Complete sequences were obtained for the coding portions of the mitochondrial (mt) genomes of Schistosoma mansoni (NMRI strain, Puerto Rico; 14 415 bp), S. japonicum (Anhui strain, China; 14 085 bp) and S. mekongi (Khong Island, Laos; 14 072 bp). Each comprises 36 genes: 12 protein-encoding genes (cox1-3, nad1-6, nad4L, atp6 and cob); two ribosomal RNAs, rrnL (large subunit rRNA or 16S) and rrnS (small subunit rRNA or 12S); as well as 22 transfer RNA (tRNA) genes. The atp8 gene is absent. A large segment (9.6 kb) of the coding region (comprising 14 tRNAs, eight complete and two incomplete protein-encoding genes) for S. malayensis (Baling, Malaysian Peninsula) was also obtained. Each genome also possesses a long non-coding region that is divided into two parts (a small and a large non-coding region, the latter not fully sequenced in any species) by one or more tRNAs. The protein-encoding genes are similar in size, composition and codon usage in all species except for cox1 in S. mansoni (609 aa) and cox2 in S. mekongi (219 aa), both of which are longer than homologues in other species. An unexpected finding in all the Schistosoma species was the presence of a leucine zipper motif in the nad4L gene. The gene order in S. mansoni is strikingly different from that seen in the S. japonicum group and other flatworms. There is a high level of identity (87-94% at both the nucleotide and amino acid levels) for all protein-encoding genes of S. mekongi and S. malayensis. The identity between genes of these two species and those of S. japonicum is less (56-83% for amino acids and 73-79% for nucleotides). The identity between the genes of S. mansoni and the Asian schistosomes is far less (33-66% for amino acids and 54-68% for nucleotides), an observation consistent with the known phylogenetic distance between S. mansoni and the other species.
Objective: The frequency of the HLA class II antigens (HLA DR, DQ and DP) were determined among Malay patients with systemic lupus erythematosus (SLE) to ascertain the role they play in disease susceptibility. Study design: Fifty-six Malay SLE patients on follow-up at the SLE Clinic of the National University of Malaysia Hospital, Kuala Lumpur were enrolled into the study. Controls were taken from healthy unrelated individuals, ethnically-matched. Materials and Methods: Five ml of anticoagulated blood was taken from each patient and control and DNA extracted. The HLADR, DQ and DP antigen/allele frequencies were determined by the technique of modified PCR-RFLP and statistical analysis done by Chi-square and Fischers exact test. Relative risk was determined by the odds ratio and significant p values were corrected for the number of antigens/alleles tested. Results: We found that the DR2 antigen was significantly increased among the patients (85.7%) as compared to controls (61%)(p corr=0.03, RR=3.83). As for HLA-DQA1, the allele most commonly found among the patients was *0102 (57 vs 49.2%). HLA-DQA1* 0601 was slightly decreased among the patients but this finding was insignificant. Both HLA-DQB1*0501 and 0601 were found to be increased among the patients even after correction of multiple comparisons made (p=0.0036, RR=4.56 and p=0.0048, RR=6.0, respectively). However, HLA-DQB1*0503 and 0301 was slightly decreased in the sle patients though not statistically significant. The frequency of HLA-DQB1*0201 was insignificantly increased among the patients. Limited studies on the DPB1 locus shows the uncertain role of this antigen in contributing to disease susceptibility. However, our analysis of the HLA-DPB1*0901 showed a slight increase among the patients as compared to controls but failed to remain significant after being corrected with number of comparisons made. All other HLA-DPB1 alleles exhibited similar frequencies between sle patients and controls. Conclusion: From this study we suggest that HLA DR2, DQB1*0501 and *0601 may be important genetic factors in conferring disease susceptibility in the Malay SLE population of Malaysia.
Objective: SLE is an autoimmune disease which affects multiple organ system. Clinical and immunological expression of the disease have been widely studied and variations occur in different ethnic groups. Here in this study, we have analyzed the clinical manifestations and immunological features of Malaysian patients with Systemic lupus erythematosus (SLE) and compared them with SLE population from some of the Asian countries. Study design: A total of 134 Malaysian patients attending the SLE Clinic of The National University Hospital of Malaysia, Kuala Lumpur and who satisfy the revised ACR (American College of Rheumatology) criteria for the classification of SLE were enrolled into the study. Data on the demography, clinical and immunological features were obtained from medical records. Materials and Methods: The female to male ratio in the study cohort was 10:1 and consisted of the Malay, Chinese and Indian races. Past clinical and immunological features were entered into a prepared questionnaire. At study entry patients were seen by a rheumatologist for assessment of present clinical condition and blood obtained for immunological tests (Antinuclear, antids DNA, antiSm, antiU1RNP, antiSSA(Ro), antiSSB(La), anticardiolipin (IgG and IgM) antibodies and complements C3 and C4). Chi-square, Fisher's exact test and Mann Whitney U Test were used to analyze data. Results: Clinical features expressed at disease presentation in order of frequency was mucocutaneous (72%), followed by musculoskeletal (58%) and renal involvement (45%) which was also similar during the course of the disease (90%, 72% and 64% respectively). A high prevalence of antiSSB (La) antibodies was found (48%). Conclusion: This study provides the literature on the clinical and immunological features of Malaysian SLE patients and further shows the different spectrum of disease profile when compared to other ethnic groups. The roles of racial and genetic factors are suggested.
The concept of primary health care (PHC) according to WHO has been implemented in Malaysia since 1978. The rural health centres which provide the primary health care have developed from about 47 in 1970 to about 772 in 1998. Since the implementation of the health centres there has been significant reduction in morbidity and mortality rates. However due to the emerging issues like changing demographic 'patterns, changing pattern of disease, and increasing demand from the public, the delivery of PHC is being reviewed. Newer programmes and review of the older programmes are being done to address the provision of PHC in the 21st century. The functions and roles of the existing staff in the health centres are being reviewed. This new concept is known as expanded scope of primary health care. The purpose of this paper is to explain the achievements in primary health care and the components of primary health care in the expanded scope.
MeSH terms: Malaysia; Primary Health Care; Rural Health
From August 1999 to January 2001, twelve chemotherapy naive patients with locally advanced and metastatic non-small cell lung cancer (NSCLC) in our hospital received vinorelbine and cisplatin. Ten patients had stage IV disease while two had stage HI disease. Patients' performance status (PS) were as follows: four had PS 1, six had PS 2, and one each PS 3 and 4. A total of 46 cycles were given as scheduled. Only major haematological toxicities were noted; one patient each with Grade 3 anaemia, Grade 3 and Grade 4 leucopenia, two had Grade 3 neutropenia and 5 had Grade 4 neutropenia without associated mortality. Three patients had Grade 3 alopecia and one had Grade 3 phlebitis. After three cycles, three patients demonstrated partial response and two had stable disease. For the four patients who completed 6 cycles, two demonstrated stable disease and two partial response. Symptom improvement was reported in all but one patient. Performance status was better in four, stable in six but declined in two patients. In conclusion, in patients with locally advanced and metastatic NSCLC, vinorelbine/cisplatin is a well-tolerated and active regimen, offering symptom palliation and improved performance status in a significant proportion of patients. KEYWORDS; Vinorelbine, lung cancer, chemotherapy.
Nine local plant species were picked randomly and their aqueous extracts have been screened to know their effects on the phagocytic capability and intracellular killing of StapllylococclIs al/rellS bacteria by mouse peritoneal macrophages. Macrophage cultures were incubated with different concentration of each plant extracts forI hour. Among these aqueous extracts, Ageratum conyzoides and Malastoma melabathricum inhibited the phagocytic capability and intracellular killing of Stapllylococclls aureus compared with controls. Elicited (activated) cells have more phagocytic capability and intracellular killing than the resident (normal) macrophages. There were no differences in the viability of cells between treated cells (with extracts) and controls (without extracts). KEYWORDS: Aqueous plant extracts, murine macrophage, phagocytosis.
We describe a rare encounte.r with a 6-year old Indian boy admitted with acute epiglottitis due to Haemophilus influenzae. Acute epiglottitis is an uncommon cause of lifethreatening upper airway obstruction and a rare presentation of invasive Haemophilus influenzae type b (Hib) disease in this region, compared to Ihe more developed West. The cause for this observation is often attributed to differences in the genetic predisposition and socio-economk parameters. The organism subtype and the host response have been shown to determine the type of invasive Hib disease. However, the evidence to explain this difference is poorly understood and remains an intriguing enigma. KEYWORDS: Epiglottitis, Haemophilus influenzae
MeSH terms: Airway Obstruction; Haemophilus; Haemophilus influenzae; Malaysia; Observation; Haemophilus influenzae type b
Improving upon the quality of teaching by teaching staff at all educational institutions is oil very significant objective. Eva luation of teaching performed by individuals at such institutions would be instrumental in assessing the quality of such teaching and a tool towards its improvement. In this article, one scheme for teaching evaluation by students and another by peers are proposed and discussed. Assessment by students may provide contrasting results to those obtained from peers. For a "just and fair'" overalJ assessment of one's teaching., it is recommended that students' evaluation would be combined with those of peers. Results of such an evaluation of teaching should be perceived as being valuable in providing feedback to the teacher and can be utilized for many purposes by academicians and administrators. KEYlVORDS: Academia, classroom teaching., evaluation by peers, evaluation by students, proposed schemes.
In mid-January 2000, the reappearance of Japanese encephalitis (JE) virus activity in the Australasian region was first demonstrated by the isolation of JE virus from 3 sentinel pigs on Badu Island in the Torres Strait. Further evidence of JE virus activity was revealed through the isolation of JE virus from Culex gelidus mosquitoes collected on Badu Island and the detection of specific JE virus neutralizing antibodies in 3 pigs from Saint Pauls community on Moa Island. Nucleotide sequencing and phylogenetic analyses of the premembrane and envelope genes were performed which showed that both the pig and mosquito JE virus isolates (TS00 and TS4152, respectively) clustered in genotype I, along with northern Thai, Cambodian, and Korean isolates. All previous Australasian JE virus isolates belong to genotype II, along with Malaysian and Indonesian isolates. Therefore, for the first time, the appearance and transmission of a second genotype of JE virus in the Australasian region has been demonstrated.
Citation: Prevalence survey of sexually transmitted diseases among sex workers and women attending antenatal clinics: Malaysia (1999-2000). Manila: World Health Organization, Regional Office for the Western Pacific; 2001
MeSH terms: Adult; Ambulatory Care Facilities; Chlamydia Infections; Cross-Sectional Studies; Gonorrhea; Humans; Malaysia; Maternal-Child Health Centers; Mothers; Sexually Transmitted Diseases; Syphilis; Trichomonas Infections; Women; HIV Infections; Sex Workers
Production of tomato (Lycopersicon esculentum) in Bangladesh, Malaysia, Myanmar, Vietnam, and Laos has been severely affected by yellow leaf curl disease. Tomato leaf samples were collected from symptomatic tomato plants from farmers' fields in the five countries from 1997 to 1999. DNA was extracted from all samples, four from Vietnam, two each from Malaysia, Laos, and Myanmar, and seven from Bangladesh. Virus DNA was amplified by polymerase chain reaction (PCR) using the begomovirus-specific degenerate primer pair PAL1v 1978/PAR1c 715(1), which amplifies the top part of DNA A. All samples gave the expected 1.4-kb PCR product. The PCR product of one sample per country was cloned and sequenced. Based on the sequences of the 1.4-kb DNA products amplified by the first primer pair, specific primers were designed to complete each of the DNA A sequences. Computer-assisted sequence comparisons were performed with begomovirus sequences available in the laboratory at the Asian Vegetable Research and Development Center, Shanhua, Tainan, and in the GenBank sequence database. The five DNA species resembled DNA A of begomoviruses. For the detection of DNA B two degenerate primer pairs were used, DNABLC1/DNABLV2 and DNABLC2/DNABLV2 (DNABLC1: 5'-GTVAATGGRGTDCACTTCTG-3', DNABLC2: 5'-RGTDCACTT CTGYARGATGC-3', DNABLV2: 5'-GAGTAGTAGTGBAKGTTGCA-3'), which were specifically designed to amplify DNA B of Asian tomato geminiviruses. Only the virus associated with yellow leaf curl of tomato in Bangladesh was found to contain a DNA B component, which was detected with the DNABLC1/DNABLV2 primer pair. The DNA A sequence derived from the virus associated with tomato yellow leaf curl from Myanmar (GenBank Accession No. AF206674) showed highest sequence identity (94%) with tomato yellow leaf curl virus from Thailand (GenBank Accession No. X63015), suggesting that it is a closely related strain of this virus. The other four viruses were distinct begomoviruses, because their sequences shared less than 90% identity with known begomoviruses of tomato or other crops. The sequence derived from the virus associated with tomato yellow leaf curl from Vietnam (GenBank Accession No. AF264063) showed highest sequence identity (82%) with the virus associated with chili leaf curl from Malaysia (GenBank Accession No. AF414287), whereas the virus associated with yellow leaf curl symptoms in tomato in Bangladesh (GenBank Accession No. AF188481) had the highest sequence identity (88%) with a tobacco geminivirus from Yunnan, China (GenBank Accession No. AF240675). The sequence derived from the virus associated with tomato yellow leaf curl from Laos (GenBank Accession No. AF195782) had the highest sequence identity (88%) with the tomato begomovirus from Malaysia (GenBank Accession No. AF327436). This report provides further evidence of the great genetic diversity of tomato-infecting begomoviruses in Asia. Reference: M. R. Rojas et al. Plant Dis. 77:340, 1993.
Overweight and obese adults are at increased risk of both mortality and morbidity, principally from cardiovascular disease and diabetes mellitus. Intentional weight loss of 5-1 0% is associated with substantial benefits. Weight reduction should be encouraged by dietary and behavioural modification initially, with realistic targets set over an initial 6-month period. It must be emphasised that these measures should continue indefinitely. This can be complemented by pharmacological intervention with orlistat, or perhaps sibutramine when available in the near future. Given the important impact environmental and social factors have on the aetiology of obesity, the community at large should effect programmes to encourage healthy lifestyles among the populace. Town and city planners should include readily available recreational and sporting facilities in residential districts, especially in the urban and sub-urban areas. Physical education sessions in schools in both primary and secondary levels should receive more emphasis to encourage the young to make sports and physical exercise a part of life, rather than being seen as a non examinable appendage of the school curriculum. The key to defeating obesity is prevention, and an effort to lose weight once it accumulates, can often be too little, too late.
Otitis media is a common disease presenting to family practitioners all over the world. There have been many changes in the way these patients were managed over the years. This article attempts to provide an overview to family physicians regarding the latest approach in managing this common condition. Keywords: Otitis, otitis media, otoscopy, eardrops.