The spectrum of beta-thalassemia mutations in Malaysia has been determined in 45 beta-thalassemia chromosomes using dot blot hybridization of the polymerase chain reaction amplified DNA and direct DNA sequencing. Eleven different molecular defects, including those previously detected in Chinese, Asian Indians, and American blacks, and a novel frameshift mutation causing beta zero-thalassemia were detected. Since this novel mutation, a T deletion in codon 15 creates a new restriction site for EcoRII enzyme; the mutation could be detected by EcoRII digestion of the appropriate amplified fragment. The results of the present study provide additional information on the molecular heterogeneity of beta-thalassemia in this population. We also demonstrated the nonradioactive detection method of the beta-thalassemia mutation based upon the digoxigenin-labeled oligonucleotide probes.
Nicardipine has been shown to have an anti-atherogenic effect in rabbits given a 2% cholesterol diet. Current evidence suggests that lipid peroxidation plays an important role in atherogenesis. This study examines the effect of nicardipine on lipid peroxidation in rabbits given a 2% cholesterol diet, 8 of these rabbits given nicardipine 0.5 mg/kg twice daily intramuscularly for ten weeks while the remaining untreated 6 were controls. After ten weeks, serum malondialdehyde in the control group was significantly higher compared to their baseline levels (P < 0.05). However, there was no increase in serum malondialdehyde in the nicardipine group after 10 weeks. The area of Sudan IV positive intimal lesions (atherosclerotic plaques) were significantly decreased (P < 0.01) in the treated group compared to the control group. The aortic tissue content of cholesterol and diene conjugates were also decreased in the nicardipine group (P < 0.01). These findings suggest a possible link between nicardipine and lipid peroxidation in mediating its antiatherogenic effects.
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.
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.
Most reports of nosocomial infection (NI) prevalence have come from developed countries with established infection control programs. In developing countries, infection control is often not as well established due to lack of staff and resources. We examined the rate of NI in our institution.
We retrospectively reviewed poisoning admissions to all government health facilities from 1999 to 2001, in an effort to expand our current knowledge on poisoning in Malaysia to a level that better reflects a nationwide burden. There were 21 714 admissions reported with 779 deaths. The case-fatality rate was 35.88/1000 admissions. The majority of admissions (89.7%) and deaths (98.9%) occurred in adults. Some 55.1% of all admissions were female, mostly involving pharmaceutical agents. Male poisoning admissions were more often due to chemical substances. The prevalence of poisoning and death was highest among Indians compared to all other races in Malaysia. Overall, the majority of poisoning admissions were due to pharmaceutical agents, with agents classified as non-opioid analgesics, anti-pyretics and anti-rheumatics the most common. Pesticides accounted for the largest number of fatalities. It was also the commonest substance reported in cases of intentional self-harm. Most cases of poisoning admissions occurred due to accidental exposure (47%), followed by cases of intentional self-harm (20.7%). Overall, this study has managed to contribute substantial additional information regarding the epidemiology of poisoning in Malaysia, highlighting important issues, such as the rampant poisonings involving pesticides and analgesics, as well as the high prevalence of poisoning among Indians in Malaysia.
A cross-sectional study was conducted to investigate the effects of acute and chronic pesticide exposure on the plasma beta-glucuronidase enzyme activity among five patients of acute pesticide poisoning in Tengku Ampuan Rahimah Hospital, Klang, 230 farmers in the MADA area, Kedah and 49 fishermen in Setiu, Terengganu. The duration of pesticide exposure among the patients was unknown, but the plasma samples from patients were collected on day one in the hospital. The duration of pesticide exposure among the farmers was between 1 and 45 years. The beta-glucuronidase activity was compared with plasma cholinesterase activity in the same individual. The plasma cholinesterase activity was measured using Cholinesterase (PTC) Reagent set kit (Teco Diagnostics, UK) based on colorimetric method, while the plasma beta-glucuronidase activity was measured fluorometrically based on beta-glucuronidase assay. The plasma cholinesterase activity was significantly reduced (p<0.05) among the patients (1386.786+/-791.291 U/L/min) but the inhibition in plasma cholinesterase activity among the farmers (7346.5+/-1860.786 U/L/min) was not significant (p>0.05). The plasma beta-glucuronidase activity among the farmers was significantly elevated (p<0.05) (0.737+/-0.425 microM/h) but not significant among the patients (p>0.05). The plasma cholinesterase activity was positively correlated with the plasma beta-glucuronidase activity among the farmers (r=0.205, p<0.01) but not among the patients (r=0.79, p>0.05). Thus, plasma beta-glucuronidase enzyme activity can be measured as a biomarker for the chronic exposure of pesticide. However, further studies need to be performed to confirm whether plasma beta-glucuronidase can be a sensitive biomarker for anticholinesterase pesticide poisoning.
Ion beams are used in radiotherapy to deliver a more precise dose to the target volume while minimizing dose to the surrounding healthy tissue. For optimum dose monitoring in ion-beam therapy, it is essential to be able to measure the delivered dose with a sensitivity, spatial resolution and dynamic range that is sufficient to meet the demands of the various therapy situations. Optical fibres have been demonstrated by this group to show promising thermoluminescence properties with respect to photon, electron and proton irradiation. In particular, and also given the flexibility and small size of optical fibre cores, for example 125.0+/-0.1 microm for the Al- and Ge-doped fibres used in this study, these fibres have the potential to fulfill the above requirements. This study investigates the thermoluminescence dosimetric characteristics of variously doped SiO(2) optical fibres irradiated with alpha particles from (241)Am. Following subtraction of the gamma contribution from the above source, the thermoluminescence characteristics of variously doped SiO(2) optical fibres have been compared with that of TLD-100 rods. The irradiations were performed in a bell jar. Of related potential significance is the effective atomic number, Z(eff) of the fibre, modifying measured dose from that deposited in tissues; in the present work, a scanning electron microscope and associated energy dispersive X-ray spectroscopy facility have been used to provide evaluation of Z(eff). For Ge-doped fibres, the effective atomic numbers value was 11.4, the equivalent value for Al-doped fibres was 12.3. This paper further presents results on dose response and the glow curves obtained. The results obtained indicate there to be good potential for use of variously doped SiO(2) optical fibres in measuring ion-beam doses in radiotherapeutic applications.
Modern linear accelerators, the predominant teletherapy machine in major radiotherapy centres worldwide, provide multiple electron and photon beam energies. To obtain reasonable treatment times, intense electron beam currents are achievable. In association with this capability, there is considerable demand to validate patient dose using systems of dosimetry offering characteristics that include good spatial resolution, high precision and accuracy. Present interest is in the thermoluminescence response and dosimetric utility of commercially available doped optical fibres. The important parameter for obtaining the highest TL yield during this study is to know the dopant concentration of the SiO2 fibre because during the production of the optical fibres, the dopants tend to diffuse. To achieve this aim, proton-induced X-ray emission (PIXE), which has no depth resolution but can unambiguously identify elements and analyse for trace elements with detection limits approaching microg/g, was used. For Al-doped fibres, the dopant concentration in the range 0.98-2.93 mol% have been estimated, with equivalent range for Ge-doped fibres being 0.53-0.71 mol%. In making central-axis irradiation measurements a solid water phantom was used. For 6-MV photons and electron energies in the range 6, 9 and 12 MeV, a source to surface distance of 100 cm was used, with a dose rate of 400 cGy/min for photons and electrons. The TL measurements show a linear dose-response over the delivered range of absorbed dose from 1 to 4 Gy. Fading was found to be minimal, less than 10% over five days subsequent to irradiation. The minimum detectable dose for 6-MV photons was found to be 4, 30 and 900 microGy for TLD-100 chips, Ge- and Al-doped fibres, respectively. For 6-, 9- and 12-MeV electron energies, the minimum detectable dose were in the range 3-5, 30-50 and 800-1400 microGy for TLD-100 chip, Ge-doped and Al-doped fibres, respectively.
This paper describes a preliminary study of the thermoluminescence (TL) response of doped SiO(2) optical fibres subjected to (241)AmBe neutron irradiation. The TL materials, which comprise Al- and Ge-doped silica fibres, were exposed in close contact with the (241)AmBe source to obtain fast neutron interactions through use of measurements obtained with and without a Cd filter (the filter being made to entirely enclose the fibres). The neutron irradiations were performed for exposure times of 1-, 2-, 3-, 5- and 7-days in a neutron tank filled with water. In this study, use was also made of the Monte Carlo N-particle (MCNP) code version 5 (V5) to simulate the neutron irradiations experiment. It was found that the commercially available Ge-doped and Al-doped optical fibres show a linear dose response subjected to fast neutrons from (241)AmBe source up to seven days of irradiations. The simulation performed using MCNP5 also exhibits a similar pattern, albeit differing in sensitivity. The TL response of Ge-doped fibre is markedly greater than that of the Al-doped fibre, the total absorption cross section for Ge in both the fast and thermal neutrons region being some ten times greater than that of Al.
This research was focused on the thermoluminescence (TL) response of commercially produced single-mode telecommunication optical fibre manufactured by INOCORP (Canada). The fibres were either in the form of pure silica (SiO2) or as SiO2 doped with Ge or Al at concentrations appropriate for total internal reflection, as required for telecommunication purposes. Each of these INOCORP fibres had a core diameter of 125 ± 0.1 μm. It was noted that dopant concentration was not included among the data provided in the accompanying product data sheet. A particularly important parameter for obtaining the highest TL yield in this study was the dopant concentration of the SiO2 fibre. The dopants tended to diffuse during the production of the optical fibre. To obtain this parameter, proton induced X-ray emission (PIXE) analysis was utilised. PIXE while having limited depth resolution could unambiguously identify elements and analyse trace elements with a detection limit approaching μg g–1. For Al-doped fibres, dopant concentrations in the range of 0.98 – 2.93 mol% had been estimated, the equivalent range for Ge-doped fibres was 0.53 – 0.71 mol%. A linear dose response was observed following 2.5 MeV proton irradiation for Ge- and Al-doped fibres for up to 7 min exposure.
Acute poisoning is a common medical emergency in Malaysia. Life can be saved if the patient is diagnosed properly and receives the appropriate treatment such as gastrointestinal decontamination techniques and resources to increase poison elimination according to clinical guidelines at a reasonable time. The aims of this study were to determine the availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in accident and emergency departments in Malaysia, and to compare the availability of such facilities among various types of hospitals. A comparative, descriptive cross-sectional study was conducted using a structured questionnaire. Seventy-four (58.3%) out of the targeted 127 hospitals replied and completed the questionnaire. The availabilities of most items related to stabilization resources were far better in general hospitals compared to district hospitals with specialists and district hospitals without specialists. These items were mechanical ventilators (p = 0.011), non-invasive positive pressure ventilators (0.024), pacemakers (p = 0.019), and transcutaneous cardiac pacing (p < 0.001). The availability of decontamination resources varied substantially with hospital type. Nevertheless, these differences did not reach statistical significance in any of the cases, whereas sodium sulphate, sorbitol, and polyethylene glycol were almost never available. The availabilities of most items related to elimination enhancement resources were far better in general hospitals and district hospitals with specialists compared to district hospitals without specialists. These items were haemodialysis (p = 0.046), haemoperfusion (p = 0.002), haemofiltration (p = 0.002), acid diuresis (p = 0.04), peritoneal dialysis (p < 0.001), and exchange transfusion (p < 0.001). Most Malaysian hospitals have certain important immediate interventions such as gastrointestinal decontamination techniques and resources to increase poison elimination. The availabilities of most facilities were far better in the general hospitals. Coordination between the National Poison Centre in Malaysia and hospitals should be established regarding the emergency facilities for effective management of poisoning cases in each hospital in order to direct the poisoned patients to the hospital where the appropriate management resources is available.
BACKGROUND: Knowledge is believed to be a driving factor for patients' early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation.
METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer.
RESULTS: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help.
CONCLUSION: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients' help seeking behavior other than knowledge.
The availability of antidotes may be considered essential and lifesaving in the management of certain poisonings. Surveys carried out in a number of countries have demonstrated inadequate availability of a variety of poisoning antidotes.
A study was carried out to isolate Brucella melitensis using established bacteriological and PCR techniques in Brucella seropositive goats in farms in Selangor, Negeri Sembilan, Melaka and Pulau Pinang. Brucella melitensis was isolated from 7 of 134 reactors with the highest isolation from the vaginal swabs (57.14%) followed by the spleen (28.57%), uterine fluid (14.29%). No Brucella was isolated from the lymph nodes. PCR confirmed all the seven isolates as B. melitensis and isolates were phylogenetically related to other isolates from India, Iran, and Israel but most closely related to isolates from Singapore.
A novel microgels were polymerized using styrene (St), methyl methacrylate (MMA), acrylamide (AAm), and acrylic acid (AAc) monomers in the presence of N,N'-methylenebisacrylamide (MBA) cross-linker. Pre-emulsified monomer was first prepared followed by polymerizing monomers using semi-batch emulsion polymerization. Fourier Transform Infrared Spectroscopy (FTIR) and (1)H Nuclear Magnetic Resonance (NMR) were used to determine the chemical structure and to indentify the related functional group. Grafting and cross-linking of poly(acrylamide-co-acrilic acid)-grafted-poly(styrene-co-methyl methacrylate) [poly(AAm-co-AAc)-g-poly(St-co-MMA)] microgels are approved by the disappearance of band at 1300 cm(-1), 1200 cm(-1) and 1163 cm(-1) of FTIR spectrum and the appearance of CH peaks at 5.5-5.7 ppm in (1)H NMR spectrum. Scanning Electron Microscope (SEM) images indicated that poly(St-co-MMA) particle was lobed morphology coated by cross-linked poly(AAm-co-AAc) shell. Furthermore, SEM results revealed that poly(AAm-co-AAc)-g-poly(St-co-MMA) is composite particle that consist of "raspberry"-shape like structure core. Internal structures of the microgels showed homogeneous network of pores, an extensive interconnection among pores, thicker pore walls, and open network structures. Water absorbency test indicated that the sample with particle size 0.43 μm had lower equilibrium water content, % than the sample with particle size 7.39 μm.
The thermoluminescent properties of boric glass modified with lithium and potassium carbonates (LKB) and co-doped with CuO and MgO are reported for the first time. Two techniques are applied to investigate the effect of dopants and co-dopants on the thermal stimulation properties of LKB. The induced TL glow curves of a CuO-doped sample are found to be at 220°C with a single peak. An enhancement of about three times is shown with the increment of 0.1 mol % MgO as a co-dopant impurity. This enhancement may contribute to the ability of magnesium to create extra electron traps and consequently the energy transfer to monovalent Cu(+) ions. LKB:Cu,Mg is low Z material (Zeff=8.55), and observed 15 times less sensitive than LiF: Mg, Ti (TLD-100). The proposed dosemeter showed good linearity in TL dose-response, low fading and excellent reproducibility with a simple glow curve, and thus, can be used in the radiation dosimetry.
New glasses Li2CO3-K2CO3-H3BO3 (LKB) co-doped with CuO and MgO, or with TiO2 and MgO, were synthesized by the chemical quenching technique. The thermoluminescence (TL) responses of LKB:Cu,Mg and LKB:Ti,Mg irradiated with 6 MV photons or 6 MeV electrons were compared in the dose range 0.5-4.0 Gy. The standard commercial dosimeter LiF:Mg,Ti (TLD-100) was used to calibrate the TL reader and as a reference in comparison of the TL properties of the new materials. The dependence of the responses of the new materials on (60)Co dose is linear in the range of 1-1000 Gy. The TL yields of both of the co-doped glasses and TLD-100 are greater for electron irradiation than for photon irradiation. The TL sensitivity of LKB:Ti,Mg is 1.3 times higher than the sensitivity of LKB:Cu,Mg and 12 times less than the sensitivity of TLD-100. The new TL dosimetric materials have low effective atomic numbers, good linearity of the dose responses, excellent signal reproducibility, and a simple glow curve structure. This combination of properties makes them suitable for radiation dosimetry.