The two vital aspects of treatment for patients with tha-lassaemia are regular blood transfusions and iron chela-tion therapy. Unfortunately, the use of blood transfu-sions exposes these patients to the risks of acquiring transfusion related viral infections such as hepatitis C. Patients who acquire the hepatitis C virus (HCV) may develop chronic hepatitis and later on hepatocellular carcinoma. Hence, patients with thalassaemia should be regularly screened for the presence of HCV. We report here the results of a cross-sectional study conducted in a typical day-care centre for thalassaemics at the Hospital Universiti Kebangsaan Malaysia, involving 85 multiply transfused patients. We found that 19 patients (22.4%) were seropositive for HCV and two of them had positive HCV-RNA. Those who had started receiv-ing their transfusions before 1995, i.e. the year routine screening for HCV amongst blood donors were com-menced, and those who received transfusions 2-4 week-ly had a significantly higher risk of acquiring HCV infection.
The causes of an isolated prolonged activated partial thromboplastin time (APTT) with a normal prothrombin time (PT) are either a deficiency of clotting factors VIII, IX, XI or XII or the presence of an inhibitor. The inhibitor may be specific to an individual clotting factor or it may be a non-specific inhibitor like the lupus anticoagulant which has opposite therapeutic implications. We report a patient referred to our hospital for treatment that was previously diagnosed at another medical institution as an acquired factor IX inhibitor following an investigation for a prolonged APTT. On further testing this turned out to be a potent lupus anticoagulant which interfered with the phospholipid-dependent factor assays. The use of dilution studies, chromogenic assays and phospholipid neutralization can help differentiate these inhibitors. Great care must be taken in the interpretation of factor assays in the presence of lupus anticoagulant to avoid misdiagnosis and inappropriate treatment.
Subdermal etonogestrel implant (Implanon®) is the newest, long term contraceptive implant which has recently been made available to Malaysian women. This prospective study was conducted to determine the effects on selected health indices among 42 women who had consented to Implanon® as their choice of contraception. Health indices were checked prior to Implanon® insertion and six months post insertion. Findings indicate a significant reduction in total cholesterol with a significant increase in total haemoglobin and BMI. However there was no significant change noted in the fasting blood sugar, glycosylated haemoglobin, systolic blood pressure and diastolic blood pressure.
Seroreactivity to syphilis is high among Malaysian blood donors and expectant mothers indicating a high degree of treponemal infection. Further epidemiological studies are required to ascertain what proportion of these could be syphilis and what porportion yaws. Blood donors hava a higher reactivity rate than expectant mothers, the reasons probably being soical. The titres obtained in the VDRL test appear to have a relation to FTA-ABS reactivity although this is not to say treponematosis can be excluded on the basis of low titre VDRL results.
This study was conducted to study the blood pressure pattern and the prevalence of hypertension and its associated factors in a rural community in two coastal villages in rural Kedah, Mahysia. Out of the total population 504 were above 20 years of age and were eligible to participate. There were 227 males and 252 females. The mean systolic blood pressure was found to rise with age, peaking in the 6l·70 years age group, For women the mean blood pressure rose earlier from the age group of 4-l· 50 years. Mean blood pressures rose with increasing body mass index. lt also varied with occupation and education. The retired and unemployed had a higher blood pressure than those employed and there was an inverse relationship with increasing education. The prevalence of hypertension was 33.6%. More females were hypertensive (36.5%) as compared to males (3 0.4%) and this finding was the same for both systolic and diastolic hypertension. Majority (71.4%) of the hypertensives were undiagnosed. 72.5% of hypertensives who were on treatment were not under control. Hypertension was more prevalent among retirees and illiterates. Prevalence of hypertension increased correspondingly with age. Obesity was associated with hypertension. There was no association with family history of hypertension. Multiple logistic regression showed a positive association only for obesity. ln conclusion, given the high prevalence of hypertension at
present, it appears that the prevalence will increase as each age cohort grows older. Obesity, especially among housewives is a significant assorted factor.
Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Plasma concentrations of folate and vitamin B12 were determined in 2,491 BC cases individually matched to 2,521 controls among women who provided baseline blood samples. Multivariable logistic regression models were used to estimate odds ratios by quartiles of either plasma B vitamin. Subgroup analyses by menopausal status, hormone receptor status of breast tumors (estrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [HER2]), alcohol intake and MTHFR polymorphisms (677C > T and 1298A > C) were also performed. Plasma levels of folate and vitamin B12 were not significantly associated with the overall risk of BC or by hormone receptor status. A marginally positive association was found between vitamin B12 status and BC risk in women consuming above the median level of alcohol (ORQ4-Q1 = 1.26; 95% CI 1.00-1.58; Ptrend = 0.05). Vitamin B12 status was also positively associated with BC risk in women with plasma folate levels below the median value (ORQ4-Q1 = 1.29; 95% CI 1.02-1.62; Ptrend = 0.03). Overall, folate and vitamin B12 status was not clearly associated with BC risk in this prospective cohort study. However, potential interactions between vitamin B12 and alcohol or folate on the risk of BC deserve further investigation.
Matched MeSH terms: Breast Neoplasms/blood; Folic Acid/blood*; Folic Acid Deficiency/blood; Neoplasms, Hormone-Dependent/blood; Vitamin B 12/blood*; Vitamin B 12 Deficiency/blood; Biomarkers/blood
Nipah virus, family Paramyxoviridae, caused disease in pigs and humans in peninsular Malaysia in 1998-99. Because Nipah virus appears closely related to Hendra virus, wildlife surveillance focused primarily on pteropid bats (suborder Megachiroptera), a natural host of Hendra virus in Australia. We collected 324 bats from 14 species on peninsular Malaysia. Neutralizing antibodies to Nipah virus were demonstrated in five species, suggesting widespread infection in bat populations in peninsular Malaysia.