Inter-simple sequence repeats (ISSRs) are regions in the genome flanked by microsatellite sequences.
PCR amplification of these regions using a single primer yields multiple amplification products that can
be used as a dominant multilocus marker system for the study of genetic variation in various organisms.
ISSR markers are easy to use, low-cost, and methodologically less demanding compared to other
dominant markers, making it an ideal genetic marker for beginners and for organisms whose genetic
information is lacking. Here, we comment upon some of the intricacies often overlooked in designing an
ISSR experiment, clarify some misconceptions, and provide recommendations on using ISSR markers
in genetic variation studies.
The ability to visualise valvular vegetations by echocardiography is a significant advantage in the management oj patients with infective endocarditis. In this report the M-Mode and Cross-Sectional echocardiographic appearances oj infective endocarditis affecting the aortic valve are described. The uses and limitations of echocardiography are discussed.
Mortality in the early phase of acute myocardial infarction occurs both during the pre-hospital period and after admission to the Coronary Care Unit. This report is an analysis of deaths that occurred in the Coronary Care Unit within a 3 year period. Forty percent of 304 patients (13 percent) unth. acute myocardial infarction died in the Coronary Care Unit, Fifty percent of the deaths were due to cardiac arrhythmias and 45 percent attributable to myocardial pump failure. Mean delay in hospital admission from onset of symptoms was 15 hours. Factors affecting early mortality and their prevention are discussed.
We report a case of delayed diagnosis of tarsal tunnel syndrome caused by a ganglion arising from the talo-calcaneal joint. Unusually the symptoms were mainly due to the lateral planter nerve compression with a positive Tinel's sign. A surgical decompression was successful in relieving the dysaesthesia in spite of a 7 years history.
Electrocardiographic features of the Woljf-Parkinson-White syndrome may be seen in normal individuals and in those with congenital or acquired heart disease. Predisposition to tachyarrhythmias and its misinterpretation are common. In this report a case of Wolff-Parkinson-White syndrome in a 25 year old Malay male who presented with cardiac arrhythmias is described. Echocardiographic findings and the role of echocardiography are discussed.
A previously well 21-year-old girl presented to Hospital Teluk Intan, Perak, Malaysia with a short history of fever, vomiting and altered sensorium. She was diagnosed with dengue encephalitis as her dengue NS-1 antigen was positive and her cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) was positive with serotype DENV-2. She also had severe hyponatremia due to Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) which caused an episode of seizure. She recovered well with supportive management. SIADH and dengue encephalitis should be considered as one of the differential diagnosis in patients presenting with fever and altered sensorium especially in dengue endemic countries like Malaysia.
We report a rare case of pectoralis major rupture during a body weight calisthenics exercise that was treated surgically. We highlighted the rehabilitation protocol which enabled him to regain full strength and return to his sport in three months.
A nasopharyngeal (Tornwaldt's) cyst is uncommon. It is often asymptomotic; however it may cause problem if it too big becomes. We present a case of a 24-year-old Malay girl who had been a habitual snorer for years but was unaware of the significance of her problem. Opportunities for an earlier referral and assessment were missed since we were not aware of her history despite previous related but non-specific consultations at our primary healthcare centre. She was referred to us a few years later when her nasopharyngeal cyst became infected. After a course of antibiotics, she proceeded with an endoscopic resection of the nasopharyngeal cyst. A follow-up visit six months later did not reveal a recurrence. This case highlights the importance of a good history for the diagnosis of a nasopharyngeal cyst.
Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.
Patients with bleeding diatheses can present in a variety of clinical situations. When these patients manifest with ocular complications, their management can be challenging. We describe a case of acute angle closure glaucoma secondary to subretinal haemorrhage, with myelodysplasia as a predisposing factor.
We report a case of 20-year-old man who presented with bilateral femoral nerve palsy following resuscitation for traumatic massive blood loss and its consequence. A high suspicious index for this complication may lead to its early recognition. Its related pathoanatomy is discussed based on the described evidences in the literature. Nonoperative treatment remains as a recommended option for coagulopathy-related neuropathy.
Spinal vascular malformation is an uncommon but potentially treatable cause of myelopathy. We describe two cases of angiographically proven spinal vascular malformation in Malaysia. The first case is a 47-year-old man who had a progressive myelopathy and the second a 60-year-old man with intermittent attacks of transient paraparesis leading to paraplegia. As the clinical presentation of spinal vascular malformation is variable, it should be considered as a cause of patients with myelopathy.
Huntington disease has not previously been recorded in Malaysia. We report the first case in a local patient with a positive family history. The implications of diagnosing this disease will be discussed.
This is a retrospectioe study of epidemiological and riskfactors ofischaemic heart disease in Malay patients admitted into the Coronary Care Unit, General Hospital, Kuala Lumpur between October 1977 and December 1979 unth. proven myocardial infarction. Ofthe 116patients (M/F sex ratio 9.5 : 1), the incidence of various risk factors were smoking 82 percent, hypertension 42 percent, hypercholesterolemia 23 percent, diabetes mellitus 20 percent and family history 9 percent. Anterior infarctions were more common than inferior. Hyperuricemia was detected in 19 percent and 96 percent had at least one major riskfactor. In terms ofoccupation, a majorproportion ofthose afflicted were pensioners, security personnel and businessmen.
Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.