MyMedR

Riley PA

JUMMEC, 1996;1:17-19.

The conventional use of aminoglycoside antibiotics has several disadvantages including the need for regular pre- and post-dose assaying and the risks of toxicity. Achieving a therapeutic and non-toxic serum concentration may be difficult in many patients especially those with severe sepsis. Correct timing of doses and assays is essential, but this is often difficult to achieve. Many of these difficulties may be remedied by the use of once daily dosing. This dosing schedule appears to be equally effective as the conventional method and i s also less toxic. There are many other advantages including the need for less assays and venepuncture resulting in reduced costs. KEYWORDS: Aminoglycosides, antibiotic therapy, toxicity, therapeutic monitoring

Commercialization of health services: implications for the laboratories

Riley PA

Malays J Pathol, 1996 Jun;18(1):21-5.

PMID: 10879220

The commercialization of health services has wide ranging implications for all medical specialties as well as for patients. Factors that must be considered include not only the financial implications, but also questions of quality and academic interests such as teaching and training. Laboratories must provide a service that the purchaser wishes to buy and must be successful in overcoming competition from the private sector. Each component part of the overall service must be analyzed in order that the laboratory is efficiently structured to provide an optimum service. A good understanding of management issues and a flexible approach are paramount in the provision of efficient, cost-effective and quality service for the ultimate benefit of the patient.

Malaysian adventure

Riemenschneider PA

Radiology, 1992 Mar;182(3):749-51.

PMID: 1535889

The author recently spent 4 months at the University of Malaya in Kuala Lumpur, Malaysia, as a visiting professor of radiology. In this report he describes his experiences in the country and at the hospital and medical school, which is one of only three in Malaysia. Each day, the author worked one-on-one with a different resident, supervising either procedures or image interpretation. Additional activities included conferences, grand rounds, and medical student teaching. Because of the mixed ethnicity of the population, the incidence and variety of pathologic conditions that were encountered clinically provided an unparalleled educational experience. The author encourages anyone with available time to consider a sabbatical such as this; it is a rewarding personal and professional experience.

[A physician's view of the health situation in Malaysia]

GIUDICE PA

Minerva Chir, 1955 Feb 28;10(4):190-1.

PMID: 14369790

Fulltext The Nipah virus outbreak--a reminder

Tambyah PA

Singapore Med J, 1999 May;40(5):329-30.

PMID: 10489488

Current status of diagnostic methods for henipavirus

Tamin A, Rota PA

Dev Biol (Basel), 2013;135:139-45.

PMID: 23689891 DOI: 10.1159/000189236

Hendra virus (HeV) and Nipah virus (NiV) are the causative agents of emerging transboundary animal disease in pigs and horses. They also cause fatal disease in humans. NiV has a case fatality rate of 40 - 100%. In the initial NiV outbreak in Malaysia in 1999, about 1.1 million pigs had to be culled. The economic impact was estimated to be approximately US$450 million. Worldwide, HeV has caused more than 60 deaths in horses with 7 human cases and 4 deaths. Since the initial outbreak, HeV spillovers from Pteropus bats to horses and humans continue. This article presents a brief review on the currently available diagnostic methods for henipavirus infections, including advances achieved since the initial outbreak, and a gap analysis of areas needing improvement.

Fulltext Corneal endothelial cell density and morphology in normal Malay eyes

Mohammad-Salih PA

Med J Malaysia, 2011 Oct;66(4):300-3.

PMID: 22299546 MyJurnal

This study was conducted to describe corneal endothelial cell density and morphology in Malay eyes. Non-contact specular microscopy was performed in 125 eyes of 125 Malay volunteers, aged 20-87 years. Studied parameters included endothelial cell density (CD), mean cell area (MCA), coefficient of variation (CV) in cell area, as well as hexagonal appearance of the cells. Mean endothelial cell density in the study population was 2648 +/- 310 cell/mm(2). Mean CA, CV and percentage of hexagonal cells were 382.8 +/- 47.7microm(2), 58.1 +/- 22.6, 44.3% +/- 11.5% respectively. There was a statistically significant decrease in endothelial cell density (correlation - 0.300, P = 0.001) and CV in cell size (correlation - 0.208, P = 0.02) with age. There was a statistically significant increase in mean cell area (correlation 0.300, P = 0.001) with increasing age. The correlation between age and percentage of hexagonal cells was insignificant (correlation 0.074, P = 0.41). In conclusion, a consistent decrease was noted in the endothelial cell density with increasing age. The differences in endothelial cell density between genders were statistically insignificant.

Evaluation of the use of Bactec anaerobic blood cultures in the detection of bacteraemia and fungaemia in children

Riley PA, Parasakthi N

Malays J Pathol, 1996 Jun;18(1):31-4.

PMID: 10879222

In an attempt to reduce costs, the role of Bactec anaerobic blood culture in the detection of bacteraemia and fungaemia in children was evaluated. Results from 3167 sets of aerobic and anaerobic blood cultures from children admitted to the University Hospital, Kuala Lumpur during a one year period, were analysed. Four hundred and eight (12.9%) sets of blood cultures were positive, of which 348 sets (11.0%) from 201 patients were clinically significant. Of the 348 significant positive sets, organisms were isolated on 177 (50.9%) occasions from both aerobic and anaerobic bottles, on 136 (39.1%) occasions from the aerobic bottle only and 35 (10.0%) occasions from the anaerobic bottle only. No strict anaerobes were isolated, but clinically significant isolates recovered from the anaerobic bottle only included Klebsiella pneumoniae, Salmonella species, Enterobacter cloacae, Staphylococcus aureus, coagulase negative staphylococci, Streptococcus pneumoniae and Group B streptococcus. Patients with bacteraemia diagnosed solely by anaerobic culture were distributed evenly across the various paediatric subspecialities. When results from the anaerobic bottles were excluded, the overall isolation rate was reduced from 11% to 9.9%. Potential financial savings resulting from omission of anaerobic cultures must be balanced against the small number of bacteraemic episodes that could be missed. Undiagnosed bacteraemia may result in increased morbidity and mortality with its own attendant financial implications.

The pill in figures and facts

Von Keep PA

Adv Fertil Control, 1967;2:1-5.

PMID: 12275322

Meeting Report: 4(th) Biennial meeting of the Society for Free Radical Research - Asia, held during July 9-12, 2009 at Langkawi, Malaysia

Devasagayam TP

Free Radic Res, 2009 Sep 11.

PMID: 19750403

Image analysis by Tchebichef moments

Mukundan R, Ong SH, Lee PA

IEEE Trans Image Process, 2001;10(9):1357-64.

PMID: 18255550 DOI: 10.1109/83.941859

This paper introduces a new set of orthogonal moment functions based on the discrete Tchebichef polynomials. The Tchebichef moments can be effectively used as pattern features in the analysis of two-dimensional images. The implementation of the moments proposed in this paper does not involve any numerical approximation, since the basis set is orthogonal in the discrete domain of the image coordinate space. This property makes Tchebichef moments superior to the conventional orthogonal moments such as Legendre moments and Zernike moments, in terms of preserving the analytical properties needed to ensure information redundancy in a moment set. The paper also details the various computational aspects of Tchebichef moments and demonstrates their feature representation capability using the method of image reconstruction.

Knowledge based system with embedded intelligent heart sound analyser for diagnosing cardiovascular disorders

Javed F, Venkatachalam PA, Hani AF

J Med Eng Technol, 2007 Sep-Oct;31(5):341-50.

PMID: 17701779 DOI: 10.1080/03091900600887876

Cardiovascular disease (CVD) is the leading cause of death worldwide, and due to the lack of early detection techniques, the incidence of CVD is increasing day by day. In order to address this limitation, a knowledge based system with embedded intelligent heart sound analyser (KBHSA) has been developed to diagnose cardiovascular disorders at early stages. The system analyses digitized heart sounds that are recorded from an electronic stethoscope using advanced digital signal processing and artificial intelligence techniques. KBHSA takes into account data including the patient's personal and past medical history, clinical examination, auscultation findings, chest x-ray and echocardiogram, and provides a list of diseases that it has diagnosed. The system can assist the general physician in making more accurate and reliable diagnosis under emergency conditions where expert cardiologists and advanced equipment are not readily available. To test the validity of the system, abnormal heart sound samples and medical data from 40 patients were recorded and analysed. The diagnoses made by the system were counter checked by four senior cardiologists in Malaysia. The results show that the findings of KBHSA coincide with those of cardiologists.

Fasciolosis (liver fluke) of the breast in a male patient: a case report

Naresh G, Gomez PA, Salmah B, Suryati MY

Breast, 2006 Feb;15(1):103-5.

PMID: 16024249

Fasciolosis is an uncommon disease in this region, as are parasitic infections of the breast. This report describes a 56-year-old man with a previous history of liver abscess presenting with a painful breast mass. He underwent a mastectomy and is well. The pathological findings revealed chronic granulomatous mastitis with Fasciola spp. ova. The literature on this very rare condition is reviewed.

Current surgical treatment of obstructed defecation among selected European opinion leaders in pelvic floor surgery

Kim M, Meurette G, Ragu R, Lehur PA

Tech Coloproctol, 2016 Jun;20(6):395-399.

PMID: 27170284 DOI: 10.1007/s10151-016-1473-z

BACKGROUND: The aim of this study was to perform a survey on the surgical management of obstructed defecation (OD) across advocated selected coloproctological experts across Europe.

METHODS: Surgeons from 42 centers of coloproctology in Europe were asked to complete a questionnaire, including seven questions about their past and present operative treatment strategy for patients with OD.

RESULTS: The questionnaire was completed by 32 experts of pelvic floor surgery in 13 European countries. All but one indicated that they consider surgical treatment for OD. Seventy-four percent of these have been using transanal stapled rectal resection (STARR) and 96 % transabdominal rectopexy. While only 65 %, who have begun performing STARR are still using transanal resection, the technique is still being used by all surgeons performing abdominal procedures. Rectopexy only, STARR only, or both approaches are offered by 52, 3, and 45 % of surgeons, respectively.

CONCLUSIONS: The use of STARR in the treatment of OD is decreasing among European opinion leaders in the field of pelvic floor surgery, while the application of transabdominal procedures continues.

Immunological parameters of Javanese carp Puntius gonionotus (Bleeker) exposed to copper and challenged with Aeromonas hydrophila

Shariff M, Jayawardena PA, Yusoff FM, Subasinghe R

Fish Shellfish Immunol, 2001 May;11(4):281-91.

PMID: 11417716

This study was to determine the median lethal concentration (LC50) of copper to Javenese carp, Puntius gonionotus (Bleeker), and the immune response after the fish were exposed to sublethal levels of copper and challenged with formalin killed Aeromonas hydrophila. The LC50 of copper on P. gonionotus at 24, 48, 72, 96 and 120 h were estimated as 2.17, 0.91, 0.57, 0.53 and 0.42 mg l(-1), respectively. To determine the effect of copper on the immune system, fish were exposed for 66 days to 0.05, 0.10 and 0.15 mg Cu l(-1). After 56 days of initial exposure to copper, fish were challenged with 0.1 ml of 4.5 x 10(5) cfu ml(-1) formalin killed A. hydrophila and maintained in the same concentration of copper. After the challenge, the immune response was monitored for 2 weeks using haematological and serological assays. During the initial phase of exposure to copper, significant changes were noted in the white blood cell, lysozyme, potential killing activity, total plasma protein, total immunoglobulin and haematocrit levels between the control and treated fish. One week after challenge with A. hydrophila, there was a significant increase in the values of white blood cells, total protein and total immunoglobulin compared to the values before the challenge. However, these values were not significantly different (P>0.05) between the control and the treated fish. In contrast, NBT and lysozyme assays exhibited a significant difference (P<0.05) in fish exposed to 0.10 mg Cu l(-1) (0.525 +/- 0.17; 24.42 +/- 3.35 x 10(2) micromg ml(-1)) and 0.15 mg Cu 1(-1) (0.536 +/- 0.19; 21.78 +/- 1.29 x 10(2) micromg ml(-1)) compared to the control (0.746 +/- 0.31; 30.73 +/- 5.42 x 10(2) micromg ml(-1)) after the bacterial challenge (day 61). There was however no significant difference (P>0.05) in NBT and lysozyme levels in fish exposed to lower level of copper (0.05 mg Cu l(-1)), suggesting the absence of immunosuppressive effects at lower level of exposure.

Characterization of the SF agent, an Ehrlichia sp. isolated from the fluke Stellantchasmus falcatus, by 16S rRNA base sequence, serological, and morphological analyses

Wen B, Rikihisa Y, Yamamoto S, Kawabata N, Fuerst PA

Int. J. Syst. Bacteriol., 1996 Jan;46(1):149-54.

PMID: 8573488

The organism designated the SF agent was originally isolated in Japan in 1962 from Stellantchasmus falcatus metacercaria parasitic on gray mullet fish. The SF agent resembles members of the genus Ehrlichia morphologically and exhibits weak antigenic cross-reactivity with Ehrlichia sennetsu. This organism causes mild clinical signs in dogs, but severe splenomegaly and lymphadenopathy in mice. This suggests that the SF agent may be similar to either Neorickettsia helminthoeca, an intracellular parasite of a fluke and the cause of salmon poisoning disease in dogs, or E. sennetsu, the causative agent of human sennetsu ehrlichiosis in Japan and Malaysia. In order to determine the phylogenetic relationship between the SF agent and other ehrlichial species, the 16S rRNA gene was amplified by the PCR and sequenced. The SF agent sequence was most closely related to the sequences of Ehrlichia risticii (level of sequence similarity, 99.1%), the causative agent of Potomac horse fever, and E. sennetsu (level of sequence similarity, 98.7%). The next most similar sequence was that of N. helminthoeca, but the level of sequence similarity was only 93.7%. E. sennetsu, E. risticii, the SF agent, and N. helminthoeca formed a distinct cluster that was separated from all other ehrlichial species. As determined by immunofluorescence labeling, antiserum against the SF agent cross-reacted strongly with E. sennetsu, E. risticii, and N. helminthoeca. When three genetically distinct ehrlichial isolates obtained from horses with Potomac horse fever were compared with the SF agent, we found that the SF agent was most closely related to Ohio isolate 081, followed by IllinoisT (T = type strain) and a Kentucky isolate. We observed strong antigenic cross-reactivities and similarities in Western blot (immunoblot) reaction profiles when we compared the SF agent, E. risticii, and E. sennetsu; however, weaker antigenic cross-reactivity was observed when the SF agent and N. helminthoeca were compared. Our results indicate that the SF agent is antigenically more closely related to E. risticii and E. sennetsu than to N. helminthoeca. The biological and antigenic characteristics and the 16S rRNA sequence data suggest that the SF agent is a new species that belongs to the genus Ehrlichia.

Development of Aeromonas hydrophila bacteremia in a patient recovering from cholera

Riley PA, Parasakthi N, Liam CK

Clin Infect Dis, 1996 May;22(5):867-8.

PMID: 8722957

Human rotavirus infection in Malaysia. III. A one year survey on the prevalence of rotavirus enteritis in children

Yap KL, Sabil D, Muthu PA

Southeast Asian J. Trop. Med. Public Health, 1983 Dec;14(4):467-9.

PMID: 6673122

The prevalence of human rotavirus enteritis in children admitted to the gastroenteritis ward of the Kuala Lumpur General Hospital was studied in 1982. Human rotavirus in the stool of the patients was detected by enzyme-linked immunosorbent assay. The survey showed that rotavirus enteritis in children were observed throughout the year, with two broad peaks of rotavirus infection occurring around March and September. The lowest incidence was recorded in July, however, no prolonged period of low prevalence of rotavirus enteritis was observed. The average prevalence for the whole of 1982 was 40% of the total diarrhoeal cases. No significant relationship was noted between the prevalence of the disease and rainfall.

Fulltext A study of the health of Malaysian plantation workers with particular reference to paraquat spraymen

Howard JK, Sabapathy NN, Whitehead PA

Br J Ind Med, 1981 May;38(2):110-6.

PMID: 7236534

Tests of pulmonary function (FVC, FEV1, FEV 1%, and single breath CO diffusion), renal function (serum creatinine and BUN), liver function (serum ALT, AST, and ALKP) and a full haematological screen were performed on 27 paraquat spraymen (mean spraying time 5.3 years; mean individual annual quantity of paraquat handled, 67.2 kg as paraquat ion) and on two control groups. One of the control groups consisted of 24 general plantation workers with minimal exposure to paraquat arising from occasional work in recently sprayed areas, and the second consisted of 23 latex factory workers with no known occupational exposure to paraquat. The results showed no significant differences as a consequence of occupational exposure to paraquat. Long-term paraquat spraying at the concentrations used produced to quantifiable harmful effects on health as measured by the indices selected for this study.

Human rotavirus infection in Malaysia. II. A study on the influence of living standard on the prevalence of rotavirus-associated gastroenteritis in children hospitalized with diarrhoea

Yap KL, Sabil D, Muthu PA

J Trop Pediatr, 1984 10;30(5):269-71.

PMID: 6512912 DOI: 10.1093/tropej/30.5.269

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