Displaying publications 1 - 20 of 27 in total

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  1. Norazizah MA, Wan Hazabbah WH, Rohaizan Y, Shatriah I
    Med J Malaysia, 2012 Feb;67(1):102-4.
    PMID: 22582557 MyJurnal
    Isolated optic neuritis as a presenting sign of tuberculosis in children is uncommon. We report a case of an immunocompetent child who displayed features of bilateral optic neuritis secondary to presumed tuberculosis. It is essential to highlight this alarming presentation in a child, as the presence of tuberculosis has re-emerged as a serious public health problem especially in developing countries.
    Matched MeSH terms: Tuberculosis/complications*
  2. Menon RK, Aziah M, Kuppusamy I
    Med J Malaysia, 1995 Dec;50(4):425-6.
    PMID: 8668071
    Matched MeSH terms: Tuberculosis/complications*
  3. Azali HY, Norly S, Wong LM, Tan KS, Safian NM
    Asian J Surg, 2007 Apr;30(2):138-40.
    PMID: 17475585
    We report an unusual co-existence of Burkholderia pseudomallei and acid fast bacilli in a young Malay gentleman with liver abscess. He was treated with antibiotics and surgical drainage. This phenomenon has not been reported in previous literature and the dilemma of its management is discussed.
    Matched MeSH terms: Tuberculosis/complications*
  4. Leong BD, Chan KW, Ramu P, Kumar VM, Chuah JA
    Med J Malaysia, 2011 Jun;66(2):146-7.
    PMID: 22106698 MyJurnal
    Gallbladder tuberculosis (GT) is an extremely rare condition. This is thought to be due to the protective property of bile against the infection. Clinical and radiological diagnosis of GT is difficult. We describe a case of GT who initially presented to us with jaundice, a right hypochondrial mass and computed tomographic findings suggestive of gallbladder empyema. Diagnosis was made from histopathological examination of the resected gallbladder which revealed epitheloid granulomas with caseating necrosis and presence of Langhan's giant cells. From a literature search and to the best of our knowledge, this is the first GT to be reported in South East Asia.
    Matched MeSH terms: Tuberculosis/complications
  5. Redha S, Suresh RL, Subramaniam J, Merican I
    Med J Malaysia, 2001 Mar;56(1):95-7.
    PMID: 11503305
    Tuberculosis, in its extrapulmonary form, though emerging as a common clinical problem, rarely affects the pancreas. Its indolent course, vague symptomatology along with its non-specific laboratory and radiographic findings call for greater vigilance. We report a case of pancreatic tuberculosis, previously managed as recurrent alcohol related pancreatitis which showed symptomatic improvement following commencement of antituberculosis drugs. The diagnosis of pancreatic tuberculosis in this case was based on the abdominal CT scan findings, response to anti-tubeculous chemotherapy and overall laboratory and radiological work-up.
    Matched MeSH terms: Tuberculosis/complications*
  6. Chan TY
    Calcif. Tissue Int., 1997 Jan;60(1):91-3.
    PMID: 9030487
    The prevalence of hypercalcemia in patients with untreated tuberculosis (TB) varies widely between countries. Since the vitamin D status and calcium intake are important determinants of hypercalcemia in TB, these two factors were compared among four populations (U.K., Hong Kong, Malaysia, Thailand) with a low prevalence (<3%) and two populations (Sweden, Australia) with a high prevalence (>25%). In the three Asian countries, the circulating vitamin D levels are abundant, but the calcium intakes are low. Subjects from the U.K. have the lowest circulating vitamin D level of all, although their calcium intake is high. In Sweden and Australia, both the circulating vitamin D levels and calcium intakes are high. Since serum 1,25(OH)2D concentration will only be raised if its substance for extrarenal conversion, 25(OH)D, is plentiful and the effect of a given serum 1,25 (OH)2D concentration on serum calcium is determined by the calcium intake, it is postulated that the regional variation in the prevalence of hypercalcemia in TB may be due to differences in the circulating vitamin D levels and calcium intakes in these populations.
    Matched MeSH terms: Tuberculosis/complications*
  7. Tan TT, Lee BC, Khalid BA
    J Trop Med Hyg, 1993 Dec;96(6):349-51.
    PMID: 8254712
    In this study we examined the incidence of hypercalcaemia among patients with tuberculosis in Malaysia. Serum calcium concentration and other calcium metabolism parameters were studied in 43 newly diagnosed tuberculous patients from the Kuala Lumpur General Hospital and the National Tuberculosis Centre. Forty-four patients admitted to the medical wards of the General Hospital, Kuala Lumpur were recruited as controls. The incidence of hypercalcaemia was found to be only 1/43 (2.3%). There was no significant difference between the mean serum calcium and other calcium metabolism parameters between the patients and the controls. Despite earlier reported incidences of 30-50%, this study showed that hypercalcaemia in tuberculosis is uncommon in Malaysia.
    Matched MeSH terms: Tuberculosis/complications*
  8. Shankar EM, Vignesh R, Ellegård R, Barathan M, Chong YK, Bador MK, et al.
    Pathog Dis, 2014 Mar;70(2):110-8.
    PMID: 24214523 DOI: 10.1111/2049-632X.12108
    Tuberculosis (TB) and human immunodeficiency virus (HIV) infection interfere and impact the pathogenesis phenomena of each other. Owing to atypical clinical presentations and diagnostic complications, HIV/TB co-infection continues to be a menace for healthcare providers. Although the increased access to highly active antiretroviral therapy (HAART) has led to a reduction in HIV-associated opportunistic infections and mortality, the concurrent management of HIV/TB co-infection remains a challenge owing to adverse effects, complex drug interactions, overlapping toxicities and tuberculosis -associated immune reconstitution inflammatory syndrome. Several hypotheses have been put forward for the exacerbation of tuberculosis by HIV and vice versa supported by immunological studies. Discussion on the mechanisms produced by infectious cofactors with impact on disease pathology could shed light on how to design potential interventions that could decelerate disease progression. With no vaccine for HIV and lack of an effective vaccine for tuberculosis, it is essential to design strategies against HIV-TB co-infection.
    Matched MeSH terms: Tuberculosis/complications*
  9. Jarmin R, Alwi RI, Shaharuddin S, Salleh KM, Gunn A
    Asian J Surg, 2004 Oct;27(4):342-4.
    PMID: 15564193
    A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.
    Matched MeSH terms: Tuberculosis/complications*
  10. Mohammad Z, Naing NN, Salleh R, Ahmad N, Hamzah WM, Mahmud R
    PMID: 12118468
    The human immunodeficiency virus (HIV) epidemic has had a profound influence on the epidemiology of tuberculosis (TB). The potential for HIV-associated TB cases to transmit M. tuberculosis and to produce a secondary increase in TB morbidity is unknown. A cross-sectional study was carried out to compare the prevalence of M. tuberculosis infection among the household contacts of HIV-positive and HIV-negative pulmonary tuberculosis (PTB) patients. Records of tuberculin (Mantoux) tests administered during routine contact investigations at the Chest Clinic, Hospital Kota Bharu, from 1999 to 2000 were reviewed. The HIV status of the patients was based on the results of ELISA tests while information on household contacts was gathered during visits to their houses. Ninety-four contacts of 39 HIV-negative patients and 44 contacts of 17 cases of HIV-positive patients were included in this preliminary study. 30% (12/40) of the contacts of HIV-positive PTB had a positive tuberculin compared with 52.8% (47/ 94) of the contacts of HIV-negative patients [OR = 0.41, 95% Confidence interval (CI) 0.17 - 0.97; p = 0.016]. The difference was still significant after performing multivariate logistic regression analysis to adjust for variables associated with infectiousness of TB (adjusted OR = 0.24, 95% CI 0.07 - 0.87; p = 0.03). This study has shown that HIV-infected PTB patients are less infectious to their contacts than HIV-negative patients. The presence of MV in the community may not necessitate a change of the current policy of the management of contacts.
    Study site: Chest Clinic, Hospital Kota Bharu, Kelantan, Malaysia
    Matched MeSH terms: Tuberculosis/complications
  11. Osowicki J, Wang S, McKenzie C, Marshall C, Gard J, Ke Juin W, et al.
    Pediatr Infect Dis J, 2016 Jan;35(1):108-10.
    PMID: 26398869 DOI: 10.1097/INF.0000000000000932
    We present the case of a male infant with congenital tuberculosis in a nonendemic setting complicated by hemophagocytic lymphohistiocytosis, who was treated successfully with antituberculous therapy and corticosteroids. We review the pediatric literature concerning the unusual association of these 2 rare conditions.
    Matched MeSH terms: Tuberculosis/complications*
  12. Lim CH, Chen HH, Chen YH, Chen DY, Huang WN, Tsai JJ, et al.
    PLoS One, 2017;12(6):e0178035.
    PMID: 28570568 DOI: 10.1371/journal.pone.0178035
    The objective of this study is to determine the risk of tuberculosis (TB) disease in biologics users among rheumatoid arthritis (RA) patients in Taiwan from 2000 to 2015. This retrospective cohort study enrolled adult RA patients initiated on first biologics at Taichung Veterans General Hospital. TB risks were determined as hazard ratio (HR) with 95% confidence interval (CI) using cox regression. A total of 951 patients were recruited; etanercept (n = 443), adalimumab (n = 332), abatacept (n = 74), golimumab (n = 60), tocilizumab (n = 31) and tofacitinib (n = 11). Twenty-four TB cases were identified; 13 in etanercept and 11 in adalimumab group with the TB incidence rate of 889.3/ 100,000 and 1055.6/ 100,000 patient-years respectively. There was no significant difference in TB risk between adalimumab and etanercept users with an incidence rate ratio of 1.27 (p = 0.556 by Poisson model). Significant 2-year TB risk factors included elderly patient >65 year-old (HR: 2.72, 95% CI: 1.06-6.99, p = 0.037), history of TB (HR: 6.24, 95% CI: 1.77-22.00, p = 0.004) and daily glucocorticoid use ≥5mg (HR:5.01, 95% CI: 1.46-17.21, p = 0.010). Sulfasalazine treatment appeared to be protective (HR: 0.32, 95% CI: 0.11-0.97, p = 0.043). Risk management plan (RMP) for TB before initiation of biologics commenced in 2012. The 2-year TB risks after RMP was compared with that before 2012 (HR:0.67, 95% CI: 0.30-1.49, p = 0.323). Elderly RA patients with a history of previous TB infection and concomitant moderate dose glucocorticoid were at higher risk of TB disease. Concurrent sulfasalazine treatment appeared to be a protective factor against TB disease.
    Matched MeSH terms: Tuberculosis/complications*
  13. Bisallah CI, Rampal L, Lye MS, Mohd Sidik S, Ibrahim N, Iliyasu Z, et al.
    PLoS One, 2018;13(2):e0192276.
    PMID: 29470530 DOI: 10.1371/journal.pone.0192276
    INTRODUCTION: The risk of development of active TB in HIV-infected individuals is 20-37 times higher than those that are HIV negative. Poor knowledge of TB amongst people living with HIV has been associated with high transmission.

    OBJECTIVES: To determine the effectiveness of a new health education intervention module in improving knowledge, attitude, and practice (KAP) regarding tuberculosis among HIV patients in General Hospital Minna, Nigeria.

    METHODS: A randomized control trial was carried out from July 2015 to June 2017. A random number generating program was used to allocate 226 respondents into 2 groups. The intervention group received health education regarding tuberculosis using the developed module. The control group received the normal services provided for HIV patients. Data were collected from December 2015 to September 2016 at baseline, immediate post intervention, three, six and nine months. The outcome measures were knowledge, attitude, and practice.

    RESULTS: There was no significant difference with respect to socio-demographic characteristics, KAP of the respondents in the intervention and control group at baseline. However, there was significant improvement in knowledge in the intervention group compared to the control group, group main effect (F = (1,218) = 665.889, p = 0.001, partial ἠ2 = 0.753, d = 5.4); time (F = (3.605, 218) = 52.046, p = 0.001, partial ἠ2 = 0.193, d = 1.52) and interaction between group with time (F = (3.605, 218) = 34.028, p = 0.001, partial ἠ2 = 0.135, d = 1.23). Likewise, there was significant improvement in attitude, group main effect (p = 0.001, d = 1.26) and time (p = 0.001, p, d = 0.65). Similarly, there was improvement in practice, group main effect, time, and interaction of group with time (p < 0.05).

    CONCLUSION: The health education intervention program was effective in improving KAP regarding tuberculosis among HIV patients.

    Matched MeSH terms: Tuberculosis/complications*
  14. Loh LC, Chan SK, Ch'ng KI, Tan LZ, Vijayasingham P, Thayaparan T
    Med J Malaysia, 2005 Oct;60(4):426-31.
    PMID: 16570703
    In the Malaysian setting of multi-ethnicity and high BCG coverage, interpretation of Tuberculin Skin Testing (TST) may be difficult. Between January 2001 and December 2003, a retrospective study on all adult patients with documented TST results treated for tuberculosis (TB) in chest clinics of two government hospitals was conducted to determine the reliability of TST and factors affecting its interpretation. One hundred and three patients [mean age (SD): 43 (17); male: 67%] were eligible for data collection: 72% and 57% of patients had positive TST results based on cut-off points of 10mm and 15mm respectively. The only significant univariate association with TST results was the severity of co-morbidity. A patient with co-morbidity score of 3 defined as those with any cancer, end-stage renal or liver disease, or HIV disease, was more likely to have a negative TST results [10mm cut-off point: Odd Ratio (95% CI) 6.6 (1.82 to 24.35), p = 0.003; 15mm cut-off point: 4.8 (1.21 to 18.95), p = 0.012]. A TST reading of 10mm had a higher sensitivity than 15mm as the cut-off point in diagnosing TB infection. Considering all possible confounding factors like ethnicity, prior BCG vaccination and TB burden in the population, severity of co-morbidity remains strongly predictive of a negative TST. Caution should be exercised in interpreting TST in these patients.
    Study site: Chest clinic, Hospital Seremban, Hospital Kuala Pilah, Negeri Sembilan, Malaysia
    Matched MeSH terms: Tuberculosis/complications
  15. Puri MM, Arora VK
    Med J Malaysia, 2000 Sep;55(3):382-4.
    PMID: 11200723
    A 25 year old woman developed a right pleural effusion 6 weeks after commencement of short course chemotherapy for left sided tuberculous pleural effusion. Since the patient improved following continuation of the same treatment, it is presumed to be a case of paradoxical response to anti-tuberculosis treatment.
    Matched MeSH terms: Tuberculosis/complications*
  16. Looi LM
    Malays J Pathol, 1994 Jun;16(1):11-3.
    PMID: 16329569
    Congo red screening of routine biopsies at the University Hospital Kuala Lumpur revealed the following categories of amyloidosis: systemic AL (5.9%); systemic AA (3.2%); isolated atrial (14%); primary localized cutaneous (7.5%); other primary localized deposits (3.2%); localized intratumour (58%); and dystrophic (8.6%). Unlike in the West, AA amyloidosis in this population was usually secondary to leprosy or tuberculosis. Liver involvement in AL amyloidosis was shown to exhibit a sinusoidal pattern and differed from the vascular pattern of AA amyloidosis. Within the category of AA amyloidosis, there were two patterns of renal involvement--glomerular and vascular, with the glomerular pattern carrying a more ominous clinical picture. Notable among the localized amyloidoses were isolated atrial amyloidosis complicating chronic rheumatic heart disease, intratumour amyloidosis within nasopharyngeal carcinomas and dystrophic amyloidosis which occurred in fibrotic tissues.
    Matched MeSH terms: Tuberculosis/complications
  17. Vignesh R, Swathirajan CR, Solomon SS, Shankar EM, Murugavel KG
    Indian J Med Microbiol, 2017 Apr-Jun;35(2):279-281.
    PMID: 28681821 DOI: 10.4103/ijmm.IJMM_16_163
    Immune reconstitution inflammatory syndrome (IRIS) continues to be a complication in HIV/tuberculosis (TB) co-infected patients initiating highly active antiretroviral therapy (HAART). The aim of this study was to evaluate the risk factors associated with developing IRIS to identify a possible biomarker to predict or diagnose IRIS in patients initiating HAART. A total of 175 HIV/TB co-infected patients initiating HAART were followed up longitudinally during September 2010 to May 2013 attending a HIV care clinic in Chennai. Patients were followed up longitudinally after HAART initiation and baseline demographic, laboratory parameters and treatment characteristics between patients with IRIS events and those without IRIS events were compared. Chi-square or Fisher's exact test for categorical variables and a Wilcoxon rank-sum test for continuous variables were performed using SPSS, version 12.0 software. Patients with IRIS had a significantly lower median baseline CD4+ T-cell count (P = 0.0039). There were no differences in terms of sex, CD4 T-cell %, plasma viral load, time interval between initiating ATT and HAART between the IRIS and non-IRIS patients. Low CD4+ T-cell count (<100 cells/μL) could be used as a marker to screen and monitor patients initiating HAART.
    Matched MeSH terms: Tuberculosis/complications*
  18. Henry RT, Jiamsakul A, Law M, Losso M, Kamarulzaman A, Phanuphak P, et al.
    J Acquir Immune Defic Syndr, 2021 May 01;87(1):720-729.
    PMID: 33399309 DOI: 10.1097/QAI.0000000000002619
    BACKGROUND: Tuberculosis (TB) is a common infection in people living with HIV. However, the risk factors for HIV/TB co-infection in second-line HIV therapy are poorly understood. We aimed to determine the incidence and risk factors for TB co-infection in SECOND-LINE, an international randomized clinical trial of second-line HIV therapy.

    METHODS: We did a cohort analysis of TB cases in SECOND-LINE. TB cases included any clinical or laboratory-confirmed diagnoses and/or commencement of treatment for TB after randomization. Baseline factors associated with TB were analyzed using Cox regression stratified by site.

    RESULTS: TB cases occurred at sites in Argentina, India, Malaysia, Nigeria, South Africa, and Thailand, in a cohort of 355 of the 541 SECOND-LINE participants. Overall, 20 cases of TB occurred, an incidence rate of 3.4 per 100 person-years (95% CI: 2.1 to 5.1). Increased TB risk was associated with a low CD4+-cell count (≤200 cells/μL), high viral load (>200 copies/mL), low platelet count (<150 ×109/L), and low total serum cholesterol (≤4.5 mmol/L) at baseline. An increased risk of death was associated with TB, adjusted for CD4, platelets, and cholesterol. A low CD4+-cell count was significantly associated with incident TB, mortality, other AIDS diagnoses, and virologic failure.

    DISCUSSION: The risk of TB remains elevated in PLHIV in the setting of second-line HIV therapy in TB endemic regions. TB was associated with a greater risk of death. Finding that low CD4+ T-cell count was significantly associated with poor outcomes in this population supports the value of CD4+ monitoring in HIV clinical management.

    Matched MeSH terms: Tuberculosis/complications*
  19. Rohela M, Jamaiah I, Menon J, Rachel J
    PMID: 15916055
    Fasciolopsiasis is a disease caused by the largest intestinal fluke, Fasciolopsis buski. The disease is endemic in the Far East and Southeast Asia. Human acquires the infection after eating raw freshwater plants contaminated with the infective metacercariae. There has been no report of fasciolopsiasis either in man or in animal in Malaysia. We are reporting the first case of fasciolopsiasis in Malaysia in a 39-year-old female farmer, a native of Sabah (East Malaysia). This patient complained of cough and fever for a duration of two weeks, associated with loss of appetite and loss of weight. She had no history of traveling overseas. Physical examination showed pallor, multiple cervical and inguinal lymph nodes and hepatosplenomegaly. Laboratory investigations showed that she had iron deficiency anemia. There was leukocytosis and a raised ESR. Lymph node biopsy revealed a caseating granuloma. Stool examination was positive for the eggs of Fasciolopsis buski. The eggs measure 140 x 72.5 microm and are operculated. In this case, the patient did not present with symptoms suggestive of any intestinal parasitic infections. Detection of Fasciolopsis buski eggs in the stool was an incidental finding. She was diagnosed as a case of disseminated tuberculosis with fasciolopsiasis and was treated with antituberculosis drugs and praziquantel, respectively.
    Matched MeSH terms: Tuberculosis/complications
  20. Ballif M, Renner L, Claude Dusingize J, Leroy V, Ayaya S, Wools-Kaloustian K, et al.
    J Pediatric Infect Dis Soc, 2015 Mar;4(1):30-8.
    PMID: 26407355 DOI: 10.1093/jpids/piu020
    BACKGROUND: The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge.

    METHODS: We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study.

    RESULTS: Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children.

    CONCLUSIONS: Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected children.

    Matched MeSH terms: Tuberculosis/complications
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