Browse publications by year: 2005

  1. Leisner JJ, Vancanneyt M, Van der Meulen R, Lefebvre K, Engelbeen K, Hoste B, et al.
    Int J Syst Evol Microbiol, 2005 May;55(Pt 3):1267-1270.
    PMID: 15879266 DOI: 10.1099/ijs.0.63434-0
    Three lactic acid bacterial (LAB) strains obtained from a Malaysian acid-fermented condiment, tempoyak (made from pulp of the durian fruit), showed analogous but distinct patterns after screening by SDS-PAGE of whole-cell proteins and comparison with profiles of all recognized LAB species. 16S rRNA gene sequencing of one representative strain showed that the taxon belongs phylogenetically to the genus Leuconostoc, with its nearest neighbour being Leuconostoc fructosum (98 % sequence similarity). Biochemical characteristics and DNA-DNA hybridization experiments demonstrated that the strains differ from Leuconostoc fructosum and represent a single, novel Leuconostoc species for which the name Leuconostoc durionis sp. nov. is proposed. The type strain is LMG 22556(T) (= LAB 1679(T) = D-24(T) = CCUG 49949(T)).
    MeSH terms: Bacterial Proteins/analysis; Bacterial Proteins/isolation & purification; Condiments/microbiology*; DNA, Bacterial/isolation & purification; DNA, Bacterial/chemistry; DNA, Ribosomal/isolation & purification; DNA, Ribosomal/chemistry; Electrophoresis, Polyacrylamide Gel; Food Microbiology*; Genes, Bacterial; Glucose/metabolism*; Leuconostoc/classification*; Leuconostoc/isolation & purification*; Leuconostoc/metabolism; Leuconostoc/chemistry; Molecular Sequence Data; Nucleic Acid Hybridization; Phylogeny; RNA, Bacterial/genetics; RNA, Ribosomal, 16S/genetics; Sequence Analysis, DNA; Genes, rRNA; Proteome
  2. Wu H, Nakano T, Daikoku E, Morita C, Kohno T, Lian HH, et al.
    J. Med. Microbiol., 2005 Dec;54(Pt 12):1117-1125.
    PMID: 16278423 DOI: 10.1099/jmm.0.46158-0
    Helicobacter pylori CagA modifies the signalling of host cells and causes gastric diseases. Although CagA is injected into gastric epithelial cells through the type IV secretion machinery, it remains unclear how CagA is transported towards the machinery in the bacterial cytoplasm. In this study, it was determined that the proton-dependent intracytoplasmic transport system correlates with the priming of CagA secretion from H. pylori. The cytotoxicity of neutral-pH- and acidic-pH-treated H. pylori was examined in the AGS cell line. The amount of phosphorylated CagA in AGS cells incubated with acidic-pH- and neutral-pH-treated H. pylori was determined by enzyme immunoassay and Western blot. The production of CagA and adherence of the treated bacteria were examined by enzyme immunoassay and light microscopy, respectively. To clarify how CagA is transported towards the inner membrane of the treated bacteria, the localization of CagA was analysed by immunoelectron microscopy. The proportion of hummingbird cells in the AGS cell line rapidly increased following the inoculation of acidic-pH-treated H. pylori but increased more slowly with neutral-pH-treated H. pylori, and the phenomenon correlated with the amount of phosphorylated CagA in AGS cells. CagA was densely localized near the inner membrane in the acidic-pH-treated bacterial cytoplasm, but this localization was not observed in the neutral-pH-treated bacterial cytoplasm, suggesting that CagA shifts from the centre to the peripheral portion of the cytoplasm as a result of an extracellular decrease in pH. This phenomenon depended on the presence of UreI, a proton-dependent urea channel, but not on the presence of urea. The pH treatments did not enhance CagA production or the adherence of the bacterium to AGS cells. The authors propose that H. pylori possesses a proton-dependent intracytoplasmic transport system that probably accelerates priming for CagA injection.
    MeSH terms: Adenocarcinoma; Antigens, Bacterial/genetics; Antigens, Bacterial/metabolism*; Bacterial Proteins/genetics; Bacterial Proteins/metabolism*; Biological Transport; Enzyme-Linked Immunosorbent Assay; Humans; Hydrogen-Ion Concentration; Protons; Stomach Neoplasms; Helicobacter pylori/genetics; Helicobacter pylori/metabolism*; Helicobacter pylori/ultrastructure; Helicobacter Infections; Gene Deletion; Phosphotyrosine/metabolism; Cell Line, Tumor
  3. Ganesananthan S, Rajvinder S, Kiew KK
    Med J Malaysia, 2005;60 Suppl A:48.
    Introduction: Megaesophagus is defined as an esophagus measuring 8cm or larger on the barium swallow examination in a patient with Achalasia cardia. Its existence defines a late stage of achalasia and therapy will include an esophagectomy in its management. The latter carries a high morbidity and mortality.
    Materials and Methods: We reviewed retrospectively all treatment naïve patients with Achalasia from 1st January 2000 and identified 10 patients with megaesophagus and these patients were analysed.
    Findings: The average presenting age is 52±15 (range 20-73) years with 4 males: 6 females with 5 Malays:3 Chinese:2 Indians. The duration of illness before diagnosis was 7±5 (range 1-16) years. All patients had dysphagia, regurgitation and weight loss. All 10 patients demonstrated aperistalsis but interestingly 8 patients failed Lower Esophageal Sphincter (LES) intubation during Standard Esophageal Manometry due to coiling of the catheter. Failure to elicit Failure of LES relaxation translates as a high technical failure of manometry (80%) in the diagnosis of Achalasia. A confident diagnosis of Achalasia was made on barium swallow in 9 cases (90%). All 10 patients underwent pneumatic dilatation. Eight patients required only single dilatation. However two patients required two dilatations. The durability of the twelve pneumatic dilatation 27±13 (Range: 9-44) months with good symptomatic relieve and an objective post procedural weight gain of 10±6 (range:1-19) kg over a period of 3-12 months. There was no complications noted post procedure.
    Conclusion: In advanced cases of achalasia, barium swallow is superior to manometry for obtaining the diagnosis. Pneumatic dilatation is an effective and safe procedure for patients with megaesophagus.
    MeSH terms: Esophageal Achalasia; Hospitals, General; Humans; Malaysia
  4. Ganesananthan S, Kiew KK, Shanti P, Hajariah H, Liew SH
    Med J Malaysia, 2005;60 Suppl A:35.
    Background: Achalasia cardia, not an uncommon disease, is diagnosed based on a good history, upper endoscopy, barium swallow, and standard esophageal manometry, is often diagnosed late and best care is delayed.
    Materials and Methods: Complete records of treatment naïve patients with achalasia from 1st January 2000 till 20th November 2004 were reviewed.
    Results: A total of 42 patients, with average presenting age at 45±17 (range 19-83) years with 15 males:27 females with 22 Malays:15 Chinese:5 Indians, were analysis. Compared to our upper endoscopy attendees, there is a trend towards a younger age group (p>0.05) but clearly demonstrating a female preponderance (p<0.005) and towards the Malays but sparing the Indians (p< 0.05). The classical symptom of dysphagia was noted in all cases (100%). Regurgitation in 37 patients (88%), heartburn in 15 patients (36%), weight loss in 10 patients, nocturnal cough in 16 patient, retro-sternal chest discomfort in 2 patients and hemetemesis in 2 patient. One patient presented with aspiration pneumonia and another had concomitant active pulmonary tuberculosis and 9 had concomitant constipation (21%). The duration of illness before diagnosis was 66±90 (range 3-360) months and their presenting weight was 52±12 (range 33-82) kg. Barium swallow examination confidently diagnosed achalasia in 28 patients (67 %). The remaining was marked as dysmotility disorder (7 cases), possible carcinoma of the esophagus (in 2 patients) and dysmotility with possible achalasia (in 5 patients). Ten had mega-esophagus and two had epiphrenic diverticulum with no pseudo-achalasia. Standard esophageal manometry, performed in 39 cases, all demonstrated aperistalsis with one vigorous achalasia. The manometric assembly failed to pass through the
    sphincter in 14 cases (36%), includes 8 patients with mega-esophagus, and LES assessment was not possible. Four cases demonstrated normal LES pressure but demonstrated incomplete relaxation (normotensive achalasia). Dilatation was performed with a 30 mm Rigiflex pneumatic dilator under fluoroscopy at 7psi for 3-30 seconds after loss of waist in 40 patients without complications and excellent symptomatic relief with 3-12 months post procedural weight gain of 7±5 (range: 0-19) kg. Six patients required a second dilatation and another required two further dilatation. The pneumatic dilatations durability during this short study was excellent at 29±11 (range 8-48) months. Similar efficacy and safety profile was noted in patients with mega-esophagus.
    Conclusion: Barium swallow (especially in advanced disease) and manometry (especially in early disease) serve as essential tools for the diagnosis of achalasia and they complement each other. We report two patients presenting with hemetemesis. We obtained excellent results with pneumatic dilatation without any
    complications and this extends to advanced cases of achalasia with mega-esophagus.
    MeSH terms: Esophageal Achalasia; Hospitals, General; Humans; Malaysia; Registries
  5. Ng CJ, Haidi NS
    Asia Pac Fam Med, 2005;4(3).
    Aim: To explore the help-seeking behavior of primary care doctors during illness. Methods: This qualitative study used focus group discussions to explore participants' help-seeking behavior during illness. It involved 22 primary care doctors (5 lecturers, 12 postgraduate trainees, 5 medical officers) working in a hospital-based primary care clinic. Result: Most primary care doctors in this study managed their illnesses without seeking help. Although most preferred to seek professional help for chronic illnesses and antenatal care, they tend to delay the consultations and were less likely to comply with treatment and follow-up. Explanations for their behavior include their ability to assess and treat themselves, difficulty to find suitable doctors, work commitment, easy access to drugs, and reluctance to assume a sick role. Conclusions: This study found that the help-seeking behavior of primary care doctors was similar to those in other studies. Due to their professional ability, heavy workload and expectations from peer and patients, primary care doctors were more likely to delay in seeking treatment especially for chronic and serious diseases. This highlights the need to enhance support services for doctors during illness. Key words: doctors, help-seeking behavior, illness
    MeSH terms: Ambulatory Care Facilities; Chronic Disease; Humans; Malaysia; Physicians, Family; Primary Health Care; Qualitative Research
  6. Wan Mahmud WMR, Hayati MR, Bashah B, Amir A, Mahmood NM
    Background: Community based epidemiological data on postpartum depression in Malaysia is scarce. Aim: To determine the prevalence and risk factors for developing postpartum depression among Malay women from a rural area in Kedah, North West of Peninsular Malaysia. Method: We screened 185 women at 4-12 weeks postpartum attending the selected health centers using the Malay versions of Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory II (BDI-11). Those scoring 12 and / or 9/10 on BDI-11 were interviewed using the Composite International Diagnostic Interview (CIDI) and the 17-items Hamilton Rating Scale for Depression (HDRS-17). All diagnoses were based on the Tenth Edition of the International Classification for Disease: Diagnostic Criteria for Research (ICD-I0: DCR-10). Results: The prevalence of postpartum depression was 21.08%. The condition was found to be significantly linked to polygamous marriages, high number of life events and financial problems over the last one year prior to delivery, and low scores on the Malay version of the MOS Social Support Survey and all its components (overall support index, informational support, affectionate support/ positive social interactions and instrumental support). Conclusions: Postpartum depression is indeed a reality among Malay women in rural areas In Kedah, North West of Peninsular Malaysia. These findings have implications for policies regarding maternal and childcare programs.
    MeSH terms: Ambulatory Care Facilities; Mental Disorders; Cross-Sectional Studies; Depression; Humans; Malaysia; Marriage; Outpatients; Risk Factors; Social Support; Women; Prevalence; Depression, Postpartum
  7. Abdul Kadir A, Nordin R, Ismail SB, Yaacob MJ, Wan Mahmud WMR
    Objective: To determine the prevalence of postnatal depression (PND), and associated risk factors among women in Kota Bharu District, Kelantan. Design: A cohort study Methods: A study involving four hundred and twenty one pregnant women attending primary health care facilities in Kota Bharu between February and September 2000 were screened for depression at 36-42 weeks of pregnancy, 1 week postpartum and 4-6 weeks postpartum using validated Malay version of Edinburgh Postnatal Depression Scale (EPDS). Results: Three hundred and seventy seven women successfully completed the EPDS (response rate = 89.8%). The prevalence of PND at 4-6 weeks postpartum, based on an EPDS score of 12 and above, was 20.7%. Depressive symptoms at the end of pregnancy (p<0.05) and one week postnatal (p<0.05) were significantly associated with PND. Conclusions: PND among women in Kota Bharu was 20.7%, which was higher than previously reported studies. Onset of depressive symptoms towards the end of pregnancy and early postnatal period independently predicted postnatal depression. © 2005 Japan International Cultural Exchange Foundation.
    MeSH terms: Ambulatory Care Facilities; Mental Disorders; Depression; Humans; Malaysia; Mothers; Outpatients; Pregnancy; Primary Health Care; Risk Factors; Women; Cohort Studies; Prevalence; Depression, Postpartum
  8. Deva MP
    Int Psychiatry, 2005 Apr;2(8):14-16.
    PMID: 31507809
    Malaysia is a tropical country in the heart of South East Asia, at the crossroads of the ancient east-west sea trade routes. Although independent from British colonial rule only in 1957, it has a recorded history dating back to at least the first century CE, when the region was already the source of valuable mineral and forest produce that found markets in China, India and further west.
    MeSH terms: Asia, Southeastern; China; India; Malaysia; Minerals; Colonialism; Forests
  9. Yeap SS, Veerapen K, Lim KKT
    DOI: 10.1111/j.1479-8077.2005.00157.x
    MeSH terms: History of Medicine; Malaysia; Rheumatology
  10. Arshad A, Shahid MS
    APLAR Journal of Rheumatology, 2005;8(3):154-158.
    DOI: 10.1111/j.1479-8077.2005.00158.x
    Rheumatoid arthritis (RA) is often regarded as benign and not a serious disease. Yet patients with RA have a substantially reduced life expectancy. Patients with RA are particularly at risk of death from cardiovascular disease, infection and renal disease. A few variables are now recognized as important predictive markers, such as disease duration, severity, sex, educational level and treatment., Copyright (C) 2005 Blackwell Publishing Ltd
    MeSH terms: Arthritis, Rheumatoid; Cardiovascular Diseases; Death; Humans; Infection; Life Expectancy; Malaysia; Mortality
  11. Arshad A
    DOI: 10.1111/j.1479-8077.2005.00116.x
    Pulmonary involvement in rheumatoid arthritis (RA) is a recognized complication but not often well described in the literature and also in major medical textbooks. Thus, for most medical practitioners who look after RA patients, pulmonary complications are often missed and not given much attention. This article will review the current literature of pulmonary involvement in RA and to increase awareness of its existence., Copyright (C) 2005 Blackwell Publishing Ltd
    MeSH terms: Arthritis, Rheumatoid; Humans; Lung Diseases
  12. Wan Azman WA, Haizal HK
    JUMMEC, 2005;8:18-22.
    Peripartum cardiomyopathy (PPCM) is a life-threatening cardiomyopathy of an unknown cause that occurs in the peripartum period in previously healthy women and this article discusses the challenges that lie in diagnosing and managing this rare yet lethal disease. KEYWORDS: Peripartum, cardiomyopathy, pregnancy, cardiac failure
    MeSH terms: Cardiology; Malaysia; Cardiomyopathies; Pregnancy; Women
  13. Wan Azman WA, Haizal HK
    JUMMEC, 2005;8:18-22.
    Peripartum cardiomyopathy (PPCM) is a life-threatening cardiomyopathy of an unknown cause that occurs in the peripartum period in previously healthy women and this article discusses the challenges that lie in diagnosing and managing this rare yet lethal disease.
    MeSH terms: Review
  14. Rosmawati M
    JUMMEC, 2005;8:1.
    MeSH terms: Malaysia; Periodicals as Topic
  15. Omar MI
    JUMMEC, 2005;8:50-55.
    A retrospective study of 102 hands with carpal tunnel syndrome which were treated conservatively initially. Patients who were successfully treated with this method were then compared with those who had failed with this method and had to be treated with surgical decompression. This study found that it took a mean period of about 5.1 months of conservative treatment before deciding on surgery. Generally, the study shows a predominant involvement of the right hand and the female sex as full-time homemakers. Those who finally needed surgery had a longer duration of symptoms prior to consultation. Surgery brought a faster relief from both pain and numbness. It is recommended that conservative treatment be abandoned after a trial period of at least three to five months in order to encourage a speedier recovery.
    MeSH terms: Carpal Tunnel Syndrome; Female; Hand; Median Nerve; Pain; Retrospective Studies; Sex
  16. Noor Azmi MA, Aniza A
    JUMMEC, 2005;8:39-44.
    To see the trend in managing singleton breech pregnancy after the term breech trial. Secondly to compare the safety of different modes of delivery for term, singleton breeches by looking at the immediate neonatal outcome, based on our own experience. Breech infants were identified by examining computer-stored maternal discharge records of hospitalization for the years 1990 and 2000 respectively. Parameters studied included planned mode of delivery, actual mode of delivery, parity, previous vaginal delivery, Apgar score at five minute, birth weight, referral to special care nursery and neonatal morbidity. Of 6,496 deliveries in 1990 and 5,081 in 2000, there were 220 (3.4%) and 148 (2.9%) term breech infants respectively, of which 115 (for 1990) and 102 (for 2000) case records were available. In 1990, 62.6% of the women had trial of vaginal breech delivery but only 24.5% of the women in 2000 were allowed to do so (p < 0.05). Caesarean section rate for singleton breeches increased from 51.3% in 1990 to 84.3% in 2000 (p < 0.05). Mean Apgar score at five minutes was significantly lower after vaginal breech delivery (9.40 ± 1.36) compared to after Caesarean section (9.72 ± 0.712) but there was no clinical significance. There was a noticeable trend towards Caesarean section and less trial of vaginal delivery. Neonatal outcomes of babies born abdominally were statistically better than those born vaginally but there was little clinical impact. Perhaps in properly selected cases, a planned vaginal breech delivery still has a role to play. KEYWORDS: Breech deliveries, Caesarean section, Apgar score
    MeSH terms: Apgar Score; Birth Weight; Child; Hospitalization; Infant; Malaysia; Morbidity; Nurseries; Obstetrics; Parity; Pregnancy; Retrospective Studies; Women
  17. Noor Azmi MA, Aniza A
    JUMMEC, 2005;8:39-44.
    To see the trend in managing singleton breech pregnancy after the term breech trial. Secondly to compare the safety of different modes of delivery for term, singleton breeches by looking at the immediate neonatal outcome, based on our own experience. Breech infants were identified by examining computer-stored maternal discharge records of hospitalization for the years 1990 and 2000 respectively. Parameters studied included planned mode of delivery, actual mode of delivery, parity, previous vaginal delivery, Apgar score at five minute, birth weight, referral to special care nursery and neonatal morbidity. Of 6,496 deliveries in 1990 and 5,081 in 2000, there were 220 (3.4%) and 148 (2.9%) term breech infants respectively, of which 115 (for 1990) and 102 (for 2000) case records were available. In 1990, 62.6% of the women had trial of vaginal breech delivery but only 24.5% of the women in 2000 were allowed to do so (p < 0.05). Caesarean section rate for singleton breeches increased from 51.3% in 1990 to 84.3% in 2000 (p < 0.05). Mean Apgar score at five minutes was significantly lower after vaginal breech delivery (9.40 ± 1.36) compared to after Caesarean section (9.72 ± 0.712) but there was no clinical significance. There was a noticeable trend towards Caesarean section and less trial of vaginal delivery. Neonatal outcomes of babies born abdominally were statistically better than those born vaginally but there was little clinical impact. Perhaps in properly selected cases, a planned vaginal breech delivery still has a role to play.
    MeSH terms: Apgar Score; Breech Presentation; Hospitals; Humans; Malaysia; Pregnancy; Retrospective Studies
  18. Moy FM, Atiya AS
    JUMMEC, 2005;8:33-38.
    Malaysia has undergone rapid pace of industrialization and urbanization in recent decades and this has brought about imminent changes in the lifestyle of Malaysians. This is a cross-sectional study which attempts to examine the lifestyle practices and the prevalence of obesity of a group of security guards and their spouses of the University of Malaya, Kuala Lumpur. Data collection was conducted by both the methods of face-to-face interview and self-administered questionnaire. The respondents were surveyed on lifestyle practices such as smoking habits, exercise and eating pattern. Anthropometric measurement such as weight and height were also taken to establish the extend of obesity by using Body Mass Index (BMI). This study reveals that the community did have some unhealthy lifestyle practices such as smoking (27.7%; 95%CI 20.2%, 36.2%), low prevalence of adequate exercise (13.8%; 95%CI 8.4%, 21.0%); high prevalence of overweight and obesity (64%; 95%CI 55.1%, 72.3%); and high prevalence of co-morbidities such as diabetes mellitus and cardiovascular diseases. In conclusion, the community is considered to be a vulnerable and high-risk group for morbidity and mortality with the above predisposed risk factors. KEYWORDS: Lifestyle practices, overweight and obesity
    MeSH terms: Cardiovascular Diseases; Cross-Sectional Studies; Data Collection; Diabetes Mellitus; Eating; Life Style; Malaysia; Morbidity; Mortality; Obesity; Preventive Medicine; Risk; Risk Factors; Smoking; Urbanization; Exercise; Comorbidity; Body Mass Index; Prevalence; Spouses
  19. Loo JT, Md Razif MA
    JUMMEC, 2005;8:56-60.
    Skin closure using simple interrupted nylon sutures was compared with closure using subcuticular nylon sutures in 80 consecutive patients undergoing semiemergency surgery, involving open reduction and internal fixation of either the forearm bones or femur. The simple interrupted technique was shown to be slower than the subcuticular technique with higher early postoperative wound complication rate. It may use an extra packet of sutures particularly if the average wound length is 19.8 cm. There is, however, no statistical difference demonstrated for the late scar complaints or subjective and objective scoring of cosmetic outcomes six months after the surgery. KEYWORDS: Simple interrupted, subcuticular, skin closure, nylon, cosmetic outcome
    MeSH terms: Humans; Malaysia; Prospective Studies; Sutures
  20. Gill JS, Jambunathan ST, Muhsin M, Abdul Rashid R
    JUMMEC, 2005;8:61-62.
    A common practice in psychiatry when treating patients is the concurrent administration of anticholinergics along with antipsychotics, either to prevent or treat extrapyramidal syndrome reactions from occurring. However, most antipsychotics have inherent anticholinergic properties themselves. Therefore, this subtype of these patients have a higher than usual risk of developing anticholinergic side-effects, of which the central nervous manifestations can mimic psychosis, and may cloud judgement on patients' progress towards their treatment. KEYWORDS: Anticholinergics, anticholinergig toxicity, antipsychotics
    MeSH terms: Case Reports; Malaysia; Psychiatry; Risk
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