Adult ; Disease Progression ; Facial Hemiatrophy ; complications ; diagnosis ; physiopathology ; Female ; Humans ; Keratoconus ; etiology ; physiopathology ; therapy

Humans ; Singapore ; Sleep Wake Disorders

Aims: Dried fruits may harbour a variety of fungi especially those that can grow in low water activity conditions. Knowledge on the occurrence of fungi on dried fruits is an important step to predict the possibility of mycotoxin contamination, thus the present study was conducted to determine the occurrence of fungi on dates, figs, kiwi and raisins. Methodology and results: Based on morphological characteristics, six genera of fungi comprising eight species, Aspergillus niger, A. flavus, Penicillium corylophilum, P. glabrum, Chaetomium globosum, Fusarium sacchari, Acremonium strictum and Mycelia sterilia were identified. Three most commonly species isolated were A. niger (19 isolates), P. corylophilum (seven isolates) and A. flavus (five isolates). The less common species were C. globosum (three isolates), Mycelia sterilia (three isolates), A. strictum (one isolate) and P. glabrum (one isolate). Conclusion, significance and impact of study: Common mycotoxin producer are the fungi from the genera Aspergillus, Penicillium and Fusarium. The occurrence of toxigenic fungi on dates, figs, kiwi and raisins suggested that some of these fungi may be an important source of mycotoxin contamination.
Fungi

Emphysematous pyelonephritis is a rare life-threatening condition caused by a severe acute necrotising infection of the renal parenchyma and its perinephric tissues, and it is commonly seen in diabetic patients. There is a rare association between emphysematous pyelonephritis and hepatic portal venous gas. Hepatic portal venous gas is an uncommon radiological finding, which implies a significant underlying abdominal disease. The management of emphysematous pyelonephritis has evolved from prompt nephrectomy to medical therapy. In the present report, we present a case of a diabetic woman diagnosed with bilateral emphysematous pyelonephritis with hepatic portal venous gas that was successfully managed medically despite the presence of poor prognostic factors, such as acute renal failure and thrombocytopenia.

Background: There is lack of normality data in the literature on the plantar response. Objective: To determine the variability of plantar response in normal population and factors that might contribute to the variability. Methods: We conducted a study of plantar response in healthy subjects aged 19-21 in two phases. First phase was plantar examination with hard strike. Subjects with big toe extension in the fi rst phase were re-examined with light and hard strike in the second phase. Results: 100 subjects recruited in fi rst phase, 19 subjects in second phase. Out of 600 attempts (3 attempts for each foot) with hard strike, responses of the big toe were fl exion (48.3%), extension (11.3%), no movement (39.8%); other toes were fl exion (55.0%), extension (13.0%), no movement (32.0%); ankle was dorsifl exion (30.8%), no movement (59.3%); knee were fl exion (15.7%), no movement (84.3%); hip were fl exion (15.2%), no movement (84.8%). Of those with big toe extension, signifi cantly less had persistent big toe extension with light strike. More (41%) among those with extensor big toe has withdrawal response (with fl exion of the hip and knee) as compared to those with fl exor big toe (18.5%, p<0.05). Interfoot asymmetry was seen in 27% (kappa 0.54). Plantar responses of sequential strikes were mostly consistent, with only 3.5% inter-attempt variability. Conclusion: Plantar response with extensor great toe is seen in about 10% of normal adults, less with lighter strike. Withdrawal response can be a partial explanation to the big toe extensor response in normal adults.

INTRODUCTIONInfluenza A H1N1 (2009) pandemic has affected countries worldwide including Singapore. Data on obstetric outcomes of women with H1N1 (2009) in pregnancy are lacking.

MATERIALS AND METHODSThis was an observational study analysing the obstetric outcomes of pregnant women with influenza A H1N1 (2009) infection who had delivered at a viable gestation (24 weeks or more) in our centre.

RESULTSBetween 23 June 2009 and 30 September 2009, 235 pregnant women were diagnosed with influenza A H1N1 (2009) at our centre, with 42 having delivered and comprising the study cohort. Median age was 27.5 years (range, 16 to 42). Multiparous women comprised 59.5% (25/42) whilst 40.5% (17/42) were primiparous. In terms of ethnicity, 61.9% were Malays, 26.2% Chinese, 4.8% Indians and 7.1% Others. All women received oseltamivir. All had shown recovery from the acute influenza infection. There were no respiratory complications. Twenty-nine women (69.0%) delivered at term. Twenty-fi ve women (59.5%) had spontaneous labour whilst 15 (35.7%) had labour induction. Two women (4.8%) did not labour. Thirty-six women (85.7%) had vaginal delivery, of whom 3 were instrumental deliveries. Apgar scores of greater than 8 at 1 min and 5 min were documented in babies of 95.2% (40/42) women, respectively. Thirty-two women (76.2%) delivered babies with birthweights greater than 2500 g. Compared with historical data from 2008, the H1N1 cohort had comparable mean birthweight and average gestational age at delivery of 38 weeks.

CONCLUSIONOur study suggested that obstetric outcomes were not adversely affected by influenza A H1N1 (2009) infection.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Apgar Score ; Birth Weight ; Female ; Gestational Age ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; drug therapy ; epidemiology ; Obstetrics and Gynecology Department, Hospital ; Oseltamivir ; therapeutic use ; Outcome Assessment (Health Care) ; Pregnancy ; Pregnancy Complications ; Singapore ; Young Adult

Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.

Humans ; Maxillary Sinus/diagnostic imaging* ; Tomography, X-Ray Computed

This study describes an evaluation of the sonographic, cholangiographic, pathological, and immunological findings, and the protective effect shown by rats reinfected with Clonorchis sinensis. Eight experimental rat groups were, namely, a normal control, a primary infection control, a reinfection I (reinfection 7 week after treatment following 3-week infection), a reinfection II (reinfection 2 week after treatment following 8-week infection), a reinfection III (exploration of the intrahepatic bile ducts 1 week after reinfection 4 week after treatment following 4-week infection), a superinfection, a secondary infection control, and an infection following immunization group. Sonographic and cholangiographic findings showed moderate or marked dilatation of the bile duct confluence in the primary infection control, reinfection II, and secondary infection control groups. Juvenile worms survived in the intrahepatic bile ducts 1 week after reinfection following treatment in the reinfection III group. It was concluded that reinfecting juvenile worms found during the first week following reinfection failed to survive or grow further. Anatomical, pathophysiological, or immunological changes may induce protection from reinfection in rats.
Animals ; Anthelmintics/administration & dosage/therapeutic use ; Antibodies, Helminth/blood ; Antigens, Helminth/administration & dosage/immunology ; Bile Duct Diseases/parasitology/*pathology/ultrasonography ; Bile Ducts, Intrahepatic/parasitology/*pathology/ultrasonography ; Cholangiography ; Clonorchiasis/parasitology/*pathology/ultrasonography ; Clonorchis sinensis/*pathogenicity ; Immunization ; Praziquantel/administration & dosage/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sound Spectrography ; Support, Non-U.S. Gov't

Introduction: In Malaysia, late stage presentation of breast cancer (stage III or IV) has been a healthcare problem that varies geographically throughout the country. This study aims to understand the factors influencing late stage of breast cancer at presentation among Malaysian women in Segamat Hospital, Johor, which is a district hospital. Methods: A retrospective descriptive study was conducted on secondary data of all newly diagnosed breast cancer women from 1st August 2011 to 28th February 2014. Secondary data includes age, ethnicity, marital status, family history, education level, occupation, presenting symptom, duration of symptom, tumour size, tumour pathology, tumour grading, oestrogen, progesterone and HER-2 receptor status were collected and analysed using SPSS version 20.0.0. Result: In total, data from 52 women was analysed and two women were excluded for incompleteness as these women defaulted. Late stage at presentation was 59.6% of all new cases (17.3%, stage III and 42.3%, stage IV). The commonest age group of all women diagnosed with breast cancer was in the 5th decade. Majority of them were Malay, married and housewives with no family history of breast cancer. The statistically significant factors associated with late stage at presentation include Malay ethnicity (p=0.019), presenting symptoms other than breast lump (p=0.047), and duration of breast lump more than 3 months (p=0.009). Discussion/Conclusion: The study demonstrated presentation at late stage of breast cancer is a major health concern among Malaysian women in district hospital. This may be attributed to different sociocultural beliefs, strong belief in complementary and alternative medicine, lack of awareness, and difficult accessibility to healthcare services.
Breast Neoplasms