PubMed | Shanghai JiaoTong University, University of Sichuan, Chang Gung Memorial Hospital, Inje University and 5 more.
Type: | Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology | Year: 2015
Early diagnosis of hepatitis C virus (HCV) infection is essential to allow appropriate treatment and prevent transmission.To evaluate the Elecsys() Anti-HCV II assay as a routine screening assay in Asia using a large number of samples from different Asian Pacific populations and compare its performance with other HCV assays routinely used in the region.The sensitivity and specificity of the Elecsys() Anti-HCV II assay were determined using routine hospital samples and compared with at least one of the following comparator assays at nine independent centers: ARCHITECT Anti-HCV; Serodia()-HCV Particle Agglutination; Vitros() ECi Anti-HCV; Elecsys() Anti-HCV; ADVIA Centaur() HCV; InTec() HCV EIA; or Livzon() Anti-HCV. Commercially available seroconversion panels were used to assess sensitivity for early detection of infection.The Elecsys() Anti-HCV II assay was more sensitive in recognizing early infection and detected acute HCV infection earlier on average than the comparator assays for all six panels tested. 7,726 routine samples were tested and 322 identified as HCV positive. Elecsys() Anti-HCV II had a sensitivity of 100% and a specificity of 99.66%, both of which were comparable or superior to the results obtained for competitor assays, which ranged from 87.5-100% and 98.98-100%, respectively.The Elecsys() Anti-HCV II assay has the sensitivity and specificity to support its use as a routine screening method in the Asia Pacific region. Furthermore, this assay shortens the diagnostic window between infection and the detection of antibodies compared with established methods.
PubMed | Sultanah Bahiyah Hospital, Hospital Ampang and Hospital Kuala Lumpur
Type: | Journal: Epidemiology and health | Year: 2016
This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity.The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution.The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05).CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.
Ambayya A.,Hospital Ampang |
Su A.T.,University Malaysia Sarawak |
Osman N.H.,Hospital Ampang |
Nik-Samsudin N.R.,Hospital Ampang |
And 5 more authors.
PLoS ONE | Year: 2014
Introduction: Similar to other populations, full blood count reference (FBC) intervals in Malaysia are generally derived from non-Malaysian subjects. However, numerous studies have shown significant differences between and within populations supporting the need for population specific intervals. Methods: Two thousand seven hundred twenty five apparently healthy adults comprising all ages, both genders and three principal races were recruited through voluntary participation. FBC was performed on two analysers, Sysmex XE-5000 and Unicel DxH 800, in addition to blood smears and haemoglobin analysis. Serum ferritin, soluble transferrin receptor and Creactive protein assays were performed in selected subjects. All parameters of qualified subjects were tested for normality followed by determination of reference intervals, measures of central tendency and dispersion along with point estimates for each subgroup. Results: Complete data was available in 2440 subjects of whom 56% (907 women and 469 men) were includ zed in reference interval calculation. Compared to other populations there were significant differences for haemoglobin, red blood cell count, platelet count and haematocrit in Malaysians. There were differences between men and women, and between younger and older men; unlike in other populations, haemoglobin was similar in younger and older women. However ethnicity and smoking had little impact. 70% of anemia in premenopausal women, 24% in postmenopausal women and 20% of males is attributable to iron deficiency. There was excellent correlation between Sysmex XE-5000 and Unicel DxH 800. Conclusion: Our data confirms the importance of population specific haematological parameters and supports the need for local guidelines rather than adoption of generalised reference intervals and cut-offs. © 2014 Ambayya et al.
Chew Y.K.,Hospital Sultanah Aminah |
Cheong J.P.,University of Malaya |
Khir A.,Hospital Pakar Sultanah Fatimah |
Brito-Mutunayagam S.,Hospital Ampang |
Prepageran N.,University of Malaya
Ear, Nose and Throat Journal | Year: 2012
Otogenic brain abscess and postauricular fistula are complications of chronic suppurative otitis media. We describe a rare case of bilateral chronic suppurative otitis media that caused a left temporal lobe abscess and a right mastoid fistula.
Omar R.,National University of Malaysia |
Hussin D.A.,Hospital Ampang |
Knight V.F.,National Defence University of Malaysia
Journal of the Medical Association of Thailand | Year: 2012
Objective: Compare the performance of Lea Symbols and Sheridan Gardiner charts against the standard test chart used to determine reduced VA during vision screening among pre-schoolers. Material and Method: Seven hundred seventy five pre-school participated where 389 subjects were boys and 386 subjects were girls were tested using the Lea Symbols chart and the Sheridan Gardiner chart. The mean age of the pre-school children was 5.3 ± 0.7 years old. Results: The Lea Symbols chart showed a higher sensitivity (97.5%) compared to the Sheridan Gardiner chart (57.1%). While the Sheridan Gardiner chart showed higher specificity (92.0%) compared to the Lea Symbols chart (45.0%). Conclusion: The Lea Symbols chart offers a better pick-up rate of visual impairment during a vision-screening program especially cases of amblyopia among pre-school children compared to the Sheridan Gardiner chart in Malaysia.
PubMed | Universiti Sains Islam Malaysia and Hospital Ampang
Type: Journal Article | Journal: La Clinica terapeutica | Year: 2017
Hereditary angioedema (HAE) is a rare and potentially life threatening autosomal dominant disease characterized by recurrent episodes of cutaneous and mucosal oedema. It results from reduced expression or loss of function of CI-esterase inhibitors (C1-INH). As opposed to the more common histamine-mediated angioedema, HAE does not respond well to conventional treatments with anti-histamines, steroids and adrenaline. Early recognition and timely intervention with the correct treatment are crucial particularly preventing airway obstruction. New disease specific treatment including plasma derived or recombinant C1-INH, ecallantide and icatibant have recently emerged and its appropriate use can reduce HAE-associated mortality and morbidity. However due to its costs, these disease specific treatments have yet to reach Malaysia. Despite that no randomized clinical trial on FFP has been performed, its efficacy in treating acute attacks of HAE is only demonstrated in case studies. This case report illustrates the successful treatment of acute HAE episode with FFP in a Malaysian government hospital setting.
PubMed | Universiti Sains Islam Malaysia and Hospital Ampang
Type: Journal Article | Journal: Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion | Year: 2016
Clinical manifestations of sickle cell disease (SCD) arise from the tendency of the sickle haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape. Sickle cell crisis is a devastating complication that may occur in patients with SCD. If not managed properly permanent organ damage and even death may be the final outcome. A case of a 32-year-old Nigerian lady, Gravida 1 Para 0 in her first trimester, with SCD who developed signs and symptoms of delayed haemolytic transfusion reaction after receiving packed red cell transfusion is demonstrated. Multiple red cell alloantibodies were detected in the patients plasma; anti-Fy a, anti-Jk b and anti-E. The patient miscarriaged and succumbed to complications of hyperhaemolysis with delayed haemolytic transfusion reaction, acute chest syndrome and renal failure. There is an urgent need for mandatory red cell antibody screen and identification especially in high-risk cases. Prevention of alloimmunization by supplying phenotype-specific red cells is also required.
PubMed | University Putra Malaysia and Hospital Ampang
Type: Journal Article | Journal: The National medical journal of India | Year: 2016
The principal cause of iron overload in patients with haematological malignancies is recurrent red cell transfusions for anaemia. The serum ferritin level reflects the iron burden in the body, in the absence of inflammation or liver disease. In Malaysia, data are lacking on the association between pre-transplant serum ferritin levels and outcome after allogeneic haemopoietic stem cell transplant.We did a cross-sectional study using retrospective data of 106 post-allogeneic haemopoietic stem cell transplant patients (HLA-matched sibling) with haematological malignancies at Hospital Ampang to determine the relationship between pre-transplant serum ferritin levels and post-transplant outcome, post-transplant complications and survival time. Patients were divided into two groups according to the iron status: serum ferritin level >1000 g/L (iron overload) and <1000 g/L.The median age for patients was 30.5 (18-58) years. The median pre-transplantation serum ferritin level and the prevalence of pre-transplantation iron overload were 2423 (408.2-7664) g/L and 87.5%, respectively. No significant association was found between iron status and demographic factors, type of haematological malignancy and post-transplant complications. Although insignificant, patients with iron overload had a shorter survival time (36 months) compared to those with no iron overload (40 months). There was also no significant association between the iron status and post-transplant outcome. Significant post-transplant complications associated with post-transplant outcome were the need for total parenteral nutrition (TPN) (p=0.014) and chronic graft-versus-host disease (GVHD) (p=0.008). Similarly, significant associations were found between age group (p=0.003), TPN (p=0.035) and chronic GVHD (p=0.012) with survival time using Kaplan-Meir analysis. However, after Cox regression, only age group was found to be significantly associated with survival time (p=0.014).Serum ferritin is an acute phase reactant and its levels increase in the presence of tissue necrosis and inflammation. Both these events occur in haematological malignancies. Although serum ferritin level is a non-invasive, relatively cost-effective, widely available and practical indicator of iron status, it is not specific to iron overload. Therefore, a true association between the serum ferritin level and iron burden is problematic in patients with haematological malignancies.
PubMed | Hospital Ampang, University of Malaya, Hospital Tengku Ampuan Rahimah and University Technology of MARA
Type: | Journal: BioMed research international | Year: 2015
Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals.
PubMed | Hospital Ampang and Institute of Medical Research
Type: Journal Article | Journal: The Medical journal of Malaysia | Year: 2017
Human enteroviruses (HEVs) have been recognized to cause a significant number of respiratory tract infections in many regions. Previous studies conducted to analyse enteroviral respiratory tract infections focused on outbreaks. Data in the Southeast Asian region is still rather limited to date.We conducted a prospective analysis to understand the epidemiological characteristics of enteroviral lower respiratory tract infections (LRTIs) among paediatric patients admitted to Hospital Ampang, a tertiary hospital in Malaysia.Nasopharyngeal aspirates for common respiratory viruses and throat swabs for enteroviruses were obtained for rtPCR analyses. All positive enteroviral results were then cultured for species identification.Of the total 211 recruited patients, enteroviral LRTIs made up 8%. The clinical features of enteroviral infections are mostly clinically indistinguishable from that of respiratory syncytial virus (RSV) infections. However, RSV appears to be more lymphocytosis causing than enteroviruses (EV). We found a higher asthma incidence within the enteroviral group compared to RSV group. Enteroviral infections continue to play an important role in LRTIs in children beyond infancy and up to school age. Among the enteroviral strains, EV71 contributes a major role in enteroviral LRTIs in our center. Routine testing for enterovirus would certainly help identify a significant proportion of unexplained viral LRTIs among paediatric patients. However, further cost analyses studies would be helpful to determine if incorporating testing for enteroviruses into routine respiratory viruses panel tests is economically feasible.