Abstract, 9th Ncms, 22 - 23 May

8/14/2019 Abstract, 9th Ncms, 22 - 23 May

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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN

74

ABSTRACTS

ORAL

PRESENTATIONS


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A PILOT STUDY OF RISK FACTORS IN CLEFT LIP/PALATE PATIENTS

Authors

A. R. Ismail,N.M. Ismail, L. Naing

Institution

School of Dental Sciences, Universiti Sains Malaysia, HealthCampus, 16150, Kubang Kerian, Kelantan, Malaysia.

Introduction

The risks of non-syndromic cleft lip with or without cleftpalate and isolated cleft palate (CLP) are influenced byvariations at several loci of the gene and these lociinteract with environmental factors to determine diseaserisk.

Objective

The aim of the study is to establish the relationshipbetween environmental risk factors and incidence of cleftlip and palate.

Methodology

This is a case controlled study of non-syndromic CLPpatients attending combined clinic in Kota Bharu andpatients attending outpatient clinic in HUSM. Informationwas obtained using questionnaires. The information inthe questionnaire includes paternal & maternal smokinghabit, amount of tobacco used, genetic consideration.Environmental factors such as area of residence, birthdates, maternal problems, use of complementarymedicine and diseases during pregnancy are explored.

Details of socio-economic status are also obtained. 201CLP patients and 212 controls were interviewed.Univariate and multiple logistic regression analysis wereused to analyze the data.

Results

It was found that demographically there were variationsto risks of non-syndromic CLP. People from Tanah Merahand Tumpat had a 8.74-fold increased risk compared topeople from Kota Bharu. There was an associationbetween passive smokers and CLP (OR) = 2.45 (95%CI: 1.52, 3.94). Maternal and paternal history of cleft,occupation of father and position of child in the familyincreased the risk of CLP (p=0.009).

Conclusion

The study suggested that there were some geographicalvariations in the risk of CLP. Maternal exposure tocigarette smoke (passive smokers) showed increasedrisk of CLP. The seventh child and above had increasedrisk of CLP.

ORAL (A2 - 5)

IN VITROSTUDIES OF PROPERTIES OF ER: YAG

LASER-TREATED HUMAN DENTINE

Authors

Adam bin Husein

Institution

Restorative Department, School of Dental Sciences, Universiti

Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan,Malaysia.

Aims

Er: YAG laser irradiation (_ = 2.94m) has been proven

to be effective in ablating human enamel and dentine.The aims of this study were firstly to examine the surfacemorphology of human dentine resulting from Er: YAGlaser ablation, compared with that produced byconventional methods of cavity preparation. Secondly,it was to test the Shear Bond Strength (SBS) ofcomposite resin (CR) to those dentine surfaces

Materials and Methods

Buccal enamel of fifty extracted human molar teeth wasremoved using a high-speed diamond wheel bur underwater spray so as to leave a planed surface of exposed

dentine. Five of each specimen were subjected to: (i)surface treatment using Er: YAG ablation (250 mJ, 10Hz, VSP), (ii) Er: YAG ablation plus acid etching (37%Phosphoric acid, 10 seconds), (iii) surface treatmentusing conventional methods (fine grit diamond bur) and(iv) conventional plus acid etching. Four groups of fiveteeth were examined under an SEM (Philip XL30). Threegroups of ten teeth underwent SBS testing to comparethe bond strength of CR to the three categories of treateddentine surfaces, using a universal testing machinefollowing ISO standard TR 11405.

Results

Results indicate that the Er: YAG laser irradiationproduces micro-irregularities on dentine surfaces withopen tubules and no smear layer present. The micro-irregularities were completely removed following acidetching procedure. The SBS tests reveal that the Er:YAG laser irradiation with or without acid etching didproduce slightly higher bond strength values than theconventional group but was not statistically significant(student t-test). The SBS values for Er: YAG laser, Er:YAG laser plus etching and conventional are 7.7 4.4MPa, 8.7 3.4 MPa and 7.4 5.3 MPa respectively.

ConclusionThe results of this study indicate that Er: YAG laser canbe successfully used as an alternative to theconventional method in preparing dentine for CRrestoration.

ORAL (A2 - 6)

PROSTHODONTICS AND ITS SCOPE IN MAXILLO

FACIAL REHABILITATION

Author

Jacob John

Institution

Klinik Pergigian Hospital Pasir Mas, Kelantan Dental division,Ministry of Health, Malaysia


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Mans need for replacement of missing or lost bodyparts probably existed as long as man himself. Althoughsocial cultures have characteristically changed and theaccepted modalities for rehabilitation have variedthroughout the centuries, there has apparently alwaysbeen a social awareness that the deformed body is not

completely accepted. A considerable number of people,each year, acquire varying facial defects due tomalignant disease, trauma or congenital deformity.Although modern plastic surgery techniques, in particularmicrosurgery, can help to restore some lost tissue, incases of radical surgery they cannot replace the lostpart in a way which creates an acceptable illusion ofnormal appearance. In addition, the age and generalmedical condition of the patient may also contraindicatemajor reconstructive surgery. In these cases a majordefect persists following surgery. These patients,therefore, can be offered prosthetic rehabilitation as analternative to help fill this void. The specialty ofProsthodontics has grown from mere replacement ofmissing teeth, to include treatment of patients with headand neck malignancy, post tumor therapy surgicalreconstruction and congenital and developmentaldefects.

ORAL (A2 - 7)

KNOWLEDGE, ATTITUDE AND PRACTICE OF PIT

AND FISSURE SEALANTS BY DENTALPRACTITIONERS IN KOTA BHARU, KELANTAN

AuthorsMani SA, Ahmad B

Institution

School of Dental Science, Universiti Sains Malaysia, HealthCampus, 16150, Kubang Kerian, Kelantan, Malaysia.

Background

It is clearly recognized that pit and fissure sealant is aneffective, safe and cost-effective method of preventingpit and fissure caries. Improvement in dental materialshave increased retention rates and shown long lasting,caries preventive effect. This study was done to

investigate the use of fissure sealant among dentalpractitioners and probable factors associated with itsusage.

Method

Forty questionnaires were handed out to dentists in 3sectors; private practice, Ministry of health and HospitalUSM. Questionnaires were designed to evaluateknowledge of type of sealant used, attitude towardsplacement of sealants and preference of type of sealantused.

Results

An eighty percent response rate was obtained, of which56.3% practice the use of pit and fissure sealants intheir clinical practice. All dentists consider age of thepatient prior to placing pit and fissure sealants and only

33.3% consider the caries risk of the patient. Delton FSwas the most commonly used band of sealant (40%).Descriptive statistics was used for this study.

Conclusion

Dental practitioners in the city have a positive attitude

towards practice of pit and fissure sealants. However,private practitioners have been slow to adopt sealantuse in their practice.

ORAL (A2 - 8)

THE DEFINITIVE DIAGNOSIS OF ORAL HAIRY

LEUKOPLAKIA IN HIV-SEROPOSITIVE AND AIDSPATIENTS.

Authors

Mohamed Mabruk1, Stephen Flint2, Mary Toner2 and Greg Atkins3

InstitutionAdvanced Medical and Dental Institute, University Sains Malaysia

Penang, Malaysia 1; Dublin Dental Hospital 2, MicrobiologyDepartment, University of Dublin3

Introduction

Oral hairy leukoplakia (OHL) is a white or grayish orallesion. OHL lesion, usually located on the ventral surfaceand/or lateral border of the tongue. The histopathologicalfeatures of OHL are not pathognomonic to establish adefinitive diagnosis. The definitive diagnosis of OHLrequires the demonstration of Epstein Barr virus in theOHL lesion.

Objective

To investigate the possibility of using Polymerase Chainreaction(PCR) technology in reaching a definitivediagnosis of OHL in tongue scraping obtained from HIV-seropositive patients and to compare our finding to theconventional in situ hybridisation on OHL biopsiesobtained from the same patients. Furthermore, we haveinvestigated the possibility of using a rapid microwavein situ-hybridisation technology in order to accelerateand simplify the definitive diagnosis of OHL.

Methodology

Polymerase chain reaction approach was carried outand compared to the conventional in situ hybridisationmethod. Furthermore, we have modified a microwavein situ hybridisation technique and designed a novel insitu hybridisation chamber to accelerate the technicalprocedures for reaching a definitive diagnosis of OHL.

Results

EBV DNA was not only detected in all OHL lesionalscrapings but also in 36.3% of normal control. However,by using a conventional in situ hybridisation approach,EBV DNA was detected only in OHL biopsies and non

in the normal healthy controls biopsies. Furthermore,using microwave in situ hybridisation and our newlydesigned chamber, we have shortened the hybridisationstep for EBV detection in OHL biopsies, from over-nightincubation to 14 minutes.


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Conclusion

PCR is highly sensitive and of low specificity and shouldnot replace in situ hybridisation for reaching a definitivediagnosis of OHL. In addition we have established arapid microwave in situ hybridisation approach forreaching a definitive diagnosis of OHL in HIV-

seropositive and AIDS patients.

ORAL (A2 - 9)

THE MAXILLARY ARCH FORM OF SELECTEDETHNIC GROUPS IN MALAYSIA AND ITS

RELATIONSHIP TO CEPHALOMETRICLANDMARKS

Authors

Khin Myo Thu1, Than Winn2, J.A.P. Jayasinghe1, Nizam Abdullah2,and G.L.Chandima3

Institution1Department of Anatomy, 2Department of Community Medicine,

School of Medical Sciences, 3School of Dental Sciences,Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,Kelantan, Malaysia.

Introduction

A correct knowledge of tooth size, dental archdimensions and head form of a population are importantfor several dental treatment procedures. Heritabledifferences present in these parameters among themare also useful for the practice of Aesthetic Dentistryand effective orthodontic treatment.

Objectives

To estimate maxillary arch measurements, the validityof the Ponts & Korkhaus indices, the relationshipbetween maxillary arch form with head form, the cephalicindex (CI) and also to compare these measurementsamong ethnic Malays and Chinese.

Methodology

A cross-sectional study was conducted on 87 Malay and89 Chinese students. Head measurement was takenusing anthropometric instrument and dental archmeasurements made on the casts. Data analysis was

done using STATA 7.0.

Result

The Cephalic Indices (CI), for Malay (86.4) and theChinese (85.9) were not significantly different. But themeans of anterior arch width (AAW), posterior-arch-width(PAW) and arch-length were significantly differentbetween two groups. AAW and PAW were significantlydifferent from their corresponding Indices for Malays butnot for Chinese. Correlation Coefficient betweenbizygomatic width and anterior-arch-width in Malay was0.18 (p >.05) and in Chinese 0.20 (p < 0.01).

ConclusionThe Ponts and Korkhaus Indices could not be appliedto the study Malays but moderately to the Chinese. C.I.of our study subjects were found to be brachycephalic

without any gender difference.

ORAL (B2 - 1)

INTERLEUKIN-6 AS A POTENTIAL EMBRYOTOXIC

FACTOR IN ENDOMETRIOSIS: LOCAL OR

SYSTEMIC EXPRESSION?

Authors

Liza Noordin1, Gregory JS Tan2 and Mohd Shukri Othman3

Institutions1Departments of Physiology and 3Obstetrics & Gynaecology,Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,

Kelantan, Malaysia. 2 School of Biomedical Sciences, TheUniversity of Notre Dame Australia P.O.Box 1225, Fremantle WA

6959 Australia.

Objectives

1. To determine interleukin (IL)-6 as a possible

embryotoxic factor in endometriosis.2. To determine the effect of IL-6 on in vitrodevelopmentof early mouse embryos.

Introduction

The aetiology of endometriosis associated infertilityremains an enigma. In recent years, peritoneal fluid andserum are two biological fluid, which have been studiedextensively as possible mediators of infertility in thisdisease through its toxic effect on early embryo growth.We have shown previously that in women withendometriosis, the peritoneal fluid was embryotoxic1.

Various embryotoxic factors have been determined in

these fluid, including interleukins.

Methodology

1. The levels of IL-6 in the peritoneal fluid and serumfrom infertile women with and without endometriosiswere measured using the ELISA method.

2. Two-cell mouse embryos were cultured in 1mlmodified Whittens medium in the presence orabsence of IL-6 at different concentrations (1.6pg/ml and 100pg/ml). The embryos were cultured andobserved for 3 consecutive days.

ResultsThe levels of IL-6 were significantly higher in theperitoneal fluid with endometriosis as compared towithout endometriosis (p


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not correlate with the serum levels suggesting thatchanges in the interleukin concentration resulting fromendometriosis occur locally.

ORAL (B2 - 2)

ASSESSMENT OF LABOUR PAIN BY MIDWIVESIN LABOUR SUITE HOSPITAL UNIVERSITY OFSAINS MALAYSIA, KELANTAN.

Authors

Intan Idiana H1, Nik Hazlina NH2, Rogayah Abd. R 2, Tengku

Norbainee TH3, Kamarul Imran M3.

Institution1School of Health Sciences, 2Department of Obstetrics andGynecology, School of Medical Sciences, 3Department ofCommunity Medicine, Universiti Sains Malaysia, Health Campus,

16150, Kubang Kerian, Kelantan, Malaysia.

IntroductionAccurate assessment of labour pain will guide theappropriate management and increase the quality ofcare. Because pain is subjective, labour pain is oftenunder or overestimated by midwives.

Objective

The aim of the study is to compare the assessment oflabour pain among midwives and mother and to identifyfactors affecting the assessment by the midwives.

Methodology

The study population consisted of 60 mothers and 30

midwives. All mothers were asked to rate their pain levelusing graphic visual analogue scale (VAS). At the sametime the mothers using the same scale exhibited theirattending midwives estimated the degree of pain, as wasexhibited by the mothers using the same scale.

Result

A good correlation (0.618) was found betweenassessment of midwives and mothers. But there wasno statistically significant different in experience, age,number of children, pain management course andmethod of assessment among midwives (p>0.05).

Conclusion

Midwives in this study were able to assess labour painaccurately as reported by the mothers and factors suchas age, experience, number of children, painmanagement course and method of assessment doesnot have any influence on the midwives assessment.

ORAL (B2 - 3)

SCREENING FOR ASYMPTOMATICBACTERIURIA (ABU) IN PREGNANCY AMONGANTENATAL ATTENDEES IN HUSM

Authors1Nik Hazlina N. Hussain, 1Nizar Bidin, 1Che Anuar Che Yaakob,2

Md. Radzi Johari, 2Maimunah Ahmad, 3Norsaadah Bachok, 3Norlen

Mohamed.

Institution1Department of Obstetrics & Gynaecology, 2Dept. of Microbiology,3Community Medicine Dept., School of Medical Sciences,Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,

Kelantan, Malaysia.

Introduction :

Asymptomatic bacteriuria in pregnancy is not withoutrisk to mother and fetus. Screening and treatment ofthis condition had been shown to improve the sequelaeof the disease. Screening for ABU is not a routinepractice in Malaysia.

Objectives

To determine the prevalence and outcomes ofasymptomatic bacteriuria in pregnancy in HUSMantenatal clinic population.

Methodology

A cross sectional study was conducted from 1st July 2002

to 1st January 2003 in HUSM antenatal clinic. MSUFEME clean catch urine for culture and sensitivity andmicroscopy was obtained from 447 women attendingHUSM antenatal clinic with no symptoms to indicateinvestigation for urinary tract infection. 72 were excludedas they have mixed growth in MSU C&S and 6 forincomplete outcome data. 369 women had either nogrowth (group A) or significant growth (group B). Thefinal outcome of the pregnancy was looked into. Alsorecorded were period of gestation at delivery, birth weightand complications that arose during the course ofpregnancy.

Results

The prevalence of ABU was 4.3% (16/375). The meanperiod of gestation at delivery was 38.6 1.6 for GroupA and 38.7 1.3 for Group B. The mean birth weightwas 3.1 0.4 for Group A and 3.2 0.5 for group B andthe difference was not significant statistically. Thematernal outcomes revealed no statistically significantdifference in UTI complications, prelabour rupture ofmembranes, preterm labour/ delivery or perinatalmortality and sepsis.

Conclusion

The prevalence of ABU was comparable with that foundin other studies. However we were unable todemonstrate the strong association with preterm delivery,low birth weight and symptomatic UTI.

ORAL (B2 - 4)

KNOWLEDGE ON CERVICAL CARCINOMA ANDPAP SMEAR AMONG WOMEN ATTENDING

GYNAECOLOGY CLINIC HUSM

Authors

K. S. Law1

, L. K. Soon1

, Nik Hazlina NH2

, and3

Tg. Norbanee Tg.H

Institution1School of Health Sciences, USM, 2Department of Obstetrics andGynecology and 3Department of Community Medicine, School


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of Medical Sciences, Universiti Sains Malaysia, Health Campus,16150, Kubang Kerian, Kelantan, Malaysia.

Introduction

Cervical carcinoma is the second most common cancerin Malaysian women.

Objective

The study is performed to explore knowledge aboutcervical carcinoma and Pap smear tests among womenattending the gynaecology clinic in HUSM

Methodology

A cross sectional study was conducted from October2003 till December 2003. Random sampling method wasused. Patients were told regarding the study and a selfanswered questionnaire was filled up by the respondent.

Result

The study found that the majority of the respondentswere aware of cervical carcinoma (90.3%) and had heardabout Pap smear (86.1%). Only 33.3% of therespondents had a high score knowledge (21-30) oncancer of the cervix and 25.7% of respondents trulyappreciate the importance of Pap smear. 68.9% ofrespondents did not acknowledge the duration of whichpap smear should be carried out on a regular basis.Further analysis revealed that majority of the informationof pap smear was obtained from reading materials(48.6%). Only 6.3% of respondents obtained theknowledge of Pap smear from their husband. There is asignificant correlation between the knowledge of Pap

smear with occupation (p= 0.005), education level(p=0.001), those who had undergone Pap smear(p


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MANAGEMENT OF COLORECTAL CARCINOMAAT HUSM DEPT OF RADIOTHERAPY ANDONCOLOGY

Authors

Dr Murali Bhavaraju*, Dr B M Biswal, Dr Nik Min Ahmad

Institution

Dept of Radiotherapy and Oncology, Universiti Sains Malaysia,Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.

Introduction

Colorectal carcinoma (CRC) is the commonest cancerof the western world, but the incidence of CRC is low inAsian countries. Surgery is the definitive treatment andthe staging of CRC is surgico-pathological staging. Therole of adjuvant treatment in the form of radiotherapyand chemotherapy is well documented in themanagement of CRC.

Objective

To analyze the pattern of presentation, stage of disease,and the protocol of management of CRC at HUSM. Thepattern of failure at the locoregional and distant siteswere analyzed.

Methodology

This is a retrospective study reviewing the case files ofpatients of CRC attending the Oncology OPD at HUSMduring the years 2001- 2003.The role of adjuvantradiotherapy and chemotherapy with 5Fu-based regimeswill be discussed.

Results

A total of 77 patients were analyzed in the present study,Dukes staging system is used for the staging. Fiftypercent of patients presented in the 6 th & 7th decade oflife. Patients age ranged from 19 years to 82 years.Rectum and recto-sigmoid region is the most commonlyaffected site in the large gut. More then 65% patients ofCRC presented in advanced stages. Thirty five percentof patients received radiotherapy and 53% receivedchemotherapy FUFA regime. Disease free status isnoted in 46% of patients and liver is the most commonsite for metastasis. The follow up ranged from 1 monthto 30 months.

Conclusion

CRC is one of the commonest cancers seen in theOncology OPD, HUSM. Most of the patients present inthe advanced stage of the disease. They needMultimodality treatment for their cancer management.

ORAL (B2 - 8)

A STUDY ON THE PSYCHOSOCIAL IMPACT AND

THE USE OF ALTERNATIVE MEDICINE

PRACTISES(HOMEOPATHY AND TRADITIONAL)ON THE INFERTILE FEMALE IN HUSM.

Authors

Norliza M1, Shaiful I1, Nik Hazlina NH2 and Hasanah CI 3

Institution1 Department of Family Medicine, 2Department of Obstetrics andGynecology, 3Department of Psychiatry, School of MedicalSciences, Universiti Sains Malaysia, Health Campus, 16150,

Kubang Kerian, Kelantan, Malaysia.

Introduction

Infertility is one of the health problems that may be facedby the married couple. However not many study iscarried out in Malaysia to look on the psychosocial impactof infertility on the infertile couples.

Objective

To determine the use of alternative medicine (traditionaland homeopathy) and its psychosocial impact oncouples in which the female is infertile.

MethodologyA cross sectional study was conducted for one yearduration to all infertile females and their partners whowere attending the Obstetric and Gynaecology Clinic,Hosiptal Universiti Sains Malaysia (HUSM). It wasconducted on 182 respondents using a self answeredquestionnaire.

Result

At least two third of the respondents, had used alternativemedicine for their infertility problem with half of thempracticing a traditional medicine, 14.8% practicinghomeopathy and 1.6% practicing both. Eighty threepercent respondents had a psychosocial impact becauseof their infertility. Statistical analysis showed that therewas a significant association between the psychosocialimpact with the education level and use of alternativemedicine. There was no significant association betweenpsychosocial impact with age, ethnic, occupation, typeof infertility, duration of marriage and duration of infertility.

Conclusion

Most of infertile female had a psychosocial impact andthis was significantly associated with education level anduse of alternative medicine. Recognition of these

relations may help in the counseling of infertile couples.The management of infertility should not only includephysical treatment but also understanding, sympathyand support.

ORAL (B2 - 9)

IMMUNE CELL CHANGES IN PRIMARY BREASTCANCER PATIENTS UNDERGOING

CHEMOTHERAPY WITH FEC REGIMENS

Authors

N. Wijayahadi1, M.R. Haron2, J. Stanslas3, Z. Yusuf1

Institution1Dept. of Microbiology & Immunology, Faculty of Medicine,Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia., 2Dept.


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of Radiotherapy and Oncology, Hospital Kuala Lumpur, KualaLumpur, Malaysia, 3Dept. of Biomedical Sciences, Faculty ofMedicine and Health Sciences, Universiti Putra Malaysia,

Serdang, Malaysia.

Introduction

Breast cancer is the most common malignancy in women

of which treatment modalities include variouscombinations of surgery, radiotherapy, chemotherapy,and hormonal therapy. Selection of therapy andprognosis is influenced by the integrity of the immunesystems, especially the profile of subsets of the immunecells. This study examines the effect of combinationchemotherapy 5-fluorouracil, epirubicin/doxorubicin andcyclophosphamide (FEC) regimens on the subsets ofthe immune cells of patients with primary breast tumours,before and after starting systemic chemotherapy. Ouraim is to determine the ability of FEC in changing profilesof immune cells of breast cancer patients.

Methods

Blood from 31 primary breast cancer patients undergoingchemotherapy with FEC was taken before chemotherapyand after every cycle (3 weeks) for 6 cycles. Blood takenfrom 31 normal healthy donors served as normal control.Subsets of lymphocytes T-helper cells (CD3+CD4+), T-cytotoxic cells (CD3+CD8+), B-cells (CD19+CD20+) andNK cells (CD16+/CD56+CD3-) were analyzed by flowcytometry (FacsCalibur, BD) using monoclonalantibodies (Multitest, BD).

Results

There was no significant difference in the immune cellsprofile between the control and pretreatment groups.FEC regimens led to increase counts of monocytes(p


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Authors

Al-Jashamy K., Zeehaida M.and Nik Zairi

Institution

Department of Medical Microbiology and Parasitoogy, School of

Medical Science, Universiti Sains Malaysia, Health Campus,16150, Kubang Kerian, Kelantan, Malaysia.

Background

Toxoplasma gondiiis an opportunist protozoan parasitethat may induce a disseminated and lethal disease inimmunosuppressed patients. Toxoplasma serologic testsare used most commonly for diagnosis, but may beinsensitive in patients lacking normal responses. Aretrospective study was conducted to review thetoxoplasma cases seen in HUSM / laboratory ofparasitology.

Methods

During the period from January 2001 to March 2004, all

the cases were recorded. Blood samples were examinedby enzyme-linked immunosorbent assay using IgG andIgM.

Results

A total of 206 blood samples were collected from thepatients who were suspected to have toxoplasmosis.The rate of positive tests for toxoplasmosis was 2.5%(1 out of 40 cases) in 2001, 6.9% (4 out of 58 cases) in2002 and 16.0% (8 out of 49 cases) in 2003. It was49.0% (29 out of 59 cases) in the period of 1st Januaryto 31 st of March 2004. The overall positivity for

toxoplamosis was 20.0%. No significant differences byage or sex were observed.

Conclusion

The studied individuals had a high prevalence ofToxoplasma gondii infection

ORAL (C2 - 3)

ANALYSIS OF G_A 211 (G71R) MUTATION OF THEUGT1A1 GENE IN NEONATAL

HYPERBILIRUBINEMIA IN MALAYS.

AuthorsSurini Y. 1, Van Rostenberghe H. 2, Norlelawati A.T.1, Abdul Aziz I.1, Noraida R.2, Isa M.N. 1, Nishio H.3 , Matsuo M.4, Narazah M. Y.1

Institution1 Human Genome Center , 2 Department of Pediatrics , School ofMedical Sciences, Universiti Sains Malaysia, Health Campus,

16150, Kelantan, Malaysia. Division of Public Health, 3Departmentof Environmental Health and Safety, Faculty of Medical Sciences, 4 Department of Pediatrics, Kobe University Graduate School

of Medicine, Kobe, Japan.

Introduction

A missense mutation of G-to-A at nucleotide 211 in exon

1 of UGT1A1 gene results in amino acid change fromglycine to arginine at codon 71 (G71R). This is one ofthe genetic risk factors in neonatal hyperbilirubinemiaamong Japanese neonates. This finding led us to

evaluate the presence of G71R mutation inhyperbilirubinemia in Malay neonates.

Subjects and methods

A total of 55 Malay neonates (36 males and 19 females)with hyperbilirubinemia and 50 Malay neonates without

hyperbilirubinemia (controls) were studied. The studysubjects were term babies, normal birth weight and withtotal serum bilirubin level more than 250 mol/L withinfirst 7 days of life. Blood was collected from afterinformed consent taken from the parents and DNAextracted by standard methods. Screening for the G_A211 mutation was performed using DHPLC. PCR primersfor PCR amplification and for DHPLC conditions wereas described before. For heteroduplex formation, crudePCR products were denatured at 950C for 5 min followedby cooling to 250C for 1h. DHPLC was performed usinga fully automated system (Varian Helix System). Thechromatograms of subjects were compared with thoseof heterozygous controls and normal controls.

Results

Out of 55 neonates, 3 neonates (5.5%) were noted tohave the G71R mutation. In the normal controls therewere 3 positive (6.0%) samples. Thus there was nosignificant association (p < 0.05) of G71R in neonateswith hyperbilirubinemia and without hyperbilirubinemia.

Conclusion

The results suggested that the high incidence of neonatalhyperbilirubinemia among Malays cannot be explained

by a high frequency of G71R mutation.

ORAL (C2 - 4 )

CYTOTOXIC EFFECTS OF THE METHANOLICEXTRACTS FROM 20 SPECIES OF ARACEAE

AGAINST HUMAN HEPATOCELLULARCARICOMA CANCER (HEPG2) CELL LINE.

AuthorsVenugopal Balakrishnan, Tengku Sifzizul Tengku Muhammad and

Shaida Fariza Sulaiman

InstitutionSchool of Biological Science, Universiti Sains Malaysia, 11800Minden, Penang, Malaysia.

The 80% (v/v) methanolic extracts from 20 speciesof Araceae were screened for their anticancer activitiesagainst Human Hepatocellular Carcinoma (HepG2) cellline and the cell survival was determined usingMethylene Blue Assay. All the plant extracts exhibiteddose-dependent inhibition on the growth of HepG2 cellline. The most significant inhibition was produced byAlocasia macrorrhizaextract with EC

50(effective

concentration that can kill 50% of cancer cells) of

15.11mg/ml. In addition, three other extract that havebeen identified as potential anti-cancer agents areAmydrium media(EC

50= 17.116 mg/ml), Ariseama waryi

(EC50

= 19.626 mg/ml) and Scindapsus aureus(EC50

=


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18.083 mg/ml. Alocasia macrorrihizawas furtherfractioned using three different solvents i.e. hexane,chloroform and 80% (v/v) methanol. Only the hexaneand chloroform fractions exhibited significant cytotoxiceffect on HepG2 cells with EC

50value of 11.018 mg/ml

and 4.217 mg/ml, respectively. The chloroform extract

was subsequently fractioned and from the 17 fractionsobtained, fraction F8 was considered the most potentfraction with EC

50value of 3.695 mg/ml against HepG2

cells. DeadEnd Colometric Apoptosis Detection Systemand DNA Fragmentation ELISA indicated that thechloroform extract and fraction F8 triggered the HepG2cell death viaapoptosis mechanism.

ORAL (C2 - 5)

SMN1 AND NAIP GENE DELETION IN MALAYSIANSMA PATIENTSAuthors

Watihayati MS1, Zilfalil BA2, Naing L4, Sutomo R5, Nishio H5,Narazah MY1, Tang TH3, Matsuo M6, Zabidi-Hussin AMH2

Institution1Human Genome Centre 2Department of Pediatrics 3Departmentof Microbiology and Parasitology, School of Medical Sciences4Biostatistician, School of Dental Sciences, Universiti Sains

Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan,Malaysia. 5Department of Public Health and 6Department of

Pediatrics, Kobe University Graduate School of Medicine, Japan.

Introduction

Spinal Muscular Atrophy (SMA) is one of the mostcommon autosomal recessive inheritance diseases.

According to the previous reports, 90-95% of SMApatients show homozygous deletion of exons 7 and 8,while the rest of the patients have other mutations inthe SMN1 gene. The NAIP gene, which exists near theSMN1 gene, is reportedly correlated with the severity ofSMA. In Malaysia, SMA has been diagnosed based onthe clinical features, muscle biopsy findings, EMG andnerve conduction studies, but not based on molecularanalysis. Here we did a molecular analysis of MalaysianSMA patients, and compared the results with the datareported previously.

ObjectivesTo determine the incidence of SMN1 gene deletion inMalaysian SMA patients and to clarify the relationshipbetween the NAIP gene deletion and severity of thedisease.

Material and methods

A total of 13 patients (Type I = 4 patients, Type II = 6patients, Type III = 3 patients) who fulfilled the diagnosticcriteria for SMA were enrolled into this study. GenomicDNA was extracted from 2.5ml of blood. The SMN geneswere analyzed by the methods of van der Steege et al,and the NAIP gene were analyzed by the methods of

Roy et al.

Results

Homozygous deletion of SMN1 was found in 77% of

our patients. Seventy-five % of Type I, 83% of Type IIand 66% of Type III patients show homozygous deletionof this gene while the NAIP gene deletion was seen in50% of both Types I and II and 33% in Type III.

Discussion

From these findings, the SMN1 gene deletion incidenceis much lower in our population than that in otherpopulations. In addition, the NAIP gene was not relatedto the severity of the disease. However, it is too early tocome to a conclusion with a limited number of thepatients. Larger scale studies are necessary todetermine the exact incidence of SMN1 gene deletionin Malaysian SMA patients and to clarify the role of theNAIP gene.

ORAL (C2 - 6)

IDENTIFICATION OF URIDINE DIPHOSPHATEGLUCURONOSYL TRANSFERASE 1A1 (UGT1A1)GENE MUTATION IN BABIES WITH EARLY ONSETOF NEONATAL JAUNDICE (NNJ)Authors

Norlelawati A.T1, H. Von Rostenberghe2 ,Sutomo R3, Selamah G,

Matsuo M. 4 Nishio H.3 and Narazah M.Y5

Institutions

Haematology Department1, PaediatricsDepartment2 and HumanGenome Centre5, School of Medical Sciences, Universiti SainsMalaysia, Health Campus, 16150, Kubang Kerian, Kelantan,

Malaysia. Division of Molecular Medicine5 and Department ofOccupational Health2, Kobe University Graduate School ofMedicine.

Introduction

NNJ, a potential cause of kernicterus is common inMalaysia. However, no obvious aetiology is identified inmost of the cases. Recently, mutations in the bilirubinUGT1A1 gene attributed to NNJ and hyperbilirubinemiasyndromes have been reported in many populations

Objective and Methods

Molecular techniques were applied for investigating ofthe UGT1A1 mutation in three babies [B1, B2, and B3]who had early onset of jaundice. Identifiable causes of

pathological jaundice have been excluded earlier. Aninherited phenomenon of this mutation wasdemonstrated by doing family study and molecularanalysis.

Results

Nucleotides sequenced identified two different novelmutations in two Malay babies [B1, B2]. One mutationwas transversion G C at nucleotide 1477 in exon 5(G493R) in B1. Another mutation was transition A Gat nucleotide 964 in exon 2 (I322V) in B2. A specificmutation i.e. transition GA at nucleotide 211 in exon 1(G71R) was identified in B3, a Chinese.

Conclusion

These results suggest that mutations in UGT1A1 genemay play a role in the pathogenesis of early onset ofNNJ.


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ORAL (C2 - 7)

PREVALENCE OF INTESTINAL PARASITESAMONG SUSPECTED CASES IN HOSPITALUNIVERSITI SAINS MALAYSIA

Authors

Al-Jashamy K. and Zeehaida M.

Institution

Department of Medical Microbiology and Parasitoogy, School of

Science, Universiti Sains Malaysia, Health Campus, 16150,Kubang Kerian, Kelantan, Malaysia.

Background

A retrospective study was conducted to review theintestinal parasites cases seen in HUSM / laboratory ofparasitology.

MethodsDuring the period from January 2001 to December 2003,all the cases were recorded. The stool samples weremicroscopically examined for intestinal parasites usingthe formalin-ether concentration technique.

Results

A total of 4588 stool samples were collected from thepatients who were suspected to have a parasiticinfection. Overall infection rate was 11% (530 out of 4588samples), with Ascaris lumbricoides(3.8% or 174 cases)and Trichuris trichiura (3.8% or 173 cases) as the

commonest parasites. The positivity of Blastocystishominiswas 1% (50), Entamoebia histolytica1% (46),Giardia lamblia0.8% (38), Hook worm 0.7% (33),Stronyloides and Entrobius vermiculariswere 0.2% and0.01% respectively. Overall positivity rate in 2001 was13% which was higher than in 2002 (11%) and 2003(11%). Conclusions: The overall positivity rate indicatedthat the parasitic infection rate was less in 2002 and2003 than 2001 using the same technique.

ORAL (C2 - 8)

HLA CLASS II ANTIGENS IN MALAYS WITH

SYSTEMIC LUPUS ERYTHEMATOSUS IN HUSM

Authors

Nurul Khaiza Y1, Nadeem A1, Kamaliah MD2.

Institution1Department of Immunology, 2Department of Medical, School ofMedical Sciences, Universiti Sains Malaysia, Health Campus,16150, Kubang Kerian, Kelantan, Malaysia.

Background

Systemic lupus erythematosus ( SLE ) is a disease ofabnormal immune regulation, characterized by theproduction of autoantibodies. Autoantibody productiondepends on the interaction of helper T lymphocytes withHLA Class II molecules on antigen presenting cells;therefore, the class II genes have a role in susceptibilitythrough alteration of T cell recognition.

Objective

This study was designed to evaluate the frequency ofHLA-DR and DQ alleles in ethnic Malays with SLE inorder to determine the role of these genes in diseasesusceptibility.

MethodologyHLA typing of fifty-five SLE patients from Malay ethnicwho fulfilled the American Rheumatism Association (ARA ) were analysed, and compared with the controlgroup consisting of 55 healthy unrelated subject withcomparable age, sex and ethnic. HLA typing of class IIantigen were carried out using MicroSSP Class II generic( DRB/ DQB ) from One Lambda Inc.

Results

We found a strong significant association of HLA-DR15and HLA-DR17 with SLE compared to healthy controlgroup ( pcorr = 0.002 , adjusted OR = 5.513 ; pcorr =

0.04, adjusted OR = 7.87 , respectively ). There was aweak decrease of HLA-DR4 which was not significantafter corrections for multiple comparisons made.

Conclusion

Our data suggests the role of the HLA Class II genes inconferring SLE susceptibility and in clinical expression.

ORAL (C2 - 9)

AN OUTBREAK OF PANTOEA SPP. IN ANEONATAL INTENSIVE CARE UNIT (NICU)

SECONDARY TO CONTAMINATED TOTALPARENTERAL NUTRITION (TPN).

AuthorsHabsah H*, Zeehaida M*, Rosliza AR*, Van Rostenberghe H**,

Noraida R**, Wan Pauzi WI**, Fatimah I**, Nik Sharimah NY**Maimunah H***

Institution

* Department of Medical Microbiology and Parasitology, **Department of Pediatric, PPSP, Infection control and Hospital

Epidemiology Unit HUSM, Universiti Sains Malaysia, HealthCampus, 16150, Kubang Kerian, Kelantan, Malaysia.

BackgroundNeonates are particularly susceptible to infectionbecause their immune system is not fully developed. Inaddition, they often require invasive diagnostic andtherapeutic procedures that are associated with anincreased risk of infection. An important source ofinfection is contaminated parenteral nutrition. Pantoeaspp. rarely cause infection in immunocompetent hostsand has never been reported to cause mortality or severemorbidity. The objective of the study is to investigate anoutbreak caused by Pantoeaspp. in a neonatal intensivecare unit.

Methodology

A descriptive study of an outbreak of sepsis in NICU,HUSM. Pantoea spp. infection was detected in eightpatients during three-days period from 24 th to 27 th


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January 2004 following the administration of TPN. Sevenof eight patients died due to the infection. An extensiveenvironmental sampling and culture were done includingin-use TPN and other unused TPN in NICU andpharmacy during the outbreak period.

ResultsPantoeaspp. was isolated from blood cultures ofinfected patients, the unused TPN from pharmacy andalso from the unused TPN from NICU. All the strains ofPantoeaspp. had the same antibiotic susceptibilitypattern and biochemical reaction.

Discussion and Conclusion

The source of the outbreak was the TPN and thecontamination occurred during the preparation of TPNin pharmacy. A thorough investigation has been carriedout and where possible corrective measures have beentaken to avoid similar outbreaks in the future.

ORAL (A3 - 1)

RISK FACTORS IN ADULT POISONING, A CASE-CONTROL STUDY AT PENANG GENERALHOSPITAL- MALAYSIA

Authors

Ahmed I Fathelrahman1, AF Ab Rahman2 and Z M Zain3

Institution1,2School of Pharmaceutical Sciences, Universiti Sains Malaysia,Minden 11800 USM Pulau Pinang Malaysia 3General Hospital

Pulau Pinang Malaysia

Introduction

Identification of risk factors related to acute poisoning isessential in any prevention or educational program. Toour knowledge worldwide, moat of the previous case-control studies on poisoning have been dealing withchildhood poisoning.

Objectives

To determine possible risk factors associated with adultsadmissions at Penang General Hospital (GHP) due toacute drug or chemical poisoning.

Methodology

The present study was a case- control study, conductedover 18 weeks. 100 acutely poisoned adult patients,consecutively admitted to GHP during the period from15 September 2003 to the third of February 2004 wereconsidered as cases. 200 Patients admitted to the samemedical wards for other illnesses during the same period,matched for age and gender with the poisoned caseswere selected as controls. McNemar test was used forunivariate analysis and logistic regression analysis formultivariate ones. The odds ratio (OR) and its 95%

confidence interval (95%CI) were calculated for eachpredictor variable.

Results

Indian race, private employment, self-employment and

living in a rental house were significant risk factorsassociated with adults admissions at GHP for poisoning.Other significant risk factors included study, family,marital and boy/ girl friend problems.

Conclusions

This study has identified risk factors can be used as aguide for targeting poison control programs.

ORAL (A3 - 2)

MENINJAU KEHADIRAN MIKROORGANISMA

PADA ALATAN GALIPOT DAN CECAIR YANGDIGUNA SAMA UNTUK PROSEDUR SEDUTANTIUB ENDOTRAKEA DAN TIUB TRAKEOSTOMI.

Authors

Anisah binti Mat Desa, Farid bin Che Ghazali,

InstitutionPusat Pengajian Sains Kesihatan, Universiti Sains Malaysia,Kampus Kesihatan, 16150, Kubang Kerian, Kelantan, Malaysia.

Pengenalan

Strategi yang mantap dalam menghalang terjadinyakolonisasi bakteria pada secincin trakea dan paru-parubukan hanya kos-efektif malah adalah kunci kepenurunan kadar mortaliti pesakit dan jumlah harimereka di wad. Terdapat beberapa laporan dansemakan penyelidikan tentang usaha untukmendapatkan data saintifik yang konkrit tentang faktorpenyebab dan yang berhubungkait dengan terjadinya

hospital infection dan peradangan paru-paru khususnyayang berhubungkait dengan prosedur endo-trachealintubations. Prosedur sedutan merupakan proseduryang perlu dalam jagarawatan klien yang berada dalamunit kritikal ICU. Prosedur ini dilakukan untukmemastikan salur udara yang sentiasa paten danberfungsi. Dipercayai peralatan yang digunakan untukmelakukan prosedur ini boleh menjadi alat transmisipatogen nasokomial.

Tujuan kajian

Kajian pilot ini dilakukan bertujuan untuk meninjaukemungkinan wujud mikroorganisma pada peralatan dancecair yang digunakan dalam prosedur sedutan bagiklien yang memerlukan bagi memastikan satu protokoljagarawatan yang asepsis dan memenuhi piawaiandigunapakai di HUSM.

Metodologi

Sampel swab diambil langsung dari galipot dan cecairyang telah digunakan untuk prosedur sedutan bagisubjek yang telah dikenal pasti pada waktu-waktu yangberbeza (jam pertama, ketiga dan kelima). Seterusnyapengkulturan mikroorganisma dilakukan ke atas sampelyang diambil dan dibiarkan selama 24-jam sebelum

bacaan dibuat. Data yang dikumpul dianalisamenggunakan SPSS versi ke 10 untuk analisa variabelfrekuensi berhubungkait dengan demografi,penggunaan antibiotik, dan jenis mikroorganisma yangdapat di kultur.


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Keputusan

Hasil daripada sampel swab didapati 30-sampelmenunjukkan pertumbuhan gram negative bacilli danmixed growth of GNB. Manakala terdapat pertumbuhanmikroorganisma yang terdiri dari basilus gram negatif,spesis klebsiella dan spesis enterobacter dari

pengkulturan sampel yang diambil dari peralatan dancecair yang telah digunakan dalam prosedur sedutan diwad 2 Delima dan ICU HUSM. Mikroorganisma inimungkin hadir dalam persekitaran ataupun dari kawasanendotrakea atau trakeostomi subjek.

Rumusan

Penggunaan alatan secara berulangkali bolehmenyebabkan kontaminasi terjadi dan ianya merupakanfaktor penyokong utama tersebarnya infeksi. Keputusanpenyelidikan ini menyarankan agar tidak dipaktikkanpemakaian alatan secara berulangkali apatah lagi dengancecair yang sama dalam tempuh masa yang agak lama.Jagarawatan dengan protokol peralatan dan cecair yangdibiarkan yang dikesan dalam penyelidikan ini yangberhubungkait dengan prosedur sedutan boleh menjadi alathubungkait transmisi patogen nosokomial. Diharapkanakan terjadi anjakan paradigma dalam teknik jagarawatanberhubungkait dengan prosedur sedutan.

ORAL (A3 - 3)

JAGARAWATAN ORAL KLIEN KANSER DIHOSPITAL UNIVERSITI SAINS MALAYSIA

AuthorsAzlina Binti Daud, Farid Bin Che Ghazali,

Institution

Pusat Pengajian Sains Kesihatan, Universiti Sains Malaysia,Kampus Kesihatan, 16150 Kubang Kerian, Kelantan, Malaysia.

Pengenalan

Jagarawatan oral merupakan satu prosedur yang palingasas dalam perawatan klien dan ianya merupakan satukeperluan asas dalam memenuhi aktiviti hidup harianklien dan menjamin kesejahteraan klien.Memandangkan klien yang mengidap kanser padaumumnya menerima rawatan kemoterapi atauradioterapi mempunyai tahap pertahanan badan yangrendah maka jagarawatan oral amatlah penting untukdilakukan sebelum dan selepas klien menjalani rawatantersebut. Semakan bacaan menunjukkan tahap kavitioral klien kanser yang menerima rawatan kemoterapiatau radioterapi mempunyai risiko yang cukup t inggiuntuk mendapat keadaan klinikal yang dikenali sebagaimukositis dan xerostomia. Keadaan ini memerlukan satustandard penilaian pada kavi ti oral dengan itujagarawatan yang saintifik, sistematik dan holistik dapatdiberikan kepada klien.

Objektif kajianKajian ini adalah untuk mengenalpasti permasalahanpada tisu kaviti oral yang dihadapi oleh klien kanser yangmenjalani rawatan kemoterapi dan radioterapi

berdasarkan carta penilaian oral yang diadaptasikan dariShareenet al., 2003 dan mengenalpasti mikroorganismayang wujud pada kaviti oral klien kanser tersebut dalamhubungkaitnya dengan keberkesanan praktisjagarawatan oral di wad onkologi Hospital UniversitiSains Malaysia.

Metodologi

Kajian berasaskan pemeriksaan dengan carta penilaianoral dilakukan terhadap 30 orang klien kanser yangdipilih secara convenience sampling, yang menerimarawatan hanya kemoterapi atau hanya radioterapi ataukedua-duanya sekali di wad onkologi (3S) HUSM.Penilaian dibuat pada hari pertama, ketiga dan kelimaklien berada di wad tersebut. Selepas setiap penilaian,swab kultur diambil dari bahagian kiri dan kanan bukalretromolar ke dalam media pengangkut Stuart untukpemeriksaan kultur.

Keputusan

Keputusan penyelidikan ini menunjukkan 46.7% klienmengalami bibir kering, ulserasi dan pendarahan.Keadaan mukosa bibir yang kering juga mengalamiulserasi dan mudah terjadi pendarahan spontan yangdikenali secara klinikal sebagai mukositis. Manakala90.0% klien menunjukkan mengalami mulut kering,96.7% mengalami membran mukosa kering dan 70.0%mengalami keadaan saliva yang kering serta 30.0%mengalami kepekatan saliva. Jumlah peratus frekuensimikroorganisma gram negatif bertambah kepada 63.3%pada hari kelima manakala mikroorganisma gram positif

16.7%, dan kandida 10.0%.

Rumusan

Hasil penyelidikan menyokong penekanan, penyerapandan aplikasi carta penilaian oral khususnya di wadonkologi HUSM bagi jagarawatan yang berkesan.Penilaian status kaviti oral sebelum memulakan rawatandapat memastikan keberkesanan rawatan danjagarawatan yang saintifik, sistematik dan bersifat holistikkepada klien.

ORAL (A3 - 4)

THE DETERMINATION OF LOCAL MALAYFEMALE BONE MINERAL DENSITY ANDITSCORRELATION WITH GEOMETRICPROPERTIES IN THE EVALUATION OF SKELETAL

STATUS

Authors

Lee Cheng Wai, Hj.Abdul Kareem, Hj.Ibrahim Lutfi Shuaib, MohdEzane Aziz, Shaiful Bahari, Nik Haslina Nik Hussain.

Institution

Hospital Universiti Sains Malaysia, Health Campus, 16150,

Kubang Kerian, Kelantan, Malaysia.

Introduction

Osteoporosis is a systemic skeletal diseasecharacterized by low bone mass, fragility and a


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consequent increase in fracture risk. Currently therecommended method to measure bone mineral density(BMD) is Dual Energy X-Ray Absorstometry (DEXA).However to be more precise in the diagnosis ofosteoporosis and fracture risk prediction, other riskfactors and biomechanics of the bone should be taken

into consideration.

Aims

1) To obtain bone mineral density reference data forlocal Malay female population.

2) To determine the correlation of geometric propertiesand BMD.

Material and Methods

A total of 137 volunteers who have given a writteninformed consent and undergone DEXA of the spine,dual femur and total body. A non-dominant handradiograph was also taken for geometric properties (GP)measurement.

Results

A graph of BMD (DEXA) versus age group was obtainedfrom the mean and standard deviation of the peak agevalue. The local BMD corresponding to -2.0 standarddeviation from the peak adult value for vertebral andtotal body BMD were 12.2% and 3.2% respectively lowerwhereas for the dual femur it was 1.2% higher comparedto the Caucasian reference data (U.S/Europe). Therewere fair to good correlation between weight and BMD(r = 0.344 0.642). Generally fair to good correlation

was seen between vertebral, dual femur and total bodyBMD with cortical area (CA), cortical thickness (CT) andmetacarpal index (MCI), particularly of the secondmetacarpal. Multi linear correlation models accountingfor CA2 and CT2 in addition to weight have improvedthe predictive power of a model for weight alone.

Conclusion

Establishment of database for each race in Malaysia isimportant for proper skeletal status evaluation, in viewof significant differences in the local Malay BMD valuecompared to other population reference data. Geometricproperties can be used as a lower cost tool to predictBMD and may improve the accuracy of diagnosis ofosteoporosis and prediction of fracture risk.

ORAL (A3 - 5)

PILOT STUDY: PREVALENCE OF NEGATIVEPLAIN CT AND POSITIVE PERFUSION CT SCANIN CASES OF ACUTE STROKE.

Authors

K. Man, M.M Abdul Kareem, A.Prasad, J. Abdullah

Institution

Department of Radiology, Department of Neurosciences, Schoolof Medical Sciences, Universiti Sains Malaysia, Health Campus,16150, Kubang Kerian, Kelantan, Malaysia.

Introduction and objectives

CT perfusion study is a new method to diagnoseinfarction in cases of normal plain CT scan. It alsoidentifies the area of ischemia and size of infarction. Theaim of this study is to determine the number of cerebralinfarction cases in Hospital USM where there is normal

plain CT scan and abnormal Perfusion CT.

Material and Methods

Forty two consecutive plain and perfusion CTexaminations of brain in patients 12 years and aboveperform from August 2002 to August 2003 wereevaluated qualitatively. Plain CT scan was performed inpatients presented with acute stroke symptoms followedby Perfusion CT.

Results

Twelve out of 42 cases were found to have normal plainCT scan. Nine out of these 12 patients were positive for

infarction in Perfusion CT scan. Two out of 12 casesturned out to be transient ischemic attack and one case,CT perfusion was normal even though patient showedsigns and symptoms of acute stroke. The prevalence ofnegative plain CT scan and positive perfusion CT foracute stroke in Hospital USM from August 2002 to August2003 was 21.3%.

Conclusion

CT perfusion is a useful imaging tool for determiningischemia and infarction in cases where the plain CT scanis normal. The results obtained from CT perfusion

scanning are used to determine mode of treatmentsuitable for acute stroke patients.

ORAL (A3 - 6)

THE PROGNOSTIC VALUE OF INITIAL ANDFOLLOW-UP COMPUTERIZED TOMOGRAPHY(CT) OF BRAIN IN ADULT PATIENTS WITH

MODERATE AND SEVERE HEAD INJURYFOLLOWING MOTOR VEHICLE ACCIDENT

Authors

Azman Kiflie, Nurul Azman Alias, Jafri Malin Abdullah, Dr. Salmah

@ Win Mar, Abdul Kareem

Institution

Department of Radiology, Department of Neurosciences, Schoolof Medical Sciences, Universiti Sains Malaysia, Health Campus,

16150, Kubang Kerian, Kelantan, Malaysia.

Overview

Head injury is still the most common problem throughoutthe world. In Malaysia, the most common cause of headinjury is due to motor vehicle accident. The impact ofthe head injury is so great because the youngergeneration is the highest populations involved. Theoutcome may ranges from good recovery and disabilityto death. In view of the important of the outcome, theauthor felt that it is important to assess the clinical aswell as the CT scan of brain of those patients in order to


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predict the outcome. Currently, it is believed that thepermanent outcome of the patient can be predicted froma follow-up CT scan of brain as early as six weeks.

Objective and Methods

The aim of this study is to predict the outcome of the

adult patients with moderate and severe head injury inmotor vehicle accident by using clinical parameters (age,Glasgow Coma Scale), initial CT scan of brain parameter(intracranial haemorrhage, volume and site of intracranialhaemorrhage, midline shift and hydrocephalus) andfollow-up CT scan of brain parameter (residualintracranial bleed, post-traumatic hydrocephalus, midlineshift and gliosis). The patient is assessed clinically onadmission for GCS. Those categorised into moderateand severe head injury with initial and follow-up CT scanof brain 6 weeks later will be selected for the study. Theparameters were analyzed statistically using univariteanalysis, chi square test and logistic regression. The pvalue of < 0.05 is taken as significant level.

Results

A total of 31 patients were selected, 67.7% are maleand 32.3% are female. The GCS of the patients werestatistically significant as outcome predictors. Othersignificant predictors analyzed from the study are midlineshift and volume of subdural haemorrhage in the initialCT scan and post-traumatic hydrocephalus and gliosisin the follow-up CT scan.

Conclusion

The study showed that the above-mentioned parametersare significant predictors of outcome. The author alsohave suggested a new outcome predictors by using theparameters from follow-up CT scan i.e. presence ofgliosis, site of gliosis and post-traumatic hydrocephalus.

ORAL (A3 - 7)

CIGARETTE SMOKING AS A RISK FACTOR FORSTROKE DEATH IN JAPAN: NIPPON DATA 80

Authors

Ueshima H1, Choudhury SR2, Okayama A3, Hayakawa T4, Kita Y1,

Kadowaki T1, Okamura T1 and NIPPON DATA80 Research Group

Institution1Department of Health Science, Shiga University of Medical

Science, Otsu, Japan. 2Department of Community Medicine,School of Medical Sciences, Universiti Sains Malaysia, HealthCampus, 16150, Kubang Kerian, Kelantan, Malaysia.

Introduction

Some previous Japanese cohort studies failed to showan association between smoking and stroke risk. Sincesuch an association has been noted in other populations,this issue should be re-examined in a recent

representative Japanese cohort with a higher totalcholesterol level.

Objectives

To investigate the association between cigarettes

smoking and stroke death in a representative Japanesepopulation.

Methods

A total of 9,638 men and women aged 30 years andolder without a history of cardiovascular disease (CVD)

at baseline in 1980 were followed for 14 years. Follow-up rate was 91.4%. Causes of death were ascertainedfrom National Vital Statistics. Cox proportional hazardratios were calculated adjusting for age, systolic bloodpressure, and other conventional risk factors.

Results

We observed 203 stroke deaths (107 cerebralinfarctions, 45 cerebral hemorrhages, and 51 others),191 heart disease deaths, and 413 CVD deaths. Theaverage serum total cholesterol level was ~4.91mmol/L. The hazard ratios for men who smoked 1-20cigarettes/day on all strokes, cerebral infarction, and

cerebral hemorrhage were 1.60 (95% confidence interval(CI), 0.91-2.79), 2.97 (CI. 1.27-6.98), and 0.42 (CI. 0.16-1.09), respectively, and for those who smoked 21cigarettes/day, they were 2.17 (CI. 1.09-4.30), 3.26(CI.1.11-9.56), and 0.68 (CI. 0.20-2.33), respectively. Forwomen who smoked 21 cigarettes/day, the hazard ratiofor all strokes was 3.91 (CI 1.18-12.90). For CVD, allheart disease, and ischemic heart disease, the hazardrisks of smoking were significant (1.49 to 4.25) for menbut not significant for women.

Conclusions :

Smoking in a cohort with moderate serum totalcholesterol level was a potent risk factor for stroke,especially cerebral infarction, for both men and women,and CVD and ischemic heart disease for men.

ORAL (A3 - 8)

DIAGNOSTIC VALUE OF ECG CHANGES,ARRHYTHMIA AND CHEST PAIN DURING

DOBUTAMINE STRESS MYOCARDIALPERFUSION IMAGING

Authors

Tuhin H1,Zurkurnai Y2, Sapawi M2, Tee MH2.

Institution1Department of Nuclear Medicine, Radiotherapy and Oncology,2Department of Medicine, School of Medical Sciences, Universiti

Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan,Malaysia.

Background

The presence of myocardial perfusion abnormalitiesassessed by dobutamine stress myocardial perfusionimaging (MPI) accurately diagnoses patients withcoronary artery disease, and are powerful predictors ofcardiac events. Thus, results of this imaging modalityhelp in selecting the appropriate management strategies.During dobutamine stress test, ECG changes,arrhythmia and chest pain occur frequently. However,data regarding diagnostic value of these parameters to


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predict myocardial perfusion abnormalities are scarce.Thus, the aim of this study was to determine thediagnostic value of ECG changes, arrhythmia and chestpain to predict myocardial perfusion abnormalities onSPECT.

MethodWe performed dobutamine-atropine stress 99Tcm-tetrofosmin/MIBI myocardial perfusion SPECT in 26patients referred to the department of nuclear medicinefor MPI. SPECT imaging was performed 30 min post-injection using one-day stress-rest protocol.

Results

Myocardial perfusion abnormalities (reversible or fixeddefects) were detected in 11(42.3%) out of 26 patients.The sensitivity and specificity of ECG changes (STdepression, ST elevation or T wave normalization) topredict myocardial perfusion defects were 45.5% and

86.7% respectively. The sensitivity and specificity ofcardiac arrhythmia (significant supraventricular orventricular arrhythmia) were 45.5% and 86.7%,and ofchest pain were 18.2% and 80% respectively.

Conclusion

ECG changes, cardiac arrhythmia and chest pain duringdobutamine stress test showed high specificity. However,the low sensitivity of these parameters warrantsperforming dobutamine stress test in conjunction with amore sensitive imaging modality such as MPI.

ORAL (A3 - 9)

VOLUME OF HIPPOCAMPAL COMPLEX INMAJOR DEPRESSION PATIENTS BEFORE AND

AFTER TREATMENT WITH SELECTIVESEROTONIN REUPTAKE INHIBITOR (SSRI)DRUGS

Authors

Magendiran A/L Shummugam; Hj. Mohd Shafie Abdullah; Mohd

Najib Alwi; Win Mar @ Salmah Jalaluddin

Institution

Department of Radiology, Hospital Universiti Sains Malaysia,Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.

Purpose

To assess change in volume of the hippocampal complexin major depression patients following treatment withSSRI drugs. This is correlated with progress of thepatients illness. To date no other institution has donethis study on humans. Similar studies on rats showedhippocampal volume increase of about 70 %.

Method

Newly diagnosed untreated major depression patients

fulfilling the study criteria are selected. First MRI of thebrain done for the hippocampal complex structure.Patients start consuming the SSRI drugs after the MRI.After six months, the MRI study is repeated followingsimilar protocols. The hippocampal complex volume

calculated from the MRI study. The volume change iscorrelated with patients clinical progress as assessedby the treating psychiatrist.

Results

Seven patients came for the initial MRI while only four

came for the second MRI. About 13 25 % increase involume of hippocampal complex was found followingtreatment. It correlated with the patients progress ofillness.

Conclusion

The result shows that there is increase in hippocampalcomplex volume following treatment which correlateswith the patients clinical improvement. In future, thisfinding can aid in assessing clinical response in majordepression patients treated with SSRI drugs.

ORAL (A3 - 10)

INSULIN SENSITIVITY STATUS OF NON-OBESENORMOGLYCEMIC MALAY SUBJECTS :RELATIONSHIP BETWEEN INSULIN SENSITIVITY

AND LIPID STATUS.

Authors

A. Kholdun Al-Mahmood, A.A. Ismail, Faridah A. Rashid, WB WanMohammed, Sohel R. Choudhury, Nor Azwany Yaakob

Institution

School of Medical Sciences, Universiti Sains Malaysia, Health

Campus, 16150, Kubang Kerian, Kelantan, Malaysia.

Introduction

Hyperlipidaemia and insulin resistance has a complexrelationship. Most of the previous studies were lookingat insulin resistance in hyperlipidaemic subjects whowere also obese. So influence of obesity andhyperlipidaemia acted simultaneously in the genesis ofinsulin resistance.

Objective

The present study was designed to determine insulinsensitivity and secretory status of non-obesenormoglycemic subjects, and to find out the relationship

between hyperlipidemia and insulin sensitivity in a non-obese population.

Methodology

A cross sectional study on 74 non-obese (BMI


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Results

The hyperlipidemic subjects showed substantially lowerinsulin sensitivity and higher insulin resistance incomparison to normolipidemic subjects. The median ofHOMA%S of hyperlipidemic and normolipidemicsubjects were 50(83) and 232(227) (p


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Conclusion

Unconventional material filters may be applied forscanning objects/organs and may provide improvedquality images.

ORAL (A3 - 13)

MICRONUTRIENTS CORRELATED TO CANCER

Authors

C.S.Kavitha Menon1 and B.V. Muralikrishna2

Institution

School of Health Sciences, University Sains Malaysia, KubangKerian, Universiti Sains Malaysia, Health Campus, 16150, KubangKerian, Kelantan, Malaysia.

Diet and cancer appear to be closely related. Severalepidemiological, experimental and metabolic studiessuggest important role for nutrients in the diet, which

modulate the process of carcinogenesis and immunefunctions. Recent studies emphasize the etiological roleof vitamins and minerals in epidemiology of cancer at anumber of sites. Micronutrient deficiencies (vitamins andminerals) are commonly encountered and significantlyinfluence carcinogenic processes. Considerable interestin the role of vitamins A, C, E and B in the genesis andprevention of cancer. Most of the vitamins seem to beacting either through the inhibition or formation ofcarcinogen, or by protecting against free radicals. Amongminerals and trace metals iron, zinc and seleniumdeficiency seem to increase the risk of cancer.

Commonly consumed foods, particularly vegetablesand fruits, are sources of numerous micronutrients.Several of these, including -carotene (a vitamin Aprecursor), vitamin E, vitamin C, selenium (which allhave antioxidant potential), calcium, vitamin D (in fish,eggs and fortified dairy products) and folate, have beenthe focus of extensive experimental and epidemiologicalresearch to determine their influence on cancer risk.Based on in vitro data, and while recognising theirprooxidant potential under certain conditions, some havepostulated that anti-oxidant micronutrients may protectagainst oxidative damage to biomolecules, such aslipids, lipoproteins and DNA, thus influencing the risk

for cancer development. Selenium is a component ofnumerous selenoproteins (e.g. glutathione peroxidase,thioredoxin reductase) that function as enzymes in redoxreactions that may affect cancer risk. Anti-oxidantmicronutrients may also influence carcinogenesisthrough other mechanisms. For example, vitamin Einhibits cell proliferation and carotenoids, including -carotene, may affect cell transformation anddifferentiation, enhance cell-to-cell communication, andenhance immune responses. Experimental evidencegenerally suggests that calcium and vitamin D mayreduce risk for colorectal cancer by decreasing cellular

proliferation.

Conclusion

Even though the role of few micronutrients either in the

genesis or prevention of cancer have identified, the roleof individual micronutrients in different types of cancersstill remains controversial.

ORAL (B3 - 1)

TRANS-SEPTAL TRANS-SPHENOIDALCOMBINED APPROACH FORHYPOPHYSECTOMY

Authors

Shahid Hassan*, Jafri Malim Abdullah**, Imran Azmi*, Zamzuri

Idris**

Institution

Dept. of ORL-HNS*,Dept. of Neurosciences**,Universiti SainsMalaysia, Health Campus, 16150, Kubang Kerian, Kelantan,

Malaysia.

Introduction

The pituitary gland is inaccessible to the surgeon directlyhowever there are indications for normal as well asneoplastic pituitary gland excision. The pituitary glandis also required to be removed for certain medicalreasons. History of pituitary gland excision shows that anumber of approaches were in practice in the past. Thisinvolved, trans-cervical and trans-sphenoidalprocedures. We experienced the trans-septal, trans-sphenoidal procedure as combined approach withneurosurgeon in hospital USM.

Objective

To highlight the practicallity and efficacy of trans-septaltrans-sphenoidal appraoch in pituitary gland lesion andhow to perform it in a feasible manner

Method

Indications of pituitary gland excision, history of variousapproaches and the video demonstration of trans-septaltrans-sphenoidal as combined ORL-neurosurgicalapproach and its outcome is analysed.

Conclusion

Treatment of pituitary gland should involve anendocrinologist, oncologist and a surgeon trained in

trans-sphenoidal approach. CT-scan can localisemicrotumors preoperatively.This is an effective methodof surgical treatment too and care being taken is liableto minimum complications.

ORAL (B3 - 2)

CENTRAL CORNEAL THICKNESS ANDMORPHOLOGY IN MYOPIC MALAY

UNDERGRADUATES OF HEALTH CAMPUS,UNIVERSITI SAINS MALAYSIAAuthors

Mohd Aziz H, Liza Sharmini AT, Mohtar I

Institution

Department of Ophthalmology, Universiti Sains Malaysia, HealthCampus, 16150, Kubang Kerian, Kelantan, Malaysia.


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Objective

To evaluate the central corneal thickness andmorphology in myopic Malay undergraduates of HealthCampus, USM.

Methods

A cross sectional study was conducted in 65 myopicand 65 emmetropic subjects, with age ranges from 20to 25 years old. Spherical equivalent and corneacurvature was determined with Humphrey autorefractor/keratometer 599 (Humphrey System, USA). Centralcorneal thickness and morphology (endothelial density,coefficient variation and hexagonality) was determinedwith Topcon SP2000P specular microscope (TopconCorp, Japan).

Results

Myopes have thinner central cornea (p=0.003), lowerendothelial density (p =0.017) and steeper cornea

curvature (p=0.017) compared to emmetropes. Therewas no difference seen in endothelial hexagonality andcoefficient variation. We observed a significant inversecorrelation between degree of myopia (measured inspherical equivalent) and central corneal thickness (r =-0.282, p =0.023).

Conclusions

Myopes have significantly thinner central cornea, lowerendothelial density and steeper cornea curvature. Higherdegree of myopia is associated with thinner centralcornea. All these factors need to be considered in

managing myopia, especially in refractive surgery

ORAL (B3 - 3)

LASER TONSILLOTOMY: AN ALTERNATIVE TOCONVENTIONAL TONSILLECTOMY IN CHILDREN

Authors

Dr A. Baharudin, Dr H. Shahid, Dr S.Rosdan, and Dr G.Asha

Institution

Dept ORL-HNS, School of Medical Sciences, Universiti SainsMalaysia, Health Campus, 16150, Kubang Kerian, Kelantan,

Malaysia.

Introduction :

Tonsillectomy in children is done on a regular basis inENT. The indications are chronic recurrent sore throatand URTI, odynophagia, sleep apnea and access todeeper structures.

Objective

The natural history of tonsilllar hypertrophy is regressionwhen a child is 6 years old or older. In children withobstructive symptoms we study the use of laser as analternative procedure to reduce the bulk of the tonsils

mass. Naturally, the remnants of the tonsils will regressas the child grows older.

Method

Children with obstructive symptoms of tonsillarhypertrophy underwent laser tonsillotomy. The tonsilswere dissected using laser from anterior pillar to posteriorpillar. The tonsils bed were left untouched. Intraoperativeand postoperative conditions were noted.

ResultIntraoperatively, blood loss was negligible.Postoperatively, all of the patients were able to swallowwith minimal discomfort and discharged the followingday after observation.

Conclusion

Laser tonsillotomy is an alternative procedure in childrenhaving obstructive tonsillar hypertrophy.

ORAL (B3 - 4)

DETECTION OF HERPES SIMPLEX INFECTION IN

VIRAL CONJUNCTIVITIS USING POLYMERASECHAIN REACTION A PILOT STUDY

Authors

Alwi AA, Hussein E, Gopalakrishnan V, Ravichandran M

Institution

Department of Ophthalmology, Department of Microbology &Parasitology, School of Medical Sciences, Universiti SainsMalaysia, Health Campus, 16150, Kubang Kerian, Kelantan,

Malaysia.

Objective

To detect the viral conjunctivitis in HUSM caused by

herpes simplex virus (HSV) using polymerase chainreaction (PCR) method.

Method

A cross-sectional hospital-based study was conducted.A total number of 70 patients with viral conjunctivitis wereseen in the ophthalmology clinic, HUSM during one yearperiod. Presenting clinical features were identified andconjunctival scrapping using sterile swab was taken fromsuperior and inferior fornices of affected eye for PCRanalysis. The PCR was performed using a commerciallyavailable primer. The presence of this amplified target

sequence was determined by agarose gel. A positiveresult reflected the prevalence of viral conjunctivitiscaused by HSV. Descriptive analysis was performedusing SPSS system.

Result

The prevalence of HSV infection among viralconjunctivitis patients seen in HUSM, using PCR methodwas 17% (95% CI=8.1,26.0). Majority of these patientspresented with moderate follicular conjunctivitis withfrequent early corneal involvement. A large portion ofpatients presented with unilateral involvement.

ConclusionThis study showed the prevalence of viral conjunctivitiscaused by HSV infection, in HUSM was higher than otherstudies.


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ORAL (B3 - 5)

INTRAVENTRICULAR CAVERNOUSHAEMANGIOMA

AuthorsRofiah Ali, Win Mar, Latifah Mohd Basheer, SS Mutum*,J.PGeorge** J. Abdullah**

Institution

Department of Radiology, *Department of Pathology and

Department of Neurosciences, Hospital Universiti Sains Malaysia,Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.

A rare case of a cavernous haemangioma in the thirdventricle is reported. This patient, a seven-year old boypresented with fever, vomiting and not active for a week.Examination revealed neck stiffness, left lateral rectusmuscle palsy and blurred right optic disc. Urgent CT-

scan revealed minimally enhancing mass in the thirdventricle. Magnetic resonance imaging was done twodays later, and showed a heterogenous, multilobulated,minimally enhancing tumour in the third ventricle. Thetumour was almost totally excised. Histology of thetumour revealed a cavernous haemangioma.Intraventricular location for a cavernous haemangiomais rare with less than 50 cases reported in literature.The clinical and radiological features are discussed andrelevant literature is briefly reviewed.

ORAL (B3 - 6)

COMPARISON OF CONJUNCTIVAL IMPRESSIONCYTOLOGY BETWEEN GLAUCOMA PATIENTSTREATED WITH TOPICAL TIMOLOL MALEATE0.5% AND TOPICAL LATANOPROST 0.005%.

Authors

Dr Tan Soo Hoi, Dr Wan Hazabbah Wan Hitam, Dr Hasnan Jaafar

Institution

Department of Oftalmology & Pathology, School of Medical

Sciences, Universiti Sains Malaysia, Health Campus, 16150,Kubang Kerian, Kelantan, Malaysia.

ObjectiveTo compare the conjunctival surface morphology thatdevelops with the use of topical timolol maleate 0.5%and topical latanoprost 0.005%.

Method

Newly diagnosed glaucoma patients are randomlydivided into 2 groups by closed envelope method:

Group 1 : treated with topical timolol maleate 0.5%Group 2 : treated with topical latanoprost 0.005%

First conjunctival impression cytology was takenbefore the treatment was started. Second conjunctivalimpression cytology was taken after 3 months oftreatment. The conjunctival impression cytology of theboth groups was compared.

Results

1. In both the timolol group and latanoprost group, therewas no change of the conjunctiva epithelial cellmorphology after three months of anti-glaucomadrugs treatment.

2. Within three months of therapy, both these drugscause significant reduction of goblet cells and mucousgranules.

3. There was no significant difference in the density ofgoblet cells and mucous granules in both groups ofpatients after 3 months of treatment.

Conclusion

Both topical timolol maleate 0.5% and topical latanoprost0.005% cause significant reduction of conjunctival gobletcells and mucous granules however there was nosignificant difference of conjunctiva surface morphologybetween the two groups after treatment.

ORAL (B3 - 7)

EXPERIENCE OF INVERTED PAPILLOMAS INKELANTAN

Authors

Shamim Ahmed Khan*, Shahid Hassan*, Mohammad Hamza*, DinSohaimi*Ramiza*, Zulkifli S**.

Institution

*Department of ORL-HNS, School of Medical Sciences, Universiti

Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan,Malaysia. ** Department of ENT, Hospital Kota Bharu, Kelantan,Malaysia.

Objective

The study looked into the demographic presentation,morbidity due to local invasion, surgical management,outcome and recurrence of inverted papillomas inKelantan.

Introduction

Inverted papillomas are slow growing, most commonlybenign neoplasms of the sinunasal tract. However theirthree characteristic features, a tendency to recur, a

destructive capability for the surrounding structures andan association with malignancy make them distinct fromother benign neoplasm of this region.

Methodology

19 operated patients for inverted papilloma were followedthrough hospital records. Besides demographic data themorbidity of the disease at the time of presentation wasnoted. The types and extent of surgical procedures werecritically evaluated for their morbidity and control of signsand symptoms.

Results

A total of 14 cases were managed through classicalmedial maxillectomies through lateral rhinotomyapproach, in another 4 cases endoscopic medialmaxillectomies while in one case intranasal excision was


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recommendable age is at 3 months. A delay in obtaininghearing aids includes poor motivation and ignorance ofparents and delay of welfare financial help. With earlyrehabilitation it is proven that the deaf children is able tospeak and enter a normal school with guidance.

ORAL (B3 - 10)

ANTIFUNGAL EFFECTS OF GAMAT EXTRACTS(STICHOPUS CHLORONATUS) IN ASPERGILLUS-KERATITIS IN RABBITS

Authors

Bakiah Shaharuddin, Abd Razak Koyakutty, Syed Mohsin Syed

Sahil, Afifi Abu Bakar

Institution

School of Medical Sciences, Universiti Sains Malaysia, Health

Campus, 16150, Kubang Kerian, Kelantan, Malaysia.

IntroductionSea cucumber or better known as gamat by the localMalaysian people possesses high nutritional value andis widely used as a traditional medicine. Fungal cornealulcers although considered rare in occurrence, usuallyresults in devastating complications and blindness. Thetreatment of fungal ulcers is still not satisfactory due tolimited availability of antifungal drugs owing to theirrestricted market value. Due to this, the treatment isvery costly and often very toxic to the eyes and alsosystemically

ObjectivesTo determine the inhibitory effect of gamat and theminimum inhibitory concentration (MIC) of gamatextracts against Aspergillus fumigatus.and to assess theantifungal effects of gamat in Aspergillus-inducedkeratitis in rabbits.

Methods

Methanolic extract of Stichopus chloronatuswas usedto prepare eye ointment based on its inhibitory effectsand MIC value. Aspergillus-keratitis was induced in botheyes of 7 New Zealand White rabbits cornea and treatedrandomly with gamat extracts and placebo. Daily clinical

examination of ocular infection was recorded.

Results

The largest inhibition zone (average =18.2 mm) wasobserved when gamat extract was dissolved inchloroform compared to other solvents. The MIC valueof 1.562 mg/ml was recorded in serial dilution of theextracts using disc diffusion method on Aspergillusfumigatus. Six rabbits were enrolled in the clinical controltrial. Inoculation of fungus was successful in all sixrabbits. Daily clinical examination showed variabledegree of infectivity and response. Colony count at the

end of five days of treatment with gamat and placeboshowed no significant difference in means between thetwo groups (p > 0.05). Limitations of this study and

suggestions were discussed.

Conclusion

Methanolic extract of gamat gave a good inhibitiontowards fungal growth in the in vitrostudy. This warrantsa future exploration of the antifungal effects of gamat

in clinical control trial with more refined instruments andmethods.

ORAL (B3 - 11)

COMPARISON OF AIR-DRIED AMNIOTIC

MEMBRANE GRAFT WITH BARE SCLERATECHNIQUE FOR PRIMARY PTERYGIUMEXCISION

Authors

Afizah Isnin, Elias Hussein, Abdul Rani Shamsuddin

InstitutionDepartment of Oftalmology & National Bank Tissue, School of

Medical Sciences, Universiti Sains Malaysia, Health Campus,16150, Kubang Kerian, Kelantan, Malaysia.

Objective

To compare recurrence rate between air-dried amnioticmembrane graft and bare sclera technique for primarypterygium excision.

Method

Primary pterygium patients were randomized into 2groups by closed enveloped method:Group A: pterygium excision with air-dried amnioticmembrane graft

Group B: pterygium excision with bare sclera technique.Post-operative pterygium recurrence were comparedwithin 7 months follow-up.

Result

1) In amniotic membrane group, the pterygiumrecurrence rate was 19.2%. The recurrence rate inbare sclera was significantly higher, 60.7% (p=0.02).However fibrous tissue (grade 3 appearance) wasseen more in amniotic membrane group at 7 months

of follow-up (31.1%) compare to bare sclera group(13.3%)

2) The significant difference for recurrence betweenthese 2 groups can be seen as early as 5 months offollow-up. 3) There was no significant differencebetween recurrence and age or sex

Conclusions

The relatively low recurrence rate for post pterygiumexcision allows one to use air-dried amniotic membranegraft as an alternative for pterygium surgery. Howeverlonger follow-up might revealed higher recurrence rate

in this technique as well?

ORAL (B3 - 12)


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LONG TERM VISUAL OUTCOME IN DIABETICRETINOPATHY AFTER LASERPHOTOCOAGULATION THERAPY

Authors

Rajesh K Khanna, Puneet Agarwal

Institution

Department of Oftalmology, School of Medical Sciences,

Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,Kelantan, Malaysia.

Introduction

Diabetic retinopathy is one of the commonest causes ofvisual loss in adults of working age in Malaysia. Sightthreatening conditions such as maculopathy andproliferative diabetic retinopathy are more amenable tolaser treatment if diagnosed at an early stage. Although,unawareness and the lack of skilled personnel remainthe major problems in early detection and treatment.

Objective

To analyse the long-term visual outcome in patients withdiabetic retinopathy after laser photocoagulation.

Methodology

The records of diabetic retinopathy patients wereanalysed for demographic data, type and duration ofdiabetes, diabetic control, associated risk factors,indication for laser therapy, pre- and post-laser best-corrected visual acuity and causes for visual impairment.

Results

After analysing the hospital records of 48 patients whounderwent laser photocoagulation therapy formaculopathy and proliferative diabetic retinopathy, aslight female preponderance (52%) was observed withmajority of Malays (91.7%) and type-2 diabetes (88%).Nearly half of them presented with retinopathy at thetime of presentation with 2 or more risk factors andbelonged to the age group between 45-60 years. Fair togood control of diabetes (


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Discussion

We hope with the implementation of universal hearingscreening in HUSM children will be detected andhabilitated early. These children, though hearingimpaired, benefit from their hearing aids or cochlearimplant to be able to speak and hopefully enter into the

mainstream education.

ORAL (C3 - 1)

MALAYSIA TOWARDS ELECTRONIC MEDICAL

RECORD

Authors

Haslina Mohd, Sharifah Mastura Syed Mohamad

Institution

School of Medical Sciences, Universiti Sains Malaysia, HealthCampus, 16150, Kubang Kerian, Kelantan, Malaysia.

Electronic Medical Record (EMR) is the corecomponent in Telehealth and Total Hospital InformationSystem (THIS). This paper will provide further insight toEMR by providing some overview of EMR, discuss thebenefits of EMR, provide some guidelines to implementEMR and finally discuss some area for future research.EMR is defined as a computer-based information systemthat integrates patients-specific information from diversesources and tracks that information over time to facilitateclinical management and information retrieval, analysisand reporting. The implementation of EMR shouldbenefits various stakeholders including government and

health care providers, administrators, clinicians, policymakers and researchers. Overall, the implementationof EMR can improve the quality of care, reduce cost inmanaging care environment and improve providerefficiency. The transition from paper-based proceduresto EMR requires proper planning. Urgent actions are toprovide legal and social framework for acceptance,introduction and implementation plan of EMR. A goodtransition to an EMR depends on commitment, researchand implementation. Since EMR in Malaysia is quite newand not very well established, many areas need furtherresearch. Users and organizational acceptance is one

of the social factors that need serious consideration inorder to ensure successful EMR implementation.Therefore, before MOH extends EMR implementationto other hospitals in Malaysia, study must be conductedto get feedbacks from the stakeholders that are currentlyinvolve with EMR. Outcome from this study can be usedas a guideline to enhance EMR features, may influencethe EMR usage, increase usefulness and easy of useof EMR. With regard to EMR design and development,important issue that needs immediate action is thestandardized identifier. Several areas that need thestandardization are message format standard, medicalterminologies, business case for patient medical record

information standard, relationship to the national healthinformation infrastructure, data quality, accountability andintegrity, diverse laws and regulations, and privacy,confidentiality and security. Therefore, another area that

needs immediate action is the research anddevelopment of at least, natio

Documents

Abstract, 9th Ncms, 22 - 23 May