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  1. Fulltext Rapamycin and its analogues (rapalogs) for Tuberous Sclerosis Complex-associated tumors: a systematic review on non-randomized studies using meta-analysis
    Sasongko TH, Ismail NF, Nik Abdul Malik NM, Zabidi-Hussin ZA
    Orphanet J Rare Dis, 2015;10:95.
    PMID: 26259610 DOI: 10.1186/s13023-015-0317-7
    Rapamycin has gained significant attention for its potential activity in reducing the size of TSC-associated tumors, thus providing alternative to surgery. This study aimed at determining the efficacy of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with Tuberous Sclerosis Complex (TSC).
    Matched MeSH terms: Adolescent
  2. Fulltext Prevalence and social determinants of smoking in 15 countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary data analyses of demographic and health surveys
    Sreeramareddy CT, Pradhan PM
    PLoS One, 2015;10(7):e0130104.
    PMID: 26131888 DOI: 10.1371/journal.pone.0130104
    BACKGROUND: Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking.
    METHODS: Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for 'current smoking' and 'current use of smokeless tobacco (SLT) products' among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design.
    FINDINGS: Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single.
    CONCLUSION: Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.
    Matched MeSH terms: Adolescent
  3. Fulltext Maternal filicide among women admitted to forensic psychiatric institutions in Malaysia: case series
    Razali S, Salleh RM, Yahya B, Ahmad SH
    East Asian Arch Psychiatry, 2015 Jun;25(2):79-87.
    PMID: 26118747
    Objectives: To examine the characteristics of maternal filicide and describe the adverse life events experienced by women who have committed filicide and been hospitalised in forensic psychiatric institutions in Malaysia.
    Methods: Registration records from 2000 through 2012 of female patients from 2 main forensic psychiatric institutions in Malaysia were reviewed. The medical records of patients who had committed maternal filicide were selected and descriptively evaluated.
    Results: A total of 18 cases of maternal filicide were identified. Family dysfunction that presented with marital discord, domestic violence, or husband with substance abuse was the main stress experienced by the women. Three social circumstances, including an adolescent who became a victim of date rape; immigrants who experienced sexual abuse; and filicide-suicide precipitated by financial difficulties were highlighted.
    Conclusion: Women who committed filicide had experienced various difficulties in their life. The presence of such life events might alert mental health professionals to investigate the possibility of filicide among their patients.
    Key words: Depressive disorder; Domestic violence; Infanticide; Maternal behavior
    Matched MeSH terms: Adolescent
  4. An online open-source tool for automated quantification of liver and myocardial iron concentrations by T2* magnetic resonance imaging
    Git KA, Fioravante LA, Fernandes JL
    Br J Radiol, 2015 Sep;88(1053):20150269.
    PMID: 26118302 DOI: 10.1259/bjr.20150269
    To assess whether an online open-source tool would provide accurate calculations of T2(*) values for iron concentrations in the liver and heart compared with a standard reference software.
    Matched MeSH terms: Adolescent
  5. Emotional intelligence as a mediator between rumination and suicidal ideation among depressed inpatients: The moderating role of suicidal history
    Abdollahi A, Talib MA
    Psychiatry Res, 2015 Aug 30;228(3):591-7.
    PMID: 26117250 DOI: 10.1016/j.psychres.2015.05.046
    Suicide is a substantial public health problem, and it remains a serious cause of death in the world. Therefore, this study was designed to examine the relationships between brooding, reflection, emotional intelligence (assessed by performance-based test), and suicidal ideation; the mediation role of emotional intelligence on the relationships between brooding and reflection with suicidal ideation; and the moderating role of suicidal history on the relationships between brooding, reflection, and emotional intelligence with suicidal ideation among Iranian depressed adolescents. The study consisted of a cross-sectional sample of 202 depressed adolescent inpatients from five public hospitals in Tehran, Iran completed measures of depression, rumination, emotional intelligence, and suicide attempt history as indices of suicidal ideation. Structural Equation Modelling estimated that depressed adolescent inpatients with high levels of brooding and reflective rumination, and low levels of emotional intelligence were more likely to report suicidal ideation. Moreover, emotional intelligence partially mediated the relationships between brooding and reflective rumination with suicidal ideation. Suicidal history moderated the relationships between brooding, reflection, and emotional intelligence with suicidal ideation. These findings reinforce the importance of emotional intelligence as an influencing factor against the deleterious effects of rumination styles and suicidal ideation. The results indicate that brooding and reflection have detrimental effects on suicidal ideation in depressed inpatients.
    Matched MeSH terms: Adolescent
  6. PREVALENCE OF CHILD MARRIAGE AMONG BANGLADESHI WOMEN AND TREND OF CHANGE OVER TIME
    Hossain MG, Mahumud RA, Saw A
    J Biosoc Sci, 2016 Aug;48(4):530-8.
    PMID: 26286142 DOI: 10.1017/S0021932015000279
    Many Bangladeshi women marry early, and many marry before the legal age of 18 years. This practice has been associated with a higher risk of health and medical morbidities, and also early pregnancy with higher pre- and postnatal complications. The aim of this study was to determine the prevalence, and factors associated with, child marriage among Bangladeshi women using multiple binary logistic regression analysis of data from the BDHS-2011. Further analysis on the trend of age at first marriage was performed with additional data sets from previous surveys. The mean and median of ages at first marriage of Bangladeshi women in 2011 were 15.69±2.97 and 15.00 years, respectively. A remarkably high percentage (78.2%) married before the age of 18; of these, 5.5% married at a very early age (before 13 years of age). Binary logistic regression analysis demonstrated that uneducated women were more likely to be married early (p<0.001) than those with secondary and higher education. Child marriage was especially pronounced among women with uneducated husbands, Muslims, those with poor economic backgrounds and those living in rural areas. Further analysis including data from previous BDHS surveys showed that child marriage among Bangladeshi women had a decreasing trend from 1993-94 to 2011. These results show that child marriage was very common in Bangladesh, and closely associated with low level of education and low economic status. The decreasing trend in child marriage indicates an improvement over the past two decades but more effort is needed to further reduce and eventually eliminate the practice.
    Matched MeSH terms: Adolescent
  7. Fulltext Practices of Dengue Fever Prevention and the Associated Factors among the Orang Asli in Peninsular Malaysia
    Chandren JR, Wong LP, AbuBakar S
    PLoS Negl Trop Dis, 2015;9(8):e0003954.
    PMID: 26267905 DOI: 10.1371/journal.pntd.0003954
    BACKGROUND: Dengue is prevalent among Malaysia's indigenous peoples, known as the Orang Asli, and it poses a serious health threat to them. The study aims to look at the socio-demographic factors, health beliefs, and knowledge about dengue and its association to dengue prevention practices among Orang Asli communities in Peninsular Malaysia.

    METHODS: A cross-sectional survey was conducted in 16 randomly selected Orang Asli villages from eight states in Peninsular Malaysia from April 2012 until February 2013.

    RESULTS: A total of 560 Orang Asli were interviewed and 505 completed the survey. Slightly above half of the participants (n = 280, 55.4%) had a total dengue prevention score of 51-100 (of a possible score of 0-100). Multivariate analysis findings showed dengue knowledge, perceived barriers to perform dengue prevention, fogging frequency, and perceived susceptibility to dengue fever as significant factors associated to dengue prevention practices. Participants with a lower dengue knowledge score (score 0-18) were less likely (OR = 0.63, 95%CI = 0.44-0.92 vs. score 19-36, P = 0.015) to practice dengue prevention. Participants with low perceived barriers to prevent dengue (score of 1-5) were more likely (OR = 2.06, 95%CI = 1.21-3.53, vs. score of 6-10, P = 0.008) to practice dengue prevention. Villages that were not fogged (OR = 0.49, 95%CI = 0.24-0.99, P = 0.045) or rarely fogged (OR = 0.40, 95%CI = 0.22-0.75, P = 0.004) had lower dengue prevention practices than villages that were fogged often. Participants with low perceived susceptibility of acquiring dengue (score of 1-5) were less likely (OR = 0.54, 95%CI = 0.33-0.89 vs. score of 6-10, P = 0.018) to practice dengue prevention measures.

    CONCLUSION: Findings imply that educational and health programmes should focus on enhancing dengue knowledge and perceived susceptibility of acquiring dengue and reducing perceived barriers to performing dengue prevention practices among the Orang Asli. More outreach on mosquito control campaigns should be carried out especially in villages where mosquito fogging is frequent.

    Matched MeSH terms: Adolescent
  8. Multisensory distortions of the hand have differential effects on tactile perception
    Treshi-marie Perera A, Newport R, McKenzie KJ
    Exp Brain Res, 2015 Nov;233(11):3153-61.
    PMID: 26195170 DOI: 10.1007/s00221-015-4384-8
    Research has suggested that altering the perceived shape and size of the body image significantly affects perception of somatic events. The current study investigated how multisensory illusions applied to the body altered tactile perception using the somatic signal detection task. Thirty-one healthy volunteers were asked to report the presence or absence of near-threshold tactile stimuli delivered to the index finger under three multisensory illusion conditions: stretched finger, shrunken finger and detached finger, as well as a veridical baseline condition. Both stretching and shrinking the stimulated finger enhanced correct touch detections; however, the mechanisms underlying this increase were found to be different. In contrast, the detached appearance reduced false touch reports-possibly due to reduced tactile noise, as a result of attention being directed to the tip of the finger only. These findings suggest that distorted representations of the body could have different modulatory effects on attention to touch and provide a link between perceived body representation and somatosensory decision-making.
    Matched MeSH terms: Adolescent
  9. The effects of negative emotion on encoding-related neural activity predicting item and source recognition
    Yick YY, Buratto LG, Schaefer A
    Neuropsychologia, 2015 Jul;73:48-59.
    PMID: 25936685 DOI: 10.1016/j.neuropsychologia.2015.04.030
    We report here a study that obtained reliable effects of emotional modulation of a well-known index of memory encoding--the electrophysiological "Dm" effect--using a recognition memory paradigm followed by a source memory task. In this study, participants performed an old-new recognition test of emotionally negative and neutral pictures encoded 1 day before the test, and a source memory task involving the retrieval of the temporal context in which pictures had been encoded. Our results showed that Dm activity was enhanced for all emotional items on a late positivity starting at ~400 ms post-stimulus onset, although Dm activity for high arousal items was also enhanced at an earlier stage (200-400 ms). Our results also showed that emotion enhanced Dm activity for items that were both recognised with or without correct source information. Further, when only high arousal items were considered, larger Dm amplitudes were observed if source memory was accurate. Three main conclusions are drawn from these findings. First, negative emotion can enhance encoding processes predicting the subsequent recognition of central item information. Second, if emotion reaches high levels of arousal, the encoding of contextual details can also be enhanced over and above the effects of emotion on central item encoding. Third, the morphology of our ERPs is consistent with a hybrid model of the role of attention in emotion-enhanced memory (Pottage and Schaefer, 2012).
    Matched MeSH terms: Adolescent
  10. Should the threshold for expired-air carbon monoxide concentration as a means of verifying self-reported smoking abstinence be reduced in clinical treatment programmes? Evidence from a Malaysian smokers' clinic
    Wee LH, West R, Mariapun J, Chan CM, Bulgiba A, Peramalah D, et al.
    Addict Behav, 2015 Aug;47:74-9.
    PMID: 25889913 DOI: 10.1016/j.addbeh.2015.03.021
    BACKGROUND: It has been proposed that the expired-air carbon monoxide (CO) threshold for confirming smoking abstinence in clinical practice be reduced below 10 ppm. Optimal thresholds may vary across regions. Data are needed to assess the impact of such a change on claimed success.
    METHODS: A total of 253 smokers who attended the Tanglin quit smoking clinic in Malaysia were followed-up 1, 3 and 6 months after the target quit date. All participants received a standard behavioural support programme and were prescribed either varenicline or nicotine replacement therapy. Expired-air CO was measured at every visit. Respondents' smoking status was assessed using a range of different CO thresholds (3, 5 and 10 ppm) and the impact on quit rates was calculated. Predictors of success as defined using the different thresholds were assessed.
    RESULTS: The 6-month abstinence rates were: 1 month - 54.9% at 10 ppm, 54.9% at 5 ppm and 48.6% at 3 ppm; 3 months - 36.0% at 10 ppm, 35.2% at 5 ppm and 30.4% at 3 ppm; 6 months - 24.1% at 10 ppm, 24.1% at 5 ppm and 20.6% at 3 ppm. Older smokers were more likely to be recorded as abstinent at 6 months regardless of the threshold used.
    CONCLUSIONS: Reducing the threshold for expired-air carbon monoxide concentrations to verify claimed smoking abstinence from 10 ppm to 5 ppm makes minimal difference to documented success rates in Malaysian smoker's clinic patients. Reducing to 3 ppm decreases success rates slightly. Predictors of success at stopping appear to be unaffected by the threshold used.
    KEYWORDS: Carbon monoxide; Predictors for abstinence; Smoking cessation; Success rates
    Matched MeSH terms: Adolescent
  11. Prognostic factors and survival rate of osteosarcoma: A single-institution study
    Faisham WI, Mat Saad AZ, Alsaigh LN, Nor Azman MZ, Kamarul Imran M, Biswal BM, et al.
    Asia Pac J Clin Oncol, 2017 Apr;13(2):e104-e110.
    PMID: 25870979 DOI: 10.1111/ajco.12346
    AIM: Osteosarcoma is a highly malignant primary bone tumor. The study aim to evaluate the prognostic factors influencing the survival rate in our center.

    METHODS: This was a retrospective cohort study of all patients treated between January 2005 and December 2010.

    RESULTS: We included 163 patients with an age range of 6-59 years (median = 19). The median follow-up was 47 months (range 36-84). The overall survival in patients who completed chemotherapy and surgery (n = 117) was 72% at 2 years and 44% at 5 years. Histologically, 99 (85%) had osteoblastic, 6 (5%) had chondroblastic and 3 (2.5%) had telangiectatic osteosarcoma. Limb salvage surgery was performed in 80 (49%) and 41 (25%) underwent amputation. However, 46 patients (28%) underwent no surgical intervention and incomplete chemotherapy. In total, 38/79 patients had a good chemotherapy response. There was a significantly better survival rate for limb salvage versus amputation. Independent prognostic factors for survival are compliance to treatment and presence of lung metastasis.

    CONCLUSION: The overall survival of osteosarcoma patients was influenced by the presence of pulmonary metastases and compliance to treatment. Histological subtype, different chemotherapy regimens and histological necrosis after chemotherapy did not significantly influence survival. The patients who did not complete treatment had significantly poorer survival.

    Matched MeSH terms: Adolescent
  12. Fulltext TERT gene harbors multiple variants associated with pancreatic cancer susceptibility
    Campa D, Rizzato C, Stolzenberg-Solomon R, Pacetti P, Vodicka P, Cleary SP, et al.
    Int J Cancer, 2015 Nov 01;137(9):2175-83.
    PMID: 25940397 DOI: 10.1002/ijc.29590
    A small number of common susceptibility loci have been identified for pancreatic cancer, one of which is marked by rs401681 in the TERT-CLPTM1L gene region on chromosome 5p15.33. Because this region is characterized by low linkage disequilibrium, we sought to identify whether additional single nucleotide polymorphisms (SNPs) could be related to pancreatic cancer risk, independently of rs401681. We performed an in-depth analysis of genetic variability of the telomerase reverse transcriptase (TERT) and the telomerase RNA component (TERC) genes, in 5,550 subjects with pancreatic cancer and 7,585 controls from the PANcreatic Disease ReseArch (PANDoRA) and the PanScan consortia. We identified a significant association between a variant in TERT and pancreatic cancer risk (rs2853677, odds ratio = 0.85; 95% confidence interval = 0.80-0.90, p = 8.3 × 10(-8)). Additional analysis adjusting rs2853677 for rs401681 indicated that the two SNPs are independently associated with pancreatic cancer risk, as suggested by the low linkage disequilibrium between them (r(2) = 0.07, D' = 0.28). Three additional SNPs in TERT reached statistical significance after correction for multiple testing: rs2736100 (p = 3.0 × 10(-5) ), rs4583925 (p = 4.0 × 10(-5) ) and rs2735948 (p = 5.0 × 10(-5) ). In conclusion, we confirmed that the TERT locus is associated with pancreatic cancer risk, possibly through several independent variants.
    Matched MeSH terms: Adolescent
  13. Fulltext Validity and reliability of the Malay version of the Structured Migraine Interview (SMI) Questionnaire
    Shaik MM, Hassan NB, Tan HL, Bhaskar S, Gan SH
    J Headache Pain, 2015 Mar 14;16:22.
    PMID: 25903056 DOI: 10.1186/s10194-015-0509-5
    BACKGROUND: The Structured Migraine Interview (SMI) is a valid and reliable instrument for migraine diagnosis. However, a Malay version of the SMI is not available to be applied to the local Malaysian population. This study was designed to access the validity and reliability of a new Malay version of the SMI questionnaire.
    METHODS: Patients with headache attending the Neurology Clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, were screened against the inclusion/exclusion criteria before recruitment. A standard translation procedure was used to translate and adapt the questionnaire into the Malay language. The translated version was tested for face, content and construct validities. Subsequently, validity and reliability studies were conducted (1(st) compilation), followed by retesting seven days later (2(nd) compilation).
    RESULTS: A total of 157 patients between 15 and 60 years of age were enrolled in this study. The kappa value was 0.70 (p 
    Matched MeSH terms: Adolescent
  14. Complementary and alternative medicine use in patients with hematological cancers in Malaysia
    Gan GG, Leong YC, Bee PC, Chin E, Teh AK
    Support Care Cancer, 2015 Aug;23(8):2399-406.
    PMID: 25876158 DOI: 10.1007/s00520-015-2614-z
    BACKGROUND: Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country.

    PATIENTS AND METHODS: This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale.

    RESULTS: A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage.

    CONCLUSION: In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.

    Matched MeSH terms: Adolescent
  15. Fulltext Relationship between trusting behaviors and psychometrics associated with social network and depression among young generation: a pilot study
    Watabe M, Kato TA, Teo AR, Horikawa H, Tateno M, Hayakawa K, et al.
    PLoS One, 2015;10(3):e0120183.
    PMID: 25836972 DOI: 10.1371/journal.pone.0120183
    Maladaptive social interaction and its related psychopathology have been highlighted in psychiatry especially among younger generations. In Japan, novel expressive forms of psychiatric phenomena such as "modern-type depression" and "hikikomori" (a syndrome of severe social withdrawal lasting for at least six months) have been reported especially among young people. Economic games such as the trust game have been utilized to evaluate real-world interpersonal relationships as a novel candidate for psychiatric evaluations. To investigate the relationship between trusting behaviors and various psychometric scales, we conducted a trust game experiment with eighty-one Japanese university students as a pilot study. Participants made a risky financial decision about whether to trust each of 40 photographed partners. Participants then answered a set of questionnaires with seven scales including the Lubben Social Network Scale (LSNS)-6 and the Patient Health Questionnaire (PHQ)-9. Consistent with previous research, male participants trusted partners more than female participants. Regression analysis revealed that LSNS-family (perceived support from family) for male participants, and item 8 of PHQ-9 (subjective agitation and/or retardation) for female participants were associated with participants' trusting behaviors. Consistent with claims by social scientists, our data suggest that, for males, support from family was negatively associated with cooperative behavior toward non-family members. Females with higher subjective agitation (and/or retardation) gave less money toward males and high attractive females, but not toward low attractive females in interpersonal relationships. We believe that our data indicate the possible impact of economic games in psychiatric research and clinical practice, and validation in clinical samples including modern-type depression and hikikomori should be investigated.
    Matched MeSH terms: Adolescent
  16. Fulltext Problem-solving skills appraisal mediates hardiness and suicidal ideation among malaysian undergraduate students
    Abdollahi A, Talib MA, Yaacob SN, Ismail Z
    PLoS One, 2015;10(4):e0122222.
    PMID: 25830229 DOI: 10.1371/journal.pone.0122222
    Recent evidence suggests that suicidal ideation is increased among university students, it is essential to increase our knowledge concerning the etiology of suicidal ideation among university students. This study was conducted to examine the relationships between problem-solving skills appraisal, hardiness, and suicidal ideation among university students. In addition, this study was conducted to examine problem-solving skills appraisal (including the three components of problem-solving confidence, approach-avoidance style, and personal control of emotion) as a potential mediator between hardiness and suicidal ideation.
    Matched MeSH terms: Adolescent
  17. Cross-cultural adaptation of the Malay version of the parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) in Malaysia
    Wo SW, Lai PS, Ong LC, Low WY, Lim KS, Tay CG, et al.
    Epilepsy Behav, 2015 Apr;45:118-23.
    PMID: 25819800 DOI: 10.1016/j.yebeh.2015.02.037
    We aimed to cross-culturally adapt the parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Malay and to determine its validity and reliability among parents of children with epilepsy in Malaysia.
    Matched MeSH terms: Adolescent
  18. Fulltext A review of the acute pain service in Hospital Kuala Lumpur
    Neelima G, Chieng DC, Lim TA, Inbasegaran K
    Med J Malaysia, 2003 Jun;58(2):167-79.
    PMID: 14569736 MyJurnal
    This study is a review of the Acute Pain Service in Hospital Kuala Lumpur for the years 1998 to 2001. 5042 records from post-operative patients were analysed. The majority of patients (81.8%) had satisfactory pain control. Eighty-two percent of patients experienced only mild pain at rest on the first post-operative day. The highest pain score occurred on the first day in 68.3% of patients. Nausea or vomiting occurred in 23.2% of the patients. Eight patients had respiratory depression. The low pain scores recorded by most patients and the low incidence of side effects reflect the efficiency of the service provided.
    Matched MeSH terms: Adolescent
  19. Non-invasive cardiac assessment in beta-thalassaemia major
    Ong ML, Hatle LK, Lai VM, Bosco J
    Int J Clin Pract, 2002 Jun;56(5):345-8.
    PMID: 12137442
    Iron deposition in the heart occurs in beta-thalassaemia major and contributes to cardiac dysfunction. Eighteen patients with beta-thalassaemia major were assessed clinically and had non-invasive investigations. They were young (15.5 +/- 3.6 years). Two patients had clinical heart failure. Doppler echocardiography demonstrated higher transmitral peak flow velocity in early and late diastole compared with controls (e: p<0.05, a: p<0.01). Transtricuspid peak late diastolic flow velocity was higher in patients (p<0.005). Isovolumic relaxation time was shortened (p<0.001). Pulmonary venous flow velocity was higher in diastole than systole (S: 0.51 +/- 0.11 m/s, D: 0.62 +/- 0.08 m/s). Reversal of pulmonary venous flow during atrial systole was seen in eight patients. These diastolic filling abnormalities did not significantly change with blood transfusion. Left ventricular ejection fraction was normal in patients. Two patients had cardiomegaly on chest X-ray. In beta-thalassaemia with iron overload, there is a restrictive pattern of diastolic dysfunction. This is not altered by recent blood transfusion. Left ventricular function remains relatively intact.
    Matched MeSH terms: Adolescent
  20. Fulltext Neurological deficit after surgery for spinal deformity--the value of normal intra operative wake-up tests in large sagitta curves. A report of two cases from an institution
    Harwant S
    Med J Malaysia, 2001 Jun;56 Suppl C:80-5.
    PMID: 11814258
    Neurological deficit after surgery for spinal deformity is a rare but devastating complication. Factors that have been associated with a post surgical deficit are congenital curves, large curves, kyphotic deformities, anterior and posterior surgery, ligation of multiple anterior vessels and hypotension; controlled or otherwise. Intra operative wake up tests have been used alone or in combination with spinal cord monitoring: to detect evolving neurological deficit in spinal deformity surgery. Despite these checks, major neurological deficits still occur post surgery. This is a report of two cases with normal intra operative wake up tests, but developed neurological deficit twelve hours after the end of surgery.
    Matched MeSH terms: Adolescent
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