Browse publications by year: 2008

  1. Rohani A, Zamree I, Joseph RT, Lee HL
    PMID: 19058573
    A study was conducted to examine the persistency of transovarial dengue virus type 2 (DEN-2) in a Selangor strain of Aedes aegypti mosquitoes. Two hundred 4-5 day old female mosquitoes were fed with blood containing dengue virus. The infected mosquitoes were reared to the 7th generation; each generation was screened for the virus using immunological staining methods. The virus was detectable until the 5th generation but absent in the 6th and the 7th generations. Therefore, dengue virus type 2 can be transmitted transovarially in Aedes aegypti mosquitoes until the fifth generation under laboratory conditions.
    MeSH terms: Aedes/virology*; Animals; Dengue Virus/isolation & purification*; Female; Insect Vectors/virology*
  2. Giak CL, Singh HS, Nallusamy R, Leong TY, Ng TL, Bock HL
    PMID: 19058579
    This study aimed to document the baseline incidence and epidemiology of intussusception (IS) in Malaysia. This retrospective surveillance examined hospital discharge data from three hospitals in Malaysia to identify IS cases over a 3-year period (2000-2003) in children <5 years of age. Identification of definite cases of IS was done through a search of computerized hospital discharge records (ICD-9-CM code 560.0) followed by confirmation of diagnosis through medical record review. The definition of IS was based on the clinical guidelines from the IS Brighton Collaboration Working Group, version 2002. During the 3-year study period, there were 62 cases hospitalized due to IS, of which 74.2% were < 1 year of age. The incidences for hospitalization due to IS in children < 1 year old and < 5 years old averaged 17.8 and 4.8 per 100,000 person-years, respectively. No IS-associated deaths were recorded and all IS cases had a favorable outcome. No distinct seasonality with IS occurrence was observed.
    MeSH terms: Child, Preschool; Female; Humans; Infant; Intussusception/diagnosis; Intussusception/epidemiology*; Intussusception/surgery; Malaysia/epidemiology; Male; Retrospective Studies; Incidence; Age Distribution
  3. Neela V, Sasikumar M, Ghaznavi GR, Zamberi S, Mariana S
    PMID: 19058585
    Methicillin-resistant Staphylococcus aureus (MRSA), an established nosocomial and emerging community pathogen associated with many fatalities due to its hyper-virulence and multiple drug resistant properties, is on the continuous rise. To update the current status on the susceptibility of local MRSA isolates to various classes of antibiotics and to identify the most potent antibiotics, thirty-two clinical isolates comprised of hospital acquired (HA) and community acquired (CA) infections were investigated by disk diffusion test. Of the 32 MRSA isolates, 14 (43.75%) and 18 (56.25%) were community and hospital acquired MRSA, respectively. All isolates were multiple drug resistant to more than 3 classes of antibiotics despite the source or specimen from which it was isolated. The oxacillin MICs for all isolates ranged from 2 to > or = 256 microg/ml. Twenty-five of 26 erythromycin-resistant MRSA isolates exhibited an inducible MLS(B) resistance phenotype while one showed an MS phenotype. More than half the isolates (68.75%) were resistant to at least one of the six aminoglycosides tested, with netilmicin as the most susceptible. The most effective antistaphylococcal agents were linezolid, vancomycin, teicoplanin and quinupristin/dalfopristin exhibited 100% susceptibility. Since MRSA is under continuous pressure of acquiring multiple drug resistance, it is imperative to focus routine surveillance on HA and CA-MRSA strains to monitor and limit the spread of this organism.
    MeSH terms: Anti-Bacterial Agents/pharmacology*; Cross Infection/microbiology; Humans; Malaysia; Staphylococcus aureus/drug effects*; Staphylococcus aureus/isolation & purification; Methicillin Resistance*; Community-Acquired Infections/microbiology; Drug Resistance, Multiple, Bacterial*; Disk Diffusion Antimicrobial Tests
  4. Hamidah A, Arini MI, Zarina AL, Zulkifli SZ, Jamal R
    PMID: 19058587
    Growth impairment is commonly seen in children with thalassemia despite regular blood transfusions and desferrioxamine treatments. We investigated the growth velocity of 26 prepubertal patients with beta-thalassemia or HbE-beta thalassemia who were transfusion dependent aged between 2 and 13 years. The prevalence of impaired growth velocity (ie, growth velocity less than the third percentile) amongst the transfusion dependent prepubertal thalassemics was 57.7% compared to 19.2% in the control group. The mean height velocity of the thalassemics was 11.1% less than controls but this difference was not statistically significant (4.23cm/year vs 4.76cm/year, p = 0.08). The mean serum ferritin level of the thalassemics with a height < 3rd percentile was higher compared to those with a height > 3rd percentile (4,567.0 vs 2,271.0, p = 0.01). Our study showed that there was a high prevalence of impaired growth velocity amongst our transfusion dependent prepubertal thalassemics. This highlights the problem of inadequate chelation therapy, and compliance with chelation therapy amongst our patients. This study emphasizes the importance of monitoring growth parameters and optimal iron chelation therapy in these patients.
    MeSH terms: Adolescent; Age Factors; Blood Transfusion/adverse effects*; Body Height*; Child; Child, Preschool; China/epidemiology; Female; Ferritins/blood; Humans; Infant; Malaysia/epidemiology; Male; beta-Thalassemia/physiopathology; beta-Thalassemia/therapy*
  5. Jayapalan JJ, Muniandy S, Chan SP
    PMID: 19058590
    Discrepancies in angiotensin-1 converting enzyme (ACE) allele genetic susceptibility with disease etiology have been attributed to ethnic differences. We investigated ACE gene polymorphism of the multiethnic Malaysian population by utilizing nested polymerase chain reaction. Allelic frequency of 0.65 and 0.35 for I and D allele, respectively in the pooled population was comparable with other Asian populations. A significant association was found between the Malaysian ethnic groups and ACE I/D genotype. The II genotype was found at higher frequency among the Malays but a greater frequency of DD genotype among Indians.
    MeSH terms: Gene Frequency; Genetics, Population; Genotype; Humans; Peptidyl-Dipeptidase A/genetics*; Malaysia; Polymorphism, Genetic; Polymerase Chain Reaction; Continental Population Groups
  6. Al-Mekhlafi MS, Surin J, Atiya AS, Ariffin WA, Mahdy AK, Abdullah HC
    PMID: 19058591
    A cross-sectional study was carried out to determine the current prevalence of protein-energy malnutrition (PEM) among Orang Asli schoolchildren and to investigate the potential predictors of malnutrition. A total of 241 (120 males and 121 females) Orang Asli schoolchildren age 7-12 years living in remote areas of Pos Betau, Pahang participated voluntarily in this study. Anthropometric and socioeconomic data were collected and the children were screened for intestinal parasitic infections. The overall prevalences of mild and significant underweight conditions were 52.3% and 37.3%, respectively, and the prevalences of mild stunting and wasting were 43.6% and 43.1%, respectively, while the prevalences of significant stunting and wasting were 43.6% and 5.6%, respectively. There was a significant association between gender (male) and malnutrition (p = 0.029). The results also showed a higher prevalence of stunting among children age < or = 10 years than in older children (p = 0.001). Other independent variables, including socioeconomic status and intestinal parasitic infections, had no significant associations with malnutrition indices. PEM is prevalent among schoolchildren in rural Malaysia and therefore of public health concern since PEM diminishes immune function and impairs cognitive function and educational performance. School-based programs of prevention through health education and interventions should be considered as an essential part of measures to improve the quality of life of schoolchildren in rural Malaysia.
    MeSH terms: Age Factors; Animals; Body Weights and Measures/statistics & numerical data; Child; Cross-Sectional Studies; Female; Humans; Intestinal Diseases, Parasitic/epidemiology; Malaysia/epidemiology; Male; Protein-Energy Malnutrition/epidemiology*; Rural Population/statistics & numerical data; Sex Factors; Socioeconomic Factors; Child Nutrition Disorders/epidemiology*; Prevalence
  7. Lee HL, Chen CD, Masri SM, Chiang YF, Chooi KH, Benjamin S
    PMID: 19058596
    The field bioefficacy of a wettable granule (WG) formulation of Bacillus thuringiensis israelensis (Bti), VectoBac WG (Bti strain AM65-52) against dengue vectors, Aedes aegypti and Ae albopictus; was evaluated in a suburban residential area (TST) and in a temporary settlement site (KB) in the state of Selangor, Malaysia. Pre-control ovitrap surveillance of the trial sites indicated a high population of both types of Aedes mosquitoes. The populations were monitored continuously by weekly ovitrapping. Bti was sprayed biweekly at a dosage of 500 g/ha by using a mist-blower. The spray application was targeted into outdoor larval habitats. If required, Bti formulation was also applied directly into indoor water-holding containers at 8 g/1,000 l. Based on ovitrap surveillance, a significant reduction in Aedes populations was evident 4 weeks after initiating the first Bti treatment. The ovitrap index (OI) and the larvae density decreased drastically in both trial sites. In TST, the indoor OI was significantly reduced from 57.50 +/- 7.50% to 19.13 +/- 5.49% (p<0.05), while the outdoor OI decreased from 38.89 +/- 11.11% to 15.36 +/- 5.93%. In KB, similarly, the OI was significantly reduced by more than half, from 66.66 +/- 6.67% to 30.26 +/- 2.99% (p< 0.05). In all cases, the reduction in OI was paralleled by reduction in larval density.
    MeSH terms: Aedes/microbiology*; Aedes/virology; Animals; Bacillus thuringiensis/growth & development*; Dengue/epidemiology; Dengue/prevention & control*; Dengue/virology; Humans; Insect Vectors/microbiology*; Insect Vectors/virology; Insecticides; Larva; Malaysia/epidemiology; Mosquito Control/methods*; Endemic Diseases
  8. Nissapatorn V
    PMID: 19058599
    Southeast Asia is a region where the number of people infected with HIV/AIDS is one of the fastest growing in the world. Tuberculosis (TB) has grown along with the HIV epidemic. TB is not only the most common AIDS-defining illness but is also the leading cause of morbidity and mortality in AIDS patients. Cryptococcosis (meningitis or disseminated) is one of the most common opportunistic infections in AIDS patients. Cryptococcal meningitis is the first in the differential diagnosis considered with meningeal irritation. Penicillosis, a unique systemic mycosis, is an important emerging public health problem and has been classified as an AIDS defining illness in endemic areas like Thailand. Pneumocystis carinii (jiroveci) pneumonia has been one of the most important opportunistic infections in AIDS patients. Among parasitic infections, cryptosporidiosis is the most common intestinal protozoan infection relating to diarrhea in AIDS patients and toxoplasmosis is the only parasitic infection of the nervous system with a substantial incidence, up to 14.8%. Cytomegalovirus (CMV) retinitis has a lower prevalence compared to other opportunistic infections. In the era of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections has significantly reduced in the past few years. Subsequently, the phenomena of immune restoration inflammatory syndrome (IRIS) in AIDS patients has been reported in this region as a result of HAART.
    MeSH terms: Asia, Southeastern/epidemiology; Cause of Death; Humans; Opportunistic Infections/microbiology*; Opportunistic Infections/epidemiology; Opportunistic Infections/virology; Pneumonia, Pneumocystis/microbiology; Pneumonia, Pneumocystis/epidemiology; Pneumonia, Pneumocystis/virology; Tuberculosis/microbiology; Tuberculosis/mortality; Tuberculosis/virology; HIV Infections/drug therapy; HIV Infections/microbiology*; HIV Infections/epidemiology; Meningitis, Cryptococcal/microbiology; Meningitis, Cryptococcal/epidemiology; Meningitis, Cryptococcal/virology; Cytomegalovirus Retinitis/microbiology; Cytomegalovirus Retinitis/epidemiology; Cytomegalovirus Retinitis/virology
  9. Ariza A
    PMID: 19058602
    Melioidosis is endemic in Malaysia. Cutaneous melioidosis is one manifestation and it may progress to necrotizing fasciitis. The case highlights a 46-year-old male, a chicken-seller who presented with scalp cellulitis which later progressed to necrotizing fasciitis and pneumonia are presented here. It illustrates several key features of the presentation, prompt laboratory diagnosis and early treatment of melioidosis which saved the patient's life.
    MeSH terms: Animals; Cellulitis/microbiology; Chickens*; Humans; Malaysia; Male; Melioidosis/diagnosis*; Melioidosis/microbiology; Melioidosis/pathology; Middle Aged; Occupational Diseases/etiology; Occupational Diseases/microbiology*; Poultry Diseases/microbiology*; Risk Factors; Pneumonia, Bacterial/microbiology*; Fasciitis, Necrotizing/microbiology*; Endemic Diseases
  10. Yap KL, Hu KN
    PMID: 19058604
    The importance of bacteria-suspending media and fingertip positions on the survival of Vibrio cholerae on human fingertips were examined. Vibrios were suspended in phosphate-buffered saline (PBS), PBS with albumin, and PBS with agarose. Each type of preparation was inoculated on the fingerpads, the hyponychia, or the eponychia and lateral nail grooves of the fourth, third and second fingers of a volunteer's hand. The last finger inoculated was immediately washed with PBS and the washing collected for examination ("0 minute" exposure). The third and fourth inoculated fingers were likewise washed for examination 2 and 5 minutes later, respectively. The vibrios obtained from the washings were enumerated by culture. For each of the different groups, which consisted of a different inoculated fingertip position, bacteria-suspending medium and exposure period of 2 or 5 minutes, the proportion of replicate inoculated fingers which retained viable vibrios (isolation rate) and the mean number of surviving vibrios, as a percentage of the inoculated vibrios at "0 minute exposure" (survival rate) were as follows: finger pads: vibrios in PBS, 2 minutes post-inoculation (isolation rate, 25%; mean survival rate, 0.002%); 5 minutes post-inoculation (isolation rate, 0%; mean survival rate, 0%). PBS-albumin: 2 minutes post-inoculation (60%, 0.004%); 5 minutes post-inoculation (40%, 0.03%). PBS-agarose: 2 minutes post-inoculation (100%, 24%); 5 minutes post-inoculation (38%, 0.005%). Lateral nail grooves and eponychia: PBS: 2 minutes post-inoculation (100%, 2.2%); 5 minutes post-inoculation (44%, 0.2%). PBS-agarose: 2 minutes post-inoculation (100%, 32%); 5 minutes post-inoculation (100%, 0.7%). Hyponychia: PBS: 2 minutes post-inoculation (100%, 8%); 5 minutes post-inoculation (100%, 0.2%). PBS-agarose: 2 minutes post-inoculation (100%, 46%); 5 minutes post-inoculation (100%, 8%). The results show that vibrios in moisture-retaining medium (PBS-agarose) and inoculated on a sheltered fingertip locations (hyponychium) have the best survival rates. However, the high survival rate was maintained briefly.
    MeSH terms: Cholera/microbiology*; Cholera/transmission; Fingers/microbiology*; Humans; Nails/microbiology; Vibrio cholerae/isolation & purification; Vibrio cholerae/physiology*
  11. Muzaffar TM, Shaifuzain AR, Imran Y, Haslina MN
    PMID: 19058606
    In this study, we compared the platelet count with erythrocyte sedimentation rates (ESR) in patients with tuberculous spondylitis to evaluate the correlation. This was a retrospective 3-year study covering January 2004 to December 2006 at the Hospital Universiti Sains Malaysia. Platelet counts, hemoglobin levels, ESR, peripheral blood counts and peripheral blood smears on 17 patients with tuberculous spondylitis were obtained. The ages of the patients ranged from 20- to 70-years-old. The male to female ratio was 3.2:1. The majority of the patients were anemic (88.2%) and 52.9% of the patients had thrombocytosis. All the patients had normal lymphocyte counts and a high in ESR at diagnosis. There was a linear correlation between the platelet count and ESR (r = 0.60, p < 0.01). The platelet count was also significantly correlated with the hemoglobin level (r = -0.6, p < 0.02). The degree of thrombocytosis was related to the degree of inflammation measured by the ESR. Thrombocytosis also correlated with the hemoglobin level. We suggest that evaluating hematological values in suspected cases of tuberculosis should be considered. The presence of hematological changes should raise the suspicion of tuberculosis in spondylitis patients.
    MeSH terms: Adult; Aged; Anemia/blood; Anemia/microbiology; Blood Sedimentation; Female; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Platelet Count; Retrospective Studies; Thrombocytosis/blood; Thrombocytosis/microbiology; Tuberculosis, Spinal/blood*; Young Adult
  12. Menon BS, Juraida E, Ibrahim H, Mohamed M, Ho C, Khuzaiah R
    PMID: 19058612
    The aims of this study were to determine the types of cancers and hematological disorders in patients attending a pediatric hematology-oncology clinic. This was a prospective study at the Pediatric Institute, General Hospital Kuala Lumpur, Malaysia from June 2005-November 2006. During the 18-month study, 803 patients attended the clinic, 730 had oncological problems and 73 had hematological problems. The age range was from 2 months to 28 years (median 6 years). The patients were Malay (66%), Chinese (23%), Indian (10%) and other races (1%). Of the oncological patients, 51% had either leukemia (n=293) or lymphoma (n=77). The other most common diagnoses were retinoblastoma, followed by Wilm's tumor and germ cell tumors. Six patients (0.8%) developed a second malignant neoplasm. Of the hematological patients, 60% had platelet disorders, most commonly chronic immune thrombocytopenic purpura. Twenty-four per cent had bone marrow failure and 16% had red cell disorders.

    Study site: Pediatric Institute, General Hospital Kuala Lumpur
    MeSH terms: Adolescent; Adult; Cancer Care Facilities; Child; Child, Preschool; Cross-Sectional Studies; Female; Hospitals, General; Hospitals, Pediatric; Humans; Infant; Malaysia/epidemiology; Male; Neoplasms/epidemiology*; Outpatient Clinics, Hospital; Prospective Studies; Hematologic Neoplasms/epidemiology*; Young Adult
  13. Logeswaran R, Chen LC
    J Med Syst, 2008 Dec;32(6):453-61.
    PMID: 19058649
    Service architectures are necessary for providing value-added services in telecommunications networks, including those in medical institutions. Separation of service logic and control from the actual call switching is the main idea of these service architectures, examples include Intelligent Network (IN), Telecommunications Information Network Architectures (TINA), and Open Service Access (OSA). In the Distributed Service Architectures (DSA), instances of the same object type can be placed on different physical nodes. Hence, the network performance can be enhanced by introducing load balancing algorithms to efficiently distribute the traffic between object instances, such that the overall throughput and network performance can be optimised. In this paper, we propose a new load balancing algorithm called "Node Status Algorithm" for DSA infrastructure applicable to electronic-based medical institutions. The simulation results illustrate that this proposed algorithm is able to outperform the benchmark load balancing algorithms-Random Algorithm and Shortest Queue Algorithm, especially under medium and heavily loaded network conditions, which are typical of the increasing bandwidth utilization and processing requirements at paperless hospitals and in the telemedicine environment.
    MeSH terms: Algorithms*; Computer Communication Networks/organization & administration*; Computer Simulation*; Humans; Information Systems/organization & administration*; Reproducibility of Results
  14. Habib SH, Makpol S, Abdul Hamid NA, Das S, Ngah WZ, Yusof YA
    Clinics (Sao Paulo), 2008 Dec;63(6):807-13.
    PMID: 19061005
    OBJECTIVE: To evaluate the effect of ginger extract on the expression of NFkappaB and TNF-alpha in liver cancer-induced rats.

    METHODS: Male Wistar rats were randomly divided into 5 groups based on diet: i) control (given normal rat chow), ii) olive oil, iii) ginger extract (100mg/kg body weight), iv) choline-deficient diet + 0.1% ethionine to induce liver cancer and v) choline-deficient diet + ginger extract (100mg/kg body weight). Tissue samples obtained at eight weeks were fixed with formalin and embedded in paraffin wax, followed by immunohistochemistry staining for NFkappaB and TNF-alpha.

    RESULTS: The expression of NFkappaB was detected in the choline-deficient diet group, with 88.3 +/- 1.83% of samples showing positive staining, while in the choline-deficient diet supplemented with ginger group, the expression of NFkappaB was significantly reduced, to 32.35 +/- 1.34% (p<0.05). In the choline-deficient diet group, 83.3 +/- 4.52% of samples showed positive staining of TNF-alpha, which was significantly reduced to 7.94 +/- 1.32% (p<0.05) when treated with ginger. There was a significant correlation demonstrated between NFkappaB and TNF-alpha in the choline-deficient diet group but not in the choline-deficient diet treated with ginger extract group.

    CONCLUSION: In conclusion, ginger extract significantly reduced the elevated expression of NFkappaB and TNF-alpha in rats with liver cancer. Ginger may act as an anti-cancer and anti-inflammatory agent by inactivating NFkappaB through the suppression of the pro-inflammatory TNF-alpha.

    MeSH terms: Animals; Anti-Inflammatory Agents/therapeutic use*; Antineoplastic Agents/therapeutic use*; Ethionine; Immunohistochemistry; Liver Neoplasms, Experimental/chemically induced; Liver Neoplasms, Experimental/drug therapy*; Liver Neoplasms, Experimental/metabolism; Male; Plant Extracts/therapeutic use*; Tumor Necrosis Factor-alpha/drug effects; Tumor Necrosis Factor-alpha/metabolism; NF-kappa B/drug effects; NF-kappa B/metabolism; Rats, Wistar; Ginger/chemistry*; Rats
  15. Mitra NK, Siong HH, Nadarajah VD
    Ann Agric Environ Med, 2008;15(2):211-6.
    PMID: 19061257
    Dermal absorption of chlorpyrifos, an organophosphate insecticide is important because of its use in agriculture and control of household pests. The objectives of this study are to investigate firstly, the biochemical changes in the blood and secondly, histomorphometric changes in the hippocampus of adult mice following dermal application of chlorpyrifos in sub-toxic doses. Male Swiss albino mice (60 days) were segregated into one control and two treated groups (n=10). Chlorpyrifos, diluted with xylene, was applied in doses of 1/2 of LD(50) (E1) and 1/5 of LD(50) (E2) over the tail of mice of the two treated groups, 6 hours daily for 3 weeks. AChE levels in the serum and brain were estimated using a spectrophotometric method (Amplex Red reagent). Coronal serial sections were stained with 0.2 % thionin in acetate buffer and pyramidal neurons of Cornu Ammonis of hippocampus were counted at 400x magnification using Image Pro Express software. At the end of 3 weeks, body weights were reduced significantly in E1 group. Serum AChE concentrations were reduced by 97 % in E1 and 74 % in E2 groups compared to controls. The neurons of CA 3 and CA 1 in the hippocampus showed evidences of morphological damage in both treated groups. Furthermore, the neuronal count was significantly reduced in CA 3 layer of hippocampus in E1 group.
    MeSH terms: Acetylcholinesterase/metabolism*; Administration, Cutaneous; Animals; Body Weight/drug effects; Cholinesterase Inhibitors/administration & dosage; Cholinesterase Inhibitors/pharmacokinetics; Cholinesterase Inhibitors/toxicity*; Chlorpyrifos/administration & dosage; Chlorpyrifos/pharmacokinetics; Chlorpyrifos/toxicity*; Hippocampus/drug effects*; Hippocampus/metabolism; Hippocampus/pathology; Humans; Insecticides/administration & dosage; Insecticides/pharmacokinetics; Insecticides/toxicity*; Lethal Dose 50; Male; Random Allocation; Mice
  16. Saraswathy TS, Zahrin HN, Apandi MY, Kurup D, Rohani J, Zainah S, et al.
    PMID: 19062691
    In 1992 surveillance of acute flaccid paralysis (AFP) cases was introduced in Malaysia along with the establishment of a national referral laboratory at the Institute for Medical Research. The objective of this study was to determine the incidence, viral etiology and clinical picture of AFP cases below 15 years of age, reported from 2002 to 2007. Six hundred seventy-eight of 688 reported cases were confirmed as AFP by expert review. The clinical presentation of acute flaccid paralysis in these cases was diverse, the most commonly reported being Guillian-Barre syndrome (32.3%). Sixty-nine viruses were isolated in this study. They were Sabin poliovirus (25), Echovirus (22), Cocksackie B (11), EV71 (5), Cocksackie A (1), and untypable (5). Malaysia has been confirmed as free from wild polio since the surveillance was established.
    MeSH terms: Acute Disease; Adolescent; Child; Child, Preschool; Humans; Malaysia/epidemiology; Paraplegia/etiology; Paraplegia/epidemiology*; Paraplegia/virology*; Poliomyelitis/complications; Virus Diseases/complications; Virus Diseases/epidemiology*; Virus Diseases/virology*; Sentinel Surveillance
  17. Shah CH, Ismail IM, Mohsin SS
    PMID: 19062707
    This study provided data by a simple method of acquiring information related to ambulance response time (ART) and determined whether it met the international standards of ART. Additionally, this paper also compared the duration of ART at this hospital before and after the implementation of an Emergency Medical Dispatcher (EMD) program. The ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint were received and ended when the emergency team arrived at the scene of the incident. The parameters recorded include call processing time, time taken to prepare the team and time taken to travel to the scene. The results of the study revealed that the ART for the university hospital (HUSM) was at 913.2 +/- 276.5 seconds (mean +/- SD) and it was far below the international standard of ART as a benchmark of a good ambulance service. However, the study suggested that the EMD program that was recently implemented at the HUSM gave a significantly improvement to the ART score.
    MeSH terms: Ambulances/organization & administration*; Ambulances/standards; Cross-Sectional Studies; Humans; Malaysia; Time Factors
  18. Tao L, Ma J, Kunisue T, Libelo EL, Tanabe S, Kannan K
    Environ Sci Technol, 2008 Nov 15;42(22):8597-602.
    PMID: 19068854
    The occurrence of perfluorinated compounds (PFCs) in human blood is known to be widespread; nevertheless, the sources of exposure to humans, including infants, are not well understood. In this study, breast milk collected from seven countries in Asia was analyzed (n=184) for nine PFCs, including perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA). In addition, five brands of infant formula (n=21) and 11 brands of dairy milk (n=12) collected from retail stores in the United States were analyzed, for comparison with PFC concentrations previously reported for breast milk from the U.S. PFOS was the predominant PFC detected in almost all Asian breast milk samples, followed by perfluorohexanesulfonate (PFHxS) and PFOA. Median concentrations of PFOS in breast milk from Asian countries varied significantly;the lowest concentration of 39.4 pg/mL was found in India, and the highest concentration of 196 pg/mL was found in Japan. The measured concentrations were similarto or less than the concentrations previously reported from Sweden, the United States, and Germany (median, 106-166 pg/mL). PFHxS was found in more than 70% of the samples analyzed from Japan, Malaysia, Philippines, and Vietnam, at mean concentrations ranging from 6.45 (Malaysia) to 15.8 (Philippines) pg/mL PFOA was found frequently only in samples from Japan; the mean concentration for that country was 77.7 pg/mL. None of the PFCs were detected in the infant-formula or dairy-milk samples from the U.S. except a few samples that contained concentrations close to the limit of detection. The estimated average daily intake of PFOS by infants from seven Asian countries, via breastfeeding, was 11.8 +/- 10.6 ng/kg bw/ day; this value is 7-12 times higher than the estimated adult dietary intakes previously reported from Germany, Canada, and Spain. The average daily intake of PFOA by Japanese infants was 9.6 +/- 4.9 ng/kg bw/day, a value 3-10 times greater than the estimated adult dietary intakes reported from Germany and Canada. The highest estimated daily intakes of PFOS and PFOA by infants from seven Asian countries studied were 1-2 orders of magnitude below the tolerable daily intake values recommended by the U.K. Food Standards Agency.
    MeSH terms: Adult; Animals; Asia; Environmental Pollutants/analysis*; Environmental Pollutants/blood; Female; Fluorocarbons/analysis*; Humans; Infant, Newborn; Milk/chemistry*; Milk, Human/chemistry*; United States; Infant Formula/chemistry*
  19. Protti D, Groen P
    Healthc Q, 2008;11(4):83-9.
    PMID: 19068935
    The success story of the Veterans Health Administration (VHA) within the US Department of Veterans Affairs has been well documented and is generally well known. What is generally not known is that the VHA's clinical information system, known as VistA, and the computerized patient record system clinical user interface front end have been successfully transported and implemented to a number of non-VHA healthcare organizations across the United States. Moreover, VistA software modules have been installed, or are being considered for installation, in healthcare institutions around the world in countries such as Mexico, Finland, Jordan, Germany, Nigeria, Egypt, Malaysia, India, Brazil, Pakistan and Samoa.
    MeSH terms: Diffusion of Innovation*; United States; United States Department of Veterans Affairs*; Medical Records Systems, Computerized/utilization
  20. Akowuah GA, Zhari I
    Pharmazie, 2008 Nov;63(11):788-90.
    PMID: 19069237
    A simple high-performance liquid chromatography (HPLC) method to determine the content of betulinic acid (BA) in rat plasma collected at different times (0-8 h) after oral administration of Orthosiphon stamineus leaf extract was developed. The features of the assay include protein precipitation using acetonitrile and isocratic elution using reverse phase C-18 column with ultraviolet (UV) detection. The recovery of BA from plasma varied from 98.4 to 102.5%. The R.S.D of intra- and inter-day precision from rat plasma ranged from 4.2 to 9.8%. The maximum concentration of BA in the plasma was 1.2 +/- 0.3 microg/ml at 1 h after oral administration of the extract.
    MeSH terms: Animals; Calibration; Chromatography, High Pressure Liquid; Data Interpretation, Statistical; Indicators and Reagents; Pharmaceutic Aids/chemistry; Plant Extracts/pharmacology; Plant Extracts/chemistry; Povidone/chemistry; Reference Standards; Triterpenes/analysis; Triterpenes/blood; Triterpenes/pharmacokinetics*; Rats, Sprague-Dawley; Plant Leaves; Spectrometry, Mass, Electrospray Ionization; Orthosiphon/chemistry*; Mice; Rats
External Links