Browse publications by year: 2005

  1. Masliza M, Daud SM, Khalid Y
    Ann Acad Med Singap, 2005 Dec;34(11):684-5.
    PMID: 16453041
    INTRODUCTION: The prevalence and severity of diastolic dysfunction (DD) among newly diagnosed hypertensives (NDHT) is not fully established. The aim of this study was to evaluate left ventricular diastolic function (LVDF) in patients with NDHT.

    MATERIALS AND METHODS: This study involved 396 subjects (198 NDHT, age and gender matched 198 normotensives; age, 30 to 50 years). Parameters of LVDF included Doppler-echocardiographic measurements of peak early (E) and late (A) diastolic velocities, E-wave deceleration time (DT) and isovolumetric relaxation time (IVRT). E/A ratio of <1 was taken as an indicative of DD.

    RESULTS: Patients with NDHT had reduced E/A ratio (1.27 +/- 0.41 vs 1.37 +/- 0.35, P <0.001) and shortened DT (180.0 +/- 40.0 ms vs 190.0 +/- 30.0 ms, P = 0.025). The peak A velocity and IVRT were increased in the NDHT group [(62.73 +/- 13.82 ms vs 58.26 +/- 12.40 ms, P = 0.002) and (90.0 +/- 20.0 ms vs 80.0 +/- 10.0 ms, P <0.001), respectively]. Peak E velocity was similar in both groups. The prevalence of DD was increased in the NDHT group, 18.6% (32) vs 3.4% (6), P <0.001. Of the 32 NDHT subjects who had DD, 84.4% (27) had no left ventricular hypertrophy (LVH) and 15.7% (5) had LVH. Diastolic function was negatively correlated with age, body mass index, systolic blood pressure, diastolic blood pressure and left ventricular mass index.

    CONCLUSION: Impairment in LVDF occurs in NDHT which may precede structural abnormalities. Hypertension, obesity, older age and LVH are associated with worsening of diastolic function.

    MeSH terms: Adult; Diastole; Echocardiography; Female; Humans; Hypertension/complications; Hypertension/physiopathology*; Male; Middle Aged; Echocardiography, Doppler; Hypertrophy, Left Ventricular/etiology; Ventricular Dysfunction, Left/complications
  2. Abdullah J, Zamzuri I, Awang S, Sayuthi S, Ghani A, Tahir A, et al.
    Acta Neurochir. Suppl., 2005;95:311-4.
    PMID: 16463872
    The monitoring of craniospinal compliance is uncommonly used clinically despite it's value. The Spiegelberg compliance monitor calculates intracranial compliance (C = deltaV/deltaP) from a moving average of small ICP perturbations (deltaP) resulting from a sequence of up to 200 pulses of added volume (deltaV = 0.1 ml, total V = 0.2 ml) made into a double lumen intraventricular balloon catheter. The objective of this study was thus to determine the effectiveness of the decompressive craniectomy done on the worst brain site with regard to compliance (Cl), pressure volume index (PVI), jugular oximetry (SjVo2), autoregulation abnormalties, brain tissue oxygen (TiO2) and cerebral blood flow (CBF). This is a prospective cohort study of 17 patients who were enrolled after consent and approval of the ethics committee between the beginning of the year 2001 and end of the year 2002. For pre and post assessment on compliance and PVI, all 12 patients who survived were reported to become normal after decompressive craniectomy. There is no significant association between pre and post craniectomy assessment in jugular oxymetry (p > 0.05), autoregulation (p > 0.05), intracranial brain oxymetry (p = 0.125) and cerebral blood flow (p = 0.375). Compliance and PVI improved dramatically in all alive patients who received decompressive craniectomy. Compliance and PVI monitoring may be crucial in improving the outcome of severe head injured patients after decompressive craniectomy.
    MeSH terms: Adolescent; Adult; Craniotomy/statistics & numerical data*; Craniocerebral Trauma/diagnosis*; Craniocerebral Trauma/epidemiology; Craniocerebral Trauma/surgery*; Humans; Hydrocephalus/diagnosis*; Hydrocephalus/epidemiology; Hydrocephalus/surgery*; Intracranial Pressure; Malaysia/epidemiology; Monitoring, Physiologic/methods*; Monitoring, Physiologic/statistics & numerical data; Pilot Projects; Postoperative Care/methods; Postoperative Care/statistics & numerical data; Preoperative Care/methods; Preoperative Care/statistics & numerical data; Prognosis; Sensitivity and Specificity; Reproducibility of Results; Cohort Studies; Trauma Severity Indices; Comorbidity; Prevalence; Treatment Outcome; Outcome Assessment (Health Care)/methods; Outcome Assessment (Health Care)/statistics & numerical data; Decompression, Surgical/statistics & numerical data*
  3. Abu Bakar UK, Pillai V, Hashim M, Daud HM
    Food Nutr Bull, 2005 Dec;26(4):432-5.
    PMID: 16465992
    Biotechnology-derived food crops are currently being developed in Malaysia mainly for disease resistance and improved post harvest quality. The modern biotechnology approach is adopted because of its potential to overcome constraints faced by conventional breeding techniques. Research on the development of biotechnology-derived papaya, pineapple, chili, passion fruit, and citrus is currently under way. Biotechnology-derived papaya developed for resistance to papaya ringspot virus (PRSV) and improved postharvest qualities is at the field evaluation stage. Pineapple developed for resistance to fruit black heart disorder is also being evaluated for proof-of-concept. Other biotechnology-derived food crops are at early stages of gene cloning and transformation. Activities and products involving biotechnology-derived crops will be fully regulated in the near future under the Malaysian Biosafety Law. At present they are governed only by guidelines formulated by the Genetic Modification Advisory Committee (GMAC), Malaysia. Commercialization of biotechnology-derived crops involves steps that require GMAC approval for all field evaluations and food-safety assessments before the products are placed on the market. Public acceptance of the biotechnology product is another important factor for successful commercialization. Understanding of biotechnology is generally low among Malaysians, which may lead to low acceptance of biotechnology-derived products. Initiatives are being taken by local organizations to improve public awareness and acceptance of biotechnology. Future research on plant biotechnology will focus on the development of nutritionally enhanced biotechnology-derived food crops that can provide more benefits to consumers.
    MeSH terms: Biotechnology; Consumer Product Safety*; Food Technology; Humans; Malaysia; Nutritive Value; Pest Control, Biological; Plant Viruses/pathogenicity; Crops, Agricultural/standards*; Plants, Genetically Modified*
  4. Kumar SK, Zain RB, Ismail SM, Cheong SC
    J Exp Clin Cancer Res, 2005 Dec;24(4):639-46.
    PMID: 16471328
    Human telomerase reverse transcriptase (hTERT), the catalytic subunit of telomerase, is strongly associated with telomerase activity implicated in cellular immortalization and tumorigenesis. In situ detection of hTERT will aid in determining the localization of telomerase positive cells. The aim of this study was to detect hTERT protein expression in multistep oral carcinogenesis using paraffin embedded tissue samples, and to study the relationship of hTERT expression with different histological stages in oral carcinogenesis. Normal (n = 4), hyperplastic (n = 4), dysplastic (n = 4) and neoplastic (n = 10) oral epithelia representing different histological stages in oral carcinogenesis were included in the study. hTERT protein detection was done by immunohistochemistry (IHC) technique. Nuclear staining intensities were noted and the hTERT-labelling index was determined. Dysplastic and neoplastic oral epithelia showed an increased percentage of hTERT positive cells (Grade 4: > 50% positive staining nuclei) with intense staining in the basal, parabasal and superficial layers of the epithelia, unlike normal oral mucosa which showed intense staining only in the basal and parabasal cell layers, which are the normal proliferative progenitor compartments. hTERT protein expression was elevated with the corresponding advancement of the histological stages of oral carcinogenesis, from normal to hyperplasia to dysplasia to carcinoma. There seems to be an upregulation of hTERT protein expression during the progression of oral cancer, therefore, this may indicate the feasibility of IHC detection of hTERT protein in oral carcinogenesis as a potential diagnostic or prognostic marker.
    MeSH terms: Cell Transformation, Neoplastic/metabolism*; Cell Transformation, Neoplastic/pathology; DNA-Binding Proteins/biosynthesis*; Humans; Hyperplasia/metabolism; Hyperplasia/pathology; Immunohistochemistry; Mouth Neoplasms/metabolism*; Mouth Neoplasms/pathology*; Precancerous Conditions/metabolism; Precancerous Conditions/pathology; Biomarkers, Tumor/analysis*; Up-Regulation; Telomerase/biosynthesis*; Cell Line, Tumor
  5. Ujang Z, Soedjono E, Salim MR, Shutes RB
    Water Sci Technol, 2005;52(12):243-50.
    PMID: 16477992
    Municipal leachate was treated in an experimental unit of constructed wetlands of subsurface flow type. The parameters studied were organics (BOD and COD), solids and heavy metals (Zn, Ni, Cu, Cr and Pb). Using two types of emergent plants of Scirpus globulosus and Eriocaulon sexangulare, more than 80% removal was achieved for all the parameters. E. sexangulare removed organics and heavy metals better than Scirpus globulosus. A higher concentration of heavy metals in the influent did not change the removal efficiency.
    MeSH terms: Organic Chemicals/isolation & purification; Organic Chemicals/metabolism; Oxygen/metabolism; Oxygen/chemistry; Refuse Disposal/methods*; Time Factors; Tropical Climate*; Waste Disposal, Fluid/methods*; Water Movements; Water Purification/methods*; Metals, Heavy/isolation & purification; Metals, Heavy/metabolism; Cyperaceae/metabolism
  6. Pulliam JR, Field HE, Olival KJ, Henipavirus Ecology Research Group
    Emerg Infect Dis, 2005 Dec;11(12):1978-9; author reply 1979.
    PMID: 16485499
    MeSH terms: Animals; Malaysia/epidemiology; Swine; Swine Diseases/epidemiology; Swine Diseases/virology*; Nipah Virus/classification*; Nipah Virus/genetics*; Henipavirus Infections/epidemiology; Henipavirus Infections/veterinary*; Henipavirus Infections/virology*
  7. Bell JD, Munro JL, Nash WJ, Rothlisberg PC, Loneragan NR, Ward RD, et al.
    Adv. Mar. Biol., 2005;49:xi-374.
    PMID: 16503428
    MeSH terms: Animals; Environment; Fisheries/methods*; Fisheries/standards*; Marine Biology; Research/trends; Research Design; Seawater
  8. Miyagi I, Toma T, Okazawa T, Mogi M, Hashim R
    J Am Mosq Control Assoc, 2005 Dec;21(4):466-8.
    PMID: 16506575
    During a mosquito survey in Ulu Gombak, Selangor, Peninsular Malaysia, October 2-16, 2003, we observed a peculiar oviposition habit of Armigeres flavus. This strange behavior is described and illustrated with photographs; although it is well known, no detailed description has been made previously.
    MeSH terms: Animals; Behavior, Animal; Female; Larva; Malaysia; Culicidae*; Oviposition*; Ovum
  9. Jayaram M
    Med J Malaysia, 2005 Dec;60(5):531-4.
    PMID: 16515101
    MeSH terms: Humans; Malaysia/epidemiology; Melioidosis/epidemiology*; Disease Notification
  10. Subramanian S, Lekhraj Rampal GR, Wong EFM, Mastura S, Razi A
    Med J Malaysia, 2005 Dec;60(5):535-9.
    PMID: 16515102
    Sinusitis is an important cause of morbidity and one of the major sources of income loss. Anatomical variations of the nose have been reported to predispose to sinusitis. These variations include concha bullosa, nasal septal deviation and oversized bulla. The aim of this study was to determine the proportion and the distribution of concha bullosa in patients with chronic sinusitis and to determine the relationship between concha bullosa and age, sex, ethnicity. A cross-sectional study was conducted at the Department of Ear, Nose and Throat in Kuala Lumpur Hospital (HKL). Data was collected retrospectively using a pretested proforma. All patients who underwent Sino nasal surgery between January 1999 and December 2000 and whose preoperative CT scans were available were included in the study. The CT scans were reviewed. Analysis was carried out using Statistical Package for Social Sciences. Out of 146 patients who underwent sinonasal surgery between January 1999 and December 2000, 101 (69.2% preoperative CT scans of these patients were available and these were reviewed. The proportion of patients with concha bullosa was 49.5%. The results showed that there was significant relationship between presence of concha bullosa and age and sex. The overall mean age of patient with concha bullosa was 35.7 years (95% CI 12.1-39.3) and ranged from 11-years to 56-years. The mean age of respondents with concha bullosa was significantly lower than patients without concha bullosa 41.98 (95% CI 37.6-46.3; t-test = 2.221; df=99; p < 0.05). Concha bullosa was significantly more in females (66.0%) compared to males (chi2 = 4.465, df=1, p < 0.05). There was no significant relationship between presence of concha bullosa and ethnicity.
    MeSH terms: Adolescent; Adult; Age Factors; China/ethnology; Cross-Sectional Studies; Female; Humans; India/ethnology; Malaysia; Male; Middle Aged; Retrospective Studies; Sex Factors; Sinusitis/ethnology*; Sinusitis/etiology*; Turbinates/abnormalities*; Asian Continental Ancestry Group*
  11. Zainal SB, Quek KF, Biswajit C
    Med J Malaysia, 2005 Dec;60(5):540-7.
    PMID: 16515103
    To determine the relationship between socio-demography, knowledge and attitude regarding prostatism among male in-patients in Teluk Intan Hospital. Two hundred respondents were recruited. Questionnaires that consist of demographic data such as age, ethnicity and religion and some question that pertaining knowledge and awareness were used. The questions eliciting symptoms of prostatism were based on the International Prostate Symptom Score (IPSS). 76.0% of the respondents were symptomatic as they presented with prostatic symptoms. The prevalence of asymptomatic cases is higher (6.7%) among the adults whereas the percentage in elderly respondents is higher than the adults in moderate to severe cases (p < 0.001). Only 10% of respondents have heard about prostatism and mass media is ranked highest as the most preferred source of information regarding this matter with 66.7% preference. About 85.70% of respondents who had a severe score and 18.5% who had a moderate score were dissatisfied with their quality of life due to prostatic symptoms. This study provides a deeper understanding on the prevalence and severity of the prostatic symptoms and its association with the quality of life. It also illustrates low awareness, poor health seeking behaviour and poor knowledge pertaining to prostatism among the study population.
    MeSH terms: Adult; Health Surveys; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Middle Aged; Prostatic Hyperplasia/epidemiology*; Rural Population*; Prevalence
  12. Rameezan BAR, Zaliha O
    Med J Malaysia, 2005 Dec;60(5):548-59.
    PMID: 16515104
    Stroke is a leading cause of death and disability in most developed countries and developing nations. Majority of the stroke survivors are left with significant physical and cognitive impairments. In addition to the improved acute stroke care, they often benefit from rehabilitation in improving their function. This was the first study done to document function for post stroke patients in Malaysia. It was prospective study conducted to document functional status of acute stroke patients upon admission, discharge and at 3 months post stroke. Assessment of functional status for these patients are based on their activities of daily living and ambulation i.e. self-care, sphincter control, mobility, locomotion, communication and social cognition. It is also aimed to describe their demographic and clinical characteristics. Correlation of functional status at 3 months post stroke with the initial severity of stroke was also explored. A total of fifty-one patients with acute stroke in University Malaya Medical Centre (UMMC) were recruited. The patient's age ranged from 38 to 83 years with a mean of 60.2 years. Thirty-six patients (71%) were first stroke sufferers and fifteen patients (29%) had recurrent stroke. At discharge from acute stay, 13% of patients were able to ambulate with aids and 87% needed assistance for ambulation in varying degrees. Eighty-two percent of patients showed improvement in overall function (both motor and cognition) at 3 months post stroke. Sixty percent of patients were independent in ambulation and 40% required assistance. Significant correlation was seen between the initial severity of stroke and functional status at 3 months post stroke. Functional status of patients with stroke has improved at 3 months post stroke. A comprehensive rehabilitation medicine programme should be incorporated into management of stroke patients to expedite functional recovery and improve patient's independence.
    MeSH terms: Academic Medical Centers; Activities of Daily Living*; Adult; Aged; Aged, 80 and over; Cognition/physiology; Female; Follow-Up Studies; Humans; Malaysia; Male; Middle Aged; Prospective Studies; Walking/physiology; Recovery of Function/physiology*; Stroke/physiopathology*; Stroke/psychology; Stroke/rehabilitation
  13. Rao SK, Rao PS
    Med J Malaysia, 2005 Dec;60(5):560-2.
    PMID: 16515105
    Post Arthroscopic intra-articular analgesia is a better method to avoid post-operative pain after arthroscopic surgery, thus avoiding the adverse effects of systemic analgesics. In this prospective randomized double blind study conducted on 90 patients, 30 patients in group A received 20 ml of intra-articular saline, 30 patients in Group B received 10 ml of intra-articular saline and 10 ml of 0.25% bupivacaine and 30 patients in Group C received 10 ml of 0.25% bupivacaine, 1 ml (30 mg) of ketorolac and 9 ml of saline intra-articularly. Ambulatory status, duration of analgesia and requirement for supplemented analgesia were compared in these three groups. Patients receiving this intra-articular analgesic combination of bupivacaine and ketorolac required significantly less supplemental postoperative analgesics. This combination significantly prolonged the duration of analgesia. Patients receiving this combination of drugs for intra-articular analgesia ambulated earlier.
    MeSH terms: Adult; Anesthetics, Local/administration & dosage*; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage*; Arthroscopy/adverse effects*; Bupivacaine/administration & dosage*; Double-Blind Method; Female; Hospitals; Humans; India; Injections, Intra-Articular; Knee Joint/surgery; Male; Pain, Postoperative/etiology; Pain, Postoperative/prevention & control*; Prospective Studies; Clinical Trial; Ketorolac/administration & dosage*
  14. Norlijah O, Menon BS, Azlyna MYY
    Med J Malaysia, 2005 Dec;60(5):563-9.
    PMID: 16515106
    To determine the immunisation status of hospitalised infants and to examine the potential risk factors associated with incomplete immunisation. Prospective study of infants admitted to a paediatric hospital in Kuala Lumpur, conducted by interviewing carers. Twenty-two percent of infants had incomplete immunisation. The most significant factor that was associated with incomplete immunisation was the carer's lack of knowledge on the timing of the next immunisation (p = 0.005). Other factors that had significant association were the presence of a previous admission to hospital (p = 0.03) and the infant's age of more than 6 months (p = 0.025). The rate of incomplete immunisation in the study population was 22%. An admission to hospital of an infant should be taken as an opportunity to update their immunisation in order to improve the rate of uptake.
    MeSH terms: Cross-Sectional Studies; Female; Hospitalization; Hospitals, General; Humans; Immunization*; Infant; Malaysia; Male; Risk Factors; Socioeconomic Factors; Treatment Refusal*
  15. Loh LC, Lai CH, Liew OH, Siow YY
    Med J Malaysia, 2005 Dec;60(5):570-7.
    PMID: 16515107
    Chronic Obstructive Pulmonary Disease (COPD) is a growing health problem worldwide and in Malaysia. Until recently, research on COPD has been slow and difficult, partly due to the huge heterogeneity of this disease, and its variable and imprecise definitions. To perform a descriptive study on a convenient sample of local patients with COPD treated in a state hospital in Malaysia. Fifty-two patients [mean (95% CI) age: 67 (63-70) years; 86% male: 38% Malays, 36% Chinese, 25% Indians; mean (95% CI) PEFR: 45 (40-51) % predicted normal] were interviewed. Clinico-demographic data was collected using a structured questionnaire and health-related quality of life was scored using St George's Respiratory Questionnaire (SGRQ). For analysis, patients were also divided into moderate (n=17) [PEFR 50% to 80%] and severe (n=35) [PEFR < 50%] disease groups. Except for education and total family income, demographic and comorbidity variables were comparable between the two groups of COPD severity. All except 9% of patients were current or ex-smokers. Breathlessness, not chronic bronchitis (i.e. cough and sputum), was the first ranking respiratory symptom in over 70% of the patients, whether currently or at early disease manifestation. Between 5 and 15% of the patients denied any symptom of chronic bronchitis as current or early stage symptoms. Duration of symptoms prior to the diagnosis varied considerably with about 9% having symptoms for over 10 years. Over 80% of the patients smoked for over 15 years before the onset of symptoms. Quality of life in patients with COPI) was generally poor and similar between both COPD severity groups. About one fifth of the patients had exacerbations more than 12 times a year. While many features described in our local patients are well recognized in COPD, the finding that 'chronic bronchitis' is not a prominent symptom in the current or past history may have important implications in the diagnosis of at risk individuals and patients with early disease requiring attention. More research is required to confirm and to understand this.
    MeSH terms: Aged; Female; Health Status*; Hospitalization; Humans; Malaysia; Male; Middle Aged; Peak Expiratory Flow Rate; Cohort Studies; Pulmonary Disease, Chronic Obstructive/complications*
  16. Chan GC, Ghazali O, Khoo EM
    Med J Malaysia, 2005 Dec;60(5):578-84.
    PMID: 16515108
    A cross-sectional study was conducted among 517 patients with diabetes mellitus at all health centres in Melaka Tengah District to examine whether these patients and their associated cardiovascular risk factors were managed according to current guidelines. All patients had Type 2 diabetes mellitus with mean age of 57.9 +/- 10.5 years and the mean duration of diabetes was 7.2 +/- 6.0 years. The glycaemic control was poor with 53.6% of the patients having HbAlc above 8% (mean = 8.5%) and 24% of them had microalbuminuria. Among these patients with poor glycaemic control, about 47.6% of them were on monotherapy. Three hundred and fifty (67.7%) patients had hypertension but only 11 (3.1%) achieved target blood pressure of less than 130/80 mmHg. Only 18.3% of the diabetics with hypertension were prescribed angiotensin converting enzyme inhibitors and 0.3% with angiotensin receptor blockers. Nearly two-third of them had low-density lipoprotein cholesterol greater than 2.6 mmol/l (mean = 3.4 mmol/l) but only 6.8% were prescribed lipid-lowering agents. Aspirin was prescribed to 8.2% of diabetics aged above 40 years. Sixteen percent of the patients smoked, 53% did not do any exercise, and the mean BMI was 26.8 kg/mn. The management of diabetes mellitus and its associated cardiovascular risk factors was suboptimal on the basis of current clinical guidelines. A greater effort in educating doctors in the health centres about these management and adherence to the guidelines is important in reducing patients' risk of cardiovascular disease and its associated morbidity and mortality.
    MeSH terms: Adult; Aged; Aged, 80 and over; Ambulatory Care Facilities; Aspirin; Cardiovascular Diseases/etiology; Cardiovascular Diseases/prevention & control*; Cross-Sectional Studies; Diabetes Mellitus, Type 2/complications; Diabetes Mellitus, Type 2/therapy*; Female; Humans; Malaysia; Male; Middle Aged; Risk Factors; Practice Guidelines as Topic; Guideline Adherence*
  17. Harvinder S, Hassan S, Sidek DS, Hamzah M, Samsudin AR, Philip R
    Med J Malaysia, 2005 Dec;60(5):585-9.
    PMID: 16515109
    Human amniotic membrane as a homograft material was compared to temporalis fascia to close tympanic membrane perforations in 50 patients with chronic otitis media. Human amniotic membrane was used in 20 patients while temporalis fascia was used in the remaining 30. Anatomical closure of the perforation and reduction of the air-bone gap was measured. The graft uptake showed a 65% success rate for the amniotic membrane and 56.7% for the temporalis fascia at 3 months post-operatively. Significant closure of air-bone gap was observed in the human amniotic group. These results indicate comparable outcomes between human amniotic membrane and the temporalis fascia graft.
    MeSH terms: Adolescent; Adult; Aged; Amnion/transplantation*; Child; Fascia/transplantation; Female; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Myringoplasty/methods*; Prospective Studies; Temporal Muscle/transplantation; Clinical Trial; Treatment Outcome; Tympanic Membrane Perforation/surgery*
  18. Darnal HK, Karim N, Kamini K, Angela K
    Med J Malaysia, 2005 Dec;60(5):590-8.
    PMID: 16515110
    Surgical biopsies of lymphnodes of 315 patients (273 adult and 42 children) were reviewed microscopically and analysed. The sex ratio was similar in adults but in children males were twice than female (2:1). Ethnically Malay patients predominated in both the groups. The commonest cause of biopsied lymphadenopathy in adults were malignancy (47%) followed by chronic nonspecific lymphadenitis (20%) and granulomatous lymphadenitis (9%) while in children chronic nonspecific lymphadenitis was the commonest (46%) followed by granulomatous lymphadentitis (21%) and malignancy (14%). Twenty percent of adults and 4% of children had normal lymphnodes. Secondary deposits in adult males and females were of squamous cell carcinoma and adenocarcinoma type respectively. In our study 100% of clildren and 96% of adults with granulomatous lymphadenitis had tubercular lesions.
    MeSH terms: Adult; Child; Female; Humans; Lymphatic Diseases/ethnology; Lymphatic Diseases/etiology*; Lymphatic Diseases/pathology*; Malaysia; Male
  19. Pagalavan L
    Med J Malaysia, 2005 Dec;60(5):599-605.
    PMID: 16515111
    A 5 year retrospective review of cases of melioidosis was carried out in Sultanah Aminah Hospital, Johor Bahru. There were 44 new cases of melioidosis which was proven by either blood or pus culture growing Burkholderia pseudomallei from the period between January 1999 and December 2003. Of these, 38 (86.4%) were males compared to only 6 (13.6%) females. Thirty-one (70.5%) were Malays, 7 (15.9%) were Chinese, 5 (11.4%) were Indians and 1 (2.2%) was a Sarawakian. The peak age group was between 50 and 59 years (31.8%). Out of these 44 new cases, only 32 medical records could be retrieved and analysed. Twenty-four out of 32 patients (75%) analysed had diabetes mellitus, 4 had chronic or end stage renal failure (CRF/ESRF) and only 1 had Human Immunodeficiency Virus (HIV). One case of "near drowning" was also recorded. Twenty-one out of 44 patients or 47.7% died, of which 8 (38.1%) died within 24 hours of admission. Pulmonary involvement was recorded in 62.6% of the patients but many had signs and symptoms of multiorgan involvement.
    MeSH terms: Adolescent; Adult; Aged; Female; Humans; Malaysia/epidemiology; Male; Melioidosis/ethnology; Melioidosis/epidemiology*; Middle Aged; Retrospective Studies; Age Distribution; Sex Distribution
  20. How SH, Ng KH, Jamalludin AR, Shah A, Rathor Y
    Med J Malaysia, 2005 Dec;60(5):606-13.
    PMID: 16515112
    We conducted a retrospective review of 135 patients with melioidosis in Pahang from January 2000 to June 2003. Patients were mostly male (78.5%) and Malay (83%) with a median age of 51 years. Seventy four percent of patients were diabetic. Common presentations were pneumonia (40.7%), septicaemic without obvious source of infection (19.3%) and multiple organ involvement (15.6%). Only 32.7% were given appropriate antibiotics empirically. The overall mortality was 54% with most deaths (65%) occurring within 48 hours of admission. Patients with pneumonia, multiple organ involvement and septicaemic of unknown source had higher mortality as compared to patients with subcutaneous, musculoskeletal or single internal organ involvement without pneumonia (p < 0.001). The relapse rate was 19.2%.
    MeSH terms: Adult; Aged; Humans; Malaysia/epidemiology; Male; Melioidosis/etiology; Melioidosis/epidemiology*; Melioidosis/therapy; Middle Aged; Retrospective Studies; Causality; Incidence; Survival Rate; Treatment Outcome
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