Displaying publications 1 - 20 of 33 in total

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  1. Sulaiman W, Othman M, Mokhtar AM, Rosman A, Ong SG, Soo IS, et al.
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A54-A55.
    DOI: 10.1111/j.1479-8077.2006.00199_24.x
    Objective: To determine the number of RA cases and to evaluate the demographic patterns in all 4 Rheumatology Referral Centers under the Ministry of Health Malaysia. Materials and methods: One thousand and eighty-four rheumatoid arthritis patients from all 4 centers i.e. Hospital Selayang, Putra Jaya, Seremban and Taiping which are situated in the west coast of West Malaysia, using rheumatoid arthritis database comprising of basic clinical and patient questionnaire, until the end of year 2004 were analysed. Results: At the time of documentation, 88.6% were female at all range of ages especially between age of 25 and 54 years (77.6%) with female to male ratio 8 :1. 52.1% were housewives. Mean age of onset of RA was 49.6 ± 11.8 SD with female 49.3 ± 11.7 SD and male 52.0 ± 12.0 SD (p < 0.05). Indian was the predominant ethnic group (54.5%), followed by Malay (31.4%), Chinese (11.6%) and others (27%). Majority had their education up to secondary level (50.8%), followed by primary (32.6%), and tertiary (6.3%) levels while 10.3% of cases had not received any formal education in their lives. 74.4% were seropositive and 87.3% fulfilled at least 4 out of 7 American College of Rheumatology (ACR) revised criteria for rheumatoid arthritis. 74% were diagnosed RA within 2 years after the onset of arthritis. Seropositivity was not significantly related to gender. Positive rheumatoid factor was dominated by Indian followed by Malay and Chinese. 83.3% were married. 23.3% female and 33.9% male between age group 25-54 were employed. 7.4% had achieved their retirement at time of entry whilst 8.9% were unemployed. Employment status was statistically significant across gender (p < 0.001). The cases differed between rheumatology centers as well as individual practices. Conclusion: There are increasing numbers of RA cases in Malaysia. Results from this study did not reflect the true prevalence of RA in Malaysia. Hence, a larger and more comprehensive database on RA with collaboration of all Government and Private Hospitals in the whole nation will provide better information about the patient case mix in different healthcare settings, treatment practice as well as disease complications. The implementation of rheumatology centers with better regional cooperation, will lead to better treatment and outcome in terms of identification of early as well as established RA cases. Early referral to the centers will be made possible for proper treatment institution and rehabilitation. Hence, improve quality of life including socio-economic status especially among those within the productive age.
  2. Pon LW, Noor-Aini MY, Ong FB, Adeeb N, Seri SS, Shamsuddin K, et al.
    Asia Pac J Clin Nutr, 2006;15(3):388-99.
    PMID: 16837432
    The objective of the study was to assess nutritional and health status as well as nutritional knowledge in urban middle-aged Malaysian women. The impact of menopause on diet and health indices was also studied. The study included 360 disease free women, non users of HRT,aged > or =45 years with an intact uterus recruited from November 1999 to October 2001. Personal characteristics, anthropometric measurements and blood sample were acquired followed by clinical examination. Nutrient intake and nutritional knowledge was determined by a quantitative FFQ and KAP. The findings showed that urban middle-aged women, aged 51.65+/-5.40 years had energy intakes (EI) 11% below RDA, consisting of 53% carbohydrates, 15% protein and a 32% fat which declined with age. The sample which comprised of 42.5% postmenopausal women had a satisfactory diet and healthy lifestyle practices. Premenopausal women consumed more dietary fat (6%) with other aspects of diet comparable to the postmenopausal women. Iron intake was deficient in premenopausal women, amounting to 56% RDA contributing to a 26% prevalence of anaemia. Overall, calcium intake reached 440 mg daily but dairy products were not the main source. The postmenopaused had a more artherogenic lipid profile with significantly higher total cholesterol (TC) and LDL-C, but more premenopausal women were overweight/obese (49% versus 35%). EI was the strongest predictor for BMI and waist circumference (WC), with WC itself an independent predictor of fasting blood sugar and TC with BMI strongly affecting glucose tolerance. High nutritional knowledge was seen in 39% whereas 20% had poor knowledge. Newspapers and magazines, followed by the subject's social circle, were the main sources of nutritional information. Nutritional knowledge was positively associated with education, household income, vitamin/ mineral supplementation and regular physical activity but inversely related to TC. In conclusion, middle-aged urban women had an adequate diet with low iron and calcium intakes. Nutritional knowledge was positively associated to healthier lifestyle practices and lower TC. A comparable nutrient intake and lifestyle between pre and postmenopausal women suggested that health changes associated with menopause was largely independent of diet.
  3. Hakim, B., Saw, Ohnmar, Malhi, F.S., Syed Rahim, S.H., Noraziana, A.W., Suhaiza, A., et al.
    MyJurnal
    Urinary retention rarely affects women. In obstructive retention the source must be determined and treated to allow the patient to void normally. A common anatomic cause of urinary retention is extrinsic compression due to a pelvic mass. In addition, obstruction can also be seen in women with pelvic organ prolapse. Haematocolpos and uterine fibroids have also been documented as causes of acute urinary retention.

    The following cases of female urinary retention highlight the need to consider haematocolpos in the adolescent girl who has not attained menarche and fibroids in the older female.
  4. Ranjbari A, Azarbayjani MA, Yusof A, Halim Mokhtar A, Akbarzadeh S, Ibrahim MY, et al.
    BMC Complement Altern Med, 2016 Mar 15;16:101.
    PMID: 26980377 DOI: 10.1186/s12906-016-1064-6
    BACKGROUND: Urtica dioica (UD) has been identified as a traditional herbal medicine. This study aimed to investigate the effect of UD extract and swimming activity on diabetic parameters through in vivo and in vitro experiments.

    METHODS: Adult WKY male rats were randomly distributed in nine groups: intact control, diabetic control, diabetic + 625 mg/kg, 1.25 g/kg UD, diabetic + 100 mg/kg Metformin, diabetic + swimming, diabetic + swimming 625 mg/kg, 1.25 g/kg UD, and diabetic +100 mg/kg Metformin + swimming. The hearts of the animals were punctured, and blood samples were collected for biochemical analysis. The entire pancreas was exposed for histologic examination. The effect of UD on insulin secretion by RIN-5F cells in 6.25 or 12.5 mM glucose dose was examined. Glucose uptake by cultured L6 myotubes was determined.

    RESULTS: The serum glucose concentration decreased, the insulin resistance and insulin sensitivity significantly increased in treated groups. These changes were more pronounced in the group that received UD extract and swimming training. Regeneration and less beta cell damage of Langerhans islets were observed in the treated groups. UD treatment increased insulin secretion in the RIN-5F cells and glucose uptake in the L6 myotubes cells.

    CONCLUSIONS: Swimming exercises accompanied by consuming UD aqueous extracts effectively improved diabetic parameters, repaired pancreatic tissues in streptozotocin-induced diabetics in vivo, and increased glucose uptake or insulin in UD-treated cells in vitro.

  5. Alhajj MN, Al-Maweri SA, Folayan MO, Halboub E, Khader Y, Omar R, et al.
    BMC Oral Health, 2022 Jan 26;22(1):18.
    PMID: 35081945 DOI: 10.1186/s12903-022-02053-0
    OBJECTIVES: E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students.

    METHODS: This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P 
  6. Yaacob R, Zainal Mokhtar A, Abang Jamari DZH, Jaafar N
    BMJ Case Rep, 2017 Sep 23;2017.
    PMID: 28942402 DOI: 10.1136/bcr-2017-220801
    Fetus-in-fetu (FIF) is a rare entity in which malformed parasitic twin grows inside the body of its twin. It is most commonly presented with mass in the abdomen. We present a case of a 15-year-old boy who presented with abdominal mass since infancy. Radiological investigations are suggestive of FIF. Intraoperatively, malformed fetus in a sac was found and excised. Postoperatively the patient recovers well and was put on follow-up.
  7. Zakaria ZA, Mohamad AS, Ahmad MS, Mokhtar AF, Israf DA, Lajis NH, et al.
    Biol Res Nurs, 2011 Oct;13(4):425-32.
    PMID: 21112917 DOI: 10.1177/1099800410386590
    Nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely used for the treatment of inflammation. However, despite their effectiveness, most NSAIDs cause various side effects that negatively affect the management of inflammation and, in part, pain. Thus, there is a need to search for new anti-inflammatory agents with few, or no, side effects. Natural products of plant, animal, or microorganism origin have been good sources of new bioactive compounds. The present study was carried out to evaluate the acute and chronic anti-inflammatory activities of the essential oil of the rhizomes of Zingiber zerumbet (Zingiberaceae) using the carrageenan-induced paw edema and cotton pellet-induced granuloma tests, respectively. The effect of the essential oil on inflammatory- and noninflammatory-mediated pain was also assessed using the formalin test. Essential oil of Z. zerumbet, at doses of 30, 100, and 300 mg/kg, was administered intraperitoneally to rats. The substance exhibited significant anti-inflammatory activity both in acute and chronic animal models. The essential oil also inhibited inflammatory- and noninflammatory-mediated pain when assessed using the formalin test. In conclusion, the essential oil of Z. zerumbet possessed anti-inflammatory activity, in addition to its antinociceptive activity, which may explain its traditional uses to treat inflammatory-related ailments.
  8. Daneshjoo A, Mokhtar A, Rahnama N, Yusof A
    Biol Sport, 2013 Dec;30(4):281-8.
    PMID: 24795499 DOI: 10.5604/20831862.1077554
    The study investigates the effects of the 11+ and HarmoKnee injury prevention programmes on knee strength in male soccer players. Under-21-year-old players (n=36) were divided equally into: the 11+, HarmoKnee and control groups. The programmes were performed for 24 sessions (20-25 min each). The hamstrings and quadriceps strength were measured bilaterally at 60°·s(-1), 180°·s(-1) and 300°·s(-1). The concentric quadriceps peak torque (PT) of the 11+ increased by 27.7% at 300°·s(-1) in the dominant leg (p<0.05). The concentric quadriceps PT of HarmoKnee increased by 36.6%, 36.2% and 28% in the dominant leg, and by 31.3%, 31.7% and 20.05% at 60°·s(-1), 180°·s(-1) and 300°·s(-1) in the non-dominant leg respectively. In the 11+ group the concentric hamstring PT increased by 22%, 21.4% and 22.1% at 60°·s(-1), 180°·s(-1) and 300°·s(-1), respectively in the dominant leg, and by 22.3%, and 15.7% at 60°·s(-1) and 180°·s(-1), in the non-dominant leg. In the HarmoKnee group the hamstrings in the dominant leg showed an increase in PT by 32.5%, 31.3% and 14.3% at 60°·s(-1), 180°·s(-1) and 300°·s(-1), and in the non-dominant leg hamstrings PT increased by 21.1% and 19.3% at 60°·s(-1) and 180°·s(-1) respectively. The concentric hamstrings strength was significantly different between the 11+ and control groups in the dominant (p=0.01) and non-dominant legs (p=0.02). The HarmoKnee programme enhanced the concentric strength of quadriceps. The 11+ and HarmoKnee programmes are useful warm-up protocols for improving concentric hamstring strength in young professional male soccer players. The 11+ programme is more advantageous for its greater concentric hamstring strength improvement compared to the HarmoKnee programme.
  9. Kamisah, S., Mokhtar, A., Hafsah, A.
    MyJurnal
    Halal food industry has grown substantively worldwide in the last few years. It has become increasingly crucial to Muslim consumers due to its safety, hygiene and quality assurance. In Islam, Muslim consumers follow the Shariah and the food they consume should be halalan-thoyyiban, i.e. lawful or permissible, authentic, wholesome, and safe. In Malaysia, halal food manufacturers should comply with MS1500:2009 in order to obtain halal certification (halal logo). However, there is an increasing number of halal logo misuse cases and halal food’s questionable status. In addition, any improper description and inappropriate preparation of halal food has significant impacts unto the demand for halal food and buyers’ trust in consuming halal food. Hence, trust is an essential element in food production and it must be upheld along the halal food supply chain by all the parties involved. Given the significant role of trust in halal food production among Muslim consumers, this study aimed at examining the influence of halal practices integrity on halal supply chain trust and supply chain performance. Using a quantitative approach, survey questionnaires were distributed to 212 Malaysian halal food and beverages companies during halal food exhibitions and festivals. Structural Equation Modeling with Partial Least Square was used to analyze the collected data. The findings showed that halal practices integrity is significantly related to halal supply chain trust and supply chain performance. The results revealed that halal supply chain trust is significantly important in enhancing halal practices integrity and supply chain performance. The Malaysian government and various agencies in the halal industry should seriously take part in the development and promotion of halal food products to maintain consumer trust. The findings of this study would give some insights into the halal food supply chain integrity.
  10. Aklilu, E., Nurhardy, A.D., Mokhtar, A., Zahirul, I.K., Siti Rokiah, A.
    MyJurnal
    Multi-drug resistant staphylococci including methicillin-resistant Staphylococcus aureus
    (MRSA) and Methicillin-resistant Staphylococcus epidermidis (MRSE) are among the emerging
    pathogens and have become a threat to both human and animals. Foods of animal origin can
    easily be contaminated by these bacteria if handled unhygienically or exposed to contaminated
    environmental surfaces. The objective of this study was to investigate the occurrence of MRSA
    and MRSE in raw chicken meat sold at wet markets in Kota Bharu, Kelantan, Malaysia. One
    hundred fresh raw chicken meat samples were collected from three different wet markets in
    Kota Bharu, Kelantan. Routine isolation and identification, selective media (Brilliance MRSA2
    agar), antimicrobial sensitivity test (AST), minimum inhibitory concentration test (MIC), and
    polymerase chain reaction (PCR) amplification of nucA gene and the resistant gene, mecA
    were conducted. Based on bacteriology results and growth on selective media, MRSA and
    MRSE were detected in 43% (43/100) of the raw chicken meat samples. Using the PCR assay,
    77% (34/43) isolates were positive for nucA gene. The detection of these emerging multidrug
    resistant bacteria in chicken meat intended for human consumption implies the potential
    contamination of food items by the bacteria which in turn may pose risk to the public health.
  11. Noraziana, A.W., Hakim, B., Mokhtar, A., Alik, R.
    MyJurnal
    Paragangliomas are uncommon tumors arising from the neuroendocrine elements (chief cells) of the paraganglia and symmetrically distributed along the aorta in close association with the sympathetic chain. Although functional tumors are easier to diagnose due to the clinical fi ndings caused by excess secretion of catecholamines and an elevation of the urinary catecholamine levels, however the diagnosis of nonfunctioning paraganglioma of the retroperitoneum is diffi cult and only few cases have been made before exploratory laparotomy. Although our patient was initially planned and operated by our gynaecological team, the incidental findings had to involve the general surgeons. She is fortunate that the tumour did not show any features of malignancy nor metastasis, however a long time follow up is needed in case of any possible recurrence.
  12. Dalia, F.A., Hamizah, I., Zalina, N., Yong, S.L., Mokhtar, A.
    MyJurnal
    Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and
    maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25
    women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on
    patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were
    found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound
    and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9
    years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and
    mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%)
    women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight
    (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or
    aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal
    delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to
    emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus.
    Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained
    placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital
    stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various
    maternal morbidities, in this case series , which could have been prevented if they were diagnosed and
    terminated at early trimester. A new direction is needed in our local practice.
  13. Murad, A.Z., Mokhtar, A., Sudesan, R., Lee, S.F., Ghazali, I.
    MyJurnal
    Subdermal etonogestrel implant (Implanon®) is the newest, long term contraceptive implant which has recently been made available to Malaysian women. This prospective study was conducted to determine the effects on selected health indices among 42 women who had consented to Implanon® as their choice of contraception. Health indices were checked prior to Implanon® insertion and six months post insertion. Findings indicate a significant reduction in total cholesterol with a significant increase in total haemoglobin and BMI. However there was no significant change noted in the fasting blood sugar, glycosylated haemoglobin, systolic blood pressure and diastolic blood pressure.
  14. Suhaiza, A., Che Anuar, C.Y., Nik Zuky, N.L., Mokhtar, A.
    MyJurnal
    Monoamniotic twin pregnancy is a rare type of twin pregnancy which poses risk of cord entanglement and
    sudden death of either one or both fetuses. The role of antenatal surveillance by Ultrasound Doppler for
    umbilical cord and ultrasonic evidence of cord entanglement or knotting may predict the pregnancy outcome
    but yet unavoidable. The discussion will include antenatal surveillance in this rare type of pregnancy.
  15. Noraziana, A.W., Mokhtar, A., Norra, H.
    MyJurnal
    Leiomyomas are the most common benign tumour of the uterus, occurring in 20-40% of women in reproductive age.Most of the myomas arise in the uterus, however extrauterine sites include fallopian tubes, cervix, round ligament, ovary and urethra. A single or polypoidal mass in the vagina is usually a leiomyomatous polyp arising from the cervix or from the cavity of the uterus. Leiomyoma developing de novo from the fibromuscular elements of the vagina is a rare entity. When such a tumour arises from anterior wall of the vagina it is often mistaken for a cervical fibroid. Parasitic leiomyoma is the rarest type of leiomyoma and develop when a leiomyoma attaches itself to another organ. Vaginal leiomyomas usually arise from anterior vaginal wall. We report a case of parasitic leiomyoma in the vagina together with uterine leiomyoma in a 48 year old lady presented with palpable mass perabdomen and anaemic symptoms. The size and location of the tumours necessitated abdominal and vaginal approach for better surgical access.
  16. Muna KA, Mokhtar A, Saad MA, Ahmed AA, Akbar JB
    MyJurnal
    Introduction: Leptin is an adipokine that has strong correlation with the body mass index (BMI). Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. Leptin may lose its correlation with the body mass index (BMI) during diabetes due to hormonal rearrangement. Diet control is the first line management in GDM. Leptin reported to increase in pregnancy and further increases in diabetic patients during GDM screening. There is paucity in the reports concerning Leptin levels in GDM patients on diet control. The present study was aimed to evaluate the changes in maternal leptin in pregnancy complicated by GDM on diet control compared to the normal pregnancy in the 3rd trimesters by comparing the means and to find the correlation of Leptin with the body mass index in both groups.
    Methods: The study included 2 groups: normal pregnancy (n = 40) and pregnancy with GDM under diet control (n = 60) both groups are at 38-40 weeks of gestation. Leptin concentration in serum was measured in both groups and statistically tested using student t test. The BMI were measured and correlated with the Leptin level in test groups.
    Results: the results indicated that Leptin will nearly triple in the third trimester (38±30 ng/ml) of pregnancy compared to the standard normal non-pregnant. Leptin level was significantly lower in diabetic women on diet control (28±16 ng/ ml) when compared with the non-diabetics (38±30 ng/ml). The hormone has no correlation with the age of the patients but have a positive correlation with the body mass index before and during pregnancy in both groups.
    Conclusion: Leptin is increasing in pregnancy as part of the physiological changes. Dieting can decrease Leptin level in diabetics’ pregnant women. Diet can restore the hormonal dysregulation of Leptin. Assessment of Leptin level might be used as an indicator for good diet control during pregnancy.
    Study site: Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
  17. Zalina, N., Ruqaiyah, B. R., Hamizah, I., Roszaman, R., Mokhtar, A., Rozihan, I., et al.
    MyJurnal
    Objective: Lower Urinary Tract Symptoms (LUTS) is a highly prevalent disease which varies by geography
    and culture. It influences the quality of life and has social implication. The objectives of this study are to
    estimate the prevalence of LUTS among women attending our gynaecology clinic, the associated risk factors
    and their quality of life. Method: This is a cross sectional study on women attending gynaecology clinic in a
    tertiary centre. Participants were given 3 sets of validated self-answered questionnaire, UDI-6, IIQ-7 and
    OAB V8. Results: the prevalence of luts is 50.6% which is common among Malay women. Forty nine percent
    is due to stress urinary incontinence (SUI). The risk of LUTS is significantly associated with obesity (AOR =
    12.14 95% CI = 1.21 to 121.99, p – value = 0.034), higher parity (AOR = 1.68 95% CI = 1.26 to 2.24, p – value =
  18. Aboodarda SJ, Yusof A, Abu Osman NA, Thompson MW, Mokhtar AH
    Int J Sports Physiol Perform, 2013 Mar;8(2):181-7.
    PMID: 23428490
    To identify the effect of additional elastic force on the kinetic and kinematic characteristics, as well as the magnitude of leg stiffness, during the performance of accentuated countermovement jumps (CMJs).
  19. Khor CG, Tan BE, Kan SL, Tsang EE, Lim AL, Chong EY, et al.
    J Clin Rheumatol, 2016 Jun;22(4):194-7.
    PMID: 27219306 DOI: 10.1097/RHU.0000000000000362
    OBJECTIVE: There is paucity of data for Takayasu arteritis (TAK) among South Asians. We aimed to evaluate the clinical features, angiographic findings, as well as treatment and outcome of TAK among Malaysian multiethnic groups.

    METHODS: This is a retrospective review of 40 patients with TAK seen in major rheumatology centres in Malaysia between April 2006 and September 2013.

    RESULTS: Majority were female patients (92.5%), with a female-to-male ratio of 12:1. Median duration of disease from diagnosis was 66 months (interquartile range, 33-177 months). Fifteen (37.5%) were Malays, 9 (22.5%) each were Indians and indigenous from East Malaysia and 7 (17.5%) were Chinese. Indian and indigenous from East Malaysia were overrepresented in this disease. The mean (SD) age of symptom onset and diagnosis were 25.5 (8.1) and 27.4 (8.4), respectively. The 3 most common clinical presentations at diagnosis were diminished or absent pulse, which occurred in 80% of the patients, followed by blood pressure discrepancy (60%) and arterial bruit (52.5%). There was no difference in clinical presentation among ethnic groups. The subclavian artery was the commonest vessel involved (72.5%), followed by the carotid artery (65%) and renal artery (47.5%). Eight patients had coronary artery involvement, and 2 patients had pulmonary artery involvement. Type I arterial involvement was the commonest (80.0%), followed by type IV (35%), present in isolation or mixed type. Glucocorticoid was the main medical treatment (90.0%). Nineteen patients (47.5%) underwent revascularization procedures. Five patients died during the follow-up period.

    CONCLUSIONS: The Malaysian TAK cohort had similarities with and differences from other published TAK cohort. A nationwide TAK registry is needed to determine the prevalence of the disease among different ethnic groups.
  20. Siti Sarah M, Nor Aini U, Nurismah MI, Hafiza A, Khalidah M, Mokhtar AB, et al.
    Clin Ter, 2014;165(1):35-9.
    PMID: 24589949 DOI: 10.7471/CT.2014.1659
    Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0%), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.
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