MyMedR

As Malaysia ages its health and social care systems will have to adapt to a changing pattern of disease and dependency. Improved public health measures extend life expectancy at the relative expense of increased prevalence of currently incurable conditions such as dementia and Parkinson's disease. In this article we discuss how these demographic changes will impact and suggest possible means of coping with the altered epidemiology of disease and disability. Malaysia will need to swiftly develop sufficient expertise in acute Geriatric Medicine, rehabilitation of older people; the management of long-term conditions in older people with multiple complex problems within Primary Care; as well as an infrastructure for home and institutional care.

EEG features of focal malformations of cortical development

Raymond AA, Fish DR

J Clin Neurophysiol, 1996 Nov;13(6):495-506.

PMID: 8978621

Recent advances in neuroimaging have allowed the detection and characterization of focal malformations of cortical developmental in a significant proportion of patients with epilepsy, many of whom were previously labelled as cryptogenic, allowing a better description of the associated electroencephalogram (EEG) features. Alpha activity is usually preserved, although superficial gyral abnormalities are often associated with overlying localized polymorphic delta activity, and occasionally abnormal fast activity. Most affected patients with epilepsy show interictal spikes. These are often broadly concordant with the structural abnormality but may show a wider anatomic distribution and be multifocal, or occasionally appear only in anatomically distant sites. In many patients the spikes are frequent and sometimes they occur continuously or in long trains. EEG findings are often stable over time, but some patients only show the development of slow wave changes or interictal spikes when followed serially for several years. A small proportion of patients with focal malformations of cortical development have EEG features mimicking idiopathic generalized epilepsy, and occasionally patients exhibit continuous generalized spike and slow wave activity in sleep. Electrocorticography studies confirm the often widespread nature of interictal spiking, but may also show highly epileptogenic patterns recorded directly from dysplastic cortex. The intrinsic epileptogenicity of areas of cortical developmental abnormalities has also been demonstrated by chronic intracranial studies and in vitro recordings of slices obtained from resected human dysplastic cortex. In this regard such developmental abnormalities are fundamentally different from acquired lesions such as tumors/vascular anomalies that usually exert their effects through changes in adjacent cortex.

Evolution of civil aeromedical helicopter aviation

Meier DR, Samper ER

South. Med. J., 1989 Jul;82(7):885-91.

PMID: 2665130

The rapid increase in the use of helicopters for hospital transport during the 1980s is the culmination of several hundred years of military medical innovation. Mass battefield casualties spurred both technologic and medical changes necessary for today's sophisticated helicopter systems in use worldwide, particularly in the United States. The Napoleonic Era and the American Civil War provided the framework for the evolution of today's state-of-the-art emergency medical techniques. The use of airplanes to evacuate the wounded eventually led to using helicopters for rescue missions in World War II. The combat experiences of the United States in Korea, the British in Malaya, and the French in Indochina proved that rotary-wing aircraft were invaluable in reducing battlefield death rates. Any skepticism about the efficacy of helicopter medical evacuation was erased during the Vietnam conflict. As an integral part of the modern battlefield, these specialized aircraft became a necessity. The observations and experience of American servicemen and medical personnel in Vietnam established the foundation for the acceptance of helicopter transport in modern hospital systems.

Evaluation of entomopathogenic bacteria against Aedes polynesiensis, the vector of lymphatic filariasis in French Polynesia

Mercer DR, Nicolas L, Thiery I

J Am Mosq Control Assoc, 1995 Dec;11(4):485-8.

PMID: 8825516

Thirteen strains among 3 species of entomopathogenic bacteria were tested against 3 medically important mosquito species in French Polynesia. Two strains of Bacillus thuringiensis were highly toxic to Aedes polynesiensis, Aedes aegypti, and Culex quinquefasciatus. Six of 7 strains of Bacillus sphaericus tested were highly toxic to Cx. quinquefasciatus but not to the Aedes spp. Clostridium bifermentans serovar. malaysia was more toxic to Ae. polynesiensis than to the other 2 species. Entomopathogenic bacteria merit field testing for larval mosquito control in French Polynesia.

Six platyhelminths from Malaysian reptiles including Paradistomoidella cerberi n.g., n.sp. (Digenea: Dicrocoeliidae)

Brooks DR, Palmieri JR

J Helminthol, 1981 Mar;55(1):39-43.

PMID: 7229330

Paradistomoidella cerberi n.g., n.sp. and Paracanthostomum cerberi from Cerberus rhynchops, Xenopharynx pyriformis and Allopharynx mehrai from Ptyas korros, Neopronocephalus orientalis from Geoemyda spinosa, and Duthiersia expansa from Varanus salvator are all reported from the area of Kuala Lumpur, Malaysia. Paradistomoidella cerberi most closely resembles members of Paradistomoides but is characterized by relatively short caeca, a cirrus sac containing a bipartite rather than sinous internal seminal vesicle, and unevenly-sized suckers. Kuala Lumpur is a new locality for Paracanthostomum cerberi, X. pyriformis, A. mehrai, and D. expansa. Ptyas korros is a new host for X. pyriformis and G. spinosa is a new host for N. orientalis.

Clinical trial of phenyelene di-iso-thiocyanate (1.4), Jonit, in the treatment of hookworm disease in Malaysia

O'Holohan DR, Hugoe-Matthews J, Kanagasabai K

Southeast Asian J Trop Med Public Health, 1971 Mar;2(1):51-5.

PMID: 5112340

ERCP induced complications

Rupa B, Rao GV, Nageshwar DR

Med J Malaysia, 2005 Jul;60 Suppl B:140.

PMID: 16108197

Burnout in Malaysia: a note

Sinoway BA, Baxter DR, Santa Maria R

J Health Hum Serv Adm, 1999;22(1):33-6.

PMID: 10848192

Characterization of group A streptococci isolated in Kuala Lumpur, Malaysia

Jamal F, Pit S, Johnson DR, Kaplan EL

J Trop Med Hyg, 1995 Oct;98(5):343-6.

PMID: 7563264

T-agglutination patterns of 190 strains of group A streptococci isolated between January 1989 and December 1993 from body fluids (10), throat culture (56), pus (51) and skin lesions (73) were determined. Mucoid colonial morphology was exhibited by 6.3% (12/190) of the strains on initial isolation. Type T-5,11,27,44 comprised 23.7%, followed by T-1,3,13,B3264 (11.1%), T-4,6 (8.4%) and T-8,25, Imp 19 (7.9%). About 42% (80/190) strains could not be characterized by T agglutination pattern. T-typing of 71 selected strains at WHO Collaborating Center, Minneapolis yielded similar results. Nineteen selected strains were further characterized by M-typing; only three strains were M-typeable. These strains were isolated from throat (M1), sputum (M5) and pus (M12). About 68% (48/71) isolates produced serum opacity factor. These data support the existence of as yet uncharacterized group A streptococcal serotypes in this region.

Imported melioidosis in a British native

Jenkins DR, Lewis AM, Strachan CJ

J Infect, 1990 Sep;21(2):221-2.

PMID: 2230183

Prevention of mental handicap and developmental disabilities in South East Asia

Sardharwalla IB, Lingam S, Harvey DR

Arch Dis Child, 1988 Jun;63(6):672-3.

PMID: 3389904

Fulltext Investigation of a suspected outbreak of Japanese encephalitis in Pulau Langkawi

Fang R, Hsu DR, Lim TW

Malays J Pathol, 1980 Aug;3:23-30.

PMID: 6312203

Correspondence: Misuse of fansidar

O'Holohan DR, Dondero TJ, Ponnampalam JT

Med J Malaysia, 1973 Jun;27(4):310.

PMID: 4270792

Microbial diversity dynamics during the self-acidification of dairy slurry

Bastami MS, Jones DL, Chadwick DR

Environ Technol, 2021 Jun;42(16):2562-2572.

PMID: 31868106 DOI: 10.1080/09593330.2019.1706644

Slurry acidification has been shown to be effective in reducing environmentally damaging gases. However, this involved the use of concentrated acids on farms. Therefore, due to the health and safety concerns, there is an interest in self-acidification of slurry technique. This study was designed to determine the microbial dynamics leading to self-acidification of slurry. A fresh cattle slurry was amended 10% brewing sugar and stored over 30 days. This fermentable carbon source promoted self-acidification of the slurry from pH 7.0 to 4.7 within four days, and was associated with the accumulation of lactic acid and a reduction in methane and relative ammonia emissions. A metagenomics approach through next generation sequencing (NGS) using an Illumina MiSeq platform was used to determine the microbial diversity and dynamics (bacteria and archaea) in the stored amended slurry. 16S ribosomal ribonucleic acid (rRNA) sequence data revealed the presence of the Order of Lactobacillales was associated with the lactic acid production. The operational taxonomic units (OTUs) abundance indicates that the methanogenic community was dominated by hydrogenotrophic methanogens from the member Order of Methanobacteriales, Methanomicrobiales, and Methanosarcinales. The decrease in tolerance by the methanogens in the self-acidified slurry was probably the main reason for the reduced methane emission. These results confirm, at the microbial level, the mechanism of inhibiting methane production via self-acidification during storage period.

Skin lesions induced by penicillamine. Occurrence in a patient with hepatolenticular degeneration (Wilson Disease)

Greer KE, Askew FC, Richardson DR

Arch Dermatol, 1976 Sep;112(9):1267-9.

PMID: 136925

A 41-year-old patient with hepatolenticular degeneration (Wilson disease), who had been treated for 15 years with penicillamine, developed small white papules at sites of venipuncture in the antecubital fossae and at surgical suture sites. Histologically, these papules showed focal areas of connective tissue degeneration in the dermis, but there was no evidence of inclusion cysts. The changes most likely resulted from the effect of penicillamine on new connective tissue formation at the sites of injury. The patient also developed crinkling of the skin of her face and neck while on the penicillamine regimen, and these changes were attributed, at least in part, to the effects of this drug on connective tissue.

Efficacy of oral brush biopsy in potentially malignant disorder management

Goodson ML, Smith DR, Thomson PJ

J Oral Pathol Med, 2017 Nov;46(10):896-901.

PMID: 28833675 DOI: 10.1111/jop.12627

BACKGROUND: Oral potentially malignant disorders (PMD) harbour unpredictable risk for squamous cell carcinoma development. Current management requires tissue biopsy for histopathology characterisation, dysplasia grading and targeted intervention to "high-risk" lesions, although evidence-based guidelines are limited and diagnoses subjective. This study investigated the use of adjunctive oral brush biopsy techniques during the management of PMD in a UK hospital population.

METHODS: Retrospective review of a 310 PMD patient cohort presenting to Maxillofacial Surgery in Newcastle upon Tyne with new, single-site lesions between December 2009 and May 2014. Patients underwent Orcellex® brush biopsy and liquid-based cytology examination in addition to conventional biopsy techniques, with management proceeding along established care pathways. Patient demographics, cytology data, most significant histopathology diagnoses and clinical outcome were all documented at the study census date (31.12.15).

RESULTS: A total of 170 male & 140 female patients (age range 18-91 years), exhibiting primarily leukoplakia (86.5%) at floor of mouth and ventrolateral tongue sites (44.9%), were identified. Management comprised: observation (49.7%), laser surgery (44.9%), antifungal treatment (3.5%) and Head & Neck clinic referral following cancer diagnosis (1.9%). Clinical outcomes were as follows: disease free (51.3%), persistent PMD (42.3%) and malignant transformation (6.4%). Histology and cytology diagnoses strongly correlated (r = .305). Treatment modality, lesion site, histology and cytology diagnoses were the best predictors of clinical outcome.

CONCLUSIONS: Orcellex® brush cytology provides reliable diagnoses consistent with conventional histopathology and offers less invasive, adjunctive assessment appropriate for long-term monitoring of patients in specialist clinics.

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