Browse publications by year: 2012

Assessment of general public perceptions toward traditional medicines used for aphrodisiac purpose in state of Penang, Malaysia

Hassali MA, Saleem F, Shafie AA, Al-Qazaz HK, Farooqui M, Aljadhey H, et al.

Complement Ther Clin Pract, 2012 Nov;18(4):257-60.
PMID: 23059442 DOI: 10.1016/j.ctcp.2012.06.001

The study aims to evaluate general public perceptions regarding the use of Traditional and Complementary Medicines (TCM) for aphrodisiac purposes. A questionnaire based, cross-sectional study was undertaken. Respondents were selected in the state of Penang, Malaysia. A total of 392 respondents were included in the study. Descriptive statistics were used for data analysis. Chi Square/Fischer Exact tests were used where appropriate. Out of 392 respondents, 150 (38.26%) reported using specific Traditional medicines for aphrodisiac purposes. Most respondents (46.94%) agreed that aphrodisiac medicines were easily available t. Moreover, 40.31% of the respondents reported that traditional aphrodisiac medicines were cheaper than modern (prescription) medicines. This study highlights limited public knowledge regarding the use of traditional aphrodisiac medicine. Healthcare professionals should be aware of informal TCM usage when prescribing allopathic medicines.

MeSH terms: Adult; Complementary Therapies/economics; Complementary Therapies/methods*; Aphrodisiacs/economics; Aphrodisiacs/therapeutic use*; Attitude to Health; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Medicine, East Asian Traditional/economics; Medicine, East Asian Traditional/methods*; Middle Aged; Surveys and Questionnaires; Young Adult
Fulltext Chemical composition and molecular structure of polysaccharide-protein biopolymer from Durio zibethinus seed: extraction and purification process

Amid BT, Mirhosseini H, Kostadinović S

Chem Cent J, 2012 Oct 14;6(1):117.
PMID: 23062269 DOI: 10.1186/1752-153X-6-117

BACKGROUND: The biological functions of natural biopolymers from plant sources depend on their chemical composition and molecular structure. In addition, the extraction and further processing conditions significantly influence the chemical and molecular structure of the plant biopolymer. The main objective of the present study was to characterize the chemical and molecular structure of a natural biopolymer from Durio zibethinus seed. A size-exclusion chromatography coupled to multi angle laser light-scattering (SEC-MALS) was applied to analyze the molecular weight (Mw), number average molecular weight (Mn), and polydispersity index (Mw/Mn).
RESULTS: The most abundant monosaccharide in the carbohydrate composition of durian seed gum were galactose (48.6-59.9%), glucose (37.1-45.1%), arabinose (0.58-3.41%), and xylose (0.3-3.21%). The predominant fatty acid of the lipid fraction from the durian seed gum were palmitic acid (C16:0), palmitoleic acid (C16:1), stearic acid (C18:0), oleic acid (C18:1), linoleic acid (C18:2), and linolenic acid (C18:2). The most abundant amino acids of durian seed gum were: leucine (30.9-37.3%), lysine (6.04-8.36%), aspartic acid (6.10-7.19%), glycine (6.07-7.42%), alanine (5.24-6.14%), glutamic acid (5.57-7.09%), valine (4.5-5.50%), proline (3.87-4.81%), serine (4.39-5.18%), threonine (3.44-6.50%), isoleucine (3.30-4.07%), and phenylalanine (3.11-9.04%).
CONCLUSION: The presence of essential amino acids in the chemical structure of durian seed gum reinforces its nutritional value.

MeSH terms: Alanine; Amino Acids; Amino Acids, Essential; Arabinose; Aspartic Acid; Biopolymers; Chromatography, Gel; Fatty Acids, Monounsaturated; Galactose; Gingiva; Glucose; Glycine; Isoleucine; Leucine; Lysine; Molecular Weight; Nutritive Value; Phenylalanine; Proline; Seeds; Serine; Stearic Acids; Threonine; Valine; Xylose; Molecular Structure; alpha-Linolenic Acid; Glutamic Acid; Oleic Acid; Palmitic Acid; Linoleic Acid; Bombacaceae
Cross neutralisation of Southeast Asian cobra and krait venoms by Indian polyvalent antivenoms

Leong PK, Tan NH, Fung SY, Sim SM

Trans R Soc Trop Med Hyg, 2012 Dec;106(12):731-7.
PMID: 23062608 DOI: 10.1016/j.trstmh.2012.07.009

Cross neutralisation of venoms by antivenom raised against closely-related species has been well documented. The spectrum of paraspecific protection of antivenom raised against Asiatic Naja and Bungarus (krait) venoms, however, has not been fully investigated. In this study, we examined the cross neutralisation of venoms from common Southeast Asian cobras and kraits by two widely used polyvalent antivenoms produced in India: Vins Polyvalent Antivenom (VPAV) and Bharat Polyvalent Antivenom (BPAV), using both in vitro and in vivo mouse protection assays. BPAV was only moderately effective against venoms of N. kaouthia (Thailand) and N. sumatrana, and either very weakly effective or totally ineffective against the other cobra and krait venoms. VPAV, on the other hand, neutralised effectively all the Southeast Asian Naja venoms tested, as well as N. naja, B. candidus and Ophiophagus hannah venoms, but the potency ranges from effective to weakly effective. In an in vivo rodent model, VPAV also neutralised the lethality of venoms from Asiatic Naja and B. candidus. In anesthetised rat studies, both antivenoms effectively protected against the N. kaouthia venom-induced cardio-respiratory depressant and neuromuscular blocking effects. Overall, our results suggest that VPAV could be used as alternative antivenom for the treatment of elapid envenomation in Southeast Asian regions including Malaysia, Thailand and certain regions of Indonesia.

MeSH terms: Animals; Antivenins/administration & dosage; Antivenins/immunology; Antivenins/pharmacology*; Asia, Southeastern; Disease Models, Animal; Elapid Venoms/antagonists & inhibitors*; Elapid Venoms/immunology; Elapid Venoms/toxicity; Horses/immunology; Lethal Dose 50; Neutralization Tests/methods; Neutralization Tests/statistics & numerical data; Snake Bites/therapy*; Survival Analysis; Elapidae*; Mice; Rats
Operational factors affecting the bioregeneration of mono-amine modified silica loaded with Acid Orange 7

Al-Amrani WA, Lim PE, Seng CE, Ngah WS

Water Res, 2012 Dec 1;46(19):6419-29.
PMID: 23062787 DOI: 10.1016/j.watres.2012.09.014

In this study, the operational factors affecting the bioregeneration of AO7-loaded MAMS particles in batch system, namely redox condition, initial acclimated biomass concentration, shaking speed and type of acclimated biomass were investigated. The results revealed that with the use of mixed culture acclimated to AO7 under anoxic/aerobic conditions, enhancement of the bioregeneration efficiency of AO7-loaded MAMS and the total removal efficiency of COD could be achieved when the bio-decolorization and bio-mineralization stages were fully aerated with dissolved oxygen above 7 mg/L. Shorter duration of bioregeneration was achieved by using relatively higher initial biomass concentration and lower shaking speed, respectively, whereas variations of biomass concentration and shaking speed did not have a pronounced effect on the bioregeneration efficiency. The duration and efficiency of bioregeneration process were greatly affected by the chemical structures of mono-azo dyes to which the biomasses were acclimated.

MeSH terms: Adsorption; Amines/chemistry; Azo Compounds/metabolism*; Azo Compounds/chemistry*; Benzenesulfonates/metabolism*; Benzenesulfonates/chemistry*; Biodegradation, Environmental; Coloring Agents/metabolism; Coloring Agents/chemistry; Industrial Waste; Oxidation-Reduction; Oxygen; Silicon Dioxide; Waste Disposal, Fluid/methods*; Biomass; Biological Oxygen Demand Analysis
Fulltext The effect of sequential intermittent pneumatic compression of foot and calf on popliteal artery mean systolic blood flow in patients with intermittent claudication

Anthonysamy D, Azizi ZA, Tajri HM

Asian J Surg, 2012 Oct;35(4):131-5.
PMID: 23063083 DOI: 10.1016/j.asjsur.2012.06.005

To determine the effect of intermittent pneumatic foot and calf compression on popliteal artery mean systolic blood flow in patients with intermittent claudication. The secondary objective was to determine the change in blood flow with posture.

MeSH terms: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Foot; Humans; Intermittent Claudication/physiopathology; Intermittent Claudication/therapy*; Leg; Male; Middle Aged; Popliteal Artery/physiopathology*; Posture; Regional Blood Flow*; Treatment Outcome; Intermittent Pneumatic Compression Devices*
WITHDRAWN: Corrigendum to "Morphological characteristics and pathogenicity of fungi associated with Roselle (Hibiscus Sabdariffa) diseases in Penang, Malaysia" [Microb Pathog (2011) 325-337]

Eslaminejad T, Zakaria M

Microb Pathog, 2012 Jun 02.
PMID: 23063498 DOI: 10.1016/j.micpath.2012.05.009

The Publisher regrets that this article is an accidental duplication of an article that has already been published, doi:10.1016/j.micpath.2012.05.010;. The duplicate article has therefore been withdrawn.
Unintentional weight loss is the most important indicator of malnutrition among surgical cancer patients

Loh KW, Vriens MR, Gerritsen A, Borel Rinkes IH, van Hillegersberg R, Schippers C, et al.

Neth J Med, 2012 Oct;70(8):365-9.
PMID: 23065984

Disease-related malnutrition is highly prevalent in hospital patients and varies from 25-40%. Early nutritional screening of patients at admission helps to improve recognition of malnourished patients to allow early interventions and enhance clinical outcomes.

MeSH terms: Adult; Aged; Aged, 80 and over; Cachexia/diagnosis; Cachexia/etiology; Cachexia/epidemiology; Cachexia/therapy; Female; Humans; Male; Middle Aged; Neoplasms/classification; Neoplasms/complications*; Neoplasms/surgery; Netherlands/epidemiology; Preoperative Care/methods*; Weight Loss/physiology; Nutrition Assessment; Body Mass Index; Prevalence; Malnutrition/diagnosis; Malnutrition/etiology*; Malnutrition/epidemiology; Malnutrition/therapy; Young Adult
Clinical pairing revisited: a study at the University of Malaya, Malaysia

Ahmad NA, Naimie Z, Lui JL, Aziz AA, Abdullah M, Abu Kasim NH, et al.

J Dent Educ, 2012 Oct;76(10):1377-83.
PMID: 23066138

This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.

MeSH terms: Achievement; Attitude of Health Personnel; Dentist-Patient Relations; Dentistry, Operative/education*; Education, Dental*; Humans; Interprofessional Relations; Learning; Malaysia; Patient Care Team*; Personal Satisfaction; Quality of Health Care; Surveys and Questionnaires; Students, Dental*; Teaching/methods; Infection Control, Dental
Fulltext A qualitative study of governance of evolving response to non-communicable diseases in low-and middle- income countries: current status, risks and options

Rani M, Nusrat S, Hawken LH

BMC Public Health, 2012;12:877.
PMID: 23067232 DOI: 10.1186/1471-2458-12-877

Segmented service delivery with consequent inefficiencies in health systems was one of the main concerns raised during scaling up of disease-specific programs in the last two decades. The organized response to NCD is in infancy in most LMICs with little evidence on how the response is evolving in terms of institutional arrangements and policy development processes.

MeSH terms: Cambodia; Fiji; Government Agencies/organization & administration; Health Planning/organization & administration; Humans; Malaysia; Mongolia; Philippines; Policy Making; Preventive Medicine/economics; Preventive Medicine/legislation & jurisprudence; Preventive Medicine/organization & administration*; Risk Factors; Developed Countries*
A randomized controlled trial of patient-controlled analgesia compared with boluses of analgesia for the control of acute traumatic pain in the emergency department

Rahman NH, DeSilva T

J Emerg Med, 2012 Dec;43(6):951-7.
PMID: 23068783 DOI: 10.1016/j.jemermed.2012.02.069

The use of patient-controlled analgesia (PCA) has been reported to provide effective pain relief, often resulting in less opioid consumption, and is associated with greater patient satisfaction when it is compared to other techniques of analgesia delivery.

MeSH terms: Adult; Analgesics, Opioid/administration & dosage*; Emergency Service, Hospital*; Humans; Middle Aged; Morphine/administration & dosage*; Pain Measurement; Wounds and Injuries/complications*; Analgesia, Patient-Controlled*; Patient Satisfaction; Young Adult; Pain Management; Acute Pain/drug therapy*
Fulltext Peptide toxin glacontryphan-M is present in the wings of the butterfly Hebomoia glaucippe (Linnaeus, 1758) (Lepidoptera: Pieridae)

Bae N, Li L, Lödl M, Lubec G

Proc Natl Acad Sci U S A, 2012 Oct 30;109(44):17920-4.
PMID: 23071323 DOI: 10.1073/pnas.1209632109

Protein profiling has revealed the presence of glacontryphan-M, a peptide toxin identified only in the sea snail genus Conus, in the wings of Hebomoia glaucippe (HG). The wings and body of HG were homogenized and the proteins were extracted and analyzed by 2D gel electrophoresis with subsequent in-gel digestion. Posttranslational protein modifications were detected and analyzed by nano-LC-MS/MS. An antibody was generated against glacontryphan-M, and protein extracts from the wings of HG samples from Malaysia, Indonesia, and the Philippines were tested by immunoblotting. Glacontryphan-M was unambiguously identified in the wings of HG containing the following posttranslational protein modifications: monoglutamylation at E55, methylation at E53, quinone modification at W61, cyanylation at C56, and amidation of the C terminus at G63. Immunoblotting revealed the presence of the toxin in the wings of HG from all origins, showing a single band for glacontryphan-M in HG samples from Malaysia and Philippines and a double band in HG samples from Indonesia. Intriguingly, sequence analysis indicated that the Conus glacontryphan is identical to that of HG. The toxin may function as a defense against diverse predators, including ants, mantes, spiders, lizards, green frogs, and birds.

MeSH terms: Amino Acid Sequence; Animals; Butterflies; Chromatography, Liquid; Methylation; Molecular Sequence Data; Mollusk Venoms/isolation & purification*; Mollusk Venoms/chemistry; Peptides, Cyclic/isolation & purification*; Peptides, Cyclic/chemistry; Protein Processing, Post-Translational; Wings, Animal/chemistry*; Blotting, Western; Electrophoresis, Gel, Two-Dimensional; Tandem Mass Spectrometry
Fulltext Quantity and configuration of available elephant habitat and related conservation concerns in the Lower Kinabatangan floodplain of Sabah, Malaysia

Estes JG, Othman N, Ismail S, Ancrenaz M, Goossens B, Ambu LN, et al.

PLoS One, 2012;7(10):e44601.
PMID: 23071499 DOI: 10.1371/journal.pone.0044601

The approximately 300 (298, 95% CI: 152-581) elephants in the Lower Kinabatangan Managed Elephant Range in Sabah, Malaysian Borneo are a priority sub-population for Borneo's total elephant population (2,040, 95% CI: 1,184-3,652). Habitat loss and human-elephant conflict are recognized as the major threats to Bornean elephant survival. In the Kinabatangan region, human settlements and agricultural development for oil palm drive an intense fragmentation process. Electric fences guard against elephant crop raiding but also remove access to suitable habitat patches. We conducted expert opinion-based least-cost analyses, to model the quantity and configuration of available suitable elephant habitat in the Lower Kinabatangan, and called this the Elephant Habitat Linkage. At 184 km(2), our estimate of available habitat is 54% smaller than the estimate used in the State's Elephant Action Plan for the Lower Kinabatangan Managed Elephant Range (400 km(2)). During high flood levels, available habitat is reduced to only 61 km(2). As a consequence, short-term elephant densities are likely to surge during floods to 4.83 km(-2) (95% CI: 2.46-9.41), among the highest estimated for forest-dwelling elephants in Asia or Africa. During severe floods, the configuration of remaining elephant habitat and the surge in elephant density may put two villages at elevated risk of human-elephant conflict. Lower Kinabatangan elephants are vulnerable to the natural disturbance regime of the river due to their limited dispersal options. Twenty bottlenecks less than one km wide throughout the Elephant Habitat Linkage, have the potential to further reduce access to suitable habitat. Rebuilding landscape connectivity to isolated habitat patches and to the North Kinabatangan Managed Elephant Range (less than 35 km inland) are conservation priorities that would increase the quantity of available habitat, and may work as a mechanism to allow population release, lower elephant density, reduce human-elephant conflict, and enable genetic mixing.

MeSH terms: Animals; Borneo; Conservation of Natural Resources*; Elephants*; Environment; Humans; Trees; Ecosystem*; Floods
Fulltext A hybrid distance measure for clustering expressed sequence tags originating from the same gene family

Ng KH, Ho CK, Phon-Amnuaisuk S

PLoS One, 2012;7(10):e47216.
PMID: 23071763 DOI: 10.1371/journal.pone.0047216

Clustering is a key step in the processing of Expressed Sequence Tags (ESTs). The primary goal of clustering is to put ESTs from the same transcript of a single gene into a unique cluster. Recent EST clustering algorithms mostly adopt the alignment-free distance measures, where they tend to yield acceptable clustering accuracies with reasonable computational time. Despite the fact that these clustering methods work satisfactorily on a majority of the EST datasets, they have a common weakness. They are prone to deliver unsatisfactory clustering results when dealing with ESTs from the genes derived from the same family. The root cause is the distance measures applied on them are not sensitive enough to separate these closely related genes.

MeSH terms: Algorithms; Multigene Family*; Cluster Analysis*; Expressed Sequence Tags*; Gene Expression Profiling/methods*
Fulltext Blood-based biomarkers of aggressive prostate cancer

Liong ML, Lim CR, Yang H, Chao S, Bong CW, Leong WS, et al.

PLoS One, 2012;7(9):e45802.
PMID: 23071848 DOI: 10.1371/journal.pone.0045802

Prostate cancer is a bimodal disease with aggressive and indolent forms. Current prostate-specific-antigen testing and digital rectal examination screening provide ambiguous results leading to both under-and over-treatment. Accurate, consistent diagnosis is crucial to risk-stratify patients and facilitate clinical decision making as to treatment versus active surveillance. Diagnosis is currently achieved by needle biopsy, a painful procedure. Thus, there is a clinical need for a minimally-invasive test to determine prostate cancer aggressiveness. A blood sample to predict Gleason score, which is known to reflect aggressiveness of the cancer, could serve as such a test.

MeSH terms: Aged; Humans; Malaysia; Male; Middle Aged; North America; Prostatic Neoplasms/blood; Prostatic Neoplasms/diagnosis*; ROC Curve; Biomarkers, Tumor/blood*; Logistic Models; Case-Control Studies; Area Under Curve; Gene Expression Profiling; Microarray Analysis; Neoplasm Grading; Real-Time Polymerase Chain Reaction
Gasifier selection, design and gasification of oil palm fronds with preheated and unheated gasifying air

Guangul FM, Sulaiman SA, Ramli A

Bioresour Technol, 2012 Dec;126:224-32.
PMID: 23073112 DOI: 10.1016/j.biortech.2012.09.018

Oil palm frond biomass is abundantly available in Malaysia, but underutilized. In this study, gasifiers were evaluated based on the available literature data and downdraft gasifiers were found to be the best option for the study of oil palm fronds gasification. A downdraft gasifier was constructed with a novel height adjustment mechanism for changing the position of gasifying air and steam inlet. The oil palm fronds gasification results showed that preheating the gasifying air improved the volumetric percentage of H(2) from 8.47% to 10.53%, CO from 22.87% to 24.94%, CH(4) from 2.02% to 2.03%, and higher heating value from 4.66 to 5.31 MJ/Nm(3) of the syngas. In general, the results of the current study demonstrated that oil palm fronds can be used as an alternative energy source in the energy diversification plan of Malaysia through gasification, along with, the resulting syngas quality can be improved by preheating the gasifying air.

MeSH terms: Air/analysis*; Biotechnology/instrumentation*; Biotechnology/methods*; Gases/chemistry*; Hot Temperature*; Oxidation-Reduction; Plant Oils/chemistry*; Rheology; Plant Leaves/chemistry*
Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults

Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M

JAMA, 2012 Oct 17;308(15):1566-72.
PMID: 23073953 DOI: 10.1001/jama.2012.13356

Administration of traditional chloride-liberal intravenous fluids may precipitate acute kidney injury (AKI).

MeSH terms: Chlorides/administration & dosage*; Chlorides/adverse effects*; Female; Fluid Therapy/adverse effects*; Hospitals, Teaching; Humans; Intensive Care Units; Isotonic Solutions/administration & dosage; Length of Stay; Male; Middle Aged; Pilot Projects; Prospective Studies; Saline Solution, Hypertonic/administration & dosage; Saline Solution, Hypertonic/adverse effects; Critical Illness; Hospital Mortality; Renal Replacement Therapy; Acute Kidney Injury/etiology*
Fulltext Follicular thyroid carcinoma in a patient with myasthenia gravis and thymoma: a rare association

Ni H, Htet A

Ecancermedicalscience, 2012;6:274.
PMID: 23074376 DOI: 10.3332/ecancer.2012.274

Myasthenia gravis (MG) is an autoantibody-mediated disorder affecting the neuromuscular junction causing characteristic fatigable muscle weakness. Though it can be associated with tumours of the thymus as well as thyroid disorders, it is rare for both to coexist. The exact prevalence of thyroid carcinoma in MG with thymoma is not known but only about a dozen cases have been reported in the literature. We report a case of a 38-year-old Myanmar lady who presented with weakness and breathlessness due to MG with neck swelling. On examination, she had fatigable proximal muscle weakness and thyroid enlargement with no obvious features of hyperthyroidism. Mediastinal widening and an enlarged thyroid gland were noted on her chest X-ray and chest CT. A subtotal thyroidectomy and thymectomy were done. The histology showed follicular carcinoma of the thyroid and benign thymoma. The majority of the reported cases of thyroid carcinoma in association with MG were papillary carcinoma. Follicular carcinoma thyroid associated with MG has not yet been reported in the literature.

MeSH terms: Myanmar; Carcinoma, Papillary; Dyspnea; Female; Hyperthyroidism; Myasthenia Gravis; Neuromuscular Junction; Thymectomy; Thymoma; Thymus Neoplasms; Thyroid Neoplasms; Thyroidectomy; Tomography, X-Ray Computed; X-Rays; Prevalence; Adenocarcinoma, Follicular; Muscle Weakness
Plant growth inhibitor from the Malaysian medicinal plant Goniothalamus andersonii and related species

Takemura T, Kamo T, Ismil R, Bakar B, Wasano N, Hiradate S, et al.

Nat Prod Commun, 2012 Sep;7(9):1197-8.
PMID: 23074907

A crude methanol extract of Goniothalamus andersonii J. Sinclair strongly inhibited elongation of lettuce (Lactuca sativa L.) radicles. We conducted bioassay-guided purification of G. andersonii bark extract and obtained goniothalamin as the major bioactive compound. Its EC50 values against elongation of lettuce radicles and hypocotyls were 50 and 125 micromol L(-1), respectively. Among the six species tested, timothy was the most sensitive to goniothalamin. Quantification of this compound in other Goniothalamus species suggested that the plant inhibitory activity of this genus is explainable by goniothalamin, with G. calcareus as an exception.

MeSH terms: Chromatography, High Pressure Liquid; Malaysia; Plant Growth Regulators; Plants, Medicinal/chemistry; Pyrones/isolation & purification; Pyrones/pharmacology*; Lettuce/drug effects*; Lettuce/growth & development; Goniothalamus/chemistry*
Fulltext An epidemiological and clinical analysis of cutaneous adverse drug reactions seen in a tertiary hospital in Johor, Malaysia

Choon SE, Lai NM

Indian J Dermatol Venereol Leprol, 2012 Nov-Dec;78(6):734-9.
PMID: 23075643 DOI: 10.4103/0378-6323.102367

BACKGROUND: The prevalence, clinical patterns, and causative drugs of cutaneous adverse drug reactions (cADR) vary among the different populations previously studied.
AIM: To determine the prevalence, the clinical patterns of drug eruptions, and the common drugs implicated, particularly in severe cADR such as Stevens-Johnson Syndrome/Toxic epidermal necrolysis (SJS/TEN) and drug rash with eosinophilia and systemic symptoms (DRESS) in our population.
METHODS: We analyzed the database established for all cADR seen by the department of Dermatology from January 2001 till December 2010.
RESULTS: A total of 362 cADR were seen among 42 170 new clinic attendees, yielding an incidence rate of 0.86%. The most common reaction pattern seen was maculopapular eruption (153 cases) followed by SJS/TEN (110 cases) and DRESS (34 cases). Antibiotics was the most commonly implicated drug group (146 cases) followed by anticonvulsants (81 cases) and antigout drugs (50 cases). The most frequently implicated drug was allopurinol (50 cases). Carbamazepine, allopurinol, and cotrimoxazole were the three main causative drugs of SJS/TEN accounting for 21.8%, 20.9%, and 12.7%, respectively, of the 110 cases seen, whereas DRESS was mainly caused by allopurinol (15 cases). Mortality rates for TEN, SJS, and DRESS were 28.6%, 2.2%, and 5.9%, respectively.
CONCLUSIONS: The low rate of cADR with a high proportion of severe reactions observed in this study was probably due to referral bias. Otherwise, the reaction patterns and drugs causing cADR in our population were similar to those seen in other countries. Carbamazepine, allopurinol, and cotrimoxazole were the three main causative drugs of SJS/TEN in our population.
Study site: department of dermatology in Hospital Sultanah Aminah

MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Allopurinol; Anti-Infective Agents/adverse effects; Anti-Inflammatory Agents, Non-Steroidal/adverse effects; Anticonvulsants/adverse effects; Child; Child, Preschool; Drug Eruptions/etiology; Drug Eruptions/epidemiology*; Drug Eruptions/pathology*; Female; Gout Suppressants/adverse effects; Hospitals; Humans; Infant; Malaysia/epidemiology; Male; Middle Aged; Stevens-Johnson Syndrome/etiology; Stevens-Johnson Syndrome/epidemiology*; Stevens-Johnson Syndrome/pathology; Time Factors; Incidence; Prevalence; Young Adult; Tertiary Care Centers
Construction and characterization of a Burkholderia pseudomallei wzm deletion mutant

Yuen CW, Ong EB, Mohamad S, Manaf UA, Najimudin N

J Microbiol Biotechnol, 2012 Oct;22(10):1336-42.
PMID: 23075783

In Burkholderia pseudomallei, the pathogen that causes melioidosis, the gene cluster encoding the capsular polysaccharide, is located on chromosome 1. Among the 19 capsular genes in this cluster, wzm has not been thoroughly studied. To study the function of wzm, we generated a deletion mutant and compared it with the wild-type strain. The mutant produced less biofilm in minimal media and was more sensitive to desiccation and oxidative stress compared with the wild-type strain, indicating that wzm is involved in biofilm formation and membrane integrity. Scanning electron microscopy showed that the bacterial cells of the mutant strain have more defined surfaces with indentations, whereas cells of the wild-type strain do not.

MeSH terms: Bacterial Proteins/genetics; Bacterial Proteins/metabolism; Cell Membrane/metabolism; Cloning, Molecular; Culture Media; Desiccation/methods; Escherichia coli/genetics; Escherichia coli/metabolism; Genes, Bacterial*; Multigene Family; Hydrogen Peroxide/pharmacology; Microscopy, Electron, Scanning; Plasmids/genetics; Plasmids/metabolism; Bacterial Capsules/genetics; Bacterial Capsules/metabolism; Burkholderia pseudomallei/drug effects; Burkholderia pseudomallei/genetics; Burkholderia pseudomallei/physiology; Burkholderia pseudomallei/ultrastructure*; Gene Deletion*; Oxidative Stress; Biofilms*; ATP-Binding Cassette Transporters/genetics*; ATP-Binding Cassette Transporters/metabolism; Microbial Viability; Bacterial Load

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