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  1. Nanoparticles Based Intranasal Delivery of Drug to Treat Alzheimer's Disease: A Recent Update
    Pandey M, Choudhury H, Verma RK, Chawla V, Bhattamisra SK, Gorain B, et al.
    CNS Neurol Disord Drug Targets, 2020;19(9):648-662.
    PMID: 32819251 DOI: 10.2174/1871527319999200819095620
    Alzheimer Association Report (2019) stated that the 6th primary cause of death in the USA is Alzheimer's Disease (AD), which leads to behaviour and cognitive impairment. Nearly 5.8 million peoples of all ages in the USA have suffered from this disease, including 5.6 million elderly populations. The statistics of the progression of this disease is similar to the global scenario. Still, the treatment of AD is limited to a few conventional oral drugs, which often fail to deliver an adequate amount of the drug in the brain. The reduction in the therapeutic efficacy of an anti-AD drug is due to poor solubility, existence to the blood-brain barrier and low permeability. In this context, nasal drug delivery emerges as a promising route for the delivery of large and small molecular drugs for the treatment of AD. This promising pathway delivers the drug directly into the brain via an olfactory route, which leads to the low systemic side effect, enhanced bioavailability, and higher therapeutic efficacy. However, few setbacks, such as mucociliary clearance and poor drug mucosal permeation, limit its translation from the laboratory to the clinic. The above stated limitation could be overcome by the adaption of nanoparticle as a drug delivery carrier, which may lead to prolong delivery of drugs with better permeability and high efficacy. This review highlights the latest work on the development of promising Nanoparticles (NPs) via the intranasal route for the treatment of AD. Additionally, the current update in this article will draw the attention of the researcher working on these fields and facing challenges in practical applicability.
    Matched MeSH terms: Blood-Brain Barrier
  2. Fulltext Strongyloides Hyperinfection Syndrome in an Immunosuppressed Patient
    Cheo, Seng Wee, Tan, Yee Ann, Low, Qin Jian
    Borneo Journal of Medical Sciences, 2019;13(1):39-43.
    MyJurnal
    Strongyloides stercoralis is an intestinal nematode which is endemic in tropical and subtropical countries. The global prevalence of Strongyloides is unknown. Strongyloidiasis is found more frequently in the socioeconomically disadvantaged, in institutionalized populations, and in rural areas. The spectrum of disease varies. It may cause asymptomatic infection, mild eosinophilia or hyperinfection syndrome in the most severe form. Here we reported a case of Strongyloides hyperinfection syndrome in an immunosuppressed patient. This patient is a 54-year-old man with myasthenia gravis on long term azathioprine and prednisolone. He presented with fever associated with diarrhoea and was in septic shock. His blood culture was positive forKlebsiella pneumoniae.Strongyloides stercoralis larvae were detected in his sputum and stool sample. He was diagnosed to have Strongyloides hyperinfection and was treated with subcutaneous ivermectin. He recovered well. Our case demonstrated the association of Strongyloideshyperinfection with superimposed gram-negative sepsis as a consequence of prolonged immunosuppression. A high index of suspicion is needed in approaching patient with risk factors of hyperinfection syndrome.
    Matched MeSH terms: Blood Culture
  3. Fulltext The effect of dietary glycemic index and glycemic load on overweight individuals and type 2 diabetes patients: an overview of the literature
    Chekima, K., Wong, B. T. Z., Ooi, Y. B. H., Ismail M. N., Tan, C. H.
    Malaysian Journal of Medicine and Health Sciences, 2019;15(102):45-45.
    MyJurnal
    Introduction: Type 2 diabetes is increasing at an alarming rate worldwide. One of the leading factors to this condition is obesity. Low glycemic index (GI) and glycemic load (GL) diets have been proposed as lifestyle changes to address obesity, however, there is a lack of consensus on the optimal approach for weight loss, glycemic control and improving insulin sensitivity. In addition, the outcome of these diets are equivocal, with some studies suggesting beneficial outcomes and others suggesting otherwise. Furthermore, discrepant study designs have led to divergent conclusions. In order to provide a comprehensive overview of the low GI and low GL diets, a systematic review of literature on relevant observational studies and randomised control trials was performed on these databases:- The Cochrane Library, Medline, PubMed, Embase, Cinahl and Web of Science. Methods: The review was conducted based on the methodological standards for the conduct and reporting of Cochrane intervention reviews, Version 1.07, November 2018. Population, Intervention, Comparison and Outcomes (PICO) tool was used as the organising framework to define key elements of the review question. Results: Pertinent outcome variables include body weight, insulin resistance, HbA1c, fasting serum glucose, BMI, waist-to-hip ratio, triglyceride, HDL and LDL cholesterol. Our current understanding of these diets has been complicated by the reports that were based on different study designs and study populations. This review defines the issues, gaps in the research, study design, and evidence that is needed to inform practice, policy making and future research. There is also a dearth of information on the effect of low GI and GL diets on the Asian populations, specifically on improving insulin resistance. High carbohydrate diets are a mainstay of Asian societies. Conclusion: As cases of obesity and type 2 diabetes surge, there is an urgent need for research on low GI and GL dietary modifications among the Asian populations.
    Matched MeSH terms: Blood Glucose
  4. Fulltext The effectiveness of probiotics, prebiotics, and dietary fiber on the lowering of cholesterol level and improvement of full lipid profile
    Farah Izzati binti Farush Khan, Yasmin Ooi Beng Houi, Patricia Matanjun, Fredie Robinson
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):31-31.
    MyJurnal
    Introduction: Coronary heart disease (CHD) has become the number one cause of death worldwide. Past studies have established the efficiency of prebiotics, probiotics, and their combination on lowering blood lipids. However, the mechanism(s) on the reduction of cholesterol involved is not fully understood due to limited in-vivo studies. Therefore, the reported hypocholesterolaemic potential of probiotics and prebiotics supplementations warrants fur-ther research. This study examined the effectiveness of the intervention products on improving lipid profiles, (to-tal cholesterol (TC), HDL-C, LDL-C, TG). Methods: A randomized, single blind intervention involving 8 weeks of treatment followed by 4 weeks of washout period was carried out on 29 volunteers with TC 5.2-6.0 mmol/L who were screened from 517 volunteers. Exclusion criteria included chronic diseases, immune-compromised diseases, consumption of cholesterol-lowering drugs, and pregnancy if female. Informed consent was obtained before com-mencement of the study. Participants were randomly assigned to receive 2g/d Lactobacillus Acidophilus NCFM pro-biotic powder, 10g/d inulin, 10g/d dietary fibre, control intervention of 20mg/d statin, or control intervention of diet counseling. Results: No significant (p>0.05) changes were observed in the fasting blood glucose, physical activities and total nutrient intake of all the groups. Inulin reduced LDL-C by 12.13%. Probiotic reduced TC by 6.98%. Dietary fibre reduced TC by 8.6%, and LDL-C by 16.08%. Conclusion: Although the results showed no significant changes, it may be clinically significant as the intervention products improve the lipid profiles. It was concluded that the im-provement in the lipid profiles may be attributable to the intervention products.
    Matched MeSH terms: Blood Glucose
  5. Fulltext Knowledge and utilization of laboratory services among employees of University Malaysia Sabah. [Abstract]
    Wynn AA, Myint O, Mya NK, Aung TS, Myint T
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):39.
    MyJurnal
    Abstracts For The 1st International Borneo Healthcare And Public Health Conference And 4th Borneo Tropical Medicine And Infectious Disease Congress. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
    Introduction: Laboratory screening tests are common elements of health care. Comprehensive care of patients is dependent on the results of laboratory investigations. Dissemination of knowledge and improving attitude of com-munity for utilization of laboratory services are utmost important in community health care. This study aimed to assess the knowledge and utilization of the laboratory services among the employees of University Malaysia Sabah, determine their expectations of employees on the medical laboratory services.
    Methods: A total of 200 UMS staff participated. The data were collected using a cross-sectional self-administered questionnaires and descriptive data analysis was done.
    Results: 5% of the participants in this study agreed to have the health check and blood screening tests every year. Less than 10% of respondents agreed to do more frequent blood tests check if they are at high risk such as family history of cancer, hypertension and diabetes 181 out of 200 respondents do not agree that doing laboratory tests can help for early diagnosis of some diseases. The most used laboratory tests were plasma sugar (70.8%), blood grouping (60.4%), urine examination (50%) and serum lipid (46%).
    Conclusion: Based on the results, recommendations were made to improve the knowledge, attitude and utilization of the laboratory services and set up laboratory services easily accessible by the university community. This will lead to positive health benefits in people and improve associated health outcomes.
    Matched MeSH terms: Blood Grouping and Crossmatching
  6. Selective targeting of cancer signaling pathways with nanomedicines: challenges and progress
    Barkat HA, Das SS, Barkat MA, Beg S, Hadi HA
    Future Oncol, 2020 Dec;16(35):2959-2979.
    PMID: 32805124 DOI: 10.2217/fon-2020-0198
    Cancer is one of the leading causes of death worldwide. Regardless of advances in understanding the molecular mechanics of cancer, its treatment is still lacking and the death rates for many forms of the disease remain the same as six decades ago. Although a variety of therapeutic agents and strategies have been reported, these therapies often failed to provide efficient therapy to patients as a consequence of the inability to deliver right and adequate chemotherapeutic agents to the right place. However, the situation has started to revolutionize substantially with the advent of novel 'targeted' nanocarrier-based cancer therapies. Such therapies hold great potential in cancer management as they are biocompatible, tailored to specific needs, tolerated and deliver enough drugs at the targeted site. Their use also enhances the delivery of chemotherapeutics by improving biodistribution, lowering toxicity, inhibiting degradation and increasing cellular uptake. However, in some instances, nonselective targeting is not enough and the inclusion of a ligand moiety is required to achieve tumor targeting and enhanced drug accumulation at the tumor site. This contemporary review outlines the targeting potential of nanocarriers, highlighting the essentiality of nanoparticles, tumor-associated molecular signaling pathways, and various biological and pathophysiological barriers.
    Matched MeSH terms: Blood-Brain Barrier
  7. Fulltext Tuberculous cold abscess of sternoclavicular joint: a case report
    Burud I, Ikram MA, Tata MD, Jaafar J
    Pan Afr Med J, 2020;36:16.
    PMID: 32774593 DOI: 10.11604/pamj.2020.36.16.20697
    Bone and joint tuberculosis is a serious medical problem; tuberculosis of sternoclavicular joint is rare. We present a case of a healthy 37-year old man with sternoclavicular joint tuberculosis. The subject presented with a three weeks history of left sternoclavicular joint painless swelling without fever or weight loss. He had no previous history of pulmonary tuberculosis. Laboratory testing revealed erythrocyte sedimentation rate of 70 mm/hour, C-reactive protein of 30 mg/liter and a normal leucocyte count. Biopsy of the lesion showed caseous necrosis and pus culture revealed Mycobacterium tuberculosis. He was treated with joint debridement and anti-tuberculous medications. Tuberculosis resolved completely but post-infection patients had residual joint arthritis. Tuberculosis may infect unusual joints such as the sternoclavicular joint.
    Matched MeSH terms: Blood Sedimentation
  8. Fulltext Cytotoxic and anticancer properties of the Malaysian mangrove pit viper (Trimeresurus purpureomaculatus) venom and its disintegrin (purpureomaculin)
    Tan CH, Liew JL, Navanesan S, Sim KS, Tan NH, Tan KY
    J Venom Anim Toxins Incl Trop Dis, 2020;26:e20200013.
    PMID: 32742279 DOI: 10.1590/1678-9199-JVATITD-2020-0013
    Background: The Asiatic pit vipers from the Trimeresurus complex are medically important venomous snakes. These pit vipers are often associated with snakebite that leads to fatal coagulopathy and tissue necrosis. The cytotoxic venoms of Trimeresurus spp.; however, hold great potential for the development of peptide-based anticancer drugs.

    Methods: This study investigated the cytotoxic effect of the venom from Trimeresurus purpureomaculatus, the mangrove pit viper (also known as shore pit viper) which is native in Malaysia, across a panel of human cancer cell lines from breast, lung, colon and prostate as well as the corresponding normal cell lines of each tissue.

    Results: The venom exhibited dose-dependent cytotoxic activities on all cell lines tested, with median inhibition concentrations (IC50) ranging from 0.42 to 6.98 µg/mL. The venom has a high selectivity index (SI = 14.54) on breast cancer cell line (MCF7), indicating that it is significantly more cytotoxic toward the cancer than to normal cell lines. Furthermore, the venom was fractionated using C18 reversed-phase high-performance liquid chromatography and the anticancer effect of each protein fraction was examined. Fraction 1 that contains a hydrophilic low molecular weight (approximately 7.5 kDa) protein was found to be the most cytotoxic and selective toward the breast cancer cell line (MCF7). The protein was identified using liquid chromatography-tandem mass spectrometry as a venom disintegrin, termed purpureomaculin in this study.

    Conclusion: Taken together, the findings revealed the potent and selective cytotoxicity of a disintegrin protein isolated from the Malaysian T. purpureomaculatus venom and suggested its anticancer potential in drug discovery.

    Matched MeSH terms: Blood Coagulation Disorders
  9. Fulltext Factors associated with glycaemic control among diabetic patients at Hulu Terengganu in 2019
    Erwan Ershad Ahmad Khan, Kamilah Mohamed, Salmiah Sidek, Noriah Mahmud
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):63-63.
    MyJurnal
    Introduction:The objectives of this study were to measure the status of glycaemic control and identify factors asso-ciated with good glycaemic control among diabetic patients treated at primary health clinics. Methods: All diabetic patients registered and under follow up of Ministry of Health facilities were monitored for their glycaemic controls through HbA1c levels. Data obtained from line listing of diabetic patients that received treatment from four health clinics at Hulu Terengganu in 2019. All of patients’ data including socio demographic characteristics, latest labo-ratory investigations and treatment modalities were recorded in the line listing. In this study, 350 active patients were randomly selected systematically. Logistic regression analysis was done to predict factors associated with good glycaemic control which is defined as having HbA1c less or equal to 6.5%. Results: In this study, the proportion of patients with good glycaemic control was lower than other published studies. It is found that 99 patients (28.3%) have good glycaemic control while 251 patients (71.7%) have poor glycemic control. Factors significantly associ-ated with good glycaemic control included age (odds ratio 0.965; 95% confidence interval 0.940-0.991), presence of comorbidity (odds ratio 0.326; 95% confidence interval 0.107- 0.995) and type of treatment (odds ratio 0.302; confidence interval 0.171-0.533). Those who were not on insulin were more likely to have good glycaemic control. Older patients were also tend to have good glycaemic control. Conclusion: Multi-disciplinary approaches and great-er efforts by healthcare providers at primary health clinics are needed in order to help more patients to achieve good glycaemic control. Younger patients and those who do not have comorbidities yet should be closely monitored as they are prone to have poor glycaemic control. Extra cautions is warranted in patients with insulin in order to achieve glycaemic target thus reducing complications and making the treatment more cost-effective.
    Matched MeSH terms: Blood Glucose
  10. Fulltext A case report: Community-acquired Pseudomonas aeruginosa necrotizing fasciitis in a morbidly obese diabetic young man can be fatal
    Mazlan MZ, Zainal Abidin H, Wan Hassan WMN, Nik Mohamad NA, Salmuna ZN, Ibrahim K, et al.
    IDCases, 2020;22:e01001.
    PMID: 33204633 DOI: 10.1016/j.idcr.2020.e01001
    We present a case study of a 26-year-old morbidly obese man with a three-day history of right leg pain and swelling. The swelling was associated with low grade fever. He was alert and conscious upon presentation to the hospital. His physical examination showed gross swelling of the entire right lower limb with no systemic manifestations. There was no discharge and bullae from the swelling area of the leg. He had high blood sugar and was newly diagnosed with type 2 diabetes mellitus. He was diagnosed with necrotizing fasciitis. An intravenous imipenem-cilastatin 500 mg every 6 h together with clindamycin 900 mg every 8 h was started empirically. Extensive wound debridement was performed. The swab culture obtained intraoperatively grew Pseudomonas aeruginosa. He required an above knee amputation due to worsening infection despite wound debridement. Post-operatively, he developed acute kidney injury with severe metabolic acidosis, which required daily hemodialysis. However, the patient deteriorated due to septic shock with multi-organ failure, resulting in his death.
    Matched MeSH terms: Blood Glucose
  11. Fulltext A glycaemic index compendium of non-western foods
    Henry CJ, Quek RYC, Kaur B, Shyam S, Singh HKG
    Nutr Diabetes, 2021 01 06;11(1):2.
    PMID: 33414403 DOI: 10.1038/s41387-020-00145-w
    Current international tables published on the glycaemic index (GI) of foods represent valuable resources for researchers and clinicians. However, the vast majority of published GI values are of Western origin, notably European, Australian and North American. Since these tables focus on Western foods with minimal inclusion of other foods from non-Western countries, their application is of limited global use. The objective of this review is to provide the GI values for a variety of foods that are consumed in non-Western countries. Our review extends and expands on the current GI tables in an attempt to widen its application in many other regions of the world.
    Matched MeSH terms: Blood Glucose
  12. Fulltext The Potential of Mesenchymal Stromal Cell as Therapy in Neonatal Diseases
    Liau LL, Al-Masawa ME, Koh B, Looi QH, Foo JB, Lee SH, et al.
    Front Pediatr, 2020;8:591693.
    PMID: 33251167 DOI: 10.3389/fped.2020.591693
    Mesenchymal stromal cells (MSCs) can be derived from various tissue sources, such as the bone marrow (BMSCs), adipose tissue (ADSCs), umbilical cord (UC-MSCs) and umbilical cord blood (UCB-MSCs). Clinical trials have been conducted to investigate the potential of MSCs in ameliorating neonatal diseases, including bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC). In preclinical studies, MSC therapy has been tested for the treatment of various neonatal diseases affecting the heart, eye, gut, and brain as well as sepsis. Up to date, the number of clinical trials using MSCs to treat neonatal diseases is still limited. The data reported thus far positioned MSC therapy as safe with positive outcomes. However, most of these trials are still preliminary and generally smaller in scale. Larger trials with more appropriate controls and a longer follow-up period need to be conducted to prove the safety and efficacy of the therapy more conclusively. This review discusses the current application of MSCs in treating neonatal diseases, its mechanism of action and future direction of this novel therapy, including the potential of using MSC-derived extracellular vesicles instead of the cells to treat various clinical conditions in the newborn.
    Matched MeSH terms: Fetal Blood
  13. Fulltext Antioxidant and Anti-Inflammatory Effects of Genus Gynura: A Systematic Review
    Tan JN, Mohd Saffian S, Buang F, Jubri Z, Jantan I, Husain K, et al.
    Front Pharmacol, 2020;11:504624.
    PMID: 33328981 DOI: 10.3389/fphar.2020.504624
    Background:Gynura species have been used traditionally to treat various ailments, such as fever, pain, and to control blood glucose level. This systematic review critically discusses studies regarding Gynura species that exhibited antioxidant and anti-inflammatory effects, thus providing perspectives and instructions for future research of the plants as a potential source of new dietary supplements or medicinal agents. Methods: A literature search from internet databases of PubMed, Scopus, Science Direct, e-theses Online Service, and ProQuest was carried out using a combination of keywords such as "Gynura," "antioxidant," "anti-inflammatory," or other related words. Research articles were included in this study if they were experimental (in vitro and in vivo) or clinical studies on the antioxidant or anti-inflammatory effects of Gynura species and if they were articles published in English. Results: Altogether, 27 studies on antioxidant and anti-inflammatory effects of Gynura species were selected. The antioxidant effects of Gynura species were manifested by inhibition of reactive oxygen species production and lipid peroxidation, modulation of glutathione-related parameters, and enzymatic antioxidant production or activities. The anti-inflammatory effects of Gynura species were through the modulation of inflammatory cytokine production, inhibition of prostaglandin E2 and nitric oxide production, cellular inflammatory-related parameters, and inflammation in animal models. The potential anti-inflammatory signaling pathways modulated by Gynura species are glycogen synthase kinase-3, nuclear factor erythroid 2-related factor 2, PPARγ, MAPK, NF-κB, and PI3K/Akt. However, most reports on antioxidant and anti-inflammatory effects of the plants were on crude extracts, and the chemical constituents contributing to bioactivities were not clearly understood. There is a variation in quality of studies in terms of design, conduct, and interpretation, and in-depth studies on the underlying mechanisms involved in antioxidant and anti-inflammatory effects of the plants are in demand. Moreover, there is limited clinical study on antioxidant and anti-inflammatory effects of Gynura species. Conclusion: This review highlighted antioxidant and anti-inflammatory effects of genus Gynura and supported their traditional uses to treat oxidative stress and inflammatory-related diseases. This review is expected to catalyze further studies on genus Gynura. However, extensive preclinical data need to be generated from toxicity and pharmacokinetic studies before clinical studies can be pursued for their development into clinical medicines to treat oxidative stress and inflammatory conditions.
    Matched MeSH terms: Blood Glucose
  14. Fulltext The association between body weight status, sodium intake and blood pressure with intraocular pressure among orang asli adolescents in Semenyih, Selangor
    Nurulain Asri, Tasneem Shaari, Mohd Zaki Awg Isa
    Journal of Optometry, Eye and Health Research, 2020;2(1):48-56.
    MyJurnal
    Abnormal intraocular pressure (IOP) if left untreated it can lead to glaucoma and permanent vision loss. However, the correlation between IOP and body weight status, sodium intake, and blood pressure (BP) are unclear among adolescents. This cross-sectional study aimed to determine the relationship between body weight status, sodium intake, and BP with IOP among orang Asli adolescents. A total sample of 50 adolescents of Orang Asli aged 13 to 17 participated in this study. Three days' dietary intake was recorded through 24-hour diet recall to determine the sodium intake. The questionnaire was administered to acquire socio-demographic information, and measurements Body Mass Index (BMI) and BP were done according to standard protocols, and IOP was measured using Tonopen. Data obtained involving 40% boys and 60% girls. Two boys (4%) were underweight, 13 boys (26%) and 17 (34%) girls were normal weight, 4 (8%) boys and 11 (22%) girls were overweight, 1 (2%) boy and 2 (4%) girls were obese. Sixty percent of subjects have exceeded the Lowest-Observed-Adverse-Effect-Level (LOAEL) of 2300 mg of sodium intake. Hypertension stage 1 was found higher than hypertension stage 2 in male and female subjects, with 38% of the female have stage 1 hypertension compared to only 14% in male subjects. 98% of subjects have normal IOP and only 2% of subjects have high IOP. There was a significant association between BMI and IOP (p
    Matched MeSH terms: Blood Pressure
  15. Fulltext Minimally Invasive versus Conventional Open Surgery for Fixation of Spinal Fracture in Ankylosed Spine
    Chung WH, Ng WL, Chiu CK, Chan C, Kwan MK
    Malays Orthop J, 2020 Nov;14(3):22-31.
    PMID: 33403059 DOI: 10.5704/MOJ.2011.005
    Introduction: This was a retrospective study aimed to investigate the perioperative outcomes of long construct minimally invasive spinal stabilisation (MISt) using percutaneous pedicle screws (PPS) versus conventional open spinal surgery in the treatment of spinal fracture in ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH).

    Material and Methods: Twenty-one patients with AS and DISH who were surgically treated between 2009 and 2017 were recruited. Outcomes of interest included operative time, intra-operative blood loss, complications, duration of hospital stay and fracture union rate.

    Results: Mean age was 69.2 ± 9.9 years. Seven patients had AS and 14 patients had DISH. 17 patients sustained AO type B3 fracture and 4 patients had type B1 fracture. Spinal trauma among these patients mostly involved thoracic spine (61.9%), followed by lumbar (28.6%) and cervical spine (9.5%). MISt using PPS was performed in 14 patients (66.7%) whereas open surgery in 7 patients (33.3%). Mean number of instrumentation level was 7.9 ± 1.6. Mean operative time in MISt and open group was 179.3 ± 42.3 minutes and 253.6 ± 98.7 minutes, respectively (p=0.028). Mean intra-operative blood loss in MISt and open group was 185.7 ± 86.4ml and 885.7 ± 338.8ml, respectively (p<0.001). Complications and union rate were comparable between both groups.

    Conclusion: MISt using PPS lowers the operative time and reduces intra-operative blood loss in vertebral fractures in ankylosed disorders. However, it does not reduce the perioperative complication rate due to the premorbid status of the patients. There was no significant difference in the union rate between MISt and open surgery.

    Matched MeSH terms: Blood Loss, Surgical
  16. Fulltext A preliminary study of possible prognostic factors of traumatic liver injury seen at University Hospital, 1984-1991
    Sim PH, Razack AH, Jalleh RP
    Med J Malaysia, 1995 Dec;50(4):346-52.
    PMID: 8668055
    A retrospective study was carried out on 42 patients (38 males, 4 females, mean age 25.9) with liver injury at the University Hospital, Kuala Lumpur from 1994 through to 1991. Prognostic factors that might help to identify those patient survival was related to pulse rate on arrival ( < or = 120 beats per minute, p = 0.027), systolic blood pressure at induction of anaesthesia ( > or = to 80 mmHg, p = 0.003) and intraoperative blood transfusion of < or = to 4 units (p = 0.05). This data were supported by the 95% confidence interval suggesting that these factors may be strong prognostic indicators individually. Increased mortality was also associated with increased total blood transfused (p = 0.002) and grade of liver injury (p = 0.02). Although the factors we have identified reflect both the severity of injury and resuscitative and surgical efforts, further studies using a prospective design are required to confirm these findings.
    Matched MeSH terms: Blood Transfusion
  17. Fulltext Haemophagocytosis in typhoid fever
    Ramanathan M, Karim N
    Med J Malaysia, 1993 Jun;48(2):240-3.
    PMID: 8350805
    This report deals with a young man who developed features of haemophogocytosis during the course of typhoid fever. The pertinent clinical and laboratory features of typhoid-associated haemophagocytosis are discussed. The need for blood component replacement therapy in addition to specific anti-microbials to treat haemophagocytosis complicating typhoid fever is stressed.
    Matched MeSH terms: Blood Component Transfusion
  18. Radical hysterectomy and pelvic lymphadenectomy for early invasive cancer of the cervix - 14-year experience
    Sivanesaratnam V, Sen DK, Jayalakshmi P, Ong G
    Int. J. Gynecol. Cancer, 1993 Jul;3(4):231-238.
    PMID: 11578351
    During a 14-year period, 397 radical hysterectomies and pelvic lymphadenectomies were performed for early invasive carcinoma of the cervix. Twenty-one patients were in stage IA2 with lymphatic/vascular channel permeation (5.2%), 340 in stage IB (85.6%) and 34 in early stage 2A disease (8.5%). Eighteen patients (4.5%) were pregnant. Adenocarcinoma comprised 26.9% of cases. The mean operative time was 4.14 h; the intraoperative blood loss was less than 1.51 in 77.3% patients. There was no operative mortality; one patient died 3 weeks after surgery from clostridium difficile enterocilitis. Eleven patients (2.7%) developed venous thrombosis; severe lymphedema occurred in four (1%). The incidence of uretero-vaginal fistula was 0.2% and that of vesico-vaginal fistula 0.5%. Ovarian metastases were noted in 4.3% of cases with adenocarcinoma. Sixty-six patients had positive nodes (16.6%). Five-year survival in patients with more than 2 positive nodes was 68%. The use of adjuvant chemotherapy in patients with 'high risk' factors resulted in survival rates approaching those without risk factors. Neo-adjuvant chemotherapy was used in 10 patients with large bulky tumors; the results were favorable. Recurrences occurred in 47 patients (11.8%); 36 patients have died (9.1%). Age did not appear to influence survival. The overall 5-year survival was 92.2%.
    Matched MeSH terms: Blood Loss, Surgical
  19. Risk factors associated with hearing loss in term neonates with hyperbilirubinaemia
    Boo NY, Oakes M, Lye MS, Said H
    J Trop Pediatr, 1994 Aug;40(4):194-7.
    PMID: 7932930
    A study of 128 jaundiced term neonates showed that 28 (22 per cent) had hearing loss based on brain stem-evoked response. There was no significant difference in the percentage of neonates with hearing loss between those with peak serum bilirubin levels of less than 340 mumol/l (16 per cent) and those with hyperbilirubinaemia > 339 mumol/l (33 per cent) (P = 0.11). Logistic regression analysis showed that severe jaundice which required exchange transfusion and earlier age of onset of hyperbilirubinaemia were statistically significant risk factors associated with hearing loss (P = 0.038 and P = 0.012, respectively).
    Matched MeSH terms: Exchange Transfusion, Whole Blood
  20. The supplementation of levothyroxine among indigenous people in endemic goitre areas: The impact of therapy
    Zaleha MI, Osman A, Iskandar ZA, Sazali S, Ali MM, Roslan I, et al.
    Asia Pac J Clin Nutr, 1998 Jun;7(2):138-50.
    PMID: 24393641
    In order to study the effect of levothyroxine in the treatment of endemic goitre, a longitudinal study was conducted among the Aborigines in Lanai Post and Sinderut Post, situated in an iodine-deficient area located in the district of Kuala Lipis, Pahang. All subjects in the treatment group (Lanai Post) were given 100 µg of levothyroxine per day and were followed for 1 1/2 years. A total of 311 subjects were examined at baseline, 323 on the first, 256 on the second, 239 on the third and 184 on the fourth visit following levothyroxine supplementation. Goitre prevalence, thyroid hormones, thyroid volume, nutritional status, urinary iodine levels, arterial blood pressure and mental performance were determined. Following the intervention, goitre prevalence was significantly reduced in the treatment group (baseline 42.8% vs final visit 13.0%, p<0.0001); however, no significant difference was noted in the control group. Total T4 levels were increased in the treatment group (p<0.0001), while a significant reduction was noted in the control group (p<0.0001). Thyroid-stimulating hormone levels increased significantly in the treatment group following 1 year of intervention, while no significant changes were observed in the control group. As for the thyroid volume, both groups showed a significant increment following the intervention (p<0.0001). With respect to the nutritional status, the treatment group showed a significant increase in body weight following the intervention (p<0.05). In addition, the mid-arm circumference and body mass index also increased after 1 year of intervention. However, the control group showed a reduction in the waist-hip ratio (p<0.0001). Although there was no statistical difference in the waist-hip ratio in the treatment group, there has been a significant reduction observed after 1 year of intervention. At 1 year, a reduction in skinfold thickness was noted in the treatment group while only the triceps and subscapular were increased in the control group. The body fat was decreased in the treatment group following 1 year of intervention (p<0.0001). No particular trend was noted in the urinary iodine excretion in the treatment group, but surprisingly, the levels were increased in the control group (p<0.0001). A significant increase in both systolic and diastolic blood pressures was observed in the treatment group following 1 year of intervention, but the controls showed a reduction in the systolic blood pressure (p<0.0001). Both groups showed a remarkable increase in mental performance, with a more pronounced effect in the treatment group (p<0.05). The correction of iodine deficiency by levothyroxine supplementation has a short-term beneficial effect in reducing the prevalence of goitre and improving the mental ability among the Aborigines in endemic areas; however, proper monitoring and close supervision are needed to maintain compliance.
    Matched MeSH terms: Blood Pressure
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