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Fulltext Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection

Lim MX, Fong KK, Yeap TB

BMJ Case Rep, 2021 Oct 13;14(10).
PMID: 34645636 DOI: 10.1136/bcr-2021-245639

COVID-19 presents with a spectrum of severity, ranging from asymptomatic or mild symptoms to those with acute respiratory distress syndrome. Corticosteroids are widely used for their efficacy in reducing inflammatory responses. However, its use may be limited to patients with immunosuppression. An adjunct therapy for cytokine storm in COVID-19 is extracorporeal blood purification therapies using high adsorptive filters, such as oXiris, to remove cytokines. We share our experience in using continuous renal replacement therapy with oXiris haemofilter as a temporising measure to high-dose corticosteroids in managing cytokine storm in a deteriorating COVID-19 patient with concomitant bacterial infection.

Matched MeSH terms: Respiratory Distress Syndrome, Adult*
Fulltext A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity

Safaei M, Sundararajan EA, Driss M, Boulila W, Shapi'i A

Comput Biol Med, 2021 09;136:104754.
PMID: 34426171 DOI: 10.1016/j.compbiomed.2021.104754

Obesity is considered a principal public health concern and ranked as the fifth foremost reason for death globally. Overweight and obesity are one of the main lifestyle illnesses that leads to further health concerns and contributes to numerous chronic diseases, including cancers, diabetes, metabolic syndrome, and cardiovascular diseases. The World Health Organization also predicted that 30% of death in the world will be initiated with lifestyle diseases in 2030 and can be stopped through the suitable identification and addressing of associated risk factors and behavioral involvement policies. Thus, detecting and diagnosing obesity as early as possible is crucial. Therefore, the machine learning approach is a promising solution to early predictions of obesity and the risk of overweight because it can offer quick, immediate, and accurate identification of risk factors and condition likelihoods. The present study conducted a systematic literature review to examine obesity research and machine learning techniques for the prevention and treatment of obesity from 2010 to 2020. Accordingly, 93 papers are identified from the review articles as primary studies from an initial pool of over 700 papers addressing obesity. Consequently, this study initially recognized the significant potential factors that influence and cause adult obesity. Next, the main diseases and health consequences of obesity and overweight are investigated. Ultimately, this study recognized the machine learning methods that can be used for the prediction of obesity. Finally, this study seeks to support decision-makers looking to understand the impact of obesity on health in the general population and identify outcomes that can be used to guide health authorities and public health to further mitigate threats and effectively guide obese people globally.

Matched MeSH terms: Metabolic Syndrome X*
Physiological and Pathophysiological Role of Cysteine Metabolism in Human Metabolic Syndrome

Muthuraman A, Ramesh M, Shaikh SA, Aswinprakash S, Jagadeesh D

Drug Metab Lett, 2021;14(3):177-192.
PMID: 34895129 DOI: 10.2174/1872312814666211210111820

Cysteine is one of the major intermediate products of cellular amino-acid metabolism. It is a semi-essential amino acid for protein synthesis. Besides, it is also employed in the regulation of major endogenous anti-oxidant molecule i.e., reduced glutathione (GSH). Further, it is a precursor of multiple sulfur-containing molecules like hydrogen sulfide, lanthionine, taurine, coenzyme A and biotin. It is also one of the key molecules for post-translational modifications of various cellular proteins. In physiological conditions, it is employed in the sulfhydration process and plays a key role in the physiology modification of the inflammatory process in various organs, including the neurological system. The catabolism of cysteine is regulated by cysteine dioxygenase enzyme activity. The dysregulated conditions of cysteine and cysteine-associated hydrogen sulfide metabolism are widely employed in the acceleration of the neurodegenerative process. Moreover, the upregulation of cysteine and hydrogen sulfide synthesis occurs via the reverse trans-sulfuration process. This process helps to manage the worsening of a pathological condition of a cellular system. Moreover, it is also employed in the accumulation of homocysteine contents. Further, both cysteine and homocysteine molecules are widely accepted as biomarkers for various types of diseases. Therefore, the targets involved in the regulation of cysteine have been considered as valid targets to treat various disorders like cardiac disease, ischemic stroke, diabetes, cancer, and renal dysfunction.

Matched MeSH terms: Metabolic Syndrome X*
Fulltext Prone ventilation in intubated COVID-19 patients: a systematic review and meta-analysis

Chua EX, Wong ZZ, Hasan MS, Atan R, Yunos NM, Yip HW, et al.

Braz J Anesthesiol, 2022;72(6):780-789.
PMID: 35809681 DOI: 10.1016/j.bjane.2022.06.007

BACKGROUND: The efficacy and safety profiles of prone ventilation among intubated Coronavirus Disease 2019 (COVID-19) patients remain unclear. The primary objective was to examine the effect of prone ventilation on the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) in intubated COVID-19 patients.
METHODS: Databases of MEDLINE, EMBASE and CENTRAL were systematically searched from inception until March 2021. Case reports and case series were excluded.
RESULTS: Eleven studies (n = 606 patients) were eligible. Prone ventilation significantly improved PaO2/FiO2 ratio (studies: 8, n = 579, mean difference 46.75, 95% CI 33.35‒60.15, p < 0.00001; evidence: very low) and peripheral oxygen saturation (SpO2) (studies: 3, n = 432, mean difference 1.67, 95% CI 1.08‒2.26, p < 0.00001; evidence: ow), but not the arterial partial pressure of carbon dioxide (PaCO2) (studies: 5, n = 396, mean difference 2.45, 95% CI 2.39‒7.30, p = 0.32; evidence: very low), mortality rate (studies: 1, n = 215, Odds Ratio 0.66, 95% CI 0.32‒1.33, p = 0.24; evidence: very low), or number of patients discharged alive (studies: 1, n = 43, Odds Ratio 1.49, 95% CI 0.72‒3.08, p = 0.28; evidence: very low).
CONCLUSION: Prone ventilation improved PaO2/FiO2 ratio and SpO2 in intubated COVID-19 patients. Given the substantial heterogeneity and low level of evidence, more randomized- controlled trials are warranted to improve the certainty of evidence, and to examine the adverse events of prone ventilation.

Matched MeSH terms: Respiratory Distress Syndrome, Adult*
Fulltext Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders: An initiative of the Indian Neurogastroenterology and Motility Association

Ghoshal UC, Sachdeva S, Ghoshal U, Misra A, Puri AS, Pratap N, et al.

Indian J Gastroenterol, 2022 Oct;41(5):483-507.
PMID: 36214973 DOI: 10.1007/s12664-022-01292-x

In the clinical setting, small intestinal bacterial overgrowth (SIBO) is a frequent, but under-diagnosed entity. SIBO is linked to various gastrointestinal (GI) and non-GI disorders with potentially significant morbidity. The optimal management of SIBO is undefined while there is a lack of published consensus guidelines. Against this background, under the auspices of the Indian Neurogastroenterology and Motility Association (INMA), formerly known as the Indian Motility and Functional Diseases Association (IMFDA), experts from the Asian-Pacific region with extensive research and clinical experience in the field of gut dysbiosis including SIBO developed this evidence-based practice guideline for the management of SIBO utilizing a modified Delphi process based upon 37 consensus statements, involving an electronic voting process as well as face-to-face meetings and review of relevant supporting literature. These statements include 6 statements on definition and epidemiology; 11 on etiopathogenesis and pathophysiology; 5 on clinical manifestations, differential diagnosis, and predictors; and 15 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservations was 80% or higher, the statement was regarded as accepted. The members of the consensus team consider that this guideline would be valuable to inform clinical practice, teaching, and research on SIBO in the Asian-Pacific region as well as in other countries.

Matched MeSH terms: Irritable Bowel Syndrome*
Fulltext "I want the doctors to know that I am as bright as a candle": : Experiences with and Hopes for Doctor Interactions Among Malaysian Key Populations and People Living with HIV

Earnshaw VA, Cox J, Wong PL, Saifi R, Walters S, Azwa I, et al.

AIDS Behav, 2023 Jul;27(7):2103-2112.
PMID: 36472685 DOI: 10.1007/s10461-022-03942-9

Stigma in healthcare settings is a pernicious barrier to HIV prevention and treatment in contexts with strong HIV-related structural stigma. Previous work has documented substantial stigma towards key populations and people living with HIV (PLWH) among Malaysian doctors. The perspectives of Malaysian key populations and PLWH, however, remain understudied. In 2021, 34 Malaysian participants representing key populations and PLWH engaged in a photovoice study designed to qualitatively explore their experiences with and hopes for doctor interactions. Many participants reported stigma from their doctors, perceiving that doctors view them as not normal, sinful, misguided, and incapable. Several emphasized that they wear figurative masks to conceal aspects of themselves from doctors. Yet, many also remain hopeful for constructive relationships with doctors. They want their doctors to know that they are bright, capable, kind, and valuable. Interventions are needed to address stigma among doctors working in contexts with strong structural stigma.

Matched MeSH terms: Acquired Immunodeficiency Syndrome*
Fulltext Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study

Fernandez DP, Kuss DJ, Justice LV, Fernandez EF, Griffiths MD

Arch Sex Behav, 2023 May;52(4):1819-1840.
PMID: 36652136 DOI: 10.1007/s10508-022-02519-w

Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.

Matched MeSH terms: Substance Withdrawal Syndrome*
EBV-Associated Smooth Muscle Tumor in the Malar Area of an HIV-Positive Patient: A Case Report

Abidin NFZ, Rahman FA, Tuck Choon K, Tilakaratne WM

Head Neck Pathol, 2023 Sep;17(3):821-825.
PMID: 37209302 DOI: 10.1007/s12105-023-01560-y

BACKGROUND: EBV-associated smooth muscle tumors (EBV-SMTs) are rare and typically develop in individuals with a compromised immune system, particularly those who have acquired immunodeficiency syndrome (AIDS) or who have undergone organ transplants.
METHODS: We document a case of EBV-SMT in an HIV-positive 25-year-old man. The lesion was incised and assessed histologically and a panel of immune markers were performed. EBV association was demonstrated by in situ hybridization for EBV-encoded RNA (EBER-ISH).
RESULTS: Microscopically, the tumor composed of mildly pleomorphic, ovoid to spindled cells with numerous slit-like vascular channels. The tumor cells exhibited diffuse and strong immunoreactivity for smooth muscle actin (SMA) and focal positivity for h-caldesmon. EBER-ISH of the tumor cells revealed strong positive nuclear signals.
CONCLUSION: The histopathological features of EBV-SMT do not conform to either benign or malignant SMTs and it has a peculiar predilection to develop at sites unusual for leiomyoma or leiomyosarcoma. The key diagnostic features of EBV-SMT include history of immunosuppression, histologic evidence of primitive and mildly pleomorphic cells maintaining blunt nuclear features in most areas, and positivity for EBER-ISH.

Matched MeSH terms: Acquired Immunodeficiency Syndrome*
Fulltext Oral Health Status in Marfan Syndrome: A Systematic Review and Meta-Analysis of 353 Cases

Alam MK, Alfawzan AA, Shrivastava D, Srivastava KC, Alswairki HJ, Mussallam S, et al.

Int J Environ Res Public Health, 2022 Apr 21;19(9).
PMID: 35564443 DOI: 10.3390/ijerph19095048

This meta-analysis aimed to compare Marfan syndrome (MFS) patients with non-MFS populations based on orofacial health status to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, for articles published between 1 January 2000 and 17 February 2022. PRISMA guidelines were followed to carry out this systematic review. We used the PECO system to classify people with MFS based on whether or not they had distinctive oral health characteristics compared to the non-MFS population. The following are some examples of how PECO is used: P denotes someone who has MFS; E stands for a medical or genetic assessment of MFS; C stands for people who do not have MFS; and O stands for the orofacial characteristics of MFS. Using the Newcastle-Ottawa Quality Assessment Scale, independent reviewers assessed the articles' methodological quality and extracted data. Four case-control studies were analyzed for meta-analysis. Due to the wide range of variability, we were only able to include data from at least three previous studies. There was a statistically significant difference in bleeding on probing and pocket depth between MFS and non-MFS subjects. MFS patients are more prone to periodontal tissue inflammation due to the activity of FBN1 and MMPs. Early orthodontic treatment is beneficial for the correction of a narrow upper jaw and a high palate, as well as a skeletal class II with retrognathism of the lower jaw and crowding of teeth.

Matched MeSH terms: Marfan Syndrome*
Fulltext An insight review on the neuropharmacological effects, mechanisms of action, pharmacokinetics and toxicity of mitragynine

Annuar NAK, Azlan UK, Mediani A, Tong X, Han R, Al-Olayan E, et al.

Biomed Pharmacother, 2024 Feb;171:116134.
PMID: 38219389 DOI: 10.1016/j.biopha.2024.116134

Mitragynine is one of the main psychoactive alkaloids in Mitragyna speciosa Korth. (kratom). It has opium-like effects by acting on μ-, δ-, and κ-opioid receptors in the brain. The compound also interacts with other receptors, such as adrenergic and serotonergic receptors and neuronal Ca2+ channels in the central nervous system to have its neuropharmacological effects. Mitragynine has the potential to treat diseases related to neurodegeneration such as Alzheimer's disease and Parkinson's disease, as its modulation on the opioid receptors has been reported extensively. This review aimed to provide an up-to-date and critical overview on the neuropharmacological effects, mechanisms of action, pharmacokinetics and safety of mitragynine as a prospective psychotropic agent. Its multiple neuropharmacological effects on the brain include antinociceptive, anti-inflammatory, antidepressant, sedative, stimulant, cognitive, and anxiolytic activities. The potential of mitragynine to manage opioid withdrawal symptoms related to opioid dependence, its pharmacokinetics and toxic effects were also discussed. The interaction of mitragynine with various receptors in the brain produce diverse neuropharmacological effects, which have beneficial properties in neurological disorders. However, further studies need to be carried out on mitragynine to uncover its complex mechanisms of action, pharmacokinetics, pharmacodynamic profiles, addictive potential, and safe dosage to prevent harmful side effects.

Matched MeSH terms: Substance Withdrawal Syndrome*
Antiphospholipid syndrome in Sarawak: real world experience in a developing country

Teh CL, Leong TS

Clin Rheumatol, 2015 Jan;34(1):175-8.
PMID: 24831689 DOI: 10.1007/s10067-014-2671-6

We performed a cross-sectional study of all antiphospholipid syndrome (APS) patients during an 8-year period (2006-2013) to describe the clinical features, serology profiles, treatment regimes, and outcomes in our center. There were a total of 59 patients in our study with the female to male ratio of 9:1. They have a mean age of 41.6 ± 12.1 years and a mean duration of illness of 38.4 ± 68.5 months. The majority of patients presented with vascular thrombosis (69.5 %) with equal arterial and venous involvements. Twenty-six patients (44.1 %) presented with obstetric complications with recurrent abortions (32.2 %) as the main manifestation. Most patients were on daily warfarin doses of 2-6 mg (91.0 %) with target INR of 2-3. There was neither recurrent thrombosis nor bleeding complications documented. There were 80 % live births following treatment in our patients.

Matched MeSH terms: Antiphospholipid Syndrome*; Antiphospholipid Syndrome/blood; Antiphospholipid Syndrome/complications; Antiphospholipid Syndrome/diagnosis*
Fulltext Nutritional and lifestyle intervention strategies for metabolic syndrome in Southeast Asia: A scoping review of recent evidence

Thor SM, Yau JW, Ramadas A

PLoS One, 2021;16(9):e0257433.
PMID: 34520483 DOI: 10.1371/journal.pone.0257433

Metabolic syndrome (MetS) is frequently associated with various health issues and is a major contributor to morbidity and mortality worldwide, particularly with its recent relevance to coronavirus disease 2019 (COVID-19). To combat its increasing prevalence in Southeast Asia, numerous intervention programs have been implemented. We conducted a scoping review on recent interventions to manage MetS among Southeast Asians using standard methodologies. Cochrane, Embase, Ovid MEDLINE, PubMed, and Scopus databases were systematically searched to yield peer-reviewed articles published between 2010-2020. We included 13 articles describing 11 unique interventions in four Southeast Asian countries: Malaysia, Thailand, Indonesia, and Vietnam. These interventions were broadly categorized into four groups: (i) nutrition (n = 4); (ii) physical activity (n = 2); (iii) nutrition and physical activity (n = 2); and (iv) multi-intervention (n = 3). Most studies investigated the effects of an intervention on components of MetS, which are anthropometry, blood pressure, glucose-related parameters, and lipid profile. Significant improvements ranged from 50% of studies reporting serum triglyceride and HDL-cholesterol levels to 100% for waist circumference. Evidence on interventions for individuals with MetS remains limited in Southeast Asia. More studies from other countries in this region are needed, especially on the effects of dietary interventions, to effectively address gaps in knowledge and provide sufficient data to design the ideal intervention for Southeast Asian populations.

Matched MeSH terms: Metabolic Syndrome X/blood; Metabolic Syndrome X/diet therapy; Metabolic Syndrome X/epidemiology*; Metabolic Syndrome X/therapy*
Melkersson-Rosenthal syndrome with involvement of masticatory muscles

Kuok SS, Ramli N, Tan CT, Goh KJ

Clin Neurol Neurosurg, 2015 Mar;130:8-10.
PMID: 25562719 DOI: 10.1016/j.clineuro.2014.12.003
Matched MeSH terms: Melkersson-Rosenthal Syndrome/complications*; Melkersson-Rosenthal Syndrome/diagnosis
Congenital yellow nail syndrome: a case report and its relationship to nonimmune fetal hydrops

Nanda A, Al-Essa FH, El-Shafei WM, Alsaleh QA

Pediatr Dermatol, 2010 Sep-Oct;27(5):533-4.
PMID: 20807364 DOI: 10.1111/j.1525-1470.2010.01259.x

Yellow nail syndrome (YNS) is an uncommon disorder characterized by a triad of nail dystrophy, lymphedema, and pleural effusion. It is rare in children and congenital occurrence of YNS has been very rarely described. We report a 2-year-old Arab boy having congenital yellow nail syndrome with mild facial dysmorphism and bilateral conjunctival pigmentation born to consanguineous parents. One of his older siblings had died of nonimmune fetal hydrops (NIFH). The case supports the genetic basis of yellow nail syndrome with a possible relationship to nonimmune fetal hydrops.

Matched MeSH terms: Yellow Nail Syndrome/genetics*; Yellow Nail Syndrome/pathology*
Fulltext Construction of a polycystic ovarian syndrome (PCOS) pathway based on the interactions of PCOS-related proteins retrieved from bibliomic data

Mohamed-Hussein ZA, Harun S

Theor Biol Med Model, 2009;6:18.
PMID: 19723303 DOI: 10.1186/1742-4682-6-18

Polycystic ovary syndrome (PCOS) is a complex but frequently occurring endocrine abnormality. PCOS has become one of the leading causes of oligo-ovulatory infertility among premenopausal women. The definition of PCOS remains unclear because of the heterogeneity of this abnormality, but it is associated with insulin resistance, hyperandrogenism, obesity and dyslipidaemia. The main purpose of this study was to identify possible candidate genes involved in PCOS. Several genomic approaches, including linkage analysis and microarray analysis, have been used to look for candidate PCOS genes. To obtain a clearer view of the mechanism of PCOS, we have compiled data from microarray analyses. An extensive literature search identified seven published microarray analyses that utilized PCOS samples. These were published between the year of 2003 and 2007 and included analyses of ovary tissues as well as whole ovaries and theca cells. Although somewhat different methods were used, all the studies employed cDNA microarrays to compare the gene expression patterns of PCOS patients with those of healthy controls. These analyses identified more than a thousand genes whose expression was altered in PCOS patients. Most of the genes were found to be involved in gene and protein expression, cell signaling and metabolism. We have classified all of the 1081 identified genes as coding for either known or unknown proteins. Cytoscape 2.6.1 was used to build a network of protein and then to analyze it. This protein network consists of 504 protein nodes and 1408 interactions among those proteins. One hypothetical protein in the PCOS network was postulated to be involved in the cell cycle. BiNGO was used to identify the three main ontologies in the protein network: molecular functions, biological processes and cellular components. This gene ontology analysis identified a number of ontologies and genes likely to be involved in the complex mechanism of PCOS. These include the insulin receptor signaling pathway, steroid biosynthesis, and the regulation of gonadotropin secretion among others.

Matched MeSH terms: Polycystic Ovary Syndrome/genetics; Polycystic Ovary Syndrome/metabolism*
Fulltext Chromosome 13q deletion with Cornelia de Lange syndrome phenotype

Ngo CT, Alhady M, Tan AK, Norlasiah IS, Ong GB, Chua CN

Med J Malaysia, 2007 Mar;62(1):74-5.
PMID: 17682579

A 3-year-old girl with facial dysmorphic features suggestive of Cornelia de Lange syndrome was seen in the ophthalmology unit for a right leukocoria. The leukocoria was found to be caused by a large retinoblastoma and the right eye was enucleated. Chromosomal analysis revealed partial chromosome 13q deletion involving band 14 which is associated with a high risk of retinoblastoma. This case shows that patient with chromosome 13q deletion syndrome cannot be diagnosed based on dysmorphic features only. Chromosomal analysis is warranted in all infants with facial dysmorphism suggestive of Cornelia de Lange syndrome so that those with chromosome 13q deletion can be referred early for early detection of retinoblastoma.

Matched MeSH terms: De Lange Syndrome/genetics*; De Lange Syndrome/physiopathology
Medicine in Malaysia: sexually transmitted diseases and AIDS

Rokiah I

Med J Malaysia, 1995 May;50 Suppl A:S42-5.
PMID: 10968014
Matched MeSH terms: Acquired Immunodeficiency Syndrome/diagnosis*; Acquired Immunodeficiency Syndrome/therapy*
Observations on the problems of HIV infection in Malaysia

Brettle RP

J Infect, 1992 Jan;24(1):101-2.
PMID: 1548408
Matched MeSH terms: Acquired Immunodeficiency Syndrome/epidemiology*; Acquired Immunodeficiency Syndrome/prevention & control
[Malaysia: loser in the fight against AIDS]

J Sykepleien, 1994 Feb 15;82(3):36.
PMID: 7946737
Matched MeSH terms: Acquired Immunodeficiency Syndrome/prevention & control*; Acquired Immunodeficiency Syndrome/transmission
Dermatoglyphics of Down's syndrome patients in Malays--a comparative study

Than M, Myat KA, Khadijah S, Jamaludin N, Isa MN

Anthropol Anz, 1998 Dec;56(4):351-65.
PMID: 10027045

There has been no recent report on the dermatoglyphics of the Malays (normal population as well as patients with Down's syndrome). A study on the frequencies of the dermal patterns (dermatoglyphics) of the digits, palms and hallucal areas was done therefore in 40 Malay patients with Down's syndrome and 200 unrelated normal controls. Only the patients with the standard 21 trisomy karyotype were included in the study. Comparison was made with the published data on studies done in various racial groups. Significant differences of the dermal patterns were found not only between the controls but also among patients of different races.

Matched MeSH terms: Down Syndrome/ethnology; Down Syndrome/genetics*

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