Browse publications by year: 2006

  1. Abdullah J, Ahmad M, Heng LY, Karuppiah N, Sidek H
    Anal Bioanal Chem, 2006 Nov;386(5):1285-92.
    PMID: 17031625
    The stacked-film immobilization of 3-methyl-2-benzothiazolinone hydrazone (MBTH) in hybrid nafion/sol-gel silicate film and horseradish peroxidase (HRP) in chitosan, performed in order to allow the determination of phenolic compounds, was investigated via an optical method. The stacked films were deposited onto a microscope glass slide by a spin-coating technique. The quinone or free radical product formed by the enzymatic reactions of phenolic compounds interacts with MBTH to form azo-dye products, which can be measured spectrophotometrically at a wavelength of 500 nm. The color intensity of the product was found to increase in proportion to the phenolic concentration after 5 min of exposure. The response of the biosensor was linear over concentration ranges of 0.025-0.500, 0.010-0.070 and 0.050-0.300 mM for guaiacol, resorcinol and o-cresol, respectively, and gave detection limits of 0.010, 0.005 and 0.012 mM. The sensor exhibited good sensitivity and stability for at least two months.
    MeSH terms: Azo Compounds/chemistry; Cresols/analysis; Coloring Agents/chemistry; Fluorocarbon Polymers/chemistry*; Gels; Guaiacol/analysis; Horseradish Peroxidase/chemistry*; Hydrazones/chemistry*; Hydrogen Peroxide/chemistry; Membranes, Artificial*; Phenols/analysis*; Resorcinols/analysis; Sensitivity and Specificity; Spectrophotometry/methods; Reproducibility of Results; Biosensing Techniques/methods; Molecular Structure; Silicates/chemistry*; Chitosan/chemistry; Benzothiazoles/chemistry*; Optics and Photonics
  2. Nesaretnam K, Sies H
    Antioxid Redox Signal, 2006 10 13;8(11-12):2175-7.
    PMID: 17034360
    The 6(th) COSTAM/SFRR (ASEAN/Malaysia) workshop, "Micronutrients, Oxidative Stress, and the Environment," was held from June 29 to July 2 at Holiday Inn Damai Beach Resort in Kuching, Sarawak. Two hundred twenty participants from 17 countries presented recent advances on natural antioxidants in the area of oxidative stress and molecular aspects of nutrition. Natural products and research are an important program in academic institutions and are experiencing unprecedented interest and growth by the scientific community and public health authorities. Progress is being driven by better understanding of the molecular mechanisms of the relation between oxidative stress and micronutrient action. The gathering of scientists from around the world was fruitful, and we hope that future work will be developed by the formal and informal interactions that took place in this beautiful tropical setting.
    MeSH terms: Carotenoids/pharmacology; Carotenoids/therapeutic use; Environment; Flavonoids/pharmacology; Flavonoids/therapeutic use; Humans; Nutritional Physiological Phenomena/drug effects; Nutritional Physiological Phenomena/physiology*; Signal Transduction/physiology; Oxidative Stress/drug effects; Oxidative Stress/physiology*; Micronutrients*; Tocotrienols/pharmacology; Tocotrienols/therapeutic use
  3. Al Aradi IK
    Dermatol Surg, 2006 Oct;32(10):1244-50.
    PMID: 17034373
    Management of periorbital syringomas is problematic and avoided by many inexperienced physicians. The medical literature presently prefers CO(2) laser resurfacing to many other modalities, but the subject of electrosurgery has not been well explored.
    MeSH terms: Adolescent; Adult; Electrocoagulation/instrumentation*; Equipment Design; Follow-Up Studies; Humans; Middle Aged; Orbit; Pilot Projects; Retrospective Studies; Sweat Gland Neoplasms/pathology; Sweat Gland Neoplasms/surgery*; Treatment Outcome; Syringoma/pathology; Syringoma/surgery*
  4. Mariappan P, Chong WL
    BJU Int, 2006 Dec;98(6):1264-8.
    PMID: 17034498
    OBJECTIVE: To determine, in a population-based survey, the prevalence of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and incontinence in community-dwelling men in multiethnic Malaysia, as currently available Western demographic data might not be applicable in the Asian population.
    SUBJECTS AND METHODS: A cross-sectional population-based survey was carried out in the State of Penang, Malaysia, with a target population of men aged > or = 40 years. Using a multistage study design, random systematic sampling was used to represent the target population, who were weighted based on ethnicity and rural-urban ratios so as to represent the general population distribution. Trained field-workers conducted direct interviews and administered the American Urological Association Symptom Index (AUA-SI), the International Index of Erectile Function (IIEF-5) questionnaire and questions on incontinence based on the International Continence Society 2002 definition.
    RESULTS: In all, 418 men aged > or = 40 years were interviewed, of whom 353 completed the AUA-SI questionnaire (84.5% response rate). The prevalence of mild, moderate and severe LUTS was 80.6%, 6% and 0.3%, respectively. The prevalent symptoms were frequency and nocturia. There was moderate and severe ED in 45.9% of men, whereas incontinence was reported by 8.2%. The AUA-SI correlated strongly with age (R = 0.291, P < 0.001), IIEF-5 (R = - 0.265, P < 0.001) and diabetes mellitus.
    CONCLUSION: The prevalence and severity of LUTS, ED and incontinence increased with age in this multiethnic Asian population, in which ED correlated strongly with LUTS. Compared to the Western population, the prevalence of LUTS was significantly lower, while the prevalence of ED and incontinence were comparable.
    MeSH terms: Adult; Aged; Asia/ethnology; Cross-Sectional Studies; Health Surveys; Humans; Erectile Dysfunction/ethnology; Erectile Dysfunction/epidemiology*; Malaysia/epidemiology; Male; Middle Aged; Quality of Life; Surveys and Questionnaires; Severity of Illness Index; Urinary Incontinence/ethnology; Urinary Incontinence/epidemiology*; Prevalence; Developed Countries; Prostatism/ethnology; Prostatism/epidemiology*
  5. Nathan S, Aziz DH, Mahadi NM
    Curr Microbiol, 2006 Nov;53(5):412-5.
    PMID: 17036210
    We constructed recombinant phage particles displaying the Bacillus thuringiensis Cry1Ba4 active toxin using the pfUSE5 and pComb3X phagemid vectors. The recombinant phage particles were screened and evaluated for displayed biologically active Cry1Ba4 toxin against the target insect larvae. Concurrent expression of Cry1Ba4 protoxin was carried out using the pETBlue -2 plasmid expression vector in Escherichia coli Tuner (DE3)pLacI and the protoxin was successfully expressed at a size of 129 kDa. In the bioassay, 3.30 mg crude extract of Cry1Ba4 protoxin, 9.35 x 10(9) TU and 7.70 x 10(9) TU of induced recombinant phage particles carrying Cry1Ba4 active toxin displayed on pComb3X and pFUSE5, respectively, demonstrated mortality of greater than 85% against Plutella xylostella (third-instar) within 48 hours. Thus, we have successfully displayed the Cry1Ba4 activated toxin on the surface of a phage and demonstrated toxicity towards larvae.
    MeSH terms: Animals; Bacterial Proteins/pharmacology*; Bacterial Toxins/pharmacology*; Bacteriophages/genetics; Endotoxins/pharmacology*; Hemolysin Proteins/pharmacology*; Insecticides/pharmacology*; Lepidoptera; Recombinant Proteins/pharmacology
  6. Eaton KA, de Vries J, Widström E, Gait TC, Bedi R, Meyers I, et al.
    Eur J Dent Educ, 2006 Nov;10(4):186-91.
    PMID: 17038009
    During the 2004 annual meeting of the International Association for Dental Research, the Education Research Group held a symposium on dental outreach teaching. After a brief introduction, which reviews relevant aspects of the relatively sparse literature, this paper summarises the proceedings, the themes and conclusions that emerged and the research issues that were identified. It aims to describe aspects of current practice around the world and to promote future discussion. Presenters gave details of outreach programmes for dental undergraduates in Australia, Finland, Malaysia (and Southeast Asia), the United Kingdom and the United States. From these presentations four themes emerged. They were: reasons for the introduction of outreach teaching, its perceived beneficial effects, organisational issues, educational issues. The reasons included a recognition of the need to educate dental undergraduates as members of 'care teams' in the environments and communities where they were ultimately like to work and the current shortage of both suitable patients and teachers (faculty) in many dental schools. A wide range of potential benefits and some disadvantages were identified. The organisational issues were, in the main, seen to relate to finance and administration. The educational issues included the need to train and monitor the performance of teachers at outreach clinics and to assess the performance of the undergraduates whilst at the outreach locations. It was concluded that new technology made it easier to teach at a distance and it was possible to create a dental 'school without walls'. It was recognised that few evaluations of dental outreach teaching have been carried out and that there were many research questions to be answered, including: whether it should be a voluntary or compulsory part of the undergraduate curriculum, how long it should last and what type of outcomes should be assessed.
    MeSH terms: Asia, Southeastern; Clinical Clerkship; Community Dentistry/education*; Community-Institutional Relations*; Education, Dental/methods*; England; Finland; Humans; Medically Underserved Area; New Jersey; Queensland; Schools, Dental; Teaching/methods
  7. Nadchatram M
    Trop Biomed, 2006 Jun;23(1):1-22.
    PMID: 17041547 MyJurnal
    Some 2,000 species of mites of the family Trombiculidae are known in the world. The 6-legged larvae are mostly ectoparasites of reptiles, birds, mammals and invertebrates. Their 8-legged active nymphs and adults are free-living predators. In the Asia-Pacific region, a few species in various genera are vectors of scrub typhus and scrub-itch. In this a paper, a very bizarre trombiculid species, Vatacarus ipoides Southcott 1957, endoparasitic in the trachea of the amphibious sea snake, Laticauda colubrina (Schenider) is re-described based mostly on new-born larvae reared in the laboratory. Life history study of the mite produced very novel and interesting results. A brief account of the life-cycle was presented at the first laboratory demonstration of the Malaysian Society of Parasitology and Tropical Medicine Meeting by Nadchatram and Audy (1965). The life history is illustrated and described here in greater detail. The active nymphal, and the akinetic teleiophane stages are bypassed, which is unusual in the life-cycle of the family Trombiculidae. Also, the larva is the only stage in the life-cycle that feeds. The sexes are predetermined in the larval neosomatic stage and give rise to small males and bigger females. Having obtained adults of the species, by rearing, it is deemed unnecessary for the original proposal by Southcott to erect a new family, Vatacaridae, because the adults share all the attributes of the family Trombiculidae. The male and female obtained through laboratory rearing are illustrated for the first time. Relationship of V. ipoides with Laticauda snakes show close host-specificity, in a group of acarines that are generally habitat-specific. Possible explanations for their association are discussed. The unusual morphology and the formation of new structures during an instar is of ontogenetic and evolutionary importance. The hypertrophic larvae are superficially vermiform, rather than typically acarine in shape. This, and other biological features, necessitated the proposal of new morphological terms, and they are discussed here.
    MeSH terms: Animals; Ecology*; Female; Host-Parasite Interactions/physiology; Malaysia; Male; Mites/anatomy & histology; Mites/classification*; Mites/physiology; Mites/ultrastructure; Tick Infestations/veterinary; Elapidae/parasitology*
  8. Chandrawathani P, Chang KW, Nurulaini R, Waller PJ, Adnan M, Zaini CM, et al.
    Trop Biomed, 2006 Jun;23(1):23-30.
    PMID: 17041548 MyJurnal
    This study was conducted to evaluate the anthelmintic effect of neem (Azadirachta indica) on nematode parasites of sheep. Twelve Santa Ines cross bred sheep from a government farm were randomly selected and equally divided into control (n = 6) and treated groups (n =6). Faecal egg counts (FEC) using the modified McMaster technique and the FAMACHA score for assessing clinical anaemia were carried out daily and recorded for 6 weeks. At the end of the study all the animals were slaughtered and the total worm count (TWC) was done. The results of FEC showed that there was no significant difference between the control and treated group (p = 0.081). However, worm burden estimations showed that the number of parasites was significantly higher in the control group compared to the treated group (p < 0.05). This result indicated that feeding Neem had an effect on worm numbers in sheep, but was not reflected in their faecal egg counts. Further work is needed to reconfirm the effect of Neem on helminth infections of sheep.
    MeSH terms: Animals; Female; Malaysia; Male; Nematoda/drug effects*; Parasite Egg Count; Sheep/parasitology*; Plant Leaves*; Azadirachta*
  9. Noor Azian MY, Lokman Hakim S, Maslawaty MN
    Trop Biomed, 2006 Jun;23(1):31-6.
    PMID: 17041549 MyJurnal
    Amoebiasis is an infectious diseased caused by parasitic one-celled protozoan called Entamoeba histolytica. Numerous protozoa also can inhabit the gastro-intestinal tract of human. Majority of these protozoa are non-pathogenic commensals or only causes disease under certain circumstances. Morphologically, E. histolytica, the invasive form, share the same characteristic with the nonpathogenic form, E. dispar. Both strains can be distinguished by using DNA identification. Many previous researches in Malaysia only reported infection with E. histolytica infection. Therefore in this study we tried to classify infection among the aborigines in Cameron Highland as true E. histolytica or E. dispar by Nested Polymerase Chain Reaction (Nested PCR) and Restriction enzyme (RE) digestion. Results showed that 31 samples were positive by microscopic examination, however of these 28 (13.2%) samples were positive for E. histolytica and 12 (5.6%) samples were positive for E. dispar by molecular tools.
    MeSH terms: Adolescent; Adult; Animals; Child; Child, Preschool; Diagnosis, Differential; Entamoeba/genetics*; Entamoeba histolytica/genetics*; Entamoebiasis/diagnosis*; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Middle Aged; Polymerase Chain Reaction/methods
  10. Lee YW, Zairi J
    Trop Biomed, 2006 Jun;23(1):37-44.
    PMID: 17041550 MyJurnal
    Studies were carried out on the residual efficacy of Bacillus thuringiensis H-14 (water dispersible granule, VectoBac ABG 6511) as direct application in the control of Aedes larvae in the field. Field Aedes sp populations in the earthen and glass jars were predetermined before initiation of the trial. On confirmation of the presence of Aedes species in the designated area, Sungai Nibong Kecil, Penang Island, Malaysia, Bti was introduced in the 55L earthen and 3L glass jars). Two test designs were carried out. The first design had treated water replenished daily with 6L of seasoned water and the second design is without the replenishment of water but evaporated water was replenished. Bti was effective in the field for at least 35 days with more than 80% reduction in the Aedes larvae in the treated containers. For earthen jars with daily replenishment of water, 100% reduction was recorded for the first 3 days, while more than 80% reduction was recorded up to day 40. At day 60, Bti still provided an efficacy of 54.32 +/- 4.61 (%) of reduction. Whilst for earthen jars without daily replenishment of water, 100% reduction was recorded for the first 5 days, while more than 80% of reduction was recorded up to day 40. For the glass jars studied, similar efficacy was observed. In jars with daily replenishment of water a better larval control was observed. Percentage of reduction from day 50 to 60 for replenishment of water was between 50 to 70% compared to without replenishment of water with less than 40%.
    MeSH terms: Aedes*; Animals; Bacillus thuringiensis*; Insecticides/pharmacology*; Larva; Mosquito Control/methods*; Pest Control, Biological/methods*
  11. Bong I, Lim P, Balraj P, Sim Ui Hang E, Zakaria Z
    Trop Biomed, 2006 Jun;23(1):53-9.
    PMID: 17041552 MyJurnal
    Colorectal carcinoma ranks third among ten leading causes of cancer in Malaysia. The colorectal carcinoma tumourigenesis involves the inactivation of tumour suppressor genes, and activation of proto-oncogenes. The p53 is one of the tumour suppressor genes that is involved in the colorectal carcinogenesis. The p53 gene is located on human chromosome 17p13.1 and comprises of 11 exons. Deficiencies in the p53 gene can cause the cancerous cells to spread to distant organs such as liver, lungs, lymph nodes, spine and bone. The most common p53 abnormalities that can lead to the metastasis of colorectal tumours are mutation and deregulation of the gene. In this study, nine colorectal carcinoma samples were used to establish a simple and sensitive strategy in the study on in vivo p53 expression by using realtime LightCycler SYBR Green I technology.
    MeSH terms: Aged; Female; Humans; Male; Middle Aged; Colorectal Neoplasms/genetics*; Polymerase Chain Reaction/methods*; Genes, p53*
  12. Lat-Lat H, Hassan L, Rehana AS, Sheikh-Omar AR, Chandrasegaram S
    Trop Biomed, 2006 Jun;23(1):61-8.
    PMID: 17041553
    A study on causes of lung condemnation in 25 abattoirs from peninsular Malaysia for a period of seven years (1998-2004) was conducted by examining the records at the Department of Veterinary Services headquarters in Kuala Lumpur. A total of 5.3% of lungs from 233,417 cattle and buffaloes were condemned from 1998 to 2004. The main cause of condemnation was congestion (2.98%). The percentage of lungs that were condemned due to parasitic infection among the total population slaughtered was low (0.11%). Parasitic infection contributed to 2.1% of all lungs condemned. It was also found that the prevalence of parasitic infection in the lungs was generally much higher in buffaloes than in cattle.
    MeSH terms: Abattoirs; Animals; Buffaloes; Cattle; Dictyocaulus Infections/epidemiology*; Lung/parasitology*; Malaysia/epidemiology; Time Factors; Prevalence
  13. Santhana Raj L, Teh Hamidah Z, Nor Asiha CP, Paramasvaran S
    Trop Biomed, 2006 Jun;23(1):69-74.
    PMID: 17041554 MyJurnal
    Transmission electron microscopy (TEM) can provide high resolution imaging of biological specimens. The study is to establish the effects of a modified glutaraldehyde (GA) compare to the standard GA fixation on Acanthamoeba castellanii from TEM perspectives and thus provide precise and accurate information on the ultrastructure studies of the parasite. By increasing the contrast, the ultrastructures of the parasite were more evident. The TEM images were obtained from parasites fixed with the modified GA and the standard GA and then the area of the nucleus and the gray values of the image of the nucleus of the parasites were measured. The mean areas of the nucleus were found to be significantly reduced in the standard GA fixed parasites (12210.4 nm2) compared to the modified GA fixed parasites (8676.3 nm2) (p < 0.05). The mean gray values of the image were significantly reduced from 2024 in the standard GA fixed parasites (2024) to the modified GA fixed parasites (1636) (p < 0.05). The study shows that the modified GA produced significantly better contrast on TEM images of the A. castellanii compared to the standard GA. This was because the modified GA generated more free water molecules during fixation and the uptake of modified GA by the nucleus of the parasite organizing all protein constituents in the cell into a more closely packed configuration than that of the standard GA. With such properties, the modified GA is a better fixative providing better images for ultrastructures of the parasite.
    MeSH terms: Animals; Cell Nucleus/ultrastructure; Glutaral/pharmacology*; Malaysia; Tissue Fixation*; Microscopy, Electron, Transmission; Acanthamoeba castellanii/ultrastructure*
  14. Lim KH, Amal NM, Hanjeet K, Mashod MY, Wan Rozita WM, Sumarni MG, et al.
    Trop Biomed, 2006 Jun;23(1):75-84.
    PMID: 17041555 MyJurnal
    Smoking among adolescent is a public health concern in Malaysia. Multiple studies on smoking prevalence and its related factors have been conducted in Malaysia, however, they were specific to either urban or rural areas alone. Studies in mixed settlement areas (urban, rural, land development area) had not been intensively investigated. This study reports the prevalence, demographic and factors related to smoking amongst form four students in the district of Kota Tinggi, Johor. A cross-sectional study of 16-year old secondary school students in Kota Tinggi district was conducted using two-stage stratified, proportionate sampling in July 2005. The study instrument used was a validated structured questionnaire on smoking and its related factors. Smoking prevalence was found to be 29.7%. More than 50% of male students were smokers. Prevalence was highest in FELDA (Federal Land Development Authority) settlement areas. Smoking was associated with having a brother or friend who smokes and poor academic performance. The study revealed that smoking prevalence was high, especially among male students in land development schemes. This situation will contribute to high smoking-related health problems in the future if proper preventive measures are not taken accordingly.
    MeSH terms: Adolescent; Child; Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Male; Smoking/epidemiology*; Prevalence
  15. Cheah WL, Chang MS, Wang YC
    Trop Biomed, 2006 Jun;23(1):85-96.
    PMID: 17041556 MyJurnal
    The objective of this study was to elucidate the association of various risk factors with dengue cases reported in Lundu district, Sarawak, by analyzing the interaction between environmental, entomological, socio-demographic factors. Besides conventional entomological, serological and house surveys, this study also used GIS technology to generate geographic and environmental data on Aedes albopictus and dengue transmission. Seven villages were chosen based on the high number of dengue cases reported. A total of 551 households were surveyed. An overall description of the socio-demographic background and basic facilities was presented together with entomological and geographical profiles. For serological and ovitrap studies, systematic random sampling was used. Serological tests indicated that 23.7% of the 215 samples had a history of dengue, either recent or previous infections. Two samples (0.9%) were confirmed by IgM ELISA and 49 samples (22.8%) had IgG responses. A total of 32,838 Aedes albopictus eggs were collected in 56 days of trapping. Cluster sampling was also done to determine whether any of the risk factors (entomological or geographical) were influenced by geographical location. These clusters were defined as border villages with East Kalimantan and roadside villages along Lundu/Biawas trunk road. The data collected were analyzed using SPSS version 10.01. Descriptive analysis using frequency, means, and median were used. To determine the association between variables and dengue cases reported, and to describe the differences between the two clusters of villages, two-sample t-test, and Pearson's Chi-Square were used. Accurate maps were produced with overlay and density function, which facilitates the map visualization and report generating phases. This study also highlights the use of differential Global Positioning System in mapping sites of 1m accuracy. Analysis of the data revealed there are significant differences in clusters of villages attributable to container density, house density, distance of the house from the main road, and number of Ae. albopictus eggs from ovitraps set indoor, outdoor and in dumping sites (Person's Chi-Square = 6.111, df = 1, p < 0.01). Further analysis using t-test showed that house density, container density, indoor mosquitoes egg count, outdoor mosquitoes egg count, and dumping sites mosquitoes egg count were higher at the roadside villages compared to border villages. A number of potential risk factors including those generated from GIS were investigated. None of the factors investigated in this study were associated with the dengue cases reported.
    MeSH terms: Aedes; Animals; Antibodies, Viral/blood; Dengue/etiology; Dengue/epidemiology*; Disease Outbreaks*; Humans; Insect Vectors; Larva; Malaysia/epidemiology; Population Surveillance; Retrospective Studies; Risk Factors; Rural Health
  16. Husniza H, Wan Nazaimoon WM
    Trop Biomed, 2006 Jun;23(1):109-15.
    PMID: 17041559 MyJurnal
    A modified micromethod for measuring urine iodine was successfully established and validated. The micromethod showed good correlation with the method used by several World Health Organization (WHO) collaborative laboratories (y = 0.9342x + 4.6213; r = 0.962; p = 0.01; n = 50). The micromethod also showed good agreement when compared to the reference WHO method. The sensitivity of the assay was 13.809 ug/L (n = 8) and mean recoveries were 114, 103 and 106% at concentrations of 30, 40 and 50 ug/L (n = 3) respectively. At iodine concentrations of 51 +/- 15.5, 108 +/- 32.4 and 149 +/- 38.6 ug/L, intra-assay coefficient of variations (CVs) were 13%, 7% and 5% respectively (n = 20), and inter-assay CVs were 10%, 15% and 7% respectively (n = 10). The assay showed good linearity plot (y = 1.0407x + 60.451; r = 0.993; n = 3).
    MeSH terms: Cost-Benefit Analysis; Humans; Iodine/urine*; World Health Organization
  17. Lee HL, Krishnasamy M, Jeffery J, Paramasvaran S
    Trop Biomed, 2006 Jun;23(1):131-2.
    PMID: 17041562 MyJurnal
    There were a spate of recent complaints of insect bites and the entomological specimens received from various sources were identified to be those of cat flea (Ctenocephalides felis) and rat flea (Xenopsylla cheopis), the tropical bed-bug (Cimex hemipterus) and the dog louse (Heterodoxus spiniger). Only the fleas and the bed-bug are known to attack humans.
    MeSH terms: Animals; Bedbugs*; Cats/parasitology*; Dogs/parasitology*; Siphonaptera*; Humans; Insect Bites and Stings; Phthiraptera*; Rats/parasitology*
  18. Hassan Shukur M
    Med J Malaysia, 2006 Feb;61 Suppl A:1-2.
    PMID: 17042219
    In this issue of the Journal, there are two articles addressing relevant clinical problems that we may encounter in our practice. The main issue related to the occurrence of the inevitability of the avascular necrosis (AVN) following treatment of two different major types of capital femoral epiphyseal 'injury'.
    MeSH terms: Epiphyses, Slipped/complications; Epiphyses, Slipped/diagnosis; Epiphyses, Slipped/radiography; Epiphyses, Slipped/surgery*; Femur Head/injuries*; Femur Head/radiography; Femur Head/surgery; Femur Head Necrosis/etiology; Femur Head Necrosis/prevention & control; Fracture Fixation, Internal; Humans; Hip Injuries/complications; Hip Injuries/radiography; Hip Injuries/surgery*
  19. Wan Hazmy CH, Chia WY, Fong TS, Ganendra P
    Med J Malaysia, 2006 Feb;61 Suppl A:3-9.
    PMID: 17042220
    The post-operatve course of amputees is poorly documented. This cross-sectional survey was unertaken to determine functional outcomes of 213 patients who had undergone either a below-knee or above-knee amputation from 2000 to 2002 in a state-hospital setting. The study comprises a self-constructed questionnaire and interview conducted by phone. Of the 213 amputees, 41 out of 61 documented telephone numbers of the patients were useful for contact. Only 30 amputees were available for the study as the remaining 11 had passed away. Included in the questionnaire was the modified Barthel Index, a measurement to assess the amputees' ability to carry out activities of daily living (ADL). It contains ten questions pertaining to ADL with a total score of 20 points. Two-thirds of the respondents (67%) use their prosthesis for less than six hours per day. The Barthel Index of 30 patients ranged from 9-20 (mean 17.7). However, the mean Barthel Index in those with and without prosthesis was 18.4 and 15.2 respectively, but this difference was not significant. Half of the respondents were unable to maintain their pre-amputation jobs, while the remaining 50% were still able to work. Forty seven percent of amputees took less than a year to return to their activities, while 33% took between one to two years. Regarding the adequacy of preamputation information provided by the doctors, 73% amputees responded in the affirmative, while 27% felt otherwise. Amputees were still facing substantial disabilities following major amputation of the lower limb. Although 80% of respondents surveyed own prosthesis, the full use of prosthesis is suboptimal due to prosthetic-related problems. Most amputees had a good functional outcome based on the modified Barthel Index. Some amputees were unhappy as they felt that they were insufficiently informed regarding post-amputation expectation prior to the amputation. Despite good support from family, the community support for amputees is still lacking.
    MeSH terms: Activities of Daily Living; Adult; Amputation*; Cross-Sectional Studies; Female; Health Surveys; Hospitals, Public; Humans; Malaysia; Male; Middle Aged; Postoperative Period*; Surveys and Questionnaires; Sickness Impact Profile; Lower Extremity/physiopathology; Lower Extremity/surgery*
  20. Naicker AS, Roohi SA, Lee CS, Chan WH, Tay LS, Din XJ, et al.
    Med J Malaysia, 2006 Feb;61 Suppl A:10-3.
    PMID: 17042221
    Poor glycaemic control and the duration of diabetes mellitus are known to accelerate development and progression of neuropathy. Diabetic co-morbidities: hypertension and hyperlipidaemia, have been postulated to associate with development of neuropathy. A diabetic foot with low temperature and frequent exposure to low temperature environment has recently been hypothesized to be at higher risk to develop early neuropathy. This cross-sectional study is undertaken to identify risk factors for diabetic neuropathy and the association between foot temperature and development of diabetic neuropathy by using simple clinical examination in the outpatient setting. From April 18, to April 30, 2005, universal sampling method was used to select 134 diabetic patients (type 1 or type 2 for >1 year) with peripheral neuropathy. Excluded are those with chronic alcoholism, drug-induced neuropathy, dietary history of vitamin B deficiency and family history of porphyria and hereditary sensorimotor neuropathy. The patient's duration of diabetes, glycaemic control status and the presence of co-morbids: hypertension and hyperlipidemia, were recorded. The temperature of the foot was measured by using thermo buddy. Of 134 patients representing Malaysian ethnic distribution with an equal number of males and females, 20.1% were in the age group of 61 to 65 years and, 85.1% and 67.9% belonged to lower socioeconomic and educational groups respectively. Associations between diabetic neuropathy and glycaemic control (p = 0.018) and duration of diabetes (p < 0.05) were significant. However, hypertension, hyperlipidaemia and low foot temperature were not significantly associated with development of diabetic neuropathy. Poor glycaemic control is significantly associated with diabetic neuropathy. Foot temperature alteration is merely an effect of autonomic neuropathy with a cold foot is attributed to co-existing peripheral arterial disease.

    Study site: Pusat Perubatan Primer Bandar Tasik Selatan, Kuala Lumpur, Malaysia
    MeSH terms: Adult; Aged; Ambulatory Care Facilities; Body Temperature/physiology*; Body Temperature Regulation/physiology; Climate; Cold Temperature/adverse effects; Cross-Sectional Studies; Diabetic Neuropathies/physiopathology; Diabetic Neuropathies/prevention & control*; Female; Geography; Humans; Hyperglycemia/physiopathology*; Malaysia; Male; Middle Aged; Surveys and Questionnaires; Risk Factors; Diabetic Foot/physiopathology; Diabetic Foot/prevention & control*; Disease Progression; Risk Assessment
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