MyMedR

Fulltext A functional henipavirus envelope glycoprotein pseudotyped lentivirus assay system

Khetawat D, Broder CC

Virol J, 2010 Nov 12;7:312.

PMID: 21073718 DOI: 10.1186/1743-422X-7-312

BACKGROUND: Hendra virus (HeV) and Nipah virus (NiV) are newly emerged zoonotic paramyxoviruses discovered during outbreaks in Queensland, Australia in 1994 and peninsular Malaysia in 1998/9 respectively and classified within the new Henipavirus genus. Both viruses can infect a broad range of mammalian species causing severe and often-lethal disease in humans and animals, and repeated outbreaks continue to occur. Extensive laboratory studies on the host cell infection stage of HeV and NiV and the roles of their envelope glycoproteins have been hampered by their highly pathogenic nature and restriction to biosafety level-4 (BSL-4) containment. To circumvent this problem, we have developed a henipavirus envelope glycoprotein pseudotyped lentivirus assay system using either a luciferase gene or green fluorescent protein (GFP) gene encoding human immunodeficiency virus type-1 (HIV-1) genome in conjunction with the HeV and NiV fusion (F) and attachment (G) glycoproteins.

RESULTS: Functional retrovirus particles pseudotyped with henipavirus F and G glycoproteins displayed proper target cell tropism and entry and infection was dependent on the presence of the HeV and NiV receptors ephrinB2 or B3 on target cells. The functional specificity of the assay was confirmed by the lack of reporter-gene signals when particles bearing either only the F or only G glycoprotein were prepared and assayed. Virus entry could be specifically blocked when infection was carried out in the presence of a fusion inhibiting C-terminal heptad (HR-2) peptide, a well-characterized, cross-reactive, neutralizing human mAb specific for the henipavirus G glycoprotein, and soluble ephrinB2 and B3 receptors. In addition, the utility of the assay was also demonstrated by an examination of the influence of the cytoplasmic tail of F in its fusion activity and incorporation into pseudotyped virus particles by generating and testing a panel of truncation mutants of NiV and HeV F.

CONCLUSIONS: Together, these results demonstrate that a specific henipavirus entry assay has been developed using NiV or HeV F and G glycoprotein pseudotyped reporter-gene encoding retrovirus particles. This assay can be conducted safely under BSL-2 conditions and will be a useful tool for measuring henipavirus entry and studying F and G glycoprotein function in the context of virus entry, as well as in assaying and characterizing neutralizing antibodies and virus entry inhibitors.

Fulltext Severe metabolic changes following oral sodium phosphate in a patient of renal cell carcinoma - On dialysis

Lim CT

Indian J Pharmacol, 2016 May-Jun;48(3):327-8.

PMID: 27298508 DOI: 10.4103/0253-7613.182875

Oral sodium phosphate (OSP), an effective bowel purgative, is available over the counter (OTC) and requires a substantially lower volume than polyethylene glycol-based preparative agents. Rarely, OSP consumption has been associated with acute hypocalcemia and hyperphosphatemia. We describe a case of chronic kidney disease patient developing symptomatic hypocalcemia following OTC OSP.

Fulltext Current concepts in the management of carotid body tumours

Desmond TH, Christopher HK

Med J Malaysia, 2010 Dec;65(4):268-70.

PMID: 21901942

To review the current management of carotid body tumours and examine our own experience at the Singapore General Hospital.

Fulltext Periprostatic lidocaine infiltration versus transrectal lidocaine gel for local anaesthesia in transrectal ultrasound guided prostate biopsy

Goh, E.H., Christopher, C.K.H., Praveen, S., Zulkifli, M.Z.

Journal of Surgical Academia, 2011;1(1):35-38.

MyJurnal

Management of pain plays an important role during prostate biopsy. Various types of management of pain plays an important role during prostate biopsy. Various types of anaesthetic methods have been used. The present study aimed to compare the efficacy and complication rate between periprostatic lidocaine infiltration and transrectal lidocaine gel in transrectal ultrasound guided prostate biopsy. All prostate biopsy patients were included except those with lidocaine, allergy, haemorrhagic diathesis, anticoagulation therapy, the inability to rate a visual analogue scale and inability to obtain consent. They were randomized into two groups. Group 1 received 20ml 2% transrectal lidocaine gel. Group 2 received 5ml 1% lidocaine infiltration for each periprostatic nerve block with 23-gauge spinal needle. After three minutes, prostate biopsy was performed with an 18 gauge 7-inch spring-loaded biopsy gun. Six biopsies were taken for each lobe. Pain during probe insertion, biopsy and immediately after the procedure was assessed using the Visual Analogue Scale. Any complication immediately after procedure, one day or after one week, was recorded. Mean pain score was lower after periprostatic lidocaine infiltration compared to transrectal lidocaine gel (3.1 + 1.9 versus 4.9 + 2.4, p = 0.027). There was no statistically significant difference in the complication rate. Transrectal ultrasound prostate biopsy using periprostatic lidocaine infiltration provides better anaesthesia as compared to the transrectal lidocaine gel application with no significant difference in complication. Thus, the use of periprostatic lidocaine infiltration in TRUS guided prostate biopsy is recommended.

Fulltext Myeloma kidney – a treatable yet often forgotten disease

Lim, Christopher Thiam Seong, Fuah, Kar Wah, Khoo, Yoong Khean

Malaysian Journal of Medicine and Health Sciences, 2017;13(2):63-65.

MyJurnal

Multiple myeloma is a blood dyscrasias that accounts of almost 10% of all hematological malignancy. The presentation of myeloma kidney is highly variable and it often presents as renal insufficiency, renal tubular dysfunction and proteinuria of various types. In Malaysia the true incidence of myeloma kidney is unknown. Often the diagnosis of myeloma kidney was missed out despite the patient has sought medical treatment early. A high index of suspicion is required when the middle to elderly age patients present with unexplained renal impairment and enlarged kidneys. We present here the presentation of a rare subtype of myeloma in a relatively young patient whereby the patient presented with nephrotic syndrome and aoztemia.

Fulltext Enterobacter gergoviae peritonitis in a patient on chronic ambulatory peritoneal dialysis - first reported case

Anna Misya’il Abdul Rashid, Lim, Christopher Thiam Seong

Malaysian Journal of Medicine and Health Sciences, 2017;13(2):67-69.

MyJurnal

Enterobacter gergoviae is a gram negative rod-shaped opportunistic organism reported to cause urinary and respiratory tract infections, but peritonitis caused by this organism is unknown. We report a case of 50-year-old patient on peritoneal dialysis (PD) presented with Enterobacter gergoviae peritonitis with septic shock. Despite Intraperitoneal (IP) cloxacillin 250mg qid and IP ceftazidime 1gram q24h and subsequent escalation with IP amikacin 2mg/kg q24h and IP vancomycin 15mg/kg q24h within the next 48 hours, his peritonitis remained refractory and required catheter removal. Although Enterobacter gergoviae is naturally sensitive to aminoglycosides, carbapenems and quinolones, it reacts differently to the beta lactam antibiotics. Their resistance to third-generation cephalosporins is fast emerging and treatment with third-generation cephalosporins may cause AmpC-overproducing mutants. The majority of
Enterobacteriaceae, including Extended-spectrum beta-lactamases producers, remain susceptible to carbapenems. Our report provides an unfavourable course of E. gergoviae peritonitis likely due to acquired secondary drug resistance during the therapy period.

Fulltext Pulmonary haemorrhage associated with severe leptospirosis – the role of low dose intravenous methylprednisolone

Thiam Seong Christopher Lim, Tan Yi Jun, Then Ru Fah

Malaysian Journal of Medicine and Health Sciences, 2018;14(1):69-72.

MyJurnal

Leptospirosis has a wide range of presentation which ranges from mild flu-like symptoms, to severe form including renal failure, liver failure, and hemorrhage. Pulmonary involvement can progress from subtle clinical features to life threatening pulmonary hemorrhage and acute respiratory distress syndrome. Although benefits of corticosteroids in adult respiratory distress syndrome have been proven and accepted, evidence for use of corticosteroids in pulmonary leptospirosis is still limited. Given the vasculitic nature of severe leptospirosis, it has been proposed that addition of intravenous corticosteroid therapy, particularly in cases of pulmonary involvement is beneficial. We report a case of leptospirosis with suspected pulmonary hemorrhage which deteriorates after a few days of admission in our tertiary hospital. We have demonstrated that the prescription of a lower dose of corticosteroid than what was widely reported in the literature can equally led to a satisfactory recovery of the pulmonary hemorrhage.

Fulltext Primary focal segmental GlomerulosSclerosis and minimal change disease as one spectrum of disease

Fah, Then Ru, Jun, Tan Yi, Lim, Christopher Thiam Seong

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):64-66.

MyJurnal

Minimal Change Disease (MCD) and Focal Segmental Glomerulosclerosis (FSGS) are common causes of nephrotic syndrome. These two conditions are similar in their presentations but differentiated via their histopathological features and responsiveness to corticosteroids. There are ongoing debates whether MCD and FSGS are at the same spectrum of disease rather than separate entities. FSGS has been postulated to be the severe end of the spectrum of MCD. We have reported a case that has primary FSGS after years of poorly controlled MCD, which supports both conditions are the same spectrum of disease.

Fulltext Rare occurrence of type lll membranoproliferative glomerulonephritis in a patient with Hepatitis C in sustained virologic response phase

Tan, Yi Jun, Then, Ru Fah, Lim, Christopher Thiam Seong

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):148-150.

MyJurnal

Hepatitis C virus (HCV) infection is known to cause acute and chronic active hepatitis. In addition, HCV also has systemic disorder involvement that links to various extra-hepatic complications. We report a case of a patient which has been diagnosed to have Hepatitis C Genotype 3A who has been started on antiviral. He achieved end treatment response and sustained virologic response. During routine follow up, he experienced acute kidney injury. Renal biopsy showed type III membranoproliferative glomerulonephritis. His proteinuria improved greatly with the addi- tion of angiotensin converting enzyme inhibitor. This case highlights the possibility of appearance of HCV related glomerulonephritis in patient who has sustained virological response.

Fulltext Effectiveness of methadone maintenance therapy (MMT) and life style improvement among opiate dependent patients registered

Christina Malini Christopher, Ahmad Fuad Shamsuddin, Noor Azizah Abdul Wahab

Jurnal Sains Kesihatan Malaysia, 2019;17(1):51-56.

MyJurnal

In Malaysia, drug addiction has been a big threat since 1983. As of by latest statistic by National Anti-Drug Agency in 2016, the number of drug abusers in Malaysia was 30846. Acknowledging the importance of drug abuse and relapse as a public health issue, Malaysian government had implemented Harm Reduction Programme .Under this programme, Methadone Maintenance Therapy (MMT) was launched in Oct 2005. This study was undertaken to evaluate the effectiveness of MMT programme among opiate dependent individuals in their daily life. In this study, 100 individuals from the Ministry of Health (MoH), Klinik Kesihatan Bayan Lepas (Bayan Lepas Health Clinic) and Agensi Anti-Dadah Kebangsaan (National Anti-Drug Agency) in Telok Bahang were involved. The subjects were interviewed with WHOQOL BREF questionnaires before joining the MMT programme and also after minimum 4 months of joining MMT. Results obtained were used for comparing life style implications among methadone patients before and after joining the MMT programme. Subjects were predominantly of Malay ethnicity (82%). Subjects were mostly aged between 51 to 60 years old (34%). Paired t-test was done on the WHOQOL scores at baseline (before MMT) and after minimum of 4 months enrolment for all four domains. Each domain showed significant improvement in QOL (P < 0.05).The highest improvement was shown in the psychology domain with the mean value increment of 15.13 ± 17.49. Physical domain showed the least improvement with the mean value of 9.39 ± 16.21.This study has proven that MMT have highly contributed to improvement of quality of life among MMT clients in Klinik Kesihatan Bayan Lepas and AADK Telok Bahang.

Malaysia: Standing firm on trade and tobacco

Nordin AS, Bullen C

Tob Control, 2014 Jan;23(1):4-5.

PMID: 24479154

Men's health issues in Asia

Ho CC, Tan HM

Aging Male, 2013 Sep;16(3):81-4.

PMID: 23822757 DOI: 10.3109/13685538.2013.809414

Men's health has gained prominence over the past few years but it is still not on par with the attention or funding that women and child health is getting. In Asia, this issue is even more conspicuous. With westernization of lifestyle, Asian men's problems emulate their Western counterparts but there are certain issues unique to Asian men due to cultural differences. This review will discuss the health issues affecting Asian men and suggest measures that can be taken to overcome them.

Fulltext Age and pathology of prostate cancer in South-Southern Nigeria; is there a pattern?

Sapira MK, Obiorah CC

Med J Malaysia, 2012 Aug;67(4):417-9.

PMID: 23082453

Prostate cancer is a common health problem world wide. Age is its strong risk factor.

Rise of herbal and traditional medicine in erectile dysfunction management

Ho CC, Tan HM

Curr Urol Rep, 2011 Dec;12(6):470-8.

PMID: 21948222 DOI: 10.1007/s11934-011-0217-x

Herbal medicine long has been used in the management of sexual dysfunction, including erectile dysfunction. Many patients have attested to the efficacy of this treatment. However, is it evidence-based medicine? Studies have been done on animal models, mainly in the laboratory. However, randomized controlled trials on humans are scarce. The only herbal medications that have been studied for erectile dysfunction are Panax ginseng, Butea superba, Epimedium herbs (icariin), Tribulus terrestris, Securidaca longipedunculata, Piper guineense, and yohimbine. Of these, only Panax ginseng, B. superb, and yohimbine have published studies done on humans. Unfortunately, these published trials on humans were not robust. Many herbal therapies appear to have potential benefits, and similarly, the health risks of various phytotherapeutic compounds need to be elucidated. Properly designed human trials should be worked out and encouraged to determine the efficacy and safety of potential phytotherapies.

Solid waste generation and decomposition using compost bin technique in Pulau Pinang, Malaysia

Akinbile CO, Yusoff MS

Waste Manag Res, 2012 May;30(5):498-505.

PMID: 21930519 DOI: 10.1177/0734242X11417974

Solid waste comprised of a grass clippings mixture was decomposed using a locally-made compost bin in Pulau Pinang, Malaysia, to eliminate challenges associated with improper waste disposal. Bulk density, pH, moisture content, nutrients content, nitrogen (N), phosphorus (P), potassium (K), iron (Fe), zinc (Zn), copper (Cu) and carbon/nitrogen (C/N) ratio were determined over 77 days. A 34% reduction in compost bin volume was observed and bulk density and pH were also reduced from 732 to 482 kg m(-3) and 7.82 to 8.41, respectively, indicating fairly good performance. The final moisture content and C/N ratio were 44.06% and 14 : 1, respectively, and the results also showed that the presence of nutrients and heavy metals in the final compost were within acceptable limits for use as a soil conditioner. Final concentrations of N, P and K were 347 mg kg(-1), 510 mg kg(-1) and 14.8 g kg(-1) and for heavy metals, Fe, Zn and Cu were 5308, 300 and 20 mg kg(-1), respectively, which considerably assisted in the decomposition process. Processed waste materials from the bin were shown to be excellent organic fertilizers with over 75% germination index for seeds grown into bean sprouts in 72 h. An improved bin design to eliminate greenhouse gas emission into the environment is suggested.

Psychosocial factors and childhood recurrent abdominal pain

Boey CC, Goh KL

J Gastroenterol Hepatol, 2002 Dec;17(12):1250-3.

PMID: 12423267

Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain-gut axis linking the central and enteric nervous systems are important mechanisms.

Fulltext Dengue-related Longitudinally Extensive Transverse Myelitis

Tan W, Lim CTS

Neurol India, 2019 9 13;67(4):1116-1117.

PMID: 31512649 DOI: 10.4103/0028-3886.266296

Editorial: Bridging the gap between animal and human studies of hearing

Hall DA, Plack CJ

Hear Res, 2019 10;382:107778.

PMID: 31470340 DOI: 10.1016/j.heares.2019.107778

Resolution of rare palatal brown tumour after parathyroidectomy

Lim CT, Thevandran TK

Clin Exp Nephrol, 2017 Apr;21(2):352-353.

PMID: 27339441 DOI: 10.1007/s10157-016-1292-6

Fulltext Bilateral transposition of maxillary canines and first premolars : orthodontic management. a case report. [Abstract]

Tan CL, Wong XH

International Medical Journal Malaysia, 2017;16(21):39.

MyJurnal

Introduction: Transposition is a rare dental anomaly in positional interchange between two adjacent teeth. Studies indicated that tooth transpositions are more frequent unilateral than bilateral (12:1). It is a very rare phenomenon when the anomaly is bilateral and affects same teeth on both sides. The case of a 17 year old girl, with class I incisor relationship on class 1 skeletal base with bilateral transposition of maxillary canines-first premolars, severe crowding and posterior crossbite, is presented. This case report demonstrates the orthodontic management of bilateral transposition of maxillary canines-first premolars and by the end of treatment, the transpositions were maintained while achieving a good functional and aesthetic result.
KEYWORDS: transposition, maxillary canine, malocclusion

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