CYP2D6 polymorphisms are well described in normal populations but there are few data on its clinical significance. We therefore investigated the influence of CYP2D6 polymorphism on steady-state plasma concentrations and apparent oral clearance of metoprolol in patients with cardiovascular diseases.
To assess the prevalence of mutations associated with drug resistance in antiretroviral-naive patients in Kuala Lumpur, Malaysia, genotypic resistance testing was conducted among drug-naive HIV-1 patients attending the University Malaya Medical Center (UMMC) between July 2003 and June 2004. Reverse transcriptase (RT) and protease genes of plasma virions were sequenced from 100 individuals. The majority of the patients were recently diagnosed. Codons 20-255 of the RT and 1-96 of the protease gene were examined for major and minor mutations associated with antiretroviral resistance reported by the International AIDS Society- USA (IAS-USA) Drug Resistance Mutations Group. The prevalence of patients with at least one major mutation conferring drug resistance was 1%, with only one patient having a Y181C amino acid substitution in the RT gene that confers high-level resistance to nevirapine and delavirdine. Minor mutations were detected in high prevalence in the protease gene. Amino acid substitutions I13V, E35D, and M36I were associated with CRF01_AE while L63P, V77I, and I93L were associated with subtype B. Baseline prevalence of major mutations associated with resistance to antiretroviral drugs was low among antiretroviral-naive HIV-1 patients, suggesting that routine drug resistance testing may be unnecessary for all individuals newly diagnosed with HIV or all patients beginning antiretroviral therapy.
MeSH terms: Adolescent; Adult; Aged; Base Sequence; Child; Codon; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Molecular Sequence Data; Mutation*; RNA, Viral/genetics; HIV-1/drug effects; HIV-1/genetics*; HIV Infections/drug therapy; HIV Infections/virology*; Prevalence; HIV Protease/genetics; DNA Primers; Anti-HIV Agents/pharmacology*; Anti-HIV Agents/therapeutic use; Drug Resistance, Viral/genetics*; HIV Reverse Transcriptase/genetics
The author carried out the present study to examine the determinants of Malaysian women's well-being. Specifically, the author proposed a theoretical model of women's roles and well-being--made up of roles, negative affectivity, conflict, and health--and statistically validated it in a group of women occupying both work and family roles (N = 389). Using a life-course approach (P. Moen, 1998) to roles and well-being, the author further examined the model in women of 3 different age groups (age of Group 1 = 20-29 years, age of Group 2 = 30-39 years, and age of Group 3 = 40 years and older). The results supported the proposed model, which showed reasonable fit when applied to the 3 groups of women. The results also indicated that the predictors of women's well-being differ according to their respective age groups. The author discussed these findings in relation to the life-course approach to women's roles.
MeSH terms: Adaptation, Psychological*; Adult; Age Factors; Conflict (Psychology); Female; Health Status*; Humans; Malaysia; Middle Aged; Models, Psychological*; Personal Satisfaction*; Personality; Role; Women/psychology*; Reproducibility of Results
There has been extensive research in the recent past looking into the molecular basis and mechanisms of the biological clock, situated in the suprachiasmatic nuclei (SCN) of the anterior hypothalamus. Neurotransmitters are a very important component of SCN function. Thorough knowledge of neurotransmitters is not only essential for the understanding of the clock but also for the successful manipulation of the clock with experimental chemicals and therapeutical drugs. This article reviews the current knowledge about neurotransmitters in the SCN, including neurotransmitters that have been identified only recently. An attempt was made to describe the neurotransmitters and hormonal/diffusible signals of the SCN efference, which are necessary for the master clock to exert its overt function. The expression of robust circadian rhythms depends on the integrity of the biological clock and on the integration of thousands of individual cellular clocks found in the clock. Neurotransmitters are required at all levels, at the input, in the clock itself, and in its efferent output for the normal function of the clock. The relationship between neurotransmitter function and gene expression is also discussed because clock gene transcription forms the molecular basis of the clock and its working.
This study was designed to evaluate the health and economic benefits of a workplace vaccination programme against influenza funded by the employer. Employees of a Malaysian petrochemical plant volunteered to take part in this prospective, non-randomised, non-placebo-controlled study. Demographic and health information, including influenza-like symptoms, sick leave and post-vaccination adverse events were collected via questionnaires. Cost-benefit analyses were performed from the employer's perspective.
RESULTS: A total of 1,022 employees took part in the study, with 504 choosing to be vaccinated against influenza, and 518 remaining unvaccinated. The rate of influenza-like illness (ILI) was lower among vaccinated (8.13%) than non-vaccinated subjects (30.31%). Fever and respiratory symptoms were associated with all ILI cases. ILI-related sick leave was taken by 58.54% of vaccinated employees with ILI and 71.34% of non-vaccinated employees with ILI. Vaccination was financially beneficial, with the employer saving up to US dollar 53.00 per vaccinated employee when labour costs only were considered. Savings rose to up to US dollar 899.70 when the operating income of each employee was also considered. Workplace vaccination of healthy adults against influenza had a clear impact on ILI rates, absenteeism and reduced productivity in this Malaysian company. The health benefits translated into financial benefits for the employer, with cost savings significantly outweighting the costs of the vaccination programme.
To determine the genetic variability of long QT syndrome (LQTS)-associated genes (KCNQ1, HERG, KCNE1 and KCNE2) among three distinct ethnic groups in the Singapore population.
AIM: To document the perception of terminally ill patients and their family members on the care provided to them, and to look at the components of holistic care that are viewed as inadequate.
METHODS: Thirty cancer patients from a 10-bed palliative ward and their family members who were the chief carers were interviewed. They were asked to give their perceptions on four major areas of care: physical, social, psychological and spiritual. The participants were asked to report which area(s) of the service were inadequate.
RESULTS: Most patients and family members perceived that they received adequate physical care. However, the psychosocial and spiritual aspect of care were perceived as inadequate by the majority of patients and their families. None of the patients interviewed had ever been asked about spiritual distress.
CONCLUSION: The holistic model of care in caring for terminally ill patients is not practised fully. Further development in the psychosocial and spiritual aspects of care is necessary. There is a need to conduct further research to address these domains.
MeSH terms: Aged; Anxiety/psychology; Attitude to Health*; Cross-Sectional Studies; Depression/psychology; Family/psychology*; Fear; Female; Grief; Health Services Needs and Demand; Holistic Health*; Humans; Inpatients/psychology*; Malaysia; Male; Middle Aged; Neoplasms/psychology*; Quality of Health Care; Surveys and Questionnaires; Social Support; Terminal Care/organization & administration; Terminal Care/psychology*; Nursing Methodology Research; Models, Nursing; Total Quality Management/organization & administration; Spirituality
Differential effect of plant growth regulators and additives in proliferation of 18-month-old calli of Ananas comosus L. cv. Moris were assessed in vitro. The proliferation of callus relied on the growth regulators and additives. Of the different auxins supplemented in the Murashige and Skoog (MS) media, 32.22 microM alpha-naphthaleneacetic acid (NAA) gave the highest mean fresh weight of callus (46.817 g). Medium supplemented with 2,4-dichlorophenoxyacetic acid (2,4-D) was inferior to NAA, while b-naphthoxy acetic acid (BNOA) and p-chlorophenoxy acetic acid (4-CPA) were not effective in proliferating 18-months old callus. Addition of casein hydrolysate and coconut water to NAA supplemented medium showed better proliferation and production of callus. However, in terms of callus production, NAA at 32.22 microM was economically better.
During January and February 2001, an outbreak of febrile illness associated with altered sensorium was observed in Siliguri, West Bengal, India. Laboratory investigations at the time of the outbreak did not identify an infectious agent. Because Siliguri is in close proximity to Bangladesh, where outbreaks of Nipah virus (NiV) infection were recently described, clinical material obtained during the Siliguri outbreak was retrospectively analyzed for evidence of NiV infection. NiV-specific immunoglobulin M (IgM) and IgG antibodies were detected in 9 of 18 patients. Reverse transcription-polymerase chain reaction (RT-PCR) assays detected RNA from NiV in urine samples from 5 patients. Sequence analysis confirmed that the PCR products were derived from NiV RNA and suggested that the NiV from Siliguri was more closely related to NiV isolates from Bangladesh than to NiV isolates from Malaysia. NiV infection has not been previously detected in India.
Recombinant Mycobacterium bovis bacille Calmette-Guèrin (rBCG) expressing the malarial epitopes F2R(II)EBA and (NANP)3 as well as two T cell epitopes of the M. tuberculosis ESAT-6 antigen, generated in favour of mycobacterium codon usage elicited specific immune response against these epitopes. Immunised Balb/c mice demonstrated an increase in almost all of the IgG subclasses against both malarial epitopes and enhanced splenocyte proliferative response against the malarial epitopes as well as selected peptides of ESAT-6. Furthermore, flow cytometric analyses showed elevated numbers of CD4+ lymphocytes expressing IFN-gamma and IL-2 against the ESAT-6 peptides, suggesting a specific Th1-mediated response. This study demonstrated that expressing malarial and TB epitopes in a single rBCG construct induced appropriate humoral and cellular immune response against immunogenic epitopes from both organisms.
Sensitization to mite and cockroach allergens is common, and diagnosis and therapy of allergy can be further complicated by the presence of allergen isoforms and panallergens. Purified recombinant and native allergens are useful for studies to resolve such problems.
This is a retrospective study to evaluate our early experience of using selective microcoil embolization in patients who had gastrointestinal (GI) haemorrhage. From December 2002 to December 2003, six patients with GI haemorrhage (upper GI, n = 1; lower GI, n = 5) underwent superselective microcoil embolization. Microcatheters were used to carry out embolizations in branches of the superior mesenteric artery. Microcoils were used in five patients and a combination of microcoils and embolospheres was used in one patient. Technical success (bleeding target devascularization) was achieved in all patients who showed active bleeding at the time of angiography. Two patients had recurrent bleeding within 24 h of embolization, of which one (16.7%) died. The other patient did not require active intervention as bleeding was minimal and resolved with conservative management. Satisfactory clinical success (no rebleeding after 30 days) was achieved in five patients. No clinical signs and symptoms of bowel ischaemia occurred in these patients. Follow-up colonoscopy carried out in two patients did not show any signs of ischaemia in the affected bowel segments. Superselective microcoil embolization is an effective and safe method of controlling and arresting bleeding in GI haemorrhage.
This study was designed to explore the potential of refined, bleached and deodorized (RBD) palm oil (PO) and palm stearin (POs) utilization in chicken frankfurters. A 10 points augmented simplex-centroid design was used to study the effect of chicken fat (CF), PO and POs as well as the interaction of these fats on the emulsion, textural and sensory properties of chicken frankfurters. All frankfurters were formulated to contain approx 25% fat, 52% moisture and 10% protein. No significant difference was found in end chopping temperatures of all meat batters even though the temperature of PO and POs upon incorporation into meat batters was 50°C higher than CF. Strong emulsions were formed as no fluid losses were observed in all the meat batters tested after heating. Texture profiles of the frankfurters containing PO and/or CF were quite similar, but increment of POs raised hardness, chewiness, and shear hardness of the frankfurters. Acceptability of the frankfurters was evaluated using hedonic test. Panelists found no difference in hardness preference between frankfurters made from totally CF and PO, while frankfurters made from POs were rated as hard and brittle. CF was important in determining acceptability of the frankfurters, as reduction of CF in formulation resulted in lower scores in chicken flavor, juiciness, oiliness and overall acceptance of the frankfurters. Frankfurters with sensory acceptability comparable to a commercial one were found to comprise of more than 17% CF, and less than 67% PO and 17% POs of the fat blend.