The incidence of envenoming from king cobra, Ophiophagus hannah in human is relatively rare. Its venom acts on the postsynaptic region of the neuromuscular junction causing descending flaccid paralysis. Locked-in syndrome is a clinical state of inability to provide motor response in a conscious patient. Many reported cases of locked-in syndrome following neurotoxic snake-bite mimics brain death. We report a case of a middle aged man who presented with progressive neurological deficit following a king cobra bite over his right arm. He had local and systemic neurotoxic envenoming. His condition deteriorated, and was intubated and ventilated in the emergency department. He received a total of 33 vials of the Ophiophagus hannah monospecific antivenom and subsequently recovered well with no neurological deficit. Retrospectively, he was able to recall the events and while he was lying paralysed and intubated under minimal sedation in the intensive care unit. He described it as a terrifying and painful experience. This case highlights the rare presentation of locked-in syndrome following a systemic envenoming from a king cobra bite. It is important to differentiate neurotoxic snake envenoming lock-in syndrome from brain dead. Patients are unable to respond to physical pain and require adequate analgesia. A patient suffering this highly distressing experience may require psychological support.
Keywords: emergency, envenoming, neurotoxicity, snakebite
Sickle cell disease (SCD) in pregnancy is uncommon in Malaysia. We present a case of sickle cell disease in pregnancy with maternal and fetal complications. The patient presented with acute pain crisis and hemolysis in the third trimester. Despite thromboprophylaxis, she developed deep vein thrombosis. The pregnancy was further complicated by severe pre-eclampsia and intrauterine growth restriction which require preterm caesarean section. The baby was admitted to Neonatal Intensive Care Unit due to prematurity and low birth weight. Multidisciplinary
approach in managing pregnant patient with SCD is essential in achieving good obstetrics outcome.
Keywords: anemia, sickle cell disease, pregnancy outcomes
Open tracheal injury is rare but can lead to disastrous consequences such as massive bleeding, airway obstruction or failure and aspiration of blood. We present a case of open tracheal injury of a man who tried to attempt suicide using a knife. In this case, the initial management was securing the airway by attempting orotracheal intubation. However, it was unsuccessful when the tube came out from the laceration wound. Intubation was then re-attempted through the distal cut-end of the trachea in the face of airway failure. A quick initial assessment and anticipation of a failed airway should always be the top priority in any emergency physician managing these cases. Direct intubation through the laceration wound might be the only option when all else fail and your patient is crashing.
Keywords: intubation, laceration, trachea
Plasmasitoma ekstramedulari adalah komplikasi myeloma berbilang yang sangat
jarang berlaku. Kami melaporkan kes seorang wanita berumur 56 tahun yang
menghidap myeloma berbilang yang telah mengalami bengkak pada mata kiri. Ia
menyebabkan bola mata beliau tersembul, luka pada kornea dan juga kemerosotan
penglihatan. Biopsi tisu menunjukkan perebakan plasma sel neoplastik yang positif
kepada CD138 dan rantai ringan Kappa yang menepati ciri-ciri plasmasitoma.
Setelah melalui rawatan radio-kemoterapi, pembengkakan mata susut dengan
ketara sekali namun kemerosotan penglihatan beliau tidak berubah.
Septic arthritis of the hip in children represents a serious disorder with unfavourable long-term sequelae. In neonates, a poor hip outcome is expected especially if the treatment was delayed. Late sequelae can lead to structural joint damage and instability, causing deformity and dislocations which ultimately may result in limb length discrepancy, early degenerative changes and limited range of motion. Surgery at the appropriate time can improve the hip condition and functional outcome. Previous classifications of post septic hip sequelae are useful guides for treatment, but did not discuss one particular group of patient. This group-septic hip dislocation with a preserved femoral head, has recently been described as a distinct entity. This report highlights an 11-year follow-up of a 2-year-old child who had a successful outcome following open reduction and varus derotation
osteotomy for a septic hip dislocation with a preserved femoral head.
Keywords: septic arthritis, hip dislocation, child, infection
MeSH terms: Arthritis, Infectious*; Child; Female; Hip Joint; Hospitals, University; Humans; Infant; Malaysia
Mild hyperkalaemia does not typically cause cardiac symptoms. However, for an elderly patient on atrio-ventricular (AV) nodal blocker, even mild hyperkalaemia may result in disastrous outcome. We report a case of persistent bradyarrythmia caused by iatrogenic hyperkalaemia in a patient who had concomitant use of AV nodal medication. An 81-year-old lady with multiple comorbidities and a long list of medications presented with symptomatic bradyarrhythmia. She, in fact, had two AV nodal blockers in her prescription, a beta-blocker and amiodarone. Her potassium level was found to be mildly elevated due to acute renal failure. She remained bradycardic despite initial treatment and was subsequently dependant on intravenous isoproterenol until her renal function improved. This case highlights the different threshold for manifestation of hyperkalaemic symptoms in a growing group of patients: elderly patients with multiple comorbidities and polypharmacy.
Keywords: bradyarrythmia, bradycardia, elderly, hyperkalaemia, polypharmacy
MeSH terms: Adult; Aged; Arrhythmias, Cardiac*; Drugs, Chinese Herbal; Humans; Hyperkalemia*; Malaysia
Intussusception is a common cause of gastrointestinal emergency in the paediatric population and it is usually diagnosed through Barium enema radiography or ultrasound. The skill of using an ultrasound by a minimally trained medical officer in diagnosing this cases in the Emergency Department are very helpful and expedite the management. We present the case of a 7-month-old girl who presented to Emergency Department (ED) with the chief complaint of passing blood in stool. Clinically she was dehydrated, irritable and in compensated shock. There was generalised tenderness per abdomen but it was soft and not distended. There was no palpable mass and bowel sound normal. Immmediate fluid resuscitated commenced. Bedside abdominal ultrasound performed by ED medical officer showed a 1.8 cm x 2.5 cm mass of alternating hypo-echoic and hyper-echoic rings at the right lower quadrant, consistent with the ‘target’ sign of intussusception. Supine plain abdominal X-ray did not reveal any abnormality. The ultrasound finding of intussusception was later confirmed by the radiologist. She underwent immediate hydrostatic reduction and was discharged well.
Keywords: diagnosis, Emergency Department, intussusception, paediatric, ultrasound
Pengesanan awal risiko kanser payudara menggunakan mammografi dapat
mengurangkan kos pengurusan rawatan dan prognosis penyakit ini. Paras
ketumpatan payudara yang dikesan menggunakan mammogram memberi
potensi faktor penyebab kepada risiko kanser payudara. Penghasilan sel epitelial
pada mamari dapat ditentukan oleh faktor genetik. Gen transforming growth
factor-beta (TGF-ß) telah dikenalpasti terlibat di dalam regulasi proliferasi sel dan
pembahagian sel. Kajian ini bertujuan untuk mengukur hubung kait polimorfisme
TGF-ß1 dengan ketumpatan payudara di kalangan wanita yang menjalani saringan
mamografi. Pengesanan genotip bagi tiga polimorfisme TGF-ß1 yang dikenali
sebagai rs1800469, rs1800470 dan rs4803455 dilakukan dengan teknik PCR-RFLP.
Frekuensi alel dan genotip dikira bagi kumpulan kawalan yang terdiri dari kalangan
wanita yang telah dikelaskan BIRADS 1 dan BIRADS 2, manakala kumpulan kes
terdiri dari kalangan wanita yang telah dikelaskan BIRADS 3 dan BIRADS 4.Dua
polimorfisme (rs1800469 dan rs1800470) telah menunjukkan hubung kait yang
signifikan dengan ketumpatan payudara dengan nilai P= 0.004 dan 0.003. Namun
begitu polimorfisme yang ketiga iaitu rs4803455 tidak menunjukkan hubung kait
(nilai P=0.090). Analisa hubung kait haplotaip mencadangkan haplotaip GAA
berupaya memberi kecenderungan ketumpatan payudara (nilai P=0.02, OR=2.21
[1.07-4.55]) berbanding haplotaip AAC yang berupaya untuk memberi kesan
perlindungan dari penghasilan ketumpatan payudara (nilai P=0.004, OR=0.40 [0.21-0.77]). Data asas hubung kait dan haplotaip ini memberi penjelasan kaitan
polimorfisme TGF-ß1 dengan ketumpatan payudara dan memberi maklumat fungsi
polimorfisme di dalam mempengaruhi pembentukan ketumpatan payudara.
Bisecting-angle-technique is a method used to improve patient comfort during periapical radiography. This technique is usually performed without X-ray beam aiming device and has been commonly associated with dental radiographic error. The use of external marker as a beam aiming device in bisecting-angle-technique is potentially effective to reduce the number of errors occurring during periapical radiography. In this study, 240 periapical radiographs were taken by undergraduate dental students. Periapical radiographs were taken using traditional method of bisecting-angle-technique (BAT), bisecting-angle-technique with the use of external marker (BAT-M) and the standard method in periapical radiography; paralleling technique (PT). All radiographic images were evaluated and errors were classified and tabled according to the type and number of errors. Chi-square test was used to compare the total number of radiographic errors made using these three techniques. One of the most common errors with BAT was cone cut error (13.8%). This error had been markedly reduced to 1.3% and 2.5% by implementation of BAT-M and PT, respectively. The total number of errors was also found to be significantly lesser for BAT-M compared to BAT, p< 0.05.
Keywords: errors, dental, radiography
Basal cell carcinoma (BCC) of the scrotum is uncommon and its pathogenesis is not well understood. The clinical behaviour of scrotal BCC is thought to be more aggressive and has a higher metastatic potential than BCC of other regions. The mainstay of treatment for localized scrotal BCC is wide local excision, while metastatic disease may need systemic chemotherapy for palliative control. A rare clinical scenario of scrotal BCC presenting concurrently with another metastatic cancer has never been reported. The present case illustrates the diagnostic challenge and management dilemma due to simultaneous presentation of scrotal BCC and metastatic squamous cell carcinoma (SCC). A 70-year-old man complained of a non-healing scrotal ulcer while he was being investigated for metastatic squamous cell carcinoma (SCC) of the external auditory meatus. The scrotal lesion was initially thought to be metastatic SCC. It was later confirmed to be BCC with biopsy and histopathological examination. He underwent surgical resection of the scrotal BCC for local control followed by palliative chemotherapy with cisplatin and radiotherapy for lymph node metastases. He remained well and did not have any local recurrence following 6 months after palliative treatment. Surgery coupled with palliative chemoradiation can offer good quality of life for patients with scrotal BCC and concurrent metastatic SCC.
Keywords: basal cell carcinoma, squamous cell carcinoma, scrotum
Kejuruteraan tisu merupakan satu bidang perubatan baru yang membolehkan tisu
manusia dibentuk secara in vitro sebelum pemindahan tisu dilakukan. Sel stem
mesenkima daripada sum sum tulang (BMSCs) adalah sumber sel yang sesuai
dalam kejuruteraan tisu tulang rawan, ekoran kebolehannya untuk membentuk
rawan hialin. Kajian ini telah dijalankan untuk mengkaji potensi BMSCs untuk
membentuk sel rawan secara in vitro dan in vivo. BMSCs dipencilkan daripada
kambing dan dibahagikan kepada dua kumpulan; iaitu kumpulan kajian dan
kumpulan kawalan. Sel di dalam kumpulan kawalan disemai di dalam medium
yang mengandungi 10% serum anak lembu (FBS). Manakala, sel di dalam kumpulan
kajian telah dikultur di dalam medium yang diperkaya dengan 1% FBS, 1% ITS, 5
ng/mL TGF-ß3, 50 ng/mL IGF-1, 40 ng/mL L-proline, 100 nM dexamethasone dan
50 μg / fosfat. Analisis pembentukan sel rawan telah dijalankan secara in vivo pada
model mencit gondol atimus. Sel didapati beragregasi di dalam kumpulan kajian
dan menunjukkan permulaannya kondrogenesis telah berlaku dalam pengkulturan
sel. Kerangka fibrin yang telah disemai bersama sel yang telah atau tidak diaruh
disediakan dan ditanamkan di dalam lapisan subkutaneus mencik gondol atimus
selama 5 minggu. Eksplan tersebut kemudiannya dikeluarkan daripada lokasi
penempelan untuk pemeriksaan histologi. Berdasarkan pewarnaan Safranin O dan
pengekspresan GAG, eksplan daripada kumpulan kajian didapati menghasilkan
matriks rawan pada kadar yang tinggi berbanding eksplan di dalam kumpulan
kawalan. Hasil kajian ini menunjukkan keberkesanan medium rendah serum yang mengandungi TGF-ß3 merangsang pembezaan sel stem mesenkima daripada
sum-sum tulang untuk menjadi sel rawa
Epidermal naevus is a congenital cutaneous hamartoma with a benign course. We highlight a rare case of epidermal naevus with concurrent basal cell carcinoma. A 79-year-old male had a skin biopsy at our centre for an enlarging skin nodule within a linear papular lesion measuring 2 x 4 cm at the left side of his neck, which was later diagnosed as basal cell carcinoma arising from an epidermal naevus. PIK3CA mutation is attributed to basal cell carcinoma which suggests the basal cell carcinoma component is independent of the epidermal naevus component. Clinicians and pathologists must be aware of possible malignant changes that might arise in an epidermal naevus.
Keywords: basal cell carcinoma, BCC, epidermal naevus
Acanthamoeba spp. merupakan ameba hidup bebas yang biasa ditemui
di persekitaran. Ia merupakan agen penyebab keratitis Acanthamoeba (AK)
dan ensefalitis ameba bergranuloma (GAE). Ameba ini juga mampu menjadi
perumah kepada pelbagai bakteria termasuklah yang bersifat patogenik seperti
Mycobacterium, Legionella dan Staphylococcus aureus rintang metisilin (MRSA).
Berdasarkan maklumat ini, satu kajian dijalankan untuk mengesan kehadiran tiga
bakteria endosimbion berkepentingan perubatan di dalam Acanthamoeba spp. yang
telah dipencilkan dari bolong penghawa dingin yang terdapat di wad and dewan
bedah di Pusat Perubatan Universiti Kebangsaan Malaysia. Kehadiran bakteria
endosimbion ini disaring menggunakan pasangan primer khusus bagi setiap genus
menggunakan reaksi rantai polimerase (PCR) konvensional dan disahkan dengan
analisis penjujukan. Dua puluh sembilan (80.56%) pencilan Acanthamoeba spp.
didapati mengandungi bakteria endosimbion patogenik yang disasarkan dengan
sekurang-kurangnya satu genus bakteria bagi setiap pencilan. Mycobacterium
(82.76 %) adalah bakteria yang paling banyak dikesan, diikuti dengan Legionella sp.
(65.52 %) dan Pseudomonas spp. (62.07 %). Tiada bakteria MRSA dikesan daripada
mana-mana pencilan dalam kajian ini. Dua endosimbion Mycobacterium yang
dikenalpasti telah dikelompokkan ke dalam strain Mycobacterium tuberculosis.
Kami membuat kesimpulan bahawa, kebanyakan Acanthamoeba berpotensi untuk
menjadi perumah bagi pelbagai bakteria patogenik, namun implikasi interaksi ini
terhadap patogenisiti kedua-dua organisma masih kurang jelas dan memerlukan
penyelidikan yang lebih lanjut.
Plasma cell myeloma is known to cause expansion of a single clone of munoglobulin (Ig) which results in the secretion of a unique homogeneous monoclonal protein (M component). However, there are cases which reported that it can also cause production of two different clones of these monoclonal proteins. Although it is relatively very rare as the prevalence is only 2% of all plasma cell myeloma cases, the clinical features are said to be similar to monoclonal gammopathy. It is suggested that these biclonal gammopathy results from either one monoclonal cell clone in monoclonal gammopathy or two different monoclonal cell clones. Whichever the mechanism of the disease be, the response to treatment seems to be similar as compared to the monoclonal cases although some reports shows chemoresistant. Here, we report a rare case of plasma cell myeloma with IgG (lambda) and IgA (lambda) type of biclonal gammopathy, the clinical presentation, the haematological and biochemical markers as well as the response to the treatment.
Keywords: biclonal gammopathy, M protein, plasma cell myeloma
Kebimbangan dan gangguan emosi amat biasa di dalam Penyakit Kecelaruan
Defisit Perhatian. Laporan kes ini mengetengahkan kes lelaki Melayu berusia
23 tahun yang menunjukkan masalah memberi perhatian dan kemerosotan
pencapaian akademiknya secara ketara. Kemerosotan pengajiannya disedari
oleh ahli keluarganya 2-3 tahun sebelum beliau mendapatkan rawatan psikiatri.
Beliau juga mengalami masalah kemurungan tetapi tidak mengalami gejala
biologi kemurungan. Beliau telah dirawat dengan ubat-ubatan Buproprion 150 mg
setiap hari dan juga ubat Ritalin 10 mg. Kebiasaannya ubat peransang digunakan
untuk rawatan penyakit kecelaruan deficit perhatian tetapi dalam kes ini ubat
anti kemurungan telah digunakan. Beliau telah menunjukkan penambahbaikan
selepas memakan ubat dan seterusnya dapat memberi fokus kepada pembelajaran
akademiknya.
Adult influenza and pneumococcal vaccinations are grossly underutilized although there is clear benefit in reducing mortality and morbidity among those at risk. The aim of the study was to assess primary care physician’s knowledge on adult influenza and pneumococcal vaccinations, their beliefs and barriers to vaccination. A cross-sectional study using self-administered questionnaires was conducted at eight primary care centres in Kuching, Sarawak. A total of 108 primary care physicians participated in this study. Median age of participants was 29 years (IQR 4.0). The median knowledge score for influenza vaccine was 9 (IQR 3) and for pneumococcal vaccine was 8 (IQR 4). Female participants scored higher compared to their male counterparts for influenza and pneumococcal vaccines (P = 0.005 & 0.007). The highest percentage of correct responses for influenza vaccination was for side effects (75.3%) while the lowest was for contraindications (9.3%). The highest percentage of correct responses for pneumococcal vaccination was for side effects (69.1%) while the lowest was for advocated target groups (6.2%). Most participants believed that pneumococcal and influenza vaccines were safe (92.8 & 99%) and beneficial for patients (89.7 & 93.8%). Cost of influenza and pneumococcal vaccines (94.8% & 96.9%) and their availability (86.6% & 89.7%) were the main barriers to prescribing them. Primary care physicians in the public sector have moderate knowledge of both adult vaccinations. Areas of knowledge paucity and barriers need to be addressed to ensure a more comprehensive health care delivery to the aging Malaysian population.
Keywords: adult, belief, influenza vaccines, knowledge, pneumococcal vaccines
MeSH terms: Ambulatory Care Facilities; Autonomic Nervous System Diseases; Cross-Sectional Studies; Diabetic Neuropathies; Glycosaminoglycans; Humans; Influenza, Human; Malaysia; Fenofibrate
Model tiga dimensi (3D) menyerupai ciri-ciri persekitaran tisu asli, justeru
morfologi dan isyarat-isyarat sel daripada kultur 3D selalunya lebih menyerupai
fisiologi asal berbanding sel kultur dua dimensi (2D). Diketahui juga, rembesan
sel mempunyai kesan parakrin kepada pertumbuhan sel-sel lain. Dalam kajian
ini, pengkulturan fibroblast hidung menggunakan system kultur sel 3D telah
dioptimumkan dan kesan bahan rembesan (BR) daripada kultur 3D terhadap kadar
pertumbuhan dan perlindungan sel telah dikaji. Fibroblas hidung dipencilkan
daripada turbinate hidung manusia. Mikrosfera yang sesuai telah dipilih melalui
pengkulturan fibroblast pemindahan ke-3 pada pelbagai jenis mikro sferapolisterin
PolyGEM™. Kemudian, sel-sel telah dikulturkan pada mikrosfera yang terpilih
menggunakan system kultur 3D dan media terkondisi (MT) telah dikumpulkan.
Media terkondisi tiga dimensi (MT3D) telah ditambah kepada fibroblast untuk
mengkaji kadar perlekatan sel, kadar proliferasi, dan perlindungan sel terhadap
kesitotoksikan Centella asiatica. Asai protein asid bicinchonic dijalankan untuk
mengetahui kuantiti protein di dalam BR. Elektroforesis gel poliakrilamida-Sodium
Dodesil Sulfat (SDS-PAGE) telah dilakukan untuk memperoleh profil awal protein
dan membandingkan profil MT3D dengan protein media terkondisi dua dimensi
(MT2D). Kajian ini menunujukkan MT3D tidak menggalakkan perlekatan dan
proliferasi sel secara signifikan. BR didapati memberikan perlindungan sel yang
signifikan pada fibroblast hidung terhadap kesitotoksikan Centella asiatica. MT3D
mempunyai kepekatan protein yang lebih tinggi berbanding MT2D. SDS-PAGE
menunjukkan MT3D mempunyai 3 jalur ekslusif manakala MT2D mempunyai 4 jalur eksklusif. Kajian masa depan harus dijalankan keatas penggunaan BR
fibroblast hidung untuk perlindungan sel terhadap agen-agen yang memudaratkan
di alam sekitar dan produk herba yang sitotoksik.
Miscarriage is one of the most common complications in pregnancy. There is emerging evidence that psychological impact following miscarriage is not unusual. Understanding the magnitude of psychological morbidity is important in the management of miscarriage. The main objective of this study was to compare the mean Hospital Anxiety and Depression Scale (HADS) score between women with miscarriage and women with successful pregnancy and to determine the sociodemographic factor and clinical characteristic that are associated with anxiety and depression. A descriptive case control study was conducted in a teaching hospital, over a period of 12-months (from October 2014 till September 2015). A total of 65 women were recruited with 32 women as the study group (miscarriage) and another 33 women as the control group (women with successful pregnancy). Mean HADS-anxiety score was higher in the study group compared to control group although it was not statistically significant (6.53 ± 3.427 vs 5.73 ± 2.875, p=0.309). Mean HADS-depression score was higher in the control group (4.34 ± 2.695 vs 4.45 ± 3.073, p=0.878). Women with maternal age more than 35 years and history of previous miscarriage had a higher tendency of anxiety and depression with higher mean HADS score. There was no association between other sociodemographic data and clinical characteristic with risk of anxiety and depression. As conclusion, there was no significant difference in women with miscarriage as compared to those with successful pregnancies, although older women with history of miscarriage had a preponderance to both disorders.
Keywords: anxiety, depression, miscarriage, morbidity, psychological
Human Immunodeficiency Virus (HIV) epidemic remains a significant burden in Malaysia. Stigma related to HIV and its effect on the quality of life (QOL) of persons living with HIV (PLHIV) remains under-reported. The aim of the present study was to assess self-perceived stigma amongst PLHIV attending an urban community clinic and its influence on their QOL. Data was collected using HIV Stigma Scale and WHO-QOL HIV BREF Scale. The overall stigma experienced by PLHIV in this community was higher than previous studies (mean ± SD; 103.37 ±18.14). Majority participants had fear disclosing their disease status, while personalized stigma or the experience of prejudice and rejection was the least experienced. The overall QOL was low and was significantly impaired in social relationship domain (mean ± SD; 12.72 ± 3.59). However, their ability to perform daily activities was not affected by the illness (mean ± SD; 14.48 ± 2.91). PLHIV with higher spiritual values demonstrate lower perception of negative self-image and inferiority (r= -0.54). This finding was unique to PLHIV in this study and suggested the importance of spirituality and personal beliefs on their self-esteem. In conclusion, stigma remains as a significant problem among PLHIV in this community. Primary care offers the best platform to promote a holistic management of PLHIV, where the integration between counselors, religious experts, family and non-governmental associations could come together. The management of PLHIV is unique in every community, hence individualized approach based on cultural norms and beliefs could assist in the overall management of PLHIV.
Keywords: HIV, quality of life, social stigma
MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Humans; Malaysia; Quality of Life*; HIV Infections*; Social Stigma*
Amplikasi isoterma berpengantara gelung (LAMP) merupakan teknik amplifikasi gen
yang menghasilkan produk akhir iaitu mendapan keruh magnesium pirofosfat yang
boleh dianalisis dengan hanya menggunakan mata kasar. Penggunaan pewarna
interkalat yang sesuai adalah penting kerana ia boleh meningkatkan sensitiviti dan
mengurangkan keputusan positif palsu dan negatif palsu untuk pengesanan. Kajian
ini bertujuan untuk membandingkan prestasi tiga pewarna interkalat yang berbeza;
SYBR Green I, SYBR Safe dan pewarna berasaskan calcein di dalam asai LAMP
HPV-16 melalui visualisasi oleh mata kasar, elektroforesis gel dan mesin masanyata
turbidimeter. Reaksi LAMP dilakukan menggunakan amplifikasi kit Loopamp
DNA berisipadu sebanyak 25 μl. Campuran reaksi dieram pada suhu 60�C selama
60 minit dan ditamatkan menggunakan suhu 80�C selama 5 minit dalam mesin
masa-nyata turbidimeter. Untuk pengesanan menggunakan mata kasar, SYBR
Green I dan SYBR Safe telah dicairkan dalam 1:10 DMSO dan telah ditambah ke
dalam tiub yang mengandungi campuran reaksi selepas proses amplifikasi berlaku
manakala calcein ditambah sebelum proses amplifikasi. Sensitiviti asai telah disiasat
menggunakan pencairan DNA HPV-16 yang berkepekatan bermula dari 101
salinan/
μl to 108
salinan/μl. Ketiga-tiga pewarna mempamerkan keputusan yang sama
dari segi sensitiviti dengan had pengesanan adalah 103
salinan/μl. Penambahan
calcein di dalam asai menunjukkan masa pengesanan bertambah selama 10 minit
dengan menggunakan mesin nyata-masa turbidimeter. Prestasi ketiga-tiga pewarna
interkalat untuk pengesanan mata kasar adalah setanding dan boleh digunakan
untuk aplikasi pemeriksaan titik akhir dalam asai HPV-16, manakala dengan mesin nyata-masa turb