Displaying publications 1 - 20 of 4249 in total

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  1. Bhattacharya P, Ellegård R, Khalid M, Svanberg C, Govender M, Keita ÅV, et al.
    Elife, 2020 09 02;9.
    PMID: 32876566 DOI: 10.7554/eLife.57869
    HIV transmission via genital and colorectal mucosa are the most common routes of dissemination. Here, we explored the effects of free and complement-opsonized HIV on colorectal tissue. Initially, there was higher antiviral responses in the free HIV compared to complement-opsonized virus. The mucosal transcriptional response at 24 hr revealed the involvement of activated T cells, which was mirrored in cellular responses observed at 96 hr in isolated mucosal T cells. Further, HIV exposure led to skewing of T cell phenotypes predominantly to inflammatory CD4+ T cells, that is Th17 and Th1Th17 subsets. Of note, HIV exposure created an environment that altered the CD8+ T cell phenotype, for example expression of regulatory factors, especially when the virions were opsonized with complement factors. Our findings suggest that HIV-opsonization alters the activation and signaling pathways in the colorectal mucosa, which promotes viral establishment by creating an environment that stimulates mucosal T cell activation and inflammatory Th cells.
    Matched MeSH terms: Young Adult
  2. Fornace KM, Alexander N, Abidin TR, Brock PM, Chua TH, Vythilingam I, et al.
    Elife, 2019 10 22;8.
    PMID: 31638575 DOI: 10.7554/eLife.47602
    Human movement into insect vector and wildlife reservoir habitats determines zoonotic disease risks; however, few data are available to quantify the impact of land use on pathogen transmission. Here, we utilise GPS tracking devices and novel applications of ecological methods to develop fine-scale models of human space use relative to land cover to assess exposure to the zoonotic malaria Plasmodium knowlesi in Malaysian Borneo. Combining data with spatially explicit models of mosquito biting rates, we demonstrate the role of individual heterogeneities in local space use in disease exposure. At a community level, our data indicate that areas close to both secondary forest and houses have the highest probability of human P. knowlesi exposure, providing quantitative evidence for the importance of ecotones. Despite higher biting rates in forests, incorporating human movement and space use into exposure estimates illustrates the importance of intensified interactions between pathogens, insect vectors and people around habitat edges.
    Matched MeSH terms: Young Adult
  3. Abu Taha A, Abu-Zaydeh AH, Ardah RA, Al-Jabi SW, Sweileh WM, Awang R, et al.
    Zoonoses Public Health, 2016 09;63(6):449-57.
    PMID: 26752329 DOI: 10.1111/zph.12249
    Antibiotics are considered to be among the most commonly sold drug classes in Palestine. Resistance to antibiotics has increased for reasons relating to the use and misuse of antibiotics. The aim of this study was to evaluate the knowledge, and attitudes regarding antibiotic use and awareness about resistance among adults visiting the emergency departments at hospitals in North Palestine. A self-administered cross-sectional questionnaire survey involving participants aged 18 or over was conducted from June 2012 to February 2013. Adults who visited the emergency departments at hospitals in North Palestine were included. Demographic characteristics, knowledge and attitudes towards antibiotic use were included in the questionnaire. Poor and good knowledge were defined as a total knowledge score of 0-7 and 8-15 of 15 questions, respectively. Attitude scores of 0-3 and 4-7 of 7 questions were considered poor and good, respectively. A total of 375 questionnaires were included in the study. A response rate of 83.3% was attained. About 55.0% of the participants had a good knowledge and 56.5% had a good attitude towards rational antibiotic use. A significant positive correlation was shown between participants' knowledge scores and participants' attitude scores towards antibiotic use (R = 0.344, P = 0.001. Participants with a high family income were more likely to be aware of appropriate antibiotic use than participants with a low family income (P-value <0.001). Participants with a higher educational level (university) had a good attitude towards rational antibiotic use than those with a lower education level (P-value <0.001). This study has documented important knowledge and attitude gaps in antibiotic use. These findings will help health policymakers in Palestine to implement intervention programmes to rationalize antibiotic use. Continuing medical education, professional development and training workshops for healthcare professionals regarding rational use of antibiotics and health risks associated with the spread of antibiotic resistance are needed. In addition, minimizing non-prescription use of antibiotics and increasing the public awareness about the health and economic hazards of antibiotic resistance are also required.
    Matched MeSH terms: Young Adult
  4. Wong LP, Alias H, Choy SH, Goh XT, Lee SC, Lim YAL, et al.
    Zoonoses Public Health, 2020 05;67(3):263-270.
    PMID: 31927794 DOI: 10.1111/zph.12681
    Malaysia is a non-endemic country for hepatitis E virus (HEV) infection. However, seroprevalence as high as 50% among samples of aboriginal people were reported over two decades ago. A total of 207 samples collected from seven aboriginal villages in rural settlements across two states in Malaysia were analysed for anti-HEV IgG and IgM by an enzyme-linked immunoassay. Following the detection of anti-HEV seroprevalence, we organized health outreach to inform and educate the community. Qualitative interviews were conducted with individuals tested positive for anti-HEV antibodies. Data derived from interviews and observations were used to investigate possible lifestyle behaviours associated with HEV infection. Anti-HEV IgG was detected in six samples (5.9%) from the village of Dusun Kubur. Qualitative inquiry and observation study revealed poor dietary and household hygiene, contaminated food and water, contact with animal faeces, unsanitary and domestic waste disposal, and wildlife reservoirs could be the contributing factors for transmission and acquisition of HEV infection. Investigation during health outreach is important to provide insights for future empirical research and implementation for improvement of lifestyle behaviours among the aborigines. Managing the risk of HEV infection in the aborigines may reduce the risk of HEV transmission to the local communities.
    Matched MeSH terms: Young Adult
  5. Wei W, Fang L, Wang N, Zhang T, Zeng JB, Lin MT
    PMID: 22875498 DOI: 10.3760/cma.j.issn.1003-9406.2012.04.009
    To investigate the frequency of CYP2C19 polymorphisms involved in clopidogrel metabolism in Fujian Han population.
    Matched MeSH terms: Young Adult
  6. Alabed AAA, Elengoe A, Anandan ES, Almahdi AY
    Z Gesundh Wiss, 2020 Oct 14.
    PMID: 33078089 DOI: 10.1007/s10389-020-01395-9
    Background: There is a major public health challenge threatening the world with the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in December 2019 from Wuhan, China.

    Objective: The aim of this study was to assess the knowledge, attitude and practice regarding COVID-19 and its transmission, causes and prevention among people living in Malaysia.

    Methods: A cross-sectional study was conducted among people living in Malaysia by using an online survey in March and April 2020.

    Results: Out of 520 respondents, the mean age was 36.9 ± 14.9, between 19 and 67 years with the majority being female. Most respondents had good knowledge, attitude and practice towards COVID-19 with mean ± sd 18.2 ± 1.7, 5.2 ± 1.1 and 4.1 ± 1.4, respectively. In addition, the majority had good knowledge regarding cause, mode of transmission, signs and symptoms, prevention and treatment and quarantine measures after answering 21 questions.

    Conclusion: To date, there is no specific treatment or vaccine for COVID-19, thus staying at home is the best preventive measure to curb the further growth of positive cases in the country. These findings could provide an insight in designing effective preparedness for future pandemic outbreaks.

    Matched MeSH terms: Young Adult
  7. Hamid MSA
    Wounds, 2018 Jul;30(7):186-190.
    PMID: 30059343
    INTRODUCTION: Despite limited clinical evidence, platelet-rich plasma (PRP) is currently used for the treatment of various soft tissue injuries, but optimal use of PRP has yet to be determined. In many instances, PRP is prepared using commercial devices that lack standardized preparation techniques and consistent quality of the PRP produced.

    OBJECTIVE: The aim of this study is to explore a simple, easy, economical method of PRP preparation that is practical for clinical use.

    MATERIALS AND METHODS: This cross-sectional study was conducted at the Sports Medicine Clinic at the University of Malaya Medical Centre, Malaysia. Participants were healthy postgraduate students and staff at the Sports Medicine Department. The PRP was prepared using a single centrifugation technique. Leukocyte and platelet levels were compared with that of a whole blood baseline and a commercial preparation kit.

    RESULTS: The PRP produced using this technique contained significantly higher mean platelet (1725.0 vs. 273.9 x 109/L) and leukocyte (33.6 vs. 7.7 x 109/L) levels compared with whole blood. There was no significant difference in the mean platelet and leukocyte levels between the PRP produced in this study and by a commercial PRP system.

    CONCLUSIONS: A single-centrifugation protocol using readily available materials in a typical clinical setting could produce PRP of comparable quality to those of a commercial PRP production system.

    Matched MeSH terms: Young Adult
  8. Habib MA, Ibrahim F, Mohktar MS, Kamaruzzaman SB, Rahmat K, Lim KS
    World Neurosurg, 2016 Apr;88:576-585.
    PMID: 26548833 DOI: 10.1016/j.wneu.2015.10.096
    BACKGROUND: Electroencephalography source imaging (ESI) is a promising tool for localizing the cortical sources of both ictal and interictal epileptic activities. Many studies have shown the clinical usefulness of interictal ESI, but very few have investigated the utility of ictal ESI. The aim of this article is to examine the clinical usefulness of ictal ESI for epileptic focus localization in patients with refractory focal epilepsy, especially extratemporal lobe epilepsy.

    METHODS: Both ictal and interictal ESI were performed by the use of patient-specific realistic forward models and 3 different linear distributed inverse models. Lateralization as well as concordance between ESI-estimated focuses and single-photon emission computed tomography (SPECT) focuses were assessed.

    RESULTS: All the ESI focuses (both ictal and interictal) were found lateralized to the same hemisphere as ictal SPECT focuses. Lateralization results also were in agreement with the lesion sides as visualized on magnetic resonance imaging. Ictal ESI results, obtained from the best-performing inverse model, were fully concordant with the same cortical lobe as SPECT focuses, whereas the corresponding concordance rate is 87.50% in case of interictal ESI.

    CONCLUSIONS: Our findings show that ictal ESI gives fully lateralized and highly concordant results with ictal SPECT and may provide a cost-effective substitute for ictal SPECT.

    Matched MeSH terms: Young Adult
  9. Quah BL, Low HL, Wilson MH, Bimpis A, Nga VDW, Lwin S, et al.
    World Neurosurg, 2016 Oct;94:13-17.
    PMID: 27368511 DOI: 10.1016/j.wneu.2016.06.081
    BACKGROUND: The optimal timing of cranioplasty remains uncertain.

    OBJECTIVE: We hypothesized that the risk of infections after primary cranioplasty in adult patients who underwent craniectomies for non-infection-related indications are no different when performed early or delayed. We tested this hypothesis in a prospective, multicenter, cohort study.

    METHODS: Data were collected prospectively from 5 neurosurgical centers in the United Kingdom, Malaysia, Singapore, and Bangladesh. Only patients older than 16 years from the time of the non-infection-related craniectomy were included. The recruitment period was over 17 months, and postoperative follow-up was at least 6 months. Patient baseline characteristics, rate of infections, and incidence of hydrocephalus were collected.

    RESULTS: Seventy patients were included in this study. There were 25 patients in the early cranioplasty cohort (cranioplasty performed before 12 weeks) and 45 patients in the late cranioplasty cohort (cranioplasty performed after 12 weeks). The follow-up period ranged between 16 and 34 months (mean, 23 months). Baseline characteristics were largely similar but differed only in prophylactic antibiotics received (P = 0.28), and primary surgeon performing cranioplasty (P = 0.15). There were no infections in the early cranioplasty cohort, whereas 3 infections were recorded in the late cohort. This did not reach statistical significance (P = 0.55).

    CONCLUSIONS: Early cranioplasty in non-infection-related craniectomy is relatively safe. There does not appear to be an added advantage to delaying cranioplasties more than 12 weeks after the initial craniectomy in terms of infection reduction. There was no significant difference in infection rates or risk of hydrocephalus between the early and late cohorts.

    Matched MeSH terms: Young Adult
  10. Sam JE, Kandasamy R, Wong ASH, Ghani ARI, Ang SY, Idris Z, et al.
    World Neurosurg, 2021 12;156:e381-e391.
    PMID: 34563715 DOI: 10.1016/j.wneu.2021.09.074
    OBJECTIVE: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.

    METHODS: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.

    RESULTS: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.

    CONCLUSIONS: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.

    Matched MeSH terms: Young Adult
  11. Wong HM, Woo XL, Goh CH, Chee PHC, Adenan AH, Tan PCS, et al.
    World Neurosurg, 2022 01;157:e276-e285.
    PMID: 34648987 DOI: 10.1016/j.wneu.2021.10.074
    BACKGROUND: Burr hole drainage is the criterion standard treatment for chronic subdural hematoma (CSDH), a common neurosurgical condition. However, apart from the surgical technique, the method of anesthesia also has a significant impact on postoperative patient outcome. Currently, there are limited studies comparing the use of local anesthesia with sedation (LA sedation) versus general anesthesia (GA) in the drainage of CSDH. The objective of this study was to compare the morbidity and mortality outcomes of using LA sedation versus GA in CSDH burr hole drainage.

    METHODS: This retrospective study presents a total of 257 operations in 243 patients from 2 hospitals. A total of 130 cases were operated under LA sedation in hospital 1 and 127 cases under GA in hospital 2. Patient demographics and presenting features were similar at baseline.

    RESULTS: Values are shown as LA sedation versus GA. Postoperatively, most patients recovered well in both groups with Glasgow Outcome Scale scores of 4-5 (96.2% vs. 88.2%, respectively). The postoperative morbidity was significantly increased by an odds ratio of 5.44 in the GA group compared with the LA sedation group (P = 0.005). The mortality was also significantly higher in the GA group (n = 5, 3.9%) than the LA sedation group (n = 0, 0.0%; P = 0.028). The CSDH recurrence rate was 4.6% in the LA sedation group versus 6.3% in the GA group. No intraoperative conversion from LA sedation to GA was reported.

    CONCLUSIONS: This study demonstrates that CSDH drainage under LA sedation is safe and efficacious, with a significantly lower risk of postoperative mortality and morbidity when compared with GA.

    Matched MeSH terms: Young Adult
  12. Ho LY, Chu PS, Consigliere DT, Zainuddin ZM, Bolong D, Chan CK, et al.
    World J Urol, 2018 Jan;36(1):79-86.
    PMID: 29051978 DOI: 10.1007/s00345-017-2097-2
    PURPOSE: The overall objective of the survey was to systematically examine patients' perspectives on lower urinary tract symptoms (LUTS) and their treatment in Southeast Asia.
    METHODS: A multinational cross-sectional survey involving adult men seeking consultation at urology outpatient clinics because of LUTS in Southeast Asia was conducted using convenience sampling. Self-reported prevalence, bother, treatment and treatment satisfaction of selected LUTS including urgency, nocturia, slow stream, and post-micturition dribble were evaluated.
    RESULTS: In total, 1535 eligible patients were enrolled in the survey. A majority of respondents were aged 56-75 years, not employed, and had not undergone prostate operation before. Overall, the self-reported prevalence of nocturia was 88% (95% CI 86-90%), slow stream 61% (95% CI 59-63%), post micturition dribble 55% (95% CI 52-58%), and urgency 52% (95% CI 49-55%). There were marked differences in the country specific prevalence of LUTS complaints. Frequently, symptoms coexisted and were combined with nocturia. More than half of patients felt at least some degree of bother from their symptoms: 61% for urgency, 57% for nocturia, 58% for slow stream, and 60% for post-micturition dribble. Before seeing the present urologists, nearly half of patients have received some form of prescribed treatment and more than 80% of patients indicated they would like to receive treatment.
    CONCLUSION: Men who sought urologist care for LUTS often presented with multiple symptoms. Nocturia emerged as the most common symptom amongst the four core symptoms studied.
    Study site in Malaysia: Urology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Young Adult
  13. Pan KL, Chan WH, Ong GB, Premsenthil S, Zulkarnaen M, Norlida D, et al.
    World J Surg Oncol, 2012;10:105.
    PMID: 22681750 DOI: 10.1186/1477-7819-10-105
    Tumor prostheses currently give the best short- and medium-term results for limb-salvage reconstruction procedures in the treatment of bone tumors. However, in developing countries, the cost of a tumor prosthesis is beyond the reach of much of the population. We report the use of autoclaved tumor-bearing bone in 10 patients, as an affordable alternative to the use of prostheses.
    Matched MeSH terms: Young Adult
  14. Chan KK, Dassanayake B, Deen R, Wickramarachchi RE, Kumarage SK, Samita S, et al.
    World J Surg Oncol, 2010;8:82.
    PMID: 20840793 DOI: 10.1186/1477-7819-8-82
    This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival.
    Matched MeSH terms: Young Adult
  15. See MH, Bhoo-Pathy N, Jamaris S, Kiran A, Evans DG, Yip CH, et al.
    World J Surg, 2018 05;42(5):1270-1277.
    PMID: 29124356 DOI: 10.1007/s00268-017-4319-6
    BACKGROUND: The rate of contralateral risk-reducing mastectomy (CRRM) is increasing in the West with controversial evidence of improved survival in early breast cancer patients. Although uptake of CRRM in Asia appears low, the trends may rise, and there is currently an urgent need to provide evidence for informed decision-making in clinical practice. This study aims to determine the risk of contralateral breast cancer (CBC) and its associated factors in an Asian setting.

    METHOD: A total of 2937 newly diagnosed patients with stage I and stage II breast cancer in University Malaya Medical Centre between Jan 1993 to Dec 2012 were included in the study. Multinomial logistic regression analysis allowing death to compete with CBC as a study outcome was used; patients with unilateral breast cancer who were alive were taken as reference. A stepwise backward regression analysis including age at diagnosis, ethnicity, family history of breast cancer, TNM stage, hormonal receptor status, HER2 status, chemotherapy, radiotherapy, and hormone therapy was conducted.

    RESULTS: Fifty women developed CBC, over a median follow-up of 6 years. The 5- and 10-year cumulative risk of contralateral breast cancer was 1.0% (95% CI 0.6-1.4%) and 2.8% (95% CI 2.0-3.6%), respectively. Young age at diagnosis of first cancer, positive family history, and stage I disease were independent predictors of CBC.

    DISCUSSION: The current study suggests that the risk of CBC is very low in a Southeast Asian setting. Any recommendations or practice of CRRM should be reviewed with caution and patients must be counseled appropriately.

    Matched MeSH terms: Young Adult
  16. Pijnappel EN, Bhoo-Pathy N, Suniza J, See MH, Tan GH, Yip CH, et al.
    World J Surg, 2014 Dec;38(12):3133-7.
    PMID: 25167896 DOI: 10.1007/s00268-014-2752-3
    In settings with limited resources, sentinel lymph node biopsy (SNB) is only offered to breast cancer patients with small tumors and a low a priori risk of axillary metastases.
    Matched MeSH terms: Young Adult
  17. Tiong V, Rozita AM, Taib NA, Yip CH, Ng CH
    World J Surg, 2014 Sep;38(9):2288-96.
    PMID: 24700093 DOI: 10.1007/s00268-014-2542-y
    Breast cancer is increasingly reported in young premenopausal women in Asia. Adjuvant chemotherapy improves survival; however, it has a unique consequence of ovarian failure in premenopausal patients.
    Matched MeSH terms: Young Adult
  18. Leow JJ, Lim VW, Lingam P, Go KT, Teo LT
    World J Surg, 2014 Jul;38(7):1694-8.
    PMID: 24510246 DOI: 10.1007/s00268-014-2459-5
    Ethnic disparities in trauma mortality outcomes have been demonstrated in the United States according to the US National Trauma Data Bank. The aim of this study was to determine the effect of race/ethnicity on trauma mortality in Singapore.
    Matched MeSH terms: Young Adult
  19. Taib NA, Yip CH, Low WY
    World J Surg, 2014 Jul;38(7):1676-84.
    PMID: 24280975 DOI: 10.1007/s00268-013-2339-4
    Advanced breast cancer presentation remains a large obstacle in lowering mortality rates in low- and middle-resource countries. This study aims to explore the reasons why women present with breast cancer at an advanced stage.
    Matched MeSH terms: Young Adult
  20. Das AK, Bin Abdullah BJ, Dhillon SS, Vijanari A, Anoop CH, Gupta PK
    World J Surg, 2013 Apr;37(4):915-22.
    PMID: 23307180 DOI: 10.1007/s00268-012-1892-6
    BACKGROUND: Critical limb ischemia (CLI) caused by peripheral arterial disease is associated with significant morbidity and mortality. This condition is associated with a 30 % amputation rate as well as mortality levels which might be as high as 25 %. There is no pharmacological therapy available, but several reports have suggested that mesenchymal stem cells (MSCs) may be a useful therapeutic option.
    METHODS: This study, done at a university hospital, evaluated 13 patients for a phase I trial to investigate the safety and efficacy of intra-arterial MSCs in CLI patients. Eight patients with ten affected limbs were recruited for the study. As two patients (three limbs) died of ischemic cardiac events during the 6-month follow-up period, seven limbs were finally evaluated for the study.
    RESULTS: There was significant pain relief. Visual analog scale (VAS) scores decreased from 2.29 ± 0.29 to 0.5 ± 0.34 (p < 0.05), ankle brachial pressure index (ABPI) increased significantly from 0.56 ± 0.02 to 0.67 ± 0.021 (p < 0.01), and transcutaneous oxygen pressure (TcPO2) also increased significantly in the foot from 13.57 ± 3.63 to 38 ± 3.47. Similar improvement was seen in the leg as well as the thigh. There was 86 % limb salvage and six of seven ulcers showed complete or partial healing.
    CONCLUSION: It was concluded that intra-arterial MSCs could be safely administered to patients with CLI and was associated with significant therapeutic benefits.
    Matched MeSH terms: Young Adult
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