Browse publications by year: 2007

  1. Devi BC, Tang TS, Corbex M
    Ann. Oncol., 2007 Jul;18(7):1172-6.
    PMID: 17434897 DOI: 10.1093/annonc/mdm105
    BACKGROUND:
    The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak.

    MATERIALS AND METHODS:
    The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff.

    RESULTS:
    Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998).

    CONCLUSIONS:
    The overall cost of this program was
    MeSH terms: Adult; Aged; Breast Neoplasms/diagnosis*; Uterine Cervical Neoplasms/diagnosis*; Female; Health Personnel/education; Humans; Malaysia/epidemiology; Middle Aged; Nasopharyngeal Neoplasms/diagnosis; Neoplasm Staging; Patient Education as Topic/methods; Pilot Projects; Population Surveillance/methods*; Vaginal Smears; Breast Self-Examination; Early Diagnosis*; Papanicolaou Test
  2. Ali A, Howden-Chapman P
    J Public Health Manag Pract, 2007 May-Jun;13(3):278-86.
    PMID: 17435495 DOI: 10.1097/01.PHH.0000267686.08282.3c
    This study was undertaken to explore the roles played by bidan kampungs and understand their contribution to rural Malay women during pregnancy and childbirth hundred sixteen pregnant women, 13 Western midwives, and 12 bidan kampungs were recruited using convenience and snowball sampling. Data were collected from focus groups, in-depth interviews, field notes, and observations. The findings indicated that although the women were happy to have Western maternity care, they valued the social and spiritual support received from bidan kampungs during pregnancy and postnatal care. Western care was considered useful for "modern" illnesses. The traditional maternity care that women received included pantang or ritual prohibitions that helped them through pregnancy and helped them achieve better postnatal recovery. The study indicates that there is a need to combine Western and traditional care for the benefit of the pregnant women and their infants' health.
    MeSH terms: Adult; Aged; Attitude of Health Personnel; Attitude to Health/ethnology*; Ceremonial Behavior; Community Health Workers/supply & distribution*; Female; Health Policy; Humans; Interviews as Topic; Malaysia/epidemiology; Maternal Health Services/manpower*; Middle Aged; Midwifery/statistics & numerical data*; Nurse Midwives/supply & distribution*; Pregnancy; Pregnancy Outcome/ethnology; Social Support; Focus Groups; Rural Health Services/manpower*; Nurse's Role*; Spirituality
  3. Sivarajasingam M, Rajan P
    Otol Neurotol, 2007 Sep;28(6):869-70.
    PMID: 17435522
    MeSH terms: Abscess/pathology; Abscess/radiography; Abscess/surgery; Actinomycosis/pathology*; Actinomycosis/radiography; Actinomycosis/surgery; Aged; Ampicillin/therapeutic use; Anti-Bacterial Agents/therapeutic use; Humans; Male; Mastoid/pathology; Mastoid/radiography; Occipital Bone/pathology; Occipital Bone/radiography; Temporal Bone/pathology*; Temporal Bone/radiography; Tomography, X-Ray Computed; Otoscopy
  4. Zakaria R, Rajikin MH, Yaacob NS, Nor NM
    Reprod Biol, 2007 Mar;7(1):41-53.
    PMID: 17435832
    The possible role of insulin-like growth factors (IGFs) and their receptors (IGFRs) in the pathogenesis of diabetic embryopathy was investigated. Sexually mature female ICR mice of 6-8 weeks old were made diabetic by a single intraperitoneal injection with 200 mg/kg streptozotocin ten days prior to mating. Fallopian tubes and uterine tissues were obtained from the superovulated diabetic and normal mice 48, 72 and 96 hours following human chorionic gonadotropin (hCG) injection. The mRNA expression of IGF-1 and IGF-2 as well as their receptors was determined in the tissues using Real-time Polymerase Chain Reaction (Real-time PCR). The mRNA expression of IGF-1 in the fallopian tube and uterus of the diabetic mice was significantly lower 72 and 96 hours after hCG treatment, respectively, as compared to the controls. The mRNA expression of IGF-1R at 96 hours post-hCG treatment was significantly higher in the fallopian tube and lower in the uterus of the diabetic mice as compared to the controls. The mRNA expression IGF-2 in the fallopian tube was significantly higher 48 and 96 hours after hCG treatment, but was lower in the uterus of diabetic mice 96 hours after hCG treatment as compared to controls. The mRNA expression of IGF-2R in the diabetic mice was significantly higher 48 and 96 hours (the fallopian tube) and 48 hours (uterus) after hCG treatments as compared to the controls. In conclusion, an alteration in mRNA expression of IGFs and their receptors in the diabetic mice as observed in this study could possibly result in diabetic embryopathy.
    MeSH terms: Animals; Diabetes Mellitus/metabolism; Fallopian Tubes/metabolism*; Female; Male; Mice, Inbred ICR; Pregnancy; Pregnancy in Diabetics/metabolism*; RNA, Messenger/metabolism; Somatomedins/metabolism*; Uterus/metabolism*; Receptors, Somatomedin/metabolism*; Embryonic Development/physiology*; Mice
  5. Cheung TK, Lim PW, Wong BC
    Dig Dis Sci, 2007 Nov;52(11):3043-8.
    PMID: 17436083 DOI: 10.1007%2Fs10620-007-9764-x
    Noncardiac chest pain (NCCP) is common and has a significant impact on health care. Primary care physicians (PCPs)' attitudes, clinical approach, preference of diagnostic tests, referral patterns, and comfort in managing patients with NCCP in the Asia-Pacific region are not known. Consequently, we performed this survey in the Asia-Pacific region. The self-completed questionnaire was sent to PCPs in the Asia-Pacific region. A 28-item questionnaire contained questions on demographic information, characteristics of practice, preferences of diagnostic tests, referral patterns, treatment plans, and opinion on Helicobacter pylori and NCCP. A total of 108 (74%) PCPs returned the questionnaire. A mean of 18% of the patients were diagnosed with NCCP by PCPs in the past 6 months. Ninety-four percent of PCPs had treated NCCP patients in the last 6 months. Only 38% of the PCPs were comfortable in diagnosing NCCP but 85.2% believed that they should manage NCCP patients. PCPs in Malaysia and Philippines were more likely to refer patients to subspecialists. Fifty-seven and four-tenths percent of PCPs believed that H. pylori infection plays a role in the development of NCCP. The study demonstrates clearly that the understanding, diagnostic strategies, and treatment strategies of NCCP in the Asia-Pacific region are suboptimal and thus highlights the importance of educational and training programs tailored for PCPs in NCCP.
    MeSH terms: Adult; Aged; Asia, Southeastern/epidemiology; Chest Pain/etiology*; Chest Pain/epidemiology; Female; Follow-Up Studies; Hong Kong/epidemiology; Humans; Malaysia; Male; Middle Aged; Practice Patterns, Physicians'; Physician's Role; Physicians, Family*; Population Surveillance/methods*; Prognosis; Referral and Consultation/standards; Retrospective Studies; Risk Factors; Incidence; Helicobacter Infections/complications*; Helicobacter Infections/epidemiology
  6. Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA
    J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.
    PMID: 17441895
    We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.
    MeSH terms: Adult; Brain Abscess/diagnosis; Brain Abscess/microbiology*; Brain Abscess/epidemiology*; Female; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases/microbiology*; Magnetic Resonance Imaging; Puerperal Infection/microbiology*; Streptococcus agalactiae*; Meningitis, Bacterial/complications; Meningitis, Bacterial/epidemiology*; Hearing Loss/etiology
  7. Machha A, Achike FI, Mohd MA, Mustafa MR
    Eur J Pharmacol, 2007 Jun 22;565(1-3):144-50.
    PMID: 17442302
    Acute exposure to the flavonoid baicalein inhibited endothelium-dependent relaxation in physiological arteries, although the mechanisms are not fully understood. We investigated the effect of baicalein on vascular tone in Wistar-Kyoto (WKY) rat isolated aortic rings in the presence and absence of oxidative stress to further determine the underlying mechanisms. Exposure to baicalein (10 microM) completely abolished endothelium-dependent relaxation induced by acetylcholine and attenuated significantly the endothelium-independent relaxation induced by sodium nitroprusside. Baicalein, similar to Nomega-nitro-L-arginine methyl ester (L-NAME, 10 microM), potentiated significantly the contractile response of aortic rings to alpha1-adrenoceptor agonist phenylephrine. In the presence of L-NAME the baicalein effect on phenylphrine contraction or acetylcholine relaxation was unaltered, suggesting that these effects of baicalein are (like L-NAME effect) endothelial nitric oxide synthase (eNOS)/endothelium-derived nitric oxide-dependent. Inhibition of cyclooxygenase activity with indomethacin (10 microM) or scavenging of superoxide anions with superoxide dismutase (150 units/ml), but not scavenging of hydrogen peroxide with catalase (800 units/ml), enhanced significantly by an essentially similar extent the relaxation to acetylcholine in baicalein-pretreated aortic rings. Relaxant effect to acetylcholine was significantly attenuated in control aortic rings, but was completely abolished in baicalein-pretreated aortic rings in the presence of reduced form of beta-nicotinamide adenine di-nucleotide (beta-NADH, 300 microM). Baicalein blocked beta-NADH (300 microM)-induced transient contractions, suggesting that baicalein may have inhibited activity of NADH/NADPH-oxidase. Baicalein did not alter the failure of acetylcholine to induce relaxation in the presence of pyrogallol (300 microM). In summary, acute exposure to baicalein impairs eNOS/endothelium-derived nitric oxide-mediated vascular tone in rat aortas through the inhibition of endothelium-derived nitric oxide bioavailability coupled to reduced bioactivity of endothelium-derived nitric oxide and to cyclooxygenase-mediated release of superoxide anions.
    MeSH terms: Acetylcholine/pharmacology; Animals; Aorta/drug effects*; Aorta/physiology; Dose-Response Relationship, Drug; Male; NAD/pharmacology; Nitroprusside/pharmacology; Rats, Inbred WKY; Superoxides/metabolism*; Vasoconstriction/drug effects; NG-Nitroarginine Methyl Ester/pharmacology; Flavanones/pharmacology*; Rats; Nitric Oxide Synthase Type III/antagonists & inhibitors; In Vitro Techniques
  8. Rahman RA, Ramli R, Rahman NA, Hussaini HM, Idrus SM, Hamid AL
    Int J Pediatr Otorhinolaryngol, 2007 Jun;71(6):929-36.
    PMID: 17442408
    Maxillofacial trauma in children is not common worldwide. Domestic injuries are frequently seen in younger children while older children are mostly involved in motor vehicle accidents (MVA). The objective of this study was to analyze the pattern of maxillofacial injuries in pediatric patients referred to three government main hospitals in different areas of West Malaysia.
    MeSH terms: Accidental Falls/statistics & numerical data; Accidents, Traffic/statistics & numerical data; Adolescent; Age Factors; Child; Child, Preschool; Female; Fracture Fixation, Internal/statistics & numerical data; Humans; Infant; Malaysia/epidemiology; Male; Mandibular Condyle/injuries; Mandibular Fractures/epidemiology; Maxillofacial Injuries/epidemiology*; Orbital Fractures/epidemiology; Retrospective Studies; Sex Factors; Skull Fractures/epidemiology; Violence/statistics & numerical data; Soft Tissue Injuries/epidemiology; Lacerations/epidemiology
  9. Yaiw KC, Ong KC, Chua KB, Bingham J, Wang L, Shamala D, et al.
    J Virol Methods, 2007 Aug;143(2):140-6.
    PMID: 17442409
    Tioman virus is a newly described bat-urine derived paramyxovirus isolated in Tioman Island, Malaysia in 2001. Hitherto, neither human nor animal infection by this virus has been reported. Nonetheless, its close relationship to another paramyxovirus, the Menangle virus which had caused diseases in humans and pigs [Philbey, A.W., Kirkland, P.D., Ross, A.D., Davis, R.J., Gleeson, A.B., Love, R.J., Daniels, P.W., Gould, A.R., Hyatt, A.D., 1998. An apparently new virus (family Paramyxoviridae) infectious for pigs, humans, and fruit bats. Emerg. Infect. Dis. 4, 269-271], raises the possibility that it may be potentially pathogenic. In this study, mice were experimentally infected with Tioman virus by intraperitoneal and intracerebral routes, and the cellular targets and topographical distribution of viral genome and antigens were examined using in situ hybridization and immunohistochemistry, respectively. The possible association between viral infection and apoptosis was also investigated using the TUNEL assay and immunohistochemistry to FasL, Caspase-3, Caspase-8, Caspase-9 and bcl-2. The results showed that Tioman virus inoculated intracerebrally was neurotropic causing plaque-like necrotic areas, and appeared to preferentially replicate in the neocortex and limbic system. Viral infection of inflammatory cells was also demonstrated. TUNEL and Caspase-3 positivity was found in inflammatory cells but not in neurons, while FasL, Caspase-8 and Caspase-9 were consistently negative. This suggests that neuronal infection was associated with necrosis rather than apoptosis. Moreover, the data suggest that there may be an association between viral infection and apoptosis in inflammatory cells, and that it could, at least in part, involve Caspase-independent pathways. Bcl-2 was expressed in some neurons and inflammatory cells indicating its possible role in anti-apoptosis. There was no evidence of central nervous system infection via the intraperitoneal route.
    MeSH terms: Animals; Antigens, Viral/analysis; Brain/cytology; Brain/pathology; Brain/virology*; Cerebellar Cortex/pathology; Cerebellar Cortex/virology; Cerebral Cortex/pathology; Cerebral Cortex/virology; Disease Models, Animal; Immunohistochemistry; Limbic System/virology; Mice, Inbred ICR; Necrosis; Paramyxoviridae/immunology; Paramyxoviridae/pathogenicity*; RNA, Viral/analysis; Viral Proteins/analysis; Apoptosis*; In Situ Hybridization; Paramyxoviridae Infections/pathology*; Paramyxoviridae Infections/virology; Proto-Oncogene Proteins c-bcl-2/analysis; Caspases/analysis; In Situ Nick-End Labeling; Mice; Fas Ligand Protein/analysis
  10. Vattoth S, Cherian J, Pandey T
    Magn Reson Imaging, 2007 Oct;25(8):1227-31.
    PMID: 17442526
    Magnetic resonance angiographic evaluation of the intracranial vasculature has been predominantly carried out using conventional angiographic techniques such as time of flight and phase contrast sequences. These techniques have good spatial resolution but lack temporal resolution. Newer faster angiographic techniques have been developed to circumvent this limitation. Elliptical centric time-resolved imaging of contrast kinetics (EC-TRICKS) is one such technique which has combined the use of elliptical centric ordering of the k-space with multiphase 3D digital subtraction MR angiogram (MRA) to achieve excellent temporal resolution of the arterial and venous circulations. Its applications have been mainly in the peripheral vasculature. We report the use of this technique in a case of a high-flow, direct carotid-cavernous fistula to demonstrate its potential in intracranial MR angiography.
    MeSH terms: Adult; Contrast Media; Female; Gadolinium*; Humans; Image Enhancement/methods*; Magnetic Resonance Angiography/methods*; Carotid-Cavernous Sinus Fistula/diagnosis*
  11. Wee SL, Tan KH, Nishida R
    J Chem Ecol, 2007 Jun;33(6):1272-82.
    PMID: 17443401 DOI: 10.1007/s10886-007-9295-0
    After pharmacophagy of methyl eugenol (ME), males of Bactrocera carambolae (Diptera: Tephritidae) produced (E)-coniferyl alcohol (CF) along with its endogenously synthesized pheromonal compounds. CF was shown to be released into the air by the ME-fed males only during the courtship period at dusk and attracted significantly more males and females than the ME-deprived males in wind tunnel assays. However, earlier onset of sexual attraction and a higher mating success were observed only in the wind tunnel and field cage assays on the third day posttreatment of ME. Field cage observations on the male-to-male interaction indicated that the ME-deprived males did not exhibit aggregation behavior, but that ME feeding promoted aggregation behavior in B. carambolae. Field cage observations revealed that the ME-deprived males were not only attracted to the ME-fed males, but also appeared to feed on their anal secretions. The secretions were subsequently confirmed to contain CF along with endogenously produced pheromonal compounds. Results obtained for B. carambolae were compared to those previously obtained from its sibling species, Bactrocera dorsalis, and are discussed in light of species advancement in fruit fly-plant relationships.
    MeSH terms: Animals; Eugenol/analogs & derivatives*; Eugenol/pharmacology; Female; Male; Phenols/metabolism; Sex Attractants/metabolism; Sexual Behavior, Animal/drug effects*; Tephritidae/drug effects*; Tephritidae/physiology
  12. Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J
    Ultrasound Obstet Gynecol, 2007 May;29(5):568-73.
    PMID: 17444553
    To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term, to assess their tolerability (in terms of pain) and ability to predict need for Cesarean delivery.
    MeSH terms: Adult; Cervix Uteri/anatomy & histology; Cervix Uteri/ultrasonography*; Cesarean Section*; Female; Gestational Age; Humans; Labor, Induced/adverse effects; Labor, Induced/methods*; Pain/etiology; Pain Measurement/methods*; Palpation/adverse effects; Palpation/methods; Parity; Predictive Value of Tests; Pregnancy; Prospective Studies; ROC Curve; Ultrasonography, Prenatal; Term Birth
  13. Boo NY, Ishak S
    J Paediatr Child Health, 2007 Apr;43(4):297-302.
    PMID: 17444833
    To determine the sensitivity and specificity of different levels of bilirubin measured by the transcutaneous bilirubinometer Bilicheck on forehead and sternum for predicting severe hyperbilirubinaemia of total serum bilirubin (TSB)>or=300 micromol/L in Malay, Chinese and Indian infants.
    MeSH terms: Bilirubin/analysis*; Bilirubin/blood; China/ethnology; Female; Forecasting; Hospitals, University; Humans; India/ethnology; Infant; Infant, Newborn; Malaysia; Male; Prospective Studies; Severity of Illness Index*; Hyperbilirubinemia, Neonatal/diagnosis*
  14. Tung WS, Bakar SA, Sekawi Z, Rosli R
    PMID: 17445254
    Enterovirus 71 (EV71) is a major causative viral agent responsible for large outbreaks of hand, foot and mouth disease (HFMD), a common rash illness in children and infants. There is no effective antiviral treatment for severe EV71 infections and no vaccine is available. The objectives of this study were to design and construct a DNA vaccine against Enterovirus 71 using the viral capsid protein (VP1) gene of EV71 and to verify the functionality of the DNA vaccine in vitro and in vivo.
  15. Ooi MH, Solomon T, Podin Y, Mohan A, Akin W, Yusuf MA, et al.
    J Clin Microbiol, 2007 Jun;45(6):1858-66.
    PMID: 17446325
    Human enterovirus 71 and coxsackievirus A16 are important causes of hand-foot-and-mouth disease (HFMD). Like other enteroviruses, they can be isolated from a range of sterile and nonsterile sites, but which clinical sample, or combination of samples, is the most useful for laboratory diagnosis of HFMD is not clear. We attempted virus culture for 2,916 samples from 628 of 725 children with HFMD studied over a 3 1/2-year period, which included two large outbreaks. Overall, throat swabs were the single most useful specimen, being positive for any enterovirus for 288 (49%) of 592 patients with a full set of samples. Vesicle swabs were positive for 169 (48%) of 333 patients with vesicles, the yield being greater if two or more vesicles were swabbed. The combination of throat plus vesicle swabs enabled the identification of virus for 224 (67%) of the 333 patients with vesicles; for this patient group, just 27 (8%) extra patients were diagnosed when rectal and ulcer swabs were added. Of 259 patients without vesicles, use of the combination of throat plus rectal swab identified virus for 138 (53%). For 60 patients, virus was isolated from both vesicle and rectal swabs, but for 12 (20%) of these, the isolates differed. Such discordance occurred for just 11 (10%) of 112 patients with virus isolated from vesicle and throat swabs. During large HFMD outbreaks, we suggest collecting swabs from the throat plus one other site: vesicles, if these are present (at least two should be swabbed), or the rectum if there are no vesicles. Vesicle swabs give a high diagnostic yield, with the added advantage of being from a sterile site.
    MeSH terms: Adolescent; Blood/virology; Cerebrospinal Fluid/virology; Child; Child, Preschool; Disease Outbreaks; Enterovirus Infections/diagnosis*; Enterovirus Infections/epidemiology; Enterovirus Infections/virology; Enterovirus/classification*; Enterovirus/isolation & purification*; Female; Hand, Foot and Mouth Disease/diagnosis*; Hand, Foot and Mouth Disease/epidemiology; Hand, Foot and Mouth Disease/virology; Humans; Infant; Male; Pharynx/virology; Rectum/virology; Specimen Handling/methods; Ulcer/virology; Virus Cultivation
  16. Raja NS
    J Microbiol Immunol Infect, 2007 Apr;40(2):178-82.
    PMID: 17446969
    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in southeast Asia and northern Australia. In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare but well-recognized manifestation of melioidosis. Patients with underlying medical conditions, such as diabetes mellitus, renal impairment, cirrhosis, and malignancy are at greater risk. The presentations of melioidotic septic arthritis often mimic other disease processes and patients may not always be clinically septic. We present a case of septic arthritis due to B. pseudomallei in a 66-year-old male with diabetes mellitus presenting with a history of fever and ankle swelling. Follow-up ankle X-ray showed soft tissue swelling. Synovial fluid and blood samples grew B. pseudomallei. The patient improved gradually after parenteral administration of ceftazidime (2 g 8-hourly) and cotrimoxazole (1440 mg 8-hourly). He was discharged on oral cotrimoxazole (1440 mg 12-hourly), doxycycline (100 mg 12-hourly), and chloramphenicol (500 mg 6-hourly) for 6 months. This case highlights the possible occurrence of melioidotic septic arthritis, and the importance of prompt initiation of appropriate antimicrobials to achieve good outcomes.
    Study site: Emergency department, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    MeSH terms: Aged; Ankle Joint/microbiology; Ankle Joint/pathology; Anti-Bacterial Agents/administration & dosage; Anti-Bacterial Agents/pharmacology; Arthritis, Infectious; Arthritis, Infectious/complications; Arthritis, Infectious/drug therapy*; Arthritis, Infectious/microbiology; Blood/microbiology; Hospitals, University; Humans; Malaysia; Male; Melioidosis/complications; Melioidosis/drug therapy*; Melioidosis/microbiology; Synovial Fluid/microbiology; Burkholderia pseudomallei/isolation & purification*; Diabetes Complications
  17. Lee LK, Chen PC, Lee KK, Kaur J
    Ann Acad Med Singap, 2007 Mar;36(3):169-74.
    PMID: 17450261
    INTRODUCTION: The aim of this study was to determine the prevalence of violence-related behaviours among adolescents and the factors associated with it.

    MATERIAL AND METHODS: This was a cross-sectional school survey conducted on 4500 adolescent students, using a structured questionnaire. Data were collected using the supervised self-administered questionnaire [a modified version of the Youth Risk Behavior Surveillance in the Malaysian National Language (Bahasa Malaysia)].

    RESULTS: Our study showed that 27.9% of students had been involved in a physical fight, 6.6% had been injured in a fight, 5.9% had carried a weapon, 7.2% had felt unsafe, 18.5% had had their money stolen and 55.0% had had their property stolen. Adolescents who carried weapons to school, smoked, used drugs, felt sad or hopeless and played truant were more likely to be involved in physical fights after adjusting for age, sex, and ethnicity.

    CONCLUSION: Violence-related behaviours among adolescents, especially involvement in physical fights, are common and are positively associated with certain factors such as smoking, taking drugs, playing truant, feeling sad or hopeless. Interventions designed at targeting adolescent violence should also address these factors and target the high-risk groups. There may be a need to identify and provide services for adolescents who exhibit these factors.

    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Male; Risk Factors; Rural Population/statistics & numerical data; Students/statistics & numerical data*; Urban Population; Violence/statistics & numerical data*; Prevalence; Logistic Models
  18. Wazir NN, Shan Y, Mukundala VV, Gunalan R
    Singapore Med J, 2007 May;48(5):e138-40.
    PMID: 17453086
    Two cases of dislocation of total knee arthroplasty presented to us within the same week. The first patient is a 71-year-old woman who underwent bilateral primary total knee arthroplasty. The left knee dislocated three weeks after the surgery. Due to failure of conservative measures, she underwent revision total knee arthroplasty. The other patient is a 72-year-old woman presenting ten years after primary total knee arthroplasty, with a traumatic dislocation of the knee joint. She was treated as an outpatient with closed manipulative reduction.
    MeSH terms: Accidental Falls; Aged; Female; Humans; Recurrence; Reoperation; Arthroplasty, Replacement, Knee*; Knee Dislocation/etiology*; Knee Dislocation/surgery
  19. Dorai AA, Halim AS
    Singapore Med J, 2007 May;48(5):e141-5.
    PMID: 17453087
    Extensive full thickness anterior abdominal wall defects pose a difficult challenge to the reconstructive surgeon. The objectives of reconstruction are the support of the intra-abdominal structures in order to preserve the functional integrity and achieve an aesthetically-acceptable appearance. Autologous tissues are versatile and provide the best reconstructive option in this type of defects. The tensor fascia latae myocutaneous flap provides identical abdominal wall musculofascial cover for full thickness defects. In extensive defects, the extended tensor fascia latae flap is a versatile option with a second microvascular anastomosis at the distal end of the flap. A total anterior abdominal wall soft tissue tumour resection defect was reconstructed with the use of the double pedicle extended free tensor fascia latae myocutaneous flap in a 60-year-old man. The patient however succumbed to the disease process six months post-reconstruction. During the follow-up period, there was no evidence of hernia at the anterior abdominal wall.
    MeSH terms: Abdominal Neoplasms/surgery; Humans; Leiomyosarcoma/surgery; Male; Middle Aged; Surgical Flaps*; Muscle Neoplasms/surgery; Reconstructive Surgical Procedures/methods*; Abdominal Wall/surgery*
  20. Pal S, Siti MI, Ankathil R, Zilfalil BA
    Singapore Med J, 2007 May;48(5):e146-50.
    PMID: 17453088
    Patients with isochromosome 18q, a rare cytogenetic abnormality, also reported as Edwards syndrome, is the second most common autosomal trisomy. However, the phenotypic features and survival of these patients are not uniform and depend upon the portion of chromosomes getting duplicated or deleted. The survival of these children may be longer, hence a good cytogenetic diagnosis is a must. Morphological characteristics of isochromosome 18q are not yet fully delineated because of the rarity of the cases and as most cases are aborted medically or terminate spontaneously. We report two cases of isochromosome 18q, one male aged two years old and the other a male aged eight months old, and review the literature on this rare syndrome.
    MeSH terms: Abnormalities, Multiple/genetics; Child, Preschool; Chromosomes, Human, Pair 18*; Humans; Infant; Male; Syndrome; Trisomy*; Isochromosomes*
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