MyMedR

Fulltext Pegylated interferon alfa-2b (peg-intron) plus ribavirin (rebetol) in the treatment of chronic hepatitis C: a local experience

Seow EL, Robert Ding PH

Med J Malaysia, 2005 Dec;60(5):637-41.

PMID: 16515116

This was an open-label, uncontrolled study with the aim of assessing the efficacy and safety of pegylated interferon alfa-2b plus ribavirin in the treatment of chronic hepatitis C. The study was conducted in Island Hospital, Penang beween January 2002 and December 2003. Thirty-three patients were enrolled in this study with ten defaulters. The overall sustained virological response (SVR) (Intention-To-Treat analysis) in naïve patients was 39.10%. However, when the study was adjusted to only include those who completed treatment and follow-up, overall SVR as 52.9%. Side-effects were tolerable in most patients with anaemia occurring in 22 patients (66.7%), leukopenia 23 patients (69.7%) and thrombocytopenia in 15 patients (45.5%). This study showed that pegylated interferon alfa-2b 1.5 mcg/kg/week plus ribavirin > 10.6 mg/kg/day is efficacious and safe to be used in the treatment of: chronic hepatitis C.

Fulltext Surgical management of large acoustic neuromas: a review

Philip R, Prepageran N, Raman R, Jennifer LP, Waran V

Med J Malaysia, 2009 Dec;64(4):294-7.

PMID: 20954553 MyJurnal

Acoutic neuromas operated at UMMC from 2001 to 2006 were retrospectively reviewed. There were a total of 27 cases. All tumors were large, measuring more than 2 cm. Hearing loss was the most common presenting symptom (63%), followed by headache (52%), dysequilibrium (30%), facial numbness (30%), tinnitus (26%) and gait disturbances (15%). Eleven (41%) of patients had hydrocephalus at the time of presentation, for which a shunt procedure was required. The translabrynthine (TL) approach was used for 12 patients and the retrosigmoid (RS) with or without presigmoid clearance for the remaining 15. Major complications included one mortality and three cerebrovascular accidents (CVA's). The one-year facial nerve outcome was good to acceptable in 62% (House-Brackmann Grade I - IV) of patients. A literature review of current management of acoustic neuromas is presented.

Term interstitial pregnancy with uterine conservation

Ng PH, NorAzlin MI, Nasri NI

Int J Gynaecol Obstet, 2007 Dec;99(3):251.

PMID: 17888439

Increased work pace is unprofitable: a beef-cutting case study

Vogel K, Karltun J, Yeow PH, Eklund J

Meat Sci, 2015 Jul;105:81-8.

PMID: 25828161 DOI: 10.1016/j.meatsci.2015.03.009

The beef industry worldwide is showing a trend towards increased cutting pace aimed at higher profits. However, prior research in the duck meat industry suggested that a higher cutting pace reduced quality and yield, leading to losses. This study aimed to test this hypothesis by investigating the effects of varying beef-cutting paces on yield, quality and economy. A field experiment was conducted on six workers cutting beef fillet, sirloin and entrecôte. Three types of paces were sequentially tested: Baseline (i.e., status quo), 'Quantity focus' (i.e., pace required to maximise quantity) and 'Quality focus' (i.e., pace required to minimise errors). The results showed a significant drop in yield, increased rate of quality deficiency and economic losses with the change to 'Quantity focus' (from Baseline and 'Quality focus') for all meat types. Workers supported these results and also added health problems to the list. The results confirmed that an increased cutting pace is unprofitable.

Fulltext The future of the health services in Malaysia. A report of a committee of council of the Malaysian Medical Association

Rajakumar MK, Suleiman AB, Lee CH, Cheah M, Yeoh PH

Citation: Rajakumar MK, Abu Bakar Suleiman, Lee CH, Cheah M, Yeoh PH. The Future of The Health Services in Malaysia. A Report of a Committee of Council of the Malaysian Medical Association. Kuala Lumpur: Malaysian Medical Association, 1980

Cytogenetic analysis of invasive breast cancer: a study of 27 Asian patients

Tan PH, Lui WO, Ong P, Lau LC, Tao M, Chong Y

Cancer Genet. Cytogenet., 2000 Aug;121(1):61-6.

PMID: 10958943

Tumor cytogenetic analysis from 27 patients with breast cancer diagnosed at the Singapore General Hospital revealed complex karyotypic aberrations in 12 cases. The study group comprised 25 women and 2 men, ranging in age from 33 to 78 years (median 52 years). Ethnic distribution consisted of 22 Chinese, 3 Malaysian, and 2 Indian patients. Pathologic assessment disclosed 24 invasive ductal, 2 invasive mucinous, and 1 mixed invasive mucinous and ductal carcinomas. Histologic grading showed 3 grade 1, 10 grade 2, and 12 grade 3 tumors; 2 cancers were not graded, because they had been subjected to prior chemotherapy. Tumor sizes ranged from 1.5 to 10 cm (median 3 cm). Eleven cases were axillary node negative, whereas the remaining 16 node-positive cancers affected as many as 3 nodes in 8 cases and 4 or more nodes in another 8. Twenty cases demonstrated estrogen-receptor positivity, and 8 cases progesterone-receptor positivity. The spectrum of cytogenetic abnormalities involved chromosomes 1, 3, 6, 7, 8, 11, 16, and 17 and ranged from gains and deletions of both long and short arms, trisomy, monosomy, and other rearrangements. There was a trend toward the presence of karyotypic abnormalities in tumors of higher grade.

Pyomyositis revisited

Kong NC, Asmah J, Lim VK, Ong PH, Adam PA

Ann Acad Med Singap, 1996 Jul;25(4):609-11.

PMID: 8893941

Pyomyositis, purportedly a common tropical infection affecting mainly healthy adults and children, appears to be most uncommon in this region. We report a case of pyomyositis caused by a Methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy army officer. This case serves to illustrate the difficulty in recognising this disease entity, which is why many cases may have been missed. With the increasing incidence of MRSA nosocomial infections, the emergence of MRSA in a hitherto community-acquired infection poses a major concern especially since intravenous drug abuse and acquired immune deficiency syndrome (AIDS) are on the rise in our country. We hope to inculcate greater awareness of this infection.

Fulltext Pressure ulcers--randomised controlled trial comparing hydrocolloid and saline gauze dressings

Chang KW, Alsagoff S, Ong KT, Sim PH

Med J Malaysia, 1998 Dec;53(4):428-31.

PMID: 10971989

An open comparative randomised study comparing the performance of hydrocolloid dressings (DuoDERM CGF) to saline gauze dressings in the treatment of pressure ulcers was done to evaluate the overall dressing performance, wound healing and cost effectiveness. Thirty-four subjects were enrolled at the University Hospital, Kuala Lumpur over a 643 days period. Inclusion criteria were Stage II or III pressure ulcers, at least 18 years of age and written informed consent. Only one pressure ulcer per subject was enrolled in the study. Patients with infected pressure ulcers, diabetes mellitus, an immuno-compromised status and known sensitivity to the study dressings were excluded. Subjects who met the enrollment criteria were randomised to one of the two dressing regimes. They were expected to participate in the study for a maximum of eight weeks or until the pressure ulcer healed, which ever occurred first. Overall subject age averaged 58 years and the mean duration of pressure ulcer existence was about 1 month. Twenty-one of the thirty-four ulcers enrolled were stage II and thirteen were stage III. The majority of the ulcers (88%) were located in the sacral area and seventeen subjects (50%) were incontinent. In the evaluation of dressing performance in terms of adherence to wound bed, exudate handling ability, overall comfort and pain during dressing removal; all favoured the hydrocolloid dressing by a statistically significant margin (p < 0.001). Subjects assigned the hydrocolloid dressing experienced a mean 34% reduction from their baseline surface area measurement compared to a mean 9% increase by subjects assigned gauze dressings. This was not statistically significant (p = 0.2318). In cost evaluation of the study products, there was no statistical significance in the total cost of wound management per subject. When only labour time and cost was evaluated, there was a statistically significant advantage towards hydrocolloid dressings.

Fulltext Retroperitoneal malignant fibrous histiocytoma with renal involvement

Sim PH, Razack AH, Pathmanathan R, Jalleh RP

Med J Malaysia, 1995 Jun;50(2):189-91.

PMID: 7565195

Malignant fibrous histiocytoma is a mesenchymal tumour which can involve the genitourinary organs primarily or by secondary extension. Both conditions are rare. We report four cases of retroperitoneal malignant fibrous histiocytoma involving the kidney by local extension. Diagnosis was difficult because of diverse, non-specific clinical features and may only be reached at operation or post mortem. Prognosis is poor. Although en bloc tumour resection with nephrectomy was possible in two patients, they returned with recurrences.

Antinuclear antibodies in systemic lupus erythematosus

Fong KY, Boey ML, Howe HS, Feng PH

Med J Malaysia, 1989 Jun;44(2):151-5.

PMID: 2626124

Autoantibodies to the three extractable nuclear antigens (ENA), Anti-SSA (Ro), Anti-Sm, Anti-RNP and antinuclear antibodies were determined in 150 patients with SLE. Seventy patients (46.7%) had Anti-SSA (Ro), 40 (26.7%) Anti-Sm and 25 (16.7%) Anti-RNP antibodies. Ninety four percent patients had a positive Fluorescent anti-nuclear antibody (FANA) test. The commonest FANA pattern is the speckled pattern. Subclinical keratoconjunctivitis sicca (KCS) was present in 60% patients. No correlation could be demonstrated between the presence of ENA autoantibodies and the clinical features of patients.

Relationship between immunoglobulin allotypes and susceptibility to nasopharyngeal carcinoma in Malaysia

Tarone RE, Levine PH, Yadav M, Pandey JP

Cancer Res, 1990 Jun 1;50(11):3186-8.

PMID: 1692255

The relationship between immunoglobulin allotypes and risk of developing nasopharyngeal carcinoma was examined in a comparative study of 50 Chinese cases and 140 Chinese controls and 50 Malay cases and 79 Malay controls residing in Malaysia. Although the most common Gm phenotype was elevated in both Chinese and Malay nasopharyngeal carcinoma patients compared to their controls, there were no significant differences between cases and controls in the distribution of Gm haplotypes in either population. There were no differences between cases and controls in the distribution of Km alleles in either population. Thus a previously reported association of Km(1) with increased nasopharyngeal carcinoma risk in Tunisia is not confirmed in two Mongoloid populations in Malaysia.

Concomitant cerebral and breast cryptococcosis

Arumugasamy N, Chin CS, Wong YH, Chew PH

Aust N Z J Surg, 1985 Oct;55(5):517-8.

PMID: 3868419

A patient with a solitary intracranial cryptococcoma of the occipital lobe of the brain and a concomitant granuloma of similar aetiology in the breast is reported. Despite resistance of the causative fungus to 5-fluorocytosine in vitro, the patient responded well to radical excisional surgery and therapy with 5-fluorocytosine.

Fulltext IgM capture ELISA for detection of IgM antibodies to dengue virus: comparison of 2 formats using hemagglutinins and cell culture derived antigens

Cardosa MJ, Tio PH, Nimmannitya S, Nisalak A, Innis B

Southeast Asian J Trop Med Public Health, 1992 Dec;23(4):726-9.

PMID: 1298081

The highly sensitive AFRIMS format IgM capture ELISA for the diagnosis of dengue virus infections requires the use of mouse brain derived hemagglutinins and consequently also the use of 20% acetone extracted normal human serum to eliminate high background. These reagents are not always easily available and we have thus compared the AFRIMS format with another published format which uses cell culture derived antigens (culture fluid, CF, format) in order to determine if it is reasonable to use cell culture derived antigens in situations where hemagglutinins and normal human serum are difficult to obtain. The study shows that using AFRIMS results as the reference point, the CF format described here has a sensitivity of 90% and a specificity of 96%.

Rhabdomyosarcoma of the middle ear and mastoid in children

Said H, Phang KS, Razi A, Khuzaiyah R, Patawari PH, Esa R

J Laryngol Otol, 1988 Jul;102(7):614-9.

PMID: 3411216

Three cases of embryonal rhabdomyosarcoma in the middle ear and mastoid in children are presented. Diagnosis was confirmed by histopathology. A multidisciplinary approach employing surgery, chemotherapy and radiation therapy is the method of choice in the management of this rare and highly lethal condition.

A dot enzyme immunoassay for dengue 3 virus: comparison with the haemagglutination inhibition test

Cardosa MJ, Noor Sham S, Tio PH, Lim SS

Southeast Asian J Trop Med Public Health, 1988 Dec;19(4):591-4.

PMID: 3238470

A dot enzyme immunoassay (DEIA) was used to determine the levels of antibody to dengue 3 virus in the acute and convalescent sera of febrile patients with a clinical diagnosis of dengue fever or dengue haemorrhagic fever. The antibody titres were compared with titres determined by the haemagglutination inhibition (HI) test. The results of the study showed that, besides being more simple to perform, the DEIA is in order of magnitude more sensitive than the HI test. Furthermore, the data suggest that it is possible to use a single dilution as a cutoff point to predict with reasonable accuracy, if a patient has had a recent dengue infection. The DEIA test for antibodies to dengue virus is an appropriate technology highly suitable for rapid diagnosis and surveillance in developing countries.

Fulltext Coronary risk factors among Malaysian male executives in two urban areas

Teo PH, Chong YH, Abdul Rahman MZ

Med J Malaysia, 1988 Jun;43(2):125-33.

PMID: 3237128

Isolation of subgenus B adenovirus during a fatal outbreak of enterovirus 71-associated hand, foot, and mouth disease in Sibu, Sarawak

Cardosa MJ, Krishnan S, Tio PH, Perera D, Wong SC

Lancet, 1999 Sep 18;354(9183):987-91.

PMID: 10501361

In mid-1997, several children died in Sarawak, Malaysia, during an epidemic of enterovirus-71 (EV71) hand, foot, and mouth disease. The children who died had a febrile illness that rapidly progressed to cardiopulmonary failure and the cause was not satisfactorily resolved. We describe the isolation and identification of a subgenus B adenovirus from the children who died.

Fulltext Rapid Generation of a Recombinant Genotype VIII Newcastle Disease Virus (NDV) Using Full-Length Synthetic cDNA

Murulitharan K, Yusoff K, Omar AR, Peeters BPH, Molouki A

Curr Microbiol, 2021 Apr;78(4):1458-1465.

PMID: 33660046 DOI: 10.1007/s00284-021-02421-z

Rescue of (-)ssRNA viruses involves the sequential assembly and cloning of the full-length cDNA, which is often a challenging and time-consuming process. The objective of this study was to develop a novel method to rapidly clone the full-length cDNA of a very virulent NDV by only one assembly step. A completely synthetic 15 kb cDNA of a Malaysian genotype VIII NDV known as strain AF2240-I with additional flanking BsmBI sites was synthesised. However, to completely follow the rule-of-six, the additional G residues that are traditionally added after the T7 promoter transcription initiation site were not synthesised. The synthetic fragment was then cloned into low-copy number transcription vector pOLTV5-phiX between the T7 promoter and HDV Rz sequences through digestion with BbsI. The construct was co-transfected with helper plasmids into BSRT7/5 cells. A recombinant NDV called rAF was successfully rescued using transfection supernatant harvested as early as 16 h post-transfection. Virus from each passage showed an intracerebral pathogenicity index (ICPI) and a mean death time (MDT) similar to the parent strain AF2240-I. Moreover, rAF possessed an introduced mutation which was maintained for several passages. The entire rescue using the one-step assembly procedure was completed within a few weeks, which is extremely fast compared to previously used methods.

Determinants of colorectal carcinoma screening amongst patients attending a public primary care health centre in Johor Bahru

Rizky NPH, Aznida FAA, Wan Fadhilah WI

Med J Malaysia, 2021 05;76(3):346-352.

PMID: 34031333

INTRODUCTION: Colorectal cancer (CRC) is one of the major causes of cancer-related mortality in Malaysia. Early screening has proven to be effective in reducing mortality due to CRC. The Malaysian CRC Clinical Practice Guidelines (2017) recommends that immunochemical faecal occult blood test (iFOBT) as the best non-invasive method for screening CRC in asymptomatic or average risk population. Outcome data on CRC screening program in the community is scarce. This study was to evaluate the prevalence and determinants of CRC among patients attending a public primary care health centre who underwent the screening program.

MATERIALS AND METHODS: Reviews of CRC Screening Registry and medical case record were conducted on patients who underwent CRC screening program at Klinik Kesihatan Mahmoodiah, Johor Bahru (KKMJB) from 2016 to 2018 period. Sociodemographic data, clinical profile of patients, iFOBT results and colonoscopy outcomes were extracted for analysis. Descriptive and inferential statistics were performed using IBM SPSS version 25.

RESULTS: Out of 591 registered patients, 584 were included for analysis. Majority of the screened individuals were males (2016-2017) compared to females (2018). Chinese were most screened individuals in 2016 [94 (46.8%)] and 2017[87 (61.7%)]. Percentage of patients with appropriate indicators for screening and underwent colonoscopy for positive iFOBT were highest recorded in 2018 (74.7%, 58.8% respectively). Prevalence of CRC among those screened with iFOBT was 1 per cent for 2017 and 2018. Adherence to annual screening with iFOBT ranged between 1.1% (2016)- 2.2% (2018). Significant association observed between gender and iFOBT results, χ2(df)= 4.747, p=0.029 (2018). Median age and ethnicity were not significantly associated with iFOBT results (p>0.05) CONCLUSION: Screening for CRC among average risk groups in primary care should focus on recruiting female patients/clients as an organised activity. Prevalence of CRC detected from screening with iFOBT was 1 per cent. CRC screening programs should focus on proportion of iFOBT positive patients progressing to receive definitive colonoscopy and complying to annual surveillance screening.

Fulltext Diagnostic and Vaccination Approaches for Newcastle Disease Virus in Poultry: The Current and Emerging Perspectives

Bello MB, Yusoff K, Ideris A, Hair-Bejo M, Peeters BPH, Omar AR

Biomed Res Int, 2018;2018:7278459.

PMID: 30175140 DOI: 10.1155/2018/7278459

Newcastle disease (ND) is one of the most devastating diseases that considerably cripple the global poultry industry. Because of its enormous socioeconomic importance and potential to rapidly spread to naïve birds in the vicinity, ND is included among the list of avian diseases that must be notified to the OIE immediately upon recognition. Currently, virus isolation followed by its serological or molecular identification is regarded as the gold standard method of ND diagnosis. However, this method is generally slow and requires specialised laboratory with biosafety containment facilities, making it of little relevance under epidemic situations where rapid diagnosis is seriously needed. Thus, molecular based diagnostics have evolved to overcome some of these difficulties, but the extensive genetic diversity of the virus ensures that isolates with mutations at the primer/probe binding sites escape detection using these assays. This diagnostic dilemma leads to the emergence of cutting-edge technologies such as next-generation sequencing (NGS) which have so far proven to be promising in terms of rapid, sensitive, and accurate recognition of virulent Newcastle disease virus (NDV) isolates even in mixed infections. As regards disease control strategies, conventional ND vaccines have stood the test of time by demonstrating track record of protective efficacy in the last 60 years. However, these vaccines are unable to block the replication and shedding of most of the currently circulating phylogenetically divergent virulent NDV isolates. Hence, rationally designed vaccines targeting the prevailing genotypes, the so-called genotype-matched vaccines, are highly needed to overcome these vaccination related challenges. Among the recently evolving technologies for the development of genotype-matched vaccines, reverse genetics-based live attenuated vaccines obviously appeared to be the most promising candidates. In this review, a comprehensive description of the current and emerging trends in the detection, identification, and control of ND in poultry are provided. The strengths and weaknesses of each of those techniques are also emphasised.

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