Displaying publications 1 - 20 of 522 in total

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  1. Azizan E, Brown M
    Malays J Pathol, 2020 Dec;42(3):363-367.
    PMID: 33361716
    In 2003, it was discovered that the entry receptor for the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) is a protein called the angiotensin-converting enzyme 2 (ACE2). This protein is present in a number of cell types, including those from the respiratory tract. Soon after the emergence of SARS-CoV-2 that is responsible for the disease Covid-19, scientists found that ACE2 was also used by the new coronavirus to infect cells. This opened some interesting possibilities to explain the striking variation in risks of catching and dying from Covid-19. The best recognised of these are the much higher risk of serious illness in older than younger people, in men than women, and in those with pre-existing comorbidities such as hypertension and cardiovascular diseases. There are several ways in which the ACE2 protein might contribute to this variation. The most obvious would be if there is more ACE2, there would be more entry points for the virus to infect the cell, e.g. in older people or in men. However, the evidence for this is rather small, partly because it is not that easy to obtain representative healthy tissues. Alternatively, it could be related to ACE2 membership of a family of proteins that has one end of the protein anchored inside the cell while most of the protein protrudes from the outside of the cell which therefore can be shed when cleaved by proteases at the cell membrane. Herein we review current evidence and theories of ACE2 role on SARS-CoV-2 infectivity and Covid-19 severity.
    Matched MeSH terms: Severity of Illness Index
  2. Khoo KL, Tan H, Liew YM
    Med J Malaysia, 2000 Jun;55(2):249-58.
    PMID: 19839155
    This paper highlights two cases of paediatric familial hyperlipidaemia (hypercholesterolaemia and hypertriglyceridaemia). The first case was an 11 year old Chinese boy, a "homozygous" (Type II) hypercholesterolaemic patient. He had extremely high blood cholesterol level (19.4 mmol/l), severe multiple xanthoma and abnormal resting electrocardiogram. He had repeated heart attacks and died at the age of 15 in spite of early intervention, treatment and follow up. The second case was a 2 1/2 years old girl who had severe hypertriglyceridaemia. She had raised cholesterol (6.2 mmol/l) and extremely high triglycerides (14.8 mmol/l). The patient did not resemble Type I lipoproteinaemia which is classically seen in childhood. On the contrary, the patient exhibited clinical and biochemical manifestations of a Type V lipoproteinaemia which often occurs in adults. Apart from a Type V lipoprotein pattern, the patient had low post hepatic lipase activity (PHLA), Apo C II and Apo E2/E3 phenotype. In addition, the lipid profile of her family members (both the parents and brothers) had raised triglycerides and thus ruled out the Type I lipoprotein inheritance pattern, which is an autosomal recessive condition. The issue of paediatric hyperlipidaemia, their management and treatments are discussed.
    Matched MeSH terms: Severity of Illness Index*
  3. Chin SP, Ng CK, Sim KH
    Indian Heart J, 2007 May-Jun;59(3):211-3.
    PMID: 19124927
    Matched MeSH terms: Severity of Illness Index*
  4. Dreyfus GD, Martin RP, Chan KM, Dulguerov F, Alexandrescu C
    J Am Coll Cardiol, 2015 Jun 2;65(21):2331-6.
    PMID: 26022823 DOI: 10.1016/j.jacc.2015.04.011
    The assessment of the etiology and severity of functional tricuspid regurgitation (FTR) has many limitations, especially when tricuspid regurgitation (TR) is more than severe. Instead of relying solely on TR severity, a new approach not only takes into account the severity of TR, but also pays strict attention to tricuspid annular dilation (size), the mode of tricuspid leaflet coaptation, and tricuspid leaflet tethering-factors often influenced by right ventricular enlargement and dysfunction. To simplify things, we propose a new staging system for functional tricuspid valve pathology using 3 parameters that may more accurately reflect the severity of the disease: TR severity, annular dilation, and mode of leaflet coaptation (extent of tethering). We believe that by utilizing these parameters, cardiologists and cardiac surgeons will be offered a better system for appraisal and decision-making in FTR.
    Matched MeSH terms: Severity of Illness Index*
  5. Golder V, Kandane-Rathnayake R, Hoi AY, Huq M, Louthrenoo W, An Y, et al.
    Arthritis Res. Ther., 2016 11 09;18(1):260.
    PMID: 27829463 DOI: 10.1186/s13075-016-1163-2
    BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic heterogeneous disease with considerable burden from disease activity and damage. A novel clinical treatment target in the form of the lupus low disease activity state (LLDAS) has been recently reported, with retrospective validation showing that time spent in LLDAS translates to reduced damage accrual. The objectives of this study were to describe the frequency and identify the predictors of attaining LLDAS in a large multinational cohort of patients with SLE.
    METHODS: Data were collected at the recruitment visit in patients with SLE enrolled in a longitudinal study in nine countries. Data were analysed cross-sectionally against the recently published definition of LLDAS, and the frequency and characteristics associated with presence of LLDAS were determined. Stepwise multivariable logistic regression was used to determine predictors of LLDAS.
    RESULTS: Of the 1846 patients assessed, criteria for LLDAS were met by 44 %. Patients with shorter disease duration were less likely to be in LLDAS (OR 0.31, 95 % CI 0.19-0.49, p 
    Matched MeSH terms: Severity of Illness Index*
  6. Hambali NL, Mohd Noh M, Paramasivam S, Chua TH, Hayati F, Payus AO, et al.
    Front Public Health, 2020;8:584552.
    PMID: 33304877 DOI: 10.3389/fpubh.2020.584552
    Interleukin 6 (IL-6) is one of the markers of immune system activation indicating existent infection and inflammation. We present here a case of a 55-year-old male COVID-19 patient with an unusual high level of interleukin 6 (IL-6). Further investigation revealed he had hepatocellular carcinoma (HCC) with underlying hepatitis B. He did not present with respiratory symptoms although a baseline chest x-ray showed changes, and the patient was categorized as Class 3A of COVID-19. Routine investigations proceeded with high-resolution computed tomography and IL-6 to monitor for progression to severe COVID-19. Notably, there was a high IL-6 level but other parameters did not show he was in severe COVID-19. In this report, we conclude that elevated IL-6 level in a COVID-19 patient is not necessarily associated with severe COVID-19.
    Matched MeSH terms: Severity of Illness Index
  7. Mohd Roslani AD, Tay ST, Puthucheary SD, Rukumani DV, Sam IC
    Am J Trop Med Hyg, 2014 Dec;91(6):1176-8.
    PMID: 25246695 DOI: 10.4269/ajtmh.14-0354
    The predictors of severe disease or death were determined for 85 melioidosis patients in Kuala Lumpur, Malaysia. Most of the patients were male, > 40 years old, and diabetic. Severe disease or death occurred in 28 (32.9%) cases. Lower lymphocyte counts and positive blood cultures were significant independent predictors of severe disease, but age, presentations with pneumonia, inappropriate empirical antibiotics, or flagellin types of the infecting isolates were not. Knowledge of local predictors of severe disease is useful for clinical management.
    Matched MeSH terms: Severity of Illness Index
  8. Cardosa MS
    Med J Malaysia, 2006 Jun;61(2):139-41.
    PMID: 16898301
    Pain remains as one of the most common reasons for visits to a doctor. The paper by Zalinawati et all published in this issue of the Journal confirmed this in two primary care settings, showing that a complaint of pain was recorded in almost a third of patients, similar to the prevalence reported in European studies.
    Matched MeSH terms: Severity of Illness Index
  9. Mardzuki AI, Abdullah J, Ghazaime G, Ariff AR, Ghazali M
    Med J Malaysia, 2003 Mar;58(1):115-9.
    PMID: 14556336 MyJurnal
    We report three cases of large occipito-encephaloceles that were managed in the Neurosciences Unit, Hospital Universiti Sains Malaysia over the last 5 years. All patients had pre-operative MRI (magnetic resonance imaging) evolution and mapping of the sagittal sinus tract. The cerebrospinal fluid (CSF) of all three patients were initially diverted by means of ventricular shunt two weeks prior to shunt removal. The slow drainage of CSF prevented electrolyte and volume disturbances due to sudden decompression during their definitive occipital encephalocele operations. After 3 years follow-up, all these patients are progressing well.
    Matched MeSH terms: Severity of Illness Index
  10. Wan Hassan WN, Yusoff Y, Mardi NA
    Am J Orthod Dentofacial Orthop, 2017 Jan;151(1):209-218.
    PMID: 28024776 DOI: 10.1016/j.ajodo.2016.08.019
    INTRODUCTION: Rapid prototyping models can be reconstructed from stereolithographic digital study model data to produce hard-copy casts. In this study, we aimed to compare agreement and accuracy of measurements made with rapid prototyping and stone models for different degrees of crowding.

    METHODS: The Z Printer 450 (3D Systems, Rock Hill, SC) reprinted 10 sets of models for each category of crowding (mild, moderate, and severe) scanned using a structured-light scanner (Maestro 3D, AGE Solutions, Pisa, Italy). Stone and RP models were measured using digital calipers for tooth sizes in the mesiodistal, buccolingual, and crown height planes and for arch dimension measurements. Bland-Altman and paired t test analyses were used to assess agreement and accuracy. Clinical significance was set at ±0.50 mm.

    RESULTS: Bland-Altman analysis showed the mean bias of measurements between the models to be within ±0.15 mm (SD, ±0.40 mm), but the 95% limits of agreement exceeded the cutoff point of ±0.50 mm (lower range, -0.81 to -0.41 mm; upper range, 0.34 to 0.76 mm). Paired t tests showed statistically significant differences for all planes in all categories of crowding except for crown height in the moderate crowding group and arch dimensions in the mild and moderate crowding groups.

    CONCLUSIONS: The rapid prototyping models were not clinically comparable with conventional stone models regardless of the degree of crowding.

    Matched MeSH terms: Severity of Illness Index
  11. Low GKK, Kagize J, Faull KJ, Azahar A
    PMID: 31373098 DOI: 10.1111/tmi.13294
    OBJECTIVE: To review the diagnostic test accuracy and predictive value of statistical models in differentiating the severity of dengue infection.

    METHODS: Electronic searches were conducted in the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE (complete), PubMed and Scopus. Eligible studies to be included in this review were cohort studies with participants confirmed by laboratory test for dengue infection and comparison among the different severity of dengue infection by using statistical models. The methodological quality of the paper was assessed by independent reviewers using QUADAS-2.

    RESULTS: Twenty-six studies published from 1994 to 2017 were included. Most diagnostic models produced an accuracy of 75% to 80% except one with 86%. Two models predicting severe dengue according to the WHO 2009 classification have 86% accuracy. Both of these logistic regression models were applied during the first three days of illness, and their sensitivity and specificity were 91-100% and 79.3-86%, respectively. Another model which evaluated the 30-day mortality of dengue infection had an accuracy of 98.5%.

    CONCLUSION: Although there are several potential predictive or diagnostic models for dengue infection, their limitations could affect their validity. It is recommended that these models be revalidated in other clinical settings and their methods be improved and standardised in future.

    Matched MeSH terms: Severity of Illness Index
  12. Soe HJ, Yong YK, Al-Obaidi MMJ, Raju CS, Gudimella R, Manikam R, et al.
    Medicine (Baltimore), 2018 Feb;97(5):e9713.
    PMID: 29384851 DOI: 10.1097/MD.0000000000009713
    Dengue virus is one of the most widespread flaviviruses that re-emerged throughout recent decades. The progression from mild dengue to severe dengue (SD) with the complications such as vascular leakage and hemorrhage increases the fatality rate of dengue. The pathophysiology of SD is not entirely clear. To investigate potential biomarkers that are suggestive of pathogenesis of SD, a small panel of serum samples selected from 1 healthy individual, 2 dengue patients without warning signs (DWS-), 2 dengue patients with warning signs (DWS+), and 5 patients with SD were subjected to a pilot analysis using Sengenics Immunome protein array. The overall fold changes of protein expressions and clustering heat map revealed that PFKFB4, TPM1, PDCL3, and PTPN20A were elevated among patients with SD. Differential expression analysis identified that 29 proteins were differentially elevated greater than 2-fold in SD groups than DWS- and DWS+. From the 29 candidate proteins, pathways enrichment analysis also identified insulin signaling and cytoskeleton pathways were involved in SD, suggesting that the insulin pathway may play a pivotal role in the pathogenesis of SD.
    Matched MeSH terms: Severity of Illness Index
  13. Thong KS, Chee KY, Ng CG, Walterfang M, Velakoulis D
    Asia Pac Psychiatry, 2016 Sep;8(3):238-40.
    PMID: 26615809 DOI: 10.1111/appy.12227
    This study aims to establish psychometric properties of the Malay Neuropsychiatry Unit Cognitive Assessment Tool (Malay NuCOG) in Alzheimer's disease. NuCOG was translated to Malay language and compared with Montreal Cognitive Assessment Tool on 80 individuals. The Malay NuCOG showed good internal consistency and reliability (Cronbach's alpha = 0.895). It demonstrated 100% sensitivity and 87.5% specificity at the cutoff score of 78.50/100. The Malay NuCOG is a valid and reliable cognitive instrument that is sensitive and specific for the detection of dementia and has clinical advantages in its ability to examine individual cognitive domains.
    Matched MeSH terms: Severity of Illness Index*
  14. Ramli R, Malik AS, Hani AF, Jamil A
    Skin Res Technol, 2012 Feb;18(1):1-14.
    PMID: 21605170 DOI: 10.1111/j.1600-0846.2011.00542.x
    INTRODUCTION: This paper presents a comprehensive review of acne grading and measurement. Acne is a chronic disorder of the pilosebaceous units, with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity. Most patients are affected with acne vulgaris, which is the prevalent type of acne. Acne vulgaris consists of comedones (whitehead and blackhead), papules, pustules, nodules and cysts.
    OBJECTIVES: To review and identify the issues for acne vulgaris grading and computational assessment methods. To determine the future direction for addressing the identified issues.
    METHODS: There are two main methods of assessment for acne severity grading, namely, lesion counting and comparison of patient with a photographic standard. For the computational assessment method, the emphasis is on computational imaging techniques.
    RESULTS: Current acne grading methods are very time consuming and tedious. Generally, they rely on approximation for counting lesions and hence the assessment is quite subjective, with both inter and intra-observer variability. It is important to accurately assess acne grade to evaluate its severity as this influences treatment selection and assessment of response to therapy. This will further help in better disease management and more efficacious treatment.
    CONCLUSION: Semi-automated or automated methods based on computational imaging techniques should be devised for acne grade assessment.
    Matched MeSH terms: Severity of Illness Index*
  15. Chan A, Malhotra C, Do YK, Malhotra R, Ostbye T
    Eur J Pain, 2011 Nov;15(10):1094-9.
    PMID: 21646030 DOI: 10.1016/j.ejpain.2011.05.006
    The objective of this paper is to test and correct for systematic differences in reporting of pain severity among older adults by age, gender, ethnic group and socio-economic status using anchoring vignettes. Data from a national survey of community-dwelling older Singaporeans (aged 60 years and over) conducted in 2009 was used. Respondents were asked to rate the severity of their own pain as well as that of others described in the vignettes on a five-point scale ranging from none to extreme. An ordered probit model was used to estimate the coefficients of the independent variables (age, gender, ethnic group, education, housing type) on self-reported pain. Reporting heterogeneity in pain severity was then corrected using a Hierarchical Ordered Probit model. The results showed that before correcting for reporting heterogeneity, women, those older, and those of Malay ethnicity reported greater severity of pain, while there was no association of reported pain severity with housing type and education. However, after correcting for reporting heterogeneity, while women and those older were found to have an even greater severity of pain than what they had reported, Malays were found to have a lower severity of pain than what they had reported. We conclude that there are systematic differences in reporting pain severity by age, gender and ethnic group. We propose that pain management may be improved if medical professionals take into account reporting heterogeneity for pain severity among various population sub-groups in Singapore.
    Matched MeSH terms: Severity of Illness Index*
  16. Ahmad Fadzil MH, Izhar LI, Nugroho H, Nugroho HA
    Med Biol Eng Comput, 2011 Jun;49(6):693-700.
    PMID: 21271293 DOI: 10.1007/s11517-011-0734-2
    Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. In this article, a computerised DR grading system, which digitally analyses retinal fundus image, is used to measure foveal avascular zone. A v-fold cross-validation method is applied to the FINDeRS database to evaluate the performance of the DR system. It is shown that the system achieved sensitivity of >84%, specificity of >97% and accuracy of >95% for all DR stages. At high values of sensitivity (>95%), specificity (>97%) and accuracy (>98%) obtained for No DR and severe NPDR/PDR stages, the computerised DR grading system is suitable for early detection of DR and for effective treatment of severe cases.
    Matched MeSH terms: Severity of Illness Index*
  17. Ahmad Fadzil M, Ngah NF, George TM, Izhar LI, Nugroho H, Adi Nugroho H
    PMID: 21097305 DOI: 10.1109/IEMBS.2010.5628041
    Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. At present, the classification of DR is based on the International Clinical Diabetic Retinopathy Disease Severity. In this paper, FAZ enlargement with DR progression is investigated to enable a new and an effective grading protocol DR severity in an observational clinical study. The performance of a computerised DR monitoring and grading system that digitally analyses colour fundus image to measure the enlargement of FAZ and grade DR is evaluated. The range of FAZ area is optimised to accurately determine DR severity stage and progression stages using a Gaussian Bayes classifier. The system achieves high accuracies of above 96%, sensitivities higher than 88% and specificities higher than 96%, in grading of DR severity. In particular, high sensitivity (100%), specificity (>98%) and accuracy (99%) values are obtained for No DR (normal) and Severe NPDR/PDR stages. The system performance indicates that the DR system is suitable for early detection of DR and for effective treatment of severe cases.
    Matched MeSH terms: Severity of Illness Index*
  18. Kuan WP, Li EK, Tam LS
    Lupus, 2010 Oct;19(12):1436-41.
    PMID: 20947554 DOI: 10.1177/0961203310370050
    Assessment of organ damage has become the standard outcome measure for morbidity and mortality in patients with lupus. Ethnicity is thought to be a marker for genetic, environmental, behavioral, and other variables that may affect disease outcomes. Previous studies suggest that Asians residing in western countries had significantly higher prevalence of damage compared with Whites. In contrast, studies performed in Chinese, Korean and Arab patients showed that the overall prevalence of damage and the most commonly involved organs (neuropsychiatric and musculoskeletal) were similar to Whites. Compared with their Asian counterparts, Pakistani and Jewish patients appeared to have a higher prevalence of damage, most likely secondary to longer disease duration. Chinese patients had an increased prevalence of premature gonadal failure, whereas patients residing in western and southern Asia had more skin damage. When compared with Whites, Asian patients had more renal damage but less ocular and cardiovascular damage. Risk factors associated with organ damage in Asian lupus patients included older age, higher disease activity, and the use of cyclophosphamide and steroids. Further investigations into other determinants such as genetic predisposition, socioeconomic factors, prevalence and severity of disease manifestations, and treatment, is needed in order to understand the variation in damage accrual in lupus patients from different ethnicities.
    Matched MeSH terms: Severity of Illness Index*
  19. Saddki N, Noor MM, Norbanee TH, Rusli MA, Norzila Z, Zaharah S, et al.
    AIDS Care, 2009 Oct;21(10):1271-8.
    PMID: 20024703 DOI: 10.1080/09540120902803216
    This study determines the validity and reliability of the Malay version of the World Health Organization Quality of Life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. A cross-sectional study on 157 patients with HIV seen at the Infectious Disease Unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan was conducted. Factor analysis identified five major domains: physical needs, spirituality, social relationship, psychological, and environment. Significant correlation was found between each domain scores and the general health questions. The instrument was able to discriminate between asymptomatic and symptomatic HIV positive patients for all domain scores except for the spirituality domain. The internal consistency of the five domains ranged from 0.70 to 0.83. The intraclass correlation coefficient (ICC) ranged from 0.60 to 0.87 across all domains. In conclusion, the Malay version of WHOQOL-HIV BREF is a valid and reliable instrument in assessing quality of life in HIV positive patients.
    Matched MeSH terms: Severity of Illness Index*
  20. Boo NY, Ishak S
    J Paediatr Child Health, 2007 Apr;43(4):297-302.
    PMID: 17444833
    To determine the sensitivity and specificity of different levels of bilirubin measured by the transcutaneous bilirubinometer Bilicheck on forehead and sternum for predicting severe hyperbilirubinaemia of total serum bilirubin (TSB)>or=300 micromol/L in Malay, Chinese and Indian infants.
    Matched MeSH terms: Severity of Illness Index*
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