Browse publications by year: 2015

  1. Abdul Rahman AR, Reyes EB, Sritara P, Pancholia A, Van Phuoc D, Tomlinson B
    Curr Med Res Opin, 2015 May;31(5):865-74.
    PMID: 25707364 DOI: 10.1185/03007995.2015.1020368
    Hypertension incurs a significant healthcare burden in Asia-Pacific countries, which have suboptimal rates of blood pressure (BP) treatment and control. A consensus meeting of hypertension experts from the Asia-Pacific region convened in Hanoi, Vietnam, in April 2013. The principal objectives were to discuss the growing problem of hypertension in the Asia-Pacific region, and to develop consensus recommendations to promote standards of care across the region. A particular focus was recommendations for combination therapy, since it is known that most patients with hypertension will require two or more antihypertensive drugs to achieve BP control, and also that combinations of drugs with complementary mechanisms of action achieve BP targets more effectively than monotherapy. The expert panel reviewed guidelines for hypertension management from the USA and Europe, as well as individual Asia-Pacific countries, and devised a treatment matrix/guide, in which they propose the preferred combination therapy regimens for patients with hypertension, both with and without compelling indications. This report summarizes key recommendations from the group, including recommended antihypertensive combinations for specific patient populations. These strategies generally entail initiating therapy with free drug combinations, starting with the lowest available dosage, followed by treatment with single-pill combinations once the BP target has been achieved. A single reference for the whole Asia-Pacific region may contribute to increased consistency of treatment and greater proportions of patients achieving BP control, and hence reducing hypertension-related morbidity and mortality.
    MeSH terms: Antihypertensive Agents/administration & dosage; Antihypertensive Agents/therapeutic use*; Asia; Blood Pressure/drug effects*; Drug Combinations; Drug Therapy, Combination; Humans; Hypertension/drug therapy*; Practice Guidelines as Topic*; Consensus
  2. Zahedi E, Sohani V, Ali MA, Chellappan K, Beng GK
    J Healthc Eng, 2015;6(1):121-44.
    PMID: 25708380 DOI: 10.1260/2040-2295.6.1.121
    The feasibility of a novel system to reliably estimate the normalized central blood pressure (CBPN) from the radial photoplethysmogram (PPG) is investigated. Right-wrist radial blood pressure and left-wrist PPG were simultaneously recorded in five different days. An industry-standard applanation tonometer was employed for recording radial blood pressure. The CBP waveform was amplitude-normalized to determine CBPN. A total of fifteen second-order autoregressive models with exogenous input were investigated using system identification techniques. Among these 15 models, the model producing the lowest coefficient of variation (CV) of the fitness during the five days was selected as the reference model. Results show that the proposed model is able to faithfully reproduce CBPN (mean fitness = 85.2% ± 2.5%) from the radial PPG for all 15 segments during the five recording days. The low CV value of 3.35% suggests a stable model valid for different recording days.
    MeSH terms: Blood Pressure/physiology; Blood Pressure Determination/methods*; Feasibility Studies; Humans; Male; Models, Cardiovascular; Signal Processing, Computer-Assisted*; Wrist/physiology; Reproducibility of Results; Photoplethysmography/methods*; Radial Artery/physiology*
  3. Xiang YT, Ungvari GS, Correll CU, Chiu HF, Lai KY, Wang CY, et al.
    Psychiatry Clin Neurosci, 2015 Aug;69(8):489-96.
    PMID: 25708964 DOI: 10.1111/pcn.12283
    Little is known about electroconvulsive therapy (ECT) use in Asian inpatients with schizophrenia. This study examined trends of ECT use for schizophrenia patients in Asia between 2001 and 2009 and its independent demographic and clinical correlates.
    MeSH terms: Adult; Asia; Combined Modality Therapy/trends; Electroconvulsive Therapy/trends*; Electroconvulsive Therapy/utilization*; Female; Humans; Inpatients/statistics & numerical data*; Male; Middle Aged; Practice Patterns, Physicians'/statistics & numerical data*; Schizophrenia/drug therapy; Schizophrenia/therapy*; Antipsychotic Agents/therapeutic use; Asian Continental Ancestry Group/statistics & numerical data*
  4. Baharuddin NS, Abdullah H, Abdul Wahab WN
    J Pharm Bioallied Sci, 2015 Jan-Mar;7(1):15-20.
    PMID: 25709331 DOI: 10.4103/0975-7406.148742
    Galls of Quercus infectoria have been traditionally used to treat common ailments, including yeast infections caused by Candida species.
    MeSH terms: Candida; Plant Extracts; Quercus
  5. Anarjan N, Jafarizadeh-Malmiri H, Nehdi IA, Sbihi HM, Al-Resayes SI, Tan CP
    Int J Nanomedicine, 2015;10:1109-18.
    PMID: 25709435 DOI: 10.2147/IJN.S72835
    Nanodispersion systems allow incorporation of lipophilic bioactives, such as astaxanthin (a fat soluble carotenoid) into aqueous systems, which can improve their solubility, bioavailability, and stability, and widen their uses in water-based pharmaceutical and food products. In this study, response surface methodology was used to investigate the influences of homogenization time (0.5-20 minutes) and speed (1,000-9,000 rpm) in the formation of astaxanthin nanodispersions via the solvent-diffusion process. The product was characterized for particle size and astaxanthin concentration using laser diffraction particle size analysis and high performance liquid chromatography, respectively. Relatively high determination coefficients (ranging from 0.896 to 0.969) were obtained for all suggested polynomial regression models. The overall optimal homogenization conditions were determined by multiple response optimization analysis to be 6,000 rpm for 7 minutes. In vitro cellular uptake of astaxanthin from the suggested individual and multiple optimized astaxanthin nanodispersions was also evaluated. The cellular uptake of astaxanthin was found to be considerably increased (by more than five times) as it became incorporated into optimum nanodispersion systems. The lack of a significant difference between predicted and experimental values confirms the suitability of the regression equations connecting the response variables studied to the independent parameters.
    MeSH terms: Diffusion; Humans; Particle Size; Solvents; Surface Properties; HT29 Cells; Xanthophylls/pharmacokinetics; Xanthophylls/chemistry; Nanotechnology/methods*
  6. Butt AM, Mohd Amin MC, Katas H
    Int J Nanomedicine, 2015;10:1321-34.
    PMID: 25709451 DOI: 10.2147/IJN.S78438
    BACKGROUND: Doxorubicin (DOX), an anthracycline anticancer antibiotic, is used for treating various types of cancers. However, its use is associated with toxicity to normal cells and development of resistance due to overexpression of drug efflux pumps. Poloxamer 407 (P407) and vitamin E TPGS (D-α-tocopheryl polyethylene glycol succinate, TPGS) are widely used polymers as drug delivery carriers and excipients for enhancing the drug retention times and stability. TPGS reduces multidrug resistance, induces apoptosis, and shows selective anticancer activity against tumor cells. Keeping in view the problems, we designed a mixed micelle system encapsulating DOX comprising TPGS for its selective anticancer activity and P407 conjugated with folic acid (FA) for folate-mediated receptor targeting to cancer cells.

    METHODS: FA-functionalized P407 was prepared by carbodiimide crosslinker chemistry. P407-TPGS/FA-P407-TPGS-mixed micelles were prepared by thin-film hydration method. Cytotoxicity of blank micelles, DOX, and DOX-loaded micelles was determined by alamarBlue(®) assay.

    RESULTS: The size of micelles was less than 200 nm with encapsulation efficiency of 85% and 73% for P407-TPGS and FA-P407-TPGS micelles, respectively. Intracellular trafficking study using nile red-loaded micelles indicated improved drug uptake and perinuclear drug localization. The micelles show minimal toxicity to normal human cell line WRL-68, enhanced cellular uptake of DOX, reduced drug efflux, increased DOX-DNA binding in SKOV3 and DOX-resistant SKOV3 human ovarian carcinoma cell lines, and enhanced in vitro cytotoxicity as compared to free DOX.

    CONCLUSION: FA-P407-TPGS-DOX micelles show potential as a targeted nano-drug delivery system for DOX due to their multiple synergistic factors of selective anticancer activity, inhibition of multidrug resistance, and folate-mediated selective uptake.

    MeSH terms: Cell Survival/drug effects; Drug Synergism; Humans; Hydrogen-Ion Concentration; Micelles*; Polyethylene Glycols/pharmacokinetics; Polyethylene Glycols/chemistry; Vitamin E/analogs & derivatives*; Vitamin E/pharmacokinetics; Vitamin E/chemistry; Cell Line, Tumor
  7. Vinuthinee N, Azreen-Redzal A, Juanarita J, Zunaina E
    Int Med Case Rep J, 2015;8:47-50.
    PMID: 25709507 DOI: 10.2147/IMCRJ.S75198
    We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT) scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic.
  8. Hamir Basah Z, Mohamad I, Ramza Ramli R, Gayadh MK, Mutum SS
    Case Rep Otolaryngol, 2015;2015:412625.
    PMID: 25709848 DOI: 10.1155/2015/412625
    Intramuscular haemangioma (IMH) is a benign mesenchymal tumour. It appears as a deep, nontender mass within the soft tissue, particularly in the extremities. This tumour may not be obvious on clinical examination. Head and neck IMHs represent only 13.5% of the total IMHs. The most common site for a head and neck IMH is the masseter muscle, followed by trapezius, sternocleidomastoid, and very rarely temporalis muscle. We present a patient with left nasal bridge swelling which was excised and histologically confirmed as intramuscular hemangioma.
  9. Su TT, Amiri M, Mohd Hairi F, Thangiah N, Dahlui M, Majid HA
    Biomed Res Int, 2015;2015:174821.
    PMID: 25710002 DOI: 10.1155/2015/174821
    This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia.
    MeSH terms: Adult; Aged; Aged, 80 and over; Body Composition*; Cardiovascular Diseases/diagnosis*; Cardiovascular Diseases/epidemiology*; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Obesity/diagnosis*; Obesity/epidemiology*; Urban Population/statistics & numerical data*; Comorbidity; Causality; Prevalence; Risk Assessment
  10. Johari SA, Mohtar M, Mohammad SA, Sahdan R, Shaameri Z, Hamzah AS, et al.
    Biomed Res Int, 2015;2015:823829.
    PMID: 25710030 DOI: 10.1155/2015/823829
    28 new pyrrolidine types of compounds as analogues for natural polyhydroxy alkaloids of codonopsinine were evaluated for their anti-MRSA activity using MIC and MBC value determination assay against a panel of S. aureus isolates. One pyrrolidine compound, MFM 501, exhibited good inhibitory activity with MIC value of 15.6 to 31.3 μg/mL against 55 S. aureus isolates (43 MRSA and 12 MSSA isolates). The active compound also displayed MBC values between 250 and 500 μg/mL against 58 S. aureus isolates (45 MRSA and 13 MSSA isolates) implying that MFM 501 has a bacteriostatic rather than bactericidal effect against both MRSA and MSSA isolates. In addition, MFM 501 showed no apparent cytotoxicity activity towards three normal cell lines (WRL-68, Vero, and 3T3) with IC50 values of >625 µg/mL. Selectivity index (SI) of MFM 501 gave a value of >10 suggesting that MFM 501 is significant and suitable for further in vivo investigations. These results suggested that synthetically derived intermediate compounds based on natural products may play an important role in the discovery of new anti-infective agents against MRSA.
    MeSH terms: Alkaloids/administration & dosage*; Alkaloids/chemistry; Anti-Bacterial Agents/administration & dosage*; Anti-Bacterial Agents/chemistry; Cell Survival/drug effects; Cell Survival/physiology; Dose-Response Relationship, Drug; Microbial Sensitivity Tests; Pyrrolidines/administration & dosage*; Pyrrolidines/chemistry; Apoptosis/drug effects; Apoptosis/physiology; Methicillin-Resistant Staphylococcus aureus/cytology; Methicillin-Resistant Staphylococcus aureus/drug effects*; Methicillin-Resistant Staphylococcus aureus/physiology*
  11. Almansour AI, Kumar RS, Arumugam N, Basiri A, Kia Y, Ali MA
    Biomed Res Int, 2015;2015:965987.
    PMID: 25710037 DOI: 10.1155/2015/965987
    A series of hexahydro-1,6-naphthyridines were synthesized in good yields by the reaction of 3,5-bis[(E)-arylmethylidene]tetrahydro-4(1H)-pyridinones with cyanoacetamide in the presence of sodium ethoxide under simple mixing at ambient temperature for 6-10 minutes and were assayed for their acetylcholinesterase (AChE) inhibitory activity using colorimetric Ellman's method. Compound 4e with methoxy substituent at ortho-position of the phenyl rings displayed the maximum inhibitory activity with IC50 value of 2.12 μM. Molecular modeling simulation of 4e was performed using three-dimensional structure of Torpedo californica AChE (TcAChE) enzyme to disclose binding interaction and orientation of this molecule into the active site gorge of the receptor.
    MeSH terms: Acetylcholinesterase/ultrastructure*; Acetylcholinesterase/chemistry*; Binding Sites; Cholinesterase Inhibitors/chemistry*; Computer Simulation; Enzyme Activation; Models, Chemical; Models, Molecular*; Naphthyridines/chemistry*; Protein Binding; Protein Conformation
  12. Ahmad A, Khan MU, Patel I, Maharaj S, Pandey S, Dhingra S
    J Res Pharm Pract, 2015 Jan-Mar;4(1):37-41.
    PMID: 25710049 DOI: 10.4103/2279-042X.150057
    OBJECTIVE: The aim of this study was to assess the knowledge, attitude and practice of B.Sc. Pharmacy students about usage and resistance of antibiotics in Trinidad and Tobago.
    METHODS: This was a cross-sectional questionnaire-based study involving B.Sc. Pharmacy students. The questionnaire was divided into five components including Demographics data, knowledge about antibiotic use, attitude toward antibiotic use and resistance, self-antibiotic usage and possible causes of antibiotic resistance. Data were analyzed by employing Mann-Whitney and Chi-square tests using SPSS version 20.
    FINDINGS: The response rate was 83.07%. The results showed good knowledge of antibiotic use among students. The overall attitude of pharmacy students was poor. About 75% of participants rarely use antibiotics, whereas self-decision was the major reason of antibiotic use (40.7%) and main source of information was retail pharmacist (42.6%). Common cold and flu is a major problem for which antibiotics were mainly utilized by pharmacy students (35.2%).
    CONCLUSION: The study showed good knowledge of pharmacy students regarding antibiotic usage. However, students' attitude towards antibiotic use was poor. The study recommends future studies to be conducted with interventional design to improve knowledge and attitude of pharmacy students about antibiotic use and resistance.
    KEYWORDS: Antibiotics; Trinidad and Tobago; knowledge; pharmacy students; resistance
    MeSH terms: Adult; Anti-Bacterial Agents*; Cross-Sectional Studies; Humans; Health Knowledge, Attitudes, Practice; Students, Pharmacy; Trinidad and Tobago
  13. Panhwar QA, Naher UA, Radziah O, Shamshuddin J, Razi IM
    Molecules, 2015 Feb 20;20(3):3628-46.
    PMID: 25710843 DOI: 10.3390/molecules20033628
    Aluminum toxicity is widely considered as the most important limiting factor for plants growing in acid sulfate soils. A study was conducted in laboratory and in field to ameliorate Al toxicity using plant growth promoting bacteria (PGPB), ground magnesium limestone (GML) and ground basalt. Five-day-old rice seedlings were inoculated by Bacillus sp., Stenotrophomonas maltophila, Burkholderia thailandensis and Burkholderia seminalis and grown for 21 days in Hoagland solution (pH 4.0) at various Al concentrations (0, 50 and 100 μM). Toxicity symptoms in root and leaf were studied using scanning electron microscope. In the field, biofertilizer (PGPB), GML and basalt were applied (4 t·ha-1 each). Results showed that Al severely affected the growth of rice. At high concentrations, the root surface was ruptured, leading to cell collapse; however, no damages were observed in the PGPB inoculated seedlings. After 21 days of inoculation, solution pH increased to >6.0, while the control treatment remained same. Field study showed that the highest rice growth and yield were obtained in the bio-fertilizer and GML treatments. This study showed that Al toxicity was reduced by PGPB via production of organic acids that were able to chelate the Al and the production of polysaccharides that increased solution pH. The release of phytohormones further enhanced rice growth that resulted in yield increase.
    MeSH terms: Aluminum/toxicity*; Bacteria/isolation & purification; Bacteria/metabolism*; Dose-Response Relationship, Drug; Fertilizers*; Hydrogen-Ion Concentration; Magnesium/pharmacology*; Oryza/drug effects; Oryza/growth & development*; Oryza/microbiology*; Soil/chemistry*; Soil Microbiology; Plant Leaves/drug effects; Plant Leaves/growth & development; Plant Roots/drug effects; Plant Roots/growth & development; Seedlings/drug effects; Seedlings/growth & development*
  14. Walsh M, Wang CY, Ong GS, Tan AS, Mansor M, Shariffuddin II, et al.
    J Am Soc Nephrol, 2015 Oct;26(10):2571-7.
    PMID: 25711126 DOI: 10.1681/ASN.2014060536
    Cardiac troponin T (cTnT), even at low concentrations, is a risk factor for 30-day mortality in patients undergoing noncardiac surgery, but it is uncertain whether that risk is generalizable to patients with poor kidney function. We, therefore, evaluated the relationship between cTnT concentration and kidney function on the outcome of 30-day mortality in a post hoc analysis of a prospective cohort study of patients undergoing noncardiac surgery. cTnT was measured for 3 days after surgery and considered abnormal if the peak was ≥0.02 ng/ml. Of the included 14,037 patients, 267 (1.9%) patients died within 30 days of surgery. The adjusted hazard ratios for death with an abnormal cTnT concentration were 4.37 (95% confidence intervals [95% CI], 3.21 to 6.22), 6.15 (95% CI, 2.95 to 140.9), 6.30 (95% CI, 3.12 to 21.23), 1.33 (95% CI, 0.56 to 4.85), and 1.46 (95% CI, 0.46 to 9.21) for eGFR≥60, 45 to <60, 30 to <45, 15 to <30, and <15 ml/min per 1.73 m(2) or on dialysis, respectively. Compared with patients with eGFR≥60 ml/min per 1.73 m(2), the adjusted hazard ratio was significantly lower for patients with eGFR=15 to <30 ml/min per 1.73 m(2) (interaction P value=0.02). Redefining abnormal cTnT concentration as ≥0.03 ng/ml or a change of ≥0.02 ng/ml did not alter results. Because the risk associated with postoperative cTnT levels may be different for patients with eGFR<30 ml/min per 1.73 m(2), additional research is required to determine how to interpret perioperative cTnT values for patients with low kidney function.
    MeSH terms: Aged; Female; Humans; Kidney/physiopathology*; Male; Middle Aged; Postoperative Complications/blood*; Postoperative Complications/mortality*; Prognosis; Prospective Studies; Troponin T/blood*
  15. Abdullah N, Abdul Murad NA, Attia J, Oldmeadow C, Mohd Haniff EA, Syafruddin SE, et al.
    Diabet Med, 2015 Oct;32(10):1377-84.
    PMID: 25711284 DOI: 10.1111/dme.12735
    AIMS: To characterize the association with Type 2 diabetes of known Type 2 diabetes risk variants in people in Malaysia of Malay, Chinese and Indian ancestry who participated in the Malaysian Cohort project.
    METHODS: We genotyped 1604 people of Malay ancestry (722 cases, 882 controls), 1654 of Chinese ancestry (819 cases, 835 controls) and 1728 of Indian ancestry (851 cases, 877 controls). First, 62 candidate single-nucleotide polymorphisms previously associated with Type 2 diabetes were assessed for association via logistic regression within ancestral groups and then across ancestral groups using a meta-analysis. Second, estimated odds ratios were assessed for excess directional concordance with previously studied populations. Third, a genetic risk score aggregating allele dosage across the candidate single-nucleotide polymorphisms was tested for association within and across ancestral groups.
    RESULTS: After Bonferroni correction, seven individual single-nucleotide polymorphisms were associated with Type 2 diabetes in the combined Malaysian sample. We observed a highly significant excess in concordance of effect directions between Malaysian and previously studied populations. The genetic risk score was strongly associated with Type 2 diabetes in all Malaysian groups, explaining from 1.0 to 1.7% of total Type 2 diabetes risk variance.
    CONCLUSION: This study suggests there is substantial overlap of the genetic risk alleles underlying Type 2 diabetes in Malaysian and other populations.
    Study name: The Malaysian Cohort (TMC) project
    MeSH terms: Alleles; Diabetes Mellitus, Type 2; Genotype; Humans; Malaysia; Nucleotides; Logistic Models; Odds Ratio; Polymorphism, Single Nucleotide; Asian Continental Ancestry Group
  16. Phing SH, Mazhorova A, Shalaby M, Peccianti M, Clerici M, Pasquazi A, et al.
    Sci Rep, 2015;5:8551.
    PMID: 25711343 DOI: 10.1038/srep08551
    Terahertz technologies recently emerged as outstanding candidates for a variety of applications in such sectors as security, biomedical, pharmaceutical, aero spatial, etc. Imaging the terahertz field, however, still remains a challenge, particularly when sub-wavelength resolutions are involved. Here we demonstrate an all-optical technique for the terahertz near-field imaging directly at the source plane. A thin layer (<100 nm-thickness) of photo carriers is induced on the surface of the terahertz generation crystal, which acts as an all-optical, virtual blade for terahertz near-field imaging via a knife-edge technique. Remarkably, and in spite of the fact that the proposed approach does not require any mechanical probe, such as tips or apertures, we are able to demonstrate the imaging of a terahertz source with deeply sub-wavelength features (<30 μm) directly in its emission plane.
    MeSH terms: Diagnostic Tests, Routine; Pharmaceutical Preparations; Heterocyclic Compounds; Pharmacy; Technology
  17. Haddadi F, Aziz MA, Abdullah SN, Tan SG, Kamaladini H
    Molecules, 2015 Feb 23;20(3):3647-66.
    PMID: 25711423 DOI: 10.3390/molecules20033647
    An Agrobacterium-mediated transformation method was applied to introduce the luciferase reporter gene under the control of the CaMV35S promoter in the pGreen0049 binary vector into strawberry cv. Camarosa. The in vitro regeneration system of strawberry leaves to be used in the transformation was optimized using different TDZ concentrations in MS medium. TDZ at 16 µM showed the highest percentage (100%) of shoot formation and the highest mean number of shoots (24) produced per explant. Studies on the effects of different antibiotics, namely timentin, cefotaxime, carbenicillin and ampicillin, on shoot regeneration of strawberry leaf explants showed the best shoot regeneration in the presence of 300 mg/L timentin and 150 mg/L cefotaxime. Assessment of the different factors affecting Agrobacterium mediated-transformation of strawberry with the luciferase gene showed the highest efficiency of putative transformant production (86%) in the treatment with no preculture, bacterial OD600 of 0.6 and the addition of 150 mg/L cefotaxime in the pre-selection and selection media. The presence of the luciferase gene in the plant genome was verified by the luciferase reporter gene assay, nested PCR amplification and dot blot of genomic DNA isolated from the young leaves of each putatively transformed plantlet.
    MeSH terms: Anti-Bacterial Agents/pharmacology*; Plasmids/genetics*; Regeneration/drug effects; Transformation, Genetic*; Polymerase Chain Reaction; Plant Leaves/drug effects; Plant Leaves/growth & development*; Plant Shoots/drug effects; Plant Shoots/growth & development*; Plants, Genetically Modified/drug effects; Plants, Genetically Modified/microbiology; Fragaria/drug effects; Fragaria/growth & development*; Agrobacterium/physiology*
  18. Low WY, Binns C
    Asia Pac J Public Health, 2015 Mar;27(2 Suppl):7S-8S.
    PMID: 25712494 DOI: 10.1177/1010539515574405
    MeSH terms: China; Health Promotion/organization & administration; Health Services Accessibility/organization & administration; Humans; Life Style; Medical Assistance/organization & administration; Public Health*
  19. Tan SH, Mun KS, Chandran PA, Manuel AM, Prepageran N, Waran V, et al.
    Childs Nerv Syst, 2015 Jul;31(7):1165-9.
    PMID: 25712744 DOI: 10.1007/s00381-015-2667-9
    This paper reports an unusual case of a transsphenoidal encephalocele and discusses our experience with a minimally invasive management. To the best of our knowledge, we present the first case of a combined endoscopic transnasal and transoral approach to a transsphenoidal encephalocele in an infant.
    MeSH terms: Adolescent; Encephalocele/complications; Encephalocele/surgery*; Endoscopy/methods*; Humans; Magnetic Resonance Imaging; Male; Mouth/surgery*; Nasal Cavity/surgery*; Respiration Disorders/etiology
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