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Fulltext Effects of sulbutiamine on diabetic polyneuropathy: an open randomised controlled study in type 2 diabetics

Kiew KK, Wan Mohamad WB, Ridzuan A, Mafauzy M

Malays J Med Sci, 2002 Jan;9(1):21-7.
PMID: 22969314 MyJurnal

Thirty patients with diabetic polyneuropathy were recruited from the diabetic clinic in Hospital Universiti Sains Malaysia from 1996 to 1998. They were randomly assigned either sulbutiamine (Arcalion(®)) (15 patients) or no treatment (control group; 15 patients). Glycaemic control was assessed by blood glucose and HbA1. Severity of neuropathy was assessed by symptom and sign score, and electrophysiological parameters (nerve conduction velocity and compound muscle action potential) at entry to the study and after 6 weeks. There were improvements in the electrophysiological parameters in the treatment group when compared to the controls with significant improvement in the median nerve conduction velocity (p<0.001), median compound muscle action potential (p<0.001), peroneal nerve conduction velocity (p<0.001), and peroneal compound muscle action potential (p<0.001). No significant improvement in symptom and sign scores were noted between the groups but a significant improvement compared to base line was noted for the sulbutiamine treated group. (p< 0.05). The glycaemic control in both groups was not significantly different at base line and was stable throughout the study. Sulbutiamine objectively improved peripheral nerve function in diabetic polyneuropathy although the symptom score did not improve, possibly due to the short duration of the study.
Malaysian mosquitocidal soil bacterium (Bacillus thuringiensis) strains with selective hemolytic and lectin activity against human and rat erythrocytes

Nadarajah VD, Chai SH, Mohammed SM, Chan KK, Kanakeswary K

Southeast Asian J Trop Med Public Health, 2006 Jan;37(1):67-78.
PMID: 16771215

The objective of this study is to determine the role of carbohydrates on the toxic effect of parasporal inclusion proteins isolated from Malaysian mosquitocidal Bacillus thuringiensis (Bt) strains on erythrocytes (human and rat). Dose response analyses on the effect of these parasporal inclusions on human and rat erythrocytes suggest that toxin action is selective depending on bacterial strains and source of erythrocytes. Results from this study suggest Bt toxin is a lectin which recognizes specific plasma membrane glycoconjugate receptor(s) with a terminal residue of either D-mannose (Man), N-acetyl-D-galactosamine (GalNAc), N-acetyl-D-glucosamine (GlcNAc) or even a combination of these monosaccharides.
Fulltext Studies on adult mosquito vectors of Japanese encephalitis in a pig farm in Selangor, Malaysia

Vythilingam I, Mahadevan S, Zaridah MZ, Ong KK, Abdullah G, Ong YF

Southeast Asian J Trop Med Public Health, 1994 Jun;25(2):383-6.
PMID: 7855662

Mosquito collections were carried out for a period of one year from January to December 1992 in a pig farm in Sungai Pelek, Selangor, Malaysia. A total of 41,022 mosquitos belonging to 52 species and 20 genera were collected. Culex tritaeniorhynchus and Cx. gelidus, the important vectors, comprised 63% of all mosquitos collected. Both these species were collected in large numbers during the wet months of May and December. The other predominant species in that area were Cx. fuscocephala, Cx. quinquefasciatus, Cx. sitiens, Aedes butleri, and Armigeres subalbatus.
Achalasia registry: the Kuala Lumpur Hospital experience. [Abstract2]

Ganesananthan S, Rajvinder S, Anil R, Kiew KK, Ng KL, Rosaida MS, et al.

Med J Malaysia, 2004;59 Suppl C:48.

Background: Achalasia cardia is an uncommon disease that is often detected late and is associated with significant morbidity. It is a primary esophageal motility disorder diagnosed based on a good history, barium swallow, upper endoscopy and a standard esophageal manometry.
Materials and Methods: We reviewed complete available records of treatment naïve patients with achalasia cardia from 1st January 2000 till April 2004.
Results: A total of 40 patients, with average presenting age at 44±16 (range 19-73) years with 14 males: 26 females with 20 Malays: 15 Chinese: 5 Indians, were suitable for further analysis. The classical symptom of dysphagia to liquids and solids were noted in all cases (100%). These patients learnt that water and sometimes-aerated drinks aid in flushing food down. Symptoms of regurgitation (36 patients-90%), heartburn (15 patients-37.5%), weight loss (10 patients–25%), nocturnal cough (16 patient-40%), retrosternal chest discomfort (2 patient-5%) and hemetemesis (2 patient-5%) was noted. One patient had aspiration pneumonia and another had concomitant active pulmonary tuberculosis and 8 had concomitant constipation (20%). In this series the duration of illness before diagnosis was 5±6 (range
0.3- 30) years and their presenting weight was 53±13 (range 33-82) kg. Barium swallow diagnosed achalasia in 27 patients (67.5%) and a dysmotility disorder in 7 cases (17.5%). There were 10 patients with mega-esophagus and two had epiphrenic diverticulum. There was no pseudoachalasia. Standard esophageal manometry, performed in 36 cases, demonstrated aperistalsis with one vigorous achalasia. The manometric assembly failed to pass through the sphincter in 14 cases and hence LOS assessment was not possible. Four cases demonstrated normal LOS pressure but demonstrated incomplete relaxation (normotensive achalasia). Pneumatic dilatation was performed in 38 newly cases without any complications with excellent symptomatic relief and a 3-12 month post procedural weight gain of 7±5 (range: 0-19) kg. Six patients required a second dilatation and another required two further dilatation. The durability of the total 45 pneumatic dilatations during this short study period was excellent at 24±12 (range 2-48) months.
Conclusion: A primary esophageal motility disorder must be excluded in any patients who present with dysphagia, with or without regurgitation and a "normal" upper endoscopy. Achalasia is not uncommon, often delayed in diagnosis and has a varied presentation. Although there is no cure for achalasia, but early detection and treatment certainly relieves symptoms and prevents complications. Pneumatic dilatation in our center has excellent durability without any complications.
Fulltext Prevalence and factors associated with smoking among adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015

Lim KH, Teh CH, Pan S, Ling MY, Yusoff MFM, Ghazali SM, et al.

Tob Induc Dis, 2018;16.
DOI: 10.18332/tid/82190

INTRODUCTION The continuous monitoring of smoking prevalence and its associated factors is an integral part of anti-smoking programmes and valuable for the evaluation of the effectiveness of anti-smoking measures and policies. This study aimed at determining prevalence of smoking and identifying socio-demographic factors associated with smoking among adults in Malaysia aged 15 years and over.
METHODS This is a cross-sectional study with a representative sample of 21 445 adults in Malaysia, aged 15 years and over, selected via a stratified, two-stage proportionate-to-size sampling method. Data were obtained from face-to-face interviews by trained research assistants, using a standard validated questionnaire. Multivariable logistic regression was performed to determine socio-demographic factors associated with smoking among Malaysians.
RESULTS The overall prevalence of smoking was 22.8% (95% CI: 21.9–23.8%), with males having a significantly higher prevalence compared to females (43.0%, 95% CI: 41.1–44.6 vs 1.4%, 95% CI: 1.1–1.7). The highest smoking prevalence was observed among other ethnicities (35.7%), those aged 25–44 years (59.3%), and low educational attainment (25.2%). Males, those with lower educational attainment and Malays were significantly associated with smoking.
CONCLUSIONS The prevalence of smoking among Malaysians, aged 15 years and over, remains high despite the implementation of several anti-smoking measures over the past decades. Specially tailored anti-smoking policies or measures, particularly targeting males, the Malays, younger adults and those with lower educational attainment, are greatly warranted to reduce the prevalence of smoking in Malaysia.
Study name: National Health and Morbidity Survey (NHMS-2015)
Fulltext The association between psychosocial and structural-level stressors and HIV injection drug risk behavior among Malaysian fishermen: A cross-sectional study

Michalopoulos LM, Jiwatram-Negrón T, Choo MK, Kamarulzaman A, El-Bassel N

BMC Public Health, 2016 06 02;16:464.
PMID: 27250497 DOI: 10.1186/s12889-016-3125-7

BACKGROUND: Malaysian fishermen have been identified as a key-affected HIV population with HIV rates 10 times higher than national rates. A number of studies have identified that psychosocial and structural-level stressors increase HIV injection drug risk behaviors. The purpose of this paper is to examine psychosocial and structural-level stressors of injection drug use and HIV injection drug risk behaviors among Malaysian fishermen.
METHODS: The study employs a cross-sectional design using respondent driven sampling methods. The sample includes 406 fishermen from Pahang state, Malaysia. Using multivariate logistic regressions, we examined the relationship between individual (depression), social (adverse interactions with the police), and structural (poverty-related) stressors and injection drug use and risky injection drug use (e.g.., receptive and non-receptive needle sharing, frontloading and back-loading, or sharing drugs from a common container).
RESULTS: Participants below the poverty line had significantly lower odds of injection drug use (OR 0.52, 95 % CI: 0.27-0.99, p = 0.047) and risky injection drug use behavior (OR 0.48, 95 % CI: 0.25-0.93, p = 0.030). In addition, participants with an arrest history had higher odds of injection use (OR 19.58, 95 % CI: 9.81-39.10, p
Fulltext Health and economic impact of combination therapy vs. Monotherapy for treatment of benign prostatic hyperplasia in hong kong

Wu DB, Yee CH, Ng AC, Chaiyakunapruk N, Lee KK

Value Health, 2014 Nov;17(7):A812.
PMID: 27203071 DOI: 10.1016/j.jval.2014.08.558
Posterolateral spinal fusion with ostegenesis induced BMSC seeded TCP/HA in a sheep model

Shamsul BS, Tan KK, Chen HC, Aminuddin BS, Ruszymah BH

Tissue Cell, 2014 Apr;46(2):152-8.
PMID: 24630213 DOI: 10.1016/j.tice.2014.02.001

Autogenous bone graft is the gold standard for fusion procedure. However, pain at donor site and inconsistent outcome have left a surgeon to venture into some other technique for spinal fusion. The objective of this study was to determine whether osteogenesis induced bone marrow stem cells with the combination of ceramics granules (HA or TCP/HA), and fibrin could serve as an alternative to generate spinal fusion. The sheep's bone marrow mesenchymal stem cells (BMSCs) were aspirated form iliac crest and cultured for several passages until confluence. BMSCs were trypsinized and seeded on hydroxyapatite scaffold (HA) and tricalcium phosphate/hydroxyapatite (TCP/HA) for further osteogenic differentiation in the osteogenic medium one week before implantation. Six adult sheep underwent three-level, bilateral, posterolateral intertransverse process fusions at L1-L6. Three fusion sites in each animal were assigned to three treatments: (a) HA constructs group/L1-L2, (b) TCP/HA constructs group/L2-L3, and (c) autogenous bone graft group/L5-L6. The spinal fusion segments were evaluated using radiography, manual palpation, histological analysis and scanning electron microscopy (SEM) 12 weeks post implantation. The TCP/HA constructs achieved superior lumbar intertransverse fusion compared to HA construct but autogenous bone graft still produced the best fusion among all.
Hepatitis C genotype and associated risks factors of patients at University Kebangsaan Malaysia Medical Centre

Mohamed NA, Zainol Rashid Z, Wong KK, S A A, Rahman MM

Pak J Med Sci, 2013 Sep;29(5):1142-6.
PMID: 24353708

Hepatitis C virus (HCV) genotyping is important for treatment and epidemiological purposes. The objective was to determine HCV genotype and their associations with certain risk factors at University Kebangsaan Malaysia Medical Centre (UKMMC).
Heaviness of smoking index, number of cigarettes smoked and the Fagerstrom test for nicotine dependence among adult male Malaysians

Lim KH, Idzwan MF, Sumarni MG, Kee CC, Amal NM, Lim KK, et al.

Asian Pac J Cancer Prev, 2012;13(1):343-6.
PMID: 22502698

Two methods of identifying smokers with high nicotine dependence, the heaviness of smoking index (HSI) and number of cigarettes per day (CPD) were compared with the Fagerstrom test for nicotine dependence (FTND). The HSI, CPD and the FTND were administered to 316 adult Malaysian male, daily smokers aged between 25-64 years old in the Malaysian NCD Surveillance-1 Survey using a two-stage stratified random sampling of enumeration blocks and living quarters, via an interview based on a validated questionnaire. The cut-off point for classification of high nicotine dependence on the HSI was a score of four or higher, and for the heavy smoking category, smoking more than 20 cigarettes per day. Classification using each method was compared with classification by the FTND (score of six or more) as the reference standard. Sensitivity, specificity and kappa statistics for concordance between both measures and the FTND were evaluated. The HSI gave a similar prevalence rate of high nicotine dependence as the FTND. There was substantial agreement between the HSI and the FTND (kappa=0.63.), with moderate sensitivity (69.8%) and high specificity (92.5%). However, prevalence of high nicotine dependence using the CPD was 7% lower than the FTND. The heavy smoking category also showed fair agreement with the FTND (kappa=0.45) and moderate sensitivity (67.0%), but specificity was high (86.9%). The findings indicate that the HSI can be used as an alternative to the FTND in screening for high nicotine dependence among daily smokers in large population-based studies, while CPD may not be a suitable alternative to the FTND.
Fulltext Methacholine challenge test as an adjunctive investigative tool in patients with asthma-like symptoms: the Sabah experience

Siew BTT, Wong JL, Beniyamin A, Ho A, Kannan SKK, Jamalul Azizi AR

Med J Malaysia, 2012 Apr;67(2):204-6.
PMID: 22822644 MyJurnal

INTRODUCTION: Patients with asthma-like symptoms pose a diagnostic dilemma when physical examination is normal. The usual practice in Malaysia would be to give empirical asthma treatment. Bronchial challenge test (BCT) is widely used in many countries to diagnose asthma objectively but it is not widely available in Malaysia.
OBJECTIVE: To describe our experience with BCT using methacholine at Queen Elizabeth Hospital as a supporting tool in the investigation of patients with asthma-like symptoms.
METHODOLOGY: Review of case notes of patients who underwent BCT from July 2008 till April 2009. BCT was performed via dosimeter technique. Results were classified as high hyper responsiveness if the provocative dose of methacholine required to achieve 20% fall in FEV1 (PD20) was less than or equal to 0.125 micromol, moderate hyper responsiveness if PD20 was between 0.125 to 1.99 micromol or mild hyper responsiveness if PD20 was between 2.00 to 6.6 micromol. PD20 of more than 6.6 micromol constitutes a negative MCT.
RESULTS: 29 patients had BCT during the study period. 19 cases were included in this review. The age ranged from 13 to 70 years old. There were 12 males and 7 females. Duration of symptoms ranged from 2 weeks to 23 years. BCT was positive (mild or moderate hyper responsiveness) in 10 out of 19 patients. No patient had high bronchial hyper responsiveness.
CONCLUSIONS: BCT is a useful adjunctive tool in the investigation of patients presenting with asthma-like symptoms. This test obviates empirical asthma treatment. BCT should be made available in all major hospitals in Malaysia.
Fulltext Identification of quantitative trait loci for blast resistance in BC₂F₃ and BC₂F5 advanced backcross families of rice

Rahim HA, Bhuiyan MA, Lim LS, Sabu KK, Saad A, Azhar M, et al.

Genet. Mol. Res., 2012;11(3):3277-89.
PMID: 23079822 DOI: 10.4238/2012.September.12.11

Advanced backcross families derived from Oryza sativa cv MR219/O. rufipogon IRGC105491 were utilized for identification of quantitative trait loci (QTL) for blast resistance using simple sequence repeat markers. Two hundred and sixty-one BC(2)F(3) families were used to construct a linkage map, using 87 markers, which covered 2375.2 cM of 12 rice chromosomes, with a mean density of 27.3 cM. The families were evaluated in a greenhouse for resistance to blast disease caused by pathotypes P7.2 and P5.0 of Magnaporthe oryzae. Five QTLs (qBL5.1, qBL5.2, qBL6.1, qBL8.1, and qBL10.1) for pathotype P5.0 and four QTLs (qBL5.3, qBL5.4, qBL7.1, and qBL8.2) for pathotype P7.2 were identified using the BC(2)F(3) families. Another linkage map was also constructed based on 31 BC(2)F(5) families, using 63 SSR markers, which covered 474.9 cM of 9 rice chromosomes, with a mean density of 8.01 cM. Five suggestive QTLs (qBL11.2, qBL11.3, qBL12.1, qBL12.2, qBL12.3) and one putative QTL (qBL2.1) were identified for pathotype P7.2. Also, seven suggestive QTLs (qBL1.1, qBL2.2, qBL4.1, qBL4.2, qBL5.3, qBL8.3, and qBL11.1) were detected for pathotype P5.0. We conclude that there is a non-race-specific resistance spectrum of O. rufipogon against M. oryzae pathotypes.
Fulltext Head and neck cancer: possible causes for delay in diagnosis and treatment

Lee SC, Tang IP, Avatar SP, Ahmad N, Selva KS, Tay KK, et al.

Med J Malaysia, 2011 Jun;66(2):101-4.
PMID: 22106686 MyJurnal

To explore the possible causes for delay in diagnosis and treatment of head and neck cancer at Sarawak General Hospital (SGH).
Fulltext Proptosis: a rare presentation of metastatic renal cell carcinoma

Ho CC, Krishna KK, Praveen S, Goh EH, Lee BC, Zulkifli MZ

Med J Malaysia, 2010 Sep;65(3):229-30.
PMID: 21939176

We present a case of a middle-aged man who was incidentally found to have right renal solid mass while investigating for his left eye proptosis. Computerised tomography (CT) scan confirmed the diagnosis of renal cell carcinoma and the tumour was successfully excised via open surgery. The histopathology examination revealed the 10x7x8 cm mass to be a clear cell type renal cell carcinoma. The rare presentation of this metastatic renal cell carcinoma, its diagnosis and management will be discussed.
Fulltext Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: analysis of survival and prognostic markers

Chan KK, Dassanayake B, Deen R, Wickramarachchi RE, Kumarage SK, Samita S, et al.

World J Surg Oncol, 2010;8:82.
PMID: 20840793 DOI: 10.1186/1477-7819-8-82

This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival.
Fulltext Progressive supra-axial cervical instability in Down syndrome: a case report emphasising the role of extended short-segment fusion

Tan GH, Tan KK, Afian MS, Liew WF, Mohamad AR

Med J Malaysia, 2005 Jul;60 Suppl C:111-3.
PMID: 16381295

We report a case of upper cervical instability associated with Down syndrome to highlight its potential progression to inflict cord compression and the rationale for surgical decompression and extended short segment occipito-axial fusion.
Acinetobacter baumannii respiratory isolates in ventilated patients are associated with prolonged hospital stay

Loh LC, Yii CT, Lai KK, Seevaunnamtum SP, Pushparasah G, Tong JM

Clin Microbiol Infect, 2006 Jun;12(6):597-8.
PMID: 16700715
Evaluation of suitable biodegradable scaffolds for engineered bone tissue

Phang MY, Ng MH, Tan KK, Aminuddin BS, Ruszymah BH, Fauziah O

Med J Malaysia, 2004 May;59 Suppl B:198-9.
PMID: 15468886

Tricalcium phosphate/hydroxyapatite (TCP/HA), hydroxyapatite (HA), chitosan and calcium sulphate (CaSO4) were studied and evaluated for possible bone tissue engineered construct acting as good support for osteogenic cells to proliferate, differentiate, and eventually spread and integrate into the scaffold. Surface morphology visualized by SEM showed that scaffold materials with additional fibrin had more cell densities attached than those without, depicting that the presence of fibrin and collagen fibers were truly a favourite choice of cells to attach. In comparison of various biomaterials used incorporated with fibrin, TCP/HA had the most cluster of cells attached.
Strategy for generating tissue-engineered human bone construct

Tan KK, Aminuddin BS, Tan GH, Sabarul Afian M, Ng MH, Fauziah O, et al.

Med J Malaysia, 2004 May;59 Suppl B:43-4.
PMID: 15468810

The strategy used to generate tissue-engineered bone construct, in view of future clinical application is presented here. Osteoprogenitor cells from periosteum of consenting scoliosis patients were isolated. Growth factors viz TGF-B2, bFGF and IGF-1 were used in concert to increase cell proliferation during in vitro cell expansion. Porous tricalcium phosphate (TCP)-hydroxyapatite (HA) scaffold was used as the scaffold to form 3D bone construct. We found that the addition of growth factors, greatly increased cell growth by 2 to 7 fold. TCP/HA proved to be the ideal scaffold for cell attachment and proliferation. Hence, this model will be further carried out on animal trial.
The use of bone marrow stem cells for bone tissue engineering

Ng MH, Aminuddin BS, Tan KK, Tan GH, Sabarul Afian M, Ruszymah BH

Med J Malaysia, 2004 May;59 Suppl B:41-2.
PMID: 15468809

Bone marrow stem cells (BMSC), known for its multipotency to differentiate into various mesenchymal cells such as chodrocyte, osteoblasts, adipocytes, etc, have been actively applied in tissue engineering. BMSC have been successfully isolated from bone marrow aspirate and bone marrow scraping from patients of various ages (13-56 years) with as little as 2ml to 5ml aspirate. BMSC isolated from our laboratory showed the presence of a heterogenous population that showed varying prevalence of surface antigens and the presence of telomerase activity albeit weak. Upon osteogenic induction, alkaline phosphatase activity and mineralization activity were observed.

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