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  1. Taai K, Harbach RE, Somboon P, Sriwichai P, Aupalee K, Srisuka W, et al.
    Trop Biomed, 2019 Dec 01;36(4):926-937.
    PMID: 33597464
    Some species of the Anopheles dirus species complex are considered to be highly competent malaria vectors in Southeast Asia. Anopheles dirus is the primary vector of Plasmodium falciparum and P. vivax while An. cracens is the main vector of P. knowlesi. However, these two species are difficult to distinguish and identify based on morphological characters. Hence, the aim of this study was to investigate the potential use of antennal sensilla to distinguish them. Large sensilla coeloconica borne on the antennae of adult females were counted under a compound light microscope and the different types of antennal sensilla were examined in a scanning electron microscope. The antennae of both species bear five types of sensilla: ampullacea, basiconica, chaetica, coeloconica and trichodea. Observations revealed that the mean numbers of large sensilla coeloconica on antennal flagellomeres 2, 3, 7, 10 and 12 on both antennae of both species were significantly different. This study is the first to describe the types of antennal sensilla and to discover the usefulness of the large coeloconic sensilla for distinguishing the two species. The discovery provides a simple, reliable and inexpensive method for distinguishing them.
    Matched MeSH terms: Female
  2. Singh A, Priyadarshi K, Raj T, Banerjee T
    Trop Biomed, 2019 Dec 01;36(4):987-992.
    PMID: 33597468
    Blastocystis species (spp.) is an emerging pathogen. There are several unsolved issues linked to this parasite ranging from its nomenclature, commensal status, standardization of laboratory diagnostic methods, genotypes and treatment. Recently, there has been an increase in reports of Blastocystis spp. from symptomatic cases which provide enough evidence of its pathogenic potential. A range of signs and symptoms, from gastro-intestinal to cutaneous manifestations have been attributed to Blastocystis infection. Few reports have established an association between intestinal infection with Blastocystis spp. and skin manifestations in form of urticaria, palmoplantar pruritus and allergy with complete resolution of cutaneous lesions with eradication of the parasite. In this report, we describe a case of Steven Johnson's syndrome (SJS) in a 6 years old girl along with infection with Blastocystis spp. marked by diarrhea and abdominal pain. Stool examination revealed the presence of all forms of the parasite with subsequent decrease in parasite burden and diarrhea over a period of time. Interestingly, the clearance of Blastocystis spp. from stool was followed by recovery from skin lesions and other symptoms. In this case, the course of SJS was clearly associated with Blastocystis infection. Though skin manifestation with Blastocystis infection has been previously reported, this is the first report of its association with SJS. This report indicates newer insights of the parasite that are less well studied.
    Matched MeSH terms: Female
  3. Azrizal-Wahid N, Sofian-Azirun M, Low VL
    Trop Biomed, 2019 Dec 01;36(4):810-821.
    PMID: 33597453
    Fleas are the common cause of skin disorders in cats. They are well-known for transmitting various pathogens to both cats and humans. Accordingly, this study was conducted to gain insights on the risk factors associated with flea infestation on cats. Flea combing conducted on 426 cats from four distinct regions in Peninsular Malaysia revealed a relatively high rate of flea infestation on 306 cats (71.83%). A total of 651 fleas were collected, all of them were identified as Ctenocephalides felis with the total intensity of 2.13 and abundance of 1.53. The sex ratio of fleas was female-biased at 2.5:1 (♀=464, ♂=187). Statistical analysis of the data revealed that flea infestation was significantly (P<0.05) associated with several risk factors including region, age, weight, status (stray, sheltered, pet), body condition, and hair length. Higher flea prevalence was also observed in female cats (77.99%), big-sized cats (91.76%), stray cats (84.94%), cats with clean body condition (73.35%), and cats with long hairs (78.38%) as compared to their contemporaries within the same comparison variables. The high infestation of fleas in this study is indicative of cats as a flea reservoir particularly C. felis. Thus the findings of this study and the knowledge gained on the risk factors can be used to develop and improve control measures and management of flea infestations.
    Matched MeSH terms: Female
  4. Choo JE, Samsudin IN, Mat Salleh MJ, Zahari Sham SY, Thambiah SC
    Malays J Pathol, 2020 Dec;42(3):433-437.
    PMID: 33361725
    INTRODUCTION: Salivary cortisol is used as an indicator of stress level and a recommended screening test for Cushing syndrome. The normal reference interval for salivary cortisol is dependent on the analytical methodology and the population studied and hence, establishment of a local population-based reference interval is recommended.

    MATERIALS AND METHODS: A total of 129 healthy blood donors and staffs of Penang General Hospital were recruited from June 2018-May 2019. Paired (morning and late-night) saliva samples were collected from individuals aged between 18 and 60 years old with no history of chronic medical illness. Salivary cortisol was assayed using electrochemiluminescence immunoassay technique. Non-parametric statistics were used for calculation of reference interval and 90% confidence intervals (90% CIs).

    RESULTS: The reference interval for morning and latenight salivary cortisol was 2.09 - 22.63 nmol/L and <12.00 nmol/L, respectively.

    CONCLUSION: The locally-derived adult reference intervals for morning and late-night salivary cortisol concentration was determined and varied with previous studies emphasising the need in establishing individual laboratory reference interval.

    Matched MeSH terms: Female
  5. Mohd Fuad SK, Adznan N, Hayati AR, Virasamy V, Rahim NS
    Malays J Pathol, 2020 Dec;42(3):439-444.
    PMID: 33361726
    INTRODUCTION: Chronic histiocytic intervillositis (CHI) is a rare placental lesion strongly associated with recurrent miscarriages and fetal losses. It requires histopathological diagnosis and can only be made after delivery of the products of conception (POC). We describe a case of CHI in a 41-yearold lady with a 16-year history of thirteen recurrent consecutive first trimester miscarriages.

    CASE REPORT: The patient is a 41-year-old lady who suffered first trimester miscarriages in all her thirteen pregnancies. The relevant clinical investigations revealed neither significant nor helpful findings in determining the cause of recurrent miscarriages. Histological findings in each except one of the submitted conceptual tissue showed similar features of histiocytic aggregates primarily within the intervillous spaces, a characteristic description of CHI. One of the samples showed degenerative changes.

    DISCUSSION: Practicing pathologists are not familiar with the histological features of CHI and this may be a potential pitfall in routine examination of POCs. Recognising this entity allows for accurate diagnosis and hence better management. The aetiology remains unclear, although an immunopathological basis are being explored.

    Matched MeSH terms: Female
  6. Zyoud TYT, Abdul Rashid SN, Suppiah S, Mahmud R, Kabeer A, Abd Manaf R, et al.
    Malays J Pathol, 2020 Dec;42(3):423-431.
    PMID: 33361724
    INTRODUCTION: Post-mortem computed tomography (PMCT) provides information that helps in the determination of the cause of death and corpse identification of disaster victims. One of the methods for corpse identification includes assessment of the body stature. There is a lack of post-mortem imaging studies that focus on the anthropometric assessment of corpses. Our aim was to identify the relationship between cadaveric spine length and autopsy length (AL) among and autopsy length (AL) among a Malaysian population and derive a regression formula for the estimation of corpse body height using PMCT.

    MATERIALS AND METHODS: We retrospectively assessed 107 cadavers that had undergone conventional autopsy and PMCT. We made 5 measurements from the PMCT that included cervical length (CL), thoracic length (TL), lumbosacral length (LS), total column length of the spine, excluding the sacrum and coccyx (TCL), and ellipse line measurement of the whole spine, excluding the sacrum and coccyx (EL). We compared these anthropometric PMCT measurements with AL and correlated them using linear regression analysis.

    RESULTS: The results showed a significant linear relationship existed between TL and LS with AL, which was higher in comparison with the other parameters than the rest of the spine parameters. The linear regression formula derived was: 48.163 + 2.458 (TL) + 2.246 (LS).

    CONCLUSIONS: The linear regression formula derived from PMCT spine length parameters particularly thoracic and lumbar spine gave a finer correlation with autopsy body length and can be used for accurate estimation of cadaveric height. To the best of our knowledge, this is the first ever linear regression formula for cadaveric height assessment using only post mortem CT spine length measurements.

    Matched MeSH terms: Female
  7. Asnawi AW, Sathar J, Mohamed R, Deraman R, Kumaran S, Hamid SS, et al.
    Indian J Hematol Blood Transfus, 2016 Jun;32(Suppl 1):251-3.
    PMID: 27408406 DOI: 10.1007/s12288-014-0495-9
    Clinical manifestations of sickle cell disease (SCD) arise from the tendency of the sickle haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape. Sickle cell crisis is a devastating complication that may occur in patients with SCD. If not managed properly permanent organ damage and even death may be the final outcome. A case of a 32-year-old Nigerian lady, Gravida 1 Para 0 in her first trimester, with SCD who developed signs and symptoms of delayed haemolytic transfusion reaction after receiving packed red cell transfusion is demonstrated. Multiple red cell alloantibodies were detected in the patient's plasma; anti-Fy a, anti-Jk b and anti-E. The patient miscarriaged and succumbed to complications of hyperhaemolysis with delayed haemolytic transfusion reaction, acute chest syndrome and renal failure. There is an urgent need for mandatory red cell antibody screen and identification especially in high-risk cases. Prevention of alloimmunization by supplying phenotype-specific red cells is also required.
    Matched MeSH terms: Female
  8. Mohd Zaki F, Moineddin R, Grant R, Chavhan GB
    Pediatr Radiol, 2016 Nov;46(12):1684-1693.
    PMID: 27406610
    BACKGROUND: Safety concerns are increasingly raised regarding the use of gadolinium-based contrast media for MR imaging.

    OBJECTIVE: To determine the accuracy of pre-contrast abdominal MR imaging for lesion detection and characterization in pediatric oncology patients.

    MATERIALS AND METHODS: We included 120 children (37 boys and 83 girls; mean age 8.94 years) referred by oncology services. Twenty-five had MRI for the first time and 95 were follow-up scans. Two authors independently reviewed pre-contrast MR images to note the following information about the lesions: location, number, solid vs. cystic and likely nature. Pre- and post-contrast imaging reviewed together served as the reference standard.

    RESULTS: The overall sensitivity was 88% for the first reader and 90% for the second; specificity was 94% and 91%; positive predictive value was 96% and 94%; negative predictive value was 82% and 84%; accuracy of pre-contrast imaging for lesion detection as compared to the reference standard was 90% for both readers. The difference between mean number of lesions detected on pre-contrast imaging and reference standard was not significant for either reader (reader 1, P = 0.072; reader 2, P = 0.071). There was substantial agreement (kappa values of 0.76 and 0.72 for readers 1 and 2) between pre-contrast imaging and reference standard for determining solid vs. cystic lesion and likely nature of the lesion. The addition of post-contrast imaging increased confidence of both readers significantly (P 

    Matched MeSH terms: Female
  9. Lam CS, Teng TK, Tay WT, Anand I, Zhang S, Shimizu W, et al.
    Eur Heart J, 2016 11 01;37(41):3141-3153.
    PMID: 27502121 DOI: 10.1093/eurheartj/ehw331
    AIMS: To characterize regional and ethnic differences in heart failure (HF) across Asia.

    METHODS AND RESULTS: We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6 ± 13.1 years, 78.2% were men, and mean body mass index was 24.9 ± 5.1 kg/m2. Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions.

    CONCLUSIONS: These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics.

    CLINICALTRIALSGOV IDENTIFIER: NCT01633398.
    Matched MeSH terms: Female
  10. Ho, S.E., Sumathi, U., Ismail, M.S., Choy, Y.C., Ahmad Zailani, H., Liu, C.Y.
    Medicine & Health, 2013;8(1):33-36.
    MyJurnal
    Child birth is associated with severely painful experience for the parturient, and often exceeds one’s expectations. Even though, severe pain is non life-threatening condition in healthy parturient women, it may lead to undesired neuropsychological consequences. When no analgesia was used, postnatal depression may be more common, and this labour pain leads to the development of post-traumatic stress disorder. Epidural analgesia is now considered gold standard for effective pain relief during labour. We here report a case of a 37-year-old G1 P0 patient at term gestation who successfully used epidural analgesia for labour pain management.
    Matched MeSH terms: Female
  11. Esa, R., Razak, I.A.
    Ann Dent, 1996;3(1):-.
    MyJurnal
    In Malaysia the School Dental Service (SDS) provides comprehensive dental treatment with the aim of rendering the child dentally fit before leaving primary school at 12 years. Hence the purpose of this study was to investigate I) the prevalence and treatment needs of traumatised permanent incisors and 2) to assess their relationship to the degree of incisor overjet amongst 12-13 year-old schoolchildren. The sample comprised of 1519 schoolchildren attending 20 secondary government and government-aided schools in Klang district. There were 772 boys and 747 girls. The sampling procedure involved a multistage, clustered and stratified random sampling. The prevalence of traumatic injuries in permanent incisors was 2.6% which confirmed the results of a previous local study. Boys suffered more trauma than girls with a ratio of about 1.5:I. A majority (77.5% ) of the children had one tooth affected. The most commonly affected teeth were the upper central incisors (91.8%) followed by the lower central incisors (4.1%). A high percentage (57.5%) of children with traumatised anterior teeth had increased overjet (>3mm). Almost all cases (93.9%) required two or more surface fillings. However the majority of affected children (56%) were satisfied with their appearance. It is concluded that traumatic dental injuries should be incorporated as part of the treatment plan for the SDS and appropriately managed soon after occurrence or not later than 12 years after which they leave the SDS. Future epidemiological studies should also give due emphasis to the relative importance of traumatised teeth in children.
    Matched MeSH terms: Female
  12. Raja Muhammad Zuha, Balkhis Bashuri, Supriyani Mustamin, Baharudin Omar, Nazni Wasi Ahmad
    MyJurnal
    In forensic entomology practice, it is more common to use raw animal tissue to breed dipteran larvae and it often brings unpleasant odour in the laboratory. Few studies suggested the use of synthetic diets, mainly agar-based media, as alternatives to animal tissue but it is rarely being practiced in forensic entomology laboratory. The present study observed the growth of a forensically important fly, Megaselia scalaris (Loew) on raw cow’s liver, nutrient agar, casein agar and cow’s liver agar. A total of 100 M. scalaris eggs were transferred each into the different media and placed in an incubator at 30°C in a continuous dark condition. Data on length and developmental period were collected by randomly sampling three of the largest larvae from each rearing media, twice a day at 0900 and 1500 hours until pupariation. M. scalaris larvae reared on raw cow’s liver recorded the highest mean length (4.23 ± 1.96 mm) followed by cow’s liver agar (3.79 ± 1.62 mm), casein agar (3.14 ± 1.16 mm) and nutrient agar (3.09 ± 1.11 mm). Larval length in raw liver and liver agar were significantly different from those in nutrient and casein agar (p < 0.05). Larvae bred in liver agar and raw liver recorded the shortest larval duration before entering the post-feeding stage (89 hours), followed by nutrient agar (119 hours) and casein agar (184 hours). Total developmental time from oviposition until adult emergence for M. scalaris in liver agar and raw liver was approximately 163 hours. All puparia in nutrient agar and casein agar failed to hatch. This research highlighted the potential use of cow’s liver agar as an alternative diet of raw liver to culture M. scalaris in laboratory.
    Matched MeSH terms: Female
  13. Meftahuddin, T., Anisah, A.B., Mohd Faizal, A.
    MyJurnal
    An outbreak of dengue and dengue haemorrhagic fever was studied in Bandar Baru Bangi, Hulu Langat District which started from epidemiological week 51 of December 2001 until ]anuary 2002. Altogether, 53 cases were reported to the Hulu Langat District Health Office with 24 cases detected in Section I and Section 6, and 5 cases in Section 4 of Bandar Baru Bangi respectively. Two cases were confirmed as dengue haernorrhagic fever (DHF). The majority of the cases were female Malays. The age of the cases ranged from 3 to 60 years with a mean of 29.17 : 13.18 years old. The majority of patients were mainly private sector workers from factories or companies with 29 cases (54.7%) and university students with 14 cases (26.4%). No deaths were reported in this outbreak. On the average, the duration taken for a patient to be admitted from the date of onset was about 4.4 - 2.0 days and the duration taken for notification from the date of admission was about 2.0 - 1.7 days. The majority of cases reported were based on classical clinical features of dengue fever. Only 18 cases (34%) were IgM positive for dengue. The statistical analysis showed that the majority were male (P>0.05), Malays (P>0.05) , age group of 21»30 years (P>0.05), platelets level < 100,000 per mm3 (p>0.05) and the serological specimens obtained 5 days after the date of onset (p2.0%) within residential premises in this locality with 46 Aedes mosquito breeding places identified and a total amount of RM 6500 of fines imposed.
    Matched MeSH terms: Female
  14. Adibah, I., Khursiah, D., Ahmad, A.I., Zaki, N.N.M.
    MyJurnal
    Introduction: The aim of treatment for hyperemesis gravidarum is to stop vomiting, correction of dehydration, starvation and electrolytes imbalance. The common types of fluid used for fluid replacement are isotonic solutions like normal saline and hartman's solutions. The absence of potassium in normal saline makes hartman's solution superior but there is a possibility that the lactate component in hartman's solution could worsen the starvation state of the patients. This study is to evaluate which of these two solutions is more effective for fluid replacement in hyperemesis gravidarum. The objectives are to compare which solution corrects dehydration, hypokalaemia and acetonuria faster and to evaluate whether the ketosis state is aggravated by lactate component in hartman's solution. Materials and Methods: Patients with hyperemesis gravidarum were randomised to receive either Hartman's solution or normal saline at the rate of 125mls/hour. Blood urea and serum electrolytes, haematocrit, lactate and urine acetone were taken during admission and repeated every 12 hours. The volume of fluid required to correct dehydration, hypokalaemia and acetonuria were compared. Comparison of the pre and post treatment level of serum lactate were also done. Results: Both hartman's solution and normal saline are both effective in correcting dehydration (11.52±3.28 pints versus 11.94 ± 2.30pints respectively) and acetonuria (11.64 ± 2.75 pints versus 11.64 ± 2.54 pints respectively).
    A lower volume of hartman's solution was needed to correct hypokalaemia (8.34 ± 2.44 pints versus 8.88 ± 2.63 pints) but was not statistically significant. Ketonaemia was not made worse after treatment with hartman's solution. Conclusion: Normal saline and hartman's solution are equally effective in treating complications of hyperemesis gravidarum.
    Matched MeSH terms: Female
  15. Mubarak, M.Y., Noordini, M.D.
    MyJurnal
    Pyomyoma (suppurative leiomyoma) is a rare complication of uterine leiomyoma. It results from infarction and infection of a leiomyoma. It may lead to diagnostic and therapeutic difficulties with potential complications such as bacteraemia, uterine rupture, compressive effect to adjacent structures and even death. We report a case of pyomyoma based on the Ultrasound (US) and Computed Tomography (CT) findings and literature review on the subject.
    Matched MeSH terms: Female
  16. Lim, K.J., Omar, M.H., Jamil, M.A., Ng, S.P.
    MyJurnal
    Introduction: Operative laparoscopy is the gold standard approach for treatment of tubal pregnancy. Although benefits of this approach are well established, data on its uptake trend in Malaysia is largely unknown. Objective: This study aims to determine the operative laparoscopy uptake in management of tubal pregnancy at a busy tertiary hospital and whether the benefits associated with laparoscopic surgery was achieved. Materials and Methods: This prospective observational study was conducted on all women admitted for tubal pregnancy at Hospital Sultanah Aminah, Johor Bahru, a public tertiary hospital over a period of 12 months. The on-call team was responsible for the surgical approach. Patient’s clinical presentation, operative laparoscopic uptake, factors affecting the choice of approach and duration of hospitalization were analyzed. Results: The tubal pregnancy rate was 7.6 per 1000 deliveries. Twenty- seven of the 138 cases (20%) had hypovolemic shock, requiring urgent laparotomy and were excluded from study. The operative laparoscopy rate for stable tubal pregnancy was only 42.3% (47 of 111 cases). Women managed laparoscopically were associated with a significantly higher pre-operative hemoglobin level, mostly nullipara and had surgery performed during office hours. They waited longer for their surgery but were discharged earlier compared to the laparotomy group. There was no difference in the duration of hospitalization. Conclusions: Less than half of all hemodynamically stable tubal pregnancies in our hospital had operative laparoscopy. The current laparoscopy uptake rate can be further improved.
    Matched MeSH terms: Female
  17. Lim, S.S., Shireene, V., Vijay, A., Tan, T.B.A., Rokiah, P., Chan, S.P.
    JUMMEC, 2007;10(1):34-38.
    MyJurnal
    We report a 33-year-old Malay lady who presented with fever, tonsillitis and pharyngitis a month after initiation of antithyroid therapy (carbimazole 15 mg tds) for thyrotoxicosis by her general practitioner. She was still clinically and biochemically thyrotoxic but not in thyroid storm. At that time, she was also confirmed to be four weeks pregnant. Her full blood count revealed neutropaenia with an absolute neutrophil count of 0.036 × 109/L. Bone marrow aspirate and trephine were compatible with carbimazole-related agranulocytosis. Carbimazole was discontinued and she was given broad spectrum antibiotics and Granulocyte Colony Stimulating Factor (GCSF), to which she responded. Verapamil was used for symptomatic heart rate control instead of beta-blockers as she had a history of bronchial asthma. The patient subsequently opted for termination of pregnancy after which she was given radioactive iodine I131 (10 mCi) for definitive therapy of her thyrotoxicosis. In conclusion, carbimazole-related agranulocytosis is an important entity to recognise and treat early to prevent morbidity and mortality. Termination of pregnancy was carried out as the treatment given during the episode of agranulocytosis may have negative effects on foetal viability and growth.
    Matched MeSH terms: Female
  18. Daud, S.S., Ibrahim, K., Ariffin, H.
    JUMMEC, 2007;10(1):11-16.
    MyJurnal
    We aimed to establish a method for quantitative analysis of mixed haematopoietic chimerism based on microchip electrophoresis of selected molecular markers following PCR amplification for accurate monitoring of graft status post-transplantation. A 12-year-old girl with relapsed acute lymphoblastic leukaemia who underwent allogeneic bone marrow transplantation had qualitative chimerism analysis using short tandem repeat markers at three time points following the procedure. Her archived DNA samples were then used to test the ability to correlate her clinical course with changes in the quantity of donor chimerism at the different time points. Quantitative chimerism analysis was performed on the Agilent 2100 bioanalyser and donor-recipient ratios were calculated from generated electropherograms. Complete donor chimerism (98%) was demonstrated three weeks post- transplantation. Decreasing amount of donor chimerism to 24% was shown after three months and this concurred with clinical relapse. Following a second transplant, full donor chimerism was reestablished where donor chimerism rose to 100%. High resolution microchip electrophoresis could be useful in predicting the occurrence of increasing recipient chimerism which may herald impending relapse in patients while the disease burden is still low. This investigational approach may provide useful information for clinicians to select appropriate intervention strategies to ensure successful transplantation.
    Matched MeSH terms: Female
  19. Nalliah, Sivalingam
    MyJurnal
    This is a cross sectional study conducted in July 2010 at the International Medical University, Seremban, Malaysia. The objective of this study was to ascertain the relationship between working memory capacity of final MBBS medical students using the digit span backward test and their academic achievement based on the total score at the modified
    essay questions (MEQ) which was the principal component of the theory examination. Seventy eight final year medical students were recruited,41 (52.6%) were females and remaining 37 (47.4%) were males. Working memory capacity was measured by digit span backward test (DSBT) which ranged from3 to 8 digits. The mean digit score was 6.6 ± 1.1 falling under the category of ‘above average’ score. There was no significant difference between working memory capacity and gender (p>0.05). There was no significant difference in the MEQ mean score and the different categories of working memory capacity (p>0.05).
    The DBST shows uniformity in working memory adequate to pass the modified essay questions. Medical students appear to use encoding and retrieval process in problem solving based on functionality and pattern recognition in tackling the problems in the MEQ.
    Matched MeSH terms: Female
  20. Iftikhar, E., Khan, Humayun I., Rabia, T., Sheikh, Shabbir A., Malik, Aaqil, Nor Iza A. Rahman
    MyJurnal
    Objective: To describe the effect of mycophenolate mofetil in Pakistani children with steroid dependent and steroid resistant nephrotic syndrome. Methods: This is cross sectional retrospective review of 16 patients; 9 boys and 7 girls (11 SD/FRNS and 5 SRNS) for a period of 4.8 years. This study was conducted in Mayo hospital and Fatima Memorial hospital specialist care centre, Lahore involving urban and suburban population. Results: The median age of the group was 4 years (1.6 to 12.6 years). Seven patients had histological diagnosis of MCN, 3 had diffuse mesangial proliferation, one of membranoproliferative glomerulonephritis and 4 had FSGS. Out of 5 SRNS 4 were found to have FSGS and 1 had membranoproliferative glomerulonephritis (MPGN). A total of three patients were completely off steroids and in two patients MMF was also successfully stopped. Number of relapses /patient /year calculated by applying Wilcoxan signed rank test was found to be 4.31 + 0.87(3.00-6.00 /patient/year) before starting MMF, which dropped to 1.12 + 0.718 (0.00- 2.000 /patient/year) after starting MMF, p=0.0001. Reduction in steroid dose from mean of 0.85 + 0.18 mg/kg/day to 0.3mg/kg/day + 1.56 was achieved in 12 months, p
    Matched MeSH terms: Female
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