Browse publications by year: 2000

  1. De Clercq E
    Med Res Rev, 2000 Sep;20(5):323-49.
    PMID: 10934347
    A large variety of natural products have been described as anti-HIV agents, and for a portion thereof the target of interaction has been identified. Cyanovirin-N, a 11-kDa protein from Cyanobacterium (blue-green alga) irreversibly inactivates HIV and also aborts cell-to-cell fusion and transmission of HIV, due to its high-affinity interaction with gp120. Various sulfated polysaccharides extracted from seaweeds (i.e., Nothogenia fastigiata, Aghardhiella tenera) inhibit the virus adsorption process. Ingenol derivatives may inhibit virus adsorption at least in part through down-regulation of CD4 molecules on the host cells. Inhibition of virus adsorption by flavanoids such as (-)epicatechin and its 3-O-gallate has been attributed to an irreversible interaction with gp120 (although these compounds are also known as reverse transcriptase inhibitors). For the triterpene glycyrrhizin (extracted from the licorice root Glycyrrhiza radix) the mode of anti-HIV action may at least in part be attributed to interference with virus-cell binding. The mannose-specific plant lectins from Galanthus, Hippeastrum, Narcissus, Epipac tis helleborine, and Listera ovata, and the N-acetylgl ucosamine-specific lectin from Urtica dioica would primarily be targeted at the virus-cell fusion process. Various other natural products seem to qualify as HIV-cell fusion inhibitors: the siamycins [siamycin I (BMY-29304), siamycin II (RP 71955, BMY 29303), and NP-06 (FR901724)] which are tricyclic 21-amino-acid peptides isolated from Streptomyces spp that differ from one another only at position 4 or 17 (valine or isoleucine in each case); the betulinic acid derivative RPR 103611, and the peptides tachyplesin and polyphemusin which are highly abundant in hemocyte debris of the horseshoe crabs Tachypleus tridentatus and Limulus polyphemus, i.e., the 18-amino-acid peptide T22 from which T134 has been derived. Both T22 and T134 have been shown to block T-tropic X4 HIV-1 strains through a specific antagonism with the HIV corecept or CXCR4. A number of natural products have been reported to interact with the reverse transcriptase, i.e., baicalin, avarol, avarone, psychotrine, phloroglucinol derivatives, and, in particular, calanolides (from the tropical rainforest tree, Calophyllum lanigerum) and inophyllums (from the Malaysian tree, Calophyllum inophyllum). The natural marine substance illimaquinone would be targeted at the RNase H function of the reverse transcriptase. Curcumin (diferuloylmethane, from turmeric, the roots/rhizomes of Curcuma spp), dicaffeoylquinic and dicaffeoylt artaric acids, L-chicoric acid, and a number of fungal metabolites (equisetin, phomasetin, oteromycin, and integric acid) have all been proposed as HIV-1 integrase inhibitors. Yet, we have recently shown that L-c hicoric acid owes its anti-HIV activity to a specific interaction with the viral envelope gp120 rather than integrase. A number of compounds would be able to inhibit HIV-1 gene expression at the transcription level: the flavonoid chrysin (through inhibition of casein kinase II, the antibacter ial peptides melittin (from bee venom) and cecropin, and EM2487, a novel substance produced by Streptomyces. (ABSTRACT TRUNCATED)
    MeSH terms: Amino Acid Sequence; Biological Products/therapeutic use*; Biological Products/chemistry; Humans; Molecular Sequence Data; Molecular Structure; HIV Infections/drug therapy*; Anti-HIV Agents/therapeutic use*; Anti-HIV Agents/chemistry
  2. Birkhahn RH, Gaeta TJ, Melniker L
    J Emerg Med, 2000 Feb;18(2):199-202.
    PMID: 10699522
    A 27-year-old male of Malaysian descent presented to the Emergency Department (ED) with rapidly progressive flaccid paralysis that quickly compromised his respiratory effort. The patient was found to have a serum potassium of 1.9 meq/L, and was diagnosed as having an acute paralytic episode secondary to thyrotoxic periodic paralysis. The paralytic attack was aborted with a combination of potassium replacement and parenteral propranolol in large doses. We report the use of a rarely described, yet possibly more effective, therapy for an acute attack of thyrotoxic periodic paralysis.
    MeSH terms: Adult; Anti-Arrhythmia Agents/administration & dosage*; Electrocardiography; Humans; Hypokalemia/complications; Hypokalemia/diagnosis; Injections, Intravenous; Male; Muscle Hypotonia/drug therapy; Muscle Hypotonia/etiology; Paralysis/drug therapy*; Paralysis/etiology*; Potassium/administration & dosage; Propranolol/administration & dosage*; Thyrotoxicosis/complications; Thyrotoxicosis/diagnosis*; Treatment Outcome
  3. Kurup VP, Yeang HY, Sussman GL, Bansal NK, Beezhold DH, Kelly KJ, et al.
    Clin Exp Allergy, 2000 Mar;30(3):359-69.
    PMID: 10691894
    BACKGROUND: Latex allergy is largely an occupational allergy due to sensitization to natural rubber latex allergens present in a number of health care and household products. Although several purified allergens are currently available for study, information on the usefulness of these purified, native or recombinant allergens in the demonstration of specific immunoglobulin (Ig) E in the sera of patients is lacking.

    OBJECTIVE: To evaluate the purified latex allergens and to demonstrate specific IgE antibody in the sera of health care workers and spina bifida patients with clinical latex allergy.

    METHODS: Two radioallergosorbent and an enzyme-linked immunosorbent assay (ELISA) using latex proteins Hev b 1, 2, 3, 4, 6 and 7 along with two glove extracts and Malaysian nonammoniated latex (MNA) were evaluated to demonstrate IgE in the sera of health care workers and spina bifida with latex allergy and controls with no history of latex allergy.

    RESULTS: ELISA using the purified latex allergens demonstrated specific IgE in 32-65% health care workers and 54-100% of spina bifida patients with latex allergy. The corresponding figures for RAST were 13-48 and 23-85 for RAST-1 and 19-61 and 36-57 for RAST-2. These results were comparable with the results obtained with glove extracts and crude rubber latex proteins.

    CONCLUSIONS: When used simultaneously, latex proteins Hev b 2 and Hev b 7 reacted significantly with specific serum IgE in 80% of health care workers and 92% of spina bifida patients with latex allergy by ELISA technique, while this combination gave lower positivity when the RASTs were used. By the addition of Hev b 3, specific IgE was detected in all spina bifida patients with latex allergy. Both RASTs failed to show specific IgE in the control subjects, while the ELISA showed significant latex-specific IgE in 22% of controls.

    MeSH terms: Allergens/adverse effects; Allergens/immunology*; Allergens/isolation & purification; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Health Personnel; Humans; Immunoglobulin E/blood*; Latex/adverse effects; Latex/immunology*; Latex/isolation & purification; Plant Proteins/immunology; Radioallergosorbent Test; Recombinant Proteins/immunology; Blotting, Western; Spinal Dysraphism/immunology; Latex Hypersensitivity/etiology; Latex Hypersensitivity/immunology*
  4. Schaubel DE, Stewart DE, Morrison HI, Zimmerman DL, Cameron JI, Jeffery JJ, et al.
    Arch. Intern. Med., 2000 8 6;160(15):2349-54.
    PMID: 10927733 DOI: 10.1001/archinte.160.15.2349
    BACKGROUND: Men in the United States undergoing renal replacement therapy are more likely than women to receive a kidney transplant. However, the ability to pay may, in part, be responsible for this finding.

    OBJECTIVE: To compare adult male and female transplantation rates in a setting in which equal access to medical treatment is assumed.

    METHODS: Using data from the Canadian Organ Replacement Register, the rate of first transplantations was computed for the 20, 131 men and the 13,458 women aged 20 years or older who initiated renal replacement therapy between January 1, 1981, and December 31, 1996. Poisson regression analysis was used to estimate the male-female transplantation rate ratio, adjusting for age, race, province, calendar period, underlying disease leading to renal failure, and dialytic modality. Actuarial survival methods were used to compare transplantation probability for covariable-matched cohorts of men and women.

    RESULTS: Men experienced 20% greater covariable-adjusted kidney transplantation rates relative to women (rate ratio, 1.20; 95% confidence interval, 1.13-1.27). The sex disparity was stronger for cadaveric transplants (rate ratio, 1.23) compared with those from living donors (rate ratio, 1.10). The 5-year probability of receiving a transplant was 47% for men and 39% for women within covariable-matched cohorts (P
    MeSH terms: Actuarial Analysis; Adult; Cadaver; Canada; Female; Health Services Accessibility/statistics & numerical data; Humans; Male; Middle Aged; Prejudice*; Sex Ratio; Cohort Studies; Kidney Transplantation/statistics & numerical data*; Living Donors
  5. Zurainee MN, Khairul Anuar A, Fong MY, Hoh HB, Choon J, Rahmah N
    JUMMEC, 2000;5:98-102.
    During the period 1996-1998, 134 patients suspected of having ocular toxoplasmosis were seen in the Ophthalmology Clinic of the University Hospital, Kuala Lumpur. Clinical presentations in these patients ranged from poor vision to severe retinal detachment. Of these patients, 72% were confirmed positive for Toxoplasma gondii infection by serological methods. Chorioretinjtis and vitritis were found to be the most apparent symptoms, both having 100%correlation with serological positivity, This was followed by uveitis, floaters, and retinal detachment with correlation at 78%, 75%and 75%, respectively. However, there was no correlation between level of serotitre and ocular presentations. KEYWORDS: Toxoplasmosis, serology, chorioretinitis, uveitis
    MeSH terms: Eye Diseases; Infection; Malaysia; Ophthalmology; Retinal Detachment; Toxoplasma; Toxoplasmosis; Uveitis
  6. Zarin Ikmal ZZ, Wan Azman WM, Asma O, Mazeni A
    JUMMEC, 2000;5:45-47.
    Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.83mm). Complete closure of the PDA was achieved in all patients.
    MeSH terms: Case Reports; Ductus Arteriosus, Patent; Hospitals; Humans; Malaysia
  7. Zarin Ikmal ZZ, Wan Azman WA, Asma O, Mazeni A
    JUMMEC, 2000;5:45-47.
    Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.831nm). Complete closure of the PDA was achieved in all patients. KEYWORDS: Patent ductus arteriosus, transcatheter device closure
    MeSH terms: Ductus Arteriosus; Female; Heart; Malaysia
  8. Wong LP, Atiya AS, Chan ESY, Lang CC
    JUMMEC, 2000;5:78-84.
    Meta-analysis is a method of review that summarises the results of previous research of the same particular issue in a systematic and quantitative way. A meta-analysis that properly combines results from different studies will average out differences caused by random variation and produce a more precise estimate of the true effect. It may also detect and investigate heterogeneity among studies thus providing a deeper understanding of clinical dilemmas and guidance on resolving them, in this way a meta-analysis will be a better guide to practice than an individual study. Meta-analysis also has its limitations as it is largely dependent on the quality of published data and requires careful planning and execution of a valid protocol, together with cautious interpretation of the results. KEYW'ORDS: Quantitative Review, CritinJ Appraisal, Overall Effect, Publintion Bias.
    MeSH terms: Malaysia; Review; Meta-Analysis
  9. Wan Omar A, Khairul Anuar A, Sulaiman O, Rahmah N, Manaf A, Rahimah A
    JUMMEC, 2000;5:41-44.
    Parasitological and serological investigations for lymphatic filariasis were performed on 450 immigrants detained at the lmmigration Centre at Semenyih, Selangor, West Malaysia. The country of origin of these immigrants were Indonesia, The Philippines, Myanmar, Bangladesh, India and Pakistan. Brugia malayi adult worm homogenate (BmAH) antigen was used for the detection of antiifilarial IgG. A monoclonal antibody-based ELISA (MAb.XC3-ELISA) specific for filarial circulating antigens and non-phosphorylcholine reactive was used to detect antigenemia in these immigrants. Parasitologically 67 (14.89 %) were positive for W. bancrofti and 54 (12.0%) for Brugia malayi. Serologically 63% had antifilarial IgG titre to the BmAH antigen. While Bancroftian filariasis is now unknown in Peninsular Malaysia, the potential of it to be reintroduced into Peninsular Malaysia by the immigrant population is discussed. KEYWORDS: Lymphatic filariasis, immigratits, antifilarial IgG, antigenemia
    MeSH terms: Adult; Antigens; Bangladesh; Brugia; Myanmar; Filariasis; India; Indium; Indonesia; Malaysia; Pakistan; Philippines; Brugia malayi
  10. Thirthagiri E, Ngeow YF
    JUMMEC, 2000;5:48-50.
    A powder (EWI) made from a mixture of herbs used for the treatment of carbuncles by traditional medicine practitioners in China was investigated for antistaphylococcal activity by agar diffusion, time-kill studies and M.I.C. determinations performed on 17 clinical isolates and a reference strain ATCC 29213. It was found that EW1 had little demonstrable in vitro activity against the clinical isolates tested but inhibited the growth of the ATCC strain at 10 mg/l and retarded its growth in broth culture by an average of 1.5 log reduction in colony count. KEYWORDS: Traditional medicine, anti-staphylococcal activity.
    MeSH terms: Agar; Complementary Therapies; China; Diffusion; Malaysia; Microbiology
  11. Teh KH, Ling KH
    JUMMEC, 2000;5:86-88.
    A cross-sectional study on the prevalence of smoking among Form 3, 4 and 5 students of a rural national co-educational school was carried out using a selfadministered questionnaire. By the age of 18 years old, three quarters of boys had tried smoking compared with 12% of girls. About a third of boys were still smokers while only 0.7% of girls were still smokers. There was a higher prevalence of smokers among students who stayed with their parents and those who were working part-time. Most smokers knew about the dangerous and addictive effect of cigarette smoking but smoked because of "influence by school peers", "curiosity" and "to increase concentration and decrease tension".
    MeSH terms: Adolescent; Cross-Sectional Studies; Malaysia; Parents; Preventive Medicine; Smoking; Students; Prevalence
  12. Subramaniam KN, Prepageran N, Jalaludin MA, Krishnan G
    JUMMEC, 2000;5:105-106.
    MeSH terms: Malaysia
  13. Rosaida MS, Goh KL
    JUMMEC, 2000;5:11-16.
    Many tests are available for the diagnosis of H. pylori infection. Broadly they can be divided into invasive- endoscopy biopsy based tests and non-invasive tests. Of the endoscopy biopsy based tests the rapid urease tests (RUT) have been found to be the most convenient, accurate and inexpensive tests and they have therefore been recommended by several consensus panels and working parties as the test of choice during endoscopy. Several RUTS are available; some are commercial: CLO test, Pyloritek, Helicobacter urease test, H. yylori test and others- "homemade". We strongly recommend the "homemade" 1 min rapid urease test using an unbuffered solution as originally described by Arvind et al. This test has been shown to be easy to prepare, inexpensive and accurate on field-testing. Several factors affect the accuracy of the RUT. The larger the size of biopsy samples, the quicker is the postive reaction time. With the CLO test, warming the tests to 37'C has also been shown to hasten the reaction time. The effect of blood on the RUT poses an important problem in testing. It is vitally important to determine the H. yylori status in patients with bleeding peptic ulcers as the recurrence of bleeding has been shown to be markedly reduced or virtually abolished with H. yylori eradication. While the results of studies have not been entirely consistent, it is likely that presence of blood does reduce the sensitivity of the RUT. It is therefore sensible that in patients with bleeding ulcers, the RUT should not be the sole endoscopy biopsy test used and that samples should also be taken for histological examination.
    MeSH terms: Biopsy; Diagnosis; Endoscopy; Infection; Malaysia; Peptic Ulcer; Reaction Time; Ulcer; Urease; Review; Helicobacter pylori; Helicobacter Infections
  14. Rohela M, Lee A, Khairul Anuar A, Zuminee MN, Johari S
    JUMMEC, 2000;5:51-52.
    This paper describes a case of invasive arnoebiasis in a 72 year old woman. About 1 week prior to admission she had right iliac fossa pain and physical examination suggested perforated appendix or carcinoma of caecum. Laparotomy revealed perforation of caecum. Histopathology of tissue removed showed abundant trophozoites of Entamoeba histolytica. After surgery treatment was instituted and patient had an uneventful recovery. KEYWORDS: Rupture of caecum, amoebiasis
    MeSH terms: Amebiasis; Appendix; Carcinoma; Case Reports; Entamoeba histolytica; Laparotomy; Malaysia; Pain; Parasitology; Patient Admission; Physical Examination; Rupture
  15. Ranjeev P, Goh KL
    JUMMEC, 2000;5:67-72.
    The majority of patients with upper gastrointestinal bleeding due to peptic ulcers stop bleeding spontaneously. The remainder of patients who have persistent or recurrent bleeding will require surgicaJ or endoscopic intervention. Medical therapy provides an attractive alternative to these two treatment options. The advent of H2 antagonists in the mid 19705 revolutionized the treatment of peptic ulcer disease as it provided good ulcer healing with a treatm.ent course of 6-8 weeks. A more potent acid suppressingdassof drugs: the proton-pump inhibitors (PPJ's) were introduced in the late 19805 and provided even better and faster ulcer healing. It was natural that the acid suppressing drugs were also used for the treatment of ulcer bleeding. Intravenous H2 antagonist and more recently intravenous PPJ's have routinely been prescribed in many hospitals as soon itS a bleeding patient is admitted. Critical evaluation of the literature shows, however, that H2 antagonists are no more effective than placebo in stopping ulcer bleeding. The prJ's, on the other hand, have been shown in several clinical studies to have a beneficial effect. The action of acid suppression in stopping ulcer bleeding is believed to be due to its effect in the stabilization of an ulcer clot by providing a high pH milieu and to commence the process of ulcer healing. KEYWORDS: Upper gastrointestinal bleed(UGIB), proton pump inhibitors(PPls), H2 antagonists
    MeSH terms: Hand; Gastrointestinal Hemorrhage; Hospitals; Malaysia; Peptic Ulcer; Ulcer; Proton Pump Inhibitors
  16. Pang MF, Ling SG
    JUMMEC, 2000;5(1):24-27.
    A descriptive study of full-term neonates with jaundice was carried out to determine factors affecting severity of neonatal jaundice for those infants presenting to the hospital from their homes. Severe jaundice (serum bilirubin >=250 µmol/l) was significantly more likely in infants whose mothers consumed traditional herbs during the postpartum period (p<0.001) and if the jaundice was first detected by the parents or relatives rather than by medical personnel (p<0.05). In addition, the interval between detection of jaundice and presentation to hospital was significantly longer in jaundice that was first detected by parents compared to those detected by medical personnel. In conclusion, factors affecting severity of neonatal jaundice for infants who present from home could be influenced by the socio-cultural practices of maternal postpartum use of herbs, the ability of parents to detect jaundice and the urgency of tlie parents in seeking medical treatment once the jaundice was detected. Further studies need to be done to explore the association of these factors with neonatal jaundice more specifically. KEYWORDS: Hyperbilirubinaemia, socio-cultural practices, herbs.
    Study site: Paediatric Institute, Kuala Lumpur Hospital, Malaysia
    MeSH terms: Bilirubin; Child; Hospitals, Pediatric; Humans; Infant, Newborn; Jaundice, Neonatal*; Malaysia; Mothers; Parents; Postpartum Period
  17. Ong BB, Krishnan R, Lee P
    JUMMEC, 2000;5:33-35.
    Head injury contributes to a significant proportion of motorcycle fatalities. The site and pattern of head injury in victims of fatal motorcycle crashes in 1995 were studied retrospectively. The site of impact on the head was determined based on the injuries on the scalp, pattern of skull fractures and injuries of the brain. Of 54 cases, 9 had massive crush injuries. Of the remaining 45 cases, the site of impact was as follows: frontal 21, lateral 14, posterior 4, vertex 1, chin 1 and unascertainable in 4 cases. The majority of injuries occurred on the front and lateral aspects of the skull. Motorcycle helmets are currently tested for impact energy attenuation and penetration test at the vertex. Helmet standards need to take into account site and nature of injury. KEYWORDS: Head injury, motorcycle fatalities, helmet standards.
    MeSH terms: Australia; Brain; Chin; Head; Malaysia; Motorcycles; Pathology; Scalp; Skull; Skull Fractures; Fractures, Bone
  18. Zainal NZ
    JUMMEC, 2000;5:103-104.
    A case of chronic fatigue syndrome (CFS) like illness was identified recently. Diagnosis CFS is commonly used in the western countries but not in Malaysia or other parts of Asia. It is probably because the diagnosis of neurasthenia has gradually disappeared especially in the United States and United Kingdom. Neurasthenia is dropped in the DSM-111 and DSM-1V but is still retained in the 10th International Classification of Disease. This paper is reporting the case and discussing the definition of chronic fatigue syndrome. (JUMMEC 2000; 2:103-104).
    MeSH terms: Asia; Diagnosis; Fatigue; Malaysia; Neurasthenia; United States
  19. Nor Zuraida Z
    JUMMEC, 2000;5:73-77.
    Chronic fatigue syndrome (CFS) is a chronic debilitating condition affecting both physical and mental functioning. It was first quoted as a 'new disease' spreading in the developed countries. It bei:ame a major issue by doctors, professionals and the media for the past 15 years. CFS was not only affecting the adults but childhood fatigue has also been noted. The CFS patients commonly described themselves to be perfectionists, highly driven, energetic U1d motivated before the condition started. Studies have been focused on the definition, diagnosis and management of CFS. However, the understanding of CFS and what cause it is stili unclear and controversial. Thus the aetiological factors of CFS are reviewed in this article. KEYWORDS; Chronic fatigue syndrome (CFS), Aetiology, Psychiatric disorders, Viral infection, Immunology
    MeSH terms: Adult; Mental Disorders; Child; Diagnosis; Fatigue; Infection; Malaysia; Review; Developed Countries
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