Browse publications by year: 2006

Fulltext Comparison by electron microscopy of intracellular events and survival of Burkholderia pseudomallei in monocytes from normal subjects and patients with melioidosis

Puthucheary SD, Nathan SA

Singapore Med J, 2006 Aug;47(8):697-703.
PMID: 16865211

Burkholderia pseudomallei (B. pseudomallei) has been shown to persist intracellularly in patients with melioidosis, until reactivated by decreasing immunocompetence. We have previously demonstrated by transmission electron microscopy, the internalisation of B. pseudomallei by human macrophages and the occurrence of phagosome-lysosome fusion.

MeSH terms: Humans; Melioidosis/microbiology; Melioidosis/physiopathology*; Microscopy, Electron*; Monocytes/microbiology*; Phagocytes; Case-Control Studies; Burkholderia pseudomallei/isolation & purification*; Burkholderia Infections/microbiology; Burkholderia Infections/physiopathology*
Fulltext A Malay boy with the Cornelia de Lange syndrome: clinical and molecular findings

Bhuiyan ZA, Zilfalil BA, Hennekam RC

Singapore Med J, 2006 Aug;47(8):724-7.
PMID: 16865217

The Cornelia de Lange syndrome is a multiple congenital anomaly syndrome characterised by dysmorphic facial features, hirsutism, severe growth and developmental delays, and malformed upper limbs. The prevalence is estimated to be one per 10,000. Recently, several independent groups proved that Cornelia de Lange syndrome is caused by mutations in the NIPBL gene, the human homologue of the Drosophila Nipped-B gene. Here, we present the first clinical case report of a Malay child, a 9-year-old boy with the Cornelia de Lange syndrome. We also report the molecular investigation of the NIPBL gene in this patient.

MeSH terms: Abnormalities, Multiple/diagnosis*; Abnormalities, Multiple/genetics; Abnormalities, Multiple/physiopathology; Child; De Lange Syndrome/diagnosis*; De Lange Syndrome/genetics; De Lange Syndrome/physiopathology; Humans; Malaysia; Male; Mutation; Polymorphism, Genetic
The antinociceptive activity of Muntingia calabura aqueous extract and the involvement of L-arginine/nitric oxide/cyclic guanosine monophosphate pathway in its observed activity in mice

Zakaria ZA, Sulaiman MR, Jais AM, Somchit MN, Jayaraman KV, Balakhrisnan G, et al.

Fundam Clin Pharmacol, 2006 Aug;20(4):365-72.
PMID: 16867020

The present study was carried out to investigate on the possible involvement of L-arginine/nitric oxide/cyclic guanosine monophosphate (L-arginine/NO/cGMP) pathway in the aqueous extract of Muntingia calabura (AEMC) leaves antinociception in mice assessed by abdominal constriction test. The AEMC, obtained by soaking the dried leaves in distilled water (DH(2)O) (1 : 2; w/v) for 24 h, was prepared in concentrations of 10%, 50% and 100% that were approximately equivalent to doses of 27, 135 and 270 mg/kg, and administered subcutaneously (s.c.) 5 min after pre-treatment (s.c.) of mice with DH(2)O, L-arginine (20 mg/kg), N(G)-monomethyl-L-arginine acetate (L-NMMA; 20 mg/kg), N(G)-nitro-L-arginine methyl esters (L-NAME; 20 mg/kg), methylene blue (MB) (20 mg/kg), respectively. The AEMC was found to exhibit a concentration-dependent antinociception after pre-challenge with DH(2)O. Interestingly, pre-treatment with L-arginine was found to block significantly (P < 0.05) the AEMC antinociception but only at the highest concentration (100%) of AEMC used. On the other hand, pre-treatment with L-NAME was found to significantly (P < 0.05) enhance the low concentration but inhibit the high concentration AEMC antinociception. MB was found to significantly (P < 0.05) enhance AEMC antinociception at all concentrations used. Except for the higher concentration of AEMC used, co-treatment with L-NAME was found to insignificantly and significantly (P < 0.05) reverse the L-arginine effect when given alone or with low concentration AEMC, respectively. In addition, co-treatment with MB significantly (P < 0.05) reversed the L-arginine effect when given alone or with 10% concentration AEMC but failed to affect the activity of the rest of concentrations used. As a conclusion, this study has demonstrated the involvement of L-arginine/NO/cGMP pathway in AEMC antinociception.

MeSH terms: Analgesics/pharmacology*; Analgesics/therapeutic use; Animals; Arginine/metabolism*; Arginine/pharmacology; Dose-Response Relationship, Drug; Enzyme Inhibitors/pharmacology; Cyclic GMP/metabolism*; Guanylate Cyclase/antagonists & inhibitors; Guanylate Cyclase/metabolism; Male; Methylene Blue/pharmacology; Mice, Inbred BALB C; Nitric Oxide/metabolism*; Pain/chemically induced; Pain/metabolism; Pain/prevention & control*; Pain Measurement; Plant Extracts/pharmacology; Plant Extracts/therapeutic use; Signal Transduction/drug effects*; Plant Leaves; Nitric Oxide Synthase/antagonists & inhibitors; Nitric Oxide Synthase/metabolism; omega-N-Methylarginine/pharmacology; NG-Nitroarginine Methyl Ester/pharmacology; Acetic Acid; Elaeocarpaceae*; Mice
Studies of reaction parameters on synthesis of Citronellyl laurate ester via immobilized Candida rugosa lipase in organic media

Serri NA, Kamaruddin AH, Long WS

Bioprocess Biosyst Eng, 2006 Oct;29(4):253-60.
PMID: 16868763

Immobilized Candida rugosa lipase was used for the synthesis of citronellyl laurate from citronellol and lauric acid. Screening of different types of support (Amberlite MB-1 and Celite) for immobilization of lipase and solvent (n-hexane, n-heptane, and iso-octane) and optimization of reaction conditions, such as catalyst loading, effect of substrates molar ratio and temperature, have been studied. The maximum enzyme activity was obtained at 310 K. The immobilized C. rugosa lipase onto Amberlite MB-1 support was found to be the best support with a conversion of 89% of citronellyl laurate ester in iso-octane compared to Celite 545. Deactivation of C. rugosa lipase at 313, 318 and 323 K were observed. Ordered bi bi mechanism with dead end complex of lauric acid was found to fit the initial rate data and the kinetic parameters were obtained by non-linear regression analysis.

MeSH terms: Computer Simulation; Enzyme Activation; Enzyme Stability; Enzymes, Immobilized/chemistry; Esters; Fungal Proteins/chemistry*; Kinetics; Laurates/chemical synthesis*; Laurates/isolation & purification; Lauric Acids/chemistry*; Lipase/chemistry*; Models, Chemical*; Organic Chemicals/chemistry; Monoterpenes/chemical synthesis*; Monoterpenes/isolation & purification; Monoterpenes/chemistry*
Physical and cognitive domains of the Instrumental Activities of Daily Living: validation in a multiethnic population of Asian older adults

Ng TP, Niti M, Chiam PC, Kua EH

J Gerontol A Biol Sci Med Sci, 2006 Jul;61(7):726-35.
PMID: 16870636

BACKGROUND: We sought to assess the validity of the physical and cognitive domains of Lawton and Brody's Instrumental Activities of Daily Living (IADL) scale and its cross-cultural applicability across ethnic groups in an Asian population of community-living older adults.
METHODS: Using data from a random population sample of noninstitutionalized Chinese, Malay, and Indian older adults 60 years old and older in Singapore (N = 1072), we modeled the dimensional structure of the 8-item IADL Scale using exploratory and confirmatory factor analyses, and assessed its convergent and divergent validity using known group differences and strengths of association.
RESULTS: Factor analyses yielded two strong and reliable factors representing underlying physical and cognitive dimensions of IADL. The validity of the model was supported by the pattern of associations of the IADL with age, gender, education, self-reported health status, hospitalization, physical comorbidities, dementia and depression, and Mini-Mental State Examination (MMSE) scores. Notably, cognitive IADL showed a greater total effect on MMSE cognitive performance score than did physical IADL, with the effect of physical IADL on MMSE score mostly explained by cognitive IADL. Reasonably good cross-cultural validity was demonstrated among Chinese, Malays, and Indians, with strongest validity for Indians.
CONCLUSION: The eight-item IADL Scale has physical and cognitive domains and is cross-culturally applicable. The cognitive IADL domain taps a set of activities directly related to cognitive functioning.

MeSH terms: Activities of Daily Living*; Aged; China/ethnology; Cognition Disorders/diagnosis; Cross-Cultural Comparison; Factor Analysis, Statistical; Female; Humans; India/ethnology; Malaysia/ethnology; Male; Surveys and Questionnaires; Singapore; Geriatric Assessment*; Chi-Square Distribution
Efficacy of VP2 protein expressed in E. coli for protection against highly virulent infectious bursal disease virus

Omar AR, Kim CL, Bejo MH, Ideris A

J Vet Sci, 2006 Sep;7(3):241-7.
PMID: 16871018

The ability of a heat-inactivated whole virus from a highly virulent infectious bursal disease virus (hvIBDV) and VP2 protein from hvIBDV expressed in E. coli provided protection against a hvIBDV challenge in specificpathogen-free (SPF) chickens. Six out of seven chickens that were injected three times with crude VP2 protein developed significant antibody titer against IBDV. However, only four out of the seven chickens survived the hvIBDV challenge. Despite showing low antibody titer profiles, all chickens immunized with the heat-inactivated whole virus also survived the challenged with hvIBDV. However, all of these chickens had bursal atrophy and mild to moderate depletion of lymphocytes. Thus, antibodies raised against IBDV VP2 protein expressed in E. coli and denatured IBDV proteins induced some degree of protection against mortality but not against bursal damage following challenge with hvIBDV.

MeSH terms: Animals; Antibodies, Viral/blood; Chickens; Enzyme-Linked Immunosorbent Assay/veterinary; Escherichia coli/genetics; Immunization/standards; Immunization/veterinary*; Infectious bursal disease virus/genetics; Infectious bursal disease virus/immunology*; Infectious bursal disease virus/pathogenicity; Poultry Diseases/immunology*; Poultry Diseases/prevention & control; Poultry Diseases/virology; Recombinant Proteins/genetics; Recombinant Proteins/immunology*; Specific Pathogen-Free Organisms; Vaccines, Attenuated/immunology; Vaccines, Attenuated/pharmacology; Vaccines, Synthetic/immunology; Vaccines, Synthetic/pharmacology; Viral Vaccines/immunology*; Viral Vaccines/pharmacology; Viral Structural Proteins/biosynthesis; Viral Structural Proteins/genetics; Viral Structural Proteins/immunology*; Birnaviridae Infections/immunology; Birnaviridae Infections/prevention & control; Birnaviridae Infections/veterinary*; Birnaviridae Infections/virology
Recombinant nipah virus vaccines protect pigs against challenge

Weingartl HM, Berhane Y, Caswell JL, Loosmore S, Audonnet JC, Roth JA, et al.

J Virol, 2006 Aug;80(16):7929-38.
PMID: 16873250

Nipah virus (NiV), of the family Paramyxoviridae, was isolated in 1999 in Malaysia from a human fatality in an outbreak of severe human encephalitis, when human infections were linked to transmission of the virus from pigs. Consequently, a swine vaccine able to abolish virus shedding is of veterinary and human health interest. Canarypox virus-based vaccine vectors carrying the gene for NiV glycoprotein (ALVAC-G) or the fusion protein (ALVAC-F) were used to intramuscularly immunize four pigs per group, either with 10(8) PFU each or in combination. Pigs were boosted 14 days postvaccination and challenged with 2.5 x 10(5) PFU of NiV two weeks later. The combined ALVAC-F/G vaccine induced the highest levels of neutralization antibodies (2,560); despite the low neutralizing antibody levels in the F vaccinees (160), all vaccinated animals appeared to be protected against challenge. Virus was not isolated from the tissues of any of the vaccinated pigs postchallenge, and a real-time reverse transcription (RT)-PCR assay detected only small amounts of viral RNA in several samples. In challenge control pigs, virus was isolated from a number of tissues (10(4.4) PFU/g) or detected by real-time RT-PCR. Vaccination of the ALVAC-F/G vaccinees appeared to stimulate both type 1 and type 2 cytokine responses. Histopathological findings indicated that there was no enhancement of lesions in the vaccinees. No virus shedding was detected in vaccinated animals, in contrast to challenge control pigs, from which virus was isolated from the throat and nose (10(2.9) PFU/ml). Based on the data presented, the combined ALVAC-F/G vaccine appears to be a very promising vaccine candidate for swine.

MeSH terms: Animals; Antibodies, Viral/blood; Brain/pathology; Brain/virology; Genetic Vectors/genetics; RNA, Viral/blood; Swine Diseases/prevention & control*; Swine Diseases/virology; Vaccines, Synthetic/immunology; Vaccines, Synthetic/therapeutic use; Viral Fusion Proteins/genetics; Viral Fusion Proteins/immunology; Viral Vaccines/immunology; Viral Vaccines/therapeutic use*; Cytokines; Virus Shedding; Canarypox virus/genetics; Sus scrofa/immunology; Sus scrofa/virology; Nipah Virus/genetics; Nipah Virus/immunology*; Nipah Virus/isolation & purification; Henipavirus Infections/veterinary*
Intestinal obstruction due to rectal endometriosis: a surgical enigma

Jarmin R, Idris MA, Shaharuddin S, Nadeson S, Rashid LM, Mustaffa WM

Asian J Surg, 2006 Jul;29(3):149-52.
PMID: 16877213

Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

MeSH terms: Adult; Endometriosis/complications*; Endometriosis/diagnosis; Endometriosis/surgery*; Female; Humans; Intestinal Obstruction/diagnosis; Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery*; Rectal Diseases/complications*; Rectal Diseases/diagnosis; Rectal Diseases/surgery*
Efficacy of phototherapy for neonatal jaundice is increased by the use of low-cost white reflecting curtains

Djokomuljanto S, Quah BS, Surini Y, Noraida R, Ismail NZ, Hansen TW, et al.

Arch. Dis. Child. Fetal Neonatal Ed., 2006 Nov;91(6):F439-42.
PMID: 16877479

To determine whether the addition of low-cost reflecting curtains to a standard phototherapy unit could increase effectiveness of phototherapy for neonatal jaundice.

MeSH terms: Bedding and Linens; Bilirubin/blood; Color; Equipment Design; Female; Humans; Infant, Newborn; Jaundice, Neonatal/economics; Jaundice, Neonatal/therapy*; Male; Phototherapy/economics; Phototherapy/instrumentation*; Treatment Outcome
Cyclic compression of chondrocytes modulates a purinergic calcium signalling pathway in a strain rate- and frequency-dependent manner

Pingguan-Murphy B, El-Azzeh M, Bader DL, Knight MM

J Cell Physiol, 2006 Nov;209(2):389-97.
PMID: 16883605

Mechanical loading modulates cartilage homeostasis through the control of matrix synthesis and catabolism. However, the mechanotransduction pathways through which chondrocytes detect different loading conditions remain unclear. The present study investigated the influence of cyclic compression on intracellular Ca2+ signalling using the well-characterised chondrocyte-agarose model. Cells labelled with Fluo4 were visualised using confocal microscopy following a period of 10 cycles of compression between 0% and 10% strain. In unstrained agarose constructs, not subjected to cyclic compression, a subpopulation of approximately 45% of chondrocytes exhibited spontaneous global Ca2+ transients with mean transient rise and fall times of 19.4 and 29.4 sec, respectively. Cyclic compression modulated global Ca2+ signalling by increasing the percentage of cells exhibiting Ca2+ transients (population modulation) and/or reducing the rise and fall times of these transients (transient shape modulation). The frequency and strain rate of compression differentially modulated these Ca2+ signalling characteristics providing a potential mechanism through which chondrocytes may distinguish between different loading conditions. Treatment with apyrase, gadolinium and the P2 receptor blockers, suramin and basilen blue, significantly reduced the percentage of cells exhibiting Ca2+ transients following cyclic compression, such that the mechanically induced upregulation of Ca2+ signalling was completely abolished. Thus cyclic compression appears to activate a purinergic pathway involving the release of ATP followed by the activation of P2 receptors causing a combination of extracellular Ca2+ influx and intracellular Ca2+ release. Knowledge of this fundamental cartilage mechanotransduction pathway may lead to improved therapeutic strategies for the treatment of cartilage damage and disease.

MeSH terms: Animals; Cattle; Models, Biological; Purines/metabolism*; Stress, Mechanical; Time Factors; Chondrocytes/cytology*; Chondrocytes/metabolism*; Calcium Signaling/physiology*; Mechanotransduction, Cellular/physiology
Clinical pathways in primary dental care in Malaysia: clinicians' knowledge, perceptions and barriers faced

Tay HL, Raja Latifah RJ, Razak IA

Asia Pac J Public Health, 2006;18(2):33-41.
PMID: 16883968 DOI: 10.1177/10105395060180020601

The Oral Health Division, Ministry of Health in Malaysia piloted clinical pathways (cpath) in primary care in early 2003. This study investigated the knowledge, perception of cpaths and barriers faced by the clinicians involved in the pilot project. Self-administered questionnaires were sent to the clinicians (n=191). Dentists (67.9%) and dental nurses (70.6%) had good overall knowledge of cpaths. The majority of the clinicians (67.9% to 95.6%) perceived cpath positively in all areas. Only 9.2% of dentists encountered difficulties in using cpath forms compared to 28.4% of dental nurses. A higher proportion of dental nurses (73.5%) compared to dentists (64.8%) were willing to continue using cpath. The majority of dentists (76.7%) and dental nurses (73.1%) were willing to participate in future development of cpaths. Overall, there was evidence of managerial support for the pilot project. A follow-up of the pilot project was somewhat lacking as less than half (43.3%) of the clinicians reported that the state coordinator obtained feedback from them. The findings auger well for the future implementation of cpath should the Oral Health Division decide to adopt cpath routinely in the public oral health care service.

MeSH terms: Adult; Ambulatory Care Facilities; Clinical Competence*; Cross-Sectional Studies; Dental Assistants/education; Dental Assistants/standards; Dental Care*; Dentists/standards; Health Personnel; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Nurses; Pilot Projects; Primary Health Care/standards*; Public Health Dentistry; Surveys and Questionnaires; Critical Pathways*
Establishment of primary care centre for University Malaysia Sabah

Viegas CM

Asia Pac J Public Health, 2006;18(2):51-5.
PMID: 16883971 DOI: 10.1177/10105395060180020901

University Malaysia Sabah campus moved to its present site in Kota Kinabalu, Sabah, Malaysia in 1999. A health centre was included in the development plans and a two-storey building was constructed to provide the facility for in-patient and out-patient care. Clinical catchments include 10,000 students, 1000 academic and support staff. The medical faculty was inaugurated in 2003, and it was given the responsibility to establish and run the facility for students and staff of the University. This paper describes the development of the facility from merely a physical structure to what is now a comprehensive, functional outpatient service catering for student healthcare, screening, preventive medicine and health promotional activities. Currently, these services are provided by the faculty members of the Medical School. The incorporation of the medical student teaching and collaborative research adds intangible value to the facility. Future plans for expansion include specialist medical services.

MeSH terms: Comprehensive Health Care; Education, Medical; Facility Design and Construction*; Faculty, Medical; Female; Health Promotion; Hospitals, University; Humans; Malaysia; Male; Outpatient Clinics, Hospital; Student Health Services/organization & administration*; Student Health Services/utilization; Biomedical Research
Detection of Epstein-Barr virus in lower gastrointestinal tract lymphomas: a study in Malaysian patients

Yunos AM, Jaafar H, Idris FM, Kaur G, Mabruk MJ

Mol Diagn Ther, 2006;10(4):251-6.
PMID: 16884329

Many studies in the literature have shown that Epstein-Barr virus (EBV) is associated with several human lymphoid and epithelial malignancies. However, the prevalence of EBV in non-Hodgkin lymphoma (NHL) of the lower gastrointestinal (GI) tract has not been fully elucidated.

MeSH terms: Adult; Aged; Child; Child, Preschool; DNA, Viral/analysis; Herpesvirus 4, Human/isolation & purification*; Female; Humans; Intestinal Neoplasms/pathology; Intestinal Neoplasms/virology*; Intestine, Large/pathology; Intestine, Large/virology; Intestine, Small/pathology; Intestine, Small/virology; Lymphoma, Non-Hodgkin/pathology; Lymphoma, Non-Hodgkin/virology*; Malaysia; Male; Middle Aged; Epstein-Barr Virus Infections/pathology; Epstein-Barr Virus Infections/virology; Lower Gastrointestinal Tract/virology
Malaysia: camel tourism trick

Simpson D

Tob Control, 2006 Aug;15(4):277-8.
PMID: 16885572
MeSH terms: Adolescent; Adult; Advertising as Topic/methods*; Humans; Malaysia; Male; South Africa; Travel*; Tobacco Industry*
Genetics and evidence for an esterase-associated mechanism of resistance to indoxacarb in a field population of diamondback moth (Lepidoptera: Plutellidae)

Sayyed AH, Wright DJ

Pest Manag Sci, 2006 Nov;62(11):1045-51.
PMID: 16886171

Bioassays (at generation G2) with a newly collected field population (designated CH3) of Plutella xylostella L. from farmers' fields in the Cameron Highlands, Malaysia, indicated resistance ratios of 813-, 79-, 171-, 498- and 1285-fold for indoxacarb, fipronil, spinosad, deltamethrin and Bacillus thuringiensis toxin Cry1Ac respectively compared with a laboratory susceptible population (Lab-UK). At G2 the field-derived population was divided into two subpopulations: one was selected (G2 to G7) with indoxacarb (indoxa-SEL), while the second was left unselected (UNSEL). A significant reduction in the resistance ratio for each compound was observed in UNSEL at G8. For indoxa-SEL, bioassays at G8 found that selection with indoxacarb gave a resistance ratio of 2594 compared with Lab-UK and of 90 compared with UNSEL. The toxicity of fipronil, spinosad and deltamethrin was not significantly different in indoxa-SEL at G8 compared with G2 but was significantly greater than UNSEL at G8. The toxicity of Cry1Ac was significantly reduced in indoxa-SEL at G8 compared with G2 but was also significantly greater than UNSEL at G8. This suggests that indoxacarb selection maintained resistance to these compounds in the indoxa-SEL population. Synergist studies indicated that resistance to indoxacarb in indoxa-SEL was esterase associated. Logit regression analysis of F1 reciprocal crosses between indoxa-SEL and Lab-UK indicated that resistance to indoxacarb was inherited as an autosomal, incompletely recessive (D(LC) = 0.35) trait. Tests of monogenic inheritance suggested that resistance to indoxacarb was controlled by a single locus.

MeSH terms: Animals; Esterases/metabolism*; Insecticide Resistance/genetics*; Insecticide Resistance/physiology; Insecticides/metabolism*; Lethal Dose 50; Moths/enzymology*; Moths/genetics*; Oxazines/metabolism*; Selection, Genetic; Inheritance Patterns
CYP2A6 polymorphisms in Malays, Chinese and Indians

Nurfadhlina M, Foong K, Teh LK, Tan SC, Mohd Zaki S, Ismail R

Xenobiotica, 2006 Aug;36(8):684-92.
PMID: 16891249

The genetically polymorphic cytochrome P450 (CYP) 2A6 is the major nicotine-oxidase in humans that may contribute to nicotine dependence and cancer susceptibility. The authors investigated the types and frequencies of CYP2A6 alleles in the three major ethnic groups in Malaysia and CYP2A6*1A, CYP2A6*1B, CYP2A6*1x2, CYP2A6*2, CYP2A6*3, CYP2A6*4, CYP2A6*5, CYP2A6*7, CYP2A6*8 and CYP2A6*10 were determined by allele-specific polymerase chain reaction (PCR) in 270 Malays, 172 Chinese and 174 Indians. Except for CYP2A6*2 and *3 that were not detected in the Malays and Chinese, all the other alleles were detected. Frequencies for the CYP2A6*4 allele were 7, 5 and 2%, respectively, in Malays, Chinese and Indians. A statistically significant high frequency of the duplicated CYP2A6*1x2 allele occurred among Chinese. Among Malays and Chinese, the most common allele was CYP2A6*1B, but it was CYP2A6*1A among Indians. These ethnic difference in frequencies suggested that further studies are required to investigate the implications on diseases such as cancer and smoking behaviour among these major ethnic groups in Malaysia.

MeSH terms: Adult; China; Cytochrome P-450 Enzyme System/genetics*; Female; Gene Frequency*; Genotype; Humans; India; Malaysia; Male; Polymorphism, Genetic*; Smoking/genetics; Cohort Studies; Databases, Genetic
Multilocus sequence typing of historical Burkholderia pseudomallei isolates collected in Southeast Asia from 1964 to 1967 provides insight into the epidemiology of melioidosis

McCombie RL, Finkelstein RA, Woods DE

J Clin Microbiol, 2006 Aug;44(8):2951-62.
PMID: 16891516

A collection of 207 historically relevant Burkholderia pseudomallei isolates was analyzed by multilocus sequence typing (MLST). The strain collection contains environmental isolates obtained from a geographical distribution survey of B. pseudomallei isolates in Thailand (1964 to 1967), as well as stock cultures and colony variants from the U.S. Army Medical Research Unit (Malaysia), the Walter Reed Army Institute for Research, and the Pasteur Institute (Vietnam). The 207 isolates of the collection were resolved into 80 sequence types (STs); 56 of these were novel. eBURST diagrams predict that the historical-collection STs segregate into three complexes when analyzed separately. When added to the 760 isolates and 365 STs of the B. pseudomallei MLST database, the historical-collection STs cluster significantly within the main complex of the eBURST diagram in an ancestral pattern and alter the B. pseudomallei "population snapshot." Differences in colony morphology among reference isolates were found not to affect the STs assigned, which were consistent with the original isolates. Australian ST84 is likely characteristic of B. pseudomallei isolates of Southeast Asia rather than Australia, since multiple environmental isolates from Thailand and Malaysia share this ST with the single Australian clinical isolate in the MLST database. Phylogenetic evidence is also provided suggesting that Australian isolates may not be distinct from those of Thailand, since ST60 is common to environmental isolates from both countries. MLST and eBURST are useful tools for the study of population biology and epidemiology, since they provide methods to elucidate new genetic relationships among bacterial isolates.

MeSH terms: Asia, Southeastern/epidemiology; DNA, Bacterial/genetics; DNA, Bacterial/chemistry; Environmental Microbiology; Genotype; Geography; Humans; Melioidosis/microbiology*; Melioidosis/epidemiology*; Phylogeny; Bacterial Typing Techniques*; Cluster Analysis; Burkholderia pseudomallei/classification*; Burkholderia pseudomallei/genetics*; Burkholderia pseudomallei/physiology; Sequence Analysis, DNA; Molecular Epidemiology
Fulltext Pain management: trends and challenges

Cardosa MS

Med J Malaysia, 2006 Jun;61(2):139-41.
PMID: 16898301

Pain remains as one of the most common reasons for visits to a doctor. The paper by Zalinawati et all published in this issue of the Journal confirmed this in two primary care settings, showing that a complaint of pain was recorded in almost a third of patients, similar to the prevalence reported in European studies.

MeSH terms: Diagnosis, Differential; Humans; Pain/diagnosis; Pain Measurement; Severity of Illness Index; Treatment Outcome; Pain Management*
Fulltext Initial experience of laparoscopic incisional hernia repair

Razman J, Shaharin S, Lukman MR, Sukumar N, Jasmi AY

Med J Malaysia, 2006 Jun;61(2):142-6.
PMID: 16898302 MyJurnal

Laparoscopic repair of ventral and incisional hernia has become increasingly popular as compared to open repair. The procedure has the advantages of minimal access surgery, reduction of post operative pain and the recurrence rate. A prospective study of laparoscopic incisional hernia repair was performed in our center from August 2002 to April 2004. Eighteen cases (n: 18) were performed during the study period. Fifteen cases (n: 15) had open hernia repair previously. Sixteen patients (n: 16) had successful repair of the hernia with the laparoscopic approach and two cases were converted to open repair. The mean hernia defect size was 156cm2. There was no intraoperative or immediate postoperative complication. The mean operating time was 100 +/- 34 minutes (75 - 180 minutes). The postoperative pain was graded as mild to moderate according to visual analogue score. The mean day of discharge after surgery was two days (1 - 3 days). During follow up, three patients (16.7%) developed seroma at the hernia sac which was resolved with conservative management after three weeks. One (5.6%) patient developed recurrence six months after surgery. In conclusion, laparoscopic repair of incisional hernia particularly recurrent hernia has been shown to be safe and effective in our centre. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.

MeSH terms: Adult; Aged; Female; Follow-Up Studies; Hernia, Ventral/surgery*; Humans; Middle Aged; Laparoscopy*; Prospective Studies; Surgical Mesh; Treatment Outcome; Prosthesis Implantation/methods*
Fulltext Tracheobronchial stenting is safe and effective in relieving upper airway obstruction

Pang YK, Liam CK, Leow CH, Shyamala P, Zal AR

Med J Malaysia, 2006 Jun;61(2):147-50.
PMID: 16898303 MyJurnal

Many studies have shown that tracheobronchial stenting is effective in relieving respiratory distress secondary to major airway obstruction due to lung or oesophageal cancer. A retrospective review on the benefits and complications of self-expandable metallic stent (SEMS) insertion through flexible bronchoscopy for the palliative treatment of upper airway obstruction in University Malaya Medical Centre was performed. Ten patients underwent this procedure. Relief of dyspnoea was immediate following stent insertion in all patients. Stent migration occurred in one patient and three patients had restenosis of the central airway. We conclude that tracheobronchial stenting via flexible bronchoscopy is feasible and safe.

MeSH terms: Aged; Airway Obstruction/surgery*; Bronchi/surgery*; Bronchoscopy/methods*; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prosthesis Design; Retrospective Studies; Trachea/surgery*; Stents*; Treatment Outcome; Prosthesis Implantation/instrumentation*

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