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Fulltext Prevalence of aspirin resistance in diabetic patients and its associated factors

Habizal NH, Abdul Halim S, Bhaskar S, Wan Bebakar WM, Abdullah JM

Malays J Med Sci, 2015 Jan-Feb;22(1):50-7.
PMID: 25892950 MyJurnal

BACKGROUND: Aspirin resistance has posed a major dilemma in the prevention of cardiovascular disease and stroke. There have been many factors that have been associated with aspirin resistance. Among these factors, the inflammatory processes of diabetes and glycaemic control have been significantly associated with aspirin resistance. Our study evaluated the prevalence of aspirin resistance and its associated factors.
METHODS: This was a cross-sectional, interventional study, which was implemented from October to November 2012 at the Hospital Universiti Sains Malaysia (HUSM). Sixty-nine patients with diabetes who were taking aspirin were enrolled. The glycosylated haemoglobin (HbA1c) and C-reactive protein (CRP) levels were measured in these patients. The thromboelastography (TEG) level was measured using a TEG machine by a trained technician employing standard methods. The variables obtained were analysed for prevalence of aspirin resistance, HbA1c, CRP, and TEG level. The Chi-square test (and Fisher exact test where applicable) were used to evaluate the associations between aspirin resistance with glycaemic control (HbA1c) and inflammatory markers (CRP).
RESULTS: The prevalence of aspirin resistance was 17.4% (95%; CI 9.3, 28.4). Glycaemic control (HbA1c) and inflammatory markers (CRP) were not associated with aspirin resistance. Aspirin resistance was prevalent in our study population and was comparable to other studies. The mean HbA1c in the aspirin-resistant group was 8.9%, whereas the mean HbA1c in the aspirin-sensitive group was 8.6%.
CONCLUSION: There was no significant difference in HbA1c between the two groups. There was no significant association between CRP levels and aspirin resistance.
KEYWORDS: aspirin resistance; diabetes mellitus; thromboelastography
Study site: NeuroMedical Specialist Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Hospitals, University
Oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia, Kelantan

Razak AA, Saddki N, Naing NN, Abdullah N

Asian Pac J Cancer Prev, 2010;11(1):187-91.
PMID: 20593955

AIMS: This study was performed to determine oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan.
METHODS: The medical records of 118 Malay patients with oral cancer admitted in HUSM from 1st January 1986 to 31st December 2005 were reviewed. Data collected include socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients. Survival status and duration were determined by active validation until 31st December 2006. Data entry and analysis were accomplished using SPSS version 12.0. The Kaplan-Meier method was used to perform survival estimates while the log-rank test and the Cox proportional hazards regression model were employed to perform univariate analysis and multivariable analysis of the variables, respectively.
RESULTS: The overall five-year survival rate of Malay patients with oral cancer was 18.0%, with a median survival time of 9 months. Significant factors that influenced survival of the patients were age, sex, tumour site, TNM stage, histological type, and treatment received.
CONCLUSION: Survival of oral cancer patients in HUSM was very low. Being elderly, male, presenting with an advanced stage at diagnosis, and not having treatment all contributed to poor survival.

Matched MeSH terms: Hospitals, University
Oral cancer presentation among Malay patients in hospital Universiti Sains Malaysia, Kelantan

Razak AA, Saddki N, Naing NN, Abdullah N

Asian Pac J Cancer Prev, 2009;10(6):1131-6.
PMID: 20192598

OBJECTIVE: The objective of this study was to identify the characteristics of oral cancer among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan.
METHODS: A retrospective record review was conducted from August to December 2006 in HUSM. Of 133 patients with oral cancer diagnosed from 1986 to 2005, 118 were Malay. Data on socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients were obtained.
RESULTS: Malay patients with oral cancer were predominantly elderly, aged 60 years old and above (51.7%) at the time of diagnosis, with a mean age of 58.1 years (SD 16.81). Most patients were males (64.4%) and the majority of them were married (83.9%). More than half (58.5%) had been smokers, and of those who smoked, 89.9% were males. Some had a betel quid chewing habit (22.9%) but none ever consumed alcohol. The majority of the patients (77.1%) were diagnosed at stage IV. The tongue was the most usual site involved (37.3%) and squamous cell carcinoma was the most common histological type seen (75.4%).
CONCLUSIONS: The prevalence of oral cancer among Malay patients in HUSM is high (88.7%). It is predominantly found in elderly males and the majority of cases present at advanced stage.

Matched MeSH terms: Hospitals, University
Fulltext Gouty wrist arthritis causing carpal tunnel syndrome--a case report

Sikkandar MF, Sapuan J, Singh R, Abdullah S

Med J Malaysia, 2012 Jun;67(3):333-4.
PMID: 23082430

A 63 year old male with a history of gout and hypertension presented with carpal tunnel syndrome. He gave history of bilateral wrist pain associated with numbness over the median nerve distribution of the hand. Tinels sign and Phalens test were positive with no obvious thenar muscle wasting on examination. Tophaceous deposits in the flexor tendons and within the synovium of the wrist joint was seen during surgery and this established gout as the cause of median nerve entrapment in this patient.

Matched MeSH terms: Hospitals, University
Fulltext Appraisal of clinical profile and management of juvenile nasopharyngeal angiofibroma in malaysia

Hassan S, Abdullah J, Abdullah B, Jihan Wd S, Jaafar H, Abdullah S

Malays J Med Sci, 2007 Jan;14(1):18-22.
PMID: 22593647 MyJurnal

Juvenile nasopharyngeal angiofibroma (JNA) is a benign but locally invasive tumour. Patients are usually in their adolescent age and present with epistaxis and nasal blockage. Diagnosis is based on clinical evaluation and the C.T. scan findings. Pre-operative superselective embolisation (SSE) and surgical excision is the treatment of choice. The out patient clinic of ORL-HNS hospital of University Science Malaysia received 25 referrals, all male, majority between 9-13 years of age and few adolescents. Clinically the patients were consistent with symptoms of recurrent epistaxis and nasal blockage. They reported from October 1998 to October 2001 from with in the state of Kelantan and the nearby states of Pahang, Kedah and Terenganu. Diagnosis was mostly made on typical radiological findings and the tumours were classified accordingly into four stages. SSE and surgical excision was carried out in all cases. Regular follow-up helped us to identify early recurrences which were treated with salvage surgery or radiotherapy in one case with extensive intracranial extension. A retrospective review of presenting features, diagnostic difficulties, surgical approaches and its outcome is presented. Maxillary swing procedure performed in three cases as a new surgical option in the management of JNA is also discussed.
Study site: ENT clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Usage of traditional and complementary medicine among dengue fever patients in the northeast region of Peninsular Malaysia

Ismail IS, Hairon SM, Yaacob NM, Besari AM, Abdullah S

Malays J Med Sci, 2019 May;26(3):90-101.
PMID: 31303853 MyJurnal DOI: 10.21315/mjms2019.26.3.7

BACKGROUND: The recent epidemic of dengue fever (DF) in Malaysia was alarming. The treatment of DF remains supportive as there is no anti-viral agent or vaccine available as yet. Traditional and complementary medicine (T&CM) provides an alternative option for the treatment of DF but there is limited evidence with regard to its usage. The aim of this study was to determine the prevalence, types and predictor factors of T&CM usage among DF patients in the northeast region of Peninsular Malaysia.
METHODOLOGY: This was a cross-sectional study of DF patients in the northeast region of Peninsular Malaysia who had been admitted to a tertiary centre from January 2014 until December 2015. Serologically-confirmed DF patients aged 18 years and above were randomly selected. Phone interviews were conducted to obtain information regarding the use of T&CM during hospitalisation. Notes were made regarding the prevalence and type of T&CM used. Binary logistic regressions were used to identify the predictor factors of T&CM usage.
RESULTS: A total of 241 DF patients with a mean age of 36.62 (SD = 14.62) years were included. The estimated prevalence of T&CM usage was 84.6% (95%CI: 80.1%, 89.2%). The most common T&CM used were crab soup (85.3%), papaya leaf extract (64.2%) and isotonic drinks (61.8%). The significant predictors for T&CM usage were age [adjusted odds ratio (AOR) 0.97; 95%CI: 0.94, 0.99], tertiary education (AOR 3.86; 95%CI: 1.21, 12.32) and unemployment (AOR 2.55; 95%CI: 1.02, 6.42).
CONCLUSION: The prevalence of T&CM usage in our population is high. Age, tertiary education and unemployment influence the use of T&CM.
Study site: Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia,

Matched MeSH terms: Hospitals, University
Fulltext Single-center experience of von Willebrand disease (vWD) among patients with menorrhagia: a diagnosis which could be missed

Hassan R, Yusof WA, Hussain NH, Abdullah WZ

Indian J Hematol Blood Transfus, 2012 Sep;28(3):157-61.
PMID: 23997452 DOI: 10.1007/s12288-011-0135-6

Menorrhagia is one of the gynecological complaints, seen in women of reproductive age. In majority of cases no organic pathology is found. To date there is no consensus on application of von Willebrand disease (vWD) testing as part of the routine investigations in menorrhagia. Diagnosis of vWD is challenging. It is complicated by intra-individual variations in von Willebrand antigen, activity, and factor VIII levels due to fluctuation of these factor levels during the menstrual cycle or hormonal therapy. The aim of this study is to detect vWD presenting with menorrhagia among Malays attending gynecology clinic by using a standard panel of haemostatic profiles. Thirty Malay patients attending gynecology clinic with unexplained menorrhagia were included in this study. Haemostatic profile such as platelet count, prothrombin time, activated partial thromboplastin time (APTT), factor VIII assay, von Willebrand factor antigen, and von Willebrand factor activity, and collagen binding assay were measured in all patients. Pre- and post hormonal haemostatic profiles were also performed in the patients diagnosed as vWD. All patients had normal APTT. Based on von Willebrand factor work-up, vWD was diagnosed in four patients (13.3%). Three of them were Type 1 and the other one was Type 2M. Investigation for vWD is essential in patients with menorrhagia and thus the laboratories performing vWD testing should provide a complete panel of diagnostic work-up in order to reduce the interpretation error. Screening for vWD should be performed before hormonal treatment as haemostatic profile post treatment could mask the diagnosis.
Study site: Gynaecology clinic, Hospital of Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Healthcare Professionals' Awareness, Knowledge, Attitudes, Perceptions and Beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: A Cross-sectional Study

Abebe TB, Bhagavathula AS, Tefera YG, Ahmad A, Khan MU, Belachew SA, et al.

J Public Health Afr, 2016 Dec 31;7(2):570.
PMID: 28299161 DOI: 10.4081/jphia.2016.570

A poor understanding of Ebola Virus Disease (EVD) among Health Care Professionals (HCPs) may put our lives at risk. We aimed to assess the awareness, knowledge, attitudes, perceptions, beliefs of HCPs towards Ebola at Gondar University Hospital (GUH) in Northwest Ethiopia. We conducted a hospital based, cross-sectional survey among 245 randomly selected HCPs working at GUH from August-October, 2015. A validated, self-administered questionnaire was used to collect the data. We calculated descriptive statistics with P<0.05 being statistically significant. Of the 245 participants, 211 (86.1%) completed the study. The majority had heard about EVD and used news media (62%) as a source of information. Still, many were afraid of getting EVD (56.4%; P=0.001). A significant number of HCPs thought EVD can cause paralysis like polio (45%) and can be treated with antibiotics (28.4%). In addition, 46.4% of the HCPs felt anger or fear towards Ebola infected patients (P=0.006). We identified poor knowledge and negative incorrect beliefs among doctors and allied health professionals. There is a need for intensive training for all HCPs reduce EVD risk.

Matched MeSH terms: Hospitals, University
Risk factors associated with diabetic retinopathy among type 2 diabetes patients at teaching hospital in Malaysia

Abougalambou SS, Abougalambou AS

Diabetes Metab Syndr, 2015 Apr-Jun;9(2):98-103.
PMID: 25470640 DOI: 10.1016/j.dsx.2014.04.019

BACKGROUND: Diabetic retinopathy (DR) is the leading cause of blindness in the United States and it is the leading cause of new cases of blindness in adults aged 20-74. It is estimated that about 20% of patients with type 2 DM have evidence of diabetic retinopathy at diagnosis with diabetes.
OBJECTIVE: To evaluate the prevalence of DR and to determine risk factors related to diabetic retinopathy among type 2 diabetes patients attending endocrinology clinics at Hospital Universiti Sains Malaysia (HUSM).
SUBJECTS AND METHODS: The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at HUSM. Diagnosis of retinopathy is based on finding the diagnostic signs of retinopathy on eye exams by fundoscopy. Logistic regression analysis was used to assess the independent variables that affect the development of retinopathy.
RESULTS: The prevalence of retinopathy was 39.3%. It has been noticed from this study findings, that the progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance.
CONCLUSION: DR is highly prevalent among type 2 DM. The progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance. DR is a serious diabetic complication and public health strategies are required in order to reduce its risk factors and decrease its prevalence.
KEYWORDS: Prevalence; Retinopathy; Risk factors; Type 2 diabetes mellitus
Study site: Endocrinology clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Hospitals, University
Prevalence and risk factors of microalbuminuria in type 2 diabetes mellitus outpatients at University Sains Malaysia Hospital

Abougalambou SS, Abougalambou AS

Diabetes Metab Syndr, 2013;7(2):64-7.
PMID: 23680242 DOI: 10.1016/j.dsx.2013.02.034

BACKGROUND AND OBJECTIVE: Microalbuminuria is early stage of diabetic nephropathy as well as a marker of cardiovascular disease. The objective of this study is to determine the prevalence of microalbuminuria and associated risk factors among type 2 diabetic outpatients, attending a diabetic clinic in University Sains Malaysia Hospital (HUSM).
PATIENTS AND METHODS: Prospective study design was used in the data collection process. The study sample consists of 1066 type 2 diabetes mellitus outpatients who fit the inclusion criteria. All the patients were recruited from the diabetic outpatient clinics from HUSM. The study period was from January till December 2008. Microalbuminuria was diagnosed if the urinary albumin excretion more than 30 mg/g of creatinine.
RESULTS: A total of 1661 patients were included in this study. Microalbuminuria was diagnosed in 273 (25.4%) patients. Multivariate logistic regression analysis indicated that microalbuminuria was positively associated with duration of hypertension (P=0.044), HbA1c (P=0.004), systolic blood pressure (<0.001), creatinine clearance (P=0.007) and the presence of neuropathy (P=0.004).
CONCLUSION: High prevalence of microalbuminuria was in type 2 diabetic outpatients. Predictive factors for microalbuminuria were duration of hypertension, HbA1c, systolic blood pressure, creatinine clearance and the presence of neuropathy. The study suggests the need to screen for microalbuminuria early and the active management of modifiable risk factors in particular, hyperglycemia, hypertension and creatinine clearance, to reduce the burden of end-stage renal disease in the future.

Study site: diabetic outpatient clinics from HUSM

Matched MeSH terms: Hospitals, University; Hospitals, University*
A study evaluating prevalence of hypertension and risk factors affecting on blood pressure control among type 2 diabetes patients attending teaching hospital in Malaysia

Abougalambou SS, Abougalambou AS

Diabetes Metab Syndr, 2013 Apr-Jun;7(2):83-6.
PMID: 23680246 DOI: 10.1016/j.dsx.2013.02.019

INTRODUCTION: Hypertension is extremely common disease found in patients with diabetes mellitus. Eighty to 90% of patients with type 2 diabetes mellitus will develop hypertension, and about 20% of hypertensive patients develop diabetes. The aim of this study was designed to assess the prevalence of hypertension and factors affecting the control of hypertension among type 2 diabetic patients.
MATERIALS AND METHODS: A total of 1077 type 2 diabetes mellitus patients were included in this study who attended at diabetes clinic of Universiti Sains Malaysia (USM) teaching hospital in Kelantan. All these patients were prospectively followed from January to December 2008. Logistic regression analysis was used to assess the independent effect of variables on hypertension.
RESULTS: The prevalence of hypertension (BP>130/80 or on medication for high blood pressure) was 92.7%. A total 471 (47.2%) patients had achieved blood pressure targets ≤ 130/80 mmHg. The logistic regression indicated that hypertension was positively associated with age (P=0.040), BMI (P=0.027), HbA1c (P=0.046), and level of education (P=0.039).
CONCLUSION: Hypertension is a common co-morbidity among diabetic patients. Hypertension was not controlled to the recommended levels of blood pressure in about one-half (52.8%) of diabetes patients. Age, BMI, HbA1c and level of education are factors affecting on hypertension.

Matched MeSH terms: Hospitals, University
Explorative study on diabetes neuropathy among type II diabetic patients in Universiti Sains Malaysia Hospital

Abougalambou SS, Abougalambou AS

Diabetes Metab Syndr, 2012 Jul-Sep;6(3):167-72.
PMID: 23158982 DOI: 10.1016/j.dsx.2012.09.002

OBJECTIVE: The aim of this study was to determine risk factors and prevalence of diabetic neuropathy (DN) among type II diabetic patients in Malaysian hospital setting.
SUBJECTS AND METHODS: a observational prospective longitudinal follow up study design was selected, total no of respondents were 1077 type 2 diabetes mellitus outpatients recruited via attended the diabetes clinics at Hospital Universiti Sains Malaysia (HUSM) in Kelantan. The diagnosis of neuropathy was confirmed by nerve conduction studies. Logistic regression analysis was used to assess the independent variables that affect the development of neuropathy.
RESULTS: The prevalence of nephropathy is 54.3%. Longitudinal logistic regression identified four predictive variables on the development and progression of diabetic neuropathy that are: duration of diabetes, retinopathy, HbA1c at second visit, and creatinine clearance third visit.
CONCLUSION: Findings of this study show high prevalence of diabetic neuropathy. HbA1c and creatinine clearance are two modifiable risk factors for the development of diabetic neuropathy.
Study site: Diabetes clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Hospitals, University
A study evaluating the postprandial plasma glucose control among type 2 diabetes patients attending a teaching hospital in Malaysia

Abougalambou SSI, Ahmed NO, Abougalambou AS

Diabetes Metab Syndr, 2017 Nov;11 Suppl 1:S445-S449.
PMID: 28434857 DOI: 10.1016/j.dsx.2017.03.033

BACKGROUND AND OBJECTIVE: Type 2 DM is rapidly rising as a global health care problem that threatens to reach pandemic levels by 2030. Type 2 diabetes mellitus is a disease with no cure and chronic disease that results in major morbidity and mortality. The main objective of this study is to evaluate postprandial plasma glucose level and to determine factors affect on postprandial plasma glucose level among type 2 diabetes outpatients attending endocrinology clinics at Hospital Universiti Sains Malaysia, Teaching Hospital.
SUBJECTS AND METHODS: The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at Hospital Universiti Sains Malaysia (HUSM) in Kelantan. Post prandial plasma glucose (PPG) parameter to measure the glycaemic control. Logistic regression analysis was used to assess the independent variables that affect the PPG control.
RESULTS: About 426 (39.6%) of the patients did not achieve the optimal postprandial plasma glucose level (<10mmol/l). In this study, the possible factors that affect postprandial plasma glucose levels (PPG) were found to be gender (OR=0.77) and the duration of diabetes (OR=1.12).
CONCLUSION: It has been found that gender and the duration of diabetes are the factors affecting PPG. New strategy to improve the current status of control of diabetes is needed. The study recommends that health-care providers should pay more attention to type 2 DM male patients and patients who had diabetic for long time.
Study site: Endocrine clinic, Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Hospitals, University
Symptom prevalence, bother, and treatment satisfaction in men with lower urinary tract symptoms in Southeast Asia: a multinational, cross-sectional survey

Ho LY, Chu PS, Consigliere DT, Zainuddin ZM, Bolong D, Chan CK, et al.

World J Urol, 2018 Jan;36(1):79-86.
PMID: 29051978 DOI: 10.1007/s00345-017-2097-2

PURPOSE: The overall objective of the survey was to systematically examine patients' perspectives on lower urinary tract symptoms (LUTS) and their treatment in Southeast Asia.
METHODS: A multinational cross-sectional survey involving adult men seeking consultation at urology outpatient clinics because of LUTS in Southeast Asia was conducted using convenience sampling. Self-reported prevalence, bother, treatment and treatment satisfaction of selected LUTS including urgency, nocturia, slow stream, and post-micturition dribble were evaluated.
RESULTS: In total, 1535 eligible patients were enrolled in the survey. A majority of respondents were aged 56-75 years, not employed, and had not undergone prostate operation before. Overall, the self-reported prevalence of nocturia was 88% (95% CI 86-90%), slow stream 61% (95% CI 59-63%), post micturition dribble 55% (95% CI 52-58%), and urgency 52% (95% CI 49-55%). There were marked differences in the country specific prevalence of LUTS complaints. Frequently, symptoms coexisted and were combined with nocturia. More than half of patients felt at least some degree of bother from their symptoms: 61% for urgency, 57% for nocturia, 58% for slow stream, and 60% for post-micturition dribble. Before seeing the present urologists, nearly half of patients have received some form of prescribed treatment and more than 80% of patients indicated they would like to receive treatment.
CONCLUSION: Men who sought urologist care for LUTS often presented with multiple symptoms. Nocturia emerged as the most common symptom amongst the four core symptoms studied.
Study site in Malaysia: Urology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Pattern of QTc prolongation in Methadone Maintenance Therapy (MMT) subjects receiving different methadone dosages: A prospective cohort study

Mohamad N, Abdul Jalal MI, Hassan A, Abdulkarim Ibrahim M, Salehuddin R, Abu Bakar NH

Pak J Med Sci, 2013 Sep;29(5):1132-6.
PMID: 24353706

OBJECTIVES: This study aimed to compare the QTc interval between low and high dose methadone groups and evaluate the pattern of QTc variation.
METHODS: This is a prospective cohort study conducted from December 2010 till August 2011 at Malaysian University of Science's Hospital. Forty six subjects, grouped in high dose (>80mg) and low dose (<80mg) oral methadone, were followed-up at 4-weekly for QTc measurements. Relevant demographic and biochemical profiles were taken at intervals with concurrent QTc measurements.
RESULTS: No significant QTc differences between methadone dosage groups were found at Week 0 (434ms vs 444ms, p = 0.166) and week 8 (446.5ms vs 459ms, p = 0.076), but not at week 4(435ms vs 450ms, p = 0.029). However, there were significant associations between the groups with QTc prolongation at week 0 and 4 (OR 4.29(95% CI 1.01, 18.72) p=0.044 and OR 5.18 (95% CI 1.34, 20.06) p =0.013, respectively) but not at week 8 (OR 2.44 (95% CI 0.74, 8.01) p=0.139). On multivariate analysis, dose group was the sole significant factor for QTc prolongation for week 0 and 4 (p values 0.047 and 0.017, respectively), but not at week 8.
CONCLUSION: High-dose methadone group is more likely to develop prolonged QTc than low-dose group. However, such effects were inconsistent and occurred even during chronic methadone therapy, mandating judicious QTc and serum methadone monitoring.
KEYWORDS: High Dose; Low Dose; Methadone; QTc

Matched MeSH terms: Hospitals, University
Fulltext Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia

Yeow TC, Wong WF, Sabet NS, Sulaiman S, Shahhosseini F, Tan GM, et al.

BMC Microbiol, 2016 Mar 18;16:45.
PMID: 26987367 DOI: 10.1186/s12866-016-0671-1

BACKGROUND: The 7.5 kb cryptic plasmid of Chlamydia trachomatis has been shown to be a virulence factor in animal models, but its significance in humans still remains unknown. The aim of this study was to investigate the prevalence and potential involvement of the C. trachomatis cryptic plasmid in causing various clinical manifestations; including infertility, reproductive tract disintegrity, menstrual disorder, and polycystic ovarian syndrome (PCOS) among genital C. trachomatis-infected patients.
RESULTS:A tot l of 180 female patients of child bearing age (mean 30.9 years old, IQR:27-35) with gynecological complications and subfertility issues, who visited Obstetrics and Gynecology clinics in Kuala Lumpur, Malaysia were recruited for the study. Prevalence of genital chlamydial infection among these patients was alarmingly high at 51.1% (92/180). Of the 92 chlamydia-infected patients, 93.5% (86/92) were infected with plasmid-bearing (+) C. trachomatis while the remaining 6.5% (6/92) were caused by the plasmid-free (-) variant. Our data showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). However, no statistical significance was detected among patients with plasmid (+) versus plasmid (-) C. trachomatis infection. Interestingly, plasmid (+) C. trachomatis was detected in all patients with PCOS, and the plasmid copy numbers were significantly higher among PCOS patients, relative to non-PCOS patients.
CONCLUSION: Our findings show a high incidence of C. trachomatis infection among women with infertility or gynecological problems in Malaysia. However, due to the low number of plasmid (-) C. trachomatis cases, a significant role of the plasmid in causing virulence in human requires further investigation of a larger cohort.
KEYWORDS: Chlamydia trachomatis; Infertility; Plasmid; Reproductive system disorders
Study site: Obstetrics and Gynecology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Dengue death with evidence of hemophagocytic syndrome and dengue virus infection in the bone marrow

Ab-Rahman HA, Wong PF, Rahim H, Abd-Jamil J, Tan KK, Sulaiman S, et al.

Springerplus, 2015;4:665.
PMID: 26558168 DOI: 10.1186/s40064-015-1463-z

INTRODUCTION: HPS is a potentially life-threatening histiocytic disorder that has been described in various viral infections including dengue. Its involvement in severe and fatal dengue is probably more common but is presently under recognized.
CASE DESCRIPTION: A 38-year-old female was admitted after 5 days of fever. She was deeply jaundiced, leukopenic and thrombocytopenic. Marked elevation of transaminases, hyperbilirubinemia and hypoalbuminemia were observed. She had deranged INR values and prolonged aPTT accompanied with hypofibrinogenemia. She also had splenomegaly. She was positive for dengue IgM. Five days later she became polyuric and CT brain image showed gross generalized cerebral edema. Her conditions deteriorated by day 9, became confused with GCS of 9/15. Her BMAT showed minimal histiocytes. Her serum ferritin level peaked at 13,670.00 µg/mL and her sCD163 and sCD25 values were markedly elevated at 4750.00 ng/mL and 4191.00 pg/mL, respectively. She succumbed to the disease on day 10 and examination of her tissues showed the presence of dengue virus genome in the bone marrow.
DISCUSSION AND EVALUATION: It is described here, a case of fatal dengue with clinical features of HPS. Though BMAT results did not show the presence of macrophage hemophagocytosis, other laboratory features were consistent with HPS especially marked elevation of ferritin, sCD163 and sCD25. Detection of dengue virus in the patient's bone marrow, fifteen days after the onset of fever was also consistent with the suggestion that the HPS is associated with dengue virus infection.
CONCLUSIONS: The findings highlight HPS as a possible complication leading to severe dengue and revealed persistent dengue virus infection of the bone marrow. Detection of HPS markers; ferritin, sCD163 and sCD25, therefore, should be considered for early recognition of HPS-associated dengue.
KEYWORDS: Bone marrow; Dengue; Ferritin; Hemophagocytic syndrome; MAS; Macrophage
Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Tsukamurella tyrosinosolvens intravascular catheter-related bacteremia in a haematology patient: a case report

Karunakaran R, Halim HA, Ng KP, Hanifah YA, Chin E, Jaafar FL, et al.

Eur Rev Med Pharmacol Sci, 2011 Nov;15(11):1343-6.
PMID: 22195371

Tsukamurella spp. are a rare but important cause of intravascular catheter-related bacteremia in immunocompromised patients. The organism is an aerobic, Gram-positive, weakly acid-fast bacillus that is difficult to differentiate using standard laboratory methods from other aerobic actinomycetales such as Nocardia spp., Rhododoccus spp., Gordonia spp., and the rapid growing Mycobacterium spp. We report a case of Tsukamurella tyrosinosolvens catheter-related bacteremia in a 51-year-old haematology patient who responded to treatment with imipenem and subsequent line removal. 16srRNA sequencing allowed for the prompt identification of this organism.

Matched MeSH terms: Hospitals, University
Fulltext Reliability, technical error of measurements and validity of length and weight measurements for children under two years old in Malaysia

Jamaiyah H, Geeta A, Safiza MN, Khor GL, Wong NF, Kee CC, et al.

Med J Malaysia, 2010 Jun;65 Suppl A:131-7.
PMID: 21488474

The National Health and Morbidity Survey III 2006 wanted to perform anthropometric measurements (length and weight) for children in their survey. However there is limited literature on the reliability, technical error of measurement (TEM) and validity of these two measurements. This study assessed the above properties of length (LT) and weight (WT) measurements in 130 children age below two years, from the Hospital Universiti Kebangsaan Malaysia (HUKM) paediatric outpatient clinics, during the period of December 2005 to January 2006. Two trained nurses measured WT using Tanita digital infant scale model 1583, Japan (0.01kg) and Seca beam scale, Germany (0.01 kg) and LT using Seca measuring mat, Germany (0.1cm) and Sensormedics stadiometer model 2130 (0.1cm). Findings showed high inter and intra-examiner reliability using 'change in the mean' and 'intraclass correlation' (ICC) for WT and LT. However, LT was found to be less reliable using the 'Bland and Altman plot'. This was also true using Relative TEMs, where the TEM value of LT was slightly more than the acceptable limit. The test instruments were highly valid for WT using 'change in the mean' and 'ICC' but was less valid for LT measurement. In spite of this we concluded that, WT and LT measurements in children below two years old using the test instruments were reliable and valid for a community survey such as NHMS III within the limits of their error. We recommend that LT measurements be given special attention to improve its reliability and validity.
Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Psoriasis in hospital population

Adam BA

Med J Malaysia, 1980 Jun;34(4):370-4.
PMID: 7219266

Two hundred and three patients with psoriasis, who attended the skin clinic were studied to identify the pattern of sporiasis. The incidence was 4%. It was more common in Indians than in the other ethnic groups and this was found to be statistically significant. Males were affected twice as common, 12.5% gave a positive family history, the lower limbs and the scalp were the commonest site, and pruritus was frequent. The pattern appears similar to those in the west.
Study site: Skin clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University

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