Displaying publications 41 - 60 of 167 in total

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  1. Fulltext Tip loaded cyclodextrin-carvedilol complexes microarray patches
    Anjani QK, Sabri AHB, Hamid KA, Moreno-Castellanos N, Li H, Donnelly RF
    Carbohydr Polym, 2023 Nov 15;320:121194.
    PMID: 37659788 DOI: 10.1016/j.carbpol.2023.121194
    Carvedilol, a β-blocker prescribed for chronic heart failure, suffers from poor bioavailability and rapid first pass metabolism when administered orally. Herein, we present the development of tip microarray patches (MAPs) composed of ternary cyclodextrin (CD) complexes of carvedilol for transdermal delivery. The ternary complex with hydroxypropyl γ-cyclodextrin (HPγCD) and poly(vinyl pyrrolidone) (PVP) reduced the crystallinity of carvedilol, as evidenced by DSC, XRD, NMR, and SEM analysis. MAPs were fabricated using a two-step process with the ternary complex as the needle layer. The resulting MAPs were capable of breaching ex vivo neonatal porcine skin to a depth ≈600 μm with minimal impact to needle height. Upon insertion, the needle dissolved within 2 h, leading to the transdermal delivery of carvedilol. The MAPs displayed minimal toxicity and acceptable biocompatibility in cell assays. In rats, MAPs achieved significantly higher AUC levels of carvedilol than oral administration, with a delayed Tmax and sustained plasma levels over several days. These findings suggest that the carvedilol-loaded dissolving MAPs have the potential to revolutionise the treatment of chronic heart failure.
    Matched MeSH terms: Heart Failure*
  2. Biowaiver monograph for immediate-release solid oral dosage forms: bisoprolol fumarate
    Charoo NA, Shamsher AA, Lian LY, Abrahamsson B, Cristofoletti R, Groot DW, et al.
    J Pharm Sci, 2014 Feb;103(2):378-91.
    PMID: 24382794 DOI: 10.1002/jps.23817
    Literature data relevant to the decision to allow a waiver of in vivo bioequivalence (BE) testing for the approval of immediate-release (IR) solid oral dosage forms containing bisoprolol as the sole active pharmaceutical ingredient (API) are reviewed. Bisoprolol is classified as a Class I API according to the current Biopharmaceutics Classification System (BCS). In addition to the BCS class, its therapeutic index, pharmacokinetic properties, data related to the possibility of excipient interactions, and reported BE/bioavailability problems are taken into consideration. Qualitative compositions of IR tablet dosage forms of bisoprolol with a marketing authorization (MA) in ICH (International Conference on Harmonisation) countries are tabulated. It was inferred that these tablets had been demonstrated to be bioequivalent to the innovator product. No reports of failure to meet BE standards have been made in the open literature. On the basis of all these pieces of evidence, a biowaiver can currently be recommended for bisoprolol fumarate IR dosage forms if (1) the test product contains only excipients that are well known, and used in normal amounts, for example, those tabulated for products with MA in ICH countries and (2) both the test and comparator dosage form are very rapidly dissolving, or, rapidly dissolving with similarity of the dissolution profiles demonstrated at pH 1.2, 4.5, and 6.8.
    Matched MeSH terms: Heart Failure/drug therapy
  3. Fulltext Interleukin 6 and Development of Heart Failure With Preserved Ejection Fraction in the General Population
    Chia YC, Kieneker LM, van Hassel G, Binnenmars SH, Nolte IM, van Zanden JJ, et al.
    J Am Heart Assoc, 2021 06;10(11):e018549.
    PMID: 33998283 DOI: 10.1161/JAHA.120.018549
    Background The cause of heart failure with preserved ejection fraction (HFpEF) is poorly understood, and specific therapies are lacking. Previous studies suggested that inflammation plays a role in the development of HFpEF. Herein, we aimed to investigate in community-dwelling individuals whether a higher plasma interleukin 6 (IL-6) level is associated with an increased risk of developing new-onset heart failure (HF) over time, and specifically HFpEF. Methods and Results We performed a case-cohort study based on the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study, a prospective general population-based cohort study. We included 961 participants, comprising 200 participants who developed HF and a random group of 761 controls. HF with reduced ejection fraction or HFpEF was defined on the basis of the left ventricular ejection fraction of ≤40% or >40%, respectively. In Cox proportional hazard regression analyses, IL-6 levels were statistically significantly associated with the development of HF (hazard ratio [HR], 1.28; 95% CI, 1.02-1.61; P=0.03) after adjustment for key risk factors. Specifically, IL-6 levels were significantly associated with the development of HFpEF (HR, 1.59; 95% CI, 1.16-2.19; P=0.004), whereas the association with HF with reduced ejection fraction was nonsignificant (HR, 1.05; 95% CI, 0.75-1.47; P=0.77). In sensitivity analyses, defining HFpEF as left ventricular ejection fraction ≥50%, IL-6 levels were also significantly associated with the development of HFpEF (HR, 1.47; 95% CI, 1.04-2.06; P=0.03) after adjustment for key risk factors. Conclusions IL-6 is associated with new-onset HFpEF in community-dwelling individuals, independent of potential confounders. Our findings warrant further research to investigate whether IL-6 might be a novel treatment target to prevent HFpEF.
    Matched MeSH terms: Heart Failure/blood*; Heart Failure/epidemiology; Heart Failure/physiopathology
  4. Fulltext Performance of a novel left ventricular lead with short bipolar spacing for cardiac resynchronization therapy: primary results of the Attain Performa quadripolar left ventricular lead study
    Crossley GH, Biffi M, Johnson B, Lin A, Gras D, Hussin A, et al.
    Heart Rhythm, 2015 Apr;12(4):751-8.
    PMID: 25533587 DOI: 10.1016/j.hrthm.2014.12.019
    The Medtronic Attain Performa quadripolar leads provide 16 pacing vectors with steroid on every electrode. This includes a short bipolar configuration between the middle 2 electrodes.
    Matched MeSH terms: Heart Failure/physiopathology; Heart Failure/therapy
  5. Fulltext An unusual presentation of atrial myxoma
    Anpalakhan S, Ramasamy D, Fan KS
    Singapore Med J, 2014 Oct;55(10):e156-8.
    PMID: 25631903
    Myxomas are uncommon primary cardiac tumours that usually affect the left atrium. We herein report the case of a patient who presented with right heart failure and proteinuria, leading to the diagnosis of atrial myxoma. Surgical resection resulted in resolution of the patient's symptoms.
    Matched MeSH terms: Heart Failure/diagnosis
  6. Fulltext Ventricular tachycardia storm: a case series and literature review
    Chia PL, Loh SY, Foo D
    Med J Malaysia, 2012 Dec;67(6):582-4.
    PMID: 23770949
    INTRODUCTION: Ventricular tachycardia (VT) storm is an uncommon but life-threatening condition. We describe the incidence, causes and management of VT storm among patients admitted to the coronary care unit of a large tertiary hospital.

    MATERIALS AND METHODS: Between 1 November 2009 and 30 April 2010, 198 patients were admitted to the coronary care unit and 7 (3.5%) presented with VT storm. A retrospective review of their records was conducted. The mean follow-up period was 268 (196 to 345) days.

    RESULTS: The mean age was 67 years and 4 patients were male. One patient had a previous myocardial infarction. All had abnormal left ventricular ejection fraction, median of 30%. Acute myocardial infarction (4 patients) was the most common trigger, followed by decompensated heart failure (1), systemic inflammatory response syndrome on a background of non-ischemic dilated cardiomyopathy (1) and bradycardia-induced polymorphic VT (1). Three patients had polymorphic VT and the rest had monomorphic VT. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful in arrhythmia control. Three patients underwent coronary revascularization, 3 patients received implantable cardioverter-defibrillators, 1 had a permanent cardiac pacemaker, 1 died during the acute episode. Five out of the 6 survivors were prescribed oral beta-blockers upon discharge. On follow-up, none of the patients had a recurrence of the tachyarrhythmia.

    CONCLUSION: Acute myocardial infarction was the main trigger of VT storm in our patients. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful at suppressing VT storm.
    Matched MeSH terms: Heart Failure
  7. Fulltext Promising Nutritional Fruits Against Cardiovascular Diseases: An Overview of Experimental Evidence and Understanding Their Mechanisms of Action
    Zuraini NZA, Sekar M, Wu YS, Gan SH, Bonam SR, Mat Rani NNI, et al.
    Vasc Health Risk Manag, 2021;17:739-769.
    PMID: 34858028 DOI: 10.2147/VHRM.S328096
    Cardiovascular diseases (CVDs) are one of the leading causes of morbidity and mortality in both developed and developing countries, affecting millions of individuals each year. Despite the fact that successful therapeutic drugs for the management and treatment of CVDs are available on the market, nutritional fruits appear to offer the greatest benefits to the heart and have been proved to alleviate CVDs. Experimental studies have also demonstrated that nutritional fruits have potential protective effects against CVDs. The aim of the review was to provide a comprehensive summary of scientific evidence on the effect of 10 of the most commonly available nutritional fruits reported against CVDs and describe the associated mechanisms of action. Relevant literatures were searched and collected from several scientific databases including PubMed, ScienceDirect, Google Scholar and Scopus. In the context of CVDs, 10 commonly consumed nutritious fruits including apple, avocado, grapes, mango, orange, kiwi, pomegranate, papaya, pineapple, and watermelon were analysed and addressed. The cardioprotective mechanisms of the 10 nutritional fruits were also compiled and highlighted. Overall, the present review found that the nutritious fruits and their constituents have significant benefits for the management and treatment of CVDs such as myocardial infarction, hypertension, peripheral artery disease, coronary artery disease, cardiomyopathies, dyslipidemias, ischemic stroke, aortic aneurysm, atherosclerosis, cardiac hypertrophy and heart failure, diabetic cardiovascular complications, drug-induced cardiotoxicity and cardiomyopathy. Among the 10 nutritional fruits, pomegranate and grapes have been well explored, and the mechanisms of action are well documented against CVDs. All of the nutritional fruits mentioned are edible and readily accessible on the market. Consuming these fruits, which may contain varying amounts of active constituents depending on the food source and season, the development of nutritious fruits-based health supplements would be more realistic for consistent CVD protection.
    Matched MeSH terms: Heart Failure/diet therapy*; Heart Failure/prevention & control
  8. Fulltext A Combination of Tachycardia-Mediated Heart Failure and Coronary Artery Vasospasm-Induced Silent Myocardial Infarction in a Patient with Severe Thyrotoxicosis
    Khoo SSK, Chu CM, Fung YK
    Case Rep Cardiol, 2018;2018:4827907.
    PMID: 29713551 DOI: 10.1155/2018/4827907
    Severe thyrotoxicosis can present with a myriad of cardiovascular complications. It may be mild features such as palpitations, tachycardia, and exertional dyspnea or may progress to life-threatening consequences such as atrial fibrillation, tachyarrhythmias, heart failure, myocardial infarction, and shock. In rare cases, they may present with myocardial ischemia secondary to coronary artery vasospasm. We report a case of a 59-year-old Malay gentleman who presented with fast atrial fibrillation and tachycardia-mediated heart failure that evolved to a silent myocardial infarction secondary to severe coronary artery vasospasm with undiagnosed severe thyrotoxicosis. He had complete resolution of heart failure and no further recurrence of coronary artery vasospasm once treatment for thyrotoxicosis was initiated and euthyroidism achieved. This life-threatening consequence has an excellent prognosis if recognised early and treated promptly.
    Matched MeSH terms: Heart Failure
  9. An integrated index for automated detection of infarcted myocardium from cross-sectional echocardiograms using texton-based features (Part 1)
    Sudarshan VK, Acharya UR, Ng EY, Tan RS, Chou SM, Ghista DN
    Comput Biol Med, 2016 Apr 1;71:231-40.
    PMID: 26898671 DOI: 10.1016/j.compbiomed.2016.01.028
    Cross-sectional view echocardiography is an efficient non-invasive diagnostic tool for characterizing Myocardial Infarction (MI) and stages of expansion leading to heart failure. An automated computer-aided technique of cross-sectional echocardiography feature assessment can aid clinicians in early and more reliable detection of MI patients before subsequent catastrophic post-MI medical conditions. Therefore, this paper proposes a novel Myocardial Infarction Index (MII) to discriminate infarcted and normal myocardium using features extracted from apical cross-sectional views of echocardiograms. The cross-sectional view of normal and MI echocardiography images are represented as textons using Maximum Responses (MR8) filter banks. Fractal Dimension (FD), Higher-Order Statistics (HOS), Hu's moments, Gabor Transform features, Fuzzy Entropy (FEnt), Energy, Local binary Pattern (LBP), Renyi's Entropy (REnt), Shannon's Entropy (ShEnt), and Kapur's Entropy (KEnt) features are extracted from textons. These features are ranked using t-test and fuzzy Max-Relevancy and Min-Redundancy (mRMR) ranking methods. Then, combinations of highly ranked features are used in the formulation and development of an integrated MII. This calculated novel MII is used to accurately and quickly detect infarcted myocardium by using one numerical value. Also, the highly ranked features are subjected to classification using different classifiers for the characterization of normal and MI LV ultrasound images using a minimum number of features. Our current technique is able to characterize MI with an average accuracy of 94.37%, sensitivity of 91.25% and specificity of 97.50% with 8 apical four chambers view features extracted from only single frame per patient making this a more reliable and accurate classification.
    Matched MeSH terms: Heart Failure
  10. Data mining framework for identification of myocardial infarction stages in ultrasound: A hybrid feature extraction paradigm (PART 2)
    Sudarshan VK, Acharya UR, Ng EY, Tan RS, Chou SM, Ghista DN
    Comput Biol Med, 2016 Apr 1;71:241-51.
    PMID: 26897481 DOI: 10.1016/j.compbiomed.2016.01.029
    Early expansion of infarcted zone after Acute Myocardial Infarction (AMI) has serious short and long-term consequences and contributes to increased mortality. Thus, identification of moderate and severe phases of AMI before leading to other catastrophic post-MI medical condition is most important for aggressive treatment and management. Advanced image processing techniques together with robust classifier using two-dimensional (2D) echocardiograms may aid for automated classification of the extent of infarcted myocardium. Therefore, this paper proposes novel algorithms namely Curvelet Transform (CT) and Local Configuration Pattern (LCP) for an automated detection of normal, moderately infarcted and severely infarcted myocardium using 2D echocardiograms. The methodology extracts the LCP features from CT coefficients of echocardiograms. The obtained features are subjected to Marginal Fisher Analysis (MFA) dimensionality reduction technique followed by fuzzy entropy based ranking method. Different classifiers are used to differentiate ranked features into three classes normal, moderate and severely infarcted based on the extent of damage to myocardium. The developed algorithm has achieved an accuracy of 98.99%, sensitivity of 98.48% and specificity of 100% for Support Vector Machine (SVM) classifier using only six features. Furthermore, we have developed an integrated index called Myocardial Infarction Risk Index (MIRI) to detect the normal, moderately and severely infarcted myocardium using a single number. The proposed system may aid the clinicians in faster identification and quantification of the extent of infarcted myocardium using 2D echocardiogram. This system may also aid in identifying the person at risk of developing heart failure based on the extent of infarcted myocardium.
    Matched MeSH terms: Heart Failure
  11. Fulltext Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimising Cardiovascular Outcomes in Patients with Type 2 Diabetes
    Tan JWC, Sim D, Ako J, Almahmeed W, Cooper ME, Dalal JJ, et al.
    Eur Cardiol, 2021 Feb;16:e14.
    PMID: 33976709 DOI: 10.15420/ecr.2020.52
    The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease.
    Matched MeSH terms: Heart Failure
  12. Gold-nanorod enhances dielectric voltammetry detection of c-reactive protein: A predictive strategy for cardiac failure
    Letchumanan I, Md Arshad MK, Balakrishnan SR, Gopinath SCB
    Biosens Bioelectron, 2019 Apr 01;130:40-47.
    PMID: 30716591 DOI: 10.1016/j.bios.2019.01.042
    This paper primarily demonstrates the approach to enhance the sensing performance on antigen C-reactive protein (CRP) and anti-CRP antibody binding event. A nanogapped electrode structure with the gap of ~100 nm was modified by the anti-CRP antibody (Probe) to capture the available CRP. In order to increase the amount of antigen to be captured, a gold nanorod with 119 nm in length and 25 nm in width was integrated, to increase the surface area. A comparative study between the existence and non-existence of gold nanorod utilization was evaluated. Analysis of the sensing surface was well-supported by atomic force microscopy, scanning electron microscopy, 3D nano-profilometry, high-power microscopy and UV-Vis spectroscopy. The dielectric voltammetric analysis was carried out from 0 V to 2 V. The sensitivity was calculated based on 3σ and attained as low as 1 pM, which is tremendously low compared to real CRP concentration (119 nM) in human blood serum. The gold nanorod conjugation with antibody has enhanced the sensitivity to 100 folds (10 fM). The specificity of the CRP detection by the proposed strategy was anchored by ELISA and failure in the detection of human blood clotting factor IX by voltammetry. Despite, CRP antigen was further detected in human serum by spiking CRP to run-through the detection with the physiologically relevant samples.
    Matched MeSH terms: Heart Failure/diagnosis*
  13. Fulltext Health utilities in Chinese patients with coronary heart disease and impaired glucose tolerance (ACE): A longitudinal analysis of a randomized, double-blind, placebo-controlled trial
    Leal J, Becker F, Lim LL, Holman RR, Gray AM
    J Diabetes, 2022 Jul;14(7):455-464.
    PMID: 35876124 DOI: 10.1111/1753-0407.13294
    BACKGROUND: We estimate health-related quality of life and the impact of four cardiovascular events (myocardial infarction [MI], stroke, congestive heart failure, angina) and gastrointestinal events in 6522 Chinese patients with coronary heart disease (CHD) and impaired glucose tolerance (IGT) participating in the Acarbose Cardiovascular Evaluation (ACE) trial.

    METHODS: Health-related quality of life was captured using the EuroQol-5 Dimension-3 Level (EQ-5D-3L), with data collected at baseline and throughout the trial. Multilevel mixed-effects linear regression with random effects estimated health-related quality of life over time, capturing variation between hospital sites and individuals, and a fixed-effects linear model estimated the impact of cardiovascular and gastrointestinal events.

    RESULTS: Patients were followed for a median of 5 years (interquartile range 3.4-6.0). The average baseline EQ-5D score of 0.930 (SD 0.104) remained relatively unchanged over the trial period with no evidence of statistically significant differences in EQ-5D score between randomized treatment groups. The largest decrement in the year of an event was estimated for stroke (-0.107, P heart failure (-0.039, P = .022), MI (-0.021, P = .047), angina (-0.012, P = .047), and gastrointestinal events (-0.005, P = .430). MI and stroke reduced health-related quality of life beyond the year in which the event occurred (-0.031, P = .006, and -0.067, P heart failure, and angina reduce health-related quality of life around the time they occurred, but only MI and stroke impacted on longer-term health-related quality of life.

    Matched MeSH terms: Heart Failure*
  14. Molecular signaling of G-protein-coupled receptor in chronic heart failure and associated complications
    Altamish M, Samuel VP, Dahiya R, Singh Y, Deb PK, Bakshi HA, et al.
    Drug Dev Res, 2020 02;81(1):23-31.
    PMID: 31785110 DOI: 10.1002/ddr.21627
    The well-known condition of heart failure is a clinical syndrome that results when the myocardium's ability to pump enough blood to meet the body's metabolic needs is impaired. Most of the cardiac activity is maintained by adrenoceptors, are categorized into two main α and β and three distinct subtypes of β receptor: β1-, β2-, and β3-adrenoceptors. The β adrenoreceptor is the main regulatory macro proteins, predominantly available on heart and responsible for down regulatory cardiac signaling. Moreover, the pathological involvement of Angiotensin-converting enzyme 1 (ACE1)/angiotensin II (Ang II)/angiotensin II type 1 (AT1) axis and beneficial ACE2/Ang (1-7)/Mas receptor axis also shows protective role via Gi βγ, during heart failure these receptors get desensitized or internalized due to increase in the activity of G-protein-coupled receptor kinase 2 (GRK2) and GRK5, responsible for phosphorylation of G-protein-mediated down regulatory signaling. Here, we investigate the various clinical and preclinical data that exhibit the molecular mechanism of upset level of GRK change the cardiac activity during failing heart.
    Matched MeSH terms: Heart Failure/complications; Heart Failure/metabolism*
  15. Ischaemic heart disease
    HARRIS CH
    Med J Malaya, 1962 Sep;17:55-61.
    PMID: 13952910
    Matched MeSH terms: Heart Failure*
  16. Multinational and multiethnic variations in health-related quality of life in patients with chronic heart failure
    Luo N, Teng TK, Tay WT, Anand IS, Kraus WE, Liew HB, et al.
    Am Heart J, 2017 Sep;191:75-81.
    PMID: 28888273 DOI: 10.1016/j.ahj.2017.06.016
    BACKGROUND: Assessing health-related quality of life (HRQoL) in patients with heart failure (HF) is an important goal of clinical care and HF research. We sought to investigate ethnic differences in perceived HRQoL and its association with mortality among patients with HF and left ventricular ejection fraction ≤35%, controlling for demographic characteristics and HF severity.

    METHODS AND RESULTS: We compared 5697 chronic HF patients of Indian (26%), white (23%), Chinese (17%), Japanese/Koreans (12%), black (12%), and Malay (10%) ethnicities from the HF-ACTION and ASIAN-HF multinational studies using the Kansas City Cardiomyopathy Questionnaire (KCCQ; range 0-100; higher scores reflect better health status). KCCQ scores were lowest in Malay (58±22) and Chinese (60±23), intermediate in black (64±21) and Indian (65±23), and highest in white (67±20) and Japanese or Korean patients (67±22) after adjusting for age, sex, educational status, HF severity, and risk factors. Self-efficacy, which measures confidence in the ability to manage symptoms, was lower in all Asian ethnicities (especially Japanese/Koreans [60±26], Malay [66±23], and Chinese [64±28]) compared to black (80±21) and white (82±19) patients, even after multivariable adjustment (P

    Matched MeSH terms: Heart Failure/ethnology*; Heart Failure/physiopathology; Heart Failure/psychology
  17. Fulltext Angiotensin receptor neprilysin inhibitor as a novel antihypertensive drug: Evidence from Asia and around the globe
    Lin DS, Wang TD, Buranakitjaroen P, Chen CH, Cheng HM, Chia YC, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):556-567.
    PMID: 33305531 DOI: 10.1111/jch.14120
    Hypertension is a worldwide epidemic that continues to grow, with a subset of patients responding poorly to current treatment available. This is especially relevant in Asia, which constitutes 61% of the global population. Hypertension in Asia is a unique entity that is often salt-sensitive, nocturnal, and systolic predominant. Sacubitril/valsartan is a first-in-class angiotensin receptor neprilysin inhibitor that was first used in heart failure with reduced ejection fraction. Sacubitril inhibits neprilysin, a metallopeptidase that degrades natriuretic peptides (NPs). NPs exert sympatholytic, diuretic, natriuretic, vasodilatory, and insulin-sensitizing effects mostly via cyclic guanosine monophosphate (cGMP)-mediated pathways. As an antihypertensive agent, sacubitril/valsartan has outperformed angiotensin II receptor type 1 blockers (ARBs), with additional reductions of office systolic blood pressures ranging between 5 and 7 mmHg, in multiple studies in Asia and around the globe. The drug was well tolerated even in the elderly or those with chronic kidney disease. Its mechanisms of actions are particularly attractive for treatment of hypertension in Asia. Sacubitril/valsartan offers a novel, dual class, single-molecule property that may be considered as first-line antihypertensive therapy. Further investigations are needed to validate its safety for long-term use and to explore other potentials such as in the management of insulin resistance and obesity, which often coexist with hypertension in Asia.
    Matched MeSH terms: Heart Failure*
  18. Fulltext Social support and self-care management among patients withchr ic heart failure
    Siti Khuzaimah Ahmad Sharoni, Halimaton Duriah Yunus
    Malaysian Journal of Public Health Medicine, 2016;16(1):92-98.
    MyJurnal
    Patients with chronic heart failure suffer from undesirable effects in their daily activities. Effective self-care management in conjunction with social support gives improved the wellbeing of patients with chronic heart failure. This study determines social support and self-care management among patients with chronic heart failure. A cross-sectional study was conducted at the Cardiology Clinic in Hospital Serdang, Selangor from April 2014 to June 2014. A questionnaire consisting of demographic characteristics, MOS Social Survey and Self-Care Heart Failure Index (SCHFI) was distributed to a total of 113 respondents. The results show moderately high level of social support (3.51±0.89) and level of self-care management (160.49±44.39). For instance, social support and self-care management were not statistically significant with the demographic characteristics (p>0.05). There was a positive correlation between social support and self-care management (r=0.263, p<0.05) and the findings suggest that social support should be considered a predictor in self-care management of patients with chronic heart failure.
    Keywords: social support, self-care management, patient(s), chronic heart failure

    Study site: Cardiology Clinic in Hospital Serdang, Selango
    Matched MeSH terms: Heart Failure*
  19. Fulltext Early lineage switch from T-acute lymphoblastic leukaemia to common B-ALL
    Hafiza, A., Azma, R.Z., Azura, A.H., Azlin, I., Zarina, A.L., Hamidah, N.H.
    Medicine & Health, 2011;6(2):131-138.
    MyJurnal
    Leukaemic stem cells have heterogenous differentiation potential. The immunophenotypes of blast cells are usually consistent throughout the disease course even at relapse. Rarely, blast cells may undergo a ‘lineage switch’ during the course of disease especially during relapse. We would like to highlight such a case in a 10- year old boy who presented with a two weeks history of lethargy, poor appetite, low grade fever, respiratory distress, cardiac failure, generalized oedema and hepatosplenomegaly. Full blood count showed a leucocyte count of 41.5x10 9 /L and platelet count of 37x10 9 /L. The peripheral blood film showed presence of numerous blast cells. Bone marrow aspiration revealed a hypercellular marrow, which consisted of mainly blast cells with high nuclear to cytoplasmic ratio and inconspicuous nucleoli. Immunophenotyping and cytochemistry results were consistent with the diagnosis of Tcell acute lymphoblastic leukaemia. The patient achieved remission after treatment with UK ALL 97 protocol, regime B chemotherapy. However, he relapsed seven months after the initial diagnosis with 26% blast cells in the bone marrow aspirate. The majority was L1 blast cells admixed with some L2 blast cells. Immunophenotyping was consistent with common precursor B acute lymphoblastic leukaemia. The treatment was changed to a more lineage specific chemotherapy. Nonetheless, the patient never achieved remission and was planned for palliative management. This case illustrated a unique and rare case of rapid lineage switch from T-cell acute lymphoblastic leukaemia to common precursor B-cell acute lymphoblastic leukaemia.
    Matched MeSH terms: Heart Failure
  20. Fulltext A case of successful extracorporeal membrane oxygenation for right ventricular failure following pericardiectomy
    Karthigesu A, Hamdan L, Arif M, Haslan G
    Med J Malaysia, 2015 Dec;70(6):369-70.
    PMID: 26988215 MyJurnal
    Extracorporeal membrane oxygenation (ECMO) is a useful but less commonly used technique in right ventricular failure post cardiac surgery in our region. We report a case of successful use of ECMO for right ventricular failure post cardiac surgery. Our patient is a 27-year-old male presented with constrictive pericarditis post completion of treatment for disseminated Tuberculosis. He underwent pericardiectomy that was complicated with acute right ventricular failure. He was placed on extracorporeal membrane oxygenation after few hours post op that lasted for five days. The patient survived to hospital discharge and remained well on follow-up. From our experience, this aggressive management approach is beneficial in right ventricular failure and can be safely utilised in all cardiothoracic centres.
    Matched MeSH terms: Heart Failure
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