Background: Database on hospital records like discharge data, birth and death certificates are widely used for epidemiological and research studies. However there are a very few validation studies on these data. The aim of this study was to validate and assess the accuracy of the ICD 10 database on congenital anomalies in the state of Penang. This study was carried out for three years, from 2002 to 2004. Methods: The list of cases coded under the general coding “Q” was extracted and approximately 30% of cases were randomly selected from the list. Medical records for the selected cases were checked and discrepancies for the diagnoses between the medical records and the ICD 10 data base were recorded for three years. Verification was done for basic demographic variables and the coding of the diseases. Discrepancies, sensitivity and specificity were calculated. Results: The ICD 10 database for congenital anomalies are classified into two types: Type 1 and Type 2. Discrepancies on demographic information were found among the age of patients (babies with congenital anomalies). In Type 1, there was a discrepancy of about 0.02 % to 0.05% probability that a congenital anomaly case can be recorded as non congenital anomaly in the ICD 10. In Type 2 there was a discrepancy that a non-congenital anomaly was classified as congenital anomaly and this ranged from 26.7% to 50.0%. The sensitivity ranged from 96.85% to 97.98%, thus it can be concluded the ICD 10 database is highly sensitive while the specificity ranged from 50.00% to 78.57 %. In other words the ICD 10 is not accurate when classifying the non- congenital anomaly cases. A fair percentage of non-congenital anomaly cases were classified as CA in the ICD 10 database. Conclusion: Even though hospital databases are used as a baseline data for a number of research and epidemiological studies it cannot be used at face value. Validation of these data is necessary before any conclusions can be drawn or intervention measures are undertaken.

Introduction : Kelantan, an east coast state of Peninsular Malaysia is rich in culture and supports a population that is dependent on agriculture. The crops cultivated are mainly paddy and rubber but in recent years tobacco is beginning to gain importance over paddy. We centered our study around Bachok District which is about 25 kilometers east of Kota Bharu, the state capital. Methods: Based on case reports we focused our study on cercarial dermatitis and also recorded the socioeconomic status of the people in the four study villages. Result: The ducks and cows were the common livestock kept by the farmers and these were found to be significantly associated (P=0.05) with the occurrence of dermatitis. Cercariae shedding by snails were found in waters used for irrigation. Conclusion : The results indicate that cercarial dermatitis is occupation specific, and its debilitating effect was having an influence on the socioeconomic status and general wellbeing of the population in these villages. The dermatitis occurred only during the field preparation and transplanting stages of paddy and was found to be significantly associated (P=<0.05) with the source of water used for irrigation. The water sources for irrigation was mainly from the river and irrigation canal and the snail Indoplanorbis exustus infected with schistosome cercariae was found to be abundant in both these sources during these stages. The ducks and cows were the common livestock kept by the farmers and these were also found to be significantly associated (P=0.05) with the occurrence of dermatitis. Therefore we concluded that the dermatitis among paddy farmers in Bachok District was due to an animal schistosome.

The Mandatory Treatment Order (MTO) became a sentencing option for select offenders with psychiatric illness in Singapore in 2011. This article aimed to study the psychiatric characteristics of the offenders in the first year of the MTO; Methods: A clinical audit was conducted on all the cases referred to the Institute of Mental Health for assessment as to their suitability to receive an MTO from January to December 2011. A psychiatrist went through all the case records. Data on the demographics, forensic history and psychiatric diagnoses were obtained from records; Results: There were differences seen between the genders in the likelihood of being granted an MTO. Gender also played a role in the length of MTOs granted and in the diagnoses of the individuals. The reasons for an MTO not being granted are presented. Conclusion: Some discussion is made regarding the availability of court diversion legislature in other countries for mentally ill offenders and the directions such diversion might take are highlighted. Potential areas for future research are pointed out.

Plants toxic to livestock species have a significantly negative impact on agriculture but can be an important source of bioactive molecules for use in medicine. The initial research on plant toxicity is focused on the response to the poisoning and the specific livestock species impacted by the toxic plant. This research emphasizes the identification of the plant and natural product(s) responsible for the toxicity to livestock, the prevention of further poisonings, and the development of treatments for the affected animals. Once the bioactive molecules impacting the livestock species have been identified, research on these compounds is then focused on determining the mechanism of action, the development of models for further study, and the identification of potential drug candidates for the treatment of disease. Specific examples of the agricultural-based research that are relevant to Human and Veterinary Medicine include: cyclopamine from Veratrum californicum (western false hellebore), piperidine alkaloids from Lupinus species (lupines), and cicutoxin from Cicuta species (water hemlock).

No abstract available.
Asthma*

The ascomycete fungus Mycosphaerella graminicola (synonym Zymoseptoria tritici) is an important pathogen of wheat causing economically significant losses. The primary nutritional mode of this fungus is thought to be hemibiotrophic. This pathogenic lifestyle is associated with an early biotrophic stage of nutrient uptake followed by a necrotrophic stage aided possibly by production of a toxin or reactive oxygen species (ROS). In many other fungi, the genes CREA and AREA are important during the biotrophic stage of infection, while the NOXa gene product is important during necrotrophic growth. To test the hypothesis that these genes are important for pathogenicity of M. graminicola, we employed an over-expression strategy for the selected target genes CREA, AREA, and NOXa, which might function as regulators of nutrient acquisition or ROS generation. Increased expressions of CREA, AREA, and NOXa in M. graminicola were confirmed via quantitative real-time PCR and strains were subsequently assayed for pathogenicity. Among them, the NOXa over-expression strain, NO2, resulted in significantly increased virulence. Moreover, instead of the usual filamentous growth, we observed a predominance of yeast-like growth of NO2 which was correlated with ROS production. Our data indicate that ROS generation via NOXa is important to pathogenicity as well as development in M. graminicola.
Ascomycota ; Fungi ; Life Style ; NADPH Oxidase ; Reactive Oxygen Species* ; Real-Time Polymerase Chain Reaction ; Triticum ; Virulence*

Objective: Practice guidelines for diverticulitis have been developed in countries where left-colon diverticulitis is dominant,but there is limited information on right-colon diverticulitis. This study examined the clinical characteristics and riskfactors of clinically severe right-colon diverticulitis. Methods: A retrospective chart review of patients diagnosed with diverticulitis in an emergency department in Koreabetween 2013 and 2017 was performed. Clinically severe diverticulitis was defined as any cause of death, intensive careunit admission, surgery, or invasive intervention due to diverticulitis, and admission for seven or more hospital days.Multivariable logistic regression was used to identify the risk factors for clinically severe diverticulitis. Results: This study analyzed 302 patients. Patients with older age (odds ratio [OR], 1.044; 95% confidence interval [CI],1.009-1.080; P=0.013), complications observed on computed tomography (CT) (OR, 6.906; 95% CI, 2.514-18.968;P<0.001), rebound tenderness on a physical examination (OR, 2.542; 95% CI, 1.041-6.218; P=0.041), high alkalinephosphatase (ALP) levels (OR, 1.014; 95% CI, 1.002-1.026; P=0.026), and high C-reactive protein (CRP) levels (OR,1.095; 95% CI, 1.017-1.178; P=0.013) were at higher risk of clinically severe diverticulitis. Conclusion Among patients diagnosed with right-colon diverticulitis in the emergency department, those of older age,distinct complications on CT, rebound tenderness on physical examination, high ALP, and high CRP levels are related toclinically severe disease.

PURPOSE: Interleukin-4(IL-4) is a critical component of the Th2 cytokine pathway and contributes to severity of respiratory syncytial virus(RSV) bronchiolitis. Previous studies observed an association between severe RSV bronchiolitis in Korean children with a common haplotype of the IL4 promoter. This study was performed to investigate functional differences of the variant IL4 promoter haplotypes. METHODS: Genomic DNA was obtained from 20 children from 6 to 48 months of age in the Department of Pediatrics, Seoul National University Bundang Hospital. The IL4 promoter spanning an 1.2 kb region was amplified and haplotype was determined by cloning and the PHASE reconstruction. Transcriptional activity of Jurkat T cells which were transfected with each IL4 haplotype were analyzed by use of luciferase assay. RESULTS: Three haplotypes of the IL4 promoter have been identified with the frequency of GCC(7 percent), TCC(17 percent), and TTT(76 percent). The TTT haplotype demonstrated the highest luciferase values in both unstimulated and PMA-stimulated Jurkat T cells. Increases in transcriptional activity compared to GCC have been shown in TTT(5.3 fold higher) followed by TCC(4.2 fold higher) in unstimulated Jurkat T cells. CONCLUSION: We provided evidence that increased transcriptional activity of the TTT haplotype of the IL4 promoter, which has previously been over-represented in Korean children with severe RSV bronchiolitis. Therefore, IL-4 could play a potential role in the pathogenesis of RSV infection, possibly via an altered transcriptional activity of the different IL4 haplotypes.
Bronchiolitis ; Child ; Clone Cells ; Cloning, Organism ; DNA ; Haplotypes* ; Humans ; Interleukin-4* ; Luciferases ; Pediatrics ; Respiratory Syncytial Viruses ; Seoul ; T-Lymphocytes ; Transcriptional Activation

A 33-year-old woman presented with tingling and paresthesia on left extremity for 2 months. Magnetic resonance imaging revealed that the tumor was iso- and hypo-intensity on T1-weighted image, mixed iso- and high-signal intensity on T2-weighted images and heterogeneously enhanced with rim enhancement. Neither arachnoid cleft nor dural tail was certain but mass was located extra-axially so meningioma was suspected. During operation, tumor wasn't attached to dura at all but arachnoid attachment was seen. Pathologically, clear cell type ependymoma was confirmed. Details of diagnosis and treatment of this tumor is described.
Adult ; Arachnoid ; Diagnosis ; Ependymoma* ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Paresthesia ; Tail

Aged ; Female ; Heart Block ; etiology ; Humans ; Ventricular Dysfunction, Left ; etiology