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  1. Effects of gestational diabetes mellitus on the quality and quantity of blood hematopoietic stem cells: a case-control study
    Tusimin M, Ahmed SME, Wei Lee K, Siew Mooi C, Md Noor S, Nordin N
    Croat Med J, 2021 Dec 31;62(6):590-597.
    PMID: 34981691
    AIM: To evaluate the effects of gestational diabetes mellitus (GDM) on the quantity and quality of hematopoietic stem cells (HSC).

    METHODS: In this case-control study, HSC were isolated from umbilical cord blood (UCB) procured at delivery from 63 mothers with GDM and 67 healthy mothers. Total nucleated cells (TNC) and CD34+ cells were quantified using BD FACSCalibur flow cytometer. The quantity and quality of stem cells were determined.

    RESULTS: The GDM group had lower total cord blood volume and lower number of nucleated HSC compared with healthy mothers. Regarding stem cell quantity parameters, they had significantly lower UCB volume (P=0.041), TNC count (P=0.022), total viable NC count (P=0.014), and CD34+ percentage (P=0.014). Regarding the quality of stem cells, they had significantly lower viable TNC percentage (P=0.015). The predictors for total TNC count were longer labor duration (adjusted B coefficient [p]: 0.031 [0.046]), greater estimated blood loss (0.089 [0.005]), female neonates (12.322 [0.049]), and higher placenta weight (0.080 [0.033]). The predictors of total viable NC count were greater estimated blood loss (0.092 [0.003]), female neonates (13.16 [0.035]), and greater placenta weight (0.083 [0.026]).

    CONCLUSION: The GDM group had much lower quantity and quality of UCB stem cells. Our results should be taken into consideration when drawing cord blood for unrelated stem cell banking in an obstetric unit to ensure the obtaining of optimal cord blood samples and to avoid unnecessary expenses.

  2. Fulltext LEMABE: a novel framework to improve analogy-based software cost estimation using learnable evolution model
    Dashti M, Javdani Gandomani T, Hasanpoor Adeh D, Zulzalil H, Md Sultan AB
    PeerJ Comput Sci, 2022;8:e800.
    PMID: 35111910 DOI: 10.7717/peerj-cs.800
    One of the most important and critical factors in software projects is the proper cost estimation. This activity, which has to be done prior to the beginning of a project in the initial stage, always encounters several challenges and problems. However, due to the high significance and impact of the proper cost estimation, several approaches and methods have been proposed regarding how to perform cost estimation, in which the analogy-based approach is one of the most popular ones. In recent years, many attempts have been made to employ suitable techniques and methods in this approach in order to improve estimation accuracy. However, achieving improved estimation accuracy in these techniques is still an appropriate research topic. To improve software development cost estimation, the current study has investigated the effect of the LEM algorithm on optimization of features weighting and proposed a new method as well. In this research, the effectiveness of this algorithm has been examined on two datasets, Desharnais and Maxwell. Then, MMRE, PRED (0.25), and MdMRE criteria have been used to evaluate and compare the proposed method against other evolutionary algorithms. Employing the proposed method showed considerable improvement in estimating software cost estimation.
  3. Fulltext Ternary Nanocomposite System Composing of Graphene Nanoplatelet, Cellulose Nanofiber and Jatropha Oil Based Waterborne Polyurethane: Characterizations, Mechanical, Thermal Properties and Conductivity
    Amri MR, Md Yasin F, Abdullah LC, Al-Edrus SSO, Mohamad SF
    Polymers (Basel), 2021 Oct 29;13(21).
    PMID: 34771296 DOI: 10.3390/polym13213740
    This work aims to evaluate the performance of graphene nanoplatelet (GNP) as conductive filler with the presence of 0.5 wt.% cellulose nanofiber (CNF) on the physical, mechanical, conductivity and thermal properties of jatropha oil based waterborne polyurethane. Polyurethane was made from crude jatropha oil using an epoxidation and ring-opening process. 0.5, 1.0, 1.5, 2.0 wt.% GNP and 0.5 wt.% CNF were incorporated using casting method to enhance film performance. Mechanical properties were studied following standard method as stated in ASTM D638-03 Type V. Thermal stability of the nanocomposite system was studied using thermal gravimetric analysis (TGA). Filler interaction and chemical crosslinking was monitored using Fourier-transform infrared spectroscopy (FTIR) and film morphology were observed with field emission scanning electron microscopy (FESEM). Water uptake analysis, water contact angle and conductivity tests are also carried out. The results showed that when the GNP was incorporated at fixed CNF content, it was found to enhance the nanocomposite film, its mechanical, thermal and water behavior properties as supported by morphology and water uptake. Nanocomposite film with 0.5 wt.% GNP shows the highest improvement in term of tensile strength, Young's modulus, thermal degradation and water behavior. As the GNP loading increases, water uptake of the nanocomposite film was found relatively small (<1%). Contact angle test also indicates that the film is hydrophobic with addition of GNP. The conductivity properties of the nanocomposite film were not enhanced due to electrostatic repulsion force between GNP sheet and hard segment of WBPU. Overall, with addition of GNP, mechanical and thermal properties was greatly enhanced. However, conductivity value was not enhanced as expected due to electrostatic repulsion force. Therefore, ternary nanocomposite system is a suitable candidate for coating application.
  4. A 5-year-old boy with left flank mass and pain: Questions
    Ag NJ, S NA, Md MA, Cj NA, F T, I MI
    Pediatr Nephrol, 2021 Nov 18.
    PMID: 34796397 DOI: 10.1007/s00467-021-05322-2
  5. A 5-year-old boy with left flank mass and pain: Answers
    Ag NJ, S NA, Md MA, Cj NA, F T, I MI
    Pediatr Nephrol, 2021 Nov 18.
    PMID: 34796396 DOI: 10.1007/s00467-021-05323-1
  6. Chemometrics analysis for the detection of dental caries via UV absorption spectroscopy
    Basri KN, Yazid F, Megat Abdul Wahab R, Mohd Zain MN, Md Yusof Z, Zoolfakar AS
    Spectrochim Acta A Mol Biomol Spectrosc, 2022 Feb 05;266:120464.
    PMID: 34634732 DOI: 10.1016/j.saa.2021.120464
    Caries is one of the non-communicable diseases that has a high prevalence trend. The current methods used to detect caries require sophisticated laboratory equipment, professional inspection, and expensive equipment such as X-ray imaging device. A non-invasive and economical method is required to substitute the conventional methods for the detection of caries. UV absorption spectroscopy coupled with chemometrics analysis has emerged as a good potential candidate for such an application. Data preprocessing methods such as mean centre, autoscale and Savitzky-Golay smoothing were implemented to enhance the signal-to-noise ratio of spectra data. Various classification algorithms namely K-nearest neighbours (KNN), logistic regression (LR) and linear discriminant analysis (LDA) were implemented to classify the severity of dental caries into International Caries Detection and Assessment System (ICDAS) scores. The performance of the prediction model was measured and comparatively analysed based on the accuracy, precision, sensitivity, and specificity. The LDA algorithm combined with the Savitzky-Golay preprocessing method had shown the best result with respect to the validation data accuracy, precision, sensitivity and specificity, where each had values of 0.90, 1.00, 0.86 and 1.00 respectively. The area under the curve of the ROC plot computed for the LDA algorithm was 0.95, which indicated that the prediction algorithm was capable of differentiating normal and caries teeth excellently.
  7. Effects of conform, non-conform, and hybrid conformity toward stress distribution at the glenoid implant and cement: A finite element study
    Abdul Wahab AH, Mohamad Azmi NA, Abdul Kadir MR, Md Saad AP
    Int J Artif Organs, 2022 Feb;45(2):200-206.
    PMID: 33645338 DOI: 10.1177/0391398821999391
    Glenoid conformity is one of the important aspects that could contribute to implant stability. However, the optimal conformity is still being debated among the researchers. Therefore, this study aims to analyze the stress distribution of the implant and cement in three types of conformity (conform, non-conform, and hybrid) in three load conditions (central, anterior, and posterior). Glenoid implant and cement were reconstructed using Solidwork software and a 3D model of scapula bone was done using MIMICS software. Constant load, 750 N, was applied at the central, anterior, and posterior region of the glenoid implant which represents average load for daily living activities for elder people, including, walking with a stick and standing up from a chair. The results showed that, during center load, an implant with dual conformity (hybrid) showed the best (Max Stress-3.93 MPa) and well-distributed stress as compared to other conformity (Non-conform-7.21 MPa, Conform-9.38 MPa). While, during eccentric load (anterior and posterior), high stress was located at the anterior and posterior region with respect to the load applied. Cement stress for non-conform and hybrid implant recorded less than 5 MPa, which indicates it had a very low risk to have cement microcracks, whilst, conform implant was exposed to microcrack of the cement. In conclusion, hybrid conformity showed a promising result that could compromise between conform and non-conform implant. However, further enhancement is required for hybrid implants when dealing with eccentric load (anterior and posterior).
  8. Feature selection and risk prediction for patients with coronary artery disease using data mining
    Md Idris N, Chiam YK, Varathan KD, Wan Ahmad WA, Chee KH, Liew YM
    Med Biol Eng Comput, 2020 Dec;58(12):3123-3140.
    PMID: 33155096 DOI: 10.1007/s11517-020-02268-9
    Coronary artery disease (CAD) is an important cause of mortality across the globe. Early risk prediction of CAD would be able to reduce the death rate by allowing early and targeted treatments. In healthcare, some studies applied data mining techniques and machine learning algorithms on the risk prediction of CAD using patient data collected by hospitals and medical centers. However, most of these studies used all the attributes in the datasets which might reduce the performance of prediction models due to data redundancy. The objective of this research is to identify significant features to build models for predicting the risk level of patients with CAD. In this research, significant features were selected using three methods (i.e., Chi-squared test, recursive feature elimination, and Embedded Decision Tree). Synthetic Minority Over-sampling Technique (SMOTE) oversampling technique was implemented to address the imbalanced dataset issue. The prediction models were built based on the identified significant features and eight machine learning algorithms, utilizing Acute Coronary Syndrome (ACS) datasets provided by National Cardiovascular Disease Database (NCVD) Malaysia. The prediction models were evaluated and compared using six performance evaluation metrics, and the top-performing models have achieved AUC more than 90%. Graphical abstract.
  9. Microplastics and nanoplastics: Recent literature studies and patents on their removal from aqueous environment
    Hanif MA, Ibrahim N, Dahalan FA, Md Ali UF, Hasan M, Jalil AA
    Sci Total Environ, 2022 Mar 01;810:152115.
    PMID: 34896138 DOI: 10.1016/j.scitotenv.2021.152115
    The presence of microplastics (MP) and nanoplastics (NP) in the environment poses significant hazards towards microorganisms, humans, animals and plants. This paper is focused on recent literature studies and patents discussing the removal process of these plastic pollutants. Microplastics and nanoplastics can be quantified by counting, weighing, absorbance and turbidity and can be further analyzed using scanning electron microscopy (SEM), dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, surface-enhanced Raman spectroscopy and Raman tweezers. Mitigation methods reported are categorized depending on the removal characteristics: (i) Filtration and separation method: Filtration and separation, electrospun nanofiber membrane, constructed wetlands; (ii) Capture and surface attachment method: coagulation, flocculation and sedimentation (CFS), electrocoagulation, adsorption, magnetization, micromachines, superhydrophobic materials and microorganism aggregation; and (iii) Degradation method: photocatalytic degradation, microorganism degradation and thermal degradation; where removal efficiency between 58 and 100% were reported. As these methods are significantly distinctive, the parameters which affect the MP/NP removal performance e.g., pH, type of plastics, presence of interfering chemicals or ions, surface charges etc. are also discussed. 42 granted international patents related to microplastics and nanoplastics removal are also reviewed where the majority of these patents are focused on separation or filtration devices. These devices are efficient for microplastics up to 20 μm but may be ineffective for nanoplastics or fibrous plastics. Several patents were found to focus on methods similar to literature studies e.g., magnetization, CFS, biofilm and microorganism aggregation; with the addition of another method: thermal degradation.
  10. Locomotor Assessment of 6-Hydroxydopamine-induced Adult Zebrafish-based Parkinson's Disease Model
    Md Hamzah N, Lim SM, Vijayanathan Y, Lim FT, Abdul Majeed AB, Tan MP, et al.
    J Vis Exp, 2021 Dec 28.
    PMID: 35037659 DOI: 10.3791/63355
    The limitations of current treatments in delaying dopaminergic neuronal loss in Parkinson's disease (PD) raise the need for alternative therapies that can restore these neurons. Much effort is currently directed toward a better understanding of neuroregeneration using preclinical in vivo models. This regenerative capability for self-repair is, however, inefficient in mammals. Non-mammalian animals like zebrafish have thus emerged as an excellent neuroregenerative model due to its capability to continuously self-renew and have a close brain homology to humans. As part of the effort in elucidating cellular events involved in neuroregeneration in vivo, we have established the 6-hydroxydopamine (6-OHDA)-induced adult zebrafish-based PD model. This was achieved through the optimized intracerebroventricular (ICV) microinjection of 99.96 mM 6-OHDA to specifically ablate dopaminergic neurons (DpN) in the ventral diencephalon (Dn) of zebrafish brain. Immunofluorescence indicated more than 85% of DpN ablation at day three postlesion and full restoration of DpN at lesioned site 30 days postlesion. The present study determined the impairment and subsequent recovery of zebrafish swimming behavior following lesion by using the open field test through which two parameters, distance traveled (cm) and mean speed (cm/s), were quantified. The locomotion was assessed by analyzing the recordings of individual fish of each group (n = 6) using video tracking software. The findings showed a significant (p < 0.0001) reduction in speed (cm/s) and distance traveled (cm) of lesioned zebrafish 3 days postlesion when compared to sham. The lesioned zebrafish exhibited full recovery of swimming behavior 30 days postlesion. The present findings suggest that 6-OHDA lesioned adult zebrafish is an excellent model with reproducible quality to facilitate the study of neuroregeneration in PD. Future studies on the mechanisms underlying neuroregeneration as well as intrinsic and extrinsic factors that modulate the process may provide important insight into new cell replacement treatment strategies against PD.
  11. Fulltext Essential Oils from the Malaysian Citrus (Rutaceae) Medicinal Plants
    Md Othman SNA, Hassan MA, Nahar L, Basar N, Jamil S, Sarker SD
    Medicines (Basel), 2016 Jun 03;3(2).
    PMID: 28930124 DOI: 10.3390/medicines3020013
    This review article appraises the extraction methods, compositions, and bioactivities of the essential oils from the Citrus species (family: Rutaceae) endemic to Malaysia including C. aurantifolia, C. grandis, C. hystrix, and C. microcarpa. Generally, the fresh peels and leaves of the Citrus species were extracted using different methods such as steam and water distillation, Likens-Nikerson extraction, solvent extraction, and headspace solid-phase micro-extraction (HS-SPME). Most of the Citrus oils were found to be rich in monoterpene hydrocarbons with limonene (1) as the major component identified in the peels of C. aurantifolia (39.3%), C. grandis (81.6%-96.9%), and C. microcarpa (94.0%), while sabinene (19) was the major component in the peels of C. hystrix (36.4%-48.5%). In addition, citronellal (20) (61.7%-72.5%), linalool (18) (56.5%), and hedycaryol (23) (19.0%) were identified as the major components in the oil of C. hystrix leaves, C. grandis blossom and C. microcarpa leaves, respectively. The C. hystrix essential oil has been experimentally shown to have antimicrobial and antifeedant activities, while no bioactivity study has been reported on the essential oils of other Malaysian Citrus species.
  12. Fulltext Polymorphism of 11 Y Chromosome Short Tandem Repeat Markers among Malaysian Aborigines
    Mohd Yussup SS, Marzukhi M, Md-Zain BM, Mamat K, Mohd Yusof FZ
    Evol Bioinform Online, 2017;13:1176934317735318.
    PMID: 29085238 DOI: 10.1177/1176934317735318
    The conventional technique such as patrilocality suggests some substantial effects on population diversity. With that, this particular study investigated the paternal line, specifically Scientific Working Group on DNA Analysis Methods (SWGDAM)-recommended Y-STR markers, namely, DYS19, DYS385, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS438, and DYS439. These markers were tested to compare 184 Orang Asli individuals from 3 tribes found in Peninsular Malaysia. As a result, the haplotype diversity and the discrimination capacity obtained were 0.9987 and 0.9076, respectively. Besides, the most diverse marker was DYS385b, whereas the least was DYS391. Furthermore, the Senoi and Proto-Malay tribes were found to be the most distant, whereas the Senoi and Negrito clans were almost similar to each other. In addition, the analysis of molecular variance analysis revealed 82% of variance within the population, but only 18% of difference between the tribes. Finally, the phylogenetic trees constructed using Neighbour Joining and UPGMA (Unweighted Pair Group Method with Arithmetic Mean) displayed several clusters that were tribe specific. With that, future studies are projected to analyse individuals based on more specific sub-tribes.
  13. Fulltext RNA-seq data of Oryza sativa cultivar Kuku Belang under PEG treatment
    Toni B, Monfared HH, Mat Isa MN, Md Isa N, Ismail I, Zainal Z
    Data Brief, 2017 Oct;14:260-266.
    PMID: 28795103 DOI: 10.1016/j.dib.2017.07.043
    Drought stress is the main abiotic factor affecting rice production. Rain-fed upland rice which is grown on unbounded fields and totally dependent on rainfall for moisture is more prone to drought stress compared to rice from other ecosystems. However, upland rice has adapted to this limited water condition, thus are more drought tolerant than rice from other ecosystems. We performed the first transcriptome sequencing of drought tolerant indica upland rice cultivar Kuku Belang to identify differentially expressed genes related to drought tolerance mechanism. Raw reads for non-treated and PEG-treated Oryza sativa subspecies indica cv. Kuku Belang were deposited in the NCBI SRA database with accession number SRP074520 (https://www.ncbi.nlm.nih.gov/sra?term=SRP074520).
  14. Polypyrrole-magnetite dispersive micro-solid-phase extraction combined with ultraviolet-visible spectrophotometry for the determination of rhodamine 6G and crystal violet in textile wastewater
    Kamaruddin AF, Sanagi MM, Wan Ibrahim WA, Md Shukri DS, Abdul Keyon AS
    J Sep Sci, 2017 Nov;40(21):4256-4263.
    PMID: 28851082 DOI: 10.1002/jssc.201700659
    Polypyrrole-magnetite dispersive micro-solid-phase extraction method combined with ultraviolet-visible spectrophotometry was developed for the determination of selected cationic dyes in textile wastewater. Polypyrrole-magnetite was used as adsorbent due to its thermal stability, magnetic properties, and ability to adsorb Rhodamine 6G and crystal violet. Dispersive micro-solid-phase extraction parameters were optimized, including sample pH, adsorbent amount, extraction time, and desorption solvent. The optimum polypyrrole-magnetite dispersive micro-solid phase-extraction conditions were sample pH 8, 60 mg polypyrrole-magnetite adsorbent, 5 min of extraction time, and acetonitrile as the desorption solvent. Under the optimized conditions, the polypyrrole-magnetite dispersive micro-solid-phase extraction with ultraviolet-visible method showed good linearity in the range of 0.05-7 mg/L (R2  > 0.9980). The method also showed a good limit of detection for the dyes (0.05 mg/L) and good analyte recoveries (97.4-111.3%) with relative standard deviations 
  15. Hyaluronic acid-modified betamethasone encapsulated polymeric nanoparticles: fabrication, characterisation, in vitro release kinetics, and dermal targeting
    Pandey M, Choudhury H, Gunasegaran TAP, Nathan SS, Md S, Gorain B, et al.
    Drug Deliv Transl Res, 2019 04;9(2):520-533.
    PMID: 29488170 DOI: 10.1007/s13346-018-0480-1
    Atopic dermatitis (AD) is a chronically relapsing eczematous skin disease characterised by frequent episodes of rashes, severe flares, and inflammation. Till date, there is no absolute therapy for the treatment of AD; however, topical corticosteroids (TCs) are the majorly prescribed class of drugs for the management of AD in both adults and children. Though, topical route is most preferable; however, limited penetration of therapeutics across the startum cornum (SC) is one of the major challenges for scientists. Therefore, the present study was attempted to fabricate a moderate-potency TC, betamethasone valerate (BMV), in the form of chitosan nanoparticles (CS-NPs) for optimum dermal targeting and improved penetration across the SC. To further improve the targeting efficiency of BMV and to potentiate its therapeutic efficacy, the fabricated BMV-CS-NPs were coated with hyaluronic acid (HA). The prepared NPs were characterised for particle size, zeta potential, polydispersity index (PDI), entrapment efficiency, loading capacity, crystallinity, thermal behaviour, morphology, in vitro release kinetics, drug permeation across the SC, and percentage of drug retained into various skin layers. Results showed that optimised HA-BMV-CS-NPs exhibited optimum physicochemical characteristics including finest particle size (
  16. Fulltext The effectiveness of a stage-based lifestyle modification intervention for obese children
    Md Yusop NB, Mohd Shariff Z, Hwu TT, Abd Talib R, Spurrier N
    BMC Public Health, 2018 03 01;18(1):299.
    PMID: 29490648 DOI: 10.1186/s12889-018-5206-2
    BACKGROUND: Interventions that encompass behavioural modifications of dietary intake and physical activity are essential for the management of obesity in children. This study assessed the effectiveness of a stage-based lifestyle modification intervention for obese children.

    METHODS: A total of 50 obese children (7-11 years old) were randomized to the intervention group (IG, n = 25) or the control group (CG, n = 25). Data were collected at baseline, at follow-up (every month) and at six months after the end of the intervention. IG received stage-based lifestyle modification intervention based on the Nutrition Practice Guideline for the Management of Childhood Obesity, while CG received standard treatment. Changes in body composition, physical activity and dietary intake were examined in both the intervention and control groups.

    RESULTS: Both groups had significant increases in weight (IG: 1.5 ± 0.5 kg; CG: 3.9 ± 0.6 kg) (p 

  17. Fulltext High frequency oscillatory ventilation in leptospirosis pulmonary hemorrhage syndrome: A case series study
    Mat Nor MB, Md Ralib A, Ibrahim NA, Abdul-Ghani MR
    Indian J Crit Care Med, 2016 Jun;20(6):342-8.
    PMID: 27390458 DOI: 10.4103/0972-5229.183906
    Hypoxemia in severe leptospirosis-associated pulmonary hemorrhage syndrome (LPHS) is a challenging clinical scenario not usually responsive to maximal support on mechanical ventilation. We described the efficacy and safety of high frequency oscillatory ventilation (HFOV) as rescue therapy in acute respiratory failure secondary to LPHS. This is a retrospective case study of five patients with diagnosis of severe LPHS, who were admitted to Intensive Care Unit from October 2014 to January 2015. They developed refractory hypoxemia on conventional mechanical ventilation and rescue therapy was indicated. All patients responded rapidly by showing improvements in oxygen index and PaO2/FiO2 ratio within first 72 h of therapy. Despite severity of illness evidenced by high Simplified Acute Physiological II and Sequential Organ Failure Assessment scores, all patients were discharged from hospital alive. In view of the rapid onset and extent of hemorrhage which may culminate quickly into asphyxiation and death, HFOV may indeed be lifesaving in severe LPHS.
  18. Protective effect of curcumin on experimentally induced arthritic rats: detailed histopathological study of the joints and white blood cell count
    Kamarudin TA, Othman F, Mohd Ramli ES, Md Isa N, Das S
    EXCLI J, 2012;11:226-36.
    PMID: 27366139
    Curcuma longa (turmeric) rhizomes contains curcumin, an active compound which possesses anti-inflammatory effects. Collagen-induced arthritis (CIA) is an accepted experimental animal model of rheumatoid arthritis. The present study aimed to observe the histological changes in the joints of experimental arthritic rats treated with curcumin. Twenty four male Sprague-Dawley (approximately 7 weeks-old) rats were randomly divided into four groups. Three groups were immunized with 150 µg collagen. All rats with established CIA, with arthritis scores exceeding 1, were orally treated with betamethasone (0.5 mg/ml/kg body weight), curcumin (110 mg/ml/kg body weight) or olive oil (1.0 ml/kg body weight) daily, for two weeks. One remaining group was kept as normal control. Treatment with 110 mg/ml/kg curcumin showed significant mean differences in the average white blood cell (WBC) count (p<0.05), cell infiltration, bone and cartilage erosion scores (p<0.05) compared to the olive oil treated group. Pannus formation scores showed that curcumin supplementation successfully suppressed the pannus formation process that occurred in the articular cartilage of the CIA joints. The mean difference for histological scores for the curcumin group was insignificant compared to the betamethasone treated group. It is concluded that supplementation of curcumin has protective effect on the histopathological and degenerative changes in the joints of CIA rats which was at par with betamethasone.
  19. Fulltext Granulomatous hypophysitis: a case of severe headache
    Wan Muhamad Hatta SF, Hamdan MF, Md Ali SA, Abdul Ghani R
    BMJ Case Rep, 2016 Sep 09;2016.
    PMID: 27613264 DOI: 10.1136/bcr-2016-216395
    Idiopathic granulomatous hypophysitis (GH) is an uncommon inflammatory disease of the pituitary with impairment of pituitary gland function due to infiltration by lymphocytes, plasma cells and macrophages. We report the case of a 39-year-old woman who presented with worsening of headaches for 1 month and blurring of vision over 5 days. An MRI revealed a homogeneous supra-sellar mass evoking a pituitary tumour with bulky pituitary stalk extending into the left and right cavernous sinuses. Hormonal investigations showed anterior pituitary hormone deficiencies; meanwhile histopathological examination revealed an aspect of hypophysitis. Clinical and radiological remission occurred immediately postglucocorticoid therapy with the addition of a steroid-sparing agent later in view of recurrence of symptoms on glucocorticoid dose reduction. GH has important diagnostic and therapeutic implications, as clinical and radiological features ameliorate via medical treatment. With further understanding and recognition of the disease, we hope to highlight a case of GH, in which signs and symptoms improved after initiation of corticosteroids.
  20. Sarcoid Myopathy Mimicking Polymyositis: A Case Report and Pool Analysis of the Literature Reviews
    Sazliyana Shaharir S, Jamil A, Kosasih S, Soo Fin L, Sridharan R, Hayati Md Pauzi S
    Acta Med Iran, 2017 Dec;55(12):800-806.
    PMID: 29373888
    A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more extensive systemic involvement, i.e., hypercalcemia, lymphadenopathy and subcutaneous nodules. Finally, a biopsy of the thigh and subcutaneous nodule revealed non-caseating granulomatous inflammation, consistent with sarcoidosis. He responded well to the corticosteroids, and finally, azathioprine was added as a steroid-sparing agent. Including our series, there are 103 cases of symptomatic muscle involvement in sarcoidosis patients published in the English literature to date. Further pool analysis of the cases will be reported in this review.
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