MyMedR

Fulltext Identification of Entamoeba histolytica trophozoites in fresh stool sample: comparison of three staining techniques and study on the viability period of the trophozoites

Tan ZN, Wong WK, Nik Zairi Z, Abdullah B, Rahmah N, Zeehaida M, et al.

Trop Biomed, 2010 Apr;27(1):79-88.

PMID: 20562817 MyJurnal

Entamoeba histolytica causes about 50 million infections worldwide with a death rate of over 100,000 annually. In endemic developing countries where resources are limited, microscopic examinations based on Wheatley trichrome staining is commonly used for diagnosis of intestinal amoebiasis. Other than being a time-consuming method, it must be performed promptly after stool collection as trophozoites disintegrate rapidly in faeces. The aim of this study was to compare the efficacies of Eosin-Y, Wheatley trichrome and Iodine stains in delineating the diagnostic features of the parasite, and subsequently to determine the suitable microscopy observation period for detection of erythrophagocytic and non-erythrophagocytic trophozoites spiked in semi-solid stool sample. Wheatley trichrome staining technique was performed using the standard method while the other two techniques were performed on the slides by mixing the respective staining solution with the spiked stool sample. One million of axenically cultured non-erythrophagocytic E. histolytica and erythrophagocytic E. histolytica were separately spiked into 2 g of fresh semisolid faeces. Percentage viability of the trophozoites in the spiked stool sample was determined at 30 minute intervals for eight hours using the 0.4% Trypan blue exclusion method. The results showed that Eosin-Y and Wheatley trichrome stained the karyosome and chromatin granules better as compared to Iodine stain. The percentage viability of non-erythrophagocytic trophozoites decreased faster than the erythrophagocytic form in the first 5 hours and both dropped to ~10% in the 6th hour spiked sample. In conclusion, Eosin-Y staining technique was found to be the easiest to perform, most rapid and as accurate as the commonly used Wheatley trichrome technique; Eosin-Y stained slide sealed with DPX could also be kept as a permanent record. A period not exceeding 6 hours after stool collection was found to be the most suitable in order to obtain good microscopy results of viable trophozoites.

PCR-ELISA for the detection of Brugia malayi infection using finger-prick blood

Rahmah N, Ashikin AN, Anuar AK, Ariff RH, Abdullah B, Chan GT, et al.

Trans R Soc Trop Med Hyg, 1998 12 16;92(4):404-6.

PMID: 9850392

A polymerase chain reaction assay based on the enzyme-linked immunosorbent assay (PCR-ELISA) has been developed to detect Brugia malayi infection in an area of low endemicity in Malaysia. Blood samples from 239 subjects were tested: 192 amicrofilaraemic individuals, 14 microfilaraemic persons and 3 chronic elephantiasis cases from endemic areas and 30 city-dwellers (non-endemic controls). PCR products were examined by ELISA and Southern hybridization. In the PCR-ELISA, digoxigenin-labelled PCR products were hybridized to a biotin-labelled probe. This was followed by incubation in streptavidin-coated microtitre wells and detection using anti-digoxigenin-peroxidase and ABTS [2,2'-azinobis(3-ethylbenzthiazoline-6-sulphonic acid)]. All microfilaraemic samples were positive by PCR-ELISA and Southern hybridization and all samples from non-endemic subjects and chronic elephantiasis patients were negative. The PCR-ELISA detected 12 times as many B. malayi infections as did thick blood film examination. Nineteen of the 194 samples from the endemic area gave positive results by both PCR-ELISA and Southern hybridization, and an additional 5 samples were positive by PCR-ELISA only. The PCR-ELISA was specific and sensitive, detected more infections, and was more reproducible than Southern hybridization.

Fulltext Assessment of perception, attitude, and practice of primary care practitioners towards allergic rhinitis practice guidelines: Development and validation of a new questionnaire

Abdullah B, Kandiah R, Hassan NFHN, Ismail AF, Mohammad ZW, Wang Y

World Allergy Organ J, 2020 Dec;13(12):100482.

PMID: 33294114 DOI: 10.1016/j.waojou.2020.100482

BACKGROUND: Primary care practitioners (PCPs), being the front liners, play an important role in treating allergic rhinitis (AR). As there is no proper tool to assess their perception, attitude, and practice in utilizing the guidelines, we aimed to develop and validate a new questionnaire for such purpose.

METHODS: The development phase consists of both literature and expert panel review. The validation phase consists of content validity, face validity, and construct validity. Cronbach's alpha was used to verify internal consistency. The development phase produced a questionnaire with 3 domains: perception, attitude, and practice consisting of 60 items (PAP-PCP questionnaire). Item response theory analysis for perception demonstrated the difficulty and discrimination values were acceptable except for 3 items. Exploratory factor analysis for attitude and practice domains showed the psychometric properties were good except for 3 items in practice domain. Experts judgement was used to decide on the final selection of questionnaire which consists of 59 items.

RESULTS: The final validated questionnaire has 3 domains with 59 items. All domains had Cronbach's alpha above 0.65 which was reliable. 302 physicians completed the questionnaire. 98% PCPs diagnosed AR based on clinical history. Although, majority agree AR guidelines is useful (67%), they had difficulty in using it to classify AR (54.9%) and determine AR severity (73.9%). Oral anti-histamines (first and second generation) were the most prescribed (>75%) followed by intranasal corticosteroids (59%) and combined intranasal corticosteroid and oral anti-histamine (51%). Majority agreed that treatment efficacy (81.8%), adverse effects (83.8%), fear of adverse effects (73.5%), route of administration (69.4%), dosing frequency (72.5%), taste (64.6%) and cost (73.5%) affect treatment compliance.

CONCLUSIONS: The newly developed and validated questionnaire is a promising instrument in understanding the treatment gap in AR. Although further testing and refinement are needed, it provides an initial means for evaluating knowledge and understanding of PCPs in treating AR.

Cryptococcocis: a rare fungal infection of the tongue

Mohamad I, Abdullah B, Salim R, Rajet KA, Naik VR

Southeast Asian J. Trop. Med. Public Health, 2010 Sep;41(5):1188-91.

PMID: 21073040

Fungal infection in the oral cavity is not uncommon. The site involved is usually species related. Cryptococcus rarely infects the oral cavity. We report an elderly patient who presented with a central lesion on the dorsum of the tongue. Biopsy revealed a fungal infection. Special stains confirmed cryptococcus. Being a rare location for cryptococcal infection, clinical suspicion should be correlated with histopathological examination. Once confirmed, the patient should be treated with an antifungal medication.

Fulltext Cerebral infarction and cerebral salt wasting syndrome in a patient with tuberculous meningoencephalitis

Loo KL, Ramachandran R, Abdullah BJ, Chow SK, Goh EM, Yeap SS

Southeast Asian J. Trop. Med. Public Health, 2003 Sep;34(3):636-40.

PMID: 15115143

A 38-year old female with underlying systemic lupus erythematosus was admitted with tuberculous meningoencephalitis. After an initial good response to anti-tuberculous treatment, she developed cerebral infarction and profound hyponatremia. This was due to cerebral salt wasting syndrome, which has only previously been described in 2 cases. The difficulties in diagnosis and management of this case are discussed.

Fulltext Clinical features of Nipah virus encephalitis among pig farmers in Malaysia

Goh KJ, Tan CT, Chew NK, Tan PS, Kamarulzaman A, Sarji SA, et al.

N Engl J Med, 2000 Apr 27;342(17):1229-35.

PMID: 10781618 DOI: 10.1056/NEJM200004273421701

BACKGROUND: Between September 1998 and June 1999, there was an outbreak of severe viral encephalitis due to Nipah virus, a newly discovered paramyxovirus, in Malaysia.
METHODS: We studied the clinical features of the patients with Nipah virus encephalitis who were admitted to a medical center in Kuala Lumpur. The case definition was based on epidemiologic, clinical, cerebrospinal fluid, and neuroimaging findings.
RESULTS: Ninety-four patients with Nipah virus infection were seen from February to June 1999 (mean age, 37 years; ratio of male patients to female patients, 4.5 to 1). Ninety-three percent had had direct contact with pigs, usually in the two weeks before the onset of illness, suggesting that there was direct viral transmission from pigs to humans and a short incubation period. The main presenting features were fever, headache, dizziness, and vomiting. Fifty-two patients (55 percent) had a reduced level of consciousness and prominent brain-stem dysfunction. Distinctive clinical signs included segmental myoclonus, areflexia and hypotonia, hypertension, and tachycardia and thus suggest the involvement of the brain stem and the upper cervical spinal cord. The initial cerebrospinal fluid findings were abnormal in 75 percent of patients. Antibodies against Hendra virus were detected in serum or cerebrospinal fluid in 76 percent of 83 patients tested. Thirty patients (32 percent) died after rapid deterioration in their condition. An abnormal doll's-eye reflex and tachycardia were factors associated with a poor prognosis. Death was probably due to severe brain-stem involvement. Neurologic relapse occurred after initially mild disease in three patients. Fifty patients (53 percent) recovered fully, and 14 (15 percent) had persistent neurologic deficits.
CONCLUSIONS: Nipah virus causes a severe, rapidly progressive encephalitis with a high mortality rate and features that suggest involvement of the brain stem. The infection is associated with recent contact with pigs.

Fulltext Parasitic infections among aborigine children at Post Brooke, Kelantan, Malaysia

Rahmah N, Ariff RHT, Abdullah B, Shariman MSM, Nazli MZM, Rizal MZM

Med J Malaysia, 1997 Dec;52(4):412-5.

PMID: 10968120

This study investigated the prevalence of parasitic infections among aborigine children at Post Brooke, Kelantan. Eighty-four formalin-fixed specimens and 78 PVA-fixed specimens were obtained. 79.8% and 35.9% of the samples were positive for helminth ova and protozoa respectively. The parasites detected (single plus mixed infections) were A. lumbricoides (50/84, 59.5%), T. trichiura (35/84, 41.7%), hookworm (5/84, 6.0%), S stercoralis (1/84, 1.2%), G. intestinalis (18/78, 23.1%), E. histolytica (7/78, 9.0%) and E. coli (7/78, 9.0%). Two hundred thick blood film examinations detected only one case of Plasmodium falciparum infection. A high prevalence of intestinal parasitic infections among the children at Post Brooke was demonstrated in this study; thus there is an urgent need to improve the hygiene, education and living standards of this population.

Fulltext Safety considerations in magnetic resonance imaging (MRI)

Abdullah BJ, Bux SI, Chien D

Med J Malaysia, 1997 Dec;52(4):445-53; quiz 454.

PMID: 10968127

MRI is now an important diagnostic tool in medical management. There are numerous safety issues to be considered by the clinicians prior to requesting an MRI examination for their patients. These include those related to the magnetic field, gradient magnetic fields, the patient and contrast medium. This paper discusses the dangers and necessary precautions essential to reduce the risk of untoward complications from MRI.

Fulltext MRI appearances of peritoneal mesothelioma--a case report

Hashim S, Abdullah BJJ, Jayaram G

Med J Malaysia, 1999 Sep;54(3):358-60.

PMID: 11045063

A rare case of diffuse malignant peritoneal mesothelioma in a 71 year-old Malay man with no previous history of asbestos or radiation exposure is described. The clinical manifestation was a large abdominal mass. At laparotomy he was found to be in the advanced stage of the disease. The tumour was not resectable and patient was sent home. He gradually deteriorated and died three months after diagnosis was made. The magnetic resonance imaging (MRI) features of peritoneal mesothelioma which has not been previously reported are described.

Fulltext Calcified vertical plate of the cricoid--a rare pitfall in the diagnosis of an oesophageal foreign body

Arasaratnam S, Abdullah BJJ, Fernandez V

Med J Malaysia, 1998 Sep;53(3):290-2.

PMID: 10968170

We present a case of rare pitfall in the diagnosis of an oesophageal foreign body due to the calcified vertical plate of the cricoid to highlight the need to be aware of this entity to avoid unnecessary morbidity.

Fulltext The impact of teleradiology in clinical practice--a Malaysian perspective

Abdullah BJ, Ng KH, Pathmanathan R

Med J Malaysia, 1999 Jun;54(2):169-74.

PMID: 10972025

Teleradiology is the most mature and rapidly evolving specialty in telemedicine. The use of teleradiology has grown tremendously during the past few years. This article describes the role of teleradiology in health care along with a brief history of its development in tandem with advances in telecommunications and computer technologies. Teleradiology standards, image acquisition, data compression, transmission and image interpretation are summarised. The impact of teleradiology in the practice of radiology, traces the evolution of the modality especially in the Malaysian perspective and its current and future role are discussed.

Fulltext X-ray based radiological procedures in Malaysia--1990-1994

Ng KH, Abdullah BJJ, Rassiah P, Sivalingam S

Med J Malaysia, 1999 Jun;54(2):185-91.

PMID: 10972028

X-ray based radiological procedure statistics and trend in Malaysia for 1990-1994 is reported; this information allows comparisons to be made with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Report. Additionally it is essential information for health care planners and providers. Malaysia is categorised as a health care level II country based on the UNSCEAR definition. In 1994, the number of physicians, radiologists, x-ray units and x-ray examinations per 1000 population was 0.45, 0.005, 0.065 and 183 respectively. 3.6 million x-ray examinations were performed in 1994, with chest radiography being the commonest study (63%). Information on x-ray examinations, number of hospitals and x-ray units is reported for the Ministry of Health, private practice and teaching hospitals. Examination frequency increased in computed tomography (161%), cardiac procedures (190%), and mammography (240%); while a decrease in barium studies (-23%), cholecystography (-36%), and intravenous urography (-51%) was noted. There is a potential and need to expand and upgrade radiological services.

Fulltext Duodenal obstruction secondary to metastatic synovial sarcoma--a case report

Hashim S, Abdullah BJ, Rajasingam V, Moosa F

Med J Malaysia, 1999 Jun;54(2):267-9.

PMID: 10972041

A 17 year old Malay student who is a known case of synovial sarcoma of left elbow (treated with an above elbow amputation) presented with duodenal obstruction. We report an unusual case of gastrointestinal tract metastases from synovial sarcoma. To our knowledge, there is no previous such report in the literature. The computed tomography (CT) and magnetic resonance imaging (MRI) features are described.

Fulltext Case of a non-pulsatile groin swelling

Razif MA, Rajasingam V, Abdullah BJJ

Med J Malaysia, 2002 Dec;57(4):499-502.

PMID: 12733179

We report a case of a non-pulsatile groin swelling in a 38 years old male drug addict without the typical clinical signs of an aneurysm. Ultrasound revealed a left femoral artery pseudo-aneurysm. He was surgically treated and the vessels were ligated without revascularisation.

Fulltext Preliminary report on somatostatin receptor imaging in rare endocrine tumours

Abdullah BJJ, Paramsothy M, Khir ASM, Chan SP

Med J Malaysia, 2000 Jun;55(2):169-73.

PMID: 19839144

Our preliminary experience of Somatostatin Receptor Positive Tumour Scintigraphy (SRPTS) in the management of some rare neuroendocrine tumours is highlighted. Six patients were evaluated using SRPTS. A single patient each with Zollinger-Ellison syndrome, recurrent medullary carcinoma of thyroid and Stage IV neuroblastoma. Two patients with phaeochromocytoma, and one patient with suspected insulinoma were evaluated. SRPTS was useful in three of the six patients studied i.e. patient with gastrinoma, recurrent medullary carcinoma of thyroid and metastatic neuroblastoma. SRPTS although expensive is a useful and cost-effective approach of rare endocrine tumours and it role as a first line tool in the diagnosis is discussed.

Fulltext Factors related to adverse outcome in inpatients with diabetic foot

Harwant S, Doshi HK, Moissinac K, Abdullah BT

Med J Malaysia, 2000 Jun;55(2):236-41.

PMID: 19839152

Sixty inpatients with diabetic foot were studied prospectively at the Orthopaedic wards of Hospital Kuala Lumpur. Data was evaluated to document the patient profile and the factors that were associated with a major amputation (either above knee or below knee) of the lower limb. Factors that were associated with increased risk of amputation were a low education level, manual occupation, poor foot care, peripheral vascular insufficiency of the lower limb, insulin dependence, anaemia and leucocytosis. However only anaemia, leucocytosis and hyperglycaemia were statistically significant in predicting a more adverse surgical procedure. This study recommends that foot care awareness and practice is important. This can be effectively dealt with at specially organised, multi disciplinary Diabetic Foot Clinics.

Fulltext The prevalence and intensity of soil-transmitted helminthiasis among pre-school children in Orang Asli resettlement villages in Kelantan

Zulkifli A, Khairul AA, Atiya AS, Abdullah B, Yano A

Med J Malaysia, 1999 Dec;54(4):453-8.

PMID: 11072462

A study of the prevalence and intensity of soil-transmitted helminthiasis among pre-school children aged 0 to 7 years from an Orang Asli village resettlement scheme in Gua Musang, Kelantan was undertaken. The overall prevalence of soil transmitted helminthic (STH) infections was 56.0%. The predominant helminth found was Ascaris lumbricoides while the commonest type of infection was a mixed infection with Ascaris lumbricoides and Trichuris trichiura. The prevalence rates of Ascaris, Trichuris and hookworm infections were 47.5%, 33.9% and 6.2% respectively. The intensity of Ascaris infections were 64.5% light, 27.3% moderate and 8.3% heavy whilst the intensity of Trichuris infections were 80.5% light, 18.3% moderate and 1.2% heavy. However, the intensity of hookworm infections were 86.7% light, 13.3% moderate and no heavy infection. The prevalence of helminthiasis (STH) shows an-age dependent relationship, with the lowest prevalence in 0-< 1 year age group and highest in the 6-< 7 year age group.

Fulltext Petrosal sinus sampling in the diagnosis of Cushing's syndrome: preliminary experience in University of Malaya Medical Centre

Norlisah R, Abdullah BJJ, Hew FL, Chan SP

Med J Malaysia, 2003 Jun;58(2):180-6.

PMID: 14569737 MyJurnal

Differentiating between Cushing's disease of pituitary origin and ectopic ACTH syndrome of extra-pituitary origin remains a major challenge to the clinician because of limitations in the diagnostic accuracy of the high-dose dexamethasone suppression test. Routine use of inferior petrosal sinus sampling (IPSS) is therefore advocated by some authors for these patients. We present our preliminary experience of IPSS in 7 consecutive patients with Cushing's disease and discuss how the results impacted on the patients' management.

Fulltext Prevalence of menopausal symptoms, its effect to quality of life among Malaysian women and their treatment seeking behaviour

Abdullah B, Moize B, Ismail BA, Zamri M, Mohd Nasir NF

Med J Malaysia, 2017 04;72(2):94-99.

PMID: 28473671

INTRODUCTION: This study aimed to determine the prevalence of menopausal symptoms, its effect to the quality of life and their treatment seeking behaviour in a multiracial community in Malaysia.

METHODS: This is a cross-sectional study involving postmenopausal women in Klang Valley, Malaysia. Data was obtained by face-to-face interview using standardised questionnaires on sociodemographic data, Menopause Rating Scale questionnaire, effect to quality of life and treatment sought.

RESULTS: A total of 258 women, including Malays (82%), Indians (14.1%) and Chinese (3.9%) were recruited. The median age was 58 (range 45-86) years old. Joint and muscular discomfort (73.3%) and fatigue (59.3%) were the most prevalent symptoms. Significant association with ethnicity were demonstrated with Malays was found to have 3.1 times higher incidence of sexual problems than Indians, (Odds Ratio (OR) 3.103; 95%CI 1.209, 7.967) and Indian had 2.6 times higher incidence of irritability compared to Malays (OR 2.598; 95%CI 1.126, 5.992). Fifty-two percent of women felt that menopausal symptoms affected their quality of life but there were only 2.7% who were severely affected. There were 24.8% of women who sought treatment and only 20.3% of those who took hormone replacement therapy. There was no significant association found between their treatment seeking behaviour in association with ethnicity, age, parity, marital and occupational status.

CONCLUSION: Menopausal symptoms were prevalent among menopausal women, although only a small group of women who were severely affected. There was a lack of tendency in seeking treatment for menopausal symptoms among the women.

Challenges in conducting post graduate otorhinolarygology-head and neck surgery specialty examination in the time of pandemic

I Mohamad I, Hamizan A, Abdullah B

Med J Malaysia, 2021 08;76(Suppl 4):45-48.

PMID: 34558559

No abstract provided.

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