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Abnormal drainage pathway of a supracardiac total anomalous pulmonary venous drainage in a neonate: a case report

Jamaluddin JA, Ali N

Cardiol Young, 2022 Jan;32(1):21-23.
PMID: 33941298 DOI: 10.1017/S1047951121001475

Supracardiac total anomalous pulmonary venous drainage is commonly associated with a left-sided ascending vein draining into innominate vein. We present a case of a newborn with a right-sided ascending vein, draining into the right superior caval vein with stenosis at the SVC-ascending vein junction, posing a surgical dilemma in corrective surgery. Usage of three-dimensional computed tomographic scan was essential in delineating the anatomy and aiding surgery. The case demonstrates the rarity of this type of cardiac disease and the complications that develop.
Salmonella enteritidis ventriculitis

Johan AJ, Hung LC, Norlijah O

Southeast Asian J. Trop. Med. Public Health, 2013 May;44(3):456-9.
PMID: 24050077

Salmonella sp are important causes of meningitis among neonates and young children in Malaysia. We present a case of Salmonella enteritidis meningitis in a six week old female who presented with a one week history of fever, diarrhea and seizures which was unsuccessfully treated with a third generation cephalosporin. She had a relapse of meningitis complicated with ventriculitis and hydrocephalus, requiring an eleven week course of meropenem. She improved clinically, but did not have improvement in the cerebrospinal fluid (CSF) glucose level despite prolonged antibiotic use. This case illustrates the dilemma in determining the duration of antibiotic needed to successfully treat Salmonella enteritidis ventriculitis.
Maximal respiratory pressures in adult Chinese, Malays and Indians

Johan A, Chan CC, Chia HP, Chan OY, Wang YT

Eur Respir J, 1997 Dec;10(12):2825-8.
PMID: 9493668

Maximal static inspiratory and expiratory mouth pressures (PI,max and PE,max, respectively) enable the noninvasive measurement of global respiratory muscle strength. The aim of this study was primarily to obtain normal values of PI,max and PE,max for adult Chinese, Malays and Indians and, secondarily, to study their effect on lung volumes in these subjects. Four hundred and fifty two healthy subjects (221 Chinese, 111 Malays, 120 Indians) were recruited. Measurements of PI,max from residual volume (RV), PE,max from total lung capacity (TLC) and forced vital capacity (FVC) were obtained in the seated position. There were significant ethnic differences in PI,max and PE,max measurements obtained in males, and FVC measurements in both males and females. Chinese males had higher PI,max values (mean (+/-SD) 88.7+/-32.5 cmH2O) and higher PE,max values (113.4+/-41.5) than Malay males (PI,max 74.0+/-22.7 cmH2O, PE,max 94.7+/-23.4 cmH2O). Chinese males had higher PE,max than Indian males (PI,max = 83.7+/-30.0 cmH2O, PE,max 98.4+/-29.2 cmH2O). There were no significant differences among Chinese females (PI,max 53.6+/-2.3 cmH2O, PE,max 68.3+/-24.0 cmH2O), Malay females (PI,max 50.7+/-18.3 cmH2O, PE,max 63.6+/-21.6 cmH2O) and Indian females (PI,max 50.0+/-15.2 cmH2O, PE,max 60.7+/-20.4 cmH2O). In both sexes, the Chinese had a higher FVC compared with Malays and Indians. After adjusting for age, height and weight, race was still a determinant for PE,max in males, and FVC in both sexes. The FVC only correlated weakly with PI,max and PE,max in both sexes. Ethnic differences in respiratory muscle strength, and lung volumes, occur among Asians. However, respiratory muscle strength does not explain the differences in lung volumes in healthy Asian subjects.
The formation of the Indo-Pacific montane avifauna

Reeve AH, Kennedy JD, Pujolar JM, Petersen B, Blom MPK, Alström P, et al.

Nat Commun, 2023 Dec 11;14(1):8215.
PMID: 38081809 DOI: 10.1038/s41467-023-43964-y

The processes generating the earth's montane biodiversity remain a matter of debate. Two contrasting hypotheses have been advanced to explain how montane populations form: via direct colonization from other mountains, or, alternatively, via upslope range shifts from adjacent lowland areas. We seek to reconcile these apparently conflicting hypotheses by asking whether a species' ancestral geographic origin determines its mode of mountain colonization. Island-dwelling passerine birds at the faunal crossroads between Eurasia and Australo-Papua provide an ideal study system. We recover the phylogenetic relationships of the region's montane species and reconstruct their ancestral geographic ranges, elevational ranges, and migratory behavior. We also perform genomic population studies of three super-dispersive montane species/clades with broad island distributions. Eurasian-origin species populated archipelagos via direct colonization between mountains. This mode of colonization appears related to ancestral adaptations to cold and seasonal climates, specifically short-distance migration. Australo-Papuan-origin mountain populations, by contrast, evolved from lowland ancestors, and highland distribution mostly precludes their further colonization of island mountains. Our study explains much of the distributional variation within a complex biological system, and provides a synthesis of two seemingly discordant hypotheses for montane community formation.
Accuracy of MRI in the diagnosis of meniscal tears in patients with chronic ACL tears

Sharifah MI, Lee CL, Suraya A, Johan A, Syed AF, Tan SP

Knee Surg Sports Traumatol Arthrosc, 2015 Mar;23(3):826-30.
PMID: 24240983 DOI: 10.1007/s00167-013-2766-7

PURPOSE: This study was conducted to evaluate the accuracy of magnetic resonance imaging (MRI) in diagnosing meniscal tears in patients with anterior cruciate ligament (ACL) tears and to determine the frequency of missed meniscal tears on MRI.
METHODS: This prospective comparative study was conducted from 2009 to 2012. Patients with ACL injuries who underwent knee arthroscopy and MRI were included in the study. Two radiologists who were blinded to the clinical history and arthroscopic findings reviewed the pre-arthroscopic MR images. The presence and type of meniscal tears on MRI and arthroscopy were recorded. Arthroscopic findings were used as the reference standard. The accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of MRI in the evaluation of meniscal tears were calculated.
RESULTS: A total of 65 patients (66 knees) were included. The sensitivity, specificity, accuracy, PPV, and NPV for the MRI diagnosis of lateral meniscal tears in our patients were 83, 97, 92, 96, and 90 %, respectively, whereas those for medial meniscus tears were 82, 92, 88, 82, and 88 %, respectively. There were five false-negative diagnoses of medial meniscus tears and four false-negative diagnoses of lateral meniscus tears. The majority of missed meniscus tears on MRI affected the peripheral posterior horns.
CONCLUSION: The sensitivity for diagnosing a meniscal tear was significantly higher when the tear involved more than one-third of the meniscus or the anterior horn. The sensitivity was significantly lower for tears located in the posterior horn and for vertically oriented tears. Therefore, special attention should be given to the peripheral posterior horns of the meniscus, which are common sites of injury that could be easily missed on MRI. The high NPVs obtained in this study suggest that MRI is a valuable tool prior to arthroscopy.
Prevalence and risk factors for obstructive sleep apnea in a multiethnic population of patients presenting for bariatric surgery in Singapore

Lee YH, Johan A, Wong KK, Edwards N, Sullivan C

Sleep Med, 2009 Feb;10(2):226-32.
PMID: 18387341 DOI: 10.1016/j.sleep.2008.01.005

INTRODUCTION: Obesity is becoming more prevalent world wide. Bariatric surgery is one treatment option for patients with severe or morbid obesity. There have been few comprehensive studies examining prevalence and risk factors for obstructive sleep apnea (OSA) in the multiracial Singaporean bariatric surgery population.
METHODS: We performed full polysomnography on 176 consecutive patients undergoing assessment for bariatric surgery. Questionnaires regarding snoring, the presence of witnessed apneas and the Epworth Sleepiness Scale (ESS) were administered. Anthropometric and demographic measurements include age, sex, race, body mass index (BMI) and neck circumference.
RESULTS: The prevalence of OSA was 72%, and 49% of the 176 patients had an AHI >= 15. There was a male predominance of OSA (X(2) = 29.7; p<0.001). OSA subjects had larger neck circumference (43.9 +/- 4.5 vs. 39.4 cm +/- 3.3; p<0.001) and higher BMI (43.1 +/- 7.6 vs. 39.1 +/- 5.4 kg/m(2); p<0.001). The neck circumference (OR = 1.37; p<0.001), presence of snoring (OR = 8.25; p<0.001) and an ESS >10 (OR = 3.24; p = 0.03) were significant independent predictors of an AHI >= 15. A neck circumference of 43 cm had an 80% sensitivity and 83% specificity for predicting an AHI >= 15.
CONCLUSIONS: OSA is common amongst Singaporeans undergoing evaluation for bariatric surgery, with a high prevalence of moderate and severe disease. An increased neck circumference is a strong independent predictor for an AHI >= 15, with a neck circumference of greater than 43 cm being a sensitive and specific predictor. Race was not found to be a risk factor.
Long-term evaluation of osteoarthritis sheep knee, treated with TGF-β3 and BMP-6 induced multipotent stem cells

Ude CC, Shamsul BS, Ng MH, Chen HC, Ohnmar H, Amaramalar SN, et al.

Exp Gerontol, 2018 04;104:43-51.
PMID: 29421350 DOI: 10.1016/j.exger.2018.01.020

BACKGROUND: Hyaline articular cartilage, which protects the bones of diarthrodial joints from forces associated with load bearing, frictions, and impacts has very limited capacities for self-repair. Over the years, the trend of treatments has shifted to regenerations and researchers have been on the quest for a lasting regeneration. We evaluated the treatment of osteoarthritis by chondrogenically induced ADSCs and BMSCs for a long time functional recovery.
METHODS: Osteoarthritis was induced at the right knee of sheep by complete resection of ACL and medial meniscus. Stem cells from sheep were induced to chondrogenic lineage. Test sheep received 5 mls single doses of 2 × 107 autologous PKH26-labelled ADSCs or BMSCs, while controls received basal medium. Functional recovery of the knees was evaluated via electromyography.
RESULTS: Induced ADSCs had 625, 255, 393, 908, 409, 157 and 1062 folds increases of collagen I, collagen II, aggrecan, SOX9, cartilage oligomeric protein, chondroadherin and fibromodullin compare to uninduced cells, while BMSCs had 702, 657, 321, 276, 337, 233 and 1163 respectively; p = .001. Immunocytochemistry was positive for these chondrogenic markers. 12 months post-treatment, controls scored 4 in most regions using ICRS, while the treated had 8; P = .001. Regenerated cartilages were positive to PKH26 and demonstrated the presence of condensing cartilages on haematoxylin and eosin; and Safranin O. OA degenerations caused significant amplitude shift from right to left hind limb. After treatments, controls persisted with significant decreases; while treated samples regained balance.
CONCLUSIONS: Both ADSCs and BMSCs had increased chondrogenic gene expressions using TGF-β3 and BMP-6. The treated knees had improved cartilage scores; PKH26 can provide elongated tracking, while EMG results revealed improved joint recoveries. These could be suitable therapies for osteoarthritis.