Browse publications by year: 2005

  1. Wong ML, Sandham A, Ang PK, Wong DC, Tan WC, Huggare J
    Eur J Orthod, 2005 Feb;27(1):91-7.
    PMID: 15743868
    The aim of this study was to measure craniofacial morphology and nasal respiratory resistance (NRR) in Malay, Indian and Chinese subjects with obstructive sleep apnoea (OSA). The sample consisted of 34 male subjects, 27-52 years of age (Malay n = 11, which included five mild and six moderate-severe OSA; Indian n = 11, which included six mild and five moderate-severe OSA; and Chinese n = 12, which included six mild and six moderate-severe OSA) diagnosed using overnight polysomnography. After use of a decongestant, NRR was recorded using anterior and posterior rhinomanometry. Standardized lateral cephalometric radiographs were used to record linear and angular dimensions. Malay subjects with moderate-severe OSA had a shorter maxillary (sp-pm) and mandibular (gn-go) length when compared with a mild OSA reference sample (P < 0.05). The hyoid bone was located more caudally in the Chinese moderate-severe subjects (hy-NL, hy-ML)(P < 0.05), and may be a useful diagnostic indicator for severity in this racial group. No pattern of differences for NRR was seen between the moderate-severe and mild OSA subjects. The consistently lower values for nasopharyngeal resistance in all the moderate-severe subjects when compared with the mild group may indicate that some compensation at this level of the airway had taken place. Strong positive correlations between craniocervical angulation (NL/OPT) and total airway resistance and the turbulent component of flow (k(2)) suggest that head posture is sensitive to fluctuations in airway resistance (P < 0.01).
    MeSH terms: Adult; Airway Resistance/physiology*; Cephalometry; China; Ethnic Groups; Facial Bones/pathology*; Head/pathology*; Humans; Hyoid Bone/pathology; India; Malaysia; Male; Mandible/pathology; Manometry/methods; Maxilla/pathology; Middle Aged; Nose/physiopathology*; Posture/physiology; Skull/pathology*; Nasal Decongestants/administration & dosage; Sleep Apnea, Obstructive/ethnology*; Sleep Apnea, Obstructive/pathology; Sleep Apnea, Obstructive/physiopathology; European Continental Ancestry Group; Asian Continental Ancestry Group/ethnology*
  2. Sariah M, Choo CW, Zakaria H, Norihan MS
    Mycopathologia, 2005 Jan;159(1):113-7.
    PMID: 15750742
    Basal stem rot of oil palm caused by Ganoderma boninense is of major economic importance. Observations of the low incidence of disease due to Ganoderma species in natural stands, suggest that the disease is kept under control by some biological means. Trichoderma spp. are saprophytic fungi with high antagonistic activities against soil-borne pathogens. However, their abundance and distribution are soil and crop specific. Trichoderma species have been found to be concentrated in the A1 (0-30 cm) and Be soil horizons (30-60 cm), although the abundance of Trichoderma was not significantly different between the oil palm and non-oil palm ecosystems. Characterisation of Trichoderma isolates based on cultural, morphological and DNA polymorphism showed that T. harzianum, T. virens, T. koningii and T. longibrachiatum made up 72, 14, 10 and 4% of the total Trichoderma isolates isolated. As Trichoderma species are present in the oil palm ecosystem, but at lower numbers and in locations different from those desired, soil augmentation with antagonistic Trichoderma spp. can be developed as a strategy towards integrated management of basal stem rot of oil palm.
    MeSH terms: Malaysia; Pest Control, Biological/methods*; Plant Diseases/microbiology*; Soil Microbiology*; Trichoderma/classification*; Trichoderma/growth & development; Colony Count, Microbial; Ecosystem; Arecaceae*; Ganoderma/classification*; Ganoderma/growth & development
  3. Susanto A, Sudharto PS, Purba RY
    Mycopathologia, 2005 Jan;159(1):153-7.
    PMID: 15750748
    Basal Stem Rot (BSR) disease caused by Ganoderma boninense is the most destructive disease in oil palm, especially in Indonesia and Malaysia. The available control measures for BSR disease such as cultural practices and mechanical and chemical treatment have not proved satisfactory due to the fact that Ganoderma has various resting stages such as melanised mycelium, basidiospores and pseudosclerotia. Alternative control measures to overcome the Ganoderma problem are focused on the use of biological control agents and planting resistant material. Present studies conducted at Indonesian Oil Palm Research Institute (IOPRI) are focused on enhancing the use of biological control agents for Ganoderma. These activities include screening biological agents from the oil palm rhizosphere in order to evaluate their effectiveness as biological agents in glasshouse and field trials, testing their antagonistic activities in large scale experiments and eradicating potential disease inoculum with biological agents. Several promising biological agents have been isolated, mainly Trichoderma harzianum, T. viride, Gliocladium viride, Pseudomonas fluorescens, and Bacillus sp. A glasshouse and field trial for Ganoderma control indicated that treatment with T. harzianum and G. viride was superior to Bacillus sp. A large scale trial showed that the disease incidence was lower in a field treated with biological agents than in untreated fields. In a short term programme, research activities at IOPRI are currently focusing on selecting fungi that can completely degrade plant material in order to eradicate inoculum. Digging holes around the palm bole and adding empty fruit bunches have been investigated as ways to stimulate biological agents.
    MeSH terms: Indonesia; Pest Control, Biological/methods*; Plant Diseases/microbiology*; Trichoderma/growth & development*; Gliocladium/growth & development*; Arecaceae*; Ganoderma/growth & development*
  4. Lim HP, Fong YK
    Mycopathologia, 2005 Jan;159(1):171-9.
    PMID: 15750750
    Basidiospores were isolated from the fruiting bodies of Ganoderma infecting oil palms from an estate in Johor and from ornamental palms (including oil palms) from Singapore. The spores were then germinated to obtain homokaryotic mycelia. Based on clamp connection formation in paired hyphal fusions, tester strains were identified from the homokaryons isolated. Compatibility tests were then carried out using these testers to determine the relatedness of the homokaryotic Ganoderma isolates, both from Johor and from Singapore. Results from the compatibility tests showed that Ganoderma from both locations belong to the same species, while the Ganoderma isolates from Singapore share some common alleles. The pathogenicity tests carried out on Chrysalidocarpus lutescens seedlings using inoculum growing on rubber wood blocks showed that dikaryotic mycelia can cause basal stem rot infection.
    MeSH terms: Plant Diseases/microbiology*; Singapore; Spores, Fungal/growth & development; Spores, Fungal/pathogenicity; Arecaceae*; Ganoderma/growth & development*; Ganoderma/pathogenicity
  5. Hooi LS, Wong HS, Morad Z
    Kidney Int Suppl, 2005 Apr.
    PMID: 15752245
    Renal replacement therapy in Malaysia has shown exponential growth since 1990. The dialysis acceptance rate for 2003 was 80 per million population, prevalence 391 per million population. There are now more than 10,000 patients on dialysis. This growth is proportional to the growth in gross domestic product (GDP). Improvement in nephrology and urology services with widespread availability of ultrasonography and renal pathology has improved care of renal patients. Proper management of renal stone disease, lupus nephritis, and acute renal failure has decreased these as causes of end-stage renal disease (ESRD) in younger age groups. Older patients are being accepted for dialysis, and 51% of new patients on dialysis were diabetic in 2003. The prevalence of diabetes is rising in the country (presently 7%); glycemic control of such patients is suboptimal. Thirty-three percent of adult Malaysians are hypertensive and blood pressure control is poor (6%). There is a national coordinating committee to oversee the control of diabetes and hypertension in the country. Primary care clinics have been provided with kits to detect microalbuminuria, and ACE inhibitors for the treatment of hypertension and diabetic nephropathy. Prevention of renal failure workshops targeted at primary care doctors have been launched, opportunistic screening at health clinics is being carried out, and public education targeting high-risk groups is ongoing. The challenge in Malaysia is to stem the rising tide of diabetic ESRD.
    MeSH terms: Humans; Kidney Failure, Chronic/mortality; Kidney Failure, Chronic/prevention & control*; Malaysia/epidemiology; Incidence; Prevalence
  6. Chua PK, Corkill JE, Hooi PS, Cheng SC, Winstanley C, Hart CA
    Emerg Infect Dis, 2005 Feb;11(2):271-7.
    PMID: 15752446
    An obligate intracellular bacterium was isolated from urine samples from 7 (3.5%) of 202 fruit bats (Eonycteris spelaea) in peninsular Malaysia. The bacterium produced large membrane-bound inclusions in human, simian, and rodent cell lines, including epithelial, fibroblastlike, and lymphoid cells. Thin-section electron microscopy showed reticulate bodies dividing by binary fission and elementary bodies in the inclusions; mitochondria surrounded the inclusions. The inclusions were positive for periodic acid-Schiff stain but could not be stained by fluorescein-labeled anti-Chlamydia trachomatis major outer membrane protein monoclonal antibody. The bacterium was resistant to penicillin and streptomycin (MICs > 256 mg/L) but susceptible to tetracycline (MIC = 0.25 mg/L) and chloramphenicol (MIC = 0.5 mg/L). Sequence analysis of the 16SrRNA gene indicated that it was most closely related to 2 isolates of Waddlia chondrophila (94% and 96% identity). The 16S and 23S rRNA gene signatures were only 91% identical. We propose this novel bacterium be called W. malaysiensis.
    MeSH terms: Acetylmuramyl-Alanyl-Isoglutamine/analogs & derivatives*; Acetylmuramyl-Alanyl-Isoglutamine/genetics; Acetylmuramyl-Alanyl-Isoglutamine/chemistry; Animals; Anti-Bacterial Agents/pharmacology; Base Sequence; Cercopithecus aethiops; Chiroptera/microbiology*; Chiroptera/urine; Chlamydiales/drug effects; Chlamydiales/genetics; Chlamydiales/isolation & purification*; Chlamydiales/ultrastructure; DNA, Bacterial/genetics; DNA, Bacterial/chemistry; Cricetinae; Humans; Microbial Sensitivity Tests; Microscopy, Electron; Molecular Sequence Data; Phylogeny; RNA, Ribosomal, 16S/genetics; RNA, Ribosomal, 16S/chemistry; RNA, Ribosomal, 23S/genetics; RNA, Ribosomal, 23S/chemistry; Vero Cells; Polymerase Chain Reaction; Sequence Alignment; 3T3 Cells; DNA, Ribosomal Spacer/genetics; DNA, Ribosomal Spacer/chemistry; Mice
  7. Ruzaidi A, Amin I, Nawalyah AG, Hamid M, Faizul HA
    J Ethnopharmacol, 2005 Apr 8;98(1-2):55-60.
    PMID: 15763363
    The present study aims to investigate the effect of cocoa extract on serum glucose levels and lipid profiles in streptozotocin-diabetic rats. Cocoa extract (contained 285.6 mg total polyphenol per gram extract) was prepared from fermented and roasted (140 degrees C, 20 min) beans by extracting using 80% ethanol in the ratio of 1-10. The extract of three dosages (1, 2, and 3%) was fed to normal and diabetic rats for a period of 4 weeks. In hyperglycaemic group, cocoa extract (1 and 3%) diets were found to significantly lower (p<0.05) the serum glucose levels compared to the control. Furthermore, supplementation of 1 and 3% cocoa extract had significantly reduced (p<0.05) the level of total cholesterol in diabetic rats. In addition, 1, 2, and 3% cocoa extract diets had significantly lowered (p<0.05) the total triglycerides. Interestingly, this study found that serum HDL-cholesterol had increased significantly (p<0.05) in diabetic rats fed with 2% cocoa extract, while the LDL-cholesterol had decreased significantly (p<0.05) in the 1% treated group. These results indicate that cocoa extract may possess potential hypoglycaemic and hypocholestrolemic effects on serum glucose levels and lipid profiles, respectively. The results also found that the effect of cocoa extract was dose-dependent.
    MeSH terms: Animals; Blood Glucose/drug effects*; Cacao/chemistry*; Diabetes Mellitus, Experimental/blood; Diabetes Mellitus, Experimental/chemically induced; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical/methods; Eating/drug effects; Cholesterol, HDL/blood; Cholesterol, HDL/drug effects; Cholesterol, LDL/blood; Cholesterol, LDL/drug effects; Malaysia/ethnology; Male; Plant Extracts/pharmacology*; Plant Extracts/therapeutic use; Plant Extracts/chemistry; Plants, Medicinal/chemistry; Streptozocin/administration & dosage; Streptozocin/adverse effects; Triglycerides/antagonists & inhibitors*; Triglycerides/blood; Weight Loss/drug effects; Rats, Wistar; Rats
  8. Shrestha N, Sharma S, Khanal B, Bhatta N, Dhakal S
    Scand. J. Infect. Dis., 2005;37(1):64-6.
    PMID: 15764193
    This is a report of the first recognized case of melioidosis in Nepal. Illness began 1 month after returning from Malaysia after a 1 y stay. The case highlights the importance of ascertaining the travel history in any patient with a suspected infectious disease in this age of global travel.
    MeSH terms: Adult; Anti-Infective Agents/therapeutic use; Diagnosis, Differential; Humans; Male; Melioidosis/diagnosis*; Melioidosis/drug therapy; Melioidosis/physiopathology; Nepal; Travel*; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use; Burkholderia pseudomallei/isolation & purification
  9. Rahman RN, Leow TC, Basri M, Salleh AB
    Protein Expr Purif, 2005 Apr;40(2):411-6.
    PMID: 15766884
    The extracellular production of T1 lipase was performed by co-expression of pJL3 vector encoding bacteriocin release protein in prokaryotic system. Secretory expression was optimized by considering several parameters, including host strains, inducer (IPTG) concentration, media, induction at A(600 nm), temperature, and time of induction. Among the host strains tested, Origami B excreted out 18,100 U/ml of lipase activity into culture medium when induced with 50 microM IPTG for 12 h. The Origami B harboring recombinant plasmid pGEX/T1S and pJL3 vector was chosen for further study. IPTG at 0.05 mM, YT medium, induction at A(600 nm) of 1.25, 30 degrees C, and 32 h of induction time were best condition for T1 lipase secretion with Origami B as a host.
    MeSH terms: Bacterial Proteins/genetics; Cloning, Molecular/methods*; Escherichia coli/genetics; Genetic Vectors; Isopropyl Thiogalactoside; Lipase/genetics*; Plasmids; Temperature; Time; Escherichia coli Proteins/genetics*
  10. Ariffin H, Lim HL
    Pediatr Blood Cancer, 2005 Aug;45(2):229.
    PMID: 15768379
    MeSH terms: Child; Cost-Benefit Analysis; Humans; Malaysia; Recurrence; Treatment Outcome; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis*
  11. Han NM, May CY, Ngan MA, Hock CC, Ali Hashim M
    J Chromatogr Sci, 2005 3 17;42(10):536-9.
    PMID: 15768840
    Crude palm oil contains 600 to 1000 ppm of tocols in the form of tocopherols and tocotrienols. These palm tocols have been isolated and analyzed in the past by various chromatographic techniques such as open column chromatography, high-performance liquid chromatography, as well as thin-layer chromatography. Supercritical fluid chromatography (SFC) has emerged as a more advanced chromatographic technique in recent years. The tocols present in palm oil are successfully isolated using SFC. Identification of these tocols is supported by various spectroscopic techniques such as 1H NMR, 13C NMR, and mass spectrometry.
    MeSH terms: Plant Oils/chemistry*; Reference Standards; Sterols/isolation & purification*; Tocopherols/isolation & purification*; Chromatography, Supercritical Fluid/methods*
  12. Qi L, Tai ES, Tan CE, Shen H, Chew SK, Greenberg AS, et al.
    J Mol Med (Berl), 2005 Jun;83(6):448-56.
    PMID: 15770500
    Perilipin is a lipid droplet surface protein present in adipocytes and steroidogenic cells. We examined five common single nucleotide polymorphisms (SNPs) at the perilipin (PLIN) locus (PLIN 6209C>T, 10171A>T, 11482G>A, 13041A>G, and 14995A>T) to investigate their association with obesity risk. The study population included 4,131 subjects of three ethnic groups (Chinese, Malay, and Indian) from Singapore. The prevalence of obesity in Malays and Indians was much higher than in Chinese. Moreover, in these groups the prevalence of obesity was three times higher in women than in men. Crude analysis indicated that haplotype 11212 (CAAAT) is shared by Malays and Indians and is significantly associated with increased obesity risk as compared to the most common haplotype 21111 (TAGAA): OR 1.65 (95% CI 1.11-2.46) in Malays and 1.94 (95% CI 1.06-3.53) in Indians. No associations between PLIN haplotypes and obesity risk were found in Chinese. To simplify the haplotype analyses we used a subgroup of three SNPs (11482G>A, 13041A>G, and 14995A>T) in positive linkage disequilibrium. These analyses revealed similar associations, showing that haplotypes XX212 (XXAAT) and XX222 (XXAGT) are associated with increased obesity risk in Malays OR 2.04 (95% CI 1.28-3.25) and 2.05 (95% CI 1.35-3.12) respectively, and that haplotype XXX212 (XXAAT) is significantly associated with increased obesity risk in Indians OR 2.16 (95% CI 1.10-4.26) after adjusting for covariates including age, sex, smoking, alcohol consumption, exercise, and diabetes status. Moreover, individual SNP analyses demonstrated that the PLIN 14995A>T SNP is the most informative single genetic marker for the observed haplotype association, being significantly associated with increased obesity risk in both Malays OR 2.28 (95% CI 1.45-3.57) and Indians OR 2.04 (95% CI 1.08-3.64). These results support the role of the PLIN locus as an ethnically dependent modulator of obesity risk in humans.
    MeSH terms: Adolescent; Adult; Carrier Proteins; China/ethnology; Female; Haplotypes*; Humans; India/ethnology; Genetic Linkage; Malaysia/ethnology; Male; Middle Aged; Obesity/genetics*; Obesity/epidemiology; Phosphoproteins/genetics*; Risk Factors; Singapore/epidemiology; Genetic Variation; Linkage Disequilibrium/genetics*; Odds Ratio; Polymorphism, Single Nucleotide; Perilipin-1
  13. Taher M, Idris MS, Ahmad F, Arbain D
    Phytochemistry, 2005 Mar;66(6):723-6.
    PMID: 15771897
    A polyisoprenylated ketone named enervosanone has been isolated from the stem bark of Calophyllum enervosum together with three known compounds, cambogin, osajaxanthone and epicatechin. Their structures were determined by spectroscopic analysis. The antimicrobial evaluations of the isolated compounds were also reported.
    MeSH terms: Anti-Bacterial Agents/isolation & purification; Bacteria/drug effects; Catechin/isolation & purification; Catechin/pharmacology; Isoflavones/isolation & purification*; Isoflavones/pharmacology; Microbial Sensitivity Tests; Terpenes/isolation & purification*; Terpenes/pharmacology; Molecular Structure; Calophyllum/chemistry*; Xanthones/isolation & purification*; Xanthones/pharmacology
  14. Ranganathan S, Moosa F, Kamarulzaman A, Looi LM
    Br J Radiol, 2005 Apr;78(928):353-4.
    PMID: 15774599
    Cryptococcus neoformans is a yeast like fungus, which is commonly found in bird droppings, especially pigeons. Most cases of cryptococcal infections occur in immunocompromised patients or in those who are on long term immunosuppressant therapies. Cryptococcal infection usually presents as a meningoencephalitis or a pulmonary infection. Skin, bone and genital infections are very rare. We report the second case of vaginal cryptococcossis to be reported in English literature and the first to be imaged with CT and MRI.
    MeSH terms: Adult; Antifungal Agents/administration & dosage; Cryptococcosis/diagnosis*; Female; Humans; Magnetic Resonance Imaging/methods; Tomography, X-Ray Computed/methods; Vaginitis/diagnosis*; Vaginitis/drug therapy; Fluconazole/administration & dosage
  15. Tan S, Rey J
    Australas Psychiatry, 2005 Mar;13(1):76-9.
    PMID: 15777418
    To examine the relationship between depression in children and adolescents, parental depression and parenting stress.
    MeSH terms: Adolescent; Child; Depressive Disorder, Major/diagnosis; Depressive Disorder, Major/psychology*; Female; Humans; Interview, Psychological; Male; Parents/psychology*; Surveys and Questionnaires; Stress, Psychological/diagnosis; Stress, Psychological/psychology*
  16. Hor YL, Kim YJ, Ugap A, Chabrillange N, Sinniah UR, Engelmann F, et al.
    Ann Bot, 2005 Jun;95(7):1153-61.
    PMID: 15781438
    The purpose of this study was to investigate the basis of the optimal hydration status for cryopreservation of intermediate oily seeds using Citrus as a model.
    MeSH terms: Citrus/physiology*; Desiccation; Lipids/physiology*; Plant Oils/metabolism; Seeds/physiology*; Water/physiology*; Cryopreservation/methods*; Germination
  17. Ahmad N, Choy CY, Aris EA, Balan S
    Anesth Analg, 2005 Apr;100(4):987-990.
    PMID: 15781511 DOI: 10.1213/01.ANE.0000147790.76114.3A
    We compared the efficacy of IV fentanyl with IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blind study we recruited 90 patients aged between 18 and 65 yr, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 3 groups: group F received 2 mL IV fentanyl 50 microg/mL (100 microg), group L received 2 mL of preservative-free lidocaine 2% (40 mg), and group P (placebo) received 2 mL of normal saline. The incidence of withdrawal response after rocuronium was 57%, 30%, and 7% in the placebo, lidocaine, and fentanyl groups, respectively. We found a significant reduction in incidence of withdrawal response in both the fentanyl and lidocaine groups when compared with the placebo group (P < 0.05), with the fentanyl group being most effective (P < 0.05). In conclusion, both fentanyl and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with fentanyl being more effective.
    MeSH terms: Adolescent; Adult; Androstanols/administration & dosage; Androstanols/adverse effects*; Anesthesia, General; Anesthetics, Local/administration & dosage; Anesthetics, Local/therapeutic use*; Neuromuscular Nondepolarizing Agents/administration & dosage; Neuromuscular Nondepolarizing Agents/adverse effects*; Double-Blind Method; Female; Fentanyl/administration & dosage; Fentanyl/therapeutic use*; Humans; Lidocaine/administration & dosage; Lidocaine/therapeutic use*; Male; Middle Aged; Prospective Studies; Substance Withdrawal Syndrome/prevention & control*; Anesthetics, Intravenous/administration & dosage; Anesthetics, Intravenous/therapeutic use*
  18. Johar A, Lim DL, Arif SA, Hawarden D, Toit GD, Weinberg EG, et al.
    Pediatr Allergy Immunol, 2005 Mar;16(2):165-70.
    PMID: 15787875
    Spina bifida children have a high prevalence of latex allergy in studies reported from Europe and the USA. This study investigated the prevalence of latex allergy in a cohort of 24 spina bifida children at the Red Cross Children's Hospital from Cape Town, South Africa. The children were investigated using a detailed questionnaire, skin prick tests (ALK-Abello), ImmunoCap RASTs, Western blotting and ELISA, using the purified latex proteins Hev b1 and Hev b3 and whole latex preparation. A low overall prevalence of latex sensitization of 16.7% was found in the children. Children who were sensitive reacted to water insoluble to Hev b1 and Hev b3 proteins. The low prevalence of latex sensitization in the South African children may not be entirely explained by stringent latex avoidance. The children were from a low socioeconomic social status and 'hygiene' and other factors should be considered.
    MeSH terms: Adolescent; Allergens/immunology; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Female; Humans; Infant; Male; Plant Proteins/immunology; Surveys and Questionnaires; Radioallergosorbent Test; Skin Tests; South Africa; Blotting, Western; Prevalence; Spinal Dysraphism/immunology*; Latex Hypersensitivity/epidemiology*; Antigens, Plant
  19. Lew YS, Thambi Dorai CR, Phyu PT
    Paediatr Anaesth, 2005 Apr;15(4):346-9.
    PMID: 15787930
    A 4-month-old healthy male infant underwent left herniotomy under general anesthesia with caudal block. Carbon dioxide (CO2) pneumoperitoneum was created through the left hernial sac for inspection of the right processus vaginalis. Episodes of desaturation associated with significant reduction in chest compliance were noted intraoperatively. This was overcome by increasing the inspired oxygen concentration (FiO2). The infant failed to regain consciousness and spontaneous respiration at the end of surgery. The chest compliance deteriorated further and clinically a CO2 pneumothorax (capnothorax) was suspected. The endtidal carbon dioxide (P(E)CO2) was initially low in the immediate postoperative period. Subsequent to the readministration of sevoflurane and manual ventilation with a Jackson Rees circuit, a sudden surge in P(E)CO2 with improvement of chest compliance was observed. At that time arterial blood gas (ABG) analysis revealed a PCO2 of 17.5 kPa (134 mmHg) and pH of 6.9. The causes of severe hypercarbia and the physiological changes observed in this infant are discussed.
    MeSH terms: Acidosis/etiology; Anesthesia; Carbon Dioxide/adverse effects; Hernia, Inguinal/surgery; Humans; Hypercapnia/etiology*; Hypercapnia/therapy; Infant; Intraoperative Complications/etiology*; Intraoperative Complications/therapy; Male; Laparoscopy; Pneumoperitoneum, Artificial/adverse effects*; Digestive System Surgical Procedures
  20. Foong AL, Ng SF, Lee CK
    J Adv Nurs, 2005 Apr;50(2):134-42.
    PMID: 15788077 DOI: 10.1111/j.1365-2648.2005.03372.x
    AIM: This paper reports a study aimed at identifying the primary health care experiences of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Malaysia. The rationale behind the study was to enable informed action for developing more responsive and effective primary care.
    BACKGROUND: Reports such as from the World Health Organisation forecast sharp escalations in the incidence of HIV/AIDS in Malaysia and the Asia-Pacific region within the next few years. With sparse information on the course of infection on the local population and an understanding of health care needs of those afflicted, health services would be ill-prepared for projected increases.
    METHOD: Semi-structured interviews were conducted with a convenience sample of 99 patients attending two major HIV/AIDS clinics in Malaysia.
    FINDINGS: Several gaps in care provision were highlighted, such as with treatment/consultation facilities and availability and accessibility of information. What is also evident is that there are a number of good support services available but not well publicized to those in need of them. That includes health professionals who could be making appropriate referrals. The lack of communications and inter-professional working appears to be part of the problem.
    CONCLUSION: The findings provide baseline data and preliminary insights to government and other service providers towards advancing, optimizing and refining existing policies and infrastructure. Although the availability of a number of primary care facilities have been identified, the study indicates the need for more effective co-ordinated efforts with clear leadership to pull together scarce resources towards the aim of some degree of seamless primary care provision. It is suggested that nurses would be well placed for such a role in view of the nature of their education and training that helps prepare them for the multi-faceted role.

    Study site: One is located
    in the main general hospital in the capital city of Kuala
    Lumpur, and the other in an outpatient clinic on the outskirts
    of the city
    MeSH terms: Adult; Cross-Sectional Studies; Developing Countries; Female; Health Services Accessibility; Health Services Needs and Demand*; Hospitals; Humans; International Agencies; Interviews as Topic; Health Knowledge, Attitudes, Practice; Malaysia/epidemiology; Male; Middle Aged; Outpatient Clinics, Hospital; Patient Education as Topic; Primary Health Care/organization & administration*; HIV Infections/ethnology; HIV Infections/psychology; HIV Infections/therapy*; Drug Costs; Marital Status; Age Distribution; Sex Distribution; Anti-HIV Agents/economics
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