Browse publications by year: 2006

  1. Biological evaluation of curcumin and related diarylheptanoids
    Abas F, Hui LS, Ahmad S, Stanslas J, Israf DA, Shaari K, et al.
    Z Naturforsch C J Biosci, 2006 12 2;61(9-10):625-31.
    PMID: 17137104
    Nine derivatives of three natural diarylheptanoids, curcumin, demethoxycurcumin and bisdemethoxycurcumin, were prepared. Their antioxidant, free radical scavenging, nitric oxide (NO) inhibitory and cytotoxic activities were evaluated and compared with those of the respective natural compounds. Curcumin (1), demethoxycurcumin (2), demethyldemethoxy-curcumin (C3), diacetyldemethoxycurcumin (AC2) and triacetyldemethylcurcumin (AC5) exhibited higher antioxidant activity than quercetin while products from demethylation of 1 and 2 exhibited higher free radical scavenging activity. Compounds AC2 and AC5 were found to be most active in inhibiting breast cancer cells (MCF-7) proliferation with IC50 values of 6.7 and 3.6 microM, respectively. The activity of AC2 is almost doubled and of AC5 almost tripled as compared to curcumin. Their selectivity towards different cell lines is also more noticeable. Compounds AC2 and AC5 also showed increased activity against a human prostate cancer cell line (DU-145) and non-small lung cancer cell line (NCI-H460) with IC50 values of 20.4, 16.3 and 18.3, 10.7 microM, respectively.
    MeSH terms: Antioxidants/isolation & purification; Antioxidants/pharmacology; Chromatography; Chromatography, Thin Layer; Curcumin/isolation & purification*; Curcumin/chemistry; Quercetin/isolation & purification; Quercetin/chemistry; Molecular Structure; Free Radical Scavengers; Diarylheptanoids/isolation & purification*; Diarylheptanoids/chemistry
  2. Psychiatric rehabilitation and its present role in developing countries
    Deva P
    World Psychiatry, 2006 Oct;5(3):164-5.
    PMID: 17139349
  3. Fulltext The product of outcome-based undergraduate medical education: competencies and readiness for internship
    Lai NM, Ramesh JC
    Singapore Med J, 2006 Dec;47(12):1053-62.
    PMID: 17139402
    INTRODUCTION: Outcome-based curriculum is adopted at the International Medical University (IMU), Malaysia, where specific learning objectives are laid out progressively under eight major outcomes. We present an outcome-guided, self-reported competency profile of our undergraduate students near the end of their training, focusing on elements that are considered most immediately relevant for their internship.
    METHODS: Anonymous surveys were conducted on two cohorts of medical students in their final semester at IMU. The surveys covered a range of competencies, including practical skills, ward routines, generic attributes and evidence-based medicine, grouped under the exit outcomes as defined by the university.
    RESULTS: A total of 92 students were assessed. In general, the students were confident of their ability on common practical skills and ward routines. They were comfortable with the level of professionalism and personal attributes required for internship, with the prospect of handling unexpected additional tasks and working away from home perceived as the main difficulties. Most students referred to at least three sources of clinical information to answer their clinical queries. However, they referred more to single journals than databases or collections. The majority could critically appraise journal articles to a variable extent, but nearly half took 30 minutes or longer to trace an abstract of interest.
    CONCLUSION: This report demonstrates the strength of outcome-based curriculum in its ability to produce competent students that are well prepared for their internship. Assessing students using this educational approach provides a clear picture of their strengths and weaknesses, and identifies stages in their training where additional inputs are required.
    MeSH terms: Clinical Competence*; Competency-Based Education/methods*; Curriculum*; Data Collection; Education, Medical, Undergraduate/methods*; Humans; Malaysia; Self-Assessment; Evidence-Based Medicine
  4. Common celiaco-mesenterico-phrenic trunk and renal vascular variations
    Nayak S
    Saudi Med J, 2006 Dec;27(12):1894-6.
    PMID: 17143371
    The knowledge of vascular variations like other anatomical variations, is important during the operative, diagnostic, and endovascular procedures in abdomen. This report describes multiple variations in the upper abdominal vessels as found during the routine dissection in a 60-year-old male cadaver. The variations found were; presence of a celiaco-mesenterico-phrenic trunk, a common inferior phrenic trunk, 2 right renal arteries originating from abdominal aorta, 2 suprarenal arteries originating from the lower right renal artery, 3 right renal veins opening separately into inferior vena cava, and termination of right testicular vein into the lowest vein among the 3 right renal veins. The existence of a celiaco-mesenterico-phrenic trunk has not been reported yet. Although, other variations reported in this case exist as individual variations, a concomitant variation of them has not been reported yet. The knowledge of such variations is quite useful in planning any upper abdominal surgery.
    MeSH terms: Abnormalities, Multiple*; Cadaver; Celiac Artery/abnormalities*; Humans; Male; Mesenteric Arteries/abnormalities*; Middle Aged; Renal Artery/abnormalities*; Renal Veins/abnormalities*
  5. Influence of initial dissolved oxygen concentration on Fenton's reagent degradation
    Aris A, Sharratt PN
    Environ Technol, 2006 Oct;27(10):1153-61.
    PMID: 17144264
    The effect of initial dissolved oxygen concentration (IDOC) on Fenton's reagent degradation of a dyestuff, Reactive Black 5 was explored in this study. The study was designed, conducted and analysed based on Central Composite Rotatable Design using a 3-1 lab-scale reactor. The participation of O2 in the process was experimentally observed and appears to be affected by the dosage of the reagents used in the study. The IDOC was found to have a significant influence on the process. Reducing the IDOC from 7.5 mg l(-1) to 2.5 mg l(-1) increased the removal of TOC by an average of about 10%. Reduction of IDOC from 10 mg l(-1) to 0 mg l(-1) enhanced the TOC removal by about 30%. The negative influence of IDOC is likely to be caused by the competition between the O2 and the reagents for the organoradicals. A model describing the relationship between initial TOC removal, reagent dosage and IDOC has also been developed.
    MeSH terms: Biodegradation, Environmental/drug effects; Coloring Agents/metabolism*; Hydrogen Peroxide/metabolism*; Hydrogen Peroxide/chemistry; Iron/metabolism*; Iron/chemistry; Naphthalenesulfonates/metabolism*; Oxidation-Reduction; Oxygen/metabolism; Oxygen/pharmacology*; Solubility; Models, Statistical
  6. Molecular analysis of vibrio cholerae strains isolated in Malaysia: public health implications
    Iyer L, Vadivelu J
    Asia Pac J Public Health, 2006;18(3):33-41.
    PMID: 17153080
    The genetic diversity or clonality among Vibrio cholerae O1, O139 and non-O1/ non-O139 of clinical and environmental origin using ribotyping and PFGE was performed in order to ascertain the public health implications of the different genotypes circulating within the Malaysian environment. Using an in-house typing scheme, of the 214 strains included, 202 strains were isolated locally between 1992 and 1998, seven were obtained from Bangladesh and five were reference strains. Amongst the 176 El Tor O1 strains, 152 clinical strains demonstrated five ribotypes--E1a, E1b, E2a, E3 and E1c. E1b was the most predominant ribotype demonstrated by 84% of the El Tor O1 strains and was present in all years demonstrating that this strain was intrinsic to Malaysia. PFGE analysis of these strains demonstrated minimal variation amongst the 15 PFGE profiles obtained. Ribotpye E2a amongst five clinical and two environmental O1 strains, were from one location and had previously been reported in Indonesia and the Philippines, thus demonstrating strong evidence that these strains may have been imported into Malaysia. Among Vibrio cholerae O139 strains, 91.7% were of ribotype A1a similar to the original O139, while two others were of ribotype A1b and one of A1e, corresponding to ribotypes 1, 2 and 3 of Dalsgaard and colleagues' scheme for O139 strains. PFGE analysis demonstrated that 89% of ribotype A1a could be differentiated into three PFGE genotypes which were very closely related. The eight non-O1/non-O139 serogroup strains were heterogeneous in both ribotype and PFGE patterns.
    MeSH terms: DNA, Bacterial/genetics; Malaysia; Public Health; RNA, Ribosomal/genetics; Vibrio cholerae/classification; Vibrio cholerae/genetics*; Vibrio cholerae/isolation & purification; Electrophoresis, Gel, Pulsed-Field; Molecular Epidemiology; Ribotyping
  7. The effect of intensity on pitch in electric hearing and its relationship to the speech perception performance of cochlear implantees
    Umat C, McDermott HJ, McKay CM
    J Am Acad Audiol, 2006 12 13;17(10):733-46.
    PMID: 17153721
    This study investigated the effect of intensity on pitch in electric hearing and its relationship to the speech perception ability of cochlear implantees. Subjects were 13 adult users of the Nucleus 22 cochlear implant system, using either the Spectra22 or ESPrit22 speech processor and the SPEAK speech processing strategy. A multidimensional scaling technique was employed. Speech perception was measured using sentences and vowels. All measurements were performed in a soundfield condition, and subjects wore their own speech processors with their normally used settings. Results showed a significant correlation between the degree of deviation of the subjects' stimulus spaces from the "ideal" space and subjects' performance with the sentences, but not with the vowels. A significant correlation was found between subjects' response variability in performing the multidimensional scaling task and their speech perception measures, suggesting that spectral smearing or underlying cognitive abilities might affect implantees' speech perception performance.
    MeSH terms: Acoustic Stimulation; Aged; Cochlear Implants*; Deafness/radiotherapy*; Female; Humans; Loudness Perception*; Male; Middle Aged; Pitch Discrimination*; Regression Analysis; Speech Perception*; Speech Reception Threshold Test; Treatment Outcome
  8. Measurement and structural invariance of parent ratings of ADHD and ODD symptoms across gender for American and Malaysian children
    Burns GL, Walsh JA, Gomez R, Hafetz N
    Psychol Assess, 2006 Dec;18(4):452-7.
    PMID: 17154767
    The purpose of this study was to examine the measurement (configural, metric, scalar, and residual) and structural (factor variance, factor covariance, and factor means) invariance of parent ratings of the attention-deficit/hyperactivity disorder - inattention (ADHD-IN), ADHD - hyperactivity/impulsivity (ADHD-HI), and oppositional defiant disorder (ODD) symptoms as described in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) across boys and girls. In an American pediatric sample (N = 1,015) and a Malaysian elementary school-age sample (N = 928), there was strong support for configural, metric, scalar, residual, factor variance, and covariance invariance across gender within each sample. Both American and Malaysian boys had significantly higher scores on the ADHD-IN and ADHD-HI factor means than did girls, whereas only in the American sample did boys score significantly higher on the ODD factor than did girls. The implications of the results for the study of gender, ethnic, and cultural differences associated with ADHD and ODD are discussed.
    MeSH terms: Attention Deficit Disorder with Hyperactivity/epidemiology*; Attention Deficit Disorder with Hyperactivity/psychology*; Child; Female; Humans; Malaysia/epidemiology; Male; Parents/psychology*; Psychometrics/methods; Surveys and Questionnaires; United States/epidemiology; Sex Distribution; Attention Deficit and Disruptive Behavior Disorders/epidemiology*; Attention Deficit and Disruptive Behavior Disorders/psychology*
  9. Impact, distress and HRQoL among Malaysian men and women with a mobility impairment
    Misajon R, Manderson L, Pallant JF, Omar Z, Bennett E, Rahim RB
    Health Qual Life Outcomes, 2006;4:95.
    PMID: 17156494
    Although non-communicable and chronic disease now accounts for 47% of the global burden of disease, little is known of the everyday experiences and social aspects of disability and disablement in middle and low income countries. This article aims to address this gap by exploring the subjective experience of mobility impairment in Malaysia. Specifically, it examines health-related quality of life and the impact and distress related to impaired mobility, and investigates any gender differences in relation to the experience of disability.
    MeSH terms: Activities of Daily Living; Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Depression; Female; Disabled Persons/psychology*; Humans; Malaysia; Male; Middle Aged; Quality of Life/psychology*; Surveys and Questionnaires; Social Isolation; Social Support; Stress, Psychological; Sickness Impact Profile*; Mobility Limitation*
  10. A study on the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis
    Chan YC, Tay YK, Sugito TL, Boediardja SA, Chau DD, Nguyen KV, et al.
    Ann Acad Med Singap, 2006 Nov;35(11):794-803.
    PMID: 17160196
    INTRODUCTION: This study evaluated the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis (AD).

    MATERIALS AND METHODS: A questionnaire survey of 255 dermatologists in Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam.

    RESULTS: Familiarity with diagnostic criteria varied considerably. The usage of moisturisers by the respondents from Vietnam and Indonesia was significantly less frequent than the other countries. Most respondents (91% to 100%) used topical corticosteroids in children with mild-to-moderately severe dermatitis. Some respondents in the Philippines (17% to 19%) and Vietnam (11% to 25%) only used topical corticosteroids for severe disease. For infected eczema, most respondents would prescribe systemic antibiotics for mild-to-moderate infection. A minority in the Philippines (14%) and Vietnam (11%) did so only for severe infection. The top 4 systemic antibiotics prescribed most frequently were: erythromycin, cloxacillin, cephalosporin and amoxicillin/clavulanic acid. In Indonesia, a large proportion of the respondents (47%) prescribed amoxicillin most frequently. The majority of respondents (60% to 100%) prescribed both sedating and non-sedating oral antihistamines. Most respondents used oral corticosteroids to treat severe AD. Some in Malaysia, Singapore and Vietnam used cyclosporin (7% to 58%), azathioprine (5% to 31%) and methotrexate (5% to 14%). With the exception of those in Singapore, the majority of respondents (71% to 97%) did not use phototherapy.

    CONCLUSION: Familiarity with diagnostic criteria, the early and judicious use of moisturisers and topical corticosteroids, as well as the treatment of Staphylococcus aureus superinfection with penicillinase-stable antibiotics should be emphasised in this region.

    MeSH terms: Anti-Bacterial Agents/therapeutic use*; Asia, Southeastern/epidemiology; Drug Administration Routes; Glucocorticoids/administration & dosage; Glucocorticoids/therapeutic use*; Histamine H1 Antagonists/therapeutic use*; Humans; Hypnotics and Sedatives/therapeutic use*; Health Knowledge, Attitudes, Practice*; Population Surveillance; Severity of Illness Index; Outcome Assessment (Health Care)*
  11. Nasal carriage of Staphylococcus aureus among healthy adults
    Choi CS, Yin CS, Bakar AA, Sakewi Z, Naing NN, Jamal F, et al.
    J Microbiol Immunol Infect, 2006 Dec;39(6):458-64.
    PMID: 17164947
    Data on the carriage rate and antibiotic sensitivity pattern of Staphylococcus aureus strains prevalent in the community are not available for many developing countries including Malaysia. To estimate the extent of community S. aureus transmission, in particular methicillin-resistant S. aureus (MRSA), the prevalence of S. aureus nasal colonization in a population of healthy adults was determined. Factors associated with S. aureus nasal carriage and antibiotic sensitivity patterns of the isolates were also analyzed.
    MeSH terms: Adult; Aged; Anti-Bacterial Agents/pharmacology*; Carrier State/microbiology; Carrier State/epidemiology*; Contraceptives, Oral; Cross-Sectional Studies; Faculty, Medical; Female; Humans; Malaysia/epidemiology; Male; Medical Staff; Methicillin/pharmacology; Middle Aged; Nasal Mucosa/microbiology*; Risk Factors; Smoking; Staphylococcal Infections/microbiology; Staphylococcal Infections/epidemiology*; Staphylococcus aureus/drug effects*; Staphylococcus aureus/isolation & purification; Students; Visitors to Patients; Methicillin Resistance
  12. Influenza as an issue on the agenda of health care workers: what can we do? What do we need?
    Vaccine, 2006 Nov 10;24(44-46):6791-2.
    PMID: 17167887
    ESWI recommends that the 25 European Union nations strive to vaccinate one-third of their collective population every year by 2010. This translates into an annual vaccine usage of 150 million doses for a population of 455 million. However, the current vaccine usage in Europe is 79 million doses, meaning that only 40% of ESWI's recommended target population is being vaccinated in the EU-25. Indeed, the EU's current risk groups equal about 28% of its population, but it is estimated that less than 62% are being vaccinated with the current vaccine supply--the equivalent of 17% of the total population. Clearly, as ESWI noted in its concluding position paper at the Malta conference, "a large proportion of those traditionally assumed to be at most risk from influenza are not being vaccinated." How to change this and minimize the consequences of a pandemic? "It's very interesting how the arithmetic works, given the goal of immunizing 75 percent of Europe's high-risk group, " said Dr K.Nichol of the University of Minnesota Medical Center who chaired the session. "If you go from a trivalent vaccine to a monovalent one, then you triple the number of doses you can manufacture. Thus, you could produce enough doses for the entire population of the EU." However, there is no coordinated approach in Europe, meaning such an optimistic scenario is unlikely in the medium-term. For the time being, emphasis must be on raising public awareness and raising vaccination rates at the local level, starting with health care workers themselves. Here the role and attitude of health policy officials and--critically--health care workers are crucial. These front-line policy and healthcare professionals constitute both the problem and the solution to a more effective influenza vaccine effort in Europe: they know first-hand the institutional obstacles blocking progress--i.e., lack of resources, poorly focused public information campaigns, etc.--but their own work practices and attitudes can be misdirected, too. To identify the issues and help the participants produce a set of recommendations, ESWI brought in Penny Lawson from to facilitate Dr.K. Nichol to steer this session's workshop debate. The participants were a diverse group of 35 health care workers from Australia, Finland, France, Germany, Malaysia, Malta, Netherlands, Norway, Poland, Portugal, Spain, Sweden and the UK.
    MeSH terms: Health Personnel*; Humans; Influenza, Human/epidemiology; Influenza, Human/prevention & control*; Influenza Vaccines/administration & dosage*; Health Knowledge, Attitudes, Practice; Patient Compliance/statistics & numerical data; Immunization Programs/standards*
  13. Patchy stomatal behavior in broad-leaved trees grown in different habitats
    Takanashi S, Kosugi Y, Matsuo N, Tani M, Ohte N
    Tree Physiol, 2006 Dec;26(12):1565-78.
    PMID: 17169896
    Effects of heterogeneity in stomatal behavior on gas-exchange characteristics of leaves from four tree species growing in different climates, including temperate, tropical monsoon and tropical rain forest, were investigated by combining gas-exchange measurements and the pressure-infiltration method. Field observations indicated linear relationships between whole-leaf conductance and the ratio of infiltrated to non-infiltrated leaf area (open stomata area) in Dipterocarpus sublamellatus Foxw. and Neobalanocarpus heimii (King) Ashton in a tropical rain forest in Peninsular Malaysia, whereas the ratio of infiltrated to non-infiltrated area rapidly increased up to the whole-leaf conductance at which the entire leaf was infiltrated in Cinnamomum camphora Sieb. in a temperate evergreen forest in Japan and in Azadirachta indica Juss. in a tropical monsoon area in Thailand. These results strongly suggest small ranges in bell-shaped stomatal conductance distributions in C. camphora and A. indica and bimodal stomatal conductance distributions in D. sublamellatus and N. heimii. The values of normalized maximum carboxylation rate at 25 degrees C (V(cmax25)) derived from gas-exchange measurements were not constant, but decreased with decreasing whole-leaf conductance in D. sublamellatus and N. heimii. A gas-exchange model analysis revealed a linear relationship between whole-leaf conductance and the ratio of infiltrated to non-infiltrated leaf area for bimodal stomatal conductance distributions, whereas for bell-shaped distributions, the relationships were nonlinear. Midday depression of apparent V(cmax25) in these species was mainly caused by bimodal stomatal closure. The bimodal stomatal distribution model could also explain diurnal changes in photosynthetic assimilation and transpiration rates in these species.
    MeSH terms: Circadian Rhythm; Climate; Models, Biological; Photosynthesis/physiology*; Trees/physiology*; Ecosystem*; Plant Leaves/physiology*; Angiosperms/physiology*
  14. Estimating self, parental, and partner multiple intelligences: a replication in Malaysia
    Swami V, Furnham A, Kannan K
    J Soc Psychol, 2006 Dec;146(6):645-55.
    PMID: 17172142
    Participants were 230 adult Malaysians who estimated their own, their parents', and their partners' overall IQs and 10 multiple intelligences. In accordance with both the previous literature and the authors' hypotheses, men rated themselves higher than did women on overall, verbal, logical-mathematical, and spatial intelligences. There were fewer gender differences in ratings of parents and in those of partners. Participants believed that they were more intelligent than both parents (but not their partners) and that their fathers were more intelligent than their mothers. Regressions indicated that participants believed that verbal intelligence and--to a lesser extent--logical-mathematical intelligence were the main predictors of overall intelligence. The authors discussed results in terms of the extant cross-cultural literature in the field.
    MeSH terms: Adult; Aged; Culture; Family Characteristics*; Female; Humans; Intelligence*; Malaysia; Male; Middle Aged; Parents*; Surveys and Questionnaires; Self Concept*; Social Perception*
  15. An improved rapid genotyping method for the study of beta-2 adrenergic receptor gene polymorphisms using single tube allele specific multiplex PCR
    Zilfalil BA, Hoh BP, Nizam MZ, Liza-Sharmini AT, Teh LK, Ismail R
    J Clin Pharm Ther, 2006 Dec;31(6):637-40.
    PMID: 17176369
    Seventeen single nucleotide polymorphisms (SNPs) have been identified so far, within the beta-2 receptor (beta(2) AR) gene. The presence of so many SNPs within the beta(2) AR gene causes a problem, for those studying beta(2) AR pharmacogenetics, in relation to which SNPs to choose. Most of the work has focused on the three common SNPs within the coding block (alleles 16, 27 and 164) and the techniques developed have been for these three functionally important alleles.
    MeSH terms: Genotype; Polymorphism, Genetic*; Polymerase Chain Reaction/methods*; Receptors, Adrenergic, beta-2/genetics*
  16. Acute renal failure after a holiday in the tropics
    Guron G, Holmdahl J, Dotevall L
    Clin. Nephrol., 2006 Dec;66(6):468-71.
    PMID: 17176921 DOI: 10.5414/cnp66468
    A 20-year-old, previously healthy woman, presented with high fever, headache and myalgia 3 days after her return from a holiday in Southeast Asia. Laboratory data on admission demonstrated a pronounced increase in plasma creatinine, marked thrombocytopenia and moderately elevated liver aminotransferases. After having ruled out malaria, dengue fever was primarily suspected and supportive intravenous fluid therapy was initiated. Still, 1 day after admission, platelet counts dropped even further and she became anuric although she did not appear hypovolemic. On day 2 after admission, urine production commenced spontaneously and the patient slowly recovered. All laboratory test results had returned to normal approximately 2 months later. Serological analysis for dengue fever was negative. It turned out that the patient had been trekking in the jungle while in Thailand and we, therefore, analyzed serology for Leptospira spirochetes which was clearly positive. The patient was diagnosed with leptospirosis which is a serious condition associated with a high mortality when complicated by acute renal failure. Differential diagnoses in patients with acute renal failure and tropical infections are reviewed. The importance of early recognition of leptospirosis, and prompt treatment with antibiotics in suspected cases, is emphasized.
    MeSH terms: Adult; Antibodies, Bacterial/analysis; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Leptospira/immunology; Leptospirosis/complications*; Leptospirosis/ethnology; Leptospirosis/microbiology; Malaysia/ethnology; Singapore/ethnology; Sweden/epidemiology; Thailand/ethnology; Travel*; Acute Kidney Injury/diagnosis; Acute Kidney Injury/etiology*
  17. Perception of students about the problem-based learning sessions conducted for medical and dental schools' students of Universiti Sains Malaysia
    Barman A, Jaafar R, Naing NN
    Educ Health (Abingdon), 2006 Nov;19(3):363-8.
    PMID: 17178518
    MeSH terms: Adult; Female; Humans; Malaysia; Male; Surveys and Questionnaires; Schools, Dental*; Schools, Medical*; Students, Medical/psychology*; Problem-Based Learning*
  18. Mitochondrial disorder, diabetes mellitus, and findings in three muscles, including the heart
    Bhattacharjee M, Venugopal B, Wong KT, Goto YI, Bhattacharjee MB
    Ultrastruct Pathol, 2006 Nov-Dec;30(6):481-7.
    PMID: 17183762
    The authors describe the case of a 50-year-old man with chronic progressive external ophthalmoplegia (CPEO), diabetes mellitus (DM), and coronary artery disease. The patient had no cardiac conduction abnormalities. During coronary artery bypass surgery, his heart and two skeletal muscles were biopsied. All three muscles showed ragged red fibers. The heart muscle showed significant glycogen accumulation. Analysis of mitochondrial DNA (mtDNA) showed a 5019-base-pair deletion, with no duplications. There were morphologically abnormal mitochondria in all 3 muscles, with clinically apparent difference in preservation of function. The combination of diabetes mellitus and mtDNA deletion is fortuitous, as they can be causally linked. The cardiac pathology allows speculation about the possible adaptive processes that may occur in the heart in DM. There are few reported cases with CPEO and excess glycogen in the heart. Most show deposition of fat and poorer clinical outcomes as compared to those with glycogen deposition. This observation may lend support to the hypothesis that in the myocardium, adaptive responses are mediated via changes in glucose handling, whereas alterations in fat metabolism likely represent maladaptation.
    MeSH terms: Coronary Artery Bypass; Biopsy; Coronary Artery Disease/complications*; Coronary Artery Disease/surgery; Diabetes Mellitus, Type 2/pathology*; DNA, Mitochondrial/genetics; Glycogen/ultrastructure; Humans; Male; Middle Aged; Mitochondria, Heart/ultrastructure; Mitochondria, Muscle/ultrastructure; Myocardium/ultrastructure*; Mitochondrial Encephalomyopathies/complications*; Ophthalmoplegia, Chronic Progressive External/complications*; Ophthalmoplegia, Chronic Progressive External/pathology; Gene Deletion; Muscle, Skeletal/ultrastructure*; Microscopy, Electron, Transmission; Diabetes Complications/pathology
  19. Continuing medical education: a needs analysis of anaesthetists
    Tucker AP, Miller A, Sweeney D, Jones RW
    Anaesth Intensive Care, 2006 Dec;34(6):765-9.
    PMID: 17183895
    The continuing medical education (CME) needs of anaesthetists within Australia, New Zealand, Hong Kong, Malaysia and Singapore have been largely unknown. The aim of this study was to undertake a comprehensive survey of the attitude to CME, learning preferences, attitudes and abilities relating to self-paced material, literature and information searching, preferred content and preferred approach to CME of anaesthetists within these countries. A survey tool was developed and refined for ease of use by pilot-testing. The survey was mailed to 3,156 anaesthetists throughout Australia, New Zealand, Hong Kong, Malaysia and Singapore. Three options for data return were offered; postal reply, facsimile and a data entry web-page. There were 1,800 responses, which represented a response rate of 57%. The demographics of the respondents were similar to the overall demographics of Fellows of the Australian and New Zealand College of Anaesthetists. A large majority of respondents (92%) stated that their involvement in CME improved patient care. However, almost half the respondents reported that they have difficulty either in participating in current CME activities (31%) or implementing new knowledge into their workplace (14%). Anaesthetists within this region appear to be motivated by the need to make better decisions based on independent standards of practice. While Australia is a world leader in flexible education, it is still emerging as a discipline. Flexible education may be used to facilitate anaesthetists' participation in CME activities and in implementation of new knowledge in their workplace.
    MeSH terms: Anesthesiology/education*; Anesthesiology/standards; Attitude of Health Personnel; Australia; Clinical Competence/standards; Education, Medical, Continuing/standards*; Hong Kong; Humans; Malaysia; New Zealand; Surveys and Questionnaires*; Singapore; Staff Development/methods*; Staff Development/trends; Program Development/methods*; Program Development/statistics & numerical data
  20. Enterobacteriaceae in dehydrated powdered infant formula manufactured in Indonesia and Malaysia
    Estuningsih S, Kress C, Hassan AA, Akineden O, Schneider E, Usleber E
    J Food Prot, 2006 Dec;69(12):3013-7.
    PMID: 17186672
    To determine the occurrence of Salmonella and Shigella in infant formula from Southeast Asia, 74 packages of dehydrated powdered infant follow-on formula (recommended age, > 4 months) from five different manufacturers, four from Indonesia and one from Malaysia, were analyzed. None of the 25-g test portions yielded Salmonella or Shigella. However, further identification of colonies growing on selective media used for Salmonella and Shigella detection revealed the frequent occurrence of several other Enterobacteriaceae species. A total of 35 samples (47%) were positive for Enterobacteriaceae. Ten samples (13.5%) from two Indonesian manufacturers yielded Enterobacter sakazakii. Other Enterobacteriaceae isolated included Pantoea spp. (n = 12), Escherichia hermanii (n = 10), Enterobacter cloacae (n = 8), Klebsiella pneumoniae subsp. pneumoniae (n = 3), Citrobacter spp. (n = 2), Serratia spp. (n = 2), and Escherichia coli (n = 2). To our knowledge, this is the first report to describe the contamination of dehydrated powdered infant formula from Indonesia with E. sakazakii and several other Enterobacteriaceae that could be opportunistic pathogens. Improper preparation and conservation of these products could result in a health risk for infants in Indonesia.
    MeSH terms: Consumer Product Safety*; Enterobacteriaceae/isolation & purification*; Food Contamination/analysis*; Food Handling/methods*; Food Handling/standards; Food Microbiology; Humans; Indonesia; Infant; Malaysia; Salmonella/isolation & purification; Shigella/isolation & purification; Colony Count, Microbial; Infant Formula*
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