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Fulltext Immunological surveys of arbovirus infections in South-East Asia, with special reference to dengue, chikungunya, and Kyasanur Forest disease

Rao TR

Bull World Health Organ, 1971;44(5):585-91.
PMID: 4400821

Serological surveys have been widely used in South-East Asia to determine the presence and activity of arboviruses. The haemagglutination-inhibition test has been most frequently employed but complement-fixation and neutralization tests have also been used in some investigations.Although virus isolations provide the most conclusive evidence, they can be carried out in a few specialized centres only, and serological surveys are very important for studying the distribution of arboviruses.The surveys have shown that group B arboviruses (principally all four types of dengue, Japanese encephalitis, and West Nile) are widely prevalent. Dengue and Japanese encephalitis viruses are more widespread than West Nile virus, which was not known previously to extend east of India although recent survyes have shown that its range extends to Burma. Japanese encephalitis is frequent in most of South-East Asia but in India is found mainly in eastern and south-eastern parts of the country. Kyasanur Forest disease (KFD) and Langat viruses are the only tick-borne group B arboviruses definitely known to occur in the region, the former in India, the latter in Malaysia. KFD virus has been isolated only from a small focus in Mysore, although human and animal sera containing neutralizing antibodies to this virus have been found sporadically in widely scattered areas. Among the group A arboviruses, chikungunya and Sindbis have been detected in serological surveys, but the former has not yet been found in Malaysia.
A simple device for circumcision

Lazim TR, Zainol J

J R Coll Surg Edinb, 1996 Apr;41(2):122-3.
PMID: 8632386

Several sizes of plastic cap were designed and made to fit the vertex of the penile glans. The foreskin is prepared in the usual manner, the glans capped with the specially made plastic cap and the foreskin pulled forwards over the cap. A crushing or non-crushing forceps is applied across the foreskin. The plastic cap separates the glans from the clamp, and its unwanted portion is cut with a knife without fear of injuries in the glans. We find this method to be safe even if it is used by a surgeon with limited experience.
Maturation of the adrenal medulla--IV. Effects of morphine

Anderson TR, Slotkin TA

Biochem Pharmacol, 1975 Aug 15;24(16):1469-74.
PMID: 7
Calanolides, the naturally occurring anti-HIV agents

Xu ZQ, Flavin MT, Jenta TR

Curr Opin Drug Discov Devel, 2000 Mar;3(2):155-66.
PMID: 19649847

Both naturally occurring and semi-synthetic calanolide compounds are potent anti-human immunodeficiency virus (HIV) agents. In fresh human cells, they are highly effective inhibitors against low passage clinical virus strains, including those representative of the various HIV-1 clade strains (A through F), syncytium-inducing (SI) and non-syncytium-inducing (NSI) isolates, and T-tropic and monocyte-tropic isolates. These compounds also exhibit an enhanced antiviral activity against one of the most prevalent non-nucleoside reverse transcriptase inhibitor (NNRTI)-resistant viruses that is engendered by the Y181C amino acid change in reverse transcriptase (RT). Further enhancement of activity is observed with RTs that possess the Y181C change together with AZT-resistant mutations. Moreover, when challenged with viruses containing Y181C and K103N dual mutations, calanolide compounds remain active. These dual mutations are highly resistant to all approved NNRTIs (eg, delavirdine, nevirapine and efavirenz). In cell culture assays, calanolide compounds, especially (+)-calanolide A, select primarily resistant viruses possessing the T139I amino acid change. This mutation appears to be unique to calanolides since it remains susceptible to other NNRTIs. Synergistic effects are observed in both cultured cells and animal models when calanolides are used in combination with other anti-HIV agents. Enzymatic analyses indicate that calanolides inhibit HIV-1 RT through a mechanism that affects both the Km for normal substrate dTTP and the Vmax, resulting in a mixed-type inhibition, which is different from that of other known NNRTIs. Two possible binding modes/sites at the HIV-1 RT enzyme have been suggested for (+)-calanolide A. Taken together, the calanolide compounds represent a novel and distinct subgroup of the NNRTI family and inclusion of a calanolide in a combination therapy may be clinically beneficial. Of particular interest is the use of calanolide in the treatment of patients who have failed other NNRTI therapy and developed the Y181C mutation or the Y181C/K103N dual mutations. Currently, (+)-calanolide A, the most potent in the series of calanolide compounds, is undergoing clinical investigation for safety and efficacy in HIV-infected individuals.
An evaluation of accelerated Portland cement as a restorative material

Abdullah D, Ford TR, Papaioannou S, Nicholson J, McDonald F

Biomaterials, 2002 Oct;23(19):4001-10.
PMID: 12162333

Biocompatibility of two variants of accelerated Portland cement (APC) were investigated in vitro by observing the cytomorphology of SaOS-2 osteosarcoma cells in the presence of test materials and the effect of these materials on the expression of markers of bone remodelling. Glass ionomer cement (GIC), mineral trioxide aggregate (MTA) and unmodified Portland cement (RC) were used for comparison. A direct contact assay was undertaken in four samples of each test material, collected at 12, 24, 48 and 72 h. Cell morphology was observed using scanning electron microscopy (SEM) and scored. Culture media were collected for cytokine quantification using enzyme-linked immunosorbent assay (ELISA). On SEM evaluation, healthy SaOS-2 cells were found adhering onto the surfaces of APC variant, RC and MTA. In contrast, rounded and dying cells were observed on GIC. Using ELISA, levels of interleukin (IL)-1beta, IL-6, IL-18 and OC were significantly higher in APC variants compared with controls and GIC (p<0.01), but these levels of cytokines were not statistically significant compared with MTA. The results of this study provide evidence that both APC variants are non-toxic and may have potential to promote bone healing. Further development of APC is indicated to produce a viable dental restorative material and possibly a material for orthopaedic
Fulltext Splenorrhaphy: omental pouch

Lazim TR, Salleh M, Bakar AS

Med J Malaysia, 1995 Jun;50(2):145-9.
PMID: 7565184

This work studies the efficacy of an autogenous viable omental pouch as a means of splenorrhaphy for saving the traumatised spleen. One sheep and 9 goat spleens were mobilised and their vascular pedicles clamped. All spleens were subjected to AAST grade IV trauma. The injured spleens were put into omental pouches and manual pressure was applied for 10 minutes after removal of the vascular clamp. Bleeding was controlled in 8 animals which became fully active 12-36 hours postoperatively. Two animals died, one due to aspiration of gastric contents during surgery and the other due to bleeding 24 hours postoperatively. All remaining spleens were harvested after 6 weeks. They were surrounded by a fibrous capsule and the previously inflicted injuries were easily identifiable. Viable omental pouch based on left epiploic vascular pedicle offers itself as a good autogenous alternative other methods used for saving the injured spleen. This method has been used in two humans so far.
Fulltext Dopa responsive dystonia with diurnal fluctuation (Segawa's syndrome)

Ong LC, Tang SF, Lal TR

Med J Malaysia, 1994 Jun;49(2):176-8.
PMID: 8090100

A 10-year-old girl presented with progressive dystonia with diurnal fluctuation. Response to low dose L-Dopa was dramatic and sustained with no complications. Recurrence of symptoms was observed on attempted withdrawal. Because of the dramatic response to therapy, dopa-responsive dystonia must be considered in the differential diagnosis of disorders presenting as gait disorders in childhood.
Effect of copper and cadmium on three Malaysian tropical estuarine invertebrate larvae

Ramachandran S, Patel TR, Colbo MH

Ecotoxicol Environ Saf, 1997 Mar;36(2):183-8.
PMID: 9126437

Three species of tropical estuarine invertebrates were exposed to copper sulfate and cadmium chloride to investigate their potential as test specimens for sediment toxicity assays in the South-east Asian regions. The larvae of the reef sea urchin (Diadema setosum), the oyster (Crassostrea iradalei), and the mud crab (Scylla seratta Forskall) were used in the 48-hr assays with copper and cadmium as reference toxicants. In addition the sea urchin were tested for end point measurements at different stages of the larval development and a 60-min sperm bioassay. The study revealed that the sea urchin first cleavage, which is an assay end point and which takes place about 1 hr after fertilization, was the most sensitive stage for both toxicants, with copper being more toxic than cadmium. Sensitivity comparisons between the three invertebrate larvae revealed the mud crab zoea larvae to be most sensitive for cadmium with an LC50 value of 0.078 microgram/ml, while the sea urchin was more sensitive for copper, with EC50 values of 0.01 microgram/ml at the first cleavage stage and 0.04 microgram/ml at the pluteus larva stage. All the invertebrates tested gave responses that made them suitable test organisms for metal bioassays in the tropical estuarine environment.
Gastric phycomycosis: report of a case in Malaysia

Ahluwalia HS, Lie KJ, Arulambalam TR

J Trop Med Hyg, 1974 May;77(5):116-8.
PMID: 4835327
Effectiveness of health education module on work safety culture in improving knowledge, attitudes and practices: a cluster randomized controlled trial among public sector administrative workers in Nigeria

Odu JO, Hamedon TR, Mahmud A, Baharudin R

Med J Malaysia, 2023 May;78(3):308-317.
PMID: 37271840

INTRODUCTION: Studies have shown that a workplace safety culture (WSC) is lacking among the general workforce in Nigeria. Poor WSC can adversely impact workers' health and high remedial costs for employers. To improve WSC, workers need to improve related knowledge, attitude, and practices (KAP) towards WSC through effective health interventional programs at the workplace. The main objective of this study is to develop, implement and evaluate the effectiveness of the Work Safety Culture Health Education Module (WSCHEM). The specific goals are to improve KAP related to office ergonomics towards WSC among public sector administrative workers in Abeokuta, Nigeria MATERIALS AND METHODS: The study was a two-armed, singleblinded cluster randomised controlled trial (CRCT) involving 247 public sector administrative workers from clusters of 20 ministries in Abeokuta, Southwestern Nigeria. The intervention group was given WSCHEM, whereas the waitlist group received a seminar on team building and leadership skills and received the WSCHEM after the intervention program ended. The evaluation was done three times using the first formal validated, self-administered Work Safety Culture Questionnaire (WSCQ) among the administrative workers: first at baseline, second at 1 month, and third at 3 months post-intervention.
RESULT: The results showed no statistically significant differences between groups regarding the respondents' characteristics (socio-demographic and occupational/officerelated ergonomic factors) and the outcome variables KAP towards WSC at baseline. For practices towards WSC, both intervention (β 6.8, 95%CI 4.85, 8.72) and time (β 6.2, 95%CI 4.49, 7.94) significantly improved the respondents' practices towards WSC in the per-protocol analysis. In the secondary outcomes, both knowledge of WSC, intervention (β 3.5, 95%CI 2.8, 4.2) and time (β 3.4, 95%CI 2.7, 5.9); and attitudes towards WSC, intervention (β1.7, 95%CI 1.25, 2.23) and time (β 2.3, 95%CI 1.92, 2.76) significantly improved the respondents' level of knowledge and attitudes respectively towards WSC.
CONCLUSION: The intervention, WSCHEM, was effective in improving the administrative workers' KAP towards WSC, as demonstrated by the significance between and within-group differences.
CKD-CHECK toolkit to improve doctors' practice in managing chronic kidney disease rapid progressors: a pilot study in primary care setting

Ang WS, Jamil TR, Kamaludin R, Mustafar R

Med J Malaysia, 2023 Nov;78(6):721-732.
PMID: 38031213

INTRODUCTION: Chronic kidney disease (CKD) rapid progression is associated with higher risk of end-stage kidney disease and higher mortality rate. Monitoring and recognition of CKD rapid progression is still lacking, however interventions have been shown to improve this. Thus, this study aimed to evaluate the acceptability and feasibility of CKD-CHECK toolkit and preliminary measure the outcome of the CKD-CHECK toolkit in assisting primary care doctor to order further tests for CKD rapid progressors and trigger appropriate nephrology referral.
MATERIALS AND METHODS: The CKD-CHECK (CKD-CHECK EGFR Chart in Kidney disease) is a toolkit that was developed to auto-generate patients' eGFR trend using a line graph, displaying the trend visually over a year. It identifies patients with rapid CKD progression, triggers the doctors to order appropriate tests (proteinuria quantification or renal imaging) and helps in decision making (continued monitoring at primary care level or referral to nephrologist). The toolkit was piloted among medical officers practising in a hospital-based primary care clinic treating patients with eGFR<60ml/min/1.73m2 using an interventional before-after study design from February to May 2022. In the preintervention period, the CKD patients were managed based on standard practice. The doctors then used the CKDCHECK toolkit on the same group of CKD patients during the intervention period. The feasibility and acceptability of the toolkit was assessed at the end of the study period using the Acceptability of Intervention Measure (AIM) and Feasibility of Intervention Measure (FIM) questionnaires. All patients' clinical data and referral rate were collected retrospectively through medical files and electronic data systems. Comparison between the pre- and post-intervention group were analysed using paired t-test and McNemar test, with statistical significance p value of <0.05.
RESULTS: A total of 25 medical officers used the toolkit on 60 CKD patients. The medical officers found the CKD-CHECK toolkit to be highly acceptable and feasible in primary care setting. The baseline characteristics of the patients were a mean age of 72 years old, predominantly females and Chinese ethnicity. Majority of the CKD patients had diabetes mellitus, hypertension and dyslipidemia. The numbers of CKD rapid progressors was similar (26.7% in the preintervention group vs 33.3% in the post-intervention group). There were no significant differences in terms of proteinuria assessment and ultrasound kidney for CKD rapid progressors before and after the intervention. However, a significant number of CKD rapid progressors were referred to nephrologists after the use of CKD-CHECK toolkit (p=0.016).
CONCLUSIONS: CKD-CHECK toolkit is acceptable and feasible to be used in primary care. Preliminary findings show that the CKD-CHECK toolkit improved the primary care doctor's referral of rapid CKD progressors to nephrologists.
A case of gastric phycomycosis in Malaysia

Ahluwalia HS, Lie Kian Joe, Arulambalam TR

Southeast Asian J Trop Med Public Health, 1973 Jun;4(2):280.
PMID: 4749089
Fulltext Experimental study on tsunami risk reduction on coastal building fronted by sea wall

Rahman S, Akib S, Khan MT, Shirazi SM

ScientificWorldJournal, 2014;2014:729357.
PMID: 24790578 DOI: 10.1155/2014/729357

This experimental study was conducted to idealize the efficacy of sea wall in controlling the tsunami forces on onshore structures. Different types of sea walls were placed in front of the building model. The tsunami forces and the wave heights were measured with and without the sea wall conditions. Types of sea wall, wall height, and wall positions were varied simultaneously to quantify the force reductions. Maximum of 41% forces was reduced by higher sea wall, positioned closer proximity to the model whereas this reduction was about 27% when the wall height was half of the high wall. Experimental investigations revealed that wall with adequate height and placed closer to the structures enables a satisfactory predictor of the force reduction on onshore structures. Another set of tests were performed with perforated wall placing near the building model. Less construction cost makes the provision of perforated sea wall interesting. The overall results showed that the efficacy of perforated wall is almost similar to solid wall. Hence, it can be efficiently used instead of solid wall. Moreover, overtopped water that is stuck behind the wall is readily gone back to the sea through perforations releasing additional forces on the nearby structures.
The incidence and use of Oryctes virus for control of rhinoceros beetle in oil palm plantations in Malaysia

Ramle M, Wahid MB, Norman K, Glare TR, Jackson TA

J Invertebr Pathol, 2005 May;89(1):85-90.
PMID: 16039309

The rhinoceros beetle, Oryctes rhinoceros, has emerged as a serious pest of oil palm since the prohibition of burning as a method for maintaining estate hygiene in the 1990s. The abundance of beetles is surprising given that the Malay peninsula was the site of first discovery of the Oryctes virus, which has been used to effect good as a biological control agent in other regions. A survey of adult beetles was carried out throughout Malaysia using pheromone traps. Captured beetles were examined for presence of virus using both visual/microscopic examination and PCR detection methods. The survey indicated that Oryctes virus was common in Malaysia among the adult beetles. Viral DNA analysis was carried out after restriction with HindIII enzyme and indicated at least three distinct viral genotypes. Bioassays were used to compare the viral strains and demonstrate that one strain (type B) is the most virulent against both larvae and adults of the beetle. Virus type B has been cultured and released into healthy populations where another strain (type A) forms the natural background. Capture and examination of beetles from the release site and surrounding area has shown that the spread and persistence of the applied virus strain is accompanied by a reduction in palm frond damage.
Effectiveness of ultrasonic files in the disruption of root canal bacteria

Ahmad M, Pitt Ford TR, Crum LA, Wilson RF

Oral Surg. Oral Med. Oral Pathol., 1990 Sep;70(3):328-32.
PMID: 2216361

The physical mechanisms of ultrasound, namely cavitation and acoustic streaming, generated by the Enac-Osada ultrasonic unit were investigated for effectiveness in disrupting Streptococcus mitis. In addition, the bactericidal effect of ultrasound in the presence of 2.5% sodium hypochlorite was examined. Bacterial suspensions were irradiated directly with ultrasound in simulated root canals, and the viability of bacteria was examined after growth on a blood agar medium under anaerobic conditions at 37 degrees C for 5 days. The results indicated that ultrasound per se failed to disrupt bacteria but resulted in increases in the viable counts; the former was considered to be because of the lack of cavitation and the latter because of the dispersal effects of acoustic streaming. The 2.5% sodium hypochlorite solution demonstrated powerful bactericidal activity.
Fulltext Minimally Invasive Total Hip Arthroplasty in a Patient with Hereditary Multiple Exostoses: A Case Report

Santoso A, Utomo P, Im CJ, Park KS, Yoon TR

Malays Orthop J, 2018 Nov;12(3):53-56.
PMID: 30555649 DOI: 10.5704/MOJ.1811.010

Hip geometry abnormalities found in patients with hereditary multiple exostoses (HME) could promote premature hip joint degeneration which needs treatment. We report the case of a 45-year old male with right hip arthrosis who underwent two-incision minimally invasive (MIS-2) total hip arthroplasty (THA), with satisfactory outcome. This technique could be an alternative approach for performing THA in patients with hereditary multiple exostoses.
Severe acute respiratory syndrome-Coronavirus-2 infection: A review of the clinical-pathological correlations of Coronavirus disease-19 in children

Teo JTR, Abidin NH, Cheah FC

Malays J Pathol, 2020 12;42(3):349-361.
PMID: 33361715

The coronavirus disease-19 (COVID-19) has become a global pandemic of acute respiratory disease in just less than a year by the middle of 2020. This disease caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has resulted in significant mortality especially among the older age population and those with health co-morbidities. In contrast, children are relatively spared of this potentially ravaging disease that culminates in the acute respiratory distress syndrome, multi-organ failure and death. SARS-CoV-2 infection induces exuberant release of pro-inflammatory mediators, causing a "cytokine storm" and hypercoagulable states that underlie these complications. The SARS-CoV-2 infection median incubation is 5.1 days, with most developing symptoms by 11.5 days. It is highly infectious, spreading via the horizontal mode of transmission, but there is yet very limited evidence of vertical transmission to the newborn infant occurring either transplacentally or through breastfeeding. This said, various immune factors during childhood may modulate the expression of COVID-19, with the multisystem inflammatory syndrome in children (MIS-C) at the severe end of the disease spectrum. This article gives an overview of the SARS-CoV-2 infection, clinical presentation and laboratory tests of COVID-19 and correlating with the current understanding of the pathological basis of this disease in the paediatric population.
Fulltext Barriers and strategies to improve influenza vaccination in Pakistan

Farrukh MJ, Ming LC, Zaidi STR, Khan TM

J Infect Public Health, 2017 Nov-Dec;10(6):881-883.
PMID: 28185822 DOI: 10.1016/j.jiph.2016.11.021

Influenza vaccination is strongly recommended by World Health Organisation on a yearly basis. The rate of immunization in Pakistan is suboptimal. High cost, traditional norms, customs and low levels of education in Pakistan are preventing people from getting vaccinated. It is timely to include influenza vaccination in the expanded programme on immunization (EPI), which is a disease prevention programme aiming to eradicate preventable diseases through subsidized or free immunization. The Ministry of National Health Services, Regulation and Coordination, Government of Pakistan should launch a national influenza vaccine policy in view of this current situation and oversee its implementation. Healthcare professionals should promote influenza vaccination and focus on high risk groups such as the elderly, pregnant women and children. Convincing and educating family members regarding immunization of pregnant women and follow-up with parents regarding a second influenza shot for their children will further improve vaccination rates in Pakistan.
Formate assay in body fluids: application in methanol poisoning

Makar AB, McMartin KE, Palese M, Tephly TR

Biochem Med, 1975 Jun;13(2):117-26.
PMID: 1
Fulltext Migratory Bone Marrow Edema Syndrome of the Hips: A Case Report

Santoso A, Ingale PS, Park KS, Yoon TR

Malays Orthop J, 2017 Nov;11(3):56-58.
PMID: 29326770 DOI: 10.5704/MOJ.1711.006

Migratory bone marrow edema syndrome (BMES) of the hip is a rare entity. We report the case of a 41-year old male with migratory BMES of the hip with eight months interval period between onset of the pain and consultation. This patient was successfully treated non-surgically. It is important to always inform the patient with unilateral BMES of the hip regarding the possibility of future involvement of the contralateral hip.

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