The first use of combination of Intrapleural Fibrinolytics (Alteplase & DNAse) for pleural infection in Malaysia

@#The use of a combination of intrapleural fibrinolytics or tissue plasminogen activator(tPA) Alteplase and deoxyribonuclease (Dnase) has been increasing for cases of complicated pleural infection/parapneumonic effusion worldwide. Its efficacy and success rate in selected cases of complicated parapneumonic effusion unresponsive to antibiotics and chest drainage are well documented. This case report demonstrates the first use of combination intrapleural fibrinolytic (Alteplase) and DNAse (Pulmozyme) in Malaysia for a case of pleural infection/parapneumonic effusion.

Individualised second line anti-tuberculous therapy for anextensively resistant pulmonary tuberculosis (XDR PTB) in East Malaysia

Clinical experience with extensively Drug Resistant tuberculosis (XDR-TB) has not been reported in Malaysia before. We describe the clinical characteristics, risk factors, progress and therapeutic regimen for a healthcare worker with XDR-TB, who had failed therapy for multidrug resistant TB (MDR TB) in our institution. This case illustrates the risk of TB among healthcare workers in high TB-burden settings, the importance of obtaining upfront culture and susceptibility results in all new TB cases, the problem of acquired drug resistance developing during MDR-TB treatment, the challenges associated with XDR-TB treatment regimens, the value of surgical resection in refractory cases, and the major quality of life impact this disease can have on young, economically productive individuals.

Comparison of clinical and laparoscopic features of infertile women suffering from genital tuberculosis [TB] or pelvic inflammatory disease [PID] or endometriosis

The objective of the study was to analyze the clinical and Laparoscopic features, which may help to differentiate between infertility in females due to Genital Tuberculosis from Pelvic Inflammatory Disease [PID] and Endometriosis. This case control study was carried out in a teaching tertiary care hospital. Medical records were searched from 1st January 1987 to 31st December 2000 and 43 infertile women with biopsy proven genital tract tuberculosis were found. Equal number of infertile females with diagnosed PID and Endometriosis were randomly selected. Comparisons were done between features of Genital Tuberculosis with PID and Endometriosis separately and also genital tuberculosis with combined controls of PID and Endometriosis. Patients with genital tuberculosis commonly had primary infertility. PID and Endometriosis patients had early menarche and increased duration of menstruation. On physical examination, patients with Genital Tuberculosis were found to have short heights. No significant findings were observes in the pelvic examination and menstruation history between the comparison groups. Laparoscopic examination revealed that fallopian tubes were abnormal, tortuous, bilaterally blocked and thickly adherent more commonly in Genital Tuberculosis when compared to other groups. The primary infertility patients with chronic malnutrition and massive adhesive fallopian tubes on laparoscopic examination should be evaluated for genital tuberculosis

Pharmacological evaluation of medicinal plants for their analgesic activity in mice

The selected parts of four medicinal plants, Achillea millefolium, Hibiscus rosasinensis, Linum usitatissimum and Pluckea lanceolata were extracted in absolute methanol to determine their analgesic activity. Analgesic activity was assessed on intact mice by tail flick latency via the tail immersion method. The analgesic activities of these plant extracts were compared with acetylsalicylic acid [300 mg/kg] which was used as the standard drug. Extracts were given orally in doses of 300, 500 and 1000 mg/kg. 0.9% saline was administered to the control group of animals. Results showed that Linum usitatissimum and Pluchea lanceolata possessed highly significant analgesic activity, while Achillea millefolium and Hibiscus rosasinensis did not show any significant effects

Serum alpha-tocopherol in patients receiving radiation therapy in head and neck cancers

The effect of anticancer therapy was evaluated on serum alpha - tocopherol in patients receiving radiation therapy. Total 84 patients with head and neck cancer were evaluated alongwith 30 controls. Serum analysis was made by HPLC technique. The serum level of alpha - tocopherol was found to be reduced [3.88 +/- 0.33 mg/L] when compared with controls [10.83 +/- 0.86 mg/L] which was statistically significant [p<0.05]. Patients responded to anticancer therapy [15.00 +/- 0.97 mg/L] showed a higher level of serum alpha - tocopherol than those patients who did not respond to therapy [9.03 +/- 0.90 mg/L]. Patients who had relative response had serum alpha - tocopherol 14.27 +/- 1.20 mg/L, who had stationary disease had 10.97 +/- 1.57 mg/L and who had progressive disease had 7.38 +/- 0.43 mg/L level of serum of alpha - tocopherol. All these values were found to be statistically significant [p<0.05]

Preliminary investigations on cardiovascular profile of ambrein

The cardiovascular properties of Ambrein were investigated on isolated rabbit heart and cats' blood pressure. Ambrein has increased the contractile force but reduced the heart rate and coronary flow in isolated heart preparation while Blood pressure lowered significantly in intact animal by this compound

Neuroleptic malignant syndrome, an underestimated complication of antipsychotics

Neuroleptic malignant syndrome [NMS] was previously reported to be a rare complication of antipsychotic drugs. It was detected in 4 out of 482 psychotics. Butyrophenones [haloperidol] showed the highest association with the development of the syndrome, especially when given parenterally. The syndrome developed regardless of the antipsychotics was following by spontaneous recovery. Anticholinergics are not recommended for treatment of the syndrome

Cell-mediated immunity in schizophrenia

The present work was performed to evaluate the cell mediated immune response of schizophrenic patients in comparison to controls. Ten chronic schizophrenic drug free patient and another ten healthy subject as a control were examined. Cell mediated immunity were evaluated by estimation of T-lymphocyte percentage in the esrum sample and also by the migration inhibition index of lymphocytes. Using the student t test of comparison between the studied groups revealed no significant difference. The present study suggests the need for further study for the T-cell subpopulation and the lymphocytic functions in schizophrenic patient

Effect of hypothermia on the basic ECG configuration and on cardiac rhythm in Na petobarbitone anaesthetized cats

The usefulness of the whole body cooling technique in man is limited by the development of ventricular fibrillation. This is a reflection of the lack of knowledge of the mechanism underlying the fibrillation process during hypothermia. Experimental studies are described in which progressive induction of hypothermia was associated with gross disturbances of cardiac function, changes in E.C.G. uniform especially with negativity of the T wave cardiac and ventricular fibrillation