1.Genetic Aberrations in Childhood Acute Lymphoblastic Leukaemia: Application of High-Density Single Nucleotide Polymorphism Array
Malaysian Journal of Medical Sciences 2010;17(3):5-12
Screening of the entire human genome using high-density single nucleotide polymorphism
array (SNPA) has become a powerful technique used in cancer genetics and population genetics
studies. The GeneChip® Mapping Array, introduced by Affymetrix, is one SNPA platform utilised
for genotyping studies. This GeneChip system allows researchers to gain a comprehensive view of
cancer biology on a single platform for the quantification of chromosomal amplifications, deletions,
and loss of heterozygosity or for allelic imbalance studies. Importantly, this array analysis has the
potential to reveal novel genetic findings involved in the multistep development of cancer. Given the
importance of genetic factors in leukaemogenesis and the usefulness of screening the whole genome,
SNPA analysis has been utilised in many studies to characterise genetic aberrations in childhood
acute lymphoblastic leukaemia.
2.Cat Flea Outbreak in Kuching District, Sarawak
Lau SM ; Jamail M ; Sarina S ; Bahtiar R ; Asmad M
Malaysian Journal of Public Health Medicine 2010;10(1):57-61
Cat fleas were reported to attack human in RPR Batu Kawa, a housing area about 3 km from Kuching town, resulting in an outbreak. A total of 19 people (10 adults and 9 children) were attacked by fleas. They presented with red spots, slightly raised (swollen) and irritation of skin, mostly found on the ankles and legs. The first 4 cases were reported on 29 September 2007 and the last case was on 17 November 2007. The remaining 12 cases which represent the majority of cases reported on 4th October 2007. The study conducted based mainly on field investigation and flea sampling from animals on field at that moment to find out the causes of the disease spread. Flea samples from human and cats were found to be Ctenocephalides felis; which is the most prevalent species in the world. However, no fleas were found on dog, rabbit and rat. This is the first reported case in Kuching; the study was carried out to determine the cause and the epidemiological pattern of the disease. This is important, because cat flea might attack human especially if house owners fail to monitor their pets and practice proper sanitation method to avoid the presence of cat flea larvae at home.
3.Return to sports after anterior cruciate ligament reconstruction - a review of patients with minimum 5-year follow-up.
Dave Y H LEE ; Sarina Abdul KARIM ; Haw Chong CHANG
Annals of the Academy of Medicine, Singapore 2008;37(4):273-278
INTRODUCTIONIt is difficult to counsel the anterior cruciate ligament (ACL) deficient patient considering surgical reconstruction on the likelihood of eventual return to sports as information on this is lacking, especially in the Asian context. We wanted to determine how many of our patients who had ACL surgery returned to their previous levels of sports, 5 years after their surgery. For those that had not returned to their previous levels of sports, we wanted to identify their reasons for not doing so.
MATERIALS AND METHODSBased on our inclusion criteria of a minimum 5-year follow-up after primary ACL reconstruction, 146 patients were identified for assessment. Sixty-four patients were successfully recalled. The mean age of our patients was 24.8 years (range, 18 to 40). The patients completed the Lysholm Knee, Tegner activity and the Subjective International Knee Documentation Committee (IKDC) questionnaires. Clinical examination of the operated knee was performed according to the Objective IKDC evaluation form and with a KT-1000 arthrometer.
RESULTSThe mean Lysholm score was 85.2 and the mean subjective IKDC score was 79.5. 81.2% of our patients had normal or nearly normal knees (IKDC A or B) with the remaining 18.8% at IKDC grade C. The mean side-side difference for anterior translation using the KT-1000 arthrometer was 1.2 mm. The median pre-injury Tegner activity level was 7 and the median 5-year post-surgery Tegner activity level was 6. Nineteen patients did not return to their pre-injury sports levels because of social reasons and were excluded. From the remaining 45 patients, 28 patients (62.2%) returned to their previous level of sports and 17 patients (28.8%) did not return to their previous level of sports. Of whom, 9 (20%) said that they did not return due to fear of re-injury and the remaining 8 (17.8%) said they had not returned because of knee instability and pain. At 5 years, the subgroup of patients who had returned to sport had the best scores: Lysholm (88.5), subjective IKDC (84.6) and IKDC Grade A&B (89.3%). When we compared this with the subgroups that did not return to sport because of fear of re-injury and because of an unstable knee, we found that the difference in knee outcome scores between these 3 groups were statistically significant.
CONCLUSIONSixty-two per cent of our patients returned to their previous level of sport at 5 years after ACL reconstruction. Fear of reinjury is an important psychological factor for these patients not returning to sports. Our results would allow the attending surgeon to counsel the ACL deficient patient who is considering surgical reconstruction the likelihood of eventual return to sports.
Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Athletic Performance ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; rehabilitation ; surgery ; Male ; Orthopedic Procedures ; rehabilitation ; Physical Examination ; Retrospective Studies ; Sports ; Surveys and Questionnaires
4.Clinical evaluation of arthroscopic-assisted allograft meniscal transplantation.
Haw Chong CHANG ; Kai Lin TEH ; Kah Lai LEONG ; Su Lian MAK ; Sarina Abdul KARIM
Annals of the Academy of Medicine, Singapore 2008;37(4):266-272
INTRODUCTIONA meniscal deficient knee is at risk of early degenerative osteoarthritis. Allograft meniscal transplantation has been used to treat the meniscus deficiency to alleviate pain symptoms and to delay progression to arthritis. This case series aims to assess the postoperative outcomes of patients who have undergone meniscal allograft transplantation in our hospital.
MATERIALS AND METHODSThis is a prospective clinical review of prospectively collected data of our Meniscal Transplantation Programme from 2004 to 2007. Twelve meniscal allografts were implanted in 12 males with symptomatic knees, using arthroscopically assisted techniques. Preoperative and postoperative assessments were conducted using the Visual Analogue Scale (VAS), Tegner Activity Level Scale, Lysholm Knee Scoring Scale, and 2000 International Knee Documentation Committee (IKDC) scoring systems.
RESULTSThe mean age was 26.7 years with a mean follow-up of 17 months (range, 5 to 37). The VAS score for pain improved from 5.5 (3- 10) to 1.4 (0-2) [P <0.05], Tegner from 3 (2-5) to 5.9 (3-9) [P <0.05], Lysholm from 62.5 (27-88) to 88.6 (70-100) [P <0.05], IKDC Subjective Score from 50 (24-79) to 79.5 (56-95) [P <0.05]. Overall IKDC Knee Examination Grades revealed 10 nearly normal and 2 abnormal scores.
CONCLUSIONSThis is the first series of allograft meniscal transplantation from Southeast Asia. Patient outcome evaluation via VAS, Tegner Activity Level Scale, Lysholm Knee Scoring Scale and 2000 IKDC Knee Evaluation Form showed improvement in symptoms and knee function after implantation.
Adult ; Arthroscopy ; Humans ; Knee Injuries ; surgery ; Male ; Medical Audit ; Menisci, Tibial ; transplantation ; Middle Aged ; Pain Measurement ; Prospective Studies ; Tibial Meniscus Injuries ; Transplantation, Homologous ; Treatment Outcome
5.Investigating Medical Cost and Mortality Among Psychiatric Patients Involuntary Admissions: A Nationwide Propensity Score-Matched Study
Pei-Ying TSENG ; Xin-Yu XIE ; Ching-Chi HSU ; Sarina Hui-Lin CHIEN ; Jen-De CHEN ; Jong-Yi WANG
Psychiatry Investigation 2022;19(7):527-537
Objective:
Involuntary admission to psychiatric inpatient care can protect both patients with severe mental illnesses and individuals around them. This study analyzed annual healthcare costs per person for involuntary psychiatric admission and examined categories of mental disorders and other factors associated with mortality.
Methods:
This retrospective cohort study collected 1 million randomly sampled beneficiaries from the National Health Insurance Database for 2002–2013. It identified and matched 181 patients with involuntary psychiatric admissions (research group) with 724 patients with voluntary psychiatric admissions (control group) through 1:4 propensity-score matching for sex, age, comorbidities, mental disorder category, and index year of diagnosis.
Results:
Mean life expectancy of patients with involuntary psychiatric admissions was 33.13 years less than the general population. Average annual healthcare costs per person for involuntary psychiatric admissions were 3.94 times higher compared with voluntary admissions. The general linear model demonstrated that average annual medical costs per person per compulsory hospitalization were 5.8 times that of voluntary hospitalization. Survival analysis using the Cox proportional hazards model found no significant association between type of psychiatric admission (involuntary or voluntary) and death.
Conclusion
This study revealed no significant difference in mortality between involuntary and voluntary psychiatric admissions, indicating involuntary treatment’s effectiveness.
6.The relationship between household income and dietary intakes of 1-10 year old urban Malaysian.
Zalilah MOHD SHARIFF ; Khor Geok LIN ; Sarina SARIMAN ; Huang Soo LEE ; Chin Yit SIEW ; Barakatun Nisak MOHD YUSOF ; Chan Yoke MUN ; Maznorila MOHAMAD
Nutrition Research and Practice 2015;9(3):278-287
BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.
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Cross-Sectional Studies
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7.Epidemiological analysis of elderly viral pneumonia in Inner Mongolia Autonomous Region in 2018-2019
Journal of Public Health and Preventive Medicine 2021;32(4):133-136
Objective To investigate the epidemiological characteristics of elderly viral pneumonia in Inner Mongolia Autonomous Region from 2018 to 2019 and analyze the pathogenic distribution, and to provide reference for the prevention and treatment of elderly viral pneumonia. Methods A total of 797 elderly patients with viral pneumonia admitted to our hospital from January 2018 to December 2019 were enrolled as the research subjects. All patients were tested for respiratory viral pathogens. According to the test results, the patients were divided into two groups, positive group (n=345) and negative group (n=452). The pathogenic characteristics of patients in the positive group were analyzed. The combined basic diseases, clinical characteristics, laboratory indicators, and distribution of viral pneumonia in different seasons were compared between the two groups. Results Among the 345 patients in the positive group, 319 (92.46%) were infected with single virus, mainly influenza virus (n=221, 64.06%), followed by parainfluenza virus (n=42, 12.17%). There were 26 cases infected with two or more viruses, accounting for 7.54%, mainly influenza virus + parainfluenza virus (n=15, 4.35%). The proportion of patients complicated with diabetes, cardiovascular and cerebrovascular diseases, and malignant tumors in the positive group was significantly higher than that in the negative group (P<0.05). The clinical characteristics of both groups were mainly fever and cough, with no significant difference (P>0.05). The Lym value of the positive group was higher than that of the negative group (P<0.05), while CRP and PCT values were significantly lower than those of the negative group (P<0.05). The incidence rate in the positive group was significantly higher than that in the negative group in winter (P<0.01), and it was significantly lower than that in the negative group in spring (P<0.01). Conclusion In Inner Mongolia Autonomous Region, elderly patients with viral pneumonia are complicated with many basic diseases, but the clinical symptoms are not typical, with high incidence in winter. The infection is mainly caused by influenza virus and parainfluenza virus. Laboratory indicators such as Lym, CRP and PCT can be used to identify viral pneumonia.
8.Analysis of Programs and Guidelines on Traditional Chinese Medicine (TCM) for COVID-19 to Provide Suggestions for Future Development of TCM Clinical Practice Guidelines
Xue FENG ; Xiao-jiao DUAN ; Bing ZHANG ; SARINA ; Xiang-fei SU ; Si-yuan MA ; Yuan LI ; Yu-bo GUO
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(14):20-28
Objective:To comprehensively analyze the diagnosis and treatment programs and prevention and treatment programs on tratidional Chinese medicine (TCM) for coronavirus disease-2019 (COVID-19), and to provide suggestions for further development of TCM clinical guidelines. Method:Diagnosis and treatment programs on TCM for COVID-19 pneumonia, as well as prevention and treatment programs, clinical practice guidelines and expert consensus, were retrieved till Feb 19, 2020. The information about TCM syndrome differentiation, state of disease, and TCM treatments (decoction and Chinese patent medicines) were extracted and analyzed. Result:A total of 24 TCM programs/guidelines were included containing 23 diagnosis and treatment programs or prevention and treatment programs and one rapid advice guideline. Of the 23 TCM programs, 14 programs described the classification of TCM syndromes and the stages of disease,22 programs described the composition of the TCM decoction; seven programs described how to add and subtract the herbs according to different TCM syndromes,17 programs described the weight/volume of the herbs of TCM decoctions, three programs described the decoction method,six programs described the usage and dosage of TCM decoction, two programs clarified the course of treatment; none of the 23 programs indicated the source of evidence. The TCM treatment within the rapid advice guideline was in reference to the fourth edition of the COVID-19 pneumonia TCM diagnosis and treatment program issued by the National Health Commission. A total of 41 Chinese patent medicines were recommended in 23 programs, of which 12 Chinese patent medicines were off-label recommended. Conclusion:In most TCM programs, TCM decoction and Chinese patent medicines are recommended based on TCM syndrome differentiation in combination with the state of disease, and the dosage of the TCM decoctions are clearly described. Some Chinese patent medicines in the TCM programs are off-label recommended. Expert experience and opinions are valued when developing TCM programs/ guidelines. All of these provide reference for developing TCM programs/guidelines in future.
9.Cytogenomic Profiling of Chronic Lymphocytic Leukaemia Patients Using DNA Microarray
Wan Norizzati Wan Mohamad Zamri ; Nazihah Mohd Yunus ; Ahmad Aizat Abdul Aziz ; Mohamad Ros Sidek ; Noratifah Mohd. Adam ; Sarina Sulong
Malaysian Journal of Medicine and Health Sciences 2023;19(No.3):160-170
Introduction: Chronic lymphocytic leukaemia (CLL) is the most frequent adult leukaemia in the Western world. The
clinical presentation varies greatly, from very indolent cases to those with aggressive and fast advancing disease.
This variation has significant implications for clinical approaches, therapeutic tactics, and, ultimately, survival durations from diagnosis. Acquired chromosomal aberrations play a key role in CLL aetiology. Due to difficulty to obtain
abnormal metaphases for analysis, few methods such as fluorescence in-situ hybridization (FISH) and multiplex
ligation-dependent probe assay (MLPA) were employed to detect chromosomal aberration however the methods are
limited to specific locus only. Thus, this study is aimed to detect the chromosomal aberrations using DNA microarray platform. Methods: In this retrospective study, DNA archive obtained from 7 CLL patients which collected at
diagnosis and subjected to Affymetrix CytoScan® 750K single nucleotide polymorphism (SNP) array following the
manufacture procedure. The raw data obtained were analysed using the Chromosome Analysis Suite (ChAS) software (Affymetrix) using annotations of genome version GRCh38 (hg38). Result: Out of 7 patients, 4 of them showing
deletion of 13q while 3 of them showing deletion of 14q in various region . Some of the deleted loci were too small
(0.42-0.6Mb) to be detected by conventional cytogenetic analysis (CCA). There was also the presence of additional
chromosomal aberrations that could be missed by CCA, FISH, or MLPA due to cryptic deletion or duplication that
was as small as 0.4MB in size. Conclusion: The present study showed that low resolution chromosomal aberration
was able to be detected using DNA microarray platform in comparison to CCA, FISH and MLPA.
10.Application of HRM Analysis in Detection of PDGFRA Exon 10 Polymorphism in CML Patients with Imatinib Resistance
Nur Sabrina Abd Rashid ; Sarina Sulong ; Azlan Husin ; Rosline Hassan ; Mohamad Ros Sidek ; Nazihah Mohd Yunus
Malaysian Journal of Medicine and Health Sciences 2022;18(No.5):130-137
Introduction: Imatinib mesylate has been widely used as a standard treatment for chronic myeloid leukemia (CML).
It acts as a selective competitive inhibitor of the BCR-ABL tyrosine kinase. Despite the excellent efficacy on CML
treatment, some patients developed resistance to the treatment. Mutation in the PDGFRA may be one of the factors
involved in the mechanism of resistance that affects the response to imatinib. The mutational status of PDGFRA is
highly relevant for prognosis and treatment prediction in CML patients. Thus, this study is intended to establish and
validate a High Resolution Melting (HRM) analysis for PDGFRA exon 10 c.1432 T>C polymorphism in CML patients.
Methods: High resolution melting (HRM) analysis was used to identify the c.1432 T > C polymorphism in PDGFRA
exon 10 (n =86; response = 43; resistance = 43). The results from HRM analysis were compared and validated with
Sanger sequencing. The association between the polymorphism and treatment response was assessed by statistical
analysis using binomial logistic regression analysis. Results: HRM analyses showed two different melt curves. One
curve followed the shape of the reference, homozygous wild type (TT) and the other curve showed a different melting profile than the reference with the TC genotype (heterozygous variant). The results revealed that heterozygous
variant (TC) genotype showed a high risk of acquiring resistance with an OR of 3.795; 95% CI: 1.502-9.591, with
a statistically significant association, p = 0.005. HRM analysis also showed 100% sensitivity and specificity in the
detection of PDGFRA exon 10. Conclusion: The HRM analysis of PDGFRA exon 10 c.1432 T>C was successfully
established. The exon 10 c.1432 T>C polymorphism shows a higher risk for the development of resistance toward
imatinib treatment.