Ethics, Medical

Mechanism ; Gallstones ; Cholesterol

Clothing ; Infectious Disease Transmission, Professional-to-Patient ; Methicillin-Resistant Staphylococcus aureus/*isolation & purification ; Physician-Patient Relations ; Safety ; Staphylococcal Infections/*transmission

Studies show that the pH of the malaria parasite’s digestive vacuole (DV) plays a key role in the physiological functions of this organelle and antimalarial drug accumulation, and yet is technically difficult to measure. In this study, a flow cytometry-based technique was developed to measure the DV pH using a ratiometric pH indicator, FITC-dextran loaded into the DV of saponin-permeabilized parasites. To calculate the DV pH, a standard pH calibration curve was generated by incubating the saponin-permeabilized cells in buffers with different pH in the presence of an ionophore, CCCP. The measured average pH of the DV was 5.27 ± 0.03 that is approximately the same in the parasites observed microscopically by Hayward et al. (2006) (5.50 ± 0.14) using the same probe. The removal of glucose from the medium, causing a rapid depletion of parasite ATP, resulted in an alkalization of the DV. The DV was reacidified upon restoration of glucose to the medium. This technique provides a rapid, simple and quantitative measurement of the DV pH on a large number of cells. It will also be useful in future attempts to evaluate the effect of antimalarial drugs (i.e. chloroquineand artemisinin-based drugs) in pH changes of the DV.

Kidney Failure, Acute

Osteo-odontokeratoprosthesis (OOKP) surgery is a technique used to replace damaged cornea in blind patients for whom cadaveric transplantation is not feasible. OOKP surgery is a complex procedure requiring lifetime follow–up. The preservation of the osteo–odontolamina is the vital feature in maintaining the stability of the OOKP. Early detection of lamina resorption enables early prophylactic measures to be taken and prevent resorption-related complications. This case illustrates the radiological findings of the first OOKP surgery in Malaysia and the role of multidetector computed tomography (MDCT) in postoperative management of OOKP surgery.

OBJECTIVE: 1.To evaluates and recognizes findings in chest radiograph in patients with laboratory-confirmed S-OIV (H1N1) infection treated at UKMMC. 2. To evaluate whether the findings on initial chest radiographs of influenza A (H1N1) patients can help to predict the prognosis. MATERIAL AND METHODS: Total of 109 adult patients presenting to the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with flu-like symptoms who were positive for influenza A and these patients had underwent chest radiographs (CXR). The initial CXRs were evaluated for the pattern (consolidation, ground-glass, and reticulation), distribution, and extend of abnormality. The disease is classifies by the clinical severity (mild, moderate or severe illness) and adverse outcome (ventilated, death or recovered well). RESULTS: The initial CXRs were normal in 56% of cases. The predominant radiographic finding was consolidation, most commonly involving the middle and lower zones (35% of cases). There is no significant association between initial CXR findings with the patient clinical outcome either fully recovered or death/ ventilated. CONCLUSION: Normal chest radiographs is the most common radiographic finding in S-OIV (H1N1) infection and the most common abnormal lung finding is consolidation. Initial chest radiographs did not determine the patient clinical outcome and a normal initial radiograph could not exclude adverse outcome.
Influenza A Virus, H1N1 Subtype

This paper highlights an uncommon complication of a percutaneous transthoracic needle biopsy (PTNB). A patient with rheumatoid arthritis who was on immune suppressive drugs underwent a PTNB of a lung nodule. The histology showed “organizing usual interstitial pneumonia-like changes.” Unfortunately, one month after the PTNB, she developed a large deep-seated chest wall abscess at the biopsy needle tract and the previously seen lung nodule was larger. Nocardiosis sp. was isolated from the chest wall abscess. The lung and chest wall lesions were resolved with Bactrium and Fluconazole. The final diagnosis was pulmonary nocardiasis complicated by chest wall seeding following the PTNB procedure.

Objective: Self-esteem is an important component of psychological health. In Malaysia, Rosenberg’s self-esteem scale remained the single most popular utilized scale for studying global self-esteem. This study aims to design a language, culture and illness specific self-esteem questionnaire. Methods: The study consisted of 2 phases. The first phase was to generate items for the new self-esteem questionnaire (SSES) in Bahasa Malaysia. Literature review on the concept of self- esteem and its’ content was conducted. This was followed by expert opinion from professional care-givers. The items were qualitatively validated by healthy subjects and patients with schizophrenia from the same locality, culture and language. The second phase consists of quantitative validation of the items. Items in the new scale were analyzed based on the responses from 165 stable schizophrenia outpatients. The validated Malay version of Rosenberg Self-Esteem scale (RSES) was used concurrently as a comparison. Results: The SSES displayed good internal consistency for its two domains (Cronbach’s alpha=0.88, 0.81) and test-retest reliability (ICC), ranged from 0.44 to 0.87. Its construct validity was confirmed by confirmatory factor analysis. The concurrent validity of SSES and RSES using Pearson correlation was 0.77. The Cronbach’s alpha for the validated Malay version of RSES is 0.67. Conclusion: This study presents a new self-esteem questionnaire (SSES) which has high concurrent validity with the standard RSES and confirms the reliability and validity of SSES in Malay patients with Schizophrenia.