MyMedR

Multiple bilateral renal abscesses in a previously healthy young patient

Tang RY, Cheong BM

Med J Malaysia, 2017 08;72(4):250-251.

The incidence of renal abscesses is not common. Patients usually have risk factors like diabetes mellitus or an underlying condition which predisposes to urinary tract infections. We report a case of a previously healthy young girl with multiple bilateral renal abscesses. Ultrasonography revealed multiple renal abscesses with a possible differential diagnosis of polycystic kidney disease with infected cysts. No renal calculi were seen. CT-scan of kidneys confirmed the diagnosis. Blood and urine cultures were repeatedly negative. She was treated with two weeks of intravenous antibiotics followed by another four weeks of oral Ciprofloxacin. No surgical intervention was carried out. Repeated ultrasound at six months showed complete resolution of all the renal abscesses.

Matched MeSH terms: Abscess/drug therapy; Kidney Diseases/drug therapy

Siphoning diesel: a fatal mistake

Leong WC, Cheong BM

Med J Malaysia, 2017 10;72(5):314-315.

PMID: 29197890 MyJurnal

Diesel is commonly used as fuel for engines and is distilled from petroleum. Diesel has toxic potential and can affect multiple organs. Exposure can occur after ingestion, inhalation or through the dermal route. The practice of siphoning diesel using a rubber tubing and the mouth is common in rural communities. This can lead to accidental ingestion and aspiration. Here we report a case of a patient who accidentally ingested diesel during siphoning, which caused extensive erosion of the oral cavity and oesophagus leading to pneumomediastinum and severe chemical lung injury. The patient responded well initially to steroids and supportive care but required prolonged hospitalisation. He developed complications of nosocomial infection and succumbed 23 days after admission.

Matched MeSH terms: Pneumonia/drug therapy; Lung Injury/drug therapy

Protection of Military Personnel Against Vector-Borne Diseases: A Review of Collaborative Work of the Australian and US Military Over the Last 30 Years

Frances SP, Edstein MD, Debboun M, Shanks GD

US Army Med Dep J, 2016 Oct-Dec.

PMID: 27613205

Australian and US military medical services have collaborated since World War II to minimize vector-borne diseases such as malaria, dengue, and scrub typhus. In this review, collaboration over the last 30 years is discussed. The collaborative projects and exchange scientist programs have resulted in mutually beneficial outcomes in the fields of drug development and personal protection measures against vector-borne diseases.

Matched MeSH terms: Dengue/drug therapy; Malaria/drug therapy

The etiology and pathology of eosinophilic lung (tropical eosinophilia)

Danaraj TJ, Pacheco G, Shanmugaratnam K, Beaver PC

Am J Trop Med Hyg, 1966 Mar;15.(2):183-9.

PMID: 5910525

The finding of microfilariae in lung tissue from patients with eosinophilic lung is reported and the histopathological appearances are described.

Matched MeSH terms: Eosinophilia/drug therapy; Filariasis/drug therapy

Adult human metapneumovirus encephalitis: A case report highlighting challenges in clinical management and functional outcome

Tan YL, Wee TC

Med J Malaysia, 2017 12;72(6):372-373.

PMID: 29308778

We report a rare case of adult human metapneumovirus (HMPV) in a healthy 32-year-old man. There was dramatic deterioration in his condition developing pneumonia with Type-I respiratory failure and encephalitis. He needed mechanical ventilation in the intensive care setting and was treated with intravenous ribavirin. Post-extubation he remained severely physically and cognitively impaired despite rehabilitation. Treatment of HMPV pneumonia is at present, still without specific antiviral therapy. Managing HMPV-encephalitis remained supportive and challenging. More definite treatment strategies are needed.

Matched MeSH terms: Encephalitis/drug therapy*; Paramyxoviridae Infections/drug therapy*

Targeting inflammation: a potential approach for the treatment of depression

Bhatt S, Devadoss T, Jha NK, Baidya M, Gupta G, Chellappan DK, et al.

Metab Brain Dis, 2023 Jan;38(1):45-59.

PMID: 36239867 DOI: 10.1007/s11011-022-01095-1

Major depressive disorder (MDD) or Depression is one of the serious neuropsychiatric disorders affecting over 280 million people worldwide. It is 4th important cause of disability, poor quality of life, and economic burden. Women are more affected with the depression as compared to men and severe depression can lead to suicide. Most of the antidepressants predominantly work through the modulation on the availability of monoaminergic neurotransmitter (NTs) levels in the synapse. Current antidepressants have limited efficacy and tolerability. Moreover, treatment resistant depression (TRD) is one of the main causes for failure of standard marketed antidepressants. Recently, inflammation has also emerged as a crucial factor in pathological progression of depression. Proinflammatory cytokine levels are increased in depressive patients. Antidepressant treatment may attenuate depression via modulation of pathways of inflammation, transformation in structure of brain, and synaptic plasticity. Hence, targeting inflammation may be emerged as an effective approach for the treatment of depression. The present review article will focus on the preclinical and clinical studies that targets inflammation. In addition, it also concentrates on the therapeutic approaches' that targets depression via influence on the inflammatory signaling pathways. Graphical abstract demonstrate the role of various factors in the progression and neuroinflammation, oxidative stress. It also exhibits the association of neuroinflammation, oxidative stress with depression.

Matched MeSH terms: Depression/drug therapy; Inflammation/drug therapy

Fulltext Regular paracetamol in severe dengue: a lethal combination?

Gan CS, Chong SY, Lum LC, Lee WS

Singapore Med J, 2013 Feb;54(2):e35-7.

PMID: 23462840

An eight-month-old female infant with severe dengue disease, who was repeatedly given therapeutic paracetamol for severe dengue, developed fulminant liver failure with encephalopathy, gastrointestinal haemorrhage and severe coagulopathy. She responded to supportive measures and N-acetylcysteine infusion. This case highlights the potential danger of administering repeated therapeutic doses of paracetamol in childhood severe dengue disease with hepatitis.

Matched MeSH terms: Hepatic Encephalopathy/drug therapy; Severe Dengue/drug therapy*

Fulltext The man with the boggy head: cranial melioidosis

Kuan YC, How SH, Ng TH, Fauzi AR

Singapore Med J, 2010 Feb;51(2):e43-5.

PMID: 20358143

Melioidosis is known to cause abscesses in various organs, including the cranium, though less commonly. We present a patient with scalp abscess and subdural empyema that was visible on computed tomography of the brain. The neurosurgical drainage grew Burkholderia pseudomallei. Despite our best effort to treat the patient using parenteral antibiotics and surgical drainage, the patient did not survive.

Matched MeSH terms: Melioidosis/drug therapy; Empyema, Subdural/drug therapy

Fulltext Cardiovascular outcomes in the comparative hypertension drug trials: more consensus than controversy

Ong HT

Singapore Med J, 2008 Aug;49(8):599-605; quiz 606.

PMID: 18756340

The comparative anti-hypertensive drug trials conducted to assess their cardiovascular protective efficacy actually produce compatible, not conflicting, results. In the last decade, there were 13 major comparative hypertension drug trials with the cardiovascular primary outcome being statistically equivalent in 11 of these 13 trials, involving over 90 percent of the randomised 168,593 patients. Where secondary outcomes favour a drug in these trials, that arm has a significantly lower treated blood pressure as in LIFE, VALUE, ASCOT and ALLHAT. Controversy occurs in seeking to attribute the benefit to drug effect; if the benefit is attributed to the lower achieved blood pressure, then the trials become consistent. The safety and value of diuretics, beta-blockers, calcium-blockers, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in reducing blood pressure, and in reducing clinical cardiovascular outcomes, is now clearly established. Overall, the importance of tight blood pressure control in reducing cardiovascular outcomes must be emphasised. Physicians should concentrate on achieving good blood pressure control, which often requires a combination of several antihypertensive drugs.

Matched MeSH terms: Cardiovascular Diseases/drug therapy*; Hypertension/drug therapy*

Fulltext Acute pulmonary embolism following Achilles tendon repair

Yusof MI

Singapore Med J, 2007 Aug;48(8):e234-6.

PMID: 17657374

Achilles tendon injury is common and surgical procedures related to it are frequently performed and are safe. The incidence of acute pulmonary embolism following these procedures is extremely rare. This case illustrates an incidence of acute pulmonary embolism following Achilles tendon repair in a 35-year-old woman. We discuss the possible causes and the need for thromboprophylaxis.

Matched MeSH terms: Pulmonary Embolism/drug therapy; Venous Thrombosis/drug therapy

Fulltext Malaysian children with: "benign epilepsy of childhood with centrotemporal spikes"

Manonmani V, Tan CT

Singapore Med J, 1994 Jun;35(3):247-9.

PMID: 7997896

Benign epilepsy of childhood with centrotemporal spikes (BECT) was studied in Malaysian children, and was observed in Chinese, Malay and Indian children in the ratio 10:6:5. There were 12 boys and 9 girls. Fit frequency varied from almost daily to a single fit. The age of onset ranged from 2-13 years and BECT was not noted in any child over 13 years old. There was a strong circadian rhythm and fits occurred mainly in sleep. Generalised seizures were more common than partial seizures. During the 3-year study from April 1989 to April 1992, 21 children with BECT were identified from the EEG records done at the University Hospital and it was found that this genetic epilepsy which is autosomal dominant with age dependent penetrance occurs in approximately 4.8% of our epileptic children. In addition there were 3 children in whom petit mal co-existed with a BECT EEG trait.

Matched MeSH terms: Epilepsies, Partial/drug therapy; Epilepsy, Temporal Lobe/drug therapy

Fulltext Pregnancy in a patient receiving busulphan for chronic myeloid leukaemia

Norhaya MR, Cheong SK, Hamidah NH, Ainoon O

Singapore Med J, 1994 Feb;35(1):102-3.

PMID: 8009265

A 33-year-old Malay lady with chronic myeloid leukaemia (CML) became amenorrhoeic during therapy with busulphan. Pregnancy was diagnosed via a urine pregnancy test and an ultrasound confirmed a viable foetus at 16 weeks. The busulphan was stopped. Her pregnancy was unremarkable and continued till term. She delivered a healthy child.

Matched MeSH terms: Pregnancy Complications, Neoplastic/drug therapy*; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy*

Fulltext Treatment of small cell lung cancer with cyclophosphamide, adriamycin and vincristine (CAV) combination therapy: experience at University Hospital, Kuala Lumpur, Malaysia

Lee SM

Singapore Med J, 1990 Aug;31(4):317-20.

PMID: 2175049

Seventeen patients with small cell lung cancer (SCLC) were treated with cyclophosphamide, adriamycin and vincristine (CAV) combination chemotherapy. The overall response rate was 76.5% with 47% achieving complete response and 29.5% partial response. In limited and extensive stage disease, complete response was achieved in 67% and 36.5% respectively. Chinese were the predominant ethnic group affected (82%). Six patients presenting with superior vena cava obstruction responded significantly to CAV chemotherapy alone. Median survival for patients with extensive disease was 7.4 months. All patients with limited disease were still alive. Two relapsed patients with limited disease achieved significant response to VP-16/Cisplatin combination chemotherapy.

Matched MeSH terms: Lung Neoplasms/drug therapy*; Carcinoma, Small Cell/drug therapy*

Antiviral actions of flavanoid-derived compounds on dengue virus type-2

Muhamad M, Kee LY, Rahman NA, Yusof R

Int J Biol Sci, 2010 May 23;6(3):294-302.

PMID: 20567498

Dengue viruses, mosquito-borne members of the Flaviviridae family, are the causative agents of dengue fever and its associated complications, dengue haemorrhagic fever and dengue shock syndrome. To date, more than 2.5 billion people in over 100 countries are at risk of infection, and approximately 20 million infections were reported annually. There is currently no treatment or vaccine available for dengue infection. This study employed a whole-cell organism model or in vitro methods to study the inhibitory property of the flavanoid-derived compounds against DENV2 activity. Results showed that at concentration not exceeding the maximum non-toxic dose (MNTD), these compounds completely prevented DENV2 infection in HepG2 cells as indicated by the absence of cytophatic effects. The in vitro antiviral activity assessed in HepG2 cells employing virus inhibition assay showed high inhibitory activity in a dose dependent manner. At concentration below MNTD, compounds exhibited inhibitory activity against DENV2 with a range of potency strengths of 72% to 100%. The plaque forming unit per ml (pfu/ml) was reduced prominently with a maximum reduction of 98% when the infected HepG2 cells were treated with the highest non-toxic dose of compounds. The highly potent activity of the compounds against DENV2 infection strongly suggests their potential as a lead antiviral agent for dengue.

Matched MeSH terms: Dengue/drug therapy*; Severe Dengue/drug therapy

Clinical and patient-reported outcome profile of patients with hepatitis B viral infection from the Global Liver Registry™

Younossi ZM, Yu ML, Yilmaz Y, Alswat KA, Buti M, Fernandez MIC, et al.

J Viral Hepat, 2023 Apr;30(4):335-344.

PMID: 36601668 DOI: 10.1111/jvh.13800

Chronic hepatitis B (CHB) infection is one of the most common causes of cirrhosis and liver cancer worldwide. Our aim was to assess clinical and patient-reported outcome (PRO) profile of CHB patients from different regions of the world using the Global Liver Registry. The CHB patients seen in real-world practices are being enrolled in the Global Liver Registry. Clinical and PRO (FACIT-F, CLDQ, WPAI) data were collected and compared to baseline data from CHB controls from clinical trials. The study included 1818 HBV subjects (48 ± 13 years, 58% male, 14% advanced fibrosis, 7% cirrhosis) from 15 countries in 6/7 Global Burden of Disease super-regions. The rates of advanced fibrosis varied (3-24%). The lowest PRO scores across multiple domains were in HBV subjects from the Middle East/North Africa (MENA), the highest - Southeast/East and South Asia. Subjects with advanced fibrosis had PRO impairment in 3 CLDQ domains, Activity of WPAI (p 0.10). The clinico-demographic portrait of CHB patients varies across regions of the world and enrollment settings. Advanced fibrosis and non-hepatic comorbidities are independently associated with PRO impairment in CHB patients.

Matched MeSH terms: Drug Therapy, Combination; Liver Cirrhosis/drug therapy

Fulltext Evaluation of the bioactivity of novel spiroisoxazoline typecompounds against normal and cancer cell lines

Najim N, Bathich Y, Zain MM, Hamzah AS, Shaameri Z

Molecules, 2010 Dec 17;15(12):9340-53.

PMID: 21169884 DOI: 10.3390/molecules15129340

The aim of this study was to investigate the in vitro cellular activity of novel spiroisoxazoline type compounds against normal and cancer cell lines from lung tissue (Hs888Lu), neuron-phenotypic cells (SH-SY5Y), neuroblastoma (SH-SY5Y), human histiocytic lymphoma (U937), lung cancer (A549), and leukaemia (HL-60). Our bioassay program revealed that the spiroisoxazoline type compounds show cytotoxicity only in lymphoma cell lines, which is in contrast with the pyrrolidine precursor of these spiroisoxazoline compounds, where significant cytotoxicity is seen in all normal and cancer cell lines. These data suggest a tumour-specific mechanism of action. In addition these data also show that spiroisoxazoline compounds are non-toxic in the human neuronphenotypic neuroblastoma SH-SY5Y cell line, and furthermore that they might protect cells from neurodegenerative disease.

Matched MeSH terms: Neoplasms/drug therapy*; Neurodegenerative Diseases/drug therapy

Fulltext Lack of efficacy of triclabendazole against Fasciola hepatica is present on sheep farms in three regions of England, and Wales

Kamaludeen J, Graham-Brown J, Stephens N, Miller J, Howell A, Beesley NJ, et al.

Vet Rec, 2019 04 20;184(16):502.

PMID: 30824600 DOI: 10.1136/vr.105209

The liver fluke Fasciola hepatica is a parasitic trematode that has a major impact on livestock production and human health. Control of F hepatica is difficult and relies on anthelmintics, particularly triclabendazole, due to its efficacy against both adult and juvenile stages of the parasite. Emergence of triclabendazole-resistant F hepatica populations has been reported in a number of countries, including the UK, but the overall prevalence and distribution of triclabendazole resistance is unknown. In this study, the authors established the presence of reduced efficacy of triclabendazole in sheep flocks in England and Wales, using a validated composite faecal egg count reduction test. Seventy-four sheep farms were sampled from Wales, southwest, northwest and northeast England between Autumn 2013 and Spring 2015. F hepatica eggs were detected in samples from 42/74 farms. Evidence of a lack of efficacy of triclabendazole was detected on 21/26 farms on which the faecal egg count reduction test was completed, with faecal egg count reductions ranging from 89 per cent to 0per cent. Regression analysis suggested that both prevalence of F hepatica and lack of efficacy of triclabendazole were spatially correlated, with higher faecal egg counts and lower percentage reductions on farms located in the northwest of England, and Wales. Overall, the results show that reduced efficacy of triclabendazole is present across England and Wales, with a complete lack of therapeutic efficacy observed on 9/26 farms.

Matched MeSH terms: Fascioliasis/drug therapy; Sheep Diseases/drug therapy*

[Cerebral cysticercosis]

Hagelskjaer LH, Hansen NJ, Christensen T

Ugeskr Laeger, 1991 Sep 23;153(39):2754-5.

PMID: 1949294

A Danish woman aged 28 years who had travelled in the Far East developed cerebral symptoms with headache and visual disturbances. Migraine was suspected. Subsequent CT scanning revealed multiple processes and metastases were suspected. As the patient had travelled in the Far East 1 1/2 years previously, she was examined for neurocysticercosis. This diagnosis was established and the patient was successfully treated with praziquantel. On account of increased travelling activity, the possibility of neurocysticercosis should be borne in mind when dealing with patients with cerebral symptoms and relevant travelling histories.

Matched MeSH terms: Brain Diseases/drug therapy; Cysticercosis/drug therapy

Fulltext Feline sporotrichosis in Asia

Han HS, Kano R

Braz J Microbiol, 2021 Mar;52(1):125-134.

PMID: 32363567 DOI: 10.1007/s42770-020-00274-5

Sporothrix schenckii sensu lato is currently recognized as a species complex with only Sporothrix brasiliensis, Sporothrix schenckii sensu stricto, Sporothrix globosa and Sporothrix pallida identified to cause disease in the cat. Feline sporotrichosis in Asia is mainly reported from Malaysia where a single clonal strain of clinical clade D, Sporothrix schenckii sensu stricto manifesting low susceptibility to major antifungal classes, has been identified as the agent of the disease. Sporothrix globosa has been identified to cause disease from a single cat in Japan while the specific species of agent has not been identified yet for the disease in Thailand. Despite efforts to elucidate and describe the pathogenicity of the agent and the disease it causes, the paucity of data highlights the need for further molecular epidemiological studies to characterize this fungus and the disease it causes in Asia. Its prognosis remains guarded to poor due to issues pertaining to cost, protracted treatment course, zoonotic potential and low susceptibility of some strains to antifungals.

Matched MeSH terms: Cat Diseases/drug therapy; Sporotrichosis/drug therapy

Fulltext New Benefits of Hydroxychloroquine in Pregnant Women with Systemic Lupus Erythematosus: A Retrospective Study in a Tertiary Centre

Abd Rahman R, Min Tun K, Kamisan Atan I, Mohamed Said MS, Mustafar R, Zainuddin AA

Rev Bras Ginecol Obstet, 2020 Nov;42(11):705-711.

PMID: 33254264 DOI: 10.1055/s-0040-1715140

OBJECTIVE: To determine pregnancy outcomes in women with systemic lupus erythematosus (SLE) who were treated with hydroxychloroquine in a tertiary center.

METHODS: A retrospective study involving pregnant women with SLE who had antenatal follow-up and delivery in between 1 January 2007 and 1 January 2017. All participants were retrospectively enrolled and categorized into two groups based on hydroxychloroquine treatment during pregnancy.

RESULTS: There were 82 pregnancies included with 47 (57.3%) in the hydroxychloroquine group and 35 (42.7%) in the non-hydroxychloroquine group. Amongst hydroxychloroquine users, there were significantly more pregnancies with musculoskeletal involvement (p = 0.03), heavier mean neonatal birthweight (p = 0.02), and prolonged duration of pregnancy (p = 0.001). In non-hydroxychloroquine patients, there were significantly more recurrent miscarriages (p = 0.003), incidence of hypertension (p = 0.01) and gestational diabetes mellitus (p = 0.01) and concurrent medical illness (p = 0.005). Hydroxychloroquine use during pregnancy was protective against hypertension (p = 0.001), and the gestational age at delivery had significant effect on the neonatal birthweight (p = 0.001). However, duration of the disease had a significant negative effect on the neonatal birthweight (p = 0.016).

CONCLUSION: Hydroxychloroquine enhanced better neonatal outcomes and reduced adverse pregnancy outcomes and antenatal complications such as hypertension and diabetes.

Matched MeSH terms: Lupus Erythematosus, Systemic/drug therapy*; Pregnancy Complications/drug therapy*

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