, no. 2, pp. 217-221.View/Download from: Publisher's site
Lim, CED & Wong, WSF 2010, 'Current evidence of acupuncture on polycystic ovarian syndrome', Gynecological Endocrinology, vol. 26, no. 6, pp. 473-478.View/Download from: Publisher's site
Objective. This paper aims to provide a literature review on evaluating the efficacy of acupuncture therapy in the treatment of polycystic ovarian syndrome (PCOS) by reviewing clinical trials; randomised and non-randomised and observational studies on PCOS. The paper will also determine the possible mechanism of acupuncture treatment in PCOS, limitations of recruited studies and suggest further improvements in future studies. Design. A comprehensive literature search was conducted through the databases Medline, PubMed, EMBASE, Cochrane, AMED (Allied and Complementary Medicine), NCCAM (The National Centre for Complementary and Alternative Medicine) to identify relevant monographs. Results. Four studies were recruited. Several studies showed that acupuncture significantly increases β-endorphin levels for periods up to 24h and may have regulatory effect on FSH, LH and androgen. β-endorphin increased levels secondary to acupuncture affects the hyperthalamic-pituitary-adrenal (HPA) axis through promoting the release of ACTH through stimulation of its precursor pro-opiomelanocortin synthesis. Inclusion criteria. All available acupuncture studies on human subjects with PCOS from June 1970 to June 2009. Exclusion criteria. Studies not meeting the inclusion criteria, published in languages other than English or animal studies. Conclusion. Acupuncture is a safe and effective treatment to PCOS as the adverse effects of pharmacologic interventions are not expected by women with PCOS. Acupuncture therapy may have a role in PCOS by: increasing of blood flow to the ovaries, reducing of ovarian volume and the number of ovarian cysts, controlling hyperglycaemia through increasing insulin sensitivity and decreasing blood glucose and insulin levels, reducing cortisol levels and assisting in weight loss and anorexia. However, well-designed, randomised controlled trials are needed to elucidate the true effect of acupuncture on PCOS. © 2010 Informa UK Ltd.
Lim, CED, Cheng, NCL, Chow, YKM, Wong, WSF & O'Sullivan, AJ 2010, 'Complementary and alternative medicine for metabolic syndrome', Journal of the Australian Traditional-Medicine Society, vol. 16, no. 4, pp. 209-216.
People with metabolic syndrome (MetS) are at high risk of developing cardiovascular diseases such as coronary heart disease and other complications such as stroke, peripheral vascular disease and type II diabetes mellitus. MetS is also known as insulin resistance syndrome due to the fact that insulin action is reduced. The major risk factors for this syndrome are thought to be abdominal obesity and insulin resistance. Other factors which are associated with MetS are physical inactivity, ageing, hypertension, dyslipidaemia, and genetic predisposition. Family physicians have an important role in managing the chronic disease of MetS. The objective of this paper is to provide a narrative review of the current evidence on using complementary and alternative medicine to treat MetS. The recommendations and findings are also reviewed.
Lim, D, Chen, WM & Lian, XF 2010, 'Clinical trials of TCM and Parkinson's disease in China', Focus on Alternative and Complementary Therapies, vol. 15, no. 4, pp. 312-313.View/Download from: Publisher's site
Luo, X, Lim, CED, Li, L & Wong, WSF 2010, 'Hysteroscopic Appearance of Endometrial Cavity after Microwave Endometrial Ablation', Journal of Minimally Invasive Gynecology, vol. 17, no. 1, pp. 30-36.View/Download from: Publisher's site
Study Objective: To assess the appearance of the endometrial cavity after microwave endometrial ablation. Design: Prospective observational study. Setting: GuangDong Women's and Children's Hospital, GuangDong, China. Patients: A total of 349 patients who underwent microwave endometrial ablation from January 2000 through August 2008 were followed up for 1 month to 8 years. At follow-up in 2007 and 2008, patients were advised of this clinical study and were randomly selected for participation if they agreed to undergo outpatient hysteroscopy to assess the uterine cavity during follow-up visits. Fifty three patients (median [range] age, 43.1 [33-53] years) were recruited into the study at the time of endometrial ablation. Intervention: Outpatient hysteroscopy. Main Results: Within the first 3 months after ablation, outpatient hysteroscopy revealed varying amounts of necrotic tissue from the endometrium and superficial myometrium of the uterus. Six months postablation, a granulomatous reaction and fibrosis were present. A fibrotic cavity was also evident, and menstrual flow was reduced or had ceased. One year after ablation, hysteroscopy demonstrated a fibrotic cavity with myofibrous scars. Most patients developed amenorrhea at this time. Two years or more postablation, a second hysteroscopy demonstrated various types of intrauterine adhesions in 28 of the 53 women (52.8%). A cervical adhesion was observed in 1 patient (1.9%), focal adhesions in the fundal area in 12 (22.6%), a narrowed and scarred uterine cavity with bilateral stenotic tubal ostia in 11 (20.7%), and complete obliteration of the cavity in 4 (7.5%). Of these 28 women, 22 had amenorrhea, 3 had vaginal spotting during menstruation, and 2 had hypomenorrhea. Of those without intrauterine adhesions, only 5 had amenorrhea, 10 had vaginal spotting, and 8 had hypomenorrhea. Conclusion: The hysteroscopic appearance of the uterine cavity after microwave endometrial ablation varies considerably. In this study, t...
Wong, FWS, Lim, CED & Smith, W 2010, 'A new bioimpedance research device (BIRD) for measuring the electrical impedance of acupuncture meridians', Journal of Alternative and Complementary Medicine, vol. 16, no. 3, pp. 257-264.View/Download from: Publisher's site
Objectives: The aim of this article is to introduce an electrical bioimpedance device that uses an old and little-known impedance measuring technique to study the impedance of the meridian and nonmeridian tissue segments. Design: Three (3) pilot experimental studies involving both a tissue phantom (a cucumber) and 3 human subjects were performed using this BIRD-I (Bioimpedance Research Device) device. This device consists of a Fluke RCL meter, a multiplexer box, a laptop computer, and a medical-grade isolation transformer. Segment and surface sheath (or local) impedances were estimated using formulae first published in the 1930s, in an approach that differs from that of the standard four-electrode technique used in most meridian studies to date. Results: Our study found that, when using a quasilinear four-electrode arrangement, the reference electrodes should be positioned at least 10 cm from the test electrodes to ensure that the segment (or core) impedance estimation is not affected by the proximity of the reference electrodes. A tissue phantom was used to determine the repeatability of segment (core) impedance measurement by the device. An applied frequency of 100kHz was found to produce the best repeatability among the various frequencies tested. In another preliminary study, with a segment of the triple energizer meridian on the lower arm selected as reference segment, core resistance-based profiles around the lower arm showed three of the other five meridians to exist as local resistance minima relative to neighboring nonmeridian segments. The profiles of the 2 subjects tested were very similar, suggesting that the results are unlikely to be spurious. Conclusions: In electrical bioimpedance studies, it is recommended that the measuring technique and device be clearly defined and standardized to provide optimal working conditions. In our study using the BIRD I device, we defined our standard experimental conditions as a test frequency of 100kHz and the posit...
Wong, FWS, Lim, CED, Karia, S & Santos, L 2010, 'Cervical endometriosis: Case series and review of literature', Journal of Obstetrics and Gynaecology Research, vol. 36, no. 4, pp. 916-919.View/Download from: Publisher's site
Cervical endometriosis is uncommon and usually an incidental or retrospective finding on histopathology reports. It can be asymptomatic or present with a diverse range of persistent symptoms and even life-threatening hemorrhage. The condition can be managed expectantly in asymptomatic patients, however persistent symptoms may warrant surgery. We encountered four cases of histologically proven cervical endometriosis at our tertiary hospital in New South Wales, Australia. All our patients had different symptoms, presentations and indications for their surgery leading to their diagnosis. This review is to report these cases followed by discussion with a review of the literature. © 2010 Japan Society of Obstetrics and Gynecology.
Wong, WSF, Lee, TCE & Lim, CED 2010, 'Novel Vaginal "Paper Roll" Uterine Morcellation Technique for Removal of Large (>500 g) Uterus', Journal of Minimally Invasive Gynecology, vol. 17, no. 3, pp. 374-378.View/Download from: Publisher's site
At laparoscopic-assisted vaginal hysterectomy with a novel "paper roll" vaginal morcellation technique, large uteri (≥500 g) can be removed via the vagina with safety, speed, and ease. The technique provides protection for the bladder and rectum, and large uteri can be removed in 1 piece, allowing the pathologist to reconstruct the entire uterus. © 2010 AAGL.
Zhang, J, Li, T, Zhou, L, Tang, L, Xu, L, Wu, T & Lim, DC 2010, 'Chinese herbal medicine for subfertile women with polycystic ovarian syndrome.', Cochrane database of systematic reviews (Online), vol. 9.
BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinology abnormalities, affecting 5% to 10% of women of reproductive age. Western medicines, such as oral contraceptives and insulin sensitizers, have been widely used to improve the symptoms and signs for PCOS. Recently, many studies have been published considering Chinese herbal medicine (CHM) as an alternative treatment for women with PCOS. OBJECTIVES: To evaluate the efficacy and safety of Chinese medicinal herbs for subfertile women with PCOS. SEARCH STRATEGY: We searched the following databases (from inception to March 2010): Menstrual Disorders and Subfertility Group Specialised Register (MDSG), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Allied and Complementary Medicine (AMED), PsycINFO, Chinese National Knowledge Infrastructure (CNKI), VIP, Wanfang. In addition, all reference lists of included trials were searched and experts in the field were contacted to locate trials. SELECTION CRITERIA: Randomized controlled trials (RCT) considering the use of CHM for the treatment of subfertile women with PCOS. DATA COLLECTION AND ANALYSIS: Two review authors independently screened appropriate trials for inclusion, assessed methodological quality, and extracted data. We contacted primary authors for additional information. Meta-analysis was conducted. Odds ratio (OR) was used for reporting dichotomous data with 95% confidence intervals (CI). MAIN RESULTS: Four RCTs involving 344 participants were included. The methodological risk of bias of included studies was poor. Different interventions were used in these four RCTs.There was evidence of statistically significant difference seen improving pregnancy rate (per woman) between CHM plus clomiphene and clomiphene (OR 2.97, 95%CI 1.71 to 5.17). However, there was no statistically significant difference seen in the other comparison groups for improving pregnancy rate (per woman).There was no evidence...
Lee, ETC, Wong, FWS & Lim, CED 2009, 'A Modified Technique of LAVH with the Biswas Uterovaginal Elevator', Journal of Minimally Invasive Gynecology, vol. 16, no. 6, pp. 755-760.View/Download from: Publisher's site
This was a review of 512 consecutive cases of laparoscopic-assisted vaginal hysterectomy (LAVH) for benign gynecologic conditions with the Biswas uterovaginal elevator (BUVE) from February 2003 through June 2008. A single operator, using the BUVE and a standard surgical protocol, performed all hysterectomies. Variables analysis included patient demographics, operative times, uterine weight, hospital stay, intraoperative blood loss, and intraoperative and postoperative complications. LAVH was successfully performed for all patients. The median operative time was 70.07 minutes, range 35 to 250 minutes. The median uterine weight was 301.97 g (range 43-1690 g). The median estimated blood loss was 118.19 mL (range 5-1600 mL). The median length of hospital stay was 1.38 days (range 1-6 days). The overall complication rate was 6.25%. No case sustained injury to the ureter or major vessels or required conversion. LAVH with the BUVE eliminates the need for laparotomy in performing hysterectomies for benign gynecologic disorders. The BUVE can achieve a full range of uterine manipulation. It allows safe and easy dissection of the bladder and precise colpotomy through simultaneous uterine elevation and delineation of vaginal fornices. Prevention of ureteric injury is made possible by moving the surgical field away from the ureter. The technique described can be used to handle a wide variety of diseases and situations and has been shown to be safe, fast, easy to learn, and reproducible and carries few complications. © 2009 AAGL.
Lim, CED, Wilkinson, JM, Wong, WSF & Cheng, NCL 2009, 'Effect of Acupuncture on Induction of Labor', JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, vol. 15, no. 11, pp. 1209-1214.View/Download from: Publisher's site
Lim, CED, Yii, MF, Cheng, NCL & Chow, YKM 2009, 'The role of micronutrients in pregnancy', Australian Family Physician, vol. 38, no. 12, pp. 980-984.
Background: The antenatal shared care model has become increasingly popular among Australian women as the preferred mode of pregnancy care. General practitioners are often asked by their pregnant women patients about the nutrients needed during pregnancy. Objective: This article discusses the role of various micronutrients and trace elements needed in pregnancy, and provides daily intake recommendations of these nutrients as a reference point. Discussion: Much attention has been given to micronutrients such as folate and iron, but less regard to other trace elements that are also important in pregnancy. Encouraging a balanced diet and ensuring the adequacy of these micronutrients is essential for minimising pregnancy complications. However, GPs should also be aware of the maximum level of recommended intakes and any possible adverse effects.
Lim, D & Wong, F 2009, 'Syndrome X', JOURNAL OF COMPLEMENTARY MEDICINE, vol. 8, no. 6, pp. 39-40.
Lim, D, Wong, F & Wong, V 2009, 'Menopausal syndrome', JOURNAL OF COMPLEMENTARY MEDICINE, vol. 8, no. 2, pp. 55-57.
Lim, DCE, Cheng, LNC & Wong, FWS 2009, 'Could it be Henoch-Schönlein purpura?', Australian Family Physician, vol. 38, no. 5, pp. 321-324.
Background: Henoch-Schönlein purpura is the most common form of systemic vasculitis in the paediatric setting with 90% of cases occuring in childhood. Although diagnosis in the primary care setting may be difficult, it is vital in order to avoid significant complications. Objective: This article outlines the pathogenesis, clinical manifestations and classification of Henoch-Schönlein purpura and details evidence based investigations and management. Discussion: Henoch-Schönlein purpura is a self limiting disease characterised by a tetrad of clinical manifestations that vary in occurrence and order of presentation. There is no single diagnostic test to confirm Henoch-Schönlein purpura; diagnosis depends on recognition of clinical manifestations. Management usually occurs in the ambulatory setting and is mainly supportive. Priorities include symptom relief and preventive therapy to reduce the risk of complications. Further trials to clarify the role of glucocorticosteroids are needed before a definitive role for steroids in the management of Henoch-Schönlein purpura can be established.
Lim, DCE, Xue, CC, Wong, FWS, O'Sullivan, AJ & Jian, PL 2009, 'Acupuncture for polycystic ovarian syndrome', Cochrane Database of Systematic Reviews, no. 2.View/Download from: Publisher's site
Luo, X, Lim, CED, Huang, C, Wu, J, Wong, WSF & Cheng, NCL 2009, 'Heterotopic pregnancy following in vitro fertilization and embryo transfer: 12 cases report', Archives of Gynecology and Obstetrics, vol. 280, no. 2, pp. 325-329.View/Download from: Publisher's site
Objective: To evaluate the incidence, predisposing factors, early diagnosis and treatment options of heterotopic pregnancy (HP) following in vitro fertilization and embryo transfer (IVF-ET) procedure. Methods: A retrospective review study was performed to identify the HP cases after IVF-ET at the Reproductive Centre in Guangdong Women and Children's Hospital in China between the years of 2002-2007. Results: Twelve out of 1,476 pregnancies (0.81%) were diagnosed for HP, of which nine patients elected for exploratory salpingectomy, two patients received selective fetal reduction by embryo aspiration under ultrasound guidance, and one patient opted for expectant treatment. Postoperatively, four intrauterine pregnancies were continued to develop until term while two were delivered at 35 weeks of gestation. The achievement ratio of continuous pregnancy was 66.7% (6/9). Conclusion: The incidence of HP is increasing due to the widespread use of assisted reproductive technology. An early transvaginal sonography performed by experienced radiologist/radiographer is considered to be essential and beneficial in establishing early diagnosis of HP. Both salpingectomy and selective fetal reduction by embryo aspiration can be administered as one of the effective therapies for HP with the optimal outcome of intrauterine pregnancy. © 2009 Springer-Verlag.
Wong, FWS, Lin, L & Lim, DCE 2009, 'Drug and herb interactions: Searching the web', Australian Family Physician, vol. 38, no. 8, pp. 627-633.
Background: Australian patients spend large sums of money on complementary medicine and therapy each year. General practitioners are often asked questions about whether prescribed medications will interact with complementary medications. What current internet resources can be accessed to assist in answering these questions? Objective: This article looks at current internet resources that can assist GPs to answer patient questions about interactions between prescribed and complementary medicines. Discussion: Many of the websites found in this study provided limited information and limited searchability. We found seven webistes out of 100 that met our selection criteria. A web portal, with risk categorisation of mild, moderate and severe for drug-herb interactions, can assist doctors in clinical decision making. Maximum benefits could be obtained by working corroboratively with the Therapeutic Goods Administration.
Wong, VCK, Lim, CED, Luo, X & Wong, WSF 2009, 'Current alternative and complementary therapies used in menopause', GYNECOLOGICAL ENDOCRINOLOGY, vol. 25, no. 3, pp. 166-174.View/Download from: Publisher's site
Yii, MF, Lim, CED, Luo, X, Wong, WSF, Cheng, NCL & Zhan, X 2009, 'Polycystic ovarian syndrome in adolescence', Gynecological Endocrinology, vol. 25, no. 10, pp. 634-639.View/Download from: Publisher's site
Background.Polycystic ovarian syndrome PCOS, which is a common endocrinopathy seen not only in adult women but also in female adolescents nowadays, is associated with reproductive, metabolic and cardiovascular problems. Objective.This article aims to review the current evidence on managing PCOS in adolescence. In addition, the pathophysiology, risk factors, clinical presentations and existing diagnostic criteria of PCOS will also be discussed. Discussion.Certain risk factors are available to assist the clinicians to identify adolescents at risk of PCOS as the signs can be masked by the normal physiological changes during puberty. It is important to screen and diagnose adolescent PCOS in order to prevent the development of future infertility, type II diabetes mellitus, cardiovascular disease, and even endometrial cancer. Lifestyle modification is of the greatest benefit for adolescents in terms of management, with the condition that full support is available from both the clinicians and their families. The psychological impact of PCOS also constitutes a major concern in adolescent PCOS. © 2009 Informa UK Ltd All rights reserved.
Professor Lim served / currently serving in the following positions:
- President, Chinese Medicine Council of NSW, NSW Government (2018-current)
- Member of Expert Committee (Research), Royal Australian College of General Practitioners
- Examiner, Royal Australian College of General Practitioners
- Member, National Research Awards Committee, Royal Australian College of General Practitioners
- Surveyor, GPA Accreditation Plus (2016-17)
- Advisory Committee Member, Multicultural Health Communication, NSW Government
- Senior (Professional) Member of NSW Civil & Administrative Tribunal, NSW Government (2015-16)
- Governor appointed Council Member, NSW Chinese Medicine Council, NSW Government (2012-18)
- Advisory Committee Member of the NSW Health Professionals Council Authority (2013-15)
- Chair of Program Advisory Committee in Chinese Medicine, University of Technology Sydney
- Conjoint Appointee, Faculty of Medicine, University of New South Wales (2006-2015)
- Adjunct Academician, School of Medicine, Sydney, University of Notre Dame Austalia (2008-14)
- President, Australian Chinese Medical Association (2012-15)(2017-18)
- President, Australasian Council of Chinese Medical Associations (2013-15)
- GP Supervisor and Clinical Teaching Visitor for GP Registrar, GP Synergy
- Medical Columnist, Australian Chinese Daily Newspaper Weekly Magazine (Since 2009)
- Medical Host, Weekly Integrative Medicine Program, TVB Australia TV Channel (2012-16)
- Medical Presenter, Weekly Medical Program, 2CR Radio (Since 2009)
- Medical Presenter, Weekly Medical Program, 2AC Radio (Since 2009)
- Ongoingly invited Medical Presenter, SBS Radio Talk Back Program