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  1. Tai, Sharon Mei-Ling, Tan, Hong-Yien, Yong, Yean-Kong, Esaki M. Shankar, Yap, Jun-Fai, Tan, Chong Tin, et al.
    Neurology Asia, 2017;22(3):209-220.
    MyJurnal
    Background: Tuberculous meningitis is a life-threatening manifestation resulting from infection
    by Mycobacterium tuberculosis, especially in the developing countries. The molecular aspects of
    pathogenesis of tuberculous meningitis remain poorly understood. We evaluated the correlation of
    cerebrospinal fluid (CSF) and serum cytokine levels with the clinical outcome of 15 HIV-negative
    patients with tuberculous meningitis. We also assessed the association of CSF and serum cytokines
    with neuroimaging of brain findings in the patients.

    Methods: The prospective longitudinal study was
    conducted at the University Malaya Medical Centre between 2012 and 2014. Neuroimaging of the
    brain was performed and the findings of leptomeningeal enhancement, hydrocephalus, tuberculoma,
    infarcts and vasculopathy were recorded. The CSF and serum specimens were analyzed for IL-1ß,
    IL-8, IL-10, IL-18, IP-10, IFN-γ, MCP-1, TGF-ß, VEGF, TNF- α, IL-18BPa and MMP-9. The clinical
    outcome was graded at 3 months based on Modified Rankin scale (mRS).

    Results: On admission and
    at one month of anti-tuberculosis treatment, the CSF levels of IL-8, IL-1β, IP-10, IFN-γ and VEGF
    were elevated in all of the patients. Serum IP-10, MCP-1, IL-1β and IL-8 levels were increased on
    admission and at one month of anti-tuberculosis treatment. There were statistically significant differences
    between good and poor outcome (mRS at 3 months) for CSF IFN-γ (p=0.033), CSF IL-10 (p=0.033)
    and serum VEGF (p=0.033) at one month of treatment. None of the patients showed any association
    between CSF and serum cytokines on admission and at one month of anti-tuberculosis treatment with
    neuro-radiological findings.

    Conclusion: The CSF cytokine levels were not related to TBM disease severity on admission, and
    changes on MRI/CT scans. CSF levels of IFN-γ and IL-10 at one month of anti-tuberculosis treatment
    were associated with clinical outcome at 3 months. CSF cytokine levels on admission were not
    associated with the clinical outcome.
  2. Yee A, Ng BS, Hashim HMH, Danaee M, Loh HH
    BMC Psychiatry, 2017 Dec 02;17(1):384.
    PMID: 29197359 DOI: 10.1186/s12888-017-1553-2
    BACKGROUND: This study evaluates the psychometric properties of the Malay version of the Brief Psychiatric Rating Scale (BPRS-M) among patients with schizophrenia in a psychiatric outpatient clinic.
    METHODS: Ninety-nine schizophrenia outpatients were administered the Malay version of the Brief Psychiatric Rating Scale (BPRS-M), Malay version of Positive and Negative Syndrome Scale (PANSS), Malay version of Calgary Depression Scale for Schizophrenia (CDSS) and Malay version of World Health Organization Quality of Life - Brief Version (WHOQOL-BREF).
    RESULTS: An exploratory factor analysis (EFA) of BPRS-M produced a seven-factor solution which accounted for 71.4% of the total variance. It exhibited fair internal consistency (Cronbach's alpha coefficient of 0.75). "Positive symptoms" and "Resistance" factors had association with unemployment and number of antipsychotics, positively correlated with PANSS but negatively correlated with WHOQOL-BREF. "Mood disturbance" factor correlated with lifetime history of suicide attempts, Malay version of CDSS and WHOQOL-BREF (psychological). Both "Negative symptoms" and "Activation" factors were associated with male, lower education, unemployment and positively correlated with Malay version of PANSS but negatively correlated with WHOQOL-BREF.
    CONCLUSIONS: The BPRS-M demonstrated promising psychometric properties in terms of dimensionality, reliability, and validity that generally justifies its use in routine clinical practice in Malaysia.
    Study site: psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  3. Mei-Ling Sharon TAI, Hazman MOHD NOR, Kartini Rahmat, Shanthi Viswanathan, Khairul Azmi Abdul Kadir, Norlisah Ramli, et al.
    Neurology Asia, 2017;22(1):15-23.
    MyJurnal
    Objective: The primary objective of this study was to describe the neuroimaging changes of tuberculous meningitis (TBM), and to determine the role of neuroimaging in the diagnosis of TBM.
    Methods: Between January 2009 and July 2015, we prospectively recruited TBM patients in two hospitals in Malaysia. Neuroimaging was performed and findings were recorded. The control consists of other types of meningo-encephalitis seen over the same period.
    Results: Fifty four TBM patients were recruited. Leptomeningeal enhancement was seen in 39 (72.2%) patients, commonly at prepontine cistern and interpeduncular fossa. Hydrocephalus was observed in 38 (70.4%) patients, 25 (46.3%) patients had moderate and severe hydrocephalus. Thirty four patients (63.0%) had cerebral infarction. Tuberculoma were seen in 29 (53.7%) patients; 27 (50.0%) patients had classical tuberculoma, 2 (3.7%) patients
    had “other” type of tuberculoma, 18 (33.3%) patients had ≥5 tuberculoma, and 11 (20.4%) patients had < 5 tuberculoma. Fifteen (37.2%) patients had vasculitis, 6 (11.1%) patients had vasospasm. Close to nine tenth (88.9%) of the patients had ≥1 classical neuroimaging features, 77.8% had ≥ 2 classical imaging features of TBM (basal enhancement, hydrocephalus, basal ganglia / thalamic infarct, classical tuberculoma, and vasculitis/vasospasm). Only 4% with other types of meningitis/encephalitis had ≥1 feature, and 1% had two or more classical TBM neuroimaging features. The sensitivity of the imaging features of the imaging features for diagnosis of TBM was 88.9% and the specificity was 95.6%.
    Conclusion: The classic imaging features of basal enhancement, hydrocephalus, basal ganglia/thalamic infarct, classic tuberculoma, and vasculitis are sensitive and specific to diagnosis of TBM.
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