Background & Objective: Symptomatic sarcocystosis has been said to be rare until recent years, when there were reports of outbreaks of febrile myositis for travellers returning from the Malaysian island resorts. In 2012, an outbreak of Sarcocystis nesbitti infection involving 92 college students and staff occurred after returning from Pangkor Island, Malaysia. A few months after recovering from the febrile illness, some patients complained of hair loss. This study aimed to determine the prevalence, clinical features and outcome of this disorder. Methods: All patients who became sick in the outbreak were asked whether they had the hair loss. For those who had, they were interviewed with standard questionnaires, examined and investigated. Patients were followed-up via an online survey 2 years later. Results: Out of 89 patients who were ill, 19 patients (21.4%) complained of alopecia. The mean peak onset was 4 months after the initial illness. Eleven patients (57.9%) reported the hair fall of more than 100 per day. The other symptoms were itch 10 (52.6%), scaling 10 (52.6%), erythema 4 (21.1%), none had scarring. Eleven patients (57.8%) had positive antinuclear factor with high titre (speckled or nucleolar pattern). Two years after the event, 10 had complete or near complete spontaneous recovery, 1 had partial response and 1 had no improvement. Conclusions: A delayed transient diffuse alopecia is seen in close to half of patients with Sarcocystis nesbittiinfection. This high frequency of positive ANF suggested an immune-mediated mechanism.
Sarcocystosis

Introduction: Steven-Johnson syndrome and Toxic Epidermal Necrolysis are rare but life threatening severe cutaneous adverse reactions to drugs. To determine the epidemiology of SJS, TEN and SJS/TEN overlap in University Malaya Medical Centre (UMMC). Methods: All patients admitted to UMMC from year 2013-2015 for SJS, SJS/TEN, TEN were recruited. The classification of SJS, SJS/TEN overlap and TEN was made based on the criteria laid down by Bastuji et al.2 Results: A total of 32 patients were recorded to have SJS, SJS/TEN overlap and TEN from 2013 to 2015. Drugs (n=32, 86.49%) remained the most common aetiology of SJS and TEN. The top three commonest drugs are allopurinol (n=6), followed by carbamazepine (n=5) and bactrim (n=3). Conclusion: This study demonstrates that drugs were the most common cause of SJS/TEN. Antibiotics were the most common drug group that caused SJS/TEN. Awareness of the common etiology such as drug is important and high index of suspicion of SJS and TEN is needed if patients were on the above medications.

Objective The ECG lead II characteristics of Beagle dog, rhesus monkey, Japanese white rabbit and tree shrew were analyzed and summarized to provide reference for drug safety evaluation studies.Methods The ECG lead II of healthy adult Beagle dog, rhesus monkey, Japanese white rabbit and tree shrew were recorded to determine the interval of P, PR, QT ( QTc) , the QRS waves and amplitude of P, R, T waves and the ST shift.Results and Conclusion All the animals had sinus rhythm.All the four species of animals had similar ECG pattern with no particular specific changes, but had some differences of the QRS wave group and T wave.The amplitude of P and T waves in Japanese white rabbit was smaller, and the heart rate of tree shrew was faster than that of the other species of animals.The ECG leadⅡdatabase of the Beagle dog, rhesus monkey, Japanese white rabbit and tree shrew is established.

OBJECTIVETo investigate the possibility and the limit in increasing the survival area of the random skin flap by extremely increasing the ratio of its length and width within 24 hours.

METHODSSD rats (n = 20) were chosen for this study. The rats were randomly divided into: subject group and control one. Pre-made skin flap was prepared as design. The subject group was carried out rapid pre-fabricated skin flap formation training. No training was performed in control group. The changes in perfusion value of micro-circulation inside skin flap were monitored during the whole process, and micro-circulation parameters of the skin flap were used to evaluate whether its blood circulation network was mature or not.

RESULTSTraining of pre-made skin flap at 18th hour, the perfusion value of its micro-circulation was basically stable, Skin flap formation was finished at 24th hour. Survival area in control group was (68.25 +/- 0.18)% and in subject group was (97.25 +/- 0.24)% (P < 0.01). There was a significant difference between the two groups.

CONCLUSIONSWithin short time, it is possible to establish micro-circulation in skin flap which exceeds the limit set by traditional theory. Digitalized judgment can be used to monitor the fast formation of super-big skin flap. This method is reliable and can increase the survival rate of random skin flap.

Animals ; Female ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Skin ; blood supply ; metabolism ; Skin Transplantation ; Surgical Flaps ; Time Factors

Anti-Bacterial Agents ; adverse effects ; Humans ; Hyperpigmentation ; chemically induced ; pathology ; Male ; Middle Aged ; Minocycline ; adverse effects

INTRODUCTIONSingapore is the first Asian country to establish a nationwide breast screening programme, but our breast cancer screening uptake lags behind the Western countries. This survey focused on the subject of screening mammography, to assess the reasons for non-attendance and explore ways to improve our screening uptake.

MATERIALS AND METHODSFemales ≥21 years old were approached at primary healthcare clinics to participate in this survey, which questioned their knowledge, perception and expectations of breast screening.

RESULTSThere were 1011 respondents. Of the 740 respondents ≥40 years old, 332 respondents (45.5%) went for regular mammogram screening. Women who had lower household incomes [<$2000 (OR 0.49; 95% CI, 0.28 to 0.85); $2000 to $3999 (OR 0.59; 95% CI, 0.36 to 0.97)], did not know anyone with breast cancer (OR 0.62; 95% CI, 0.42 to 0.92), did not perform breast self-examination (OR 0.42; 95% CI, 0.28 to 0.62), had lower knowledge scores (OR 0.34; 95% CI 0.22 to 0.51), did not attend other health screening (OR 0.14; 95% CI, 0.05 to 0.41), and perceived mammography as embarrassing (OR 0.55; 95% CI, 0.31 to 0.96), were less likely to attend mammographic screening. Many did not know that screening is for the asymptomatic (51.2%), or the age to start screening (46.3%). Most respondents preferred to have their mammograms in the polyclinics (62.2%) and their screening reminders to be through short messaging service (SMS) (46.0%).

CONCLUSIONOur results show the current influences on Singapore women's screening practices, and also revealed that their understanding of mammogram screening is limited despite a high level of breast cancer awareness.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; Breast Self-Examination ; Early Detection of Cancer ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Mammography ; Middle Aged ; Patient Acceptance of Health Care ; Singapore ; Surveys and Questionnaires ; Young Adult

0.05).Moreover,the growth curves of the two kinds of cells were similar.Con- clusions The cell growth properties of cultured transplanted rabbit SMG are similar to that of normal SMG,the cytobiological charac- teristic of transplanted autologous free rabbit SMG are not changed evidently.

Background/Aims: Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC. Methods: MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model. Results: Seventeen articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (95% confidence interval [CI], 13.99–38.11%) and 22.20% (95% CI, 10.07–42.09%) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%;95% CI, 4.42–44.20%) and highest in self-reported scales (30.03%; 95% CI, 17.19–47.01%). Depression in patients with HCC was lowest in the Americas (16.44%; 95% CI, 6.37–36.27%) and highest in South-East Asia (66.67%; 95% CI, 56.68–75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC. Conclusions One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide CIs in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

Hemorrhoids/surgery* ; Humans ; Lasers ; Ligation