MyMedR

Fulltext Reactive arthritis accompanying sporotrichosis post cat scratch: a Malaysian case report

Jamallulail S.I., Wahinuddin S., Abdullah A.C.

Asian Journal of Medicine and Health Sciences, 2019;2(1):119-123.

MyJurnal

Sporotrichosis is a fungal infection caused by Sporothrix schenckii, a dimorphic fungus. Transmission of this infection is usually through contact with infected soil, decaying vegetation and plants as well as zoonotic inoculation such as cat scratches. We present an uncommon case of lymphocutaneous sporotrichosis accompanied by reactive arthritis in a 51-year-old woman due to a cat scratch in Malaysia.

Fulltext Intriguing manifestation of miliary tuberculosis - a case report

Wahinuddin S., Ainon M.M., Ng, E.K., Muhaini, O., Norraha A.R.

Asian Journal of Medicine and Health Sciences, 2019;2(1):113-118.

MyJurnal

This report is a case of a 24-year-old immunocompetent lady treated with anti-tuberculous drug for disseminated tuberculosis diagnosed by bone marrow finding. She presented with concurrent intracranial and intramedullary tuberculoma associated with tuberculous spondylodiscitis evidenced by serial magnetic resonance imaging (MRI) screening after a month of anti-tuberculous therapy. These complications are thought to be paradoxical effects of anti-tuberculous therapy. Symptoms resolved with continuation of anti-tuberculous treatment and a course of corticosteroid.

Ewing's Sarcoma Mimicking Tuberculosis - A Case Report

Shalini B, Wahinuddin S, Monniaty M, Rosemi S

Malays J Med Sci, 2002 Jan;9(1):52-4.

PMID: 22969319

A 13-year old Malay school girl who had been apparently normal previously, presented with a three-month history of fever, malaise and loss of weight. She had anemia and raised values for ESR, lactic dehydrogenase, C-reactive protein, ferritin and a positive mantoux test. Her routine chest x-ray showed hilar prominence suggestive of hilar lymph node enlargement. C.T. Scan of the thorax revealed a posterior mediastinal mass, the histopathology of which was suggestive of Ewing's sarcoma. The rarity of the location of the tumour and its unusual mode of presentation prompted us to report this case.

Fulltext Glibenclamide induced chronic cholestasis simulating primary biliary cirrhosis: a case report

Ramanathan M, Wahinuddin S, Kew ST

Med J Malaysia, 1996 Mar;51(1):140-3.

PMID: 10967995

A 43-year-old lady with long standing non-insulin dependent diabetes mellitus on glibenclamide presented with cholestatic liver disease. Initially she was thought to have developed primary biliary cirrhosis (PBC). When she made a spontaneous recovery following the withdrawal of glibenclamide, it became obvious that the patient had been suffering from drug-induced chronic cholestasis (DICC). The subtle differences between PBC and DICC are highlighted.

Fulltext Common manifestations of systemic lupus erythematosus in tertiary rheumatology centre, Perak

Wahinuddin S., Rashrina A.R., Muhammad Faiz M.S., Muhammad A.A., Abdullah A.C., Ong, P.S., et al.

Asian Journal of Medicine and Health Sciences, 2019;2(1):94-100.

MyJurnal

Objective. A hospital-based cross-sectional descriptive study documenting the common clinical manifestations of systemic lupus erythematosus (SLE) in a tertiary rheumatology center in the state of Perak in Malaysia. Method. The 1997 American College of Rheumatology classification revised criteria and the 2012 Systemic Lupus International Collaborating Clinic criteria were used and all patients attending the rheumatology clinic at a tertiary referral centre were included. The demographics and other clinical information were retrieved from patients’ outpatient clinical records.

Results. One-hundred SLE patients were included in this cross-sectional study, the majority of whom were of the Malay ethnic group (47%) followed by Chinese (41%) and Indians (12%). Almost 91% of the patients in our study were females. Mean age was 34.94 years (SD = 12.7; 95% confidence interval, 32.42 – 37.46), almost 79% were in the 20-50 years age group. Anti-nuclear antibody (ANA) was positive in 70% of patients while only 28% were positive for anti-double-stranded deoxyribonucleic antibody (dsDNA). Major clinical manifestations were hematological disorders (53%) followed by a malar rash (41%), photosensitivity (30%) and oral ulcers (27%).

Conclusion. Clinical phenotypes, demographics of SLE patients in this study shows no significant difference across age, gender, and ethnic groups. The current data, though limited, shows a high frequency of hematological and mucocutaneous manifestation in these patients.

Fulltext Abdominal tuberculosis: a presumptive diagnosis

Ramanathan M, Wahinuddin S, Safari E, Sellaiah SP

Singapore Med J, 1997 Sep;38(9):364-8.

PMID: 9407759

Abdominal tuberculosis (TB) is common. But the diagnosis of abdominal TB is fraught with difficulties as it is often not possible to get a microbiological confirmation of the infection. We therefore undertook this study to highlight those pertinent clinical and laboratory features which would enable one to make a provisional diagnosis of abdominal TB early, to pave way for a trial of anti-tuberculosis chemotherapy.

HLA-A, -B, -C, -DRB1 and -DQB1 alleles and haplotypes in 194 Southeast Asia Chinese from Peninsular Malaysia

Too CL, Tan LK, Heselynn H, Nor-Shuhaila S, Eashwary M, Wahinuddin S, et al.

Hum Immunol, 2019 Nov;80(11):906-907.

PMID: 31558331 DOI: 10.1016/j.humimm.2019.09.005

A total of 194 Southeast Asia Chinese from Peninsular Malaysia were genotyped for HLA-A, -B, -C -DRB1, and -DQB1 loci using polymerase chain reaction sequence-specific oligonucleotide probe hybridization methods. In this report, the HLA-B, HLA-DRB1 and HLA-DQB1 were in Hardy-Weinberg proportions (HWEP) (p > 0.05). We observed significant deviation from HWEP in HLA-A (p 

HLA-A, -B, -C, -DRB1 and -DQB1 alleles and haplotypes in 951 Southeast Asia Malays from Peninsular Malaysia

Tan LK, Mohd-Farid B, Salsabil S, Heselynn H, Wahinuddin S, Lau IS, et al.

Hum Immunol, 2016 Oct;77(10):818-819.

PMID: 27370684 DOI: 10.1016/j.humimm.2016.06.022

A total of 951 Southeast Asia Malays from Peninsular Malaysia were genotyped for HLA-A, -B, -C -DRB1, and -DQB1 loci using polymerase chain reaction sequence-specific oligonucleotide probe hybridization methods. In this report, there were significant deviation from Hardy-Weinberg proportions for the HLA-A (p<0.0001), -B (p<0.0001), -DRB1 (p<0.0001) and -DQB1 (p<0.01) loci. Minor deviations from HWEP were detected for HLA-C (p=0.01). This genotype data was available in Allele Frequencies Network Database (AFND) Gonzalez-Galarza et al. (2015).

Fulltext The spectrum of association in HLA region with rheumatoid arthritis in a diverse Asian population: evidence from the MyEIRA case-control study

Tan LK, Too CL, Diaz-Gallo LM, Wahinuddin S, Lau IS, Heselynn H, et al.

Arthritis Res Ther, 2021 01 30;23(1):46.

PMID: 33514426 DOI: 10.1186/s13075-021-02431-z

BACKGROUND: Fine-mapping of human leukocyte antigen (HLA) region for rheumatoid arthritis (RA) risk factors has identified several HLA alleles and its corresponding amino acid residues as independent signals (i.e., HLA-A, HLA-B, HLA-DPB1, and HLA-DQA1 genes), in addition to the well-established genetic factor in HLA-DRB1 gene. However, this was mainly performed in the Caucasian and East Asian populations, and data from different Asian regions is less represented. We aimed to evaluate whether there are independent RA risk variants in both anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative RA patients from the multi-ethnic Malaysian population, using the fine-mapping of HLA region strategy.

METHODS: We imputed the classical HLA alleles, amino acids, and haplotypes using the Immunochip genotyping data of 1260 RA cases (i.e., 530 Malays, 259 Chinese, 412 Indians, and 59 mixed ethnicities) and 1571 controls (i.e., 981 Malays, 205 Chinese, 297 Indians, and 87 mixed ethnicities) from the Malaysian Epidemiological Investigation of Rheumatoid Arthritis (MyEIRA) population-based case-control study. Stepwise logistic regression was performed to identify the independent genetic risk factors for RA within the HLA region.

RESULTS: We confirmed that the HLA-DRB1 amino acid at position 11 with valine residue conferred the strongest risk effect for ACPA-positive RA (OR = 4.26, 95% CI = 3.30-5.49, PGWAS = 7.22 × 10-29) in the Malays. Our study also revealed that HLA-DRB1 amino acid at position 96 with histidine residue was negatively associated with the risk of developing ACPA-positive RA in the Indians (OR = 0.48, 95% CI = 0.37-0.62, PGWAS = 2.58 × 10-08). Interestingly, we observed that HLA-DQB1*03:02 allele was inversely related to the risk of developing ACPA-positive RA in the Malays (OR = 0.17, 95% CI = 0.09-0.30, PGWAS = 1.60 × 10-09). No association was observed between the HLA variants and risk of developing ACPA-negative RA in any of the three major ethnic groups in Malaysia.

CONCLUSIONS: Our results demonstrate that the RA-associated genetic factors in the multi-ethnic Malaysian population are similar to those in the Caucasian population, despite significant differences in the genetic architecture of HLA region across populations. A novel and distinct independent association between the HLA-DQB1*03:02 allele and ACPA-positive RA was observed in the Malays. In common with the Caucasian population, there is little risk from HLA region for ACPA-negative RA.

HLA-A, -B, -C, -DRB1 and -DQB1 alleles and haplotypes in 271 Southeast Asia Indians from Peninsular Malaysia

Nurul-Aain AF, Tan LK, Heselynn H, Nor-Shuhaila S, Eashwary M, Wahinuddin S, et al.

Hum Immunol, 2020 Jun;81(6):263-264.

PMID: 32312605 DOI: 10.1016/j.humimm.2020.04.004

A total of 271 Southeast Asia Indians from Peninsular Malaysia were genotyped for HLA-A, -B, -C, -DRB1, and -DQB1 loci using polymerase chain reaction sequence-specific oligonucleotide probe hybridization methods. In this report, HLA-B and HLA-DQB1 was in Hardy-Weinberg proportions (HWEP) (p > 0.05). We observed significant deviation from the HWEP for HLA-A (p

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