We aimed to establish a method for quantitative analysis of mixed haematopoietic chimerism based on microchip electrophoresis of selected molecular markers following PCR amplification for accurate monitoring of graft status post-transplantation. A 12-year-old girl with relapsed acute lymphoblastic leukaemia who underwent allogeneic bone marrow transplantation had qualitative chimerism analysis using short tandem repeat markers at three time points following the procedure. Her archived DNA samples were then used to test the ability to correlate her clinical course with changes in the quantity of donor chimerism at the different time points. Quantitative chimerism analysis was performed on the Agilent 2100 bioanalyser and donor-recipient ratios were calculated from generated electropherograms. Complete donor chimerism (98%) was demonstrated three weeks post- transplantation. Decreasing amount of donor chimerism to 24% was shown after three months and this concurred with clinical relapse. Following a second transplant, full donor chimerism was reestablished where donor chimerism rose to 100%. High resolution microchip electrophoresis could be useful in predicting the occurrence of increasing recipient chimerism which may herald impending relapse in patients while the disease burden is still low. This investigational approach may provide useful information for clinicians to select appropriate intervention strategies to ensure successful transplantation.
Objective: This study aimed to assess self-perceived aesthetics and orthodontic need, information-seeking behaviours and knowledge on orthodontic treatment among young adults in Malaysia.
Methods: A cross-sectional study was conducted among 933 polytechnic students in Malaysia using a selfadministered questionnaire. The Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used to assess self-perceived orthodontic need. Respondents were also asked about their intention to seek orthodontic treatment. Those showing intention were further asked about their reason(s) for seeking treatment, their information-seeking behaviours, and knowledge on orthodontic treatment. Data was analysed using SPSS.
Results: The overall response rate was 93.2% with the mean age of 20.43 (SD±1.07). Although most of the respondents rated themselves under the no treatment need category of the AC-IOTN scale, 61.9% reported intention to seek orthodontic treatment. The main reason for seeking treatment was to improve dental function (45.3%) and aesthetics (40.1%). Most claimed to look for information prior to orthodontic treatment, either using online or offline platforms. Many relied on friends (83.3%) as a source of information and more than half used online sources including social media and websites. A minority demonstrated lack of knowledge in terms of appropriate places to receive treatment (2.2%) and qualification of orthodontic practitioners (37.7%).
Conclusions: The majority of young Malaysian adults have high intention to seek orthodontic treatment regardless of their perceived need. A minority had lack of knowledge about qualified orthodontic providers and places to receive treatment. Majority reported positive attitudes towards information-seeking behaviour prior to seeking orthodontic treatment.
A case of penetrating cardiac injury is reported where cardiorrhaphy is done without cardiopulmonary bypass and via a right thoracotomy even though median stelnotoluy is the usual approach. It is also stressed that all precordial stab wounds must be carefully explored. KEYWORDS: Penetrating cardiac injury, Without cardiopulmonary bypass, Right posterolateral thoracotomy, Centrally placed chest injury.
The use of brain slice preparatiotis has become ilicreasiligly popular among scientists of different disciplines in recent decades for the study of the mammalian central nervous system (CNS) in general and of synaptic phenomena in particular. The in vitro hippocampal slice may be the single most used preparation, among other slices of different parts of the brain areas. The use of brain slices in different experimental work offers certain advantages over the in vivo approaches to the study of the CNS; however, such preparations may have some limitations. This review describes the hippocampal slice technique, explores some of the different types of studies in which it was employed and points out the advantages and limitations of its use. KEYWORDS: Hippocalnpal slices, brain slices, technique, synaptic function, electrophysiology, in vitvo.
Improving upon the quality of teaching by teaching staff at all educational institutions is oil very significant objective. Eva luation of teaching performed by individuals at such institutions would be instrumental in assessing the quality of such teaching and a tool towards its improvement. In this article, one scheme for teaching evaluation by students and another by peers are proposed and discussed. Assessment by students may provide contrasting results to those obtained from peers. For a "just and fair'" overalJ assessment of one's teaching., it is recommended that students' evaluation would be combined with those of peers. Results of such an evaluation of teaching should be perceived as being valuable in providing feedback to the teacher and can be utilized for many purposes by academicians and administrators. KEYlVORDS: Academia, classroom teaching., evaluation by peers, evaluation by students, proposed schemes.
Cardiopulmonary exercise testing is a non-invasive physiological test which incorporates the conventional method of exercise stress test with a more advanced breath-to-breath ventilatory analysis. The physiological parameters obtained from the test help to illustrate the cardiovascular, respiratory and metabolic responses to physical exertion. Individual's functional capacity and aerobic fitness is reflected by the value of maximal oxygen consumption (VO2 max) obtained from the cardiopulmonary exercise test. This non-invasive and sophisticated test is regarded as a valuable assessment tool in research and clinical practice. Cardiopulmonary exercise test has been extensively utilized to define the mechanisms of exercise intolerance in various clinical disorders, to evaluate responses to therapy and indicate disease prognosis. Emerging data obtained from the use of the cardiopulmonary exercise testing in the research field, has led to its extensive clinical usage. It is now utilized as an integral part of the patients' clinical evaluation in the field of respiratory and cardiovascular medicine, sports medicine, surgery as well as occupational and rehabilitative medicine. It has a clinical role in assessing patient's functional capacity, monitoring disease progression and response to therapy, predicting prognosis, and perioperative morbidity and mortality, as well as constructing and monitoring training and rehabilitative programs. This article aims to give an overview of the physiological profiles obtained from cardiopulmonary exercise testing, its methodological aspects, as well as its utility in research and clinical practice. KEYWORDS: Cardiopulmonary, exercise, physiology, respiratory medicine, oxygen consumption
Tuberculosis (TB) is a major public health problem worldwide. It is estimated that 2 billion people, a third of
the world population, have TB infection, but are not down with the disease. Globally, incident cases of TB
showed a rising trend, with a 6.6 million reported in 1990, 8.3 million in 2000, 9.24 million in 2004, and an
estimated 9.27 million incident cases in 2007. The aim of this study was to evaluate the treatment outcome of
TB patients in Nigeria in the state of Jigawa. A cross sectional retrospective study was conducted to evaluate the
treatment outcome in directly observed treatment with a short course for tuberculosis (TB DOTS) in facilities
in the state between the years 2010 to 2014. The study population were all the patients with TB, who had
access to DOTS therapy. Data were collected from the various local governmental areas for tuberculosis control
(LGA TB) register. The LGA TB control registers contained basic information of the patients, and a statistical
software SPSS-V22.0 was used to analyse the data. A total of 963 TB patients were studied. More than half
(57.4%) of the patients were male, and nearly three- fourths (71.2%) of the patients accessed care from urban
local government areas in the state. The greater majority (96.3%) of the cases had pulmonary tuberculosis
(PTB). Among the patients, more than two-fifths (45%) were cured, and a little over one-fifth (20.6%) of them
were HIV positive. This study revealed that the treatment success rate (TSR) in the Jigawa State of Nigeria
was higher than the overall TSR of Nigeria, and the defaulter rate in this state was lower than the Nigerian
average. The aim of this study was to evaluate the treatment outcome of TB patients in Nigeria in the state
of Jigawa. A cross sectional retrospective study was conducted to evaluate the treatment outcome in directly
observed treatment with a short course for tuberculosis (TB DOTS) in facilities in the state between the years
2010 to 2014. The study population were all the patients with TB, who had access to DOTS therapy. Data were
collected from the various local governmental areas for tuberculosis control (LGA TB) register. The LGA TB
control registers contained basic information of the patients, and a statistical software SPSS-V22.0 was used
to analyse the data. A total of 963 TB patients were studied. More than half (57.4%) of the patients were
male, and nearly three- fourths (71.2%) of the patients accessed care from urban local government areas in
the state. The greater majority (96.3%) of the cases had pulmonary tuberculosis (PTB). Among the patients,
more than two-fifths (45%) were cured, and a little over one-fifth (20.6%) of them were HIV positive. This study
revealed that the treatment success rate (TSR) in the Jigawa State of Nigeria was higher than the overall TSR
of Nigeria, and the defaulter rate in this state was lower than the Nigerian average.
Information regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
Background: Breast cancer (BC) is the most common cancer in women globally. In low- and middle-income countries, the use of appropriate breast cancer genetics services for screening and personalized treatments is severely lacking. This review is aimed to assess and summarize the reported mutation profiles of Malaysian BC patients.
Methods: A literature search was performed in PubMed and Google Scholar from 2002 to 2019 using a set of keywords and MESH terms.
Results: Data from 14 eligible studies are presented here. A total of 28 genes were studied in Malaysian BC patients in which 445 genetic alterations (229 deleterious, 209 variants with unknown clinical significance (VUC), and seven protective variants) have been reported, with 73 being novel (16% novel). The frequency ranged from 0.2% to 76% for VUC and 2.1 to 15% for deleterious variations. Only BRCA1, BRCA2, PALB2, APOBEC3B, and P53 have been associated with BC risk in Malaysian patients. Nine of these studies were conducted using the overlapped source of patients, which may limit the generalizability of the findings to the whole population of Malaysia.
Conclusion: Information on the genetic basis of BC in the Malaysian population is scant. Multidisciplinary efforts with appropriate sample selection techniques and study design with multicenter collaboration are needed to address this issue. Out of thirteen high- and moderated-penetrance pathogenic mutations for BC, only five have been linked to Malaysians’ BC susceptibility. The findings from this review is valuable for decision-makers, researchers, and physicians, to enhance the research plans and utility of genetic services for screening and prevention.
Six groups of adult male Sprague Dawley rats, each consisting of six animals were used throughout the experiment. The gastroprotective effects of aqueous plant extract alone, honey alone or honey in combination with ethanolic or aqueous extracts of A. conyzoides and cimetidine were investigated in rats against ethanol-HCl induced gastric ulcer. Efficacy was assessed by determination of ulcer index and inhibition percentage. Oral administration of ethanol-HCl (5 ml kg-1 body weight) to fasted rats produced extensive lesions of gastric mucosa (Group 1). Pre-treatment with honey (2.5 g kg-1 body weight) alone (Group 2), aqueous plant extract alone (10% w/v 5 ml kg-1) (Group 3), or honey in combination with each of alcoholic extract (10% w/w 5 ml kg-1) (Group 4), aqueous extract (10% w/w 5 ml kg-1) (Group 5) or cimetidine (10 mg/ml honey 5 ml kg-1) (Group 6) orally 30 minutes before administration of absolute ethanol-HCl significantly (p < 0.05) protected gastric lesions by 46.74%, 61.50%, 76.68%, 78.39% and 56.55% respectively. Although the mechanism of gastric protection is unknown, honey in combination with each plant extract appears to increase the resistance of gastric mucosal cells to the necrotizing effect of strong irritants in the absolute ethanol-HCl mixture. The results suggest that honey in combination with each plant extract might be beneficial in the treatment of a variety of diseases in which gastric mucosal injury is present.
Six groups of adult male Sprague Dawley rats, each consisting of six animals were used throughout the experiment. The gastroprotective effects of aqueous plant extract alone, honey alone or honey in combination with ethanolic or aqueous extracts of A. conyzoides and cimetidine were investigated in rats against ethanol-HClinduced gastric ulcer. Efficacy was assessed by determination of ulcer index and inhibition percentage. Oral administration of ethanol-HCl (5 ml kg-1 body weight) to fasted rats produced extensive lesions of gastric mucosa (Group 1). Pre-treatment with honey (2.5 g kg-1 body weight) alone (Group 2), aqueous plant extract alone (10% w/v 5 ml kg-1) (Group 3), or honey in combination with each of alcoholic extract (10% w/w 5 ml kg-1) (Group 4), aqueous extract (10% w/w 5 ml kg-1) (Group 5) or cimetidine (10 mg/ml honey 5 ml kg-1) (Group 6) orally 30 minutes before administration of absolute ethanol-HCl significantly (p < 0.05) protected gastric lesions by 46.74%, 61.50%, 76.68%, 78.39% and 56.55% respectively. Although the mechanism of gastric protection is unknown, honey in combination with each plant extract appears to increase the resistance of gastric mucosal cells to the necrotizing effect of strong irritants in the absolute ethanol-HCl mixture. The results suggest that honey in combination with each plant extract might be beneficial in the treatment of a variety of diseases in which gastric mucosal injury is present. KEYWORDS: Honey, A. conyzoides, cimetidine, rats, ulcer
This paper attempts to examine the socio-demographic profile of the respondents in Migrant Health studies. It was based on questionnaire survey among 820 respondents from the Klang Valley and the State of Kelantan from 6th January 1998 to 14th January 1999. Majority of the respondents (47.9%) were from Bangladesh, followed by Indonesia (14.8%), Thailand (13.7%), Myanmar (20.4%), Pakistan (9.9%) and Others (1.3%). The male to female ratio is 7:1. He age of respondents ranged from 18 to 69 years with a mean of 30.5 years. More than 70% of them are adults (25-44 years). Females were older than males (mean age of 33.8 years and 30.5 years respectively). Majority of the respondents were married (females 75.8% and males 52.6%), 93.7 were Muslims. About 87.4% of them had some formal education. Majority of the foreign workers were employed as factory workers (35.7%), followed by construction workers (18.3%), agricultural workers (33.6%), service workers (13.3%) and self-employed (11%). Nevertheless, the profile of these responding do not conform to the national profile.
Background: There are rising concerns for the deterioration of outdoor thermal comfort (OTC) level as it influences the health and well-being of sensitive and vulnerable urban communities such as school children. However, the understanding of OTC among school children in an urban setting has been poorly highlighted in existing literature.
Methods: A cross-sectional quantitative study was conducted among secondary school students in a selected area within Greater Kuala Lumpur (GKL) so as to understand their thermal perception towards the urban outdoor environment. A clustered random sampling was used to gather a total of 236 students for this study. Meteorological data were collected concurrently with the questionnaire survey which was conducted during the peak urban heating hours (0800 – 2000) from July 2018 to January 2019.
Results: The secondary school students in the selected study area felt hot (n=120, 51%) and experienced little discomfort (n=144, 61%). If given a choice, 76% (n=179) of the students preferred a cooler environment although 56% (n=132) accepted the current thermal environment. Findings based on the on-site meteorological observations revealed that the students were constantly exposed to a mean of 32.7°C Physiological Equivalent Temperature (PET) while the expected neutral temperature was found to be 25.1°C PET.
Conclusion: Based on these outcomes, it can be deduced that the students in this study showed traits of thermal acclimatization. Future studies should be conducted to identify the influence of other confounding factors, such as gender, ethnicity, and clothing variations among the secondary school students so as to ensure that the students are able to better adapt to the deteriorating OTC levels in urban outdoor spaces.
A 71-year-old lady with rheumatoid arthritis developed painful peripheral vasculitic neuropathy of the lower limbs and was treated with high dose steroid and cyclophosphamide. Eight months later, she presented with left hip and back pain for a week, with minimal relief from regular analgesia. Although the initial pelvic radiograph was normal, a repeat film performed two weeks later showed a destructive lytic lesion in the left pubic bone, confirmed as osteomyelitis with intramuscular collection by MRI. Cloxacillin was started empirically, and when the blood culture isolated methicillin-sensitive Staphylococcus aureus (MSSA), it was planned to be given for six weeks via a peripherally inserted central catheter. Despite an initial response, she became febrile on the fifth week of antibiotic therapy. Subsequent blood culture isolated Trichosporon asahii. Her condition deteriorated, and she succumbed on the fourth day of antifungal therapy. In conclusion, the diagnosis of osteomyelitis pubis, a rare complication of MSSA bacteremia, could be delayed in an atypical presentation.
Congenital heart disease (CHD) is the result of a complicated interplay between genetic and non-genetic, or “environmental,” factors acting on the foetus and one of those environmental factors is maternal hyperglycemia. Maternal diabetes has teratogenic effects on the evolution of the foetal cardiovascular system; as a consequence, cardiovascular malformations are the most common anomalies in infants of diabetic mothers with transposition of the great arteries, tricuspid atresia and truncus arteriosus being some of the common cardiac malformations encountered. Thus, it is important to perform a detailed heart examination at autopsy of perinatal deaths in order to ascertain related anomalies. We present a case of stillbirth in a woman with Type 1 Diabetes mellitus on insulin therapy who claims she was unaware about her pregnancy.
A common practice in psychiatry when treating patients is the concurrent administration of anticholinergics along with antipsychotics, either to prevent or treat extrapyramidal syndrome reactions from occurring. However, most antipsychotics have inherent anticholinergic properties themselves. Therefore, this subtype of these patients have a higher than usual risk of developing anticholinergic side-effects, of which the central nervous manifestations can mimic psychosis, and may cloud judgement on patients’ progress towards their treatment.
A common practice in psychiatry when treating patients is the concurrent administration of anticholinergics along with antipsychotics, either to prevent or treat extrapyramidal syndrome reactions from occurring. However, most antipsychotics have inherent anticholinergic properties themselves. Therefore, this subtype of these patients have a higher than usual risk of developing anticholinergic side-effects, of which the central nervous manifestations can mimic psychosis, and may cloud judgement on patients' progress towards their treatment. KEYWORDS: Anticholinergics, anticholinergig toxicity, antipsychotics