Browse publications by year: 2005

  1. An efficient method for the computation of Legendre moments
    Yap PT, Paramesran R
    IEEE Trans Pattern Anal Mach Intell, 2005 Dec;27(12):1996-2002.
    PMID: 16355666
    Legendre moments are continuous moments, hence, when applied to discrete-space images, numerical approximation is involved and error occurs. This paper proposes a method to compute the exact values of the moments by mathematically integrating the Legendre polynomials over the corresponding intervals of the image pixels. Experimental results show that the values obtained match those calculated theoretically, and the image reconstructed from these moments have lower error than that of the conventional methods for the same order. Although the same set of exact Legendre moments can be obtained indirectly from the set of geometric moments, the computation time taken is much longer than the proposed method.
    MeSH terms: Algorithms*; Artificial Intelligence*; Image Enhancement/methods*; Image Interpretation, Computer-Assisted/methods*; Numerical Analysis, Computer-Assisted*; Pattern Recognition, Automated/methods*; Signal Processing, Computer-Assisted; Imaging, Three-Dimensional/methods
  2. Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography
    Piovella F, Wang CJ, Lu H, Lee K, Lee LH, Lee WC, et al.
    J Thromb Haemost, 2005 Dec;3(12):2664-70.
    PMID: 16359505
    BACKGROUND: The incidence of postsurgical venous thromboembolism is thought to be low in Asian ethnic populations.

    OBJECTIVE: We studied the incidence of deep-vein thrombosis (DVT) in Asian patients undergoing major orthopedic surgery of the lower limbs.

    PATIENTS/METHODS: We performed a prospective epidemiological study in 19 centers across Asia (China, Indonesia, South Korea, Malaysia, Philippines, Taiwan, and Thailand) in patients undergoing elective total hip replacement (THR), total knee replacement (TKR) or hip fracture surgery (HFS) without pharmacological thromboprophylaxis. The primary endpoint was the rate of DVT of the lower limbs documented objectively with bilateral ascending venography performed 6-10 days after surgery using a standardized technique and evaluated by a central adjudication committee unaware of local interpretation.

    RESULTS: Overall, of 837 Asian patients screened for this survey, 407 (48.6%, aged 20-99 years) undergoing THR (n = 175), TKR (n = 136) or HFS (n = 96) were recruited in 19 centers. DVT was diagnosed in 121 of 295 evaluable patients [41.0%, (95% confidence interval (CI): 35.4-46.7)]. Proximal DVT was found in 30 patients [10.2% (7.0-14.2)]. Total DVT and proximal DVT rates were highest in TKR patients (58.1% and 17.1%, respectively), followed by HFS patients (42.0% and 7.2%, respectively), then THR patients (25.6% and 5.8%, respectively). DVT was more frequent in female patients aged at least 65 years. Pulmonary embolism was clinically suspected in 10 of 407 patients (2.5%) and objectively confirmed in two (0.5%).

    CONCLUSIONS: The rate of venographic thrombosis in the absence of thromboprophylaxis after major joint surgery in Asian patients is similar to that previously reported in patients in Western countries.

    MeSH terms: Adult; Aged; Aged, 80 and over; Asia/epidemiology; Female; Humans; Male; Mass Screening/methods; Middle Aged; Phlebography; Postoperative Complications/diagnosis*; Epidemiologic Factors; Incidence; Orthopedic Procedures/adverse effects*; Venous Thrombosis/etiology; Venous Thrombosis/epidemiology*; Lower Extremity/blood supply; Lower Extremity/physiopathology
  3. [Nipah virus infections]
    Kitsutani P, Ohta M
    Nippon Rinsho, 2005 Dec;63(12):2143-53.
    PMID: 16363687
    Nipah virus (NiV) is a zoonotic paramyxovirus that was first recognized in 1999 as the causative agent of outbreaks of human encephalitis in Malaysia and Singapore, in association with severe respiratory and neurological disease in pigs. Since then, outbreaks of NiV encephalitis have also occurred in Bangladesh during 2001-2004, but without an association to infected swine or other animals. Although NiV infections typically result in acute encephalitis with high mortality, other clinical manifestations, including asymptomatic infection, relapsed encephalitis, and pulmonary disease, have been observed. The article will summarize the virology, epidemiology, clinical features, treatment, and control and prevention of NiV infections in humans.
    MeSH terms: Animals; Humans; Swine; Zoonoses; Nipah Virus*
  4. Midterm results of cemented Press Fit Condylar Sigma total knee arthroplasty system
    Asif S, Choon DS
    J Orthop Surg (Hong Kong), 2005 Dec;13(3):280-4.
    PMID: 16365492
    To evaluate the midterm results of 50 patients who underwent total knee replacement using Press Fit Condylar (PFC) Sigma system.
    MeSH terms: Adult; Aged; Aged, 80 and over; Female; Humans; Knee Prosthesis*; Male; Middle Aged; Prosthesis Design; Retrospective Studies; Treatment Outcome; Arthroplasty, Replacement, Knee/instrumentation*
  5. 13C NMR relaxation study of molecular motions in tetraphenyltin and tetra(p-tolyl)tin in solution
    Ng S, Sathasivam RV, Lo KM, Xie Y, Schaefer HF
    J Phys Chem A, 2005 Dec 29;109(51):12059-63.
    PMID: 16366662
    The Woessner approach is applied to the 13C relaxation data for tetraphenyltin (1) and tetra(p-tolyl)tin (2) in CDCl3 solution over the temperature range 5-42 degrees C to obtain correlation times for rotational motions and hence the activation barriers. Quantum mechanical computations were carried out to obtain the rotational energy barriers for comparison. For 2 the relaxation data indicate (1) slower ring rotation than in 1, (2) highly hindered internal rotation of the methyl group. IR and chemical shift data support the hypothesis of hyperconjugation of the methyl correlated with interaction between the pi-electrons and the 5d orbitals of tin in the (p-tolyl)Sn moiety to account for the hindrances to the rotations of the ring and the methyl. The activation barrier for the tolyl group rotation is found to be much higher than that for the phenyl rotation. However, the Woessner approach yields an anomalously high barrier for the methyl rotation. An explanation based on correlated rotations of the tolyl ring and the methyl is offered.
  6. Brain white and gray matter anatomy of MRI segmentation based on tissue evaluation
    Salih QA, Ramli AR, Mahmud R, Wirza R
    MedGenMed, 2005;7(2):1.
    PMID: 16369380
    Different approaches to gray and white matter measurements in magnetic resonance imaging (MRI) have been studied. For clinical use, the estimated values must be reliable and accurate when, unfortunately, many techniques fail on these criteria in an unrestricted clinical environment. A recent method for tissue clusterization in MRI analysis has the advantage of great simplicity, and it takes the account of partial volume effects. In this study, we will evaluate the intensity of MR sequences known as T1-weighted images in an axial sliced section. Intensity group clustering algorithms are proposed to achieve further diagnosis for brain MRI, which has been hardly studied. Subjective study has been suggested to evaluate the clustering group intensity in order to obtain the best diagnosis as well as better detection for the suspected cases. This technique makes use of image tissue biases of intensity value pixels to provide 2 regions of interest as techniques. Moreover, the original mathematic solution could still be used with a specific set of modern sequences. There are many advantages to generalize the solution, which give far more scope for application and greater accuracy.
    MeSH terms: Algorithms; Artificial Intelligence; Brain/anatomy & histology*; Brain/cytology; Brain Mapping/methods*; Humans; Image Enhancement/methods*; Image Interpretation, Computer-Assisted/methods*; Magnetic Resonance Imaging/methods*; Nerve Fibers, Myelinated/pathology*; Neurons/cytology; Pattern Recognition, Automated/methods*; Sensitivity and Specificity; Reproducibility of Results; Cluster Analysis; Antiporters; Imaging, Three-Dimensional/methods; Saccharomyces cerevisiae Proteins
  7. Fulltext Choice of antihypertensive drug in the diabetic patient
    Ong HT, Cheah JS
    MedGenMed, 2005;7(2):74.
    PMID: 16369452
    The hypertensive patient with type 2 diabetes is especially at risk of adverse cardiovascular events. The United Kingdom Prospective Diabetes Study (UKPDS) and Hypertension Optimal Treatment (HOT) studies suggested that treatment to a lower target blood pressure resulted in better prevention of clinical disease in these patients. Most trials comparing antihypertensive drugs have shown only minimal differences between the various agents. The evidence from the trials suggests that diuretics, beta-blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors, and the angiotensin-receptor antagonists (ARBs) will all successfully reduce adverse clinical events. The largest of the comparative hypertensive drug trials, the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), demonstrated that a diuretic has a better hypotensive effect, and was more successful in preventing many aspects of cardiovascular disease compared with CCBs and ACE inhibitors. The importance of good blood pressure control and the general equivalence of antihypertensive drugs were again shown in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, which compared an ARB with a CCB. Choice of antihypertensive agent should be individualized and guided by the presence of concomitant clinical disease and the need to protect any specific target organ system in the diabetic hypertensive. Diuretics, being potent hypotensive drugs with clearly demonstrated clinical benefit, should form part of the antihypertensive regimen of most diabetic hypertensives. ACE inhibitors and ARBs are especially useful in preventing nephropathy. Most patients will require a combination of antihypertensive drugs to achieve tight blood pressure control of under 130/80 mm Hg in the diabetic hypertensive. The clinician should concentrate on seeking this lower target blood pressure rather than be excessively concerned about which is the best antihypertensive agent.
    MeSH terms: Antihypertensive Agents/administration & dosage*; Antihypertensive Agents/classification; Cardiovascular Diseases/etiology*; Cardiovascular Diseases/prevention & control*; Clinical Trials as Topic; Diabetes Mellitus, Type 2/complications*; Diabetes Mellitus, Type 2/drug therapy*; Humans; Hypertension/complications*; Hypertension/drug therapy*; Practice Patterns, Physicians'; Treatment Outcome; Practice Guidelines as Topic
  8. Antiviral properties of ent-labdene diterpenes of Andrographis paniculata nees, inhibitors of herpes simplex virus type 1
    Wiart C, Kumar K, Yusof MY, Hamimah H, Fauzi ZM, Sulaiman M
    Phytother Res, 2005 Dec;19(12):1069-70.
    PMID: 16372376
    Andrographolide, neoandrographolide and 14-deoxy-11,12-didehydroandrographolide, ent-labdene diterpenes isolated from Andrographis paniculata showed viricidal activity against herpes simplex virus 1 (HSV-1). None of these compounds exhibited significant cytotoxicity at viricidal concentrations.
    MeSH terms: Animals; Antiviral Agents/pharmacology*; Cercopithecus aethiops; Diterpenes/pharmacology; Glucosides/pharmacology; Plant Extracts/pharmacology*; Tetrahydronaphthalenes/pharmacology; Vero Cells; Herpesvirus 1, Human/drug effects*; Plant Leaves; Andrographis*
  9. Hendra and Nipah viruses: pathogenesis and therapeutics
    Eaton BT, Broder CC, Wang LF
    Curr Mol Med, 2005 Dec;5(8):805-16.
    PMID: 16375714
    Within the past decade a number of new zoonotic paramyxoviruses emerged from flying foxes to cause serious disease outbreaks in man and livestock. Hendra virus was the cause of fatal infections of horses and man in Australia in 1994, 1999 and 2004. Nipah virus caused encephalitis in humans both in Malaysia in 1998/99, following silent spread of the virus in the pig population, and in Bangladesh from 2001 to 2004 probably as a result of direct bat to human transmission and spread within the human population. Hendra and Nipah viruses are highly pathogenic in humans with case fatality rates of 40% to 70%. Their genetic constitution, virulence and wide host range make them unique paramyxoviruses and they have been given Biosecurity Level 4 status in a new genus Henipavirus within the family Paramyxoviridae. Recent studies on the virulence, host range and cell tropisms of henipaviruses provide insights into the unique biological properties of these emerging human pathogens and suggest approaches for vaccine development and therapeutic countermeasures.
    MeSH terms: Animals; Antiviral Agents/therapeutic use; Disease Models, Animal; Humans; Viral Vaccines; Virulence; Drug Design; Hendra Virus/classification; Hendra Virus/pathogenicity*; Nipah Virus/classification; Nipah Virus/pathogenicity*; Henipavirus Infections/epidemiology; Henipavirus Infections/therapy*; Henipavirus Infections/virology*
  10. Neutralization of Burkholderia pseudomallei protease by Fabs generated through phage display
    Nathan S, Rader C, Barbas CF
    Biosci Biotechnol Biochem, 2005 Dec;69(12):2302-11.
    PMID: 16377887
    The isolation of therapeutic and functional protease inhibitors in vitro via combinatorial chemistry and phage display technology has been described previously. Here we report the construction of a combinatorial mouse-human chimeric antibody fragment (Fab) antibody library targeted against the protease of the tropical pathogen, Burkholderia pseudomallei. The resulting library was biopanned against the protease, and selected clones were analyzed for their ability to function as protease inhibitors. Three families of Fabs were identified by restriction fingerprinting, all of which demonstrated high specificity towards the protease of B. pseudomallei. Purified Fabs also demonstrated the capacity to inhibit B. pseudomallei protease activity in vitro, and this inhibitory property was exclusive to the pathogenic protease. Thus these recombinant antibodies are candidates for immunotherapy and tools to aid in further elucidation of the mechanism of action of the B. pseudomallei protease.
    MeSH terms: Amino Acid Sequence; Animals; Enzyme-Linked Immunosorbent Assay; Humans; Immunoglobulin Fab Fragments/pharmacology*; Immunoglobulin Fab Fragments/chemistry; Molecular Sequence Data; Peptide Hydrolases/immunology; Peptide Hydrolases/chemistry*; Protease Inhibitors*; RNA/analysis; RNA/biosynthesis; Stem Cells; DNA Fingerprinting; Burkholderia pseudomallei/enzymology*; Peptide Library*; Mice
  11. Dichlorinated pulvinic acid derivative from a Malaysian Scleroderma sp
    van der Sar SA, Blunt JW, Cole AL, Din LB, Munro MH
    J Nat Prod, 2005 Dec;68(12):1799-801.
    PMID: 16378381
    A new dichlorinated pulvinic acid derivative, methyl-3',5'-dichloro-4,4'-di-O-methylatromentate, was isolated from the fruiting body of a Scleroderma sp. The structure was determined using spectroscopic methods, and an X-ray analysis was carried out for confirmation of the structure. Compound was found to display moderate antimicrobial activity against Bacillus subtilis.
    MeSH terms: Anti-Bacterial Agents/isolation & purification*; Anti-Bacterial Agents/pharmacology; Anti-Bacterial Agents/chemistry; Bacillus subtilis/drug effects*; Carboxylic Acids/isolation & purification*; Carboxylic Acids/pharmacology; Carboxylic Acids/chemistry; Lactones/isolation & purification*; Lactones/pharmacology; Lactones/chemistry; Malaysia; Microbial Sensitivity Tests; Molecular Conformation; Molecular Structure; Crystallography, X-Ray; Nuclear Magnetic Resonance, Biomolecular; Fruiting Bodies, Fungal/chemistry*
  12. Solid waste collection and recycling in Nibong Tebal, Penang, Malaysia: a case study
    Isa MH, Asaari FA, Ramli NA, Ahmad S, Siew TS
    Waste Manag Res, 2005 Dec;23(6):565-70.
    PMID: 16379126
    The implementation of a suitable solid waste management programme with appropriate methods of recycling as an inherent element is vital to the alleviation of the problems associated with solid waste generation, handling and disposal, environmental conservation, public hygiene, etc. The present work is a case study on solid waste collection and recycling practices in Nibong Tebal town, Penang, Malaysia. The amount and types of domestic waste generated, household participation in recycling, identification of existing problems related to the implementation of the recycling programme, etc. formed the basis of this study. Surveys (interviews/questionnaires) and on-site observations were conducted to gather information on the solid waste collection and recycling practice of the residents. A focus group of 60 individuals was selected and their response to a questionnaire, prepared according to a Likert scale, was obtained and analysed. The majority of the respondents expressed concerns about recycling and wanted more to be done in this regard. Illegal collection, aesthetically displeasing sites and a lack of public awareness were problems of major concern. Issues related to inadequate funding and manpower as well as end market are also addressed and suggestions made.
    MeSH terms: Cities; Conservation of Natural Resources*; Data Collection; Household Products; Humans; Interviews as Topic; Malaysia; Surveys and Questionnaires; Refuse Disposal*; Waste Disposal, Fluid/methods*; Waste Management/methods*
  13. Fulltext Rubella immunization in Malaysia--20 years on, and the challenges ahead
    Narimah A
    Med J Malaysia, 2005 Aug;60(3):267-8.
    PMID: 16379177
    MeSH terms: Humans; Malaysia; Rubella/prevention & control*; Rubella Vaccine*; Immunization Programs/trends*
  14. Fulltext Congenital deafness: high prevalence of a V37I mutation in the GJB2 gene among deaf school children in Alor Setar
    Ruszymah BHI, Wahida IF, Zakinah Y, Zahari Z, Norazlinda MD, Saim L, et al.
    Med J Malaysia, 2005 Aug;60(3):269-74.
    PMID: 16379178
    Twenty percent of all childhood deafness is due to mutations in the GJB2 gene (Connexin 26). The aim of our study was to determine the prevalence and spectrum of GJB2 mutations in childhood deafness in Malaysia. We analyzed the GJB2 gene in 51 deaf students from Sekolah Pendidikan Khas Alor Setar, Kedah. Bidirectional sequencing indicates that 25% of our childhood deafness has mutation in their GJB2 gene. Sixty two percent of these children demonstrate V37I missense mutation. Interestingly, V37I mutation in the GJB2 gene have been reported as polymorphism in Western countries, however in our country it behaved as a potentially disease-causing missense mutation, causing childhood deafness as it was not found in the normal control.
    MeSH terms: Adolescent; Child; Deafness/congenital; Deafness/genetics*; Deafness/epidemiology*; Female; Humans; Malaysia/epidemiology; Male; Prevalence; Connexins/genetics*; Mutation, Missense*
  15. Fulltext Review of risk factors associated with the anastomosis leakage in anterior resection in Hospital Universiti Kebangsaan Malaysia
    Teoh CM, Gunasegaram T, Chan KY, Sukumar N, Sagap I
    Med J Malaysia, 2005 Aug;60(3):275-80.
    PMID: 16379179 MyJurnal
    This is a retrospective study evaluating the risk factors for clinical anastomotic leakage after anterior resection in 64 patients with rectal cancer operated from November 2001 till August 2003. The percentage of anastomosis leakage was higher in those patients with diabetic, low albumin level, neoadjuvant radiotherapy, higher staging, and poorly differentiated tumour. However, these differences were statistically not significant. There was a significant difference (p=0.03) of anastomosis leakage in those patients with very distal tumour of < 4cm from anal verge (42%), when compare to those patients with proximal tumor of > 15cm from anal verge (4.3%). The mortality associated with this complication was 30%. Hence, a surgeon may consider a covering stoma or be more vigilant in operating patients with multiple risk factors.
    MeSH terms: Adenocarcinoma/epidemiology*; Adenocarcinoma/surgery*; Anastomosis, Surgical/adverse effects*; Anastomosis, Surgical/statistics & numerical data; Humans; Malaysia/epidemiology; Middle Aged; Postoperative Complications/epidemiology; Retrospective Studies; Risk Factors; Colorectal Neoplasms/epidemiology*; Colorectal Neoplasms/surgery*
  16. Fulltext Challenges in the treatment of sinonasal undifferentiated carcinoma: a ray of hope
    Norleza AN, Gendeh BS
    Med J Malaysia, 2005 Aug;60(3):281-5.
    PMID: 16379180 MyJurnal
    We studied nine cases of SNUCs presented to the Department of Otorhinolaryngology, Hospital University Kebangsaan Malaysia from 1999 to 2003. There were 8 males and 1 female with ages ranging from 24 to 78 years (mean 46.5y). The racial distribution consisted of 5 Chinese (55.5%), 3 Malays (33.3%) and 1 Indian (11.1%). Three patients were Kadish B (33.3%) and six were Kadish C (66.6%) by classification. In our series 2 years survival was 26.3% and median survival time was 14.2 months.
    MeSH terms: Adult; Aged; Carcinoma/mortality; Carcinoma/secretion; Carcinoma/surgery*; Female; Humans; Male; Middle Aged; Nose Neoplasms/mortality; Nose Neoplasms/pathology; Nose Neoplasms/surgery*; Paranasal Sinus Neoplasms/mortality; Paranasal Sinus Neoplasms/pathology; Paranasal Sinus Neoplasms/surgery*; Survival Rate
  17. Fulltext Attitude towards rape: a comparative study among prospective physicians of Malaysia
    Sivagnanam G, Bairy KL, D'Souza U
    Med J Malaysia, 2005 Aug;60(3):286-93.
    PMID: 16379181 MyJurnal
    The global statistics reveal that at least one in every five women experiences rape or attempted rape during her lifetime. Rape myths encompass a set of (false) beliefs. Adolescents have high rates of rape victimization than other age groups. Rape myths among health care providers may have a negative influence on proper care of the victims. A total of 422 medical undergraduates of both sexes, studying at two Malaysian Institutes took part in the study. A validated questionnaire used in an earlier study was used for the present study, with a slight modification of scoring system. The age range of medical students was 17 to 34 years: mean +/- SD of men and women, were 20.6 +/- 2.1 and 20.3 +/- 2 respectively. Only about 19% of women and 11% of men had a very good positive attitude. Nearly 1/3 of women and 1/2 of men had a more negative attitude. On the whole the average total score of women was significantly higher (p=0.0004) than men. Nearly 50% of candidates with a village background carried more negative attitude. Violence against women is a significant public health problem. The major revelation of the present study is that only less than 20% of the medical undergraduates had a more positive attitude towards rape. Introduction of courses on 'sexual violence' in medical curriculum is likely to increase a) awareness, b) skills in management, c) in providing support and care for the victims and d) in implementing preventive actions.
    MeSH terms: Adolescent; Adult; Attitude of Health Personnel*; Female; Folklore; Humans; Malaysia; Male; Surveys and Questionnaires; Rape/psychology*; Students, Medical/psychology*
  18. Fulltext Prevalence of nocturnal polyuria in patients with benign prostatic hyperplasia
    Yoong HF, Sundaram MB, Aida Z
    Med J Malaysia, 2005 Aug;60(3):294-6.
    PMID: 16379182
    Nocturia is a common symptom associated with benign prostatic hyperplasia which can persist even after effective treatment of BPH. Other causes may be responsible. We investigated a group of patients who were treated for BPH and continue to have nocturia. Our study has found a high prevalence (85.4%) of nocturnal polyuria in this group of patients. It has important clinical implication since the condition can be effectively treated with oral desmopressin. Empirical treatment without a routine frequency volume chart may be appropriate due to its high prevalence.
    MeSH terms: Aged; Enuresis/epidemiology*; Humans; Male; Middle Aged; Polyuria/epidemiology*; Prostatic Hyperplasia/epidemiology*; Prevalence
  19. Fulltext Deaths in children during an outbreak of hand, foot and mouth disease in Peninsular Malaysia--clinical and pathological characteristics
    Shekhar K, Lye MS, Norlijah O, Ong F, Looi LM, Khuzaiah R, et al.
    Med J Malaysia, 2005 Aug;60(3):297-304.
    PMID: 16379183
    From July through December 1997, 11 previously healthy children in Peninsular Malaysia succumbed to an illness clinically characterised by an acute severe refractory left-ventricular failure, following a brief prodromal illness, in the midst of an outbreak of hand, foot and mouth disease (HFMD), similar to the reported experience in Sarawak and Taiwan. Retrospective reviews of the clinical features and results of laboratory, pathological and virological investigations of cases were conducted. The median age of the 11 case-patients was 31 months (range, 13 to 49 months); 6 were males. A brief prodromal illness of 3 days (range, 2 to 5 days) was characterised by fever (axillary temperature > 38 degrees C) (100%), oral ulcers (72%), extremity rashes (45%) and significant vomiting (55%). Upon hospitalisation, 7 of 11 case-patients had features suggestive of cardiogenic shock, while 4 of 11 case-patients developed shock during hospitalisation as evidenced by marked sustained tachycardia (heart rate > or = 180 beats per minute), poor peripheral pulses and peripheral perfusion, mottled extremities, pulmonary oedema (haemorrhagic pulmonary secretions in 8 of 11 cases during tracheal intubation, often precipitated by conservative crystalloid boluses, and radiographic evidence of acute pulmonary oedema in 5 of 7 cases) and markedly impaired left ventricular function on echocardiographic examination (7 of 7 cases). Three of 4 case-patients had aseptic meningitis while one case-patient also had an acute flaccid paraparesis. Despite supportive therapy, death occurred within a median of 13.4 hours following hospitalization. Post-mortem findings (all 8 specimens examined) consistently demonstrated brain-stem encephalitis with foci of neuronal necrosis and micro-abscesses. None of the 11 specimens examined revealed histological evidence of myocarditis. Enterovirus 71 (EV71) was detected in 10 of 11 case-patients, many (7) from various sterile tissue sites (5 from central nervous tissues). No other viruses were isolated or identified. Clinical features and pathological studies closely paralleled the reported experience in Sarawak and Taiwan. The uniform necropsy findings of necrotizing brain-stem encephalitis coupled with essentially normal myocardial histology, in concert with the concurrent and consistent detection of EV71 points to a primary EV71 encephalitis; as yet unclear neurogenic mechanisms may account for the cardiovascular manifestations.
    MeSH terms: Child, Preschool; Female; Hand, Foot and Mouth Disease/mortality*; Hand, Foot and Mouth Disease/pathology*; Humans; Infant; Malaysia/epidemiology; Male; Meningitis, Aseptic/mortality; Meningitis, Aseptic/pathology; Myocarditis/mortality; Myocarditis/pathology; Paralysis/mortality; Paralysis/pathology; Pulmonary Edema/mortality*; Pulmonary Edema/pathology*
  20. Fulltext Maternal passive smoking and its effect on maternal, neonatal and placental parameters
    Ramesh KN, Vidyadaran MK, Goh YM, Nasaruddin AA, Jammal ABE, Zainab S
    Med J Malaysia, 2005 Aug;60(3):305-10.
    PMID: 16379184
    A study was undertaken to 1) determine the effects of tobacco smoke exposure on maternal and neonatal weight and body mass index (BMI) and placental weight, volume and surface area and 2) establish any correlations between the placental surface area, volume and weight with maternal and neonatal body weight and BMI in mothers exposed to cigarette smoke. A total of 154 full-term placentae, 65 from mothers exposed to tobacco smoke and 89 from non-exposed mothers were collected from Kuala Lumpur Maternity Hospital. The placental surface area was determined using a stereological grid, the volume by Scherle's method and the weight by using an electronic weighing machine. In general there were no differences in maternal, placental and neonatal parameters between the exposed and non-exposed groups. However, there were significant correlations between placental weight with maternal weight and maternal BMI in both exposed (r = 0.315; p = 0.013) and (r = 0.265; p = 0.038), and non-exposed (r = 0.224; p = 0.035) and (r = 0.241; p = 0.023) mothers. It was also found that the maternal weight on admission correlated significantly with placental weight in both Malay (r = 0.405; p = 0.020) and Indian (r = 0.553; p = 0.050) passive smokers. Correcting the placental parameters for the maternal weight had no effect on the results.
    MeSH terms: Birth Weight; Female; Humans; Infant, Newborn; Organ Size; Placenta/pathology*; Pregnancy; Tobacco Smoke Pollution/adverse effects*; Body Mass Index
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