3.Doctor's attire and patient safety.
The Medical Journal of Malaysia 2009;64(3):185-6
4.Measuring pH of the Plasmodium falciparum digestive vacuole by flow cytometry
Tropical Biomedicine 2015;32(3):485-493
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.
7.Imaging of Osteo-odontokeratoprosthesis(OOKP) Using Multidetector Computed Tomography: A UKMMC Experience
The Medical Journal of Malaysia 2013;68(1):73-75
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.
8.Chest Radiograph Findings In Novel Swine-Origin InfluenzaA (H1N1) Virus (S-OIV) Infection: A UKMMC Experience
Norzailin Abu Bakar ; Norhafizah Ehsan
The Medical Journal of Malaysia 2015;70(2):93-97
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
9.Research Ethics, Governance, Oversight And Public Interest
Abu Bakar Suleiman ; Joon-Wah Mak
International e-Journal of Science, Medicine and Education 2008;2(supp1):35-38
A better educated public has started to challenge
the way decisions are made in medical research activities.
Although Institutional and National Guidelines on
Research are in place, there are fears that Institutional
Review Boards (IRBs) and funding agencies are only fairly
active in scientific and ethical reviews of research proposals
but not on oversight of projects after their initiation. These
issues are integral to good research governance and
researchers and custodians of research ethics must ensure
that public interest is not compromised.
Medical progress is based on research including human
experimentation carried out according to guiding
principles as enunciated in the Declaration of Helsinki
(2000), but the quality of compliance with the
Declaration is an important issue.
Better choice and appropriate training of members of IRBs
to improve the quality of decision making and governance
processes are urgently needed. Competency in evaluation
of proposals requires not only the appropriate scientific
knowledge but also access to relevant preclinical and
other data. Unfortunately, the completeness and quality of
such data may not be adequate.
Public interest demands that injury to trial subjects in
clinical trials is minimized if not avoided completely.
Unfortunately this is not always possible with trials
where novel biological modes of action are tested.
A more robust evaluation mechanism for project
approval may minimize but not completely avoid injury
to subjects; thus insurance cover to provide care and
compensation to subjects must be compulsory.
The decision to approve or reject a project must be
based on the balance of potential risks and benefits,
taking into consideration justifiable distributive risks to
target communities and populations. Economic
considerations should never be the primary focus,
especially when there are real concerns that the
migration of early phase clinical trials including vaccine
trials to developing countries is based on the perceived
less stringent ethical requirements and oversight there.