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Fulltext Shoulder arthrodesis in brachial plexus injuries--a review of six cases

Wong ELW, Kwan MK, Loh WYC, Ahmad TS

Med J Malaysia, 2005 Jul;60 Suppl C:72-7.
PMID: 16381288

Shoulder arthrodesis is a secondary reconstructive option for patients with brachial plexus injuries requiring a stable shoulder. This study was undertaken to evaluate the clinical and radiological outcomes of shoulder fusion in six patients with flail upper limbs following complete brachial plexus injuries. The shoulder was fused in 30 degrees abduction, 30 degrees internal rotation and 30 degrees flexion via a direct lateral approach by using a 4.5 mm reconstruction plate without bone grafting. The average follow-up was 10.3 months. Radiological union was obtained in all patients. Five patients (83%) had relief of pain after the shoulder fusion. Improvement of function was observed in all patients with a mean improvement of 56.6 degrees (range 30 degrees-75 degrees) and 47.5 degrees (range 30 degrees-60 degrees) active flexion and abduction respectively. One patient developed humeral fracture distal to the plate and the fracture eventually healed with a splint. Successful stable fusion of the shoulder in patients with brachial plexus injuries requires rigid fixation with a single 4.5 mm reconstruction plate, protection of bone healing with a triangular abduction brace for 12 weeks and functional trapezius, levator scapulae, serratus anterior and rhomboid muscles for optimizing the functional result.
Fulltext Resection arthrodesis for primary bone tumour about the knee

Kwan MK, Ng ES, Penafort R, Saw A, Sengupta S

Med J Malaysia, 2005 Jul;60 Suppl C:66-71.
PMID: 16381287 MyJurnal

Bone defect following en bloc resection of primary bone tumor around the knee can be reconstructed by allograft or prothesis or combination of both. Resection-arthrodesis is an alternative option for young vigorous patients facing circumstances of financial constrain or limited supply of allograft. This study was undertaken to determine the outcome and complications associated with resection-arthrodesis of 22 primary bone tumors (13 giant cell tumors and 9 osteosarcomas) around the knee treated between 1990 and 2003 at the University Malaya Medical Center. The mean follow-up was 6 years (range 1-13 years). hree patients with osteosarcoma died of lung metastasis, 3 required above knee amputation and 2 defaulted follow-up. Local complications of the procedure include infection in 8 cases (36.4%), non-union 7 (31.8%) and mal-union. Of 14 patients who returned for final evaluation, 79.8% had satisfactory outcomes according to the Musculoskeletal Tumor Society grading system. In conclusion, resection-arthrodesis of the knee is a viable treatment option for selected patients with primary bone tumor around the knee, and good functional outcome can be expected in the presence of short-term local complications.
The distribution of major histocompatibility complex class I polymorphic Alu insertions and their associations with HLA alleles in a Chinese population from Malaysia

Dunn DS, Choy MK, Phipps ME, Kulski JK

Tissue Antigens, 2007 Aug;70(2):136-43.
PMID: 17610418

The frequency and association of polymorphic Alu insertions (POALINs) with human leucocyte antigen (HLA) class I genes within the class I genomic region of the major histocompatibility complex (MHC) have been reported previously for three populations: the Australian Caucasian, Japanese and north-eastern Thai populations. Here, we report on the individual insertion frequency of the five POALINs within the MHC class I region, their HLA-A and HLA-B associations, the POALIN haplotype frequencies and the HLA-A/POALIN four-loci haplotype frequencies in the Malaysian Chinese population. The phylogenetic relationship of the four populations based on the five POALIN allele frequencies was also examined. In the Malaysian Chinese population, the POALIN AluyHG was present at the highest frequency (0.560), followed by AluyHJ (0.300), AluyMICB (0.170), AluyTF (0.040) and AluyHF (0.030). The most frequent five-loci POALIN haplotype of the 16 inferred haplotypes was the AluyHG single insertion haplotype at a frequency of 0.489. Strong associations were present between AluyHJ and HLA-A24, HLA-A33 and HLA-A11 and between AluyHG and HLA-A2, HLA-A24 and HLA-A11, and these were reflected by the inferred haplotype frequencies constructed from the combination of the HLA-A locus and the AluyHG, AluyHJ and AluyHF loci. The strongest association of AluyMICB was with the HLA-B54 allele (five of five), whereas the associations with the other 17 HLA-B alleles were weak, moderate or undetermined. Phylogenetic analysis of the five POALIN allele frequencies places the Malaysian Chinese closest to the Japanese and north-eastern Thai populations in the same cluster and separate to the Australian Caucasian population. The MHC POALINs are confirmed in this study to be informative genetic markers in lineage (haplotype) analysis, population genetics and evolutionary relationships, especially in studying the MHC genomic region.
Fulltext Apollo total knee replacements in University Malaya Medical Centre: a short-term outcome

Abbas AA, Merican AM, Kwan MK, Mohamad JA

Med J Malaysia, 2006 Feb;61 Suppl A:83-7.
PMID: 17042237

Total knee arthroplasty is the most preferred option for treatment of severe osteoarthritis of the knee. We report the short-term outcome of 48 total knee replacements in 31 patients utilizing the Apollo Total Knee System after an average follow-up of 48 months (range 15 to 70 months). Records of all patients who underwent TKA using Apollo Total Knee System were retrospectively reviewed. Functional outcome was evaluated using visual analogue scale for pain rating and the Oxford 12-item questionnaire. Postoperative radiographs of the replaced knees were assessed by using the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Degenerative osteoarthritis was the commonest indication for TKA. The average patient's age was 63.7 years (range, 30-77 years). The mean visual analogue scale for pre- and post-operative pain was eight and zero respectively. The mean Oxford 12-item questionnaire score pre- and post-operatively was 44.8 and 16.5 respectively. Patient satisfaction was notable in 98% of the cases with an average improvement in arc of flexion of 111 degrees. There were four failures; deep infection (one) and aseptic loosening (three) giving rise to a 94% implant survivor. The short-term results of this series is comparable with or better than a number of outcome studies of the Apollo Knee System or other implants of similar design.
Fulltext Pancreatoblastoma: a rare tumour accidentally found

Naik VR, Jaafar H, Leow VM, Bhavaraju VM

Singapore Med J, 2006 Mar;47(3):232-4.
PMID: 16518559

A 15-year-old girl, who was previously well, complained of a mass in the abdomen after a minor motor vehicle accident. Physical and radiological investigations revealed a mass in the body of pancreas containing proteinaceous material and multiple nodules in both lobes of liver. Serological investigations for malignancy were normal. Histopathological examination of the resected specimen showed pancreatoblastoma. Pancreatoblastoma is an unusual malignant tumour seen in infants and children although rare cases have also been reported in adults. They are clinicopathologically distinct from adult pancreatic ductal carcinoma. The histogenesis, clinical features and treatment options are discussed along with presentation of the case.
Loss of human leucocyte antigen class I and gain of class II expression are early events in carcinogenesis: clues from a study of Barrett's oesophagus

Rajendra S, Ackroyd R, Karim N, Mohan C, Ho JJ, Kutty MK

J Clin Pathol, 2006 Sep;59(9):952-7.
PMID: 16467164

Human leucocyte antigen (HLA) expression is altered in oesophageal carcinomas compared with normal tissue. It is unclear, however, whether this phenotype precedes malignant transformation or results as a consequence of it.
Dydrogesterone in threatened abortion: pregnancy outcome

Omar MH, Mashita MK, Lim PS, Jamil MA

J Steroid Biochem Mol Biol, 2005 Dec;97(5):421-5.
PMID: 16293412

To determine whether therapy with dydrogesterone in threatened abortion during the first trimester of pregnancy will improve pregnancy outcome.
Fulltext Socio-demographic Factors of Geriatric Depression

Barua A, Ghosh MK, Kar N, Basilio MA

Indian J Psychol Med, 2010 Jul;32(2):87-92.
PMID: 21716860 DOI: 10.4103/0253-7176.78503

Depression is a common mental health problem in geriatric population and the overall prevalence rate of depression in this age group varies between 10 and 20%.
Detection and genetic profiling of infectious hypodermal and haematopoietic necrosis virus (IHHNV) infections in wild berried freshwater prawn, Macrobrachium rosenbergii collected for hatchery production

Hazreen Nita MK, Kua BC, Bhassu S, Othman RY

Mol Biol Rep, 2012 Apr;39(4):3785-90.
PMID: 21755294 DOI: 10.1007/s11033-011-1155-x

Infectious hypodermal and haematopoietic necrosis virus (IHHNV) has been detected widely in penaeid culture facilities in Asia and the Americas. IHHNV infection on sub-adult and postlarvae of the giant freshwater prawn, Macrobrachium rosenbergii which had caused up to 80% mortalities was first reported in Southeast Taiwan in 2006. In Malaysia, although, there has been no report on IHHNV infections in M. rosenbergii, preliminary work suggests that there is an urgent need to setup a screening protocol for IHHNV for both wild and cultured populations. In this study, polymerase chain reaction based screening was carried out on 30 randomly sampled berried wild M. rosenbergii before and after spawning. All samples did not showed any sign of IHHNV infection. However, the results showed that 20% of the samples were IHHNV positive. Sequence analysis of the amplified band using NCBI-BLAST showed that the putative IHHNV sequence had 98% nucleotide sequence (388 bp) identity with the IHHNV isolate AC-05-005 non-structural protein 1 gene and seven other IHHNV strains in the data bank further affirming the suggestion on the presence of IHHNV in wild freshwater prawn populations in Malaysia.
Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism?

Tambi MI, Imran MK, Henkel RR

Andrologia, 2012 May;44 Suppl 1:226-30.
PMID: 21671978 DOI: 10.1111/j.1439-0272.2011.01168.x

In most countries, millions of people are relying on herbal medicines as remedy for numerous ailments. In South-East Asia, Eurycoma longifolia Jack, also known as 'Malaysian ginseng' or Tongkat ali, is used to combat stress and disease and to improve physical strength. Moreover, the compounds of the roots of this plant are reported to have aphrodisiac and testosterone enhancing effects in the rat. Considering that human studies are not available, 76 of 320 patients suffering from late-onset hypogonadism (LOH) were given 200 mg of a standardised water-soluble extract of Tongkat ali for 1 month. The Ageing Males' Symptoms (AMS) according to the standardised rating scale and the serum testosterone concentration were taken. Results show that treatment of LOH patients with this Tongkat ali extract significantly (P < 0.0001) improved the AMS score as well as the serum testosterone concentration. While before treatment only 10.5% of the patients did not show any complaint according to the AMS scale and 35.5% had normal testosterone levels, after the completed treatment 71.7% and 90.8% of the patients showed normal values, respectively. Thus, Tongkat ali extract appears to be useful as a supplement in overcoming the symptoms of LOH and for the management of hypogonadism.
Fulltext Antibacterial activity of different degree of hydrolysis of palm kernel expeller peptides against spore-forming and non-spore-forming bacteria

Tan YN, Ayob MK, Osman MA, Matthews KR

Lett Appl Microbiol, 2011 Nov;53(5):509-17.
PMID: 21848644 DOI: 10.1111/j.1472-765X.2011.03137.x

The goal of this study was to determine inhibitory effect of palm kernel expeller (PKE) peptides of different degree of hydrolysis (DH %) against spore-forming bacteria Bacillus cereus, Bacillus circulans, Bacillus coagulans, Bacillus licheniformis, Bacillus megaterium, Bacillus pumilus, Bacillus stearothermophillus, Bacillus subtilis, Bacillus thuringiensis, Clostridium perfringens; and non-spore-forming bacteria Escherichia coli, Lisinibacillus sphaericus, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella Typhimurium and Staphylococcus aureus.
First study of the F508del mutation in Malaysian children diagnosed with cystic fibrosis

Nathan AM, Thong MK, deBruyne J, Ariffin H

J Paediatr Child Health, 2011 Aug;47(8):573-5.
PMID: 21843195 DOI: 10.1111/j.1440-1754.2011.02149.x
A parapharyngeal meningioma presenting as a neck mass and multiple cranial nerve palsies

Mohamad I, Abdullah B, Idris Z, Naik VR, Bhavaraju VM

Ceylon Med J, 2011 Jun;56(2):73-4.
PMID: 21789871
Effect of des-aspartate-angiotensin I on the actions of angiotensin II in the isolated renal and mesenteric vasculature of hypertensive and STZ-induced diabetic rats

Dharmani M, Mustafa MR, Achike FI, Sim MK

Regul. Pept., 2005 Jul 15;129(1-3):213-9.
PMID: 15927718

The present study investigated the action of des-aspartate-angiotensin I (DAA-I) on the pressor action of angiotensin II in the renal and mesenteric vasculature of WKY, SHR and streptozotocin (STZ)-induced diabetic rats. Angiotensin II-induced a dose-dependent pressor response in the renal vasculature. Compared to the WKY, the pressor response was enhanced in the SHR and reduced in the STZ-induced diabetic rat. DAA-I attenuated the angiotensin II pressor action in renal vasculature of WKY and SHR. The attenuation was observed for DAA-I concentration as low as 10(-18) M and was more prominent in SHR. However, the ability of DAA-I to reduce angiotensin II response was lost in the STZ-induced diabetic kidney. Instead, enhancement of angiotensin II pressor response was seen at the lower doses of the octapeptide. The effect of DAA-I was not inhibited by PD123319, an AT2 receptor antagonist, and indomethacin, a cyclo-oxygenase inhibitor in both WKY and SHR, indicating that its action was not mediated by angiotensin AT2 receptor and prostaglandins. The pressor responses to angiotensin II in mesenteric vascular bed were also dose-dependent but smaller in magnitude compared to the renal vasculature. The responses were significantly smaller in SHR but no significant difference was observed between STZ-induced diabetic and WKY rat. Similarly, PD123319 and indomethacin had no effect on the action of DAA-I. The findings reiterate a regulatory role for DAA-I in vascular bed of the kidney and mesentery. By being active at circulating level, DAA-I subserves a physiological role. This function appears to be present in animals with diseased state of hypertension and diabetes. It is likely that DAA-I functions are modified to accommodate the ongoing vascular remodeling.
Modification of granular activated carbon using low molecular weight polymer for enhanced removal of Cu(2+) from aqueous solution

Yin CY, Aroua MK, Daud WM

Water Sci Technol, 2007;56(9):95-101.
PMID: 18025736

Palm shell activated carbon was modified via surface impregnation with polyethyleneimine (PEI) to enhance removal of Cu(2+) from aqueous solution in this study. The effect of PEI modification on batch adsorption of Cu(2+) as well as the equilibrium behavior of adsorption of metal ions on activated carbon were investigated. PEI modification clearly increased the Cu(2+) adsorption capacities by 68% and 75.86% for initial solution pH of 3 and 5 respectively. The adsorption data of Cu(2+) on both virgin and PEI-modified AC for both initial solution pH of 3 and 5 fitted the Langmuir and Redlich-Peterson isotherms considerably better than the Freundlich isotherm.
Settling behaviour of aerobic granular sludge

Nor Anuar A, Ujang Z, van Loosdrecht MC, de Kreuk MK

Water Sci Technol, 2007;56(7):55-63.
PMID: 17951868

Aerobic granular sludge (AGS) technology has been extensively studied recently to improve sludge settling and behaviour in activated sludge systems. The main advantage is that aerobic granular sludge (AGS) can settle very fast in a reactor or clarifier because AGS is compact and has strong structure. It also has good settleability and a high capacity for biomass retention. Several experimental works have been conducted in this study to observe the settling behaviours of AGS. The study thus has two aims: (1) to compare the settling profile of AGS with other sludge flocs and (2) to observe the influence of mechanical mixing and design of the reactor to the settleability of AGS. The first experimental outcome shows that AGS settles after less than 5 min in a depth of 0.4 m compared to other sludge flocs (from sequencing batch reactor, conventional activated sludge and extended aeration) which takes more than 30 min. This study also shows that the turbulence from the mixing mechanism and shear in the reactor provides an insignificant effect on the AGS settling velocity.
Fulltext Total knee replacement subsequent to severe necrotising fasciitis of the lower limb

Ling HT, Kwan MK, Saw A, Choon DS

Med J Malaysia, 2006 Aug;61(3):380-2.
PMID: 17240598 MyJurnal

The incidence of wound related complication following total knee arthroplasty is as high as 10%-20%. To perform total knee arthroplasty in a knee with extensive scarring around the knee can be a challenging task. We report a case of 55-year-old diabetic woman, who had total knee arthroplasty, performed two years after she had recovered from necrotizing fasciitis around the right knee. Understanding the vascular anatomy around the knee is of paramount importance in the planning of skin incision to ensure fewer wound related complications.
Evaluation of a new predictive equation for automated calculation of size-specific dose estimate (SSDE) in CT imaging

Osman ND, Abdulkadir MK, Shuaib IL, Nasirudin RA

Radiography (Lond), 2024 Jan;30(1):237-244.
PMID: 38035439 DOI: 10.1016/j.radi.2023.11.012

INTRODUCTION: The adoption of size-specific dose estimate (SSDE) in clinical practice is still limited owing to the tedious and complex manual measurement of individual patient size for the clinical calculation of SSDE. Thus, the automation of SSDE is imperative. This study aims to evaluate a predictive equation for the automated calculation of SSDE.
METHODS: A user-friendly software was developed to accurately predict the individual size-specific dose estimation of paediatric patients undergoing computed tomography (CT) scans of the head, thorax, and abdomen. The software includes a calculation equation developed based on a novel SSDE prediction equation that used a population's pre-determined percentage difference between volume-weighted computed tomography dose index (CTDIvol) and SSDE with age. American Association of Physicists in Medicine (AAPM RPT 204) method (manual) and segmentation-based SSDE calculators (indoseCT and XXautocalc) were used to assess the proposed software predictions comparatively.
RESULTS: The results of this study show that the automated equation-based calculation of SSDE and the manual and segmentation-based calculation of SSDE are in good agreement for patients. The differences between the automated equation-based calculation of SSDE and the manual and segmentation-based calculation are less than 3%.
CONCLUSION: This study validated an accurate SSDE calculator that allows users to enter key input values and calculate SSDE.
IMPLICATION FOR PRACTICE: The automated equation-based SSDE software (PESSD) seems a promising tool for estimating individualised CT doses during CT scans.
β-cyclodextrin polymer composites for the removal of pharmaceutical substances, endocrine disruptor chemicals, and dyes from aqueous solution- A review of recent trends

Kamaraj M, Suresh Babu P, Shyamalagowri S, Pavithra MKS, Aravind J, Kim W, et al.

J Environ Manage, 2024 Feb;351:119830.
PMID: 38141340 DOI: 10.1016/j.jenvman.2023.119830

Cyclodextrin (CD) and its derivatives are receiving attention as a new-generation adsorbent for water pollution treatment due to their external hydrophilic and internal hydrophobic properties. Among types of CD, β-Cyclodextrin (βCD) has been a material of choice with a proven track record for a range of utilities in distinct domains, owing to its unique cage-like structural conformations and inclusion complex-forming ability, especially to mitigate emerging contaminants (ECs). This article outlines βCD composites in developing approaches of their melds and composites for purposes such as membranes for removal of the ECs in aqueous setups have been explored with emphasis on recent trends. Electrospinning has bestowed an entirely different viewpoint on polymeric materials, comprising βCD, in the framework of diverse functions across a multitude of niches. Besides, this article especially discusses βCD polymer composite membrane-based removal of contaminants such as pharmaceutical substances, endocrine disruptors chemicals, and dyes. Finally, in this article, the challenges and future directions of βCD-based adsorbents are discussed, which may shed light on pragmatic commercial applications of βCD polymer composite membranes.
Fulltext Utilizing mollusk soft tissue and shells as biomarkers for monitoring heavy metal pollution in mangrove forests

Krishnan K, Saion E, Halimah MK, Yap CK

MethodsX, 2023 Dec;11:102281.
PMID: 37519950 DOI: 10.1016/j.mex.2023.102281

The primary objective of the study was to examine the distribution of various elements, namely Cadmium (Cd), Copper (Cu), Iron (Fe), Nickel (Ni), and Lead (Pb), in the soft tissues, shells, and associated surface sediments of Cerithidea obtusa (C. obtusa) mangrove snails collected from Sungai Besar Sepang. To conduct the analysis, the preferred and most convenient methods employed were Instrumental Neutron Activation Analysis (INAA) and Atomic absorption spectrometry (AAS). The results showed that the mean concentration of elements in the sediments and soft tissues followed the order Fe > Cu > Ni > Pb > Cd, while for the shell of C. obtusa, it was Fe > Ni > Cu > Pb > Cd.•Iron (Fe) showed the highest concentration among all elements monitored in sediments, soft tissues, and shells of C. obtusa.•The PF results indicated higher incorporation of Pb and Ni into shells.•BSAF results showed that C. obtusa shells accumulated more Cu and Cd from sediments, making them effective biomonitors.

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