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  1. Malik AS, Ismail A, Pennie RA, Naidu JV
    J Trop Pediatr, 1998 02;44(1):10-4.
    PMID: 9538599 DOI: 10.1093/tropej/44.1.10
    Streptococcus pneumoniae (S. pneumoniae) is the most common bacterial cause of pneumonia, meningitis, and otitis media, with the highest incidence among young children and the elderly. S. pneumoniae was once routinely susceptible to penicillin, but since the mid-1980s the incidence of resistance to penicillin and other antimicrobial agents has been increasing all over the world. To optimize empirical regimens and initial therapy for S. pneumoniae infections, clinical healthcare providers must be informed about the prevalence and pattern of drug resistance among the isolates in their communities. No such data are available for the Malaysian population. Therefore, this study was designed to determine the antibiotic susceptibility pattern of S. pneumoniae among colonized pre-school children in Kota Bharu, Malaysia. Pharyngeal swabs were collected from children 1 month to 6 years of age. S. pneumoniae isolates were identified according to the standard and tested for penicillin resistance with a 1-microgram oxacillin disk by the Kirby-Bauer disk diffusion methods. Of 355 nasopharyngeal specimens obtained from kindergarten students, in-patients and pediatric clinics over a period of 1 year, S. pneumoniae was isolated from 36 (10 per cent). All isolates, except one, were susceptible to penicillin. The resistant isolates was susceptible to erythromycin, chloramphenicol and cephalosporins.
    Study site: kindergarten, schools, pediatric outpatients clinics, and in-patient wards of Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.
  2. Rao R, Naidu J, Muhammad Nawawi KN, Wong ZQ, Ngiu CS, Mohammed F, et al.
    Med J Malaysia, 2018 12;73(6):436-438.
    PMID: 30647226
    Hepatic haemangioma is a solitary liver lesion and prevalent among the female patients. We report a case of diffuse hepatic haemangiomatosis in a 62-year-old man, who was referred for an incidental finding of multiple liver nodules. History and physical examinations were unremarkable. Computed tomography and magnetic resonance imaging of the liver were performed and showed multiple haemangiomatosis. In view of the rarity of this condition in men, a liver biopsy was done and confirmed haemangiomas. Available published literature on diffuse hepatic haemangiomatosis was reviewed.
  3. Rahman FA, Naidu J, Ngiu CS, Yaakob Y, Mohamed Z, Othman H, et al.
    Asian Pac J Cancer Prev, 2016;17(8):4037-41.
    PMID: 27644658
    BACKGROUND: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre.

    MATERIALS AND METHODS: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups.

    RESULTS: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were 4.9 ± 3.2 months and 8.3 ± 2.0 months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria.

    CONCLUSIONS: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.

  4. Naidu J, Wong Zh, Palaniappan Sh, Ngiu ChS, Yaacob NY, Abdul Hamid H, et al.
    Asian Pac J Cancer Prev, 2017 04 01;18(4):933-939.
    PMID: 28545190
    Background and Aims: Patients with inflammatory bowel disease (IBD) are subjected to a large amount of ionizing
    radiation during the course of their illness. This may increase their risk of malignancy to a greater level than that due
    to the disease itself. In Caucasian patients with Crohn’s disease, this has been well documented and recommendations
    are in place to avoid high radiation imaging protocols. However, there are limited data available on radiation exposure
    in Asian IBD patients.We therefore sought to identify total radiation exposure and any differences between ethnically
    diverse ulcerative colitis (UC) and Crohn’s disease (CD) patients at our centre along with determining factors that may
    contribute to any variation. Methods: The cumulative effective dose (CED) was calculated retrospectively from 2000
    to 2014 using data from our online radiology database and patients’ medical records. Total CED in the IBD population
    was measured. High exposure was defined as a radiation dose of greater than 0.2mSv (equivalent to slightly less than
    ½ a year of background radiation). Results: A total of 112 cases of IBD (36 CD and 76 UC) were reviewed. Our CD
    patients were diagnosed at an earlier age than our UC cases (mean age 26.1 vs 45.7). The total CED in our IBD population
    was 8.53 (95% CI: 4.53-12.52). Patients with CD were exposed to significantly higher radiation compared to those
    with UC. The mean CED was 18.6 (7.30-29.87) and 3.65 (1.74-5.56, p=0.01) for CD and UC patients respectively. 2
    patients were diagnosed as having a malignancy during follow up with respective CED values of 1.76mSv and 10mSv.
    Conclusions: CD patients, particularly those with complicated disease, received a higher frequency of diagnostic
    imaging over a shorter period when compared to UC patients. Usage of low radiation imaging protocols should be
    encouraged in IBD patients to reduce their risk of consequent malignancy.
  5. Loong TH, Soon NC, Nik Mahmud NRK, Naidu J, Rani RA, Abdul Hamid N, et al.
    Biomed Rep, 2017 Nov;7(5):460-468.
    PMID: 29181158 DOI: 10.3892/br.2017.985
    There is a lack of non-invasive screening modalities to diagnose chronic atrophic gastritis (CAG) and intestinal metaplasia (IM). Thus, the aim of the present study was to determine the sensitivity and specificity of serum pepsinogen I (PGI), PGI:II, the PGI:II ratio and gastrin-17 (G-17) in diagnosing CAG and IM, and the correlations between these serum biomarkers and pre-malignant gastric lesions. A cross-sectional study of 72 patients (82% of the calculated sample size) who underwent oesophageal-gastro-duodenoscopy for dyspepsia was performed in the present study. The mean age of the participants was 56.2±16.2 years. Serum PGI:I, PGI:II, G-17 and Helicobacter pylori antibody levels were measured by enzyme-linked immunosorbent assay. Median levels of PGI:I, PGI:II, the PGI:II ratio and G-17 for were 129.9 µg/l, 10.3 µg/l, 14.7 and 4.4 pmol/l, respectively. Subjects with corpus CAG/IM exhibited a significantly lower PGI:II ratio (7.2) compared with the control group (15.7; P<0.001). Histological CAG and IM correlated well with the serum PGI:II ratio (r=-0.417; P<0.001). The cut-off value of the PGI:II ratio of ≤10.0 demonstrated high sensitivity (83.3%), specificity (77.9%) and area under the receiver operating characteristic curve of 0.902 in detecting the two conditions. However, the sensitivity was particularly low at a ratio of ≤3.0. The serum PGI:II ratio is a sensitive and specific marker to diagnose corpus CAG/IM, but at a high cut-off value. This ratio may potentially be used as an outpatient, non-invasive biomarker for detecting corpus CAG/IM.
  6. Naidu J, Bartholomeusz D, Zobel J, Safaeian R, Hsieh W, Crouch B, et al.
    Endoscopy, 2021 Jan 13.
    PMID: 33440437 DOI: 10.1055/a-1353-0941
    AIM: This study evaluated clinical outcomes of combined chemotherapy and Endoscopic Ultrasound (EUS) guided intra-tumoral radioactive phosphorus-32 (32P OncoSil) implantation in locally advanced pancreatic adenocarcinoma (LAPC).

    METHODS: Consecutive patients with a new histological diagnosis of LAPC were recruited over 20 months. Baseline CT and 18FDG PET-CT were performed and repeated after 12 weeks to assess response to treatment. Following 2 cycles of conventional chemotherapy, patients underwent EUS-guided 32P OncoSil implantation followed by a further six cycles of chemotherapy.

    RESULTS: Twelve patients with LAPC (8M:4F; median age 69 years, IQR 61.5-73.3) completed the treatment. Technical success was 100% and no procedural complications were reported. At 12 weeks, there was a median reduction of 8.2cm3 (95% CI 4.95-10.85; p=0.003) in tumour volume, with minimal or no 18FDG uptake in 9 (75%) patients. Tumour downstaging was achieved in 6 (50%) patients, leading to successful resection in 5 (42%) patients, of which 4 patients (80%) had clear (R0) resection margins.

    CONCLUSIONS: EUS guided 32P OncoSil implantation is feasible and well tolerated and was associated with a 42% rate of surgical resection in our cohort. However, further evaluation in a larger randomized multicenter trial is warranted. (32P funded by OncoSil Medical Ltd, equipment and staff funded by the Royal Adelaide Hospital, ClinicalTrials.gov number, NCT03003078).

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