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  1. Dried Blood Spots-A Platform for Therapeutic Drug Monitoring (TDM) and Drug/Disease Response Monitoring (DRM)
    Zailani NNB, Ho PC
    Eur J Drug Metab Pharmacokinet, 2023 Sep;48(5):467-494.
    PMID: 37495930 DOI: 10.1007/s13318-023-00846-4
    This review provides an overview on the current applications of dried blood spots (DBS) as matrices for therapeutic drug (TDM) and drug or disease response monitoring (DRM). Compared with conventional methods using plasma/serum, DBS offers several advantages, including minimally invasiveness, a small blood volume requirement, reduced biohazardous risk, and improved sample stability. Numerous assays utilising DBS for TDM have been reported in the literature over the past decade, covering a wide range of therapeutic drugs. Several factors can affect the accuracy and reliability of the DBS sampling method, including haematocrit (HCT), blood volume, sampling paper and chromatographic effects. It is crucial to evaluate the correlation between DBS concentrations and conventional plasma/serum concentrations, as the latter has traditionally been used for clinical decision. The feasibility of using DBS sampling method as an option for home-based TDM is also discussed. Furthermore, DBS has also been used as a matrix for monitoring the drug or disease responses (DRM) through various approaches such as genotyping, viral load measurement, assessment of inflammatory factors, and more recently, metabolic profiling. Although this research is still in the development stage, advancements in technology are expected to lead to the identification of surrogate biomarkers for drug treatment in DBS and a better understanding of the correlation between DBS drug levels and drug responses. This will make DBS a valuable matrix for TDM and DRM, facilitating the achievement of pharmacokinetic and pharmacodynamic correlations and enabling personalised therapy.
    Matched MeSH terms: Hematocrit
  2. Hematological values in pregnancy in Orang Asli (aboriginal) women
    Ong HC
    Med J Malaysia, 1973 Jun;27(4):240-2.
    PMID: 4270778
    Matched MeSH terms: Hematocrit*
  3. Salinity tolerance in Clarias gariepinus (Burchell, 1822): insight on blood parameter variations and gill histological changes
    Okomoda VT, Isah S, Solomon SG, Ikhwanuddin M
    Fish Physiol Biochem, 2024 Apr;50(2):605-616.
    PMID: 38165562 DOI: 10.1007/s10695-023-01293-3
    This study was designed to evaluate the tolerance of Clarias gariepinus juveniles to a gradual and abrupt increase in salinity over time. To this effect, C. gariepinus juveniles were exposed to three salinity incremental protocols namely 1 g L-1 day-1, 5 g L-1 day-1, and 10 g L-1 day-1. Changes in the hematological parameters and the gill histology of fish were analyzed to determine the impact of osmotic stress on the health status of the fish and its osmoregulatory ability. The result obtained showed that juveniles of C. gariepinus can tolerate salinity stress up to 14 g L-1. At 15 g L-1 and beyond, all samples died regardless of gradual (i.e., 1 g L-1 day-1 administered for 15 days) or abrupt salinity exposure (i.e., 5 g L-1 day-1 administered for three days and 10 g L-1 day-1 administered for two days). Interestingly, more than 90% of the fish survived a direct 10 g L-1 exposure for 24 h without prior acclimation. The hematological parameters accessed in the fish exposed to 10 g L-1 (either gradually or abruptly) showed a significant increase in the white blood cells and a decrease in the red blood cells, packed cell volume, hemoglobin concentration, and all derived blood parameters. The results of the serum biochemistry show a lower total protein and albumin in the salinity-treated fish compared to the control group. However, the serum glucose and the plasma electrolytes (i.e., K+, Na+, and Cl-) were higher in the former group than in the latter. Aside from the stress response expressed in the blood parameters, severe gill degenerations were seen in the histological micrograph obtained for the salinity-treated fish, while the control had a near-normal gill architecture. It was concluded that C. gariepinus could tolerate salinity exposure of 10 g L-1 day-1 (administered gradually or abruptly) and below without killing the fish within 24 h.
    Matched MeSH terms: Hematocrit
  4. Fulltext Experimental data of phospholipid supplementary in full fishmeal replacement diets on growth indices, whole body nutrient composition, muscle fatty acid composition, haematocrit value and serum lysozyme activity in Malaysian mahseer (Tor tambroides)
    Mian S, Ishak SD, Noordin NM, Kader MA, Abduh YM, Khatoon H, et al.
    Data Brief, 2020 Apr;29:105287.
    PMID: 32123713 DOI: 10.1016/j.dib.2020.105287
    The data collection was initiated to evaluate the effects of supplementary phospholipid to non-fishmeal based diet in order to make functional diets for the Malaysian Mahseer, Tor tambroides. Four iso-nitrogenous and iso-lipidic diets were formulated to consist 100% fishmeal (FM100), 0% fishmeal or full fishmeal replacement (FM0), and 0% fishmeal supplemented with 4% phospholipids (FM0+4%PL), 6% phospholipids (FM0+6%PL). A 60-day feeding trial was conducted and data collection was carried out for the following parameters; growth indices, somatic parameters, whole body nutrient composition, muscle fatty acid composition, haematocrit value and serum lysozyme activity. Fish fed FM0 diets showed significantly poor performance (P 
    Matched MeSH terms: Hematocrit
  5. Fulltext Hematocrit change as a predictor of readmission for decompensated heart failure: a retrospective single centre study
    Zulastri MAM, Hafidz MI, Ismail MD, Zuhdi ASM
    Rev Cardiovasc Med, 2021 Jun 30;22(2):505-512.
    PMID: 34258919 DOI: 10.31083/j.rcm2202058
    In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is to see if achieving hemoconcentration prior to discharge is linked to a lower risk of re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit, University Malaya Medical Centre (UMMC) for AHF between November 2019 and November 2020 were enrolled. Information on patients' clinical characteristics, laboratory values and in-hospital treatments were collected through electronic medical record. At admission and discharge, the change in hematocrit (HCT) levels was calculated, and patients were stratified based on two quantiles of delta HCT, either discharged with hemoconcentration (ΔHCT >1.5%) or without hemoconcentration (ΔHCT ≤1.5%). The study's outcome was AHF readmission after a 90-day follow-up period. Readmission was significantly associated with ejection fraction (p = 0.032) and HCT change (p = 0.005). Consecutively, logistic regression performed revealed that patients with haemoconcentration were 78.3% less likely to be readmitted than those without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078-0.605) and Patients with a lower ejection fraction have a threefold greater chance of being readmitted than those with a preserved ejection fraction (OR = 3.316, p = 0.022, 95% CI = 1.188-9.256). In conclusion, among patients hospitalized and discharged for AHF, those that (i) do not achieve haemoconcentration and (ii) patients with a reduced ejection fraction were more likely to be readmitted with acute heart failure. Therefore, optimising patients' haematocrit levels prior to discharge may potentially reduce rehospitalizations among heart failure patients.
    Matched MeSH terms: Hematocrit
  6. Effects of Ficus deltoidea aqueous extract on hematological and biochemical parameters in rats
    Fazliana MS, Muhajir H, Hazilawati H, Shafii K, Mazleha M
    Med J Malaysia, 2008 Jul;63 Suppl A:103-4.
    PMID: 19025006
    Aqueous extract of Ficus deltoidea var. agustifolia was examined for the subchronic toxicity effects in rats. Groups of 10 rats were given the extract daily by oral gavage for 90 days at 0 (control), 100 and 300mg/kg/body weight, respectively. Blood samples were collected upon sacrificed and analysed for haemogram and biochemistry. The results showed there were no significant changes of the blood parameters in all treated groups compared to the control.
    Matched MeSH terms: Hematocrit*
  7. Serum proteins, haematocrits, heights and weights of Aborigine subjects in West Malaysia
    Brearley A
    Med J Malaya, 1970 Mar;24(3):183-6.
    PMID: 4246797
    Matched MeSH terms: Hematocrit*
  8. Fulltext Hematology and serum biochemistry parameters for rescued common palm civets (Paradoxurus hermaphroditus) in different age groups
    Ahmad AA, Jayarajah P, Han GWY, Yin SJOW, Rasedee A
    J Vet Med Sci, 2017 Jun 29;79(6):1134-1137.
    PMID: 28484127 DOI: 10.1292/jvms.16-0082
    Currently, there are no complete parameters established for serum biochemistry and hematology for the determination of health status of rescued common palm civets (Paradoxurus hermaphroditus). In this study, blood samples were obtained from 18 adults and 15 juvenile civets caught on Singapore Main Island. Significant age-related differences (P<0.05) were noted in the hemoglobin, erythrocyte count, packed cell volume (PCV), total serum protein and globulin concentration in the adult civets showing higher values compared with the juvenile civets. The mean corpuscular volume (MCV), the alkaline phosphatase (ALP) and the phosphorus concentrations were significantly higher (P<0.05) in juveniles compared with adult civets.
    Matched MeSH terms: Hematocrit/veterinary
  9. Fulltext Risk factors associated with development of dengue haemorrhagic fever or dengue shock syndrome in adults in Hospital Tengku Ampuan Afzan Kuantan
    Tee HP, How SH, Jamalludin AR, Safhan MN, Sapian MM, Kuan YC, et al.
    Med J Malaysia, 2009 Dec;64(4):316-20.
    PMID: 20954558 MyJurnal
    A retrospective study was conducted to investigate 183 serologically-confirmed cases of dengue fever (DF) admitted from October 2004 to March 2005 in a large hospital in Pahang. Clinical and laboratory features, progress and outcome of these patients were analysed in order to identify risk factors associated with development of dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Individually, we found that older patients, secondary dengue infection, high baseline haematocrit levels, low platelet levels and prolonged activated partial thromboplastin time (APTT) ratio were significant associations with bleeding tendencies. Of these risk factors, haematocrit and APTT ratio were two independent significant risk factors on multivariate analysis. Older patients with primary infection and younger patients with secondary infection had significant bleeding tendencies. We also verified the validity of the haematocrit levels suggested as cut-off levels for plasma leakage for the Malaysian population by Malaysian Clinical Practice Guidelines for Dengue Infection in Adults (2003).
    Matched MeSH terms: Hematocrit
  10. Fulltext Risk profiles of referred chronic kidney disease patients in a tertiary nephrology centre
    Lim CT, R R, A S MZ
    Pak J Med Sci, 2016 Mar-Apr;32(1):27-30.
    PMID: 27022339 DOI: 10.12669/pjms.321.8214
    OBJECTIVES: The aims of this study were to determine the seroprevalence of acute dengue in Universiti Kebangsaan Malaysia (UKM) Medical Centre and its correlation with selected haematological and biochemical parameters.
    METHODS: This cross-sectional study was conducted from January to June 2015. A patient was serologically diagnosed with acute dengue if the dengue virus IgG, IgM or NS-1 antigen was reactive.
    RESULTS: Out of 1,774 patients suspected to have acute dengue, 1,153 were serologically diagnosed with the infection, resulting in a seroprevalence of 64.9%. Dengue-positive patients had a lower mean platelet count (89 × 10(9)/L) compared to the dengue-negative patients (171 × 10(9)/L) (p<0.0001). The mean total white cell count was also lower in the dengue-positive cases (4.7 × 10(9)/L vs. 7.2 × 10(9)/L; p<0.0001). The mean haematocrit was higher in patients with acute dengue (42.5% vs. 40.0%; p<0.0001). Likewise, the serum alanine transaminase level was also higher in patients with acute dengue (108 U/L vs. 54 U/L; p<0.0001).
    CONCLUSIONS: Dengue is very prevalent in UKM Medical Centre as most patients suspected to have acute dengue had serological evidence of the infection. The platelet count was the single most likely parameter to be abnormal (i.e. low) in patients with acute dengue.
    KEYWORDS: DENV; Dengue; IgG; IgM; NS1; Seroprevalence
    Matched MeSH terms: Hematocrit
  11. Erythrocyte transketolase activity and anaemia
    Chong YH, Ho GS
    Med J Malaysia, 1973 Dec;28(2):113-4.
    PMID: 4276226
    Matched MeSH terms: Hematocrit
  12. Ultrasound findings of plasma leakage as imaging adjunct in clinical management of dengue fever without warning signs
    Xin Tian C, Baharuddin KA, Shaik Farid AW, Andey R, Ridzuan MI, Siti-Azrin AH
    Med J Malaysia, 2020 11;75(6):635-641.
    PMID: 33219170
    INTRODUCTION: Plasma leakage is a major cause of morbidity and mortality in dengue fever. Few studies have shown the sensitivity of thoracoabdominal ultrasound in detecting plasma leakage in severe dengue, however its sensitivity in the early presentation of dengue fever without warning signs remains unknown. This study is aimed to determine the role of serial ultrasound in order to detect plasma leakage in dengue fever without warning signs.

    METHODS: This prospective cohort study was conducted at Hospital Universiti Sains Malaysia (USM) from 1st October 2016 to 30th November 2017. Serial bedside ultrasound procedures were performed for 83 patients who were diagnosed as having dengue fever without warning signs and were initially treated as outpatients. Ultrasonography evidence of plasma leakage either pleural effusion, thickened gallbladder wall, ascites or pericardial effusion were compared with clinical findings and laboratory parameters for plasma leakage.

    RESULTS: Of the 83 dengue patients, eventually 72.3% had dengue fever with warning signs and 6.0% had severe dengue fever. There were 38 patients who had subclinical plasma leakage at initial presentation, 84.2% and 7.9% of them then progressed to dengue fever with warning signs and severe dengue respectively. There was a minimal agreement between serial bedside ultrasound and haematocrit level in the detection of plasma leakage (observed kappa 0.135).

    CONCLUSIONS: Serial bedside ultrasound is an adjunct procedure to physical examination and may detect plasma leakage earlier compared to haemoconcentration. The early usage of serial ultrasound is of paramount importance in detecting dengue patients who are at risk of progressing to severe dengue.

    Matched MeSH terms: Hematocrit
  13. A review of recent advances in microsampling techniques of biological fluids for therapeutic drug monitoring
    Tey HY, See HH
    J Chromatogr A, 2021 Jan 04;1635:461731.
    PMID: 33285415 DOI: 10.1016/j.chroma.2020.461731
    Conventional sampling of biological fluids often involves a bulk quantity of samples that are tedious to collect, deliver and process. Miniaturized sampling approaches have emerged as promising tools for sample collection due to numerous advantages such as minute sample size, patient friendliness and ease of shipment. This article reviews the applications and advances of microsampling techniques in therapeutic drug monitoring (TDM), covering the period January 2015 - August 2020. As whole blood is the gold standard sampling matrix for TDM, this article comprehensively highlights the most historical microsampling technique, the dried blood spot (DBS), and its development. Advanced developments of DBS, ranging from various automation DBS, paper spray mass spectrometry (PS-MS), 3D dried blood spheroids and volumetric absorptive paper disc (VAPD) and mini-disc (VAPDmini) are discussed. The volumetric absorptive microsampling (VAMS) approach, which overcomes the hematocrit effect associated with the DBS sample, has been employed in recent TDM. The sample collection and sample preparation details in DBS and VAMS are outlined and summarized. This review also delineates the involvement of other biological fluids (plasma, urine, breast milk and saliva) and their miniaturized dried matrix forms in TDM. Specific features and challenges of each microsampling technique are identified and comparison studies are reviewed.
    Matched MeSH terms: Hematocrit
  14. Haematologic parameters in Malaysian patients with acute myocardial infarction acute coronary syndromes
    Quek DKL, George E, Sahak S, Baharim Z
    Family Physician, 1991;3:39-44.
    Haematologic abnormalities are found in patients who develop acute ischaemic syndromes including acute myocardial infarction (AMI). A coronary care unit population of 660 consecutive patients were studied for their haematologic parameters on admission. There were 263 patients who had AMI, 207 who had non-infarct acute ischaemic syndromes (CAD), and the other 190 non-coronary patients served as controls. Overall patients with AMI had signijicantly higher haemoglobin (145 ± 2.2 vs 12.9 ± 3.0 g/dl, p<0.0001), haematocrit (45.4 ± 5.8% vs 41.2 ± 8.8%. P < 0.001). red cell count (5.0 ± 0.7 vs 4.5 ± 10^12 p<0.001), but there were no significant differences in their leucocyte count, platelet count or mean corpuscular volume. Patients with CAD had higher haemoglobin and red cell counts (p<0.002, p<0.02 respectively). Although infarct women tended to have lower counts (p<0.001), they still had significantly higher haemoglobin (p<0.01), haematocrit (p<0.02) and red cell count(p<0.002) when compared with controls. Interestingly, there were no ethnic differences at all with regard to haematologic values for infarct patients; haemoglobin, haematocrit, and red count were each significantly higher than controls. Our results suggest that a relatively high baseline Hb, haematocrit or RBC count may be associated with increased likelihood of acute ischaemic syndromes including AMI among Malaysians. Increased viscosity and abnormal haemorheological characteristics may contribute to the development and subsequent outcome of unstable coronary syndromes. Keywords: acute myocardial infarction, coronary artery disease, haemoglobin, haematocrit, haemorheology.
    Matched MeSH terms: Hematocrit
  15. Fulltext Hartman's solution or normal saline in the treatment of hyperemesis gravidarum among South East Asian population: a randomised controlled trial
    Adibah, I., Khursiah, D., Ahmad, A.I., Zaki, N.N.M.
    International Medical Journal Malaysia, 2008;7(2):21-24.
    MyJurnal
    Introduction: The aim of treatment for hyperemesis gravidarum is to stop vomiting, correction of dehydration, starvation and electrolytes imbalance. The common types of fluid used for fluid replacement are isotonic solutions like normal saline and hartman's solutions. The absence of potassium in normal saline makes hartman's solution superior but there is a possibility that the lactate component in hartman's solution could worsen the starvation state of the patients. This study is to evaluate which of these two solutions is more effective for fluid replacement in hyperemesis gravidarum. The objectives are to compare which solution corrects dehydration, hypokalaemia and acetonuria faster and to evaluate whether the ketosis state is aggravated by lactate component in hartman's solution. Materials and Methods: Patients with hyperemesis gravidarum were randomised to receive either Hartman's solution or normal saline at the rate of 125mls/hour. Blood urea and serum electrolytes, haematocrit, lactate and urine acetone were taken during admission and repeated every 12 hours. The volume of fluid required to correct dehydration, hypokalaemia and acetonuria were compared. Comparison of the pre and post treatment level of serum lactate were also done. Results: Both hartman's solution and normal saline are both effective in correcting dehydration (11.52±3.28 pints versus 11.94 ± 2.30pints respectively) and acetonuria (11.64 ± 2.75 pints versus 11.64 ± 2.54 pints respectively).
    A lower volume of hartman's solution was needed to correct hypokalaemia (8.34 ± 2.44 pints versus 8.88 ± 2.63 pints) but was not statistically significant. Ketonaemia was not made worse after treatment with hartman's solution. Conclusion: Normal saline and hartman's solution are equally effective in treating complications of hyperemesis gravidarum.
    Matched MeSH terms: Hematocrit
  16. Fulltext Iron intake and iron deficiency anaemia among young women in Kuala Lumpur
    Loh, S. P., Khor, G. L.
    Malaysian Journal of Medicine and Health Sciences, 2010;6(1):63-70.
    MyJurnal
    Objective: To assess the prevalence of iron deficiency, anaemia and iron deficiency anaemia (IDA) in women aged 20-40 years and its association with iron intake. Methods: A total of 388 women were recruited from universities and work sites in Kuala Lumpur and its suburbs. The subjects comprised 135 Malays, 130 Chinese and 123 Indians. Dietary intake was estimated using a single 24-hour food recall and a semi-quantitative food frequency questionnaire. Haemoglobin (Hb), haematocrit (hct), mean corpuscular volume (MCV) and serum ferritin were determined. Results: The prevalence of anaemia (Hb
    Matched MeSH terms: Hematocrit
  17. Fulltext Effects of dietary inclusion of spirulina meal on growth and hematological parameters of cultured Asian sea bass, Lates calcarifer
    Tan, Chin Yong, Galaz, German Bueno, Shapawi, Rossita
    Borneo Journal of Marine Science and Aquaculture, 2017;1(1):1-6.
    MyJurnal
    This study was conducted to investigate the effects of dietary inclusion of Spirulina platensis on growth performance and hematological parameters of juvenile Asian sea bass (Lates calcarifer) reared in a freshwater culture system. Five experimental diets were prepared by replacing fish meal protein with the microalga at replacement levels of 5% (SP5), 10% (SP10), 20% (SP20) and 30% (SP30), and the substitution effect was compared with a control diet (Con) in which fish meal was the sole protein. Fish were stocked in net cages placed in a 150-ton tank with a stocking density of 20 fish per cage. After 8 weeks of feeding trial, the fish did not show any significant differences in growth performance but numerically higher weight gain and specific growth rate were achieved in the fish stock fed diet SP10 compared to other treatments. Feed conversion ratio and survival rate of fish were significantly affected by the inclusion of Spirulina in the diets. Except for crude ash content, whole-body proximate composition of the experimental fish was also significantly influenced by the diets. Regarding the effects of diets on blood parameters, only hematocrit, hemaglobin, HDL-c and AST were significantly affected by the inclusion of Spirulina in the diets. This study demonstrated that Spirulina could replace up to 10% of FM protein in practical diets of juvenile Asian sea bass without negative effects on growth performance. However, replacement of fish meal with Spirulina meal at 5% might be considered for commercial use considering a significant decrease in survival above this value.
    Matched MeSH terms: Hematocrit
  18. Fulltext The association between obesity and dengue virus (DENV) infection in hospitalised patients
    Tan VPK, Ngim CF, Lee EZ, Ramadas A, Pong LY, Ng JI, et al.
    PLoS One, 2018;13(7):e0200698.
    PMID: 30016369 DOI: 10.1371/journal.pone.0200698
    Both obesity and DENV infections are growing public health concerns that have far-ranging socioeconomic effects, especially in developing countries. Despite the increasing prevalence of these conditions, there is a scarcity of data investigating the potential relationships between these two entities. Our study aims to examine the influence of obesity on various clinical and laboratory parameters amongst patients with DENV infections. A total of 335 hospitalized patients aged >12 years who were DENV non-structural protein 1 (NS1) antigen-positive were enrolled in this study. Clinical and laboratory variables were compared between patients with and without obesity. Multivariate analysis showed that the following admission clinical findings and laboratory results were independently associated with obesity; chills and rigors (AOR:2.653, 95% CI: 1.286-5.474), higher temperature (AOR:1.485, 95% CI: 1.080-2.042), higher systolic BP (AOR:1.057, 95% CI:1.037-1.078), raised haematocrit (AOR: 1.953, 95% CI: 1.010-3.778), elevated creatinine (AOR:3.504, 95% CI:1.351-9.008) and elevated ALT (AOR: 4.146, 95% CI:1.878-9.154). Obesity was found to be significantly associated with hospitalization >3 days (AOR: 1.990, 95% CI: 1.134-3.494) and the presence of increasing haematocrit with decreasing platelets (AOR: 2.134, 95% CI = 1.235-3.688). Serial assessment of laboratory data revealed that peak haematocrit was significantly higher and nadir platelets levels were significantly lower in obese patients. Both peak and admission levels of leukocyte counts, AST, ALT and creatinine were significantly higher in the obese group. Conversely, both admission and nadir albumin levels were lower for the obese group, although only nadir albumin levels achieved statistical significance. These findings support closer clinical monitoring of obese patients who present with DENV infections, as this patient cohort may possess an increased tendency towards developing more severe clinical manifestations of DENV infections as compared to non-obese patients.
    Matched MeSH terms: Hematocrit
  19. Fulltext The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors
    Ahmad MH, Ibrahim MI, Mohamed Z, Ismail N, Abdullah MA, Shueb RH, et al.
    Int J Environ Res Public Health, 2018 09 15;15(9).
    PMID: 30223572 DOI: 10.3390/ijerph15092018
    Objectives: To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. Methods: A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Results: Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). Conclusion: A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.
    Matched MeSH terms: Hematocrit
  20. Field studies on the biological control of nematode parasites of sheep in the tropics, using the microfungus Duddingtonia flagrans
    Chandrawathani P, Jamnah O, Adnan M, Waller PJ, Larsen M, Gillespie AT
    Vet Parasitol, 2004 Mar 25;120(3):177-87.
    PMID: 15041093
    Long-term field studies were conducted on two government managed small ruminant research farms, located in different geo-climatic regions and approximately 300 km separate from each other, on Peninsula Malaysia. The Infoternak trial (48 weeks) and the Chalok trial (43 weeks) each compared nematode parasite control in separately managed groups of young sheep, either short-term rotationally grazed around a suite of 10 paddocks in addition to receiving a daily supplement of Duddingtonia flagrans spores (Fungus Group); or similar groups of sheep being rotationally grazed alone (Control Group). The prevailing weather conditions at Infoternak farm were of below average rainfall conditions for the most of the trial. As a consequence, only very low worm infections (almost exclusively Haemonchus contortus) were acquired by the 17 sets of tracer lambs that grazed sequentially with the experimental lambs. However on all except 2 occasions in the early part of the trial, the mean tracer worm burdens were significantly lower (P < 0.05) and the experimental lambs grew significantly better (P = 0.054) in the Fungus Group. Rainfall at Chalok farm during the course of the trial was also below average. As a consequence infectivity of pastures was assumed to be relatively low based on faecal egg counts (epg) of the experimental sheep, which following an anthelmintic treatment prior to allocation, remained very low in both treatment groups. Faecal egg counts of undosed replacement lambs in the latter half of the Chalok study, showed a progressive increase in the Control Group to levels exceeding 3000 epg, whereas the Fungus Group remained static at approximately 500 epg. These results show that the deployment of the nematophagous fungus, D. flagrans, can improve the level of parasite control of sheep in the tropics above that which can be achieved by the short-term rotational grazing strategy alone.
    Matched MeSH terms: Hematocrit/veterinary
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