MyMedR

Experimental investigation of the flow of bile in patient specific cystic duct models

Al-Atabi M, Chin SB, Luo XY

J Biomech Eng, 2010 Apr;132(4):041003.

PMID: 20387966 DOI: 10.1115/1.4001043

Three-dimensional scaled-up transparent models of three human cystic ducts were prepared on the basis of anatomical specimens. The measurement of pressure drop across the cystic duct models and visualization of the flow structures within these ducts were performed at conditions replicating the physiological state. The flow visualization study confirmed the laminar nature of the flow of bile inside the cystic duct and values of pressure drop coefficient (Cp) decreased as the Reynolds number (Re) increased. The three tested models showed comparable behavior for the curve of Reynolds number versus the pressure drop coefficient. The results show that the tested cystic ducts have both increased pressure drop and complicated flow structures when compared with straight conduits. High resistance in a cystic duct may indicate that the gallbladder has to exert large force in expelling bile to the cystic duct. For patients with diseased gallbladder, and even in healthy persons, gallbladder is known to stiffen with age and it may lose its compliance or flexibility. A high resistance cystic duct coupled with a stiffened gallbladder may result in prolonged stasis of bile in the gallbladder, which is assumed to encourage the formation of gallstones.

Experiences from a medical students' well-being workshop

Yusoff MS, Rahim AF

Med Educ, 2009 Nov;43(11):1108-9.

PMID: 19874520 DOI: 10.1111/j.1365-2923.2009.03474.x

Fulltext Awareness of prostatism among male patients in Teluk Intan Hospital

Zainal SB, Quek KF, Biswajit C

Med J Malaysia, 2005 Dec;60(5):540-7.

PMID: 16515103

To determine the relationship between socio-demography, knowledge and attitude regarding prostatism among male in-patients in Teluk Intan Hospital. Two hundred respondents were recruited. Questionnaires that consist of demographic data such as age, ethnicity and religion and some question that pertaining knowledge and awareness were used. The questions eliciting symptoms of prostatism were based on the International Prostate Symptom Score (IPSS). 76.0% of the respondents were symptomatic as they presented with prostatic symptoms. The prevalence of asymptomatic cases is higher (6.7%) among the adults whereas the percentage in elderly respondents is higher than the adults in moderate to severe cases (p < 0.001). Only 10% of respondents have heard about prostatism and mass media is ranked highest as the most preferred source of information regarding this matter with 66.7% preference. About 85.70% of respondents who had a severe score and 18.5% who had a moderate score were dissatisfied with their quality of life due to prostatic symptoms. This study provides a deeper understanding on the prevalence and severity of the prostatic symptoms and its association with the quality of life. It also illustrates low awareness, poor health seeking behaviour and poor knowledge pertaining to prostatism among the study population.

Fluoroquinolones for treating tuberculosis

Ziganshina LE, Vizel AA, Squire SB

Cochrane Database Syst Rev, 2005.

PMID: 16034951

Fluoroquinolones are sometimes used to treat multiple-drug-resistant and drug-sensitive tuberculosis. The effects of fluoroquinolones in tuberculosis regimens need to be assessed.

Elemental analysis of herbal preparations for traditional medicines by neutron activation analysis with the k0 standardization method

Sarmani SB, Abugassa I, Hamzah A, Yahya MD

Biol Trace Elem Res, 1999;71-72:365-76.

PMID: 10676512

Medicinal herb preparations prescribed for specific treatment purposes were purchased from markets and were analyzed by instrumental neutron activation analysis with k0 standardization. Then, 500-700 mg of each sample was pelletized under a pressure of six tones and irradiated together with monitors for alpha and neutron flux ratio determinations for about 6 h in a thermal flux of 2.29 x 10(12) n/cm2/s. The accuracy of the method was established by analyzing standard reference materials. Twenty-nine elements, Ag, As, Au, Ba, Br, Ca, Ce, Co, Cr, Cs, Eu, Fe, Hf, K, La, Mn, Mo, Na, Rb, Sb, Sc, Se, Sm, Sr, Th, U, Yb, and Zn, were measured in all the samples, and Hg was detected in some samples, with good accuracy and reproducibility. The concentration of elements determined was found to vary depending on the composition of the herbs used. Although the trend linking the element of the medicinal plants to its curative abilities could not be clearly determined, this study showed that the toxic elements found in the samples were below the levels prescribed by health regulations. Nevertheless, such data are important to understand the pharmacological action and the exact mechanisms of action and formation of active constituents for each medicinal plant and to decide the dosage of the herbs used in the final formulation.

Mercury determination in hair of Malaysian fishermen by neutron activation analysis

Sarmani SB, Kiprawi AZ, Ismail RB

Biol Trace Elem Res, 1994;43-45:435-41.

PMID: 7710858

Fish has been known as a source of nonoccupational mercury exposure to fish-consuming population groups. In this study, hair samples collected from fishermen and their families residing in an industrialized area in Penang and a nonindustrialized area in Terengganu were analyzed for mercury by neutron activation. The range, arithmetic mean, geometric mean, and median of the mercury concentrations for the groups in Penang and in Terengganu were 0.45-16.68, 3.61, 3.49, and 2.96 and 6.79-18.31, 12.08, 11.69, and 12.05 mg/kg, respectively. Somewhat lower values than from the Penang group were found in a group from Selangor consisting mainly of office workers. The group in Penang took about 40-100 g of fish/d, whereas the group in Terengganu consumed twice as much. This shows that hair mercury levels depend on a fish consumption pattern, and not on the location of the population. The levels of mercury found in this study were similar to those reported by other workers for fish-consuming population groups worldwide.

Eating disorders in Hong Kong

Goh SE, Ong SB, Subramaniam M

Br J Psychiatry, 1993 Feb;162:276-7.

PMID: 8435714

Isolation of a mannose-binding and IgE- and IgM-reactive lectin from the seeds of Artocarpus integer

Lim SB, Chua CT, Hashim OH

J Immunol Methods, 1997 Dec 01;209(2):177-86.

PMID: 9461333

A mannose-binding lectin, termed champedak lectin-M, was isolated from an extract of the crude seeds of champedak (Artocarpus integer). On gel filtration chromatography, the lectin eluted in a single peak at elution volumes corresponding to 64 kDa. SDS-PAGE showed the mannose-binding lectin to be composed of 16.8 kDa polypeptides with some of the polypeptides being disulphide-linked to give dimers. When tested with all isotypes of immunoglobulins, champedak lectin-M demonstrated a selective strong interaction with human IgE and IgM, and a weak interaction with IgA2. The binding interactions of lectin-M were metal ion independent. The lectin was also shown to interact with horseradish peroxidase, ovalbumin, porcine thyroglobulin, human alpha1-acid glycoprotein, transferrin and alpha1-antitrypsin. It demonstrated a binding preference to Man alpha 1-3Man ligands in comparison to Man alpha 1-6Man or Man alpha 1-2Man.

Fulltext Marked junctional bradycardia, prolonged QT interval and torsade de pointes in acute phenothiazine intoxication in a schizophrenic patient. A case report

Quek DK, Ong SB, Chan PY

Med J Malaysia, 1988 Jun;43(2):173-7.

PMID: 2907093

Knob-positive and knob-negative Plasmodium falciparum differ in expression of a strain-specific malarial antigen on the surface of infected erythrocytes

Aley SB, Sherwood JA, Howard RJ

J. Exp. Med., 1984 Nov 01;160(5):1585-90.

PMID: 6208311

We have investigated the expression of a strain-specific malarial antigen on the surface of erythrocytes infected with knobless (K-) variants of knob-positive (K+) strains of Plasmodium falciparum. Aotus blood infected with K+ or K- parasites derived from two independent geographical isolates (Malayan camp and Santa Lucia) was surface iodinated by the lactoperoxidase method. Infected and uninfected erythrocytes were then separated by a new procedure involving equilibrium density sedimentation on a Percoll gradient containing sorbitol. Strain-specific antigens were readily identified on the surface of erythrocytes infected with either of the K+ strains by their characteristic size and detergent solubility. These proteins were not detected on the surface of erythrocytes infected with either of the K- variants nor on uninfected erythrocytes isolated from K+- or K- -infected blood. These results are consistent with a role for the strain-specific surface antigen in cytoadherence of P. falciparum-infected erythrocytes. Our findings represent the second biochemical difference (with the knob-associated histidine-rich protein) between K+ and K- P. falciparum.

Fulltext A preliminary study on the use of counterimmunoelectrophoresis and coagglutination methods in the diagnosis of bacterial meningitis

Cheong YM, Jegathesan M, Lo SB

Med J Malaysia, 1984 Mar;39(1):38-41.

PMID: 6513838

The usefulness of counterimmunoelectrophoresis (CIEP) and coagglutination (COAG) methods in the diagnosis of bacterial meningitis was evaluated. Out of the 31 cerebrospinal fluid (CSF) specimens which had a cell count of >5 x10^6 wbc/l and were negative on gram stain and culture, pneumococcal antigens were detected in four specimens and Haemophilus influenzae type b antigen was detected in one specimen by both the methods. No false positives were detected in 10 specimens obtained from cases of febrile fits whose CSF showed no evidence of meningitis. One CSF sample, from which Klebsiella spp. was isolated, cross reacted with the meningococcal polyvalent group A-D antiserum in the CIEP test. From this study we found that these methods are rapid, simple and useful adjunctive tests In the diagnosis of bacterial meningitis, especially in the partially treated cases.

Fulltext Myocardial infarction, circadian rhythm and delay in hospital admission

Quek DK, Ong SB, Lim LY

Med J Malaysia, 1989 Mar;44(1):14-22.

PMID: 2626108

Circadian variations have been observed in the onset of acute coronary syndromes including acute myocardial infarction. We studied 422 acute myocardial infarction patients who presented to the coronary care unit of General Hospital Kuala Lumpur. Of the 318 (75.4%) patients whose data was complete, a circadian rhythm with bimodal peak was demonstrated. The second quarter of the day i.e. 6.00 a.m. to 12 noon was shown to have a significantly increased frequency of onset of acute myocardial infarction (p less than 0.05). Time delay in presenting to the hospital was also determined. This showed that 56.8% of acute myocardial infarction patients presented early, within four hours of the onset of symptoms. By six hours, more than 71% had sought hospital care. This early presentation to the hospital may offer a realistic opportunity for optimal thrombolytic therapy should this treatment modality be offered as routine to infarct patients.

Fulltext Cigarette smoking and the risk of myocardial infarction, and acute non-infarct coronary events among Malaysian women

Quek DK, Lim LY, Ong SB

Med J Malaysia, 1989 Sep;44(3):210-23.

PMID: 2626136

In a prospective case-control study over a two-year period involving 1006 women, 264 women with acute myocardial infarction (AMI), 305 with non-infarct acute coronary syndromes (CAD) were compared with 437 women with no coronary heart disease (Controls), to determine the relationship between cigarette smoking and other risks factors with coronary heart disease. A history of current cigarette smoking was strongly associated with the risk of coronary events for both AMI And CAD (p less than 0.001). 23.9% of patients with acute coronary syndromes were current smokers, compared with only 12.8% among controls. Overall, women smokers had about a two-fold increase in risk for all coronary events. Younger women smokers (less than 40 years) and those between 61-70 years had particularly higher risks (10.3 and 2.7 times respectively (p less than 0.01, p less than 0.02). A dose-response pattern of increased AMI risks (from 2.0 to 2.9 times) among women smokers was also found, corresponding to the number of cigarettes smoked per day (p less than 0.05). Other significant coronary risk factors established were: postmenopausal status (OR 6.5), diabetes mellitus (OR 5.1), hypertension (OR 1.6), family history of premature coronary heart disease less than 50 years (OR 1.3) and use of oral contraceptive pills (OR 1.4). Our results thus emphasize that cigarette smoking is an important determinant of acute coronary events even among Malaysian women.

Psychometric properties of the mentor behaviour scale in a sample of Malaysian medical students

Mohammad JAM, Yusoff MSB

J Taibah Univ Med Sci, 2018 Feb;13(1):58-63.

PMID: 31435303 DOI: 10.1016/j.jtumed.2017.04.005

Objectives: To determine the psychometric properties of the Mentor Behaviour Scale (MBS), a 15-item inventory that evaluates four supportive mentor behaviours in terms of construct validity and internal consistency.

Method: A cross-sectional study was carried out on a sample of medical students in their final year at Universiti Sains Malaysia. Confirmatory factor analysis (CFA) was performed using AMOS 22 to assess construct validity. Reliability analysis was performed using SPSS 22 to assess internal consistency.

Results: A total of 159 final year medical students participated. CFA showed that the original four-factor model with 15 items achieved acceptable values for the goodness of fit indices, suggesting a good model fit (X2 = 198.295, ChiSq/df = 2.418, RMSEA = 0.095, GFI = 0.867, CFI = 0.953, NFI = 0.923, TLI = 0.940). The Cronbach's alpha values of the mentoring relationship structure, engagement, and competency support domains were 0.96, 0.90 and 0.88, respectively. For autonomy support, the Cronbach's alpha value was 0.62.

Conclusion: MBS demonstrates a satisfactory level of construct validity and a high level of internal consistency in measuring supportive mentor behaviours in a medical school setting. This result suggests that MBS can be used as a mentorship evaluation tool for feedback in the context of a Malaysian medical school.

Fulltext Cholecystokinin hyperresponsiveness in functional dyspepsia

Chua AS, Keeling PW

World J Gastroenterol, 2006 May 07;12(17):2688-93.

PMID: 16718754 DOI: 10.3748/wjg.v12.i17.2688

Functional dyspepsia (FD) is a common disorder of yet uncertain etiology. Dyspeptic symptoms are usually meal related and suggest an association to gastrointestinal (GI) sensorimotor dysfunction. Cholecystokinin (CCK) is an established brain-gut peptide that plays an important regulatory role in gastrointestinal function. It inhibits gastric motility and emptying via a capsaicin sensitive vagal pathway. The effects on emptying are via its action on the proximal stomach and pylorus. CCK is also involved in the regulation of food intake. It is released in the gut in response to a meal and acts via vagal afferents to induce satiety. Furthermore CCK has also been shown to be involved in the pathogenesis of panic disorder, anxiety and pain. Other neurotransmitters such as serotonin and noradrenaline may be implicated with CCK in the coordination of GI activity. In addition, intravenous administration of CCK has been observed to reproduce the symptoms in FD and this effect can be blocked both by atropine and loxiglumide (CCK-A antagonist). It is possible that an altered response to CCK may be responsible for the commonly observed gastric sensorimotor dysfunction, which may then be associated with the genesis of dyspeptic symptoms.

Complete enclosure of gall bladder inside the lesser omentum - a rare anomaly

Nayak SB, Shetty SD, Vasudeva SK

Morphologie, 2021 Jun 16.

PMID: 34147369 DOI: 10.1016/j.morpho.2021.06.001

Gall bladder is known for many congenital anomalies such as duplication, intrahepatic position, floating position etc. Most of its anomalies can be detected in ultrasound examination and radiography. We report an extremely rare congenital anomaly of gall bladder as observed in a male cadaver during dissection classes. The gall bladder was totally enclosed in the right free margin of the lesser omentum, in front of the usual contents of the right free margin of lesser omentum. The size, shape and blood supply of the gall bladder were normal. Though this anomaly might not cause any functional disturbances, it might result in complications during laparoscopic cholecystectomy.

Effect of the mannose-binding Artocarpus integer lectin on the cellular proliferation of murine lymphocytes

Lim SB, Kanthimathi MS, Hashim OH

Immunol Invest, 1998 Dec;27(6):395-404.

PMID: 9845424

The effect of the mannose-binding champedak (Artocarpus integer) lectin-M on the cellular proliferation of murine lymphocytes was investigated in this study. Our data demonstrated that the lectin was the main mitogenic component in the crude extract of the champedak seeds. It stimulated the proliferation of murine T cells at an optimal concentration of 2.5 microg/ml in a 3 day culture. Lectin-M appeared to be a T-cell mitogen as it does not induce significant DNA synthesis when cultured with spleen cells from the nude mouse. In the absence of T cells, the lectin was incapable of inducing resting B cells to differentiate into immunoglobulin secreting plasma cells.

Warfarin Dosing Algorithms Underpredict Dose Requirements in Patients Requiring ≥7 mg Daily: A Systematic Review and Meta-analysis

Saffian SM, Duffull SB, Wright D

Clin. Pharmacol. Ther., 2017 Aug;102(2):297-304.

PMID: 28160278 DOI: 10.1002/cpt.649

There is preliminary evidence to suggest that some published warfarin dosing algorithms produce biased maintenance dose predictions in patients who require higher than average doses. We conducted a meta-analysis of warfarin dosing algorithms to determine if there exists a systematic under- or overprediction of dose requirements for patients requiring ≥7 mg/day across published algorithms. Medline and Embase databases were searched up to September 2015. We quantified the proportion of over- and underpredicted doses in patients whose observed maintenance dose was ≥7 mg/day. The meta-analysis included 47 evaluations of 22 different warfarin dosing algorithms from 16 studies. The meta-analysis included data from 1,492 patients who required warfarin doses of ≥7 mg/day. All 22 algorithms were found to underpredict warfarin dosing requirements in patients who required ≥7 mg/day by an average of 2.3 mg/day with a pooled estimate of underpredicted doses of 92.3% (95% confidence interval 90.3-94.1, I(2) = 24%).

Studies in family planning. 4. Malaysia

Hardee JG, Rahman SB, Ann TB

Stud Fam Plann, 1973 May;4(5):111-3.

PMID: 4710478 DOI: 10.2307/1964727

Morphologic changes in red blood cells: An illustrated review of clinically important light microscopic findings

Tyrrell L, Rose G, Shukri A, Kahwash SB

Malays J Pathol, 2021 Aug;43(2):219-239.

PMID: 34448787

In this article, we provide an illustrated review that may serve as a microscope companion, as well as a reference for the diagnosis of red blood cells alterations and the interpretation of their significance. Beginners in the fields of clinical haematology and haematopathology may benefit from this manuscript's brevity and practical points, while the more advanced will find it useful as a teaching tool.

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