Browse publications by year: 1999

  1. Underwood AP, Bianco AE
    Mol. Biochem. Parasitol., 1999 Mar 15;99(1):1-10.
    PMID: 10215019
    Random amplification of polymorphic DNA (RAPD) was used to analyse genomic DNA from virgin females and males of Brugia malayi, with a view to identifying sex-specific differences predicted by an XX/XY system of chromosomal sex determination. A product of 2338 bp, amplified with the arbitrary primer 5' GTTGCGATCC 3', was obtained exclusively from males. Primers based on the sequence of this product amplified a DNA fragment of the expected size from each of two independent isolates of B. malayi (from Malaysia and Indonesia) by PCR. No reaction product was obtained from the closely related species Brugia pahangi. In a genetic cross between B. malayi males and B. pahangi females, F1 hybrid microfilariae were PCR-positive, indicating that the locus is paternally-inherited. Southern blotting demonstrated that the target sequence resides in the high molecular weight fraction of genomic DNA, confirming that it is of chromosomal, rather than mitochondrial, origin. Sequencing of the locus revealed significant similarity with members of a family of reverse transcriptase-like genes in Caenorhabditis elegans. In-frame stops indicate that the gene is non-functional, but multiple bands of hybridisation in Southern blots suggest that the RT sequence may be the relic of a transposable element. Multiple repeats of the dinucleotide AT occurred in another region of the sequence. These varied in number between the two isolates of B. malayi in the manner of a microsatellite, surprisingly the first to be described from the B. malayi genome. Because of its association with the Y chromosome, we have given the locus the acronym TOY (Tag On Y). Identification of this chromosome-specific marker confirms the XX/XY heterogametic karyotype in B. malayi and opens the way to elucidation of the role of Y in sex determination.
    MeSH terms: Amino Acid Sequence; Animals; Crosses, Genetic; Female; Genetic Markers/genetics*; Male; Molecular Sequence Data; RNA-Directed DNA Polymerase/genetics; Species Specificity; Y Chromosome/genetics*; Blotting, Southern; Brugia malayi/genetics*; Brugia malayi/physiology; DNA, Helminth/analysis; DNA, Helminth/isolation & purification; Microsatellite Repeats/genetics; Random Amplified Polymorphic DNA Technique; Sex Determination Processes
  2. Yuen KH, Peh KK, Tan BL
    Drug Dev Ind Pharm, 1999 May;25(5):613-8.
    PMID: 10219530
    This study was conducted to compare the bioavailability of two controlled-release metformin preparations (Diabetmin Retard and Glucophage Retard) and also to correlate the in vitro and in vivo data obtained with the two preparations. Twelve healthy volunteers participated in the study, conducted according to a completely randomized, two-way crossover design. The preparations were compared using area under the plasma concentration-time curve AUC0-infinity, time to reach peak plasma concentration Tmax, and peak plasma concentration Cmax, while correlation was determined between in vitro release and in vivo absorption. Diabetmin Retard demonstrated a slower rate of in vitro release, but a faster rate of in vivo absorption than Glucophage Retard. However, the in vivo absorption of both products was found to be slower than that of drug released in vitro. A satisfactory relationship could be established between the in vitro and in vivo results, but there was no rank order correlation. No statistically significant difference was observed between the two preparations in the parameters AUC0-infinity and Cmax. However, a slight but statistically significant difference was observed between the Tmax values, but it may not be therapeutically significant. Moreover, the 90% confidence interval for the ratio of the logarithmic transformed AUC0-infinity values, as well as the logarithmic transformed Cmax values, of Diabetmin Retard over those of Glucophage Retard was within the acceptance criteria of 0.80-1.25.
    MeSH terms: Adult; Chemistry, Pharmaceutical; Humans; Hypoglycemic Agents/administration & dosage*; Male; Metformin/administration & dosage*; Metformin/pharmacokinetics; Metformin/chemistry; Middle Aged; Solubility; Cross-Over Studies
  3. Raman R
    Ear Nose Throat J, 1999 Apr;78(4):306-7.
    PMID: 10224707
    This article describes a new approach to permeatal surgery in the middle ear that does not require the use of an aural speculum.
    MeSH terms: Ear, Middle/surgery*; Humans; Surgical Instruments
  4. Easton A
    BMJ, 1999 May 08;318(7193):1232.
    PMID: 10231244
    MeSH terms: Animals; Disease Outbreaks; Encephalitis Viruses/isolation & purification; Humans; Malaysia/epidemiology; Swine; Swine Diseases/epidemiology; Swine Diseases/transmission; Swine Diseases/virology; Encephalitis, Viral/epidemiology*; Encephalitis, Viral/transmission; Encephalitis, Viral/veterinary; Encephalitis, Viral/virology
  5. Enserink M
    Science, 1999 Apr 16;284(5413):407, 409-10.
    PMID: 10232977 DOI: 10.1126/science.284.5413.407
    MeSH terms: Agricultural Workers' Diseases/epidemiology*; Agricultural Workers' Diseases/virology; Animals; Disease Outbreaks*; Encephalitis, Japanese/epidemiology; Humans; Malaysia/epidemiology; Paramyxoviridae/isolation & purification*; Swine/virology*; Swine Diseases/epidemiology; Swine Diseases/transmission; Swine Diseases/virology; Paramyxoviridae Infections/epidemiology*; Paramyxoviridae Infections/transmission; Paramyxoviridae Infections/virology
  6. Choon SE, Khoo JJ
    Br. J. Dermatol., 1999 Mar;140(3):557-8.
    PMID: 10233296
    MeSH terms: Administration, Oral; Adult; Antifungal Agents/therapeutic use*; Coccidioides; Coccidioidomycosis/drug therapy*; Coccidioidomycosis/epidemiology; Humans; Malaysia/epidemiology; Male; Itraconazole/therapeutic use*
  7. Amar HS, Ho JJ, Mohan AJ
    J Paediatr Child Health, 1999 Feb;35(1):63-6.
    PMID: 10234638
    OBJECTIVE: To determine the community prevalence of human immunodeficiency virus (HIV) in women at the time of delivery in a Malaysian setting.

    METHODOLOGY: Cord blood samples from a pilot screening programme for congenital hypothyroidism in 1995 at Ipoh city and surrounding district hospitals were screened anonymously for HIV 1 and 2. HIV status was determined using chemiluminescent technology. Positive samples were retested using the Genelavia Mixt assay.

    RESULTS: A total of 4927 samples were tested. The ethnic breakdown included 51.7% Malays, 18.9% Chinese, 14.3% Indian, 2.3% Others and 12.9% unknown. The geographical distribution of samples was 73.9% urban, 24.2% rural and 1.9% unknown. The seroprevalence of HIV positivity was 3.25 per 1000 deliveries (95% CI: 1.92-5.16). Seroprevalence was higher for samples from rural and Malay mothers.

    CONCLUSION: The high seroprevalence in this study suggests that the spread of HIV is far wider than that anticipated by mandatory national reporting. It also supports antenatal screening and the use of antiretroviral therapy as an important strategy to reduce perinatal transmission.

    MeSH terms: Female; Fetal Blood/virology; Humans; Infant, Newborn; Malaysia/epidemiology; Pregnancy; Pregnancy Complications, Infectious/diagnosis*; Pregnancy Complications, Infectious/ethnology; Pregnancy Complications, Infectious/immunology; Pregnancy Complications, Infectious/epidemiology*; Residence Characteristics; AIDS Serodiagnosis/methods*; HIV Seroprevalence*; HIV Infections/diagnosis*; HIV Infections/ethnology; HIV Infections/immunology; HIV Infections/epidemiology*; HIV Infections/transmission; Neonatal Screening/methods*; Infectious Disease Transmission, Vertical/statistics & numerical data*; Delivery, Obstetric*
  8. Craig ME, Vale T, Robertson P, Rawlinson WD, Gould B
    J Paediatr Child Health, 1999 Feb;35(1):107-8.
    PMID: 10234649
    MeSH terms: Australia/ethnology; Child, Preschool; Disease Outbreaks/statistics & numerical data*; Emigration and Immigration*; Enterovirus Infections/classification*; Enterovirus Infections/genetics; Enterovirus Infections/epidemiology*; Enterovirus Infections/virology*; Female; Humans; Malaysia/epidemiology; Male; Myocarditis/virology; Serotyping; Reverse Transcriptase Polymerase Chain Reaction
  9. Chiu CL, Wang CY
    Paediatr Anaesth, 1999;9(3):268-70.
    PMID: 10320610
    Two children with Tetralogy of Fallot presented for dental extraction. Anaesthesia was induced rapidly and smoothly by inhalation of sevoflurane. We discussed the advantages of sevoflurane as an induction agent as compared to halothane in these children.
    MeSH terms: Anesthesia Recovery Period; Anesthesia, Dental*; Anesthesia, Inhalation*; Atracurium/administration & dosage; Child; Neuromuscular Nondepolarizing Agents/administration & dosage; Female; Halothane/administration & dosage; Humans; Male; Methyl Ethers/administration & dosage*; Tetralogy of Fallot/complications*; Tooth Extraction*; Anesthetics, Inhalation/administration & dosage*; Neuromuscular Blockade
  10. Halder D, Dharap AS, Than M
    Anthropol Anz, 1999 Mar;57(1):69-75.
    PMID: 10320927
    Early identification of a syndrome at birth is of paramount importance for genetic counselling and possible prevention. Often malformation of the hands and fingers are cardinal manifestations of recognizable syndromes. As there are no published standards for hand and finger size for Malay newborn infants, this study was undertaken to establish normal values for hand, middle finger and palmar lengths, and their indices. A cross-sectional study was done on 509 consecutive newborn Malay babies between 34 and 42 weeks of gestation. Measurements were made on the right hand according to the recommended guidelines of Bergsma & Feingold (1975). The mean values for the measurements did not differ significantly between boys and girls, or change with gestation. For the whole group the mean value for total hand length was 64.4 +/- 3.42 mm, middle finger length 37.1 +/- 2.91 mm, palmar length 27.4 +/- 2.15 mm, finger index 0.425 +/- 0.03 and palmar index 0.58 +/- 0.03. A comparison with published measurements for newborns of different racial origin shows significant differences for the total hand length, middle finger length and palm length from Indian and Jewish infants, but not from Japanese infants. The indices were similar in Malay, Indian, Jewish and Japanese newborn infants.
    MeSH terms: Anthropometry; Female; Fingers/physiology*; Gestational Age*; Hand/physiology*; Humans; Infant, Newborn/physiology*; Malaysia; Male; Pregnancy; Reference Values; European Continental Ancestry Group/genetics; Asian Continental Ancestry Group/genetics
  11. Sakai S, Kato M, Inoue T
    Am. J. Bot., 1999 May;86(5):646-58.
    PMID: 10330067
    The pollinators of 29 ginger species representing 11 genera in relation to certain floral morphological characteristics in a mixed-dipterocarp forest in Borneo were investigated. Among the 29 species studied, eight were pollinated by spiderhunters (Nectariniidae), 11 by medium-sized Amegilla bees (Anthophoridae), and ten by small halictid bees. These pollination guilds found in gingers in Sarawak are comparable to the pollination guilds of neotropical Zingiberales, i.e., hummingbird-, and euglossine-bee-pollinated guilds. Canonical discriminant analysis revealed that there were significant correlations between floral morphology and pollination guilds and suggests the importance of plant-pollinator interactions in the evolution of floral morphology. Most species in the three guilds were separated on the plot by the first and second canonical variables. Spiderhunter-pollinated flowers had longer floral tubes, while Amegilla-pollinated flowers had wider lips than the others, which function as a platform for the pollinators. Pistils and stamens of halictid-pollinated flowers were smaller than the others. The fact that gingers with diverse morphologies in a forest with high species diversity were grouped into only three pollination guilds and that the pollinators themselves showed low species diversity suggests that many species of rare understory plants have evolved without segregating pollinators in each pollination guild.
  12. Ismail R
    Clin. Dermatol., 1999 5 20;17(2):127-35; discussion 105-6.
    PMID: 10330595
    MeSH terms: Acquired Immunodeficiency Syndrome/economics; Acquired Immunodeficiency Syndrome/epidemiology*; Acquired Immunodeficiency Syndrome/transmission; Adolescent; Adult; Asia, Southeastern/epidemiology; Child; Developing Countries/statistics & numerical data; Disease Outbreaks; Female; Humans; Male; Middle Aged; Pregnancy; Pregnancy Complications, Infectious/epidemiology; Prostitution; Risk-Taking; Sexually Transmitted Diseases/economics; Sexually Transmitted Diseases/epidemiology*; Sexually Transmitted Diseases/transmission; Socioeconomic Factors; HIV Infections/economics; HIV Infections/epidemiology*; HIV Infections/transmission; Substance Abuse, Intravenous; Prevalence; AIDS-Related Opportunistic Infections/epidemiology; Homosexuality, Male; Heterosexuality
  13. Tan CE, Emmanuel SC, Tan BY, Jacob E
    Diabetes Care, 1999 Feb;22(2):241-7.
    PMID: 10333940
    OBJECTIVE: The purpose of the 1992 Singapore National Health Survey was to determine the current distribution of major noncommunicable diseases and their risk factors, including the prevalence of diabetes and dyslipidemia, in Singapore.

    RESEARCH DESIGN AND METHODS: A combination of disproportionate stratified sampling and systematic sampling were used to select the sample for the survey. The final number of respondents was 3,568, giving a response rate of 72.6%. All subjects fasted for 10 h and were given a 75-g glucose load, except those known to have diabetes. Blood was taken before and 2 h after the glucose load. Diagnosis of diabetes was based on 2-h glucose alone.

    RESULTS: The age-standardized prevalence of diabetes in Singapore residents aged 18-69 years was 8.4%, with more than half (58.5%) previously undiagnosed. Prevalence of diabetes was high across all three ethnic groups. The prevalence of impaired glucose tolerance was 16.1%, that of hypertension was 6.5%, and 19.0% were regular smokers. The total cholesterol (mean +/- SD) of nondiabetic Singaporeans was 5.18 +/- 1.02 mmol/l; 47.9% had cholesterol > 5.2 mmol/l, while 15.4% had levels > 6.3 mmol/l. Mean LDL cholesterol was 3.31 +/- 0.89 mmol/l; HDL cholesterol was 1.30 +/- 0.32 mmol/l, and triglyceride was 1.23 +/- 0.82 mmol/l.

    CONCLUSIONS: Prevalence of diabetes was high across all three ethnic groups. Ethnic differences in prevalence of diabetes, insulin resistance, central obesity, hypertension, smoking, and lipid profile could explain the differential coronary heart disease rates in the three major ethnic groups in Singapore.
    MeSH terms: Adolescent; Adult; Age Factors; Aged; Body Constitution; Cardiovascular Diseases/epidemiology*; China/ethnology; Cholesterol/blood; Diabetes Mellitus/epidemiology*; Diabetic Angiopathies/epidemiology*; Ethnic Groups/statistics & numerical data*; Female; Health Surveys*; Humans; India/ethnology; Insulin Resistance; Malaysia/ethnology; Male; Middle Aged; Prediabetic State; Risk Factors; Sex Factors; Singapore; Singapore/epidemiology; Triglycerides/blood; Body Mass Index; Prevalence; Diabetes Complications
  14. Indudharan R, Haq JA, Aiyar S
    Ann. Otol. Rhinol. Laryngol., 1999 May;108(5):440-5.
    PMID: 10335703
    Conservative medical management of chronic suppurative otitis media (CSOM) is an important step in achieving a dry ear. Topical antibiotic ear drops and aural toilet form the mainstay of medical management of noncholesteatomatous CSOM. This study analyzes the causal organisms and their sensitivity to various antibiotics. Out of 382 swabs examined, the major organisms isolated were Pseudomonas aeruginosa (27.2%), followed by Staphylococcus aureus (23.6%). The sensitivity of P. aeruginosa was 100% to ceftazidime, 98.9% to ciprofloxacin, 96.3% to gentamicin, and 95.4% to polymyxin B, whereas the sensitivity of S. aureus was 98.6% to ciprofloxacin, 97.4% to cloxacillin sodium, 96.5% to cotrimoxazole, and 90.7% to gentamicin. Pseudomonas aeruginosa was almost completely resistant to ampicillin (97.6%) and chloramphenicol (96.6%), whereas S. aureus was almost completely resistant to ampicillin (73.8%) and polymyxin B (98.3%). Among the available topical antibiotic preparations for use in the ear, we found that ciprofloxacin and gentamicin are the best choices.
    MeSH terms: Adolescent; Adult; Aged; Anti-Bacterial Agents/therapeutic use*; Bacteria/isolation & purification; Child; Child, Preschool; Chronic Disease; Humans; Infant; Microbial Sensitivity Tests*; Middle Aged; Otitis Media, Suppurative/drug therapy; Otitis Media, Suppurative/microbiology*
  15. Razali SM, Hasanah CI
    Aust N Z J Psychiatry, 1999 Apr;33(2):283-4.
    PMID: 10336231
    MeSH terms: Adult; Antidepressive Agents, Tricyclic/economics*; Antidepressive Agents, Tricyclic/therapeutic use*; Cost-Benefit Analysis; Depressive Disorder/drug therapy*; Developing Countries*; Humans; Malaysia; Time Factors
  16. Singh HJ, Mohammad NH, Nila A
    J Matern Fetal Med, 1999 May-Jun;8(3):95-100.
    PMID: 10338062
    To ascertain the calcium status in normal pregnant Malay women.
    MeSH terms: Adult; Body Weight; Calcium/blood*; Calcium/urine; Creatinine/urine; Cross-Sectional Studies; Diuresis; Female; Gestational Age; Hematocrit; Humans; Parathyroid Hormone/blood*; Potassium/blood; Potassium/urine; Pregnancy/blood*; Sodium/blood; Sodium/urine
  17. Thong MK, Rudzki Z, Hall J, Tan JA, Chan LL, Yap SF
    Hum. Mutat., 1999;13(5):413.
    PMID: 10338100
    Beta-thalassemia major is one of the commonest genetic disorders in South-East Asia. The spectrum of beta-thalassemia mutations in the various ethnic sub-populations on the island of Borneo is unknown. We studied 20 Dusun children from the East Malaysian state of Sabah (North Borneo) with a severe beta-thalassemia major phenotype, using a combination of Southern analysis, polymerase chain reaction analysis and direct sequencing. We found the children to be homozygous for a large deletion, which has a 5' breakpoint at position -4279 from the cap site of the beta-globin gene (HBB) with the 3' breakpoint located in a L1 family of repetitive sequences at an unknown distance from the beta-globin gene. This was similar to a recent finding of a large deletion causing beta-thalassemia first described in unrelated beta-thalassemia heterozygotes of Filipino descent. This report describes the first 20 families with homozygosity of the deletion causing a severe phenotype. It provides the first information on the molecular epidemiology of beta-thalassemia in Sabah. This finding has implications for the population genetics and preventative strategies for beta-thalassemia major for nearly 300 million individuals in South-East Asia.
    MeSH terms: Globins/genetics*; Humans; Malaysia; Phenotype; Blotting, Southern; Polymerase Chain Reaction; beta-Thalassemia/genetics*; Gene Deletion*; Sequence Analysis, DNA
  18. Norhaya MR, Yap TM, Zainudin BM
    Respirology, 1999 Mar;4(1):77-81.
    PMID: 10339734 DOI: 10.1046/j.1440-1843.1999.00153.x
    The effect of adding inhaled salmeterol to inhaled corticosteroids was studied in patients with poorly controlled nocturnal asthma. In a double-blind, cross-over study, 20 patients were randomized to receive either salmeterol 50 micrograms twice daily or placebo via a Diskhaler after a 1-week run-in period. After 4 weeks of treatment, patients were subsequently crossed over to receive the other treatment for a further 4 weeks with a 2-week wash-out period in between. The response to treatment was assessed by peak expiratory flow rates (PEF) measured in the morning and evening, symptom scores of asthma, number of bronchodilators used, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) at regular intervals. Patients' preference for the Diskhaler or metered-dose inhaler was assessed at the last visit. The results showed that morning PEF was significantly higher while on salmeterol than on placebo (296.9 +/- 70.2 vs 274.6 +/- 77.4 L/min). Evening PEF showed a trend towards a higher value while on salmeterol than on placebo (321.1 +/- 73.4 vs 288.7 +/- 79.4 L/min), but the difference was not significant. There was no statistically significant improvement in symptom scores, number of rescue bronchodilators used and FEV1 or FVC between the two treatment groups. The occurrence of side effects in terms of tremors and palpitations between treatment and placebo were similar. There were more patients who preferred Diskhaler to metered-dose inhaler (70% vs 30%). We conclude that salmeterol 50 micrograms twice daily produces significant improvement in morning PEF and is well tolerated in patients with nocturnal asthma. Diskhaler is a device which is easy to use and preferred to a metered-dose inhaler.
    Study site: Respiratory Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    MeSH terms: Salmeterol Xinafoate; Adult; Albuterol/analogs & derivatives*; Albuterol/therapeutic use; Asthma/drug therapy*; Bronchodilator Agents/therapeutic use*; Double-Blind Method; Drug Therapy, Combination; Female; Glucocorticoids/therapeutic use*; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Outpatient Clinics, Hospital; Peak Expiratory Flow Rate; Matched-Pair Analysis; Cross-Over Studies; Statistics, Nonparametric
  19. Goh AY, Chan PW
    Respirology, 1999 Mar;4(1):97-9.
    PMID: 10339738
    Acute myopathy complicating treatment of status asthmaticus has been increasingly recognized since its original description in 1977. We report a case of an 11-year-old boy with severe asthma requiring mechanical ventilation. He was given high doses of parenteral steroids and neuromuscular blockade with non-depolarizing agents in order to achieve controlled hypoventilation with an ensuing hypercapnoea. He developed rhabdomyolysis with elevated creatinine kinase and renal impairment secondary to myoglobinuria. Electrophysiological studies revealed myopathic abnormalities. The aetiology for this myopathy appears to be related to therapy with parenteral steroids, muscle-relaxant agents and respiratory acidosis. Patients treated with steroids and neuromuscular blocking agents should be regularly monitored for development of myopathy.
    MeSH terms: Acidosis/complications*; Acidosis/etiology; Acute Disease; Anti-Inflammatory Agents/adverse effects*; Child; Humans; Male; Cardiomyopathies/etiology*; Neuromuscular Depolarizing Agents/adverse effects*; Respiration, Artificial/adverse effects*; Status Asthmaticus/complications; Status Asthmaticus/therapy*; Steroids
  20. Huang X, Butow P, Meiser B, Goldstein D
    Aust N Z J Med, 1999 Apr;29(2):207-13.
    PMID: 10342019
    BACKGROUND: The information needs of ethnic minorities often differ from that of the dominant culture, leading to dissatisfaction among both patients and health professionals.

    AIMS: This research project aims to identify attitudes towards cancer and associated information and communication needs of Chinese patients and their relatives in Sydney, thereby providing a framework for the provision of culturally appropriate cancer care for Chinese-Australians.

    METHODS: A qualitative data collection strategy was selected as the most appropriate method, because no validated measures are available and no previous research has examined attitudes and needs of Chinese-Australian cancer patients. Patients were recruited from three major teaching hospitals in Sydney and from a Chinese cancer support organisation. Sampling was discontinued when informational redundancy was achieved. Four focus groups and 26 individual telephone interviews were conducted with a total of 36 cancer patients and 12 relatives born in China, Singapore and Malaysia.

    RESULTS: While individual differences were observed, a majority view was expressed on a range of issues. Non-disclosure of a poor prognosis was favoured, and the role of the family in liaising between health professionals and the patient was emphasised. Patients preferred a confident and clear diagnosis and treatment recommendation. Most patients wished to incorporate Chinese culture-specific treatments into their care. The need for interpreters and psychological and spiritual support was emphasised.

    CONCLUSIONS: Providing information in a culturally sensitive manner will assist doctors in providing optimum care and support for ethnic minority groups in this country.

    MeSH terms: Attitude to Health/ethnology*; Australia; China/ethnology; Clinical Trials as Topic/psychology; Communication; Family/ethnology; Family/psychology; Humans; Medical Oncology; Neoplasms/ethnology*; Neoplasms/psychology; Physician-Patient Relations*; Prognosis
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