Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital disorder with persistent cutis marmorata, telengiectasia, and phlebectesia, which may be associated with cutaneaus atrophy and ulceration of the involved skin. We herewith report a three month old male baby with CMTC at birth involving left side of the face, upper limbs, both flanks, and left gluteal and left leg with ulceration over the extensor aspects of the left knee joint. The baby had a reticulated bluish purple skin changes all over the body including the face and limb. Although it resembled physiological cutis marmorata, it was strikingly pronounced and defi n i t e ly was unvarying and permanent. A variety of vascular malformation has been described along with this disorder. Etiology is not very clear. Prognoses in uncomplicated cases are good.

Glutathione S-transferases (GSTs) are multifunctional enzymes involved in detoxification of xenobiotic compounds in many insect groups. This work investigated the expression of GSTs in Aedes albopictus by using affinity chromatography and proteomic analysis. The study compared the expression of GSTS isoforms in larvae of three Ae. albopictus strains (susceptible (VCRU) strain, field Kuala Lumpur (KL) strain and laboratory permethrintreated strain). The study demonstrated that the expression of sixteen isoforms (GSTS1-1, GSTS1-4, GSTS1-3, GSTS1-4, GSTD1-3, GSTD1-2, GSTD1-5, GSTD1-6, GSTD1-7, GSTD1-8, GSTD1-9, GSTD1-10, GSTD1-11, GSTT, GSTD1-12, and GSTD1-13) were significantly increased in the field KL strain (p<0.05) compared to the susceptible VCRU strain. GSTD1-1, GSTD1-2 and GSTS1-5 showed no significant difference in expression between the two strains (p>0.05). However, while comparing the expression of GST isoforms in field KL larvae and laboratory permethrin-treated strain, the same pattern was observed for all the GSTs especially for Theta and Sigma class (p>0.05). In Delta class, only GSTD1-1, GSTD1-9, GSTD1-11, GSTD1- 12 and GSTD1-13 shows significant difference in expression between these two strain (p<0.05). This comparative data on GST expression in Ae. albopictus can be useful database to identify possible underlying mechanisms governing insecticide resistance by GSTs.

Nasopharyngeal carcinoma (NPC) is a non-lymphomatous, squamous cell carcinoma that occurs in the epithelial lining of the nasopharynx, an area that shows varying degrees of differentiation. Although relatively rare worldwide, NPC has substantial incidence and mortality in populations in Southeast Asia and in people with Southern Chinese ancestry. In Malaysia, NPC is a leading cancer type. In the clinic, NPC presents on a very wide spectrum. Therefore, a high degree of suspicion on the part of the clinician and an increased awareness by the patient is essential for the recognition of an early lesion. Early detection of the cancer is important as it affects the patient’s prognosis and the mode of treatment. Managing patients with NPC is very challenging as patients usually present late when the cancer is already in an advanced stage. Here, we review the challenges in the management of NPC.

Ocular chemical injury is a true ophthalmic emergency requiring immediate medical intervention. Damages can be devastating and potentially resulting in blindness, corneal perforation and phthisis bulbi. We describe here a successful treatment outcome in a patient who sustained Roper-Hall Grade 4 injury to both eyes. Patient received medical therapy followed by serial ocular surgeries with eventual visual recovery in one eye from counting finger to 6/15 after a decade. In conclusion, after maximum medical therapy, a carefully planned serial surgeries of cultivated oral mucosal epithelial transplantation (COMET) and PK has proven beneficial for this patient with advanced limbal stem cell deficiency (LSCD).

Child ; Folic Acid ; administration & dosage ; therapeutic use ; Folic Acid Antagonists ; adverse effects ; Hematinics ; administration & dosage ; therapeutic use ; Humans ; Hypesthesia ; chemically induced ; drug therapy ; Injections, Spinal ; Leukoencephalopathies ; chemically induced ; Male ; Methotrexate ; adverse effects ; Quadriplegia ; chemically induced ; drug therapy ; Time Factors ; Vitamin B Complex ; administration & dosage ; therapeutic use

Objective: This study aimed to evaluate the prevalence of sensorineural hearing loss (SNHL) in β-thalassaemia patients treated with Desferrioxamine (DFO) and determine the correlation of SNHL with average daily DFO dosage, serum ferritin level and Therapeutic index (T.I). Methods: This is a cross sectional descriptive study carried out for a period of 14 months and 54 patients were recruited. The recruited patients are transfusion dependant β- thalassaemia patient aged 3 years and above treated with DFO. An interview, clinical examination and hearing assessment, which included tympanogram, and Pure Tone Audiometry (PTA) or behaviour alaudiometry were performed. The data on age started on DFO, average daily DFO, duration of DFO intake, serum ferritin past 1 year and Therapeutic Index (T.I) were obtained from patients’ case notes. Results: The prevalence of SNHL was 57.4% and majority has mild hearing loss (93.6%). Fourteen patients (25.9%) have bilateral ear involvement and as many as 17 patients (31.5%) have SNHL in either ear. A total of 23 patients (42.6%) have normal hearing level. Although the prevalence of SNHL was 57.4%, only a small percentage of the patient noticed and complained of hearing loss (11.1%). There is no association between age started on DFO, average daily DFO and duration of DFO intake with normal hearing group and those patients with SNHL. Positive correlation was seen between average daily DFO with 2000 and 4000Hz on PTA in the left ear and between serum ferritin level past 1 year with 4000 and 8000Hz in the right ear and 8000Hz in the left ear. No significant correlation was seen between T.I on PTA. Conclusion: The prevalence of SNHL from hearing assessment is high in β-thalassaemia patients in this study. However, it is manifested clinically in a smaller percentage. We suggest a baseline hearing assessment should be carried on all β-thalassaemia patients prior to DFO chelation therapy.

Background: To investigate factors influencing disconnection hyperprolactinemia, including tumour volume, degree of pituitary stalk displacement and extent of tumour growth based on a modified Wilson-Hardy classification in a non-functioning pituitary macroadenoma and to confirm reductions in serum prolactin levels after endoscopic transphenoidal surgery. Methods: This prospective, descriptive study was conducted in the Department of Neurosurgery, General Hospital Kuala Lumpur from Jan 1, 2011 to Jan 1, 2013. Forty patients fulfilling the inclusion criteria were enrolled. All patients underwent endoscopic transphenoidal resection of non-functioning pituitary macroadenoma. Pituitary stalk angle, tumour volume and extent of tumour growth were measured from Magnetic Resonance Imaging (MRI) pre- and post-operatively. These variables were compared to serum prolactin levels measured pre and post operatively. SPSS 21 was used to perform statistical analyses. Results: In 40 patients, the mean tumour volumes were 10.58 cm3 (SD 7.81) pre-operatively and 3.1 cm3 (SD 3.45) post-operatively. There was a 70% reduction in tumour volume post-operatively (P < 0.01). The mean serum prolactin was 457 mIU/L (SD 66.93) pre-operatively and 297 mIU/L (SD 6.73) post-operatively. There was a 65% reduction in prolactin serum levels after surgery (P < 0.01). The mean pituitary stalk angles were 93.45 ± 3.89 degrees pre-operatively and 51.45 ± 1.46 degrees post-operatively (P = 0.01). The mean pituitary stalk angle in the control group was 50.4 ± 8.80 degrees. Hence, there was a 98% reduction in pituitary stalk angle after surgery (P < 0.01). This study showed a linear correlation between the pre-operative and post-operative tumour volumes and serum prolactin levels (P = 0.01 pre-and post-operative) and between serum prolactin levels and pituitary stalk angle (P = 0.20 pre-operative; P = 0.01 post-operative). Conclusion: Tumour volume and pituitary stalk angle displacement have positive predictive values for disconnection hyperprolactinemia in non-functioning pituitary macroadenoma. However, a larger sample size and further objective studies are needed to confirm these findings.
Hyperprolactinemia

OBJECTIVES: The objectives of this study were to determine the psychological fatigue and analyze muscle activity of production workers who are performing processes jobs while standing for prolonged time periods. METHODS: The psychological fatigue experienced by the workers was obtained through questionnaire surveys. Meanwhile, muscle activity has been analyzed using surface electromyography (sEMG) measurement. Lower extremities muscles include: erector spinae, tibialis anterior, and gastrocnemius were concurrently measured for more than five hours of standing. Twenty male production workers in a metal stamping company participated as subjects in this study. The subjects were required to undergo questionnaire surveys and sEMG measurement. RESULTS: Results of the questionnaire surveys found that all subjects experienced psychological fatigue due to prolonged standing jobs. Similarly, muscle fatigue has been identified through sEMG measurement. Based on the non-parametric statistical test using the Spearman's rank order correlation, the left erector spinae obtained a moderate positive correlation and statistically significant (rs = 0.552, p < 0.05) between the results of questionnaire surveys and sEMG measurement. CONCLUSION: Based on this study, the authors concluded that prolonged standing was contributed to psychological fatigue and to muscle fatigue among the production workers.
Electromyography ; Fatigue ; Humans ; Lower Extremity ; Male ; Muscle Fatigue ; Muscles ; Surveys and Questionnaires

OBJECTIVEThe goal of study is to explore the cytotoxic activity and its underlying mechanisms of the extract of Spatholobus suberctus in human lung cancer A549 cells.

METHODThe inhibitory effects of the extract on proliferation of human lung cancer cell line A549 was measured by MTT cell viability assay and growth curve. Cell cycle was analyzed using flow cytometry. Apoptotic morphological changes was observed by HE staining technique and AO/PI double-staining confocal laser scanning microscope (CLSM). Employing agarose gel electrophoresis and Annexin V-PI assay, we examed the presence of cytoplasmic histone-associated DNA fragments, and membrane phosphatidylserine (PS) externalization as well as caspase-3 activation.

RESULTThe extract of S. suberctus shows strong cytotoxic power on A549 cells during 24 hours and IC50 is 25.54 mg x L(-1). The cells in S-phase increase while the cells in G0-G1 and G2-M decrease. These changes recovered after 48 hours. The nucleus became pyknosis between 8 to 12 hours and many vacuoles and granules in cytoplasm can be seen. Membrane phosphatidylserine externalization occurs in a dose-dependent and time-dependent manner afer 12 hours. Caspase-3 activity has no more changes in a converse dose-dependent manner. No cytoplasmic histone-associated DNA fragments was detected by agarose gel electrophoresis.

CONCLUSIONThe extract of S. suberctus shows a direct anti-tumor activity. The drug acts quickly and causes S delay in one cell cycle. The main cell death feature appears to be non-apoptotic programmed cell death.

Caspase 3 ; metabolism ; Cell Cycle ; drug effects ; Cell Death ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Fabaceae ; chemistry ; Flow Cytometry ; Humans ; Lung Neoplasms ; Microscopy, Confocal

OBJECTIVETo observe the effect of anti-tumor and mechanism of the extract of Spatholobus suberctus (SSCE) in vivo.

METHODThe mouse model of Lewis lung carcinoma was used to investigate the effects of SSCE on tumor growth and metastasis. Furthermore, we explored the mechanism of anti-tumor by analyze the cell cycle and determine the apoptosis.

RESULTThe studies demonstrated that the tumor inhibitory rate of SSCE in low dose group was the highest (30.65%) on Lewis lung cancer. SSCE can resist metastasis, at the same time, it can induce cell cycle arrested in G1 phase, whereas, there was no significant difference in apoptotic rate each group.

CONCLUSIONWe verified that SSCE exits anti-tumor effect and resist metastasis, furthermore, it can arrest function cell in G1 phase.

Animals ; Antineoplastic Agents ; pharmacology ; therapeutic use ; Carcinoma, Lewis Lung ; drug therapy ; physiopathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Disease Models, Animal ; Fabaceae ; chemistry ; Humans ; Lung Neoplasms ; drug therapy ; physiopathology ; Male ; Mice ; Mice, Inbred C57BL ; Plant Extracts ; pharmacology ; therapeutic use