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Cardiopulmonary bypass in surgery for complex-combined vascular malformation of the lower limb: case report

Ismail MS, Sharaf I, Thambidorai CR, Zainal A, Somasundaram S, Adeeb S, et al.

Pediatr Surg Int, 2005 May;21(5):392-5.
PMID: 15806424

A 16-year-old boy was referred with features of Parkes Weber syndrome (PWS) involving the right lower limb. He had presented at birth with cutaneous vascular malformations (VM) in the right thigh and at the age of 7 years developed congestive cardiac failure, which was controlled with drugs. He received alpha interferon and steroids during this period without any benefit. He defaulted follow-up and at 12 years of age presented with further enlargement of the VM in the right thigh and leg with skin and soft tissue thickening. At this stage, embolization and subsequent excision of the VM were tried, but the surgery was abandoned because of massive hemorrhage. Over the next 4 years, the boy became totally bedridden because of massive increase in the size of the limb, repeated hemorrhages, and secondary infection of the VM. Right hip disarticulation was considered the best option to improve his quality of life. To prevent uncontrollable hemorrhage during surgery, the disarticulation was done under cardiopulmonary bypass with low circulatory flow. Postoperatively, the patient required intensive care nursing for a week. He is presently ambulatory with crutches. Cardiopulmonary bypass with low flow has been used for treating posttraumatic arteriovenous malformations. However, its use in surgery for PWS has not been reported earlier.

Matched MeSH terms: Adolescent
Fulltext An epidemiological investigation of an outbreak of leptospirosis associated with swimming, Beaufort, Sabah

Koay TK, Nirmal S, Noitie L, Tan E

Med J Malaysia, 2004 Oct;59(4):455-9.
PMID: 15779577

From October 13 to October 21, 1999, a total of 46 males, aged 8 to 19 years, were admitted to Beaufort Hospital after swimming in the creek near an oil palm plantation in Kampung (Kg) Kebatu, Beaufort. Thirty (30) presented with symptoms including fever, vomiting, bodyache, giddiness, headache, chest pain and cough, while 16 others, were asymptomatic. One, a 15 year old boy, died from haemorrhagic shock secondary to pulmonary haemorrhage. The onset of the illness was from 11 October to 19 October 1999. A case-control study found that the outbreak was associated with swimming in the creek (p<0.0001). A total of 44 paired sera samples were sent for microscopic agglutination test (MAT), 5 pairs showed sero-conversion, 3 pairs had 4 fold rise in titre and 18 pairs were positive at >320. The findings indicated that Leptospirosis was the cause of the outbreak of this illness and the contaminated creek water was the source of the infection. The occurrence of flooding and stagnation in the creek following the heavy rainfall during the first week of October 1999 could have contributed to the timing of the outbreak.

Matched MeSH terms: Adolescent
Fulltext Nerve injuries in anterior shoulder dislocations

Yeap JS, Lee DJK, Fazir M, Kareem BA, Yeap JK

Med J Malaysia, 2004 Oct;59(4):450-4.
PMID: 15779576

A retrospective study was conducted to determine the incidence of nerve injuries in anterior dislocations of the shoulder and to determine if a neurological examination is routinely performed in such cases. One hundred and fifteen shoulder dislocations in 100 patients (74 males, 26 females; mean age 35+/-18 years) were reviewed. Eighty-seven patients were examined for neurological injuries prior to reduction and 8 of these patients (9.2%) were found to have sustained neurological injuries. Following reduction, neurological examination was performed in 85 patients. Three patients who were not examined initially prior to reduction were subsequently found to have nerve injuries after reduction. Seven patients (7%) were not examined for neurological injury both before and after reduction of the dislocation. Eleven patients were found to have sustained nerve injuries in the final analysis. Axillary nerve injuries were the most common, occurring in 8 patients. In conclusion, nerve injuries are common in shoulder dislocations. The importance of performing and documenting the findings of neurological examination anterior shoulder dislocations needs to be reiterated.

Matched MeSH terms: Adolescent
Fulltext Production of Nanoemulsions from Palm-Based Tocotrienol Rich Fraction by Microfluidization

Goh PS, Ng MH, Choo YM, Amru NB, Chuah CH

Molecules, 2015;20(11):19936-46.
PMID: 26556328 DOI: 10.3390/molecules201119666

In the present study, tocotrienol rich fraction (TRF) nanoemulsions were produced as an alternative approach to improve solubility and absorption of tocotrienols. In the present study, droplet size obtained after 10 cycles of homogenization with increasing pressure was found to decrease from 120 to 65.1 nm. Nanoemulsions stabilized with Tween series alone or emulsifier blend Brij 35:Span 80 (0.6:0.4 w/w) homogenized at 25,000 psi and 10 cycles, produced droplet size less than 100 nm and a narrow size distribution with a polydispersity index (PDI) value lower than 0.2. However blend of Tween series with Span 80 produced nanoemulsions with droplet size larger than 200 nm. This work has also demonstrated the amount of tocols losses in TRF nanoemulsion stabilized Tweens alone or emulsifier blend Brij 35:Span 80 (0.6:0.4 w/w) ranged between 3%-25%. This can be attributed to the interfacial film formed surrounding the droplets exhibited different level of oxidative stability against heat and free radicals created during high pressure emulsification.

Matched MeSH terms: Adolescent
Fulltext Randomised prior feedback modulates neural signals of outcome monitoring

Mushtaq F, Wilkie RM, Mon-Williams MA, Schaefer A

Neuroimage, 2016 Jan 15;125:868-879.
PMID: 26497268 DOI: 10.1016/j.neuroimage.2015.10.046

Substantial evidence indicates that decision outcomes are typically evaluated relative to expectations learned from relatively long sequences of previous outcomes. This mechanism is thought to play a key role in general learning and adaptation processes but relatively little is known about the determinants of outcome evaluation when the capacity to learn from series of prior events is difficult or impossible. To investigate this issue, we examined how the feedback-related negativity (FRN) is modulated by information briefly presented before outcome evaluation. The FRN is a brain potential time-locked to the delivery of decision feedback and it is widely thought to be sensitive to prior expectations. We conducted a multi-trial gambling task in which outcomes at each trial were fully randomised to minimise the capacity to learn from long sequences of prior outcomes. Event-related potentials for outcomes (Win/Loss) in the current trial (Outcomet) were separated according to the type of outcomes that occurred in the preceding two trials (Outcomet-1 and Outcomet-2). We found that FRN voltage was more positive during the processing of win feedback when it was preceded by wins at Outcomet-1 compared to win feedback preceded by losses at Outcomet-1. However, no influence of preceding outcomes was found on FRN activity relative to the processing of loss feedback. We also found no effects of Outcomet-2 on FRN amplitude relative to current feedback. Additional analyses indicated that this effect was largest for trials in which participants selected a decision different to the gamble chosen in the previous trial. These findings are inconsistent with models that solely relate the FRN to prediction error computation. Instead, our results suggest that if stable predictions about future events are weak or non-existent, then outcome processing can be determined by affective systems. More specifically, our results indicate that the FRN is likely to reflect the activity of positive affective systems in these contexts. Importantly, our findings indicate that a multifactorial explanation of the nature of the FRN is necessary and such an account must incorporate affective and motivational factors in outcome processing.

Matched MeSH terms: Adolescent
Fulltext Multiracial Facial Golden Ratio and Evaluation of Facial Appearance

Alam MK, Mohd Noor NF, Basri R, Yew TF, Wen TH

PLoS One, 2015;10(11):e0142914.
PMID: 26562655 DOI: 10.1371/journal.pone.0142914

This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18-25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05) but no significant difference was found between races. Out of the 286 subjects, 49 (17.1%) were of ideal facial shape, 156 (54.5%) short and 81 (28.3%) long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts.

Matched MeSH terms: Adolescent
Fulltext Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents--Findings from the MyBreakfast Study

Ak N, Koo HC, Hamid Jan JM, Mohd Nasir MT, Tan SY, Appukutty M, et al.

PLoS One, 2015;10(10):e0138247.
PMID: 26473369 DOI: 10.1371/journal.pone.0138247

Diets rich in whole grain are associated with several health benefits. Little is known however, about whole grain consumption patterns in Malaysia. The aim of this study was to assess whole grain intakes and dietary source in Malaysian children and adolescents.

Matched MeSH terms: Adolescent
Fulltext Effect of ethnicity and socioeconomic variation to the gut microbiota composition among pre-adolescent in Malaysia

Chong CW, Ahmad AF, Lim YA, Teh CS, Yap IK, Lee SC, et al.

Sci Rep, 2015;5:13338.
PMID: 26290472 DOI: 10.1038/srep13338

Gut microbiota plays an important role in mammalian host metabolism and physiological functions. The functions are particularly important in young children where rapid mental and physical developments are taking place. Nevertheless, little is known about the gut microbiome and the factors that contribute to microbial variation in the gut of South East Asian children. Here, we compared the gut bacterial richness and composition of pre-adolescence in Northern Malaysia. Our subjects covered three distinct ethnic groups with relatively narrow range of socioeconomic discrepancy. These included the Malays (n = 24), Chinese (n = 17) and the Orang Asli (indigenous) (n = 20). Our results suggested a strong ethnicity and socioeconomic-linked bacterial diversity. Highest bacterial diversity was detected from the economically deprived indigenous children while the lowest diversity was recorded from the relatively wealthy Chinese children. In addition, predicted functional metagenome profiling suggested an over-representation of pathways pertinent to bacterial colonisation and chemotaxis in the former while the latter exhibited enriched gene pathways related to sugar metabolism.

Matched MeSH terms: Adolescent
Fulltext Quality of Life in Rural Communities: Residents Living Near to Tembeling, Pahang and Muar Rivers, Malaysia

Idris K, Mohamed Shaffril HA, Md Yassin S, Abu Samah A, Hamzah A, Abu Samah B

PLoS One, 2016;11(3):e0150741.
PMID: 26974837 DOI: 10.1371/journal.pone.0150741

The main aim of this study is to identify the quality of life (QoL) among communities residing near the Tembeling, Pahang and Muar Rivers in Malaysia. This quantitative study used a constructed questionnaire as main tool to collect data on the QoL of river communities. A total of 240 villagers were selected as respondents. The results indicated that the dimensions of settlement, safety, involvement and social relationships, as well as education scored highest, while dimensions of physical environment, financial and job security yielded moderate scores. Dimensions of infrastructure facilities yielded a low mean score. Recommendations are provided, in the hope that our results may be useful for strategies that could enhance QoL of these river communities.

Matched MeSH terms: Adolescent
Fulltext Front to back ocular injury from a vaping-related explosion

Khairudin MN, Mohd Zahidin AZ, Bastion ML

BMJ Case Rep, 2016 Apr 05;2016.
PMID: 27048399 DOI: 10.1136/bcr-2016-214964

We describe a case of extensive ocular injury secondary to an electronic cigarette (e-cigarette)-related explosion. The explosion was the result of modifications made to a heating element of the e-cigarette device by a non-professional. Extensive ocular injuries that result from an explosion of an e-cigarette device can potentially cause significant and permanent visual impairment.

Matched MeSH terms: Adolescent
Fulltext Early central nervous system involvement in a young patient with dengue encephalitis

Alice V, Cheong BM

Med J Malaysia, 2016 02;71(1):41-3.
PMID: 27130747

A previously well 13-year-old boy presented with a short history of fever and altered mental status. His mother was admitted for dengue fever and there had been a recent dengue outbreak in their neighbourhood. He was diagnosed with dengue encephalitis as both his dengue non-structural protein 1 (NS-1) antigen and cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) were positive. He did not have haemoconcentration, thrombocytopenia or any warning signs associated with severe dengue. He recovered fully with supportive treatment. This case highlights the importance of considering the diagnosis of dengue encephalitis in patients from dengue endemic areas presenting with an acute febrile illness and neurological symptoms.

Matched MeSH terms: Adolescent
Fulltext Stomach trichobezoar (rapunzel syndrome) with iatrogenic intussusception

Yik YI, How AK

Med J Malaysia, 2016 04;71(2):74-6.
PMID: 27326947 MyJurnal

We present a rare case of stomach trichobezoar complicated with iatrogenic intussusception noted intra-operatively after failed attempt of endoscopic removal in a 13-year-old girl. At presentation, she had gastric outlet obstruction with anaemia. Endoscopy established the diagnosis of trichobezoar. Surgical removal was warranted after failed endoscopic removal. Her postoperative course was uneventful. Detailed history and careful examination disclosed trichotillomania and associated trichophagia. Psychiatric referral was sought with the intention to prevent future recurrence.

Matched MeSH terms: Adolescent
Orthotic treatment of idiopathic hyperkyphosis with Milwaukee brace

Mehdikhani M, Behtash H, Ganjavian MS, Khalaj N

J Back Musculoskelet Rehabil, 2016 Aug 10;29(3):515-9.
PMID: 26836834 DOI: 10.3233/BMR-150651

Hyperkyphosis with unknown reason is common in teenagers and can be corrected by orthotic management.

Matched MeSH terms: Adolescent
Victimization After Meeting With Online Acquaintances: A Cross-Sectional Survey of Adolescents in Malaysia

Marret MJ, Choo WY

J Interpers Violence, 2018 08;33(15):2352-2378.
PMID: 26787607 DOI: 10.1177/0886260515625502

This study aimed to determine contact and privacy risks encountered by Malaysian adolescents with access to the Internet and mobile phones and factors associated with face-to-face meetings with online acquaintances as well as to estimate the prevalence of subsequent victimization. Secondary school students from randomly selected public schools in Selangor and Kuala Lumpur responded to an anonymous self-administered questionnaire (78% response rate). Out of 3,349 Internet or mobile phone users, 51% had been invited to meet offline with an online-meeting acquaintance and 30% complied. Of the 1,005 respondents who went to offline meetings, 55% had meetings with more than six people. Male gender, Malay ethnicity, online access at an Internet café, viewing pornography on the Internet, the absence of parental restrictions on visiting certain website and chat rooms, not being explicitly forbidden to meet strangers encountered online, and disclosure of personal information were significantly associated with increased odds of face-to-face meetings with online acquaintances. Verbal, physical, or sexual assaults were reported by 5.5% of the 1,005 including 13 males and five females who reported forced sexual intercourse. Similarities as well as differences in factors associated with risk-taking behavior compared with adolescents in Western countries have important implications on policy and intervention.

Matched MeSH terms: Adolescent
What does the multiple mini interview have to offer over the panel interview?

Pau A, Chen YS, Lee VK, Sow CF, Alwis R

Med Educ Online, 2016 Jan;21(1):29874.
PMID: 28165931 DOI: 10.3402/meo.v21.29874

Introduction This paper compares the panel interview (PI) performance with the multiple mini interview (MMI) performance and indication of behavioural concerns of a sample of medical school applicants. The acceptability of the MMI was also assessed. Materials and methods All applicants shortlisted for a PI were invited to an MMI. Applicants attended a 30-min PI with two faculty interviewers followed by an MMI consisting of ten 8-min stations. Applicants were assessed on their performance at each MMI station by one faculty. The interviewer also indicated if they perceived the applicant to be a concern. Finally, applicants completed an acceptability questionnaire. Results From the analysis of 133 (75.1%) completed MMI scoresheets, the MMI scores correlated statistically significantly with the PI scores (r=0.438, p=0.001). Both were not statistically associated with sex, age, race, or pre-university academic ability to any significance. Applicants assessed as a concern at two or more stations performed statistically significantly less well at the MMI when compared with those who were assessed as a concern at one station or none at all. However, there was no association with PI performance. Acceptability scores were generally high, and comparison of mean scores for each of the acceptability questionnaire items did not show statistically significant differences between sex and race categories. Conclusions Although PI and MMI performances are correlated, the MMI may have the added advantage of more objectively generating multiple impressions of the applicant's interpersonal skill, thoughtfulness, and general demeanour. Results of the present study indicated that the MMI is acceptable in a multicultural context.

Matched MeSH terms: Adolescent
Stages in third molar development and eruption to estimate the 18-year threshold Malay juvenile

Mohd Yusof MY, Cauwels R, Martens L

Arch Oral Biol, 2015 Oct;60(10):1571-6.
PMID: 26276268 DOI: 10.1016/j.archoralbio.2015.07.017

Age 18 years is considered as the age of majority by most countries. To ascertain the age of interest, both third molar development (TMD) and eruption (TME) staging scores are beneficial without needing multiple imaging modalities. This study aimed to assess the chronological course of TMD and TME in a Malay sub-adult population and evaluate predictions when specific stage(s) of TMD and TME have been attained that are pertinent to the age group of interest (<18 years or ≥18 years). A sample of 714 digital panoramic images for subjects stratified by age between 14.1 and 23.9 years was retrospectively collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage TMD and TME, respectively. A binary logistic regression was performed to predict the 18-year threshold with staging score as predictors. Stages 4-6 (TMD) and A-B (TME) for males and stages 4 (TMD) and A (TME) for females were found to discriminate the <18-year group. For both genders, stages 9-10 (TMD) and D (TME) can be used as reference stages to estimate whether a subject is likely to be ≥18 years, with 94.74-100% and 85.88-96.38% correct predictions, respectively. Stages 4 (TMD) and A (TME) can also be used to identify juveniles (<18 years) with a high degree of correct predictions, 100%. The juvenility of an individual is easily anticipated by using the specific staging scores of both third molar variables (TMD and TME) without complex calculations.

Matched MeSH terms: Adolescent
Oral malodour among adolescents and its association with health behaviour and oral health status

Rani H, Ueno M, Zaitsu T, Kawaguchi Y

Int J Dent Hyg, 2016 May;14(2):135-41.
PMID: 26098532 DOI: 10.1111/idh.12160

OBJECTIVE: To assess oral malodour level and its association with health behaviour, oral health behaviour and oral health status among adolescents.
METHOD: A questionnaire survey and clinical examination that included tongue coating and oral malodour status were conducted on 665 senior high school students in Saitama, Japan. Analyses of Pearson chi-square, independent samples t-test and logistic regression were conducted using SPSS 19.0 with the significance level set at P

Matched MeSH terms: Adolescent
Trends and factors associated with mental health problems among children and adolescents in Malaysia

Ahmad N, MuhdYusoff F, Ratnasingam S, Mohamed F, Nasir NH, MohdSallehuddin S, et al.

International journal of culture and mental health, 2015 Apr 03;8(2):125-136.
PMID: 26000035

Studying trends in mental health morbidity will guide the planning of future interventions for mental and public health services. To assess the trends in mental health problems among children and adolescents aged 5 through 15 years in Malaysia from 1996 to 2011, data from the children's mental health component of three population-based surveys was analysed using a two-stage stratified sampling design. Mental health problems were assessed using the Reporting Questionnaire for Children. The prevalence of mental health problems among children and adolescents aged 5 through 15 years showed an increasing trend from 13.0% (95% Confidence Interval [CI]: 11.5-14.6) in 1996 to 19.4% (95% CI: 18.5-20.3) in 2006 and 20.0% (95% CI: 18.8-21.3) in 2011. In 2011, male children and adolescents and those who were in less affluent families were significantly associated with mental health problems. The findings indicate that even though mental health problems among children and adolescents in Malaysia are increasing, the rate of increase has decreased in the past five years. Socially and economically disadvantaged groups were most vulnerable to mental health problems.

Matched MeSH terms: Adolescent
ConnectViz: Accelerated Approach for Brain Structural Connectivity Using Delaunay Triangulation

Adeshina AM, Hashim R

Interdiscip Sci, 2016 Mar;8(1):53-64.
PMID: 26260066 DOI: 10.1007/s12539-015-0274-9

Stroke is a cardiovascular disease with high mortality and long-term disability in the world. Normal functioning of the brain is dependent on the adequate supply of oxygen and nutrients to the brain complex network through the blood vessels. Stroke, occasionally a hemorrhagic stroke, ischemia or other blood vessel dysfunctions can affect patients during a cerebrovascular incident. Structurally, the left and the right carotid arteries, and the right and the left vertebral arteries are responsible for supplying blood to the brain, scalp and the face. However, a number of impairment in the function of the frontal lobes may occur as a result of any decrease in the flow of the blood through one of the internal carotid arteries. Such impairment commonly results in numbness, weakness or paralysis. Recently, the concepts of brain's wiring representation, the connectome, was introduced. However, construction and visualization of such brain network requires tremendous computation. Consequently, previously proposed approaches have been identified with common problems of high memory consumption and slow execution. Furthermore, interactivity in the previously proposed frameworks for brain network is also an outstanding issue. This study proposes an accelerated approach for brain connectomic visualization based on graph theory paradigm using compute unified device architecture, extending the previously proposed SurLens Visualization and computer aided hepatocellular carcinoma frameworks. The accelerated brain structural connectivity framework was evaluated with stripped brain datasets from the Department of Surgery, University of North Carolina, Chapel Hill, USA. Significantly, our proposed framework is able to generate and extract points and edges of datasets, displays nodes and edges in the datasets in form of a network and clearly maps data volume to the corresponding brain surface. Moreover, with the framework, surfaces of the dataset were simultaneously displayed with the nodes and the edges. The framework is very efficient in providing greater interactivity as a way of representing the nodes and the edges intuitively, all achieved at a considerably interactive speed for instantaneous mapping of the datasets' features. Uniquely, the connectomic algorithm performed remarkably fast with normal hardware requirement specifications.

Matched MeSH terms: Adolescent
Is neck tilt and shoulder imbalance the same phenomenon? A prospective analysis of 89 adolescent idiopathic scoliosis patients (Lenke type 1 and 2)

Kwan MK, Wong KA, Lee CK, Chan CY

Eur Spine J, 2016 Feb;25(2):401-8.
PMID: 25962815 DOI: 10.1007/s00586-015-4016-9

PURPOSE: To introduce a new clinical neck tilt grading and to investigate clinically and radiologically whether neck tilt and shoulder imbalance is the same phenomenon in AIS patients.
METHODS: 89 AIS Lenke 1 and 2 cases were assessed prospectively using the new clinical neck tilt grading. Shoulder imbalance and neck tilt were correlated with coracoid height difference (CHD), clavicle\rib intersection distance (CRID), clavicle angle (CA), radiographic shoulder height (RSH), T1 tilt and cervical axis.
RESULTS: Mean age was 17.2 ± 3.8 years old. 66.3 % were Lenke type 1 and 33.7 % were type 2 curves. Strong intraobserver (0.79) and interobserver (0.75) agreement of the clinical neck tilt grading was noted. No significant correlation was observed between clinical neck tilt and shoulder imbalance (0.936). 56.3 % of grade 3 neck tilt, 50.0 % grade 2 neck tilt patients had grade 0 shoulder imbalance. In patients with grade 2 shoulder imbalance, 42.9 % had grade 0, 35.7 % grade 1, 14.3 % grade 2 and only 7.1 % had grade 3 neck tilt. CHD, CRID, CA and RSH correlated with shoulder imbalance. T1 tilt and cervical axis measurements correlated with neck tilt.
CONCLUSIONS: In conclusion, neck tilt is distinct from shoulder imbalance. Clinical neck tilt has poor correlation with clinical shoulder imbalance. Clinical neck tilt grading correlated with cervical axis and T1 tilt whereas clinical shoulder grading correlated with CHD, RSH CRID and CA.

Matched MeSH terms: Adolescent

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