Browse publications by year: 2016

Fulltext Prophylactic bilateral internal iliac artery balloon occlusion in the management of placenta accreta: A 36-month review

Tan YL, Suharjono H, Lau NL, Voon HY

Med J Malaysia, 2016 Jun;71(3):111-6.
PMID: 27495883

The contemporary obstetrician is increasingly put to the test by rising numbers of pregnancies with morbidly adherent placenta. This study illustrates our experience with prophylactic bilateral internal iliac artery occlusion as part of its management.

MeSH terms: Adult; Female; Hospitals; Humans; Iliac Artery; Placenta Accreta*; Retrospective Studies
Fulltext Community-acquired bacteremia in Paediatrics: Epidemiology, aetiology and patterns of antimicrobial resistance in a tertiary care centre, Malaysia

Nor Azizah A, Mohd Nor F, Mohamad M, Zainal Abidin AS, Ariza A, Mohd Nor NS, et al.

Med J Malaysia, 2016 Jun;71(3):117-21.
PMID: 27495884 MyJurnal

Bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens.

MeSH terms: Child; China/ethnology; Female; Hospitals; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Microbial Sensitivity Tests; Retrospective Studies; Bacteremia*
Fulltext Association of Cobb angle progression and neuraxial abnormality on MRI in asymptomatic Adolescent Idiopathic Scoliosis

Mohd Zaki F, Ng KL, Te BC, Azman MH, Nur Aifaa L, Mohd Razali N, et al.

Med J Malaysia, 2016 Jun;71(3):122-5.
PMID: 27495885 MyJurnal

Detection of neuraxial abnormality in neurologically asymptomatic adolescent idiopathic scoliosis (AIS) is crucial prior to surgery. It can only be detected on magnetic resonance imaging (MRI), which was not routinely done in this group of patient. On the other hand, whole spine radiographs for measurement of Cobb angle have been routinely included during clinic follow-up. This study aimed to determine the correlation between Cobb angle progression and neuraxial abnormality finding on MRI in asymptomatic AIS.

MeSH terms: Adolescent; Hospitals, University; Humans; Magnetic Resonance Imaging; Malaysia; Retrospective Studies; Scoliosis*
Fulltext Acute kidney injury following coronary artery bypass graft surgery in a tertiary public hospital in Malaysia: an analysis of 1228 consecutive cases

Hiew KC, Sachithanandan A, Muhammad Nor MA, Badmanaban B, Jasid AM, Ismail F, et al.

Med J Malaysia, 2016 Jun;71(3):126-30.
PMID: 27495886 MyJurnal

Acute kidney injury (AKI) following cardiac surgery is well established but the reported incidence is variable due to varying definitions and criteria. Furthermore there is a paucity of such data from Southeast Asia.

MeSH terms: Coronary Artery Bypass*; China/ethnology; Female; Hospitals; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Retrospective Studies; Acute Kidney Injury*
Fulltext Routine measurements of cord arterial blood lactate levels in infants delivering at term and prediction of neonatal outcome

Subramaniam RN

Med J Malaysia, 2016 Jun;71(3):131-3.
PMID: 27495887 MyJurnal

INTRODUCTION: There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements.
METHODS: Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay.
RESULTS: Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle.
CONCLUSION: Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.
Study site: Klinik Kesihatan Kampar, Perak, Malaysia

MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Humans; Infant, Newborn; Lactates*; Malaysia
Fulltext Serotype prevalence of Streptococcus pneumoniae in Malaysia - the need for carriage studies

McNeil HC, Clarke SC

Med J Malaysia, 2016 Jun;71(3):134-8.
PMID: 27495888

Pneumococcal disease, caused by the bacterium Streptococcus pneumoniae, is a major burden to global health. Although the World Health Organisation (WHO) strongly recommends the inclusion of pneumococcal conjugate vaccines in national immunisation programmes (NIP's) worldwide, this has not occurred in many countries in the WHO South East Asia and Western Pacific regions - particularly longstanding middle-income countries. It is widely accepted that carriage of S. pneumoniae is a precursor to developing any pneumococcal disease. The reduction in pneumococcal disease from vaccine serotypes (VT) following widespread implementation of the pneumococcal conjugate vaccine (PCV) is believed to be through the direct immunogenic protective effect of immunised individuals as well as indirectly through herd immunity diminishing the incidence of disease in nonimmunised individuals. In Malaysia, pneumococcal disease is not included in national surveillance programmes and although PCVs have been licensed, they have not been included in the NIP. Hence, the vaccine is only available privately and the majority of the population is not able to afford it. There is an urgent need to develop surveillance programmes in Malaysia to include pneumococcal serotype data from carriage and invasive disease so that it may help guide national vaccine policy prior to a decision being taken on the inclusion of PCVs in the NIP.

MeSH terms: Bacteria*; Malaysia; Streptococcus pneumoniae*; Prevalence
Fulltext Thoracic aortic aneurysm as a cause of Ortner's syndrome - a case series

Zaharudin I, Azizi ZA

Med J Malaysia, 2016 Jun;71(3):139-41.
PMID: 27495889

Hoarseness due to left recurrent laryngeal nerve paralysis was first described in 1897 by Norbert Ortner. Various cardiopulmonary and thoracic arch aorta pathologies associated with left recurrent laryngeal nerve palsy have been described over the last 100 years and is also known as cardio-vocal syndrome. We report our experience with seven cases of Ortners syndrome due to thoracic aortic aneurysm with compression of the left recurrent laryngeal nerve and resultant hoarseness.

MeSH terms: Adult; Aortic Aneurysm*; Case Reports; Female; Hoarseness*; Humans; Malaysia; Male; Recurrent Laryngeal Nerve Injuries*
Fulltext Allergic reaction to stainless steel sternotomy wires requiring removal: A case report and literature review

Lopez JM, Sachithanandan A, Leow MP

Med J Malaysia, 2016 Jun;71(3):142-3.
PMID: 27495890 MyJurnal

Hypersensitivity to stainless steel sternal sutures are an uncommon occurrence. We present a case of such a patient who developed chronic tissue overgranulation over a sternotomy wound eight weeks post-operatively. Primary suspicion was infection, a more common complication however radiological and laboratory investigation showed otherwise. Conservative management provided limited ephemeral success. After ensuring adequate sternal bone healing, the sutures and granulation tissue were eventually surgically removed without complication and the reoperated wound healed well.

MeSH terms: Adult; Case Reports; Humans; Hypersensitivity*; Malaysia; Male; Steel; Sternotomy
Fulltext Polypoid endometriosis of post vaginal fornix: utility of MRI imaging of pelvis with diffusion weighted imaging for diagnosis

Tham WP, Busmanis I, Tan WC, Kwek JW

Med J Malaysia, 2016 Jun;71(3):144-6.
PMID: 27495891

Polypoid endometriosis is an uncommon variant of endometriosis which can mimic malignancy due to its presentation as masses. We present a case of polypoid endometriosis which simulated cervical malignancy both on clinical examination and on computed tomography (CT) scanning and discuss how magnetic resonance (MR) imaging, in particular Diffusion Weighted Imaging (DWI), can help to distinguish this condition from true malignancy and avoid invasive surgery.

MeSH terms: Adult; Case Reports; Endometriosis*; Female; Humans; Magnetic Resonance Imaging; Singapore
Fulltext Cardiac tamponade: a rare but preventable complication of central venous catheter in neonates

Atmawidjaja RW, Zainal Abidin MA, Ismail IH

Med J Malaysia, 2016 Jun;71(3):147-8.
PMID: 27495892 MyJurnal

Pericardial effusion with cardiac tamponade is a rare and life-threatening complication of peripherally inserted central catheter (PICC) in a neonate. We report a 33-week preterm neonate who had sudden clinical deterioration at day seven of total parenteral nutrition regime via PICC. Recognition of pericardial effusion with cardiac tamponade in neonates with a PICC requires a high index of suspicion and steps in prevention include proper catheter tip placement and continuous monitoring of line position and function.

MeSH terms: Cardiac Tamponade*; Case Reports; Hospitals; Humans; Infant, Premature; Malaysia; Central Venous Catheters
Fulltext Primary breast tuberculosis (TB) in a patient with known invasive breast carcinoma: A case report

Lee CH, Sharif SZ

Med J Malaysia, 2016 Jun;71(3):149-51.
PMID: 27495893 MyJurnal

Breast tuberculosis (TB) is rare even in endemic countries. Most of these cases occur as secondary TB due to a concurrent infection. Primary breast TB is diagnosed when it is the only site of disease without other foci of infection. The presentation of primary breast TB may often mimic carcinoma of the breast. While imaging is not specific, histopathology provides a definitive diagnosis. Here, we present a case of primary breast TB in a breast cancer patient and review the literature.

MeSH terms: Adult; Breast; Breast Neoplasms; Case Reports; Female; Humans; Malaysia; Tuberculosis*
Fulltext Gram-negative infection as an unusual cause of endocarditis in a hemodialysis patient

Balakrishnan S, Aamar A, Rhee S, Zakaria S, Khaliq W

Med J Malaysia, 2016 Jun;71(3):152-3.
PMID: 27495894

Gram-negative endocarditis is rare and it has high mortality if there is a delay in diagnosis and treatment. Gram-negative organisms should be considered in the differential diagnosis of IE in hemodialysis patients. Central lineassociated bloodstream infections (CLABSIs) can be prevented by following sterile measures during catheter insertion and proper management of catheter site.

MeSH terms: Adult; Case Reports; Endocarditis*; Great Britain; Renal Dialysis*; Humans; Nursing Homes
Fulltext Sinonasal angioleiomyoma

Lau YW, Tharumalingam V, Tan TY, Tang IP

Med J Malaysia, 2016 Jun;71(3):154-5.
PMID: 27495895 MyJurnal

Angioleiomyoma of the nasal cavity is an extremely rare benign neoplasm. It usually occurs in the lower extremities. Up to date, only few cases of angioleiomyoma have been reported. First case of angioleiomyoma of nasal cavity was reported in 1966. We report a rare case of angioleiomyoma arising from the right maxillary sinus.

MeSH terms: Adult; Case Reports; Female; Humans; Malaysia; Paranasal Sinuses; Angiomyoma*
Fulltext Effects of dietary postbiotic and inulin on growth performance, IGF1 and GHR mRNA expression, faecal microbiota and volatile fatty acids in broilers

Kareem KY, Loh TC, Foo HL, Akit H, Samsudin AA

BMC Vet Res, 2016;12(1):163.
PMID: 27496016 DOI: 10.1186/s12917-016-0790-9

Postbiotics (metabolic products by lactic acid bacteria) and prebiotics have been established as substitute to antibiotics in order to enhance immunity and growth performance in broiler chickens. Nonetheless, insufficient information is available on the effects of postbiotics and prebiotics combination on growth performance, faecal microbiota, pH and volatile fatty acids (VFA), as well as liver insulin like growth factor 1 (IGF1) and growth hormone receptor (GHR) mRNA expressions in broiler chickens. The aim of this experiment was to evaluate the effects of different types of postbiotics with different levels of prebiotic (inulin) on broiler for those parameters.

MeSH terms: Animals; Anti-Bacterial Agents; Chickens; Fatty Acids, Volatile; Feces; Hydrogen-Ion Concentration; Insulin-Like Growth Factor I; Inulin; Liver; Receptors, Somatotropin; RNA, Messenger; Lactobacillales; Prebiotics; Microbiota
Consumer quality use of medicines: An important element in public health

Hassali MA, Al-Tamimi SK, Dawood OT

Res Social Adm Pharm, 2016 07 14;13(1):261-265.
PMID: 27496382 DOI: 10.1016/j.sapharm.2016.06.011
MeSH terms: Drug Utilization/standards*; Health Services Accessibility; Humans; Public Health*; Quality of Health Care/standards*; Safety; Drug Costs; Medication Adherence
RGD-TPGS decorated theranostic liposomes for brain targeted delivery

Sonali, Singh RP, Sharma G, Kumari L, Koch B, Singh S, et al.

Colloids Surf B Biointerfaces, 2016 Nov 01;147:129-141.
PMID: 27497076 DOI: 10.1016/j.colsurfb.2016.07.058

The aim of this work was to formulate RGD-TPGS decorated theranostic liposomes, which contain both docetaxel (DTX) and quantum dots (QDs) for brain cancer imaging and therapy. RGD conjugated TPGS (RGD-TPGS) was synthesized and conjugation was confirmed by Fourier transform infrared (FTIR) spectroscopy and electrospray ionisation (ESI) mass spectroscopy (ESI-MS). The theranostic liposomes were prepared by the solvent injection method and characterized for their particle size, polydispersity, zeta-potential, surface morphology, drug encapsulation efficiency, and in-vitro release study. Biocompatibility and safety of theranostic liposomes were studied by reactive oxygen species (ROS) generation study and histopathology of brain. In-vivo study was performed for determination of brain theranostic effects in comparison with marketed formulation (Docel™) and free QDs. The particle sizes of the non-targeted and targeted theranostic liposomes were found in between 100 and 200nm. About 70% of drug encapsulation efficiency was achieved with liposomes. The drug release from RGD-TPGS decorated liposomes was sustained for more than 72h with 80% of drug release. The in-vivo results demonstrated that RGD-TPGS decorated theranostic liposomes were 6.47- and 6.98-fold more effective than Docel™ after 2h and 4h treatments, respectively. Further, RGD-TPGS decorated theranostic liposomes has reduced ROS generation effectively, and did not show any signs of brain damage or edema in brain histopathology. The results of this study have indicated that RGD-TPGS decorated theranostic liposomes are promising carrier for brain theranostics.

MeSH terms: Theranostic Nanomedicine*; Animals; Antineoplastic Agents/administration & dosage; Antineoplastic Agents/pharmacology; Brain/drug effects*; Brain Neoplasms/drug therapy; Drug Carriers*; Liposomes/chemistry*; Rats, Inbred Strains; Vitamin E/chemistry*; Drug Delivery Systems*; Reactive Oxygen Species/metabolism; Taxoids/administration & dosage; Taxoids/pharmacology*; Quantum Dots; Rats; Nanoparticles/administration & dosage; Nanoparticles/chemistry; Drug Liberation
Factors contributing to hearing impairment in patients with cleft lip/palate in Malaysia: A prospective study of 346 ears

Cheong JP, Soo SS, Manuel AM

Int J Pediatr Otorhinolaryngol, 2016 Sep;88:94-7.
PMID: 27497393 DOI: 10.1016/j.ijporl.2016.06.045

OBJECTIVE: To determine the factors contributing towards hearing impairment in patients with cleft lip/palate.
METHOD: A prospective analysis was conducted on 173 patients (346 ears) with cleft lip and palate (CL/P) who presented to the combined cleft clinic at University Malaya Medical Centre (UMMC) over 12 months. The patients' hearing status was determined using otoacoustic emission (OAE), pure tone audiometry (PTA) and auditory brainstem response (ABR). These results were analysed against several parameters, which included age, gender, race, types of cleft pathology, impact and timing of repair surgery.
RESULTS: The patients' age ranged from 1-26 years old. They comprised 30% with unilateral cleft lip and palate (UCLP), 28% with bilateral cleft lip and palate (BCLP), 28% with isolated cleft palate (ICP) and 14% with isolated cleft lip (ICL). Majority of the patients (68.2%) had normal otoscopic findings. Out of the 346 ears, 241 ears (70%) ears had passed the hearing tests. There was no significant relationship between patients' gender and ethnicity with their hearing status. The types of cleft pathology significantly influenced the outcome of PTA and ABR screening results (p

MeSH terms: Adolescent; Adult; Audiometry, Pure-Tone; Child; Child, Preschool; Cleft Lip/epidemiology*; Cleft Lip/pathology; Cleft Lip/surgery; Cleft Palate/epidemiology*; Cleft Palate/pathology; Cleft Palate/surgery; Ethnic Groups/statistics & numerical data*; Female; Hearing; Humans; Infant; Malaysia; Male; Prospective Studies; Sex Factors; Evoked Potentials, Auditory, Brain Stem; Otoacoustic Emissions, Spontaneous; Reconstructive Surgical Procedures; Hearing Loss/epidemiology*; Hearing Loss/physiopathology; Otoscopy/methods; Young Adult
The effects of air pollution on human mortality: does gender difference matter in African countries?

Aliyu AJ, Ismail NW

Environ Sci Pollut Res Int, 2016 Nov;23(21):21288-21298.
PMID: 27497851

The relationship between environmental factors and human health has long been a concern among academic researchers. We use two indicators of environmental pollution, namely particulate matter (PM10) and carbon dioxide (CO2) to examine the effects of poor air quality on human mortality. This study explores an issue that has largely been ignored, particularly in the African literature, where the effect of air pollution on human mortality could be influenced by gender specification. We analyse a panel data from 35 African countries and our result suggests that the elevated levels of PM10 and CO2 have a significant effect on the increasing mortality rates in infants, under-five children and adults. Although the effect of poor air quality on adults is found to differ between genders, such difference is not statistically significant. We conclude that the air pollution effects, on average, are similar between genders in the African countries.

MeSH terms: Adult; Africa/epidemiology; Age Factors; Air Pollution*; Carbon Dioxide/analysis; Carbon Dioxide/pharmacology; Child; Female; Humans; Infant; Male; Mortality*; Particulate Matter/analysis; Particulate Matter/pharmacology
Rice bodies in the wrist joint

Sulaiman H, Atiya N, Loi KW, Ng KP

Eur J Intern Med, 2016 Nov;35:e7-e8.
PMID: 27498273 DOI: 10.1016/j.ejim.2016.07.014
MeSH terms: Aged; Antitubercular Agents/therapeutic use; Female; Humans; Magnetic Resonance Imaging; Wrist Joint/microbiology; Wrist Joint/pathology*; Mycobacterium avium Complex/isolation & purification*; Mycobacterium avium-intracellulare Infection/drug therapy; HIV Infections/complications*; HIV Infections/drug therapy; Anti-Retroviral Agents/adverse effects
Morphometric relations in the grey eel catfish Plotosus canius in the coastal waters of Port Dickson, Peninsular Malaysia

Usman BI, Amin SM, Arshad A, Kamarudin MS

J Environ Biol, 2016 Jul;37(4):573-8.
PMID: 27498503

Samples of grey eel catfish Plotosus canius were collected from the coastal waters of Port Dickson, Malaysia from January to December, 2012. A total of 341 specimens (172 males and 169 females) were used to estimate the length-weight relationship parameters. Mean population size of females were 0.72 cm taller than the males, however difference was not significant (t-test, P > 0.05). The overall relationship equations between total length (TL) and body weight (BW) were established for males as Log TW = 2.71 Log TL - 1.85 (R2 = 0.95) and for females as Log TW = 2.88 Log TL-2.10 (R2 = 0.95). The estimated relative growth co-efficient (b) values were 2.71 for males and 2.88 for females. It is revealed that growth pattern of the species showed negative allometry. In both males and females, relationship between TL and SL gave highest regression coefficient (0.99). While relationship between TL and EL gave lowest regression coefficient in both males and females (0.87 and 0.81 respectively). The findings from this study contributed first information on morphometric relations of the fish from Malaysian coastal waters and could be useful for sustainable management options of P. canius in Malaysia.

MeSH terms: Animals; Catfishes/growth & development*; Conservation of Natural Resources*; Female; Malaysia; Male

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