Browse publications by year: 2004

Antimicrobial screening of plants used for traditional medicine in the state of Perak, Peninsular Malaysia

Wiart C, Mogana S, Khalifah S, Mahan M, Ismail S, Buckle M, et al.

Fitoterapia, 2004 Jan;75(1):68-73.
PMID: 14693223

Seventy-two extracts (methanol) obtained from the leaves, barks, and roots of 50 plant species used in the traditional medicine of Perak, Peninsular Malaysia, have been screened for antibacterial and antifungal activities. Peristrophe tinctoria, Polyalthia lateriflora, Knema malayana, Solanum torvum, Celosia argentea, Eclipta prostrata, Ancistrocladus tectorius, Dillenia suffruticosa, Piper stylosum and Rafflesia hasseltii displayed the broadest spectrum of activity.

MeSH terms: Anti-Infective Agents/administration & dosage; Anti-Infective Agents/pharmacology*; Anti-Infective Agents/therapeutic use; Mitosporic Fungi/drug effects; Gram-Negative Bacteria/drug effects*; Gram-Positive Bacteria/drug effects*; Humans; Malaysia; Phytotherapy*; Medicine, Traditional; Microbial Sensitivity Tests; Plant Extracts/administration & dosage; Plant Extracts/pharmacology*; Plant Extracts/therapeutic use; Plants, Medicinal*; Plant Leaves; Plant Roots; Plant Bark
Fulltext Factors related to smoking habits of male adolescents

Naing NN, Ahmad Z, Musa R, Hamid FR, Ghazali H, Bakar MH

Tob Induc Dis, 2004 Sep 15;2(3):133-40.
PMID: 19570279 DOI: 10.1186/1617-9625-2-3-133

A cross-sectional study was conducted to identify the factors related to smoking habits of adolescents among secondary school boys in Kelantan state, Malaysia. A total of 451 upper secondary male students from day, boarding and vocational schools were investigated using a structured questionnaire. Cluster sampling was applied to achieve the required sample size. The significant findings included: 1) the highest prevalence of smoking was found among schoolboys from the vocational school; 2) mean duration of smoking was 2.5 years; 3) there were significant associations between smoking status and parents' smoking history, academic performance, perception of the health hazards of smoking, and type of school attended. Peer influence was the major reason students gave for taking up the habit. Religion was most often indicated by non-smokers as their reason for not smoking. Approximately 3/5 of the smokers had considered quitting and 45% of them had tried at least once to stop smoking. Mass media was indicated as the best information source for the students to acquire knowledge about negative aspects of the smoking habit. The authors believe an epidemic of tobacco use is imminent if drastic action is not taken, and recommend that anti-smoking campaigns with an emphasis on the religious aspect should start as early as in primary school. Intervention programs to encourage behavior modification of adolescents are also recommended.
Diffuse pulmonary arteriovenous malformation - a case report

Zain Z

Images Paediatr Cardiol, 2004 Jan;6(1):13-6.
PMID: 22368636
Fulltext Research Activities in Malaysia from the Perspectives of USM Medical School; The Reality and the Strategy

Othman NH

Malays J Med Sci, 2004 Jan;11(1):1-8.
PMID: 22977355
Fulltext Cell targeting in anti-cancer gene therapy

Lila MA, Siew JS, Zakaria H, Saad SM, Ni LS, Abdullah JM

Malays J Med Sci, 2004 Jan;11(1):9-23.
PMID: 22977356 MyJurnal

Gene therapy is a promising approach towards cancer treatment. The main aim of the therapy is to destroy cancer cells, usually by apoptotic mechanisms, and preserving others. However, its application has been hindered by many factors including poor cellular uptake, non-specific cell targeting and undesirable interferences with other genes or gene products. A variety of strategies exist to improve cellular uptake efficiency of gene-based therapies. This paper highlights advancements in gene therapy research and its application in relation to anti-cancer treatment.

MeSH terms: Proteins; RNA; Genetic Therapy; Genetic Research
Anaerobic threshold: its concept and role in endurance sport

Ghosh AK

Malays J Med Sci, 2004 Jan;11(1):24-36.
PMID: 22977357 MyJurnal

aerobic to anaerobic transition intensity is one of the most significant physiological variable in endurance sports. Scientists have explained the term in various ways, like, Lactate Threshold, Ventilatory Anaerobic Threshold, Onset of Blood Lactate Accumulation, Onset of Plasma Lactate Accumulation, Heart Rate Deflection Point and Maximum Lactate Steady State. But all of these have great role both in monitoring training schedule and in determining sports performance. Individuals endowed with the possibility to obtain a high oxygen uptake need to complement with rigorous training program in order to achieve maximal performance. If they engage in endurance events, they must also develop the ability to sustain a high fractional utilization of their maximal oxygen uptake (%VO(2) max) and become physiologically efficient in performing their activity. Anaerobic threshold is highly correlated to the distance running performance as compared to maximum aerobic capacity or VO(2) max, because sustaining a high fractional utilization of the VO(2) max for a long time delays the metabolic acidosis. Training at or little above the anaerobic threshold intensity improves both the aerobic capacity and anaerobic threshold level. Anaerobic Threshold can also be determined from the speed-heart rate relationship in the field situation, without undergoing sophisticated laboratory techniques. However, controversies also exist among scientists regarding its role in high performance sports.
Fulltext What We Know about the Molecular Genetics of Central Nervous System (CNS) Tumours in Malaysia

Sulong S, Yusoff AA, Zainuddin N, Abdullah JM, Pannatil JG, Jaafar H, et al.

Malays J Med Sci, 2004 Jan;11(1):37-43.
PMID: 22977358 MyJurnal

The new millennium has been regarded as a genomic era. A lot of researchers and pathologists are beginning to understand the scientific basis of molecular genetics and relates with the progression of the diseases. Central nervous system (CNS) tumours are among the most rapidly fatal of all cancers. It has been proposed that the progression of malignant tumours may result from multi-step of genetic alterations, including activation of oncogenes, inactivation of tumour suppressor genes and also the presence of certain molecular marker such as telomerase activity. In this paper, we review some recent data from the literature, including our own studies, on the molecular genetics analysis in CNS tumours. Our studies have shown that two types of tumour suppressor genes, p53 and PTEN were involved in the development of these tumours but not in p16 gene among the patients from Hospital Universiti Sains Malaysia (HUSM). Telomerase activity also has been detected in various types of CNS tumours. Thus, it is important to assemble all data which related to this study and may provide as a vital information in a new approach to neuro-oncology studies in Malaysia.

MeSH terms: Humans; Malaysia; Oncogenes; Tumor Suppressor Protein p53; Central Nervous System Neoplasms; Telomerase; Genes, p16; Genomics; Pathologists
Fulltext Physical and mental health problems of the elderly in a rural community of Sepang, Selangor

Mohd Sidik S, Rampal L, Afifi M

Malays J Med Sci, 2004 Jan;11(1):52-9.
PMID: 22977360 MyJurnal

The prevalence of aging population is increasing not only in developed countries, but also in developing countries like Malaysia. The aim of this study was: (1) to determine the prevalence of physical and mental health problems, and (2) to determine the association of these health problems with socio demographic factors among the elderly in a rural community in Sepang, Selangor. A cross sectional study design was used. Five out of nine villages were selected via random sampling. The elderly in the selected villages were interviewed using a pre-tested structured questionnaire which included the GDS-30, ECAQ and Barthel Index. Out of 263 elderly residents (6.2% of the total population), 223 agreed to participate in the study giving a response rate of 84.8%. The mean age of the respondents was 69.7 + 6.8 years with a median of 68 years. The prevalence of physical health problems such as chronic illness and functional dependence were 60.1% and 15.7%, respectively. While the prevalence of mental health problems such as depression and cognitive impairment were 7.6% and 22.4%, respectively. Among the health problems studied, depression was found to be significantly associated with unemployment (p<0.05), where as cognitive impairment was significantly associated with age, gender, ethnicity, marital status and level of education (p<0.05).

MeSH terms: Aged; Chronic Disease; Cross-Sectional Studies; Depression; Depressive Disorder; Developing Countries; Educational Status; Humans; Malaysia; Mental Health; Middle Aged; Surveys and Questionnaires; Rural Population; Unemployment; Prevalence; Marital Status; Developed Countries
Correcting Metered-Dose Inhaler Technique vs Switching to Turbohaler in Asthmatic Patients a Study on 'Real-Life' Effectiveness

Loh LC, Ngor Teh P

Malays J Med Sci, 2004 Jan;11(1):60-5.
PMID: 22977361

In practice, asthmatic patients whose metered-dose inhaler (MDI) technique is inefficient are either corrected or changed to dry powder breath-actuated or spacer device that is easier to handle. Based on 'real life clinic circumstances', we studied 15 symptomatic asthmatic patients whose MDI techniques were inefficient that either received correction in their technique (n=9) or were changed to turbohaler (n=6). For comparison, we also studied a similar group of symptomatic asthmatic patients (n=6) with appropriate MDI techniques that were treated by doubling of inhaled corticosteroid (ICS) dose. After 4 weeks, FEV(1) and symptom scores in the turbohaler group was significantly improved from baseline but not in the corrected MDI group. The group whose ICS dose was doubled also showed significant improvement in symptom scores but not in FEV(1). We question the benefit gained by correcting MDI technique in some asthmatic patients compared to that of switching over to more user-friendly devices such as turbohaler. In our study, the improvement observed with turbohaler appears to be more than a mere doubling of drug delivery to the lungs and may relate to the recognized greater consistency of drug delivery by turbohaler compared to MDI device.
The prevalence of diastolic dysfunction in patients with hypertension referred for echocardiographic assessment of left ventricular function

Mohamed AL, Yong J, Masiyati J, Lim L, Tee SC

Malays J Med Sci, 2004 Jan;11(1):66-74.
PMID: 22977362

Hypertension is the major cause of congestive cardiac failure all over the world. It is under diagnosed and achievement of optimal therapy is difficult and costly. Diastolic dysfunction is an early poor prognostic factor in hypertension and is a reversible condition. Early detection and treatment is necessary to avoid cardiac complications. The objective of this study was to assess the occurrence of diastolic dysfunction in hypertensive patients referred for echocardiograph assessment of left ventricular function in a secondary hospital. It was also designed to determine whether contributing factors such as age, gender, systolic and diastolic pressure, duration of hypertension, previous myocardial infarct or ischemic heart disease and choice of anti-hypertensive drugs influence the development of diastolic dysfunction in these hypertensive patients. The analysis of diastolic dysfunction was based on the E/A ratio using Doppler echocardiogram. All of the patients were recruited from the Echocardiography Unit, Department of Medicine, Seremban General Hospital. Fifty patients with history of hypertension were selected for the study. Out of These 22 patients (44%) were found to have diastolic dysfunction; 39.1% of male patients (9 out of 23) and 48.1% of female patients (13 out of 27). Other contributing factors of diastolic dysfunction were found in patients : (a) with more than 8 years history of hypertension (12%) (b) with history of preexisting IHD/AMI (20%), (c) stages II - III of systolic hypertension based on 6th Joint National Committee recommendation (73%) (d) on ACE-inhibitor (18%) and (e) on Beta-blocker (28%) In conclusion, the study had demonstrated that the duration of hypertension, both systolic and diastolic blood pressure and age of patients are important prognostic indicators in predicting the development of diastolic dysfunction in hypertensive patients.
The incidence of post-operative deep vein thrombosis in general surgical patients of hospital universiti sains malaysia

Tun M, Shuaib IL, Muhamad M, Mat Sain AH, Ressang AS

Malays J Med Sci, 2004 Jan;11(1):75-80.
PMID: 22977363

The incidence of deep vein thrombosis is believed to be rare in Asians. During recent years, a few reports have appeared with high incidence in orthopaedic patients comparable to Western studies. This study was carried out to find out the incidence of post-operative deep vein thrombosis (DVT) after major surgical procedures in general surgical patients in an Asian population. In a prospective study of 45 consecutive Asian patients after major general surgery, colour-flow duplex scan of the legs as an initial screening was done twice within two weeks. Mean age of the patients was 54 years 5 months and 87% of patients were included in the moderate and high risk group for deep vein thrombosis. Ascending venography was used to confirm deep vein thrombosis on patients with equivocal or positive results from colour flow duplex scan. One patient showed positive evidence of post-operative deep vein thrombosis on colour flow duplex scan which was further confirmed by ascending venography; giving an incidence of 2.2%. The incidence of post-operative deep vein thrombosis in general surgical patients is lower than the Western studies.

MeSH terms: Color; Humans; Middle Aged; Orthopedics; Phlebography; Prospective Studies; Radionuclide Imaging; Incidence; Venous Thrombosis; Asian Continental Ancestry Group
Fulltext Love tragedy, she wrote

Mat Esa MS, Othman Z, Jamil Yaacob M

Malays J Med Sci, 2004 Jan;11(1):86-9.
PMID: 22977365

A case of a 53-year old-single, Kelantanese lady with a diagnosis of paranoid schizophrenia for 28 years is reported with aims to illustrate the influence of life experiences particularly based on education and intelligent on delusion illustrate the evolving nature of the complexity of delusions as well as to show the importance of documentation in psychiatric practice. We concluded that this patient had used defense mechanism of suppression, reaction formation and persecution throughout her delusion. The final persecutory delusion evolved through series of transformation via object of admirations. We postulated that in-depth emotional insight about effects of schizophrenia might have contributed to her self-reflection that have made her frustrated with her poor achievement in life.

MeSH terms: Defense Mechanisms; Delusions; Documentation; Emotions; Female; Frustration; Humans; Life Change Events; Schizophrenia, Paranoid
Recombinant VP9-based enzyme-linked immunosorbent assay for detection of immunoglobulin G antibodies to Banna virus (genus Seadornavirus)

Mohd Jaafar F, Attoui H, Gallian P, Isahak I, Wong KT, Cheong SK, et al.

J Virol Methods, 2004 Mar 01;116(1):55-61.
PMID: 14715307

Banna virus (BAV, genus Seadornavirus, family Reoviridae) is an arbovirus suspected to be responsible for encephalitis in humans. Two genotypes of this virus are distinguishable: A (Chinese isolate, BAV-Ch) and B (Indonesian isolate, BAV-In6969) which exhibit only 41% amino-acid identity in the sequence of their VP9. The VP7 to VP12 of BAV-Ch and VP9 of BAV-In6969 were expressed in bacteria using pGEX-4T-2 vector. VP9 was chosen to establish an ELISA for BAV, based mainly on two observations: (i). VP9 is a major protein in virus-infected cells and is a capsid protein (ii). among all the proteins expressed, VP9 was obtained in high amount and showed the highest immuno-reactivity to anti-BAV ascitic fluid. The VP9s ELISA was evaluated in three populations: French blood donors and two populations (blood donors and patients with a neurological syndrome) from Malaysia, representing the region where the virus was isolated in the past. The specificity of this ELISA was >98%. In mice injected with live BAV, the assay detected IgG-antibody to BAV infection 21 days post-injection, which was confirmed by Western blot using BAV-infected cells. The VP9 ELISA permits to determine the sero-status of a population without special safety precautions and without any requirements to propagate the BAV. This test should be a useful tool for epidemiological survey of BAV.

MeSH terms: Animals; Antibodies, Viral/blood*; Antigens, Viral/genetics; Antigens, Viral/immunology*; Ascitic Fluid/immunology; Ascitic Fluid/virology; Cross Reactions; Enzyme-Linked Immunosorbent Assay/methods*; Genotype; Humans; Immunoglobulin G/blood; Recombinant Proteins/immunology; Reoviridae Infections/diagnosis*; Reoviridae Infections/epidemiology; Sensitivity and Specificity; Viral Proteins/genetics; Viral Proteins/immunology*; Coltivirus/immunology*; Mice
Which nests to choose: collecting shed hairs from wild orang-utans

Goossens B, Abdullah ZB, Sinyor JB, Ancrenaz M

Folia Primatol., 2004 Jan-Feb;75(1):23-6.
PMID: 14716150
MeSH terms: Animals; Feces*; Hair*; Malaysia; Pongo pygmaeus*; Specimen Handling/methods*; Plant Leaves
Norovirus cross-contamination during food handling and interruption of virus transfer by hand antisepsis: experiments with feline calicivirus as a surrogate

Bidawid S, Malik N, Adegbunrin O, Sattar SA, Farber JM

J Food Prot, 2004 Jan;67(1):103-9.
PMID: 14717359

While there is good epidemiological evidence for foods as vehicles for norovirus transmission, the precise means of spread and its control remain unknown. The feline calicivirus was used as a surrogate for noroviruses to study infectious virus transfer between hands and selected types of foods and environmental surfaces. Assessment of the potential of selected topicals in interrupting such virus transfer was also made. Ten microliters of inoculum of feline calicivirus deposited onto each fingerpad of adult subjects was allowed to air dry and the contaminated area on individual fingerpads was pressed (10 s at a pressure of 0.2 to 0.4 kg/cm2) onto 1-cm-diameter disks of ham, lettuce, or brushed stainless steel. The virus remaining on the donor and that transferred to the recipient surfaces was eluted and plaque assayed. Virus transfer to clean hands from experimentally contaminated disks of ham, lettuce, and stainless steel was also tested. Nearly 46 +/- 20.3, 18 +/- 5.7, and 13 +/- 3.6% of infectious virus was transferred from contaminated fingerpads to ham, lettuce, and metal disks, respectively. In contrast, approximately 6 +/- 1.8, 14 +/- 3.5, and 7 +/- 1.9% virus transfer occurred, respectively, from ham, lettuce, and metal disks to hands. One-way analysis of variance test showed that pretreatment (washing) of the fingerpads either with water or with both topical agent and water significantly (P < 0.05) reduced virus transfer to < or = 0.9%, as compared with < or = 2.3 and < or = 3.4% transfer following treatments with either 75% (vol/vol) ethanol or a commercial hand gel containing 62% ethanol, respectively. Despite wide variations in virus transfer among the targeted items used, intervention agents tested reduced virus transfer significantly (P < 0.05) when compared with that without such treatments (71 +/- 8.9%). These findings should help in a better assessment of the potential for cross-contamination of foods during handling and also assist in developing more effective approaches to foodborne spread of norovirus infections.

MeSH terms: Disinfection/methods; Equipment Contamination*; Food Contamination/analysis*; Food Contamination/prevention & control; Food Handling/methods*; Food Microbiology; Hand Disinfection; Humans; Meat Products/virology; Stainless Steel; Lettuce/virology
Expression of beta-catenin, COX-2 and iNOS in colorectal cancer: relevance of COX-2 adn iNOS inhibitors for treatment in Malaysia

Hong SK, Gul YA, Ithnin H, Talib A, Seow HF

Asian J Surg, 2004 Jan;27(1):10-7.
PMID: 14719508

BACKGROUND: Promising new pharmacological agents and gene therapy targeting cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) could modulate treatment of colorectal cancer in the future. The aim of this study was to elucidate the expression fo beta-catenin and teh presence of COX-2 and iNOS in colorectal cancer specimens in Malaysia. This is a useful prelude to future studies investigating interventions directed towards COX-2 adn iNOS.
METHODS: A cross-section study using retrospective data over a 2-year period (1999-2000) involved 101 archival, formalin-fixed, paraffin-embedded tissue samples of colorectal cancers that were surgically resected in a tertiary referral.
RESULTS: COX-2 production was detected in adjacent normal tissue in 34 sample (33.7%) and in tumour tissue in 60 samples (59.4%). More tumours expressed iNOS (82/101, 81.2%) than COX-2. No iNOS expression was detected in adjacent normal tissue. Intense beta-catenin immunoreactivity at the cell-to-cell border. Poorly differentiated tumours had significantly lower total beta-catenin (p = 0.009) and COX-2 scores (p = 0.031). No significant relationships were established between pathological stage and beta-catenin, COX-2 and iNOS scores.
CONCLUSIONS: the accumulation of beta-catenin does not seem to be sufficient to activate pathways that lead to increased COX-2 and iNOS expression. A high proportion of colorectal cancers were found to express COX-2 and a significant number produced iNOS, suggesting that their inhibitors may be potentially useful as chemotherapeutic agents in the management of colorectal cancer.

MeSH terms: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Cytoskeletal Proteins/metabolism*; Female; Humans; Immunohistochemistry; Isoenzymes/antagonists & inhibitors; Isoenzymes/metabolism*; Malaysia; Male; Membrane Proteins; Middle Aged; Prostaglandin-Endoperoxide Synthases/metabolism*; Retrospective Studies; Colorectal Neoplasms/enzymology; Colorectal Neoplasms/metabolism*; Colorectal Neoplasms/pathology; Trans-Activators/metabolism*; Gene Expression Regulation, Enzymologic; Gene Expression Regulation, Neoplastic; Cyclooxygenase Inhibitors/therapeutic use; Statistics, Nonparametric; Nitric Oxide Synthase/antagonists & inhibitors; Nitric Oxide Synthase/metabolism*; beta Catenin; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Nitric Oxide Synthase Type II
Antrochoanal polyps: clinical presentation and the role of powered endoscopic polypectomy

Gendeh BS, Long YT, Misiran K

Asian J Surg, 2004 Jan;27(1):22-5.
PMID: 14719510

Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%), followed by rhinorrhoea (44%), epistaxis (33%), postnasal drip (28%), and snoring (22%). Chronic sinus was the most common associated rhinological finding (50%). Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%), endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7%) and Caldwell-Luc surgery in one patient (5.6%). No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.

MeSH terms: Adolescent; Adult; Child; Endoscopy; Female; Humans; Male; Middle Aged; Nasal Polyps/complications; Nasal Polyps/diagnosis; Nasal Polyps/surgery*; Retrospective Studies
Appropriateness of colonoscopy in a tertiary referral centre

Jabar MF, Halim ME, Gul YA

Asian J Surg, 2004 Jan;27(1):26-31.
PMID: 14719511

The aim of this study was to determine the appropriateness of colonoscopy in relation to its diagnostic yield, with reference to the guidelines set by the American Society of Gastrointestinal Endoscopy (ASGE). A prospective 90-day audit was performed at Hospital Kualal Lumpur, which is a tertiary referral centre in Malaysia, to examine the appropriateness of colonoscopy by indication. During that time, 257 colonoscopies were performed in 244 patients. The predominant indications for colonoscopy were altered bowl habit (37%) and rectal bleeding (18%). Of the 257 colonoscopies, 216 (84%) were judged to be appropriate by ASGE guidelines. Only 43% of all colonoscopies had positive findings. Positive findings were found in 93% of cases judged appropriate compared with only 7% found in cases deemed inappropriate. There were statistically significant relationships between appropriateness and overall positive yield and between appropriateness and neoplastic findings (p < 0.05). Colonoscopy performed for appropriate indications yield more significant findings, this, we advocate the use of accepted guidelines to maintain or improve the standard colonoscopy services.

MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Colonoscopy/utilization*; Female; Hospitals; Humans; Malaysia; Male; Medical Audit; Middle Aged; Prospective Studies; Utilization Review*; Practice Guidelines as Topic*; Guideline Adherence*
Localized Castleman's disease presenting as a vascular right iliac fossa mass

Muhsein KA, Liew NC, Shaker AR, Shahrin IA

Asian J Surg, 2004 Jan;27(1):54-7.
PMID: 14719517

Castleman's disease is a rare lymphoproliferative disorder of unknown aetiology. The presentation is varied, diagnosis is difficult, and optimum management is still unknown. We report our experience with a case of Castleman's disease in a 34-year old woman who presented with pallor, hepatosplenomegaly, and a right iliac fossa mass that was 5 cm in diameter. this was initially diagnosed as a soft tissue sarcoma and preoperative tumour embolization was planned before excision. Mesenteric arteriogram revealed that the feeder arteries arose from the superior mesenteric artery and embolization was aborted for fear of causing bowel ischaemia. On laparotomy, lymphoid enlargement was found between the leaves of the jejunal mesentery. The tumour was relatively avascular and the overlying mesenteric vessels contributed to teh duplex ultrasound and computerized tomography appearance of hypervascularity. The tumour with the mesentery and the overlying segment of jejunum was excised completely. Histopathology confirmed Castleman's disease. The purpose of this report is to present this rare case that caused a diagnostic dilemma and to review the management of this disorder.

MeSH terms: Adult; Female; Giant Lymph Node Hyperplasia/pathology*; Humans; Ilium/pathology*; Jejunum/pathology; Mesentery*; Peritoneal Diseases/pathology*
Transport of critically ill children in a resource-limited setting: alternatives to a specialized retrieval team

Goh AY, El-Amin Abdel-Latif M

Intensive Care Med, 2004 Feb;30(2):339.
PMID: 14727017 DOI: 10.1007/s00134-003-2112-5
MeSH terms: Child; Critical Care; Humans; Malaysia; Patient Transfer/methods*; Patient Transfer/standards; Intensive Care Units, Pediatric; Critical Illness/mortality; Critical Illness/therapy*

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