Displaying publications 21 - 40 of 367 in total

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  1. Fulltext A report on an unusual presentation of autonomic dysreflexia
    Suhaida SS, Engkasan JP
    Med J Malaysia, 2012 Dec;67(6):616-7.
    PMID: 23770957 MyJurnal
    A 48-year-old male with complete tetraplegia C6 presented with sweating and flushing of the right half of the face and neck that recurred when lying in supine and left lateral positions. The symptoms subsided immediately upon sitting upright or lying in a right lateral position. The symptoms were associated with occasional mild head discomfort rather than headache and were accompanied by marked elevation of blood pressure, which was 190-200/120-130 mmHg compared to his previous baseline blood pressure of 80-90/50-70 mmHg, and he had a heart rate of 60-70 beats per minute. We believe that post-traumatic syringomyelia, found upon further investigation, was the cause of the Autonomic dysreflexia (AD) in this patient. He was advised to avoid the positions causing the symptoms and the progression of symptoms was monitored regularly. AD might not have been diagnosed in this patient because of the atypical and unusual presentations. Therefore, knowledge and a heightened level of awareness of this possible complication are important when treating individuals with spinal cord injury (SCI).
  2. A survey of essential national health research in nine developing countries
    Figueroa JP, Baris E, Chandiwana S, Kvaale E
    West Indian Med J, 2002 Jun;51(2):97-101.
    PMID: 12232950
    A survey of Essential National Health Research (ENHR) was conducted between December 1997 and November 1998 in nine developing countries. A total of 27 respondents from seven South East Asian and two Caribbean countries completed questionnaires. Respondents included 14 men and 13 women with a median age of 48 years (range 25-69 years); 15 were researchers, seven were health providers, three policy makers and one a community representative (one no response). ENHR was formally adopted in five countries mainly through public policy statements. Seven countries had a mechanism in place for promotion of ENHR and national meetings were held in five countries in the year prior to the survey. A special activity was conducted in order to define health research priorities in eight countries and a list of these priorities was available in seven countries. The level of ENHR activity was ranked as low or moderate in most countries except India and Malaysia which were rated as moderate to high. Three countries reported that the process resulted in new or additional funds being made available for research, while India reported available funds being reallocated to meet the priorities defined. The respondents of six countries said that ENHR networking had led to tangible results, including improved collaboration among researchers and research institutions and the sharing of resources among different organizations (five countries). The ENHR process had resulted in research findings being used to formulate or change health policy in five countries. Most countries had not produced any new research protocols through the ENHR process. However, there were 250 new research protocols in India and 68 in Pakistan, of which 20 and between 25 and 35, respectively, were funded and 15 peer reviewed articles had been published from India. This survey does suggest that the ENHR process may be promoting health research on priority health problems and the use of results to formulate policy in selected countries. However, it is too early to assess the contribution of ENHR to health and development and a variety of different studies would be needed to conduct this assessment.
  3. Fulltext Ocular chlamydial infection in a university eye clinic
    Deva JP, Ngeow YF
    Med J Malaysia, 1991 Dec;46(4):344-8.
    PMID: 1840443
    In the University Hospital, Kuala Lumpur, from 1984 to 1990, 184 patients with acute conjunctivitis were examined for chlamydial infection by direct immunofluorescence. Overall, 52 (28.3%) were found to be positive for chlamydial antigen. There was no significant difference in the detection rate between men and women and among the 3 major ethnic groups. The detection rate was highest among sexually active adults. Epidemiological and clinical features suggest that most of the chlamydial ocular infections seen were inclusion conjunctivitis and not classical trachoma.
    Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  4. Maternal literacy modifies the effect of toilets and piped water on infant survival in Malaysia
    Esrey SA, Habicht JP
    Am J Epidemiol, 1988 May;127(5):1079-87.
    PMID: 3358408 DOI: 10.1093/oxfordjournals.aje.a114884
    The effect of toilets, piped water, and maternal literacy on infant mortality was analyzed using data from the Malaysian Family Life Survey collected in 1976-1977. The effect of toilets and piped water on infant mortality was dependent on whether or not mothers were literate. The impact of having toilets was greater among the illiterate than among the literate, but the impact of piped water was greater among the literate than among the illiterate. The effect on the infant mortality rate for toilets decreased from 130.7 +/- 17.2 deaths in the absence of literate mothers to 76.2 +/- 25.9 deaths in the presence of literate mothers. The reduction in the mortality rate for maternal literacy dropped from 44.4 +/- 14.1 deaths without toilets to -10.1 +/- 23.9 deaths with toilets. Reductions in mortality rates for piped water increased from 16.7 +/- 12.7 deaths without literate mothers to 36.8 +/- 21.0 deaths with literate mothers. Similarly, reductions in the mortality rate for maternal literacy rose from 44.4 +/- 14.1 deaths in the absence of piped water to 64.5 +/- 19.5 deaths in the presence of piped water. The results from a logistic model provided inferences similar to those from ordinary least squares. The authors infer that literate mothers protect their infants especially in unsanitary environments lacking toilets, and that when piped water is introduced, they use it more effectively to practice better hygiene for their infants.
  5. Light and the gonadal cycle of the black-headed Munia, Munia malacca malacca
    Pandha SK, Thapliyal JP
    Endocrinol. Jpn., 1969 Feb;16(1):157-61.
    PMID: 5394323
  6. A case of probable sporadic Creutzfeldt-Jacob Disease in a tertiary care hospital in Malaysia
    Mugilan SR, Joseph JP
    Med J Malaysia, 2018 12;73(6):433-435.
    PMID: 30647225
    The diagnosis of Creutzfeldt-Jakob disease (CJD) can be challenging as findings are non-specific and there is low awareness of the disease. We present a case of an 83-yearold man with a two months history of rapidly progressive dementia. After a series of extensive diagnostic examinations, he was diagnosed with probable sporadic CJD with key findings of rapidly progressive dementia, myoclonus, pyramidal signs, abnormal hyperintensity signals on diffusion-weighted magnetic resonance imaging (DW-MRI) and typical electroencephalograph (EEG). His symptoms progressively worsened and he died four months after the onset of symptoms.
  7. Polygamy and productivity of laboratory mice
    WALTERS JP, HARRISON JL
    Med J Malaya, 1959 Dec;14:99-105.
    PMID: 13842715
  8. Uncaria elliptica a major source of rutin
    Balz JP, Das NP
    Planta Med, 1979 Jun;36(2):174-7.
    PMID: 461570
  9. Who decides? A qualitative study on the decisional roles of patients, their caregivers and doctors on the method of bladder drainage after spinal cord injury
    Engkasan JP, Ng CJ, Low WY
    Spinal Cord, 2015 Feb;53(2):130-4.
    PMID: 25403504 DOI: 10.1038/sc.2014.199
    STUDY DESIGN: Qualitative study using individual in-depth interviews.

    OBJECTIVE: To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI).

    SETTING: Five public hospitals in Malaysia.

    METHODS: Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals.

    RESULTS: Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers.

    CONCLUSIONS: A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.
  10. Factors influencing bladder management in male patients with spinal cord injury: a qualitative study
    Engkasan JP, Ng CJ, Low WY
    Spinal Cord, 2014 Feb;52(2):157-62.
    PMID: 24276416 DOI: 10.1038/sc.2013.145
    STUDY DESIGN: Qualitative study using individual in-depth interviews.
    OBJECTIVES: The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI).
    SETTING: Public hospitals in Malaysia.
    METHODS: Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses.
    RESULTS: The choice of bladder management was influenced by treatment attributes, patients' physical and psychological attributes, health practitioners' influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals' and peers' opinions on treatment options had a significant influence on participants' decision. In addition, patients' choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method.
    CONCLUSION: The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.
    Study design: Qualitative study using individual in-depth interviews.
  11. Fulltext The predictors of subclinical cerebral infarcts in ischaemic stroke patients
    Hamidon BB, Joseph JP, Raymond AA
    Med J Malaysia, 2007 Jun;62(2):114-6.
    PMID: 18705441
    Subclinical cerebral infarcts (SCI) have been increasingly shown to cause a significant clinical impact. However, there are limited data available on Asian patients. The objectives of this study were to determine the prevalence of SCI in ischaemic stroke patients seen in the Hospital Universiti Kebangsaan Malaysia (HUKM) and to identify its associated risk factors. We evaluated the brain computed tomography (CT) evidence of subclinical infarcts in ischaemic stroke patients. The patients were selected from those who were on regular follow up in the neurology clinic following an ischaemic stroke. The risk factors associated with subclinical infarct were documented. The brain CTs were done during acute admission and reviewed for SCI. Sixty-one patients were enrolled in this study. Twenty-two (36.1%) out of the 61 patients had SCI. The risk factors for SCI in our study were hypertension (OR 14.16 CI 2.04-97.89), diabetes mellitus (OR 12.48; CI 1.95-79.77) and leukoaraiosis (OR 28.39; CI 2.33-284.16). Subclinical cerebral infarcts were present in about one third of our ischaemic stroke patients. This finding is higher than in previous studies done on Caucasians. Hypertension, diabetes mellitus and leukoaraiosis independently predict SCI.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  12. Fulltext Genetic causes of familial hypercholesterolaemia in a Malaysian population
    Khoo KL, Van Acker P, Tan H, Deslypere JP
    Med J Malaysia, 2000 Dec;55(4):409-18.
    PMID: 11221151
    A total of 86 unrelated Malaysian patients with familial hypercholesterolaemia (FH) were studied for mutations in their low-density lipoprotein receptor (LDL-R) gene. Amongst them, 23 had a LDL-R gene mutation, while none having an Apolipoprotein B-3500 (Apo B-3500) mutation. Patients with the LDL-R gene defect appeared to have a higher level of low-density lipoprotein cholesterol (LDL-C), an increased incidence of xanthomas and coronary heart disease (CHD), but no relationships were found between the type of LDL-R gene mutations and their lipid levels or clinical signs of CHD. In contrast to Western data, our findings seemed to indicate a predominance of mutations in the ligand binding domain and an absence of Apo B-3500 gene mutation. The latter finding may offer a genetic basis as to why Asian patients with familial hypercholesterolaemia have lower LDL-C levels and less premature CHD than their Western counterparts.
  13. Organochlorine pesticides and polychlorinated biphenyls in foodstuffs from Asian and oceanic countries
    Kannan K, Tanabe S, Giesy JP, Tatsukawa R
    Rev Environ Contam Toxicol, 1997;152:1-55.
    PMID: 9297984
    Public concern about the adverse environmental and human health impacts of organochlorine contaminants led to strict regulations on their use in developed nations two decades ago. Nevertheless, DDT and several other organochlorine insecticides are still being used for agriculture and public health programs in developing countries in Asia and the South Pacific. As a consequence, humans in this region are exposed to greater dietary levels of organochlorines. In this review, published information on organochlorine concentrations in foodstuffs from South and Southeast Asia and Oceanic countries has been compiled. Foodstuffs that contribute to human exposures and dietary intakes of organochlorines were examined, and the data compared with those reported from more developed nations. Among various developing countries in Asia, considerable information on organochlorines in foodstuffs has been available from India since the late 1960s. DDT and HCH were the major insecticides in Indian foodstuffs. Concentrations of these insecticides have declined more than two orders of magnitude in farm products, such as food grains and vegetables, in two decades. Milk and milk products are the major sources of dietary exposure to DDT and HCH in India. The residues of these insecticides in dairy products were close to or above the MRLs of the FAO/WHO. Dietary intake of DDT and HCH by Indians was > 100 fold that in more developed nations. Sporadic incidences of greater concentrations (> 1 microgram/g) of aldrin, dieldrin, and heptachlor have been measured in Indian vegetables. Untreated surface waters could be a potential source of DDT and HCH exposure. In most Southeast Asian countries DDT was the common contaminant in animal origin foodstuffs. The higher percentage of p,p'-DDT in meat and fish from Southeast Asian countries, except Japan and Korea, indicated the recent use of DDt in vector control operations. Dietary intakes of DDt and HCH in Southeast Asia were an order of magnitude less than those of Indians but 5- to 10 fold greater than in more developed nations. In addition to DDT, aldrin and dieldrin were prominent in meat collected from Thailand and Malaysia. Aquatic food products from more industrialized countries, such as Japan, South Korea, Hong Kong, and Taiwan, contained significant levels of PCBs. In South Pacific countries, particularly in Australia and New Zealand, chlordanes and PCBs were the most prevalent organochlorines in foodstuffs. Food contamination by DDT, HCH, aldrin, and dieldrin was less than in developing countries in Asia but greater than in the U.S. and Japan. Intake of PCBs in Australia was greater than in the U.S. Meat and fish were the major sources of organochlorine exposure by Australians. Human dietary intake of organochlorines has been declining more slowly in developing countries in Asia. Current intakes were at least 5- to 100 fold greater than those in more developed nations, suggesting a greater risk from organochlorine exposure. Factors such as malnutrition, common among rural poor in developing nations, can increase these risks. Of greatest concern is the magnitude of exposure to organochlorines to which infants and children are subjected through human and dairy milk. The estimated intake of DDT by infants was at least 100 fold greater than the ADI of the FAO/WHO. In addition to DDT, excessive exposures to HCH and dieldrin may cause potential health effects in infants because they are more vulnerable to toxic effects. The design and implementation of appropriate epidemiological studies and their integration with monitoring of human, food, and environmental samples would be a major step in assessing the risks of organochlorine residues in foods and controlling or eliminating them. With the continued globalization of trade in food products, and the concomitant risk that food contaminated through point-source pollution may be widely distributed, identification of sources and their control should be matters of
  14. Mother's milk and sewage: their interactive effects on infant mortality
    Habicht JP, DaVanzo J, Butz WP
    Pediatrics, 1988 Mar;81(3):456-61.
    PMID: 3344191
    If they lived in households without piped water or a toilet, Malaysian infants who did not breast-feed were five times more likely to die after 1 week of age than those who breast-fed, when other significant factors affecting infant mortality were taken into account. This is double the relative risk associated with not breast-feeding for infants born into households with toilets, whether or not they had piped water. Analogously, improvements in toilet sanitation appear to have reduced mortality twice as much among infants who did not breast-feed as among those who did. These findings, from a retrospective survey of infants born to a probability sample of 1,262 women in peninsular Malaysia, confirm the pernicious synergistic effect of poor sanitation and nonbreastfeeding that was postulated previously on theoretical grounds. Promoting and maintaining high initiation of breast-feeding is thus particularly important where poor sanitation is prevalent. Even more affluent areas should not be neglected, however, because socioeconomic improvement, including improved environmental sanitation, is often accompanied by decreased breast-feeding. Although the risk to each nonbreast-fed infant was less in those areas, infants there were less likely to breast-feed in Malaysia, and hence they made up a significant proportion of lives that could be saved by breast-feeding.
  15. Environmental factors in the relationship between breastfeeding and infant mortality: the role of sanitation and water in Malaysia
    Butz WP, Habicht JP, DaVanzo J
    Am J Epidemiol, 1984 Apr;119(4):516-25.
    PMID: 6711541
    Mothers' recall data collected in Malaysia in 1976-1977 are analyzed to study correlates of mortality of 5471 infants. Respondent population is 1262 women living in 52 primary sampling units of Peninsular Malaysia. Lengths of unsupplemented and supplemented breastfeeding and presence of piped household water and toilet sanitation are related to infant mortality in regressions that also control other correlates. The analysis is disaggregated into three periods of infancy. Through six months of feeding, unsupplemented breastfeeding is more strongly associated with fewer infant deaths than is supplemented breastfeeding. Type of sanitation is generally more strongly associated with mortality than is type of water supply. The effects of breastfeeding and the environmental variables are shown to be strongly interactive and to change systematically during the course of infancy. Breastfeeding is more strongly associated with infant survival in homes without piped water or toilet sanitation. In homes with both modern facilities, supplemented breastfeeding has no significant effect, and unsupplemented breastfeeding is statistically significant only for mortality in days 8-28. Presence of modern water and sanitation systems appears unimportant for mortality of infants who are breastfed without supplementation for six months.
  16. Does breastfeeding really save lives, or are apparent benefits due to biases?
    Habicht JP, DaVanzo J, Butz WP
    Am J Epidemiol, 1986 Feb;123(2):279-90.
    PMID: 3946377
    Analysis of mothers' recall data collected in 1976-1977 by a probability survey in Peninsular Malaysia shows an association between breastfeeding up to six months of age and improved survival of infants throughout the first year of life. Inappropriate sample selection and inadequate control of confounding can introduce large biases in these analyses. The magnitude and direction of these biases are presented. Even when these biases are dealt with, unsupplemented breastfeeding appears more beneficial than supplemented breastfeeding. The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of deaths averted. The use of powdered infant formula did not appear to offset the detrimental effects of early weaning and supplementation. The positive relationships found in these analyses between breastfeeding and survival are not due to death precluding or terminating breastfeeding. Nor are they likely to be due to a shift away from breastfeeding because of recent illness, which was also controlled in the analyses. Nor are they likely to be due to other factors that both increase mortality risk and shorten breastfeeding; when such factors are taken into account, the beneficial effects of breastfeeding become stronger and imply that, if there had been no breastfeeding in this sample, twice as many babies would have died after the first week of life.
  17. Assessing socioeconomic correlates of birthweight in peninsular Malaysia: ethnic differences and changes over time
    DaVanzo J, Habicht JP, Butz WP
    Soc Sci Med, 1984;18(5):387-404.
    PMID: 6729519
    This paper presents evidence from the Malaysian Family Life Survey that mothers' reports of their babies' birthweights, including reports of unweighed babies' approximate size at birth, can be used to examine many biological and socioeconomic correlates of birthweight. The study uses a sample of 5583 singleton births that occurred between 1945 and 1976. In these data, the frequency distribution of birthweights and their bivariate and multivariate relationships with the biological correlates of mother's age, baby's sex, first parity and infant mortality are consistent with those found in prospective studies. A new biological correlate, mother's age at menarche, is introduced as a proxy for the mother's nutrition during childhood. Late age at menarche is associated with lower birthweight. Other results show mothers younger than 20 years and older than 35 appear to be at greater risk of bearing small babies, but the former effect is no longer important when parity is controlled. Short interbirth intervals are associated with small babies. We attempt to distinguish whether this is due to prematurity or to maternal nutritional depletion; both effects appear to be operating. Higher income appears to mitigate the pernicious effect of short interbirth intervals. Indian babies weigh significantly less than those of other ethnic groups. Furthermore, birthweights have increased since the 1950s for Malays and Chinese, but not for Indians. The lower birthweights and lack of improvement over time for Indians appear to be due to close birthspacing, lack of access to medical care and falling incomes.
  18. Potential transmission of hymenolepiasis by a practice of Malaysian Chinese folk medicine
    Sullivan JT, Palmieri JP, Chu GS
    J Parasitol, 1977 Feb;63(1):172.
    PMID: 845735
  19. Ultrastructure of sarcocysts from water buffalo in India
    Dubey JP, Speer CA, Shah HL
    Vet Parasitol, 1989 Nov;34(1-2):149-52.
    PMID: 2511659
    The ultrastructure of sarcocysts of macro- and microscopic species of Sarcocystis was compared from naturally infected water buffalo from India. Grossly visible sarcocysts had walls consisting of cauliflower-like villar protrusions, typical of S. fusiformis. The sarcocyst wall of the microscopic species of Sarcocystis was 6.4 microns thick and consisted of tightly packed conical villar protrusions that were 9.6 microns long and 3.7 microns wide at the base. At approximately 3 microns above the base, the distal two-thirds of the villar protrusion became conical shaped and was bent laterally at an angle of 45 degrees to the sarcocyst surface. The granular layer beneath the villar protrusions was 0.9 microns thick. In S. levinei the granular layer was 1.9 microns thick, the villar protrusions were narrow and it had a highly undulating primary cyst wall. Whether the microscopic S. levinei-like sarcocysts of Indian and Malaysian water buffalo are distinct species of Sarcocystis will require further investigation.
  20. Synergistic effects of VE-TPGS and riboflavin in crosslinking of dentine
    Daood U, Matinlinna JP, Fawzy AS
    Dent Mater, 2019 02;35(2):356-367.
    PMID: 30528297 DOI: 10.1016/j.dental.2018.11.031
    OBJECTIVE: Effect of d-alpha-tocopheryl poly(ethyleneglycol)-1000-succinate (VE-TPGS) with riboflavin-5'-phosphate solution on crosslinking of dentine collagen was investigated to analyze collagen's structural integrity.

    METHODS: VE-TPGS was added to RF-solution, at RF/VE-TPGS (w/w) ratios of 0.125/0.250 and 0.125/0.500. Demineralized dentine beams were used (10wt.% phosphoric acid), rinsed using deionized-water and analysed using ELISA (Human MMP2 ELISA; Human CTSK/Cathepsin-K for MMP2 and Cathepsin K analysis). AFM of dentine collagen-fibrils structure was done before and after dentine specimens' placement in mineralization solution and tested after 14days in artificial saliva/collagenase (AS/Co) solution. The specimens were tested after 24h in mineralization solution for surface/bulk elastic modulus. Nano-indentation was carried out for each specimen on intertubular-dentine with lateral spacing of 400nm. Reduced elastic-modulus and nano-hardness were calculated and collagen content was determined using hydroxyproline-assay. Micro-Raman were performed. TEM was carried out to study structural variations of dentine-collagen in artificial-saliva (collagenase). Data were presented as mean±standard deviation and analyzed by SPSS v.15, by analysis of variance.

    RESULTS: Synergetic effect of VE-TPGS was observed with RF through higher structural integrity of dentine collagen-fibrils shown by TEM/AFM. Superior surface/bulk mechanical stability was shown by nano-indentation/mechanical testing. Improvement in collagenase degradation resistance for hydroxyproline release was observed and lower endogenous-protease release of MMP-2/Cathepsin-K. Raman-analysis analysed chemical interactions between RF and collagen confirming structural-integrity of collagen fibrils after crosslinking. After 24h mineralization, AFM showed mineral depositions in close association with dentine-collagen fibrils with RF/VE-TPGS formulations.

    SIGNIFICANCE: Potential synergetic effect of RF/VE-TPGS was observed by reflection of higher structural integrity and conformational-stability of dentine-collagen fibrils.

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