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Cheras, Malaysia

Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.

Ahmad M.H.,University Putra Malaysia | Mustapha A.,UKM | Khairudin N.M.,University Putra Malaysia
International Review on Computers and Software | Year: 2013

Web usage mining enables organizations and website owners to study the user access patterns or behaviors when navigating their websites. In predicting user navigation patterns, previous study has proposed a two-stage clustering-and-classification of web log data. The main issues in web usage mining is the precision of recommendations in user navigation patterns since it's will affect the quality of prediction of user future navigation. The quality and precision of navigation patterns produce in the clustering stage is useful contribution in designing an accurate user prediction system. This paper aims to undertake comparative analysis on two clustering algorithms, which are graph partitioning and agglomerative hierarchical clustering to compare user navigation patterns produced by each clustering technique. The results from clustering experiments showed that graph partitioning algorithm produced a detailed list of navigation patterns compared to agglomerative hierarchical clustering. © 2013 Praise Worthy Prize S.r.l. - All rights reserved.

Brehler R.,UKM | Klimek L.,Center for Rhinology and Allergy | Pfaar O.,Center for Rhinology and Allergy | Hauswald B.,TU Dresden | And 2 more authors.
Allergy and Asthma Proceedings | Year: 2010

Conventional subcutaneous immunotherapy (SCIT) for allergy treatment needs several injections over several weeks to reach the maintenance dose. Shorter up-dosing regimens are desired but limited by the potential of side effects. This study was designed to compare the safety of Depigoid (Laboratorios LETI, Spain) - SCIT 1 day versus 3 weeks up-dosing in patients with Type 1 allergy caused by clinically relevant sensitization against tree pollen, grass pollen, and house-dust mites. A total of 303 patients with confirmed allergic rhinitis/conjunctivitis were included. A rush build-up schedule administering 0.2 mL and then 0.3 mL of the concentrate at day 1 followed by 0.5 mL at day 28 was compared with a conventional 4-week build-up schedule. The number of patients reaching the maintenance phase without systemic reactions or major deviation from treatment schedule were compared. Of the rush 91.8% and in the conventional group 90.9% reached the maintenance phase without dose modification. Neither the proportions of patients with systemic reactions (5.8% rush versus 2% conventional) nor the proportions of patients with local reactions differed significantly between the two regimens (24% rush versus 11% conventional). There was no difference with respect to the applied allergen group. The proposed rush build-up schedule for the immunotherapy treatment with depigmented allergoids without premedication is safe and not inferior to the conventional schedule. Copyright © 2010, OceanSide Publications, Inc.

Kasirossafar M.,Amirkabir University of Technology | Ardeshir A.,Amirkabir University of Technology | Shahandashti R.L.,UKM
World Environmental and Water Resources Congress 2012: Crossing Boundaries, Proceedings of the 2012 Congress | Year: 2012

While it comes to "Sustainable design", it's usually defined by the concepts like energy consumption optimization, natural sources utilization and environmental protection. Despite of designers focus on these requirements, the financial issues could also affect the sustainability of a design. When a worker injured or dead, it has a direct effect on the financial aspect of the sustainable design beside it is obviously in contradiction to the green design principals. So it may provide a design with the most sustainability when the occupational safety and health, energy conversation and environmental protection come together. To help designers in PtD, a variety of tools have been developed. The newest category of tools are 3D(three-dimensional) and 4D computer-aided-design(CAD) models and Building Information Modeling (BIM) technologies which assist in visualizing 3D components to detect interferences between building systems and spatial-temporal workspace conflicts during construction. This research assessed perceptions about the impact of the implementation of 3D/4D BIM on construction safety. A qualitative survey with a response rate of 62 completed surveys, and based on Iran's construction incidents distribution and happened incidents percentage in 7 primary accident's category, showed that 75% of the respondents thought that construction accidents can be eliminated or lessened through using 3D/4D BIM. The highest three ranking in order of most preventable category of accidents were falls from height, cuts or blows from objects and tools, and thermal contacts or electrical shocks. Beside the safe design idea, sustainable design can also be developed and improved with design suggestions in combination of new design for safety tools and technologies like 3D/4D virtual construction and BIM. This will make ease in correct choices among different designing options and in some cases even would be ended in the new design suggestions. © 2012 ASCE.

Van Baalen A.,University of Kiel | Hausler M.,RWTH Aachen | Boor R.,University of Kiel | Rohr A.,University of Kiel | And 4 more authors.
Epilepsia | Year: 2010

Encephalitis is generally presumed, even when seizures follow banal febrile infection, and pathogen detection in cerebrospinal fluid fails. This retrospective multicenter case series reports on 22 previously healthy children aged 3-15 years (median 6.5 years) with prolonged or recurrent seizures occurring 2-14 days (median 5 days) after fever onset (19 children with respiratory or nonspecific infections). Cerebrospinal fluid studies revealed 2-42 cells/μl (median 5 cells/μl) and no pathogens. Electroencephalography showed diffuse slowing or multifocal discharges. Neuroimaging demonstrated normal findings in 10 children. Brain biopsies were performed in seven children showing gliosis but no inflammation. Anesthetic barbiturates were used in 14 children with refractory status epilepticus, and immunotherapy in 9. Two children died, eight remained in a state of impaired consciousness, eight developed therapy-refractory epilepsies, two had behavioral disturbances, and two recovered. The lack of evidence for encephalitis suggests another infection-related pathogenesis of this disastrous epileptic encephalopathy. Therefore, we propose the term "febrile infection-related epilepsy syndrome" (FIRES). © 2010 International League Against Epilepsy.

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