MyMedR

Fulltext Intralenticular metallic foreign body: a case report

Reddy SC

Int J Ophthalmol, 2011;4(3):326-8.

PMID: 22553673 DOI: 10.3980/j.issn.2222-3959.2011.03.25

A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After six months, his vision deteriorated grossly due to cataract formation. He regained good vision following removal of foreign body, extracapsular extraction with posterior chamber intraocular lens implantation. This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability; and good visual recovery following cataract surgery with intraocular lens implantation.

Fulltext The Temerloh Hospital cataract complications study: factors associated with, types and outcomes of cataract surgery complications

Thevi T, Reddy SC, Chinna K

International Eye Science, 2014;14(8):1367-1372.

DOI: 10.3980/j.issn.1672-5123.2014.08.01

AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.
METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.
RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture (3.6%) was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction (ICCE) and phacoemulsification converted to extracapsular cataract extraction (ECCE) were significantly associated with more complications (P<0.001). The visual outcome was significantly poor in patients with complications (P<0.001).
CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.

Fulltext Factors affecting knowledge and skills retained among nurses after a neonate resuscitation training programme

Sek SC, Chan SG

The Malaysian Journal of Nursing, 2014;6(1):50-55.

Neonate Resuscitation Program, NRP training is given to nurses in batches. Such programs are vital because neonate resuscitation procedure or aid given to new born during delivery, help them begin breathing on their own, which can save many lives. Although such training is given to the nurses, no assessment has been done on the effectiveness of such training with regard to knowledge retention and transfer of training among the trainees. This study is retrospective in nature; it evaluates the level of knowledge and the conﬁdence in carrying out the neonate resuscitation procedure among 91 nurses involved such training. Besides that, the study ascertains their preparedness before undergoing the training and the opportunities provided to them to practice the skills learnt from the training at their work place. Factors that inﬂuence both their knowledge and skills after the training are also indentiﬁed. Study sample consist of 51 nurses from hospitals and 40 nurses from health clinics. Results show that skills acquired from training as measured by their conﬁdence at carrying out the learnt skill deteriorate faster than knowledge. Level of knowledge retained, conﬁdence at carrying out the neonate resuscitation procedure and opportunities for practicing the skill are all signiﬁcantly higher for the nurses at the hospitals compared to their counterparts in the health clinics at the 95 percent level. The recent trainees (2009) scored higher compared to the old trainees (2007 and 2008) with regard to their preparedness or motivation before the training although memory factor could play a part here. Conﬁdence at carrying out the neonate resuscitation procedure at the work place is a measure of the effectiveness of the NRP training because it constitutes transfer of training. Level of knowledge retained and opportunities for practicing skill at work place after the training, together with trainees' preparedness and motivation before the NRP training, all three contribute 35.7% towards trainees' conﬁdence in carrying out the NRP procedure at their work place. Contribution of these three variables is signiﬁcant at the 95% level or p< 0.05. Findings are consistent with the Model of factors that affect Learning Outcomes and Transfer of Training by Goldstein and Ford (2002).
Keywords: NEONATE RESUSCITATION

The inhibition of human T cell proliferation by the caspase inhibitor z-VAD-FMK is mediated through oxidative stress

Rajah T, Chow SC

Toxicol Appl Pharmacol, 2014 Jul 15;278(2):100-6.

PMID: 24768707 DOI: 10.1016/j.taap.2014.04.014

The caspase inhibitor benzyloxycarbony (Cbz)-l-Val-Ala-Asp (OMe)-fluoromethylketone (z-VAD-FMK) has recently been shown to inhibit T cell proliferation without blocking caspase-8 and caspase-3 activation in primary T cells. We showed in this study that z-VAD-FMK treatment leads to a decrease in intracellular glutathione (GSH) with a concomitant increase in reactive oxygen species (ROS) levels in activated T cells. The inhibition of anti-CD3-mediated T cell proliferation induced by z-VAD-FMK was abolished by the presence of low molecular weight thiols such as GSH, N-acetylcysteine (NAC) and l-cysteine, whereas d-cysteine which cannot be metabolised to GSH has no effect. These results suggest that the depletion of intracellular GSH is the underlying cause of z-VAD-FMK-mediated inhibition of T cell activation and proliferation. The presence of exogenous GSH also attenuated the inhibition of anti-CD3-induced CD25 and CD69 expression mediated by z-VAD-FMK. However, none of the low molecular weight thiols were able to restore the caspase-inhibitory properties of z-VAD-FMK in activated T cells where caspase-8 and caspase-3 remain activated and processed into their respective subunits in the presence of the caspase inhibitor. This suggests that the inhibition of T cell proliferation can be uncoupled from the caspase-inhibitory properties of z-VAD-FMK. Taken together, the immunosuppressive effects in primary T cells mediated by z-VAD-FMK are due to oxidative stress via the depletion of GSH.

Reddy SC, Tajunisah I

Ann Ophthalmol (Skokie), 2008;40(1):39-44.

PMID: 18556981

Fifty-six contact lens-related corneal ulcers (central in 32; hypopyon in 24 and stromal abscess in 6) were studied. Culture was positive in 78.9%. Corneal ulcers healed with intense antibiotic therapy in nearly all patients. Increased awareness of lens care/disinfection and frequent replacement of storage cases and solution, and early detection of pathogens and intensive appropriate antibiotic therapy are key points in management.

Fulltext Dropped nucleus following phacoemulsification cataract surgery

Tajunisah I, Reddy SC

Med J Malaysia, 2007 Dec;62(5):364-7.

PMID: 18705466 MyJurnal

Twenty two cases of dropped nucleus following 1,196 phacoemulsification procedures in cataract surgery were examined retrospectively to determine the incidence, predisposing factors and visual outcomes of this dreaded complication. All the cases underwent pars plana vitrectomy and the lens fragments were removed with phacofragmotome, vitrectomy cutter or delivered through limbus. The incidence of dropped nucleus was 1.84%. The predisposing factors were hard cataracts (13.6%), polar cataracts (9.1%), previously vitrectomized eyes (4.5%) and high myopia (4.5%). The final visual outcome was > or = 6/12 in 10 eyes (45.5%); complications were seen in 5 eyes (22.7%). The interval between initial surgery and vitrectomy, the method of fragment removal and the type of lens implanted, did not influence the final visual outcome.

Acute retinal necrosis complicating chickenpox in a healthy adult--a case report and review of literature

Tajunisah I, Reddy SC

Compr Ther, 2007;33(1):25-31.

PMID: 17984490

Acute retinal necrosis (ARN) is known to occur in conjunction with primary varicella or chickenpox infection. The majority of ARN cases reported in the literature were of milder form with mild to moderate vitritis, limited retinitis, and rare occurrence of retinal breaks or detachment that responded well to intravenous acyclovir, with or without oral prednisolone. We report a case of unilateral ARN with marked vitritis and retinal necrosis leading to retinal breaks following chickenpox in a 32-year-old healthy lady. This patient was successfully treated with intravenous acyclovir followed by oral acyclovir and orbital floor triamcinolone injections to contain the inflammation with barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity, and to our knowledge, orbital floor triamcinolone therapy was not used earlier to contain ARN inflammation.

Glutathione S-transferase activities in African catfish injected with β-naphthoflavone: effects of ploidy, gender, dose, and sampling time

Karami A, Courtenay SC

Environ Monit Assess, 2015 Nov;187(11):681.

PMID: 26452505 DOI: 10.1007/s10661-015-4906-7

Glutathione S-transferases (GST) are considered among the most controversial biomarkers of water pollutants in fish with little known about factors influencing their activities. The objective of this study was to investigate how gender, dose, ploidy, and sampling time alter hepatic GST activities in African catfish (Clarias gariepinus) following β-naphthoflavone (β-NF) injection. Newly matured male and female diploid and triploid fish were intraperitoneally (i.p.) injected with 0, 15, or 75 mg/kg of β-NF, and livers were excised 24, 48, and 72 h post-injection. Results showed that hepatic GST activities were significantly inhibited by both doses of β-NF. Inhibition was greater in females than males, but no significant differences were observed between diploid and triploid fish. Enzymatic activities differed over time with lowest levels 72 h post-injection. These results extend our understanding of GST activity in fish and highlight the necessity of considering confounding factors when comparing different studies.

Update: Outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000

Stone SC, McNutt E

Ann Emerg Med, 2001 Jul;38(1):83-4.

PMID: 11423818

Lymphoma: an introduction into historical background, classification schemes, aetiology, geographical variation and epidemiological trend

Peh SC, Poppema S

Malays J Pathol, 2001 Dec;23(2):49-63.

PMID: 12166593

Fulltext Topical chloramphenicol/gentamicin in the empirical treatment of acute conjunctivitis--is it rational?

Subramania A, Reddy SC

Med J Malaysia, 1996 Dec;51(4):491.

PMID: 10968042

Detection of Clostridium difficile from an enhancement broth by gas-liquid chromatography

Hassan H, Cheng SC

Malays J Pathol, 1991 Jun;13(1):29-31.

PMID: 1795558

Gas-Liquid chromatography (GLC) was used to detect the presence of isocaproic acid produced by Clostridium difficile from 54 stool samples grown in cycloserine-cefoxitin broth. Isocaproic acid was detected in 12 samples of which 5 were confirmed to be Clostridium difficile by culture and biochemical tests. The detection of isocaproic acid by GLC together with the presence of presumptive colonies on primary selective culture media provides a more rapid laboratory diagnosis for Clostridium difficile.

Angiomyolipoma of the vagina--an uncommon tumour. Case report

Peh SC, Sivanesaratnam V

Br J Obstet Gynaecol, 1988 Aug;95(8):820-3.

PMID: 3166957

The rate of loss of maxillary anterior alveolar bone height in patients with leprosy

Subramaniam K, Marks SC, Seang Hoo Nah

Lepr Rev, 1983 Jun;54(2):119-27.

PMID: 6888141

Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters

Reddy SC, Jackson N

Acta Ophthalmol Scand, 2004 Feb;82(1):81-5.

PMID: 14738490

PURPOSE: To determine the prevalence of retinal changes in newly diagnosed acute leukaemia patients, and to establish the relationship between retinal lesions and haematological parameters in these patients.

METHODS: A total of 127 patients with acute leukaemia (myeloid and lymphoid), of both genders, aged between 13 and 77 years, were examined by an ophthalmologist for retinal changes using direct/indirect ophthalmoscopy within 2 days of diagnosis before starting chemotherapy.

RESULTS: Retinal lesions were seen in 62 cases (49%), with intraretinal haemorrhages being the most common lesion (42%). A high white blood cell count was significantly associated with intraretinal haemorrhages (p = 0.04) and white-centred haemorrhages (p = 0.001), while a low platelet count was significantly associated with intraretinal haemorrhages (p = 0.03) in acute myeloid leukaemia patients.

CONCLUSIONS: A high white blood cell count may be considered as important as a low platelet count in the pathogenesis of leukaemic retinopathy.

Differential gene expression during flowering in the oil palm (Elaeis guineensis)

Singh R, Cheah SC

Plant Cell Rep, 2000 Jul;19(8):804-809.

PMID: 30754873 DOI: 10.1007/s002999900179

The technique of mRNA fingerprinting was used to isolate flower-specific cDNAs in the oil palm. Differences in the RNA populations between vegetative tissue (leaf) and inflorescences at various stages of flower development were examined using 18 primer combinations. A total of 16 flower-specific cDNAs were identified, of which 15 were successfully re-amplified. Reverse Northern analysis confirmed that 8 of the 15 cDNAs appeared to truly represent differentially expressed mRNAs in flowering tissues. Northern blot analysis subsequently showed that 5 of the clones are preferentially or exclusively expressed in the flowering tissues of oil palm.

Fulltext Adult Attention Deficit Hyperactivity Disorder in a Malaysian Forensic Mental Hospital: a Cross-sectional Study

Woon LSC, Zakaria H

East Asian Arch Psychiatry, 2019 Dec;29(4):118-123.

PMID: 31871308 DOI: 10.12809/eaap1851

OBJECTIVE: To determine the prevalence of adult attention deficit hyperactivity disorder (ADHD) and comorbid mental disorders in a Malaysian forensic mental hospital.

METHODS: All adult patients admitted to the forensic wards who were able to understand Malay or English language and give written informed consent were included. Participants were assessed using the Conners Adult Attention-Deficit Diagnostic Interview for DSM-IV (for presence of adult ADHD and a history of childhood ADHD) and the Mini International Neuropsychiatric Interview (for psychiatric comorbidities). Sociodemographic and offence-related data were also collected.

RESULTS: Of 199 patients admitted, 120 were included for analysis. The mean age of participants was 36.3 years. 94.2% were men. 81.7% were single, divorced, or separated. 25% had a history of childhood ADHD. The prevalence of adult ADHD was 15.8%. The persistence rate was 63%. Among the 19 participants with adult ADHD, the most common psychiatric comorbidities were substance dependence (68.4%), lifetime depression (63.2%), and generalised anxiety disorder (47.4%). Compared with participants without ADHD, participants with adult ADHD were less likely to be married (0% vs 21.8%, p = 0.022) and more likely to have alcohol abuse (15.8% vs 2%, p = 0.028), lifetime manic/hypomanic episodes (42.1% vs 7.9%, p = 0.001), and generalised anxiety disorder (47.4% vs 19.8%, p = 0.017), and were of younger age at first offence (21.8 years vs 26.9 years, p = 0.021).

CONCLUSIONS: Adult ADHD is common in a Malaysian forensic mental hospital and is associated with unmarried status, alcohol abuse, lifetime manic/hypomanic episodes, generalised anxiety disorder, and younger age at first offence.

Fulltext Clinical presentation of retinoblastoma in Malaysia: a review of 64 patients

Reddy SC, Anusya S

Int J Ophthalmol, 2010;3(1):64-8.

PMID: 22553520 DOI: 10.3980/j.issn.2222-3959.2010.01.15

To analyze the demography, presenting clinical features, spread of the disease of retinoblastoma in patients who were treated in two tertiary hospitals in Malaysia.

Ocular malignant melanoma - a report of two cases

Reddy SC, Darnal HK

Nepal J Ophthalmol, 2014 Jan;6(11):113-8.

PMID: 25341837 DOI: 10.3126/nepjoph.v6i1.10783

INTRODUCTION: Melanoma is a rare malignant tumour in the eye.

OBJECTIVE: To report two cases of malignant melanoma in the eye, one in the conjunctiva and the other in the choroid.

CASES: The first case was in a 49-year-old lady who presented with a swelling on the inner side of left upper eyelid. The vision was 6/6. On everting the eyelid, multiple, pigmented, nodular swellings were noted on the tarsal conjunctiva. Excision biopsy confirmed the diagnosis of malignant melanoma of the conjunctiva. A pigmented nodular swelling occurred on the lower bulbar conjunctiva in the same eye one-and-a-half years after the first presentation. There were no secondary nodules in the body. Excision biopsy confirmed malignant melanoma of the conjunctiva. The second case was in a 72-year-old lady who presented with pain and bleeding in the right eye. There was no perception of light. The cornea was hazy and the details behind it could not be seen. There was micro perforation of the cornea with oozing of blood and secondary glaucoma. B-scan ultrasonography of the right eye revealed an intraocular tumour. The histopathology of the enucleated eyeball confirmed the diagnosis of malignant melanoma of the choroid.

CONCLUSION: In the case of conjunctival melanoma, the occurrence of tumour at multiple sites and absence of recurrence at the original site suggests the possibility of de novo origin of the tumour. Secondary glaucoma and bleeding may be the presenting features of melanoma in the choroid.

Colesevelam for Type 2 diabetes mellitus: an abridged Cochrane review

Ooi CP, Loke SC

Diabet Med, 2014 Jan;31(1):2-14.

PMID: 24024701 DOI: 10.1111/dme.12295

Colesevelam, a second-generation bile acid sequestrant, may be beneficial in controlling both glycaemia and lipids simultaneously. Our goal was to evaluate the systemic effects of colesevelam on Type 2 diabetes mellitus.

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