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Fulltext Pattern of drug utilization in rural Malaysia

Hasamnis AA, Patil SS, Narayan KA, Khan AR, Mohanty BK

Ann Afr Med, 2010 Apr-Jun;9(2):106-7.
PMID: 20587935 DOI: 10.4103/1596-3519.64746
Fulltext A case of Hodgkin's disease presenting with recurrent laryngeal nerve palsy and tracheoesophageal fistula

Munshi A, Pandey MB, Kumar L, Karak AK, Mohanti BK

Med J Malaysia, 2006 Mar;61(1):97-9.
PMID: 16708743

Malignancy is the most common cause of tracheoesophageal fistulas. The malignancies commonly implicated in the development of tracheoesophageal fistulas are primary bronchial or esophageal carcinomas. Hodgkins disease rarely leads to such a fistula. We report a case of Hodgkin's disease with a tracheoesophageal fistula as well as a left recurrent nerve palsy at presentation. This presentation has no precedent in literature. The patient was treated with systemic chemotherapy and involved field radiotherapy. On follow up 1 year after the completion of treatment, he was clinically and radiologically disease free.
Fulltext Co-administration of conjugated linoleic acid and rosiglitazone increases atherogenic co-efficient and alters isoprenaline-induced vasodilatation in rats fed high fat diet

Chai BK, Lau YS, Loong BJ, Rais MM, Ting KN, Dharmani DM, et al.

Physiol Res, 2018 Nov 14;67(5):729-740.
PMID: 29750886

The cis(c)-9, trans(t)-11 (c9,t11) and t10,c12 isomers of conjugated linoleic acid (CLA) have been reported as agonists of peroxisome proliferator-activated receptor (PPAR) and beneficial in lipidemia and glycemia. However, it is unclear whether CLA isomers enhance or antagonize effects of conventional drugs targeting PPAR. Male Sprague-Dawley rats were fed high fat diet (HFD) for 8 weeks and treated without or with CLA, rosiglitazone or both for 4 weeks. Oral glucose tolerance and surrogate markers of insulin resistance were not significantly different for all treatments compared to untreated normal diet (ND) or HFD group, except lipoprotein levels. The combination of CLA and rosiglitazone had suppressed levels of low and high density lipoproteins (46 % and 25 %, respectively), compared to HFD-alone. Conversely, the atherogenic co-efficient of the animals received HFD or HFD+rosiglitazone+CLA was 2-folds higher than ND, HFD+rosiglitazone or HFD+CLA. Isolated aortic rings from the combined CLA and rosiglitazone treated animals were less sensitive to isoprenaline-induced relaxation among endothelium-denuded aortas with a decreased efficacy and potency (R(max)=53+/-4.7 %; pEC50=6+/-0.2) compared to endothelium-intact aortas (R(max)=100+/-9.9 %; pEC50=7+/-0.2). Our findings illustrate that the combination of CLA and rosiglitazone precede the atherogenic state with impaired endothelium-independent vasodilatation before the onset of HFD-induced insulin resistance.
Plasma vitamin C and tocotrienols changes in response to dietary supplementation among young male adults

Zahara AM, Lee CC, Fatimah IS, Poh BK, Khairul O, Das S, et al.

Clin Ter, 2010;161(2):121-4.
PMID: 20499024

Intake of the antioxidant vitamins C and E lowers the oxidative stress. The study aimed to determine plasma concentrations of vitamin C and tocotrienols after supplementation of both vitamins in young male adults.
Fulltext Clinical standards for the diagnosis and management of asthma in low- and middle-income countries

Jayasooriya S, Stolbrink M, Khoo EM, Sunte IT, Awuru JI, Cohen M, et al.

Int J Tuberc Lung Dis, 2023 Sep 01;27(9):658-667.
PMID: 37608484 DOI: 10.5588/ijtld.23.0203

BACKGROUND: The aim of these clinical standards is to aid the diagnosis and management of asthma in low-resource settings in low- and middle-income countries (LMICs).METHODS: A panel of 52 experts in the field of asthma in LMICs participated in a two-stage Delphi process to establish and reach a consensus on the clinical standards.RESULTS: Eighteen clinical standards were defined: Standard 1, Every individual with symptoms and signs compatible with asthma should undergo a clinical assessment; Standard 2, In individuals (>6 years) with a clinical assessment supportive of a diagnosis of asthma, a hand-held spirometry measurement should be used to confirm variable expiratory airflow limitation by demonstrating an acute response to a bronchodilator; Standard 3, Pre- and post-bronchodilator spirometry should be performed in individuals (>6 years) to support diagnosis before treatment is commenced if there is diagnostic uncertainty; Standard 4, Individuals with an acute exacerbation of asthma and clinical signs of hypoxaemia or increased work of breathing should be given supplementary oxygen to maintain saturation at 94-98%; Standard 5, Inhaled short-acting beta-2 agonists (SABAs) should be used as an emergency reliever in individuals with asthma via an appropriate spacer device for metered-dose inhalers; Standard 6, Short-course oral corticosteroids should be administered in appropriate doses to individuals having moderate to severe acute asthma exacerbations (minimum 3-5 days); Standard 7, Individuals having a severe asthma exacerbation should receive emergency care, including oxygen therapy, systemic corticosteroids, inhaled bronchodilators (e.g., salbutamol with or without ipratropium bromide) and a single dose of intravenous magnesium sulphate should be considered; Standard 8, All individuals with asthma should receive education about asthma and a personalised action plan; Standard 9, Inhaled medications (excluding dry-powder devices) should be administered via an appropriate spacer device in both adults and children. Children aged 0-3 years will require the spacer to be coupled to a face mask; Standard 10, Children aged <5 years with asthma should receive a SABA as-needed at step 1 and an inhaled corticosteroid (ICS) to cover periods of wheezing due to respiratory viral infections, and SABA as-needed and daily ICS from step 2 upwards; Standard 11, Children aged 6-11 years with asthma should receive an ICS taken whenever an inhaled SABA is used; Standard 12, All adolescents aged 12-18 years and adults with asthma should receive a combination inhaler (ICS and rapid onset of action long-acting beta-agonist [LABA] such as budesonide-formoterol), where available, to be used either as-needed (for mild asthma) or as both maintenance and reliever therapy, for moderate to severe asthma; Standard 13, Inhaled SABA alone for the management of patients aged >12 years is not recommended as it is associated with increased risk of morbidity and mortality. It should only be used where there is no access to ICS.The following standards (14-18) are for settings where there is no access to inhaled medicines. Standard 14, Patients without access to corticosteroids should be provided with a single short course of emergency oral prednisolone; Standard 15, Oral SABA for symptomatic relief should be used only if no inhaled SABA is available. Adjust to the individual's lowest beneficial dose to minimise adverse effects; Standard 16, Oral leukotriene receptor antagonists (LTRA) can be used as a preventive medication and is preferable to the use of long-term oral systemic corticosteroids; Standard 17, In exceptional circumstances, when there is a high risk of mortality from exacerbations, low-dose oral prednisolone daily or on alternate days may be considered on a case-by-case basis; Standard 18. Oral theophylline should be restricted for use in situations where it is the only bronchodilator treatment option available.CONCLUSION: These first consensus-based clinical standards for asthma management in LMICs are intended to help clinicians provide the most effective care for people in resource-limited settings.
Fulltext The Anticancer, Antioxidant and Antimicrobial Properties of the Sesquiterpene β-Caryophyllene from the Essential Oil of Aquilaria crassna

Dahham SS, Tabana YM, Iqbal MA, Ahamed MB, Ezzat MO, Majid AS, et al.

Molecules, 2015;20(7):11808-29.
PMID: 26132906 DOI: 10.3390/molecules200711808

The present study reports a bioassay-guided isolation of β-caryophyllene from the essential oil of Aquilaria crassna. The structure of β-caryophyllene was confirmed using FT-IR, NMR and MS. The antimicrobial effect of β-caryophyllene was examined using human pathogenic bacterial and fungal strains. Its anti-oxidant properties were evaluated by DPPH and FRAP scavenging assays. The cytotoxicity of β-caryophyllene was tested against seven human cancer cell lines. The corresponding selectivity index was determined by testing its cytotoxicity on normal cells. The effects of β-caryophyllene were studied on a series of in vitro antitumor-promoting assays using colon cancer cells. Results showed that β-caryophyllene demonstrated selective antibacterial activity against S. aureus (MIC 3 ± 1.0 µM) and more pronounced anti-fungal activity than kanamycin. β-Caryophyllene also displayed strong antioxidant effects. Additionally, β-caryophyllene exhibited selective anti-proliferative effects against colorectal cancer cells (IC50 19 µM). The results also showed that β-caryophyllene induces apoptosis via nuclear condensation and fragmentation pathways including disruption of mitochondrial membrane potential. Further, β-caryophyllene demonstrated potent inhibition against clonogenicity, migration, invasion and spheroid formation in colon cancer cells. These results prompt us to state that β-caryophyllene is the active principle responsible for the selective anticancer and antimicrobial activities of A. crassnia. β-Caryophyllene has great potential to be further developed as a promising chemotherapeutic agent against colorectal malignancies.
Fluorescence studies of selected 2-alkylaminopyrimidines

Abdullah Z, Tahir NM, Abas MR, Aiyub Z, Low BK

Molecules, 2004 Jun 30;9(7):520-6.
PMID: 18007451

The reactions of 2-chloropyrimidine with methylamine, ethylamine and piperidine gave the corresponding 2-N-methylamino-, 2-N-ethylamino- and 2N- piperidinopyrimidines, respectively. The fluorescence properties of these alkylamino derivatives in chloroform, ethyl acetate, carbon tetrachloride, acetone, ether, ethanol and methanol were studied. All the alkylamino derivatives showed the highest fluorescence intensity in polar protic solvents; thus 2-N-methylaminopyrimidine (highest fluorescence intensity at 377 nm when excited at 282 nm) and 2-N-ethylaminopyrimidine (highest fluorescence intensity at 375 nm, when excited at 286 nm) showed the highest fluorescence in methanol. In ethanol, 2-N-piperidinopyrimidine showed a fluorescence peak at 403 nm when excited at 360 nm and in chloroform it fluoresced at 392 nm when excited at 356 nm.
The molecular mechanisms of probiotic strains in improving ageing bone and muscle of d-galactose-induced ageing rats

Hor YY, Ooi CH, Lew LC, Jaafar MH, Lau AS, Lee BK, et al.

J Appl Microbiol, 2021 Apr;130(4):1307-1322.
PMID: 32638482 DOI: 10.1111/jam.14776

AIM: The aim of this study was to evaluate the molecular mechanisms of Lactobacillus strains in improving ageing of the musculoskeletal system.
METHODS AND RESULTS: The anti-ageing mechanism of three probiotics strains Lactobacillus fermentum DR9, Lactobacillus paracasei OFS 0291 and L. helveticus OFS 1515 were evaluated on gastrocnemius muscle and tibia of d-galactose-induced ageing rats. Upon senescence induction, aged rats demonstrated reduced antioxidative genes CAT and SOD expression in both bone and muscle compared to the young rats (P
Lactobacilli reduce recurrences of vaginal candidiasis in pregnant women: a randomized, double-blind, placebo-controlled study

Ang XY, Chung FY, Lee BK, Azhar SNA, Sany S, Roslan NS, et al.

J Appl Microbiol, 2021 May 22.
PMID: 34022103 DOI: 10.1111/jam.15158

AIMS: The aim of this study was to investigate the effects of lactobacilli strains in preventing the recurrences of vaginal candidiasis (VC) in 78 pregnant women with VC (lactobacilli, n = 39; placebo, n = 39) and the potential benefits on quality of life.
METHODS AND RESULTS: The lactobacilli putative probiotic (SynForU-HerCare; two capsules/day of 9·5 log CFU per capsule) or placebo was administered for 8-weeks in a randomized, double-blind, placebo-controlled study. Subjects were assessed for vaginal and gut health conditions at baseline, week-4 and week-8 via questionnaires. The vulvovaginal symptom questionnaire not only covered aspects pertaining to vulvovaginal symptoms but also the quality of life impacts such as emotional, social and sexual. The administration of lactobacilli reduced symptoms of irritation (P = 0·023) and discharge (P = 0·011) starting week-4 and continued after week-8 (P
Fulltext Paraquat poisoning: experience in Hospital Taiping (year 2008 - october 2011)

Tan JT, Letchuman Ramanathan G, Choy MP, Leela R, Lim BK

Med J Malaysia, 2013 Oct;68(5):384-8.
PMID: 24632866 MyJurnal

INTRODUCTION: Paraquat is a quaternary nitrogen herbicide which is highly toxic to human. Death is usually from respiratory failure and may occur within days up to a month after exposure. It is easily available and commonly abused to commit suicide.

METHODOLOGY: This is a retrospective study describing the demographic characteristics, clinical features and outcomes of paraquat poisoning cases admitted to Hospital Taiping from 1st January 2008 to 30th October 2011. Medical records of 79 patients were reviewed.

RESULT: Majority were of the Indian ethnicity (72.2%) followed by Chinese (13.9%) and Malay (10.1%). Majority was male (73.4%) and between 20 to 29 years old (34.2%). The median age of the patients was 30 years old. The mean length of stay was 6.2 days. Most exposures were intentional (69.6%) and presented to the hospital early at less than 6 hours after exposure (72.2%). Patients with positive urine paraquat result had significantly higher mortality rate compared to patients with negative results (47.4% vs 15.2% respectively). We found that neither hemofiltration nor immunosuppressive therapies help to improve survival.

CONCLUSION: The non-survivor characteristics of patients with paraquat poisoning are intentional exposure, delay from exposure to hospital admission, urine paraquat positivity and manifestation of respiratory failure. The demographic characteristics, reasons for exposure and mortality rate are similar to previous reports. Urine paraquat may be used to assess severity of the exposure as well as prognosis. Hemofiltration and immunosuppression therapy do not improve patients' survival and paraquat remains a lethal killer.
The opium smoking habit and its treatment

Lim BK

Journal of the Malaya Branch of the British Medical Association, 1905.
University of Hong Kong. Address by the Hon. Dr. Lim Boon Keng.

Lim BK

J Trop Med Hyg, 1919;22:77-9.

On tlie occasion of his being elected an Honorary LL.D. of the University of Hong-Kong in January, 1919, Dr. Lim Boon Keng, of Singapore, addressed the assembly in the University Hall as follows:—
Tuberculosis among the Singapore Chinese

Lim BK

Journal of the Malaya Branch of the British Medical Association, 1903.
Erratum to "The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)" [Gynecol. Oncol. 144 (2017) 405-413]

Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, et al.

Gynecol Oncol, 2017 Jul 05.
PMID: 28687170 DOI: 10.1016/j.ygyno.2017.06.032
Bone health among older persons in medical clinic: A clinical audit

Teh CL, Chuah SL, Lee HK, Wan SA, Leong TS, Tan FHS, et al.

Med J Malaysia, 2020 03;75(2):191-193.
PMID: 32281610

Osteoporosis is commonly underdiagnosed and undertreated. We performed a clinical audit to assess the risk factors and clinical care for osteoporosis among older persons who attended medical clinic during a 4-week period in August 2013. There was a total of 128 patients with a mean age of 73.1±5.8 years, and 20.3%. had a history of fall. Fracture Risk Assessment Tool (FRAX) scores assessment showed 14.2% and 68.8% had a 10-year risk of major osteoporotic and hip fractures respectively. Only 6.3% underwent Dual-energy X-ray absorptiometry (DXA) and 73.4% did not receive any preventive treatment for osteoporosis. Older persons attending medical clinic at high risk of osteoporosis fractures did not receive appropriate screening and treatment. There is a need to improve the suboptimal care for bone health among older persons.
Hypothalamic-pituitary fungal infection causing panhypopituitarism

Chin YH, Yap YL, Chin HH, Lau BK

Med J Malaysia, 2021 07;76(4):606-609.
PMID: 34305132

Madam LPS, a 69 years old lady complained of left eye blurring of vision since January 2017. It was associated with left orbital swelling with chemosis, eye redness, epiphora, several episodes of self-limiting epistaxis and bilateral ophthalmoplegia. Other neurological examinations and cerebellar systems were intact. Magnetic Resonance Imaging (MRI) Brain and Orbit were performed, depicting a sellar mass with suprasellar extension with blood investigations results showed panhypopituitarism. She underwent bilateral orbital decompression. Trans-nasal endoscopic biopsy showed suppurative granulomatous lesion, which cultured Candida Albicans and Candida Galbrata. She was started on antifungal and hormonal replacement therapy for panhypopituitarism. Unfortunately, she did not respond well to treatment as repeated MRI Brain on December 2018 showed increase in size of sellar mass causing obstructive hydrocephalus and increasing size of left orbital lesion. She was counselled for another debulking surgery with a ventriculoperitoneal (VP) shunt. HPE taken were reported as chronic inflammatory process in favour to fungal infection. Pituitary infections may mimic pituitary mass. Some may exhibit symptoms of panhypopituitarism as well. Thus, physical examination, MRI brain imaging as well as HPE of biopsy are important aids to achieve diagnosis. Optimal treatment of fungal pituitary abscess includes transsphenoidal surgery combined with antifungal therapy.
Immunoglobulin levels in various clinical groups of human Brugian filariasis in Malaysia

Sim BK, Mak JW, Kwa BH

Z Parasitenkd, 1983;69(3):371-5.
PMID: 6880344

Quantitation of serum immunoglobulin M, G, A, D and E levels was carried out in Malaysians with Brugia malayi infections. Results showed highly elevated levels of IgM and IgE as well as moderately elevated levels of IgG. These were most significant in patients with tropical pulmonary eosinophilia or elephantiasis. Serum IgE levels were extremely high in microfilaraemic patients (6,060 +/- 3,958 IU ml) probably due to a constant antigenic stimulation by dead and dying microfilariae.
Fulltext Application of geophysical techniques for 3D geohazard mapping to delineate cavities and potential sinkholes in the northern part of Kuala Lumpur, Malaysia

Bakhshipour Z, Huat BB, Ibrahim S, Asadi A, Kura NU

ScientificWorldJournal, 2013;2013:629476.
PMID: 24501583 DOI: 10.1155/2013/629476

This work describes the application of the electrical resistivity (ER) method to delineating subsurface structures and cavities in Kuala Lumpur Limestone within the Batu Cave area of Selangor Darul Ehsan, Malaysia. In all, 17 ER profiles were measured by using a Wenner electrode configuration with 2 m spacing. The field survey was accompanied by laboratory work, which involves taking resistivity measurements of rock, soil, and water samples taken from the field to obtain the formation factor. The relationship between resistivity and the formation factor and porosity for all the samples was established. The porosity values were plotted and contoured. A 2-dimensional and 3-dimensional representation of the subsurface topography of the area was prepared through use of commercial computer software. The results show the presence of cavities and sinkholes in some parts of the study area. This work could help engineers and environmental managers by providing the information necessary to produce a sustainable management plan in order to prevent catastrophic collapses of structures and other related geohazard problems.
Fulltext Attitude of doctors towards physical characteristics of solid oral dosage forms

Hasamnis AA, Patil SS, Mohanty BK, Thu K, Kumar A

J Pharm Bioallied Sci, 2010 Apr;2(2):151.
PMID: 21814452 DOI: 10.4103/0975-7406.66998
Co-digestion of palm oil mill effluent for enhanced biogas production in a solar assisted bioreactor: Supplementation with ammonium bicarbonate

Zaied BK, Nasrullah M, Siddique MNI, Zularisam AW, Singh L, Krishnan S

Sci Total Environ, 2020 Mar 01;706:136095.
PMID: 31862587 DOI: 10.1016/j.scitotenv.2019.136095

Lack of sufficient nitrogenous substrate and buffering potential have been acknowledged as impediments to the treatment of palm oil mill effluent through co-digestion processes. In this study, ammonium bicarbonate was used to provide the nitrogenous substrate and buffering potential. To regulate the impact of ammonium bicarbonate toxicity on the anaerobic co-digestion system, dosages from 0 to 40 mg/L were supplemented. The biogas yield was used to indicate the effects of NH4+ toxicity. In a solar-assisted bioreactor, solar radiation was first collected by a solar panel and converted into electricity, which was then used to heat a mixture of palm oil mill effluent and cattle manure to maintain the reactor in the mesophilic temperature range. This co-digestion operation was performed semi-continuously and was analyzed at a 50:50 mixing ratio of palm oil mill effluent and cattle manure. The results indicate that the additional dosing of ammonium bicarbonate can significantly enhance biogas production. Maximum cumulative biogas and methane productions of 2034.00 mL and 1430.51 mL, respectively, were obtained with the optimum addition of 10 mg/L ammonium bicarbonate; these values are 29.80% and 42.30% higher, respectively, than that obtained in the control co-digestion operation without addition of ammonium bicarbonate. Utilization of a mathematical equation (G = Gmk/t) to describe a kinetic analysis of the biogas yield also indicated that the optimum ammonium bicarbonate dose was 10 mg/L. The results of this study suggest that supplementation with ammonium bicarbonate doses of up to 40 mg/L can be used to provide nitrogenous substrates and buffering potential in anaerobic co-digestion processes. The determination of the optimal dose provides an alternative and efficient option for enhanced biogas production, which will have obvious economic advantages for feasible industrial applications.

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