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Aggregation and predisposition to Ascaris lumbricoides and Trichuris trichiura at the familial level

Chan L, Bundy DA, Kan SP

Trans R Soc Trop Med Hyg, 1994 1 1;88(1):46-8.
PMID: 8153999 DOI: 10.1016/0035-9203(94)90492-8

This study examines the persistence of familial aggregation and familial predisposition to Ascaris lumbricoides and Trichuris trichiura infection over 2 periods of treatment and reinfection, in an urban community in Kuala Lumpur, Malaysia. Both parasite species were shown to be aggregated (assessed by the variance to mean ratio) within families at all 3 interventions, although no consistent trend in aggregation was observed over the period of the study. Associations between mean A. lumbricoides and T. trichiura infection levels of families, at all 3 interventions, were highly significant (P < 0.0001), suggesting persistent predisposition at the family level.

Matched MeSH terms: Recurrence
Fulltext Coronary stents in the management of coronary artery disease review of first 100 stents

Ng SC, Sawatt C, Foo LK, Hitam O, Khor PG, Lee YK

Med J Malaysia, 1996 Mar;51(1):75-9.
PMID: 10967983

This is a review of the first 100 coronary stents implanted for the indications of PTCA restenosis, acute or threatened closure and De Novo lesions. The success rates were high and complications rates were low. Subacute stent thrombosis rates were low and stenting for De Novo lesions in > 3.0 mm arteries provide the best short and long term results. Six months restenosis rate was low. Stent assisted high pressure balloon angioplasty is an important advance.

Matched MeSH terms: Recurrence
Fulltext Treatment of bleeding gastroesophageal varices: a report of forty-four cases

Tay SK, Leong YP, Meah FA, Abdullah T, Zain AR

Med J Malaysia, 1992 Dec;47(4):267-72.
PMID: 1303478

Bleeding gastroesophageal varices is associated with a high morbidity and mortality. Forty-four cases of bleeding gastroesophageal varices were treated at the Department of Surgery, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur over four and a half years. Thirty-two of them had liver cirrhosis. Hepatitis B infection was noted in 13 and alcoholic abuse was present in 14 patients. Five patients had associated hepatoma. Thirty-four percent had gastric fundal varices and a third of these bled from them. A total of 179 endoscopic injection sclerotherapy sessions were performed averaging 4 per person. Rebleeding rate was 4% and mortality was high (50%) in these cases. It was concluded that injection sclerotherapy is a safe and effective means of controlling bleeding oesophageal varices. Operative surgery was employed in those who rebled after injection and would be considered in those in Child's A.

Matched MeSH terms: Recurrence
Prevention of duodenal ulcer relapse with omeprazole 20 mg daily: a randomized double-blind, placebo-controlled study

Goh KL, Boonyapisit S, Lai KH, Chang R, Kang JY, Lam SK

J Gastroenterol Hepatol, 1995 1 1;10(1):92-7.
PMID: 7620115

We report the first double-blind, placebo-controlled study that assesses the efficacy and safety of omeprazole 20 mg daily in the maintenance treatment of duodenal ulcer. For the healing phase, 128 patients with endoscopically proven active duodenal ulcer and a history of three or more relapses during the 2 years prior to the study were treated until healing with omeprazole 40 mg daily for 2 and up to 8 weeks. One hundred and twenty-three patients whose ulcers were healed were randomized to receive omeprazole 20 mg daily (n = 60) or placebo (n = 63) for 12 months as maintenance treatment. Patients were interviewed at 3, 6, 9 and 12 months, and endoscopy was performed at 3, 6 and 12 months and whenever symptoms recurred. The healing rates of the 124 patients completing the healing phase were 84, 98 and 100% at 2, 4 and 8 weeks, respectively. During the maintenance phase, eight and four patients discontinued treatment from the omeprazole and placebo groups, respectively. The proportion of patients in remission in the omeprazole group and placebo group after 12 months were 94 and 9% respectively (life table estimates, P < 0.0001). No significant clinical or laboratory changes were observed in patients on therapy with omeprazole. Patients with a history of frequent relapses thus continued to have a very high relapse rate without prophylactic treatment. Omeprazole 20 mg daily was effective and safe in maintaining such patients in remission.

Matched MeSH terms: Recurrence
Fulltext Recurrent aphthous stomatitis

Ramanathan K, Ng KH, Chelvanayagam PI

Med J Malaysia, 1980 Mar;34(3):317-22.
PMID: 7412673

Despite the high prevalence of oral ulcers little is known about what causes them and how best they can be treated. Recurrent aphthous stomatitis (RAS) is a' chronic inflammatory disease characterized by painful recurring ulcerations of the oral mucosa. RAS can be clinically subdivided into four varieties viz - minor aphthous ulcer, major aphthous ulcer, herpetiform ulcers and Behcet's syndrome. A report on 134 patients with RAS is reported. Minor aphthous ulcer (63%) followed by major aphthous ulcer (29%) were the most frequent. A review of current research on RAS is summarized.
Study site: Department of Stomatology, Institute for Medical Research, Kuala Lumpur, Malaysia

Matched MeSH terms: Recurrence
Fulltext Comparison of an IgM capture ELISA with a dot enzyme immunoassay for laboratory diagnosis of dengue virus infections

Cardosa MJ, Zuraini I

Southeast Asian J. Trop. Med. Public Health, 1991 Sep;22(3):337-40.
PMID: 1818383

This study describes the use of an IgM capture ELISA using cell culture derived antigens and a polyclonal rabbit antiflavivirus antisera for the detection of dengue positive cases. The IgM capture ELISA is compared with the dot enzyme immunoassay and the results are discussed in the context of dengue endemicity.

Matched MeSH terms: Recurrence
Fulltext Dermatitis cruris pustulosa et atrophicans: case reports

Ting HC

Med J Malaysia, 1984 Mar;39(1):82-4.
PMID: 6513846

The presence of dermatitis cruris pustulosa et atrophicans in three local patients is documented and the condition briefly discussed.

Matched MeSH terms: Recurrence
Rupture of the pregnant uterus--a 21-year review

Rachagan SP, Raman S, Balasundram G, Balakrishnan S

Aust N Z J Obstet Gynaecol, 1991 Feb;31(1):37-40.
PMID: 1872771

Uterine rupture is still a common problem in developing countries although even here the incidence varies from urban to rural settings. This article is a review of uterine rupture in an urban referral hospital in Malaysia. It examines aetiology, clinical presentation, complications and management of the problem. Meticulous screening of patients together with optimal antenatal and intrapartum care will markedly reduce the incidence of uterine rupture. Early diagnosis and prompt treatment will further help reduce morbidity and mortality to both mother and fetus.

Matched MeSH terms: Recurrence
Relapsed non-Hodgkin's lymphoma with high CA-125 mimicking ovarian tumour

Leong CF, Cheong SK, Ng P, Amran AR

Hosp Med, 2003 Nov;64(11):686-7.
PMID: 14671884
Matched MeSH terms: Recurrence
Congenital diaphragmatic hernia: a case report

Damodaran A, Nair S, Somasundram R

Med J Malaysia, 1973 Dec;28(2):99-102.
PMID: 4276265
Matched MeSH terms: Recurrence
Fulltext Chylothorax and central vein thrombosis, an under-recognized association: a case series

Kho SS, Tie ST, Chan SK, Yong MC, Chai SL, Voon PJ

Respirol Case Rep, 2017 May;5(3):e00221.
PMID: 28250931 DOI: 10.1002/rcr2.221

Chylothorax is defined as the presence of chyle in the pleural cavity. Central vein thrombosis is an under-recognized cause of chylothorax in the adult population and is commonly related to central venous catheterization. Case 1 illustrates a patient with AIDS and disseminated tuberculosis with left chylothorax and central vein thrombosis after a month of antituberculosis therapy. Case 2 was a patient with advanced seminoma who presented with left chylothorax and central vein thrombosis while on chemotherapy. Chylothorax resolved with anticoagulation for both cases. Case 3 was a lymphoma patient with central vein thrombosis who developed chylothorax during chemotherapy. Chylothorax resolved with the continuation of anticoagulation and did not recur despite his progressive underlying lymphoma. There was no central venous catheterization in any of these three cases. These cases illustrate the unique association of central vein thrombosis and chylothorax and the importance of anticoagulation in its management.

Matched MeSH terms: Neoplasm Recurrence, Local
Primary spontaneous pneumothorax in children: factors predicting recurrence and contralateral occurrence

Ng GYH, Nah SA, Teoh OH, Ong LY

Pediatr Surg Int, 2020 Mar;36(3):383-389.
PMID: 31993738 DOI: 10.1007/s00383-020-04619-x

BACKGROUND: The risk factors for recurrence in primary spontaneous pneumothorax (PSP) in children are not well known. We aimed to identify possible risk factors, and to evaluate the utility of computerised tomography (CT) scans in predicting future episodes.
METHODS: We reviewed children aged

Matched MeSH terms: Recurrence
Predictors of Recurrent Ischemic Stroke in Obese Patients With Type 2 Diabetes Mellitus: A Population-based Study

Albitar O, Harun SN, Abidin NE, Tangiisuran B, Zainal H, Looi I, et al.

J Stroke Cerebrovasc Dis, 2020 Oct;29(10):105173.
PMID: 32912507 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105173

BACKGROUND: Diabetes and obesity are established risk factors for stroke. The current study aimed to assess risk factors of ischemic stroke recurrence in diabetic patients based on their body mass index (BMI).
METHODS: A total of 4005 diabetic patients who had a history of ischemic stroke were identified in a retrospective cross-sectional dataset from the Malaysian National Neurology Registry. Patients were classified based on BMI, and multivariable regression analysis was used to evaluate the association between risk factors and recurrent ischemic stroke.
RESULTS: Among obese patients, those with ischemic heart disease (aOR, 1.873; 95% CI, 1.131-3.103), received formal education (aOR, 2.236; 95% CI, 1.306-3.830), and received anti-diabetic medication (aOR, 1.788; 95% CI, 1.180-2.708) had a higher stroke recurrence risk, while receiving angiotensin receptors blockers (aOR, 0.261; 95% CI, 0.126-0.543) lowered the odds of recurrence. Overweight patients with hypertension (aOR, 1.011; 95% CI, 1.002-1.019) for over 10 years (aOR, 3.385; 95% CI, 1.088-10.532) and diabetes prior to the first stroke (aOR, 1.823; 95% CI, 1.020-3.259) as well as those received formal education (aOR, 2.403; 95% CI, 1.126-5.129) had higher odds of stroke recurrence, while receiving angiotensin-converting enzyme inhibitors (aOR, 0.244; 95% CI, 0.111-0.538) lowered the recurrence risk. Normal weight East Malaysians (aOR, 0.351; 95% CI, 0.164-0.750) receiving beta-blockers (aOR, 0.410; 95% CI, 0.174-0.966) had lower odds of stroke recurrence.
CONCLUSIONS: Ischemic heart disease, hypertension, receiving anti-hypertensive agents, and educational level were independent predictors of recurrent stroke in obese patients. Managing the modifiable risk factors can decrease the odds of stroke recurrence.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Bioengineered siRNA-Based Nanoplatforms Targeting Molecular Signaling Pathways for the Treatment of Triple Negative Breast Cancer: Preclinical and Clinical Advancements

Hattab D, Bakhtiar A

Pharmaceutics, 2020 Sep 29;12(10).
PMID: 33003468 DOI: 10.3390/pharmaceutics12100929

Triple negative breast cancer (TNBC) is one of the most aggressive types of breast cancer. Owing to the absenteeism of hormonal receptors expressed at the cancerous breast cells, hormonal therapies and other medications targeting human epidermal growth factor receptor 2 (HER2) are ineffective in TNBC patients, making traditional chemotherapeutic agents the only current appropriate regimen. Patients' predisposition to relapse and metastasis, chemotherapeutics' cytotoxicity and resistance and poor prognosis of TNBC necessitates researchers to investigate different novel-targeted therapeutics. The role of small interfering RNA (siRNA) in silencing the genes/proteins that are aberrantly overexpressed in carcinoma cells showed great potential as part of TNBC therapeutic regimen. However, targeting specificity, siRNA stability, and delivery efficiency cause challenges in the progression of this application clinically. Nanotechnology was highlighted as a promising approach for encapsulating and transporting siRNA with high efficiency-low toxicity profile. Advances in preclinical and clinical studies utilizing engineered siRNA-loaded nanotherapeutics for treatment of TNBC were discussed. Specific and selective targeting of diverse signaling molecules/pathways at the level of tumor proliferation and cell cycle, tumor invasion and metastasis, angiogenesis and tumor microenvironment, and chemotherapeutics' resistance demonstrated greater activity via integration of siRNA-complexed nanoparticles.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Protein and gene expression of leukemia stem cells markers in acute myeloid leukemia

Amrina Mohamad Amin, Maha Abdullah, Sabariah Md Noor, Raudhawati Osman, Wan Hayati Mohd Yaacob, Cheong Soon Keng

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):23-23.
MyJurnal

Introduction: Acute myeloid leukaemia (AML) is a clonal haematological neoplasm characterised by proliferation of immature myeloid cells in the bone marrow resulting in impairment normal cell development in bone marrow. This leads to anaemia, thrombocytopenia and neutropenia. AML primarily affects older adults, with a median age at diagnosis of 69 years but is also seen in all other age groups. AML is recognized as a kind of cancer with marked heterogeneity in both biology of the cells and reactions to treatment. Treatment with intensive chemotherapy regi-mens of adult AML patients who are ≤ 60 years old results in hematologic remission in about 35% of patients, but at least 30% of these patients will experience a relapse. Mechanism leading to early relapse is still unclear. Leukaemia stem cell (LSC) is shown to correlate with poor prognosis. Biomarkers such as aldehyde dehydrogenase (ALDH) and CD34+CD38- have been identified as potential LSC biomarkers in previous studies. The objective of this study is to examine the expression of such markers for LSC and determine the association. Methods: Peripheral blood or bone marrow samples from untreated, newly diagnosed acute myeloid leukemias of all age, gender and race were collect-ed from Hospital Melaka and Kelang. Diagnosis of AML is based on WHO classification which include morphology, cytochemistry, immunophenotyping and cytogenetics. Mononuclear cells were isolated from bone marrow aspirate samples by gradient density centrifugation on Ficoll-Hypaque. Immunophenotyping using CD13, CD14, CD33, CD34, CD38 and ALDH were carried out to identify the presence and proportion of the various populations of inter-est. Results: There was a strong, positive correlation between ALDH and CD34+CD38- cell population, which was statistically significant (rs = 0.5989, p< 0.05). Conclusion: The strong correlation of ALDH activity and CD34+CD38- expression supported the potential of these biomarkers to identify LSCs cell in AML patients. However, due to the heterogeneity of AML, further studies using more markers and larger sample size are needed to determine the validity and to correlate with disease-free survival rate of AML patients.

Matched MeSH terms: Recurrence
Fulltext Targeting bladder cancer stem cells using Newcastle disease virus

Arcana Thirumorthy, De-Ming Chau, Khatijah Yusoff, Abhi Veerakumarasivam

Malaysian Journal of Medicine and Health Sciences, 2019;15(108):24-24.
MyJurnal

Introduction: Bladder cancer is associated with high risk of tumour recurrence and therapeutic resistance. Cancer stem cells (CSC) within a particular tumour are postulated to drive tumorigenesis and influence tumour behaviour. Recent studies have shown that Newcastle disease virus (NDV) is able to selectively kill and exert a strong oncolytic effect against various cancer types. However little is known about the oncolytic effect of NDV against CSC. In this study, the oncolytic effect of NDV against putative bladder CSC was examined. Methods: Putative bladder CSC was selectively grown in the form of 3D-spheroids from six different bladder cancer cell lines. The spheroid cells were characterised for their stemness properties to ensure that these cells truly represent CSC. This was conducted via the analysis of CSC associated genes and cell surface markers expression. Subsequently, the oncolytic effect of the wild-type NDV-AF2240 strain against the bladder cancer spheroids was investigated. Results: All the spheroids expressed significantly high levels of CSC-associated genes. Flow-cytometry analysis revealed that the expression pattern of the CSC-associated surface markers was different in the spheroid cells; suggesting heterogeneity in the expression signatures of these cells. The infection of spheroids with NDV showed that the NDV was able to target bladder cancer spheroids but there was a spectrum of response across the different spheroids. Intriguingly, NDV was able to persistently infect bladder cancer spheroids that were not sensitive towards NDV infection as the presence of NDV viral genes were detected in the spheroid cells. The NDV persistently infected bladder cancer spheroids were resistant to superinfection and developed an antiviral state by expressing low levels of interferon-beta (IFN-b). NDV persistency of infection affects the process of epithelial to mesenchymal transition (EMT) of cancer cells as the spheroid forming ability of an established NDV persistently infected bladder cancer cell line, EJ28-PI was shown to be impaired. The EJ28-PI cells expressed significantly high levels of the EN2 gene. Knockdown of the EN2 expression reduced the viability of EJ28-PI cells; suggesting a role for EN2 in mediating NDV persistency of infection in cancer cells. Conclusion: Bladder CSC gene expression signatures influence the efficacy of NDV-mediated oncolysis. Our current work is focused on identifying genes and signalling pathways that influence NDV-mediated oncolysis us-ing whole-transcriptomic sequencing. The findings of this study can potentially be used to enhance the efficacy of NDV-mediated oncolysis and accelerate the translation of NDV as an oncotherapeutic agent in the clinic.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Can post-treatment oral cancer patients' concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation?

Aminnudin AN, Doss JG, Ismail SM, Chai MB, Abidin MZ, Basri CSJM, et al.

Ecancermedicalscience, 2020;14:1118.
PMID: 33209109 DOI: 10.3332/ecancer.2020.1118

Background: Oral cancer and its treatment impact patients' post-treatment outcomes, challenging clinicians to manage them optimally. Addressing patients' concerns is central to holistic patient-centred care.
Objectives: This study aimed to determine post-treatment oral cancer patients' concerns and its relationship with patients' clinical characteristics, health-related quality of life (HRQoL), psychological distress and patient satisfaction with the follow-up consultation.
Methods: A total of 85 oral cancer patients were recruited from a three-armed pragmatic RCT study on the patient concerns inventory for head and neck cancer (PCI-H&N), which was conducted at six hospital-based oral maxillofacial specialist clinics throughout Malaysia. Malaysians aged 18 years and above and on follow-ups from 1 month to 5 years or more were eligible. Patients completed the PCI-H&N, functional assessment of cancer therapy -H&N v4.0 and Distress Thermometer at pre-consultation and satisfaction questionnaire at post-consultation. The data were analysed descriptively; multiple linear regression and multivariate logistic regression analyses were used to determine possible predictors of patients' HRQoL and psychological distress.
Results: 'Recurrence or fear of cancer coming back' (31.8%) was most frequently selected. 43.5% of patients selected ≥4 concerns. A significantly high number of concerns were associated with patients of '1-month to 1-year post-treatment' (n = 84%; p = 0.001). A significant association existed between 'time after treatment completed' and patients' concerns of 'chewing/eating', 'mouth opening', 'swelling', 'weight', 'ability to perform', 'cancer treatment' and 'supplement/diet-related'. 'Chewing/eating' was predicted for low HRQoL (p < 0.0001) followed by 'appearance' and 'ability to perform recreation activities' (personal functions domain). Patients with high psychological distress levels were 14 times more likely to select 'ability to perform recreation activities' and seven times more likely to select 'feeling depressed'. No significant association was identified between patients' concerns and patients' satisfaction with the consultation.
Conclusion: Routine follow-up consultations should incorporate the PCI-H&N prompt list to enhance patient-centred care approach as the type and number of patients' concerns are shown to reflect their HRQoL and psychological distress.TRIAL REGISTRATION: NMRR-18-3624-45010 (IIR).

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Neuroendocrine tumour masquerading as intussusception: A case report

Wong L, Kanthasamy SV, Durairaj G, Thangaratnam RR

Int J Surg Case Rep, 2020;77:48-52.
PMID: 33137672 DOI: 10.1016/j.ijscr.2020.10.091

INTRODUCTION: Intussusception usually occurs in the paediatric population. When it occurs in the adult population, it is normally caused by a malignant intraluminal pathology.
PRESENTATION OF CASE: A 72-year-old female presented to us with right-sided abdominal pain for 3 weeks, associated with vomiting and diarrhoea. She had an appendectomy done 30 years ago and a recent myocardial infarction. Abdominal examination revealed a previous appendectomy scar and tenderness over the right lumbar region. Computed tomography showed ileocaecal intussusception. Right hemicolectomy with a double barrel stoma was performed as she was unstable intraoperatively. Histopathological examination of the tumour showed a well-differentiated neuroendocrine tumour. Subsequent PET scan showed no systemic disease and a reversal of the stoma was done. She remained disease free for a year.
DISCUSSION: Our patient had undergone a right hemicolectomy despite the high risk of mortality, as there is a high chance of malignancy. Double barrel stoma was done, as she was unstable intraoperatively. Fortunately, she recovered well and had her stoma reversed without any further recurrence of her disease.
CONCLUSION: Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.

Matched MeSH terms: Neoplasm Recurrence, Local
Fulltext Case Report: Two Cases of Recurring Ovale Malaria in Sarawak, Malaysia, after Successful Treatment of Imported Plasmodium falciparum Infection

Liew JWK, Ooi CH, Snounou G, Lau YL

Am J Trop Med Hyg, 2019 12;101(6):1402-1404.
PMID: 31595863 DOI: 10.4269/ajtmh.19-0305

Here are two cases of recurring ovale malaria in Sarawak, Malaysia, that are likely relapses that occurred 1-2 months after successful treatment of the initial imported falciparum malaria with artemisinin-based combined therapy. The patients have no history or recollection of previous malaria episodes. These cases add to the limited evidence on the relapsing nature of Plasmodium ovale, after a febrile episode. In regions where P. ovale is not known to be autochthonous, active follow-up of treated imported malaria patients is highly recommended following their return, particularly to areas nearing or having achieved elimination.

Matched MeSH terms: Recurrence
Fulltext A case of primary pleural synovial sarcoma with endobronchial recurrence

Wan JL, Lam YF, Foong KW, Abdul Ghani N, Lachmanan K

Respirol Case Rep, 2020 Apr;8(3):e00547.
PMID: 32166036 DOI: 10.1002/rcr2.547

Primary pleural synovial sarcoma (PPSS) is an extremely rare malignancy without a known cause. The diagnosis is made after excluding metastasis from an extra-thoracic sarcoma. We report a case of a 67-year-old gentleman who presented with an incidental finding of a left lung mass on a routine chest X-ray. A computed tomography (CT) of the thorax and whole-body positron emission tomography (PET)-CT was done confirming a left lung mass with no other extra-thoracic involvement. A lobectomy was performed with a diagnostic and therapeutic intent. The histopathological examination and immunohistochemistry study revealed a pleural-based tumour with features suggestive of synovial sarcoma. Subsequently, he underwent post-operative radiotherapy. However, three months later, he developed an endobronchial recurrence, complicated by post-obstructive pneumonia resulting in his demise. This case highlights a rare form of malignancy with a rare site of recurrence.

Matched MeSH terms: Neoplasm Recurrence, Local

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