Twenty-one patients who underwent ablative surgery for head and neck cancer at Bristol Dental Hospital and School, England between the years 1996 and 2002 were enrolled in the study. A self-completed questionnaire based on Head and Neck Specific measures was addressed to the patients. The overall post-operative quality of life among these patients is acceptable. About half of the patients complained of moderate to severe difficulty in opening mouth wide (55%) and dry mouth (45%) and about one-third had major problems in swallowing solid food (36%), sleep disturbance (32%), trouble eating and enjoying meals (32%) and speech problems (32%). The study shows a tendency for the quality of life to improve steadily with increasing post-operative interval. It is hoped that the results will provide an insight into the patients' functional and psychological recovery, which will in turn help to facilitate the planning of appropriate strategies to improve their quality of life.
MeSH terms: Deglutition; England; Head and Neck Neoplasms; Humans; Neck; Quality of Life; Surveys and Questionnaires; Speech; Xerostomia
Hand, foot, and mouth disease (HFMD) is endemic in Malaysia. In 1997, a large outbreak of enterovirus 71 (EV-71) associated HFMD resulted in 41 deaths due to severe left ventricular dysfunction and central nervous system infection with extensive damage to the medulla and pons. The clinical presentation in all these patients were rapid cardio-respiratory decompensation leading to cardiac arrest. Another large outbreak of HFMD with 55 fatal cases and a similar clinical picture was reported in Taiwan in 1998. In 2000, an outbreak of HFMD resulted in the deaths of three children who had rapid cardio-respiratory decompensation and one child who survived a central nervous system infection.
Rapid immune plaque assays have been developed to quantify biohazard level 4 agents Hendra and Nipah viruses and detect neutralising antibodies to both viruses. The methods rely on the fact that both viruses rapidly generate large syncytia in monolayers of Vero cells within 24 h and that monospecific antiserum to the Hendra virus phosphoprotein (P) detects that protein in both Hendra and Nipah virus-induced syncytia after methanol fixation of virus-infected cells. The P protein is a constituent of the ribonucleoprotein core of the viruses and a component of the viral RNA-dependent RNA polymerase and is made in significant amounts in infected cells. In the immune plaque assay, anti-P antibody is localised by an alkaline phosphatase-linked second antibody and the Western blot substrates 5-bromo-4-chloro-3-indolyl phosphate and p-nitro blue tetrazolium. A modification of the rapid immune plaque assay was also used to detect antibodies to Nipah virus in a panel of porcine field sera from Malaysia and the results showed good agreement between the immune plaque assay and a traditional serum neutralisation test. After methanol fixation, plates can be stored for up to 7 months and may be used in the immune plaque assay to complement the enzyme-linked immunosorbent assay screening of sera for antibodies to Nipah virus. At present, all enzyme-linked immunosorbent assay positive sera are subject to confirmatory serum neutralisation tests. Use of the immune plaque assay may reduce the number of sera requiring confirmatory neutralisation testing for Nipah virus antibodies under biohazard level 4 conditions by identifying those that generate false positive in the enzyme-linked immunosorbent assay.
Four nucleic acid extraction protocols were examined for their suitability for extraction of the ssRNA, dsRNA and dsDNA genomes of gastroenteritis viruses, for PCR detection. Protocol (A), employed specimen lysis with guanidinium thiocyanate, extraction with phenol-chloroform-isoamyl alcohol and nucleic acid purification by size-fractionated silica particles. Protocol (B), utilised specimen lysis with guanidinium thiocyanate and nucleic acid purification by silica, followed by phenol-chloroform-isoamyl alcohol extraction. Protocol (C), employed specimen lysis with guanidinium thiocyanate and nucleic acid purification by RNAID glass powder. Protocol (D), employed specimen lysis with sodium dodecyl sulphate, proteinase K digestion and extraction with phenol-chloroform-isoamyl alcohol. Of the four protocols, (B) appeared to be a suitable candidate 'universal' nucleic acid extraction procedure for PCR detection of different viral agents of gastroenteritis in a single nucleic acid extract of a faecal specimen, irrespective of genome composition. Omission of the phenol-chloroform extraction step did not affect negatively the ability of protocol (B) to allow PCR detection of gastroenteritis viruses in faecal specimens. PCR detection of NLVs, astroviruses, rotaviruses and adenoviruses, in single nucleic acid extracts of faecal specimens obtained from the field, confirmed the universality of the modified protocol (B). We propose the modified protocol (B) as a 'universal' nucleic acid extraction procedure, for monoplex PCR detection of gastroenteritis viruses in single nucleic acid extracts of faecal specimens and for development of multiplex PCR for their simultaneous detection.
All patients with a first-ever stroke admitted to the HUSM (Hospital Universiti Sains Malaysia) from 1997 to 1998 were included in this study. All risk factors were determined and analysed prospectively. There were 158 cases of stroke admitted during the study period. The majority of the patients were Malays (86.1%), with a male preponderance. The mean age (SD) of the patients with stroke was 59.3 (12.28) years. Hypertension was present in both cerebral infarct and intracerebral haemorrhage patients at almost the same rate (65.2 and 69.2%, respectively). The overall mortality was 37%, and most patients died in the 1st month after stroke (34%). We hope this study will highlight the problems associated with the presentation and management of stroke in Southeast Asia.
MeSH terms: Adult; Aged; Aged, 80 and over; Cause of Death*; Cross-Cultural Comparison*; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Prospective Studies; Risk Factors; Causality; Survival Analysis; Stroke/etiology; Stroke/mortality*; Asian Continental Ancestry Group*
The discovery that c-fos, a proto-oncogene, has a role in pain, has triggered extensive research on the consequences of c-fos expression. It has been shown that c-fos, through its protein form, FOS, leads to expression of dynorphin gene and subsequently dynorphin protein which is implicated in the development of a pain state. This mini review looks at the properties of c-fos and the consequences of its expression following noxious (painful) stimulation.
Sixty primary school children, were measured for for accommodation and, vergence facility, accommodation accuracy, relative accommodation, fusional vergence / reserve and heterophoria.Analysis of Variance revealed that no - single factor was significant by involved among the six age groups for all the above (p>0.05). However, a significant age difference (p<0.05) was found in the fusional reserve. The mean and standard deviation was 20.08 (±6.43) cpm for the monocular accommodation facility, 19.77 (±6.26) cpm for the binocular accommodation facility, 20.18 (±5.00) cpm for the vergence facility, 0.44 (±0.27) D for the accommodation accuracy, -0.28 (±0.82) PD for the heterophoria at distance, -1.84 (±3.9) PD for the near heterophoria, 3.25 (±0.79) D for the negative relative accommodation, and -3.90 (±1.32) D for the positive relative accommodation.There was no age difference in the accommodation and the vergence status between years the ages of 7 and 12 years old but the fusional reserve component of the vergence system varied with age. The vergence and the accommodation findings in our subjects were discussed and compared with previous studies to serve as a guideline in clinical data interpretation and diagnosis for binocular vision problems in Malay children.
Thirty patients with diabetic polyneuropathy were recruited from the diabetic clinic in Hospital Universiti Sains Malaysia from 1996 to 1998. They were randomly assigned either sulbutiamine (Arcalion(®)) (15 patients) or no treatment (control group; 15 patients). Glycaemic control was assessed by blood glucose and HbA1. Severity of neuropathy was assessed by symptom and sign score, and electrophysiological parameters (nerve conduction velocity and compound muscle action potential) at entry to the study and after 6 weeks. There were improvements in the electrophysiological parameters in the treatment group when compared to the controls with significant improvement in the median nerve conduction velocity (p<0.001), median compound muscle action potential (p<0.001), peroneal nerve conduction velocity (p<0.001), and peroneal compound muscle action potential (p<0.001). No significant improvement in symptom and sign scores were noted between the groups but a significant improvement compared to base line was noted for the sulbutiamine treated group. (p< 0.05). The glycaemic control in both groups was not significantly different at base line and was stable throughout the study. Sulbutiamine objectively improved peripheral nerve function in diabetic polyneuropathy although the symptom score did not improve, possibly due to the short duration of the study.
MeSH terms: Action Potentials; Blood Glucose; Diabetes Mellitus; Diabetic Neuropathies; Humans; Malaysia; Neural Conduction; Peripheral Nerves; Thiamine; Control Groups
The relationship between left ventricular mass (LVM) and the mean arterial blood pressure (MAP) was investigated, using M-Mode echocardiography. MAP was higher in hypertensive patients (p<0.05, n=9) compared to that of controlled subjects. The results showed that LVM index for hypertensive patients was significantly higher (p<0.05, n=9) than that for the normal group. LVM index correlates fairly (r=0.6) with MAP for hypertensive patients. The results also show that the increase of intraventricular septal wall thickness (IVST) was due to hypertension. The LVM (r =0.9) and IVST (r=0.75) of the normal subjects were linearly dependent on the body surface area (BSA). The hypertensive group revealed a non-linear relationship to the BSA.
MeSH terms: Body Surface Area; Echocardiography; Humans; Hypertension; Arterial Pressure
Despite common occurrence, congenital talipes equinovarus (clubfoot) is still a subject of controversy. It poses a significant problem with its unpredictable outcome, especially when the presentation for treatment is late. The true etiology remains unknown although many theories have been put forward. A standard management scheme is difficult as there is no uniformity in the pathoanatomy, classification and radiographic evaluation. These differ according to the age of the child and the severity of the condition. The paper discusses these controversies with an emphasis on the proposed etiologies and types of treatment performed.
The aim of this study was to determine the incidence and associated risk factors of postpartum depression among Malay women in Beris Kubor Besar, Bachok, Kelantan The study was conducted between February to August 1998. A two-stage population survey approach was employed. Firstly, all the women who delivered between the months of February and May 1998 in the catchment area were identified. In stage 1, the 30 items GHQ was used as the screening instrument at 6 to 8 weeks postpartum. All the potential cases (scoring above 6 on the questionnaire) were later interviewed using the CIS in stage 2 of the study. Diagnosis of postpartum depression was only made if the women fulfilled required criteria. Of the 174 women who were recruited, 17 of them fulfilled the criteria for postpartum depression yielding an incidence rate of 9.8 %. The condition was found to be significantly linked to low income or socioeconomic status, having marital problems (mainly financial in nature) and not breast - feeding.
MeSH terms: Breast Feeding; Female; Humans; Malaysia; Poverty; Surveys and Questionnaires; Risk Factors; Social Class; Incidence; Depression, Postpartum; Postpartum Period
Biliary cystadenoma is a rare neoplasm of the biliary ductal system. Surgical management yields an excellent result. We present a case of recurrent biliary cystadenoma in the left lobe of the liver. The cyst was successfully treated with hepatic segmentectomy. The lobulated smoothly marginated septated cystic lesion noted on computed tomography (CT) were highlighted and the other imaging studies, differential diagnosis and management were reviewed.
A 13-year old Malay school girl who had been apparently normal previously, presented with a three-month history of fever, malaise and loss of weight. She had anemia and raised values for ESR, lactic dehydrogenase, C-reactive protein, ferritin and a positive mantoux test. Her routine chest x-ray showed hilar prominence suggestive of hilar lymph node enlargement. C.T. Scan of the thorax revealed a posterior mediastinal mass, the histopathology of which was suggestive of Ewing's sarcoma. The rarity of the location of the tumour and its unusual mode of presentation prompted us to report this case.
In the title compound, [Zn(CH3COO)2(C4H8N2S)2]*H2O, the Zn atom is tetrahedrally coordinated in the ZnO2S2 form. N-H...O and O-H...O intramolecular and intermolecular hydrogen bonds are formed by the four N atoms and the water molecule. N-H...O intermolecular hydrogen bonds and C-H...S and C-H...O intermolecular interactions interconnect columns formed by the molecules into layers. Adjacent layers are then linked by other N-H...O and O-H...O intermolecular hydrogen bonds to form a three-dimensional framework throughout the structure. The orientations of the acetate planes are such that the Zn atom lies within them.
The title compound, bis(2,4-dinitrophenolato-kappa2O,O')(1,4,7,10,13,16-hexaoxadecane-kappa6O)barium(II), [Ba(C6H3N2O5)2(C12H24O6)], is a 1:1 complex of barium(II)-2,4-dinitrophenolate and 1,4,7,10,13,16-hexaoxacyclooctadecane (18-crown-6). Its structure is located on a crystallographic inversion centre. The temperature dependence of the crystal structure has been studied. The monoclinic beta angle of the P2(1)/n space group increases with increasing temperature. The packing structure of the complex is stabilized by intermolecular C-H...O interactions.
In the title compound, C20H16N2O5, both of the 1-acetylisatin (1-acetyl-1H-indole-2,3-dione) moieties are planar and form a dihedral angle of 74.1 (1) degrees. Weak intermolecular hydrogen bonds and C-H...pi interactions stabilize the packing in the crystal.
In the title complex, the 1:1 ionic adduct of hexamethylenetetraminium and 2,4,6-trinitrophenolate, C6H13N4+*C6H2N3O7-, the cation acts as a donor for bifurcated hydrogen bonds to the O atoms of the phenolate and one of the nitro groups of the 2,4,6-trinitrophenolate anion. The crystal structure is built from sheets of cations and anions, and is stabilized by intermolecular C-H...O and C-H...pi interactions.
In the title complex, C6H12N4*C8H8O3, the hexamethylenetetramine molecule accepts a single intermolecular O-H...N hydrogen bond from the hydroxy group of the 4-hydroxy-3-methoxybenzaldehyde moiety. The non-centrosymmetric crystal structure is built from alternating molecular sheets of 4-hydroxy-3-methoxybenzaldehyde and hexamethylenetetramine molecules, and is stabilized by intermolecular O-H...N, C-H...O and C-H...pi interactions.
Treatment of vanadium(V) oxide with an ethanol-concentrated sulfuric acid mixture, followed by the addition of an equimolar amount of beta-alanine and sodium hydroxide, and finally raising the pH to 3.9 with sodium carbonate solution, under continuous heating in a water bath and in the presence of air, leads to the polyionic sodium cyclo-[mu(6)-(sulfato-O,O',O'')tris[mu-(beta-alanine-O,O')-mu-oxo]tris(mu-hydroxo-mu-oxo)hexa[oxovanadium(V)]] sulfate tridecahydrate which crystallizes in the monoclinic P2(1)/n space group [a = 9.5192(4), b = 20.1185(9), c = 22.6174(9) A, beta = 97.011(1) degrees; Z = 4]. The crown-shaped polyoxovanadium(V) cluster cation, with carboxylate-bridging amino acid ligands, has an Anderson structure with two unique capping sulfato ligands. Its structural analysis, together with IR, UV-vis, and preliminary data on its solution properties, is presented.