Stricture, NOS ; MALAYSIAN

BACKGROUND: One under-explored area in chronic obstructive pulmonary disease (COPD) patients is anxiety and/or depression, which may have negative impact in the patients' condition. This is possibly the first study to possibly assess the burden of anxiety and depression in COPD patients in the Philippines.

STUDY DESIGN: This is a prospective descriptive survey in three tertiary care hospitals in Manila, Philippines.

PARTICIPANTS: A total of 204 patients were enrolled in the study with the following inclusion criteria: Filipino patients who are aged more than or equal to 40 years with a diagnosis of COPD (documented post-bronchodilator FEV1/FVC ratio less than 0.7) by a physician seen at the outpatient clinics of three tertiary care hospitals with no primary diagnosis of asthma, no previous lung volume reduction surgery, lung transplantation or pneumonectomy and at least finished Grade 2 education.

Exclusion criteria include pregnant patients and patients previously diagnosed to have an anxiety, depression, or on any anti-depressant medications.

METHODS: Descriptive statistics was obtained with frequency and percentages of the demographic and physiologic variables in the study by tabulation and graph. The prevalence of anxiety and depression was determined by calculating the percentage of each patient with a score of 8 or higher on the Hospital Anxiety and Depression Scale (HADS) with validated Tagalog version, respectively.

RESULTS: The prevalence of anxiety in Filipino COPD patients is 47.55%. The prevalence of depression in Filipino COPD patients is 31.37%.

CONCLUSION: The prevalence of depression in Filipino COPD patients is comparable to the prevalence of depression from other general medical conditions nationwide according to the study of Batar (31.37% vs. 31%). Anxiety is slightly more prevalent in COPD from other general medical conditions (47.55% vs. 36%). A study on the risk factors of anxiety and depression among Filipino COPD patients is recommended.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Anxiety ; Depression ; Pulmonary Disease, Chronic Obstructive ; Patients ; Depression

Aged ; Carcinoma, Squamous Cell ; diagnosis ; etiology ; Facial Neoplasms ; diagnosis ; Female ; Humans ; Skin Neoplasms ; diagnosis ; etiology ; Skin Ulcer ; complications ; diagnosis ; Tooth Extraction

Congenital partial aplasia of the atlas with a posterior arch remnant is rare. It may be found as an incidental radiological finding or patients can present with neurological signs and symptoms after head or neck trauma. A 36 year old female presented with a 3 day history of right sided neck pain radiating down the right arm. Radiographs of the cervical spine showed a radiolucent area in the region of the posterior arch of the atlas. Computed tomography subsequently revealed partial absence of the posterio

Introduction: The aims of this study were to determine the proximate composition, functional properties and antioxidant activity of pumpkin seeds and rind. Besides, the effects of dietary fibre in pumpkin seeds and rinds on bread qualities and properties were evaluated. Methods: Formulations for bread substituted with 0%, 5% and 10% pumpkin seed and rind, respectively were produced. Sensory evaluation of the prepared bread samples for such attributes as appearance, aroma, flavour, texture and overall acceptability was undertaken. The physical properties of the bread samples, including dough expansion, loaf volume, crumb colour and bread texture, were determined. Proximate analysis and determination of antioxidant activity of the bread samples were also conducted. Results: Crude fibre of the pumpkin seeds and pumpkin rinds was high at 31.48% and 14.83%, respectively. The total phenolic compound (TPC) and DPPH radical scavenging activity for the pumpkin rinds were 38.60 mg GAE/ 100 g dry weight and 69.38%, respectively, which were higher than those of pumpkin seeds. A 5% level of pumpkin rind bread gave the best overall acceptability and sensory attributes, followed by 5% pumpkin seed bread. Total dietary fibre, total phenolic compound and DPPH radical scavenging activity in breads substituted with 5% pumpkin seed and 5% pumpkin rind flour were higher than the values in control bread. Conclusion: Pumpkin seeds and rinds can be used as dietary fibre sources in bakery.

Background Cutaneous tuberculosis (TB) is a form of extrapulmonary tuberculosis. Diagnosis of cutaneous TB is often difficult because of the diverse clinical presentations. The positive yields from cultures are often low. To describe the demographic, clinical, histopathological and bacteriological aspects of cutaneous TB. Materials and Methods This retrospective review looked at cases of cutaneous tuberculosis treated at the Respiratory and Dermatology unit, Penang Hospital from 1996 to 2007. Data were analysed with SPSS 13.0 version. Results A total of 23 cases of cutaneous tuberculosis were reviewed. The male to female ratio was 2.3 to 1. The mean age was 37.7 ± 20.7 years. There were 10 Malays, 9 Chinese, 2 Indians and 2 Indonesian. The types of cutaneous tuberculosis observed were lupus vulgaris (47.8%), tuberculides (17.5%), tuberculosis verrucosa cutis (13.0%), scrofuloderma (13.0%) and primary inoculation TB (8.7%). 43.5% of patients had systemic involvement. Mantoux tests were positive in 85.0% of cases. Skin biopsies were performed in 91.3% of patients and 71.4% of them showed classical histopathologic findings suggestive of tuberculosis. Mycobacterium tuberculosis was isolated in the culture from 28.6% of patients. Localized diseases were found more often in BCG-vaccinated individuals. Regional lymphadenopathy was noted more often in patients with disseminated disease. No correlation was found between Mantoux reactivity and the extent of disease. Conclusion Lupus vulgaris was the commonest form of cutaneous tuberculosis. Cultures were positive in only a small proportion of patients. Almost half of our patients had systemic involvement. The presence of regional lymphadenopathy often indicates disseminated disease. Patients without BCG vaccination were at higher risk of disease dissemination.

Night work and rotating shift work are found to be detrimental to the health of workers. A cross sectional analytical study was conducted among the employees of a public medical centre in Kuala Lumpur. A total of 380 employees participated in the health screening and questionnaire survey. The majority of the respondents were Malays, females, and with mean age of 49 years old. The shift workers persistently had higher but non-significant proportions of being overweight/ obesity and unhealthy clinical indicators such as systolic and diastolic blood pressure, fasting blood glucose and lipid profile except waist circumferences and HDL-cholesterol. There were also slightly more shift workers diagnosed with diabetes mellitus, hypertension or coronary heart disease (p>0.05). Although the present study could not provide established evidence for a relationship between shift work and cardiovascular risks, this could serve as a pilot study for future studies in this area.
Health Education

Since the initial outbreak of Nipah encephalitis in Malaysia in 1998, the virus has reemerged in Bangladesh and the adjacent Indian state of West Bengal since 2001. To date more than 470 patients have been affected with over 250 fatalities in total. Although the source of the virus is believed to be the Pteropus fruit bats both in Malaysia and Bangladesh, there are also significant epidemiological and clinical differences in the outbreaks occurring in these two regions. Epidemiologically, in the Bangladesh and India outbreaks, bat-to-human transmission through food and animal and human-tohuman transmissions were the predominant modes, the outbreaks were on a smaller scale and they have recurred every year except 2002 and 2006. Clinically, the mortality was higher and respiratory manifestation was more prominent in the Bangladeshi and Indian patients compared with their Malaysian counterparts, which might reflect differences in care and medical practices. There remain however, important differences in clinical manifestations which are likely to be due to some genetic variations in the virus.

In pemphigus foliaceus (PF), immunoglobulin G (IgG) autoantibodies directed against desmoglein-1 (Dsg-1), a cell adhesion molecule expressed mainly in the granular layer of the epidermis, are responsible for the intercellular widening between desmosomes resulting in intraepidermal blisters. Rituximab is a chimeric monoclonal antibody that by binding specifically to the transmembrane antigen CD20 found on the surface of normal and malignant B cells, leads to B-cell depletion. We report a 19-year-old Filipino woman with PF and controlled idiopathic thrombocytopenia purpura, initially treated with high-dose prednisone and azathioprine. Due to rapid PF progression with associated moderate reactive depression, rituximab was added to the treatment regimen with prompt improvement of lesions and clearance after five months. Five years later, lesions recurred with erythematous, dry, scaly plaques on both breasts, axillae, and on the scalp, associated with moderate to severe intermittent pruritus. After the first of a series of four weekly infusions, rituximab monotherapy resulted in immediate and sustained clearance up to 22 months. In parallel with skin clearance, serum CD19 and CD20 B cells decreased to almost zero after the first infusion, to zero after the second, while the decrease of Dsg-1 levels was more gradual, and down to normal after four months.
We offer this case report to show that rituximab can be given as a first-line monotherapy option for indications similar to ours such as drug reactions (steroid-induced depression) or a history of recalcitrant PF to the usual medications; and to suggest using CD19 and CD20 in addition to the desmoglein levels to monitor disease activity and molecular change from which to learn how to continue to monitor for disease activity after clearance.

Human ; Female ; Adult ; Antigens, Cd20 ; Autoantibodies ; Azathioprine ; B-lymphocytes ; Blister ; Desmosomes ; Immunoglobulin G ; Pemphigus ; Rituximab

The authors propose a musculoskeletal (MSK) magnetic resonance imaging (MRI) protocol using selected sequences for common orthopaedic indications. Selected sequences allow optimal visualisation of the indicated pathology while screening for other common conditions. The authors emphasise the need for standard positioning of the patient and standard orientation of scan planes to facilitate comparison with follow-up scans.