APSR Short-Term Research/Training Scholarship

First of all, I would like to express my sincerest gratitude to the APSR Short-term Research/Training Committee for offering me a scholarship to facilitate my research and fellowship training in Brisbane.

The Lady Cilento Children's Hospital is a tertiary centre that receives paediatric referrals from throughout the state of Queensland, Australia. It also sees the largest number of paediatric cystic fibrosis (CF) patients in the country. Thus, I had the privilege to see a large variety of complicated paediatric respiratory cases including CF patients with a wide spectrum of disease stages. Besides taking part in clinical patient care, I also attended the department's weekly hand over meeting and educational activities such as Continuous Medical Education (CME), lung function test discussion, radiology conference, airway meeting and teaching sessions for the fellows and registrars. These have substantially heightened my knowledge in paediatric respiratory medicine and enhanced my clinical skills in managing various complex respiratory cases. Additionally, I also had the opportunity to improve my skills in flexible bronchoscopy under the outstanding guidance of my host supervisors.

During my year of training, I took up two research projects related to flexible bronchoscopy, an increasingly important tool in the clinical practice of paediatric pulmonologists. Flexible bronchoscopy allows direct visualisation of macroscopic airway inflammation (bronchitis), a common finding in children with chronic wet cough. However, to date, there is no objectively assessed or quantified score to define bronchitis in children bronchoscopically. Such a tool would likely be useful both in the clinical context and research. The aim of the research projects was to develop and validate a bronchoscopically-defined bronchitis scoring system by relating quantified scores based on visualised airway mucosa (oedema, erythema, mucosal ridging and pallor), and secretions (amount and colour) to airway neutrophilia (increased neutrophil percentage in the bronchoalveolar lavage).

At the TSANZ Annual Scientific Meeting with Dr Anne Chang (centre) and Dr Rahul Thomas (right)

Together with another respiratory fellow, Dr Rahul Thomas, we conducted a retrospective study entitled "Towards developing a valid scoring tool for bronchitis during flexible bronchoscopy". We reviewed and scored the digital bronchoscopy recordings of 100 children independently and found that airway secretion amount and colour, mucosal oedema and erythema positively correlated to airway neutrophilia. This scoring system was validated in my other research project, "Development and validation of a bronchoscopically defined bronchitis tool in children", in which we analysed 142 children prospectively and found similar findings. I presented the preliminary report of my study result in the recent Thoracic Society of Australia and New Zealand (TSANZ) Congress held in Adelaide.

At the TSANZ Scientific Meeting after poster presentation with Dr Rahul Thomas (left)

Other than the TSANZ Congress, I also attended the APSR scientific meeting held in Sydney in November 2017. This gave me a great opportunity to learn from the experts and gained knowledge on new and novel research, besides networking with the renowned researchers from the region that will facilitate my future endeavours in respiratory and sleep medicine.

In the past year, with the guidance of my distinguished host supervisor, Dr Anne Chang, I have obtained a publication in an open access journal entitled "Editorial: Chronic suppurative lung disease and bronchiectasis in children and adolescents", and peer-reviewed two articles.

Last but not least, I would like to express my sincerest gratitude to my host supervisors, Dr Anne Chang and Dr Ian Brent Masters, for their excellent guidance in research as well as clinical work. I would also like to thank the CAARG (Cough, Asthma and Airway Research Group) members of CCHR, the respiratory consultants, fellows, scientists, nurses and administrative staff of LCCH for their warmth and kind assistance throughout my stay in Brisbane. Not to forget my home supervisors, Dr Jessie de Bruyne, Dr Anna Nathan and Dr Surendren Thavanagnam, with much appreciation for their invaluable support. It was an amazing and fruitful year to me and I really enjoyed my stay in Brisbane, a beautiful river city.

Photo with the CAARG members after a monthly research meeting

At the APSR Scientific Meeting in Sydney with the APSR Deputy Executive Manager, Ms Suga Konno (right)

Dr Ian Brent Masters (left) and Dr Eg Kah Peng (right)