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  1. Fulltext Diagnosis and management of mild cognitive impairment in the community: What is the role of primary care physician?
    Ambigga Devi SK, Suthahar A, Ramli AS, Ng KK, Radziah AR, Marymol K
    Malays Fam Physician, 2011;6(2-3):74-8.
    PMID: 25606229 MyJurnal
    Dementia is a large and growing problem in the ageing population but often not diagnosed in its earlier stages which is Mild Cognitive Impairment (MCI). MCI represents the phase between normal ageing and early dementia. About 12% of patients with MCI develop dementia per year, usually Alzheimer's disease. It is a diagnosis given to individuals who have cognitive impairments beyond that is expected for their age and education. However, this condition does not interfere significantly with daily activities as these individuals retain their critical thinking and reasoning skills. Nevertheless, due to its complexity and vague initial presentation, many cases of MCI can be missed. Therefore, it is imperative for primary care physicians to recognise these symptoms as opposed to normal ageing memory changes, and refer these patients to the memory clinic early to confirm the diagnosis. This paper illustrates a common primary care presentation of a patient with MCI. As there is no proven pharmacological treatment for MCI, the mainstay of management is to provide lifestyle intervention and long term support to these patients in the community. Primary care physicians should work as a team with the geriatrician, allied health personnel, support groups and caregivers in providing this care.
    Matched MeSH terms: Alzheimer Disease
  2. Fulltext Henipavirus RNA in African bats
    Drexler JF, Corman VM, Gloza-Rausch F, Seebens A, Annan A, Ipsen A, et al.
    PLoS One, 2009;4(7):e6367.
    PMID: 19636378 DOI: 10.1371/journal.pone.0006367
    Henipaviruses (Hendra and Nipah virus) are highly pathogenic members of the family Paramyxoviridae. Fruit-eating bats of the Pteropus genus have been suggested as their natural reservoir. Human Henipavirus infections have been reported in a region extending from Australia via Malaysia into Bangladesh, compatible with the geographic range of Pteropus. These bats do not occur in continental Africa, but a whole range of other fruit bats is encountered. One of the most abundant is Eidolon helvum, the African Straw-coloured fruit bat.
    Matched MeSH terms: Disease Reservoirs
  3. Fulltext Leigh syndrome: MRI findings in two children
    Kartikasalwah A, Lh N
    Biomed Imaging Interv J, 2010 Jan-Mar;6(1):e6.
    PMID: 21611066 MyJurnal DOI: 10.2349/biij.6.1.e6
    Leigh syndrome is a progressive neurodegenerative disorder of childhood. The symmetrical necrotic lesions in the basal ganglia and/or brainstem which appear as hyperintense lesions on T2-weighted MRI is characteristic and one of the essential diagnostic criteria. Recognising this MR imaging pattern in a child with neurological problems should prompt the clinician to investigate for Leigh syndrome. We present here two cases of Leigh syndrome due to different biochemical/genetic defects, and discuss the subtle differences in their MR neuroimaging features.
    Matched MeSH terms: Leigh Disease
  4. Fulltext Chronic cough with multiple causes
    Chew BH
    Malays Fam Physician, 2010;5(2):101-4.
    PMID: 25606197 MyJurnal
    This case reports a 57-year-old lady presented with cough of two months duration despite repeated treatments from multiple general practitioners. It took her another two months to know her diagnoses and a further couple of months to be relieved of her cough and became asymptomatic. Chronic cough management in primary care often needs an empiric integrative approach and requires good doctor-patient rapport with informed follow ups and continuity of care to be successful.
    Matched MeSH terms: Chronic Disease
  5. Renal outcome following on- and off-pump coronary artery bypass graft surgery
    Ooi JS, Abdul Rahman MR, Shah SA, Dimon MZ
    Asian Cardiovasc Thorac Ann, 2008 Dec;16(6):468-72.
    PMID: 18984756
    A prospective study was carried out to compare the outcomes of patients with preexisting non-dialysis-dependent renal dysfunction who underwent coronary artery bypass grafting with or without cardiopulmonary bypass. Elective off-pump coronary artery bypass was performed in 29 patients with renal dysfunction. Their results were compared with those of a similar group of 35 patients who underwent the conventional on-pump coronary artery grafting. There was a significant deterioration in creatinine clearance in the on-pump group on days 1, 2, and 4 after surgery, while creatinine clearance in the off-pump group remained close to the baseline level. Both groups had improved to the preoperative creatinine clearance values on follow-up at 4 weeks. It was concluded that off-pump surgery provided better renal protection than the conventional on-pump technique in patients with preexisting non-dialysis-dependent renal dysfunction.
    Matched MeSH terms: Coronary Artery Disease/complications; Coronary Artery Disease/physiopathology; Coronary Artery Disease/surgery*
  6. Prevalence, risk factors, and clinical features of thyroid-associated ophthalmopathy in multiethnic Malaysian patients with Graves' disease
    Lim SL, Lim AK, Mumtaz M, Hussein E, Wan Bebakar WM, Khir AS
    Thyroid, 2008 Dec;18(12):1297-301.
    PMID: 19012471 DOI: 10.1089/thy.2008.0044
    The prevalence of thyroid-associated ophthalmopathy (TAO) has been reported to be lower in several Asian populations than in Caucasians. The risk factors for TAO that have been demonstrated in Caucasians have not been studied in Asian populations. The aim of this study, therefore, was to determine the prevalence, risk factors, and clinical features of TAO in a cohort of multiethnic Malaysian patients with Graves' disease (GD).
    Matched MeSH terms: Graves Disease/diagnosis; Graves Disease/etiology; Graves Disease/epidemiology
  7. Acute polyhydramnios causing bilateral obstructive hydronephrosis and impaired renal function
    Valayatham V, Kakarla A, Rymer J
    J Obstet Gynaecol, 2007 Oct;27(7):736-7.
    PMID: 17999311
    Matched MeSH terms: Acute Disease
  8. Human enterovirus 71 disease in Sarawak, Malaysia: a prospective clinical, virological, and molecular epidemiological study
    Ooi MH, Wong SC, Podin Y, Akin W, del Sel S, Mohan A, et al.
    Clin Infect Dis, 2007 Mar 01;44(5):646-56.
    PMID: 17278054
    BACKGROUND: Human enterovirus (HEV)-71 causes large outbreaks of hand-foot-and-mouth disease with central nervous system (CNS) complications, but the role of HEV-71 genogroups or dual infection with other viruses in causing severe disease is unclear.

    METHODS: We prospectively studied children with suspected HEV-71 (i.e., hand-foot-and-mouth disease, CNS disease, or both) over 3.5 years, using detailed virological investigation and genogroup analysis of all isolates.

    RESULTS: Seven hundred seventy-three children were recruited, 277 of whom were infected with HEV-71, including 28 who were coinfected with other viruses. Risk factors for CNS disease in HEV-71 included young age, fever, vomiting, mouth ulcers, breathlessness, cold limbs, and poor urine output. Genogroup analysis for the HEV-71-infected patients revealed that 168 were infected with genogroup B4, 68 with C1, and 41 with a newly emerged genogroup, B5. Children with HEV-71 genogroup B4 were less likely to have CNS complications than those with other genogroups (26 [15%] of 168 vs. 30 [28%] of 109; odds ratio [OR], 0.48; 95% confidence interval [CI], 0.26-0.91; P=.0223) and less likely to be part of a family cluster (12 [7%] of 168 vs. 29 [27%] of 109; OR, 0.21; 95% CI, 0.10-0.46; P

    Matched MeSH terms: Hand, Foot and Mouth Disease/complications; Hand, Foot and Mouth Disease/epidemiology*; Hand, Foot and Mouth Disease/virology
  9. Performance of the rural health improvement scheme in reducing the incidence of waterborne diseases in rural Sarawak, Malaysia
    Liew KB, Lepesteur M
    Trans R Soc Trop Med Hyg, 2006 Oct;100(10):949-55.
    PMID: 16730364 DOI: 10.1016/j.trstmh.2005.11.018
    This study evaluates and discusses the impact of the rural health improvement scheme in reducing the incidence of dysentery, enteric fever, cholera and viral hepatitis in Sarawak, Malaysia, using data compiled from state and federal health department reports. This study suggests that from 1963 to 2002, water supply intervention contributed to a more than 200-fold decrease in dysentery and a 60-fold decrease in enteric fever. Variations in reporting of viral hepatitis during that period make it difficult to detect a trend. Cholera was still endemic in 2002. Cholera and dysentery outbreaks, occurring when rural populations relied on contaminated rivers for their water supply, suggested that sanitation intervention was not as effective in reducing waterborne diseases. Recommendations are made for successive one-component interventions focusing on catchment management to ensure protection of current and alternative water supplies.
    Matched MeSH terms: Communicable Disease Control/standards*; Disease Outbreaks/prevention & control
  10. The application of one health approaches to henipavirus research
    Hayman DT, Gurley ES, Pulliam JR, Field HE
    Curr. Top. Microbiol. Immunol., 2013;365:155-70.
    PMID: 23160861 DOI: 10.1007/82_2012_276
    Henipaviruses cause fatal infection in humans and domestic animals. Transmission from fruit bats, the wildlife reservoirs of henipaviruses, is putatively driven (at least in part) by anthropogenic changes that alter host ecology. Human and domestic animal fatalities occur regularly in Asia and Australia, but recent findings suggest henipaviruses are present in bats across the Old World tropics. We review the application of the One Health approach to henipavirus research in three locations: Australia, Malaysia and Bangladesh. We propose that by recognising and addressing the complex interaction among human, domestic animal and wildlife systems, research within the One Health paradigm will be more successful in mitigating future human and domestic animal deaths from henipavirus infection than alternative single-discipline approaches.
    Matched MeSH terms: Disease Reservoirs
  11. Fulltext Defining p47-phox deficient Chronic Granulomatous Disease in a Malay family
    Gill HK, Kumar HC, Dhaliwal JS, Zabidi F, Sendut IH, Noah RM, et al.
    Asian Pac J Allergy Immunol, 2012 Dec;30(4):313-20.
    PMID: 23393912
    BACKGROUND: The most common autosomal form of Chronic Granulomatous Disease, p47-phox deficient CGD, generally features a GT (deltaGT) deletion in the GTGT sequence at the start of exon 2 on the NCF-1 gene. This consistency is due to the coexistence of and the recombination between 2 homologous pseudogenes (psi s) and NCF-1. The GTGT: deltaGT ratio mirrors the NCF-I: NCF-1 psi ratio and is 2:4 in normal individuals.
    OBJECTIVE: To determine the molecular basis of the Autosomal-CGD in a family with 2 children, a male and female, affected by the disease. The female patient suffered recurrent infection, retinitis pigmentosa and discoid lupus.
    METHODS: Chemiluminescence (CL) was used to study the respiratory burst, while genetic analysis was done by RT-PCR, PCR, deltaGT and the 20bp gene scans.
    RESULTS: The CL response of the patient was profoundly low. The patient's p47-phox band was absent in the RT-PCR for NADPH-oxidase component mRNAs. The deltaGT scan showed that the patient's GTGT: deltaGT ratio was 0:6, the parents' and the younger brother's was 1:5 and the younger sister's was 2:4. Examination of other NCF-1/ NCF-1 psi s differences showed that the father had a compound deltaGT allele ie. deltaGT-20bp, inherited by the patient, and that both parents had compound GTGT alleles with a single 30bp segment in intron 1.
    CONCLUSIONS: The patient was a classic, homozygous deltaGT p47-phox deficient CGD with one allele harbouring a compound deltaGT-20bp gene. The deltaGT and 20bp gene scans offer a relatively simple and efficient means of defining a p47-phox deficient CGD patient.
    Key words: Chronic Granulomatous Disease, Primary Immunodeficiency, NCF-1, p47-phox, NADPH-oxidas
    Matched MeSH terms: Granulomatous Disease, Chronic/enzymology; Granulomatous Disease, Chronic/genetics*; Granulomatous Disease, Chronic/pathology
  12. Fulltext What are the antioxidant status predictors' factors among male chronic obstructive pulmonary disease (COPD) patients?
    Pirabbasi E, Najafiyan M, Cheraghi M, Shahar S, Abdul Manaf Z, Rajab N, et al.
    Glob J Health Sci, 2013 Jan;5(1):70-8.
    PMID: 23283038 DOI: 10.5539/gjhs.v5n1p70
    Imbalance between antioxidant and oxidative stress is a major risk factor for pathogenesis of some chronic diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to determine antioxidant and oxidative stress status, and also theirs association with respiratory function of male COPD patients to find the antioxidant predictors' factors. A total of 149 subjects were involved in a cross-sectional study. The study was conducted at two medical centers in Kuala Lumpur, Malaysia. Results of the study showed that plasma vitamin C was low in most of the subjects (86.6%). Total antioxidant capacity was the lowest in COPD stage IV compare to other stages (p < 0.05). Level of plasma vitamin A (p= 0.012) and vitamin C (p= 0.007) were low in malnourished subjects. The predictors for total antioxidant capacity were forced vital capacity (FVC) % predicted and intake of ?-carotene (R2= 0.104, p= 0.002). Number of cigarette (pack/ year) and smoking index (number/ year) were not associated with total antioxidant capacity of this COPD population. Plasma oxidative stress as assessed plasma lipid peroxidation (LPO) was only positively correlated with plasma glutathione (p= 0.002). It might be a need to evaluate antioxidant status especially in older COPD patients to treat antioxidant deficiency which is leading to prevent COPD progression.
    Study site: Outpatient clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Institute of Respiratory Medicine, Kuala Lumpur, Malaysia
    Matched MeSH terms: Disease Progression; Pulmonary Disease, Chronic Obstructive/blood*; Pulmonary Disease, Chronic Obstructive/physiopathology
  13. Fulltext A combined case of macroprolactinoma, growth hormone excess and Graves' disease
    Hussein Z, Tress B, Colman PG
    Med J Malaysia, 2005 Jun;60(2):232-6.
    PMID: 16114168
    Thyrotoxicosis due to Graves disease is a relatively common endocrine disorder. The occurrence of a prolactinoma with co-secretion of growth hormone (GH) is on the other hand, rare. We report the rare co-existence of Graves' disease in a patient with macroprolactinoma and GH hypersecretion and describe the successful response to medical therapy with dopamine agonist and antithyroid therapy. We hypothesize that hyperprolactinaemia played a role in promoting autoimmune thyroid disease in our patient and that treatment of hyperprolactinaemia may have been important in suppressing autoimmune disease activity in Graves' disease. This case also reflects on the close and complex interactions between thyroid hormones, prolactin (PRL), GH and testosterone (T).
    Matched MeSH terms: Graves Disease/blood; Graves Disease/complications*; Graves Disease/drug therapy
  14. Molecular characterization of infectious bursal disease virus isolates from Nepal based on hypervariable region of VP2 gene
    Sharma K, Hair-Bejo M, Omar AR, Aini I
    Acta Virol., 2005;49(1):59-64.
    PMID: 15929400
    Two Infectious bursal disease virus (IBDV) isolates, NP1SSH and NP2K were obtained from a severe infectious bursal disease (IBD) outbreak in Nepal in 2002. The hypervariable (HV) region of VP2 gene (1326 bp) of the isolates was generated by RT-PCR and sequenced. The obtained nucleotide sequences were compared with those of twenty other IBDV isolates/strains. Phylogenetic analysis based on this comparison revealed that NP1SSH and NP2K clustered with very virulent (vv) IBDV strains of serotype 1. In contrast, classical, Australian classical and attenuated strains of serotype 1 and avirulent IBDV strains of serotype 2 formed a different cluster. The deduced amino acid sequences of the two isolates showed a 98.3% identity with each other and 97.1% and 98.3% identities, respectively with very virulent IBDV (vvIBDV) isolates/strains. Three amino acids substitutions at positions 300 (E-->A), 308 (I-->F) and 334 (A-->P) within the HV region were common for both the isolates. The amino acids substitutions at positions 27 (S-->T), 28 (I-->T), 31 (D-->A), 36 (H-->Y), 135 (E-->G), 223 (G-->S), 225 (V-->I), 351 (L-->I), 352 (V-->E) and 399 (I-->S) for NP1SSH and at position 438 (I-->S) for NP2K were unique and differed from other IBDV isolates/strains. NP1SSH and NP2K showed highest similarity (97.8%) with the BD399 strain from Bangladesh as compared with other vvIBDV isolates/strains. We conclude that the NP1SSH and NP2K isolates of IBDV from Nepal represent vvIBDV of serotype 1.
    Matched MeSH terms: Infectious bursal disease virus/classification; Infectious bursal disease virus/genetics*; Infectious bursal disease virus/isolation & purification
  15. Brain functional connectivity patterns for emotional state classification in Parkinson's disease patients without dementia
    Yuvaraj R, Murugappan M, Acharya UR, Adeli H, Ibrahim NM, Mesquita E
    Behav Brain Res, 2016 Feb 1;298(Pt B):248-60.
    PMID: 26515932 DOI: 10.1016/j.bbr.2015.10.036
    Successful emotional communication is crucial for social interactions and social relationships. Parkinson's Disease (PD) patients have shown deficits in emotional recognition abilities although the research findings are inconclusive. This paper presents an investigation of six emotions (happiness, sadness, fear, anger, surprise, and disgust) of twenty non-demented (Mini-Mental State Examination score >24) PD patients and twenty Healthy Controls (HCs) using Electroencephalogram (EEG)-based Brain Functional Connectivity (BFC) patterns. The functional connectivity index feature in EEG signals is computed using three different methods: Correlation (COR), Coherence (COH), and Phase Synchronization Index (PSI). Further, a new functional connectivity index feature is proposed using bispectral analysis. The experimental results indicate that the BFC change is significantly different among emotional states of PD patients compared with HC. Also, the emotional connectivity pattern classified using Support Vector Machine (SVM) classifier yielded the highest accuracy for the new bispectral functional connectivity index. The PD patients showed emotional impairments as demonstrated by a poor classification performance. This finding suggests that decrease in the functional connectivity indices during emotional stimulation in PD, indicating functional disconnections between cortical areas.
    Matched MeSH terms: Parkinson Disease
  16. The utility of a 'non-significant' coronary angiogram
    Wang TK, Oh TH, Samaranayake CB, Webster MW, Stewart JT, Watson T, et al.
    Int J Clin Pract, 2015 Dec;69(12):1465-72.
    PMID: 26304046 DOI: 10.1111/ijcp.12723
    Coronary angiography is the gold standard for assessing coronary artery disease (CAD). In many patients with chest pain, no or mild CAD (< 50% stenosis) is found. It is uncertain whether this 'non-significant' result influences management and outcomes. We reviewed characteristics and outcomes in a contemporary cohort of chest pain referrals who had mild or absent CAD on coronary angiography.
    Matched MeSH terms: Coronary Artery Disease
  17. Fulltext Genome Sequence of Salmonella enterica subsp. enterica Serovar Typhi Isolate PM016/13 from Untreated Well Water Associated with a Typhoid Outbreak in Pasir Mas, Kelantan, Malaysia
    Muhamad Harish S, Sim KS, Najimudin N, Aziah I
    Genome Announc, 2015;3(6).
    PMID: 26564032 DOI: 10.1128/genomeA.01261-15
    Salmonella enterica subsp. enterica serovar Typhi is a human-restricted pathogen that causes typhoid fever. Even though it is a human-restricted pathogen, the bacterium is also isolated from environments such as groundwater and pond water. Here, we describe the genome sequence of the Salmonella enterica subsp. enterica serovar Typhi PM016/13 which was isolated from well water during a typhoid outbreak in Kelantan, Malaysia, in 2013.
    Matched MeSH terms: Disease Outbreaks
  18. Nepenthes ampullaria (Nepenthaceae) Pitchers Are Unattractive to Gravid Aedes aegypti and Aedes albopictus (Diptera: Culicidae)
    Chou LY, Dykes GA, Wilson RF, Clarke CM
    Environ Entomol, 2016 Feb;45(1):201-6.
    PMID: 26518035 DOI: 10.1093/ee/nvv164
    Nepenthes pitcher plants are colonized by a variety of specialized arthropods. As Aedes mosquitoes are container breeders, Nepenthes pitchers are a potential candidate oviposition site for vector species, such as Aedes aegypti (L.) and Aedes albopictus (Skuse). However, Aedes spp. are not commonly encountered in Nepenthes pitchers, and the environment inside the pitchers of some species is lethal to them. One exception is Nepenthes ampullaria Jack, whose pitchers are known to be colonized by Ae. albopictus on very rare occasions. Given that Ae. albopictus larvae can survive in N. ampullaria pitcher fluids, we sought to determine why pitcher colonization is rare, testing the hypothesis that gravid Aedes mosquitoes are deterred from ovipositing into container habitats that have similar characteristics to N. ampullaria pitchers. Using plastic ovitraps of different sizes, colors, and with different types of fluids (based on the characteristics of N. ampullaria pitchers), we compared oviposition rates by Aedes mosquitoes in urban and rural areas within the geographical range of N. ampullaria near Kuala Lumpur, Malaysia. Ovitraps that were black and large (>250-ml capacity) accumulated significantly more eggs than ovitraps that were smaller, or green in color. In terms of size and color, small, green ovitraps are analogous to N. ampullaria pitchers, indicating that these pitchers are not particularly attractive to gravid Ae. albopictus. Although Aedes spp. are capable of colonizing N. ampullaria pitchers, the pitchers are relatively unattractive to gravid females and do not represent a significant habitat for larvae of dengue vectors at present.
    Matched MeSH terms: Disease Vectors
  19. Fulltext Outcome of Surgical Treatment for Displaced Acetabular Fractures
    Anizar-Faizi A, Hisam A, Sudhagar KP, Moganadass M, Suresh C
    Malays Orthop J, 2014 Nov;8(3):1-6.
    PMID: 26401227 MyJurnal DOI: 10.5704/MOJ.1411.001
    The aim of this study was to assess the outcome of surgical treatment in displaced acetabular fractures in our local facilities. Previous studies reveal good outcome via open reduction method with achievement of congruent joint. We note that studies in this respect have not been conducted in our region. We retrospectively analyzed thirty patients with acetabular fractures who underwent open reduction and internal fixation. The data collection was performed over a 4-year period, from 2008 to 2011. The results showed 20 out of 30 patients (66.7%) had excellent/good results (Harris Hip Score equal or more than 80). Post operative complications were deep infection (6.7%), iatrogenic sciatic nerve injury (10.0%), avascular necrosis (16.7%), heterotopic ossificans (3.3%), degenerative changes in hip joint (43.3%) and loss of reduction (3.3%). In conclusion, surgical treatment of displaced acetabular fractures produces good functional outcome despite the complications.
    Matched MeSH terms: Iatrogenic Disease
  20. Fulltext Scleractinian corals (Fungiidae, Agariciidae and Euphylliidae) of Pulau Layang-Layang, Spratly Islands, with a note on Pavonamaldivensis (Gardiner, 1905)
    Waheed Z, Benzoni F, van der Meij SE, Terraneo TI, Hoeksema BW
    Zookeys, 2015.
    PMID: 26312025 DOI: 10.3897/zookeys.517.9308
    Layang-Layang is a small island part of an oceanic atoll in the Spratly Islands off Sabah, Malaysia. As the reef coral fauna in this part of the South China Sea is poorly known, a survey was carried out in 2013 to study the species composition of the scleractinian coral families Fungiidae, Agariciidae and Euphylliidae. A total of 56 species was recorded. The addition of three previously reported coral species brings the total to 59, consisting of 32 Fungiidae, 22 Agariciidae, and five Euphylliidae. Of these, 32 species are new records for Layang-Layang, which include five rarely reported species, i.e., the fungiids Lithophyllonranjithi, Podabaciasinai, Sandalolithaboucheti, and the agariciids Leptoseriskalayaanensis and Leptoseristroglodyta. The coral fauna of Layang-Layang is poor compared to other areas in Sabah, which may be related to its recovery from a crown-of-thorns seastar outbreak in 2010, and its low habitat diversity, which is dominated by reef slopes consisting of steep outer walls. Based on integrative molecular and morphological analyses, a Pavona variety with small and extremely thin coralla was revealed as Pavonamaldivensis. Since specimens from Sabah previously identified as Pavonamaldivensis were found to belong to Pavonaexplanulata, the affinities and distinctions of Pavonamaldivensis and Pavonaexplanulata are discussed.
    Matched MeSH terms: Disease Outbreaks
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