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The prevalence of Helicobacter pylori in patients with oesophageal stenosis

Ylmaz Ö, Temur A, Almal N, Dülger AC, Sasmaz MI

Trop Biomed, 2018 Dec 01;35(4):1148-1153.
PMID: 33601862

Oesophageal strictures often occur following esophagectomy which is performed for cases of oesophageal cancer. These patients require repeated dilation procedures. The aim of this study is to investigate the effects of dietary regimens, which are changed because of stenosis, caused by Helicobacter pylori (H. pylori). In this retrospective study, 28 patients who had operation for oesophageal cancer and underwent dilation due to development of stricture were studied. 30 female and 30 male patients who were admitted to the Gastroenterology Clinic with complaints of dyspepsia and did not receive treatment for the eradication of H. pylori were randomly selected and included in this study as a control group. Patients' histopathological records on the hemogram, biochemistry, and endoscopic biopsy were analysed. There were 26 H. pylori (+) cases (92.8 %) in the stenosis group consisting of 28 patients, and 37 H. pylori (+) cases (61.6%) in the control group consisting of 60 patients. These results were found to be statistically significant (P=0.003). The albumin level in the stenosis group was reported to be statistically low (P=0.002). The incidence of H. pylori was found to be significantly higher in patients with stenosis. We ascribed this outcome due to changes in dietary regimens. Our findings showed that the dietary regimens of all patients who underwent esophagectomy should be regulated during the postoperative period considering H. pylori. The relationship between H. pylori and stenosis was significant, there is a need for further research with a larger sample size to enrich the findings.
Factors influencing the release of Mitragyna speciosa crude extracts from biodegradable P(3HB-co-4HB)

Chee JW, Amirul AA, Majid MI, Mansor SM

Int J Pharm, 2008 Sep 1;361(1-2):1-6.
PMID: 18584978 DOI: 10.1016/j.ijpharm.2008.05.007

Copolyesters of 3-hydroxybutyrate (3HB) and 4-hydroxybutyrate (4HB) were produced by Cupriavidus sp. (USMAA2-4) (DSM 19379) from carbon sources of 1,4-butanediol and gamma-butyrolactone. The composition of copolyesters produced varied from 0 to 45 mol% 4HB, depending on the combination of carbon sources supplied. The P(3HB-co-4HB) films containing Mitragyna speciosa crude extract were prepared with the ratio varying from 10 to 40% (w/w). The in vitro crude extract release of the films was studied in 0.1M phosphate buffer (pH 7.4) at 37 degrees C. Although the release rate was slow, it was maintained at a constant rate. This suggests that the crude extract release was due to the polymer degradation because the amount of crude extract released was consistent. The amount of degradation was based on the films' dry weight loss, decrease in molecular weight and surface morphology changes. The degradation rate increased with the 4HB content. This showed that the polymer degradation is dependant on the molecular weight, crystallinity, thermal properties and water permeability. The different drug loading ratio which led to surface morphology changes also gave an effect on polymer degradation.
The health burden of malaria and household choices regarding treatment and prevention in Pakistan

Khan M, Mahmood HZ, Noureen S, Muhmood K, Husnain MIU, Hameed Khaliq I

Trop Biomed, 2019 Sep 01;36(3):664-676.
PMID: 33597488

The extent of the economic burden of malaria and its imposed mechanisms are both relevant to public policy. This paper investigates the economic burden of malaria and household behaviour in relation to the treatment and prevention of the illness in Pakistan. In this regard, data were collected from a randomly selected sample of 360 households using structured questionnaires. The survey results indicate that 23.4% of household members contracted malaria during the three-month reference period. The average per person cost of malaria is estimated at 3116 Pakistani rupees (PKR) (USD 32). The estimated cost of the illness was found to be equivalent to, on average, 6.7% of monthly household income. Although high-income households face a higher financial burden due to better preventive and mitigation measures, the negative consequences hit low-income households harder due to liquidity constraints and poor access to effective treatment. We recommend that malaria control policies be integrated into development and poverty reduction programs.
Effect of Artocarpus integer lectin on functional activity of guinea-pig complement

Hashim OH, Gendeh GS, Cheong CN, Jaafar MI

Immunol Invest, 1994 Mar;23(2):153-60.
PMID: 8194855

The effect of Artocarpus integer lectin (lectin C) on the functional activity of guinea-pig complement was investigated. Purified and crude extract of lectin C from six cultivars of Artocarpus integer seeds were found to consume complement and thus decreased the complement-induced haemolytic activity of sensitized sheep erythrocytes. The change in the complement-mediated haemolytic activity was significantly decreased when incubation of the lectins was performed in the presence of melibiose. The reversal effect of the carbohydrate, which is a potent inhibitor of the lectin's binding to O-linked oligosaccharides of glycoprotein, demonstrate involvement of the lectins interaction with O-glycans of glycoproteins in the consumption of guinea-pig complement.
Fulltext Chronic heel pain: It could be tuberculosis

Muhamad Effendi F, Ibrahim MI, Rozali KN, Miswan MF

Malays Fam Physician, 2016;11(2-3):20-23.
PMID: 28461854 MyJurnal

INTRODUCTION: Heel pain is a common presentation at a primary care setting. The majority of these cases are benign and self limiting in nature. Common differential diagnoses include plantar fasciitis and peroneal muscle sprains. However, certain conditions-if undetected early-may cause significant morbidity to the patient. A high index of suspicion and early referral for further investigations are needed to prevent long-term morbidities.

METHODS: A clinical review of a patient with chronic left heel pain was performed. Blood parameters and imaging investigations indicated chronic infection of the calcaneum. Histopathological examination was highly suggestive of tuberculosis.

RESULT: The patient responded well to antituberculous therapy. She was pain free and showed no signs of recurrence at final follow-up.

CONCLUSION: Here, we report a case of chronic heel pain, which was later diagnosed as tuberculosis of the calcaneum and successfully treated with antituberculous therapy.
Novel usage of fresh frozen plasma in hereditary angioedema

Hanizah N, Affirul CA, Farah NA, Shamila MA, Ridzuan MI

Clin Ter, 2016 Nov-Dec;167(6):182-184.
PMID: 28051822 DOI: 10.7417/CT.2016.1969

Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Early recognition and timely intervention with the correct treatment are crucial particularly preventing airway obstruction. New disease specific treatment including plasma derived or recombinant C1-INH, ecallantide and icatibant have recently emerged and its appropriate use can reduce HAE-associated mortality and morbidity. However due to its costs, these disease specific treatments have yet to reach Malaysia. Despite that no randomized clinical trial on FFP has been performed, its efficacy in treating acute attacks of HAE is only demonstrated in case studies. This case report illustrates the successful treatment of acute HAE episode with FFP in a Malaysian government hospital setting.
Development of QSAR model to predict the ecotoxicity of Vibrio fischeri using COSMO-RS descriptors

Ghanem OB, Mutalib MIA, Lévêque JM, El-Harbawi M

Chemosphere, 2017 Mar;170:242-250.
PMID: 28006757 DOI: 10.1016/j.chemosphere.2016.12.003

Ionic liquids (ILs) are class of solvent whose properties can be modified and tuned to meet industrial requirements. However, a high number of potentially available cations and anions leads to an even increasing members of newly-synthesized ionic liquids, adding to the complexity of understanding on their impact on aquatic organisms. Quantitative structure activity∖property relationship (QSAR∖QSPR) technique has been proven to be a useful method for toxicity prediction. In this work,σ-profile descriptors were used to build linear and non-linear QSAR models to predict the ecotoxicities of a wide variety of ILs towards bioluminescent bacterium Vibrio fischeri. Linear model was constructed using five descriptors resulting in high accuracy prediction of 0.906. The model performance and stability were ascertained using k-fold cross validation method. The selected descriptors set from the linear model was then used in multilayer perceptron (MLP) technique to develop the non-linear model, the accuracy of the model was further enhanced achieving high correlation coefficient with the lowest value being 0.961 with the highest mean square error of 0.157.
Structural identification of haemoglobin E in Malayan ethnic groups

Blackwell RQ, Lie-Injo LE, Weng MI

Trop Geogr Med, 1971 Sep;23(3):294-5.
PMID: 5099000
Clinical Measurement of the Tibio-femoral Angle in Malay Children

Mohd-Karim MI, Sulaiman AR, Munajat I, Syurahbil AH

Malays Orthop J, 2015 Jul;9(2):9-12.
PMID: 28435602 MyJurnal DOI: 10.5704/MOJ.1507.005

BACKGROUND: This study was conducted to find out the age when tibiofemoral angle starts to be in valgus and reaches maximum angle. The differences of the angles between genders were also studied.
METHODOLOGY: This cross sectional study on tibiofemoral angle was conducted among 160 normal healthy children using clinical measurement method. The children between 2 18 months to 6 years old were assigned to 5 specific age groups of 32 children with equal sex distribution.
RESULT: This study had shown a good inter-observer reliability of tibiofemoral angle measurement with intraclass correlation coefficient (ICC) of 0.87 with narrow margin of 95% confident interval (95% CI: 0.73, 0.94). The mean tibiofemoral angle for children at 2 , 3 , 4 , 5 and 6 years old were 2.25° (SD=0.53), 8.73° (SD=0.95), 7.53° (SD=1.40), 7.27° (SD=1.14) and 6.72° (SD=0.98) respectively. The age when they achieved maximum valgus tibiofemoral angle was 3 years old. The maximum mean (SD) tibiofemoral angle for boys, girls and all children were 8.91° (SD=1.17), 8.56° (SD=0.62) and 8.73° (SD=0.95)respectively. The mean tibiofemoral angle showed no statistically significant difference between girls and boys except for the 5-year-old group, in which the mean TF angle for girls was 7.560 (SD=0.95) and for the boys was 6.970 (SD=1.26) with p-value of 0.037.
CONCLUSION: Measurement of tibiofemoral angle using the clinical method had a very good inter-observer reliability. The tibiofemoral angle in Malay population was valgus since the age of 2 years with maximum angle of 8.730 (SD=0.95) achieved at the age of 3 years.
Fulltext Patient satisfaction on waiting time and duration of consultation at Orthopedic Clinic, Universiti Kebangsaan Malaysia Medical Centre

Raja Lexshimi RG, Zaleha MI, Shamsul AS, Suriawati G

Medicine & Health, 2009;4(1):35-49.
MyJurnal

Patients are increasingly dissatisfied with the “waiting time” and “duration of consultation” at outpatient clinics. A cross sectional study was carried out to measure waiting time and duration of consultation and to examine patients’ level of satisfaction towards waiting time and duration of consultation at the Orthopedic Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This study also examined patient’s satisfaction towards the overall clinic services. Data was collected using a self-administered questionnaire. A total of 81 patients participated in this study with a response rate of 100 percent. Findings indicated a significant difference in the mean between expected waiting time level II (from the time the patient is given the calling number till the time patient is called into the doctor’s room) and the actual waiting time level II experienced. A significant difference in the mean between the expected duration of consultation and the actual duration of consultation experienced was also noted. However, no significant difference was found between the mean of expected waiting time level I (the time patient register at the counter till the patient is given the calling number) and the actual waiting time (p>0.05). Overall, patient satisfaction towards waiting time was low (29.6%) and duration of consultation was of moderate level (41.9%). The overall satisfaction towards the clinic services were of average level (56.8%). Findings also indicated that patient satisfaction was not influenced by socio-demographic factors of respondents such as age, ethnic, education level, occupation and income level. Important findings from this study may help staff managing the clinic in addressing patients’ complaint on waiting time and improve patients’ satisfaction on the overall services of the Orthopedic clinic in UKMMC.
Study site: Orthopedic clinc, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Lupus nephritis with visual field defect secondary to hypertensive retinopathy: a case report

Hor SM, Norshamsiah md, Mushawiahti M, Hazlita MI

Journal of Surgical Academia, 2017;7(2):32-36.
MyJurnal

A 23-year-old lady presented with both eye progressive painless blurring of vision for two weeks in 2011. Prior to that she had malar rash, hair loss, photosensitivity and bilateral leg swelling. Ocular examination showed that visual acuity on the right was 6/60 and on the left was 6/24. Both optic disc were swollen with extensive peripapillary cotton wool spot (CWS), flame shape haemorrhages, dilated and tortuous vessels with macular oedema. Systemic examination revealed blood pressure of 176/111 mmHg, malar rash and alopecia. Diagnosis of grade 4 hypertensive retinopathy secondary to SLE was made. The diagnosis was confirmed by positive ANA/ dsDNA, low C3/ C4 and renal biopsy showed lupus nephritis. She was treated with oral prednisolone, hydroxychloroquine and cyclosporin A. Throughout the monitoring for hydroxychloroquine toxicity, vision over both eyes were 6/9, but serial visual fields showed non-progressive left superior and inferior scotoma while right eye showed inferior scotoma. The intraocular pressure was normal with pink optic disc and cup disc ratio of 0.3. Optical coherence tomography (OCT) showed temporal and nasal retinal nerve fiber layer thinning bilaterally. However, macula OCT, fundus fluorescein angiography and autofluorescence were normal. The visual field defect was concluded secondary to CWS indicating microinfarction of the retinal nerve fiber secondary to previous hypertensive retinopathy. Non-progressive visual field defects may occur after the appearance of CWS in hypertensive retinopathy and it should not be overlooked when diagnosing glaucoma or hydroxychloroquine toxicity.
Is tenofovir the answer to further preventing mother-to-child transmission of hepatitis B?

Abdul Hafidz MI, Tan SS, Lee YY

J R Coll Physicians Edinb, 2016 12;46(4):248-250.
PMID: 28504780 DOI: 10.4997/JRCPE.2016.409
Quantifying the ultrastructure changes of air-dried and irradiated human amniotic membrane using atomic force microscopy: a preliminary study

Mohd S, Ghazali MI, Yusof N, Sulaiman S, Ramalingam S, Kamarul T, et al.

Cell Tissue Bank, 2018 Dec;19(4):613-622.
PMID: 30056604 DOI: 10.1007/s10561-018-9711-4

Air-dried and sterilized amnion has been widely used as a dressing to treat burn and partial thickness wounds. Sterilisation at the standard dose of 25 kGy was reported to cause changes in the morphological structure as observed under the scanning electron microscope. This study aimed to quantify the changes in the ultrastructure of the air-dried amnion after gamma-irradiated at several doses by using atomic force microscope. Human placentae were retrieved from mothers who had undergone cesarean elective surgery. Amnion separated from chorion was processed and air-dried for 16 h. It was cut into 10 × 10 mm, individually packed and exposed to gamma irradiation at 5, 15, 25 and 35 kGy. Changes in the ultrastructural images of the amnion were quantified in term of diameter of the epithelial cells, size of the intercellular gap and membrane surface roughness. The longest diameter of the amnion cells reduced significantly after radiation (p
Multiplex real-time RT-PCR assay for transfusion transmitted viruses in sero-negative allogeneic blood donors: an experience from Southern Pakistan

Sultan S, Nasir MI, Rafiq S, Baig MA, Akbani S, Irfan SM

Malays J Pathol, 2017 Aug;39(2):149-154.
PMID: 28866696

BACKGROUND: Blood transfusion safety commences with healthy donor recruitment. The threat of transfusion transmitted infections is greatly minimized by serological tools but not entirely eliminated. Recently, nucleic-acid testing for blood donor screening has virtually eliminated this jeopardy.
METHODS: This prospective study was conducted from February 2015 to February 2016. Samples from seronegative donors were run on multiplex assay (Cobas, S-201 system platform, Roche) in a batch of six [MP-NAT]. In case of reactive pool, tests were run on every individual sample [IDNAT].
RESULTS: Of 16957 donors, 16836 (99.2%) were replacement donors and the remaining 121 (0.7%) were voluntary donors, with a mean age of 29.09 ± 7.04 years. After serologic screening of all 16957 donors, 955 (5.6%) were found to be reactive; 291(1.71%) were reactive for hepatitis-B surface antigen, 361 (2.12%) for antibody to hepatitis C virus (anti-HCV), 14 (0.08%) for antibody to human immunodeficiency virus, 287 (1.69%) for syphilis and 2 (0.01%) for malaria. 14 (0.08%) NAT reactive donors were identified after testing the 16002 seronegative donors, with an overall NAT yield of one reactivity out of 1143 blood donations; 10 donors for HBV-DNA (HBV NAT yield-1:1600) and remaining 4 for HCV-RNA (HCV-NAT yield-1:4000). None were HIV positive.
CONCLUSION: NAT has improved the safety attributes in blood products. Although the positivity rate for NAT testing is low but in view of the high prevalence of transfusion transmitted infections in our country, we recommend the parallel use of both serology and NAT screening of all donated blood.
The unusual traumatic locked young knee

Mohd Miswan MF, Latiff Alsagoff S, Muhamad Effendi F, Ibrahim MI

Malays Fam Physician, 2019;14(2):26-28.
PMID: 31827732

Locked knee is an orthopaedic condition requiring urgent treatment. Although the condition can be diagnosed via history, physical examination and imaging studies, the cause of the mechanical obstruction may only be apparent during arthroscopic examination of the knee joint. It is known that imaging plays a role in evaluating the integrity of intra-articular structures, however in some atypical cases, imaging cannot identify the definitive cause of locked knee. Here we report on two cases of locked knee, due to uncommon conditions which were unobservable via normal imaging studies.
Levodopa-induced myocardial infarction in a patient with Parkinson's disease and severe coronary artery disease

Ng CF, Tiau PW, Tan HJ, Norlinah MI

J R Coll Physicians Edinb, 2019 Mar;49(1):37-39.
PMID: 30838990 DOI: 10.4997/JRCPE.2019.108

Levodopa is the most effective medical treatment for Parkinson's disease (PD) to date. As dopamine is known to increase cardiac inotropism and vasomotor tone, peripheral dopamine decarboxylase inhibitor is coadministered to suppress the peripheral conversion of levodopa to dopamine. Levodopa poses potential cardiovascular risks, thus its use in patients with existing coronary artery disease needs to be carefully monitored. We report a case of an elderly male with newly diagnosed PD who developed non-ST-elevation myocardial infarction following levodopa (Madopar) initiation.
Disturbance of mangrove forests causes alterations in estuarine phytoplankton community structure in Malaysian Matang mangrove forests

Hilaluddin F, Yusoff FM, Natrah FMI, Lim PT

Mar Environ Res, 2020 Jun;158:104935.
PMID: 32217292 DOI: 10.1016/j.marenvres.2020.104935

To assess the effects of environmental changes on phytoplankton community structure in a mangrove ecosystem, phytoplankton distribution in Matang mangrove, Malaysia was examined. Phytoplankton and water samples, and in situ environmental parameters from three estuaries with differing levels of disturbance were examined monthly for one year. Two species, Cyclotella choctawhatcheeana and Skeletonema costatum, were dominant in the least disturbed and moderately disturbed areas, respectively. Skeletonema costatum was also the most dominant in the most disturbed area. Significant differences in phytoplankton density and biodiversity between the least and most disturbed areas were also observed. Principle component 1 (salinity, conductivity, total solids/water transparency and nitrogenous compounds) and PC2 (dissolved oxygen, pH and temperature) explained 60.4% of the total variance. This study illustrated that changes in phytoplankton community structure in Matang mangrove estuaries were significantly correlated with environmental parameters which were in turn influenced by ecosystem disturbance levels as well as seasonal changes.
Bluish swelling on the floor of the mouth

Hassan BM, Intan Suhana MA, Megat Mustaqim MI

Malays Fam Physician, 2020;15(1):64-67.
PMID: 32284810
Fulltext Hyperthermia by near infrared radiation induced immune cells activation and infiltration in breast tumor

Wan Mohd Zawawi WFA, Hibma MH, Salim MI, Jemon K

Sci Rep, 2021 05 13;11(1):10278.
PMID: 33986437 DOI: 10.1038/s41598-021-89740-0

Breast cancer is the most common cancer that causes death in women. Conventional therapies, including surgery and chemotherapy, have different therapeutic effects and are commonly associated with risks and side effects. Near infrared radiation is a technique with few side effects that is used for local hyperthermia, typically as an adjuvant to other cancer therapies. The understanding of the use of near NIR as a monotherapy, and its effects on the immune cells activation and infiltration, are limited. In this study, we investigate the effects of HT treatment using NIR on tumor regression and on the immune cells and molecules in breast tumors. Results from this study demonstrated that local HT by NIR at 43 °C reduced tumor progression and significantly increased the median survival of tumor-bearing mice. Immunohistochemical analysis revealed a significant reduction in cells proliferation in treated tumor, which was accompanied by an abundance of heat shock protein 70 (Hsp70). Increased numbers of activated dendritic cells were observed in the draining lymph nodes of the mice, along with infiltration of T cells, NK cells and B cells into the tumor. In contrast, tumor-infiltrated regulatory T cells were largely diminished from the tumor. In addition, higher IFN-γ and IL-2 secretion was observed in tumor of treated mice. Overall, results from this present study extends the understanding of using local HT by NIR to stimulate a favourable immune response against breast cancer.
Review on diagnosis and molecular characterization of Toxoplasma gondii in humans and animals

Uddin AHMM, Hossain D, Ahsan MI, Atikuzzaman M, Karim MR

Trop Biomed, 2021 Dec 01;38(4):511-539.
PMID: 35001919 DOI: 10.47665/tb.38.4.091

Toxoplasma gondii is an obligate intracellular protozoon which causes toxoplasmosis, an important zoonotic disease that is endemic worldwide. Common sources of T. gondii infection in humans are food or water contaminated with oocysts and raw or undercooked meat with cysts. In animals, common sources of infection include feed, water, or litter contaminated with oocysts. The diagnosis and molecular characterization of T. gondii infection in humans and animals is crucial due to public and veterinary health importance. Various traditional and serological methods have been used in clinical practice for toxoplasmosis diagnosis, but interpreting the results remains a challenge. Several molecular techniques have also been used for the detection and genetic characterization of T. gondii , but primarily in research settings. In this paper, we review the techniques that are currently used for the diagnosis and genetic characterization of T. gondii in humans and animals, along with their advantages and disadvantages. The techniques reviewed have laid the groundwork for the future development of more effective and precise detection and characterization of T. gondii . These advances will contribute to a better understanding of epidemiology, prevention and control of toxoplasmosis. Thus, this review would be of particular interest to clinical physicians, veterinarians and researchers.

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