Haematopoietic stem cell transplantation (HSCT) has progressed rapidly since its introduction about five decades ago. There is now an increasing demand for transplant physicians in both public and private domains to perform this procedure in view of significant improvement of remission rates in haematological malignancies and increasing indications of HSCT. Peripheral blood has largely replaced bone marrow as the preferred source of haematopoietic stem cells (HSC). Transplantation-related mortality and morbidity rates have considerably decreased because of improved conditioning regimens, human leukocyte antigen (HLA) typing methods, supportive care, and most importantly, prophylaxis, diagnosis and treatment of serious infections. New transplantation strategies, such as reduced intensity transplantation, have extended the use of allogeneic transplant to patients with older age and co-morbidities. Current efforts are focused on ways to increase the donor pool and to improve the long term outcome of HSCT survivors in particular to reduce the relapse rate and the late effects of HSCT. This article summarizes the sources and procurement of HSC, the types and process of HSCT, indications for HSCT and complications associated with HSCT with particular reference to the current practice within the local settings.
Matched MeSH terms: Graft vs Host Disease/epidemiology
The author presents reports of foot and mouth disease (FMD) submitted between 1996 and 2001 to the Office International des Epizooties (OIE: World organisation for animal health) Sub-Commission for FMD in South-East Asia. Of the ten countries in South-East Asia, FMD is endemic in seven (Cambodia, Laos, Malaysia, Myanmar, the Philippines, Thailand and Vietnam) and three are free of the disease (Brunei, Indonesia and Singapore). Part of the Philippines is also recognised internationally as being free of FMD. From 1996 to 2001, serotype O viruses caused outbreaks in all seven of the endemically infected countries. On the mainland, three different type O lineages have been recorded, namely: the South-East Asian (SEA) topotype, the pig-adapted or Cathay topotype and the pan-Asian topotype. Prior to 1999, one group of SEA topotype viruses occurred in the eastern part of the region and another group in the western part. However, in 1999, the pan-Asian lineage was introduced to the region and has become widespread. The Cathay topotype was reported from Vietnam in 1997 and is the only FMD virus currently endemic in the Philippines. Type Asia 1 has never been reported from the Philippines but was reported from all countries on the mainland except Vietnam between 1996 and 2001. Type A virus has not been reported from east of the Mekong River in the past six years and seems to be mainly confined to Thailand with occasional spillover into Malaysia. The distribution and movement of FMD viruses in the region is a reflection of the trade-driven movement of livestock. There is great disparity across the region in the strength and resources of the animal health services and this has a direct impact on FMD control. Regulatory environments are not well developed and enforcement of regulations can be ineffectual. The management of animal movement is quite variable across the region and much market-driven transboundary movement of livestock is unregulated. Formal quarantine approaches are generally not supported by traders or are not available. Vaccination is not used widely as a control tool because of the expense. However, it is applied by the Veterinary Services in Malaysia to control incursions of the disease and there is a mass vaccination programme for large ruminants in Thailand where the Government produces and distributes vaccine. Vaccination is also used by the commercial pig sector, particularly in the Philippines and Thailand.
François Sirois' influential paradigm for diagnosing episodes of epidemic hysteria is discussed. The part of his schema addressing the large diffuse outbreak should be eliminated as it does not possess characteristic features of mass hysteria and overlooks the potential social, cultural, political, ritualistic and institutional patterning of collective behavior. A case study involving the collective delusion of phantom rockets over Sweden during 1946 illustrates the complexities of such episodes.
The Reason for Encounter Classification (RFEC) was designed by a WHO Working Party to classify the reasons why patients seek care at the primary care level. It is designed along two axes: Chapters and Components. Each chapter carries an alpha-code which is the first character of the basic 3-character alphanumeric code. Each chapter is subdivided into seven "components" carrying 2-digit numeric codes. The field trial was undertaken by family physicians and nurses in: Australia, Barbados, Brazil, Hungary, Malaysia, the Netherlands, Norway and the US. 90497 RFE's were analysed. Their distribution over the chapters and components characterize the content of international primary care. Listings with the most common RFE's in the participating countries reflect the cultural differences. It is concluded that the RFEC is not only feasible to classify reasons why patients seek care but also to classify the diagnosis and the process of primary care. As a result of this, the International Classification of Primary Care (ICPC) succeeds the RFEC.
Preliminary studies have shown that Lymnaea rubiginosa, a common fresh-water snail in Peninsular Malaysia, which is easily colonized and reared in the laboratory, is a capable experimental intermediate host for Angiostrongylus malaysiensis. Overall 73% of the snails tested became infected following 6 hours exposure to infective rat faeces. Higher infection rates, up to 100%, and heavier worm loads, occurred among the larger sized snails. Snail attrition was low except when very heavy worm loads were acquired.
Parkinson's disease (PD) is a member of a larger group of neuromotor diseases marked by the progressive death of dopamineproducing cells in the brain. Providing computational tools for Parkinson disease using a set of data that contains medical information is very desirable for alleviating the symptoms that can help the amount of people who want to discover the risk of disease at an early stage. This paper proposes a new hybrid intelligent system for the prediction of PD progression using noise removal, clustering and prediction methods. Principal Component Analysis (PCA) and Expectation Maximization (EM) are respectively employed to address the multi-collinearity problems in the experimental datasets and clustering the data. We then apply Adaptive Neuro-Fuzzy Inference System (ANFIS) and Support Vector Regression (SVR) for prediction of PD progression. Experimental results on public Parkinson's datasets show that the proposed method remarkably improves the accuracy of prediction of PD progression. The hybrid intelligent system can assist medical practitioners in the healthcare practice for early detection of Parkinson disease.
The CORFIS Programme was conceived by the Clinical Research Centre, HKL in 2007 in the hope of piloting a chronic disease management strategy among the Malaysian private general practitioners to tackle the current epidemic of cardiovascular chronic diseases. 1-5 The programme was implementing as a clinical research study i.e. a community trial in June 2007. The study recruited a total of 70 GPs within the Klang Valley region with an enrolment of 705 patients diagnosed with hypertension, diabetes mellitus (DM) and/or hyperlipidaemia. The GPs were clustered randomised centrally in a 2:1 ratio to provide either chronic disease care (CORFIS) or usual care. Patients were followed up for a period of 6 months from date of enrolment. (Copied from article).
Radicular cyst is the most common cyst in the mandible. It usually presents in the later age of life because the formation of the cyst is the last step in a progression of inflammatory events following a periapical inflammatory lesion. The cyst usually goes unnoticed because of the size that is rarely palpable, and it is often painless. In this paper, we present a 12 year-old girl who developed a relatively large cyst for the age. The outline of management is discussed.
Children with musculoskeletal symptoms are commonly seen by general practitioners (GPs). Those that present with atraumatic limp pose a particular diagnostic challenge. Although uncommon, Perthes disease (PD) is an important cause of atraumatic limp in children and may result in debilitating consequences if missed. We put forward a case of delayed diagnosis of PD in a child, thus highlighting the need for a greater index of suspicion among GPs in approaching any child with a limp.
Bacterial leaf blight (BLB) is one of the major rice diseases in Malaysia. This disease causes substantial yield loss as high as 70%. Development of rice varieties which inherited BLB resistant traits is a crucial approach to promote and sustain rice industry in Malaysia. Hence, this study aims were to enhance BLB disease resistant characters of high yielding commercial variety MR219 through backcross breeding approach with supporting tool of marker-assisted selection (MAS). Broad spectrum BLB resistance gene, Xa7 from donor parent IRBB7 were introgressed into the susceptible MR219 (recurrent parent) using two flanking markers ID7 and ID15. At BC3F4, we managed to generate 19 introgressed lines with homozygous Xa7 gene and showed resistant characteristics as donor parent when it was challenged with Xanthomonas oryzae pv. oryzae through artificial inoculation. Recurrent parent MR219 and control variety, MR263 were found to be severely infected by the disease. The improved lines exhibited similar morphological and yield performance characters as to the elite variety, MR219. Two lines, PB-2-107 and PB-2-34 were chosen to be potential lines because of their outstanding performances compared to parent, MR219. This study demonstrates a success story of MAS application in development of improved disease resistance lines of rice against BLB disease.