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Gross anatomy and ultrasonographic images of the reproductive system of the Malayan tapir (Tapirus indicus)

Lilia K, Rosnina Y, Abd Wahid H, Zahari ZZ, Abraham M

Anat Histol Embryol, 2010 Dec;39(6):569-75.
PMID: 20809915 DOI: 10.1111/j.1439-0264.2010.01030.x

The Malayan tapir (Tapirus indicus) is the largest among the four tapir species and is listed as an endangered species. Ultrasound examination and description of the external anatomy of the female reproductive system of three adult females were performed, whereas the internal anatomy was investigated in necropsied samples of four adult females and one subadult female. Descriptions of the male external genitalia were conducted on one adult male. Gross examination revealed the presence of a bicornuate uterus. The uterine cervix is firm and muscular with projections towards its lumen, which is also evident on ultrasonography. The elongated and relatively small ovaries, which have a smooth surface, could not be imaged on ultrasonography, due to their anatomical position. The testes are located inside a slightly pendulous scrotum that is sparsely covered with soft, short hairs. The penis has one dorsal and two lateral penile projections just proximal to the glans penis.
Fulltext Knowledge, attitude and practice among healthcare staffs in the Emergency Department, Hospital Universiti Sains Malaysia towards Rape Victims In One Stop Crisis Centre (OSCC)

Chew KS, Noredelina MN, Ida ZZ

Med J Malaysia, 2015 Jun;70(3):162-8.
PMID: 26248779 MyJurnal

INTRODUCTION: Aimed at providing integrated multi-level crisis intervention to women experiencing violence such as rape, One Stop Crisis Centre (OSCC) in Malaysia is often located in the emergency department. Hence, it is imperative that emergency department healthcare providers possess adequate knowledge and acceptable attitudes and practices to ensure the smooth running of an efficient OSCC work process.

METHOD: To study the knowledge, attitude and practice of rape management in OSCC among four groups of healthcare providers in the emergency department [i.e., the emergency medicine doctors (EDs), the staff nurses (SNs), the medical assistants (MAs) and the hospital attendants (HAs)], a selfadministered questionnaire in the form of Likert scale was conducted from January to October 2013. Correct or favourable responses were scored appropriately.

RESULTS: Out of the 159 participants invited, 110 responded (69.2% response rate). As all data sets in the Knowledge, Attitude and Practice sections are non-parametric, Kruskal- Wallis test was performed. Homogeneity of variance was verified using non-parametric Levene test. In all three sections, there are statistically significant differences in scores obtained among the four groups of healthcare providers with H(3) = 16.0, p<0.001 for Knowledge, H(3) = 27.1, p<0.001 for Attitude and H(3) = 15.8, p<0.001 for Practice sections. Generally, the SNs obtained the highest mean rank score in the knowledge and practice sections but the EDs obtained the highest mean rank score in the attitude section. Some of the responses implied that our healthcare providers have the victim-blaming tendency that can negatively impact the victims.

CONCLUSION: Healthcare providers must not only have adequate knowledge but also the non-judgemental attitude towards victims in OSCC.
Fulltext An eight-year review of blood culture and susceptibility among sepsis cases in an emergency department in Northeastern Malaysia

Hashairi F, Hasan H, Azlan K, Deris ZZ

Trop Biomed, 2011 Dec;28(3):599-605.
PMID: 22433889 MyJurnal

An understanding of common pathogens and their antibiotic sensitivity patterns is critical for proper management of sepsis in Emergency Department (ED). The goal of the study was to identify common organisms isolated from blood cultures of patients attended to ED and their antimicrobial susceptibility. Beginning from 2002, all cases of positive blood culture collected by the ED, Hospital Universiti Sains Malaysia (HUSM) were recorded and analysed. Over the period of eight years, we documented 995 cases of positive blood cultures. Of these samples, 549 (55.2%) were Gram-negative bacteria; 419 (42.1%) were Gram-positive bacteria; 10 (1.0%) were anaerobic organisms; 10 (1.0%) were fungus; and 7 (0.7%) cases were mixed organisms. Gram-negative bacteria were observed to develop more resistance to antimicrobial agents, especially those commonly used in an outpatient setting with less than 80% sensitivity to ampicillin, cotrimoxazole and ciprofloxacin. By contrast, there has been no marked change in the sensitivity trends of Gram-positive bacteria over the same period. In conclusion, ED physicians are more equipped to initiate empirical antimicrobial therapy especially when dealing with possibility of Gram-negative sepsis.
Study site: Emergency department, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Fulltext Prevalence, Risk Factors and Microbiological Profile of Orthopaedic Surgical Site Infection in North-Eastern Peninsular Malaysia

Chua WC, Rahman SA, Deris ZZ

Malays Orthop J, 2022 Nov;16(3):94-103.
PMID: 36589372 DOI: 10.5704/MOJ.2211.015

INTRODUCTION: The devastating outcome of orthopaedic surgical site infections (SSI) are largely preventable if its risk factors, causative organisms and antimicrobial susceptibility patterns in the regional area are known.
MATERIALS AND METHODS: We conducted a retrospective study to address the lack of epidemiological and microbiological data on orthopaedic SSI in Malaysia. All the 80 patients diagnosed and treated for microbiologically proven orthopaedic SSIs in a tertiary hospital in Malaysia from April 2015 to March 2019 were included in a 1:2 case control study.
RESULTS: The prevalence of SSI in clean and clean-contaminated surgeries was 1.243%, which is consistent with most of the studies worldwide, but is low compared to other studies done in Malaysia. The most common type of orthopaedics SSI were internal fixation infections (46.25%), superficial SSIs (25.2%) and Prosthetic joint infections (18.75%). Obesity and tobacco use were found to be significant risk factors of orthopaedic SSI. The most common perioperative prophylaxis used was IV cefuroxime. Majority of the cases (86.5%) received prolonged prophylactic antibiotics. The most common causative agent was Staphylococcus aureus (31.25%), followed by Pseudomonas aeruginosa (26.25%) and Enterobacter spp (7.5%). Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 20% of the S. aureus infections. Up to 19.4% of the Gram-negative organisms are multidrug resistant. The higher rate of isolation of organisms resistant to the prophylactic antibiotics being used may be related to the prolonged use of prophylactic antibiotics, which exerted selective pressure for the acquisition of resistant organisms.
CONCLUSION: Despite its relatively low prevalence in our local institution and worldwide, the prevention of SSI in orthopaedic practice is crucial to avoid morbidity, mortality and high healthcare cost. This may be achieved by control of modifiable risk factors such as obesity and tobacco use, appropriate use of prophylactic antibiotics and implementation of good surgical and infection control practices.
Evaluation of semen collected by electroejaculation from captive lesser Malay chevrotain (Tragulus javanicus)

Haron AW, Ming Y, Zainuddin ZZ

J Zoo Wildl Med, 2000 Jun;31(2):164-7.
PMID: 10982126

Thirteen sexually mature captive male lesser Malay chevrotains (Tragulus javanicus) were each anesthetized twice with tiletamine-zolazepam for electroejaculation. Viable spermatozoa were collected from all animals. The semen was creamy, milky, pale yellowish, or watery. The mean values for ejaculate volume, sperm concentration, and percentages of sperm motility, normality and viability were 23.7 +/- 2.5 microl, 366.9 +/- 127.8 x 10(6) spermatozoa/ml, 40.0% +/- 3.1%, 71.4% +/- 1.6%, and 59.6% +/- 2.1%, respectively. Semen pH was 7-8. No adverse effects of electroejaculation were noted. These are the first reported values for semen of lesser Malay chevrotain. Electroejaculation should be usable for routine semen collection in this species.
Fulltext Evaluation of physicochemical changes of spray-dried honey jackfruit (Artocarpus heterophyllus Lam.) powder during storage

Wong, C. W., Leow, R. K. S., Lim, W. Y., Siew, Z. Z.

International Food Research Journal, 2020;27(2):366-375.
MyJurnal

The present work was undertaken to investigate the effect of different packaging materials, namely polyethylene terephthalate (PET) and aluminium laminated polyethylene (ALP) on the physicochemical properties and microbiological stability of spray-dried honey jackfruit powder over seven weeks of storage at 38 ± 2°C and 90% relative humidity. The moisture content of honey jackfruit powder packaged in PET was doubled (12.32%) than of those packaged in ALP (5.31%). The water activity (aw) of the powders were lower than 0.6 for both packaging materials, thus considered shelf-stable. Hygroscopicity increased up to 42.44 and 39.84% for powder packaged in PET and ALP, respectively. The angle of repose for powders flowability increased to 19° (ALP) and 28° (PET), which indicated that the powders flowabili- ty significantly decreased upon storage. The degree of caking for powder packaged in ALP (43.69%) was much less severe than that of PET (84.51%). Powder packaged in ALP showed good solubility (81.07 - 99.01%) and satisfactory microbiological results (< log 2.58 CFU/g). The results recommended that ALP packaging was better suited for keeping spray-dried honey jackfruit powder.
Fulltext Transcathether closure of patent ductus arteriosus: our initial experience in University of Malaya Medical Centre

Zarin Ikmal ZZ, Wan Azman WA, Asma O, Mazeni A

JUMMEC, 2000;5:45-47.

Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.831nm). Complete closure of the PDA was achieved in all patients. KEYWORDS: Patent ductus arteriosus, transcatheter device closure
Fulltext Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review

Sreeramareddy CT, Qin ZZ, Satyanarayana S, Subbaraman R, Pai M

Int J Tuberc Lung Dis, 2014 Mar;18(3):255-66.
PMID: 24670558 DOI: 10.5588/ijtld.13.0585

OBJECTIVE: To systematically review Indian literature on delays in tuberculosis (TB) diagnosis and treatment.
METHODS: We searched multiple sources for studies on delays in patients with pulmonary TB and those with chest symptoms. Studies were included if numeric data on any delay were reported. Patient delay was defined as the interval between onset of symptoms and the patient's first contact with a health care provider. Diagnostic delay was defined as the interval between the first consultation with a health care provider and diagnosis. Treatment delay was defined as the interval between diagnosis and initiation of anti-tuberculosis treatment. Total delay was defined as time interval from the onset of symptoms until treatment initiation.
RESULTS: Among 541 potential citations identified, 23 studies met the inclusion criteria. Included studies used a variety of definitions for onset of symptoms and delays. Median estimates of patient, diagnostic and treatment delay were respectively 18.4 (IQR 14.3-27.0), 31.0 (IQR 24.5-35.4) and 2.5 days (IQR 1.9-3.6) for patients with TB and those with chest symptoms combined. The median total delay was 55.3 days (IQR 46.5-61.5). About 48% of all patients first consulted private providers; an average of 2.7 health care providers were consulted before diagnosis. Number and type of provider first consulted were the most important risk factors for delay.
CONCLUSIONS: These findings underscore the need to develop novel strategies for reducing patient and diagnostic delays and engaging first-contact health care providers.
Multimodal 3-D reconstruction of human anatomical structures using SurLens Visualization System

Adeshina AM, Hashim R, Khalid NE, Abidin SZ

Interdiscip Sci, 2013 Mar;5(1):23-36.
PMID: 23605637 DOI: 10.1007/s12539-013-0155-z

In the medical diagnosis and treatment planning, radiologists and surgeons rely heavily on the slices produced by medical imaging devices. Unfortunately, these image scanners could only present the 3-D human anatomical structure in 2-D. Traditionally, this requires medical professional concerned to study and analyze the 2-D images based on their expert experience. This is tedious, time consuming and prone to error; expecially when certain features are occluding the desired region of interest. Reconstruction procedures was earlier proposed to handle such situation. However, 3-D reconstruction system requires high performance computation and longer processing time. Integrating efficient reconstruction system into clinical procedures involves high resulting cost. Previously, brain's blood vessels reconstruction with MRA was achieved using SurLens Visualization System. However, adapting such system to other image modalities, applicable to the entire human anatomical structures, would be a meaningful contribution towards achieving a resourceful system for medical diagnosis and disease therapy. This paper attempts to adapt SurLens to possible visualisation of abnormalities in human anatomical structures using CT and MR images. The study was evaluated with brain MR images from the department of Surgery, University of North Carolina, United States and CT abdominal pelvic, from the Swedish National Infrastructure for Computing. The MR images contain around 109 datasets each of T1-FLASH, T2-Weighted, DTI and T1-MPRAGE. Significantly, visualization of human anatomical structure was achieved without prior segmentation. SurLens was adapted to visualize and display abnormalities, such as an indication of walderstrom's macroglobulinemia, stroke and penetrating brain injury in the human brain using Magentic Resonance (MR) images. Moreover, possible abnormalities in abdominal pelvic was also visualized using Computed Tomography (CT) slices. The study shows SurLens' functionality as a 3-D Multimodal Visualization System.
Fulltext The association between dyslipidaemia and types of antipsychotic medications among patients with chronic schizophrenia

Ruzanna ZZ, Ong LY, Cheah YC, Fairuz A, Midin M

Med J Malaysia, 2012 Feb;67(1):39-44.
PMID: 22582547 MyJurnal

This cross sectional study aimed to explore the association between dyslipidaemia and types of antipsychotics in 100 patients with chronic schizophrenia. Lipid profile, weight, height and waist circumference together with other relevant factors were measured. We found there was a high rate of dyslipidaemia among patients with chronic schizophrenia treated with antipsychotics (66%), however there was no significant difference found between typical or atypical antipsychotics (OR=1). All sociodemographic and clinical factors were not significantly associated with dyslipidaemia. Only non-Malays were found to have significant dyslipidaemia (p<0.1). Effective management is needed to deal with the dyslipidaemia in this group.
Locating abnormalities in brain blood vessels using parallel computing architecture

Adeshina AM, Hashim R, Khalid NE, Abidin SZ

Interdiscip Sci, 2012 Sep;4(3):161-72.
PMID: 23292689 DOI: 10.1007/s12539-012-0132-y

CT and MRI scans are widely used in medical diagnosis procedures, but they only produce 2-D images. However, the human anatomical structure, the abnormalities, tumors, tissues and organs are in 3-D. 2-D images from these devices are difficult to interpret because they only show cross-sectional views of the human structure. Consequently, such circumstances require doctors to use their expert experiences in the interpretation of the possible location, size or shape of the abnormalities, even for large datasets of enormous amount of slices. Previously, the concept of reconstructing 2-D images to 3-D was introduced. However, such reconstruction model requires high performance computation, may either be time-consuming or costly. Furthermore, detecting the internal features of human anatomical structure, such as the imaging of the blood vessels, is still an open topic in the computer-aided diagnosis of disorders and pathologies. This paper proposes a volume visualization framework using Compute Unified Device Architecture (CUDA), augmenting the widely proven ray casting technique in terms of superior qualities of images but with slow speed. Considering the rapid development of technology in the medical community, our framework is implemented on Microsoft.NET environment for easy interoperability with other emerging revolutionary tools. The framework was evaluated with brain datasets from the department of Surgery, University of North Carolina, United States, containing around 109 MRA datasets. Uniquely, at a reasonably cheaper cost, our framework achieves immediate reconstruction and obvious mappings of the internal features of human brain, reliable enough for instantaneous locations of possible blockages in the brain blood vessels.
Reduced susceptibility of Burkholderia pseudomallei following exposure to carbapenem

Zamani A, Zueter AR, Muhd Besari A, Hasan H, Harun A, Deris ZZ

Trop Biomed, 2020 Sep 01;37(3):783-790.
PMID: 33612791 DOI: 10.47665/tb.37.3.783

Reduced susceptibility in Burkholderia pseudomallei during carbapenem therapy may lead to treatment failure. We isolated a clinical strain that had developed reduced susceptibility to carbapenems while on treatment. After reviewing the patient's clinical notes, the initial isolate (BUPS01/14) was exposed to carbapenem in vitro to mimic the clinical scenario. The stability of susceptibility of the carbapenem-exposed strain (BUPS01/14R) was examined by serial subculture in antibiotic-free broth. Biochemical and morphological comparison was performed by the VITEK® system and electron microscopy. MICs increased 32-fold following carbapenem exposure and became stable in the antibiotic-free environment. On electron microscopic examination, the BUPS01/14R cells were smoother and less wrinkled compared to BUPS01/14 cells. This report highlights a potential anti-melioidosis treatment failure due to the emergence of resistance while on carbapenem monotherapy. Further study of this strain is necessary to understand the mechanism of resistance at a molecular level.
Role of Mg(NO3)2 as Defective Agent in Ameliorating the Electrical Conductivity, Structural and Electrochemical Properties of Agarose-Based Polymer Electrolytes

Ali NI, Abidin SZZ, Majid SR, Jaafar NK

Polymers (Basel), 2021 Sep 30;13(19).
PMID: 34641173 DOI: 10.3390/polym13193357

Polymer electrolytes based on agarose dissolved in DMSO solvent complexed with different weight percentages of Mg(NO3)2 ranging from 0 to 35 wt% were prepared using a solution casting method. Electrochemical impedance spectroscopy (EIS) was applied to study the electrical properties of this polymer electrolyte, such as ionic conductivity at room and different temperatures, dielectric and modulus properties. The highest conducting film has been obtained at 1.48 × 10-5 S·cm-1 by doping 30 wt% of Mg(NO3)2 into the polymer matrix at room temperature. This high ionic conductivity value is achieved due to the increase in the amorphous nature of the polymer electrolyte, as proven by X-ray diffractometry (XRD), where broadening of the amorphous peak can be observed. The intermolecular interactions between agarose and Mg(NO3)2 are studied by Fourier transform infrared (FTIR) spectroscopy by observing the presence of -OH, -CH, N-H, CH3, C-O-C, C-OH, C-C and 3,6-anhydrogalactose bridges in the FTIR spectra. The electrochemical properties for the highest conducting agarose-Mg(NO3)2 polymer electrolyte are stable up to 3.57 V, which is determined by using linear sweep voltammetry (LSV) and supported by cyclic voltammetry (CV) that proves the presence of Mg2+ conduction.
Underdiagnosis of Borderline oxacillin-resistant Staphylococcus aureus (BORSA) - Case series

Samsudin N, Chua WC, Hasan H, Hassan SA, Deris ZZ

Malays J Pathol, 2024 Apr;46(1):95-102.
PMID: 38682849

Borderline oxacillin-resistant Staphylococcus aureus (BORSA) are mecA-negative strains with oxacillin minimum inhibitor concentration (MIC) close to the resistance breakpoint of ≥ 4μg/mL. Instead of producing penicillin-binding protein with low affinity to methicillin (oxacillin) mediated by mecA gene as in methicillin-resistant S. aureus (MRSA), BORSA strains are characterised by the hyperproduction of β-lactamase enzymes, thus able to break down methicillin. Common laboratory methods to detect MRSA such as cefoxitin disk diffusion alone may fail to detect methicillin resistance due to BORSA. We report five cases of BORSA blood-stream infections in a university teaching hospital. All isolates were found to be susceptible to cefoxitin using disk diffusion, resistant to oxacillin using automated MIC method, and did not harbour mecA gene. All patients were suscessfully treated with anti-MRSA antibiotics, and removal of primary sources were done if identified. A more cost-effective method for screening and diagnosis of BORSA is needed in addition to cefoxitin disk diffusion test, in order to monitor the spread, and to enable routine detection and treatment of this pathogen.
Association between risk factors of osteoporosis and bone mineral density in women of different ethnic groups in a Malaysian hospital

Chan PJ, Nurul ZZ, Chuah JS, Nabil MMA, Isa NM, Sabarul AM, et al.

International Journal of Osteoporosis and Metabolic Disorders, 2014;7(1):1-11.
DOI: 10.3923/rjom.2014.1.11

Risk factors of osteoporosis need to be identified for prevention of osteoporosis. However, studies on the risk factors of osteoporosis in the Malaysian population are lacking. The study aimed to determine the relationship between potential risk factors of osteoporosis and hip BMD of postmenopausal women in a Malaysian tertiary hospital setting. A cross-sectional study was carried out on 76 postmenopausal women, who were scheduled for Dual-energy X-ray Absorptiometry (DXA) scan at UKM Medical Centre (UKMMC) from February to May, 2014. Interview sessions using structured questionnaire were conducted to obtain information on social demographic and potential risk factors of osteoporosis. The DXA scan results of the hip BMD for all the respondents were recorded to determine the association between the potential risk factors of osteoporosis and hip BMD. In this study, 44.7% of patients had normal hip BMD measurement (T score >-1.0), while 55.3% had low hip BMD measurement (T score0.05) between hip BMD and family history of osteoporosis, lifestyle activities and smoking. Parity, habitual tea consumption and BMI were positively associated with hip BMD, whereas duration of sleep was negatively associated with hip BMD among postmenopausal women in UKMMC. © 2014 Asian Network for Scientific Information.
Fulltext Does clinical exposure to patients in medical school affect trainee doctors' attitudes towards mental disorders and patients?--A pilot study

Tan SMK, Azmi MT, Reddy JP, Shaharom MH, Rosdinom R, Maniam T, et al.

Med J Malaysia, 2005 Aug;60(3):328-37.
PMID: 16379188

Stigmatising attitudes towards mental illness may improve with clinical exposure during medical school training. Attitudes of 48 fourth year medical students in Universiti Kebangsaan Malaysia were assessed before and after their compulsory attachment in Psychiatry, using the Attitude Towards Psychiatry-30 (ATP) and the Attitude towards Mental Illness (AMI) questionnaires. ATP scores improved significantly with training (104.8 and 114.4, pre- and post-attachment respectively) as did AMI scores (63.4 and 68.1 respectively). Both improvements were statistically significant. (ATP: z = 4.55, p < 0.0005) (AMI: z = 3.75, p < 0.0005). Attitudes towards mental illness appeared to have become more favourable with clinical training in psychiatry.
Hyperkalemia measurement between Blood Gas Analyser and Main Laboratory Biochemistry Analyser

Ismail MH, Baharuddin KA, Suliman MA, Mohd Shukri MF, Che Has SN, Lo ZZ

Med J Malaysia, 2021 03;76(2):157-163.
PMID: 33742622

INTRODUCTION: Potassium level is measured for patients with high risk of hyperkalemia in the emergency department (ED) using both blood gas analyser (BGA) and biochemistry analyser (BCA). The study was conducted to evaluate the correlation and agreement of potassium measurement between BGA and BCA.
MATERIALS AND METHODS: This is a prospective cross-sectional study on the data obtained from Hospital Universiti Sains Malaysia (Hospital USM) from Jun 2018 until May 2019. Blood samples were taken via a single prick from venous blood and sent separately using 1ml heparinised syringe and were analysed immediately in ED using BGA (Radiometer, ABL800 FLEX, Denmark) and another sample was sent to the central laboratory of Hospital USM and analysed by BCA (Architect, C8000, USA). Only patients who had potassium levels ≥5.0mmol/L on blood gas results were included. A total of 173 sample pairs were included. The correlation and agreement were evaluated using Passing and Bablok regression, Linear Regression and Bland-Altman test.
RESULT: Of the 173 sample pairs, the median of potassium level based on BGA and BCA were 5.50mmol/L (IQR: 1.00) and 5.90mmol/L (IQR: 0.95) respectively. There was significant correlation between two measurements (p<0.001, r: 0.36). The agreement between the two measurements showed within acceptable mean difference which was 0.27 mmol/L with 95% limit of agreement were 1.21mmol/L to 1.73mmol/L.
CONCLUSION: The result of blood gas can be used as a guide for initial treatment of hyperkalaemia in critical cases where time is of the essence. However, BCA result is still the definitive value.
Clone, expression and plasminogen binding property of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis

Li S, Lu BP, Feng J, Zhou JJ, Xie ZZ, Liang C, et al.

Trop Biomed, 2020 Dec 01;37(4):852-863.
PMID: 33612738 DOI: 10.47665/tb.37.4.852

Fructose-1,6-bisphosphate aldolase (FbA), a well characterized glycometabolism enzyme, has been found to participate in other important processes besides the classic catalysis. To understand the important functions of three fructose-1,6-bisphosphate aldolases from Clonorchis sinensis (CsFbAs, CsFbA-1/2/3) in host-parasite interplay, the open reading frames of CsFbAs were cloned into pET30a (+) vector and the resulting recombinant plasmids were transformed into Escherichia coli BL21 (DE3) for expression of the proteins. Purified recombinant CsFbAs proteins (rCsFbAs) were approximately 45.0 kDa on 12% SDS-PAGE and could be probed with each rat anti-rCsFbAs sera by western blotting analysis. ELISA and ligand blot overlay indicated that rCsFbAs of 45.0 kDa as well as native CsFbAs of 39.5 kDa from total worm extracts and excretory-secretory products of Clonorchis sinensis (CsESPs) could bind to human plasminogen, and the binding could be efficiently inhibited by lysine analog ε-aminocaproic acid. Our results suggested that as both the components of CsESPs and the plasminogen binding proteins, three CsFbAs might be involved in preventing the formation of the blood clot so that Clonorchis sinensis could acquire enough nutrients from host tissue for their successful survival and colonization in the host. Our work will provide us with new information about the biological function of three CsFbAs and their roles in hostparasite interplay.
The effect of a clinical posting in psychiatry on the attitudes of medical students towards psychiatry and mental illness in a Malaysian medical school

Reddy JP, Tan SM, Azmi MT, Shaharom MH, Rosdinom R, Maniam T, et al.

Ann Acad Med Singap, 2005 Sep;34(8):505-10.
PMID: 16205829

INTRODUCTION: The stigma attached to mental illness and the mentally ill is a universal phenomenon and a major barrier to the provision of mental health services. Stigmatising attitudes among doctors themselves can result in compromised patient care. The aim of this research project is to study the impact of a clinical posting in psychiatry on the attitudes of medical students to mental illness and to psychiatry. This paper reports the results of the first phase of a longitudinal study.
MATERIALS AND METHODS: A total of 122 year 4 medical students responded to this study. The Attitudes Towards Mental Illness (AMI) and Attitudes Towards Psychiatry (ATP) questionnaires were administered before and after an 8-week attachment in psychiatry.
RESULTS: We found that students had somewhat favourable attitudes towards psychiatry and mental illness at the start of their attachment, with a mean score of 108.34 on ATP (neutral score, 90) and 68.24 on AMI (neutral score, 60). There was a significant increase in the mean scores of both scales following the psychiatric attachment for female students (ATP: P = 0.003; AMI: P <0.0005), but not male students (ATP: P = 0.435; AMI: P = 0.283).
CONCLUSIONS: An 8-week clinical posting of fourth-year medical students in psychiatry was associated with an increase in positive attitudes to mental illness and to psychiatry among female students but not among male students.
Fulltext Penile augmentation with resultant foreign material granuloma and sequalae

Inn FX, Imran FH, Ali MF, Ih R, Z Z

Malays J Med Sci, 2012 Oct;19(4):81-3.
PMID: 23613653 MyJurnal

Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, which cannot achieve erection. Local complications of penile lipogranuloma include infection, ulceration, local migration, and cavernosal invasion; leading to functional impairment. Meanwhile, systemic complications include foreign body embolization, organ infarct, and death. Penile lipogranuloma is best treated surgically. Granulomatous skin needs to be completely excised; wound closure with a scrotal skin flap, Cecil's inlay operation and split thickness skin graft commonly used options. Our case series has shown that penile lipogranuloma, induced by subcutaneous foreign body injections into the penile shaft, and its subsequent adverse outcomes to patients and their partners.

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