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Biomedical subjects

A Omar

Publications and source records attributed to A Omar.

At least 37 records · Page 2Linked to original sources

A review of haematogenous osteomyelitis in children in Kuala Lumpur Hospital.

We review 81 cases of acute haematogenous osteomyelitis from 1983 to 1990 to establish current pattern of clinical presentation, modes of treatment and success of therapy. Majority of the patient (70%) presented within a week of symptom and significant number of them came with fever and swelling of the affected limb. Sedimentation rate was found to be raised in all of them. Fifty-four (55%) of them were treated surgically. The average antibiotic time was one week by intravenous administration followed by additional oral therapy for period up to four weeks. Average follow-up was 9 months. Six of them (7.5%) end up with various complication which was believed to be due to delay in getting medical treatment.

Anti-Bacterial Agents↗

Characterisation of a chromatographically produced anti-D immunoglobulin product.

A chromatographic fractionation method has been developed for the production of a liquid-stable anti-D immunoglobulin product for intravenous and intramuscular use. An immunoglobulin fraction, highly enriched with anti-D immunoglobulins, was isolated by cation-exchange column chromatography and further polished, first by anion-exchange chromatography, followed by an aluminium hydroxide gel treatment. The process includes two specific steps for virus inactivation and removal, namely S/D treatment and nanofiltration. The overall anti-D process yield is about 56%. The final product is stabilised with human albumin and glycine and placed in ready-to-use syringes. The anti-D product was shown to be stable in liquid state for at least 30 months at 4 degrees C.

Chemical Fractionation↗

Virus inactivation by pepsin treatment at pH 4 of IgG solutions: factors affecting the rate of virus inactivation.

BACKGROUND: IgG preparations have rarely transmitted infectious diseases; however, because such transmission has occurred a few times, manufacturers are required to present experimental proof that their specific production process removes and/or inactivates viruses that may be present in the starting material. STUDY DESIGN AND METHODS: The kinetics of virus inactivation mediated by pepsin treatment at pH 4 during the production of intravenous immunoglobulin was assessed with spiking experiments using human immunodeficiency virus, bovine viral diarrhea virus, Semliki Forest virus, and pseudorabies virus. The influence of various factors on the rate of virus inactivation also was studied by modifying the composition of the IgG solutions with respect to IgG, sucrose, and NaCl content. RESULTS: Virus inactivation at 37 degrees C was extremely rapid and resulted in a complete loss of infectivity within 5 minutes to 1 hour. Inactivation was much slower at lower temperatures. Furthermore, inactivation was dependent on the solute composition. Increasing the sucrose content from 0 to 15 percent reduced the rate of inactivation of pseudorabies virus but did not affect the rate of inactivation of Semliki Forest virus. In contrast, increasing the NaCl content from 0 to 150 mM resulted in a reduction in the rate of inactivation of Semliki Forest virus, whereas the rate of inactivation of pseudorabies virus remained unaffected. Moreover, increasing the IgG concentration from 0 to 10 percent resulted in an increased rate of inactivation of pseudorabies virus but a decreased rate of inactivation of Semliki Forest virus. CONCLUSION: Inactivation of viruses by pepsin treatment at pH 4 essentially is temperature-dependent, and the reaction rate is selectively influenced by the solute composition of the IgG solution. This has to be taken into account when safety data for different products are compared.

Animals↗

A new technique for treatment of simple post-prostatectomy urinary incontinence: preliminary experience.

PURPOSE: Because of the complexity of reconstructive surgical techniques, the high failure rate and cost of the devices used, as well as the associated mechanical malfunctions there is need for an alternative operation to treat post-prostatectomy urinary incontinence. We present a new procedure along with promising results in cases of simple post-prostatectomy incontinence after transurethral resection of the prostate or open prostatectomy. MATERIALS AND METHODS: The principles of our technique include lysis of the pelvic urethra with preservation of the neurovascular bundle, as well as suspension of the prostatic capsule to the anterior abdominal wall. With this technique we corrected post-prostatectomy sphincteric incompetence in 21 patients. Preoperative evaluation included physical examination, excretory urography, ascending urethrocystography and urethrocystoscopy. Urodynamic investigations included uroflowmetry, cystometrography and urethral pressure profilometry. The patients were reevaluated radiologically and urodynamically 3 months postoperatively. Mean followup was 19 months. RESULTS: All patients tolerated the procedure well. Few intraoperative and postoperative complications were encountered. The success rate was 81% and these 17 patients became continent day and night. CONCLUSIONS: Our procedure combines the continence enhancing features of pelvic urethral elongation, urethral suspension, angulation of the prostatomembranous junction and prostatic fixation. The preliminary success rate of this technique is encouraging. However, larger numbers of patients and long-term followup are needed to confirm our findings.

Humans↗

Hyperplasia of thymic gland.

Hyperplasia of the thymus is the most common anterior mediastinal mass in infants. It is however exceedingly difficult to evaluate by the weight of the gland as it continues to grow after birth until puberty and thereafter undergoes progressive atrophy. It normally maintains most of the radiographic characteristics of the normal thymus. Massive thymic hyperplasia, a rare variant of true thymic hyperplasia is extremely rare during the first two decades of life and clinically can cause mediastinal compression or acute and recurrent pulmonary infection. Two such cases are reported and the clinico-pathology is briefly described and discussed.

Diagnosis, Differential↗

Absenteeism in the workforce, Klang Valley, Malaysia--preliminary report.

The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the "lost time" percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.

Absenteeism↗

Pattern of acute rheumatic fever in a local teaching hospital.

Hospital records of children admitted to the department of Paediatrics, University Hospital, Kuala Lumpur, from January 1981 to December 1990, who were diagnosed to have acute rheumatic fever (ARF) were studied. 134 children satisfied the Jones' modified criteria, thus giving a hospital incidence of 21.2/100,000 paediatric admission per year, of which incidence of first attack was 15.8/100,000 per year and recurrent attack was 5.38/100,000 per year. The M:F ratio is 1.39:1. Majority of cases occur in the 6-11 years age group with 6 cases encountered below the age of 5. The Indians had a higher relative risk to develop both the first acute attack as well as recurrences with a relative risk of 2.4 and 4.10 respectively as compared to the Malays. Majority of the patients, irrespective of the ethnic group, came from families with low income.

Acute Disease↗

The management of severe malaria in children: a review.

We have attempted to summarise an approach to management of severe malaria from our experience and that of others from published data in this review. This represents our current state of knowledge and practices which may change as research continues in this field. It also represents what we feel should be the minimum aim in treating severe malaria even at district hospital level. It focuses on practical issues encountered when admitting such patients: initial assessment, immediate supportive management, use of transfusion, appropriate anti-malarial treatment and ongoing management.

Child↗

The usefulness of a stretch-polyester pouch to encase implanted pacemakers and defibrillators.

This study was undertaken to assess the effects of enclosing permanent pacemaker and ICD pulse generators in a stretch-polyester pouch prior to implantation. Follow-up of 223 patients with oversized pacemakers and with ICDs and 344 with standard-sized pacemaker pulse generators showed that the pouch was effective in decreasing the frequency of pulse generator migration and extrusion.

Defibrillators, Implantable↗

Partitioning and inactivation of viruses during isolation of albumin and immunoglobulins by cold ethanol fractionation.

Albumin solutions invariably transmitted infectious hepatitis viruses before the introduction of pasteurisation in the final container. Immunoglobulin solutions (the older intramuscular as well as the current intravenous ones), on the other hand, only rarely transmitted hepatitis. The apparent safety of the latter was usually attributed to the presence of neutralizing antibodies and to the fractionation process. It was shown that viruses tend to concentrate in those fractions of the cold ethanol precipitation procedure which are used neither for albumin nor for immunoglobulin preparations. Additionally, ethanol alone inactivates some viruses, albeit much less at low temperatures than at room temperature. According to EC-directives, all manufacturers of stable blood products must introduce production steps which inactivate viruses or they have to prove that certain production steps, which are already being used, do inactivate viruses. In either case, the inactivation has to be validated with appropriate experiments. Procedures that are now recognized as virucidal are, e.g., pasteurisation (i.e., heating of the liquid product at 60 degrees C for 10 hours), solvent/detergent (S/D) treatment, photodynamic treatment, or incubation at pH4 with pepsin.

Albumins↗

Fishy-looking liars: deception judgment from expectancy violation.

To explain how people judge that others are lying, an expectancy-violation model is proposed. According to the model, deception is perceived from nonverbal behavior that violates normative expectation. To test the model, 3 experiments were conducted, 2 in the United States and 1 in India. In each experiment, people described acquaintances while exhibiting weird nonverbal behaviors, such as arm raising, head tilting, and staring. Other Ss watched the videotapes of the descriptions and made deception judgments. Consistent with the expectancy-violation model, both American undergraduates and Indian illiterates inferred deception from weird behaviors. Implications of the model are discussed.

Adult↗

Leukemic infiltrate versus anterior uveitis.

Anterior segment leukemic infiltrate (ASLI) is rare; it is found in 0.5% to 2.5% of all leukemic relapses. Its clinical manifestations, at times, are similar to those of anterior uveitis (AU). We report the cases of three patients, all of whom had ASLI as their primary manifestation of relapse. We observed some major clinical differences between ASLI and AU that may help differentiate these two conditions without using anterior chamber paracentesis and/or iris biopsy. The development of resistance to leukemic therapy is the major factor in treatment failure.

Adolescent↗

Semliki Forest virus envelope proteins function as proton channels.

It has been shown that isolated nucleocapsids of Semliki Forest virus (SFV) contract upon low pH exposure (Soederlund et al., 1972). This contraction of the nucleocapsids has been used as an indicator to demonstrate that the spike proteins of SFV can translocate protons into the interior of the virus particle upon low pH (5.8) exposure. Spikeless virus particles obtained after bromelain digestion, which were used as a control, did not translocate protons. This implies that the ectodomain of the spike plays a crucial role for the proton translocation.

Aedes↗

Diagnosis and management of purulent pericarditis. Experience with pericardiectomy.

Twelve cases of purulent pericarditis seen over 6 years are described. Staphylococcus aureus was the most common causative organism (six patients), and a respiratory infection was the most common preceding illness. The chest radiograph and echocardiogram were useful pointers to the diagnosis, but the electrocardiogram was not reliable. Antibiotics, surgical drainage, and pericardiectomy were used in all 12 cases. There was one death (8.3%), which occurred in a patient who was seen late. A review of the literature dealing with the diagnosis and management of this condition is presented. The importance of early diagnosis before a significant degree of cardiac tamponade occurs is noted. Although there is general agreement that surgical drainage is mandatory, the approach, methods of drainage, and extent of pericardial resection have been the subject of some discussion, and at least seven techniques are available. We conclude that pericardiectomy has a definite place in the management of purulent pericarditis.

Adult↗

Semliki Forest virus induced cell-cell fusion at neutral extracellular pH.

Semliki Forest virus-induced cell-cell fusion from within was considered to exclusively occur at mildly acidic pH (less than 6.2). Data of this study show that such cell fusion can also be triggered by transient acidification of the cytoplasm of infected cells at an extracellular, neutral pH. Results were obtained by utilizing NH4Cl pulses combined with covalent modification of cell surface proteins. The observation implies a revision of the current consensus regarding the mechanism of Semliki Forest virus induced cell-cell fusion. We propose a model in which at least two peptide segments of the viral spike protein E1 may be involved in triggering the fusion event.

Aedes↗