Displaying publications 1 - 20 of 37 in total

Abstract:
Sort:
  1. Martono, Fatmawati F, Mulyanti S
    Malays J Med Sci, 2023 Jun;30(3):84-92.
    PMID: 37425387 DOI: 10.21315/mjms2023.30.3.7
    The case of coronavirus disease (COVID-19) has become a global crisis. In addition, more variants of the virus have been discovered with easier transmission and more harmful effects. Thus, understanding the risk factors associated with the susceptibility and severity of COVID-19 is critical for disease control. This review article aims to describe the risk factors associated with the severity of COVID-19. This study uses the article review method from research results obtained through searching the journal sites Google Scholar, PubMed, ProQuest and ScientDirect in the 2020-2021 period. To find articles that match the inclusion criteria we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategy. A total of nine studies met the inclusion criteria for this review. These nine studies were assessed for quality, data extraction and synthesis. Risk factors that contribute to the severity of COVID-19 are age, gender, chronic comorbidities, cardiovascular disease, diabetes, hypertension, kidney failure, cancer and a history of smoking. New findings, unvaccinated patients are at higher risk of severity. Risk factors associated with the severity of COVID-19 include a person's individual characteristics, co-morbidities, smoking history and unvaccinated.
  2. Oswari L, Hidayat R, Fatmawati F, Hayati L, Alisa BS
    Open Access Maced J Med Sci, 2019 Oct 15;7(19):3149-3152.
    PMID: 31949507 DOI: 10.3889/oamjms.2019.758
    BACKGROUND: Uncaria gambir (local name: gambir) is a plant native to Sumatera, Malaya and Borneo. This plant is potential as local wisdom for therapeutics. In Sumatera, gambir was used as a traditional treatment for fever, diarrhoea, diabetics and wound healing.

    AIM: To explore the efficacy of gambir extract on TNF alpha level, prostaglandin E2 level, lesson area, body weight, lipid profile and leptin level in Wistar rat-model gastritis.

    METHODS: This study was an experimental study, with a pre-post-test control group design. The subjects in this study were 30 male rats, 8 weeks old, weight 150-200 gram. Rats were administered with gambir extract at the dose of 20, 40 and 80 mg/kg BW/day for 3 days. Gambir was extracted by maceration methods. Statistical analysis was performed by SPSS 18.

    RESULTS: Gambir extract at the dose of 80 mg/kg BW exhibited the highest efficacy in reducing TNF alpha level, lesion area and increasing prostaglandin E2 level compared to gambir extract at doses of 20 mg/kg BW, 400 mg/kg BW, negative control, and positive control.

    CONCLUSION: Gambir extract was effective in reducing TNF alpha level, lesson area, and increasing prostaglandin E2 level in Wistar rat-model gastritis.

  3. Fatmawati, Dewantara JA
    PMID: 35571877 DOI: 10.1002/casp.2611
    The Dayak indigenous community has belief and confidence in taking a stance and taking actions towards a situation and circumstances that affect their social life. This belief is based on their customs and traditions passed down from generation to generation until now. The Dayak traditional custom is a form of social resilience for the community on the border to anticipate the spread of the coronavirus disease 2019 (COVID-19) pandemic, which has become a problem in all aspects of community lives. Despite facing various issues and difficulties in dealing with the pandemic, the indigenous Dayak community in Indonesia has managed to survive and resolve these problems. In dealing with the social impact of the COVID-19 pandemic, the Salako Dayak indigenous community on the Indonesia-Malaysia border carried out a traditional ritual called Besamsam. The indigenous Salako Dayak community believes this ritual boosts the social and psychological resilience of the Salako Dayak indigenous community. The research findings showed that the Besamsam ritual had changed people's beliefs about lifestyle, behaviour and perceptions in dealing with the COVID-19 pandemic. The Besamsam ritual can specifically affect the community's personalities, attitudes and actions towards the spread of COVID-19. Indigenous peoples have become easier to organize, dynamic, empowered, resilient, motivated to meet their needs, and capable of facing various challenges and social problems during and after the COVID-19 pandemic. These findings prove that indigenous communities psychologically have strong confidence in their customary beliefs rather than cautionary advice from outside their community. The social impact of the Besamsam custom can serve as a model of awareness and a driving force for indigenous peoples' elements to work cooperatively to break the chain of COVID-19 spread.
  4. Fatmawati S, Yuliana, Purnomo AS, Abu Bakar MF
    Heliyon, 2020 Jul;6(7):e04396.
    PMID: 32685725 DOI: 10.1016/j.heliyon.2020.e04396
    Cassia alata or locally known as Ketepeng Cina (Indonesia) and Gelenggang (Malaysia) has been used as a traditional medicine to treat various diseases, especially skin diseases. In addition, C. alata has been reported to have potential anti allergic, anti inflammatory, antioxidant, anticancer, antidiabetic, and antifungal. Metabolite compounds that have been isolated from C. alata include flavones, flavonols, flavonoids glycosides, alatinon, alanonal and β-sitosterol-β-D-glucoside. The compounds have been isolated mainly from the leaves. Further identification is needed to discover the secondary metabolites from other parts of the plant such as seed, flower and bark which are reported to have potent antibacterial and antifungal activity. Therefore, this article highlights the secondary metabolites and biological activity of this plant which has been shown to have pharmacological properties against selected diseases.
  5. Putri NK, Melania MKN, Fatmawati SMY, Lim YC
    BMC Health Serv Res, 2023 Jul 05;23(1):730.
    PMID: 37408024 DOI: 10.1186/s12913-023-09677-0
    BACKGROUND: Most studies in advanced care settings reported that the increasing workload increases the work-life imbalance and harms the mental health of health workers. The COVID-19 Pandemic's tracing, testing, treatment, and mass vaccination also have multiplied the primary healthcare workers' workload. Nevertheless, studies on primary care workers are scarce. This study aimed to investigate how the COVID-19-related work-life balance impact stress on primary healthcare workers in the third years of the pandemic.

    METHODS: The study was a cross-sectional, web-based survey conducted on primary healthcare workers in Kediri Regency, Indonesia, with the highest Omicron case surge worldwide. It was conducted right after the surge between July and August 2022, the third year of the COVID-19 pandemic hit Indonesia. Under coordination with the local government health officials, primary healthcare workers were invited to participate in an online survey. The respondents were asked to evaluate their sociodemography, work conditions, personal life, and perceived stress (using the Perceived Stress Scale) during the pandemic. Their work-life balance was evaluated using the Work/Non-work Interference and Enhancement Scale. We used several hierarchical linear regression models to determine which variables contribute to work stress among primary healthcare workers.

    RESULTS: Sociodemographic characteristics, including gender, age, marital status, years of professional experience, and educational level, were not significantly associated with stress levels among our respondents. Separately, work conditions and personal life variables did not associate with stress levels. However, primary healthcare workers' work and personal lives interfere with each other during the pandemic and are associated with their higher stress.

    CONCLUSION: During the pandemic, the work life of primary health workers interferes with their personal life more than the interference of personal life on their work life. At the same time, the work life's enhancement on the personal life and vice versa were lower than its interference. Those conditions are associated with higher perceived stress of primary health workers.

  6. Hamdan MA, Mohd Amin KN, Adam F
    Food Chem, 2024 May 04;452:139556.
    PMID: 38744133 DOI: 10.1016/j.foodchem.2024.139556
    This study explores the molecular interactions and structural changes in κ-carrageenan crosslinked with isovanillin to create a biocomposite material suitable for hard capsule and bio-degradable packaging applications. Proton Nuclear Magnetic Resonance (1H NMR) spectroscopy revealed chemical changes in the conjugate molecule, indicating improved electronegativity due to intermolecular hydrogen bonding between κ-carrageenan and isovanillin. Time-of-flight Secondary Ion Mass Spectrometry (ToF-SIMS) analysis revealed enhanced ion intensity due to intermolecular interactions, particularly between sulphate and hydrogen ions. X-ray Photoelectron Spectroscopy (XPS) study demonstrated that κ-carrageenan and isovanillin form stronger hydrogen bonds, with a shift in binding energy indicating higher electronegativity. These findings shed light on the molecular mechanisms that underpin the formation of the biocomposite material, as well as its potential for use in hard capsule and biodegradable packaging materials, addressing the need for sustainable alternatives in the pharmaceutical and packaging industries while also contributing to environmental conservation.
  7. Abdul Kadir RF, Hanafiah M, Johari B, Zainudin LD
    Clin Case Rep, 2021 Oct;9(10):e04847.
    PMID: 34631066 DOI: 10.1002/ccr3.4847
    "Crazy paving" on CT images refers to the superimposition of ground-glass opacity and linear pattern resembling irregularly shaped paving stones. Initially, "crazy paving" was described as a pathognomonic sign of alveolar proteinosis. Subsequently, this pattern has been reported in a variety of disorders of the lung. We demonstrated CT images of lung adenocarcinoma demonstrating both solid and crazy-paving appearances.
  8. Mohamad Isa MZ, Mohamed-Yassin MS, Abdul Kadir RF
    Clin Pract, 2020 Mar 31;10(1):1218.
    PMID: 32373307 DOI: 10.4081/cp.2020.1218
    Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.
  9. Johari B, Abdul Kadir RF, Abd Ghani F, Peter AB
    Respirol Case Rep, 2021 Jun;9(6):e00764.
    PMID: 33976893 DOI: 10.1002/rcr2.764
    It has recently been recognized that the clinical course of coronavirus disease 2019 (COVID-19) and secondary organizing pneumonia (OP) tend to follow a subacute progression of respiratory illness. We present images of radiological progression of COVID-19 pneumonia and secondary OP.
  10. Ramli NA, Adam F, Ries ME, Ibrahim SF
    Int J Biol Macromol, 2024 May 14.
    PMID: 38754668 DOI: 10.1016/j.ijbiomac.2024.132385
    CNCs are intensively studied to reinforce biocomposites. However, it remains a challenge to homogeneously disperse the CNC in biocomposites for a smooth film surface. Mechanochemical treatment via ultrasonication in deep eutectic solvent (DES) generated a stable dispersion of CNC before incorporation into carrageenan biocomposite. Shifted peaks of choline chloride (ChCl) methylene groups to 3.95-3.98 ppm in 1H NMR indicated a formation of eutectic mixture between the hydrogen bond acceptor (HBA) and hydrogen bond donor (HBD) at the functional group of CH3···OH. The swelling of CNC in the DES was proven by the formation of intermolecular H-bond at a length of 2.46 Å. The use of DES contributed to a good dispersion of CNC in the solution which increased zeta potential by 43.2 % compared to CNC in deionized water. The ultrasonication amplitude and feed concentration were varied for the best parameters of a stable dispersion of CNC. The crystallinity of 1 wt% of CNC at 20 % sonication amplitude improved from 76 to 81 %. The high crystallinity of CNCDES resulted in an increase in film tensile and capsule loop strength of Carra-CNCDES by 20.7 and 19.4 %, respectively. Improved dispersion of CNCDES reduced the surface roughness of the biocomposite by 21.8 %. H-bond network in CNCDES improved the biocomposite properties for an ingenious reinforcement material.
  11. Johari B, Khor BH, Musa AN, Abdul Kadir RF
    Respirol Case Rep, 2022 Mar;10(3):e0911.
    PMID: 35223042 DOI: 10.1002/rcr2.911
    Tuberculosis (TB) is a common disease which is still endemic in many countries including Malaysia. Acquired cystic lung disease is a rare complication of post-TB infection. We aim to describe two cases of young patients who developed cystic lung disease during treatment for TB, which were further complicated with recurrent pneumothorax. We reiterate the need to consider TB in the differential diagnoses of cystic lung disease in the appropriate clinical context.
  12. Yee LS, Abu Bakar MF, Abdullah N, Abu Bakar FI, Fatmawati S
    J Complement Integr Med, 2023 Dec 01;20(4):772-778.
    PMID: 37561949 DOI: 10.1515/jcim-2020-0141
    OBJECTIVES: An increase in gout prevalence has drawn attention among society and this situation drives the exploration of more favourable treatment using traditional medicinal plants which are rich in phenolic and flavonoid to avoid the side effects of modern medication. However, there are only few studies regarding the optimization of phytochemicals and anti-gout properties of medicinal plants and their combinations. The objectives of this study were to determine the optimal formulation of Strobilanthes crispus, Orthosiphon stamineus Benth and Stevia rebaudiana with maximum total phenolic and flavonoid contents as well as minimum IC50 of in vitro xanthine oxidase inhibitory activity and to examine their correlations among the formulations.

    METHODS: Plant extracts from hot water infusion were tested for the total phenolic content, total flavonoid content and enzyme inhibition through Folin-ciocalteu assay, aluminium chloride method and xanthine oxidase inhibition assay, respectively. Simplex-centroid mixture design was applied in this study and 13 polyherbal formulations were generated by Design Expert Software.

    RESULTS: Linear, special cubic and quadratic models were selected to describe the interaction effect between polyherbal formulations and their responses. Low IC50 value (13.90 μg/mL) of xanthine oxidase activity was found in the binary combination of O. stamineus and S. rebaudiana and this probably related to its high phenolic and flavonoid contents as xanthine oxidase inhibition and phytochemicals were correlated.

    CONCLUSIONS: The suggested optimal formulation was comprised of 44.26 % O. stamineus and 55.74 % S. rebaudiana and it could be developed as an alternative treatment for gout.

  13. Abu Bakar FI, Abu Bakar MF, Abdullah N, Endrini S, Fatmawati S
    PMID: 32047524 DOI: 10.1155/2020/4501261
    Gout is a common disease affected most of the people due to the elevation of uric acid in the blood. Flavonoid and phenolic compounds are reported to exert the anti-gout activity of medicinal plants. Hence, this study aimed at optimizing the extraction conditions of phenolic and flavonoid compounds as well as the anti-gout (xanthine oxidase inhibitory activity) in vitro of Euphorbia hirta using response surface methodology (RSM). The plant part used was the whole plant excluding roots. The effects of three independent variables (extraction time, X1; extraction temperature, X2; and solid-to-liquid ratio, X3) on three response variables (total flavonoid content, Y1; total phenolic content, Y2; and xanthine oxidase inhibitory activity, Y3) were determined using central composite design (CCD) while phytochemical profiling of the extracts was determined by liquid chromatography-mass spectrometry (LC-MS). Quadratic models produced a satisfactory fitting of the experimental data with regard to total flavonoid content (r2 = 0.9407, p < 0.0001), total phenolic content (r2 = 0.9383, p < 0.0001), and xanthine oxidase inhibitory activity (r2 = 0.9794, p < 0.0001). The best extraction conditions observed for total flavonoid content, total phenolic content, and xanthine oxidase inhibitory activity were at a temperature of 79.07°C for 17.42 min with solid-to-liquid ratio of 1 : 20 g/ml. The optimum values for total flavonoid, total phenolic, and xanthine oxidase inhibitory activity were 67.56 mg RE/g, 155.21 mg GAE/g, and 91.42%, respectively. The main phytochemical compounds in the optimized E. hirta extract are neochlorogenic acid, quercetin-3β-D-glucoside, syringic acid, caffeic acid, ellagic acid, astragalin, afzelin, and quercetin. As conclusion, this study clearly demonstrated the best conditions to obtain higher xanthine oxidase inhibitory activity and phytochemical compounds which can be further used for the development of anti-gout agents.
  14. Olunusi SO, Ramli NH, Fatmawati A, Ismail AF, Okwuwa CC
    Int J Biol Macromol, 2024 Apr;264(Pt 2):130682.
    PMID: 38460636 DOI: 10.1016/j.ijbiomac.2024.130682
    Tropical fruits, predominantly cultivated in Southeast Asia, are esteemed for their nutritional richness, distinctive taste, aroma, and visual appeal when consumed fresh. However, postharvest challenges have led to substantial global wastage, nearly 50 %. The advent of edible biopolymeric nanoparticles presents a novel solution to preserve the fruits' overall freshness. These nanoparticles, being edible, readily available, biodegradable, antimicrobial, antioxidant, Generally Recognized As Safe (GRAS), and non-toxic, are commonly prepared via ionic gelation owing to the method's physical crosslinking, simplicity, and affordability. The resulting biopolymeric nanoparticles, with or without additives, can be employed in basic formulations or as composite blends with other materials. This study aims to review the capabilities of biopolymeric nanoparticles in enhancing the physical and sensory aspects of tropical fruits, inhibiting microbial growth, and prolonging shelf life. Material selection for formulation is crucial, considering coating materials, the fruit's epidermal properties, internal and external factors. A variety of application techniques are covered such as spraying, and layer-by-layer among others, including their advantages, and disadvantages. Finally, the study addresses safety measures, legislation, current challenges, and industrial perspectives concerning fruit edible coating films.
  15. Hussain MH, Abu Bakar NF, Mustapa AN, Low KF, Othman NH, Adam F
    Nanoscale Res Lett, 2020 Jul 02;15(1):140.
    PMID: 32617698 DOI: 10.1186/s11671-020-03370-5
    Complicated and strict protocols are followed to tune the size of gold nanoparticles (GNPs) in chemical synthesis methods. In this study, we address the polarity of solvents as a tool for tailoring the size of GNPs in the chemical reduction method. The effects of varying polarity index of the reaction medium on synthesizing gold nanoparticles by chemical reduction method have been investigated. Ethanol as a polar solvent, ethanol-water mixture as reaction medium, L-ascorbic acid as reducing agent, and polyvinylpyrrolidone as stabilizer were used to synthesize GNPs. The polarity index of the reaction medium was adjusted by changing the volume ratio of ethanol to water. UV-Vis, dynamic light scattering (DLS), and transmission electron microscopy (TEM) characterizations reveal that the growth of nanoparticles was gradually increased (~ 22 to 219 nm hydrodynamic diameter) with decreasing value of polarity index of the reaction medium (~ 8.2 to 5.2). Furthermore, the high polarity index of the reaction medium produced smaller and spherical nanoparticles, whereas lower polarity index of reaction medium results in bigger size of GNPs with different shapes. These results imply that the mechanistic of the growth, assembly, and aggregation phenomena of ligand or stabilizer-capped GNPs strongly rely on the polarity of solvent molecules. Using the proposed methodology, wide size range of GNPs with different morphology sizes can be synthesized by simply modulating the volume percentage of organic solvent in the reaction medium.
  16. Abd Aziz NAW, Iezhitsa I, Agarwal R, Abdul Kadir RF, Abd Latiff A, Ismail NM
    Neurol Res, 2020 Mar;42(3):189-208.
    PMID: 32013788 DOI: 10.1080/01616412.2020.1716470
    Objective:Trans-resveratrol has been shown to have neuroprotective effects and could be a promising therapeutic agent in the treatment of intracerebral haemorrhage (ICH). This study aimed to investigate the involvement of the adenosine A1 receptor (A1R) in trans-resveratrol-induced neuroprotection in rats with collagenase-induced ICH.Methods: Sixty male Sprague-Dawley rats weighing 330-380 g were randomly divided into five groups (n = 12): (i) control, (ii) sham-operated rats, (iii) ICH rats pretreated with vehicle (0.1% DMSO saline, i.c.v.), (iv) ICH rats pretreated with trans-resveratrol (0.9 µg, i.c.v.) and (v) ICH rats pretreated with trans-resveratrol (0.9 µg) and the A1R antagonist, DPCPX (2.5 µg, i.c.v.). Thirty minutes after pretreatment, ICH was induced by intrastriatal injection of collagenase (0.04 U). Forty-eight hours after ICH, the rats were assessed using a variety of neurobehavioural tests. Subsequently, rats were sacrificed and brains were subjected to gross morphological examination of the haematoma area and histological examination of the damaged area.Results: Severe neurobehavioural deficits and haematoma with diffuse oedema were observed after intrastriatal collagenase injection. Pretreatment with trans-resveratrol partially restored general locomotor activity, muscle strength and coordination, which was accompanied with reduction of haematoma volume by 73.22% (P < 0.05) and damaged area by 60.77% (P < 0.05) in comparison to the vehicle-pretreated ICH group. The trans-resveratrol-induced improvement in neurobehavioural outcomes and morphological features of brain tissues was inhibited by DPCPX pretreatment.Conclusion: This study demonstrates that the A1R activation is possibly the mechanism underlying the trans-resveratrol-induced neurological and neurobehavioural protection in rats with ICH.
  17. Kamarulzaman NS, Dewadas HD, Leow CY, Yaacob NS, Mokhtar NF
    Cancer Cell Int, 2017;17:74.
    PMID: 28785170 DOI: 10.1186/s12935-017-0442-6
    BACKGROUND: Increased expression of voltage-gated sodium channels (VGSCs) have been implicated with strong metastatic potential of human breast cancer in vitro and in vivo where the main culprits are cardiac isoform Nav1.5 and its 'neonatal' splice variant, nNav1.5. Several factors have been associated with Nav1.5 and nNav1.5 gain of expression in breast cancer mainly hormones, and growth factors.

    AIM: This study aimed to investigate the role of epigenetics via transcription repressor, repressor element silencing transcription factor (REST) and histone deacetylases (HDACs) in enhancing Nav1.5 and nNav1.5 expression in human breast cancer by assessing the effect of HDAC inhibitor, trichostatin A (TSA).

    METHODS: The less aggressive human breast cancer cell line, MCF-7 cells which lack Nav1.5 and nNav1.5 expression was treated with TSA at a concentration range 10-10,000 ng/ml for 24 h whilst the aggressive MDA-MB-231 cells was used as control. The effect of TSA on Nav1.5, nNav1.5, REST, HDAC1, HDAC2, HDAC3, MMP2 and N-cadherin gene expression level was analysed by real-time PCR. Cell growth (MTT assay) and metastatic behaviors (lateral motility and migration assays) were also measured.

    RESULTS: mRNA expression level of Nav1.5 and nNav1.5 were initially very low in MCF-7 compared to MDA-MB-231 cells. Inversely, mRNA expression level of REST, HDAC1, HDAC2, and HDAC3 were all greater in MCF-7 compared to MDA-MB-231 cells. Treatment with TSA significantly increased the mRNA expression level of Nav1.5 and nNav1.5 in MCF-7 cells. On the contrary, TSA significantly reduced the mRNA expression level of REST and HDAC2 in this cell line. Remarkably, despite cell growth inhibition by TSA, motility and migration of MCF-7 cells were enhanced after TSA treatment, confirmed with the up-regulation of metastatic markers, MMP2 and N-cadherin.

    CONCLUSIONS: This study identified epigenetics as another factor that regulate the expression level of Nav1.5 and nNav1.5 in breast cancer where REST and HDAC2 play important role as epigenetic regulators that when lacking enhances the expression of Nav1.5 and nNav1.5 thus promotes motility and migration of breast cancer. Elucidation of the regulatory mechanisms for gain of Nav1.5 and nNav1.5 expression may be helpful for seeking effective strategies for the management of metastatic diseases.

  18. Wong YS, Abidin ZZ, Musa AN, Kadir RFA, Johari B
    Respir Med Case Rep, 2023;43:101834.
    PMID: 36950023 DOI: 10.1016/j.rmcr.2023.101834
    INTRODUCTION: Unilateral pulmonary artery agenesis (UPAA) is a rare congenital malformation of the pulmonary artery due to agenesis of the sixth aortic arch during embryogenesis. Diagnosis can be challenging due to variable clinical presentations.

    CASE: A 29-year-old female at third trimester of twin pregnancy presented with massive hemoptysis. Computed tomography angiogram (CTA) showed unilateral absence of the right pulmonary artery with multiple dilated tortuous bronchial arteries supplying the right lung. Selective embolization of the bronchial artery was performed post-partum.

    CONCLUSION: Clinicians should have a high clinical suspicion of collateral artery bleeding in patients who present with unexplained hemoptysis and typical UPAA radiographic findings.

  19. Lim GY, Wong YS, Tawil Z, Abdul Kadir RF, Ramanathan A, Natasya Musa A
    Respirol Case Rep, 2023 May;11(5):e01133.
    PMID: 37032709 DOI: 10.1002/rcr2.1133
    Krukenberg tumours are unusual metastatic tumours of the ovary with primary tumours from the stomach, breast and gastrointestinal malignancies. Krukenberg tumour from pulmonary malignancy represents an extremely rare situation. This is an elaboration of a case of young women with Krukenberg tumour rising from lung adenocarcinoma. A 38-year-old woman presented with progressive abdominal distention for the past 2-years. Computed tomography (CT) of thorax, abdomen and pelvis revealed a huge ovarian mass with left lung nodules and left-sided pleural effusion. A detailed immunohistochemical staining on pleural fluid cytology confirmed the diagnosis of metastatic adenocarcinoma of lung origin. She underwent doublet platinum chemotherapy as molecular testing for oncogenic mutation was negative. The patient responded well to chemotherapy with a significant reduction in ovarian tumour size. Early identification of the primary source of Krukenberg tumour is paramount to avoid invasive diagnostic surgical intervention for ovarian metastasis.
  20. Lim SC, Md-Yusof YL, Johari B, Abdul-Kadir RF, Tang SP
    Turk J Pediatr, 2021;63(5):743-751.
    PMID: 34738356 DOI: 10.24953/turkjped.2021.05.002
    BACKGROUND: Neuropsychiatric lupus (NPSLE) serves as a marker of severe disease in children with juvenile onset systemic lupus erythematosus (JSLE). This study aims to characterise the clinical and imaging features at diagnosis; and outcomes after 12 months in Malaysian children with NPSLE.

    METHODS: A retrospective study of all NPSLE patients seen at the Pediatric Rheumatology Unit, Selayang Hospital from January 2004 to May 2017.

    RESULTS: Twenty-eight (19.8%) of 141 JSLE patients had NPSLE with a median presenting age of 10 years (IQR 9 - 12), median follow-up of 7 years (IQR 4 - 11) and female: male ratio of 3.7:1. Twenty-three patients had single episodes of NPSLE and five patients had two distinct episodes each. The mean disease activity score (SLEDAI- 2K) was 24.9±11.8 at presentation with 81.8% having high disease activity (score > 12). Majority (60.6%) present with NPSLE within the first year of SLE diagnosis whilst the remainder occurred at a median of five years (IQR 3-7) post-SLE diagnosis. Majority (75.8%) had central nervous system (CNS) involvement commonly presenting with seizures, delirium and visual complaints whilst 24.2% had peripheral nervous system (PNS) involvement. Frequent accompanying features included hypocomplementemia, acute cutaneous lupus and lupus nephritis. Autoantibodies were common; ANA (100%), anti-dsDNA (78.8%) anti-RNP (39.4%) and anti-Sm (39.4%). Abnormalities were seen in 85.7% of the magnetic resonance imaging (MRI) studies performed, predominantly supratentorial white matter hyperintensities on T2 images whilst cerebrospinal fluid examination was normal in the majority. All patients with CNS involvement received corticosteroids with immunosuppressive therapy: Cyclophosphamide (20), Rituximab (2). Treatment for PNS involvement included corticosteroids with Azathioprine (6) or Mycophenolate mofetil (2). At 12 months post-NPSLE, majority (85.7%) recovered without any neurological sequelae.

    CONCLUSIONS: Juvenile-onset NPSLE presents with a myriad of clinical features. It is associated with high disease activity and non-specific MRI features. With early diagnosis and treatment, the majority had good prognosis.

Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links