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  1. Diffusion-in-gel enzyme-linked immunosorbent assay, ELISA and IFA test in the detection of malarial antibodies
    Kumar GS, Mak JW, Lam PL, Tan MA, Lim PK
    Southeast Asian J. Trop. Med. Public Health, 1987 Dec;18(4):502-6.
    PMID: 3129797
    Malarial antibodies in 80 patients were measured using the diffusion-in-gel enzyme linked immunosorbent assay (DIG-ELISA), enzyme-linked immunosorbent assay (ELISA) and the indirect fluorescent antibody (IFA) test. Good correlations were obtained between all three tests in terms of sensitivity and reliability. DIG-ELISA has the advantage of being a rapid diagnostic tool for the detection of malarial antibodies.
    Matched MeSH terms: Predictive Value of Tests
  2. Fulltext A validity study of the Middlesex Hospital Questionnaire in Malaysian population
    Kasmini K, Kyaw O
    Singapore Med J, 1988 Feb;29(1):48-52.
    PMID: 3406767
    The Middlesex Hospital Questionnaire (MHQ) with its subscales on anxiety, phobia, somatic symptoms, depression and hysteria was devised by Crown and Crisp(1). it has been used to differentiate between neurotic and normal population. The MHQ has been translated into the Malay language and this paper shows the results of an attempt to validate this translated questionnaire in the Malaysian population. The translated questionnaire is found to have useful validity as a whole and also for subscales on anxiety, somatic symptoms and depression.
    Matched MeSH terms: Predictive Value of Tests
  3. The ELISA-U: an enzyme-linked immunosorbent assay using urease as the enzyme marker for rapid detection of Plasmodium falciparum antibody in human serum
    Lee M, Lambros C
    Am J Trop Med Hyg, 1988 Nov;39(5):421-6.
    PMID: 3057927
    A visual, enzyme-linked immunosorbent assay using urease (ELISA-U) as the enzyme marker was adapted for rapid detection of antibody against Plasmodium falciparum. Flat-bottom, 96-well microtiter plates were coated with P. falciparum soluble antigen obtained by saponin and NP-40 treatment of parasite cultures. Antibody was detected by successive incubations with test sera, urease-conjugated rabbit-human antibody, and urease substrate. Reactive sera developed a definite and easily visualized purple color. Sera from patients with single infections of P. vivax or P. ovale were unreactive. No cross-reactivity was noted with sera from patients with rheumatoid arthritis, filariasis, amebiasis, schistosomiasis, dengue, scrub typhus, leptospirosis, or toxoplasmosis. The procedure can be performed at room temperature and completed within 1 hr. The sensitivity of the assay is comparable to that of the indirect fluorescent antibody test at all but the lowest dilutions tested.
    Matched MeSH terms: Predictive Value of Tests
  4. Gynaecological cancer screening
    Sivanesaratnam V
    Ann Acad Med Singap, 1989 Jan;18(1):75-9.
    PMID: 2712524
    One hundred years ago cervical cancer was rapidly fatal, regardless of therapy rendered. Today with cytological screening, early diagnosis is possible and ablative therapy can be instituted in appropriate cases. The advent of coloscopy has helped reduce unnecessary cone biopsy for diagnosis. However, the same cannot be said of the use of cytology for screening endometrial cancer, and often endometrial tissue biopsy is necessary. Ovarian cancer is notoriously silent in its early stages and symptoms if present are generally non-specific. To date there is no other useful and reliable method for its early detection than routine pelvic examination. An annual cytological screening test for cervical cancer will give an opportunity for examination of the breasts, abdomen and pelvis. Screening techniques for female genital tract malignancies are discussed.
    Matched MeSH terms: Predictive Value of Tests
  5. Malaysian schistosomiasis: description of a population at risk
    Greer GJ, Dennis DT, Lai PF, Anuar H
    J Trop Med Hyg, 1989 Jun;92(3):203-8.
    PMID: 2738992
    A stable population at risk of Malaysian schistosomiasis was studied. Census results indicated that approximately one-fourth of the inhabitants used a stream where Schistosoma malayensis-infected snails were present as their principal source of water for bathing, drinking, and household tasks. The general population also contacted this stream when fording it or while fishing. Serological surveys using enzyme-linked immunosorbent assay (ELISA) and the circumoval precipitin (COP) test revealed six (9%) and three (4%) positives, respectively, among 67 persons examined. No schistosome ova were found in a general survey of 56 persons which included five ELISA positive and two COP test positive patients. ELISA and COP test prevalences among those dependent on the foci of transmission for water, 13 and 7% respectively, were only slightly higher than prevalences among the remainder of the population, 8 and 4% respectively. These results indicate that even among a stable population at risk of Malaysian schistosomiasis the prevalence is low. Our findings support the hypothesis that S. malayensis is a zoonotic infection in man and that it is unlikely to become a significant public health problem.
    Matched MeSH terms: Predictive Value of Tests
  6. A rapid sporozoite ELISA using 3,3',5,5'-tetramethylbenzidine as the substrate chromogen
    Lee M, Harrison BA, Lewis GE
    Am J Trop Med Hyg, 1990 Apr;42(4):314-9.
    PMID: 2184690 DOI: 10.4269/ajtmh.1990.42.314
    A modified version of the standard 2-site sporozoite enzyme-linked immunosorbent assay (ELISA) using 3,3',5,5'-tetramethylbenzidine (TMB) as the substrate chromogen solution was adapted for rapid detection and identification of Plasmodium falciparum and P. vivax circumsporozoite (CS) proteins. The TMB-ELISA was evaluated using sporozoites from experimentally infected mosquitoes and laboratory colonized uninfected mosquitoes. Our data indicate comparable sensitivity levels between the TMB-ELISA and the standard ELISA, i.e., 50 P. falciparum or P. vivax sporozoites/50 microliters of test solution. Reactions inherent to the method were specific and background reactivity was minimal. The TMB-ELISA is rapid (1 hr), simple, uses a minimal amount of monoclonal antibodies, and is suitable for use in a wide range of laboratories.
    Matched MeSH terms: Predictive Value of Tests
  7. Multi-laboratory evaluation of a scrub typhus diagnostic kit
    Kelly DJ, Wong PW, Gan E, Chye CT, Cowan D, Lewis GE
    Am J Trop Med Hyg, 1990 Sep;43(3):301-7.
    PMID: 2121057
    Scrub typhus is a major cause of febrile illness throughout the Asia-Pacific region. It is commonly undiagnosed, partly because of the lack of a simple, reliable diagnostic test which can be used in clinical laboratories. The indirect immunoperoxidase technique, configured into a test kit, was provided to technicians who were trained in its use. They used the kit during a 2 year field trial in their respective clinical hospital laboratories throughout Malaysia. In an evaluation using 1,722 consecutive sera tested in those laboratories, the kit was found to have a median sensitivity for IgG detection of 0.85 (range 0.33-0.95), a median specificity of 0.94 (range 0.88-1.00), reproducibility of 0.86, and efficiency of 0.92 when compared to the reference laboratory. In a proficiency survey in which 10 laboratories received 3 coded test samples, all but 2 laboratories had results within 1 dilution of the reference laboratory in quantitating specific IgG, whereas 7 laboratories were within 1 dilution in quantitating IgM. The shelf life of the kit was at least 1 year at 4 degrees C.
    Matched MeSH terms: Predictive Value of Tests
  8. Fulltext Noninvasive cardiac risk evaluation before elective abdominal aortic aneurysm surgery--clinical value of the Goldman index and echocardiography
    Quek DK, Pung LY
    Med J Malaysia, 1990 Sep;45(3):208-19.
    PMID: 2152082
    Cardiac complications comprise as much as 50% of perioperative vascular surgical morbidity and mortality. Using the Goldman multifactorial index for evaluating cardiac risk pre-operatively, 53 consecutive patients who underwent abdominal aortic aneurysm surgery were prospectively studied. Forty patients (75.5%) were also evaluated with echocardiography for assessment of left ventricular function. There were 14 (23.7%) peri-operative events, of which nine (17.0%) were acute myocardial infarctions--two of whom died (3.8%). The minor complications included three with hypovolaemic renal failure, and one each with acute respiratory failure and cerebrovascular accident. Patients with Goldman cardiac risk index (CRI) classes III and IV were associated with significantly higher risks of peri-operative complications (p less than 0.001), i.e. 77.8% and 66.7% respectively, compared with class II (22.7%) and class I (nil). Echocardiographic left ventricular shortening fraction (LVFS) of less than 28% helped identify high risk groups in all classes, although its positive predictive value was low (42.3%). Combining LVFS less than 28% with Goldman CRI categories II to IV improved the sensitivity to 91.7% and the positive predictive value to 61.1%. Careful pre-operative assessment using the simple Goldman index and echocardiography is helpful in identifying higher risk patients who would benefit from pre-operative stabilisation and more rigorous perioperative hemodynamic monitoring preferably including intensive care (ICU) management, so as to reduce cardiac complications.
    Matched MeSH terms: Predictive Value of Tests
  9. Fulltext Psychiatric morbidity in schizophrenic relatives--use of Self-Reporting Questionnaires (SRQ)
    Salleh MR
    Singapore Med J, 1990 Oct;31(5):457-62.
    PMID: 2259943
    A validated study of the Self-Reporting Questionnaire (SRQ-20) of the World Health Organization against ICD-9 was found to have good validation indices at the cut-off point of 5/6. The sensitivity was 84.8% and specificity 83.7%. However, SRQ-24 had poor validation indices and are too sensitive to detect psychotic illness. Twenty-three per cent of 264 schizophrenic relatives who had been staying together with them and or actively involved in their care for at least one year had neurotic disorders compared with 1% who had latent schizophrenia. The prevalence of psychiatric morbidity was higher in the first-degree relatives compared with non-first degree relatives.
    Matched MeSH terms: Predictive Value of Tests
  10. Development and evaluation of dot-immunobinding assay for detection of scrub typhus infection in Leptotrombidium fletcheri (Acari: Trombiculidae)
    Ho TM, Shara S, Koay AS, Cheong YM
    J Med Entomol, 1992 Jul;29(4):611-3.
    PMID: 1495069
    A dot-immunobinding assay (DIBA) was compared with a direct fluorescent antibody technique (DFAT) for the detection of Rickettsia tsutsugamushi infection in Leptotrombidium fletcheri (Womersley & Heaslip). Laboratory colonies of infected and noninfected chiggers were examined. The relative proportions of positive, negative, and indeterminate results were significantly different between DIBA and DFAT for infected but not for noninfected chiggers. DIBA was more sensitive and had a better negative predictive value and a lower false negative percentage than DFAT. It was concluded that DIBA is a suitable alternative to DFAT for detecting scrub typhus infection in chiggers.
    Matched MeSH terms: Predictive Value of Tests
  11. Outcome prediction in early management of severe head injury: an experience in Malaysia
    Selladurai BM, Jayakumar R, Tan YY, Low HC
    Br J Neurosurg, 1992;6(6):549-57.
    PMID: 1472321
    The outcome of 109 patients with severe head injury was studied in relation to clinical and computed tomographic (CT) criteria on admission, after resuscitation. Age, Glasgow Coma Score (GCS) and state of pupils strongly correlated with outcome. The presence of hypothalamic disturbances, hypoxia and hypotension were associated with an adverse outcome. The CT indicators associated with poor outcome were perimesencephalic cistern (PMC) obliteration, subarachnoid haemorrhage, diffuse axonal injury and acute subdural haematoma. The prognostic value of midline shift and mass effect were influenced by concomitant presence of diffuse brain injury. For the subset of patients aged < 20 years, with GCS 6-8 and patent PMC (n = 21), 71.4% correct predictions were made for a good outcome. For the subset of patients aged > 20 years, with GCS 3-5 and partial or complete obliteration of PMC (n = 28), 89.3% correct predictions were made for a poor outcome.
    Matched MeSH terms: Predictive Value of Tests
  12. Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas
    Choo KE, Razif AR, Oppenheimer SJ, Ariffin WA, Lau J, Abraham T
    J Paediatr Child Health, 1993 Feb;29(1):36-9.
    PMID: 8461177
    Data are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP-CP) for Salmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP-CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positive S. typhi culture in a febrile child (culture positive vs the rest) showed the best model to be an O- and/or H-titre of > or = 1 in 40 (sensitivity 89%; specificity 89%). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of O and H (> 1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP-CN patients really were typhoid but were missed by culture. The TYP-CN patients showed a very similar clinical and age profile to TYP-CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific 'fever screen' for typhoid although it will not identify all cases. In children, lower cut-off points for O- and H-titres should be used than are generally recommended.
    Matched MeSH terms: Predictive Value of Tests
  13. Detection of antibodies against Salmonella typhi outer membrane protein (OMP) preparation in typhoid fever patients
    Verdugo-Rodriguez A, Gam LH, Devi S, Koh CL, Puthucheary SD, Calva E, et al.
    Asian Pac J Allergy Immunol, 1993 Jun;11(1):45-52.
    PMID: 8216558
    An indirect ELISA was used to detect antibodies against outer membrane protein preparations (OMPs) from Salmonella typhi. Sera from patients with a definitive diagnosis of typhoid fever (TF) gave a mean absorbance reading, at 414 nm, of 1.52 +/- 0.23 as compared to 0.30 +/- 0.11 for sera from healthy individuals. This gave a positive to negative ratio of absorbance readings of approximately 5.1. Suspected TF patients (no isolation of S. typhi), with positive and negative Widal titers had mean absorbance readings of 1.282 +/00.46 and 0.25 +/- 0.19, respectively. Sera from patients with leptospirosis, rickettsial typhus, dengue fever, and other infections gave mean absorbances of 0.20 +/- 0.08, 0.24 +/- 0.08, 0.27 +/- 0.08, and 0.31 +/- 0.16, respectively. The sensitivity, specificity, positive and negative predictive values were 100%, 94%, 80% and 100%, respectively. The antibody response detected in the definitive TF cases was predominantly IgG in nature and no cross-reactivity was seen with OMP preparations extracted from E. coli. Variable reactivity was noted with OMP preparations obtained from other Salmonella spp. Three major OMPs are presented in the antigen preparation and strong binding of positive sera was detected to all three bands.
    Matched MeSH terms: Predictive Value of Tests
  14. Fine needle aspiration cytology of the breast: an analysis of 1,094 aspirates
    Sharifah NA, Hayati AR, Meah F, al-Rashid Z
    Malays J Pathol, 1993 Jun;15(1):53-8.
    PMID: 8277791
    Our experience with 1,094 consecutive fine needle aspirations (FNAs) of the breast in 918 cases is presented. Correlation between the FNA cytology and subsequent histology of the lesions was available in 211 cases. FNA had a sensitivity rate of 87.3%, a specificity rate of 99.3% and a positive predictive value of 98.2%. A false negative diagnosis rate of 5.1% occurred. The overall diagnostic accuracy rate was 95.7%.
    Matched MeSH terms: Predictive Value of Tests
  15. Fulltext Development of ELISA for diagnosis of allergy to Dermatophagoides farinae
    Ho TM, Radha K, Shahnaz M, Singaram SP
    Med J Malaysia, 1993 Sep;48(3):308-12.
    PMID: 8183144
    An indirect enzyme linked immunosorbent assay (ELISA) was developed for the diagnosis of allergy to a house dust mite, Dermatophagoides farinae. The efficacy of the ELISA was then evaluated against a prick test using a commercial allergen. Eighty five suspected allergic rhinitis patients from the Otorhinolaryngology Department, Kuala Lumpur General Hospital, were tested with the ELISA and prick test. Prick test and ELISA results were positive in 84.7% and 80.0% of the patients respectively. The ELISA was found to have 87.5% sensitivity, 61.5% specificity, 92.6% positive predictive value, 47.1% negative predictive value, 7.4% false positive and 52.9% false negative. There was total agreement between the prick test and ELISA for prick test grades of 3+ and 4+. It is concluded that the ELISA is a useful assay for detection of individuals who are highly sensitive to D. farinae.
    Matched MeSH terms: Predictive Value of Tests
  16. Fulltext The rapid urease test in the diagnosis of Helicobacter pylori infection
    Goh KL, Parasakthi N, Peh SC, Puthucheary SD, Wong NW
    Singapore Med J, 1994 Apr;35(2):161-2.
    PMID: 7939811
    With the increasing recognition of the importance of H. pylori in gastrointestinal disease, there is a need for a reliable, efficient and yet inexpensive diagnostic test. The performance of the rapid urease test (RUT) as an endoscopy suite diagnostic test was compared to the established methods of culture, histology and Gram stain of tissue smear, in 274 gastric biopsy samples. Histology had the highest sensitivity of 99.3% followed by the RUT (96.6%). Culture and Gram stain of tissue smear had 100% specificity, while the rapid urease test had 99.2% specificity. The RUT had a positive predictive value of 99.3% and a negative predictive value of 96.2%. The RUT is an inexpensive, rapid and reliable diagnostic test of H. pylori infection.
    Matched MeSH terms: Predictive Value of Tests
  17. Squamous cell carcinoma antigen as an adjunct tumour marker in primary carcinoma of the lung
    Cheah PL, Liam CK, Yap SF, Looi LM
    J Clin Pathol, 1994 Jun;47(6):535-7.
    PMID: 8063936
    AIMS: To determine (1) the detection rate of primary carcinoma of the lung by serological assay of CEA (carcinoembryonic antigen); and (2) whether addition of seroassay of squamous cell carcinoma related antigen before treatment improves detection sensitivity.

    METHODS: A prospective study spanning 27 months was conducted at the University Hospital, Kuala Lumpur. Serum CEA (Abbott IMx) and serum squamous cell carcinoma antigen (Abbott IMx) from patients clinically suspected of having primary carcinoma of the lung, were assayed using the microparticle enzyme immunoassay method.

    RESULTS: Thirty seven cases of histologically confirmed primary lung carcinoma were studied. Of these, 17 were squamous cell carcinomas, 10 adenocarcinomas, nine small cell carcinomas, and one large cell carcinoma. The patients' ages ranged from 34-82 years. The male:female ratio was 3.6:1. Squamous cell carcinoma antigen was raised above the cutoff value of 1.5 ng/ml in 94.1% of squamous cell carcinomas, 20.0% of adenocarcinomas, and 11.1% of small cell carcinomas. By comparison, CEA was raised above the cutoff value of 3.0 ng/ml in 70.6% of squamous cell carcinomas, 77.8% of small cell carcinomas, and 100% of adenocarcinomas. CEA and squamous cell carcinoma antigen were not raised in the patient with large cell carcinoma and in 14 healthy volunteers. None of 15 patients with a variety of benign lung diseases showed a rise of CEA, while two patients--a 25 year old Indian woman with pneumonia and a 64 year old Malay man with bronchial asthma--had raised squamous cell carcinoma antigen values above the cutoff. Serum CEA and squamous cell carcinoma antigen values did not seem to correlate with stage or degree of differentiation of the tumours.

    CONCLUSIONS: The findings suggest that CEA is a good general marker for carcinoma, particularly adenocarcinoma. In contrast, squamous cell carcinoma antigen is more specific for squamous carcinoma.

    Matched MeSH terms: Predictive Value of Tests
  18. IgA/VCA as a follow-up marker in the monitoring of nasopharyngeal carcinoma
    Sam CK, Abu-Samah AJ, Prasad U
    Eur J Surg Oncol, 1994 Oct;20(5):561-4.
    PMID: 7926060
    Titers of IgA/VCA from 92 nasopharyngeal carcinoma (NPC) patients were monitored for 3 to 11 years from the time of diagnosis. The fluctuations in the IgA/VCA titers during follow-up did not correlate with the clinical status of the patients, suggesting that IgA/VCA is of marginal significance in the monitoring of NPC patients during follow-up. In addition, the frequency of recurrence of NPC was independent of presence or absence of elevated IgA/VCA at diagnosis.
    Matched MeSH terms: Predictive Value of Tests
  19. Fulltext The role of maternal serum alpha-fetoprotein, human chorionic gonadotrophin and oestriol in the antenatal screening of Down's syndrome
    Chang TC, Cheng HH
    Med J Malaysia, 1994 Dec;49(4):351-4.
    PMID: 7545778
    The use of maternal age alone to identify pregnant mothers at risk of a fetus with Down's syndrome has recently been supplemented by maternal serum screening using biochemical markers such as alpha-protein, human chorionic gonadotrophin and oestriol. These tests have been reported to increase the sensitivity of antenatal detection of such fetuses from 35% to 67% with a false positive rate of 5%. However, these maternal serum markers may be affected by maternal weight, the smoking history of mothers and diabetes mellitus. Furthermore, such sensitivities are achieved only when gestational age is assessed accurately by ultrasound. Many further studies need to be carried out before the introduction of maternal serum screening into routine obstetric practice in Singapore. These include studies on the incidence of Down's syndrome in the local population, studies on the distribution of these serum markers in the second trimester of pregnancy, sensitivities and positive predictive values of such a test in the local population as well as the socio-economic implications of implementing such a screening test in the local obstetric population.
    Matched MeSH terms: Predictive Value of Tests
  20. Fulltext Usefulness of the "CAGE" in Malaysia
    Indran SK
    Singapore Med J, 1995 Apr;36(2):194-6.
    PMID: 7676267
    This study examines the usefulness of the "CAGE", (which is an acronym for "cut down", "annoyed", "guilty" and "eye-opener"), a 4-question screening test to identify excessive drinkers among Malaysian inpatients. The CAGE questionnaire after translation and back translation was administered to all inpatients in the General Hospital, Kuala Lumpur. The author interviewed 'blindly' all who score positive on the CAGE score and 10% of all negatives using the DSM III interview schedule for alcohol abuse dependence. The results show that the CAGE performs best at a cut-off point of 2 and above, with a sensitivity of 92%, specificity of 62%, positive predictive values of 38% and Kappa (K) of 0.37 with a DSM III R diagnosis for alcohol abuse/dependence. The poor agreement with a DSM III diagnosis indicates that the CAGE is not useful in the Malaysian population. Reasons suggested for this are: cultural factors in the Malaysian population resulting in the overrating of the question of 'guilt' by Muslims and translations into the local languages which are only the closest approximations.
    Matched MeSH terms: Predictive Value of Tests
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