Browse publications by year: 2006

Antiplatelet activity of aporphine and phenanthrenoid alkaloids from Aromadendron elegans Blume

Jantan I, Raweh SM, Yasin YH, Murad S

Phytother Res, 2006 Jun;20(6):493-6.
PMID: 16619347

Six aporphine and one phenanthrenoid alkaloids isolated from Aromadendron elegans Blume were investigated for their ability to inhibit arachidonic acid (AA), collagen and ADP induced platelet aggregation in human whole blood. The antiplatelet activity of the compounds was measured in vitro by the Chrono Log whole blood aggregometer using an electrical impedance method. Of the compounds tested, (-)-N-acetylnornuciferine, (-)-N-acetylanonaine and 1-(N-acetyl-N-methylamino)ethyl-3,4,6-trimethoxy-7-hydroxyphenanthrene showed strong inhibition on platelet aggregation caused by all three inducers. (-)-N-acetylanonaine was the most effective antiplatelet compound as it inhibited both arachidonic acid, collagen and ADP-induced platelet aggregation with IC(50) values of 66.1, 95.1 and 80.6 microm, respectively.

MeSH terms: Alkaloids/isolation & purification; Alkaloids/pharmacology*; Aporphines/isolation & purification; Aporphines/pharmacology; Humans; Phenanthrenes/isolation & purification; Phenanthrenes/pharmacology; Platelet Aggregation/drug effects*; Platelet Aggregation Inhibitors/isolation & purification*; Magnoliaceae/chemistry*
Direct effects of quercetin on impaired reactivity of spontaneously hypertensive rat aortae: comparative study with ascorbic acid

Ajay M, Achike FI, Mustafa AM, Mustafa MR

Clin Exp Pharmacol Physiol, 2006 Apr;33(4):345-50.
PMID: 16620299

1. There is a growing interest in the anti-oxidant characteristics and use of flavonoids in the management of cardiovascular diseases. The cardiovascular mechanism of action of these plant derivatives remains controversial. This study compared the effects of the flavonoid quercetin with those of the anti-oxidant vitamin ascorbic acid (vitamin C) on the reactivity of aortic rings from spontaneously hypertensive rats (SHR). 2. The phenylephrine (PE)-induced contractile and the endothelium-dependent and independent relaxant responses of aortic rings from 21 to 22 week old SHR and age-matched normotensive Wistar (WKY) rats were observed in the presence of quercetin or ascorbic acid. All the experiments were performed in the presence of the cyclooxygenase inhibitor, indomethacin (10 micromol/L). 3. The endothelium-dependent and independent relaxations to acetylcholine (ACh) and sodium nitroprusside (SNP), respectively, were significantly lesser in the SHR compared to the WKY tissues whereas the contractile responses to PE were similar in both tissues. Pretreatment of WKY rings with quercetin or ascorbic acid had no effect on the responses to ACh or PE. In the SHR tissues, however, quercetin or ascorbic acid significantly improved the relaxation responses to ACh and reduced the contractions to PE with greater potency for quercetin. Both compounds lacked any effects on the responses to SNP in either aortic ring types. N(omega)-nitro-L-arginine methyl ester (l-NAME, 10 micromol/L) significantly attenuated the vasodepressor effects of quercetin and ascorbic acid, raising the responses to PE to a level similar to that observed in the control SHR tissues. In l-NAME pretreated aortic rings, quercetin and ascorbic acid inhibited the contractile responses to PE with the same magnitude in WKY and SHR tissues. 4. The present results suggest that acute exposure to quercetin improves endothelium-dependent relaxation and reduces the contractile responses of hypertensive aortae with a greater potency than ascorbic acid. This suggests a better vascular protection with this flavonoid than ascorbic acid in the SHR model of hypertension and possibly in human cardiovascular diseases.

MeSH terms: Acetylcholine/pharmacology; Adrenergic alpha-Agonists/pharmacology; Animals; Aorta/drug effects*; Ascorbic Acid/pharmacology*; Endothelium, Vascular/physiology; Enzyme Inhibitors/pharmacology; Male; Muscle Contraction/drug effects; Muscle Relaxation/drug effects; Muscle, Smooth, Vascular/drug effects; Nitroprusside/pharmacology; Phenylephrine/pharmacology; Quercetin/pharmacology*; Rats, Inbred SHR; Rats, Inbred WKY; Vasodilator Agents/pharmacology; Vitamins/pharmacology*; NG-Nitroarginine Methyl Ester/pharmacology; Rats; Nitric Oxide Synthase Type III/antagonists & inhibitors; Adrenergic alpha-1 Receptor Agonists; In Vitro Techniques
Inhibitory activity of cyclohexenyl chalcone derivatives and flavonoids of fingerroot, Boesenbergia rotunda (L.), towards dengue-2 virus NS3 protease

Kiat TS, Pippen R, Yusof R, Ibrahim H, Khalid N, Rahman NA

Bioorg Med Chem Lett, 2006 Jun 15;16(12):3337-40.
PMID: 16621533

Boesenbergia rotunda (L.) cyclohexenyl chalcone derivatives, 4-hydroxypanduratin A and panduratin A, showed good competitive inhibitory activities towards dengue 2 virus NS3 protease with the Ki values of 21 and 25 microM, respectively, whilst those of pinostrobin and cardamonin were observed to be non-competitive. NMR and GCMS spectroscopic data formed the basis of assignment of structures of the six compounds isolated.

MeSH terms: Chalcone/analogs & derivatives*; Chalcone/pharmacology*; Chalcone/chemistry*; Cyclohexanes/pharmacology*; Cyclohexanes/chemistry*; Flavonoids/pharmacology*; Flavonoids/chemistry*; Protease Inhibitors/pharmacology*; Protease Inhibitors/chemistry*; Serine Endopeptidases/metabolism*; Molecular Structure; Plant Roots/chemistry; Zingiberaceae/chemistry*
Computerized tomographic measurement of the cervical pedicles diameter in a Malaysian population and the feasibility for transpedicular fixation

Yusof MI, Ming LK, Abdullah MS, Yusof AH

Spine (Phila Pa 1976), 2006 Apr 15;31(8):E221-4.
PMID: 16622365

The cervical pedicle diameter size differs between Asians and non-Asians. The authors studied the transverse pedicle diameter of the C2-C7 of the cervical spine in a Malaysian population using computerized tomography (CT) measurements. The transverse diameter of the pedicle is the determinant of the feasibility of this technique because the sagittal diameter of the pedicle has been wider than the transverse pedicle diameter.

MeSH terms: Adult; Bone Screws*; Cervical Vertebrae/anatomy & histology*; Cervical Vertebrae/radiography*; Feasibility Studies; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Tomography, X-Ray Computed*; Internal Fixators
Population variation in the incidence of the medial (hamate) facet of the carpal bone lunate

Dharap AS, Lutfi I, Abu-Hijleh MF

Anthropol Anz, 2006 Mar;64(1):59-65.
PMID: 16623089

Studies on the wrist joint have shown two types of the carpal bone lunate. In type II lunate there is a facet on the medial side of the lunate for articulation with the proximal pole of the hamate; such a facet is absent in type I lunate. Type II lunates have different kinematics, are more prone to clinically relevant degenerative changes in the hamato-lunate joint and are an uncommon cause of ulnar-sided wrist pain. Ninety plain radiographs showing postero-anterior views of the wrist (52 right and 38 left wrists) were studied in a population of Malays from Malaysia (mean age 48 years; age range 23 to 67 years) to determine the incidence of type I and type II lunates. Our findings were compared with those in other reports in the literature. In Malays, only 24 wrists (26.7%) showed a type II lunate compared to a reported incidence of 50% or more in populations from the Western world. Such a low incidence of type II lunate has not been reported before and may represent a genetic variation in Malays. Consequently, osteoarthritis of the hamate or lunate may play a less significant role in causing ulnar-sided wrist pain in Malays. In conclusion, the prevalence of type II lunate might vary in different population groups and further studies could be necessary to confirm this observation.

MeSH terms: Adult; Aged; Anthropometry/methods*; Carpal Bones/anatomy & histology*; Carpal Bones/radiography*; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Lunate Bone/anatomy & histology; Lunate Bone/radiography; Wrist Joint/anatomy & histology; Wrist Joint/radiography*; Hamate Bone/anatomy & histology; Hamate Bone/radiography
Arginase activity in a murine macrophage cell line (RAW264.7) stimulated with lipopolysaccharide from Actinobacillus actinomycetemcomitans

Sosroseno W, Musa M, Ravichandran M, Fikri Ibrahim M, Bird PS, Seymour GJ

Oral Microbiol. Immunol., 2006 Jun;21(3):145-50.
PMID: 16626370

The aim of the present study was to determine whether or not lipopolysaccharide from Actinobacillus actinomycetemcomitans could stimulate arginase activity in a murine macrophage cell line (RAW264.7 cells).

MeSH terms: Animals; Anti-Bacterial Agents/pharmacology; Arginase/antagonists & inhibitors; Arginase/biosynthesis*; Cell Line; Dexamethasone/pharmacology; Enzyme Activation/drug effects; Glucocorticoids/pharmacology; Lipopolysaccharides/immunology; Macrophages/enzymology*; Polymyxin B/pharmacology; Valine/analogs & derivatives; Valine/pharmacology; Cytokines/pharmacology; Aggregatibacter actinomycetemcomitans/physiology*; Antigens, CD14/pharmacology; Toll-Like Receptor 2/metabolism; Toll-Like Receptor 4/metabolism; Mice
Role of CD4 and CD8 T-cells in the induction of oral tolerance to Actinomyces viscosus in mice

Sosroseno W, Bird PS, Gemmell E, Seymour GJ

Oral Microbiol. Immunol., 2006 Jun;21(3):151-8.
PMID: 16626371

Mucosal presentation of Actinomyces viscosus results in the induction of antigen specific systemic suppressor cells in mice. The aim of the present study was to determine the phenotype of the suppressor cells responsible for the induction of oral tolerance to low doses of A. viscosus. When CD8 cell-depleted DBA/2 mice were intragastrically immunized and systemically immunized with A. viscosus, the delayed type hypersensitivity response was suppressed but not the levels of antigen specific serum antibodies. Adoptive transfer of orally tolerized CD4(+) cells to CD4(+)-depleted mice resulted in suppression of delayed type hypersensitivity response but not of the levels of antigen specific serum antibodies. In contrast, adoptive transfer of orally immunized CD8(+) cells to CD8(+)-depleted mice resulted in partially suppressed delayed type hypersensitivity response but significantly inhibited the levels of antigen specific serum antibodies. When orally tolerized CD8(+) cells were cocultured with systemically immunized CD8(+) cell-depleted spleen cells, splenic specific antibodies were inhibited. However, no suppression of splenic specific antibodies could be observed in the cultures containing orally tolerized CD4(+) cells and systemically immunized CD4(+) cell-depleted spleen cells. The results of the present study suggest that oral tolerance of humoral and cellular immunity induced by low doses of A. viscosus may be mediated by CD8(+) and CD4(+) cells, respectively.

MeSH terms: Analysis of Variance; Animals; Antibodies, Bacterial/blood; Female; Hypersensitivity, Delayed; Immune Tolerance/immunology*; Mice, Inbred DBA; Mouth Mucosa/immunology; Mouth Mucosa/microbiology*; CD4-Positive T-Lymphocytes/physiology*; CD4-CD8 Ratio; Actinomyces viscosus/pathogenicity*; CD8-Positive T-Lymphocytes/physiology*; Coculture Techniques; Immunity, Mucosal; Adoptive Transfer; Mice
An improved selective and differential medium for the isolation of Burkholderia pseudomallei from clinical specimens

Francis A, Aiyar S, Yean CY, Naing L, Ravichandran M

Diagn Microbiol Infect Dis, 2006 Jun;55(2):95-9.
PMID: 16626918

Isolation and culture of Burkholderia pseudomallei remains the main stay in the diagnosis of melioidosis. Thus, the search for selective and differential media for B. pseudomallei has been ongoing. A number of such media have been reported with varying efficacy. Ashdown medium is the most established selective medium for the isolation of B. pseudomallei. There are no reports of differential media differentiating B. pseudomallei from Burkholderia cepacia. This report documents such a selective and differentiating medium for B. pseudomallei. Of a total of 1042 clinical specimens containing mixed flora and gram-negative isolates that were tested on this medium, 16 of the specimens yielded B. pseudomallei. The isolation rate was found to be 1.5%. This medium was found to be simple and inexpensive, can be made by small laboratories, and called as Francis medium. Based on the colony morphology and color, a preliminary report can be made within 18-24 h for the presence of B. pseudomallei. Our study showed that this medium had an overall sensitivity of 78.4% with a specificity of 92.2%. The use of this medium as an early diagnostic tool will help to reduce mortality and morbidity of melioidosis patients.

MeSH terms: Bacteriological Techniques; Culture Media/chemistry*; Humans; Melioidosis/diagnosis; Sensitivity and Specificity; Burkholderia pseudomallei/isolation & purification*
PCR fingerprinting of Blastocystis isolated from symptomatic and asymptomatic human hosts

Tan TC, Suresh KG, Thong KL, Smith HV

Parasitol Res, 2006 Sep;99(4):459-65.
PMID: 16628457

Genomic DNA from 16 Blastocystis hominis isolates comprising of eight asymptomatic isolates (A1-A8) and eight symptomatic isolates (S1-S8) was amplified by arbitrarily primed polymerase chain reaction (AP-PCR) using 38 arbitrary 10-mer primers. Six primers (A10, B5, C20, D1, F6, and F10) generated reproducible DNA fingerprints. AP-PCR amplification revealed similar DNA fingerprints among all symptomatic isolates (S1-S8) with common bands at 850 bp using primer A10, 920 bp using primer B5, and 1.3 kbp using primer D1. Isolates A1, A3, A4, A5, A6, and A7 showed similar DNA banding patterns and all asymptomatic isolates (A1-A8) shared a major band at 1 kbp using primer B5. Isolates A2 and A8 showed distinct DNA banding patterns that differed from the remainder of the isolates. The results of the phylogenetic analyses showed that all symptomatic isolates (S1-S8) formed a clade with >70% similarity among the isolates and which were clearly separate from asymptomatic isolates A1, A3, A4, A5, A6, and A7. Asymptomatic isolates A2 and A8 formed two distinct and separate clades. AP-PCR revealed higher genetic variability within the asymptomatic isolates than within the symptomatic isolates. The present study suggests that AP-PCR can be a valuable method for differentiating between isolates of B. hominis and our results support the hypothesis that our asymptomatic and symptomatic B. hominis isolates may represent two different strains/species with varying pathogenic potential.

MeSH terms: Adolescent; Adult; Aged; Animals; Female; Humans; Male; Middle Aged; Phylogeny; DNA, Protozoan/genetics*; Polymerase Chain Reaction/methods*; DNA Fingerprinting*; Blastocystis Infections/diagnosis; Blastocystis Infections/microbiology*; Blastocystis hominis/classification; Blastocystis hominis/genetics; Blastocystis hominis/isolation & purification*
NeuroVision treatment for low myopia following LASIK regression

Lim KL, Fam HB

J Refract Surg, 2006 Apr;22(4):406-8.
PMID: 16629076

PURPOSE: To evaluate a novel non-surgical method for improving vision in a refractive surgery patient.
METHODS: A 45-year-old man who had undergone LASIK 5 years previously presented with blurred distance vision. Unaided vision in the right eye was 20/329-2) and 20/20 in the left eye. He enrolled for NeuroVision treatment (NeuroVision Pte Ltd, Singapore), a computer-based interface in which a repetitive set of visual excerises is performed for 10 to 12 weeks.
RESULTS: After 35 sessions, unaided visual acuity in the right eye was 20/16(-3) and 20/20(-1) in the left eye, representing 2.8 lines of improvement in the right eye and 1.6 lines in the left eye.
CONCLUSIONS: NeuroVision, a noninvasive treatment based on the concept of perceptual learning, is a benefit in cases in which surgical enhancement is not recommended.

MeSH terms: Adaptation, Ocular/physiology*; Cornea/physiopathology*; Cornea/surgery; Follow-Up Studies; Humans; Male; Middle Aged; Myopia/physiopathology; Myopia/therapy*; Refraction, Ocular/physiology*; Psychotherapeutic Processes*; Visual Acuity/physiology; Keratomileusis, Laser In Situ*
Why do patients with chronic illnesses fail to keep their appointments? A telephone interview

Zailinawati AH, Ng CJ, Nik-Sherina H

Asia Pac J Public Health, 2006;18(1):10-5.
PMID: 16629433 DOI: 10.1177/10105395060180010301

Missed appointments affect patients' health in addition to reducing practice efficiency. This study explored the rate and reasons of non-attendance among patients with chronic illnesses. It was a cross-sectional descriptive study carried out in a family practice clinic over a one-month period in 2004. Those who failed turn up for scheduled appointments were interviewed by telephone based on a structured questionnaire. Out of 671 patients, the non-attendance rate was 16.7%. Sixty-seven percent of non-attenders were successfully interviewed. Males (p = 0.01), Indians (p = 0.015), patients with coronary artery disease (p = 0.017), multiple diseases (> 4) (p = 0.036) and shorter appointment intervals (p = 0.001) were more likely to default. The main reasons for non-attendance were: forgot the appointment dates (32.9%), not feeling well (12.3%), administrative errors (19.1%) and work or family commitments (8.2%). The majority would prefer a reminder through telephone (71.4%), followed by letters (41.3%). In conclusion, appropriate intervention could be taken based on the reasons identified in this study.

Study site: Family Practice Clinic of the
Department of Primary Care
Medicine, University of Malaya
Medical Centre, Malaysia

MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Ambulatory Care Facilities; Appointments and Schedules*; China/ethnology; Chronic Disease/therapy*; Cross-Sectional Studies; Ethnic Groups; Female; Hospitals, University; Humans; India/ethnology; Interviews as Topic*; Malaysia; Malaysia/ethnology; Male; Middle Aged; Outpatient Clinics, Hospital; Health Behavior*; Reminder Systems
Screening results of anaemia among infants in a village in Okinawa, Japan: a cross-sectional study

Quek KF, Hokama T, Yogi C

Asia Pac J Public Health, 2006;18(1):24-8.
PMID: 16629435

The aim of this study is to highlight the baseline characteristics of the results of a screening test for anaemia among infants in a village in Okinawa, Japan. The groups were classified into two; infants with and without anaemia. A total of 201 infants were screened at 3-4 months, 9-10 months and 18 months. The study showed that gestational age and BMI were predictive of anaemia at 3-4 months of age. At 9-10 months, types of feeding and weight ratio were the only factors that were found to be significantly predictive of anaemia. However, no factor was found to be predictive of anaemia at 18 months. Anaemia cases were found to occur at 3-4 months and 9-10 months. Most of the anaemia cases have successfully undergone treatment.

MeSH terms: Anemia/epidemiology*; Breast Feeding/statistics & numerical data; Cross-Sectional Studies; Female; Humans; Immunization/statistics & numerical data; Infant; Japan/epidemiology; Male; Body Mass Index; Body Size
Ethnicity as a determinant of asthma-related quality of life in a multiracial country

Loh LC, Teh PN, Seth KD, Raman S, Vijayasingham P, Thayaparan T

Asia Pac J Public Health, 2006;18(1):49-55.
PMID: 16629438 DOI: 10.1177/10105395060180010801

In a multiracial country like Malaysia, ethnicity may influence the measurement of health-related quality of life (HRQL) in asthmatic patients. We invited 131 adult patients [44 Malays, 42 Chinese and 45 Indians; mean (95% CI) age: 43 (40.2-45.7) yrs; 28.2% male] with moderate-to-severe persistent asthma followed up in an urban-based hospital outpatient clinic to complete a disease-specific HRQL questionnaire [St Georges' Respiratory Questionnaire (SGRQ)] and to provide socio-demographic and asthma-related data. Indians reported significantly worse SGRQ total score, compared to Malays [mean (95% CI) difference: 10.15 (0.51-19.78); p = 0.037] and SGRQ activity score, compared to Malays [13.50 (1.95-25.05); p = 0.019] and Chinese [11.88 (0.19-25.05); p = 0.046]. Further analysis using multivariate linear regression showed that Indian ethnicity remained independently associated with SGRQ scores. Our finding highlights the relevance of ethnicity in assessing HRQL of asthmatic patients in a multiracial country such as Malaysia.

Study site: chest clinic of an urban-based
university teaching hospital

MeSH terms: Adult; Asthma/ethnology*; Cross-Sectional Studies; Female; Hospitals, General; Humans; Malaysia/epidemiology; Male; Middle Aged; Outpatient Clinics, Hospital; Quality of Life*; Respiratory Function Tests; Socioeconomic Factors; Urban Population; Linear Models; Asian Continental Ancestry Group*
Effect of time delay on survival in patients with non-small cell lung cancer--a Malaysian study

Loh LC, Chan LY, Tan RY, Govindaraju S, Ratnavelu K, Kumar S, et al.

Asia Pac J Public Health, 2006;18(1):69-71.
PMID: 16629441

The prognosis of lung cancer remains poor with overall five year survival figures varying between five and 10% worldwide, However, it has been shown that surgery in patients with early stage disease in non-small cell lung cancer can achieve five year survival rates up to 80%, suggesting that early or delay diagnosis can influence prognosis. Nevertheless, studies addressing this have been inconclusive and mostly derived from Western countries.

MeSH terms: Carcinoma, Non-Small-Cell Lung/diagnosis*; Carcinoma, Non-Small-Cell Lung/mortality; Carcinoma, Non-Small-Cell Lung/surgery*; Female; Humans; Lung Neoplasms/diagnosis*; Lung Neoplasms/mortality; Lung Neoplasms/surgery*; Male; Prognosis
Fulltext Lifestyle factors and breast cancer: a case-control study in Kuala Lumpur, Malaysia

Kamarudin R, Shah SA, Hidayah N

Asian Pac J Cancer Prev, 2006 Jan-Mar;7(1):51-4.
PMID: 16629515

Breast cancer is the most common female cancer and the commonest cause of death due to cancer for women in Malaysia. This study was performed to identify the relationship with lifestyle factors. A case-control study was conducted among females with breast cancer who came for treatment to the Breast Clinic Hospital Kuala Lumpur in July until September 2004. A total of 203 female patients were recruited as cases along with 203 patients who attended the Outpatient Clinic, Hospital Kuala Lumpur during the study period as the controls. The study showed women who did not exercise regularly to have four times higher risk (adjusted odds ratio is 3.49, 95% CI is 1.84 to 6.62) compared to those who exercised regularly. Women with a high fat diet were also at elevated risk (adjusted odds ratio 3.84, 95% CI is 1.20 to 12.34) compared to those consuming a low fat diet. Women without breast cancer generally had a longer duration of lifetime lactation with a median of thirty-three months compared to women with breast cancer (twenty months, p<0.05). Women who did not take oral contraceptive pills but had breast-fed their child have a 56.0% lower risk (crude odds ratio 0.44, CI is 0.22 to 0.87) compared to women who did not take oral contraceptive pill and also did not breast-feed their child. If they had breast fed for thirteen months and above, they faced a 61.0% lower risk (crude odds ratio 0.39, 95% CI is 0.17 to 0.87). There was a significant inverse trend for lifetime lactation and breast cancer risk. In conclusion certain life styles of women are associated with a higher risk of breast cancer development. Therefore, the promotion of a healthy life style should be emphasized.
Study site: Breast Clinic, Outpatient clinic, Hospital Kuala Lumpur, Malaysia

MeSH terms: Adult; Aged; Breast Feeding; Breast Neoplasms/diagnosis*; Breast Neoplasms/epidemiology*; Contraceptives, Oral/administration & dosage; Contraceptives, Oral/adverse effects; Female; Hospitals, General; Humans; Life Style; Life Style*; Malaysia/epidemiology; Middle Aged; Outpatient Clinics, Hospital; Probability; Reference Values; Urban Population; Exercise/physiology*; Prevalence; Confidence Intervals; Odds Ratio; Survival Analysis; Case-Control Studies; Age Distribution; Risk Assessment; Diet, Fat-Restricted*
Fulltext Gastro-oesophageal reflux disease in 'difficult-to-control' asthma: prevalence and response to treatment with acid suppressive therapy

Wong CH, Chua CJ, Liam CK, Goh KL

Aliment Pharmacol Ther, 2006 May 1;23(9):1321-7.
PMID: 16629937 DOI: 10.1111/j.1365-2036.2006.02888.x

BACKGROUND: The causal association between gastro-oesophageal reflux disease (GERD) and difficult-to-control asthma is unclear.
AIM: To determine the prevalence of GERD and response to proton pump inhibitor therapy in patients with difficult-to-control asthma.
METHODS: Consecutive patients with difficult-to-control asthma as defined by persistent and recurrent symptoms despite on optimal asthmatic medications were recruited for the study. GERD was diagnosed by symptoms, gastroscopy and 24-h oesophageal pH monitoring. All patients were prescribed a course of lansoprazole 30 mg daily for 8 weeks. Improvement to treatment was assessed by a change in pulmonary symptom score and also by patient's subjective assessment of improvement.
RESULTS: Seventeen of 30 (56.7%) patients with difficult-to-control asthma were diagnosed with GERD. Pulmonary symptom score improved significantly only in patients with GERD (35.0 to 21.0; P = 0.002). Twelve of 16 (75%) patients with GERD reported an improvement in asthma symptoms; 1 of 11 (9.1%) without GERD reported mild symptom improvement. There was no significant change in peak expiratory flow rate and forced expiratory volume.
CONCLUSIONS: More than half of patients with difficult-to-control asthma were diagnosed with GERD. In these patients the severity of asthma improved significantly with potent acid suppression therapy. This underlines the critical role of acid reflux in this subset of patients with difficult-to-control asthma.
Study site: Respiratory clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

MeSH terms: Antacids/therapeutic use*; Asthma/complications; Asthma/drug therapy*; Female; Forced Expiratory Flow Rates; Forced Expiratory Volume/drug effects; Gastroesophageal Reflux/complications; Gastroesophageal Reflux/drug therapy*; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Omeprazole/analogs & derivatives*; Omeprazole/therapeutic use; Outpatient Clinics, Hospital; Peak Expiratory Flow Rate/drug effects; Prospective Studies; Cohort Studies; Treatment Outcome; 2-Pyridinylmethylsulfinylbenzimidazoles; Proton Pump Inhibitors*; Lansoprazole
Unrecognised infection in a cystic fibrosis patient

Asiah K, Hanifah YA, Norzila MZ, Hasniah L, Rusanida A

J Paediatr Child Health, 2006 Apr;42(4):217-8.
PMID: 16630326

We report a 17-year-old Malay boy with cystic fibrosis who over a 14-month period experienced worsening respiratory symptoms and deteriorating lung function. Burkholderia pseudomallei was eventually isolated from his sputum. He improved clinically following treatment for meliodosis and his lung function returned to normal.

MeSH terms: Adolescent; Anti-Bacterial Agents/administration & dosage; Cystic Fibrosis/drug therapy; Cystic Fibrosis/microbiology*; Cystic Fibrosis/pathology; Humans; Malaysia; Male; Melioidosis/diagnosis*; Melioidosis/drug therapy; Melioidosis/microbiology; Pseudomonas/isolation & purification; Sputum/microbiology; Staphylococcus aureus/isolation & purification; Burkholderia pseudomallei/isolation & purification*
DYT1 mutations amongst adult primary dystonia patients in Singapore with review of literature comparing East and West

Jamora RD, Tan EK, Liu CP, Kathirvel P, Burgunder JM, Tan LC

J Neurol Sci, 2006 Aug 15;247(1):35-7.
PMID: 16631205

Dystonia is a heterogenous group of movement disorders whose clinical spectrum is very wide. At least 13 different genes and gene loci have been reported. While a 3-bp deletion in the DYT1 gene is the most frequent cause of early limb-onset, generalized dystonia, it has also been found in non-generalized forms of sporadic dystonia. An 18-bp deletion in the DYT1 gene has also been reported.

MeSH terms: Adult; Humans; India/ethnology; Malaysia/ethnology; Middle Aged; Mutation; Singapore; Sequence Deletion; Molecular Chaperones/genetics*; Dystonic Disorders/genetics*; European Continental Ancestry Group; Asian Continental Ancestry Group
The influence of ethnicity on health-related quality of life in diabetes mellitus: a population-based, multiethnic study

Wee HL, Li SC, Cheung YB, Fong KY, Thumboo J

J Diabetes Complications, 2006;20(3):170-8.
PMID: 16632237 DOI: 10.1016/j.jdiacomp.2005.06.010

OBJECTIVES: The aims of this study were to evaluate the influence of ethnicity on health-related quality of life (HRQoL) in diabetic participants using both profile [the Short-Form 36 (SF-36)] and single-index (the SF-6D) instruments and to evaluate the usefulness of the SF-6D as a summary measure for the SF-36.
RESEARCH DESIGN AND METHODS: Using data from a cross-sectional, population-based survey of Chinese, Malay, and Indians in Singapore, we analyzed the influence of ethnicity and other variables on each SF-36 scale and SF-6D scores using linear regression models to adjust for the influence of known determinants of HRQoL.
RESULTS: Data from 309 diabetic respondents were analyzed. Compared with other ethnicities, Indians were most likely to report impaired HRQoL. The unadjusted influence of ethnicity on HRQoL exceeded the minimum clinically important difference (MCID) for all SF-36 scales (MCID: 5 points) and the SF-6D (MCID: 0.033 points). After adjusting for gender, age, and education, the influence of Chinese ethnicity exceeded the MCID for all SF-36 scales, except vitality (VT) and mental health (MH), as well as for the SF-6D. The influence of Malay ethnicity exceeded the MCID only for the SF-36 MH scale and the SF-6D. The influence of ethnicity on HRQoL persisted after adjusting further for other determinants of HRQoL. The SF-6D reflected the ethnic trends for some but not all SF-36 scales.
CONCLUSIONS: After adjusting for demographic, socioeconomic, and other factors known to influence HRQoL, ethnicity remained an important factor influencing HRQoL in this population-based multiethnic sample of diabetic Asians. Further studies to identify modifiable factors explaining the ethnic disparities in HRQoL among diabetic participants are needed. The SF-6D may be a useful summary measure for the SF-36.

MeSH terms: Adult; Aged; China/ethnology; Cross-Sectional Studies; Diabetes Mellitus/ethnology*; Diabetes Mellitus/psychology; Female; Health Status Indicators*; Humans; India/ethnology; Malaysia/ethnology; Male; Middle Aged; Quality of Life*; Singapore; Social Class; Population Groups/ethnology; Population Groups/statistics & numerical data
Fulltext The clinical picture of neonatal infection with Pantoea species

Van Rostenberghe H, Noraida R, Wan Pauzi WI, Habsah H, Zeehaida M, Rosliza AR, et al.

Jpn J Infect Dis, 2006 Apr;59(2):120-1.
PMID: 16632913

Pantoea infections are uncommon in humans. Most reports have involved adults or children after thorn injuries. There are only a few reports of systemic infections with Pantoea. This is the first report of the clinical picture of systemic Pantoea spp. infection in neonates as observed during an outbreak in a neonatal intensive care unit caused by infected parenteral nutrition solutions. Even though detected early, the infections had a fulminant course, causing septicemic shock and respiratory failure. Pulmonary disease was prominent and presented mainly as pulmonary hemorrhage and adult respiratory distress syndrome. The organism was sensitive to most antibiotics used in neonatal intensive care units, but the clinical response to antibiotic therapy was poor. The fatality rate was very high: 7 out of 8 infected infants succumbed to the infection (87.5%).

MeSH terms: Anti-Bacterial Agents/therapeutic use*; Cross Infection/drug therapy; Cross Infection/microbiology; Cross Infection/epidemiology*; Cross Infection/transmission; Disease Outbreaks; Drug Contamination*; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases/drug therapy; Infant, Premature, Diseases/microbiology; Infant, Premature, Diseases/epidemiology; Intensive Care Units, Neonatal; Male; Parenteral Nutrition/adverse effects*; Parenteral Nutrition/standards; Gram-Negative Bacterial Infections/drug therapy; Gram-Negative Bacterial Infections/microbiology; Gram-Negative Bacterial Infections/epidemiology*; Gram-Negative Bacterial Infections/transmission; Fatal Outcome; Pantoea/isolation & purification; Pantoea/pathogenicity*

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