Displaying publications 141 - 160 of 822 in total

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  1. Methanol related death in National Institute of Forensic Medicine, Hospital Kuala Lumpur: A case series
    Chng KL, Lai PS, Siew SF, Md Yaro SW, Mahmood MS
    Malays J Pathol, 2020 Apr;42(1):99-105.
    PMID: 32342937
    INTRODUCTION: Methanol is a widely available chemical with a range of uses including as solvent, as a fuel, in chemical synthesis and anti-freeze preparations. Most of the cases are accidental exposures to drinking beverages contaminated with methanol.

    MATERIALS AND METHODS: In mid-September 2018, there was a single outbreak of methanol poisoning in Malaysia especially involving the state of Federal Territory Kuala Lumpur and Selangor. There were 33 reported deaths suspected due to methanol poisoning in this current outbreak where 11 of them were brought in to the Institute of Forensic Medicine (NIFM), Kuala Lumpur. The last outbreak was in the year 2013 with 29 deaths reported out of 44 cases.

    RESULTS: There were 3 cases (27.2%) died in hospital and the remaining 8 cases (72.8%) were found dead at home and were later brought in dead to the hospital. A full autopsy was carried out for each case. Autopsy findings, as well as lab results pertaining to cases that survived and directly brought in dead, were of a different spectrum.

    CONCLUSION: Methanol related deaths are almost always as a result of greed. The running truism is 'methanol poisoning is a result of deliberate addition/adulteration with industrial methanol'. Prevention of the illegal production of methanol and methylated spirits should be established to curb this matter in the future.

  2. Expression of transforming growth factor-beta and determination of apoptotic index in histopathological sections for assessment of the effects of Apigenin (4', 5', 7'- Trihydroxyflavone) on Cyclosporine A induced renal damage
    Chong FW, Chakravarthi S, Nagaraja HS, Thanikachalam PM, Lee N
    Malays J Pathol, 2009 Jun;31(1):35-43.
    PMID: 19694312
    Cyclosporine A (CsA), a calcineurin inhibitor produced by the fungi Trichoderma polysporum and Cylindrocarpon lucidum, is an immunosuppressant prescribed in organ transplants to prevent rejection. Its adverse effect on renal dysfunction has limited its use in a clinical setting. Apigenin (4',5',7'-Trihydroxyflavone), a herbal extract, with anti-inflammatory and anti-tumour properties, has been investigated for properties to reverse this adverse effect. This research was conducted to establish a standard protocol for immunohistochemical estimation of Transforming Growth Factor beta (TGF-beta) expression, as an indicator of Cyclosporine A induced damage, and to observe whether apoptotic index and TGF-beta expression can be used to assess effects of Apigenin on CsA induced renal dysfunction. Six groups of 5 male Sprague-Dawley albino rats each were dosed once daily for 21 days, as follows: (1) negative control--oral corn oil, (2) positive control--Cyclosporine A (25 mg/kg), (3) Group 3--Apigenin (20 mg/kg), (4) Group 4--Cyclosporine A (25 mg/kg) +Apigenin (10 mg/kg), (5) Group 5--Cyclosporine A (25 mg/kg) +Apigenin (15 mg/kg) and (6) Group 6--Cyclosporine A (25 mg/kg) +Apigenin (20 mg/kg). Cyclosporine A was administered intra-peritoneally while Apigenin was given orally. The rat kidneys were harvested and examined microscopically to assess the apoptotic index, and stained by immunohistochemistry for multifunctioning polypeptide TGF-beta expression. A high apoptotic index and TGF-beta intensity was observed in the Cyclosporine A group. Apigenin significantly reduced the both apoptotic index and TGF-beta intensity. The apoptotic index correlated with TGF-beta intensity, especially in glomeruli. This study indicates that Cyclosporine A can enhance the TGF-beta expression in rat kidney, signifying accelerated apoptosis. TGF-beta and apoptotic index may be used to assess Apigenin and its effect on Cyclosporine A induced renal damage.
  3. Malignant neoplasms at the Universiti Kebangsaan Malaysia 1980-1984
    Chong SM
    Malays J Pathol, 1986 Aug;8:41-8.
    PMID: 3682943
  4. Determination of salivary cortisol reference interval in a selected Malaysian population
    Choo JE, Samsudin IN, Mat Salleh MJ, Zahari Sham SY, Thambiah SC
    Malays J Pathol, 2020 Dec;42(3):433-437.
    PMID: 33361725
    INTRODUCTION: Salivary cortisol is used as an indicator of stress level and a recommended screening test for Cushing syndrome. The normal reference interval for salivary cortisol is dependent on the analytical methodology and the population studied and hence, establishment of a local population-based reference interval is recommended.

    MATERIALS AND METHODS: A total of 129 healthy blood donors and staffs of Penang General Hospital were recruited from June 2018-May 2019. Paired (morning and late-night) saliva samples were collected from individuals aged between 18 and 60 years old with no history of chronic medical illness. Salivary cortisol was assayed using electrochemiluminescence immunoassay technique. Non-parametric statistics were used for calculation of reference interval and 90% confidence intervals (90% CIs).

    RESULTS: The reference interval for morning and latenight salivary cortisol was 2.09 - 22.63 nmol/L and <12.00 nmol/L, respectively.

    CONCLUSION: The locally-derived adult reference intervals for morning and late-night salivary cortisol concentration was determined and varied with previous studies emphasising the need in establishing individual laboratory reference interval.

  5. Epigenetics in disease and cancer
    Choo KB
    Malays J Pathol, 2011 Dec;33(2):61-70.
    PMID: 22299205
    Since the discovery of the double-helical structure of DNA, genetic regulation of gene expression has been well elucidated. More recently, another equally, if not more, important scheme of regulation of gene expression, called epigenetics, has emerged to explain the many biological observations that traditional genetic mechanisms have failed to decipher. Epigenetics is a discipline of study on the biological consequences of cellular alterations that do not involve nucleotide changes, as opposed to genetic mutations. Epigenetic changes are reversible and may lead to loss or gain of biological functions. The three most reported mechanisms of epigenetic regulation of gene expression involve changes in: (i) chromatin remodelling, (ii) DNA methylation and (iii) microRNA (miRNA). More importantly, many of the elucidated epigenetic changes are linked to the pathogenesis of human diseases and cancers. In this mini review, core concepts and basic experimental approaches in the study of epigenetic regulation of gene expression are briefly reviewed in relation to disease, with emphasis on cancer. This mini review also intends to highlight the fact that, besides genetics, epigenetics is now a discipline physicians and clinical research scientists can no longer ignore in their pursuit to understand disease and cancer and to develop new therapeutic strategies for treatment.
  6. Fulltext A comparison of 1995 WHO classification with 2003 ISN/RPS classification of lupus nephritis: a single centre observation
    Chow TK, Looi LM, Cheah PL
    Malays J Pathol, 2015 Dec;37(3):239-46.
    PMID: 26712669
    BACKGROUND: In the past, lupus nephritis was histologically classified according to the 1995 WHO Classification. With the introduction of the 2003 ISN/RPS Classification, many nephropathology services converted to this new classification. This study was undertaken to compare both classification systems in a single centre practice.
    METHODS: 103 consecutive adequate renal biopsies initially reported as lupus nephritis in the Department of Pathology, Faculty of Medicine, University of Malaya were reassessed using the criteria of both the 1995 WHO Classification and the 2003 ISN/ RPS Classification.
    RESULTS: The relative prevalence for each class using the WHO Classification were: Class I (1%), Class II (8.7%), Class III (6.8%), Class IV (60.2%), Class V (20.4%), Class VI (2.9%) while the prevalence using the 2003 ISN/RPS Classification were: Class I (1%), Class II (8.7%), Class III (6.8%), Class IV (61.2%), Class V (21.3%), Class VI (1%). Both classifications were essentially comparable with regards to Classes I, II and III. The differences in Classes IV, V and VI were significant in potential to alter patient management. The identification of segmental lesions (Class IV-S) over and above a global nephritis (Class IV-G) deserves more focused clinicopathological studies to gauge whether these groups have different clinical manifestations and outcomes. With regards Class V, the ISN/RPS system, by requiring that all mixed classes be stipulated in the diagnostic line, minimizes the chances of patients missing out on additional treatment. The ISN/ RPS system has stricter criteria for Class VI, which again minimizes patients missing out on therapy. On the whole, the ISN/RPS system is more user-friendly as criteria are more clearly defined which translates to more benefits to patient care.
    Study site: Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  7. Fulltext A comparative evaluation of dengue diagnostic tests based on single-acute serum samples for laboratory confirmation of acute dengue
    Chua KB, Mustafa B, Abdul Wahab AH, Chem YK, Khairul AH, Kumarasamy V, et al.
    Malays J Pathol, 2011 Jun;33(1):13-20.
    PMID: 21874746
    A prospective study was carried out to evaluate the sensitivity of dengue NS1 antigen-capture ELISA in comparison with dengue virus isolation, conventional RT-PCR and real-time RT-PCR for laboratory confirmation of acute dengue based on single-acute serum samples. Four primary healthcare centres were involved to recruit patients with clinical diagnosis of dengue illness. Patient's demographic, epidemiological and clinical information were collected on a standardized data entry form and 5 ml of venous blood was collected upon consent. In the laboratory, six types of laboratory tests were performed on each of the collected acute serum sample. Of the 558 acute serum samples collected from 558 patients with clinical diagnosis of dengue from mid-August 2006 to March 2009, 174 serum samples were tested positive by the dengue NS1 antigen-capture ELISA, 77 by virus isolation, 92 by RT-PCR and 112 by real-time RT-PCR. A total of 190 serum samples were tested positive by either one or a combination of the four methods whereas, only 59 serum samples were tested positive by all four methods. Thus, based on single-acute serum samples, 190 of the 558 patients (34.1%) were laboratory-confirmed acute dengue. The overall test sensitivity was 91.6%, 40.5%, 48.4% and 58.9% for dengue NS1 antigen-capture ELISA, virus isolation, conventional RT-PCR and real-time RT-PCR respectively. Statistically, dengue NS1 antigen-capture ELISA was the most sensitive and virus isolation was the least sensitive test for the laboratory confirmation of acute dengue based on single-acute serum specimens. Real-time RT-PCR was significantly more sensitive than the conventional RT-PCR.
  8. Fulltext Risk factors, prevention and communication strategy during Nipah virus outbreak in Malaysia
    Chua KB
    Malays J Pathol, 2010 Dec;32(2):75-80.
    PMID: 21329177 MyJurnal
    An outbreak of acute febrile encephalitis affecting pig-farm workers and owners was recognized in peninsular Malaysia as early as September 1998. The outbreak was initially thought to be due to Japanese encephalitis (JE) virus and thus very intensive prevention, control and communication strategies directed at JE virus were undertaken by the Ministry of Health and Ministry of Agriculture of Malaysia. There was an immediate change in the prevention, control and communication strategies with focus and strategies on infected pigs as the source of infections for humans and other animals following the discovery of Nipah virus. Information and understanding the risks of Nipah virus infections and modes of transmission strengthened the directions of prevention, control and communication strategies. A number of epidemiological surveillances and field investigations which were broadly divided into 3 groups covering human health sector, animal health sector and reservoir hosts were carried out as forms of risk assessment to determine and assess the factors and degree of risk of infections by the virus. Data showed that there was significant association between Nipah virus infection and performing activities involving close contact with pigs, such as processing of piglets, administering injection or medication to pigs, assisting in the birth of piglets, assisting in pig breeding, and handling of dead pigs in the affected farms. A complex process of anthropogenic driven deforestation, climatic changes brought on by El Niño-related drought, forest fire and severe haze, and ecological factors of mixed agro-pig farming practices and design of pig-sties led to the spillovers of the virus from its wildlife reservoir into pig population.
  9. Fulltext Epidemiology, surveillance and control of Nipah virus infections in Malaysia
    Chua KB
    Malays J Pathol, 2010 Dec;32(2):69-73.
    PMID: 21329176 MyJurnal
    The outbreak of Nipah virus, affecting pigs and pig-farm workers, was first noted in September 1998 in the north-western part of peninsular Malaysia. By March 1999, the outbreak had spread to other pig-farming areas of the country, inclusive of the neighbouring country, Singapore. A total of 283 human cases of viral encephalitis with 109 deaths were recorded in Malaysia from 29 September 1998 to December 1999. During the outbreak period, a number of surveillances under three broad groups; Surveillance in Human Health Sector, Surveillance in Animal Health Sector, and Surveillance for the Reservoir Hosts, were carried out to determine the prevalence, risk of virus infections and transmission in human and swine populations as well as the source and reservoir hosts of Nipah virus. Surveillance data showed that the virus spread rapidly among pigs within infected farms and transmission was attributed to direct contact with infective excretions and secretions. The spread of the virus among pig farms within and between states of peninsular Malaysia was due to movement of pigs. The transmission of the virus to humans was through close contact with infected pigs. Human to human transmission was considered a rare event though the Nipah virus could be isolated from saliva, urine, nasal and pharyngeal secretions of patients. Field investigations identified fruitbats of the Pteropid species as the natural reservoir hosts of the viruses. The outbreak was effectively brought under control following the discovery of the virus and institution of correct control measures through a combined effort of multi-ministerial and multidisciplinary teams working in close co-operation and collaboration with other international agencies.
  10. Genetic diversity of enterovirus 71 isolated from cases of hand, foot and mouth disease in the 1997, 2000 and 2005 outbreaks, Peninsular Malaysia
    Chua KB, Chua BH, Lee CS, Chem YK, Ismail N, Kiyu A, et al.
    Malays J Pathol, 2007 Dec;29(2):69-78.
    PMID: 19108398
    All known field isolates of enterovirus 71 (EV71) can be divided into three distinct genogroups (A, B, C) and 10 subgenogroups (A, B1-5, C1-4) based on VP1 gene sequences. We examined VP1 gene sequences of 10, 12 and 11 EV71 strains isolated in peninsular Malaysia during the outbreaks of hand, foot and mouth disease in 1997, 2000 and 2005 respectively. Four EV71 strains isolated in the hand, foot and mouth disease outbreak of 2006 in Sarawak (Malaysian Borneo) were included to describe their genetic relationship. Four subgenogroups (C1, C2, B3 and B4) of EV71 co-circulated and caused the outbreak of hand, foot and mouth disease in peninsular Malaysia in 1997. Two subgenogroups (C1 and B4) were noted to cause the outbreak in 2000. In the 2005 outbreak, besides EV71 strains of subgenogroup C1, EV71 strains belonged to subgenogroup B5 were isolated but formed a cluster which was distinct from EV71 strains of the subgenogroup B5 isolated in 2003. The four EV71 strains isolated from clinical specimens of patients with hand, foot and mouth disease in the Sarawak outbreak in early 2006 also belonged to subgenogroup B5. Phylogenetic analysis of the VP1 gene sequences showed that the four Sarawak EV71 isolates belonged to the same cluster as the EV71 strains that were isolated in peninsular Malaysia as early as May 2005. The data suggested that the EV71 strains causing the outbreak in Sarawak could have originated from peninsular Malaysia.
  11. Fulltext A modified mycological medium for isolation and culture of Malassezia furfur
    Chua KB, Chua IL, Chua IE, Chong KH, Chua KH
    Malays J Pathol, 2005 Dec;27(2):99-105.
    PMID: 17191392
    A mycological medium was developed for primary isolation and culture of lipophilic yeasts. It was initially based on published information of nutrients and trace components that would promote the growth of these yeasts. It was subsequently modified and adjusted to specifically promote the growth of lipophilic yeasts and simultaneously avoid the luxurious growth of other fungi and bacteria. With this medium, the conventional bacteriological procedures such as microbial streaking for pure culture and anti-microbial sensitivity testing could be carried out for these lipophilic yeasts.
  12. A new cell culture tube in diagnostic virology for virus isolation
    Chua KB, Chua KH, Chua IL, Chen KF
    Malays J Pathol, 2004 Jun;26(1):69-71.
    PMID: 16190110
    Virus isolation and accurate characterization plays a crucial role in the rapid identification of the causative agents of infectious disease outbreaks especially if the causative viruses are novel where no pre-existing diagnostic reagents would be available. A new cell culture tube, named Jui Meng (JM) Cell Culture Tube, was developed to reduce the cost and improve the efficiency and biosafety of work pertaining to virus isolation. The design of the tube is based heavily on the principle of practicability, functionality, biosafety and long-term cost saving for diagnostic laboratory work in virus isolation. It is designed to culture an initial inoculum of one milliliter of culture medium containing 1 x 10(4) to 1 x 10(5) cells/ml.
  13. Fulltext Anthropogenic deforestation, El Niño and the emergence of Nipah virus in Malaysia
    Chua KB, Chua BH, Wang CW
    Malays J Pathol, 2002 Jun;24(1):15-21.
    PMID: 16329551
    In late 1998, a novel paramyxovirus named Nipah virus, emerged in Malaysia, causing fatal disease in domestic pigs and humans with substantial economic loss to the local pig industry. Pteropid fruitbats have since been identified as a natural reservoir host. Over the last two decades, the forest habitat of these bats in Southeast Asia has been substantially reduced by deforestation for pulpwood and industrial plantation. In 1997/1998, slash-and-burn deforestation resulted in the formation of a severe haze that blanketed much of Southeast Asia in the months directly preceding the Nipah virus disease outbreak. This was exacerbated by a drought driven by the severe 1997-1998 El Niño Southern Oscillation (ENSO) event. We present data suggesting that this series of events led to a reduction in the availability of flowering and fruiting forest trees for foraging by fruitbats and culminated in unprecedented encroachment of fruitbats into cultivated fruit orchards in 1997/1998. These anthropogenic events, coupled with the location of piggeries in orchards and the design of pigsties allowed transmission of a novel paramyxovirus from its reservoir host to the domestic pig and ultimately to the human population.
  14. Fulltext Seroprevalence of Malassezia furfur in an urban population in Malaysia
    Chua KB, Devi S, Hooi PS, Chong KH, Phua KL, Mak JW
    Malays J Pathol, 2003 Jun;25(1):49-56.
    PMID: 16196378
    An in-house prepared M. furfur antigen was used to carry out a seroprevalence study in an urban population in Malaysia by indirect immunofluorescence assay. Of the 800 serum samples from all ages screened, 738 samples were positive for M. furfur specific IgG, giving an overall seropositive rate of 92.3%. There was no significant difference in the seropositive rates among the different gender group and races. However, there was a statistical significant difference in the seropositive rate among different age groups with a lower rate (73%) for the age group 5 years old and below, which increased rapidly to 99% for the 16 to 20 years old age group but declined slightly for the oldest age group. The degree of seropositivity, which semi-quantitatively reflect the anti-M. furfur specific IgG titre, did not show any significant difference among the gender and racial groups. On the other hand, there was a significant difference in the degree of seropositivity among the various age groups, with the 16 to 20 years old age group having the highest antibody titre and the extreme of age groups having the lower antibody titre.
  15. A sleeve gastrectomy with pseudo-infiltrative pancreatic heterotopia and fundic gland polyps
    Chua TH, Takano A
    Malays J Pathol, 2021 04;43(1):121-125.
    PMID: 33903314
    No abstract available.
  16. Intra-articular loose bodies: a clinico-radiological conundrum with distinctive pathological morphologies
    Chua TH, Tang YL
    Malays J Pathol, 2021 08;43(2):337-338.
    PMID: 34448799
    No abstract available.
  17. Guidelines on sample management (version 1/2004)
    College of Pathologists, Academy of Medicine of, Malaysia
    Malays J Pathol, 2005 Jun;27(1):73-4.
    PMID: 16676699
  18. Guidelines on safe laboratory practice (version 1/2004)
    College of Pathologists, Academy of Medicine of, Malaysia
    Malays J Pathol, 2005 Jun;27(1):71-2.
    PMID: 16676698
  19. Guidelines on maintenance and operation of equipment in a pathology laboratory (version 1/2004)
    College of Pathologists, Academy of Medicine of, Malaysia
    Malays J Pathol, 2005 Jun;27(1):69-70.
    PMID: 16676697
  20. Fulltext Guidelines on minimum qualification, training and experience of professional personnel working in a pathology laboratory (version 1/2004)
    College of Pathologists, Academy of Medicine of Malaysia
    Malays J Pathol, 2005 Jun;27(1):57-62.
    PMID: 16676695
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