IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Detection of FMS-Like Tyrosine Kinase 3 (FLT3) and Nucleophosmin 1 (NPM1) Mutations from Marrow Tissues in Patients with Acute Myeloid Leukaemia
Get PDFINTRODUCTION: Acute myeloid leukaemia is a haematological malignancy with diverse cytogenetic abnormalities and molecular mutations. Amongst the important mutations are FMS-related tyrosine kinase 3 (FLT3) and nucleophosmin 1 (NPM1) gene mutations. These mutations have been shown to be of prognostic significance. A cross-sectional study to examine the frequency of these mutations and their association with the haematological and cytogenetic characteristics of the cases was carried out in Kuantan, Pahang, Malaysia. MATERIALS AND METHODS: A total of 43 cases were included in the study. Polymerase chain reaction-based assays were employed for mutation detection from the retrieved trephine biopsy tissue blocks. Mutation positivity was subsequently validated by Sanger DNA sequencing. RESULTS: Six of the 43 cases (14.0%) of the acute myeloid leukaemia were positive for FLT3-type internal tandem duplications (FLT3-ITD) and a similar proportion (6/43, 14.0%) were positive for NPM1 mutations. FLT3 mutations at codon D835 (FLT3-D835) mutation was identified in three of the cases (7.0%) while concurrent mutations of NPM1 and FLT3-ITD were seen in two of the mutation-positive cases (4.7%). The total white cell count was found to be significantly higher in patients with FLT3 mutations (p=0.001). Other haematological parameters and the cytogenetic results did not reveal any significant association with the mutational status. CONCLUSION: The frequency of FLT3-ITD, FLT3-D835, and NPM1 mutations among AML patients were 14%, 7%, and 14% respectively. Follow-up studies to include the clinical parameters and the treatment outcomes are advocated
Spontaneous Rupture of Unscarred Uterus in Second Trimester Pregnancy Presented as Acute Appendicitis; An Unusual Obstetric Emergency and the Importance of Imaging in Suspected Acute Appendicitis in Pregnancy
No full textSpontaneous uterine rupture in an unscarred uterus in early trimester is very rare and difficult to diagnose. We reported a case of 28 years old lady at 15th week of gestation with three previous uneventful obstetrical history presented with one-day history of acute right iliac fossa pain and vomiting. She was subjected for an open appendectomy after an assessment by obstetric and surgical team which revealed ruptured of uterine fundal. She recovered well but she lost her pregnancy. Traditional management of acute appendicitis in pregnant patients is an early exploration. However recent studies showed that it was unpractical as the rate of pregnancies loss was two times with negative appendectomy compared to simple appendicitis; and almost as high as complicated appendicitis. All suspected appendicitis cases required ultrasound studies, and when the diagnosis is uncertain, further imaging such as computed tomography (CT) scan or magnetic resonance imaging is needed prior to surgery.
Brain Derived Neurotrophic Factor (BDNF) Gene in Peripheral Blood Cells of Stable Schizophrenia
Get PDFINTRODUCTION: Epigenetic mechanisms regulate gene functions without causing a change in the nucleotide sequence of DNA. Brain-derived neurotrophic factor (BDNF) is a neurotrophin that regulates synaptic transmission and plasticity and has an essential role in neurodevelopment. Collected evidence suggests that epigenetic changes in the BDNF gene are related to the pathophysiology of psychiatric disorders such as schizophrenia. Therefore, the aim of this study was to assess the association of BDNF DNA methylation with schizophrenia. In addition, the relationship between BDNF DNA methylation and antipsychotics was studied. MATERIALS AND METHODS: Overall, 118 (88 male and 30 female) schizophrenia patients and 122 (92 male and 30 female) healthy controls were included in the study and methylation status was investigated using the Methylight Taqman® assay. RESULTS: There was no significant change in the DNA methylation status between schizophrenia patients and controls in this study despite its increased level (p=0.073). However, DNA methylation level was associated with sex and the difference was more significantly prominent in the male subjects (p=0.016). In addition, BDNF DNA methylation showed a positive significant correlation with the positive symptoms (p=0.032) of schizophrenia and antipsychotics use (p=0.013). CONCLUSION: The BDNF DNA methylation could be affected by gender and has a clinical association
Clinico-Radiological Features of Ileocaecal Duplication Cyst in Children
Get PDFEnteric duplication cyst (EDC) is a rare malformation of the alimentary tract which can potentially cause intestinal obstruction in children. It can cause obstruction directly either by narrowing the bowel lumen, or indirectly by causing an intussusception. We are reporting three cases of ileocaecal EDC in children who presented with symptoms of distal bowel obstruction; one case of ileal EDC with intussusception and two cases of chronic obstruction by an EDC at caecum and terminal ileum. Ultrasound showed a typical cystic lesion with gut signature sign in two of them. Resection was performed in all cases; primary repair was performed in the intussusception case and diversion stoma with delayed closure was performed in the other two cases with chronic obstruction.
Differences in Brain Activity for Temporal Lobe Epilepsy Patients and Healthy Subjects: Findings from Resting-state fMRI
Get PDFINTRODUCTION: Temporal lobe epilepsy (TLE) is a chronic disorder of the nervous system with focal seizures that may spread to other brain regions. Present knowledge regarding the spread of seizure is scarce. This study investigated activity in brain regions outside temporal lobe of TLE patient (TLEP) that may be affected by the spread. The findings were compared with healthy subject (HS). MATERIALS AND METHODS: Resting-state functional MRI (rsfMRI) were performed on 14 TLEPs and 14 HSs. Spatial activation, laterality index (LI) and functional connectivity (FC) involving several brain regions were analysed. RESULT: Bilateral precuneus (PRE) and supramarginal gyrus (SMG) which were activated (puncorr.<0.001) outside the temporal lobe were chosen for analysis. In the left and right hemispheres, two-way analysis of variance (ANOVA) showed a significant difference between PRE and SMG activation (p<0.001) but not between TLEP and HS (p>0.001). SMG was found to be moderately right-lateralised in both TLEP and HS with LI = -0.309 and -0.125, respectively. For PRE, HS showed moderate left lateralisation (LI = 0.121), while TLEP showed weak right lateralisation (LI= -0.002). FC results revealed that the activity in PRE and SMG changed over time for HS and TLEP but only in the left hemisphere. CONCLUSION: Although resting-state activations in the two selected brain areas outside the temporal lobe in both hemispheres were incomparable between TLEP and HS, evidences from LI and FC analyses suggested anomalies especially in the left hemisphere that could be due to the spread of seizure
Translation and Validation of Computer Vision Syndrome Scale 17 (CVSS 17) – The Malay Version
Get PDFIntroduction: Computer Vision Syndrome Scale 17 (CVSS17) is a questionnaire to measure computer-related visual and ocular symptoms among video display terminal workers. This study aimed to translate CVSS17 into Malay languag and determine its psychometric properties among video display terminal workers. Materials and Methods: This was a cross-sectional validation study involving 206 workers in Universiti Teknologi MARA UiTM Selayang and Sungai Buloh Campus. The English version of the CVSS17 questionnaire is a 17-item scale measuring two key factors, which are internal symptom factors (11 items) and external symptom factors (6 items). The CVSS17 underwent forward-backward translation, face validation, and field testing to produce the Malay version. Validity of the items assessing psychometric properties was performed using exploratory factor analysis. The reliability testing was performed using internal consistency and test-retest reliability. Results: The validated CVSS17-Malay version retained all 17 items with acceptable factor loadings. There were 13 items in the external, and 4 items in the internal symptom factors domain. In comparison to the original version, 4 items (A2, A22, A28, A30) were swapped from internal to external symptom factors and 2 items (C16 and C23) swapped from external to internal symptom factors. The changes of these items into different domains were discussed. The overall Cronbach’s α was 0.867 and the intraclass correlation coefficient was 0.866. The Kaiser-Meyer-Olkin was 0.928, and Bartlett’s test of sphericity was p-value <0.001. Conclusion: The CVSS17 Malay version is valid, reliable, and stable over time, to be used in measuring computer vision syndrome among Malay-speaking workers.
Mechanism of Chlorpyrifos Induced Chronic Nephrotoxicity
Get PDFINTRODUCTION: Chlorpyrifos is one of the most commonly used organophosphates in agriculture. Report on animal models of chronically exposed chlorpyrifos showed significant histo-structural renal damage. Moreover, evidence of high incidence of diabetes mellitus were observed among agricultural workers exposed to organophosphates. Available evidence linking derangement of glucose metabolism pathway with renal damage in this chronically exposed chlorpyrifos is lacking. The aim of this study was to determine the involvement of advanced glycation end-products formation in the development of nephrotoxicity in animals with chronic subcutaneous exposure to chlorpyrifos. MATERIALS AND METHODS: Eighteen rats were divided into three groups, with six rats in each group. Group 1 served as a control group, while Groups 2 and 3 received subcutaneous 3% dimethyl sulfoxide and 97% volume per volume soy oil as a vehicle or chlorpyrifos, respectively, alternate day for 180 days. Blood samples were taken for biochemical analysis. Kidney tissues were examined for immunohistochemistry and gene expression of pathways related to oxidative stress and advanced glycation end-products. RESULTS: Serum fasting glucose, creatinine, advanced glycation end-products and malondialdehyde levels were significantly increased (p<0.05), whereas paraoxonase-1 level was decreased in chlorpyrifos-treated rats compared with the control groups (p<0.05). The proximal tubular cells and the glomeruli of chlorpyrifos-exposed kidney showed strong malondialdehyde and advanced glycation end-products expression respectively. Gene expression of catalase and glutathione reductase were downregulated in the chlorpyrifos-treated rats. CONCLUSION: Glucose derangement and oxidative stress are the possible mechanisms of organophosphate-induced kidney damage
Cognitive Behavioural Therapy for Chronic Pain Management: A Narrative Review
Get PDFChronic pain is disabling and impacts an individual’s psychosocial and functioning in multiple areas. Cognitive Behavioural Therapy (CBT) appears to be one of the psychotherapies that has good potential of prominent efficacy in managing chronic pain. This narrative review aims to provide the necessary information and latest development on the delivery, results efficacy and barriers of CBT in chronic pain management. A search was conducted at Pubmed and Web of Science in April 2021 yielding a total of 251 articles. After careful screening and filtration, a total of 21 articles was selected for this review. Of these 21 articles, CBT was observed to be commonly delivered through online, which helped to preserving cost, promoting adherence, having good efficacy and also safer during the time of the Covid-19 pandemic. Most of the articles showed significant efficacy of CBT in chronic pain management. In order to improve CBT for better efficacy, understanding and consideration towards mediators that affect pain outcome and barriers in implementation are crucial in developing modules in CBT for chronic pain management. As such, CBT can be improved by integrating customised components in the modules to target mediators specifically, and training can be provided for psychotherapist to combat the barrier of online communication and time management. For future research, direction can be focused on development of CBT modules that are specific to chronic pain management.
Nutritional Status of Under-Five Children and the Relationship with Household Food Wastage and Food Security in Samarahan, Malaysia
Get PDFIntroduction: Malnutrition is prevalent among children in developing countries. The cause of malnutrition, although complex, can be attributed to demographic factors, household food wastage, and food insecurity. This study aims to determine the under-five nutritional status of children and its association with household food wastage and food security in the Samarahan division in Sarawak, Malaysia. Materials and Methods: This is a cross-sectional study involving 304 children from rural areas of Asajaya and Samarahan District using a random sampling technique. An interviewer-administered questionnaire was used to collect data from the parents. The nutritional status of the children was assessed by anthropometry. IBM SPSS Version 27.0 and WHO Anthro version 3.2.2 were used for data analysis. A p-value < 0.05 was considered statistically significant. Results: Analysis revealed that 9.5% of the children were moderately wasted, followed by 5.9% who were severely wasted; 20.4% were moderately stunted and 8.9% were severely stunted. Hierarchical regression analysis indicated that male gender (AOR = 1.931, 95% CI: 1.139, 3.274; p<0.05), low birth weight (AOR =2.645, 95% CI: 1.245, 5.618, p<0.05), poor appetite (AOR = 2.547; 95% CI: 1.298, 4.995, p<0.05), and preventive attitude (AOR = 0.460, 95% CI: 0.227, 0.929, p < 0.05) of household food wastage appeared to be significant predictors of nutritional status. However, household food insecurity had a negative correlation but did not significantly impact the nutritional status. Conclusion: Under-five malnutrition was prevalent in the study area and still a public health concern. Although the study did not find any significant association between household food wastage and food security towards the nutritional status of children, addressing the nutritional problem warranted an appropriate Public Health approach for the specific group, especially the modifiable risk factors such as birth weights, appetite, and attitude.