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Pre-employment screening & monitoring of the health of foreign workers

Khairul Anuar A, Nooriah MS

JUMMEC, 2002;7:82-84.
Rapid urease test in the diagnosis of Helicobacter pylori infection

Rosaida MS, Goh KL

JUMMEC, 2000;5:11-16.

Many tests are available for the diagnosis of H. pylori infection. Broadly they can be divided into invasive- endoscopy biopsy based tests and non-invasive tests. Of the endoscopy biopsy based tests the rapid urease tests (RUT) have been found to be the most convenient, accurate and inexpensive tests and they have therefore been recommended by several consensus panels and working parties as the test of choice during endoscopy. Several RUTS are available; some are commercial: CLO test, Pyloritek, Helicobacter urease test, H. yylori test and others- "homemade". We strongly recommend the "homemade" 1 min rapid urease test using an unbuffered solution as originally described by Arvind et al. This test has been shown to be easy to prepare, inexpensive and accurate on field-testing. Several factors affect the accuracy of the RUT. The larger the size of biopsy samples, the quicker is the postive reaction time. With the CLO test, warming the tests to 37'C has also been shown to hasten the reaction time. The effect of blood on the RUT poses an important problem in testing. It is vitally important to determine the H. yylori status in patients with bleeding peptic ulcers as the recurrence of bleeding has been shown to be markedly reduced or virtually abolished with H. yylori eradication. While the results of studies have not been entirely consistent, it is likely that presence of blood does reduce the sensitivity of the RUT. It is therefore sensible that in patients with bleeding ulcers, the RUT should not be the sole endoscopy biopsy test used and that samples should also be taken for histological examination.
Response: review of patients with Strongyloides stercoralis infestation in a tertiary teaching hospital, Kelantan

Nurul Azira MS

Malays J Pathol, 2013 Dec;35(2):188.
PMID: 24362485
Fulltext Dietary spices protect against hydrogen peroxide-induced DNA damage and inhibit nicotine-induced cancer cell migration

Jayakumar R, Kanthimathi MS

Food Chem, 2012 Oct 01;134(3):1580-4.
PMID: 25005983 DOI: 10.1016/j.foodchem.2012.03.101

Spices are rich sources of antioxidants due to the presence of phenols and flavonoids. In this study, the DNA protecting activity and inhibition of nicotine-induced cancer cell migration of 9 spices were analysed. Murine fibroblasts (3T3-L1) and human breast cancer (MCF-7) cells were pre-treated with spice extracts and then exposed to H₂O₂ and nicotine. The comet assay was used to analyse the DNA damage. Among the 9 spices, ginger, at 50 μg/ml protected against 68% of DNA damage in 3T3-L1 cells. Caraway, cumin and fennel showed statistically significant (p<0.05) DNA protecting activity. Treatment of MCF-7 cells with nicotine induced cell migration, whereas pre-treatment with spices reduced this migration. Pepper, long pepper and ginger exhibited a high rate of inhibition of cell migration. The results of this study prove that spices protect DNA and inhibit cancer cell migration.
Fulltext A case report of ocular toxocariasis

Azira NM, Zeehaida M

Asian Pac J Trop Biomed, 2011 Apr;1(2):164-5.
PMID: 23569750 DOI: 10.1016/S2221-1691(11)60018-X

Ocular toxocariasis is prevalent among children. The symptoms and signs may mimic other ocular pathologies such as malignancies and other infectious diseases (such as toxoplasmosis and syphilis). We presented a case of progressive blurring of vision in a single eye of a 9-year-old boy. The presence of anti-toxocara antibody in serum samples helps to confirmation the diagnosis in our patient. Despite of treatment, the boy had lost his vision on the affected eye.
Tooth wear in three ethnic groups in Sabah (northern Borneo)

Milosevic A, Lo MS

Int Dent J, 1996 Dec;46(6):572-8.
PMID: 9023582

The prevalence and associated aetiologies of tooth wear were investigated in three ethnic groups in Sabah (Northern Borneo) using the Tooth Wear Index (TWI). The number of surfaces with enamel wear only, dentine exposed for less than a third or dentine exposed for more than a third were categorised into the TW minimal, moderate or severe respectively. A structured questionnaire was used to elicit medical/dental history, oral hygiene practices, satisfaction with body image, diet and other personal habits/details. The sample comprised of a self selected sample of 148 dental hospital attenders; 47 (32 per cent) each of ethnic Chinese and Malay and 54 (36 per cent) of ethnic Kadazan, matched for age and with a similar number of scoreable teeth per subject. Dentine exposure within the total sample was a common finding (95 per cent TW with moderate, 41 per cent TW severe). The Kadazan group had significantly (P < 0.05) more surfaces with severe tooth wear than the Chinese or Malay. Tobacco chewing was positively associated (rho = +0.4, P < 0.05) with both moderate and severe tooth wear, as was the habit of crushing/eating bones. Neither carbonated beverages or fresh fruit intake were associated with tooth wear, but their frequency of consumption was low. The buccal and occlusal surfaces of the posterior teeth were the most severely worn. Generally, wear was greater in the upper anterior sextant compared to the lower anterior sextant, with the exception of the lower incisal edges in the Kadazan group. Tooth wear into dentine was a common occurrence, especially among the Kadazan subjects and least among the Chinese subjects. The aetiological factors associated with this tooth wear are different to those encountered in Western cultures.
Fulltext Acute myocardial injury: an entity of acute coronary syndromes

Daud MS, Khalid Y

Med J Malaysia, 1997 Jun;52(2):183-5.
PMID: 10968081

A 46-year-old Indian man was admitted with unstable angina (Braunwald's class IIIB1)--the chest pain at rest was associated with inferolateral ischaemia on the ECG at admission. His serial total creatine kinase levels were elevated but CKMB was not detected. Serial serum troponin T levels were significantly raised suggesting the presence of significant acute myocardial injury.
Child sexual abuse: psychosocial aspects of 101 cases seen in an urban Malaysian setting

Kassim K, Kasim MS

Child Abuse Negl, 1995 Jul;19(7):793-9.
PMID: 7583735

This paper describes a case note and interview study of a cross sectional sample comprised of all children seen and confirmed as being sexually abused between June 1985 and December 1990 by the Suspected Child Abuse and Neglect (SCAN) Team of Kuala Lumpur General Hospital. A total of 101 cases, which represented 18.2% of all child abuse cases, were seen together with their accompanying adults. Information about ethnicity, socioeconomic status, family constellation relationship of perpetrator to the child, and reported psychosocial factors that could have contributed towards the abuse were recorded. The Indian ethnicity group was found to be overrepresented. The mean age of children was 6-8 years, SD 4.1, with age ranging 1.5-16 years. Forty-one and one-half percent were in the age range 5-9 years. Among the important associated psychosocial factors found were the absence of another adult at home, unemployment, and history of drug abuse among the perpetrators.
Compliance with treatment in schizophrenia: a drug intervention program in a developing country

Razali MS, Yahya H

Acta Psychiatr Scand, 1995 May;91(5):331-5.
PMID: 7639089

The compliance with drug regimens and follow-up visits of 225 known cases of relapsed schizophrenia was assessed. About 27% of the patients met the criteria for good compliance. The compliance was found to be significantly related to the patients' view of usefulness of the medication, treatment duration of less than 5 years, dosage schedule of once or twice per day and the supervision of medication at home. Patients with poor compliance who were prescribed drug dosage of not more than twice per day throughout follow-up and underwent counseling to enhance treatment compliance had a significantly lower relapse rate than the controlled group at the end of 1 year of follow-up. The importance of family support and understanding patients' cultural background in ensuring good compliance was highlighted.
Morbidity and mortality patterns in Malaysian children

Kasim MS, Paramjothy M

J Singapore Paediatr Soc, 1987;29 Suppl 1:24-31.
PMID: 3657092
Bisexual feelings and opposite-sex behavior in male Malaysian medical students

Buhrich N, Armstrong MS, McConaghy N

Arch Sex Behav, 1982 Oct;11(5):387-93.
PMID: 7181646

The sexual identity of 65 Malaysian male medical students was investigated by anonymous questionnaire. Of these students, 40% were aware of homosexual feelings prior to age 15 years, and 16% were so aware currently. There were correlations between current homosexual feelings and feminine sex dimorphic behavior during childhood and between current homosexual feelings and feminine gender identity. The results are discussed in light of results of a similar questionnaire completed by 138 male medical students in Sydney, Australia.
Study site: National University of Malaysia (Universiti Kebangsaan Malaysia), Kuala Lumpur, Malaysia
Fulltext Noise exposure and hearing threshold profile among Zumba fitness regulars in Kuantan, Pahang, Malaysia

Ailin Razali, M. S. Othman, M. S. Rahman, N. F.I. Misaridin

IIUM Medical Journal Malaysia, 2020;19(2):67-73.
MyJurnal

Recreational noise exposure has become a major threat to the hearing system, and this
includes exposure to loud noise during group exercises such as Zumba Fitness, where loud music plays an
important role. This study aimed to assess the noise exposure and hearing threshold profile among Zumba
Fitness regulars in Kuantan, Malaysia. MATERIALS AND METHODS: Noise exposure and hearing profile
threshold were measured during Zumba Fitness sessions at a fitness studio in Kuantan, Malaysia from 24th
June 2014 to 12th August 2014. Noise exposure was measured using a noise dosimeter for one hour of Zumba
Fitness session with a total of nine sessions run by three different instructors while sound level pressure was
taken using a sound level meter during ambient, peak session and during cooling down. Thirty participants
answered questionnaires and underwent pure tone diagnostic audiometry test at a local clinic for hearing
threshold documentation. RESULTS: Some areas of the hall posed higher risks of causing noise-induced
hearing loss especially near the amplifiers. There were periods when the hearing level exceeded 115 dBA.
Early abnormal pattern could be observed in the hearing profiles of some of the participants to suggest
preliminary hearing problems. CONCLUSION: Zumba Fitness regulars have a risk of developing noise-induced
hearing loss and preventive steps should be properly addressed as NIHL is permanent and irreversible.
Preliminary results of a pilot study on the safety and efficacy of balloon dilatation of the Eustachian tube for nasopharyngeal cancer patients with chronic Eustachian tube dysfunction post irradiation

Wong MSL, Prepageran N

J Laryngol Otol, 2021 Aug;135(8):691-694.
PMID: 34342558 DOI: 10.1017/S0022215121001560

OBJECTIVE: Eustachian tube dysfunction is a known complication following radiotherapy to the head and neck region. Unfortunately, treatment options are limited, with significant associated morbidity. Balloon Eustachian tube dilatation has been used successfully to treat Eustachian tube dysfunction; hence, this study aimed to determine the safety and efficacy of this method in treating Eustachian tube dysfunction in post-radiotherapy patients with nasopharyngeal carcinoma.
METHOD: This interventional cohort pilot study on patients with Eustachian tube dysfunction compared those with nasopharyngeal carcinoma to patients without. Outcome assessment was based on tympanometry type and Eustachian Tube Dysfunction Questionnaire score.
RESULTS: A total of 14 ears (12 patients) were tested. Only 14 per cent of the nasopharyngeal carcinoma cohort showed improvement, while 71 per cent of the non-nasopharyngeal carcinoma group were successfully treated. No significant adverse effect was reported in any patient during this study.
CONCLUSION: Balloon Eustachian tube dilatation was not shown to be beneficial for post-radiotherapy Eustachian tube dysfunction in nasopharyngeal carcinoma patients in the preliminary stages of this pilot study.
Fulltext Severe chronic iron deficiency anaemia secondary to Trichuris dysentery syndrome - a case report

Azira N MS, Zeehaida M

Trop Biomed, 2012 Dec;29(4):626-31.
PMID: 23202608

Trichuris dysentery syndrome is caused by Trichuris trichiura which contributes to one of the most common helminthic infections in the world. It is associated with heavy colonic infection that manifests as mucoid diarrhoea, rectal bleeding, rectal prolapse, iron deficiency anaemia, and finger clubbing. Here, we report a case of trichuris dysentery syndrome complicated with severe chronic iron deficiency anaemia in a 4-year-old girl who required blood transfusion. The nematode was visualized on stool microscopic and colonoscopic examination. A longer duration of anti-helminthic treatment is required to achieve effective and better outcome.
Fulltext Strongyloides stercoralis hyperinfection in a diabetic patient: case report

Azira NM, Zeehaida M

Trop Biomed, 2010 Apr;27(1):115-9.
PMID: 20562820 MyJurnal

Strongyloides stercoralis is a widespread, soil-transmitted helminth affecting humans. Autoinfection occurs in S. stercoralis infection and this leads to a continuous build-up of worm burden in human host. This may lead to hyperinfection syndrome which has the potential to cause serious life-threatening disease especially in immunocompromised and immunosuppressed patients. Thus, patient with underlying risk factors should be suspicious of having this infection as severe strongyloidiasis carries a high mortality rate if the diagnosis is delayed. Here, we report a case of S. stercoralis hyperinfection in a diabetic patient.
Tropical pyomyositis

Owen-Smith MS

Aust N Z J Surg, 1975 Feb;45(1):57-60.
PMID: 1057403

Six cases of tropical pyomyositis occurring in Australian, New Zealand and British soldiers in Malaysia and Singapore are described.
Vaginal Brenner tumor with literature review: does this tumour originate from Walthard nests?

Park S, Cho MS

Malays J Pathol, 2017 Apr;39(1):89-93.
PMID: 28413211

Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.
Potential of repurposing chloroquine as an adjunct therapy for melioidosis based on a murine model of Burkholderia pseudomallei infection

Ganesan N, Embi N, Hasidah MS

Trop Biomed, 2020 Jun 01;37(2):303-317.
PMID: 33612800

Burkholderia pseudomallei is the etiologic agent of melioidosis, a major cause of community-acquired pneumonia and sepsis in the endemic areas. The overall mortality of patients with severe melioidosis remains high due to severe sepsis attributed to overwhelming inflammatory cytokine response in spite of recommended antibiotic therapy. It is crucial that therapeutic approaches beyond just effective antibiotic treatment such as adjunct therapy be considered to mitigate the dysregulated inflammatory signaling and augment host defenses. In an acute B. pseudomallei infection model, we have previously demonstrated that treatment with anti-malarial drug, chloroquine, modulated inflammatory cytokine levels and increased animal survivability via Akt-mediated inhibition of glycogen synthase kinase-3β (GSK3β). GSK3β is a downstream effector molecule within the phosphatidylinositol 3-kinase (PI3K)/ Akt axis which plays a pivotal role in regulating the production of pro- and anti-inflammatory cytokines. Here we evaluate the effect of chloroquine treatment in combination with a subtherapeutic dose of the antibiotic doxycycline on animal survivability, cytokine levels and phosphorylation states of GSK3β (Ser9) in a murine model of acute melioidosis infection to investigate whether chloroquine could be used as an adjunct therapy along with doxycycline for the treatment of melioidosis. Our findings revealed that 50 mg/kg b.w. chloroquine treatment together with a dose of 20 mg/kg b.w. doxycycline improved survivability (100%) of mice infected with 3 X LD50 of B. pseudomallei and significantly (P<0.05) lowered the bacterial loads in spleen, liver and blood compared to controls. B. pseudomallei-infected mice subjected to adjunct treatment with chloroquine and doxycycline significantly (P<0.05) reduced serum levels of pro-inflammatory cytokines (TNF-α, IFN-γ and IL-6) but increased levels of antiinflammatory cytokines (IL-4 and IL-10). Western blot analysis demonstrated that the intensities of pGSK3β (Ser9) in liver samples from mice treated with chloroquine and doxycycline combination were significantly (P<0.05) higher suggesting that the adjunct treatment resulted in significant inhibition of GSK3β. Taken together the bacteriostatic action of doxycycline coupled with the cytokine-modulating effect of chloroquine gave full protection to B. pseudomallei-infected mice and involved inhibition of GSK3β. Findings from the present study using B. pseudomallei-infected BALB/c mice suggest that chloroquine is a plausible candidate for repurposing as adjunct therapy to treat acute B. pseudomallei infection.
Modelling the effect of intervention on the transmission of malaria in East Malaysia

Collett D, Lye MS

Stat Med, 1987 10 1;6(7):853-61.
PMID: 3321316

To assess the public health importance of malaria on Banggi Island, Sabah, baseline epidemiological and entomological data were obtained in a study of three villages. These data were used to model the transmission of malaria using a non-seasonal version of the deterministic model of Dietz, Molineaux and Thomas. The model provided a satisfactory description of prevalence rates of Plasmodium falciparum parasitaemia. Modifications to the basic model enable the effects of mass chemotherapy with various combinations of schizonticidal and gametocidal drugs to be simulated. In this way, the relative merits of different procedures of mass drug administration can be compared. The fitted model is also used to examine the relationship between the overall prevalence of infection and the vectorial capacity, and to predict the consequences of a reduction in the size of the vector population.
The impact of cleft lip and palate on the quality of life of young children: A scoping review

Yusof MS, Mohd Ibrahim H

Med J Malaysia, 2023 Mar;78(2):250-258.
PMID: 36988538

INTRODUCTION: Cleft lip and palate (CL/P) are among the most common congenital abnormalities. The purpose of the present study was to review the literature relating to the quality of life (QoL) in young patients with cleft lip and/or palate (CL/P) and to identify the specific aspect of QoL in young patients with CL/P that is mostly affected. Other associated variables within studies that may have an impact on QoL were also identified.
MATERIALS AND METHODS: Systematic searches of PubMed, Scopus and Web of Science databases were conducted. Independent reviewers screened the title, abstract and full texts according to predetermined inclusion and exclusion criteria. Articles published in English from January 2012 to March 2022 reporting the QoL of non-syndromic young patients aged 7-18 years with CL/P were included. Review articles and articles reporting the psychological adjustment of parents or other family members with CL/P were excluded.
RESULTS: 975 publications were identified, of which 20 studies met our inclusion criteria. The majority of studies reported that the CL/P condition has a negative impact on the QoL. Psychological health, functional well-being, socialemotional well-being and school environment are domains that are affected. Compared with typically developing young patients, those with CL/P had lower QoL scores even though QoL was assessed using different instruments across studies. The impact of CL/P on overall QoL scores varied by age but not gender or cleft type.
CONCLUSION: Our reviews had shown the presence of CL/P negatively affects the QoL of young patients. Psychological health is the most affected QoL domain. Understanding the impacted domain will help in planning and delivering better health care for individuals with CL/P and reducing the stigma commonly associated with CL/P. Future studies should target intervention on psychological health and consider resilience factors towards positive adjustment.

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