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ASSESSMENT OF HEAVY METAL CONCENTRATION IN MARINE SEDIMENTS IN TERENGGANU WATERS

YIP TAIM HING, TAN EVONNE, POONG JUN HAN, TEE LIAN SHENG, MUHAMMAD HASBI RAMLI, ONG MENG CHUAN, et al.

UMT Journal of Undergraduate Research, 2020;3(2):1-12.
MyJurnal

The distribution of heavy metals (Cu, Zn, Cd, Pb) in surface sediments was examined in waters off the coast of Marang, Terengganu. A total of 20 samples were collected using Ponar grab and analysed by inductively coupled plasma-mass spectrometer after closed digestion with acid. The sediments were filtered using a dry sieving method to determine their particle size. The spatial distribution maps on the concentration of selected metals were drawn using the ArcGIS software. Results showed that the average concentration of Cu, Zn, Cd, and Pb were 2.33±0.38 µg/g dry weight, 28.4±3.78 µg/g dry weight, 0.09±0.01 µg/g dry weight and 8.35±1.48 µg/g dry weight, respectively. The level of pollution was also evaluated using the Index of Geoaccumulation (Igeo) and Pollution Load Index (PLI). All Igeo and PLI values obtained were low, which indicated low or no pollution. Meanwhile, the sediment mean size ranged between -0.77Ø and 3.18Ø, which characterised a sandy type of sediment. Correlation analysis showed a positive correlation between the heavy metals and sediment size. The results indicated that there was a common source of heavy metal pollution in the study area, possibly from shipping activities. Overall, there was no significant heavy metal pollution in the waters off Marang. This finding is important as the data could be used to evaluate the risk of metal contamination and the impact of anthropogenic activities on the marine environment.

Matched MeSH terms: Plasma
Fibrinogen isoforms as potential blood-based biomarkers of Alzheimer's disease using a proteomics approach

Rehiman SH, Lim SM, Lim FT, Chin AV, Tan MP, Kamaruzzaman SB, et al.

Int J Neurosci, 2020 Dec 15.
PMID: 33280461 DOI: 10.1080/00207454.2020.1860038

Objective: Alzheimer's disease (AD), the commonest form of dementia which is characterized by progressive decline in cognitive function, can only be definitively diagnosed after death. Although biomarkers may aid diagnosis, currently available AD biomarkers, which are predominantly based on cerebrospinal fluid and neuroimaging facilities, are either invasive or costly. Blood-based biomarkers for AD diagnosis are highly sought after due to its practicality at the clinic. This study was undertaken to determine the differential protein expression in plasma amongst Malaysian AD, mild cognitive impairment (MCI) and non-AD individuals. Methods: A proteomic approach which utilized two-dimensional differential in gel electrophoresis (2 D DIGE) was performed for blood samples from 15 AD, 14 MCI and 15 non-AD individuals. Results: Mass spectrometry (MS)-based protein identification via MALDI ToF/ToF showed that fibrinogen-β-chain (spot 64) and fibrinogen-γ-chain (spot 91) with differential expression ratio >1.5 were significantly upregulated (p

Matched MeSH terms: Plasma
Fulltext Normalisation of the International Normalised Ratio (INR) Prior to Interventional Procedure: is it necessary?

Mohd Tarmizi Mohamad Mahyedin, Afifah Hassan, Abdul Rahim Hussein

Malaysian Journal of Medicine and Health Sciences, 2018;14(201):1-7.
MyJurnal

The fresh frozen plasma (FFP) is frequently prescribed either for therapeutic or prophylactic transfusion. The international normalised ratio (INR) value of 1.50 and above is frequently reported to be a transfusion trigger for FFP prior to interventional procedure. This study aimed to evaluate the efficacy of prophylactic FFP transfusion in normalising the INR and to determine the post-transfusion outcomes. Methods: A prospective cross-sectional study involved 81 patients who received prophylactic FFP transfusion over a period of three months. All demographic, clinical data and outcomes of FFP transfusion were captured and filled in the research proforma. Results: The proportion of patients achieved posttransfusion INR below 1.51 was 30.30% (n=27). The majority of patients underwent the interventional procedures with posttransfusion INR > 1.50 (n=52) without experiencing any bleeding episodes. Overall, FFP transfusion resulted in significant median INR difference from 1.89 (IQR, 0.53) to 1.60 (IQR, 0.25); p< 0.001. The greater median INR difference was observed in group with pretransfusion INR > 2.00 and who received FFP doses between 10.00 to 20.00 ml kg-1 (p < 0.001). The INR difference showed the significant, positive correlation with pretransfusion INR values (rs= 0.83, p < 0.001) and FFP doses (rs= 0.72, p< 0.001). Conclusions: The interventional procedures were safely carried out despite abnormal posttransfusion INR. The prophylactic FFP transfusions could be avoided in patients with mild coagulopathy (INR 1.50 - 2.00) prior interventional procedures.

Matched MeSH terms: Plasma
Fulltext A case of recurrent respiratory papillomatosis successfully removed via endoscopic argon plasma coagulation (APC) with no evidence of recurrence

Wong JL, Tie ST, Lee J, Kannan SK, Rashid Ali MR, Ibrahim A, et al.

Med J Malaysia, 2014 Aug;69(4):195-6.
PMID: 25500852 MyJurnal

Recurrent respiratory papillomatosis (RRP) is a benign disease caused by the human papilloma virus (HPV), characterized by the formation of recurrent, epithelial neoplastic lesions in the airways. While benign, they can cause significant airway obstruction in some cases. Difficulties in treatment arise from the recurrent nature of the lesions despite repeated procedures. Other known procedures that result in deep tissue damage also cause unacceptable collateral damage to the underlying airway mucosa. We describe a case of recurrent papillomatosis that was successfully treated with argon plasma coagulation ( APC) when laser and electrocautery ablation had failed in the past. After the papillomatasis was treated with APC, there is no recurrence on repeat scope at 4 months and 9 months after the initial procedure. The procedure was done as a day case and there is no complication from the procedure. The property of the APC that allows it to cause only superficial thermal damage to the tissue makes it a suitable adjunct therapy to the treatment of papillomas, which are usually superficial lesions.

Matched MeSH terms: Argon Plasma Coagulation
Fulltext Lack of Association between the Serotonin Transporter (5-HTT) and Serotonin Receptor (5-HT2A) Gene Polymorphisms with Smoking Behavior among Malaysian Malays

Rozak NI, Ahmad I, Gan SH, Abu Bakar R

Sci Pharm, 2014 07 18;82(3):631-42.
PMID: 25853073 DOI: 10.3797/scipharm.1406-01

An insertion/deletion polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) and a polymorphism (rs6313) in the serotonin 2A receptor gene (5-HT2A) have previously been linked to smoking behavior. The objective of this study was to determine the possible association of the 5-HTTLPR and 5-HT2A gene polymorphisms with smoking behavior within a population of Malaysian male smokers (n=248) and non-smokers (n=248). The 5-HTTLPR genotypes were determined using the polymerase chain reaction (PCR) and were classified as short (S) alleles or long (L) alleles. The 5HT2A genotypes were determined using PCR-restriction fragment length polymorphisms (PCR-RFLP). No significant differences in the distribution frequencies of the alleles were found between the smokers and the non-smokers for the 5-HTTLPR polymorphism (x(2) = 0.72, P>0.05) or the 5HT2A polymorphism (x(2) = 0.73, P>0.05). This is the first study conducted on Malaysian Malay males regarding the association of 5-HTTLPR and 5HT2A polymorphisms and smoking behavior. However, the genes were not found to be associated with smoking behavior in our population.

Matched MeSH terms: Serotonin Plasma Membrane Transport Proteins
Fulltext Pharmacokinetics of Free Oxytetracycline and Oxytetracycline Loaded Cockle Shell Calcium Carbonate-Based Nanoparticle in BALB/c Mice

Idris SB, Abdul Kadir A, Abdullah JFF, Ramanoon SZ, Basit MA, Abubakar MZZA

Front Vet Sci, 2020;7:270.
PMID: 32613011 DOI: 10.3389/fvets.2020.00270

The development and utilization of nano-antibiotics is currently gaining attention as a possible solution to antibiotic resistance. The aim of this study was therefore to determine the pharmacokinetics of free oxytetracycline (OTC) and oxytetracycline loaded cockle shell calcium carbonate-based nanoparticle (OTC-CNP) after a single dose of intraperitoneal (IP) administration in BALB/c mice. A total of 100 female BALB/c mice divided into two groups of equal number (n = 50) were administered with 10 mg/kg OTC and OTC-CNP, respectively. Blood samples were collected before and post-administration from both groups at time 0, 5, 10, 15, and 30 min and 1, 2, 6, 24, and 48 h, and OTC plasma concentration was quantified using a validated HPLC-UV method. The pharmacokinetic parameters were analyzed using a non-compartment model. The Cmax values of OTC in OTC-CNP and free OTC treated group were 64.99 and 23.53 μg/ml, respectively. OTC was detected up to 24 h in the OTC-CNP group as against 1 h in the free OTC group following intraperitoneal administration. In the OTC-CNP group, the plasma elimination rate of OTC was slower while the half-life, the area under the curve, and the volume of the distribution were increased. In conclusion, the pharmacokinetic profile of OTC in the OTC-CNP group differs significantly from that of free OTC. However, further studies are necessary to determine the antibacterial efficacy of OTC-CNP for the treatment of bacterial diseases.

Matched MeSH terms: Plasma
Emerging cold plasma treatment on rice grains: A mini review

Ikmal Misnal MF, Redzuan N, Firdaus Zainal MN, Raja Ibrahim RK, Ahmad N, Agun L

Chemosphere, 2021 Jul;274:129972.
PMID: 33979941 DOI: 10.1016/j.chemosphere.2021.129972

Future demand of rice is projected to increase with the increase of global population. However, the presence of bacteria, insects, and fungi has resulted in various changes in the physical and chemical characteristics of rice grain. To make it worse, the overuse of post-harvest chemicals (fungicide and pesticide) has caused possible risks to human health through either occupational or non-occupational exposure. For the last few years, cold plasma has been developed as an alternative non-thermal emerging technology for rice grains treatment due to its ability to inactivate or decontaminate pathogens without causing thermal damage and free of any harmful residues. Therefore, this review describes the operational mechanism of cold plasma treatment technology on rice grains, existing reactor system designs, and parameters influenced by the treatment technology (reactor design parameters and treatment process parameters). Possible advanced investigation on future reactor design modification as well as standard operating range of influenced parameters were suggested for improved efficiency and effectiveness of cold plasma treatment.

Matched MeSH terms: Plasma Gases*
Luteolin and apigenin derived glycosides from Alphonsea elliptica abrogate LPS-induced inflammatory responses in human plasma

Attiq A, Jalil J, Husain K, Mohamad HF, Ahmad A

J Ethnopharmacol, 2021 Jul 15;275:114120.
PMID: 33857595 DOI: 10.1016/j.jep.2021.114120

ETHNOPHARMACOLOGICAL RELEVANCE: Numerous Alphonsea species including Alphonsea elliptica (mempisang) leaves and fruits are indigenously used in inflammatory conditions such as postpartum swelling and rheumatism in southeast Asian countries. In our previous in-vitro findings, A. elliptica methanol extract exhibited platelet-activating factor inhibition, suggesting the presence of phyto-constituents with anti-inflammatory potential.
AIM OF THE STUDY: However, so far there is no literature available on the anti-inflammatory activity of this species. Henceforth, based on the above background and our previous laboratory findings, we hypothesize that phytoconstituents of A. elliptica could possess anti-inflammatory potential against inflammatory mediators including prostaglandin-E2 (PGE2), cyclooxegenase-2 (COX-2) and cytokines (IL-1β and IL-6).
MATERIALS AND METHODS: Vacuum and column chromatography techniques were employed for the isolation of phytoconstituents. The structure elucidation was carried out using HRESI-MS, 1H and 13C-NMR analysis and compared with the published literature. For cytotoxicity analysis, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was performed on peripheral blood mononuclear cells. In-vitro anti-inflammatory activities were evaluated against the levels of PGE2, COX-2, IL-1β and IL-6 in lipopolysaccharide (LPS)-induced human plasma using enzyme-linked immunosorbent assay and radioimmunoassay.
RESULTS: Unprecedentedly, chromatographic purification of methanolic leaves extract afforded five flavones namely vitexin, isovitexin, orientin, isoorientin, schaftoside with three flavanols; kaempferol, myricetin and rutin from A elliptica. In cell viability analysis, isolates did not present cytotoxicity up to 50 μM. In anti-inflammatory evaluation, orientin and isoorientin exhibited strong (≥70%), while isovitexin and vitexin produced strong to moderate (50-69%) PGE2, COX-2, IL-1β and IL-6 inhibition at 25 and 50 μM. Isoorientin, orientin, isovitexin, and vitexin showed significant (p plasma at non-cytotoxic concentrations.

Matched MeSH terms: Plasma
Fulltext Factors influencing locum practice among government medical officers in Negri Sembilan and Malacca

Mohd Anis, H., Syed Mohamed, A., Ahmad Razid, S.

Malaysian Journal of Public Health Medicine, 2006;6(2):20-25.
MyJurnal

A cross»sectional study using self administered questionnaires on sociodemographic and service factors influencing locum practice was undertaken among all Government medical officers in Negeri Sembilan and Malacca for 8 months from 2 7 April 1999 to 9. l January ZOOO. Universally chosen samples were made of 335 Government medical officers from both the 'Public Health Division' and ”Hospital Division' and from 154 who responded, only 147 samples were chosen and analysed in the study. Results revealed that locum were still being practised by 51 .9% of male Government medical officers, 41 .0% of Government medical ofhcers aged less than 30 years, 43.4% of Government medical officers who had served less than 5 years and 55.6% of Government medical officers who had earned nett income less than RM 1 000. Meanwhile, 80.9% of Government medical officers who had earned gross income more than RM 5 OOO did not practice locum during the study. Logistic Regression analysis then revealed that locum practice among Government medical ofhcers can positively be influenced by gender (male) , Malay ethnic, service duration of less than 5 years, practice in the 'Public Health Divisionl and nett income of less than RM 1 OOO (p

Matched MeSH terms: Norepinephrine Plasma Membrane Transport Proteins
18F-FDG PET Uptake in the Scalp After Platelet-Rich Plasma Therapy

Usmani S, Al-Turkait D, Al-Kandari F, Ahmed N

Clin Nucl Med, 2022 Jan 01;47(1):e43-e44.
PMID: 34034312 DOI: 10.1097/RLU.0000000000003707

18F-FDG PET/CT has been found useful for the detection of the source of infection/inflammation in the body. Platelet-rich plasma is a new treatment modality in which plasma is injected subdermally or intradermally for potential hair regrowth into the scalp. We report a case of 43-year-old woman with right breast cancer who underwent surgery, chemotherapy, and radiotherapy 2 years ago and is currently on hormonal therapy. 18F-FDG PET/CT demonstrate incidental findings of increased FDG avidity in the scalp after platelet-rich plasma therapy.

Matched MeSH terms: Platelet-Rich Plasma*
Fulltext Efficiency of different sampling tools for aquatic macroinvertebrate collections in Malaysian streams

Wan Mohd Hafezul Wan Abdul Ghani, Che Salmah Md Rawi, Suhaila Abd. Hamid, Al-Shami, Salman Abdo

Trop Life Sci Res, 2016;27(1):115-133.
MyJurnal

This study analyses the sampling performance of three benthic sampling tools
commonly used to collect freshwater macroinvertebrates. Efficiency of qualitative D-frame
and square aquatic nets were compared to a quantitative Surber sampler in tropical
Malaysian streams. The abundance and diversity of macroinvertebrates collected using
each tool evaluated along with their relative variations (RVs). Each tool was used to
sample macroinvertebrates from three streams draining different areas: a vegetable farm,
a tea plantation and a forest reserve. High macroinvertebrate diversities were recorded using the square net and Surber sampler at the forested stream site; however, very low
species abundance was recorded by the Surber sampler. Relatively large variations in the
Surber sampler collections (RVs of 36% and 28%) were observed for the vegetable farm
and tea plantation streams, respectively. Of the three sampling methods, the square net
was the most efficient, collecting a greater diversity of macroinvertebrate taxa and a
greater number of specimens (i.e., abundance) overall, particularly from the vegetable
farm and the tea plantation streams (RV

Matched MeSH terms: Norepinephrine Plasma Membrane Transport Proteins
Fulltext Prevalence, sociodemographic and clinical characteristics of G6PD deficient blood donors in Terengganu and the effects of storage on their donated blood

Hayati Mansor, Eusni Rahayu Mohd. Tohit, Faridah Idris, Alawiyah Abdul Rahman

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):126-134.
MyJurnal

Introduction: Glucose-6-phosphate dehydrogenase (G6PD) deficiency causes red blood cell destruction due to oxi- dative stress. G6PD is essential for NADPH conversion; which is critical for glutathione reductase to prevent damage to cellular structures. In Malaysia, blood donors are not routinely screened for G6PD deficiency. We hypothesise that G6PD-deficient red blood cells are more likely to haemolyse during storage due to increased oxidative molecules. The objectives of this study were to determine the prevalence of G6PD deficiency among blood donors, describe their characteristics and to evaluate the effects of storage on G6PD-deficient donated blood. Methods: This study was conducted at selected mobile donation centres in Terengganu. Consented blood donors were screened for G6PD sta- tus using fluorescent spot tests (FST). G6PD enzyme activities were measured for donors who were G6PD deficient. Effects of storage on haemolysis from G6PD-deficient donors were compared with non G6PD-deficient group. Sixty ml of blood was collected from blood unit to transfer pouch for estimation of haemoglobin (Hb), plasma Hb, per- centage of haemolysis and plasma potassium. Serial sampling with a 7-day interval was done from Day 1 to Day 35. Statistical analysis was considered significant if p 0.05. Results: A total of 440 blood donors were screened and 12 male donors were found to be G6PD deficient by FST. Enzymatic activities were measured in 11 donors as one donor sample failed to be sent to the centre due to logistic problem. Their enzymatic activities ranged from 1.66-2.93 U/g Hb whereby 6 have severe deficiency and the other 5 were categorised as partial deficiency. Donors were asymp- tomatic for haemolytic episode. Serial sampling showed there was no significant difference of haemolytic parameters in blood units of G6PD-deficient donors as compared to control (p>0.05). Conclusion: Prevalence of G6PD blood donors in Terengganu mobile centres was 2.7%. G6PD enzyme activities did not correlate with clinical symptoms. Haemolytic parameters were not affected in blood units which were G6PD-deficient.

Matched MeSH terms: Plasma
Promising applications of cold plasma for microbial safety, chemical decontamination and quality enhancement in fruits

Mir SA, Siddiqui MW, Dar BN, Shah MA, Wani MH, Roohinejad S, et al.

J Appl Microbiol, 2020 Sep;129(3):474-485.
PMID: 31800143 DOI: 10.1111/jam.14541

Consumers' demand is increasing for safe foods without impairing the phytochemical and sensory quality. In turn, it has increased research interest in the exploration of innovative food processing technologies. Cold plasma technology is getting popularity now days owing to its high efficacy in decontamination of microbes in fruit and fruit-based products. As a on-thermal approach, plasma processing maintains the quality of fruits and minimizes the thermal effects on nutritional properties. Cold plasma is also exploited for inactivating enzymes and degrading pesticides as both are directly related with quality loss and presently are most important concerns in fresh produce industry. The present review covers the influence of cold plasma technology on reducing microbial risks and enhancing the quality attributes in fruits.

Matched MeSH terms: Plasma Gases/chemistry*
Fulltext Response to intradermal autologous platelet rich plasma injection in refractory dermal melasma: report of two cases

Yew, C.H., Ramasamy, T.S., Amini, F.

JUMMEC, 2015;18(2):1-6.
MyJurnal

Refractory dermal melasma is resistant to conventional treatment. Platelet rich plasma (PRP) may help to reduce the pigmentation of melasma. We present a case report on the clinical outcome of 2 patients with melasma, given PRP, as an adjunct therapy. PRP was administered at a monthly interval for 2 sessions in combination with a monthly Q-switched Nd Yag laser treatment and topical alpha arbutin application. A modified melasma area and severity index (MASI) was evaluated by two dermatologists who were blinded. At the follow up on the 3rd months, the MASI score was reduced by mean 33.5% for case 1 and 20% for case 2. There were no clinical complications for case 1. However recurrence of melasma was noted in case 2 by a worsening of the MASI score mean to 53% at the sixth months follow up. In conclusion, intradermal PRP injection as an adjunct to the conventional treatment of melasma presented with differing results in two cases.

Matched MeSH terms: Platelet-Rich Plasma
Microwave induced plasma for solid fuels and waste processing: A review on affecting factors and performance criteria

Ho GS, Faizal HM, Ani FN

Waste Manag, 2017 Nov;69:423-430.
PMID: 28811144 DOI: 10.1016/j.wasman.2017.08.015

High temperature thermal plasma has a major drawback which consumes high energy. Therefore, non-thermal plasma which uses comparatively lower energy, for instance, microwave plasma is more attractive to be applied in gasification process. Microwave-induced plasma gasification also carries the advantages in terms of simplicity, compactness, lightweight, uniform heating and the ability to operate under atmospheric pressure that gains attention from researchers. The present paper synthesizes the current knowledge available for microwave plasma gasification on solid fuels and waste, specifically on affecting parameters and their performance. The review starts with a brief outline on microwave plasma setup in general, and followed by the effect of various operating parameters on resulting output. Operating parameters including fuel characteristics, fuel injection position, microwave power, addition of steam, oxygen/fuel ratio and plasma working gas flow rate are discussed along with several performance criteria such as resulting syngas composition, efficiency, carbon conversion, and hydrogen production rate. Based on the present review, fuel retention time is found to be the key parameter that influences the gasification performance. Therefore, emphasis on retention time is necessary in order to improve the performance of microwave plasma gasification of solid fuels and wastes.

Matched MeSH terms: Plasma Gases*
Domestic and imported products--the Malaysian experience in assuring safe and sufficient plasma products

Ayob Y

Dev Biol (Basel), 2007;127:169-73.
PMID: 17486890
Matched MeSH terms: Plasma/chemistry*
Piezoresistive Effect in Plasma-Doping of Graphene Sheet for High-Performance Flexible Pressure Sensing Application

Haniff MASM, Hafiz SM, Huang NM, Rahman SA, Wahid KAA, Syono MI, et al.

ACS Appl Mater Interfaces, 2017 May 03;9(17):15192-15201.
PMID: 28418234 DOI: 10.1021/acsami.7b02833

This paper presents a straightforward plasma treatment modification of graphene with an enhanced piezoresistive effect for the realization of a high-performance pressure sensor. The changes in the graphene in terms of its morphology, structure, chemical composition, and electrical properties after the NH3/Ar plasma treatment were investigated in detail. Through a sufficient plasma treatment condition, our studies demonstrated that plasma-treated graphene sheet exhibits a significant increase in sensitivity by one order of magnitude compared to that of the unmodified graphene sheet. The plasma-doping introduced nitrogen (N) atoms inside the graphene structure and was found to play a significant role in enhancing the pressure sensing performance due to the tunneling behavior from the localized defects. The high sensitivity and good robustness demonstrated by the plasma-treated graphene sensor suggest a promising route for simple, low-cost, and ultrahigh resolution flexible sensors.

Matched MeSH terms: Plasma
Fulltext Merging worlds of nanomaterials and biological environment: factors governing protein corona formation on nanoparticles and its biological consequences

Foroozandeh P, Aziz AA

Nanoscale Res Lett, 2015;10:221.
PMID: 25995715 DOI: 10.1186/s11671-015-0922-3

Protein corona has became a prevalent subject in the field of nanomedicine owing to its diverse role in determining the efficiency, efficacy, and the ultimate biological fate of the nanomaterials used as a tool to treat and diagnose various diseases. For instance, protein corona formation on the surface of nanoparticles can modify its physicochemical properties and interfere with its intended functionalities in the biological microenvironments. As such, much emphasis should be placed in understanding these complex phenomena that occur at the bio-nano interface. The main aim of this review is to present different factors that are influencing protein-nanoparticle interaction such as physicochemical properties of nanoparticle (i.e., size and size distribution, shape, composition, surface chemistry, and coatings) and the effect of biological microenvironments. Apart from that, the effect of ignored factors at the bio-nano interface such as temperature, plasma concentration, plasma gradient effect, administration route, and cell observer were also addressed.

Matched MeSH terms: Plasma
Fulltext Maternal level of pregnancy-associated plasma protein A as a predictor of pregnancy failure in threatened abortion

Hanita O, Roslina O, Azlin MI

Malays J Pathol, 2012 Dec;34(2):145-51.
PMID: 23424777 MyJurnal

Threatened miscarriage is a common complication of pregnancy. Despite initial viability confirmation by ultrasound scan, some of these patients had further spontaneous abortion. A highly sensitive and specific biomarker would be useful to determine the outcome of pregnancy and to prevent emotional impact to these women. A prospective 14-month cohort study was conducted in the Obstetrics and Gynaecology Department of Universiti Kebangsaan Malaysia Medical Centre to determine whether low serum levels of pregnancy-associated plasma protein A (PAPP-A) measured in early pregnancy can predict the outcome of threatened abortion. 42 pregnant women between 6 to 22 weeks of gestation with threatened abortion and 40 controls were enrolled. Serum samples were collected at presentation and PAPP-A was assayed by electrochemiluminescent immunoassay technique. Pregnancies were followed-up until 22 weeks of gestations and the outcome documented. Nine patients (11%) developed spontaneous abortion and 73 patients (89%) had successful pregnancy. The median PAPP-A level was significantly lower in patients with spontaneous abortion compared to those who had successful pregnancies in the threatened abortion group: 0.78 MoM (0.41-1.00 MoM) vs 1.00 MoM (1.00-2.0 MoM) respectively (p < 0.05). The best sensitivity of 44% and specificity of 93% were obtained at the cut of value of 0.66 MoM (95% CI, 0.561-0.773). In conclusion, low PAPP-A value in threatened abortion women is associated with pregnancy failure, although the use of PAPP-A as a one-time single marker has limited value.

Matched MeSH terms: Pregnancy-Associated Plasma Protein-A/metabolism*
Unexpected sequelae of plantar fasciitis: Iatrogenic calcaneal osteomyelitis following plantar heel injection

Mohd Khalid SA, Bajuri MY

Malays Fam Physician, 2019;14(3):80-83.
PMID: 32175048

The injection of a local anesthetic in combination with a corticosteroid is an accepted choice in the treatment of plantar fasciitis with recalcitrant heel pain. When the injection is performed properly, post-injection infection is extremely rare. We are reporting a rare case of chronic calcaneal osteomyelitis that developed secondary to a local corticosteroid injection. A 56-year-old lady diagnosed with right plantar fasciitis presented with a 6-month history of pain and a persistent sinus with serous discharge of her right heel following a local infiltration of a corticosteroid. A Magnetic Resonance Imaging demonstrated right calcaneal osteomyelitis with intramuscular abscess. Surgical drainage and debridement were done, followed by antibiotic therapy. A recurrence of infection was not detected throughout the duration of follow-up. It is suggested that a plantar heel injection be done in a more controlled environment, such as in operating theatre, to reduce the risk of infection and to avoid injecting a steroid as compared to platelet-rich plasma (PRP) in view of their safety profiles. However, such an injection should only be offered after conservative treatment has failed, as 80% of patients recover well after initial conservative management.

Matched MeSH terms: Platelet-Rich Plasma

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