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Isolation and PCR detection of rickettsiae from clinical and rodent samples in Malaysia

Tay ST, Rohani MY, Ho TM, Devi S

Southeast Asian J Trop Med Public Health, 2002 Dec;33(4):772-9.
PMID: 12757225

Isolation of rickettsiae from patients' blood samples and organ samples of wild rodents from areas with high seroprevalence of rickettsial infections was attempted using cell culture assay and animal passages. L929 mouse fibroblast cells grown in 24 well tissue culture plate were inoculated with buffy coat of febrile patients and examined for the growth of rickettsiae by Giemsa, Gimenez staining and direct immunofluorescence assay. No rickettsiae were isolated from 48 patients' blood samples. No symptomatic infections were noted in mice or guinea pigs infected with 50 organ samples of wild rodents. There was no rickettsial DNA amplified from these samples using various PCR detection systems for Orientia tsutsugamushi, typhus and spotted fever group rickettsiae.

Matched MeSH terms: Antibodies, Bacterial/blood; Rickettsia Infections/blood; Rodent Diseases/blood
Anticoagulation Therapy in Patients with Chronic Kidney Disease

Saheb Sharif-Askari F, Syed Sulaiman SA, Saheb Sharif-Askari N

Adv Exp Med Biol, 2017;906:101-114.
PMID: 27628006

Patients with chronic kidney disease (CKD) are at increased risk for both thrombotic events and bleeding. The early stages of CKD are mainly associated with prothrombotic tendency, whereas in its more advanced stages, beside the prothrombotic state, platelets can become dysfunctional due to uremic-related toxin exposure leading to an increased bleeding tendency. Patients with CKD usually require anticoagulation therapy for treatment or prevention of thromboembolic diseases. However, this benefit could easily be offset by the risk of anticoagulant-induced bleeding. Treatment of patients with CKD should be based on evidence from randomized clinical trials, but usually CKD patients are excluded from these trials. In the past, unfractionated heparins were the anticoagulant of choice for patients with CKD because of its independence of kidney elimination. However, currently low-molecular-weight heparins have largely replaced the use of unfractionated heparins owing to fewer incidences of heparin-induced thrombocytopenia and bleeding. We undertook this review in order to explain the practical considerations for the management of anticoagulation in these high risk population.

Matched MeSH terms: Blood Platelets/drug effects; Blood Platelets/metabolism; Blood Platelets/pathology
Nocardiosis Causing Hypocellular Bone Marrow after Allogeneic Peripheral Blood Stem Cell Transplantation

Fadilah SA, Cheong SK, Raymond AA, Norlela S

Hematology, 2001;6(5):337-9.
PMID: 27405528 DOI: 10.1080/10245332.2001.11746588

Nocardia infection is rare in bone marrow transplant (BMT) recipients with less than 30 cases reported in the literature [1-4]. The majority of the cases occurred late in the post-transplant period. Common clinical presentations included formation of widespread and multiple abscesses. Bone marrow hypoplasia is an uncommon finding. We describe the first case of nocardiosis, diagnosed at day 100 after non-myeloablative allogeneic peripheral blood stem cell transplantation, presenting as pancytopenia and hypocellular marrow. Eradication of the infection with antibiotics resulted in complete hematological recovery.

Matched MeSH terms: Peripheral Blood Stem Cell Transplantation
Clinical significance of SLC2A9/GLUT9 rs11722228 polymorphisms in gout

Das Gupta E, Sakthiswary R, Lee SL, Wong SF, Hussein H, Gun SC

Int J Rheum Dis, 2018 Mar;21(3):705-709.
PMID: 27456670 DOI: 10.1111/1756-185X.12918

AIM: The main objective of this study is to elucidate the clinical significance of the SLC2A9/GLUT9 rs11722228 polymorphism among male gout patients.
METHOD: We consecutively recruited all newly diagnosed male gout patients who were treatment-naive from the rheumatology outpatient clinics of two Malaysian hospitals. Age-matched healthy male adults were employed as controls. All subjects were tested for the SLC2A9/GLUT9 rs11722228 genotypes, serum uric acid (SUA), urine uric acid and creatinine levels. All gout subjects were examined for the presence of tophi and sonographically screened for renal calculi.
RESULTS: A total of 73 male gout patients and 73 age-matched healthy male adults were recruited in this study. The genotypic frequencies of SLC2A9/GLUT9 rs1172228 did not differ significantly between the gout cases and the healthy controls. The gout subjects with the CC genotype had significantly higher SUA levels (P = 0.002), family history of gout (P < 0.050) and the occurrence of renal calculi (P = 0.026). The SUA-adjusted odds ratios (OR) of the occurrence of renal calculi in the CC genotype (OR = 1 [reference]) was significantly higher than the CT genotype (OR = 0.338, 95%CI: 0.141-0.813) and the TT genotype (OR = 0.271, 95%CI: 0.086-0.854).
CONCLUSIONS: The genotypic distribution of SLC2A9/GLUT9 rs1172228 in male gout patients did not differ significantly from that of healthy male controls. However, the CC genotype in gout had significant associations with higher levels of SUA, renal calculi and a positive family history of gout.
Study site: Rheumatology clinic, Tuanku Jaafar Hospital, Malaysia and Putrajaya Hospital, Malaysia

Matched MeSH terms: Gout/blood; Kidney Calculi/blood; Uric Acid/blood
Concomitant measurements of serum annexin A5 levels and hematological indices as markers in recent and old myocardial infarction with low ejection fraction: A preliminary study

Alhusseiny AH, Al-Nimer MS, Mohammad FI, Ali Jadoo SA

Int J Cardiol, 2016 Nov 15;223:514-518.
PMID: 27552568 DOI: 10.1016/j.ijcard.2016.08.244

Serum annexin A5 (anxA5) level is significantly increased in patients with acute coronary syndrome. Hematological indices are significantly increased in patients with ischemic heart disease. This study aimed to demonstrate the changes in the distribution of blood cells and the levels of anxA5 in patients presented with significant low ejection fraction ST-elevation acute myocardial infarction (STEMI) in comparison with corresponding patients with ischemic heart disease.

Matched MeSH terms: Blood Cells
Rigid membranes of Malayan ovalocytes: a likely genetic barrier against malaria

Mohandas N, Lie-Injo LE, Friedman M, Mak JW

Blood, 1984 Jun;63(6):1385-92.
PMID: 6722355

A high frequency of nonhemolytic hereditary ovalocytosis in Malayan aborigines is thought to result from reduced susceptibility of affected individuals to malaria. Indeed, Kidson et al. recently showed that ovalocytes from Melanesians in Papua New Guinea are resistant to infection in culture by the malarial parasite Plasmodium falciparum. In order to determine if protection against parasitic invasion in these ovalocytes might be the result of some altered membrane material property in these unusual cells, we measured their membrane and cellular deformability characteristics using an ektacytometer . Ovalocytic red cells were found to be much less deformable in comparison to normal discoid red cells. Similar measurements on isolated membrane preparations revealed a marked reduction in ovalocytic membrane deformability. To produce equal deformation of ovalocytic and normal membranes, ovalocytes required an 8-10-fold increase in applied shear stress, indicating that their membrane was capable of deforming under sufficient stress. To test the possibility that this increased membrane rigidity might confer resistance to parasitic invasion, we performed an in vitro invasion assay using Plasmodium falciparum merozoites and Malayan ovalocytes of varying deformability from seven different donors. The level of infection of the ovalocytes ranged from 1% to 35% of that in control cells, and the extent of inhibition appeared to be closely related to the reduction in membrane deformability. Moreover, we were able to induce similar resistance to parasitic invasion in nonovalocytic normal red cells by increasing their membrane rigidity with graded exposure to a protein crosslinking agent. Our findings suggest that resistance to parasite invasion of Malayan ovalocytes is the result of a genetic mutation that causes increased membrane rigidity.

Matched MeSH terms: Blood Viscosity
Uterine bleeding with an IUD requiring emergency hysterectomy

Glew S, Singh A

Adv Contracept, 1989 Mar;5(1):51-3.
PMID: 2782134

A case is described of profuse uterine bleeding with a dislodged Multiload Cu 250 intrauterine device (IUD). Multiple blood transfusions were necessary, and ultimately, an emergency hysterectomy was performed.

Matched MeSH terms: Blood Transfusion
Epidemiology of persistent hepatitis B virus infection

Lopez CG

Malays J Pathol, 1985 Aug;7:7-10.
PMID: 3843253
Matched MeSH terms: Blood Donors
Fulltext Glucose-6-phosphate dehydrogenase deficiency: a preventable cause of mental retardation

Singh H

Br Med J (Clin Res Ed), 1986 Feb 08;292(6517):397-8.
PMID: 3080188 DOI: 10.1136/bmj.292.6517.397

Over two years cord blood from 27 879 babies was screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency. The overall incidence was 3.1% in boys and 1.6% in girls. Sixty nine babies had severe jaundice (bilirubin concentration greater than 380 mmol/l (20 mg/100 ml], and exchange transfusion was performed. Parents were given written and verbal instructions to avoid herbs and drugs that trigger kernicterus, which reduced the incidence of kernicterus and thereby prevented mental retardation. G6PD deficiency is common in all three ethnic groups (Malays, Chinese, and Indians) in Malaysia and screening is recommended.

Matched MeSH terms: Exchange Transfusion, Whole Blood
Prognostic significance of morphological and cytochemical markers in adult acute myelogenous leukaemia: concepts and observations

George E, Kamarulzaman E

Med J Malaysia, 1979 Dec;34(2):184-6.
PMID: 297198
Matched MeSH terms: Blood Cell Count
Fulltext A Holistic Approach to Managing Microalgae for Biofuel Applications

Show PL, Tang MS, Nagarajan D, Ling TC, Ooi CW, Chang JS

Int J Mol Sci, 2017 Jan 22;18(1).
PMID: 28117737 DOI: 10.3390/ijms18010215

Microalgae contribute up to 60% of the oxygen content in the Earth's atmosphere by absorbing carbon dioxide and releasing oxygen during photosynthesis. Microalgae are abundantly available in the natural environment, thanks to their ability to survive and grow rapidly under harsh and inhospitable conditions. Microalgal cultivation is environmentally friendly because the microalgal biomass can be utilized for the productions of biofuels, food and feed supplements, pharmaceuticals, nutraceuticals, and cosmetics. The cultivation of microalgal also can complement approaches like carbon dioxide sequestration and bioremediation of wastewaters, thereby addressing the serious environmental concerns. This review focuses on the factors affecting microalgal cultures, techniques adapted to obtain high-density microalgal cultures in photobioreactors, and the conversion of microalgal biomass into biofuels. The applications of microalgae in carbon dioxide sequestration and phycoremediation of wastewater are also discussed.

Matched MeSH terms: Blood Gas Analysis
Evaluation of the carotid artery stenosis based on minimization of mechanical energy loss of the blood flow

Sia SF, Zhao X, Li R, Zhang Y, Chong W, He L, et al.

Proc Inst Mech Eng H, 2016 Nov;230(11):1051-1058.
PMID: 28095764 DOI: 10.1177/0954411916671752

BACKGROUND: Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss.
METHODS: Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss.
RESULTS: We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

Matched MeSH terms: Regional Blood Flow
Aqueous calyxes extract of Roselle or Hibiscus sabdariffa Linn supplementation improves liver morphology in streptozotocin induced diabetic rats

Nazratun Nafizah AH, Budin SB, Zaryantey AH, Mariati AR, Santhana RL, Osman M, et al.

Arab J Gastroenterol, 2017 Mar;18(1):13-20.
PMID: 28336227 DOI: 10.1016/j.ajg.2017.02.001

BACKGROUND AND STUDY AIMS: The complex series of deleterious events among diabetes patients leads to multiple organ failure. Therefore, a holistic approach of treatment is urgently required to prevent worsening of complications. The present investigation was carried out to study the possible protective effects of Roselle or Hibiscus sabdariffa Linn (HSL) calyxes aqueous extract, as an antidiabetic and antioxidant agent against oxidative liver injury in streptozotocin-induced diabetic rats.
MATERIAL AND METHODS: A single dose of streptozotocin (45mg/kg body weight, iv) was used to induced diabetes in male Sprague Dawley rats which were then divided into two groups: Diabetic control (DC) and HSL-treated diabetic (DR) group. Normal rats were divided into normal control (NC), HSL-treated control (NR). Aqueous calyxes extract of HSL (100mg/kg/day, orally) was given for 28 consecutive days in the treated group. Weight, biochemical and histopathological (light and electron microscopic) parameters were compared in all groups.
RESULTS: Supplementation of HSL significantly lowered the level of fasting blood glucose and increased plasma insulin level in DR group compared to DC group (p<0.05). Alanine aminotransaminases and aspartate aminotransferase enzymes level were found to be significantly reduced in DR compared to DC. Microscopic examination demonstrated destruction of the liver architecture, cytoplasmic vacuolation of the hepatocytes and signs of necrosis in diabetic rats. Moreover, dilatation and congestion of blood vessels with leucocytes adherence were detected. Ultrastructural study using electron microscope showed homogeneous substance accumulation in nuclear chromatin, a decrease of organelles and mitochondrial degeneration in the diabetic rats.
CONCLUSION: Administration of HSL in diabetic rats causes significant decrease in hepatocyte destruction and prevented the changes associated with the diabetic condition. Thus, our findings provide a scientific rationale for the use of HSL as promising agent in preventing liver injury in diabetes.

Matched MeSH terms: Blood Glucose/metabolism; Insulin/blood
Piper sarmentosum Effects on 11β-Hydroxysteroid Dehydrogenase Type 1 Enzyme in Serum and Bone in Rat Model of Glucocorticoid-Induced Osteoporosis

Mohamad Asri SF, Mohd Ramli ES, Soelaiman IN, Mat Noh MA, Abdul Rashid AH, Suhaimi F

Molecules, 2016 Nov 15;21(11).
PMID: 27854305

Glucocorticoid-induced osteoporosis is one of the common causes of secondary osteoporosis. Piper sarmentosum (Ps) extract possesses antioxidant and anti-inflammatory activities. In this study, we determined the correlation between the effects of Ps leaf water extract with the regulation of 11β-hydroxysteroid dehydrogenase (HSD) type 1 enzyme activity in serum and bone of glucocorticoid-induced osteoporotic rats. Twenty-four Sprague-Dawley rats were grouped into following: G1: sham-operated group administered with intramuscular vehicle olive oil and vehicle normal saline orally; G2: adrenalectomized (adrx) control group given intramuscular dexamethasone (120 μg/kg/day) and vehicle normal saline orally; G3: adrx group given intramuscular dexamethasone (120 μg/kg/day) and water extract of Piper sarmentosum (125 mg/kg/day) orally. After two months, the femur and serum were taken for ELISA analysis. Results showed that Ps leaf water extract significantly reduced the femur corticosterone concentration (p < 0.05). This suggests that Ps leaf water extract was able to prevent bone loss due to long-term glucocorticoid therapy by acting locally on the bone cells by increasing the dehydrogenase action of 11β-HSD type 1. Thus, Ps may have the potential to be used as an alternative medicine against osteoporosis and osteoporotic fracture in patients on long-term glucocorticoid treatment.

Matched MeSH terms: Corticosterone/blood; Osteoporosis/blood; 11-beta-Hydroxysteroid Dehydrogenase Type 1/blood
Fulltext Predictors of stroke-associated pneumonia after the first episode of acute ischaemic stroke

Nor Adina, A.T., Ahmad, M.A., Uduman, A., Hamidon, B.B.

Malaysian Journal of Medicine and Health Sciences, 2012;8(1):37-43.
MyJurnal

Pneumonia is one of the most common complications of stroke with significant impact on patients’ outcome. The aim of this study is to look for the predictors of stroke-associated pneumonia (SAP) and its 30-day mortality and to analyse the survival of ischaemic stroke patients with pneumonia. Methodology: This is a prospective observational study, involving all acute first time ischaemic stroke patients admitted to a tertiary hospital that fulfilled the inclusion and exclusion criteria over a 6-month period. Demographic data were obtained on admission. Patients were reassessed for SAP, on day 5 and day 30. Assessment was done using the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index and modified Rankin scale (MRS). All patients with pneumonia were assessed with the pneumonia severity index (PSI) for SAP. Results: One hundred and twenty patients were enrolled consecutively within the 6-month study period. 15.8% developed SAP. Independent predictors of SAP were clinical dysphagia (OR 76.32; 95%CI 4.46 to 1307.05), random blood glucose (RBS) on admission (OR 1.34; 95%CI 1.06 to 1.68) and NIHSS score on admission (OR 1.15; 95%CI 1.02 to 1.30). Independent predictors for 30-day mortality were NIHSS score on day 5 (OR 1.20; 95%CI 1.08 to 1.33) and occurrence of pneumonia (OR 14.90; 95% CI 3.34 to 66.42). There was a significant difference in mean survival between SAP and non-SAP patients. Conclusions: Clinical dysphagia, RBS on admission and NIHSS score on admission were independent predictors of SAP. NIHSS score on day 5 and pneumonia were independent predictors of 30-day mortality. SAP patients had shorter survival
time compared to non-SAP patients.

Matched MeSH terms: Blood Glucose
Fulltext Awareness of glycosylated haemoglobin (hba1c) among type 2 diabetes mellitus patients in Hospital Putrajaya

Intan Nureslyna Samsudin, Thambiah, Subashini C., Wan Mohamad Asyraf Wan Mohammed Ayub, Cheng, Ng Wan, Zanariah Hussein, Nurain Mohd Noor, et al.

Malaysian Journal of Medicine and Health Sciences, 2015;11(2):1-8.
MyJurnal

The glycosylated haemoglobin (HbA1c) test is the most widely accepted laboratory test for evaluating long term glycaemic control. Patient’s understanding of HbA1c can lead to better glycaemic control. This study is aimed to determine the awareness and level of understanding of HbA1c among type 2 DM patients and its association with glycaemic control. A cross-sectional descriptive study among Type 2 DM patients undergoing routine follow up in an endocrine clinic of a tertiary centre in Malaysia. Patients were invited to answer a validated questionnaire which assessed their awareness and understanding of HbA1c. Their last HbA1c results were retrieved from the laboratory information system. A total of 92 participants were recruited. Fifty-six (60.9%) were aware of the term HbA1c. Fifty percent were categorised as having good HbA1c understanding, with age, monthly income and level of education being the factors associated with understanding. No significant association was noted between HbA1c understanding and glycaemic control, although more patients with good HbA1c understanding had achieved the target glycaemic control compared to those with poor understanding. The level of HbA1c awareness and understanding was acceptable. Factors associated with understanding were age, income and level of education. Continuing efforts however, must be made to improve patients understanding of their disease and clinical disease biomarkers.

Matched MeSH terms: Blood Glucose
Ethnic differences in physiological responses to maximal effort in Malaysian adolescents

Thinakaran T, Nor M, Duncan MT, Chan OL, Klissouras V

Med J Malaysia, 1974 Sep;29(1):24-8.
PMID: 4282626
Matched MeSH terms: Blood Gas Analysis
Fulltext Comparison of cardiovascular responses between remifentanil and fentanyl on laryngoscopy and tracheal intubation in patients undergoing elective surgery

Lai, S.C., Choy, Y.C.

Journal of Surgical Academia, 2014;4(1):20-25.
MyJurnal

This was a prospective, randomized, double-blind study comparing the effect of remifentanil and fentanyl on cardiovascular responses from laryngoscopy and tracheal intubation. Forty-four ASA I or II patients aged between 18-65 yrs scheduled for elective surgery under general anaesthesia, were recruited and randomized into two groups. Each patient in Group R received remifentanil of 0.5 mcg/kg bolus over 30 seconds followed by an infusion of 0.25 mcg/kg/min and each patient in Group F received fentanyl of 2 mcg/kg bolus over 30 seconds followed by an infusion of normal saline. Anaesthesia was then induced with propofol, rocuronium and 2% sevoflurane with 100% oxygen. Cardiovascular changes were recorded every minute for 3 minutes after induction and 5 minutes after tracheal intubation. The heart rate remained stable throughout the induction and intubation period in both groups. None of the patients in the remifentanil group develop bradycardia. Systolic blood pressure (SBP) and mean arterial pressure (MAP) were significantly lower in the fentanyl group at the 3rd minute post-induction and 5th minute post- intubation (p < 0.05). Diastolic blood pressure (DBP) in the fentanyl group was significantly lower at the 2nd and 3rd minute post-induction and 4th and 5th minute post-intubation (p < 0.05). The blood pressure remained stable for the remifentanil group throughout the induction and intubation period. Six patients (27.2%) in the fentanyl group and one patient (4.5%) in the remifentanil group experienced hypertension. Three patients (13.7%) from each group experienced hypotensive episodes. In conclusion, remifentanil 0.5 mcg/kg bolus followed by 0.25 mcg/kg/min infusion resulted in SBP, MAP and DBP remained slightly lower than baseline throughout the whole period but still consider stable, as these changes were not statistically significant.

Matched MeSH terms: Blood Pressure
Fulltext Hypoglycaemic properties of Malaysian cocoa (Theobroma cacao) polyphenols-rich extract

Ruzaidi, A., Abbe Maleyki, Amin, I., Nawalyah, A.G., Muhajir, H., Pauliena, M.B.S.M., et al.

International Food Research Journal, 2008;15(3):305-312.
MyJurnal

The objective of the study was to investigate the hypoglycaemic properties of Malaysian cocoa (Theobroma cacao) polyphenols extract in-vivo and insulin sensitivity in-vitro. Cocoa extract (CE) (containing 190 - 286 mg total polyphenol per gram extract) was prepared from fermented and roasted (140°C, 20 min) beans by extracting with 80% ethanol in the ratio of 1 to 10. For the in-vivo study, the CE was administered in three dosages (1%, 2%, and 3%) to groups of normal and diabetic rats for a period of 4 weeks by forcefeeding. Results showed that dosages of 1% and 3% CE significantly reduced (p < 0.05) plasma glucose levels in the diabetic rats. An in-vitro study (BRIN-BD11 cell lines) was used to evaluate the effect of CE on insulinsensitivity. The results demonstrated that CE at a concentration of 0.1 mg/ml significantly increased (p < 0.05) insulin level compared to the control. The results of this study showed that Malaysian cocoa polyphenol extract have the potential of being an insulin-mimetic agent. Further studies are on-going to elucidate the underlying mechanisms of polyphenols present in CE that contribute to the reduction of plasma glucose levels and insulin mimicking activity.

Matched MeSH terms: Blood Glucose
Fulltext In vivo antidiabetic and acute toxicity of spray-dried Vernonia amygdalina water extract

Yeap, S.K., Beh, B.K., Liang, W.S., Ho, W.Y., Yousr, A.N., Alitheen, N.B.

International Food Research Journal, 2013;20(2):613-616.
MyJurnal

The spray-dried Vernonia amygdalina water extract was evaluated for antidiabetic effect using normoglycaemic, glucose induced hyperglycaemic and streptozotocin induced diabetic mice. This effect was compared with an oral dose of Momordica charantia. Besides, acute toxicity of the extract was also evaluated at concentration 2000 and 5000 mg/kg body weight. The extract was able to reduce blood glucose level in glucose and streptozotocin induced hyperglycaemic mice without causing hypoglycemic effect on fasting normoglycaemic mice. Moreover, mice appeared to be normal and no mortality was observed in the acute toxicity study after treated with up to 5000mg/kg of extract. These results indicated that the spray-dried Vernonia amygdalina water extract was a potential antidiabetic agent which does not induce hypoglycemic and acute toxicity on normal subject.

Matched MeSH terms: Blood Glucose

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