A retrospective case series review was conducted to determine the pre-operative role and safety of pre-operative adjunctive anti-vascular endothelial growth factor (anti- VEGF) agent ranibizumab “LUCENTISTM” in patients with diabetic retinopathy requiring vitrectomy. The study involved twenty consecutive eyes of sixteen patients (age range: 46-72 years; mean 57.5 years) which received intravitreal injection of 0.5 - 1 mg of ranibizumab 3 to 8 days (mean 4.4 days) prior to vitrectomy for diabetic retinopathy. There were no local or systemic post-injection complications. Indications for vitrectomy were retinal detachment (RD) [n=11; 3 combined tractional (TRD) - rhegmatogenous RD (RRD), 8 TRD], TRD with vitreous haemorrhage (VH) (n=3) ,VH (n=8) and vitreomacular traction syndrome (n=1). Inclusion criteria include all consecutive eyes of diabetic patients requiring vitrectomy receiving a first pre-operative injection of anti- VEGF. Pre-operative visual acuity (VA) ranged from 6/36 to light perception. All eyes had minimal to moderate intraoperative bleeding. Post-operative VH in eyes without tamponade or gas tamponade was nil (n=1), mild (n=13) or moderate (n=1). Silicone filled eyes had nil (n=1), moderate (n=3) or severe haemorrhages (n=1). Post-operative VA was unchanged (n=2) (10%), improved (n = 14) (70%) or worsened (n=4). VA was 2/60 or better (n=15) to no light perception (n=1). Two eyes achieved 6/12 or better vision (10%). Ten eyes (50%) had 6/36 or better vision. In conclusion, pre-operative intravitreal ranibizumab is safe and useful in diabetic vitrectomy and appears to help with perioperative bleeding leading to improvement in vision.
Facial nerve schwannoma is a rare slow growing benign tumour which arises from the Schwann cell of the neurilemma. A retrospective review of 6 patients who had been diagnosed with facial nerve schwannoma between 1998 and 2008 was conducted. There was equal distribution of male and female patients. The mean age was 42 years (range 19 to 66 years). The tumour originated in the internal auditory canal (2 patients), intra-temporal (3 patients) and intraparotid (1 patient) segments of the facial nerve. All tumours were successfully removed and facial nerve continuity was pre-served in 2 cases. The presenting symptoms of facial nerve schwannoma are non specific and dependent on the site of tumour origin. It is a great mimicker of other lesions that can present at the same location. The surgeon should have a high index of suspicion when patients present with progressive facial nerve palsy. Patients should always be counselled regarding risk of facial paralysis because the diagnosis of facial nerve schwannoma is often confirmed intra-operatively.
Coronary Artery Bypass Grafting (CABG) surgery has increased the survival rate for individuals suffering from myocardial infarction or coronary ischemia. The present study aimed to examine the perception of quality of life amongst post CABG patients at the National Heart Institute Malaysia. A total of 69 post CABG patients, were studied using the Medical Outcomes Short Form 36 (SF-36). The findings showed that post CABG respondents possessed good level of quality of life (SF-36) physically and mentally. There were significant differences between the role physical in the physical functioning domains of quality of life with gender (t=0.286, p
A cross sectional study was done to determine the prevalence and distribution of human papillomavirus (HPV) genotypes in pre-invasive (cervical intraepithelial neoplasia, grade 3 or CIN 3) and invasive cervical cancer (ICC), in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 80 paraffin-embedded tumour tissue blocks (20 CIN 3, 60 invasive cancers) between 1999 to 2007 were retrieved from the archives of the Department of Pathology. Patient’s medical records were obtained from the Medical Records Office. Among invasive cancers (n=60), squamous cell carcinoma (SCC) account for 75% and adenocarcinoma 25%. The mean age of cases studied was 52.0 ± 12.2 years and Chinese was the predominant ethnicity (66.3%). Twelve HPV genotypes were identified, namely, HPV 16, 33, 18, 39,52, 45, 58, 59, 31, 35, 6 and 11. The prevalence of HPV was 92.5% with types 16 being the most common (73.8%), followed by types 33 (30%) and 18 (22.5%). A total of 31 cases (38.8%) showed single HPV genotype, while 43 (53.8%) had multiple HPV (two genotypes or more) genotypes. In ICC, HPV 16, followed by types 33, 18, 52 and 39 were the top five common HPV genotypes detected. High prevalence of HPV and multiple HPV infections were major findings among patients with pre-invasive and invasive cervical cancer.
A cross-sectional study was carried out in 2006 to determine the prevalence of Ascaris lumbricoides infection among Orang Asli (aborigines) children in Pos Lenjang, Pahang. A total of 71 faecal samples were collected from the children (40 girls and 31 boys) aged between 1-12 years. The samples were examined for the presence of the ova of A. lumbricoides using direct faecal smear and formalin-ether concentration techniques. 42.3%. The prevalence of A. lumbricoides infection was found to be slightly higher in males (45.2%) compared to females (40%) (p>0.05). The school-aged children showed higher prevalence of infection (48.6%) as compared to the preschool children (35.3%) (p
The study of human-environmental relations is complex and by nature draws on theories and practices from multiple disciplines. There is no single research strategy or universal set of methods to which researchers must adhere. Particularly for scholars interested in a political ecology approach to understanding human-environmental relationships, very little has been written examining the details of "how to" design a project, develop appropriate methods, produce data, and, finally, integrate multiple forms of data into an analysis. A great deal of attention has been paid, appropriately, to the theoretical foundations of political ecology, and numerous scholarly articles and books have been published recently. But beyond Andrew Vayda's "progressive contextualization" and Piers Blaikie and Harold Brookfield's "chains of explanation," remarkably little is written that provides a research model to follow, modify, and expand. Perhaps one of the reasons for this gap in scholarship is that, as expected in interdisciplinary research, researchers use a variety of methods that are suitable (and perhaps unique) to the questions they are asking. To start a conversation on the methods available for researchers interested in adopting a political ecology perspective to human-environmental interactions, I use my own research project as a case study. This research is by no means flawless or inclusive of all possible methods, but by using the details of this particular research process as a case study I hope to provide insights into field research that will be valuable for future scholarship.
MeSH terms: Agriculture/trends; Archives; Conservation of Natural Resources/history; Conservation of Natural Resources/methods*; Data Collection/methods; Ecology; Environment*; Geography; Humans; Malaysia; Politics; Interdisciplinary Communication; History, 19th Century; History, 20th Century
To reveal whether bats serve as an amplifying host for Yokose virus (YOKV), we conducted a serological survey and experimentally infected fruit bats with YOKV isolated from microbats in Japan. YOKV belongs to the Entebbe bat virus group of vector unknown group within the genus Flavivirus and family Flaviviridae. To detect antibodies against YOKV, we developed an enzyme-linked immunosorbent assay (ELISA) using biotinylated anti-bat IgG rabbit sera. Serological surveillance was conducted with samples collected in the Philippines and the sera supplied from Malaysia. One of the 36 samples from the Philippines (2.7%) and 5 of the 26 samples from Malaysia (19%) had detectable ELISA antibodies. In the experimental infections, no clinical signs of disease were observed. Moreover, no significant viral genome amplification was detected. These findings revealed that YOKV replicates poorly in the fruit bat, suggesting that fruit bats do not seem to serve as an amplifying host for YOKV.
Altitude training is sometimes employed by elite endurance athletes to improve their sea level performance. This improvement results from the increased red cell mass consequent upon the boost in erythropoietin (EPO) level that occurs as a response to the relatively hypoxic environment at high altitudes. We measured serum EPO levels together with various red cell and reticulocyte parameters including immature reticulocyte fraction (IRF) in eight national track-endurance cyclists, resident at sea-level, prior to and upon return from an altitude of approximately 1905 m. Reticulocytes and soluble transferrin receptor (sTfR) were significantly increased with reduction in ferritin levels immediately on return from high altitude indicating increased erythropoietic activity. IRF in particular showed a significant peak immediately on return but decline to sub-baseline levels by day 9, and recovery to baseline by day 16. Our results indicate that IRF is a sensitive marker of erythropoietic status in athletes undergoing altitude training and subsequent loss of EPO stimuli on return to sea level.
To study the effect of haemodialysis on intraocular pressure (IOP) of patients at the University Malaya Medical Centre, Kuala Lumpur, and the influence of anterior chamber angles, surgery, and diabetes on the change in IOP after haemodialysis.
The present study examined the sociocultural adjustment of 249 sojourning Malaysian undergraduates in Britain. One-hundred and ten Malay and 139 Chinese students enrolled in various courses answered a self-report questionnaire that examined various aspects of sociocultural adjustment and socio-demographics. Overall, Malay students reported significantly poorer sociocultural adjustment than Chinese students, as well as more negative outcomes on a range of predictors. Path analysis for the total sample showed that higher family income led to greater sociocultural adjustment, but partially because it led to more contact with host and conationals, better language proficiency, lower perceived cultural differences and less perceived discrimination. Moreover, participants with higher English proficiency were better adapted, but partially because they perceived less cultural differences as well as having more contact with host nationals. Additionally, individuals reporting better sociocultural adjustment also reported better health statuses. The same model was equally useful at predicting sociocultural adjustment for both Malay and Chinese participants. These results are discussed in terms of the role played by income in buffering against the negative aspects of sociocultural adjustment.
MeSH terms: Acculturation*; Adaptation, Psychological*; Adolescent; Adult; Communication Barriers; Cross-Cultural Comparison; Cultural Characteristics; Family; Female; Great Britain; Health Status; Humans; Income/statistics & numerical data; Malaysia/ethnology; Male; Surveys and Questionnaires; Social Adjustment*; Students/psychology*; Students/statistics & numerical data; Universities; Asian Continental Ancestry Group/psychology; Asian Continental Ancestry Group/statistics & numerical data; Emigrants and Immigrants/psychology*; Emigrants and Immigrants/statistics & numerical data
There are many factors that influence PM(10) concentration in the atmosphere. This paper will look at the PM(10) concentration in relation with the wet season (north east monsoon) and dry season (south west monsoon) in Seberang Perai, Malaysia from the year 2000 to 2004. It is expected that PM(10) will reach the peak during south west monsoon as the weather during this season becomes dry and this study has proved that the highest PM(10) concentrations in 2000 to 2004 were recorded in this monsoon. Two probability distributions using Weibull and lognormal were used to model the PM(10) concentration. The best model used for prediction was selected based on performance indicators. Lognormal distribution represents the data better than Weibull distribution model for 2000, 2001, and 2002. However, for 2003 and 2004, Weibull distribution represents better than the lognormal distribution. The proposed distributions were successfully used for estimation of exceedences and predicting the return periods of the sequence year.
This study compared the enzymatic activity of clinical isolates of Cryptococcus neoformans, Cryptococcus gattii, environmental isolates of C. neoformans and non-neoformans Cryptococcus. Most of the cryptococcal isolates investigated in this study exhibited proteinase and phospholipase activities. Laccase activity was detected from all the C. neoformans and C. gattii isolates, but not from the non-neoformans Cryptococcus isolates. There was no significant difference in the proteinase, phospholipase and laccase activities of C. neoformans and C. gattii. However, significant difference in the enzymatic activities of beta-glucuronidase, alpha-glucosidase, beta-glucosidase and N-acetyl-beta-glucosaminidase between C. neoformans and C. gattii isolates was observed in this study. Environmental isolates of C. neoformans exhibited similar enzymatic profiles as the clinical isolates of C. neoformans, except for lower proteinase and laccase activities.
After 12 serial Nipah virus outbreaks in humans since 1998, it has been noted that all except the initial event in Malaysia occurred during the first 5 months of the year. Increasingly higher morbidity and mortality have been observed in subsequent outbreaks in India and Bangladesh. This may have been related to different virus strains and transmission capability from bat to human without the need for an amplifying host and direct human-to-human transmission. A survey of virus strains in Pteropus lylei and seasonal preference for spillover of these viruses was completed in seven provinces of Central Thailand between May 2005 and June 2007. Nipah virus RNA sequences, which belonged to those of the Malaysian and Bangladesh strains, were detected in the urine of these bats, with the Bangladesh strain being dominant. Highest recovery of Nipah virus RNA was observed in May. Of two provincial sites where monthly surveys were done, the Bangladesh strain was almost exclusively detected during April to June. The Malaysian strain was found dispersed during December to June. Although direct contact during breeding (in December to April) was believed to be an important transmission factor, our results may not entirely support the role of breeding activities in spillage of virus. Greater virus shedding over extended periods in the case of the Malaysian strain and the highest peak of virus detection in May in the case of the Bangladesh strain when offspring started to separate may suggest that there may be responsible mechanisms other than direct contact during breeding in the same roost. Knowledge of seasonal preferences of Nipah virus shedding in P. lylei will help us to better understand the dynamics of Nipah virus transmission and have implications for disease management.
The next generation of medical information system will integrate multimedia data to assist physicians in clinical decision-making, diagnoses, teaching, and research. This paper describes MIARS (Medical Image Annotation and Retrieval System). MIARS not only provides automatic annotation, but also supports text based as well as image based retrieval strategies, which play important roles in medical training, research, and diagnostics. The system utilizes three trained classifiers, which are trained using training images. The goal of these classifiers is to provide multi-level automatic annotation. Another main purpose of the MIARS system is to study image semantic retrieval strategy by which images can be retrieved according to different levels of annotation.
MeSH terms: Artificial Intelligence*; Diagnostic Imaging*; Humans; Image Processing, Computer-Assisted; User-Computer Interface; Information Storage and Retrieval*
Analysis and forecasting of air quality parameters are important topics of atmospheric and environmental research today due to the health impact caused by air pollution. This study examines transformation of nitrogen dioxide (NO(2)) into ozone (O(3)) at urban environment using time series plot. Data on the concentration of environmental pollutants and meteorological variables were employed to predict the concentration of O(3) in the atmosphere. Possibility of employing multiple linear regression models as a tool for prediction of O(3) concentration was tested. Results indicated that the presence of NO(2) and sunshine influence the concentration of O(3) in Malaysia. The influence of the previous hour ozone on the next hour concentrations was also demonstrated.
MeSH terms: Environmental Monitoring; Forecasting; Malaysia; Nitrogen Dioxide/analysis*; Ozone/analysis*; Time Factors; Urban Population; Linear Models*
The purpose of this study was to determine the association between different ethnic groups and the prevalence, awareness, and control of diabetes in Malaysia. A population-based cross-sectional study using multistage sampling was conducted in Malaysia. Diabetes is defined as having a fasting blood glucose > or =7 mmol/L or a self-reported diabetic on treatment. Among the 7683 respondents aged > or =30 years, the prevalence of diabetes mellitus was 15.2% (95% CI = 14.1, 16.4). Multivariate analysis showed that compared with Malays, Chinese had lower odds (adjusted odds ratio [aOR] 0.71; 95% CI = 0.56, 0.91) and Indians had higher odds of having diabetes (aOR 1.54; 95% CI = 1.20, 1.98). The odds of diabetes increased with age, family history of diabetes, body mass index, and lower education levels. Among those with diabetes mellitus, 45.0% were aware and 42.7% were under treatment. Among treated diabetics, 25.1% had their fasting blood sugar under control. There is a significant association between prevalence of diabetes and different ethnic groups.
Today, many raw materials used in factories may have a dangerous effect on the physiological system of workers. One of them which is widely used in the polyurethane factories is diisocyanates. These compounds are widely used in surface coatings, polyurethane foams, adhesives, resins, elastomers, binders, and sealants. Exposure to diisocyanates causes irritation to the skin, mucous membranes, eyes, and respiratory tract. Hexamethylene diamine (HDA) is metabolite of hexamethylene diisocyanate (HDI). It is an excretory material by worker's urine who is exposed to HDI. Around 100 air samples were collected from five defined factories by midget impinger which contained dimethyl sulfoxide absorbent as a solvent and tryptamine as reagent. Samples were analyzed by high-performance liquid chromatography with EC\UV detector using NIOSH 5522 method of sampling. Also, 50 urine samples collected from workers were also analyzed using William's biological analysis method. The concentration of HDI into all air samples were more than 88 microg/m(3), and they have shown high concentration of pollutant in the workplaces in comparison with NIOSH standard, and all of the workers' urine were contaminated by HDA. The correlation and regression test were used to obtain statistical model for HDI and HDA, which is useful for the prediction of diisocyanates pollution situation in the polyurethane factories.
MeSH terms: Air Pollutants, Occupational/analysis*; Air Pollutants, Occupational/urine; Chromatography, High Pressure Liquid; Cyanates/metabolism; Cyanates/toxicity*; Diamines/urine*; Industry*; Polyurethanes*; Models, Statistical; Occupational Exposure*; Air Pollution, Indoor*; Isocyanates
Multivariate analysis including correlation, multiple stepwise linear regression, and cluster analyses were applied to investigate the heavy metal concentrations (Cd, Cu, Fe, Ni, Pb, and Zn) in the different parts of bivalves and gastropods. It was also aimed to distinguish statistically the differences between the marine bivalves and the gastropods with regards to the accumulation of heavy metals in the different tissues. The different parts of four species of bivalves and four species of gastropods were obtained and analyzed for heavy metals. The multivariate analyses were then applied on the data. From the multivariate analyses conducted, there were correlations found between the soft tissues of bivalves and gastropods, but none was found between the shells and the soft tissues of most of the molluscs (except for Cerithidea obtusa and Puglina cochlidium). The significant correlations (P < 0.05) found between the soft tissues were further complemented by the multiple stepwise linear regressions where heavy metals in the total soft tissues were influenced by the accumulation in the different types of soft tissues. The present study found that the distributions of heavy metals in the different parts of molluscs were related to their feeding habits and living habitats. The statistical approaches proposed in this study are recommended for use in biomonitoring studies, since multivariate analyses can reduce the cost and time involved in identifying an effective tissue to monitor the heavy metal(s) bioavailability and contamination in tropical coastal waters.
MeSH terms: Animals; Environmental Monitoring/methods; Malaysia; Mollusca/chemistry*; Tissue Distribution; Water Pollutants/analysis*; Water Pollutants/pharmacokinetics; Multivariate Analysis; Metals, Heavy/analysis*; Metals, Heavy/pharmacokinetics
This study is carried out to determine the potential of phytic acid extracted from rice bran in the suppression of colon carcinogenesis induced by azoxymethane (AOM) in rats. Seventy-two male Sprague-Dawley rats were divided into 6 groups with 12 rats in each group. The intended rats for cancer treatment received two intraperitoneal injections of AOM in saline (15mg/kg bodyweight) over a 2-week period. The treatments of phytic acid were given in two concentrations: 0.2% (w/v) and 0.5% (w/v) during the post-initiation phase of carcinogenesis phase via drinking water. The colons of the animals were analyzed for detection and quantification of aberrant crypt foci (ACF) after 8 weeks of treatment. The finding showed treatment with 0.2% (w/v) extract phytic acid (EPA) gave the greatest reduction in the formation of ACF. In addition, phytic acid significantly suppressed the number of ACF in the distal, middle and proximal colon as compared to AOM alone (p<0.05). For the histological classification of ACF, treatment with 0.5% (w/v) commercial phytic acid (CPA) had the highest percentage (71%) of non-dysplastic ACF followed by treatment with 0.2% (w/v) EPA (61%). Administration of phytic acid also reduced the incidence and multiplicity of total tumors even though there were no significant differences between groups. In conclusion, this study found the potential value of phytic acid extracted from rice bran in reducing colon cancer risk in rats.