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1.  Prevalence of Abnormal Glucose Tolerance and Risk Factors in Urban and Rural Malaysia 
Diabetes Care  2011;34(6):1362-1364.
To determine the prevalence of prediabetes and diabetes among rural and urban Malaysians.
This cross-sectional survey was conducted among 3,879 Malaysian adults (1,335 men and 2,544 women). All subjects underwent the 75-g oral glucose tolerance test (OGTT).
The overall prevalence of prediabetes was 22.1% (30.2% in men and 69.8% in women). Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were found in 3.4 and 16.1% of the study population, respectively, whereas 2.6% of the subjects had both IFG and IGT. Based on an OGTT, the prevalence of newly diagnosed type 2 diabetes was 12.6% (31.0% in men and 69.0% in women). The prediabetic subjects also had an increased prevalence of cardiovascular disease risk factors.
The large proportion of undiagnosed cases of prediabetes and diabetes reflects the lack of public awareness of the disease.
PMCID: PMC3114358  PMID: 21498788
3.  Monocyte chemoattractant protein-1: a proinflammatory cytokine elevated in sarcopenic obesity 
Sarcopenic obesity (SO) is associated with poorer physical outcomes and functional status in the older adult. A proinflammatory milieu associated with central obesity is postulated to enhance muscle catabolism. We set out to examine associations of the chemokine monocyte chemoattractant protein-1 (MCP-1) in groups of older adults, with sarcopenia, obesity, and the SO phenotypes.
A total of 143 community dwelling, well, older adults were recruited. Cross-sectional clinical data, physical performance, and muscle mass measurements were collected. Obesity and sarcopenia were defined using revised National Cholesterol Education Program (NCEP) obesity guidelines and those of the Asian Working Group for Sarcopenia. Serum levels of MCP-1 were measured by enzyme-linked immunosorbent assay (ELISA).
In all, 25.2% of subjects were normal, 15.4% sarcopenic, 48.3% obese, and 11.2% were SO. The SO groups had the lowest appendicular lean mass, highest percentage body fat, and lowest performance scores on the Short Physical Performance Battery and grip strength. The MCP-1 levels were significantly different, with the highest levels found in SO participants (P<0.05).
Significantly raised MCP-1 levels in obese and SO subjects support the theory of chronic inflammation due to excess adiposity. Longitudinal studies will reveal whether SO represents a continuum of obesity causing accelerated sarcopenia and cardiovascular events, or the coexistence of two separate conditions with synergistic effects affecting functional performance.
PMCID: PMC4378871  PMID: 25848236
chemokine C-C motif ligand 2 (CCL-2); elderly; sarcopenia
5.  Genetic Variation among African Swine Fever Genotype II Viruses, Eastern and Central Europe 
Emerging Infectious Diseases  2014;20(9):1544-1547.
African swine fever virus (ASFV) was first reported in eastern Europe/Eurasia in 2007. Continued spread of ASFV has placed central European countries at risk, and in 2014, ASFV was detected in Lithuania and Poland. Sequencing showed the isolates are identical to a 2013 ASFV from Belarus but differ from ASFV isolated in Georgia in 2007.
PMCID: PMC4178389  PMID: 25148518
African swine fever; genotype II; intergenic regions; genetic variability
6.  Plasma Concentrations of Isoniazid and Rifampin Are Decreased in Adult Pulmonary Tuberculosis Patients with Diabetes Mellitus 
Antimicrobial Agents and Chemotherapy  2013;57(11):5740-5742.
Plasma isoniazid and rifampin concentrations, but not pyrazinamide and ethambutol concentrations, were decreased by about 50% (P < 0.05) in diabetic pulmonary tuberculosis patients. The prevalences of subnormal plasma isoniazid, rifampin, pyrazinamide, and ethambutol concentrations were 49% or 100% (P < 0.01), 66% or 100% (P < 0.05), 30% or 50% (P = 0.198), and 32% or 21% (P = 0.742) in nondiabetic or diabetic tuberculosis patients, respectively. These data show that plasma concentrations of isoniazid and rifampin were greatly reduced in diabetic tuberculosis patients.
PMCID: PMC3811326  PMID: 23979746
7.  Green Fluorescent Diamidines as Diagnostic Probes for Trypanosomes 
Light-emitting diode (LED) fluorescence microscopy offers potential benefits in the diagnosis of human African trypanosomiasis and in other aspects of diseases management, such as detection of drug-resistant strains. To advance such approaches, reliable and specific fluorescent markers to stain parasites in human fluids are needed. Here we describe a series of novel green fluorescent diamidines and their suitability as probes with which to stain trypanosomes.
PMCID: PMC3957857  PMID: 24366732
8.  Evaluation of the Potentials of Autologous Blood Injection for Healing in Diabetic Foot Ulcers 
Healing is a complex multifactorial process, hence it is not easy to be studied accurately. In this paper we tried to demonstrate the potentials of application of autologous blood by injection into the raw areas and ulcers of three diabetic patients using their blood as an alternative to synthesized and cultured stem cells or growth factors. It was found that a natural easily obtained blood can be used to enrich the media of the wound. Also it was applicable in relation to its cost–effectiveness as well as availability. The healing process was accelerated in the injected side more than the non-injected one.
PMCID: PMC3921244  PMID: 24527383
Autologous blood; Blood injection; Healing; Diabetic ulcers
10.  Draft Genome Sequence of a Clinical Isolate of Mycobacterium tuberculosis Strain PR05 
Genome Announcements  2013;1(3):e00397-13.
We report the annotated genome sequence of a clinical isolate, Mycobacterium tuberculosis strain PR05, which was isolated from the human cerebrospinal fluid of a patient diagnosed with tuberculosis.
PMCID: PMC3707602  PMID: 23788553
11.  A rare cause of deep peroneal nerve palsy due to compression of synovial cyst – Case report 
Synovial cyst is a rare cause of compression neuropathy and its differential diagnosis can be misleading.
This article presents clinical, radiological, and histological findings of deep peroneal nerve palsy due to compression of a synovial cyst in a 30-year-old patient admitted with sudden drop foot.
Focal nerve entrapment in lower extremity due to synovial cystis a rare entity. Differential diagnosis is important. Surgical excision is the main treatment method with high success rate.
Synovial cyst compression which can be treated easily with surgical excision should be considered in rapidly progressed drop foot.
PMCID: PMC3731734  PMID: 23567545
Synovial cyst; Peroneal nerve; Compression; Neuropathy
12.  Multidrug-Resistant Tuberculosis, Somalia, 2010–2011 
Emerging Infectious Diseases  2013;19(3):478-480.
In a nationwide survey in 2011, multidrug-resistant tuberculosis (MDR TB) was found in 5.2% and 40.8% of patients with new and previously treated TB, respectively. These levels of drug resistance are among the highest ever documented in Africa and the Middle East. This finding presents a serious challenge for TB control in Somalia.
PMCID: PMC3647667  PMID: 23621911
Mycobacterium tuberculosis and other mycobacteria; drug resistance; surveillance; Somalia
13.  Oxidative Stress in Vivax Malaria 
Malaria is still a leading cause of morbidity and mortality. The increase in lipid peroxidation reported in malaria infection and antioxidant status may be a useful marker of oxidative stress during malaria infection. The aim of this study was to investigate the role of antioxidant enzymes against toxic reactive oxygen species in patients infected with Plasmodium vivax and healthy controls. Malondialdehyde levels, superoxide dismutase, and glutathione peroxidase activities were determined in 91 P. vivax patients and compared with 52 controls. Malondialdehyde levels, superoxide dismutase, and glutathione peroxidase activities were 8.07±2.29 nM/ml, 2.69±0.33 U/ml, and 49.6±3.2 U/g Hb in the patient group and 2.72±0.50 nM/ml, 3.71±0.47 U/ml, and 62.3±4.3 U/g Hb in the control group, respectively. Malondialdehyde levels were found statistically significant in patients with vivax malaria higher than in healthy controls (P<0.001). On the other hand, superoxide dismutase and glutathione peroxidase activities were found to be significantly lower in vivax malaria patients than in controls (P<0.05). There was an increase in oxidative stress in vivax malaria. The results suggested that antioxidant defense mechanisms may play an important role in the pathogenesis of P. vivax.
PMCID: PMC3514434  PMID: 23230340
Plasmodium vivax; malondialdehyde; superoxide dismutase; glutathione peroxidase; malaria
14.  Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia 
Oman Medical Journal  2012;27(6):505-508.
In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients’ knowledge and perception regarding the used of NSAIDS.
A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient’s knowledge and perception on the side effects of NSAIDs were recorded.
Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once.
This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.
PMCID: PMC3515043  PMID: 23226825
NSAIDs; Knowledge; Side effects; Rheumatology
15.  Thoracic Computed Tomography Findings in Malignant Mesothelioma 
Iranian Journal of Radiology  2012;9(4):209-211.
Malignant pleural mesothelioma (MPM) is an uncommon neoplasm. MPM occurs more frequently in patients born or living in certain villages of Turkey.
We aimed to review radiological findings of MPM.
Patients and Methods
We reviewed the CT findings in 219 biopsy-proven MPM patients admitted to our clinic between 1993 and 2008.
The most common CT findings included pleural thickening (n=197, 90%) classified as diffuse (n=138, 63%), nodular (n=49, 22%) and mass-type (n=16, 7%). Pleural effusion was found in 173 patients (79%), involvement of the interlobar fissures in 159 (73%), mediastinal pleural involvement in 170 (78%), volume contraction in 142 (65%), mediastinal shift in 102 (47%) and mediastinal lymphadenopathy in 54 (25%).
MPM may present with diverse radiological features. Pleural thickening and pleural effusion were the most frequent radiological findings. Thoracic CT scans might be assessed more cautiously in patients with environmental exposure to asbestos.
PMCID: PMC3569553  PMID: 23407863
Asbestos; Tomography; X-Ray Computed; Mesothelioma; Cystic; Thorax
16.  Possible Laboratory Contamination Leads to Incorrect Reporting of Vibrio cholerae O1 and Initiates an Outbreak Response 
Journal of Clinical Microbiology  2012;50(2):480-482.
Vibrio cholerae O1 in a river water specimen in South Africa was reported, and a public health response followed in order to prevent an outbreak. Further investigation determined this to be a pseudoalert of V. cholerae O1, possibly linked to laboratory contamination. Following culture of bacteria from the water specimen, the testing laboratory possibly contaminated the culture with a V. cholerae O1 reference strain and then mistakenly reported isolation of V. cholerae O1.
PMCID: PMC3264189  PMID: 22162543
17.  Genetic Characterization of Multidrug-Resistant, Extended-Spectrum- β-Lactamase-Producing Vibrio cholerae O1 Outbreak Strains, Mpumalanga, South Africa, 2008 ▿ †  
Journal of Clinical Microbiology  2011;49(8):2976-2979.
Thirty-one antimicrobial-resistant, extended-spectrum-β-lactamase-producing strains of Vibrio cholerae O1 serotype Ogawa associated with an outbreak of cholera in South Africa (2008) were investigated. Ten selected cholera strains were PCR positive for the SXT element, harbored mutations in the quinolone resistance-determining regions of GyrA (Ser83-Ile) and ParC (Ser85-Leu), and produced TEM-63 β-lactamase.
PMCID: PMC3147719  PMID: 21653763
18.  Extragastrointestinal Stromal Tumor (EGIST) in the abdominal wall: Case report and literature review 
Gastro Intestinal Stromal Tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract (GI). GIST that arises primarily outside the GI tract is termed Extragastrointestinal Stromal Tumor (EGIST). To the best of our knowledge, few cases of EGIST in the abdominal wall were reported.
We present a rare case of EGIST in the abdominal wall of a 57 year-old female patient. The asymptomatic tumor was located in the superior aspect of the left rectus abdominis muscle, measured 5.4 × cm 5.3 × cm 6.9 cm and was well circumscribed. Histological examination showed an epithelioid cell morphology. The mitotic count was 7/50 HPFs. Immunohistochemistry showed diffuse strong CD117 positivity, focal positivity for S100. The tumor was excised and the margins were free of malignancy. The patient was doing well postoperatively and was discharged on STI-571 regimen.
Although GIST is the most common mesenchymal tumor of the gastrointestinal tract, a case with EGIST in the abdominal wall is rare. Positive immunohistochemical staining for CD117 is a defining feature of GISTs. A great percentage of EGISTs represent a metastasis from a primary GIST. In our case, the clinical and diagnostic work-up have been proved it to be an EGIST.
The existing data on EGIST is insufficient to make a final conclusion regarding the malignant potential and clinicopathological factors of EGISTs that determine patient prognosis. Thus a follow-up for a long period is required. EGISTs should be kept in mind in the differential diagnosis for patients presenting with solid mass of the abdominal wall.
PMCID: PMC3215203  PMID: 22096744
GIST; EGIST; Abdominal wall mass; CD117
19.  Post-biopsy renal allograft compartment syndrome: Addressing the problem, illustrated with a case report 
Renal allograft compartment syndrome (RACS) has recently been coined to describe early allograft dysfunction secondary to raised pressure in the retroperitoneal space. This may be caused by direct compression of the renal vessels or by a diffuse renal parenchymal compression. Herein, we report a renal allograft compartment syndrome secondary to a needle core transplant biopsy and discuss the management strategies in line with an updated literature review.
Presentation of Case
A retrospective case-note review was carried out where a 45-year-old male had a transplant renal biopsy at 4-weeks after transplant for raising creatinine. Following biopsy patient developed abdominal discomfort and had haematuria.
Doppler ultrasound scanning of graft demonstrated good perfusion but a small haematoma (2 × 2 × 2 cm) in the upper pole of the kidney at the site of the biopsy. Patient was thereafter assessed conservatively with serial ultrasound monitoring. After 24 h, significant deterioration of graft function was observed. The third scan, demonstrated reversed flow in diastole in the upper pole of the kidney with a resistive index of 1.0 in the main renal vessel. With the above findings the kidney transplant was explored immediately and the transplant released from a 300 ml of liquefied haematoma, which was under considerable pressure. In the next 24-h, the patient showed an immediate return of graft function.
We recommend sequential ultrasound Doppler scanning as an invaluable tool to help identify early RACS. The surgical exploration and adequate heamostasis with surgical glue should be sought out in all RACS.
PMCID: PMC3199704  PMID: 22096723
Kidney; Allograft; Compartment syndrome; Transplantation
20.  Characteristics of Children Hospitalized for Pandemic (H1N1) 2009, Malaysia 
Emerging Infectious Diseases  2011;17(4):708-710.
To determine effects of pandemic (H1N1) 2009 on children in the tropics, we examined characteristics of children hospitalized for this disease in Malaysia. Of 1,362 children, 51 (3.7%) died, 46 of whom were in an intensive care unit. Although disease was usually mild, >1 concurrent conditions were associated with higher death rates.
PMCID: PMC3377409  PMID: 21470467
Children; Malaysia; tropical; hospitalized; co-morbidities; death; influenza; viruses; pandemic (H1N1) 2009; dispatch
21.  Intestinal Parasite Infections in Pigs and Beef Cattle in Rural Areas of Chungcheongnam-do, Korea 
The present study was performed to investigate the infection status of intestinal parasites in pigs and beef cattle in rural areas of Chungcheongnam-do, Korea. From November 2009 to April 2010, a total of 241 fecal samples of pigs and beef cattle (136 and 105, respectively) were examined by direct smear and centrifugal sedimentation methods. The overall positive rates of intestinal parasites among pigs and beef cattle were 73.5% and 4.8%, respectively, and the double-infection rate was 10.3% in pigs. Of 136 specimens from pigs, Balantidium coli, Ascaris suum, and Entamoeba spp. infections were found in 88 (64.7%), 24 (17.6%), and 5 cases (3.7%), respectively. Of 105 beef cattle, Entamoeba spp. infections were detected in 5 cases (4.8%). From these results, it is shown that pigs raised on rural farms in Chungcheongnam-do had a high B. coli infection rate and a moderate A. suum infection rate. These results demonstrate that environmentally resistant cysts or eggs could be widespread on the farms examined, and thus an effective hygienic management system is needed to prevent them from serving as the source of infection for human beings.
PMCID: PMC3018588  PMID: 21234241
prevalence; intestinal parasites; beef cattle; pigs
23.  Naphthaquinones of Alkanna Orientalis (L.) BOISS 
The roots of Alkanna orientalis (L.) Boiss yielded α- methyl-n-butyl alkannin (compound 1) and alkannin acetate (compound 2). The compounds were identified by UV, MS, 1H NMR and 13C NMR. Quantitative determination of α- methyl-n-butyl alkannin and alkannin acetate in Alkanna orientalis (L) Boiss roots was established by TLC densitometry.
PMCID: PMC2816436  PMID: 20162072
Alkanna orientalis; naphthaquinones; NMR; α- methyl-n-butyl alkannin; alkannin acetate; TLC densitometry
24.  Reported chemical sensitivities in a health survey of United Kingdon military personnel 
Method: Cross sectional postal survey of three cohorts of United Kingdom military personnel comprising Gulf veterans (n=3531), those who had served in Bosnia (n=2050), and those serving during the Gulf war but not deployed there (Era cohort, n=2614).
Results: Sensitivity to at least one everyday chemical was reported by a considerable proportion of all three cohorts, and particularly by veterans of the Gulf war (Era: 14%; Bosnia: 13%; Gulf: 28%).
Conclusion: Reported chemical sensitivities were common in all three military cohorts. Our understanding of chemical sensitivities remains limited and objective evidence for a causal link between low level exposures to chemicals and reported symptoms is lacking. Given their frequency in the population, further work in this area is necessary.
PMCID: PMC1763621  PMID: 11886951
25.  An unusually aggressive case of endometriosis showing p53 expression 
Journal of Clinical Pathology  2001;54(5):396-398.
A 43 year old woman who underwent a hysterectomy and bilateral salpingo-oophorectomy for secondary dysmenorrhoea was found to have bilateral ovarian endometriosis. During the following four years she developed a series of tumour-like vaginal masses, which were locally excised, a pelvic mass causing acute large bowel obstruction, which necessitated an emergency Hartmann's procedure, and a further pelvic mass causing hydronephrosis with a non-functioning kidney. Pathological examination of all the resected specimens showed endometriosis with abundant stromal and glandular elements. Immunoreactivity for p53 protein was detected within endometriotic foci from the initial oophorectomy as well as the latest resection specimens. Immunostaining for p53 may help identify potentially aggressive cases of endometriosis for proactive treatment.
Key Words: endometriosis • p53 • immunocytochemistry
PMCID: PMC1731432  PMID: 11328841

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