MyMedR

Re-innervation of muscles after nerve injury in neonates

Naidu MD, Subramaniam K, Vrbová G

Restor. Neurol. Neurosci., 1996 Jan 1;10(1):35-42.

PMID: 21551851 DOI: 10.3233/RNN-1996-10105

Three-day-old neonatal rats had their common peroneal nerve crushed 3 mm from the extensor digitorum longus (EDL) muscle. At periodic intervals of 7, 10, 14, 21 and 28 days following nerve injury the EDL muscles were removed, weighed, stained using the silver cholinesterase method and their muscle fibres counted. In these rats during the re-innervation process, the bands of Biingner were absent, some endplates disintegrated and a large proportion of the muscle fibres were lost. This study has shown that interruption of the normal nerve-muscle interaction during the neonatal period is highly detrimental to the subsequent growth and development of the muscle.

Anatomical variability of the frontal sinuses and their application in forensic identification

Nambiar P, Naidu MD, Subramaniam K

Clin Anat, 1999;12(1):16-9.

PMID: 9890725

The uniqueness of anatomical structures and their variations provides the basis for forensic identification of unknown deceased persons. Similar to fingerprints, each frontal sinus is so distinctive and unique that the chances of two individuals having the same morphology of the frontal sinuses is extremely remote. Radiographs, especially the occipitomental view commonly used in the assessment of paranasal pathology, provide excellent records of these sinuses. The case illustrated here is an application of the frontal sinus identification of a victim in a mass disaster.

Racial characteristics of human teeth with special emphasis on the Mongoloid dentition

Yaacob H, Nambiar P, Naidu MD

Malays J Pathol, 1996 Jun;18(1):1-7.

PMID: 10879216

Determining the racial affinity of an unknown individual from dentition for identification is indeed a difficult endeavour. However, there are certain dental characteristics which are predominant in certain racial groups and these contribute important indicators in the identification process. Inherited dental characteristics are modified by prenatal and postnatal environmental and nutritional conditions. They can also become less discernible due to admixture of the various races.

Erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis in northeastern Malaysia

Kamaliah MD, Zainal D, Mokhtar N, Nazmi N

Int J Dermatol, 1998 Jul;37(7):520-3.

PMID: 9679693

BACKGROUND: Previous studies have reported that drugs and infections are common causes of erythema multiforme (EM) and Stevens-Johnson syndrome (SJS). Toxic epidermal necrolysis (TEN) is mainly related to drugs. No study has been conducted in Kelantan, the northeastern state of Malaysia, to assess these cutaneous reactions.

METHODS: A retrospective study of all hospitalized cases of EM, SJS, and TEN was conducted covering an 8-year period from 1987 to 1994.

RESULTS: There were four cases (13.8%) of EM, 22 cases (75.9%) of SJS, and three cases (10.3%) of TEN. Drugs as a definitive cause was observed in one case (25%) of EM, 12 cases (54.5%) of SJS, and two cases (66.7%) of TEN. Drugs as a probable cause was observed in seven cases (31.8%) of SJS and one case (33.3%) of TEN. The male to female ratio was equal in EM and SJS. Antiepileptics were the commonest culprits, followed by antibiotics. One patient died of SJS and one patient died of TEN, giving mortality rates of 4.5% and 33.5% respectively. Fever was noted in 18 patients (62.1%). Leukocytosis was noted in 10 patients (34.5%), and nine patients (31.0%) had elevated liver transaminase enzymes. No significant correlation was noted between these biochemical changes and cutaneous eruption. Secondary infections were observed in 11 patients (37.9%): Staphylococcus aureus was the commonest isolated organism.

CONCLUSIONS: This study shows that drugs remain the commonest culprit in SJS and TEN. Despite adequate treatment, the mortality rate remains high, especially in TEN. These findings are similar to those of other reported studies.

Cancer of the colon and rectum in the first three decades of life

Shahrudin MD, Noori SM

Hepatogastroenterology, 1997;44(14):441-4.

PMID: 9164516

BACKGROUND/AIMS: Recently an increasing number of young colorectal carcinoma patients attending the University Hospital, Kuala Lumpur were noted. This report represents our experience with patients suffering from colorectal cancer aged 30 years or younger.
MATERIALS AND METHODS: All cases of primary carcinoma of the colon and rectum admitted to the University Hospital during 1990 to 1994 were respectively reviewed. Inclusion criteria was that the patient had been 30 years or younger. Data collected included age, gender, race, site of tumour, presenting symptomatology, duration of symptoms, histology, extension of tumour and nodal involvement predisposing factors, treatment and follow-up.
RESULTS: 21 patients were included, 5 patients (24%) were 30 years old at diagnosis, 12 (57%) patients were aged 20-29 years and 4 patients (19%) were less than 20 years old. Thirteen of the 21 patients were female, and 8 (38%) were male, 6 of the 21 patients (29%) were Malaysian, while 1 was Indian (4%). The remainder were Chinese, 14 patients (67%). Six patients (29%) had their primary tumour located in the rectosigmoid, 4 (19%) in the left colon, 1 (4%) in the splenic flexure, 2 in the transverse colon (9%), 1 in the hepatic flexure (4%) and 5 in the caecum 24(%). One patient had a tumour too diffuse to detect a primary site at the time of operation. One patient with a family history of polyps had his entire colon removed at age 14. He had 3 separate foci of tumour. The 5-year survival rate was 25%.
DISCUSSION: Most patients with extensive disease and mucinous histology. Lesions are commonly seen beyond the transverse colon (57%). Presentation included most commonly abdominal pain, haematochezia or haemoccult positive stools.
CONCLUSION: The symptoms above should alert surgeons to colorectal carcinoma as a differential diagnosis

Pancreatic pseudocyst: the controversial value of total parenteral nutrition

Shahrudin MD, Noori SM

Hepatogastroenterology, 1997 Mar-Apr;44(14):559-63.

PMID: 9164537

Total parenteral nutrition (TPN) for the non-operative treatment of acute pancreatic pseudocyst has been of hypothetical benefit.

Biloma and biliary fistula associated with hepatorrhaphy for liver injury

Shahrudin MD, Noori SM

Hepatogastroenterology, 1997 Mar-Apr;44(14):519-21.

PMID: 9164529

To review our experience in managing post-hepatorrhaphy complications in liver trauma.

Immunomodulation by morphine and marijuana

Yahya MD, Watson RR

Life Sci, 1987 Dec 07;41(23):2503-10.

PMID: 2824957

The immunomodulatory effects of morphine and the active components of marijuana, particularly tetrahydrocannabinol, on various aspects of the host immune parameters include alterations in humoral, cell-mediated and innate immunity. Most studies have shown immunosuppressive effects due to use of these abused substances, although there are reports that they may not produce any deleterious effect and may even enhance some aspects of host immunity. They reduce resistance to cancer growth and microbial pathogens in animals.

Malaria control in the Federation of Malaya

REID JA, AHMAD MD

Med J Malaya, 1958 Jun;12(4):569-84.

PMID: 13577150

Fulltext Rhabdomyolysis and acute renal failure following a switchover of therapy between two fibric acid derivatives

Kamaliah MD, Sanjay LD

Singapore Med J, 2001 Aug;42(8):368-72.

PMID: 11764054

Drug induced myopathy has been reported with the use of fibric acid derivatives, hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and nicotinic acid. Over the last three decades, hypolipemiants like fibric acid derivatives and statins have been increasingly recognised as causes of rhabdomyolysis and acute renal failure especially during combination therapy and in the presence of underlying renal impairment. We report two cases of bezafibrate-induced rhabdomyolysis in patients with underlying coronary artery disease and pre-existing renal impairment. Both patients developed rhabdomyolysis leading to acute renal failure soon after their hyperlipidaemia treatment was changed from gemfibrozil to bezafibrate. There were no intercurrent illnesses or co-administration of other lipid lowering drugs in both patients. Even though both drugs belong to the same fibric acid derivatives group, these patients developed the complication only after a switchover of therapy.

Fulltext In vitro activity of teicoplanin, vancomycin, A16686, clindamycin, erythromycin and fusidic acid against anaerobic bacteria

Hassan H, O'Hare MD, Felmingham D

Singapore Med J, 1990 Feb;31(1):56-8.

PMID: 2139737

The in vitro activity of teicoplanin and A16686, two new glycopeptide antibiotics was determined against 196 isolates of anaerobic bacteria. The activity of teicoplanin and A16686, in comparison with that of vancomycin, clindamycin, erythromycin and fusidic acid was 2 to 16 times higher against the gram positive anaerobes, namely, Propionibacterium acnes, Clostridium perfringens, Clostridium difficile, Clostridium species, Peptococcus species and Peptostreptococcus species. However, Bacteroides fragilis was resistant to teicoplanin and A16686 while Bacteroides melaninogenicus and Bacteroides bivius were found to be sensitive.

Liquid biopsy in breast carcinoma: Are we there yet?

Wijesinghe HD, Lokuhetty MDS

Malays J Pathol, 2023 Aug;45(2):175-186.

PMID: 37658527

Breast carcinoma is the most common malignancy among women worldwide. Liquid biopsy is a method of obtaining tumour-derived material from blood and body fluid. This includes the assessment of circulating tumour cells (CTCs), circulating tumour deoxyribose nucleic acid (ctDNA), tumour educated platelets (TEPs) and exosomes. Detection of CTCs and ctDNA in liquid biopsy has been shown to have prognostic and predictive value in both early and metastatic breast carcinoma. The study of CTCs could also advance our understanding of aspects of tumour biology, including epithelial mesenchymal transition. ctDNA can be used to assess and monitor the molecular profile of breast carcinoma. It may help detect new genetic alterations in tumours and predict disease progression before the onset of clinical features or radiological evidence. TEPs and exosomes are also emerging as diagnostic, prognostic and predictive markers of breast carcinoma. Thus, liquid biopsy provides a non-invasive, repeatable method for the dynamic assessment of the tumour. Many methods have been used for the detection of CTCs and ctDNA. Most of these are still in the research stage and only the CellSearch method for the detection of CTCs and Therascreen PIK3CA RGQ polymerase chain reaction (PCR) assay for the detection of PIK3CA (Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Alpha) mutations in liquid biopsy have approval of the United States, Food and Drug Administration. However, their high costs, lack of standardized procedures, and a long and complicated detection process have limited their use. Despite its limitations, liquid biopsy is a useful tool in clinical decision making and has the potential to play an increasingly important role in the management of breast carcinoma in the future as we move toward more personalized cancer care.

Fulltext Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain

Izny Hafiz Z, Rosdan S, Mohd Khairi MD

Med J Malaysia, 2014 Apr;69(2):74-8.

PMID: 25241816 MyJurnal

The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.

Fulltext Delay in diagnosis of upper gastrointestinal cancer: whose fault is it?

Tata MD, Dharmendran R, Ramesh G, Kandasami P

Med J Malaysia, 2013 Jun;68(3):275-7.

PMID: 23749025 MyJurnal

Stomach and esophageal cancers are both deadly and difficult to diagnose early. Stomach cancer is the second most common cancer in Asia. Both these are one of the most common causes of cancer related death in the world.

Right-sided Aortic Arch with Aberrant Left Subclavian Artery from Kommerell's Diverticulum

Mubarak MY, Kamarul AT, Noordini MD

Iran J Radiol, 2011 Sep;8(2):103-6.

PMID: 23329925

A previously healthy 52-year-old man had a chest radiograph for medical check-up and found to have a right-sided aortic arch. Computed tomography of the thorax revealed a right-sided aortic arch with aberrant left subclavian artery originated from Kommerell's diverticulum. Barium swallow examination showed compression of the posterior wall of the esophagus. He was asymptomatic and no surgical intervention was performed.

Fulltext Depressive disorders and family functioning among the caregivers of patients with schizophrenia

Osman CB, Alipah B, Tutiiryani MD, Ainsah O

East Asian Arch Psychiatry, 2010 Sep;20(3):101-8.

PMID: 22348863

Objective: To determine the prevalence of depressive disorders among caregivers of patients with schizophrenia, its association with patient’s and caregiver’s socio-demographic characteristics and family functioning.
Methods: This was a cross-sectional study of caregivers of patients with schizophrenia at the outpatient clinic, Hospital Permai Johor Bahru, Malaysia. The study was conducted between August and October 2008. A total of 243 caregivers who fulfilled the inclusion criteria were enrolled, of whom 232 completed the self-administered socio-demographic questionnaire, the General Health Questionnaire (GHQ-30) and the McMaster Family Assessment Device. A total of 33 caregivers with the GHQ-30 cut-off point of 7/8 were assessed further by the Mini International Neuropsychiatric Interview to diagnose depressive disorder.
Results: The prevalence of psychological distress in our study sample was 14% (n = 33) and that of depressive disorders was 6% (n = 14). There was no association between patients’ and caregivers’ sociodemographic characteristics with depressive disorders, but there were significant associations between depressive disorders and family functioning dimensions in terms of Communication and Roles.
Conclusion: Although the causal link was not established, the results suggested that depression had a significant association with family functioning among caregivers of patients with schizophrenia.
Key words: Caregivers; Depressive disorder; Schizophrenia

Study site: outpatient clinic, Hospital Permai Johor Bahru, Malaysia.

Analysis of pterygium size and induced corneal astigmatism

Mohammad-Salih PA, Sharif AF

Cornea, 2008 May;27(4):434-8.

PMID: 18434847 DOI: 10.1097/ICO.0b013e3181656448

To study the relationship between pterygium size (extension, width, total area) and corneal astigmatism in eyes with unilateral primary pterygium. Also to determine the critical size for surgery before the occurrence of a significant corneal astigmatism.

Amplifying the manganese scavenging potential of Streptococcus zooepidemicus to reactive oxygen species during production of hyaluronic acid

Mashitah MD, Masitah H, Ramachandran KB

Med J Malaysia, 2004 May;59 Suppl B:59-60.

PMID: 15468818

Streptococcus zooepidemicus (SZ) is an aerotolerant bacteria and its ability to survive under reactive oxidant challenge raises the question of the existence of a defense system. Thus growth, hyaluronic acid (HA) and hydrogen peroxide (H2O2) production by SZ in the presence of increasing concentration of Mn2+ were studied. The results suggested that the tested strain supported growth and HA production in cultures treated with 1 and 10 mM of Mn2+ regardless of H2O2 presence in the medium. This showed that SZ have acquired elaborate defense mechanisms to scavenge oxygen toxicity and thus protect cells from direct and indirect effect of this radical. In contrast, cells treated with 25 mM Mn2+ were sensitive, in which, the HA production was reduced considerably. Thus showing that the oxygen scavenger systems of the cells may be fully saturated at this concentration.

Fulltext The autoantibody profile and its association with clinical manifestations in Malay SLE patients

Maraina CH, Kamaliah MD, Ishak M

Asian Pac J Allergy Immunol, 2004 Mar;22(1):33-7.

PMID: 15366656

A cross sectional study was conducted to determine the auto-antibody profile of Malay SLE patients in Kelantan, North East Malaysia and to correlate them with clinical presentations. Eighty-two Malay SLE patients who fulfilled the ARA criteria underwent the following tests: ANA, anti-dsDNA antibody, anti-ENA antibody and RF. The results revealed that ANA was positive in 91.5% of the patients, anti-dsDNA antibody in 53.7%, however, anti-ENA antibodies were positive in only 9.8% of the cases at the time of the study and none had a positive RF. The profile of autoantibodies was similar to other studies except for a lower incidence of anti-ENA antibodies. Sixty three percent of patients had lupus nephritis. The pattern of clinical presentations were noted to be more similar to those found among Chinese and Indian SLE populations than compared to the Caucasians. There was a significant association between anti-dsDNA antibody and lupus nephritis and between anti-ENA antibody and thrombocytopenia.

Dynamic kinetic resolution: alternative approach in optimizing S-ibuprofen production

Fazlena H, Kamaruddin AH, Zulkali MM

Bioprocess Biosyst Eng, 2006 Mar;28(4):227-33.

PMID: 16215728

A lipase catalysed enantioselective hydrolysis process under in situ racemization of the remaining (R)-ibuprofen ester substrate with sodium hydroxide as the catalyst was developed for the production of S-ibuprofen from (R,S)-ibuprofen ester in isooctane. Detailed investigations on parameters study indicated that 0.5 M NaOH, addition of 20% (v/v) co-solvent (dimethyl sulphoxide), operating temperature of 45 degrees C, and 40 mmol/L substrate gave 86% conversion and 99.4% optical purity of S-ibuprofen in dynamic kinetic resolution. Meanwhile, in common enzymatic kinetic resolution process, only 42% conversion of the racemate and 93% enantiomeric excess of the product was obtained which are of lower values as compared to dynamic kinetic resolution. The S-ibuprofen produced during each process was evaluated and approximately 50% increment in concentration of S-acid product was produced when dynamic kinetic resolution was applied into the process.

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