Spondyloarthropathy (SpA) is a group of inflammatory conditions that include spondylitis, sacroiliitis, asymmetrical peripheral arthritis and enthesitis. This condition is known as juvenile SpA when the diagnosis is made in patients up to 16 years of age. Enthesitis is a highly specific feature that occurs more often in juvenile SpA than in the adult form. In contrast to adult onset SpA, the initial manifestation of juvenile SpA rarely presents as inflammatory back pain. Peripheral arthritis is the more common presenting feature. We report a case of a 12-year-old boy who presented with a 1-year history of progressive low back pain, gluteal pain and thigh pain. There were no clinical symptoms of arthropathy of the distal extremities. MRI of the whole spine was performed twice, which, unfortunately, was unyielding. Finally, MRI of the sacroiliac joints revealed asymmetric sacroiliitis as well as enthesitis of the hips and pelvis. Further laboratory data showed negative rheumatoid factor and positive human leucocyte antigen (HLA) B27. A diagnosis of juvenile SpA with sacroiliitis and enthesitis was made. The imaging characteristics of juvenile SpA are highlighted.
The generic assignment of the draconine lizard Gonocephalus robinsonii from the highlands of West-Malaysia has been uncertain since the original description. Here we present a study based on morphology, previously published karyotype data and molecular phylogenetics using 16S rRNA sequences to evaluate the systematic status of G. robinsonii. As a result we describe Malayodracon gen. nov. to accommodate the species.
The genus Procoryphaeus Mazur, 1984 is revised herein. It contains three species: Procoryphaeus violaceus (Lewis, 1905) from Thailand: Tenasserim Mountains; Malaysia: Borneo: Sabah; Indonesia: Java, Sumatra and Papua, Procoryphaeus pilosus (Lewis, 1893) from Tanimbar Island, Indonesia and Procoryphaeus wallacei (Marseul, 1864) from Indonesia: Papua. All type specimens are figured, and male genitalia of P. violaceus are drawn. Lectotypes of Pachycraerus (Coryphaeus) wallacei Marseul, 1864, Coryphaeus violaceus Lewis, 1905 and Coryphaeus pilosus Lewis, 1893 are designated. The exact identities of P. violaceus and P. wallacei species remain unclear since they are morphologically very similar and both respective type specimens are females. A key to species is given.
The final stadium larva of Onychargia atrocyana Selys, 1865, is described and illustrated based on two female specimens collected at Gunung Mulu National Park, Sarawak, East Malaysia. The larvae were identified by matching the mitochondrial marker COI with that of known adult specimens from Gunung Mulu, Bintulu and Kuching in Sarawak and from Pahang state in West Malaysia. The specimens presented close matches with all adults in this gene. As O. atrocyana is a taxonomically isolated species with no close congeners in Borneo the determination is beyond doubt. O. atrocyana is the only member of the Onychargiinae for which the larva is known. It is compared with the known larvae of other platycnemidid subfamilies, and the possible significance of larval morphology in higher classification of the group is discussed.
Five new species of the family Rotundabaloghiidae are described from Indonesia and Malaysia. Angulobaloghia pedunculata sp. nov. differs from the other Angulobaloghia Hirschmann, 1979 species in the shape of the genital shield of the female. Rotundabaloghia (Rotundabaloghia) wangi sp. nov. has one pair of short and pilose setae (V8) on the ventral idiosoma, which is unique in the subgenus Rotundabaloghia (Rotundabaloghia) Hirschmann, 1975. Rotundabaloghia (Circobaloghia) javaensis sp. nov. has a small triangular anterior process on genital shield of female, which has not been detected previously in South-East Asian members of this subgenus. The long and thick ventral seta (V4) in Depressorotunda (Depressorotunda) robusta sp. nov. is a character state so far unknown in the subgenus Depressorotunda (Depressorotunda) Kontschán, 2010. Depressorotunda (Depressorotunda) hirca sp. nov. has two apically serrate anterior branches on the margin of the female genital shield.
Breast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia.
INTRODUCTION: Due to globalization and changes in the health care delivery system, there has been a gradual change in the attitude of the medical community as well as the lay public toward greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As euthanasia has gained world-wide prominence, the objectives of our study therefore were to explore the attitude of physicians and chronically ill patients toward euthanasia and related issues. Concomitantly, we wanted to ascertain the frequency of requests for assistance in active euthanasia.
MATERIALS AND METHODS: Questionnaire based survey among consenting patients and physicians.
RESULTS: The majority of our physicians and patients did not support active euthanasia or physician-assisted suicide (EAS), no matter what the circumstances may be P < 0.001. Both opposed to its legalization P < 0.001. Just 15% of physicians reported that they were asked by patients for assistance in dying. Both physicians 29.2% and patients 61.5% were in favor of withdrawing or withholding life-sustaining treatment to a patient with no chances of survival. Among patients no significant differences were observed for age, marital status, or underlying health status.
CONCLUSIONS: A significant percentage of surveyed respondents were against EAS or its legalization. Patient views were primarily determined by religious beliefs rather than the disease severity. More debates on the matter are crucial in the ever-evolving world of clinical medicine.
KEYWORDS: Attitude; euthanasia; legalization; multi-cultural; physician-assisted suicide
Generally, clinical presentations of Graves' disease range from asymptomatic disease to overt symptomatic hyperthyroidism with heat intolerance, tremor, palpitation, weight loss, and increased appetite. However, atypical presentation of Graves' disease with hematological system involvement, notably pancytopenia, is distinctly uncommon. Hereby, we present and discuss a series of three untreated cases of Graves' disease clinically presented with pancytopenia and the hematological abnormalities that responded well to anti-thyroid treatment. With resolution of the thyrotoxic state, the hematological parameters improved simultaneously. Thus, it is crucial that anti-thyroid treatment be considered in patients with Graves' disease and pancytopenia after a thorough hematological evaluation.
We report a cross-cultural study designed to investigate crossmodal correspondences between a variety of visual features (11 colors, 15 shapes, and 2 textures) and the five basic taste terms (bitter, salty, sour, sweet, and umami). A total of 452 participants from China, India, Malaysia, and the USA viewed color patches, shapes, and textures online and had to choose the taste term that best matched the image and then rate their confidence in their choice. Across the four groups of participants, the results revealed a number of crossmodal correspondences between certain colors/shapes and bitter, sour, and sweet tastes. Crossmodal correspondences were also documented between the color white and smooth/rough textures on the one hand and the salt taste on the other. Cross-cultural differences were observed in the correspondences between certain colors, shapes, and one of the textures and the taste terms. The taste-patterns shown by the participants from the four countries tested in the present study are quite different from one another, and these differences cannot easily be attributed merely to whether a country is Eastern or Western. These findings therefore highlight the impact of cultural background on crossmodal correspondences. As such, they raise a number of interesting questions regarding the neural mechanisms underlying crossmodal correspondences.
Simulium (Gomphostilbia) hiroyukii is described based on females, males, pupae and larvae collected in Mount Murud, Sarawak, Malaysia. This new species is assigned to the Simulium darjeelingense species-group of the subgenus Gomphostilbia, and is characterized by the darkened fore coxae and the pupal gill with eight long filaments, of which middle and dorsal triplets have elongated primary and secondary stalks, respectively.
Research in schizophrenia has advanced tremendously. One hundred and seventy five articles related to Schizophrenia were found from a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. This project aims to examine published research articles, in local and international journals in order to provide a glimpse of the research interest in Malaysia with regards to schizophrenia. Single case study, case series report, reviews and registry reports were not included in this review. Medication trial, unless it concerned a wider scope of psychopharmacology was also excluded from this review. A total of 105 articles were included in this review. Despite numerous genetics studies conducted and published, a definitive conclusion on the aetiology or mechanism underlying schizophrenia remains elusive. The National Mental Health - Schizophrenia Registry (NMHR) proved to be an important platform for many studies and publications. Studies stemmed from NMHR have provided significant insight into the baseline characteristic of patients with schizophrenia, pathway to care, and outcomes of the illness. International and regional collaborations have also encouraged important work involving stigma and discrimination in schizophrenia. Ministry of Health's hospitals (MOH) are the main research sites in the country with regards to schizophrenia research. Numbers of schizophrenia research are still low in relation to the number of universities and hospitals in the country. Some of the weaknesses include duplication of studies, over-emphasising clinical trials and ignoring basic clinical research, and the lack of publications in international and regional journals.
Dengue infection is a major cause of morbidity and mortality in Malaysia. To date, much research on dengue infection conducted in Malaysia have been published. One hundred and sixty six articles related to dengue in Malaysia were found from a search through a database dedicated to indexing all original data relevant to medicine published between the years 2000-2013. Ninety articles with clinical relevance and future research implications were selected and reviewed. These papers showed evidence of an exponential increase in the disease epidemic and a varying pattern of prevalent dengue serotypes at different times. The early febrile phase of dengue infection consist of an undifferentiated fever. Clinical suspicion and ability to identify patients at risk of severe dengue infection is important. Treatment of dengue infection involves judicious use of volume expander and supportive care. Potential future research areas are discussed to narrow our current knowledge gaps on dengue infection.
We performed a prospective study of all hospitalized patients with a diagnosis of Gout in Sarawak General hospital from 1st July 2011 to 1st July 2012. There were a total of 126 patients in our study of which 112 (88.9%) were males. The majority of our patients were from the indigenous populations (71.7%). They have a mean age of 60.0 ± 14.2 years. Most of our patients were overweight (68%) with comorbities of hypertension (78.6%), Chronic Kidney Failure (48.4%), Type II diabetes Mellitus (30.2%), dyslipidemia (27.8%) and Ischaemic heart disease (11.9%). Polyarticular gouty arthritis was the main presenting pattern during hospitalization (88.1%). The mean length of stay for our patients was 9.8 ± 6.0 days which was significantly longer than the mean length of stay for other patients without gout (p<0.05). Only 17 patients had gout on admission and the majority developed gout during hospitalizations. Our patients were admitted respectively for medical problems (45.4%), surgical problems (28.6%) and orthopaedic problems (9.2%). Colchicine (73.8%) and steroid (40.5%) were the main stays of treatment for our patients. Our hospitalized gout patients were complicated patients with multiple comorbidities.
Aeromonas hydrophila has emerged worldwide as a human pathogen. Here, we report the draft whole-genome sequence of a freshwater isolate from Malaysia, A. hydrophila strain M062, and its N-acylhomoserine lactone genes are also reported here.
Nitratireductor basaltis strain UMTGB225 is a Gram-negative bacterium isolated from a marine tunicate found in Bidong Island, Terengganu, Malaysia. In this study, the genome of Nitratireductor basaltis UMTGB225 was sequenced to gain insight into the role of this bacterium and its association with tunicate hosts in a coral reef habitat.
AIM: To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting.
METHODS: The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week.
RESULTS: A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged <60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met.
KEYWORDS: admission; elderly; emergency department attendances; investigations; procedures
This paper deals with the performance and emission analysis of a multicylinder diesel engine using biodiesel along with an in-depth analysis of the engine heat losses in different subsystems followed by the energy balance of all the energy flows from the engine. Energy balance analysis allows the designer to appraise the internal energy variations of a thermodynamic system as a function of ''energy flows" across the control volume as work or heat and also the enthalpies associated with the energy flows which are passing through these boundaries. Palm and coconut are the two most potential biodiesel feed stocks in this part of the world. The investigation was conducted in a four-cylinder diesel engine fuelled with 10% and 20% blends of palm and coconut biodiesels and compared with B5 at full load condition and in the speed range of 1000 to 4000 RPM. Among the all tested blends, palm blends seemed more promising in terms of engine performance, emission, and heat losses. The influence of heat losses on engine performance and emission has been discussed thoroughly in this paper.
Riegeriana gen. nov. is described to accommodate Physopelta apicalis Walker, 1873. A lectotype of Ph. apicalis is de-signated. Iphita fasciata Stehlík & Jindra, 2008, syn. nov., is recognized as a new junior subjective synonym of Riegeriana apicalis. In addition, Iphita lata sp. nov. is described from southern India and a check-list of the species of the genus Iphita Stål, 1873 is provided. The etymology of Iphita nigris Ahmad & Abbas, 1992 and the lectotype designation of Dindymellus coimbatorensis Distant, 1919 are discussed. The following new or confirmed country records are provided: Iphita coimbatorensis (Distant, 1919) from India (Karnataka, Orissa); I. dubia (Breddin, 1901) from Indonesia (Papua); I. limbata Stål, 1870 from Cambodia, China (Hainan), India (Arunachal Pradesh), Indonesia (Sumatra, Kalimantan), Malaysia (Pahang: Tioman Island), and Vietnam; I. lycoides (Walker, 1873) from the Philippines (Panay Island).
Pineapples (Ananas comosus (L.) Merr.) cultivation on drained peats could affect the release of carbon dioxide (CO2) into the atmosphere and also the leaching of dissolved organic carbon (DOC). Carbon dioxide emission needs to be partitioned before deciding on whether cultivated peat is net sink or net source of carbon. Partitioning of CO2 emission into root respiration, microbial respiration, and oxidative peat decomposition was achieved using a lysimeter experiment with three treatments: peat soil cultivated with pineapple, bare peat soil, and bare peat soil fumigated with chloroform. Drainage water leached from cultivated peat and bare peat soil was also analyzed for DOC. On a yearly basis, CO2 emissions were higher under bare peat (218.8 t CO2 ha/yr) than under bare peat treated with chloroform (205 t CO2 ha/yr), and they were the lowest (179.6 t CO2 ha/yr) under cultivated peat. Decreasing CO2 emissions under pineapple were attributed to the positive effects of photosynthesis and soil autotrophic activities. An average 235.7 mg/L loss of DOC under bare peat suggests rapid decline of peat organic carbon through heterotrophic respiration and peat decomposition. Soil CO2 emission depended on moderate temperature fluctuations, but it was not affected by soil moisture.
Honey is a supersaturated solution of sugars, enriched with proteins, minerals, vitamins, organic acids and polyphenols. Gamma irradiation is a physical technique of food preservation which protects the honey from insects' and microbial contamination during storage. We investigated the effect of gamma irradiation on physicochemical properties in two types of Malaysian honey, Gelam and Nenas.