Browse publications by year: 2008

  1. Lai LC
    Malays J Pathol, 2008 Dec;30(2):67-71.
    PMID: 19291914 MyJurnal
    HbA1c is used for assessing glycaemic control in patients with diabetes. It is also used for treatment goals and as a target for therapeutic intervention. The Direct Control and Complications Trial in the USA showed that HbA1c can be used to predict the risk of complications. Hence, it is important for HbA1c assays to be standardised. The National Glycohemoglobin Standardization Program (NGSP) in the USA was formed in 1996 so that HbA1c results from different laboratories would be comparable to those reported in the DCCT study. There were also HbA1c standardisation programmes in Sweden and Japan. These three standardisation programmes are, in fact, direct comparison methods (DCMs), and yield different HbA1c results. In 1994, the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) established a Working Group on Standardisation of HbA1c. This working group has developed a global HbA1c reference system with very much improved intra-assay and inter-assay coefficients of variation. Recommendations have been made to report HbA1c results as IFCC-HbA1c values in SI units (mmol HbA1c/mol Hb) and NGSP-HbA1c (%) as well as estimated average glucose (eAG), once a tight relationship has been shown to exist between eAG and HbA1c.
    MeSH terms: Blood Chemical Analysis/standards*; Chemistry, Clinical/standards*; Clinical Trials as Topic; Hemoglobin A, Glycosylated/analysis*; Humans; Research Design/standards*
  2. Tan YF, Sim GC, Habsah A, Leong CF, Cheong SK
    Malays J Pathol, 2008 Dec;30(2):73-9.
    PMID: 19291915 MyJurnal
    Dendritic cells (DC) are professional antigen presenting cells of the immune system. Through the use of DC vaccines (DC after exposure to tumour antigens), cryopreserved in single-use aliquots, an attractive and novel immunotherapeutic strategy is available as an option for treatment. In this paper we describe an in vitro attempt to scale-up production of clinical-grade DC vaccines from leukemic cells. Blast cells of two relapsed AML patients were harvested for DC generation in serum-free culture medium containing clinical-grade cytokines GM-CSF, IL-4 and TNF-alpha. Cells from patient 1 were cultured in a bag and those from patient 2 were cultured in a flask. The numbers of seeding cells were 2.24 x 10(8) and 0.8 x 10(8), respectively. DC yields were 10 x 10(6) and 29.8 x 10(6) cells, giving a conversion rate of 4.7% and 37%, respectively. These DC vaccines were then cryopreserved in approximately one million cells per vial with 20% fresh frozen group AB plasma and 10% DMSO. At 12 months and 21 months post cryopreservation, these DC vaccines were thawed, and their sterility, viability, phenotype and functionality were studied. DC vaccines remained sterile up to 21 months of storage. Viability of the cryopreserved DC in the culture bag and flask was found to be 50% and 70% at 12 months post cryopreservation respectively; and 48% and 67% at 21 months post cryopreservation respectively. These DC vaccines exhibited mature DC surface phenotypic markers of CD83, CD86 and HLA-DR, and negative for haemopoietic markers. Mixed lymphocyte reaction (MLR) study showed functional DC vaccines. These experiments demonstrated that it is possible to produce clinical-grade DC vaccines in vitro from blast cells of leukemic patients, which could be cryopreserved up to 21 months for use if repeated vaccinations are required in the course of therapy.
    MeSH terms: Cell Differentiation/immunology; Dendritic Cells/cytology; Dendritic Cells/immunology*; Humans; Immunotherapy/methods*; Lymphocyte Culture Test, Mixed; Tumor Necrosis Factor-alpha/immunology; Leukemia, Myeloid, Acute/immunology*; Leukemia, Myeloid, Acute/therapy; Antigens, CD/immunology; Antigens, CD/metabolism; Cryopreservation; Granulocyte-Macrophage Colony-Stimulating Factor/immunology; Cell Culture Techniques/methods*; Cancer Vaccines/immunology*
  3. Thevarajah TM, Nani N, Chew YY
    Malays J Pathol, 2008 Dec;30(2):81-6.
    PMID: 19291916 MyJurnal
    HbA1c measurement is currently routinely used to predict long term outcome of diabetes, thus playing a fundamental role in the management of diabetes. The relationship between HbA1c value and long term diabetic complications has been established by a randomised control Diabetes Control and Complications Trial (DCCT) which used high performance liquid chromatography (HPLC) as a reference method for HbA1c assay. To ensure that HbA1c results from a variety HbA1c assay methods are similar to the DCCT values, the American Diabetes Association (ADA) recommended that all laboratories should use methods certified by the National Glycohemoglobin Standardization Programme (NGSP) with interassay coefficient variation (CV) of < 5% (ideally < 3%). The International Federation of Clinical Chemistry (IFCC) working group on HbA1c standardisation has set a CV < 2.5% as a criteria for its reference laboratories.
    MeSH terms: Blood Chemical Analysis/instrumentation*; Blood Chemical Analysis/methods; Blood Chemical Analysis/standards*; Chemistry, Clinical/instrumentation*; Chemistry, Clinical/methods; Chemistry, Clinical/standards*; Hemoglobin A, Glycosylated/analysis*; Humans; Reproducibility of Results
  4. Fazlina N, Maha A, Zarina AL, Hamidah A, Zulkifli SZ, Cheong SK, et al.
    Malays J Pathol, 2008 Dec;30(2):87-93.
    PMID: 19291917
    Multidrug resistance (MDR) is believed to be responsible for poor response of patients towards chemotherapy particularly patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). The best-characterized resistance mechanism is the one mediated by permeability-glycoprotein (P-gp) encoded by MDR1 gene, which is responsible for drug efflux. We studied P-gp and multidrug resistance-associated protein 1 (MRP1) expression and functional activities in 43 newly diagnosed acute leukemia cases (19 paediatric ALL cases and 24 adult AML cases). The expression and functional activities were examined using flow cytometry and MultiDrugQuant assay kit (involving calcein AM uptake and efflux). P-gp and MRP1 expression and its functional activities were observed in 68.4% of paediatric ALL. In adult AML cases, all cases expressed MRP1 and its functional activities but only 58.3% were positive for P-gp and its functional activities. We were able to show a significant correlation between the expression of the multidrug resistant protein (P-gp and MRP1) and their functional activity in adult AML and paediatric ALL samples.
    MeSH terms: Child; Child, Preschool; Female; Flow Cytometry; Humans; Male; Middle Aged; Reagent Kits, Diagnostic*; Protein Biosynthesis; Leukemia, Myeloid, Acute/metabolism*; P-Glycoprotein/biosynthesis*; Multidrug Resistance-Associated Proteins/biosynthesis*; Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism*
  5. Lee KH, Chen YS, Judson JP, Chakravarthi S, Sim YM, Er HM
    Malays J Pathol, 2008 Dec;30(2):95-102.
    PMID: 19291918 MyJurnal
    The effect of water extracts of Euphorbia hirta on the histological features and expressions of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in the rat articular cartilage was investigated. Arthritis was induced in rats using Freund's Complete Adjuvant containing heat-killed M. tuberculosis, and treated with water extracts of E. hirta. Paraffin tissue sections of the arthritic joints were evaluated. The extent of cartilage degeneration was found to be greatest in rats treated with the highest dosage of E. hirta, followed by rats in the untreated group. Rats treated with the intermediary and low dosages of Euphorbia hirta showed improved histology. MMP-13 levels were found to be decreased with decreasing dosages of E. hirta. TIMP-1 levels were found to increase with decreasing dosages of E. hirta. MMP-3 levels fluctuated without any appreciable pattern. Low dosages of E. hirta seem to be beneficial in reducing cartilage degeneration in cases of arthritis.
    MeSH terms: Animals; Arthritis, Experimental/complications; Arthritis, Experimental/drug therapy*; Cartilage Diseases/etiology; Cartilage Diseases/pathology*; Dose-Response Relationship, Drug; Immunohistochemistry; Phytotherapy*; Plant Extracts/administration & dosage*; Rats, Wistar; Matrix Metalloproteinase 3/drug effects; Matrix Metalloproteinase 3/metabolism; Tissue Inhibitor of Metalloproteinase-1/drug effects; Tissue Inhibitor of Metalloproteinase-1/metabolism; Euphorbia*; Rats; Matrix Metalloproteinase 13/drug effects; Matrix Metalloproteinase 13/metabolism
  6. Cheah PL, Looi LM, Nazarina AR, Mun KS, Goh KL
    Malays J Pathol, 2008 Dec;30(2):103-7.
    PMID: 19291919 MyJurnal
    Transaminase enzymes, alanine (ALT) and aspartate transaminase (AST), have been reported to be raised and implicated to have prognostic value in hepatocellular carcinoma (HCC). Ki67, a marker of cellular proliferative activity, has also been noted to be increased in HCC. A study was conducted at the Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur to determine the possible association of proliferative activity, as determined by Ki67, with the transaminase enzymes. 31 cases of histologically diagnosed HCC who underwent tumour resection were retrieved from departmental archives. The patients' ages ranged between 40 to 79 years with a mean of 58.3 years. There was a male preponderance with M:F = 2.9:1. Ethnic Chinese formed 83.9% of the cases. 4 microm sections, cut from the formalin-fixed, paraffin-embedded tumour tissue block of each case, were immunohistochemically stained with Ki67 (DAKO monoclonal MIB-1) using the commercial DakoCytomation EnVision+System-HRP kit. The latest ALT and AST levels, assayed within 7 days prior to tumour resection, were retrieved from the patients' case records. 24 (77.4%) HCC demonstrated elevation of either ALT and/or AST. 27 (87.1%) HCC were immunopositive for Ki67. Ki67 immunoexpression was significantly correlated with raised transaminases (p<0.05). Hypothetically, the mechanism by which this phenomenon may occur may simply be release of transaminases due to destruction of hepatocytes by the cancer. Thus rising levels of the transaminases could signal a more rapid growth of the tumour and these routinely performed tests can be of prognostic value in management of HCC patients.
    MeSH terms: Adult; Aged; Alanine Transaminase/blood*; Aspartate Aminotransferases/blood*; Female; Carcinoma, Hepatocellular/metabolism*; Carcinoma, Hepatocellular/pathology; Humans; Immunohistochemistry; Liver Neoplasms/metabolism*; Liver Neoplasms/pathology; Male; Middle Aged; Ki-67 Antigen/biosynthesis*
  7. Ngu LH, Zabedah MY, Shanti B, Teh SH
    Malays J Pathol, 2008 Dec;30(2):109-14.
    PMID: 19291920 MyJurnal
    We report the biochemical profiling in two siblings with mitochondrial 2-methylacetoacetyl-CoA thiolase deficiency. Organic aciduria typical of this rare inborn error metabolism was found when the elder sibling presented with an episode of severe ketoacidosis at 20 months of age, which consisted of excessive excretion of ketones, tiglylglycine, 2-methyl-3-hydroxybutyrate, and 2-methylacetoacetate. Blood acylcarnitiness profile showed elevation of C5OH-carnitine, which represents 2-methyl-3-hydroxybutyrylcarnitine. A similar biochemical profile was identified in the younger sibling during screening although he had only mild clinical symptoms. Both patients reported a favourable outcome on follow-up.
    MeSH terms: Acetyl-CoA C-Acyltransferase/deficiency*; Child, Preschool; Female; Humans; Infant; Male; Metabolism, Inborn Errors/physiopathology*; Metabolism, Inborn Errors/urine*; Mitochondria/enzymology*; Siblings
  8. Pailoor J, Iyengar KR, Chan KS, Sumithra S
    Malays J Pathol, 2008 Dec;30(2):115-9.
    PMID: 19291921
    Follicular dendritic cell sarcomas (FDCS) are rare neoplasms that involve lymph nodes or extranodal sites. They show varied histological features and thus can be mistaken for carcinoma or sarcoma. Correct identification is important for further management. A 43-year-old Indian female presented with a three-month history of progressive swelling at the right inguinal region. It was excised completely and was reported as lymph node with metastatic poorly differentiated carcinoma based on Haematoxylin and eosin (H&E) stain findings. Computerized tomography (CT) scans of thorax, abdomen and pelvis were normal and did not reveal a primary site. Following this, the case was referred to one of the authors. The slides were reviewed and a variety of immunocytochemical markers were done. The tumour cells were negative for epithelial, melanocytic, neural, leucocyte and soft tissue tumour markers. They were immunopositive for CD21, CD35 and negative for CD68. Based on the immunocytochemical findings, a final diagnosis of FDCS was made. This case highlights the histological and immunophenotypical profile of a rare tumour which requires a high index of suspicion for diagnosis.
    MeSH terms: Adult; Carcinoma/pathology; Carcinoma/secondary; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Inguinal Canal/pathology; Lymph Nodes/pathology*; Biomarkers, Tumor/analysis; Immunophenotyping; Dendritic Cell Sarcoma, Follicular/metabolism*; Dendritic Cell Sarcoma, Follicular/pathology*
  9. How SH, Kuan YC, Ng TH, Ramachandram K, Fauzi AR
    Malays J Pathol, 2008 Dec;30(2):129-32.
    PMID: 19291924 MyJurnal
    Pulmonary cryptococcosis can be clinically silent in non-HIV infected patients but can also present as nodules and masses on the chest radiograph, which can be mistaken for tuberculosis or lung cancer. Common symptoms include fever and cough, and uncommonly haemoptysis. This report illustrates a non-HIV infected patient whose main complaint was haemoptysis and headache. He was diagnosed with pulmonary cryptococcosis from biopsy of an endobronchial mass found on flexible bronchoscopy. Disseminated cryptoccoccal infection should be considered as a differential diagnosis in non-HIV infected patients presenting with haemoptysis and headache. Early recognition and administration of appropriate therapy will improve clinical outcome in these patients.
    MeSH terms: Adult; Amphotericin B/therapeutic use; Antifungal Agents/therapeutic use; Cryptococcosis/complications; Cryptococcosis/drug therapy; Cryptococcosis/pathology*; Diagnosis, Differential; Headache/etiology*; Hemoptysis/etiology*; Humans; Lung Diseases, Fungal/complications; Lung Diseases, Fungal/drug therapy; Lung Diseases, Fungal/pathology*; Lung Neoplasms/pathology; Recurrence; Fluconazole/therapeutic use
  10. Manohar A, Nizlan MN
    Orthopedics, 2008 Jul;31(7):710.
    PMID: 19292371
    A 60-year-old man presented with a 3-month history of nonhealing ulcer over the tip of his right thumb. The ulcer started as a blister over the tip of the thumb that later ruptured and spread proximally to cover the whole pulp area of the thumb. There was no history of trauma, fever, weight loss, or loss of appetite. He is a pensioner and an avid gardener. He has a few cats as pets. The patient initially presented to a private orthopedic surgeon with a nonhealing ulcer of the right thumb. Multiple debridements were unsuccessful in ameliorating the ulcer. Three months after the onset of the initial lesion, multiple painless erythematous nodules had developed on his right arm, and one on the right thigh. All routine blood investigations were nondiagnostic. Swab culture from the ulcer failed to grow any organism and a course of antibiotics did not resolve the problem. Cultures of the biopsy specimen using Sabouraud's dextrose agar and potato carrot medium grew dark brown plaques that microscopically appeared to be branching hyphae. A diagnosis of sporotrichosis of the right upper limb was made and the patient was started on antifungal treatment immediately (T. Itraconazole [Sporanox] 200 mg BD). One month after commencement of antifungal treatment, the ulcer began to dry up and at 3 months all the lesions including the one on the right thigh had healed.
    MeSH terms: Antifungal Agents/therapeutic use; Carcinoma, Basal Cell/diagnosis; Carcinoma, Basal Cell/surgery; Chronic Disease; Diagnosis, Differential; Humans; Male; Middle Aged; Skin Neoplasms/diagnosis; Skin Neoplasms/surgery; Skin Ulcer/diagnosis*; Skin Ulcer/drug therapy*; Sporotrichosis/diagnosis*; Sporotrichosis/drug therapy*; Thumb/pathology*; Treatment Outcome; Treatment Failure; Itraconazole/therapeutic use*
  11. Misnan R, Murad S, Jones M, Taylor G, Rahman D, Arip M, et al.
    Asian Pac J Allergy Immunol, 2008 Dec;26(4):191-8.
    PMID: 19317337
    The purpose of this study was to characterize major allergens of Indian scad (Decapterus russelli) which is among the most commonly consumed fish in Malaysia. Raw and cooked extracts of the fish were prepared. Protein profiles and IgE binding patterns were produced by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting using sera from subjects with fish allergy. The major allergens of the fish were then identified by two-dimensional electrophoresis (2-DE), followed by mass spectrometry of the peptide digests. The SDS-PAGE of the raw extract revealed 27 protein fractions over a wide molecular weight range, while the cooked extract demonstrated only six protein fractions. The 1-DE immunoblotting detected 14 IgE-binding proteins, with a molecular weight range from 90 to < 6.5 kDa. Three protein fractions with molecular weights of approximately 51, 46 and 12 kDa were identified as the major allergens of this fish. The approximately 12 kDa band was a heat-resistant protein while the approximately 51 and 46 kDa proteins were sensitive to heat. The 2-DE gel profile of the raw extract demonstrated > 100 distinct protein spots and immunoblotting detected at least 10 different major IgE reactive spots with molecular masses as expected and isoelectric point (pI) values ranging from 4.0 to 7.0. A comparison of the major allergenic spot sequences of the 12 kDa proteins with known protein sequences in databases revealed extensive similarity with fish parvalbumin. In conclusion, this study demonstrated that a parvalbumin which is similar to Gad c 1 is the major allergen of Indian scad. Interestingly, we also detected heat-sensitive proteins as major allergenic components in our fish allergy patients.
    MeSH terms: Allergens/immunology*; Animals; Food Hypersensitivity/blood; Food Hypersensitivity/immunology*; Humans; Immunoglobulin E/blood*; Parvalbumins/immunology*; Parvalbumins/metabolism; Perciformes/immunology*; Perciformes/metabolism; Protein Array Analysis
  12. Liong MT
    Int J Mol Sci, 2008 May;9(5):854-863.
    PMID: 19325789 DOI: 10.3390/ijms9050854
    Probiotics are live bacteria that could exert health beneficial effects upon consumption. In additional to their conventional use as gut modulators, probiotics are investigated for their role to prevent cancer. In-vivo and molecular studies have demonstrated encouraging outcomes, mainly attributed to its antimicrobial effects against carcinogen-producing microorganisms, antimutagenic properties, and alteration of the tumor differentiation processes. Prebiotics are indigestible food components that could promote the growth of beneficial bacteria including probiotics. Present studies have suggested that prebiotics also possess protective effect against colon carcinogenesis, mainly attributed to the production of short chain fatty acids upon its fermentation by gut microflora, and alteration of gene-expressions in tumor cells. Synbiotic (combination of probiotic and prebiotic) has been found to exert a synergistic effect in improving colon carcinogenesis compared to when both were used individually. This paper highlights the colon cancer preventive effects by probiotics, prebiotics and synbiotics. In addition, the controversial outcomes on the insignificant effect of these food adjuncts will be discussed.
  13. Ganesan K, Alias Y
    Int J Mol Sci, 2008 Jun;9(7):1207-13.
    PMID: 19325800 DOI: 10.3390/ijms9071207
    The (1)H-NMR shifts of the imidazolium protons of some novel dimeric ionic liquids were examined in various deuterated solvents. Interactions between the solvent and the imidazolium salt of butyl substituted ionic liquids were observed to give higher chemical shifts than methyl substitution.
    MeSH terms: Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Protons; Sodium Chloride; Solvents; Sodium Chloride, Dietary; Ionic Liquids; Proton Magnetic Resonance Spectroscopy
  14. Chew KS, Mohidin MA, Ahmad MZ, Tuan Kamauzaman TH, Mohamad N
    Int J Emerg Med, 2008 Sep;1(3):205-8.
    PMID: 19384518 DOI: 10.1007/s12245-008-0054-y
    Despite being a favorite delicacy, only 200-300 of the 5,000 known mushroom species have been clearly established to be safe for consumption. Cases of mushroom poisoning have been reported with diverse clinical syndromes. A syndromic classification of mushroom poisoning has recently been developed to facilitate early interventions. We present a series of five cases of mushroom poisoning with muscarinic manifestations to highlight the difficulties we faced with exact species and toxin identification and the importance of this syndromic classification. The common symptoms in our case series are blurred vision, diarrhea, vomiting, and abdominal cramps.
    MeSH terms: Agaricales; Colic; Diarrhea; Humans; Mushroom Poisoning; Syndrome; Toxins, Biological; Vomiting; Cholinergic Agents
  15. Chew KS, Yazid MN
    Int J Emerg Med, 2008 Dec;1(4):301-9.
    PMID: 19384646 DOI: 10.1007/s12245-008-0070-y
    BACKGROUND: Despite the importance of early effective chest compressions to improve the chance of survival of an out-of-hospital cardiac arrest victim, it is still largely unknown how willing our Malaysian population is to perform bystander cardiopulmonary resuscitation (CPR).

    AIMS: We conducted a voluntary, anonymous self-administered questionnaire survey of a group of 164 final year medical students and 60 final year dental students to unravel their attitudes towards performing bystander CPR.

    METHODS: Using a 4-point Likert scale of "definitely yes," "probably yes," "probably no," and "definitely no," the students were asked to rate their willingness to perform bystander CPR under three categories: chest compressions with mouth-to-mouth ventilation (CC + MMV), chest compressions with mask-to-mouth ventilation (CC + PMV), and chest compressions only (CC). Under each category, the students were given ten hypothetical victim scenarios. Categorical data analysis was done using the McNemar test, chi-square test, and Fisher exact test where appropriate. For selected analysis, "definitely yes" and "probably yes" were recoded as a "positive response."

    RESULTS: Generally, we found that only 51.4% of the medical and 45.5% of the dental students are willing to perform bystander CPR. When analyzed under different hypothetical scenarios, we found that, except for the scenario where the victim is their own family member, all other scenarios showed a dismally low rate of positive responses in the category of CC + MMV, but their willingness was significantly improved under the CC + PMV and CC categories.

    CONCLUSION: This study shows that there are unique sociocultural factors that contribute to the reluctance of our students to perform CC + MMV.

  16. Fadilah SA, Leong CF, Cheong SK
    Med J Malaysia, 2008 Oct;63(4):279-80.
    PMID: 19385484 MyJurnal
    MeSH terms: Humans; Malaysia
  17. Gan GG, Zakaria Z, Sangkar JV, Haris AR, Bee PC, Chin E, et al.
    Med J Malaysia, 2008 Oct;63(4):281-7.
    PMID: 19385485 MyJurnal
    We analysed the outcome of 104 patients from a single institution who underwent allogeneic haematopoietic stem cell transplantation (AHSCT) from their HLA-identical siblings between 1993 and 2006. Sixty-nine percent of patients had peripheral blood stem cell (PBSC) as the stem cell source and the remaining had bone marrow (BM). The majority of patients are Chinese (60%) followed by Malays (24%) and Indians (14%). The median time to reach white cell counts of >1 x 10(9)/L and platelet counts of >30 x 10(9)/L was 13 and 15 days, respectively in patients who had PBSC transplantation compared with 16 and 25 days in patients who had BM transplantation, (p < 0.0001 and p < 0.001). Acute graft-versus-host disease (aGVHD) of grade II to IV was observed in 34% of patients and chronic graft-versus-host disease (cGVHD) in 38% of patients. Although not statistically significant, there was a higher incidence of overall aGVHD in Indian patients (73%) compared to Chinese and Malays (57% and 56% respectively). There was no significant difference in the incidence of aGVHD and cGVHD with the source of stem cells. Overall survival (OS) and disease free survival (DFS) was 50% and 60% at five years respectively. Multivariate analysis showed that patients transplanted in standard risk and those who had limited cGVHD had a significant better OS, (p = 0.05 and p = 0.05). Patients who had cGVHD and transplanted in standard risk had a better DFS, (p = 0.002 and p < 0.001). In summary, AHSCT in standard risk patients is associated with a better outcome than those transplanted in high risk and although not statistically significant, there is a higher incidence of aGVHD in Indian patients.
    MeSH terms: Adolescent; Adult; Female; Graft vs Host Disease/epidemiology; Humans; Malaysia; Male; Middle Aged; Retrospective Studies; Transplantation, Homologous; Disease-Free Survival
  18. Jahanfar S, Lim AW, Loh MA, Yeoh AG, Charles A
    Med J Malaysia, 2008 Oct;63(4):288-92.
    PMID: 19385486 MyJurnal
    Malaysia is confronted with an increasing incidence of HIV and AIDS among adolescents and young adults. The effectiveness of various programs offered to school going teenagers is unknown. The objective of this study is to measure the effectiveness of two hours talk on sex education offered by a non governmental organization (NGO) in improving youngsters' knowledge and perception towards HIV and AIDS. A cross sectional study was conducted among the adolescent students from a secondary school in Ipoh, Perak, a province of Malaysia. A total of 182 students participated in the study. A standard questionnaire consisting of demographic data, knowledge and perception towards HIV/ADIS were distributed before (pre-test) and after the intervention (post-test). Performance of participants was compared to establish the effectiveness of the intervention. Our findings suggests that there was a significant increase in participants' knowledge and perception after the intervention (p = 0.000). Knowledge improvement was found in both genders however, improvement in perception was higher among female students. Interestingly, 80% of participants disagree that sexual education will encourage sex among youngsters. NGOs are playing a supplementary role in providing sex education programs in schools. This program although of short duration but it is effective in enhancing adolescence awareness about HIV/AIDS.
    MeSH terms: Acquired Immunodeficiency Syndrome/prevention & control*; Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice; Male; Perception; Schools; Sex Education*; Students; HIV Infections; HIV Infections/prevention & control*; Knowledge*
  19. Asma A, Wan Fazlina WH, Almyzan A, Han YS, Jamilah AG, Roslin S, et al.
    Med J Malaysia, 2008 Oct;63(4):293-7.
    PMID: 19385487 MyJurnal
    The importance of universal newborn hearing screening (UNHS) in identifying hearing-impaired infants as early as possible is already well recognized. Transient evoked otoacoustic emissions (TEOAE) have been established as a reliable method for UNHS in full term infants. This is a cross sectional study between April 2003--December 2005. Thirteen thousand five hundred and ninety eight (13,598) newborns were screened for hearing loss with portable otoacoustic emission (OAE) before discharge. The initial coverage rate during the 3 years study period was 85.9% (13,598) with 89.2% (3762), 79.0% (4480) and 90.3% (5356) for 2003, 2004 and 2005 respectively. The mean age when hearing loss was diagnosed using ABR were 3.56 months old, 3.08 months old, and 2.25 months old and 3.01 months old for 2003, 2004, 2005 respectively and it was statistically significant. The defaulter rate at the third stage during the 3 years study period was 35% (21), 15.2% (7) and 18.2% (2) for 2003, 2004 and 2005 respectively. This study showed significant improvement in initial referral rate, coverage rate and age of diagnosis. However, we need to improve on high defaulter rates.
    MeSH terms: Cross-Sectional Studies; Hearing Tests*; Humans; Infant; Infant, Newborn; Referral and Consultation; Neonatal Screening*; Evoked Potentials, Auditory, Brain Stem; Otoacoustic Emissions, Spontaneous; Hearing Loss/diagnosis
  20. Ng TH, How SH, Kuan YC, Hasmah H, Norra H, Fauzi AR
    Med J Malaysia, 2008 Oct;63(4):298-301.
    PMID: 19385488 MyJurnal
    Medical thoracoscopy has gain its popularity in Malaysia recently. This paper presents our early experience in thoracoscopy using semi-rigid fiberoptic thoracoscope. All thoracoscopy records since October 2006 were retrieved. The patients' records, thoracocentesis investigations results, thoracoscopic findings and all pleural biopsy results were reviewed. Twenty-four thoracoscopic procedures on 22 patients in whom two patients had repeated thoracoscopy. Ten patients were confirmed carcinoma. Eight patients had inconclusive thoracoscopic pleural biopsy results. Three patients underwent pleurodesis for malignant effusion. One patient had adhesiolysis for empyema. There was no procedure-related deaths or intraoperative accidents. Thoracoscopy is a relatively safe procedure.
    MeSH terms: Adolescent; Adult; Aged; Biopsy; Female; Humans; Male; Middle Aged; Pleura/pathology; Thoracoscopy*; Tuberculosis, Pleural/diagnosis; Pleural Effusion, Malignant/diagnosis; Pleurodesis
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