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  1. Articular cartilage regeneration with autologous peripheral blood progenitor cells and hyaluronic acid after arthroscopic subchondral drilling: a report of 5 cases with histology
    Saw KY, Anz A, Merican S, Tay YG, Ragavanaidu K, Jee CS, et al.
    Arthroscopy, 2011 Apr;27(4):493-506.
    PMID: 21334844 DOI: 10.1016/j.arthro.2010.11.054
    PURPOSE: The purpose of this study was to evaluate the quality of articular cartilage regeneration after arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous peripheral blood progenitor cells (PBPCs) in combination with hyaluronic acid (HA).
    METHODS: Five patients underwent second-look arthroscopy with chondral core biopsy. These 5 patients are part of a larger pilot study in which 180 patients with International Cartilage Repair Society grade III and IV lesions of the knee joint underwent arthroscopic subchondral drilling followed by postoperative intra-articular injections. Continuous passive motion was used on the operated knee 2 hours per day for 4 weeks. Partial weight bearing was observed for the first 6 to 8 weeks. Autologous PBPCs were harvested 1 week after surgery. One week after surgery, 8 mL of the harvested PBPCs in combination with 2 mL of HA was injected intra-articularly into the operated knee. The remaining PBPCs were divided into vials and cryopreserved. A total of 5 weekly intra-articular injections were given.
    RESULTS: Second-look arthroscopy confirmed articular cartilage regeneration, and histologic sections showed features of hyaline cartilage. Apart from the minimal discomfort of PBPC harvesting and localized pain associated with the intra-articular injections, there were no other notable adverse reactions.
    CONCLUSIONS: Articular hyaline cartilage regeneration is possible with arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous PBPCs in combination with HA.
    LEVEL OF EVIDENCE: Level IV, therapeutic case series.
    Matched MeSH terms: Young Adult
  2. The prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area
    Koay CL, Lim JA, Siar CH
    Oral Dis, 2011 Mar;17(2):210-6.
    PMID: 20796228 DOI: 10.1111/j.1601-0825.2010.01724.x
    OBJECTIVES: To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area.
    SUBJECTS AND METHODS: A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents.
    RESULTS: One hundred eighty-one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P 
    Matched MeSH terms: Young Adult
  3. Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review
    Deris ZZ, Hasan H, Siti Suraiya MN
    J Infect Dev Ctries, 2010 Aug 04;4(7):430-5.
    PMID: 20818090
    BACKGROUND: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia.

    METHODOLOGY: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia.

    RESULTS: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission.

    CONCLUSIONS: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

    Matched MeSH terms: Young Adult
  4. Analysis of the comprehensibility of chemical hazard communication tools at the industrial workplace
    Ta GC, Mokhtar MB, Mohd Mokhtar HA, Ismail AB, Abu Yazid MF
    Ind Health, 2010;48(6):835-44.
    PMID: 20616463
    Chemical classification and labelling systems may be roughly similar from one country to another but there are significant differences too. In order to harmonize various chemical classification systems and ultimately provide consistent chemical hazard communication tools worldwide, the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) was endorsed by the United Nations Economic and Social Council (ECOSOC). Several countries, including Japan, Taiwan, Korea and Malaysia, are now in the process of implementing GHS. It is essential to ascertain the comprehensibility of chemical hazard communication tools that are described in the GHS documents, namely the chemical labels and Safety Data Sheets (SDS). Comprehensibility Testing (CT) was carried out with a mixed group of industrial workers in Malaysia (n=150) and factors that influence the comprehensibility were analysed using one-way ANOVA. The ability of the respondents to retrieve information from the SDS was also tested in this study. The findings show that almost all the GHS pictograms meet the ISO comprehension criteria and it is concluded that the underlying core elements that enhance comprehension of GHS pictograms and which are also essential in developing competent persons in the use of SDS are training and education.
    Matched MeSH terms: Young Adult
  5. Fulltext Dendritic cell distribution in lymphomas
    Hussin HN, Zulkifli FN, Phang KS, Cheong SK
    Malays J Pathol, 2009 Dec;31(2):105-12.
    PMID: 20514853 MyJurnal
    Dendritic cells (DC) are specialized antigen presenting cells (APC) that have important roles in host defenses and in generating anti-tumour immune response. Altered frequency and maturation of DC have been reported in malignant tumours. We studied the distribution and maturation status of DC by immunohistochemistry, on the formalin-fixed, paraffin-embedded lymph node tissues of 32 histologically diagnosed lymphomas and 40 inflammatory conditions that were retrieved from the Department of Pathology, UKM Medical Centre, Kuala Lumpur. Our study showed a significant reduction in the total DC counts in the lymphoma tissues compared to the inflammatory conditions. The mature and immature DC counts were both significantly reduced (p = 0.008 and 0.001 respectively), although a greater reduction was observed in mature DC numbers. We also observed compartmentalization of DC where the immature DC were seen within the tumour tissues and the mature DC were more in peri-tumoural areas. Our findings were similar to other reports, suggesting that reduced numbers of DC appears to be a factor contributing to lack of tumour surveillance in these cases.
    Matched MeSH terms: Young Adult
  6. A retrospective study of oral and maxillofacial injuries in Seremban Hospital, Malaysia
    Ramli R, Rahman NA, Rahman RA, Hussaini HM, Hamid AL
    Dent Traumatol, 2011 Apr;27(2):122-6.
    PMID: 21281443 DOI: 10.1111/j.1600-9657.2010.00968.x
    Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia.
    Matched MeSH terms: Young Adult
  7. Fulltext A survey of knowledge of sexually transmitted infections among patients at a public hospital in Pulau Pinang, Malaysia
    Anwar M, Sulaiman SA, Khan TM
    Med Princ Pract, 2010;19(4):312-8.
    PMID: 20516709 DOI: 10.1159/000312719
    OBJECTIVE: The aim of this study was to assess the patients' knowledge and awareness of sexually transmitted infections (STIs).
    SUBJECTS AND METHODS: A face-to-face interview was conducted among the patients visiting the Venereal Diseases Outpatient Department of the General Hospital of Pulau Pinang (Malaysia). A 19-item questionnaire was used. A total of 116 patients participated in the study and 107 patients had valid responses. The reliability and internal consistency of the questionnaire tool was estimated on the basis of Cronbach's alpha (= 0.81). The Statistical Package for Social Sciences (SPSS 13.0(R)) was used for data analysis. Student's t test and analysis of variance were used to analyse the knowledge differences among the groups.
    RESULTS: Of the 107 patients, 82 (76.6%) were diagnosed with syphilis; AIDS was the most commonly known STI among the patients. Of the 107 patients, 35 were sexually active and of these 23 (65.7%) had more than 1 sexual partner. The most popular source of knowledge was newspapers (51 patients, 47.7%), with hospitals (3 patients, 2.8%) being the least popular one. Overall mean score on knowledge questions was 12.21 out of the maximum of 33 points. Knowledge about causative organisms, risk groups, transmission, symptoms, prevention and treatment of STIs was inadequate. The knowledge level was significantly related to gender (p = 0.03), religion (p = 0.005), educational level (p = 0.000), marital status (p = 0.000) and income level (p = 0.036).
    CONCLUSION: This study demonstrated evidence of poor knowledge of STIs amongst the patients attending an STI service in the General Hospital of Pulau Pinang (Malaysia). Hence there is an immediate need for efforts towards improving patient knowledge of STIs.
    Study site: Venereal Diseases Outpatient Department, General Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Young Adult
  8. Fulltext Lack of association of ABCB1 and PXR polymorphisms with response to treatment in epilepsy
    Haerian BS, Lim KS, Mohamed EH, Tan HJ, Tan CT, Raymond AA, et al.
    Seizure, 2011 Jun;20(5):387-94.
    PMID: 21316268 DOI: 10.1016/j.seizure.2011.01.008
    It is proposed that overexpression of P-glycoprotein (P-gp), encoded by the ABC subfamily B member 1 (ABCB1) gene, is involved in resistance to antiepileptic drugs (AEDs) in about 30% of patients with epilepsy. Genetic variation and haplotype patterns are population specific which may cause different phenotypes such as response to AEDs. Although several studies examined the link between the common polymorphisms in the ABCB1 gene with resistance to AEDs, the results have been conflicting. This controversy may be caused by the effect of some confounders such as ethnicity and polytherapy. Moreover, expression of the ABCB1 gene is under the control of pregnane X receptor (PXR). Evidence showed that PXR gene contribute to the response to treatment. The aim of this study was to assess the association of ABCB1 and PXR genetic polymorphisms with response to the carbamazepine (CBZ) or sodium valproate (VPA) monotherapy in epilepsy. Genotypes were assessed in 685 Chinese, Indian, and Malay epilepsy patients for ABCB1 (C1236T, G2677T, C3435T) and PXR (G7635A) polymorphisms. No association between these polymorphisms and their haplotypes, and interaction between them, with response to treatment was observed in the overall group or in the Chinese, Indian, and Malay subgroups. Our data showed that these polymorphisms may not contribute to the response to CBZ or VPA monotherapy treatment in epilepsy.
    Matched MeSH terms: Young Adult
  9. Fulltext Susceptible and protective HLA class 1 alleles against dengue fever and dengue hemorrhagic fever patients in a Malaysian population
    Appanna R, Ponnampalavanar S, Lum Chai See L, Sekaran SD
    PLoS One, 2010;5(9).
    PMID: 20927388 DOI: 10.1371/journal.pone.0013029
    The human leukocyte antigen alleles have been implicated as probable genetic markers in predicting the susceptibility and/or protection to severe manifestations of dengue virus (DENV) infection. In this present study, we aimed to investigate for the first time, the genotype variants of HLA Class 1(-A and -B) of DENV infected patients against healthy individuals in Malaysia.
    Matched MeSH terms: Young Adult
  10. Fulltext Clinical characteristics of renal cancer in Malaysia : a ten year review
    Singam P, Ho C, Hong GE, Mohd A, Tamil AM, Cheok LB, et al.
    Asian Pac J Cancer Prev, 2010;11(2):503-6.
    PMID: 20843141
    Renal cancer is rare and its incidence is 1.9 per 100,000 in the Malaysian population, which consists of three major ethnic groups (Malay, Chinese and Indians). A retrospective study was her conducted to identify clinical characteristics and ethnic background influences on presentation. The study included all renal cancer patients from a single medical institution over ten years, with a total of 75 cases. Seventy-three patients underwent surgery while 2 received only radiotherapy or chemotherapy. The male to female ratio was 2.75:1. Incidence was equal among the Malay (49.3%) and Chinese ethnic groups (45.3%). Mean age of patients were 57.1 (18-93) years old. There were 26 (37.4%) patients with Stage I disease, 14 (18.7%) at Stage II, 23 (30.7%) at Stage III and 12 (16%) at Stage IV. The Chinese race presented at mean older age (p= 0.02) and later stage of disease (p= 0.046). Patients above 40 years old had more advanced stage disease (p= 0.023). Tumour histology were clear cell (72%), urothelial cell (13.3%), sarcomatoid cell and nephroblastoma each contributed 2.7%. The mean tumour size was 8.1 (2-20) cm. There was substantial agreement between the pre and post operative staging (kappa 0.691). In conclusion we observed significant influences of age and race in the clinical presentation of renal cancer in our institution based population. There was larger male to female ratio and mean tumour size as compared to previous epidemiology studies.
    Matched MeSH terms: Young Adult
  11. Notch4 overexpression in ameloblastoma correlates with the solid/multicystic phenotype
    Siar CH, Nagatsuka H, Chuah KS, Rivera RS, Nakano K, Ng KH, et al.
    Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010 Aug;110(2):224-33.
    PMID: 20659700 DOI: 10.1016/j.tripleo.2010.03.009
    Notch signaling has been implicated in cell fate decisions during odontogenesis and tumorigenesis of some odontogenic neoplasms; however, its role in solid/multicystic (SA), unicystic (UA), and recurrent (RA) ameloblastoma remains unclear. The aim of this study was to determine Notch receptor and ligand expressions in these subtypes and to speculate on their significance.
    Matched MeSH terms: Young Adult
  12. Dietary exposure to heterocyclic amines in high-temperature cooked meat and fish in Malaysia
    Jahurul MH, Jinap S, Ang SJ, Abdul-Hamid A, Hajeb P, Lioe HN, et al.
    Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 2010 Aug;27(8):1060-71.
    PMID: 20589547 DOI: 10.1080/19440041003801190
    The intake of heterocyclic amines is influenced by the amount and type of meat and fish ingested, frequency of consumption, cooking methods, cooking temperature, and duration of cooking. In this study, the dietary intake of heterocyclic amines in Malaysia and their main sources were investigated. Forty-two samples of meat and fish were analysed by high-performance liquid chromatography with photodiode array detector to determine the concentration of the six predominant heterocyclic amines, namely: 2-amino-3-methylimidazo[4,5-f] quinoline (IQ), 2-amino-3,4-dimethylimidazo[4,5-f] quinoline(MeIQ), 2-amino-3,8-dimethylimidazo[4,5-f] quinoxaline (MeIQx), 2-amino-3,4,8-trimethylimidazo[4,5-f] quinoxaline (4,8-DiMeIQx), 2-amino-3,7,8-trimethylimidazo[4,5-f] quinoxaline (7,8-DiMeIQx), and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP). Dietary intake data were obtained using a food-frequency questionnaire when interviewing 600 Malaysian respondents. The level of total heterocyclic amines in food samples studies ranged from not detected to 38.7 ng g(-1). The average daily intake level of heterocyclic amine was 553.7 ng per capita day(-1). The intake of PhIP was the highest, followed by MeIQx and MeIQ. The results reveal that fried and grilled chicken were the major dietary source of heterocyclic amines in Malaysia. However, the heterocyclic amine intake by the Malaysian population was lower than those reported from other regions.
    Matched MeSH terms: Young Adult
  13. Fulltext Cost-effectiveness of HPV vaccination in the prevention of cervical cancer in Malaysia
    Wan Puteh WP, Aljunid S
    Asian Pac J Cancer Prev, 2010;11(1):79-90.
    PMID: 20593935
    INTRODUCTION: Cervical cancers (CC) demonstrate the second highest incidence of female cancers in Malaysia. The costs of chronic management have a high impact on nation's health cost and patient's quality of life that can be avoided by better screening and HPV vaccination.

    METHODOLOGY: Respondents were interviewed from six public Gynecology-Oncology hospitals. Methods include experts' panel discussions to estimate treatment costs by severity and direct interviews with respondents using costing and SF-36 quality of life (QOL) questionnaires. Three options were compared i.e. screening via Pap smear; quadrivalent HPV Vaccination and combined strategy (screening plus vaccination). Scenario based sensitivity analysis using screening population coverage (40-80%) and costs of vaccine (RM 300-400/dose) were calculated.

    RESULTS: 502 cervical pre invasive and invasive cervical cancer (ICC) patients participated in the study. Mean age was 53.3 +/- 11.2 years, educated till secondary level (39.4%), Malays (44.2%) and married for 27.73 +/- 12.1 years. Life expectancy gained from vaccination is 13.04 years and average Quality Adjusted Life Years saved (QALYs) is 24.4 in vaccinated vs 6.29 in unvaccinated. Cost/QALYs for Pap smear at base case is RM 1,214.96/QALYs and RM 1,100.01 at increased screening coverage; for HPV Vaccination base case is at RM 35,346.79 and RM 46,530.08 when vaccination price is higher. In combined strategy, base case is RM 11,289.58; RM 7,712.74 at best case and RM 14,590.37 at worst case scenario. Incremental cost-effectiveness ratio (ICER) showed that screening at 70% coverage or higher is highly cost effective at RM 946.74 per QALYs saved and this is followed by combined strategy at RM 35,346.67 per QALYs saved.

    CONCLUSION: Vaccination increase life expectancy with better QOL of women when cancer can be avoided. Cost effective strategies will include increasing the Pap smear coverage to 70% or higher. Since feasibility and long term screening adherence is doubtful among Malaysian women, vaccination of young women is a more cost effective strategy against cervical cancers.
    Matched MeSH terms: Young Adult
  14. Assessment of polymerase chain reaction in the detection of pseudomonas aeruginosa in contact lens-induced severe infectious keratitis
    Subrayan V, Peyman M, Lek Yap S, Mohamed Ali NA, Devi S
    Eye Contact Lens, 2010 Jul;36(4):201-3.
    PMID: 20531205 DOI: 10.1097/ICL.0b013e3181e3efa3
    PURPOSE: The aim of this study is to evaluate the role of real-time polymerase chain reaction (PCR) and conventional bacterial culture methods in the detection of Pseudomonas aeruginosa in contact lens-induced severe, partially treated corneal ulcers referred to a tertiary center.
    METHODS: The study duration was 6 months. All patients with contact lens-related corneal ulcer, requiring admission during the study period were recruited. Samples from corneal scrapings were simultaneously sent at the time of admission for PCR and culture testing. An in-house real-time PCR was developed to detect the P. aeruginosa lasA gene. The results of PCR and culture were compared using McNemar's chi2 test.
    RESULTS: Ten patients were recruited. The mean age was 33 years (20-45 years). All the patients had contact lens-related keratitis (>4 mm) of which eight (80%) were found positive for P. aeruginosa by PCR or culture. There was no significant difference between PCR and culture in detecting P. aeruginosa (P<0.05).
    CONCLUSIONS: PCR is, at least, as good as conventional cultures in detecting P. aeruginosa. It is a rapid assay as compared with culture, and early detection enables prompt treatment thus reducing the destructive effect of the organism on the cornea.
    Matched MeSH terms: Young Adult
  15. Public sources of information and information needs for pandemic influenza A(H1N1)
    Wong LP, Sam IC
    J Community Health, 2010 Dec;35(6):676-82.
    PMID: 20411411 DOI: 10.1007/s10900-010-9271-4
    Providing health information during disease outbreaks is a fundamental component of outbreak control strategies. This study aimed to explore sources of influenza A(H1N1)-related information, specific information needs and preferences of the lay public during the peak of the outbreak. A cross-sectional, population-based, computer-assisted telephone interview of 1,050 respondents was conducted in Malaysia between July 11 and September 12, 2009. Newspaper, television and family were three main sources of information about A(H1N1). There were substantial ethnic differences; the Malays were significantly more likely to identify television as main source, while newspapers and family were identified as the main sources by the Chinese and Indians, respectively. Overall, the two main information needs identified were prevention and treatment. The Malays expressed lesser need for overall information than other ethnic groups. The three most preferred sources of information were television, newspapers and healthcare providers. There were significant positive correlations between amount of information received with knowledge (r = 0.149), perceived susceptibility to infection (r = 0.177), and other behavioral responses. Health information dissemination should be dedicated to meeting the information needs of diverse sociodemographic and ethnic groups. The findings highlight the importance of providing information that increases awareness and behavioral changes in disease prevention yet reduce fear.
    Matched MeSH terms: Young Adult
  16. Fulltext Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
    Bachireddy C, Bazazi AR, Kavasery R, Govindasamy S, Kamarulzaman A, Altice FL
    Drug Alcohol Depend, 2011 Jul 1;116(1-3):151-7.
    PMID: 21232882 DOI: 10.1016/j.drugalcdep.2010.12.001
    Pre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts.
    Matched MeSH terms: Young Adult
  17. Inherent differential propensity of dental pulp stem cells derived from human deciduous and permanent teeth
    Govindasamy V, Abdullah AN, Ronald VS, Musa S, Ab Aziz ZA, Zain RB, et al.
    J Endod, 2010 Sep;36(9):1504-15.
    PMID: 20728718 DOI: 10.1016/j.joen.2010.05.006
    Lately, several new stem cell sources and their effective isolation have been reported that claim to have potential for therapeutic applications. However, it is not yet clear which type of stem cell sources are most potent and best for targeted therapy. Lack of understanding of nature of these cells and their lineage-specific propensity might hinder their full potential. Therefore, understanding the gene expression profile that indicates their lineage-specific proclivity is fundamental to the development of successful cell-based therapies.
    Matched MeSH terms: Young Adult
  18. Phenotype and TCR-gamma gene rearrangements in a Malaysian cohort of T-cell leukaemia/lymphoma cases
    Maha A, Gan GG, Koh CL
    Hematology, 2010 Dec;15(6):382-90.
    PMID: 21114900 DOI: 10.1179/102453310X12719010991902
    T cells undergo a series of complex phenotypic changes before achieving maturation. Discrete stages of T-cell differentiation are simplified to four stages (pro-, pre-, cortical and mature-T cell) and used in the classification of T-cell leukaemia. HLA-DR has been reported to be expressed in immature T-cell acute lymphoblastic leukemia (ALL) and also confer a poorer treatment outcome. Simultaneously, the genotype goes through distinct pattern changes due to rearrangement of T-cell receptor (TCR) genes. TCR gene rearrangement is important in the diagnosis of clonality and used as markers to detect minimal residual disease in lymphoproliferative disorders. We identified a subset within Pro-T and Pre-T cell cases distinguished by the expression of HLA-DR. These subgroups appeared to be more immature as rearrangement of the TCR-gamma gene was either at germline or involved only the first constant region (C1) unlike a more rearranged pattern in the HLA-DR-subgroups. We also observed a higher incidence of mediastinal mass (67%) in the HLA-DR-subgroup in the Pre-T stage. These characteristics may be useful as markers to further refine staging of T-cell ALL and determine prognosis.
    Matched MeSH terms: Young Adult
  19. The changing pattern of primary glomerulonephritis in Singapore and other countries over the past 3 decades
    Woo KT, Chan CM, Mooi CY, -L-Choong H, Tan HK, Foo M, et al.
    Clin. Nephrol., 2010 Nov;74(5):372-83.
    PMID: 20979946
    This review of 2,586 renal biopsies over the past 3 decades in Singapore documents the changing pattern of glomerulonephritis (GN) from that of a third world country to that of a developed nation. In the 1st decade, mesangial proliferative glomerulonephritis was the most common form of primary GN, just as it was in the surrounding Asian countries. In the 2nd decade, the prevalence of mesangial proliferative GN decreased with a rise in membranous, GN which is also seen in China and Thailand. In the 3rd decade, there was a dramatic increase in focal sclerosing glomerulosclerosis. This increase reflects aging and obesity in keeping with more developed countries like Australia, India, Thailand and the United States of America. IgA nephritis remains the most common GN. Apart from the geographical influence, other socioeconomic factors play a significant role in the evolution of the renal biopsy pattern. Mesangial proliferative GN remains prevalent in many Asian countries, but in Singapore the prevalence is decreasing just as it is in Japan, Korea and Malaysia. Worldwide, the prevalence of focal sclerosing glomerulosclerosis continues to increase in many countries.
    Matched MeSH terms: Young Adult
  20. Efficacy of 1-week proton pump inhibitor triple therapy as first-line Helicobacter pylori eradication regime in Asian patients: is it still effective 10 years on?
    Qua CS, Manikam J, Goh KL
    J Dig Dis, 2010 Aug;11(4):244-8.
    PMID: 20649738 DOI: 10.1111/j.1751-2980.2010.00445.x
    OBJECTIVE:
    To re-examine the efficacy and tolerability of 1-week proton pump inhibitor triple therapy as a first-line Helicobacter pylori (H. pylori) eradication therapy.

    METHODS:
    Consecutive participants with a positive rapid urease test during an outpatient upper endoscopy were included. All participants were given pantoprazole 40 mg b.i.d., amoxycillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. for 1 week. They were asked to return after 1 week to report any side effects related to the medications and to check for compliance. Successful eradication was defined by negative (13)C-urea breath test at least 4 weeks after the completion of therapy.

    RESULTS:
    A total of 191 patients were recruited into the study, of whom 81 were male (42.4%) and 110 female (57.6%), with a mean age of 55.6 (range 21-88) years. Overall 26 patients (13.6%) defaulted follow up and five patients were not compliant (taking less than 85%) with the medications. Per-protocol and intention-to-treat eradication rates were 84.4% (95% CI: 78.6-89.9%) and 71.2% (95% CI: 64.5-77.6%), respectively. Overall 68 participants (42.5%) reported no side effects, followed by 58 (36.3%) with a taste disturbance, 16 (10.0%) with epigastric pain, 15 (9.4%) with diarrhea, 13 (8.1%) with nausea or vomiting, 12 (7.5%) with loss of appetite, nine (5.6%) with dizziness and two (1.3%) with an allergic skin rash, none of which was severe.

    CONCLUSION:
    The current regime using pantoprazole, amoxycillin and clarithromycin is highly tolerable and effective and should continue to be recommended as a first-line therapy for H. pylori eradication in our setting.
    Matched MeSH terms: Young Adult
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