Factors associated with control of type I diabetes in Malaysian adolescents and young adults.

Objectives: To examine the association between ethnicity, depression, quality of life, and diabetic control in Malaysian adolescents and young adults with type I diabetes mellitus.

Methods: Fifty-two outpatients with type I diabetes (mean age 15.5 years) who attended a Diabetes Clinic were included.

Prospective randomized clinical trial on suction elastic band ligator versus forceps ligator in the treatment of haemorrhoids.

Objective: This prospective randomized clinical trial was undertaken to compare the use of a single-operator vacuum suction ligator and the traditional forceps ligator in terms of pain perception following the procedure, intra-procedure bleeding and other complications.

Methods: One hundred consecutive patients with second- and third-degree haemorrhoids presenting between July 2002 and September 2003 were randomized into suction and forceps groups for rubber band ligations. They were equally distributed in both groups, with a mean age of 48.

Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction.

Objectives: To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction.

Design: A prospective observational study.

Setting: In the labour room, operation theatre, postnatal wards and neonatal intensive care unit (NICU) of a tertiary teaching hospital.

Prolonged remission after splenectomy for refractory Evans syndrome--a case report and literature review.

We describe a patient with Evans syndrome (autoimmune hemolytic anemia and autoimmune thrombocytopenia) who was refractory to steroids and intravenous immunoglobulin. She responded to splenectomy and has remained in clinical remission for 3 years. In the majority of cases, splenectomy rarely induces a durable remission but it may be beneficial in a small group of patients, hence should be considered as alternative therapy in the management of these patients.

Effectiveness of a simple heated water-filled mattress for the prevention and treatment of neonatal hypothermia in the labour room.

Introduction: This study aimed to determine the proportions of normothermic infants who remained normothermic, and hypothermic infants who became normothermic following the use of a heated water-filled mattress (HWM) in the labour room.

Methods: A prospective observational study carried out in the labour room over a 2.5 month period on 228 well term infants delivered by lower segment caesarean section (LSCS) in the operating theatre (environmental temperature 18 degrees Celsius).

Malignant cervical teratoma in an adult presenting with impending airway obstruction.

Extragonadal teratomas and germ cell tumours are uncommon. Most teratomas of the head and neck present in the paediatric age group. Occurrence of such tumours in an adult is extremely rare and, to date, less than 40 cases have been reported in the literature.

Comparison of serum cardiac troponin T and creatine kinase MB isoenzyme mass concentrations in asphyxiated term infants during the first 48 h of life.

Objective: This prospective study aimed to compare serum creatine kinase MB isoenzyme (CK-MB) mass concentrations and cardiac troponin T (cTnT) concentrations during the first 48 h of life in asphyxiated term infants.

Methods: Serum cTnT and CK-MB mass concentrations of 50 term infants with clinical features of perinatal asphyxia were measured at birth and at 12, 24 and 48 h of age by chemiluminescence immunoassay. These infants were followed up until discharge or death.

Insulin-transferrin-selenium prevent human chondrocyte dedifferentiation and promote the formation of high quality tissue engineered human hyaline cartilage.

This study was to investigate the effects of insulin-transferrin-selenium (ITS) on the proliferation and quantitative gene expression of adult human nasal septum chondrocytes in monolayer culture expansion and the formation of tissue engineered hyaline cartilage. Effects of ITS on human nasal septum chondrocytes monolayer culture expansion and gene expression were evaluated in various culture media either added with 2% fetal bovine serum (FBS) or 1 ng/mL basic fibroblast growth factor plus 1 ng/mL transforming growth factor or both serum and growth factors supplementation in comparison with medium added with 10%FBS. Chondrocytes cultured in medium added with 2% fetal bovine serum and growth factors either supplemented with or without ITS were then mixed with pluronic F-127 hydrogel for in vivo tissue engineered cartilage formation in nude mice model.

Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants: a randomised control study.

Objective: To compare the incidence of nasal trauma associated with the use of prong or mask during nasal continuous positive airway pressure (nCPAP) support in very low birthweight (<1501 g) infants.

Design: Randomised controlled clinical trial.

Setting: Tertiary care university hospital, Department of Paediatrics, Kuala Lumpur, Malaysia.

An unusual radiographic presentation of posterior cruciate ligament avulsion fracture.

A case of traumatic posterior cruciate ligament (PCL) avulsion fracture presenting with unusual radiographic findings is described. CT scan of the right knee showed features suggestive of combined ACL and PCL avulsion fractures. Arthroscopic findings showed that the injury was in fact a PCL avulsion fracture that was displaced anteriorly so as to mimic an ACL avulsion fracture on CT scan.

The rusty knee--pigmented villonodular synovitis.

Pigmented villonodular synovitis (PVNS) is a distinct but rare clinical entity often presents late with a diagnostic difficulty. Its non-specific manifestations require exclusion of several chronic inflammatory disorders and other humorous lesions but all investigations including highly predictive magnetic resonance imaging (MRI) and arthroscopic examination are non-diagnostic demanding confirmatory tissue biopsy. A typical case of such lesion is presented to highlight some potential difficulties.

Multifocal choroiditis: ocular TB or side-effects of anti-TB therapy?

A patient with end-stage renal failure secondary to polycystic kidney disease was seen in the Eye Clinic for a corneal abrasion. Incidental fundal examination revealed bilateral multiple, small, raised, pale yellow sub-retinal nodules. Past medical history of inadequately treated pulmonary tuberculosis was obtained.

Comparison of bioengineered human bone construct from four sources of osteogenic cells.

Osteoprogenitor cells have been reported to be present in periosteum, cancellous and cortical bone, and bone marrow; but no attempt to identify the best cell source for bone tissue engineering has yet been reported. In this study, we aimed to investigate the growth and differentiation pattern of cells derived from these four sources in terms of cell doubling time and expression of osteoblast-specific markers in both monolayer cells and three-dimensional cell constructs in vitro. In parallel, human plasma derived-fibrin was evaluated for use as biomaterial when forming three-dimensional bone constructs.

Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine.

We compared the efficacy of IV fentanyl with IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blind study we recruited 90 patients aged between 18 and 65 yr, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 3 groups: group F received 2 mL IV fentanyl 50 microg/mL (100 microg), group L received 2 mL of preservative-free lidocaine 2% (40 mg), and group P (placebo) received 2 mL of normal saline.

Hashimoto's thyroiditis: a rare cause for rhinosinusitis.

Rhinosinusitis is a common disorder with various etiological factors. In our clinical practice allergy seems to be a predominant cause followed by other less common causes like infection, drugs and aspirin hypersensitivity. We present a case of chronic rhinosinusitis secondary to hypothyroidism.

Tocolysis in term breech external cephalic version.

Objectives: To study the effect of ritodrine tocolysis on the success of external cephalic version (ECV) and to assess the role of ECV in breech presentation at our centre.

Material And Methods: A prospective randomized double-blind-controlled trial comparing ritodrine and placebo in ECV of singleton term breech pregnancy at a tertiary hospital.

Results: Among the 60 patients who were recruited, there was a success rate of 36.

The role of serum insulin-like growth factor I (IGF-I) in neonatal outcome.

Aims: To determine the role of serum insulin-like growth factor I (IGF-I) in predicting the occurrence of septal hypertrophic cardiomyopathy in infants of mothers with diabetes.

Methods/materials: In this prospective study, 100 pregnant women (50 with diabetes and 50 controls), matched for age and race, were studied. One intrapartum blood sample was taken at 28 weeks of gestation from both groups of mothers and another sample at delivery.

Concurrent mycobacterial infection and non-Hodgkin's lymphoma at the same site in an AIDS patient.

A 31 years old Chinese male with acquired immunodeficiency syndrome (AIDS) presented with concurrent mycobacterial infection and a synchronous non-Hodgkin's lymphoma of the nose. The diagnoses were made over a period of two months. Treatment for the mycobacterial infection was administered but he succumbed to the disease shortly after the diagnosis of NHL was established.

Age and gender effect on the growth of bone marrow stromal cells in vitro.

Bone marrow harvested by aspiration contains connective tissue progenitor cells which can be selectively isolated and induced to express bone phenotype in vitro. The osteoblastic progenitor can be estimated by counting the number of cells attach using the haemacytometer. This study was undertaken to test the hypothesis that human aging is associated with a significant change on the number of osteoblastic progenitors in the bone marrow.

Comparison of chitosan scaffold and chitosan-collagen scaffold: a preliminary study.

Chitosan has similar structure to glycosaminoglycans in the tissue, thus may be a good candidates as tissue engineering scaffold. However, to improve their cell attachment ability, we try to incorporate this natural polymer with collagen by combining it via cross-linking process. In this preliminary study we evaluate the cell attachment ability of chitosan-collagen scaffold versus chitosan scaffold alone.

The effects of age on monolayer culture of human keratinocytes for future use in skin engineering.

Skin is the largest organ in human system and plays a vital role as a barrier against environment and pathogens. Skin regeneration is important in tissue engineering especially in cases of chronic wounds. With the tissue engineering technology, these skins equivalent have been use clinically to repair burns and wounds.

The use of bone marrow stem cells for bone tissue engineering.

Bone marrow stem cells (BMSC), known for its multipotency to differentiate into various mesenchymal cells such as chodrocyte, osteoblasts, adipocytes, etc, have been actively applied in tissue engineering. BMSC have been successfully isolated from bone marrow aspirate and bone marrow scraping from patients of various ages (13-56 years) with as little as 2ml to 5ml aspirate. BMSC isolated from our laboratory showed the presence of a heterogenous population that showed varying prevalence of surface antigens and the presence of telomerase activity albeit weak.