Browse publications by year: 2013

  1. Sasidharan S
    Molecules, 2013 Mar 27;18(4):3839-40.
    PMID: 23535517 DOI: 10.3390/molecules18043839
    A recent Comment by M. Sharma published in the journal Molecules [1] raises issues with our previously published paper [2]. After reviewing its content, and although we respectfully stand by our experimental description whereby we were able to prepare stock and working solutions of the substance being tested, the arguments presented do raise concerns about the true identity of the compound actually used and hence the results and conclusions of our paper.
    MeSH terms: Publications; Dissent and Disputes
  2. Islam MA, Sundaraj K, Ahmad RB, Ahamed NU
    PLoS One, 2013;8(3):e58902.
    PMID: 23536834 DOI: 10.1371/journal.pone.0058902
    BACKGROUND: Mechanomyography (MMG) has been extensively applied in clinical and experimental practice to examine muscle characteristics including muscle function (MF), prosthesis and/or switch control, signal processing, physiological exercise, and medical rehabilitation. Despite several existing MMG studies of MF, there has not yet been a review of these. This study aimed to determine the current status on the use of MMG in measuring the conditions of MFs.

    METHODOLOGY/PRINCIPAL FINDINGS: Five electronic databases were extensively searched for potentially eligible studies published between 2003 and 2012. Two authors independently assessed selected articles using an MS-Word based form created for this review. Several domains (name of muscle, study type, sensor type, subject's types, muscle contraction, measured parameters, frequency range, hardware and software, signal processing and statistical analysis, results, applications, authors' conclusions and recommendations for future work) were extracted for further analysis. From a total of 2184 citations 119 were selected for full-text evaluation and 36 studies of MFs were identified. The systematic results find sufficient evidence that MMG may be used for assessing muscle fatigue, strength, and balance. This review also provides reason to believe that MMG may be used to examine muscle actions during movements and for monitoring muscle activities under various types of exercise paradigms.

    CONCLUSIONS/SIGNIFICANCE: Overall judging from the increasing number of articles in recent years, this review reports sufficient evidence that MMG is increasingly being used in different aspects of MF. Thus, MMG may be applied as a useful tool to examine diverse conditions of muscle activity. However, the existing studies which examined MMG for MFs were confined to a small sample size of healthy population. Therefore, future work is needed to investigate MMG, in examining MFs between a sufficient number of healthy subjects and neuromuscular patients.

    MeSH terms: Humans; Muscle Contraction/physiology; Myography; Exercise; Muscle, Skeletal/physiology*; Muscle Fatigue/physiology; Muscle Strength/physiology
  3. Guan TK, Pancharatnam D, Chandran H, Hooi TK, Kumar G, Ganesan D
    J Med Case Rep, 2013;7:87.
    PMID: 23537099 DOI: 10.1186/1752-1947-7-87
    Cystic meningiomas are rare variants of meningiomas; they can pose a radiological diagnostic dilemma.
  4. Chew BH, Zain AM, Hassan F
    BMC Med Educ, 2013;13:44.
    PMID: 23537129 DOI: 10.1186/1472-6920-13-44
    BACKGROUND: Research on emotional intelligence (EI) suggests that it is associated with more pro-social behavior, better academic performance and improved empathy towards patients. In medical education and clinical practice, EI has been related to higher academic achievement and improved doctor-patient relationships. This study examined the effect of EI on academic performance in first- and final-year medical students in Malaysia.
    METHODS: This was a cross-sectional study using an objectively-scored measure of EI, the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Academic performance of medical school students was measured using continuous assessment (CA) and final examination (FE) results. The first- and final-year students were invited to participate during their second semester. Students answered a paper-based demographic questionnaire and completed the online MSCEIT on their own. Relationships between the total MSCEIT score to academic performance were examined using multivariate analyses.
    RESULTS: A total of 163 (84 year one and 79 year five) medical students participated (response rate of 66.0%). The gender and ethnic distribution were representative of the student population. The total EI score was a predictor of good overall CA (OR 1.01), a negative predictor of poor result in overall CA (OR 0.97), a predictor of the good overall FE result (OR 1.07) and was significantly related to the final-year FE marks (adjusted R(2) = 0.43).
    CONCLUSIONS: Medical students who were more emotionally intelligent performed better in both the continuous assessments and the final professional examination. Therefore, it is possible that emotional skill development may enhance medical students' academic performance.
    MeSH terms: Cross-Sectional Studies; Education, Medical/standards; Educational Status*; Female; Humans; Malaysia; Male; Psychological Tests; Students, Medical/psychology*; Young Adult; Emotional Intelligence*
  5. Amir A, Sum JS, Lau YL, Vythilingam I, Fong MY
    Parasit Vectors, 2013;6:81.
    PMID: 23537404 DOI: 10.1186/1756-3305-6-81
    Anopheles cracens has been incriminated as a vector for the simian malaria parasite, Plasmodium knowlesi, that is the fifth Plasmodium species infecting humans. Little experimental data exists on this mosquito species due to the lack of its availability in laboratories.
    MeSH terms: Animals; Anopheles/growth & development*; Breeding; Disease Vectors*; Entomology/methods*; Female; Cricetinae; Humans; Malaysia; Male
  6. Shariat M, Samsudin MW, Zakaria Z
    Chem Cent J, 2013 Mar 27;7(1):58.
    PMID: 23537478 DOI: 10.1186/1752-153X-7-58
    BACKGROUND: The derivatives of 2-substituted 4H-3,1-benzoxazin-4-one belong to a significant category of heterocyclic compounds, which have shown a wide spectrum of medical and industrial applications.

    RESULTS: A new and effective one-pot method for the synthesis of 2-substituted 4H-3,1-benzoxazin-4-one derivatives is described in this paper. By using the iminium cation from a mixture of cyanuric chloride and dimethylformamide as a cyclizing agent, a series of 2-substituted 4H-3,1-benzoxazin-4-one derivatives was synthesized in high yield under mild conditions and simple workup.

    CONCLUSIONS: The iminium cation from a mixture of cyanuric chloride and N,N-dimethylformamide is an effective cyclizing agent for the room temperature one-pot synthesis of 2-substituted 4H-3,1-benzoxazin-4-one derivatives in high yields through a cyclodehydration reaction. Furthermore, the method was performed under mild conditions characterized by simplified pathways and workup, minimized energy, and fewer reaction steps, compared with the previous methods. The proposed method, which is a simpler alternative than the published methods, is applicable for the synthesis of other 2-substituted 4H-3,1-benzoxazin-4-one derivatives.

  7. Yap MK, Tan NH, Sim SM, Fung SY
    Toxicon, 2013 Jun;68:18-23.
    PMID: 23537711 DOI: 10.1016/j.toxicon.2013.02.017
    Existing protocols for antivenom treatment of snake envenomations are generally not well optimized due partly to inadequate knowledge of the toxicokinetics of venoms. The toxicokinetics of Naja sputatrix (Javan spitting cobra) venom was investigated following intravenous and intramuscular injections of the venom into rabbits using double-sandwich ELISA. The toxicokinetics of the venom injected intravenously fitted a two-compartment model. When the venom was injected intramuscularly, the serum concentration-time profile exhibited a more complex absorption and/or distribution pattern. Nevertheless, the terminal half-life, volume of distribution by area and systemic clearance of the venom injected intramuscularly were not significantly different (p > 0.05) from that of the venom injected intravenously. The systemic bioavailability of the venom antigens injected by intramuscular route was 41.7%. Our toxicokinetic finding is consistent with other reports, and may indicate that some cobra venom toxins have high affinity for the tissues at the site of injection. Our results suggest that the intramuscular route of administration doesn't significantly alter the toxicokinetics of N. sputatrix venom although it significantly reduces the systemic bioavailability of the venom.
    MeSH terms: Animals; Elapid Venoms/pharmacokinetics*; Enzyme-Linked Immunosorbent Assay; Half-Life; Immunoglobulin G/isolation & purification; Injections, Intramuscular*; Injections, Intravenous*; Rabbits; Snake Bites/drug therapy; Elapidae*
  8. Yap PS, Lim SH, Hu CP, Yiap BC
    Phytomedicine, 2013 Jun 15;20(8-9):710-3.
    PMID: 23537749 DOI: 10.1016/j.phymed.2013.02.013
    In this study we investigated the relationship between several selected commercially available essential oils and beta-lactam antibiotics on their antibacterial effect against multidrug resistant bacteria. The antibacterial activity of essential oils and antibiotics was assessed using broth microdilution. The combined effects between essential oils of cinnamon bark, lavender, marjoram, tea tree, peppermint and ampicillin, piperacillin, cefazolin, cefuroxime, carbenicillin, ceftazidime, meropenem, were evaluated by means of the checkerboard method against beta-lactamase-producing Escherichia coli. In the latter assays, fractional inhibitory concentration (FIC) values were calculated to characterize interaction between the combinations. Substantial susceptibility of the bacteria toward natural antibiotics and a considerable reduction in the minimum inhibitory concentrations (MIC) of the antibiotics were noted in some paired combinations of antibiotics and essential oils. Out of 35 antibiotic-essential oil pairs tested, four of them showed synergistic effect (FIC≤0.5) and 31 pairs showed no interaction (FIC>0.5-4.0). The preliminary results obtained highlighted the occurrence of a pronounced synergistic relationship between piperacillin/cinnamon bark oil, piperacillin/lavender oil, piperacillin/peppermint oil as well as meropenem/peppermint oil against two of the three bacteria under study with a FIC index in the range 0.26-0.5. The finding highlighted the potential of peppermint, cinnamon bark and lavender essential oils being as antibiotic resistance modifying agent. Reduced usage of antibiotics could be employed as a treatment strategy to decrease the adverse effects and possibly to reverse the beta-lactam antibiotic resistance.
    MeSH terms: Anti-Bacterial Agents/pharmacology*; Drug Synergism; Escherichia coli/drug effects*; Escherichia coli/genetics; Microbial Sensitivity Tests; Oils, Volatile/pharmacology*; Plant Oils/pharmacology*; Plasmids/genetics; Drug Resistance, Multiple, Bacterial
  9. Ong TA, Yaakup NA, Sivalingam S, Razack AH
    Urology, 2013 Apr;81(4):904-7.
    PMID: 23537760 DOI: 10.1016/j.urology.2012.10.077
    To describe a novel technique for localizing small testicular mass during testicular-sparing surgery (TSS).
    MeSH terms: Humans; Male; Neoplasms, Germ Cell and Embryonal/surgery*; Neoplasms, Germ Cell and Embryonal/ultrasonography; Orchiectomy; Urologic Surgical Procedures, Male/instrumentation*; Testicular Neoplasms/surgery*; Testicular Neoplasms/ultrasonography; Testis/surgery*; Testis/ultrasonography; Young Adult
  10. Santhirasegaram V, Razali Z, Somasundram C
    Ultrason Sonochem, 2013 Sep;20(5):1276-82.
    PMID: 23538119 DOI: 10.1016/j.ultsonch.2013.02.005
    Ultrasonic treatment is an emerging food processing technology that has growing interest among health-conscious consumers. Freshly squeezed Chokanan mango juice was thermally treated (at 90 °C for 30 and 60s) and sonicated (for 15, 30 and 60 min at 25 °C, 40 kHz frequency, 130 W) to compare the effect on microbial inactivation, physicochemical properties, antioxidant activities and other quality parameters. After sonication and thermal treatment, no significant changes occurred in pH, total soluble solids and titratable acidity. Sonication for 15 and 30 min showed significant improvement in selected quality parameters except color and ascorbic acid content, when compared to freshly squeezed juice (control). A significant increase in extractability of carotenoids (4-9%) and polyphenols (30-35%) was observed for juice subjected to ultrasonic treatment for 15 and 30 min, when compared to the control. In addition, enhancement of radical scavenging activity and reducing power was observed in all sonicated juice samples regardless of treatment time. Thermal and ultrasonic treatment exhibited significant reduction in microbial count of the juice. The results obtained support the use of sonication to improve the quality of Chokanan mango juice along with safety standard as an alternative to thermal treatment.
    MeSH terms: Beverages/analysis*; Carotenoids/isolation & purification; Sonication*; Temperature*; Mangifera/chemistry*; Polyphenols/isolation & purification
  11. Saleh MA, Ramli AT, Alajeramie Y, Suhairul H, Aliyu AS, Basri NA
    Radiat Prot Dosimetry, 2013 Sep;156(2):246-52.
    PMID: 23538891 DOI: 10.1093/rpd/nct061
    An extensive survey was carried out for gamma dose rates (GDRs) in the Mersing district, Johor, Malaysia. The average value of GDR measured in the district was found to be 140 nGy h(-1), in the range of 40-355 nGy h(-1). The mean weighted dose rate to the population, annual effective dose equivalent, collective effective dose equivalent, lifetime cancer risk were 0.836 mSv y(-1), 0.171 mSv, 1.18 × 10(1) man Sv y(-1) and 6.98 × 10(-4) Sv y, respectively. An isodose map was produced for the district. One way analysis of variance was used to test for differences due to different geological formations present in the Mersing District.
    MeSH terms: Background Radiation*; Gamma Rays*; Humans; Malaysia; Radiation Dosage; Radiation Monitoring*; Models, Statistical; Geologic Sediments/analysis*
  12. Isa SN, Aziz AA, Rahman AA, Ibrahim MI, Ibrahim WP, Mohamad N, et al.
    J Dev Behav Pediatr, 2013 May;34(4):262-8.
    PMID: 23538932 DOI: 10.1097/DBP.0b013e318287cdfe
    Caring for children with disabilities brings about a significant impact on the parents and families. The purposes of this study were to determine the impact of having children with disabilities on parents' health-related quality of life (HRQOL), family functioning, and total family impact and to identify the associated factors.
    MeSH terms: Adolescent; Adult; Aged; Child; Child, Preschool; Cross-Sectional Studies; Family/psychology*; Female; Humans; Malaysia; Male; Middle Aged; Parents/psychology*; Psychological Tests; Quality of Life/psychology*; Disabled Children/psychology*; Young Adult
  13. Salehmin MN, Annuar MS, Chisti Y
    Bioprocess Biosyst Eng, 2013 Nov;36(11):1527-43.
    PMID: 23539203 DOI: 10.1007/s00449-013-0943-1
    This review is focused on the production of microbial lipases by high cell density fermentation. Lipases are among the most widely used of the enzyme catalysts. Although lipases are produced by animals and plants, industrial lipases are sourced almost exclusively from microorganisms. Many of the commercial lipases are produced using recombinant species. Microbial lipases are mostly produced by batch and fed-batch fermentation. Lipases are generally secreted by the cell into the extracellular environment. Thus, a crude preparation of lipases can be obtained by removing the microbial cells from the fermentation broth. This crude cell-free broth may be further concentrated and used as is, or lipases may be purified from it to various levels. For many large volume applications, lipases must be produced at extremely low cost. High cell density fermentation is a promising method for low-cost production: it allows a high concentration of the biomass and the enzyme to be attained rapidly and this eases the downstream recovery of the enzyme. High density fermentation enhances enzyme productivity compared with the traditional submerged culture batch fermentation. In production of enzymes, a high cell density is generally achieved through fed-batch operation, not through perfusion culture which is cumbersome. The feeding strategies used in fed-batch fermentations for producing lipases and the implications of these strategies are discussed. Most lipase-producing microbial fermentations require oxygen. Oxygen transfer in such fermentations is discussed.
    MeSH terms: Fermentation*; Lipase/biosynthesis*; Oxygen/metabolism*; Biomass
  14. Saenphoom P, Liang JB, Ho YW, Loh TC, Rosfarizan M
    Asian-Australas J Anim Sci, 2013 Apr;26(4):537-44.
    PMID: 25049820 DOI: 10.5713/ajas.2012.12463
    This study examined whether pre-treating palm kernel expeller (PKE) with exogenous enzyme would degrade its fiber content; thus improving its metabolizable energy (ME), growth performance, villus height and digesta viscosity in broiler chickens fed diets containing PKE. Our results showed that enzyme treatment decreased (p<0.05) hemicellulose and cellulose contents of PKE by 26.26 and 32.62%, respectively; and improved true ME (TME) and its nitrogen corrected value (TMEn) by 38% and 33%, respectively, compared to the raw sample. Average daily gain (ADG), feed intake and feed conversion ratio (FCR) of chickens fed on different dietary treatments in the grower period were not significantly different. Although there was no difference in feed intake (p>0.05) among treatment groups in the finisher period, ADG of chickens in the control (PKE-free diet) was higher (p<0.05) than in all treatment groups fed either 20 or 30% PKE, irrespective of with or without enzyme treatment. However, ADG of birds fed with 20% PKE was higher than those fed with 30% PKE. The FCR of chickens in the control was the lowest (2.20) but not significantly different from those fed 20% PKE diets while birds in the 30% PKE diets recorded higher (p>0.05) FCR. The intestinal villus height and crypt depth (duodenum, jejunum and ileum) were not different (p>0.05) among treatments except for duodenal crypt depth. The villus height and crypt depth of birds in enzyme treated PKE diets were higher (p<0.05) than those in the raw PKE groups. Viscosity of the intestinal digesta was not different (p>0.05) among treatments. Results of this study suggest that exogenous enzyme is effective in hydrolyzing the fiber (hemicellulose and cellulose) component and improved the ME values of PKE, however, the above positive effects were not reflected in the growth performance in broiler chickens fed the enzyme treated PKE compared to those received raw PKE. The results suggest that PKE can be included up to 5% in the grower diet and 20% in the finisher diet without any significant negative effect on FCR in broiler chickens.
    MeSH terms: Animals; Cellulose; Chickens; Diet; Duodenum; Ileum; Jejunum; Nitrogen; Polysaccharides; Viscosity
  15. Dollah MA, Parhizkar S, Izwan M
    Avicenna J Phytomed, 2013;3(2):152-8.
    PMID: 25050269
    Nigella sativa (N. sativa) is an amazing herb which is used in traditional medicine for a wide range of illnesses including bronchial asthma, dysentery, gastrointestinal problems, as well as beneficial effect on blood lipids, lowering blood pressure, serum cholesterol, and triglycerides level. This study aimed to determine the toxic effect of N. sativa powder on the kidney function which was evaluated by serum urea and creatinine and through histopathological examination of kidney tissue.
  16. Chan HH, Zairi J
    J Med Entomol, 2013 Mar;50(2):362-70.
    PMID: 23540125
    Insecticide resistance has become a serious issue in vector management programs. Information on insecticidal resistance and its associated mechanisms is important for successful insecticide resistance management. The selection of a colony of permethrin-resistant Aedes albopictus (Skuse) (Diptera: Culicidae), originating from Penang Island, Malaysia, yielded high larval-specific resistance to permethrin and cross-resistance to deltamethrin. Synergism assays showed that the major mechanism underlying this resistance involves cytochrome P450 monooxygenase. The resistance is autosomal, polygenically inherited and incompletely dominant (D = 0.26). Resistant larvae were reared under different conditions to assess the fitness costs. Under high larval density, larval development time of the resistant SGI strain was significantly longer than the susceptible VCRU strain. In both high- and low-density conditions SGI showed a lower rate of emergence and survival compared with the VCRU strain. Resistant larvae were more susceptible to predation by Toxorhynchites splendens (Wiedemann) (Diptera: Culicidae) larvae. The body size of SGI females reared under high-density conditions was larger compared with females of the susceptible strain. SGI females survived longer when starved than did VCRU females. The energy reserve upon eclosion was positively correlated with the size of the adults.
    MeSH terms: Aedes/drug effects*; Aedes/genetics*; Animals; Female; Insecticide Resistance*; Insecticides/pharmacology*; Larva/drug effects; Larva/genetics; Malaysia; Male; Nitriles/pharmacology*; Pyrethrins/pharmacology*; Food Chain; Permethrin/pharmacology*; Heredity; Genetic Fitness
  17. Padmanabhan E, Eswaran H, Reich PF
    Sci Total Environ, 2013 Nov 1;465:196-204.
    PMID: 23541401 DOI: 10.1016/j.scitotenv.2013.03.024
    The relationship between greenhouse gas emission and climate change has led to research to identify and manage the natural sources and sinks of the gases. CO2, CH4, and N2O have an anthropic source and of these CO2 is the least effective in trapping long wave radiation. Soil carbon sequestration can best be described as a process of removing carbon dioxide from the atmosphere and relocating into soils in a form that is not readily released back into the atmosphere. The purpose of this study is to estimate carbon stocks available under current conditions in Sarawak, Malaysia. SOC estimates are made for a standard depth of 100 cm unless the soil by definition is less than this depth, as in the case of lithic subgroups. Among the mineral soils, Inceptisols tend to generally have the highest carbon contents (about 25 kg m(-2) m(-1)), while Oxisols and Ultisols rate second (about 10-15 kg m(-2) m(-1)). The Oxisols store a good amount of carbon because of an appreciable time-frame to sequester carbon and possibly lower decomposition rates for the organic carbon that is found at 1m depths. Wet soils such as peatlands tend to store significant amounts of carbon. The highest values estimated for such soils are about 114 kg m(-2) m(-1). Such appreciable amounts can also be found in the Aquepts. In conclusion, it is pertinent to recognize that degradation of the carbon pool, just like desertification, is a real process and that this irreversible process must be addressed immediately. Therefore, appropriate soil management practices should be instituted to sequester large masses of soil carbon on an annual basis. This knowledge can be used effectively to formulate strategies to prevent forest fires and clearing: two processes that can quickly release sequestered carbon to the atmosphere in an almost irreversible manner.
    MeSH terms: Academies and Institutes; Atmosphere; Carbon; Carbon Dioxide; Conservation of Natural Resources; Gases; Lithium; Malaysia; Minerals; Soil; Climate Change; Carbon Sequestration
  18. Muhamad MH, Sheikh Abdullah SR, Mohamad AB, Abdul Rahman R, Hasan Kadhum AA
    J Environ Manage, 2013 May 30;121:179-90.
    PMID: 23542216 DOI: 10.1016/j.jenvman.2013.02.016
    In this study, the potential of a pilot-scale granular activated carbon sequencing batch biofilm reactor (GAC-SBBR) for removing chemical oxygen demand (COD), ammoniacal nitrogen (NH3-N) and 2,4-dichlorophenol (2,4-DCP) from recycled paper wastewater was assessed. For this purpose, the response surface methodology (RSM) was employed, using a central composite face-centred design (CCFD), to optimise three of the most important operating variables, i.e., hydraulic retention time (HRT), aeration rate (AR) and influent feed concentration (IFC), in the pilot-scale GAC-SBBR process for recycled paper wastewater treatment. Quadratic models were developed for the response variables, i.e., COD, NH3-N and 2,4-DCP removal, based on the high value (>0.9) of the coefficient of determination (R(2)) obtained from the analysis of variance (ANOVA). The optimal conditions were established at 750 mg COD/L IFC, 3.2 m(3)/min AR and 1 day HRT, corresponding to predicted COD, NH3-N and 2,4-DCP removal percentages of 94.8, 100 and 80.9%, respectively.
    MeSH terms: Charcoal/chemistry; Chlorophenols/isolation & purification*; Paper; Pilot Projects; Nitrogen Compounds/isolation & purification*; Biofilms; Bioreactors*; Biological Oxygen Demand Analysis; Recycling; Waste Water/chemistry*
  19. Yik MY, Zain MM, Zakaria Z, Yusoff NM
    J Clin Diagn Res, 2013 Feb;7(2):355-7.
    PMID: 23543039 DOI: 10.7860/JCDR/2013/4354.2767
    The premature ovarian failures with underlying chromosomal abnormalities are normally X-linked, although their associations with the autosomal and the Robertsonian translocations are also possible. Here, we are reporting a case of premature ovarian failure which was associated with a translocation between the long arm of chromosome 7 at q11.23 and the short arm of chromosome 5 at p15.3. The proband was a 26-year-old Malay woman who presented with premature ovarian failure, who was referred for cytogenetic testing due to the suspicion of a chromosomal anomaly. Her physical examination revealed that she had no abdominal or pelvic masses and that she had normal secondary sexual characteristics. Her medical history as well, revealed no points for concern. However, a consanguineous relationship existed, as the patient's paternal grandmother and maternal grandfather were biological cousins. Our present case indicated that region p15.3 of chromosome 5 and region q11.23 of chromosome 7 possibly carried essential genes for the ovarian function and that they postulated a link between the consanguinity and the chromosomal abnormalities.
  20. Karanth L, Jaafar SH, Kanagasabai S, Nair NS, Barua A
    Cochrane Database Syst Rev, 2013 Mar 28;2013(3):CD009617.
    PMID: 23543581 DOI: 10.1002/14651858.CD009617.pub2
    BACKGROUND: During pregnancy, a Rhesus-negative (Rh-negative) woman may develop antibodies if her fetus is Rh-positive, which can cause fetal morbidity or mortality in following pregnancies, if untreated.

    OBJECTIVES: To assess the effects of administering anti-D immunoglobulin (Ig) after spontaneous miscarriage in a Rh-negative woman, with no anti-D antibodies.

    SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012).

    SELECTION CRITERIA: Randomised controlled trials (RCT) in Rh-negative women without antibodies who were given anti-D Ig following spontaneous miscarriage compared with no treatment or placebo treatment following spontaneous miscarriage as control.

    DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and trial quality. Two review authors extracted data and checked it for accuracy.

    MAIN RESULTS: We included one RCT, involving 48 women who had a miscarriage between eight to 24 weeks of gestation. Of the 19 women in the treatment group, 14 had therapeutic dilatation & curettage (D&C) and five had spontaneous miscarriage; of the 29 women in the control group, 25 had therapeutic D&C and four had spontaneous miscarriage. The treatment group received 300 µg anti-D Ig intramuscular injection and were compared with a control group who received 1 cc homogenous gamma globulin placebo.This review's primary outcomes (development of a positive Kleihauer Betke test (a test that detects fetal cells in the maternal blood; and development of RhD alloimmunisation in a subsequent pregnancy) were not reported in the included study.Similarly, none of the review's secondary outcomes were reported in the included study: the need for increased surveillance for suspected fetal blood sampling and fetal transfusions in subsequent pregnancies, neonatal morbidity such as neonatal anaemia, jaundice, bilirubin encephalopathy, erythroblastosis, prematurity, hypoglycaemia (low blood sugar) in subsequent pregnancies, maternal adverse events of anti-D administration including anaphylactic reaction and blood-borne infections.The included study did report subsequent Rh-positive pregnancies in three women in the treatment group and six women in the control group. However, due to the small sample size, the study failed to show any difference in maternal sensitisation or development of Rh alloimmunisation in the subsequent pregnancies.

    AUTHORS' CONCLUSIONS: There are insufficient data available to evaluate the practice of anti-D administration in an unsensitised Rh-negative mother after spontaneous miscarriage. Thus, until high-quality evidence becomes available, the practice of anti-D Immunoglobulin prophylaxis after spontaneous miscarriage for preventing Rh alloimmunisation cannot be generalised and should be based on the standard practice guidelines of each country.

    MeSH terms: Abortion, Spontaneous/immunology*; Female; Humans; Immunologic Factors/administration & dosage*; Pregnancy; Rh Isoimmunization/prevention & control*; Randomized Controlled Trials as Topic; Rho(D) Immune Globulin/administration & dosage*
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