To compare the effects of dietary palmitic acid (16:0) vs oleic acid (18:1) on serum lipids, lipoproteins, and plasma eicosanoids, 33 normocholesterolemic subjects (20 males, 13 females; ages 22-41 years) were challenged with a coconut oil-rich diet for 4 weeks. Subsequently they were assigned to either a palm olein-rich or olive oil-rich diet followed by a dietary crossover during two consecutive 6-week periods. Each test oil served as the sole cooking oil and contributed 23% of dietary energy or two-thirds of the total daily fat intake. Dietary myristic acid (14:0) and lauric acid (12:0) from coconut oil significantly raised all the serum lipid and lipoprotein parameters measured. Subsequent one-to-one exchange of 7% energy between 16:0 (palm olein diet) and 18:1 (olive oil diet) resulted in identical serum total cholesterol (192, 193 mg/dl), low-density lipoprotein cholesterol (LDL-C) (130, 131 mg/dl), high-density lipoprotein cholesterol (HDL-C) (41, 42 mg/dl), and triglyceride (TG) (108, 106 mg/dl) concentrations. Effects attributed to gender included higher HDL in females and higher TG in males associated with the tendency for higher LDL and LDL/HDL ratios in men. However, both sexes were equally responsive to changes in dietary fat saturation. The results indicate that in healthy, normocholesterolemic humans, dietary 16:0 can be exchanged for 18:1 within the range of these fatty acids normally present in typical diets without affecting the serum lipoprotein cholesterol concentration or distribution. In addition, replacement of 12:0 + 14:0 by 16:0 + 18:1, but especially 16:0 or some component of palm olein, appeared to have a beneficial impact on an important index of thrombogenesis, i.e., the thromboxane/prostacyclin ratio in plasma.
A total of 103 beta thalassemia genes from 78 children (45 with Hb E/beta thalassemia, 8 with beta thalassemia heterozygotes, and 25 with homozygous beta thalassemia) were analyzed using dot-blot hybridization of the polymerase chain reaction-amplified DNA and direct DNA sequencing. Nine mutations were characterized in 98/103 (95%) of beta thalassemia alleles, of which six (a 4 bp deletion in codons 41-42, a G-C transition at position 5 of IVS-1, A-G transition at codon 19, an A-T transition at codon 17, an A-G transition at position -28 upstream of the beta globin gene, a G-T transition at position 1 of IVS-1), accounted for 92%. The spectrum of beta thalassemia mutations in Chinese Thai is similar to that reported among the Chinese from other parts of the world. The distribution of beta thalassemia mutations in Muslim Thai is similar to that reported among Malaysians. The most common beta thalassemia mutation in Thai and Chinese Thai patients is the frameshift mutation at codons 41-42, in comparison with the Muslim Thai in whom the G-C transition at position 5 of the IVS-1 mutation predominates. The heterogeneity of molecular defects causing beta thalassemia should aid in the planning of a prenatal diagnosis program for beta thalassemia in the South of Thailand.
The frequency distribution for serum lipoprotein(a) (Lp(a)) concentrations in healthy Japanese was highly skewed, with a mean +/- S.D. of 14.6 +/- 13.6 mg/dl and a median of 11.0 mg/dl. The present study provides the first evidence on the frequencies of Lp(a) phenotypes and alleles in healthy Japanese subjects. There was a strong inverse relationship between the apparent molecular weights of apo(a) isoforms and plasma Lp(a) concentrations, as reported previously. However, because of the considerable overlap between the Lp(a) concentrations of the different phenotypes, it was impossible to predict Lp(a) concentration from Lp(a) phenotypes, or vice versa. The present results suggest that the distribution of Lp(a) concentrations, mean and median values and Lp(a) phenotype and allele frequencies in healthy Japanese are not significantly different from the results for Europeans, whereas they are significantly different from other Asian populations, i.e. Chinese, Indians and Malaysians.
A 26-year-old Chinese-Malaysian female patient with beta-thalassemia is presented. The main hematological values found in this patient were as follows: 1) normocytic hypochromic anemia (RBC 444 x 10(4)/microliters, Hb 11.8 g/dl) with marked anisopoikilocytosis, 2) erythroid hyperplasia, and 3) increased HbF (HbA 41.4%, HbA2 2.9%, HbF 48.9%). DNA obtained from peripheral leukocytes was analyzed using dot blot hybridization of the polymerase chain reaction (PCR)-amplified DNA with allele-specific oligonucleotide probes. A C----T substitution at position 654 of the second intervening sequence (IVS-2) was detected in her beta-globin clone.
A cross-sectional study was conducted in four Orang Asli settlements, in the district of Kuala Langat, to determine the knowledge and practice associated with diarrhoeal disease among the Orang asli children (0-5 years). It was seen that the social and environmental factors of the settlements were poor. Only 26% of the households had sanitary latrines and 36% had access to safer water supplies. Ninety-five percent of them had monthly income below the national poverty line. The diarrhoeal incidence was high, ie 240/1000 and the most affected were the older children in the age group of 49 - 60 months. Knowledge of diarrhoeal disease was poor. But the majority (84.2%) knew that breast feeding is the best milk for the child in order to avoid diarrhoeal disease.
MeSH terms: Breast; Breast Feeding; Child; Cross-Sectional Studies; Diarrhea; Health Knowledge, Attitudes, Practice; Milk; Poverty; Water; Water Supply; Incidence; Knowledge
Stop the bleeding - digital pressure, packing. Once the bleeding has stopped, performed coagulation studies. Refer to an ENT surgeon for opinion particularly as you may be dealing with nasopharyngeal carcinoma.
MeSH terms: Airway Obstruction; Epistaxis; Family Practice
A retrospective study of 100 patients with acute right upper quadrant pain was performed in order to indicate the diagnostic role of ultrasound including the diagnostic role of ultrasound including guided percutaneous procedures in the evaluation of such cases at the General Hospital Kota Bharu (GH, KB). In the majority of these patients the leading clinical consideration was acute cholecystitis. In all the patients the initial sonographic diagnoses were compared with the final diagnoses. In 35 patients (35%) biliary pathology was diagnosed. In this group the conographic correlation was good. In 65 patients (65%) the symptoms were due to non-biliary pathology. In this group ultrasound detected the actual site of pathology in 28%. Ultrasonography which can image multiple organs rapidly is a useful initial screening procedure in patients presenting with acute right upper quadrant pain because it can detect the actual size of pathology in about two-thirds of the cases.
The reasons for referral of 189 patients referred to the Primary Care Out-patient Clinics, University Hospital Kuala Lumpur, were studied. 55.6% of them were from private general practitioners. 51.0% of the referrals were for evaluation of symptoms and 46.5% were for management of diseases. The profile of the referrals helps in curriculum planning of Primary Care Medicine. Other applications of the results are discussed.
Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Hospitals; Humans; Malaysia; Outpatient Clinics, Hospital; Outpatients; Primary Health Care; Referral and Consultation